bluuebunny/crossref_metadata_2025 huggingface dataset:
The study of macro- and microelement status in patients with the chronic bacterial prostatitis
Authors: Є. А. Литвинець  , А. Кабіру
Published: December 2018

According to the data more of urologists 9–35% men suffers from a c chronic prostatitis. Near 80% work out men for 20 to 50 years old. Lately events of chronic prostatitis increase because also increases different forms of uretritis, epydidimoorchitis, lowering of the resistance of organism and the influence of outside environment.The objective: of our study was to conduct a comparative analysis of the normal contents and bacterial prostatitis (BP) macro– and  traceelement composition of blood to optimize the regeneration of the processes.Materials and methods. The study involved 65 patients with bacterial prostatitis aged from 18 to 48 years, who were divided into groups: Group І patients with BP, group ІІ – control group, consisted of 25 healthy persons with patients of similar age. Determination of serum microelements was carried out by atomic absorption spectrophotometry. Statistical analysis of the results of research was carried out by  using a standard computer program Microsoft Excel.Results. Thus, the determination of Zinc in blood showed that in general patients with BP observed a significant reduction of trace elements such as Zinc content was (0,48±0,02) mg% and differed significantly from that seen in healthy persons (P<0,001). This result is quite significant, since it is known that Zinc deficiency is associated with reduced antioxidant enzyme systems and formation of adequate response of the body to the action of bacterial agents in BP.Conclusions. The presence of an imbalance in the system ofbioele ments is one of the pathogenetic mechanisms of development and progress ofinflammation in patients with bacterial prostatitis. Clinical implementation of metabolic disorders occurs at the level of the element with the violation of immunological resistance of the organism.
Clinical experience of the Zydena drug in the therapy of erectile dysfunction
Authors: Ю. М. Гурженко
Published: December 2018

The objective: to evaluate the efficacy and tolerability of the drug udenafil (ZYDENA), 100 mg tablets in the treatment of erectile dysfunction compared with the efficacy and tolerability of the reference drug (Sildenafil).Materials and methods. The clinical efficacy and safety of the ZYDENA drug in the treatment of erectile dysfunction in a clinical group of 35 patients with ED of mixed origin was studied. The control group included 30 patients who received Sildenafil therapy. Efficiency monitoring was carried out using the questionnaire on the scale of ICEF and dopplerography.Results. The excellent effect of therapy with udenafil was noted in 26 patients (74.3%), good – in 8 patients (22.8%), in one patient (2.9%) the effect was  considered satisfactory. The final evaluation of the therapeutic efficacy showed «excellent» and «good» results in 97.1% of patients.Conclusions. The prescription of ZYDENA drug to patients with erectile dysfunction (100 mg) leads to a significant increase in integration parameters in 2 2.5 times, which is 1.15 1.25 times higher than in patients who used the drug Sildenafil. The clinical efficacy and safety of Zydena in the treatment of erectile dysfunction on a group of 35 patients with ED of mixed origin was studied. The control group consisted of 30 patients receiving therapy with Sildenafil. The effectiveness was monitored using a questionnaire on the ICEF scale and dopplerography. Purpose of the drug ZYDENA patients with erectile dysfunction (100 mg each) leads to a significant increase in integration parameters in 2 2.5 times, which is 1.15 1.25 times higher than in patients who used the drug Sildenafil. The clinical efficacy of ZYDENA is 97.1%. According to the duration of the action, ZYDENA is more effective than the reference preparation 2.38 times
Combined therapy of erectile dysfunction
Authors: Р. О. Бистриця
Published: December 2018

The objective: evaluation of the efficacy and safety of combination therapy of L-arginine and PDE-5 inhibitors in erectile dysfunction.Materials and methods. The subject of the study was 34 patients with erectile dysfunction aged 20 to 45 years, with the presence of manifestations of erectile dysfunction from mild to moderate severity. Patients took L-arginine daily for 30 days and a day later PDE-5 inhibitors. The criterion of therapeutic effectiveness of the drug was the dynamics of the quality of erection.Results. After the course of combination therapy, 28 patients (82,3%) could have intimate proximity with a sufficient erection, and in 4 (11,7%) patients the erection recovered completely, which indicates the high effectiveness of these drugs.Conclusion. Combined therapy with L-arginine and an inhibitor of PDE-5 type in erectile dysfunction has a positive effect on the severity of erections.
Shock wave therapy in the treatment of erectile dysfunction
Authors: П. В. Аксьонов  , М. Г. Романюк  , В. І. Мироненко
Published: December 2018

A study of the effectiveness and comparative evaluation of the use of shock wave therapy in 205 patients with vasculogenic erectile dysfunction as a monotherapy or in combination treatment with selective inhibitors of phosphodiesterase type 5 was conducted.
Modern views on etiopathogenesis and treatment of post-ejaculation pain
Authors: Ю. М. Гурженко  , В. В. Спиридоненко
Published: December 2018

The article analyzes the statistics of the occurrence of post-ejaculation pain in men, as well as some aspects of its etiology and pathogenesis. Literature analysis established significant efficacy of pain treatment after ejaculation with a specific alpha adrenoblocker tamsulosin.
Violation and principles of diagnostics of sexual function of women in periminopauzal age
Authors: Ю. П. Вдовиченко  , О. Ю. Гурженко
Published: December 2018

The paper highlights the issue of violations and the principles of diagnosis of the sexual function of women at the perimenopausal age.The objective: analysis of the structure of sexual disorders in women during perimenopause, development of methodological approaches to early diagnosis of sexual dysfunctions.Materials and methods. The study involved 34 women with sexual disorders during the perimenopause. The age of the patients ranged from 45 to 66 years. The average age of patients was 56.3±0.3 years, with women 50-59 years old predominating " 28 (82.4%). To study the characteristics of the course of sexual dysfunctions in women of perimenopausal age, a set of clinical and laboratory and paraclinical methods of research was assigned.Results. When studying the age-related features of women of perimenopausal age and the impact on their sexual health of somatic and psychosomatic disorders, certain features of the diagnosis of this pathology were identified for the purpose of appropriate therapy.Conclusions. The main features of sexual dysfunctions in women of perimenopausal age are determined: the incidence of sexual dysfunctions is 76,5%. In the spectrum of sexual disorders, dysfunctions predominated: 85,3% – violation of lubrication, 47,1% – desire disability, 44,1% – excitation disorders, 50,0% – primary and 55,9% – secondary anorgasmia, 70,6% – discrepancy. It was found that among women with a menopause duration of more than 2 years 76,5% remained sexually active, and 85,3% of women in the perimenopause period consider sexual activity to be one of the components of quality of life factors. In addition, in women of perimenopausal age, changes in hormonal homeostasis, such as hypoestrogenia, hypoterosteronemia, have been identified, which is one of the prerequisites for the formation of a spectrum of sexual dysfunctions.
Women’s orgasm and fertility
Authors: Г. С. Кочарян
Published: December 2018

The opinions of various authors, the results of scientific researches, hypotheses (poles, bursts, evolutionary) are submitted which attempt to explain the connection or its absence between the female orgasm and the possibility of becoming pregnant. From the presented materials it follows that at present there are no scientific data which could unconditionally testify to the direct connection of orgasm in women and this possibility. You can only talk about the existence of such assumptions. Even scientists believing in this hypothesis could not prove it as a result of their researches. Numerous observations, including ours, show that women, including those who have never experienced orgasms during their entire life, can have good reproductive potential. However, it should be noted that female orgasm can indirectly contribute to an increase in the likelihood to get pregnant, since it can lead to increase of sexual activity frequency in women
Treatment of patients with oxalate urolithiasis after extracorporeal shock wave lithotripsy of ureteral calculi
Authors: М. Є. Сабадаш  , О. В. Шуляк
Published: December 2018

The frequency of recurrence of urolithiasis within the first 3 years after treatment reaches 53%, of which more than half of cases are detected in the first year of follow-up. In the remote period of observation, the frequency of recurrent stone formation reaches 77%.The objective: to evaluate the metaphylactic effect of phytotherapy in patients with oxalate urolithiasis after extracorporeal shock wave lithotripsy (ESWL) of the ureteral calculi.Materials and methods. The clinical study was conducted as a non-interventional open controlled, in two groups of patients with initial state control. The study included 64 patients with urolithiasis, oxalate concreting ureter, who performed one session of ESWL and achieved complete fragmentation of the stone. All patients of the main group (n = 32) were prescribed basic therapy + herbal medicine for 1 month with a repeat treatment at 6 months. Patients of the control group (n = 32) received baseline therapy without the study drug. The duration of follow-up is 12 months.Results. After 12 months of observation in the patients of the main group, the concentration of citrates in the urine was 2.67 ± 0.14 mmol / L compared with 2.32 ± 0.11 mmol / L in the control group (p <0.05). In patients of the main group, the daily excretion of oxalates after 12 months of observation was reduced to 38.4 ± 3.45 mg / d compared with the control group patients - 50.1 ± 2.56 mg / d (p <0.05). After 12 months of observation, a consistently high diuresis was noted in the patients of the main group 1.96 ± 0.24 l / d compared with patients of the control group 1.62 ± 0.12 l / d (p <0.05). The concentration of uric acid in the urine of the patients of the main group decreased to 4.42 ± 0.27 mmol / L, in patients of the control group - up to 4.59 ± 0.22 mmol / l. After 12 months of observation, the serum uric acid concentration was 0.210 ± 0.64 ?mol / l in patients of the main group and 0.305 ± 0.73 ?mol / l in the control group (p <0.05).Conclusion. Results of examination after 12 months of metaphylactic treatment of patients of the main group with oxalate nephrolithiasis showed no recurrent stone formation, in the control group 3 (9.4%) of the patient with recurrent formation of concrements up to 5 mm in the pulmonary calcification system of the kidney (p <0.05 ). The obtained results confirm the pathogenetic mechanisms of the action of phytopreparation Urolesan® on risk factors for oxalate nephrolithiasis, which is manifested in the stable normalization of the risk factors of this pathology
The effectiveness of metabolic therapy in the treatment of patients with the gestational pyelonephritis
Authors: Є. А. Литвинець  , В. Є. Литвинець  , Я. В. Гоцуляк
Published: December 2018

The objective: the study of effectiveness and antioxidativ activity of the medicine with the sicca extracti hibiscus and deproteinization haemoderivative of calf’s blood in the treatment of patients with the gestational pyelonephritis.Material and methods. We examine and treatment of 70 pregnant women with the gestational pyeloephritis. All illness where devoted into two groups. Into the first group entered patients (30 persons), which reseived the traditional treatment (reconstruction of the urine’s passage, antibiotic of cephalosporins II or III, spasmolytics in therapeutic doses). The aim group consists illness (40 persons), which reseived medicine with the sicca extracti hibiscus and deproteinization haemoderivative of calf’s blood. In the control group included 25 healthy pregnant women aged 18 to 40 years.Results. The using of the tradition therapy was promoted increasing clinicodiagnostic signs of illness. But stay high-level products of system lipid peroxidation and antioxidative protection are indication for progress and chronization of pathologic process after stopping the treatment. The using in illness of general group the medicine with the sicca extracti hibiscus and deproteinization haemoderivative of calf’s blood was promoted to norm clinic and the laboratorial measures and the increasing of process lipid peroxidation and the reductantion the activity in the system antioxidative protection.Conclusion. The activity of process lipid peroxidation and the reductantion the activity in the system antioxidative protection was important role in the process of chronisation and the progress of gestational pyeloephritis. The using in illness of general group the medicine with the sicca extracti hibiscus and deproteinization haemoderivative of calf’s blood in the complex treatment of patients with the gestational pyeloephritis lead to increasing the terms of normalization clinic and laboratorial indices, which reactivated of process lipid peroxidation and antioxidative protection.
MIRNA-371а-3r expression as a predictive factor in patients with germ cell testicular tumors
Authors: А. В. Сакало  , В. Є. Досенко
Published: December 2018

GCTT is more often diagnosed in the age group of 20–35 years, thanks to the success of chemotherapy in most patients it is possible to achieve long-term remission or recovery. The search for new markers is relevant, since an increase of the level of standard markers (AFP, XGT and LDH) is observed in 60% of the cases.The objective: to study the possibility of using miRNA-367-3p as a prognostic marker in patients with GCTT.Materials and methods. The expression of miRNA-367-3p in the blood serum was studied in 24 patients with GCTT in different stages, control – 2 patients with rhabdomyosarcoma and acute epididymitis. Results. Depending on the stage of disease and the morphological structure of the primary tumor, active observation or chemotheraphy was performed. miRNA-367-3p was determined by reverse transcription in real-time PCR.Conclusion. The sensitivity/specificity of miRNA-367-3p exceeds those for AFP and HGT, so, miRNA-367-3p can be considered as a molecular marker for GCTT; in teratomatous tumors the level of miRNA-367-3p is minimal or no expression; in nonseminomatous tumors, the level of miRNA-367-3p is statistically higher than in seminomas. Preliminary data indicate a correlation of the level of miRNA-367-3p with complete or incomplete remission after chemotherapy, but the hypothesis requires confirmation on a larger number of patients.
Modern approaches to the diagnosis and management of gastric and duodenal ulcer at the primary level of medical care
Authors: Л. В. Хіміон  , О. Б. Ященко  , С. В. Данилюк  , Т. О. Ситюк
Published: December 2018

The article presents the main causation factors, diagnostic criteria and management of patients with peptic and duodenal ulcer in the primary care medicine. The algorithm of primary care physician’s actions in the management of patients with peptic and duodenal ulcer is formulated. The main directions of primary and secondary prevention of this pathology by family doctor are given.
Potential for etiotropic treatment of influenza
Authors: O. М. Зінчук  , О. О. Зубач  , Н. В. Марітчак  , Г. С. Кульчицька-Костик  , Т. І. Алексанян
Published: December 2018

The article presents data on the results of the use of Remavir and Furasol in the complex treatment of influenza patients.The objective: was to study the efficacy of Remavir (remantadine hydrochloride) in influenza as etiotropic therapy, as well as to study the efficacy of using Furasol for local therapy of the oropharyngeal inflammatory process in influenza.Materials and methods. Seventy-nine patients with a moderate-to-severe course of influenza who underwent in-patient treatment at the Lviv Oblast Infectious Clinical Hospital during the two epidemic seasons 2015–2016 and 2016–2017 were under observation. The patients were divided into two groups. The first group consisted of 49 patients with influenza who received Remavir and Furasol as etiotropic therapy. The second group consisted of 30 patients with influenza, in the complex treatment of which conventional methods of pathogenetic therapy (antipyretic drugs, detoxification therapy) were used, without the use of etiotropic therapy and means for topical treatment of inflammatory phenomena of the oropharynx.Results. In the first group, the manifestations of intoxication syndrome were reliably faster, the pain in the throat decreased reliably faster than in the second group. The changes in the immunological parameters of the patients of the first group, who received in the complex treatment of the Remavir flu, largely characterize the positive dynamics of cellular immunity and contribute to the successful completion of the infectious process.The conclusion. In patients receiving complex treatment of Remavir, on the 5th–6th day of treatment, activation of the mechanisms of the «early» and «subliminal» immune-dependent inflammation, as well as the processes of Fas-dependent programmable apoptosis, was observed, which, in response to stimulation of other factors of cellular immunity, facilitated rapid disappearance symptoms, signs of intoxication and speedy recovery.
Application of medical aphorisms at the general practice-family medicine teaching on the pregradual stage of high medical education
Authors: О. О. Воронцов  , Л. С. Бабінець
Published: December 2018

The article presents the results of the analysis of literary sources on the history of medicine and formed the actual content of the aphorisms of the great doctors and philosophers in the field of medicine for their using in the teaching of discipline «general practice–family medicine» at the pregradual stage of higher medical education. The aim is to create and strengthen the motivation of future specialists in the primary health care in relation to healthy lifestyles, prevention and rehabilitation of the most common diseases in the human population. It is recommended to use this material as an additional pedagogical method of optimizing the supply of materials for preparing students for classes.
Activity of non-specific inflammatory process in arterial hypertension in patients with type 2 diabetes
Authors: Л. В. Хіміон  , М. О. Рибицька  , Л. С. Тимощук
Published: December 2018

One of the main factors of cardiovascular risk in both the general population and in patients with type 2 diabetes is arterial hypertension (AH). An important pathogenetic link in many cardiovascular diseases, including AH, is nonspecific inflammation in the intima of the vessels, where the C-reactive protein (CRP) level in the serum is a special prognostic marker.The objective: to determine the relationship between the marker level of the nonspecific inflammatory process of the C-reactive protein and the level of arterial pressure in patients with type 2 diabetes.Materials and methods. The study included 145 patients with type 2 diabetes (72 men and 73 women, the average age was 53.0 (49,0–60,5) years). A complex examination during 3 years of observation was carried out: an analysis of the dynamics of blood pressure (BP) and determination of serum CRP. Statistical analysis of the data and processing of the results were carried out using the integrated software package «SPSS Statistics 20».Results. According to the results of the dynamic observation: mean SBP levels are 140,0 (130,83–150,0) mmHg, DBP – 85,0 (80,0–91,67) mmHg, hrCRP – 4,2 (2,91–5,8) mg/l. Patients with type 2 diabetes were divided into three groups depending on the mean level of SBP: group I – 55 patients (37,9%) with an average SBP level<135 mmHg, group II – 51 patients (35,2%) with a mean SBP of 135–149 mmHg, group III – 39 patients (26,9%) with an average SBP>150 mmHg. Patients of group III had significantly higher average levels of hsCRP (5,0 (3,8–6,15) mg/l) compared to patients with sufficient control of CAT from group I (3,33 (2,0–5,8) mg/l) (p<0,05). Also in group III there was a bigger portion of people with high CVD risk with an average hsCRP >3,0 mg/l. The direct correlation with the medium strength between the hsCRP in the blood serum and the level of BP in patients with type 2 diabetes was found (r = 0,32; p<0,05).Conclusions. In patients with type 2 diabetes with higher BP the number of hsCRP in the blood serum is significantly higher; the direct correlation with the medium strength between the hsCRP in the blood serum and the level of BP in patients with type 2 diabetes is observed, that can be a prognostic marker of CVD progression.
Correction of neurogumoral and psycho-emotional disorders in patients with stable coronary artery disease and arterial hypertension: adaptation possibilities of Noofen®
Authors: Т. М. Соломенчук  , О. В. Восух
Published: December 2018

The objective: study the efficacy and tolerability of Noofen® in the standard treatment of patients with stable forms of coronary artery disease (CAD) in combination with arterial hypertension (AH) based on the analysis of the dynamics of their clinical course, daily blood pressure (BP) monitoring (DBPM) and daily cortisol levels.Materials and methods. The study involved 58 patients with stable CAD and AH with a mean age of 59,4±2,05 years. Group І – patients received standard therapy AH + CAD, II – patients, who received Noofen® (Olainfarm, Latvia) on the background of standard treatment at 250 mg three times a day. At the beginning of the study and after 12 weeks, all patients were followed by DBPM; assessed the psychoemotional status of the HADS screening scales of anxiety and depression and the Spielberg-Hanin test; determined the presence of cognitive disorders using the Luria, MMSE and FAB tests; determined the level of daily cortisol and the main indicators of lipid and carbohydrate metabolism.Results. Most patients with stable forms of CAD and AH, in which anxiety-depressive disorders (ADD) were detected, generally did not achieve optimal control of the basic parameters of BP. The use of Noofen® in the complex treatment of patients with stable CAD and AH with detectable ADD for 12 weeks is accompanied by a significant reduction in their manifestations of anxiety and depression, improvement of level of daily cortisol and control of the average levels of daily, day and night BP, correction of circadian rhythm BP and decrease in the variability of BP associated with the manifestations of ADD.Conclusions. The use of Noofen® in the complex of CAD and AH therapy will increase the adaptive properties of the body and reduce the development of undesirable cardiovascular events in patients with concomitant ADD.
The effect of chronic obstructive pulmonary disease on the clinical and functional state of myocardium in patients with ischemic heart disease
Authors: І. М. Фуштей  , С. Л. Подсевахіна  , О. І. Паламарчук  , О. В. Ткаченко  , О. С. Чабанна
Published: December 2018

The objective: the goal of the study was to investigate clinically functional characteristics of the myocardium in patients with chronic obstructive pulmonary disease combined with ischemic heart disease.Materials and methods. We examined 68 patients with chronic obstructive lung disease and ischemic heart disease. The 1st group included 22 patients with ischemic heart disease with stable angina of II–III functional class; the 2nd group included 22 patients with chronic obstructive pulmonary disease; the 3rd one – 24 subjects with comorbidity. All the patients were undergone clinical examination. Also, investigation of the distance at 6-minute walk, daily electrocardiogram monitoring, respiratory function test, pulse oximetry, Doppler were performed.Results. Based on the obtained data, at subjects with comorbid pathology at 73,2% of cases a characteristic feature of angina clinical course was the typical pain syndrome together with shortness of breath and palpitation. Lipid profile in patients with the comorbid pathology changes in lipid metabolism matched type IIA dyslipidemia A. Fredrikson classification. The data analysis of daily monitoring of the electrocardiogram was observed more frequent presence of arrhythmias in patients with combined pathology; also it was noted a significantly greater number of episodes of silent ischemia, which was confirmed by the decrease of the integral parameter of the functional status of patients during the tests with the 6-minute walk and the by the results of the analysis of blood gas composition.Conclusion. Thus, in patients with comorbidity typical pain accompanied by shortness of breath and palpitations, more frequently registered the presence of various arrhythmias and painless form of ischemia, as well as more expressed systolic dysfunction of the left ventricle due to the presence of mixed (circulatory, hypoxic and tissue) type of hypoxia.
Characteristics of acute ischemic stroke depending on the structure of gravity and the duration of arterial hypertension
Authors: Т. М. Черенько  , Ю. Л. Гелетюк
Published: December 2018

Hypertension is one of the main modifiable independent factors of stroke and one of the leading factors that can determine stroke course and its outcome. Evaluation of hypertension severity and duration in patients with acute ischemic stroke of different neurological deficit, pathogenesis, localization and size of the damage area will contribute to adequate prediction of stroke outcome and will improve its prevention.The objective: to characterize ischemic stroke depending on its clinical and instrumental features in view of the hypertension severity and duration.Materials and methods. Complex clinical and neurological examination of 150 patients: 74 (49,3%) women and 76 (50,7%) men aged 43 to 80 years (mean age – 67,4Ѓ}0,7 years) with acute ischemic stroke and documented history of arterial hypertension was provided. Stroke severity was assessed using the NIHSS scale. The diagnosis of hypertension, its severity and duration was based on data from clinical, instrumental examination and medical documentation.Results. Severity of ischemic stroke by the NIHSS scale was 9,5±0,35 points on admission; 57,4% of patients had moderate neurological disorders. The mean anamnestic duration of hypertension was 12,3±0,64 years. Hypertension with its duration more than 6–10 years (46%) was observed the most commonly. Hypertension duration in anamnesis significantly correlated with the severity of neurological deficit on admission. Analysis of the patients differentiation by the hypertension stage showed that almost half of patients had hypertension, stage II – 72 (48,0%), about one third – 48 (32%) patients – hypertension, stage III, in 20% of patients mild hypertension was observed. The relationship between hypertension duration and its degree was moderate and direct, r = 0,592 (p = 0.001), as well as between the NIHSS score and hypertension stage, r = 0,612 (p = 0.001). In case of severe stroke, patients with hypertension, stage III were dominated – 26 (68,4%) (p<0.05). Hypertension, stage I was mainly associated with the development of minor and moderate-severe stroke in most patients – 28 (93,3%).Conclusions. The proportion of hypertension of different stages, both severity and duration, is not the same in stroke patients and depends on the stroke severity. The proportion of hypertension of different stages and duration significantly differed in the pathogenetic stroke subtypes. There was no significant difference in the hypertension duration and its severity structure in patients with different sizes of infarct zones. Hypertension severity and duration in anamnesis significantly affect ischemic stroke severity on admission that require early diagnostics improving, prevention of severe hypertension, and also predetermines further study of the hypertension effect on the stroke outcome.
Tuberculosis in the family doctor practice: peculiarities of documents formation for MSEC
Authors: І. С. Борисова  , Г. Ю. Трайдук  , Н. А. Марченко
Published: December 2018

The article defines the role of the family doctor in the medical and social expertise of disability for tuberculosis patients, using modern regulatory legal acts. There is a complicated epidemiological situation In Ukraine. In this regard, the connective work between phthisiatricians and family doctors became very important. Especially, it concerns cases of dispensary registration and rehabilitation of some categories of tuberculosis patients. The using of data presented in the publication will improve the family doctor qualified care in medical and social expertise of population.
Organization and monitoring of timely medical and psychological care at the first level in acute and post traumatic stress disorders
Authors: Л. Г. Матвієць
Published: December 2018

The article presents modern views with acute stress disorder and post-traumatic stress disorder in terms of epidemiology, etiology, pathogenesis and diagnosis at the first level of medical care. The fundamental principles of treatment and rehabilitation of patients with acute stress disorder and posttraumatic stress disorder, general practitioners and family doctors are considered. Present article devoted to the steps for implementation unified clinical protocol of the primare, secondary (specialized) and tertiary (highly specialized) medical care «Reaction to severe stress and adaptation disorders. Post traumatic stress disorder» to the practical activities.
Pharmacotherapeutic facets of levofloxacin
Authors: В. Й. Мамчур  , С. М. Дронов
Published: December 2018

According to international post marketing trials, levofloxacin now belongs to the antimicrobial agents being in a great demand in clinical practice. This review article provides the data that characterize its therapeutic efficacy in current clinical practice in the face of growing resistance of pathogenic microorganisms, pharmacokinetics, pharmacodynamics, and safety.
The treatment efficacy of comorbidity of hypertension and irritable bowel syndrome
Authors: В. І. Тарасова
Published: December 2018

The objective: is evaluation of the treatment efficacy of combination therapy with metoprolol and magnesium supplementation to control comorbidity of hypertension (HTN) and irritable bowel syndrome (IBS).Patients and methods. Among 112 patients with HTN, IBS was existed in 52 patients. All patients were measured BP over time. Ambulatory blood pressure monitoring (ABPM) was performed to 30 patients. The concentration of ionized magnesium and calcium were studied in blood serum of 69 patients with HTN. As monotherapy or in combination with other antihypertensive agents metoprolol was used. The complex therapy of 69 patients included magnesium supplementation for 14 days. 43 HTN patients received standard treatment.Results. There was a positive clinical, laboratory and instrumental dynamics in all patients with HTN. Normalized BP was documented by ABPM. Comorbidity of HTN and IBS is associated with a worsening of the current HTN, the worst response to therapy, which was confirmed by the dynamics of clinical BP and ABPM; and required a comprehensive approach with increasing scope and duration of the therapy. Adding magnesium agent to the treatment was accompanied by elimination of calcium and magnesium deficiency. Thus systolic BP in patients with HTN was lower than in patients with HTN and IBS.Conclusions. Antihypertensive treatment with combination of magnesium supplementation coused to eliminating calcium and magnesium deficiency. Сorrection of hypomagnesemia and calcium magnesium ratio in patients with comorbidity of HTN and IBS must be long term.
The risk of chronic kidney disease and diabetes mellitus in patients with arterial hypertension
Authors: В. С. Джуряк  , І. В. Бондарчук  , Л. П. Сидорчук  , М. М. Сем’янів  , Ю. В. Репчук  , Л. Г. Крикливець  , І. Г. Флюндра
Published: December 2018

The objective: the study of individual clinical demographic factors as the risk of chronic kidney disease (CKD) and diabetes mellitus (DM) in 93 patients esentsiynu arterial hypertension (EAH) in general medical practice.Patients and methods. Among the patients 49 (52.69%) men and 44 (47.31%) men, mean age 58,80 ± 9,60 years, disease duration from 4 to 25 years (average 15.2 ± 2 '68). At present 12 people with diabetes type 2 diabetes and CKD. All patients were complex research: general clinical, laboratory, instrumental and consult an ophthalmologist and neurologist.Results. It was established that obesity is a marker that increases the risk of DM in patients with EAH in 1,54 times [OR=2,63; OR 95% CI=0,73–9,44; p>0.05]. Body mass index ≤ 24,9 kg/m2, hyperglycemia and alanine aminotransferase elevation in blood (ALT >0,68 mmol/h*ml) cause the risk of CKD increase in 2,45 times [OR=3,18; OR 95% CI=0,82–12,37; p>0,05], 5 times [OR=25,0; OR 95% CI=2,92–213,9; p=0,001] and 3,37 times [OR=4,56; OR 95% CI=1,12–18,59; p=0,045], respectively. Increased body weight and obesity did not affect the risk of CKD in patients with EAH.Conclusion. The hypertension degrees are not associated with DM appearance in EAH patients, but EAH 3rd degree increases the CKD risk in 13,5 times [OR=16,0; OR 95% CI=1,33–192,8; p=0,043].
Optimal combinations of metabolic drugs for the treatment of cardiovascular disorders
Authors: М. М. Селюк  , М. М. Козачок  , І. М. Льовкін  , О. В. Селюк
Published: December 2018

This review of the literature is devoted to cover issues of the formation of ATP in the cells both in terms of adequate blood supply and under conditions of ischemia. The basic mechanisms of adaptation to ischemia in cardiomyocytes are described. Discovered the role of nitricoxide in the pathogenesis and progression of major cardiovascular diseases.The data of research proving the feasibility of L arginine in the treatment of diseases of the cardiovascular system.Demonstrated reasonable evidence of the necessity to use meldonium to improve vital signs of patients suffering from cardiovascular disease. Given the metabolic effects of drugs on different pathogenesis of cardiovascular diseases and data analysis of numerous studies, we recommend the most rational in terms of performance and safety combination of these drugs.
Determination of the neurological state of the patiens with spinal dyzrafiya in depending on the neural segmental level of destraction of the spinal cord
Authors: Ю. М. Гук  , Т. М. Секер  , А. І. Чеверда
Published: December 2018

The objective: to determine the neurological status of patients with spinal dyzrafizm depending on the neuro segmental level of the spinal cord lesion.Patients and methods. Treat analysis of 58 patients aged 5 to 18 years. Defined: function of cranio cerebral nerves, state of liquor system of the brain, muscle tone, tendon reflexes, sensitivity, muscle strength of upper and lower limbs, the ability to movement. To determine muscular strength and depth of paresis of the lower limbs used six point scale assessment of muscle strength by M. Weiss and L. McPeak, ability to move evaluated by Hoffer et al. classificationResult. In 11 patients were carried CSF shunt surgery during the first year of life, patients under the supervision of a neurosurgeon. In all patients was noted a decrease the muscle tone, tendon reflexes of the lower extremities and reducing surface sensitivity according to the level of injury. Upper limb muscle strength was not broken, in the lower limbs was reduced to 1–3 points. According to the functional  muscle strength of the lower limbs and the actual degree of movement of all patients were divided into five functional groups.Conclusion. Defining features of neurological manifestations in patients with consequences of spinal dyzrafizm facilitates timely neurological and orthopedic treatment, wich allows to improve the quality of life.
Management of patients of elderly age with acute bronchitis on the background of comorbid pathology
Authors: І. М. Фуштей  , С. Л. Подсевахіна  , О. С. Чабанна  , О. І. Паламарчук  , О. О. Савченко
Published: December 2018

The objective: The goal of the study was to evaluate ergosterin and azithromycin administration clinical efficacy and safety in the treatment program of elderly patients with acute bronchitis and comorbid pathology.Patients and methods. 36 patients (20 men and 16 women, mean age –  71,4±1,5 years) with acute bronchitis and comorbid pathology (diabetes  mellitus type 2, chronic heart failure NYHA functional class III–IV,   bronchial asthma, rheumatoid arthritis) were examined. Acute bronchitis reatment program included erdostein in the dose of 300 mg twice daily and azithromycin in the dose of 500 mg on the first day, followed by 250 mg from day 2 to day 5. Observation period of the dynamics of the condition lasted for 2 weeks. To evaluate the effectiveness of the therapy, an individual patient card was used, which included a daily score on the scale of such symptoms: shortness of breath, cough, the nature and amount of sputum, the consistency of sputum, general health.Results. As a result of research not shown znachymыh It would set limitations Application for drugs. Provedennыy safety analysis allows us Set withdrawal of good safety profiles and эrdosteyna Treatment with azithromycin patsyentov pozhyloho age with komorbydnoy pathology.Conclusion. Both physician and patients noted the reduction in the timing of reduction of such major symptoms as cough and dyspnea against the background of ongoing therapy. Also, on the background of therapy, attending physician and patients revealed significant improvement of the patients’ well being and life quality. The addition  of ergosterin and azithromycin to therapy did not lead to any increase in the incidence of adverse events.
Study of the insulin gene in children with insulin-dependent diabetes mellitus in the Azerbaijani population
Authors: Г. А. Ахмедов
Published: December 2018

Insulin-dependent diabetes mellitus is autoimmune disease and in persons with an identical genotype frequency of its occurrence can be up to 70%. In the hereditary transmission of the disease, special loci are involved, which are called IDDM1, IDDM2, etc. The IDDM2 gene belongs to the INS gene.The objective: the study of the insulin gene in representatives of the Azerbaijani population.Patients and methods. The insulin gene was studied in 160 children with diabetes mellitus type 1, and in 271 healthy people from the Azerbaijani population. Of the 160 patients, 50.6% (n = 81) were boys, 49.4% (n = 79) were girls. All patients with diabetes were under the age of 18 years. The average age of the patients was 9.1 years. The survey was conducted on the basis of children’s clinical hospital number 6 in Baku  city. For all patients, a special questionnaire was filled out. Only children of Azerbaijani nationality were included in the study. As a comparison group, 271 students from the Medical College No. 1 in Baku were involved. Of these: 29.1% (n = 79) were boys, 70.9% (n = 192) girls.Results. Collected blood samples were sent for further study by the medical genetic laboratory of the University Hospital of Motol at Charles University, located in the city of Prague (Czech Republic).Conclusion. According to the data obtained in our study, it can be argued that in the Azerbaijani population the insulin gene 23HphI does not play a role in the development of diabetes mellitus.
Thrombocytopenia as a differential diagnostic problem in clinical practice
Authors: С. В. Видиборець
Published: December 2018

The modern sidhts on etiology, pathogeneses, diagnosis, differential diagnosis and treatment of the thrombocytopenia are described. The special attention was paid to their laboratory diagnosis.
The complex biochemical study of the content of glycolisis in erythrocytes of active blood donors
Authors: В. В. Орлик
Published: December 2018

The objective: Research purpose: to study the dynamics of maintenance of glucoso-6-phosphatdegidrogenase in the red corpuscles of peripheral venous blood of active donors.Patients and methods. 76 donors were inspected in age from 19 to 56 years (48 men and 28 women). The content of iron in the blood whey (SZH) and index of general iron binding ability of the whey (OZHSS) were determined by batofenantrolin method. The index of the unsaturated iron binding ability of the whey (NZHSS) was calculated as a difference between OZHSS and SZH. The coefficient of saturation of transferrin by iron (KNTZH) was determined as correlation of maintenance of SZH to OZHSS. The contents of transferrin (TF) was determined on the index of OZHSS, ferritin (FN) by a radiometric method.Results. The main indicators of iron metabolism and existence of glucoso-6-phosphatdegidrogenase in erythrocytes of active blood donors due to donor experience were studied during the process of correction of the revealed breaches by iron sulfate.Conclusion. The revealed changes prove that long term donation directly depends on number of donations, term of donation and is associated by formation of latent iron deficiency.
Discoid lateral meniscus of the knee-joint (questions of classification and diagnostics)
Authors: О. А. Бур’янов  , Ю. Л. Соболевський  , О. В. Рябікін  , Л. А. Міроняк  , Ф. Хасанзаде Гасабех
Published: December 2018

In this article is analysed MRI of knee-joints of 409 patients and results of 15 knee joint arthroscopic revisions of patients with a discoid lateral meniscus. Considered a few classifications of discoid lateral meniscus types. Based on the possibilities of MRI and arthroscopy in detecting of discoid lateral meniscus abnormalities, taking into account the correlation these researches’ results there was highlighted Watanabe classification as the main for discoid lateral meniscus description as at MRI so at during arthroscopy. The third type of discoid lateral meniscus in Watanabe classification is selected as most clinically significant, while it is most hardness differentiated on MRI, that requires further scientific research.
Empirical antibiotic therapy for acute infections of the urogenital system with fluoroquinolone levofloxacin in the practice of a family doctor
Authors: В. В. Козлов  , М. В. Трофімов  , Д. А. Ісаєвський
Published: December 2018

The issues of prevention and treatment of infections of the genitourinary system are important not only for urologists and nephrologists, but also for general practitioners. It is the primary care physicians, in the first place, that help this category of patients. The article presents the results of studying the efficacy, safety and tolerability of Levofloxacin, as well as its effect on clinical course and laboratory parameters in empirical antibacterial therapy of patients with acute infections of the genitourinary system. The results obtained demonstrate high clinical and bacteriological efficacy, good tolerability and safety of levofloxacin in patients of this group. Relatively low cost and affordability makes it possible to recommend levofloxacin as an antibacterial first line drug for empirical antibacterial therapy of urinary tract infections in the practice of family doctors.
Modern approaches to the diagnosis and management of chronic cholecystitis at the primary level of medical care
Authors: Л. В. Хіміон  , О. Б. Ященко  , С. В. Данилюк  , Т. О. Ситюк  , Н. В. Кіча  , Т. М. Будько
Published: December 2018

The article presents the main etiological factors, diagnostic criteria and tactics for the management of patients with chronic noncalculous cholecystitis under the conditions of the primary care unit. The algorithm of the action of the general practitioner – family medicine in the management of patients with chronic noncalculous cholecystitis is formulated. The main directions of primary and secondary prevention of this pathology by the family doctor are given.
Assessment of underlying causes in patients with implantation fails in ivf cycles
Authors: Л. В. Суслікова  , А. В. Сербенюк
Published: December 2018

The article presents an analysis of literature data and the results of own retrospective studies of the incidence of cases of lag in the development of the endometrium in women with unsuccessful attempts to treat infertility of tubal peritoneal genesis using auxiliary reproductive technologies (ART). Clinico-anamnestic factors that negatively affect the state of the endometrium and are associated with the risk of an unsuccessful attempt at treatment have been revealed.The objective: to retrospectively analyze the cases of unsuccessful attempts to treat tubal peritoneal infertility in order to elucidate the frequency and extent of the development of the endometrium in the proliferative phase of the cycle in ART programs, as well as clinical and anamnestic factors negatively affecting the endometrium.Materials and methods. A retrospective analysis of 838 attempts to treat infertility of tubal-peritoneal genesis by ART methods was carried out. The criteria for selecting patients in the study were: 1) the reproductive age from 20 to 40 years; 2) normogonadotropicity; 3) absence or complete obstruction of the existing fallopian tubes; 4) absence of endometriosis, hyperprolactinemia, diabetes mellitus and other endocrine disorders; 5) absence of pathology of the uterus body; 6) normospermia in men. The embryological protocol indicates that embryos are of satisfactory quality, the number of embryos is two or more.Results. In cycles of infertility treatment of tubal peritoneal genesis by ART methods, the lag in the development of the endometrium (of varying severity) is 1/3 of the total number of cycles performed. Hypoplasia of the endometrium, found on the 7th day of the stimulation cycle, persists throughout the proliferative phase before the administration of hCG in 100% of patients. In patients with a marked lag in the development of the endometrium compared with women with normal and moderate retardation, intrauterine manipulation and their complications from anamnesis are significantly more frequent.Conclusion. The results of the study clearly demonstrate the need to analyze the effectiveness of the use of conventional methods for correcting deviations in the development of pregravid endometrium in cycles of treatment with assisted reproductive technologies (ART) and the impact of various degrees of lag in the development of pregravid endometrium on the clinical consequences of ART-infertility programs of tubal peritoneal genesis and their optimization.