bluuebunny/crossref_metadata_2025 huggingface dataset:
Peculiarities of glucose intake in fetal tissues in chronic hypoxemia
Authors: Oshovskyy V.I.
Published: December 2018

Objective — to investigate fetal blood distribution and glucose metabolism of heart, liver and brain during chronic hypoxaemia. Establishment of a model of real time measurement of the metabolic changes during chronic fetal hypoxaemia using PET-CT measurement in pregnant sheep after iatrogenic induction of chronic fetal hypoxaemia. Laser coagulation of placental vessels was performed in pregnant sheep in order to cause fetal hypoxaemia 14 days before the PET-procedure. The following PET-Scans were performed after 18F-FDG was injected into the jugular vein of the sheep. Fetal glucose uptake was scanned in fetal brain, liver, heart and kidneys during a period of 60 min after injection of the FDG tracer. Glucose uptake of these organs was measured in comparison with placental glucose uptake during the above-called 60 minutes course. Here we present the analysis of the metabolic changes in fetal hypoxaemia in a small series of 8 fetal sheep. It was found that FDG Uptake in the placenta, brain, liver and heart of the fetus was measured at normal oxygenation and in chronic hypoxia in 8 sheep fetuses, between 112 and 135 days of pregnancy (gestational age) 125±4 days (mean±SD). Umbilical cord artery resistance was significantly higher in hypoxemic fetuses compared to normoxemic. Venous duct reactions as a respond to hypoxia was observed. Index of pulsation in the umbilical artery was not significantly increased during hypoxia (1,06±0,18 та 1,67±0,12, р=0,018). PI in venous duct during chronic hypoxia (0,62±0,25) was increased in compare with normoxemic (0,41±0,2), but not significantly. Relative FDG uptake was about 3.8 times higher in brain of hypoxemic fetuses (0.019±0.005) compared to normoxemic (0.005±0.002), (р=0,02). In contrast, hypoxic fetal heart showed no significant difference in absorption of FDG compared to normoxemic fetal brain (p=0.11). Relative FDG uptake in the liver did not differ substantially between the two groups (p=0.97). Thus, it was shown that chronic maternal hypoxemia led to decreased placental and increased brain blood flow, although, glucose metabolism was not decreased in the fetal liver and heart.
Peculiarities of a girl`s sexual development in pubertal age with primary dysmenorrhea of different somatotypes
Authors: Markevich B.A. , Chayka G.V.
Published: December 2018

Most of the problems of the female reproductive system in fertile age are a direct consequence of those pathologies that have arisen in puberty age, in the period of the establishment of its functions. Therefore, the formation of the normal physical and sexual development of adolescent girls depends on the formation of reproductive capacity, the improvement of the demographic situation and the health of future generations. The aim of the study — detection of the relationship between the features of sexual development in healthy and girls with primary dysmenorrhea of puberty age. The results of researches of 306 girls of puberty age of different somatotypes are analyzed, defined by the Hit-Carter method. Statistical processing of the results obtained was carried out in a licensed package “Statistica 6.1”. The study group included 76 girls with primary dysmenorrhea, and the control group consisted of 230 healthy girls (data were taken from the database of the SRC National Pirogov Memorial Medical University, Vinnytsya). We investigated the peculiarities of the development of the reproductive system of girls of pubertal age with primary dysmenorrhea of different somatotypes. The results of our research show that there is a connection between the age-depending dynamics of sexual development: the thelarche, axillary hair growth, the formation of menstrual function in girls of pubertal age who suffer from primary dysmenorrhea in comparison with healthy girls. The results of our study should be taken for the diagnosing of primary dysmenorrhea of girls of pubertal age in order to reduce clinical manifestations and further development of complications in reproductive age.
Detection of particles of metals in the shell casing for a partial species identification of weapons with the use of x-ray function-spectral analysis
Authors: Mikhailenko A.V. , Chikhman Ya.V.
Published: December 2018

One of the current in the examination of gunshot injuries is to determine the combustion charge or factors that accompany the shot. At the same time, the question remains about the use of a scapegoat or non-narrative short-barrel weapon. Therefore, by detecting particles of metal balls membrane formed passing through the bore rifle, their visual, stereomikroskopichnoho research and using infrared rays and renthenfluorestsentnoho spectral analysis was possible species of partial identification of said weapons. The archival material of the department of the word-medical criminology of the Kiev city clinic bureau of a forensic medicine was used in the work. The obtained results were processed by standard methods of variation statistics. The study in the thickness of the lower edge of the input gunshot wounds were found strips of metal density yellow color with a high content of copper (Cu), zinc (Zn) and lead (Pb), which indicates the characteristics of the membrane balls outside covered with red brass (an alloy of copper and zinc). The main metal of bullets of 4 mm caliber, provided for examination, was lead. In the study of the surface of the globe №1, facing the canal weapons found four areas of wiping material shell formed from the action fields rifling firearms is the rifling on the surface membrane of the globe, the bottom of which is parallel to the rolls and grooves alternating with one another . Thus, the detection of metallic strips of yellow density, resulting from passing through the channel rifle, gave reason to identify it as the weapon used in isolation. Elevated levels of copper (Cu), zinc (Zn) and lead (Pb) indicates that the outside shell of the balls were coated red brass (an alloy of copper and zinc). So the ball was shell.
Dynamic control of local immunity parameters in patients with rhinosinusitis
Authors: Jomaa Al Hariri Mahmoud , Semenenko S.I. , Semenenko A.I. , Yakubovska O.М.
Published: December 2018

Despite the large number of studies devoted to the problem of diagnosis and treatment of rhinosinusitis remains a discursive issue of effective diagnosis, optimal volume of medical support in such patients. Objective — to determine the degree of violation of the indices of local immunity of the mucous membranes of the upper respiratory tract in patients with rhinosinusitis. 60 patients were examined. All patients were divided into two groups: the first included 30 patients (control group), with rhinosinusitis on baseline therapy, and the second group consisted of 30 patients diagnosed with rhinosinusitis, to which the immunomodulator (inоsine pranobex) was added to the baseline therapy. The drug was administered at a dose of 500 mg. three times a day, within 7 days. In determining the level of sIgA we tested in nasal secretion in patients with rhinosinusitis, it was found that the levels of this secretory immunoglobulin were determined within the lower limits (from 0,72 to 0,98 mg/l) than the standard norms for persons in this age category (1,3–13,3 mg/l) and had no statistically significant difference. In a repeated study of the level sIgA in the subjects treated with baseline therapy and patients who received the immunomodulator (inоsine pranobex) in the basal therapy of rhinosinusitis, the following results were obtained: in the group of patients treated with baseline therapy, an increase in sIgA concentration was observed in 2,1 times, and in the group of patients with the addition of an immunomodulator — 2,6 times, which means a significant improvement in indices of local immunity when adding an immunomodulator to basic therapy. So, in patients with various forms of rhinosinusitis are a low baseline sIgA, indicating insufficient protection of the mucous membrane of the nasopharynx from infectious agents.
Estimation of efficiency of remineralizative therapy in children of primary school age with a high level of intensity of dental caries
Authors: Ruda I.V. , Dуdik E.P. , Chugu T.V. , Rudyi Y.I.
Published: December 2018

The purpose of our study was to determine the intensity of dental caries and the level of oral hygiene in boys and girls, depending on age and conducting remineralizative therapy in the observed group of children with the aim of prevention of dental caries. The study was carried out with the informed consent of parents of examining children. We carried out dental examination of 60 schoolchildren in Vinnytsya, aged 6–8 years old, who were divided into two even groups, near 30 persons in evey group who was provided remineralizative therapy of dental hard tissue using the preparation “Bifluorid 10” VOCO (Germany). In the article the clinical discussion of high efficiency of preventive remineralizative therapy of dental hard tissues in children 6-8 years is presented. According to the results of the primary examination in the observed children, it was found that the average of oral hygiene index of Fedorova-Volodkina was 2.3±0.16 scores in the main group and 2.31±0.13 scores in the control group, which indicates an unsatisfactory level of oral hygiene in both groups. Dental caries was determined in 100% of cases among the examined children, caries intensity indexes DMFT+df were corresponded to 5.57±1.04 in the main group and 5.7±0.95 in the control group. The intensity of the color of the TER-test in the basic observation was — 3.88±0.75 in the main group and 4.19±0.91 the control group. The oral hygiene index slightly increased after 12 months of research. In children of the main group it was 1.52±0.12 and 1.58±0.15 in the control group, which corresponds to satisfactory oral hygiene. However, in general, during the period of our investigation, the oral hygiene index was significantly improved in comparing to the primary scores on 33.9% in the main group and on 31.64% in the control group. The index of growth of caries intensity was — 7 (23%) in the control group and in the main group — 1 (3.3%) in the main one. The parameters of the TER test were within the range of 2.1±0.3 scores in the basic and 3.93±0.7 scores in the control groups, which corresponds to the improvement of the mineralization of the dental hard tissue (p <0.05). Consequently, the problem of high dental caries intensity and caries prevalence of primary and permanent teeth suggests about cariogenic situation in the oral cavity of children during the period of the eruption of the first permanent molars. Professional oral hygiene, the formation of regular oral hygienic habits, deep fluoridation using the Bifluorid 10 VOCO (Germany), not only improve the oral hygiene status, but also reduce the growth index of dental caries and have a high efficiency of prevention of dental caries.
Ultrasound characteristics of blood circulation in uterine vessels in the I trimester of pregnancy in women with the history of recurrent miscarriage
Authors: Bulavenko O.V. , Muntyan О.А. , Konkov D.H. , Furman O.V.
Published: December 2018

Recurrent miscarriage is one of the main problems of obstetrics, gynecology and reproductive medicine. The incidence of recurrent misscarriage is fairly high, with most cases of abortion occurring at I trimester, and the true cause is difficult to establish. The aim of the work is to find out the predictors of early reproductive losses in women with a history of habitual miscarriage. The study included 88 women with a habitual miscarriage (the main group) and 50 women with a physiological course of I trimester of gestation (control group). The study was carried out on the basis of the Vinnitsa maternity hospital No. 2. The following research methods were used: clinical, instrumental, mathematical-statistical. Methods of research: clinical, laboratory, biochemical, instrumental, fluorescence spectroscopy, mathematical and statistical methods. According to the results of the retrospective analysis of women with the usual miscarriage during the period from 2009 to 2016 it was found that their number is approximately the same every year. Although in 2015, the proportion of non-pregnancy cases was the smallest (10.68%) compared with 2013 (18.29%) (p=0.008), the share of women with this pathology continued to increase. During the ultrasound assessment of the blood flow in the uterine vessels, it was found that the index of resistance and pulsation index in women of the main group was lower than that of control group women. It was also found that there was a strong direct correlation between certain blood flow parameters in uterine arteries and spiral arteries. So, conducting an ultrasound study for all women with a history of unexplained pregnancy and detecting changes in the blood flow in the uterine vessels will enable us to predict the pathology of placenta in the early stages, and to timely correct the findings.
Impact of different methods of treatment of hip osteoarthritis on the clinical manifestations during short- and long-term observation
Authors: Lutsyshyn V.G. , Kalashnikov A.V. , Maiko O.V. , Maiko V.M.
Published: December 2018

The course of coxarthrosis, its short-term and long-term prognosis remains sufficiently unknown, and the influence of one or another method of treatment on the course of the disease and the time of onset of irreversible changes is still the subject of scientific research. The aim of the study is to evaluate the dynamics of clinical data in patients with the initial stages of coxarthrosis in the observation interval of 1–5 years with various treatment regimens that include both medical therapy and arthroscopic intervention. The analysis of the dynamics of clinical parameters (using the modified Harris scale) in the course of various treatment methods (non-steroidal anti-inflammatory drugs with / without chondroprotector or hyaluronic acid) with a group of arthroscopically operated patients was carried out after 1, 3 and 5 years from the diagnosis of 225 patients with initial stages coxarthrosis. All quantitative data obtained are processed by variational statistics methods (Wilkoxon test for 2 groups of dependent populations and Mann-Whitney U-test for 2 groups of independent populations). It has been established that the combination of NSAID therapy with symptom-modifying delayed-action drugs contributes to the solution of individual therapeutic problems in patients with coxarthrosis during the short and medium term observation period. Reception of chondroprotectors improves the effectiveness of pain control, intra-articular administration of hyaluronic acid contributes to a longer preservation of the motor function of the affected joint. The most effective method in overcoming the progression of loss of motor function of the hip joint and increasing the intensity of the pain syndrome is arthroscopic treatment. The obtained data allow us to state that arthroscopy has a pathogenetic and preventive orientation, slows the progression of the disease and, as a consequence, improves the patient's quality of life.
PARVOVIRUS INFECTION IN PREGNANT WOMEN: SOME ASPECTS OF CLINICAL PROGRESSION AND DIAGNOSTICS
Authors: Bondarenko N.P. , Lakatosh V.P. , Antonyuk M.I. , Kochmaruk O.A.
Published: December 2018

Human parvovirus (B19V) infection is a well-known fetotropic agent that may lead to a fetal loss. Nevertheless, the routine testing for B19V is not included into antenatal or preconception screening programs, and some authors find it a reason of delay in management of pregnancies complicated by B19V. The aim of our research was to reveal practicability of B19V screening tests in pregnant women in certain population, and also to assess the proportion between asymptomatic and manifest forms of B19V infection in our population, whether some diagnostic methods and their combinations are useful in testing, and to investigate correlation between clinical symptoms in fetus and laboratory parameters of expectant mother. The observation of 129 pregnant women (patients of Perinatal Centre in Kyiv) with suggested B19V infection in different terms of gestation was conducted. Diagnostic systems used were: ELISA test (DRG) and immunoblot testing system EUROIMMUN (Germany), and DNA detection of B19V in mother’s blood samples was conducted with the use of PCR. In addition, we turned our attention to epidemiologic cyclicity of B19V infection, seasonal prevalence and other ordinary for infection processes characteristics. In observed population the incidence of B19V infection had no correlation with the terms of gestation; more significant correspondence was observed with cyclicity waves (2 years of low morbidity were followed by periods increased morbidity), seasonal prevalence, environment of pregnant women (the professional and household one). Except of apparent but nonspecific general blood changes, in 46/129 (35,6%) pregnant women the acute B19V infection was diagnosed with the use of PCR with the presence of B19V DNA in blood samples and negative or uncertain serological results. In 85,1% (40/47)cases of symptomatic fetus injury B19V DNA load was found in mother’s blood samples, and that was the difference when compared with the group of women with asymptomatic course of disease, in which the viral load was found in 32,6% (16/49) of cases. The long-term viremia in mothers was found in cases of fetal infection (B19V DNA until 120 days) associated with seroconversion. The results of this study demonstrated some certain particularities of clinical course of disease in observed population except of common features of B19V, and revealed reasonability of combined laboratory testing if suspecting B19V infection. Further achievements in B19V infection research will provide better algorithms and methods of diagnosing; will lead to effective prophylaxis as well as for the development of novel therapeutic options.
Clinico-morphological features of the postoperative period and healing process of the uterine scar tissue after re-cesarean section
Authors: Golyanovskyy O.V. , Dyadyk О.O. , Slobodian Y.V. , Kozlova K.S. , Stetsiuk K.V.
Published: December 2018

A high number of repeat cesarean sections increases a risk of excessive bleeding, uterine atony, hysterectomy. The aim of study was to evaluate the efficacy of medical and technical methods (argon plasma coagulation, tranexamic acid, carbetocin) to prevent complications following repeat cesarean section and to improve the myometrial wound healing, to establish morphological features of uterine scar tissue in case of using argon plasma coagulation of myometrium in the area of the suture during the previous operation. Prospective cohort study of 77 patients who had undergone repeat cesarean section. I group included 37 women who had repeat cesarean section using argon plasma coagulation. Ten minutes before the operation, 15 mg/kg of tranexamic acid was injected intravenously. 100 mcg carbetocin was administered intravenously after cutting the umbilical cord. ІІ group comprised 40 women who had traditional cesarean section using Stark's technique and Joel-Cohen incision. Pathomorphological study of scarred lower uterine segment myometrium was performed. Immunohistochemical staining against CD3, CD34, CD68, vimentin, α-SMA was performed. Results are presented as Mean±SD. Total operative time was significantly shorter in the І group (37,0±2,1 minutes) compared to ІІ (46,1±1,8 minutes) (р<0,05). Volume of blood loss in the І group was 465,7±37,5 ml, and in the ІІ — 547, 7±34,6 ml (p<0.05). Patients of the І group needed analgesic for 18-24 hours, the ІІ group — 36-48 hours after operation. The width of the uterine cavity in group І was 9,8±0,37 mm, in group ІІ — 14,6±0,54 mm (р<0,05). One patient of group І and 9 patients of group ІІ had signs of uterine subinvolution. Length of hospital stay after surgery in group I was 4,7±0,12 days, in ІІ — 6,6±0,28 days. The ultrasound thickness of myometrium in group I and group II is an average of 9,32±0,64 mm and 6,24±0,59 mm, respectively. Pathomorphological data of scarred lower uterine segment myometrium showed that in group I regenerative processes have more favorable course, a tendency to restore the structure of myometrium, while in group II there were processes of disturbed regeneration with the replacement of smooth muscle tissue varying maturity of connective tissue, moderate inflammatory process. So, the use of tranexamic acid, carbetocin and argon plasma coagulation is effective in reducing perioperative blood loss, total operative time, dosage of uterotonic and analgesic medications and postoperative hospital stay in patients giving birth by repeat cesarean section. According to the pathomorphological study, argon plasma coagulation of myometrium in the area of suture increases the value of the reparative processes and promotes the formation of a morphologically complete scar, with the predominance of smooth muscle cells over connective tissue.
Peculiarities of psychoemotional condition of pregnant women-displaced persons
Authors: Zhabchenko I.A. , Kornietz N.G. , Tertychnaya-Telyuk S.V. , Kovalenko T.N.
Published: December 2018

One of the most important options of a favorable course of pregnancy, fetal development and physiological delivery is a balanced and preserving psycho-emotional condition of a woman during pregnancy. In order to study peculiarities of psycho-emotional condition of pregnant women-displaced people, dynamic prospective examination of 96 pregnant women in term of gestation more than 22 weeks (the main group) and 34 pregnant women from the local area (the control group) was conducted. According to STAI data, the mean score of the state anxiety in the main group was 1,6 times higher, personal anxiety — 1,4 times. According to results of the testing by I.V. Dobrjakov, the optimal PCGD type was characterized for 36 (37,5%) pregnant women-displaced people, 24 (25,0%) — hypogestognostic, 9 (9, 4%) — an euphoric, 18 (18,7%) — an anxious, 9 (9,4%) — a depressive. However, every second pregnant woman from the control group had optimal PCGD type – 20 (58,8%; p<0, 05), 12 (35,3%) — a hypogestognostic, 2 (5,9%) — an euphoric. The results of the testing by L. M. Rabovaluk confirmed, that almost all pregnant women of the control group had shown a low anxiety rate, at the same time, choosing the statements of the test, every fifth pregnant women of the main group (21–21,9%) obtained high diagnostic points, which give evidence of high anxious, depression presence. The study of indicators of anxiety, depression and violations of the attitude to pregnancy among pregnant women-displaced person will allow to individualize the approaches to antenatal observation, improve the quality indicators of a mother’s and newborn’s health.
Correction of sexual dysfunction in women of perimenopausal age with stress urinary incontinence
Authors: Hryhorenko А.P. , Horbatiuk О.H. , Shatkovska А.S. , Binkovska А.M. , Onyshko V.Y.
Published: December 2018

The article presents the data on a study of sexual function in perimenopausal age women with stress urinary incontinence after transobturator tape (TOT) sling procedure with the subsequent prescription of vaginal estrogens during the month. Purpose — to assess the effectiveness of influence transobturator tape (TOT) sling procedure with the subsequent prescription of vaginal estrogens during the month on sexual function in perimenopausal age women with stress urinary incontinence. We evaluate the recovery of sexual function in 16 perimenopausal age (45-50 years) women with stress urinary incontinence after transobturator tape (TOT) sling procedure with the subsequent prescription of vaginal estrogens during the month using the Incontinence Quality of Life (I-QOL) questionnaire. In 1 month after the treatment we found an improvement in the daily activity of women in 3 times, self-esteem in 2.6 times, sexual function in 2 times, the overall quality of life in 3.3 times, a decrease of emotional stress in 2.8 times, the reduction of additional effort in 3.3 times. A decrease in sexual discomfort was found in the postoperative period in 75% of women, number women with lack of libido decreased by 31.25%, and a number of women who had orgasms during coitus increased by 25%. Thus, transobturator tape (TOT) sling procedure with the subsequent prescription of vaginal estrogens during the month normalized sexual dysfunction in perimenopausal age women with stress urinary incontinence.
Retrospective analysis of reproductive anamnesis of women with birth in the breech presentation
Authors: Kalanzhova О.М., , Galych S.R.
Published: December 2018

At present, the study of the peculiarities of the reproductive history of patients planning pregnancy is considered to be a promising area for the effective ensuring the timely and highly successful implementation of their reproductive intentions. Goal — to conduct an analytical retrospective assessment of the reproductive history of patients with childbirth in the pelvic presentation. A retrospective analysis of medical records has been conducted on the basis of the Odessa Regional Perinatal Center, medical records of 300 primipara and secundipara with pregnancy with one fetus in the breech presentation have been studied: I — the main group (MG) (n=150), women who gave birth in the pelvic presentation; ІІ — control group (CG) (n=150), women who gave birth in the cephalic presentation. Statistical processing of the results of the study was carried out using the statistical packages of the program Statistica for Windows (version 6.1) by the means of parametric and nonparametric statistics. The study of submitted medical documents showed a statistically less favorable gynecological history of women from MG: while the majority of women with MG were multipara — 96 (64%), in CG, the number of patients was lower — 67 (44.6%) cases (p<0.05). The number of cases of urgent labor in the MG — 137 (91.3%) was greater than in the control group — 118 (78.7%) (p <0.05). The frequency of operative birth in MG was 102 (68%) cases compared to 44 (29.3%) (p<0.05) in CG. The operative birth in CG occurred only in 5 (11.4%) cases, whereas in MG there were 13 cases (100%) (p<0.05). Therefore, the prevalence of cases of operative delivery and less amount of cases of preterm births have been indicated in MG.
Main risk factors symptoms of manifestation of urinary incontinence in childbearing age women with overactive bladder syndrome
Authors: Kostjuk I.Y.
Published: December 2018

Since many factors can affect the manifestation of urinary disorders in a particular woman at different periods of life, some of them can cause urinary incontinence, affect the choice of method and the success of treatment. Syndrome of a hyperactive bladder is, in addition to medical, a serious socio-economic problem and leads to social disadaptation of the individual. The aim of research was to identify predictors (provoking, contributing factors or risk factors) of hyperactive urinary bladder syndrome in pregnant women of different age groups in early stages of pregnancy. A total of 75 pregnant women with a hyperactive bladder syndrome (the main group) and 60 practically healthy pregnant women with no incontinence (control group) at the gestation period of 12 weeks were examined. It was determined that in the general group of women with hyperactive urinary bladder the working, with satisfactory and unsatisfactory economic conditions prevailed. Among occupational hazards, 61,3% of pregnant women noted permanent physical activity, forced delay in urination (44%), prolonged orthostatic body position (20,0%), and significant physical activity (29,3 %). It was found that among pregnant women more extragenital pathology, almost all women smoke (93,3%) and drink alcohol often enough (89,3 %), besides the length of smoking is much larger, compared with the swearing smokers of practically healthy women. It was found that in the hyperactive bladder group, unsatisfactory family relationships (58,7%) predominate, resulting in more single women. The overwhelming majority of women with hyperactive urinary bladder begin their sexual life up to 14 years old and have more than 4 sexual partners, which, in combination with contraception in the form of interrupted sexual intercourse, leads to an increase in the third and fourth degree of vaginal purity, as well as the appearance of more bacterial vaginosis and diseases in women with hyperactive urinary bladder, sexually transmitted infections. It was established that in the main group all the indicators of anesthetic history prevail in comparison with the main group. In the general group, the majority of pregnant women associated with the emergence of hyperactive bladder with pregnancy and childbirth (40%), a large weight of the fetus (18,3%); 14,7% of women were considered to be the reason for motility disorders, which were postponed during the lunar and gestational periods; 13.7% of urinary incontinence appeared after a change in sexual partner, and also after sexual intercourse (13,3%). The results of the research indicate that a survey of diseases such as hyperactive bladder syndrome requires a comprehensive approach by carefully collecting the socioeconomic status, style and quality of life, extragenital diseases, family, obstetric-gynecological and hereditary history, as well as sexual function women in the reproductive period.
Surgical treatment of the consequences of the computed damage of the median nerve in the proximal part of the upper limb
Authors: Tretyak I.B. , Kovalenko I.V. , Tretyakova A.I. , Gatskiy A.A. , Bazik A.N.
Published: December 2018

Aim of the study – to assess the efficacy of surgical reconstruction of the combined proximal median nerve injuries, to evaluate the efficacy of the staged orthopedic reconstruction of the thumb opposition. The retrospective analysis of the reconstruction of 14 proximal median nerve injuries was conducted. 11 men and 3 women were enrolled into the study, mean age of participants was 42,3 years. In all cases proximal median nerve injury was accompanied by either axillary (4 cases) or brachial artery (10 cases) injury. 5 patients received direct repair of the median nerve. 9 patients received autologous grafting of the median nerve with mean gap between the stumps 7,5 cm. Both motor and sensory components of recovery were evaluated with MRC Scale and Seddon Scale respectively. Each patient evaluated the recovered median nerve mediated functions with Brief Michigan Hand Questionnaire. 14 cases with poor or no recovery of thenar muscles required tendon transfer (Bunne’sl transfer) to restore thumb opposition in later terms. Mean terms of recovery of the entire muscle-complex of the anterior surface of the forearm in all 14 patients with proximal median nerve injury was 12,9 months (with no reliable dependence on method of reconstruction). Mean MRC Scale score among all 14 patients was: 3,8 points for m. flexor pollicis longus, 4,4 points for mm. flexores digitorum and 4,4 points for m. flexor carpi radialis respectively. The median nerve mediated sensation recovered to 2,8 points on Seddon scale. Not a single patient showed effective recovery of the thenar muscles. Mean Brief MHQ score was 64,2 points – satisfactory recovery. 14 patients received effective thumb opposition within next 2 months post Bunnel’s tendon transfer. Mean Brief MHQ score increased to 78,2 points – good recovery. Surgical reconstruction of proximal median nerve injuries brings satisfying recovery of the entire muscle-complex of the anterior surface of the forearm, as well as the recovery to the median nerve mediated sensory component. Poor or no recovery of the thump opposition is majorly related to the distance between the site of the lesion and thenar’s motor-endplates. Bunnel’s tendon transfer dramatically increases functional outcomes at proximal median nerve injuries.
Influence of long-term using of soft contact lenses on indicators of oxidative-reducing potential of glutathione, peroxidation of lipids, and the state of cell membranes and cellular structures of the epithelium of the cornea
Authors: Veliksar T.A. , Leus M.F. , Haydamaka T.B. , Mykheitseva I.M. , Drozhzhina G.I. , Kolomiychuk S.G.
Published: December 2018

Contact lenses are increasingly used worldwide for correcting refraction disorders. However, contact lenses can destroy a biochemical composition of the tear. Purpose — to determine the effect of long-term use of silicone-hydrogel contact lenses on the parameters of the oxidation-reduction potential of glutathione, lipid peroxidation and the stability of cell membranes and subcellular structures of the cornea of the epithelium by identifying marker enzymes in a tear. We determined the activity of lactate dehydrogenase, glucose-6-phosphate dehydrogenase, acid phosphatase, succinatе dehydrogenase, glutathione (recovered and oxidized forms) and products of lipid peroxidation (malonic dialdehyde, diene conjugates) in tears of patients divided into two groups. Study group comprised 72 people — mild and moderate myopia patients continuously wearing soft contact lenses. Control group consisted of 33 people — mild and moderate myopia patients, spectacles wearers. We revealed a significant increase in the activity of lactate dehydrogenase and glucose-6-phosphate dehydrogenase by >33% and >26%, respectively, as well as a significant increase in the activity of acid phosphatase by >21% and of succinatе dehydrogenase by >18% in the tudy group patients comparing to controls. The study of the level of products of lipid peroxidation in the tear fluid of the main group showed a significant accumulation of them, as well as a violation of the glutathione balance in comparison with the control group. The dependence of biochemical changes in the composition of the tear on the duration of contact lens wear has been revealed. Therefore, with prolonged wearing of MKL, prooxidant-antioxidant equilibrium in the tissues of the eye surface, in particular in the cornea, is violated, activation of free radical processes and reduction of antioxidant reserves occur, which leads to destruction of cellular and subcellular membranes. We assume that the medical correction of these pathological changes will help prevent the development of severe complications of contact correction.
Prevention of pregnancy and sickness after a sustained method of conservative myomectomy
Authors: Golyanovskyy O.V. , Budchenko M.A.
Published: December 2018

The number of surgical interventions in the uterus, including conservative myomectomy in women of reproductive age, has increased significantly, and, accordingly, the percentage of patients with a scar on the uterus has increased. It is difficult for women to make a pregnancy plan, to determine the best way and time of delivery. After the performed myomectomy, pregnancy planning is required not earlier than 6 months after the operation (provided the normal state of health and absence of complications). The peculiarity of the course of pregnancy after myomectomy is the presence of scarring on the uterus, and the importance of the volume and nature of the operation performed. Childbirth through natural birth lines can be resolved by specialists in the following cases: in the absence of exacerbations in the recovery period; if laboratory-instrumental studies confirm the fact of the fullness of the lower segment of the uterus; at placental placenta outside the scar tissue of the uterus; when the mother's pelvis matches the fetal head; with obligatory tracking of childbirth process using monitors; if possible, a cesarean section urgently, but not later than fifteen minutes after the decision to intervene. We proposed innovative approach is conservative myomectomy performed using electrosurgical techniques (argon plasma coagulation and radio wave scalpel) and such medications as Terlipressin (synthetic analogue of vasopressin), Defensal (anti-adhesion barrier). The conducted clinical research has determined the effectiveness of the complex method of surgical treatment of uterine leiomyomas with the use of modern drugs and technical support for the improvement of reproductive function in treated women.
Optimization of the observation of postpartum pyo-inflammatory diseases in patients after vacuum-aspiration using the method of fluorescent spectroscopy
Authors: Bulavenko O.V. , Ostapiuk L.R. , Rud V.O. , Voloshinovskii A.S. , Maliy T.S.
Published: December 2018

The growth of the frequency of postpartum purulent-inflammatory diseases requires the development of new approaches to their early diagnosis and treatment. The purpose of the study is to choose the optimal time for manual vacuum aspiration in patients with postpartum endometritis and to control the state of patients after it, using the method of fluorescence spectroscopy. The results of treatment of 392 patients who were on inpatient treatment in the gynecological department №2 of the City Clinical Maternity Hospital №2 were analyzed. Of these, 120 patients were selected for the diagnosis of which, in addition to the standard algorithm, the method of fluorescence spectroscopy was included. Manual vacuum aspiration was performed in 96 cases (80,0%). In 15% of patients, after vacuum-aspiration of the uterine cavity, blood serum tests using the method of fluorescence spectroscopy were carried out in dynamics. In 92,8% of them, an increase in fluorescence intensity and a shift of lmax in the short-wave region was observed, which was a reliable sign of improving the condition of the patients. Thus, the improvement of the state of patients after vacuum aspiration was confirmed at the appropriate level, using the method of fluorescence spectroscopy, which is a reliable method of diagnostics of postpartum purulent-inflammatory diseases.
Changes of the sleep in pregnant women with intrauterine fetal growth restriction
Authors: Berbets A.M.
Published: December 2018

Objective – to study the reasons of appearance, terms of manifestation and types of the sleep disorders in pregnant women with intrauterine growth restriction of fetus. 80 pregnant women with placental insufficiency, manifesting as intrauterine fetal growth restriction (IUGR) of II–III degree in the 3rd pregnancy trimester (study group) and 30 women with normal clinical flow of pregnancy (control group) were questioned. They were asked about pregnancy term when the complains of the sleep disorders were firstly expressed, as well as about types of the sleep disorders and their frequency (in times per week). Questioning showed that pregnant women with IUGR in 86% cases experience the sleep disorders starting from pregnancy term 12–22 weeks (healthy pregnant women — mostly after 30 weeks, 57% cases), more commonly wake up 2 or more times per night (71% of positive answers, in control group – 23%), and 3 or more times per week (78% of positive answers, in control group – 17%). Thus, sleep disorders in pregnant women with IUGR appear earlier and seem to be more expressed then in pregnant women with normal fetal growth. Expression of the complains of insomnia, in our opinion, might be considered as an early diagnostic sign of forming of placental insufficiency, which is later realized as IUGR.
Peculiarities of microbiological monitoring in the pathological status of the vegina and cervix in women of reproductive age
Authors: Dzis N.P.
Published: December 2018

Vulvovaginal and cervical infections are a risk factor of developing purulent inflammatory diseases of the pelvic organs, miscarriage, antenatal and intranatal infections, with frequent pathogens Ureaplasma, Mycoplasma, Gardnerella vaginalis, Bacterioides. Particular importance is given to the mix-infection as a reservoir of a large number of different potentially harmful microorganisms. The purpose of our study was to study the specific composition of microorganisms in women of reproductive age with pathological secretions from the genital tract and to determine the incidence of genitalurea / mycoplasmosis. 54 patients of reproductive age with complaint on itch, heartburn, excessive secretions from the non-slippery genital tract and / or with an unpleasant smell, which were repeated 2 or more times during the year after the treatment, were examined. During gynecological examination, the following diseases were detected in patients: erosion of the cervix in 8 (14.8%) patients, cervicitis in 6 (11.1%), cervical cyst in 2 (3.7%) women, leukoplakia in 3 (5,55%) of the surveyed. According to the results of bacterioscopy, bacterial vaginosis was detected in 4 (7.4%) patients, unspecified bacterial colpitis — 28 (51.8%), vaginal candidiasis — in 17 (31.5%). In cytological screening, CIN I was diagnosed in 9 (16.6%) subjects, CIN II in 4 (7.4%). Analyzing the results of the study conducted by the polymerase chain reaction of HPV-infection was found in 8 (14,8%), ureaplasma — in 14 (25,9%), mycoplasma — in 6 (11,1%) patients. Staphylococcus aureus 105 — 4 (7.4%), Staphylococcus epidermidis 103 — 1 (1.8%), E. coli 105 — 7 (12.9%), Enterococcus, were detected during bacteriological examination of vaginal and cervical extracts. Fecalis 106 — 9 (16.6%), Candida albicans 105 — 6 (11.1%), Clebsiela 106 — 3 (5.5%), Gardnerella vaginalis 107 —11 (20.3%), Streptococcus 106 — 5 (9.2%). Thus, diagnosed high percentage (22.2%) ureaplasmas combination with other types of conditional — pathogenic microorganisms and viruses and cervical pathology (13%), namely the combination of ureaplasma pathogenic microflora was observed in 8 (14.8%) cases of HPV — 6 (11.1%), with mycoplasma, and pathogenic microflora — 5 (9.3%) patients. In general, 35.2% of cases. Assessing the infection of reproductive age women ureaplasma and mycoplasma less with recurrent abnormal discharge from the genital tract after treatment leads to the search and introduction of modern methods of their diagnosis and treatment.
Peculiarities of psychoacoustics as a differential diagnostic criteria of schizoaffective disorder and paranoid schizophrenia at the early stages of development
Authors: Kostyuchenko N.V. , Filts O.O.
Published: December 2018

The work carried out the assessment of interconnection between the presence of musical ear and defective manifestations in patients with paranoid schizophrenia and schizoaffective disorder (SAD). SAD remained one of the most uncertain mental disorders. The certain variability and instability in the diagnostic interpretation of this nosology, the fuzziness of the criterion assessment greatly affected the quality of diagnosis and differential diagnosis, especially in the early stages of development of mental disorders of this spectrum (affectively-paranoid). The aim of the study was to compare the peculiarities of psychoacoustics (namely the presence/absence of musical ear) in patients with the SAD diagnosis and in patients with paranoid schizophrenia (PS), as well as the degree of severity of negative symptoms. In our research we conducted comparative evaluation of negatives symptoms in 40 patients with paranoid schizophrenia and 40 patients with schizoaffective disorder by means of NSA-16 scale and PANSS negative symptoms subscale. Comparison of difference probability between indexes of research groups is done by means of chi-squared and Mann-Whitney tests. In the group of patients with schizoaffective disorder, most persons had musical ear, the rates of negative symptoms were significantly lower than in patients with paranoid schizophrenia, who did not have developed musical ear. Thus, the average assessment of negative symptoms according to the scale of NSA-16 in the group of patients with a diagnosis of paranoid schizophrenia was 4.89±0,10, which by 2.6 (р<0,01) higher than in the group of patients diagnosed with schizoaffective disorder – 1,84±0,10. In both groups, the highest average rates of negative symptoms were inherent to the symptoms “Sexual attraction” and “Limited purposefulness”. The average assessment of the key points of evaluation in the group of patients with PS, by 2,77 (р<0,01) higher than in the group of patients with SAD — 4,74±0,11 against 1,71±0,08, according to the analysis of the subscale of negative symptoms of the PANSS. The violation of spontaneity and fluidity of speech occupied one of the leading places among all the negative symptoms of this scale in both groups of patients. So, the dependence between the factor of presence or absence of musical ear and the degree of severity of negative symptoms of schizophrenia and schizoaffective disorder was established, which allowed to confirm the expediency of evaluating musical abilities in such patients for the expansion of prognostic and diagnostic possibilities in psychiatric practice.
Modern view on the problem of optimization of therapy in pregnant women with functional cervical insufficiency
Authors: Oleshko V. F.
Published: December 2018

A functional cervical insufficiency plays an important role in the etiology of miscarriage and premature birth. The aim of research was to estimate the hormonal balance indexes during the course of pregnancy in pregnant women with functional cervical insufficiency and to correct the revealed violations in order to prevent obstetric complications. 101 pregnant women with confirmed diagnosis of a functional cervical insufficiency in term of gestation 22–32 weeks of pregnancy (the main group) and 34 pregnant women and women in labor with physiological condition of the cervix (the control group) were examined. The content of estradiol, progesterone, cortisol and prolactin was examined in the blood serum. On the second stage of examination 63 pregnant women obtained general basic therapy (I main group) and 38 pregnant women (II main group) received a developed treatment complex which included progesterone support by the micronized progesterone 200–400 mg twice a day up to 34–35 weeks of pregnancy, magnesium support by the magnesium orotate dehydrate in the therapeutic dosage and arginine glutamate in the therapeutic dosage. The correction of cervical insufficiency was performed with the help of a cervical pessary (according to indications). The examination of hormonal balance revealed an accurate decease of progesterone concentration on the background of high concentration of estradiol and increased levels of stress-associated hormones. Propitious influence of the developed therapy is proved by increase of progesterone concentration in the blood serum, normalization in stress-associated hormones balance according to gestational age. All this provideded the decrease of specific weight of threatened preterm labors, placental dysfunction, vaginitis, bacterial vaginosis and delay the labors up to 38–39 weeks of gestation in 97,4% of pregnant women (82,5% in the I main group). Prescription of micronized progesterone, magnesium orotate dehydrate, arginine glutamate to pregnant women with a cervical insufficiency is reasonable and effective one comparing with general and traditional therapy.