bluuebunny/crossref_metadata_2025 huggingface dataset:
PECULIARITIES OF PRENATAL VAGINA MORPHOGENESIS
Authors: Khmara Tetiana V. , Zamorskii Іhor І. , Ryznychuk Mariana O. , Kryvchanska Mariana I. , Boichuk Oleh M. , Dmytrenko Roman R.
Published: October 2020

Introduction: The rapid development of perinatal gynecology requires from the anatomists comprehensive studies of the patterns of prenatal morphogenesis and the
development of topographic and anatomical relationships of female reproductive organs in the human fetuses of different age groups.
The aim: To study the development and formation of the vaginal topography in the prenatal period of human ontogenesis.
Materials and methods: The study has been conducted based on 23 series of histological and topographic-anatomical sections of human prefetuses aged 9-12 weeks with
31.0-80.0 mm of crown-rump length (CRL) and 83 specimens of female human fetuses aged 4-9 months with 81.0-345.0 mm of CRL by means of a complex of adequate
morphological methods of investigation.
Results and conclusions: Vaginal formation occurs during the 9th week of embryogenesis (prefetuses of 31.0-41.0 mm of CRL) due to the fusion of two different embryonic
structures: mesodermal paramesonephral ducts and endodermal urogenital sinus. In this case, the caudal regions of the paramesonephral ducts are transformed into the uterus
and the superior two thirds of the vagina, and the inferior third of the vagina develops from the urogenital sinus.
Common uterovaginal canal, divided into right and left cavities by mesenchymal septum, is formed in the female prefetuses of 38.0-43.0 mm of CRL due to the fusion of the caudal regions of
the paramesonephral ducts in the area of the posterior wall of the urogenital sinus. Complete dissolving of the septum of the uterovaginal canal occurs in prefetuses of 55.0-58.0 mm of CRL.
The anterior and posterior vaginal vaults of the same depth are formed in 5-month-old fetuses. Canalization of vagina in the caudo-cranial direction is observed in the fetuses
of 170.0-185.0 mm of CRL, with no clear boundary between the uterovaginal canal and the urogenital sinus. The vaginal epithelium in the upper third part originates from the
uterovaginal canal, and in the lower two thirds of the vagina – from the urogenital sinus.
In the 6-month-old fetuses there was detected the variability of the shape of the superior, middle and inferior third of the vagina, namely: oval (5 cases), elongated-oval (2
cases), stellate (1 case); in the lower third, the H-shaped form was predominantly found (6 fetuses).
The proliferation of the hymen membrane occurs in fetuses of 220.0-245.0 mm of CRL. The absence of timely proliferation of the hymen membrane can lead to its atresia, and
its premature proliferation causes the appearance of transverse vaginal septa.
MODERN APPROACHES TO PREVENTION OF PERIODONTAL DISEASES IN PREGNANCY: A REVIEW
Authors: Ostrovskaya Liudmyla I.
Published: October 2020

Introduction: In the modern literature, a variety of treatment regimens for periodontal diseases in pregnant women have been suggested and recommended for use in practical public health. And yet the concept of “dental diseases prevention in pregnancy” does not fully reflect the essence of the necessary measures to maintain the dental health of women during this period. The aim: The aim of the present paper is to study the scientific literature on the issue of preventing periodontal diseases in pregnancy. Materials and methods: The subject under discussion was considered on the basis of 59 sources on this issue, using the method of content analysis, comparative and contrastive, analytical and biblio-semantic methods. Review and conclusions: The analysis of scientific literature justifies the need for an integrated approach to treatment and prophylactic measures during the entire pregnancy period. Furthermore, the review of literature sources allows us to advocate the need to improve the existing approaches and to develop new individual programs for primary and secondary prevention of periodontal diseases in pregnant women, taking into account pathogenesis and the peculiarity of their course. Diagnosis of dental status in pregnant women with assessment of early and long-term clinical observations provides a prognostic model of the course and outcome of dental diseases. Meanwhile, the introduction of the follow-up observation for the maternity leave group enhances the dental health of pregnant women and prevents multiple pathological conditions of the unborn child.
THE GENESE OF PREDICTIVE-PERSONIFIED MEDICINE
AND THE PROBLEMS OF ITS IMPLEMENTATION IN UKRAINE
Authors: Terzi Olena O.
Published: October 2020

The concepts, content and significance of predictive-personified medicine that are able to improve the quality of treatment, using genetic information when choosing the medical
procedures that are necessary for a particular person are considered. Characteristic of the principles of predictive-personified medicine and its fundamental foundations are
carried out: genomics; proteomics; metabolism; bioinformatics The history of the formation and development of predictive-personified medicine in the world is investigated,
the relevant legal documents are analyzed.
The main advantages of predictive-personified medicine are determined: detection of an illness at an earlier stage, when its treatment is more efficient and cheaper; division
of patients into similar groups for the choice of optimal therapy; reduction of adverse reactions to drugs by more effective early assessment of individual negative reactions;
improvement of the selection of new biochemical indicators, allowing to control the action of medicinal products; reducing the time, cost, and the number of failures in clinical
trials of new treatments.
It is noted that in Ukraine none of the well-known projects approved by the American and European committees on gene therapy are implemented. However, the priority direction
of research in the field of genetics is chosen annually by more and more medical institutions of Ukraine. Examples of the introduction of predictive-personified medicine into
medical institutions and scientific institutes in Ukraine are presented.
It is concluded that ensuring the effectiveness of this direction of modern medicine depends on the elimination of many problems of socio-managerial and regulatory nature.
In addition to their solution, the priority tasks in this area include the carrying out of significant informational and enlightening work with the population; increase of state
funding for the development of preventive medicine; creation of public-private partnership of base centers.
DIAGNOSTIC ROLE OF SYSTEMIC INFLAMMATION, BLOOD
COAGULATION AND PADUA PREDICTION SCORE IN LUNG
THROMBOSIS RISK ESTIMATION IN HOSPITALIZED PATIENTS
WITH COMMUNITY-ACQUIRED PNEUMONIA
Authors: Pertseva Tetyana , Kireieieva Tetyana , Krykhtina Mariia , Bielosludtseva Kseniia , Dyagovets Kateryna
Published: October 2020

Introduction: Some coagulation and thrombotic disorders during severe CAP could lead to some intravascular disorders and even be the reason of lethal end in hospitalized
patients with CAP. But this fact hadn’t been established to the end yet.
The aim was to study the intravascular changes in patients with severe CAP and to estimate the role of parameters of systemic inflammation (procalcitonin (PCT), C-reactive
protein (CRP)), blood coagulation test (fibrinogen, D-dimer, heparin time, prothrombin time) and risk of thrombosis in patients with moderate and severe CAP.
Materials and methods: The main group was 63 patients with moderate to severe CAP. The mean age was 54.0 [37.0–63.0] years old, men – 46 (73.0%)). Depending on the
severity all patients of the main group were divided into 2 subgroups: subgroup 1 – 36 patients with moderate CAP (the mean age was 51.0 [32.5–62.5] years old, men – 29 (80.5%)),
subgroup 2 – 27 patients with severe CAP (the mean age was 56.0 [46.0–68.0] years old, men – 17 (63.0%). Subgroups had no significant difference according to age (p=0,348) and
sex (p=0,237). Received results were compared with values in control group. The control group was 10 healthy people (the mean age was 52.0 [35.6–62.0] years old, men – 5 (50.0%)).
Results and conclusions: Patients with severe CAP had significantly higher levels of PCT, CRP, D-dimer, prothrombin time, heparin index and the lowest level of heparin time.
This fact shows the highest risk of thrombosis in patients with severe CAP on the background of severe systemic inflammation. The mean level of scores by Padua scale in patients
with severe CAP was 5.0 [5.0–6.0] scores, which was significantly higher than in patients with moderate CAP, who had 1.0 [1.0–2.0] scores.
On autopsy of 5 died patients with severe CAP we found thrombosis of lung vessels which differ from embolism or post-mortem blood clots. These changes maybe reflect systemic
thrombosis at patients with severe CAP and could be the reasons of increased mortality in this category of patients.
MODERN MODEL OF GENETIC MONITORING AS A PROMISING TOOL
FOR REDUCING INCIDENCE OF GENETIC PATHOLOGIES IN UKRAINE
Authors: Mykytenko Dmytro O. , Gruzieva Tetiana S.
Published: October 2020

Introduction: The medical and social substantiation of an optimized system of genetic monitoring in Ukraine for providing of quality medical care with economic substantiation
should be developed for quality medical care and justification of budget expenditures and the economic evaluation of the effectiveness of treatment and prevention measures.
The aim is to develop a modern model for the genetic monitoring and provide substantiation of the measures for the prevention of hereditary transmission of genetic defects and birth of children with congenital defects.
Materials and methods: The following research methods have been employed: systematic approach and analysis technique; bibliographic and semantic method; method of conceptual modeling.
Conclusions: The model of genetic monitoring with the modern concepts of healthcare reform in Ukraine has been developed taking into account the priorities of the state
health policy, modern internationally recognized and recommended by WHO.
CHANGES IN PENTRAXIN-3 LEVEL AND ITS INTERACTION
WITH METABOLIC INDICES IN PATIENTS WITH CORONARY
ARTERY DISEASE AND TYPE 2 DIABETES MELLITUS
Authors: Kravchun Pavlo G. , Kadykova Olga I. , Molotyagin Dmitry G.
Published: October 2020

Introduction: Recently great attention is paid to studying of coronary artery disease (CAD) pathogenesis against the background of the diabetes mellitus (DM). First of all, the
question of an inflammatory component role in development of atherosclerosis in patients with DM 2 types is studied. One of new perspective markers of immune inflammation
is pentraxin-3 (PTX-3).
The aim of the study was to evaluate the nature of changes in the level of pentraxin-3 in patients with coronary artery disease, depending on the presence of type 2 diabetes
mellitus and to investigate the nature of the relationship with metabolic parameters.
Materials and methods: Comprehensive examination of 110 patients with CAD was conducted. Patients were divided into groups depending on presence of type 2 DM: to
the first group (n = 75) entered patients with CAD and type 2 DM , the group of comparison was made by 35 patients with CAD without type 2 DM. 25 almost healthy persons
entered into control group.
Results: As a result of a research it is established the reliable increase in PTX-3 level in all patients with CAD in comparison with group of control for 65.40% . And in the
conditions of the combined current of CAD and type 2 DM, PTX-3 level is for 80.14% higher, than in persons of control group. Also interrelation between PTX-3 and indicators
of dcarbohydrate and lipidic exchanges were defines. According to the carried-out correlation analysis there was revealed existence of direct integral probable connections
between PTX-3 level and levels of glucose (r = 0.41; p <0,05), insulin (r = 0.36; p <0,05), index of HOMA (r = 0.89; p <0,05), TG level (r = 0.74; p <0,05) and the return with
the HDL (r = - 0.54; p <0,05).
Conclusions: In patients with CAD with the accompanying type 2 DM it is established higher PTX-3 level, than in patients without type 2 DM and control group that demonstrates
autoimune link activation. In the examined patients PTX-3 level increase was associated with violation of lipid and carbohydrate exchanges.
A NEW METHOD OF DIAGNOSIS OF THE HIATAL HERNIA ASSOCIATED WITH GASTROESOPHAGEAL REFLUX DISEASE
Authors: Stasyshyn Andriy R. , Bychkov Mykola A. , Bychkova Solomiia V.
Published: October 2020

Introduction: Gastroesophageal reflux disease (GERD) is one of the most common gastroduodenal diseases. The relationship between the hiatal hernia and the GERD is established. It is advisable to develop an accessible non-invasive diagnostic method for this combined pathology. The aim of the research was to estimate measuring of calcium in patients’ saliva samples as simple non-invasive diagnostic method of GERD associated with the hiatal hernia. Materials and methods: The samples of saliva were obtained from 37 patients with hiatal hernia associated with GERD and 22 healthy volunteers. The content of calcium in saliva was measured using calcium-sensitive dye Arsenazo III by photometrical method at a wavelength of 590-650 nm. Results: It has been established that in the saliva of patients with hiatal hernia, the calcium content was increased by 100.9% compared to the control group. Such a significant increase in the level of calcium in the saliva of patients with hiatal hernia may be due to the fact that the development of this pathology is a disorder of calcium homeostasis. Conclusions: It has been found that the calcium content in the saliva of patients with hiatal hernia exceeded the norm almost twice. Thus, the determination of calcium content in saliva can be used as a simple non-invasive diagnostic marker of hiatal hernia associated with GERD.
ANALYSIS OF THE STATE OF NITRATE POLLUTION OF AQUIFER
OF KHARKIV REGION ACCORDING TO LABORATORY TESTS
Authors: Lytvynenko Mykola I. , Zalyubovska Olha I. , Korobchanski Volodymyr O. , Tiupka Tetiana I. , Zlenko Viktor V. , Avidzba Yuliia N.
Published: October 2020

Introbuction: The scientific-methodical substantiation of measures on supplying the population with drinking water of guaranteed quality is one of the main factors of sanitary
and epidemiological welfare of the population of the region.
The aim: The aim of this work is the analysis of the state of nitrate pollution of sources of drinking water supply in Kharkiv region
Materials and methods: Studies of drinking water were conducted and evaluated according to the requirements of current standards
Results: In recent years in the area there has been a tendency of deterioration of the quality of drinking water from decentralized water supply facilities (wells and capping sources)
Conclusions: The percentage of drinking water samples with exceeding the established standards on sanitary-chemical indicators of the objects of centralized water supply in
recent years is on the average 15%, and it is 30% for the facilities of decentralized water supply.
PROCESS MODEL OF THE PHARMACEUTICAL INTEGRATED
MANAGEMENT SYSTEM
Authors: Ubohov Serhii H. , Trokhymchuk Viktor V. , Todorova Violetta I. , Zahoriy Volodymyr A.
Published: October 2020

Introduction: One of the innovative trends in the modern development of the pharmaceutical sector is the introduction of integrated management systems (IMS) at the
enterprises for the production and distribution of medicines.
The aim: to substantiate and develop a process model and approaches to the regulation and documentation, performance evaluation and improvement of the IMS within the
pharmaceutical institution (PI) and hospital pharmaceutical service (HPS).
Materials and methods: research materials used: international standards, regulations and guidelines of the Ministry of Health of Ukraine, scientific publications, information of
PI and hospitals, placed on official websites and collected in the process of direct observation. Research methods are: systemic-review, generalization, observation, documentary,
structural-logical and graphic modeling.
Results: Based on the requirements of good practices and international standards in the field of management of quality, ecology, occupational health and safety, social responsibility,
a typical process model of the IMS of PI and HPS (pharmaceutical integrated management system − PIMS) has been substantiated and developed. The content of each process of
a typical PIMS model is described and structured. The expected results (outputs) of the PIMS processes are determined. The approaches to the regulation and documentation of
the PIMS processes in the conditions of functioning of the four-level documented information system are substantiated. A matrix of responsibility and authority of the staff of PI
and hospitals within the PIMS is developed. The structurally hierarchical model of the performance evaluation and improvement of the PIMS has been designed and described.
Conclusions: The results are the basis for the establishing, regulating and documenting of the PIMS and the development of a system for its performance evaluation and
continual improvement.
IS AN EMERGENCY DEPARTMENT A SAFER PLACE FOR HYPOTHERMIC VICTIMS THAN AN AMBULANCE? A COMPARISON OF THE KNOWLEDGE OF MEDICAL PERSONNEL CONCERNING HYPOTHERMIA
Authors: Podsiadło Paweł , Nogalski Adam , Kosiński Sylweriusz , Sanak Tomasz , Sałapa Kinga , Gałązkowski Robert , Darocha Tomasz
Published: October 2020

Introduction: Improper initial management of a victim in severe hypothermia is associated with a risk of cardiac arrest. At the same time, an uncontrolled drop in core body temperature in trauma victims is an independent risk factor for mortality. Medical personnel require a thorough understanding of the pathophysiology and treatment of hypothermia. Gaps in this understanding can lead to serious complications for patients. The aim: To compare knowledge concerning hypothermia between medical personnel working in emergency departments (ED) and emergency medical services (EMS). Materials and methods: A total of 5,362 participants were included in the study. In this study, EMS and ED personnel were encouraged to participate in an e-learning course on hypothermia. Subsequently, the scores of a pre-test, lesson tests and post-test completed by participants of this course were compared. Results: Pre-test scores were significantly higher among personnel working in EMS compared with those working in EDs. Nurses employed in EDs had significantly more failures in completing the course than EMS nurses. The most difficult topics for all practitioners were post-traumatic hypothermia and hypothermia-related clotting disorders. Conclusions: EMS personnel have a higher level of knowledge of hypothermia than ED personnel. Moreover, an e-learning course is an effective tool for improving medical personnel’s knowledge of hypothermia.
AN ATTEMPT TO ASSESS WOMEN'S KNOWLEDGE ABOUT
CAESAREAN SECTION IN THE QUESTIONNAIRE SURVEY
Authors: Zielińska Patrycja , Janik Inga , Maciejewska Martyna , Sipak Olimpia
Published: October 2020

Introduction: In last year the proportion of caesarean sections constantly growing.
The aim: To evaluate the knowledge in the questionnaire survey of women about the Caesarean section.
Materials and methods: 1462 women in age 18-57 were tested by the method of diagnostic survey. The tool of research was own survey composed of 26 question.
Results: Among 1462 of women, which was poll, 79,6% described anxiety as the main factor to make a decision to have a caesarean section. The most frequently mentioned
disease in 93,6%, which may appear among women after surgery were adhesions, while a delay of lactation in 59,36% has a negative influence on newborn children.
Conclusions: 1. The percentage increase of elective caesarean sections is related to the extension of procedures related to psychiatric indications. However, most women, still
prefer a natural birth because of safety for the mother and the child.
2. The awareness of women with higher education causes a higher percentage of cesarian sections, because of the greater anxiety about their own health, health of the newborn
and safety of a natural birth.
3. Women in a reproductive age should have access to literature and antenatal schools, but also to psychoeducational meetings and a detailed discussion on this subject of
both forms of delivery.
4. Increasing the number of cesarean sections to avoid criminal, civil and professional liability contributes to the increase of awareness and claims and by the knowledge of the law by the society.
LATERAL INSTABILITY OF THE KNEE JOINT AND DISORDER
OF THE ANKLE JOINT EXTENSION DISORDER IN MEN
Authors: Tittinger Tomasz , Słoniak Rafał , Szczepański Damian , Gaździk Tadeusz Szymon , Kulesa-Mrowiecka Małgorzata , Kikowski Łukasz
Published: October 2020

Introducion: The flexion of the knee joints in the movement of the squat may be accompanied by physiological varus deformity that increases smoothly with the lowering of
the center of gravity, followed by a return to the starting position. Observing the disturbances of the physiological movement of the knee joints in the frontal plane, the authors
correlated them with the mobility of the ankles in the sagittal plane.
The aim: To show the relationship of knee joint motion disorders in the frontal plane with the movement of the ankle joints in the sagittal plane in the movement of the squat. The
authors asked themselves about the number of subjects with the physiological mobility of both joints in the given planes and in what part of the subjects there are disorders and
whether they relate to the ipsi or the contralateral part of the body. There was also the question of whether and in which group there are deviations not meeting the above criteria.
Materials and methods: 20 healthy right-handed men aged 25-35 were examined with physiological mobility of lower limb joints, confirmed in a physiotherapeutic study.
Exclusion criteria included: polyarticular laxity, systemic diseases, rheumatoid arthritis, osteoarthritis. The subjects performed a three-time squat after putting in the Biomech
measuring system inertial sensors on the lower limbs and the pelvis. Assessment was related to the movement of the knee joint in the frontal plane with the movement of the
ankle joint in the sagittal plane.
Results: Alternating deformity with right knee valgus occurred in 16 people in the right knee joint (80% of subjects) and in 6 men in the left knee joint (30% of subjects). Three
subjects (15%) had a degenerative disorder in both knee joints. The others presented physiological mobility or single (not correlating) disturbances in the mobility of selected joints.
Conclusions: The tests confirmed that the ankle joint is functionally connected to the dysfunctional knee joint on the opposite side, despite various surfaces of mutual movement.
Dysfunction of the knee joint is about 10 ° reduction of varus deformity during squat during maximum flexion of the knee joint and again varus deformation when lifting the
center of gravity, which ends in distortion until the starting position. These deflections are accompanied by a decrease in the opposite ankle extension at the time of knee valgus
deformity in the maximum flexion. The above dysfunctions occurred in 100% instability of the non-dominant knee joint, and on the dominant side in 63%.
NATURAL ENVIRONMENT AS COMPONENT OF PUBLIC HEALTH:
SOME ASPECTS OF ITS LEGAL REGULATION
Authors: Pashkov, Vitalii M. , Trotska Maryna V.
Published: October 2020

Introduction: Human health depends on various factors that have a different physical origin, degree of influence on the human body, methods of manifestation and other
characteristics. Within public health, their research is carried out implementing an integrated approach and understanding the causation of the factors that influence each other
as well as their effects on the human body. The natural environment, namely its state in general and individual natural objects, in particular, is one of the elements having both
direct and indirect effects on human health.
The aim: To analyze the legal basis for the regulation of the impact of the natural environment as a component of public health.
Materials and methods: The study examines provisions of international documents and scientists’ attitudes. The article analyzes generalized information from scientific
journals by means of scientific methods from a medical and legal point of view. This article is based on dialectical, comparative, analytic, synthetic and comprehensive research
methods. Within the framework of the system approach, as well as analysis and synthesis, the concepts of public health, health and influence of the natural environment on
them are researched.
Review: As a result of the study of a particular range of problems, it may be noted that human health depends on a number of factors that allow it to be adequately addressed.
The environmental component, namely, the state of the natural environment affecting the human body both directly and indirectly, is not the least of them. Proper legal
settlement of the above-mentioned range of problems will allow a comprehensive approach to understanding the causation of human health and the natural environment.
Conclusions: when researching the impact of the natural environment within public health, it can be noted that the legal basis for the multidimensional regulation of the notion
of health in general, as well as its individual components, in particular, has been formed and reflected in a number of regulatory legal acts. In turn, inadequate implementation of
the systematic approach with an in-depth understanding of the real and potential factors that affect human condition in one way or another does not allow the fullest possible
determination of their causation both on the positive and negative sides.
HEART FAILURE - MEDICAL, ECONOMIC AND SOCIAL PROBLEM
Authors: Feusette Piotr , Płonka Joanna , Bugajski Jarosław , Duszańska Agata , Łabuz-Roszak Beata , Gierlotka Marek
Published: October 2020

Heart failure has accompanied mankind since the dawn of time. The first mentions of the disease, which today we describe as heart failure, come from ancient times. Epidemiology
of symptomatic heart failure is well known , especially in Europe. Heart failure affects approximately 2% of the adult population in Europe. The article presents: definition,
epidemiology and prognosis of patients with heart failure. The article presents current methods of pharmacotherapy and treatment of heart failure. An important element in
the management of patients with heart failure is medical rehabilitation and the prevention of cardiovascular diseases, according to the ESC guidelines. The topic also discussed
in the article is the analysis of socio-economic costs of heart failure. The article concludes that: heart failure is a medical problem, because despite the introduction of new
treatment methods, it is a disease that is still characterized by poor prognosis; heart failure is an economic problem because its treatment is expensive and absorbs 2% of all
costs of healthcare; heart failure is a social problem because it is a disorder affecting mainly elderly people, leading to a significant reduction in their ability to live independently,
which results in their exclusion from social life
CLINICAL CASE OF SUCCESSFUL MANAGEMENT
OF ACUTE MYOCARDIAL INFARCTION DURING PREGNANCY
Authors: Loskutov Oleh A. , Zhezher Andrii O. , Sulimenko Yevhen M.
Published: October 2020

Introduction: There have recently been increasingly frequent reports of myocardial infarction (MI) in pregnancy and in the postpartum period. Pertinent and timely treatment
affect maternal and fetal morbidity and mortality.
Clinical case: We are reporting about a 42 years old woman at the 19th week of gestation, with complains of chest pain with irradiation into the left arm, and shortness of
breath. It was known from the history of present illness, that at the time of the event ventricular fibrillation was recorded and resuscitation measures with cardioversion were
performed. Subsequently, after an additional examination in the hospital, a diagnosis of MI has been determined. Coronary angiography with cardiac ventriculography (CVG)
has been performed and stenosis of left anterior descending coronary artery (LAD) and right coronary artery (RCA) detected. A revascularization with the insertion of the
bare-metal stent system has performed and double antiplatelet therapy prescribed. At 37 weeks of gestation, the patient gave birth to a healthy child by caesarean section.
Conclusions: This clinical case illustrates the importance of minimizing the time to hospitalization of a pregnant woman with a MI to a specialized center for timely and complete
diagnostic measures, which, in turn, allow to properly choose the tactics of patient management. Timely revascularization and properly selected anticoagulation are the key
factors of the successful management in this category of patients.
CONTRACTION OF THE TENSOR FASCIAE LATAE MUSCLE
OF THE FASCIA OF THE BROAD THIGH AND FLEXION
OF THE KNEE JOINT IN THE RUNNERS
Authors: Słoniak Rafał , Tittinger Tomasz , Szczepański Damian , Gaździk Tadeusz Szymon , Kulesa-Mrowiecka Małgorzata , Kikowski Łukasz
Published: October 2020

Introduction: The illustration of the ranges of bending the limb during the outflow allowed to divide the study group into two parts. In the majority of respondents, the initial flexion
prevailed over the final one. The researchers focused on finding the reasons for the advantage of the final bend over the initial one in 30% of the subjects.
The aim: The analysis of the dynamic stride under the control of the MVN Biomech system in the bending of the knee joint of the lateral limb, comparing the preparation to
the leg (initial bending) and its ending (final)
Materials and Methods: 18 right-handed 25 to 35 year old runners were selected after the following exclusion criteria were applied: polyarticular hypermobility, systemic
diseases, Rheumatoid arthritis, osteoarthritis, post-traumatic instability. The MVN Biomech system assessed the three-dimensional movements of the joints of the free part of
the lower limb and pelvis, and the flexibility of the muscles was subject to physiotherapeutic assessment.
Results: In 55% of respondents dominated the pattern in which the initial flexion exceeded by min. 10⁰ final bend in both limbs (decreasing type). The researchers focused on finding the reasons
for the smaller difference or the advantage of the final bending on both sides in 30% of respondents (mixed type). The comparison of physiotherapeutic examination results and measurements
of MVN Biomech showed functional contractures of the tensor fasciae latea muscles in 5 subjects with a mixed type (83% of subjects with a mixed type).
Conclusions: Contraction of the tensor fasciae latae constrained the initial flexion of the knee joint of the lateral limb, and also increased bilateral visitation of the hip joints
during the dynamic mixed-type twitch. The remaining muscles of the lower limbs show no statistically significant differences in elasticity compared to the type of the leg.
VITAMIN D IN NORMAL AND PATHOLOGICALLY CHANGED
ENDOMETRIUM
Authors: Duda-Wiewiórka Magdalena , Pityński Kazimierz
Published: October 2020

More and more evidence from research confirms the significance of vitamin D (VD) in the development of endometrial pathologies. Apart from the well known role of VD in
regulation of calcium levels, VD acts as modulator to many genes involved in cell growth, immunological functions and protein synthesis. The newest research shows that VD acts
multidirectionally and its common deficiency has a causal link to the pathogenesis of many gynecological and cancerous conditions. It is postulated that VD affects the endometrium
via various mechanisms. The discovery that most tissues have VD receptors was ground-breaking in understanding its role in various medical conditions, including the neoplasmal
development mechanism, but the degree, to which the VD metabolism in the eutopic endometrium during pathological conditions is impaired, has not yet been explained.
EFFECT OF PRIMARY STENTING OF CORONARY ARTERIES ON CLINICAL COURSE AND REMODELING OF THE LEFT VENTRICLE IN PATIENTS WITH ACUTE ST SEGMENT ELEVATION MYOCARDIAL INFARCTION (RESULTS AFTER 12 MONTHS)
Authors: Melen Yurii P. , Skybchik Vasyl A. , Fedechko Maryana Y. , Kopchak Lesya M.
Published: October 2020

The aim: To determine the predictive effect of primary stenting of coronary artery on the clinical course and features of left ventricular remodeling in patients with acute myocardial infarction (MI) with ST segment elevation and LV diastolic dysfunction (DD) in the remote period (12 months).
Materials and methods: The study included 80 patients with STEMI who undergo primary PCI (group 1) and 20 patients with STEMI who did not undergo myocardial revascularization (group 2). In both groups, the levels of NT-proBNP were determined, echocardiography, bicycle ergometry; quality of life was determined according to SAQ questionnaire scales; marked cardiovascular complications. Patients were re-examined after 12 months.
Results: The average level of NT-proBNP for 5 days and 12 months of patients in group 1 significantly decreased – 434.6 ± 36.3 and 122.8 ± 4.13 g / ml (p <0.001), indicating a less pronounced late remodeling of LV in patients undergoing revascularization with STEMI. Diastolic function was evaluated by E/A and DT. After 12 months, the 1st group was markedly lower than E/A and DT compared to the 2nd – 0.76 ± 0.03 and 198 ± 4.7 m / s and 1.49 ± 0.01 and 135 , 3 ± 2.91 m/s, respectively (p <0.05), which characterizes a decrease in the parameters of the DD by the type of the relaxation processes of the left ventriculi. Patients in Group 1, according to SAQ scales, had better quality of life and higher exercise tolerance at I-II level than patients without revascularization.
Conclusions: In patients with STEMI, after a primary stenting of coronary artery, a significantly lower NT-proBNP level and less pronounced DD manifestations in the long-term (12 months) period demonstrated a better tolerance to physical activity and improved quality of life, as determined by the SAQ questionnaire and a lower rate of development cardiovascular complications.
GENETIC POLYMORPHISM IN PATIENTS WITH EARLY AND LATE ONSET OF ULCERATIVE COLITIS
Authors: Dorofeyev Andriy E. , Dorofeyeva Anna A. , Kiriyan Elena A. , Rassokhina Olga A. , Dynia Yulia Z.
Published: October 2020

The aim was to investigate SNPs of TLR-2,3,4, NOD2/CARD15, JAK-2, and IL-10 in patients with the early and late UC onset.
Matherials and methods: 126 patients with UC were investigated. To assess the predisposition of the early and late UC onset the incidence of the following SNPs: Arg753Gln TLR2 gene, Phe412Leu TLR3 gene, Asp299Gly and Thr399Ile TLR4 gene, C-819T, G-1082A and C-592A gene IL-10, Val617Phe gene JAK2, Gly908Arg gene NOD2/CARD15 were analyzed.
Results: 76 patients had early disease onset and 50 had a late one. SNPs of TLR3 were observed in 50.8% cases. TLR4 polymorphism was more common than TLR3, and was observed in 81 (64.3%) UC patients. Polymorphism of NOD2/CARD15 and IL-10 genes were revealed with almost the same frequency 49 (38.9%) and 50 (39.9%) patients, respectively.
Conclusions: Polymorphisms of TLR-2,3 genes and TLR4 Asp299Gly, NOD2/CARD15 prevailed in patients with the late UC onset that allows to suppose that bacterial flora plays one of the key roles in modification of immune response and UC development. In patients with early UC onset polymorphisms of the JAK2 and IL-10 genes prevailed responsible for the cytokine cascade activation and cause the immune mechanism that might lead to a more aggressive course of the disease.
PREGNANCY, COMPLICATED BY PREECLAMPSIA: FETOPLACENTAL COMPLEX IMMUNE DEADAPTATION AND HISTOSTRUCTURAL FEATURES
Authors: Yavorskyi Pavlo V. , Zozulia Vitalii M. , Vanchuliak Oleh Ya. , Garazdiuk Marta S.
Published: October 2020

The aim: to study and compare the features of the interleukins levels and morphological changes of placenta at various stages of preeclampsia.
Materials and methods: 109 pregnant women with preeclampsia of varying severity (study group) and 30 pregnant women with uncomplicated pregnancy (control group) were examined. Immunohistochemical method, proinflammatory interleukins levels, morphological and morphometric analysis of peripheral and central placental areas biopsies on the optical and electron-microscopic level have been used.
Results: Morphofunctional changes in the placenta in case of preeclampsia and the increase in the expression level of the transforming growth factor have a series of regular stages from the formation, strain and disruption of adaptive mechanisms with more pronounced signs of morphological immaturity of parenchymal and stromal elements of the placenta, especially in the area of syncytiotrophoblast and spiral vessels. The degree of clinical manifestation of preeclampsia has a correlation relationship with IL-10 deficiency and with the increase in TNF-α, stimulation of macrophage-protein production that contributes to the change in the ratio of Thl / Th2, which are antagonists and inhibit each other’s development.
Conclusions: The severity of the preeclampsia course correlates with the state of morphofunctional changes in the placenta and changes in the ratio of the pro- and anti-inflammatory interleukins.
TIME COURSE OF ENDOTHELIAL DYSFUNCTION AND ATHEROTHROMBOSIS MARKERS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION WITH ST SEGMENT ELEVATION AND TYPE 2 DIABETES MELLITUS DEPENDING ON REPERFUSION THERAPY APPROACH
Authors: Minukhina Diana V. , Babadjan Volodymir D. , Minukhin Dmitriy V. , Yevtushenko Denis A. , Tverezovskiy Mihail V. , Kudrevych Oleksandr M.
Published: October 2020

The aim: To evaluate the levels of plasminogen activator type 1 inhibitor, asymmetric dimethylarginine and endothelial nitric oxide synthase on day 10-14 in patients, depending on the presence or absence of concomitant type 2 diabetes and the type of reperfusion therapy.
Materials and methods: The study involved 130 patients with acute myocardial infarction, divided into 2 groups: Group 1 consisted of patients with acute myocardial infarction with type 2 diabetes mellitus (n = 73), Group 2 comprised patients with acute type 2 diabetes mellitus (n = 57). The quantitative content of IAP-1 was determined by enzymelinked immunosorbent assay using a commercial test system manufactured by Technoclone PAI-1 ELISA Kit (Austria), NOS – Enzyme-Linked Immunosorbent Assay (ELISA) Kit for Nitric Oxide Synthase Endothelial (NOS) ADMA ELISA Kit (Austria).
Results and conclusions: Percutaneous coronary intervention contributes to a significant reduction in the content of ADMA, which is a marker of endothelial dysfunction and increase NOS on the 10-14th day of acute myocardial infarction compared with standard therapy. During PCI, the level of IAP-1 did not significantly change in the time course of treatment due to post-inflammatory and post-traumatic activation of platelets in the vascular wall.
APPLICATION OF COGNITIVE-BEHAVIORAL THERAPY IN PATIENTS WITH UNCONTROLLED BRONCHIAL ASTHMA DUE TO EXCESS BODY WEIGHT AND OBESITY
Authors: Bazhora Yana I.
Published: October 2020

The aim: The aim of our study was to determine the effect of CBT in patients with uncontrolled BA against the background of excess body weight and obesity.
Materials and methods: By the study design there were examined 78 patients who had a primary diagnosis of uncontrolled BA.
Results: The patients in the main group had significant positive dynamics regarding a number of AQLQ questionnaires, namely emotions, activity, overall quality of life (p≤0.05). These patients also had a positive dynamics in overcoming anxiety-depressive disorders, namely from 10.23 ± 0.81 points anxiety disorders scored 7.65 ± 0.98 points after CBT, and depressive changes – from 10.01 ± 0.79 points to 7.69 ± 0.67 points by the HADS scale (p≤0.05).
Conclusions: The use of CBT has a positive effect on certain indices of the AQLQ questionnaire (p≤0.05) and has a positive effect on the psychological state of the patient, namely, it reduces the manifestations of anxiety and depression (p≤0.05) in patients with uncontrolled asthma as well as improves the course of uncontrolled asthma by a number of indices, namely reducing the frequency of use of short-acting β-2-agonists, nocturnal symptoms of asthma, the amount of oral and peroral steroids.
THE PROCESS OF SCIENTIFIC KNOWLEDGE INTEGRATION IN CRIME PREVENTION AND TRENDS OF MEDICAL CRIMINALISTICS DEVELOPMENT IN UKRAINE IN XIX – EARLY XX CENTURY
Authors: Shepitko Valery Yu. , Olkhovsky Vasyl O. , Shepitko Mykhaylo V.
Published: October 2020

The aim: To carry out a historical review of the formation and development of medical forensics in the XIX – early XX century in Ukraine, as well as to identify its trends at the present stage. Materials and methods: The article is based on the study of archival and published materials, the results of integrating expert judgments, judicial practice and regulatory acts of the Ministry of Health of Ukraine, interviewing investigators and court experts. In the course of the research a system of scientific methods has been used: historical, comparative, terminological analysis, formal-logical, sociological. Conclusions: In the XIX and early XX centuries, the foundations for the formation of medical criminalistics were laid, which facilitated the development of forensic medicine, criminalistics and forensic examination. Special medical knowledge is widely used in investigative, judicial and expert practice. The synthesis of medical and forensic knowledge enhanced the development of a method of personal identification, based on his/her genetic properties, the formation of molecular genetic examination, the study of individual objects at the modern level.
Heart reaction of male and female with streptozotocin induced diabetes on cholinergic impacts
Authors: Bandrivska Orysia O. , Mykhailiuk Vitalij M. , Mykhailiuk Iryna A. , Malko Natalia V.
Published: October 2020

The aim: Find out the nature of the changes sensitivity of the heart to the cholinergic influences the development of diabetes depending on gender.
Materials and methods: In experiments on adult male and female rats, type 1 diabetes by momentary introduction of streptozotocin at a dose of 60 mg/ kg into the peritoneal cavity was modeled. Animals were examined after 15, 30, 60 and 90 days after introduction of streptozotocin. We studied the sensitivity of cholinoreceptors of sinus node by the intensity of bradycardia with intravenous injection of acetylcholine and electrical stimulation of the peripheral segment of the right vagus nerve.
Results: It was established that the intensity of the negative chronotropic effect of heart of males by electric stimulation of the vagus nerve, which depends on the reserves of acetylcholine in the presynaptic section and sensitivity of postsynaptic cholinoreceptors, increased gradually and after 90 days prevailed the output value in 2.2 times. This occurred at the background of a slight (10 %) decrease in response to exogenous acetylcholine that reflected the decrease in sensitivity of cholinoreceptors. In females the maximum increase (in 4.4 times) of the intensity of the negative chronotropic effect of vagus nerve stimulation was observed after 30 days from the start of the experiment. After 90 days, this indicator prevailed the controlled one in 3.3 times, which occurred at the background of heart response decreasing to exogenous acetylcholine (in 1.7 times).
Conclusions: Obtained results suggest a more significant change in state of cholinoceptor system of myocardium of females compared with males in the dynamics of development of streptozotocin-induced diabetes.
The key role of pancreatic fibrosis severity in the surgical treatment algorithm of patients with chronic pancreatitis
Authors: Kanikovskiy Oleh E. , Pavlyk Ihor V. , Oliinyk Iryna V. , Mosondz Vasyl V.
Published: October 2020

The aim of the work was to improve the results of surgical treatment of complicated forms of chronic pancreatitis.
Materials and methods: The results of surgical treatment of 181 patients with complicated forms of chronic pancreatitis have been analyzed. All these patients were treated in surgical clinic of 2 nd medical faculty of National Pyrogov Memorial Medical University in Vinnytsya.
Results: It is possible preoperative indirectly assess the severity of fibro- degenerative changes in pancreas, that includes 1 – the definition of pain type; 2 – CT or MRI (Marseilles- Rome classification); 3 – assessment of the stage of chronic pancreatitis (Büchler classification); 4 – patient's nutrition status and preoperative differential diagnosis with pancreatic cancer; 5 – assessment of the fibrosis severity (elastomers). The key point in treatment depended on intraoperative examination: detection of strictures of the main pancreatic duct (pacemaker of chronic pancreatitis); the tissue pressure resistance to the liquid, which is the maximum value> 200 mmHg, in the region of stricture and falls in other parts of the pancreas; pressure in the main pancreas duct, which rises only in 59.5% of patients. The head of the pancreas was involved in the pathological process in 83.8%, in 16.2% it was isolated in the isthmus or the body and tail of the pancreas. In general, the distal pancreas was involved in 37.8%. At computer morphometry of histological samples, the area of connective tissue fields reached 81.4 ± 6.62%, preserved exocrine part in 4.87 ± 1.62%, endocrine – 1.92 ± 0.12%, total area of ducts – 6 , 47 ± 1.12%.
Conclusions: The combined Frey-Izbickiy local resection provides a wide excision of the pacemaker (stricture) of chronic pancreatitis. In case of extrapancreatic complications or repeated surgical interventions on the pancreas due to chronic pancreatitis, this effect can be achieved by pancreatoduodenal resection.
Bone remodeling features in elderly and senile patients with the proximal femur fractures after hip replacement
Authors: Khvysyuk Oleksandr M. , Babalian Volodymyr O. , Pavlov Serge B. , Pavlova Galina B.
Published: October 2020

The aim of this study is to identify the dependence of the result of surgical treatment of patients of elderly and senile age with fractures of the proximal femur on the characteristics of the response cytokine-mediated regulatory response to trauma and surgery.
Materials and methods: In 74 patients after hip arthroplasty, serum levels of bone metabolism markers were determined using enzyme-linked immunosorbent assay. Patients were divided into 2 groups depending on the results of treatment.
Results: It was found that compared with group 2 (treatment outcome is worse) in group 1 (treatment outcome is better) there was a greater number of correlations. In group 1, correlations were found between OPG and RANKL (r = 0.88; p = 0.000), OPG and OPG/RANKL (r = 0.44; p = 0.006), TGF-β1 and OPG/RANKL (r = 0.66; p = 0.000) , IL-6 and OPG (r = 0.67; p = 0.000), IL-6 and RANKL (r = 0.53; p = 0.001), IL-6 and OPG/RANKL (r = 0.39; p = 0.016). In group 2, only between OPG and OPG/RANKL (r = 0.72; p = 0.000), RANKL and OPG/RANKL (r = −0.53; p = 0.0007). In patients of group 2, there was a decrease in the level of OPG relative to the control and a less significant increase in TGF-β1 and IL-6 relative to group 1.
Conclusion: The prognosis of the results of treatment of patients with proximal femur fractures is largely determined by the nature of the adaptive response to injury and the implant, the synchronism of the mechanism of stress remodeling of the bone. A less favorable prognosis after arthroplasty is associated with exacerbation of the initial metabolic disorders in the bone tissue due to severe cytokine-mediated dysfunction of the regulatory pathways.