bluuebunny/crossref_metadata_2025 huggingface dataset:
Espejos de virtud: los santos fundadores de la Sacristía de San Pedro en Lima
Authors: Michaud Cécile
Published: December 2021

El artículo analiza los retratos de Santos Fundadores en la sacristía del Colegio Máximo de San Pablo de la Compañía de Jesús, hoy iglesia San Pedro de Lima, una sacristía de mayor importancia en la historia visual del Perú virreinal. Un primer propósito de la investigación es explorar las relaciones entre la serie y sus fuentes grabadas europeas. Un segundo propósito es una lectura teológica y holística de los lienzos en relación al espacio de la sacristía jesuita en la Lima de los años 1660-1680.
COMPLEX BIOSTRATIGRAPHIC SCHEME OF THE JURASSIC DEPOSITS OF THE PIENNINE ZONE OF THE UKRAINIAN CARPATHIANS
Authors: Zhabina N.M.
Published: December 2021

The article summarizes the results of the study of paleontology and biostratigraphy of the Jurassic of the Piennine Zone of the Ukrainian Carpathians by domestic and foreign researchers. For the first time, a summary paleontological description of these sediments is presented, taking into account numerous published data on identified macro- and mictofossils. A correlation biozonal scale has been created, as well as complex biostratigraphic schemes for each Jurassic series of its region in accordance with the International Stratigraphic Scale (2020). Because the stratigraphic sequence was disturbed by disjunctive dislocations, these schemes were developed by analysis of fragmentary sections. At present, three series of the Jurassic are determined by ammonites, belemnites, pelecypods, brachiopods, the Lower and Upper series are also dated by dinocysts, the Upper also by foraminifera and tintinnids. The stages and standard zones of the modern international scale are determined by ammonites: Liasicus of the Gettangian; Bucklandi, Obtusum, Raricostatum of the Sinemurian; Jamesoni, Emaciatum of the Pliensbachian; Tenuicostatum, Serpentinum, Bifrons, Thouarcense of the Toarcien; Opalinum, Murchisonae, Bradfordensis, Concavum of the Aalenian; Propinquans, Humpriesianum, Parkinsoni of the Bajocian; Zigzag, Aurigerus, Subcontractus, Bremeri, Retrocostatum of the Bathonian; Athletа of the Callovian; Plicatilis і Bifurcates of the Oxfordian; Divisum, Acanticum і Cavouri of the Kimmeridgian. Continuous dinocyst zonation is traced in the Upper Jurassic – Fibrata Аcme (Upper Oxfordian), Parvula Acme, Moluccana і Borzai (Kimmerigian), Pulla, Tithonica, Malmica, Semiradiata (Lower Tithonian) and all standard tintinnide zones of Tithonian — Chitinoidella (підзони Dobeni і Boneti), Praetintinnopsella, Crassicollaria. The boundaries of the stages from the Gettangiean to the Oxfordian are not determined. The boundaries between the Lower and Upper Oxfordian as well as between the Kimmeridgian substages are determined by ammonites as well as the boundary between the Kimmeridgian and Tithonian is determined by dinocysts, and the boundary between the Jurassic and Cretaceous is determined by tintinnids (corresponds to the boundary between the zones Crassicollaria of Tithonian and Calpionella of Berriassian). Stratigraphic unconformities were revealed by the macro- and mictofossils: the regional erosion on the boundary between the Aalenian and Bajocian as well as in Early Callovian, and short gap on the boundary between the Lower and Upper Bajocian.
Modern Treatment Strategy of Iron Deficient Anemia
Authors: Gaidukova Svitlana , Vydyborets Stanislav
Published: December 2021

Modern views of epidemiology, etiology and pathogenesis of iron deficiency anemia (IDA) are considered. This review deals with up-to-date methods of the laboratory diagnostics of IDA. Some ideas of iron methabolism in an organism and pathogenetic mechanisms of clinical and laboratory symptomps are briefly presented. The diagnostic value of laboratory methods for diagnosing IDA is interpreted. A conclusion is drawn about the integrated approach to the diagnostics of IDA diagnostics. Causes of low treatment efficiency are discussed and the ways to address this problem are proposed based on the published results of clinical research. Present article devoted to the steps for implementation unified clinical protocol of the primary, secondary (specialized) medical care “Iron deficiency” to the practical activities.
Evaluation of Integrated Approach to Treatment Perennial Allergic Rhinitis the Background Helminthosis
Authors: Bondarenko Tetiana
Published: December 2021

The article reflects the urgency of the problem helminthosis, which is who is hiding under the guise of other diseases. We have studied cellular and humoral immunity in patients with perennial allergic rhinitis with concomitant helminthosis following a comprehensive treatment, including antiparasitic, immunomodulatory, allergospecific therapy.
The Relevance of Correction of Vitamin-mineral Deficiencies in Adults and Children
Authors: Mihniova Nataliia
Published: December 2021

Nutrient deficiency in the diet increases the risk of various diseases. The article discusses the physiological role of vitamins and minerals, especially vitamin-mineral metabolism in the human body, the main causes of their deficiency in the diet. Recommendations for the prevention and correction of vitamin and mineral deficiencies using customized vitamin and vitamin-mineral complexes.
Prevention of Arterial Hypertension in Adolescents with Existing Risk Factors in Rural Clinics
Authors: Matіukha Larysa , Orlovska Nataliia , Buchanovska Tetiana
Published: December 2021

The objective: to determine the frequency and impact of risk factors among adolescent children in the countryside on the possibility of arterial hypertension (AH) development and to devise the family doctor recommendations for its prevention.
Patients and methods. The cohort study of 214 children at the age of 12–17 years who attend Khotiv educational complex «Secondary school of I–III levels – gymnasium» in Kiev region was implemented in order to identify the elevated numbers of blood pressure (BP) and the impact of risk factors on the development of hypertension in future. The sociological poll about the existing risk factors for cardio-vascular disease, the measurement of height and weight with the following bodymass index (BMI) calculation, the Rufe’s test for evaluating the physical efficiency, the BP measurement in the office, the electrocardiography (ECG), the blood pressure daily monitoring (BPDM) and the ophthalmoscopy were carried out.
Results. Pre-hypertension was revealed among 29 children that made 13,6±2,3% of respondents, and arterial hypertension was diagnosed for 25 children that made 11,6±2,2%. Arterial hypertension was detected 2.5 times more often among boys in comparison with girls (8,3±1,9% and 3,3±1,5% accordingly). Most of respondents with arterial hypertension were 141year1old children. The most common complaints of the respondents were sleep disturbance (59,3±3,6%), exertional dyspnea (57,0±3,4%), headache (41,1±3,4%) and rapid fatigue (21,0±2,8%). The following risk factors as sex, hereditary factor for arterial hypertension especially combined with diabetes, myocardial infarction, stroke; smoking of respondents, smoking of parents, overuse of products containing the excess of table salt, insufficient use of vegetables and fruit (less than 200 g/day or no daily usage), the use of energy drinks, inactive way of life, low physical activity, the change of body weight (the overweight and the underweight) were significant.
Conclusions. The frequency of arterial hypertension among the examined children who live in the countryside is 11.6%, including 8.3% among boys and 3.3% among girls. The main risk factors of arterial hypertension are the overweight, the underweight, the family history of arterial hypertension, the smoking of parents and physical inactivity of children. It has been found out that the absolute risk of arterial hypertension development in future is 40 per cent higher among the smokers, 10 per cent higher among the children whose parents smoke, 20 per cent higher among the dyspn(o)eic respondents, 20 per cent higher among the underweight children, 30 per cent higher among the overweight children, 30 per cent higher among the children with the changes of the fundus of eye, 20 per cent higher among the children with sinus tachycardia and 40 per cent higher among children with a single supraventricular extrasystole or sinus arrhythmia.
Features of the Course and Treatment of Hypertension in Combination with Chronicis Chemic Heart Disease in Patients with Gastroesophagel Refluxdisease. Role of Proton Pump Inhibitors Test in the Diagnosis and Treatment of Different Forms of GERD
Authors: Prikhodko Viktoriia , Moreva Diana
Published: December 2021

The analysis of epidemiological data shows that the prevalence of GERD in Ukraine is 11.1. Prevalence of GERD increases with the age of respondents, which leads to changes in the structure of clinical disease and dominance of extraesophageal manifestations of disease.

The objective: To study features of arterial hypertension (AH) combined with chronic coronary heart disease (CHD) in patients with GERD. Establish a connection presence of gastroesophageal reflux with possible clinical manifestations of coronary heart disease (arrhythmias, ischemic episodes according to the daily ECG monitoring, assessment of the severity of pain in the chest), and parameters of blood pressure and its lability.

Patients and methods. As part of the fragment study examined 50 patients with hypertension I–II art. combined with chronic ischemic heart disease. Methods of examination: antopometric, biochemical blood tests, ambulatory blood pressure monitoring. Holter ECG, upper endoscopy, echocardiography, tests on a scale GerdQ.

Results. Comorbidity of hypertension and chronic ischemic heart disease and GERD is associated with a higher frequency of abdominal type of obesity and metabolic syndrome, which increases the level of cardiovascular risk in patients with GERD. The presence of gastroesophageal reflux disease in patients with hypertension with chronic coronary artery disease causes an increase in the frequency and severity of arrhythmias. Patients on the background of GERD is more common atrial fibrillation (AF). When concomitant GERD in patients with chronic ischemic heart disease was significantly greater frequency and duration of ischemic episodes. Comorbidity with GERD worsens hypertension and characterized by higher rates of SBP and DBP at night and high variability in SBP and DBP during the day.

Conclusion. The presence of GERD in patients with hypertension and chronic ischemic heart disease is associated with more severe clinical manifestations of the underlying disease and can therefore be regarded as complicating CHD- and AH-factor.
The Significance of Renal Functional Reserve in Еssential Hypertension
Authors: Khimion Liudmyla , Tymoshchuk Liliia , Rybytska Mariia
Published: December 2021

In the structure of causes of the end-stage chronic kidney disease is essential hypertension (EH) which takes the leading role. One of the pathogenic mechanisms of hypertensive nephropathy is a violation of intrarenal blood flow, which clinically manifesting with hyperfiltration.
The objective: of the frequency of subclinical renal damage of patients with stage I EAH by water and salt loading and comparing these data with the standard criteria of essential nephropathy with hypertension.
Patients and methods. The study involved 30 patients aged 27 to 59 years with diagnosed grade 1 essential hypertension who did not receive medical treatment and did not have the disease (lesions) of the kidneys. Mean albumin/creatin ratio of patients constituted 15,12±5,02 mg/g. According to the analysis of outpatient cards hypertension duration do not exceed during 5 years. All patients underwent 24-hour blood pressure monitoring and determining the method RFR water and salt load (under patent Ukraine 42,860) [9].
The results of daily monitoring of blood pressure (DMAT) were patients divided into two groups: the 1st group included patients who had been diagnosted the I step and I stage of EH, it comprised 22 patients (73.3%). Second group included patients who had been diagnosted the II stage of EH – 8 patients (26.7%).
Results. Subclinical kidney damage were found in 8 patients (26.7%) in determining the method of water-salt load. (RFR 10±2,01% in 8 patients (26.7%) 1st group and RFR 22,31±3,9% in 22 patients (73.3%) significant difference between groups (p<0.05). Among them, the state of hyperfiltration detected in 15 patients (50%) 281,55±40,66 ml/min per 1.73 m2. In eGFR 51,36±9,98 ml/min per 1.73 m2 had 6 people (20%), RFR was reduced and amounted to 11,02±6,65%.
This shows that when increasing the blood pressure, kidney begins to lose its physiological reserve and its clinically possible to trace the transition state of hyperfiltration in decreased GFR. In determining GFR formula CKD-EPI reliable differences between groups were found.
Conclusions. 1. Hypertension is an urgent problem and requires constant attention of the doctors of various specialties, complex problems that affect the incidence of kidney damage in the preclinical stage of hypertensive nephropathy.
2. The early hypertensive nephropathy criteria for the development of microalbuminuria may appear hyperfiltration and reduce renal functional reserve.
3. In EH patients with grade 1 hypertension, II stage, compared with patients with hypertension with I stage of kidney damage, were often observed and showed low RFR.
4. Using water-salt load for patients with EH and stages for the evaluation of kidney function can detect subclinical renal involvement, the development of microalbuminuria and reduced GFR.
Subclinical Hyperthyroidism: Diagnostic Criteria and Principles of Treatment
Authors: Galytska Vita
Published: December 2021

This article presents the European Thyroid Association guidelines for diagnosis and treatment of subclinical hyperthyroidism, 2015. Determination of thyroid1stimulating hormone levels can help to diagnose a variety of pathological conditions: hypertension, cardiac fibrillation, atrial fibrillation, mineral density reduction in bones, menstrual irregularities, infertility, which require specific treatment after detection of hormonal status disorders (subclinical, overt), taking into account the patient’s age.

Diagnosis of endogenous subclinical hyperthyroidism is based solely on the results of laboratory tests, not clinical criteria. Endogenous subclinical hyperthyroidism is defined by the presence of subnormal levels of thyroid-stimulating hormone with normal levels of free thyroxine, total triiodothyronine, and/or free triiodothyronine. There are two categories of endogenous subclinical hyperthyroidism: stage 1 – the level of thyroid1stimulating hormone is 0,1–0,39 mIU/l; stage 2 – the level of thyroid1stimulating hormone is <0.1 mIU/l. The levels of free thyroxine and free triiodothyronine, as a rule, are medium-high value at a subclinical level of thyroid hormone and can help differentiate between endogenous subclinical hyperthyroidism from overt hyperthyroidism.

It is recommended to study the thyroid-stimulating hormone level as the first test for the diagnosis of subclinical hyperthyroidism. In identifying low levels of thyroid1stimulating hormone it is necessary to investigate the level of free thyroxine, free or bound triiodothyronine. Patients with primary subnormal levels of thyroid-stimulating hormone with concentration of thyroid hormones in the upper limit or in normal range should be evaluated within 2-3 months. It is recommended to perform scintigraphy and possible 24-hour test the absorption of radioactive iodine if in patient with 2nd degree endogenous subclinical hyperthyroidism there is nodular goiter to determine treatment strategy.

Ultrasonography with color Doppler can be informative for patients with endogenous subclinical hyperthyroidism and nodular goiter. Determining the level of antibodies to thyroid-stimulating hormone receptors can confirm the etiology of autoimmune-induced hyperthyroidism.
Features Pyramidal and Sensory Disorders in Multiple Sclerosis Patients Under Comorbidity
Authors: Chupryna Hennadii , Svyrydova Nataliia , Galusha Anatolii
Published: December 2021

Reduced muscle strength is one of the most important factors in violation of life in multiple sclerosis (MS). Muscle spasticity – another significant common symptom in patients with MS, which is one of the main reasons for the deepening of disability.
The objective: to determine the prevalence of pyramidal disorders (PD), and sensory disorders (SD) in patients with MS and to find out the characteristics of their curs in the aspect of comorbidity.
Patients and methods. Neurological examination 216 MS patients with different forms of process was held a points assessment of the disturbed functional systems of the FS-1 – FS-7 (scale FS1 Functional System for J. Kurtzke, 1983), determined the level of disability (the EDSS), revealed the presence or absence PD and SD in the survey, to determine the degree of severity and character.
Results. At 88,4% PC patients had PD. Changes in muscle tone were found in 73.2% of patients with MS. In 65.3% of MS patients the total sample were clinical signs of superficial and deep sensitivity changes. In addition to medication for relief of PD and SD in patients with MS were effectively used methods of acupuncture, which allowed more quickly and efficiently to reduce the severity of spasticity and pain.
Conclusions. 1. The average prevalence of PD in our study of MS patients is 88.4%, and the average prevalence of the SD – 65.3%.
2. In the group with the presence of comorbid pathology PD significantly more often manifested tetraparesis and high spastic tone.
3. In the group with the presence of comorbid pathology SD significantly more often manifested dysesthesia, termogiperestesia, palleanestesia.
Study of Efficacy and Safety of Ginger Root Extract in Treatment of Patients with Low Back Pain
Authors: Shuba Neonila , Voronova Tetiana , Hambir Tetiana
Published: December 2021

The objective: to study efficacy and safety of treatment with herbal formulation of standardized extract of ginger root in patients with low back pain; to study impact of the formulation on the dynamics of inflammation process indices, hepatic and renal markers, purine, carbohydrate and lipid metabolism.

Patients and methods. The study involved 35 patients (28 women and 7 men) aged between 30 and 80 years with primary LBP syndrome. The treatment was provided using herbal formulation of standardized extract of ginger root at dose of 300 mg twice daily during two months. We evaluated efficacy of the formulation using VAS, Oswestry, Roland-Morris, McGill questionnaires. We analyzed effect of the drug product on cytokines levels (IL-1β, IGF-1), NO, CRP, ESR, metabolism indices (lipid, carbohydrate, liver function markers, uric acid levels).

Results. By the end of the study, in 2 months of the treatment, the VAS parameters had statistically significantly decreased from 55,71±2,98 mm to 23,17 mm±2,38, Oswestry parameters – from 16,66±1,09 to 8,69±1,06, McGill parameters – from 8,49±0,73 to 3,09±0,4, Roland-Morris parameters – from 5,37±0,54 to 2,22±0,33. We observed a statistically significant reduction in CRP, ESR, proinflammatory cytokines (IL-1β), free radical (NO), as well as cholesterol and glucose. The study did not demonstrate any dynamics in such laboratory parameters as bilirubin, ALT, AST, creatinine and uric acid.

Conclusions. Based on the study results we concluded that the standardized ginger root extract was effective and safe in treatment of patients with LBP. In the course of the treatment, the patients demonstrated reduction in pain intensity by 58%, life quality improvement by 48%, psycho-emotional state improvement by 59%, and vital activity improvement by 58%. We observed the anti-inflammatory effect of ginger root extract exerted by the drug product through degrading indices of CRP, ESR, proinflammatory cytokine IL-1β, and NO.
Anxiety Syndrome in Neurologic Practice: Possibilities and Strategies of Pharmacotherapy
Authors: Burchinsky Serhii
Published: December 2021

In the present paper a modern approaches to pharmacotherapy of anxiety syndrome in neurological practice have been looked. An advantages and disadvantages of main groups of drugs, using with this purpose have been analyzed. A main attention paid to possibilities of drugs representing “small neuroleptics” and its “golden standard” sulpiride (Eglonil) as an instrument of complex correction of anxiety, phobic, depressive and psychoautonomic symptoms of neurological pathology. A questions of safety during therapy of sulpiride (Eglonil) as one of the main choice criteria of this drug have been looked. An expedience of use of sulpiride (Eglonil) in treatment of different forms of anxiety disorders in neurology has been grounded.
The Necessity of Undergraduate Medical Education Syllabus Renewal as a Result of the Priority of General Practice and Family Medicine
Authors: Babynets Liliia , Borovyk Iryna , Koryl’chuk Neonila , Botsyuk Nataliia , Starodub Yevhen , Vorontsov Oleksandr , Ryabokon’ Svitlana , Mihenko Bohdan , Tvorko Vadym , Yasniy Oksana
Published: December 2021

This article is devoted to practical proposals for the development of national multidisciplinary syllabus of teaching «General practice-family medicine» at the undergraduate level. Relevant aspects of syllabus creation are the accent on motivating forces concerning the priority of Family Medicine introduction, the intensification of practical direction in teaching process and scientific evidence of academic content that corresponds to practical demands of Ukrainian society.
The Fetal Diaphragmatic Hernia, Diagnosis and Therapy
Authors: Veropotvelyan Petro , Veropotvelyan Mykola , Bondarenko Alla , Zhuravleva Svitlana
Published: December 2021

The objective. early prenatal diagnosis signs of the congenital fetal diaphragmatic hernia determination by using ultrasound.
Patients and мethods. 46 publications analysis by Ukrainian and foreign researchers.
Results. The ultrasound diagnosis of the diaphragmatic hernia at 24–26 weeks of gestation dependends on the damaged side and a copathology presence (in 60–70%).
Conclusion. A co-pathology, intrathoracic liver location, lungs hypoplasia degree and heart compression index are main predictive signs which correlate with fetal survival.
Сontent of Middle Mass Molecules in the Blood Plasma, Obtained by Different Plasmapheresis Methods
Authors: Korzh Andrii
Published: December 2021

The objective: the study of the content of molecules of average weight (MSM) in blood plasma obtained from donors of different methods to select the priority method.
Patients and methods. The plasma samples of 34 primary donors (22 men and 12 women) for the first time given the plasma by automated plasmapheresis (control surveillance), and 152 active donors of blood plasma (110 men and 42 women) being donors with non-less 14 days interval between donations, have been examined. The active male donors’ plasma averaged at 18.63±1.71 with individual index fluctuations from 2 to 78, female donors’ – 14.09±1.95 with individual index fluctuations from 2 to 45. According to the method of plasma obtaining, the active plasma donors were divided into two groups: manual plasmapheresis method – I (first) observation group – 40 men and 14 women: method of automatic plasmapheresis – II (second) group of observations – 70 men and 28 women. The surveyed groups were homogeneous for age and sex.
Results. Hematologic and biochemical parameters of all those persons have been examined and, basing on the conclusion of the professionals, everyone was admitted to the plasma donation. The content of middle mass molecules in plasma were determined by metod of Gabrieljan N. I., Lipatovoj V. I. (1984). Analysis of the results showed that in the donor plasma samples obtained by manual plasmapheresis level of middle mass molecules is significantly higher. The significance of obtained results has also been discussed.
Conclusions. When manual plasmapheresis in the obtained samples of blood plasma revealed significantly higher content of molecules of average weight (MSM) compared to samples from donors who underwent automated plasmapheresis. A method of automatic plasmapheresis is pain gentle, compared with the method of manual plasmapheresis, allows to obtain the plasma with the contents of the MSM are not different from the original.
Effect of Concomitant COPD on Blood Clotting in Patients with Stage II Hypertension
Authors: Samoilova Svitlana
Published: December 2021

We know that comorbidity COPD and arterial hypertension has an adverse effect on the disease and the presence of complications in such patients. To determine the state of coagulation link of hemostasis, we have examined 150 people: 15 healthy (control), 36 patients with COPD II-III without GC (I group), 69 patients with essential hypertension with concomitant COPD (second group) and 30 patients GC II stage (third group). We found that comorbid course AH and COPD leads to imbalance in the blood coagulation system, which is manifested by slowing prothrombinase formation (coagulation I phase) evidenced prolongation of APTT and lebetoks test, combined with a strong activation of the final phase of clot formation, a reflection of what there is a significant increase in fibrinogen and RFMK and shortening ehitoks and antsystron tests.
Research of Quality of Life of Men of the Zhytomyr Region with the Diagnosis of a Malignant New Growth of a Prostate Gland
Authors: Didyk Ivan
Published: December 2021

The article presents the results of studying quality of life in patients with prostate cancer (PCA) men in Zhytomyr region. A sociological study was carried out using an adapted standardized questionnaire SF-36.
The purpose of the study: the study of components of quality of life of patients with prostate cancer depending on the stage of the cancer process.
Materials and methods. The patients were divided into two groups: basic (n=381) and control (n=100). The study used the classical methods of social medicine: bibliometrical, medical, statistical, and sociological.
Results. Analysis of the results of the sociological research shows that prostate cancer has a relatively long course and depending on the stage of first diagnosis of the disease and used the tactics of the patient may lead to permanent loss of sexual function. As a result of the sociological survey identified the changes that happen from the time of diagnosis of prostate cancer.
Conclusion. Information on the quality of life of patients with a diagnosis of prostate cancer is necessary to ensure communication and feedback doctors with a patient.
The Most Common Causes of Comorbidity in Patients with Rheumatoid Arthritis
Authors: Zhdan Viacheslav , Tkachenko Maksym , Babanina Maryna , Kitura Yevdokiia , Kyrian Olena
Published: December 2021

Rheumatoid arthritis is a chronic autoimmune disease that affects the synovial membrane of the joints and leads to progressive joint damage, disability and reduced quality of life. Notwithstanding the emergence of more advanced therapeutic strategies that have improved the duration of remission, rheumatoid arthritis is associated with high rates of comorbidities, infections, malignant neoplasms, and cardiovascular pathology. It is known that some existing pathogenic inflammatory mediators in rheumatoid arthritis, such as interleukin-1β (IL-1β) and tumor necrosis factor, may play a key role in the development of cardiovascular diseases.
Various preclinical and clinical studies have shown that biological therapy, which is widely used to treat patients with rheumatoid arthritis, may be effective in treatment of cardiovascular diseases. In this context, it was proposed to study the involvement of adipocytokines. Adipocytokines are pleiotropic molecules that are primarily released from the white adipose tissue and immune cells. Adipocytokines modulate the function of various tissues and cells, and, in addition to energy homeostasis and metabolism, enhance the process of inflammation, the immune response and tissue damage. Adipocytokines can contribute to the pro-inflammatory condition in patients with rheumatoid arthritis and the development of bone tissue damage. Moreover, they may be associated with the development of cardiovascular diseases.
In the present study, we considered the already known data on the role of adipocytokines in the pathogenesis of rheumatoid arthritis, despite the fact that they are also actively involved in the pathogenesis of the cardiovascular diseases and are possible biomarkers for predicting the treatment outcomes, as well as in connection with their potential, as a possible new therapeutic target.
Ischemic Heart Disease and Heterozygous Familial Hypercholesterolemia: the Problem of Diagnosis and Treatment (Clinical Case)
Authors: Zhdan Viacheslav , Kitura Yevdokiia , Babanina Maryna , Kitura Oksana , Tkachenko Maksym
Published: December 2021

Familial hypercholesterolemia (FH) is a genetic disorder, characterized by high blood cholesterol levels, particularly – very high low-density lipoprotein (LDL) levels, which leads to the development of cardiovascular disease at a young age.
Heterozygous FH is diagnosed in the general population in most countries in one of 500 people. Certain phenotypic manifestations of this disease have been identified, namely: tendon xanthomas, lipid arch of the cornea and xanthelasma. Patients with FH are prone to early development of atherosclerosis and clinically manifest forms of cardiovascular diseases, in particular ischemic heart disease.
A direct correlation has been established between morbidity, mortality from coronary heart disease and blood cholesterol level. It has also been proven that hypercholesterolemia is the main risk factor for the development of atherosclerosis and its complications. Early diagnosis and modern lipid-lowering therapy play an important role for patients with signs of hereditary lipid metabolism disorders. Patients with heterozygous FH are usually treated by statins, which act by inhibiting an enzyme in the liver. Statins are effective in lowering total cholesterol and LDL levels. Sometimes other drugs are additionally prescribed. The diagnosis of this pathology requires a genetic consultation.
All patients with FH require lifelong pharmacological therapy. The use of statins leads to a decrease in coronary mortality by 25–40%, and decrease in the risk of ischemic events – by 26–30%.
An observational study of a large British registry noted that mortality in patients with FH began to decline slightly from the early 90s of the XX century, when statins were started to use in treatment.
The article presents a clinical case of ischemic heart disease in heterozygous FH patent, considers diagnostic criteria and modern approaches to the management of patients with hereditary disorders of lipid metabolism.
The Role of Kallikrein-kinin System in Complex Regional Pain Syndrome I (CRPS I) Pathophysiologic Mechanisms
Authors: Buryanov Oleksandr , Khimion Liudmyla , Kotiuk Viktor
Published: December 2021

Inflammation, edema and local vascular permeability changes are essential features of the complex regional pain syndrome type I (CRPS I). The role of kallikrein-kinin system components as the major mediators in the development of these symptoms is poorly investigated.

The objective: to investigate the role of kallikrein-kinin system in pathophysiologic mechanisms of CRPS I.

Patients and methods. We have investigated level of prekallikrein (PK), activity of fast-reacting (FRI) and time-dependent (TDI) inhibitors of plasma kallikrein, and blood plasma proteolytic activity (BPPA) in 45 patients with CRPS I and 15 healthy volunteers.

Results. Analysis of kininogenesis activity and sympathetic-adrenal system revealed their close interdependence. Our data corresponds well with the literature information about depressive effect of sympathetic nervous system on kininase activity. This leads to the accumulation of vasoactive peptides in the injures segment of the extremity. Decrease of neurogenic effects at the later stages of CRPS I leads to the fall of the basal kininogenesis level.

Conclusion. Local humoral factors such as the components of kallikrein-kinin system play an important role in CRPS I pathophysiologic mechanisms and are dependent on sympathetic-adrenal system activity.
Pain Syndrome, Markers of Bone Metabolism in Patients with Osteoarthritis, Approaches to Drug Therapy and the Impact of Obesity
Authors: Kuryata Oleksandr , Cherkasova Anna
Published: December 2021

The objective: to assess the nature of pain in patients with osteoarthritis, the impact of obesity on the clinical efficacy of treatment of osteoarthritis (OA) and dynamics of bone metabolism markers.
Patients and methods. The research included 150 patients with OA, who were divided into two groups, according to the receiving therapy. Patients of the main group – received diacerein (drug «Flexirin» PC «Kyiv Vitamin Factory») and patients of control group – received only nonsteroidal anti-inflammatory drugs (NSAIDs).
Results. The prevalence of neuropathic pain component in patients with OA was 64,7%, among which 80,7% use NSAIDs as an analgesic therapy. Obesity in patients with OA was associated with significantly higher levels of pain from the side of knee joints and higher degree of stiffness according to WOMAC index. The results of the study demonstrated a direct moderate correlation (R = 0,49; p = 0,04) between PICP level and the severity of pain at physical load from the side of hands and hip joints. The therapy by diacerein within 3 months resulted in a reliable decrease of pain syndrome intensity from the side of all articular zones, unlike to isolated NSAIDs use, where a reliable analgesic effect was demonstrated only from the side of knee joints. Obesity in patients with OA led to a significant decrease in clinical efficacy of therapy in point of functional status of the joints.
Conclusions. Neuropathic pain is quite common among patients with OA, which at the same time is associated with the lack of patient’s awareness about possible risks during NSAID’s use. Medical treatment by diacerein (drug “Flexirin”) causes stability of osteocalcin level, in contrast to the isolated NSAIDs use, where priority changes have been demonstrated against osteocalcin level decrease. The use of diacerein also resulted to additional positive effects from the side of zonal prevalence of analgesic effect and improving of functional ability of joints. Obesity in patients with OA was associated with a reliable increase of pain level intensity from the side of knee joints and the higher degree of functional limitation, causing at the same time, reduction of clinical efficacy of therapy in point of achieving analgesic effect and improving functional ability of joints.
Cardiac and Psycho-vegetative Abnormalities During Menopause Period and the Ways for Their Therapeutic Correction
Authors: Katerenchuk Ivan
Published: December 2021

The objective: to study the features of cardiac and autonomic symptoms in women in climacteric period and determination of the effectiveness of Maksipim in the correction of violations.

Patients and methods. There were examined 62 patients perimenopausal and postmenopausal period of life between the ages from 48 to 67 years (average age of 51.2±7,42 years). Women in the control group (n=32) received conventional therapy according to the standards (nitrates, beta-blockers, ACE inhibitors, statins). Women of the controlled group (n=30) on the background of basic therapy were receiving additional Maksipim (STADA, Germany) (active substance 3-hydroxy-6-methyl-2-ethylpyridine succinate) for 5 ml intravenously once a day, 5 injections, then oraly 1 tablet (0.125 g) 3 times a day for 1 month.

Results. The results of these studies showed that menopause lipid disorders, clinical manifestations of angina, presence of hypertension and psycho-vegetative disorders.

Conclusion. Application in complex therapy of patients with coronary heart disease (CHD) combined with arterial hypertension in the menopausal period of the drug Maksipim, helps normalize lipid metabolism, reduce the clinical manifestations of CHD, decrease of blood pressure. Concurrent use Maksipim helps to eliminate manifestations of somatic vegetative and psycho-vegetative disorders, which favorably affects the quality of patients’ life.
The Study of the Effectiveness of Natural Biologically Active Substances in Wound Healing of Oral Cavity by Using of Microcirculation Indicators
Authors: Guliyev Tamraz
Published: December 2021

In this study we investigated the effect of biologically active substances on postoperative oral wounds healing. By Laser Doppler flowmetry were evaluated microvasculature in postoperative field. It was found that resveratrol improves microcirculation and creates optimal conditions for the healing of postoperative wounds in the oral mucosa.
Disseminated Intravascular Coagulation
Authors: Vydyborets Stanislav , Andriiaka Artem
Published: December 2021

Disseminated intravascular coagulation (DIC) is characterized by an acute generalized, widespread activation of coagulation, which results in thrombotic complications, due to the intravascular formation of fibrin, as well as diffuse hemorrhages, due to the consumption of platelets and coagulation factors. In this lecture, we discuss regarding the controversies in diagnosis and management of DIC. Bleeding is a more common manifestation of DIC. We report the present knowledge about the treatment of DIC. Therapy of DIC aims at treating the primary cause. We focus on the current standard treatment of overt DIC in clinical practice. Moreover, particular attention is made to novel therapeutic strategies, who reflect the important progresses in the understanding of the pathogenesis of this syndrome in the last few years.
Analysis Methods of Use Acupuncture Diagnostics in Multiple Sclerosis Patients Under Comorbidity
Authors: Chupryna Hennadii , Svyrydova Nataliia , Galusha Anatolii
Published: December 2021

When optimizing the use of acupuncture methods in the complex treatment of patients with MS, important individual approach to treatment is based on a differentiated compilation of recipes acupuncture, built according to the diagnostic data obtained on the basis of current scientific knowledge and understanding of traditional Chinese medicine (TCM)

The objective: to determine the features of these acupuncture diagnostic methods (ADM) in MS patients based on comorbidity and clarify their relationship with the clinical neurological symptoms of MS patients examined.

Patients and methods. ADM was conducted in 216 patients with MS who were divided into 2 groups: without concomitant diseases (n=109) and the presence of concomitant diseases (n=107).

Results. When conducting syndromic ADM according to TCM, in all patients (100%) of us was diagnosed three dominant syndrome of TCM, which we have identified as the main: «spleen qi deficiency», «deficiency of liver and kidney yin», «liver qi stagnation».

Conclusions. As a result of multi-component ADM MS patients were identified pre-emptive involvement in the pathological process of functional systems TCM «Spleen-pancreas», «Kidney», «Liver».
Analysis of Cerebral Vascular Lesion Pools in Ischemic Stroke Based on the Analysis and the Prognostic Assessment of Risk Factors in Patients with Primary and Recurrent Ischemic Stroke
Authors: Mikitey Oksana
Published: December 2021

Stroke is an important medical and social problem, and stroke risk assessment tools have difficulty on the interaction of risk factors and the effects of certain risk factors with analysis by age, gender, race, because this information fully available to global risk assessment tools. In addition, these tools tend to be focused and usually do not include the entire range of possible factors contributing. The aim of the study was to conduct a comparison of brain vascular lesions pool with ischemic stroke (II) based predictive analysis and assessment of the main risk factors in patients with primary and recurrent ischemic stroke. Prognostically significant risk factors for recurrent ischemic stroke is not effective antihypertensive therapy, multiple stenoses any one pool vascular brain, duration of hypertension (AH) over 5 years and regular smoking patients (p<0.001). In the initial localization in the second vertebrobasilar recurrent stroke was significantly (p<0.05) more developed in the same pool in women than in men; and the localization of the primary carotid AI in the pool, re-developed stroke often unreliable in the same pool in women than in men.
Subclinical Hyperthyroidism: Diagnostic Criteria and Principles of Treatment
Authors: Galitskaya Vita
Published: December 2021

This article presents the European Thyroid Association guidelines for diagnosis and treatment of subclinical hyperthyroidism, 2015. Determination of thyroid1stimulating hormone levels can help to diagnose a variety of pathological conditions: hypertension, cardiac fibrillation, atrial fibrillation, mineral density reduction in bones, menstrual irregularities, infertility, which require specific treatment after detection of hormonal status disorders (subclinical, overt), taking into account the patient’s age.

Diagnosis of endogenous subclinical hyperthyroidism is based solely on the results of laboratory tests, not clinical criteria. Endogenous subclinical hyperthyroidism is defined by the presence of sub-normal levels of thyroid-stimulating hormone with normal levels of free thyroxine, total triiodothyronine, and/or free triiodothyronine. There are two categories of endogenous subclinical hyperthyroidism: stage 1 – the level of thyroid-stimulating hormone is 0,1–0,39 mIU/l; stage 2 – the level of thyroid-stimulating hormone is <0.1 mIU/l. The levels of free thyroxine and free triiodothyronine, as a rule, are medium-high value at a subclinical level of thyroid hormone and can help differentiate between endogenous subclinical hyperthyroidism from overt hyperthyroidism.

It is recommended to study the thyroid-stimulating hormone level as the first test for the diagnosis of subclinical hyperthyroidism. In identifying low levels of thyroid-stimulating hormone it is necessary to investigate the level of free thyroxine, free or bound triiodothyronine. Patients with primary sub-normal levels of thyroid-stimulating hormone with concentration of thyroid hormones in the upper limit or in normal range should be evaluated within 2-3 months.

It is recommended to perform scintigraphy and possible 24-hour test the absorption of radioactive iodine if in patient with 2nd degree endogenous subclinical hyperthyroidism there is nodular goiter to determine treatment strategy.

Ultrasonography with color Doppler can be informative for patients with endogenous subclinical hyperthyroidism and nodular goiter.

Determining the level of antibodies to thyroid-stimulating hormone receptors can confirm the etiology of autoimmune-induced hyperthyroidism.
Development of the Immune Response in Pneumonia Caused Pseudomonas aeruginosa (Part 1)
Authors: Abaturov Oleksandr , Nikulina Anna
Published: December 2021

Nosocomial bacterial pneumonia associated with Gram-negative pathogens, characterized by severe, high risk of complications and death. This article describes the immune response to infection with gram-negative bacterium Pseudomonas aeruginosa respiratory tract, which provide an effective clearance of the pathogen. The mechanisms of the respiratory tract showcased that an image-recognition receptors cells inducing pathogen-associated molecular structures Pseudomonas aeruginosa.
Characteristics of Bronchial Obstruction in Patients with Chronic Obstructive Pulmonary Disease, Depending on the Comorbidity with CHD
Authors: Kolesnikova Olena
Published: December 2021

The objective: to study the basic spirometry and pneumotachometry in patients with isolated COPD and patients with COPD combined with coronary artery disease.
Patients and methods. A total of 3 groups of patients: group 1 – 43 patients with stage II COPD and concomitant coronary heart disease, stable exertional angina (SEA) FC II, group 2 – 47 patients with stage II COPD and group 3 – 26 patients with coronary artery disease, CCH FC II.
Results. It is found that in COPD presence of coronary artery disease associated with a statistically significant lower rates VC, PIF, MIF at 25%, 50%, 75% FVC as well as a statistically significant reduction MEF in the interval from 25% to 75% FVC compared with those of patients with isolated over COPD.
Conclusion. The presence of coronary artery disease, stable angina FC II patients with COPD II stage. It is associated with more severe bronchial hyperresponsiveness and more pronounced decrease in VC, FVC, FEV1, ratios of FEV1/FVC, and significantly more pronounced changes in bronchial obstruction in the form of reduced rates of PIF, MIF25, MIF50, MIF75, MEF25-75 compared with their values in patients with COPD isolated passage.
The Clinical Course of Irritable Bowel Syndrome in Young Patients with Neurocirculatory Dystonia
Authors: Suprun Olena
Published: December 2021

The clinical picture of the combined course of irritable bowel syndrome (IBS) and neurocirculatory dystonia (NCD) in young patients has been described in the article. Features of abdominal pain syndrome and disorders of defecation, depending on the type of NCD (hypertonic or hypotonic) were shown.

The conditions under which the exacerbation of IBS occurred in these patients were reviewed. The role of the family doctor in monitoring of the comorbid conditions was shown.
Comparative Efficacy of Infliximab and Budesonide in Treatment of Patients with Ulcerative Colitis
Authors: Niroda Antonina , Bratasyuk Andrii , Chubirko Kseniia , Varvarynets Antonina
Published: December 2021

The objective: to compare the effectiveness of treatment with infliximab and budesonide in patients with ulcerative colitis (UC).

Patients and methods. 16 patients with UC were included in the study. They were divided into 2 groups. 8 patients in Group I received infliximab, patients in Group II were assigned budesonide.

Results. It was found that in patients, who were treated with infliximab, disease activity significantly decreased by 59,96%, while treatment with budesonide led to a significant reduction of inflammatory activity only by 15,56%. Endoscopic inflammation activity index significantly changed in both groups, but in Group I it has decreased by 50,00%, while in the second group – by 17,70% that corresponds to 1,22±0,44 and 2,00±0,50 points respectively (p<0,05).

Conclusions. The treatment of moderate severity UC effectiveness of infliximab was significantly higher compared to budesonide.
Managing Patients with Gastroesophageal Reflux Disease on Primary Step of Medical Care
Authors: Skrypnyk Liubov , Matkovska Nataliia , Chaplinska Nataliia
Published: December 2021

In order to improve the quality and efficiency of primary medical care are widely deployed standards, diagnostics and treatment algorithms. The leader among the diseases of the upper gastrointestinal tract is gastroesophageal reflux disease. To improve the diagnosis and treatment of patients in the clinical practice of a general practitioner – family medicine is recommended to use questionnaires that allows to estimate the severity of the disease, the correct to refer patient for further diagnostic steps. This will allow prescribe the appropriate therapeutic schemes, to reduce the frequency of recurrences and improve the patient’s quality of life.
Medical Personnel and Their Professional Level is the Main Component of Family Medicine
Authors: Goida Nina , Shcherbyns’ka Olena
Published: December 2021

The paper focuses on new approaches to the development of family medicine in Ukraine. There has been made a brief historical overview of stages of family medicine development. The main component of the successful development of general practice–family medicine is stated to be human resources: personnel availability, personnel staffing, professional level. The medical education, including continuing professional development, plays an important role in the professional development of family physicians. The modern educational technologies are widely used in Shupyk NMAPE. The paper describes one-day scientific workshops in the format of the off-site training and videoconferences that are conducted under the methodical direction of the Academy.