bluuebunny/crossref_metadata_2025 huggingface dataset:
Antihistamine Therapy: Levocetirizine in the Practice of a Family Doctor
Authors: М. М. Кочуєва  , А. В. Рогожин
Published: September 2019

Allergic diseases with each passing year attract more and more attention from doctors of different specialties. Despite the fact that allergic diseases have been known to humans for more than two and a half thousand years, today’s world problems associated with the diagnosis, treatment and prevention of allergic pathologies remain very relevant. Over the past decade, the problem of allergy has embraced the scale of the global medical and social problem. At the same time allergic diseases suffer from 10–15% of the population. According to world statistics, in the structure of all allergic diseases 20–40% is allergic rhinitis (AR) and about 7–10% is bronchial asthma (BA), as well as 15% of patients with AR suffer from asthma and 76% of patients with asthma have AR. This article is based on numerous studies and emphasizes the importance of choosing the right drugs for the treatment of allergies. The Ukrainian and foreign literary sources, as well as the results of studies on the efficacy of Levzirin compared with other popular antihistamines, were studied and analyzed. Levzirin in the treatment of allergic diseases, in the complex therapy of respiratory pathology, which runs on an allergic background, demonstrates greater effectiveness in terms of suppression of the skin response to histamine than other popular H1-histamine receptor antagonists. Levzirin was more effective in influencing hyperemia compared with Loratadine. In one study, Levzirin showed a faster onset of action when the symptoms of seasonal allergic rhinitis were lessened in patients who were exposed to grass dust and also proved to be more effective than Fexofenadine, 22 hours after taking the medication and later, indicating a longer duration of action and the activity of this drug. When evaluating the effectiveness and safety of Levzirin and Olopatadine, it turned out that the latter was associated with a more pronounced side effects profile. Given the findings, Levzirin is an effective and safe agent of antihistamines of the new generation, so it is advisable to recommend it to patients with allergic diseases, which will improve their general condition and quality of life.
Management of Patients with Systemic Lupus Erythematosus at the Stage of Primary Care: Answers to Frequently Asked Questions
Authors: І. Ю. Головач  , Є. Д. Єгудіна
Published: September 2019

Systemic lupus erythematosus (SLE) is an autoimmune disease in which many systems and organs are affected, including skin, musculoskeletal system, renal, lungs, hematologic,  cardiovascular, nervous and reproductive systems. Family physicians should be familiar with the manifestations of lupus to aid in early diagnosis, monitoring patients with mild disease, recognizing warning signs of exacerbation that require referral to a rheumatologist, and helping to monitor disease activity and treatment in patients with moderate to severe disease. The American College of Rheumatology offers 11 classification criteria for SLE diagnosis. If a patient meets at least four criteria, lupus can be diagnosed with 95% specificity and 85% sensitivity. All patients with SLE should receive information about the disease, regular counseling, and medical support. Hydroxychloroquine is the cornerstone of treatment, reducing the frequency of disease flares and other common symptoms. Low doses of glucocorticoids can be used to treat most manifestations of SLE. The use of immunosuppressants and cytotoxic agents depends on depends on the body systems affected. To optimize treatment, to improve chronic care, prevent and screen for the comorbidity presence, strong collaboration between a rheumatologist, a patient, and a family physician is important. In this review, we summarize practical recommendations for family physiacians and provide updated information regarding the early diagnosis and management of a patient with SLE, discuss the main associated diseases that complicate the course of the disease, and recommended preventive measures.
Features of the Lipid Profile in Different Activity of the Components of the Renin-angiotenzin-aldosterone System in Patients with Essential Hypertention and Obesity
Authors: М. М. Кочуєва  , В. Г. Псарьова  , Н. М. Кириченко  , Л. А. Рубан  , Г. І. Кочуєв  , А. С. Шалімова
Published: September 2019

The objective: the aim of the study was to evaluate the features of the lipid profile in the case of different activity of the components of the renin-angiotensin-aldosterone system in patients with arterial hypertension (AH) and concomitant obesity.Materials and methods.188 patients with essential hypertension (EH) and obesity I–II degrees were examined (who gave informed written consent to participate in the study and met the inclusion criteria). The control group consisted of 25 practically healthy individuals, matched by age and sex with the main group patients.Results. It was established that in patients with comorbidity of EH and obesity I–II degrees, the low-renin AH (LRAH) was found in 9,4% of cases. The LRAH and high-renin AH (HRAH) in obese patients did not differ in anthropometric indices.Conclusion. In the presence of LRAH in patients with obesity I–II degrees the levels of atherogenic lipoproteins were significantly lower than in HRAH.
Indicators of Quality of Life and Functional Status of Patients with Arterial Hypertension and Gout
Authors: Г. П. Кузьміна  , О. М. Лазаренко
Published: September 2019

The objective: to evaluate the quality of life (QOL) and functional status of patients with arterial hypertension (AH) and gout, to determine the factors influencing the QOL in this category of patients.Materials and methods. The study included 61 patients with AH, mean age (SD) of 54,25±10,29 years, which were divided into 2 groups: group 1 (n=36, main) –patients with AH and gout, group 2 (n=25, comparison) – patients with AH. The control group included 10 patients. The QOL was evaluated using the Short Form Medical Outcomes Study (SF-36) questionnaire, the Health Assessment Questionnaire (HAQ-DI) and the 10-point Patient Global Assessment (PGA).Results. Patients with AH and gout were more likely to have lowered their physical health indicators and the role-emotional. The average value of the HAQ-DI questionnaire was significantly lower in the main group, and on the PGA scale, in the main and comparison group.Conclusion. QOL of patients with AH and gout has been reduced to a greater extent in comparison with patients without gout due to chronic pain syndrome, functional constraints, psychological problems. Factors affecting the lung in this category of patients are the clinical manifestations of AH and gout: age, number of exacerbations of AH per year, total cardiovascular risk (TCVR), total number of affected joints, severity of gout, comorbidity.
Efficiency of Phytoimmunocorrection in Case of Recurrent Respiratory Infections and in the Case of Their Combined Course in Children Against the Background of Undifferentiated Connective Tissue Dysplasia
Authors: Г. С. Барчан
Published: September 2019

The objective: to study the effectiveness of treatment of recurrent respiratory infections, as well as in the case of their combined course in children with undifferentiated connective tissue dysplasia (NDST).Materials and methods. The analysis of the effectiveness of the use of the phytoimmunomodulator Imupret® was carried out in 89 children who were divided into two groups: 1st group – 43 children with recurrent respiratory infections (RRI), 2nd group – 46 children with RRI on the background of NDST. The program for studying the functional state of the system was complex.Results. In the group of children with RRI without NDCT, after the treatment, positive dynamics was revealed, which manifested a significant (p <0.05) increase in the proportion of Lymphocyte tact from 38.7 ± 0.74% to 42.6 ± 0.8%; a significant (p <0.05) increase in the specific weight of CD3+lymphocytes from 55.2 ± 0.84% to 57.4 ± 0.42%; a significant (p <0.05) increase in the specific gravity of CD4+lymphocytes from 37.59 ± 0.85% to 42.9 ± 0.73% and, in fact, «normalization» of IC RBTL (before treatment – 24.8 ± 1.5 u, after treatment – 28.7 ± 1.3 units).Under the influence of the phytoimmunomodulator, the phagocytic and metabolic functions of granulocytes improved significantly (p <0.05) (the NBT test), including significantly (ph <0.05) the phagocytic number increased from 50.6 ± 1.5% to 57.5 ± 1.3%, respectively, and phagocytic index – from 5.1 ± 0.2 to 5.9 ± 0.2.Conclusion. The results of the study indicate the benefits of improving the functional state of granulocytes under the influence of the drug Imupret®. In general, the state of T-, B- and phagocytic chains of immune protection after treatment is characterized by full compliance of immunograms with reference values.
Сardiac tumors. Literature Review and the Clinical Case
Authors: Б. М. Юрочко  , Л. І. Бурлакова  , С. М. Романов
Published: September 2019

Сardiac tumors are a rare pathology with a polymorphic clinical picture and the complexity of intravital diagnosis. All neoplasms of the heart are divided into primary benign (75% of all primary tumors) and malignant (25%), and secondary malignant tumors. Most cases among primary cardiac tumors are myxomas, which are more often localized in the left atrium (in 75% of cases). In addition to cardiac myxoma, a group of nonmyxomatous benign heart tumors is distinguished: rhabdomyomas, fibromas, lipomas, leiomyomas, angiomas, neurinomas and others. Primary malignant neoplasms are mainly represented by sarcomas. Secondary (metastatic) neoplasms occur 13–40 times more often than primary tumors. Clinical manifestations of cardiac tumors depend on the infringement of inflow or outflow from the affected heart chambers, the presence of an embolic syndrome, the general reaction of the organism to a tumor. Echocardiography is the main research method for the initial diagnosis of cardiac tumors, which pelps to determine the size of the tumor, localization, attachment site, mobility, the relationship with the valve apparatus and the character of hemodynamics. Modern methods of research use magnetic resonance imaging and computed tomography. Treatment of benign heart tumors is surgical. In the treatment of malignant tumors, three methods are used: surgical, radiation and chemotherapy. The article presents the clinical case of a patient with a left atrial and pericardial tumor without obstruction of blood flow.
General Practice in Netherlands: Professional Training and Organization of Medical Care
Authors: В. І. Ткаченко  , О. І. Алексейченко
Published: September 2019

The collaboration of Ukrainian movement of young general practitioners (UMYGP) with the Dutch organization LOVAH (Netherlands) provides the opportunity for many young Ukrainian general practitioners/family doctors (GPs) to take part in experience exchange programs that include 1 day visiting practice of Dutch GP, 1 day participation at GP professional training at university and 2 days participation at the conference in family medicine. The article represent the received experience from dutch exchange program about features of professional training of family doctors, organization of primary care, working day of family doctor, using computer registration system. The experience and active work of the UMYGP representatives allows young family doctors to gain international practice, promote the status and prestige of the general practice/family medicine in the country, especially among young people, helps to improve the development of family medicine in Ukraine, medical and scientific specialty «General practice-family medicine».
Seasonal Influenza Vaccination – Modern View to the Issue
Authors: О. В. Оніськова  , Л. О. Ющенко  , В. С. Олійник  , В. О. Тихолаз
Published: September 2019

The objective: is to evaluate the attitude of the Ukrainian population towards seasonal influenza vaccination.Materials and methods. An online survey of social networks in different groups has been conducted using Google Forms with the topic «Seasonal Flu Vaccination». These groups are interested in vaccination. 220 people have been interviewed in the survey.Results. About 27,7% of interviewed people get annual seasonal influenza vaccination. The same number of people has got seasonal 2017–2018 influenza vaccination at first time. 23,2% have never got seasonal influenza vaccination at all. The rest of interviewed people chose other answers, such as they have got vaccine only once or in the past. Some of them chose another answer. The main reasons for the refusal of vaccination are doubtful vaccine quality (31,1%) and low knowledge level about vaccination (23%). The influenza vaccination statistics in different countries, including Ukraine, have been reviewed using world information services and Ukrainian health system.Conclusions. Increasing a public awareness towards vaccination leads to increasing vaccination coverage. The main reasons for the refusal of vaccination are doubtful vaccine quality and low knowledge level about vaccination.
Iron Deficiency Predictors in Patients with Chronic Heart Failure and Reduced Left Ventricular Ejection Fraction
Authors: Л. Г. Воронков  , В. В. Горбачова  , А. В. Ляшенко  , Т. І. Гавриленко  , Л. С. Мхітарян
Published: September 2019

The objective: to study the iron deficiency (ID) predictors in patients with chronic heart failure (CHF) and reduced left ventricular ejection fraction (rLVEF).Materials and methods. In a period from January 13, 2016 till February 28, 2018, on a basis of the Heart Failure Department of National Scientific Center «M.D. Strazhesko Institute of Cardiology, MAS of Ukraine» 134 stable patients with CHF (113 (84.3%) of men and 21 (15,7%) of women), 18–75 years old, NYHA class II-IV, with left ventricular ejection fraction <40% were screened. Patients were included in a clinical compensation phase. Quality of life was assessed by the Minnesota living with heart failure questionnaire (MLHFQ), physical activity was estimated by the Duke University index, functional status – by assessing the 6-minute walking test (6MWT) and a standardized lower limb extension test.Results. ID was found in 83 (62%) of 134 patients with CHF and rLVEF. ID predictors are found to be the presence of anemia, III–IV NYHA functional class and the worse quality of life by the Minnesota questionnaire. There is a lower risk of developing ID in patients with NYHA class II and with greater thigh quadriceps endurance. Probability of ID decreases with higher values of hemoglobin, MCV, MCH, GFR. At the same time, higher levels of citrulline and NTproBNP are reliably associated with increased risk of ID occurrence. According to the results of multivariable regression model, independent ID predictors are decreased erythrocyte’s MCV and elevated NTproBNP level.Conclusions. Among patients with CHF and reduced LV EF, iron deficiency is found in 62% of cases and is dependent on concomitant anemia. Risk of ID is higher in patients with NYHA class III-IV, in patients with poorer quality of life, with elevated citrulline and NTproBNP levels. Hemoglobin, MCV, MCH, GFR and better thigh quadriceps endurance are directly associated with the presence of ID. Independent predictors of ID are MCV and NTproBNP levels.
Reconstruction of the Algorithm for the Appointment of the Start-up Medication of Arterial Hypertension by the European Clinical Protocol (Finland) in the Teaching of Family Medicine on the Pregraduate Level
Authors: Л. С. Бабінець
Published: September 2019

The article analyzes the actual aspects of the introduction into the teaching process of general practice-family medicine at the stage of pregraduation education of the algorithms for the appointment of start-up medication depending on the severity of hypertension in out-patient practice according to the European clinical protocol for primary care (Finland).
Method for the Predicting Renal Failure Progression in Patients with Essential Arterial Hypertension I Stage
Authors: Л. В. Хіміон  , Л. С. Тимощук
Published: September 2019

The article deals with the method of improving the prognosis of kidney damage in patients with essential arterial hypertension І stage. The principle of the method of forecasting, its advantages of use in clinical practice is described. The indexes of dynamic series, stability estimation on the value of rank correlation with the subsequent construction of the regression model of forecasting, determination of its significance by the level of determination are given.The objective: to improve the way of predicting the risk of developing kidney damage in patients with EH I stage.Materials and methods. The study was attended by 129 patients. The main group consisted of 101 patients diagnosed with essential arterial hypertension I stages according to the diagnostic criteria of the WHO/ISH, 2003 (World Health Organization/International Society of Hypertension) and Order of the Minister of Health from May, 24, 2012 No.384 [2, 4, 9]. (the average duration of the EH I stage is 3,7 ±2,1 years, women – 31 (30,7%), men – 70 (69,3%), middle age – 41,0 [33,0-47,0] years); 28 practically healthy persons in relation to the main group as a control group (women – 17 (60,7%), men – 11 (39,3%), middle age – 37,0 (31,0-46,0) years. The following criteria were not included: symptomatic arterial hypertension, valve heart failure, rhythm disturbance, chronic heart failure, chronic kidney disease, diabetes mellitus, ischemic heart disease, patients in the main group did not take antihypertensive therapy. All patients were followed by the following examinations: clinical examination, general clinical blood tests and urine, biochemical blood test (total protein, urea, creatinine, glucose, lipid profile); daily monitoring of AT (DMAT), ECG, Echo-KG and ultrasound of carotid arteries, ophthalmoscopy; and determination of renal function reserve (RFR) water and salt load (according to the Ukrainian patent number 1133692.) [3]. The statistical processing of the results was carried out using Microsoft Excel 2016, an application suite of statistical analysis software IBM SPSS Statistics 20 using a variety of methods of parametric and nonparametric statistics.Results. A prognostic regression model was built, which will help to identify patients with a high risk of kidney damage in stage EH I stage. It was revealed that the most significant factors determining the prognosis of the development of kidney damage during EH are age, gender (male), blood creatinine, rSHCFreat, and the level of DBP.Conclusion. The application of the developed and proposed prediction method will increase the accuracy of the assessment of the probability of development of kidney damage in patients with EH I stage, which will provide an adequate definition of the further tactics of patient management at the stage of primary care with the appointment of a corresponding complex of additional examinations, and therefore, more correct treatment.
Method of Prediction the Development of Arterial Hypertension in Type 1 and 2 Diabetes
Authors: Л. А. Могильницька
Published: September 2019

The objective: to create a mathematical model of prediction the development arterial hypertension in type 1 and type 2 diabetes based on traditional risk factors for cardiovascular diseases and the serum level of vascular endothelial factors.Materials and methods. The study was attended by 97 people. We examined 33 type 1 diabetes patients: 23 hypertensive and 10 nonhypertensive. Also 64 type 2 diabetes patients: 41 hypertensive and 23 non-hypertensive. Were studied BMI, blood glucose, HbA1c, total cholesterol, HDL, LDL, triglycerides, insulin, HOMA, Caro, serum level of EMAP-II, fibronectin, VEGF, ICAM-1, VCAM-1, E-selectin by immunoenzyme assay in all patients. Endothelial-dependent dilatation was investigated by Celermajer metod. Static analysis was performed by metod of logistic regression.Results. In type 1 diabetes patient, among 15 factors, 3 were selected that had a provocative effect on the development of arterial hypertension: blood glucose, EMAP-II, fibronectin. In type 2 diabetes patients, among 18 factors, 5 were identified, the combination of which had a provocative effect on the development of arterial hypertension: BMI, HbA1c, triglycerides, ICAM-1, endothelial-dependent dilatation. A computer program «Estimation of prediction the development arterial hypertension in diabetes mellitus» has been launched based on the obtained mathematical formulas.Conclusion. A computer program «Estimation of prediction the development arterial hypertension in diabetes mellitus» and mathematical models, which formed the basis for it, allow identifying risk factors for arterial hypertension in type 1 and type 2 diabetes patients. Early started preventive work, continuous monitoring of risk factors helps prevent the development of arterial hypertension in these patients.
Features of Diagnostics and Prophylaxis of Fetal Distress in Women with Autonomicdisorders
Authors: Л. І. Воробей
Published: September 2019

The objective: to establish relationships between prenatal stress changes, autonomic disorders and the fetal distress development in pregnant women with perinatal losses in history.Materials and methods. 214 pregnant women were examined. In the 104 pregnant women with perinatal a history of losses, the control group (group II) – 110 women without obstetric history. Study groups were identical in age, duration of pregnancy and parity of childbirth. To study the state of vegetative regulation was usedanalysis of cardiointervalography indicators. Assessment of adaptation reactions was carried out in terms of regulatory activity systems. To study the hemodynamic component of the system «mother–placenta–fetus» was performed by Doppler ultrasound.Results. In the majority of women in control group (82.7%), the normal reactivity of both departments of the autonomic nervous system was noted. Autonomic reactivity in the main group was manifested as sympathotonia in 48.1% of women and hypersympathotonia in 34.6% of patients. The norm-adaptive state was detected in 90% of pregnant women of II group. In 50% of patients with complicated obstetric history a hypoadaptive state of regulatory systems was established. Symptoms of placental dysfunction occurred in 46.2% of pregnant women in group I and in 29.1% of control group patients. Ultrasound signs of fetal distress were found in 10.6% in I group and 2.7% in II group. At the same time, in 7.7% of the main group, fetal distress occurred in preterm pregnancy. In the control group preterm caesarian section due to fetal distress was perform in 0.9% of women.Conclusions. In women with perinatal losses, an autonomic dysfunction, which is manifested by hypersympathotonia, and disorders of regulatory and adaptive mechanisms are installed, which lead to a functional reserves exhaustion. In pregnant women with perinatal losses a greater frequency of placental dysfunction with the hemodynamic disorders in the system of «mother–placenta–fetus» and fetal distress are observed due to established autonomic disorders.
Primary Health Care Center as a Form of Organization of Family Medicine of the United Territorial Community
Authors: Л. В. Глушко  , Х. С. Симчич  , Т. Ю. Гавриш  , В. Т. Рудник  , М. М. Островська
Published: September 2019

The article is devoted to the analysis of the modern process of reorganization of healthcare institutions of the united territorial community (OTG) and the algorithm for creating a center of primary medical and sanitary care. The legal framework of medical reform and aspects of the activity of the primary medical care system of the OTG were studied. Modern approaches to the organization of a patientoriented model of primary care and the implementation of measures to improve medical and technical equipment and the financial distribution of funds are highlighted. It has been established that the creation of a primary health care center in financially independent communities will make it possible to fully embody a patient-oriented model in compliance with the development directions and principles of primary care in rural areas. The best is a clear division of labor between the economic part and the medical work. Promising is the conclusion of contracts in the framework of inter-municipal cooperation and civil-law relations with general practitioners-family medicine, who work as individual entrepreneurs.
Epidemiology, pathogenesis, molecular characteristics, classification and prognosis of the diffuse large B-cell lymphoma
Authors: С. М. Гайдукова  , С. В. Видиборець  , Ю. Ю. Попович
Published: September 2019

The article presents the results of systematic review of the available literature sources (search in JAMA, Scholar, NCBI, Cochrane Library and PubMed databases, 2007–2018 has been performed) about the epidemiology, pathogenesis, molecular characteristics, classification and risk factors of the epidemiology, pathogenesis, molecular characteristics, classification and risk factors of the diffuse large B-cell lymphoma (DLBCL).
Effect of L-arginine Aspartate on Plasma Hemostasis in Patients with Hypertension Stage II with Concomitant Hyperuricemia
Authors: М. С. Валігура
Published: September 2019

The prevalence of hypertension is increasing in many countries and is an important risk factor for cardiovascular morbidity and mortality. The established risk factors for hypertension include aging, dyslipidemia, and diabetes. Recently, the role of an increased level of uric acid as a risk factor for atherosclerosis, endothelial dysfunction, and hypertension has been actively studied.The objective: аnalysis of L-arginine aspartate on the parameters of plasma hemostasis as a hemostasiological component, which reflects the severity of endothelial dysfunction in patients with hypertension stage II with concomitant hyperuricemia.Materials and methods. We examined 74 patients (43 males and 31 females), whose average age was 55,86±6,34 years, all patients were divided into 2 groups. The first group consisted of 26 people with arterial hypertension with normal uric acid levels, the second group consisted of 34 people with hypertension and concomitant hyperuricemia, and the control group consisted of 14 healthy individuals matched for age and sex.Results. When treating L-arginine aspartate, fibrinogen level decreased by 17,9% (p=0,05) in hypertensive patients and by 25,4% (p<0,001) in hypertensive patients with concomitant hyperuricemia, thrombin time increased in patients I groups by 40,2% (p<0,001), in group II by 65,8% (p<0,001), an increase in soluble fibrin monomer complexes is observed in all groups of patients: in the group of hypertensive patients without hyperuricemia by 39,2% (p<0,001), with combined pathology by 34,6% (p<0,001) in comparison with the baseline indicators of these patient groups. On the part of the anticoagulant system, we observed an increase in the level of antithrombin III by 27,3% (p<0,01) in hypertensive patients and by 23,4% (p<0,01) in patients with combined pathology, an increase in the level of protein C by 8,99% (p<0,05) in group I patients and 11,26% (p<0,01) in group II patients. Indicators of the fibrinolytic system of blood such as Hageman-dependent fibrinolysis decreased by 33,8% (p<0,001) in group I of patients and by 32,1% in group II of patients, plasminogen in group I increased by 22,6% (p<0,01) and in group II by 27,8% (p<0,001).Conclusion. The use of L-arginine aspartate in patients with hypertension stage II in combination with hyperuricemia, as a secondary prevention, provides improved plasma hemostasis and has an indirect effect on the activity of inflammation as a component of the cardiovascular continuum.
The Influence of Risk Factors on the Duodenum Ulcer Disease Development Among School-age Children
Authors: Д. В. Мельник
Published: September 2019

This article highlights the results of the analysis of digestive system diseases, which are risk factors for a duodenum ulcer disease development. This pathology is the second rate such in adults as in children at present. The prevalence of chronic gastritis and duodenitis among school-age children are 27,66% in the structure of the prevalence of diseases of the digestive system of this age group. The prevalence of chronic gastritis and duodenitis among children aged 15–17 years is 3.89 times higher than among children aged 0–14 years. Our researches have shown a high level of the prevalence of the digestive system various diseases among children, which are risk factors for the development of duodenal ulcer diseases. The current situation may be linked not only with economic instability, but also with the prevalence of harmful habits among children, neglect of a healthy lifestyle, etc.The objective: to study the influence of risk factors on the status of digestive system diseases in school-age children, primarily – of a duodenum ulcer disease.Materials and methods. The method of semantic evaluation of scientific documents and the method of system and process analysis were used.Results. Analysis of the studies show that there has been a lack of attention of parents, health workers and teachers to improve the physical activity of children. The reduction of physical activity of school-age children, restrictions on sports, as well as the majority of children «sedentary» lifestyle reduce energy costs, while the energy value of diets is growing. The dynamics of the distribution of schoolage children by health groups indicates a decrease the number of children with the first group of health according to school age in 2016: 21,5% (Junior), 12,6% (average), 10,8% (senior), while their peers 50 years ago there was a different proportion of the increase in the number of healthy children, in particular, 36,5% (Junior), 47,1% (middle), 62,0% (senior school age) with age. The definition of risk factors for child’s health allows us to determine the real threat to the schoolage children health, and makes it possible to prevent the duodenal ulcer disease in the early stages by of preventive measures.Conclusion. The researches results indicate an increase in the incidence, deterioration of physical and neuropsychological development, decrease in the level of physical activity of school-age children, which should be taken into account in the organization of treatment and preventive care for schoolchildren and is a confirmation of negative trends in the health of children in the modern world stage.
The Influence of Combined Therapy on Lipid, Glucose Profile in Patients with Diabetes Mellitus Type II
Authors: О. П. Федорова  , О. В. Дудко  , О. А. Світлицька  , Т. І. Кікнадзе
Published: September 2019

According to the International Federation of Diabetes, 7% of the population of the world suffers from diabetes. Optimizing the treatment of diabetes with herbal medicines will reduce the patient’s drug burden.The objective: the aim of the study was to assess the efficacy of combined treatment with the complex vitamin-herbal pills Insuvit, Metformin and Atorvastatin in patients with diabetes mellitus type II.Materials and methods. 69 patients (women – 44, men – 25) were treated with diabetes mellitus type II in the therapeutic department of the University Hospital of the ESMC «University Clinic». The average age was 63,4±7,82 years, the duration of diabetes – 7,0±4,11 years. Fasting blood glucose levels, glycosylated hemoglobin (HbA1c), lipid profile were determined onset. Patients were randomized on 2 groups: the main group – 33 patients, who received additionally Insuvit (1 tablet twice a day) for 12 weeks to standard therapy (20 mg of Atorvastatin, 1000 mg of Metformin). Control – 36 patients with similar therapy, but without the appointment of Insuvit.Results. The levels of HbA1c (by 10,7%), glucose (by 14,7%) and triglycerides (by 35,4%) (p<0,05) significantly decreased after 12 weeks therapy in the main group in comparison with control group. In 39,4% patients of the main group there was s decrease in the sensation of paresthesias, which led to an improvement in overall well-being.Conclusions. The additional use of the drug Insuvit accelerates the compensation of glucose and HbA1c levels in patients with diabetes mellitus type II, which allows them to reach their target levels more quickly.
Modification of the Pre-conceptional Treatment Program at the Stage of Pregnancy Planning Regarding the Psychoemotional State of Women
Authors: Н. В. Якимчук  , Н. І. Геник
Published: September 2019

The course of normal pregnancy is accompanied by significant changes in the functioning of almost all physiological systems and the tension of adaptive processes to new requirements, while the complicated period of pregnancy, is an extremely strong psycho-emotional factor.The objective: was to determine the structure and prevalence of the types of psychological component of gestational dominant (PCGD), taking into account psycho-emotional state in women, to assess its impact on reproductive loss and complicated pregnancy as well as to develop a modified complex of pre-conceptional treatment.Materials and methods. In order to solve the target tasks, we conducted an experimental psycho-diagnostic study and an in-depth clinical and laboratory-instrumental examination of 120 patients with a burdened reproductive history who underwent the preconceptional treatment on the basis of the Conscious Parenthood Center «Divia». The assessment of the psychological component of the gestational dominant was carried out by the method of «Pregnant woman attitude test» by I.V. Dobriakov, modified for pregnant patients, Spielberg’s and Beck’s tests were also used to assess the level of personal and reactive anxiety and signs of depression. The state of the vegetative nervous system was assessed on the basis of the main characteristics: vegetative tonus, vegetative index (SI) Kerdo), vegetative reactivity and vegetative maintenance of activity (orthostatic test). For the evaluation of the effectiveness of the proposed pre-bladder training from 120 women, where the type of PCGD was assessed, 70 patients with anxiety and depressive type of PCGD were identified, which formed two groups: the main (35 women) who received the proposed complex of psychological and medicamental correction, and the comparative group (35 patients), where the pre-conceptional treatment included traditional, in accordance with modern guidelines, – folate therapy.Results. Experimental and psychodiagnostic research allowed to establish a high percentage of unfavorable pregnancy types of PCGD, among which the most sufficient were anxiety and depression types. Most attention on the specifics of pregnancy course deserve differences in the incidence of preterm delivery, preeclampsia resistance to treatment and the proportion of labor activity anomalies and its medicamental correction, which 2.6 times prevailed in case of anxiety and depression types of psychological components of gestational dominant.Conclusion. The proposed pre-conceptional treatment, modified by a differentiated complex of psychological correction and a medicamental package with the inclusion of neuroprotectors and plant adapters, allowed not only to strengthen the adaptation mechanisms at the stage of pregnancy planning, but also to significantly reduce the proportion of gestational complications in the process of its monitoring.
International Classification of Primary Care (ICPC-2): History, Structure, Coding Principles (Distance Learning Lecture)
Authors: В. І. Ткаченко
Published: September 2019

The lecture presents data about World Organization of Family Doctors WONCA, one of its working groups – the Committee of the International Classification of Primary Care ICPC, history and prerequisites for its creation, principles of structure and coding, the concepts of the cause of encounter and the episode of primary care are disclosed, coding examples are given for individual causes of encounter, medical problems and processes, as well as episodes.
25 Years on Guard of Medical Education and Health of Prykarpattya
Authors: Х. C. Симчич
Published: September 2019

У 1993 році в Івано-Франківському медичному інституті відбулося відкриття нового факультету інтернатури, а 15 березня 2003 року (наказ ІФДМІ №22/47д від 15.03.1993 р.) – створення кафедри терапії факультету інтернатури. Ректор Івано-Франківського медичного інституту академік Академії наук України, фундатор Прикарпатської школи терапевтів Євген Михайлович Нейко штурвал керівництва кафедрою та заразом і формування післядипломної освіти на Прикарпатті доручив заслуженому лікареві України, д-ру мед. наук, професору Глушку Любомиру Володимировичу.
From a Competent to an Experienced Family Medicine Instructor (According to the Results of the Training Course «Leonardo EURACT. Level 2». Jerusalem, Israel, 2018)
Authors: І. В. Климась
Published: September 2019

The article presents an overview of the event and the experience of participating in the international training course for family medicine teachers «Leonardo EURACT Course Level 2 for Trainers in Family Medicine», 13–16 October 2018, Jerusalem (Israel).
Clinical and Instrumental Assessment of the Intestinal State in Children with Respiratory Pathology and Correction of the Revealed Violations
Authors: Ю. В. Марушко  , Т. В. Гищак  , О. Д. Московенко  , Т. В. Іовиця
Published: September 2019

The need for frequent and long-term use of antibiotic therapy for respiratory pathology of bacterial origin often leads to the development of the intestinal microflora disorders and requires the inclusion of probiotics in treatment regimens. Probiotics containing Bacillus clausii have proven themselves in the treatment of antibiotic associated diarrhea.The objective: to assess the state of the intestine according to clinical data and the results of hydrogen breath test with lactulose in children with acute respiratory diseases and the effectiveness of the revealed violations correction by adding probiotic containing B. Clausii to the complex therapy.Materials and methods. Under the supervision there were 38 children of 4–10 years old, who in the course of antibiotic therapy of acute respiratory diseases were added probiotic containing B. Clausii (Probiz kids). In the І group of the study (20 children), probiotic was used simultaneously with antibiotic therapy for 7–10 days course. The ІІ group was formed by 18 children, for 7–10 days they received Probiz kids after completing a course of antibiotics. At the beginning of treatment, at 10–12 and for 25–30 days from the start of therapy, the presence of intestinal manifestations was evaluated and a hydrogen respiratory test with a load of lactulose was performed (HRTLL).Results. In the first group, on the 10–12th day from the beginning of the study, the syndrome of excessive bacterial growth disappeared in half of the children. But among the children of group II, the normalization of indicators in a repeated study of HRTLL did not occur in one child. On the 25–30 day from the start of treatment, the absence of excessive bacterial growth was detected in 80% of children of the first group and 50% of children of the second group.Conclusion. The results of the study indicate that probiotic Probiz kids has a positive effect on the intestinal state in children against the background of antibacterial therapy.
Croatian Primary Care: Features of Family Doctors’ Training and Work. Ukrainian Movement of Young General Practitioners’ Activity in Exchange Programs
Authors: В. І. Ткаченко  , О. І. Алексейченко
Published: September 2019

The article represents the results of the activities of the Ukrainian movement of young general practitioners, participation in Croatian exchange program, which provided an opportunity to get acquainted with the features of training and work of Croatian family doctors. The achievements and challenges of Croatian primary care and education of family doctors as steps for improvement in Ukraine are described.
PENGEMBANGAN DESAIN ARSITEKTUR DAN INTERIOR YANG REHABILITATIF SEBAGAI PENDUKUNG PENYEMBUHAN SECARA PSIKOLOGIS PADA RUMAH SAKIT IBU DAN ANAK
Authors: Utomo Dian Cahyo
Published: September 2019

Abstract: Given that maternal mortality rate at delivery in Indonesia is still very high, according to UNFPA data in 2013, maternal mortality at delivery is 359 deaths per 100,000 live births. This research aims to create a guideline in the design of maternity and child hospital design that is comfortable and rehabilitative, and able to facilitate the requirement of health services especially children, both mentally and psychologically. This research includes a design guideline that can support not only medically healing patients, but can also support psychological healing. As the concept of green open space design in a room designed to minimize a child's terrifying hospital image, the creation of a child supporting IRNA can keep an intensely ill child, and the concept of maternal IRNA that can be as comfortable as possible , with the aim that pregnant mothers can remain calm at the time of therapy. Creation of supporting facilities and infrastructure for a mother who has fear in childbirth normally.Keywords: Maternal mortality rate, psychological, rehabilitative, maternal and child hospital.
PENERAPAN NILAI-NILAI ISLAM DALAM SEBUAH SIMULASI PERANCANGAN HUNIAN RUMAH TINGGAL SEDERHANA
Authors: Ardhy Surya
Published: September 2019

Abstract: This study aims to explore Islamic values that have implications on the habitation aspects and illustrate how these values can be translated in the physical embodiment of dwelling. Literature review has been done to find the formulation of Islamic principles in residential environment. Precedent study by observing housings close to hypothetical site of the design simulation case was also taken as a part of contextual design approach. The concepts referred in design derived from the formulation of principles and contexts. This study concludes that Islamic values are highly potential to be explored in developing residential design concepts. The principles derived from Islamic values are more universal-qualitative criterias, so that in the realm of design, can be implemented with a very adaptive to the local contexts.Keyword: dwelling, Islamic values, design simulation, context
ALTERNATIF TEKNIK PASSIVE COOLING YANG EFISIEN PADA RUANG AUDITORIUM GEDUNG B UNIVERSITAS ‘AISYIYAH YOGYAKARTA
Authors: Pujiyanti Indah
Published: September 2019

Abstract: The title of this paper research result is “The Passive Cooling Alternatif Technique Which Is Efficient In Auditorium Room ‘Aisyiyah Yogyakarta University. The problem which is going to be discussed in this final assignment research is to find the passive cooling technique which is applicable and effective to thermal comfort aspect for auditorium room ‘Aisyiyah Yogyakarta University. The goal which is going to be achieved in this final assignment is to know the passive cooling technique which is applicableand effective to thermal comfort aspect for auditorium room ‘Aisyiyah Yogyakarta University.The research method is conducted by direct observation on sample. Then the research model is made according to observation result. Then, the research model was tested by ecotect software to measure the temperature made by each model. The data got from the measurement were analyzed for thermal quality.Based on the analysis result, it is known that temperature in auditorium room ‘Aisyiyah Yogyakarta University until 30 celcius and that is not recommendation for comfortable room. Passive cooling techniques which are applicable for auditorium room ‘Aisyiyah Yogyakarta University are ventilative cooling and mass effect cooling (single banked room). It is also known that the effective passive cooling technique is mix-ventilation type with ratio ventilation more than 1:6,79. It is also known that there is a relation between room volume percentages which is passed by air stream with its air temperature in the room.Keywords: passive cooling technique, applicable, effective, auditorium room, UNISA
PERGESERAN PARADIGMA DAN PERSEPSI KARYA ARSITEKTUR BAGI ARSITEK DI ERA INFORMASI
Authors: Prihastomo Bondan
Published: September 2019

Abstract: In the course of time, an architectural work always undergoes a change of perception, both by the general public and among architectural practitioners. In the digital age, this is quite important. This is related to technological advances that are able to provide convenience to the designer to create an architectural masterpiece. Some architectural works have an unfinished value, because it has only one aspect of value only, that is most of the visual aspect.Keywords : paradigm, persepsi, arsitektur, arsitek, era informasi
PPF Dependent Fixed Points of Generalized Suzuki Type Contractions via Simulation Functions
Authors: GUTTİ Venkata Ravindranadh Babu , MADUGULA Vinod Kumar
Published: September 2019

In this paper, we introduce the notion of generalized Suzuki type ZG,\alpha,\mu,\eta -contraction with respect to \zeta by using the notion of CG-simulation function introduced by Liu, Ansari, Chandok and Radenovic[21] and prove the existence PPF dependent fixed points in Banach spaces. We draw some corollaries and examples to illustrate our results.
Some qualitative properties of mild solutions of a second-order integro-differential inclusion
Authors: CERNEA Aurelian
Published: September 2019

We prove the Lipschitz dependence on the initial data of the solution set of a Cauchy problem associated to a second-order integro-differential inclusion by using the contraction
principle in the space of selections of the multifunction instead of the space of solutions. A Filippov type existence theorem for this problem is also provided.
Surface focusing, holographic geometry and surface integral
Authors: Kuyukov Vitaly
Published: September 2019

Surface focusing, holographic geometry and surface integral
Evaluation of the Role of Internal Audit Effectiveness of Internal Control System Raw Materials. Case study on PT. Darmawan Hospitality Management Catering Unit
Authors: Nurhayati  , Iriyadi
Published: September 2019

Inventories of raw materials and goods is a very important company assets as an asset that has a value large enough and has a big enough risk associated with misuse of company assets (fraud). To the need for good internal control systems and procedures over inventory warehousing of raw materials, which ideally systems and procedures need to be evaluated and repaired to avoid the weaknesses inherent risk control and minimize inventory.The purpose of this study is to determine how much the role of internal audit of the inventory of raw materials at PT. DHM unit catering, as well as to determine the role of internal audit of the inventory of raw materials in order to improve the effectiveness of the internal control system of the raw materials in the PT. DHM catering unit.Internal audit consists of stages starting from audit planning, audit execution, audit reporting and follow-up repairs. System of internal control of raw materials at PT. DHM catering units already exist that have guided the implementation of operational procedures relating to the supply of raw materials consisting of raw material purchase procedures, procedures for raw materials, and procedures for requesting and raw material expenses.Of the discussion that has been done, the authors conclude that internal audit has an important role on the effectiveness of the control of raw materials in order to achieve efficient use of raw materials, as auditors conduct periodic evaluation and review that allows to improve the system's growing. It can be seen from compliance by the warehouse inventory of raw materials in implementing systems and procedures that have been made, repaired and recommended by the auditors in the form of operational standards in terms of running a good warehousing system with strong control.Keywords : Internal Audit