bluuebunny/crossref_metadata_2025 huggingface dataset:
A Clinical Study on Chikungunya Fever in a Multidisciplinary Hospital of Dhaka City
Authors: Rabbani Safia Binte , Saha Pradip Ranjan , Hossain Md Iqbal , Begum Afsana , Talukder Md Jahangir
Published: June 2019

Chikungunya is one of the most rapidly spreading Aedes mosquito-borne viral infectious diseases. Recently in Bangladesh it has emerged as an important public health issue. Chikungunya virus (CHIKV) mostly spread by Aedes aegypti and Aedes albopictus, an anthropophilic mosquito species widely distributed in Asia, Europe, Africa and America. Our objective was to determine the clinical, biochemical and radiological features of patients at the acute phase of CHIKV infection. The purpose of study was to evaluate the literature and summarize the current state of CHIKV-associated disease, including clinical presentation, diagnosis, risk factors for development of severe diseases, complications and treatment. We present 253 confirmed cases of chikungunya having different clinical presentations occurring among adult patients from different background including foreigner in Dhaka city, admitted in a tertiary level hospital situated in Gulshan from march’17 to November 2017 . All patients had fever and joint pain. Other common features were rash, diarrhoea, vomiting, confusion, and altered liver biochemistry. Adult patients with multiple co-morbidities admitted in hospital with male preponderance of 59 % and rest were female 41%. Most common complication was post CHIKV arthritis (79%) and rest of the less common complications were post viral asthenia (34%), myocarditis (27%), pneumonitis (30%). Dengue was excluded in all patients. Paracetamol remained the mainstay of treatment during febrile periods, but around 62% of the patients had prolonged joint symptoms requiring non-steroidal antiinflammatory drugs, colchicines, steroid. Among joint involvement, ankle joints were commonly involved joint presented with post viral arthritis. Since there is no specific treatment of chikungunya, prevention through vector control and public health education is the key.

J Bangladesh Coll Phys Surg 2019; 37(3): 124-129
Psychiatric Disorders among Suicidal Behavior Patients Attending Mental Health Facilities: A Descriptive Crosssectional Study
Authors: Islam Md Shahedul , Mamun Sk Abdullah Al , Haque Md Mosharul , Mohammad Khan Niaz , Rashid Md Harun Ar , Sinha Ramendra Kumar , Abedin Mohammed Forhad , Uddin Md Nizam
Published: June 2019

Background: Suicide is a leading cause of death worldwide. This is the first study in Bangladesh to find out the psychiatric morbidity profile and suicidal behavior. The study was aimed to delineate the types of suicidal behavior and the psychiatric morbidity profile, and sociodemographic status of patients.

Methods: A descriptive cross-sectional study was done in Depatrment of Psychiatry, Cumilla Medical College, Cumilla from October 2015 to March 2017. A total 120 patient aged 9 to 40 years who fulfilled the enrolment criteria included in the study. The Composite International Diagnostic Interview (CIDI) module was used to assess the suicidal behavior. DSM-5 was used to diagnose the psychiatric disorders. Semi structural questionnaire were used for collecting information about the risk factors for psychiatric morbidity and sociodemographic information. Result: Of 120 suicidal behavior patients’ psychiatric disorders was 65%. Among suicidal behavior patients neurotic disorders was 19%, psychotic disorders was 15%, personality disorders was 39% and others disorder was 27%. Among 78 psychiatric patients borderline personality disorder was 25.64%, adjustment disorders were 15.38%, mood disorders were 11.53%, psychotic disorder was 7.69%, multiple personality disorder and oppositional defiant disorder were 6.42%, hystrionic personality disorder and substance use disorder were 3.84%, antisocial personality disorder, conduct disorder and anxiety disorder were 2.57%, and composite disorder was 11.53%. Among suicidal behavior in psychiatric patients suicidal ideation was 54, suicidal plan was 13, suicidal attempt was 45 , ideators only proceeded to plan was 17, ideation to attempt was 59. Among suicidal behavior in total 120 participants suicidal ideation was 84, suicidal plan was 19, suicidal attempt was 56, ideators only proceeded to plan was 26, ideation to attempt was 76, planned attempt was 14 and impulsive attempt was 62. Most of the suicidal behavior participants were female (77.5%) and age group of <24 years (60%).

Conclusions: Psychiatric disorders are important risk factors for the onset and persistence of suicidal behaviour, with this risk being the greatest in childhood, and early adult.

J Bangladesh Coll Phys Surg 2019; 37(3): 130-134
Duodenal Varices: A Rare Manifestation of Portal Hypertension
Authors: Basak Deepankar Kumar , Gomes Richmond Ronald , Arfin Md Samsul
Published: June 2019

We report a case of haematemesis & melaena due to ectopic varices located in the duodenum in a patient with NASH related CLD. Duodenal varices are a rare but potentially serious consequence of portal hypertension in the event of a bleeding. The etiology of duodenal varices can be classified into hepatic (e.g. cirrhosis) or extra hepatic (e.g. portal, splenic or superior mesenteric vein thrombosis). Endoscopic injection sclerotherapy (EIS) and endoscopic variceal ligation (EVL) are widely accepted as primary therapies for esophageal variceal bleeding whereas bleeding gastric fundal varices are usually treated with cyanoacrylate injection or shunt procedures. However there is no widely accepted treatment modality for duodenal varices. In the case presented, we used injection sclerotherapy with ethanolamine oleate, to obliterate varices and control bleeding. A short review on the etiology pathogenesis and management of ectopic varices is presented.

J Bangladesh Coll Phys Surg 2019; 37(3): 156-159
Spor Tükenmişliği Envanteri’nin Türk Kültürüne Uyarlanması ve Psikometrik Özellikleri
Authors: Çam Zekeriya , Kardaş Ferhat , Eşkisu Mustafa , Gelibolu Sedat
Published: June 2019

Bu araştırmanın
amacı spor alanında öğrenim gören öğrencilerde spora bağlı olarak gözlenen
tükenmişliğin incelenmesi amacıyla geliştirilen Spor Tükenmişliği Envanterini Türkçe’ye
uyarlamaktır. Bu amaçla Sorkkila, Ryba, Aunola, Selänne ve Salmela-Aro (2017)
tarafından geliştirilen 10 madde ve üç alt boyuttan oluşan Spor Tükenmişliği
Envanteri Türkçe’ye uyarlanarak, geçerlik ve güvenirlik çalışması
gerçekleştirilmiştir. Araştırma verileri beden eğitimi ve spor alanında öğrenim
gören 250 (98 kadın %39.2, 152 erkek %60.8) üniversite öğrencisinden
toplanmıştır. Envanterin yapı geçerliği DFA işlemi ile test edilmiş ve modelin
geçerliği uyum indeksleri ile değerlendirilmiştir. Envanter için hesaplanan
uyum iyiliği katsayıları ise χ2/Sd=
3.21; RMSEA= .094; GFI= .91; AGFI= .84; CFI= .95, IFI= .95; NFI= .92 ve NNFI=
.92 olarak hesaplanmıştır. Ayrıca ölçme aracının uyum geçerliği ve ayırt edici
geçerlik çalışmaları gerçekleştirilmiştir. Uyum geçerliği kapsamında Beck
Depresyon Envanteri ile Spor Tükenmişliği Envanteri arasındaki ilişki
hesaplanmıştır. Ayırt edici geçerlik çalışması kapsamında ise Rosenberg Özsaygı
Ölçeği ile Spor Tükenmişliği Envanteri arasındaki ilişki incelenmiştir. Ayrıca
envanterin güvenirlik düzeyinin belirlenmesi için Cronbach alfa iç tutarlılık
katsayısı hesaplanmış, Cronbach alfa iç tutarlılık katsayısının ölçme aracının
tümü için 0.81, Tükenme boyutu için 0.61, Duyarsızlaşma boyutu için 0.69 ve
Yetersizlik boyutu için 0.61 olduğu görülmüştür. Spor Tükenmişliği Envanteri’nin
spor alanında öğrenim gören üniversite öğrencilerinin spor tükenmişliği
düzeylerini ölçmede geçerli ve güvenilir bir ölçme aracı olduğu söylenebilir.
Araştırmadan elde edilen bulgular ilgili alanyazın ışığında tartışılarak
uygulayıcılara, gelecekteki araştırmacılara ve ruh sağlığı alanına ilişkin
öneriler sıralanmıştır.
12 Haftalık Hentbol Teknik ve Kuvvet Antrenmanlarının Atış ve Güç Performansı Üzerindeki Etkilerinin Değerlendirilmesi
Authors: Pilça Oğuzhan , Altun Muammer
Published: June 2019

Hentbolda kuvvet
antrenmanının performans arttırıcı etkilerini destekleyen çok sayıda çalışma
bulunmasına karşın, teknik antrenmanın etkisini gösteren kanıt yoktur. Bu
çalışmanın amacı, hentbol teknik ve kuvvet antrenmanlarının 9 m atış isabeti ve
güç performansı üzerindeki etkilerini karşılaştırmaktı. Çalışmaya 19-24 yaş
arasında 30 sağlıklı erkek hentbol oyuncusu gönüllü olarak katıldı. Ön testte
dikey sıçrama, 20 m sürat koşusu, sağlık topu atma, 30 sn şınav, 30 sn mekik ve
9 m kale atışı değerlendirildi. Sporcular, ön-test performanslarına göre
sayıları ve özellikleri eşit olan iki gruba ayrıldı. 12 hafta boyunca bir grup
teknik antrenman, diğer grup kuvvet antrenmanı yaptı. Antrenman programlarının
bitiminden 2 gün sonra aynı testler son test olarak tekrar edildi. Antrenman
programı sonrasında teknik grup 9 m isabet, dikey sıçrama ve 20 m süratte
anlamlı gelişme gösterdi (p<0.05). Diğer yandan kuvvet antrenmanı grubu,
şınav (p<0.05), mekik ve sağlık topu fırlatmada (p<0.01) anlamlı gelişme
gösterdi. Sonuç olarak, teknik antrenmanların hentbol oyuncularının hızlanmasını,
dikey sıçrama kuvvetini ve atış isabetlerini arttırması nedeniyle antrenman
programlarında teknik antrenmanlara daha fazla önem verilmesi gerektiği
söylenebilir.
Psychological Constructs as Predictors of Strength Gains in a Strength Training Course
Authors: Hadley Kathrine , Morrissey Joanna
Published: June 2019

Strength training has many benefits, both affective and physical health-related. However, little research has been done on the psychological constructs that play an important role in exercise adherence, maintenance, and outcomes regarding strength training specifically. The purpose of this study was to examine self-efficacy (SE), perceived competence (PC), and outcome expectancy (OE), several of the key psychological constructs, as predictors of strength gains in a strength training course. It was hypothesized that the changes in participants’ measures of SE, PC, and OE from baseline to post-training would predict participants’ actual strength gains, but not the levels of SE, PC, and OE at baseline and post-training independently. Participants (n=20; 50% 20-21 years old, 40% 22-24 years old, 10% 25 years or older; 60% female, 40% male; 45% Caucasian, 30% Hispanic/Latino, 20% multiracial, 5% Asian/Pacific Islander) in a 15-week strength training technique (STT) course completed a battery of psychological questionnaires assessing SE, PC, and OE in addition to fitness tests consisting of a vertical jump test, an estimated one repetition maximum bench press and a back squat at baseline, mid- and post-training. One-way repeated measures ANOVA was used to examine differences in SE, PC, and OE at baseline, mid-, and post-training. Spearman correlation and multiple regression analyses were used to determine the predictive specificity of baseline, mid-, post-training levels, and changes in SE, PC, and OE on strength gains. ANOVA results show a significant time effect, as there was a significant increase in all three variables over time, suggesting that course participation increased students’ SE, OE, and PC about strength training. Baseline scores, post-training scores, and changes in SE, PC, and OE were not significant predictors of changes in strength or power scores. These results suggest that while an instructor-led STT course may increase SE, OE, and PC for individuals with varying strength training experience and positively influence college students’ well-being, these psychological constructs may not predict strength gains. Future research should examine possible predictive factors for strength training outcomes in larger, more heterogeneous populations.
KEYWORDS: StrengthTraining; Self-Efficacy; Perceived Competence; Outcome Expectancy; Psychological Constructs; Kinesiology; Strength and Conditioning; Resistance Training
Surgical and intervention treatment of secondary pancreatic infections
Authors: Krivoruchko I. A. , Boyko V. V. , Mushenko Y. V. , Drozdova A. G.
Published: June 2019

Introduction. Many experimental and clinical studies have improved our understanding of the pathophysiology of acute pancreatitis. Today, there are no disagreements over the timing and basic indications for surgery in this disease, but there are still various surgical approaches.

Methods. A retrospective and prospective two-center controlled study was conducted in 582 patients with acute pancreatitis treated in 2004–2018. Age of patients was 53 ± 12,5 years. The classification of the disease was used according to the recommendations of the International Consensus 2012. Patients included in the study were treated in accordance with the IAP/APA (2013) recommendations adapted to local resources and procedures. Of 582 patients, 387 (66,5%) patients with mild to moderate heaviness performed complex treatment, including 89 patients undergoing surgery. According to the goals and objectives of the study, other patients were divided into two groups: the main group – 103 patients with secondary pancreatic infection, who used the tactic of treatment «step-up approach»; а comparison group – 92 patients with open surgical intervention.

Results. In the comparison group were used open necrosectomy and drainage. Postoperative complicationshavearisenin52 (56,2%)patients. After surgery died 26 patients (28,3%), 19 had a 30-day mortality and 7 had a 90-daymortalityof them. In the main group 62 (60,2%) patients were treated by percutaneous controlled ultrasound intervention, 26 (25,2%) by videolaparoscopic necrosectomy and drainage and at 5 (4,9%) drainage through the wall of the stomach or duodenum. In 10 (9,7%) open operations were performed (minilumbotomy, upper medial, left or right-winged minilaparotomy with formation of mini-bursostomy) with pancreatic necrosectomy, including at 5 decompressive VAC-laparostomy local access. Postoperative complications have arisen in 33 (32%) patients. After surgery died 15 patients (14,6%), 6 had a 30-day mortality and 9 had a 90-day mortality of them. When comparing the two strategies of the treatment-tactical approach, the number of postoperative complications and mortality were lower than in the group of patients who performed only open surgical interventions (х2 = 6,976, p = 0,011).

Conclusion. The our research showed that an individualized approach to patients with secondary pancreatic infection using the step-up approach provides a reduction in the number of laparotomic pancreatic necrosectomies and allows postponing «open» surgical interventions for a period after the 4th week from the onset of the disease and reducing the number of postoperative complications and mortality (х2 = 6,976, р = 0,031).
Diagnosis and treatment of destructive forms of acute pancreatitis
Authors: Mishchenko V. V. , Hrubnyk V. V. , Pustovoyt P. I. , Horyachyy V. V. , Velychko V. V. , Vododyuk R. Yu.
Published: June 2019

Purpose of the study. The study of the diagnosis and treatment of destructive forms of acute pancreatitis and the identification of possible ways to optimize them.

Materials and methods. Destructive forms of acute pancreatitis were found in 16,8%. The algorithm for treating acute destructive pancreatitis consisted in artificial ventilation of the lungs, adequate infusion therapy, peridural anesthesia, setting up a nasoenteric probe, stimulating the bowels, correcting hemodynamics, intraand extracorporal detoxification, antisecretory, anti-bacterial, hepatoprotective, cerebroprotective, antioxidant therapy, directed immune correction, use of anti-enzyme drugs, suppression of the release of mediators inflammation, external secretory activity of the pancreas. Medical video laparoscopy and puncture interventions under the control of ultrasound were used as the first stage of surgical treatment. The indications for traditional surgical interventions are large areas of aseptic destruction, unlimited infected pancreatic necrosis, infection of necrotic areas with complete cell sequestration, abscesses with large sequesters, abdominal phlegmon, signs of progressive multiple organ failure and the development of arousal hemorrhage, perforation of cystic formations in the abdominal cavity, perforation of a hollow organ, purulent peritonitis.

Results. The developed therapeutic tactics allowed, in destructive forms of acute pancreatitis, to achieve a reduction in overall mortality to 23,4%.

Conclusion. Diagnostic and treatment tactics for destructive forms of acute pancreatitis should be standardized depending on the timing, severity of the disease, localization and prevalence of the destructive process, systemic and local complications.
Structural analysis of morphometric and morphofunctional state of immunocompetent blood cells in case of purulent-inflammatory diseases of soft tissues on the background of type 2 diabetes
Authors: Zheliba M. D. , Bogachyuk M. G. , Pokidko M. I. , Khimich S. D.
Published: June 2019

Relevance. According to the study’s results, steady changes in various parts of the immune system: cellular, humeral, phagocytic activity is revealed in patients with type 2 diabetes. Hyperglycemia, hyperlipidemia, insulin resistance, and adaptive ehyperinsulinemia affect the cells of the immune system, promoting the development of metabolic immunosuppressant and forming a stable immunological disorder.

The purpose of the study into the morphometric and morphofunctional state of peripheral blood leukocytes in patients with type 2 diabetes to determine their significance in the development of purulent-inflammatory diseases of soft tissues are research.

Materials and methods. In this work, the analysis of morphometric, cytogystochemical and laboratory study results of the control (20 healthy volunteers) and thematic (47 patients with supportive soft tissue disease son the background of type 2 diabetes mellitus) study groups with the statistical processing of the obtained results was used.

Results. The investigation of morphofunctional features of nonspecific and specific protection cells for purulent inflammatory diseases of tissues on the background of type 2 diabetes showed that the basis of diabetic complications are there vealed changes in the bactericidal activity of segmented neutrophils. The trend of indicators of leukocyte formula and the distribution curve of mononuclear cells by size, as well as the growth of the lymphocyticgranulocytic index, indicate a chronic formation of endotoxin synthesize of diabetes.

Conclusions. Lowering the level of cationic proteins, the activity of myeloperoxidase and the NBT-test under stimulation of neutrophil granulocytes bylectinsis a sign of unsatisfactory state of the bactericidal cells system, which may be the cause of chronic and acute inflammatory processes in the body that accompany type 2 diabetes, to a functional exhaustion of the macrophage link in the organism immune defense.
Diagnosis and management of necrotizing fasciitis in the light of the recent recommendations
Authors: Kosulnikov C. O. , Lisnichaya V. N. , Besedin A. M. , Karpenko S. І. , Tarnopolsky S. A. , Kravchenko K. V. , Kudriavtsev A. S.
Published: June 2019

Summary: Necrotizing fasciitis is a rare but life-threatening infection of the soft tissues. It is characterized by spreading inflammation and necrosis starting from the fascia, muscles, and subcutaneous fat, with subsequent necrosis of the overlying skin. Necrotizing fasciitis is classified into four types, depending on microbiological findings. The diagnosis of this disease is difficult. Late diagnosis is observed in 85–100% of cases and is considered the only cause of deaths. Emergency surgical debridement is the primary management modality for necrotizing fasciitis. Vacuum assisted closure therapy is fast and effective wound closure method. Antibiotics and surgical debridement play a key role in the treatment of necrotizing fasciitis.In our hospital, there were 75 patients with necrotizing fasciitis in the last 5 years (type I – 92%, type II – 8%). We observed localization of necrotizing fasciitis in the perineum (32%), upper extremities and chest (25%), lower extremities (28%), abdominal wall and retroperitoneal space (15%). Mortality was 9,5%.
The differential diagnostics and sepsis surgical treatment and induced metabolically diseases in diabetic foot lesions patients
Authors: Podpryatov S. E. , Korchak V. P. , Podpriiatov S. S. , Nikolska V. V. , Nikolsky I. S.
Published: June 2019

Purpose of the study. The sepsis differentiation criteria and metabolically induced diabetic foot lesions must be established.

Material and methods. The 115 patients were observed.

Results and discussion. Sepsis by the qSOFA criteria was diagnosed in 3, heart failure of 3–4 class by NYHA classification estimated in 39 cases. High limb amputation had been performed to 18 patients, surgery on the foot to 97. Foot lesion relapse accompanied by unstable glycaemia had been observed in 25 cases. For the surgical correction of the diabetes ileoduodenoplasty had been performed in 7 cases, which resulted in uncomplicated wound healing in all patients.

Conclusion. Sepsis progression in patient with diabetic foot case proof indicates the necessity high lower limb amputation. Foot lesion relapse after the effective surgical sanitation indicate on metabolic disorder, not on sepsis. Surgical correction of the diabetes by mean of ileoduodenoplasty performing seems to be the reliable method of foot lesion relapse preventing.
Personalized approach to acute peritonitis treatment based on genetic studies
Authors: Polianskyi I. Yu. , Moskaliuk V. I.
Published: June 2019

The research presents treatment results of patients with peritonitis by using the personalized medicine principles, which are based on the choice of diagnostic, treatment and preventive measures taking in to account genetic, physiological, biochemical and other features of the patient.

Purpose of the study. The treatment results improvement of patients with peritonitis, the reduction of the complications frequency.

Materials and methods. 226 patients with signs of acute peritonitis had complex examination with serum cytokines and serotonin levels determination and analysis of the polymorphic sites alleles of IL1ß (-511C / T) and 5-HTTLPR genes by polymerase chain reaction evaluated the treatment outcomes using the developed algorithms. The treatment results with the use of developed algorithms were evaluated.

Results. The processes of peroxide oxidation, antioxidant protection, proteolysis, fibrinolytic activity and their role in systemic disorders of homeostasis are shown. The connection between the nature of inflammatory reactions, its distribution in the peritoneal cavity and variants of the IL1ß gene (-511C/T) was proved. The relationship between the character of intestinal motility disorders in the postoperative period and variants of the 5-HTTLPR gene, which regulates the serotoninergic mechanisms of intestinal contractility, is shown. The algorithms for personalized approach to the peritonitis diagnostics, prognosis of and choice of treatment tactics were developed on the basis of the identified genetically determined individual characteristics of the inflammatory process. Advanced stages of surgical intervention were developed.

Conclusion. Predictionofthecourseofperitonitis and the development of various complications based on genetic research allows developing algorithms of personalized therapeutic tactics, significantly improving the results of its treatment.
Step-up approach for acute infected necrotizing pancreatitis
Authors: Dronov O. I. , Kovalska I. O. , Gorlach A. I. , Lubenets T. V.
Published: June 2019

Purpose of the study. The role of interventional methods of the treatment of acute infected necrotic pancreatitis depending on the morphological characteristics of the disease was determined.

Material and methods. In present prospective cohort study, we included 96 patients with acute infected necrotizing pancreatitis. All patients were stratified according to morphologic features. Stepup approach with following steps of interventions was applied: percutaneous drainage of infected fluid collections, increasing of drainages diameter and number of it and open or minimally invasive necrosectomy. Clinical, laboratory, and instrumental monitoring were the defining indicators for the stopping of the treatment or for the passing to the next step of the treatment.

Results. At the first step 7 of 96 patients with superficial focal necrosis, a necrosis index of 2 points and a category D were successfully treated. Other 89 patients were passed to the second step of treatment, of which 23 patients with superficial subtotal necrosis, necrosis index of 2 points and category E were successfully treated. Another 66 patients had undergone a third step of treatment. A multivariate regression analysis was conducted that allowed to identify predictive factors of inefficiency of using of percutaneous drainage interventions (stages I and II) as a final stage of treatment: transmural subtotal or total necrotizing pancreatitis (OR = 1,58; 95% CI 1,03–3,88; p = 0,033); Necrosis index of 4 or more points (OR = 3.19, 95% CI 1.57–8.37; p = 0,003); heterogeneous peripancreatic fluid collection (OR = 4,15, 95% CI 1,49–5.19; p = 0,001); The CT-index of severity of acute pancreatitis of 7 or more points (OR = 1,89, 95% CI: 1,03–3,43; p = 0,029).

Conclusion. Step-up approach showed following results: 7,3% patients were treated at the first step, 24% – at the second step. Third step of treatment was applied in 68,7% of patients, of witch 12,5% was treated with laparoscopic necrosectomy. Predictors of ineffectiveness of ultrasound guided percutaneous drainage as the final treatment method are: necrosis index of 4 or more, heterogeneous paripancreatic fluid collections, subtotal and transmural necrotizing pancreatitis.
The deep femoral artery as a inflow source for distal reconstruction
Authors: Rusyn V. I. , Korsak V. V. , Rusyn V. V. , Horlenco F. V. , Dobosh V. M.
Published: June 2019

Purpose of the study. To improve the treatment outcomes of patients with occlusion-stenotic lesions of the femoral-popliteal-tibial segment, long-term results of the profundafemorispopliteal autologous vein bypass surgery have been studied.

Material and methods. In the surgical clinic of A. Novak Regional Clinical Hospital during the last 10 years has been performed 300 isolated profundoplasty at chronic limb ischemia. In 16 patients with deep femoral popliteal autologous vein bypass, a distal segment of arteria profunda femoris was used as the «tidal» artery, which varied from 0,51 to 0,63 in diameter (0,58 cm in average).

Results. In the immediate and long-term follow-up period, no thrombosis of profunda femoris popliteal autologous vein shunt was observed in 5 years. The ankle-brachial pressure index after surgery increases almost twice and approaches 0,9 on posterior tabial artery. The mean profunda popliteal collateral index score decreased to 0,301 ± 0,099 in all patients after surgery. Ifwecomparethequalityoflifeafterprofunda femoris popliteal autologous vein reconstruction, it should be noted that the quality of life in our patients before the operation was 21,8 ± 4,9 points, after the operation − 45,6 ± 4,9 points.

Conclusion. Profundafemorispopliteal autologous vein bypass by a length of up to 15 cm provides blood supply to the limb with stenoticocclusive lesions of the femoral-popliteal-tibial segment, with the passage of at least one artery of the leg and the arteries of the pedis.
Endotoxicosis indices as means of prognosis in surgical sepsis caused by purulent-necrotic complications of sugar diabetes
Authors: Pavliak A. Ya. , Pyptiuk O. V.
Published: June 2019

Purpose of the study. to study how the consequences of surgical sepsis caused by purulent-necrotic complications of sugar diabetes depend on the dynamics of endotoxicosis indices in the course of treatment.

Material and methods. The research included 30 patients with the symptoms correlating with the criteria for surgical sepsis caused by purulentnecrotic complications of sugar diabetes. The patients had their level of endotoxicosis measured and the severity of their condition evaluated according to the scale.

Results. 26 patients were discharged from hospital due to their recovery, 4 patients died. The purulent-necrotic complications lead to the development of intoxication syndrome and sepsis causing, in its turn, the decompensating of the disease, poly-organic insufficiency and the high lethality. Despite the conservative and surgical treatment carried out, the high indices of endogenic intoxication in the dynamics of the treatment proved to be a bad prognostic sign.

Conclusion. the monitoring of endogenous intoxication in patients with surgical sepsis caused by the purulent-necrotic complications of sugar diabetes in the treatment dynamics proves to be an important diagnostic and prognostic element helping to correct the treatment tactics and diminish the lethality.
Multidisciplinary treatment of ischemic forms of diabetic foot
Authors: Ivanova Y. V. , Klimova O. M. , Kryvoruchko I. A , Korobov A. M. , Prasol V. O. , Pityk O. I.
Published: June 2019

Purpose of the study. The phototherapy, platelet growth factor and coating materials in the treatment complex using for improve the results of wound treatment in patients with the ischemic form of diabetic foot.

Materials and methods. The analysis of the results of treatment of 48 patients with ischemic forms of diabetic foot syndrome has been performed in the work. The patients were divided into the study and comparative groups. The patients were treated at the clinic of the State institution «V.I. Zaitsev Institute of General and Emergency Surgery National Academy of Medical Sciences of Ukraine» from 2012–2018, and all patients had II stage diabetes mellitus and IV degree of ischemia by Fontaine. Patients in both groups performed open and hybrid reconstructions. In the patients of the study group, the developed treatment technology was applied, containing phototherapy and photodynamic therapy with a range of: λ 470, 525 or 405 nm in the preoperative period, closure with synthetic coating with application plasma enriched of transforming growth factor.

The implementation of the developed tactics allowed to achieve complete wound healing in 91,7% of patients, partial healing – in 8,3% of patients. The terms treatment terms for these patients did not exceed 2 months, high amputation was not required.

Conclusions. Plastic closure of the wounds of the lower extremities after revascularization operations in an ischemic diabetic foot syndrome is indicated in cases where wounds do not tend to spontaneous healing. The use of a treatment complex consisting of phototherapy and photodynamic therapy, the closure of wounds with a synthetic coating of transforming growth factor is the effective stimulator of development of granulation tissue in the wound, suitable for further autodermoplasty.
The ankle-brachial index value in patients with purulent-necrotic complications of diabetic foot syndrome
Authors: Matviychuk B. O. , Zaremba V. S. , Fedchyshyn N. R. , Tsymbala O. P.
Published: June 2019

Diabetes and predetermined him heavy purulent-necrotic complications is actual problem medicine today’s. It is proved that patients with diabetes have big risk to development of heart-vessel disease due to the development of atherosclerosis. Standard of diagnosis peripheral arterial disease of lower limb is finding ankle-brachia index (ABI). This method is good at definition of degree of arterial occlusion.

Purpose of the study. Purpose of the work: to analyse the diagnostic capability of ABI in patients who have purulent-necrotic complications of diabetic foot.

Material and methods. The prospective studies covered 218 patients. The average patients age 54,2 ± 10,3years, 45,5% of them – men. The mild form of disease was in 33,2%, moderate severity – in 45,2%, severe – in 21,6%. The duration of purulent-necrotic complications was 11,5 ± 1,2 days.

Results. We have seen that 128 patients have different degrees of macroangiopathy. in patients who performed amputation at the level of the thigh of ABI was 0,41 ± 0,13; at the level of the leg – 0,59 ± 0,12.

Conclusion. 1. Timely diagnosis is the basis of effective treatment of purulent necrotic complications of diabetic foot. 2. In treatment, it is necessary to take into account the indicators of ABI as the main diagnostic marker of peripheral artery disease of lower limb. 3. Definition of ABI is an objective and valuable predictive marker.
The closed method of surgical treatment of the post injection abscess of the gluteal region complicated by septic shock
Authors: Kapshitar A. V. , Kapshitar A. A.
Published: June 2019

We are represent the rare clinical case of the using of a closed method for the surgical treatment of the post-injection abscess of the gluteal region, complicated by septic shock and comorbidities (diabetes Mallory’s, lung silicosis, obesity) in the volume of opening an abscess, sanitation, throughand-through drainage with polyvinylchloride drain tube through an contrapperture and primary suture of wound with following-up permanent sanitation the abscess cavity. After the elimination of the purulentnecrotic process in the primary septic focus in conjunction with the multicomponent conservative intensive therapy, it was possible to impart an abortive course to the septic process after 4 weeks with a gradual normalization of the overall clinical picture, laboratories and biochemical parameters, coagulograms. The recovery has come.
The microbial landscape action on development destructive erysipelas forms
Authors: Vasilevskaya L. A.
Published: June 2019

Objective. Changes in the monoculture of the pathogen in the microbial association of bacterial pathogens is accompanied, depending on their species composition, the progression of the inflammatory process with the development of destructive forms. The object was to install the value of microbial landscape in predicting the development of destructive forms of erysipelas.

Material and methods. The diseases histories and cultures of wound secretions with the definition of sensitivity of microorganisms to antibiotics were analyses.

Results. Of our studies indicate that the microflora of the primary cells in destructive forms of the erysipelas changed both quantitatively and qualitatively. Detected microbial pathogens in bacteriological studies of soft tissue exudates allowed installing criteria for forecasting the development of purulent complications.

Conclusion. Bacteriological studies indicate that necrotizing skin lesions are preceded by the presence of S. Pyogenes in the exudates.
Abdominal Sepsis and Peritonitis: discussion and unsolved questions
Authors: Fomin P. D. , Shapoval S. D. , Sidorchuk R. I.
Published: June 2019

Abdominal sepsis (AS) is one of the most severe complications in abdominal surgery. Mortality from the AS according to various data can reach up to 80–90% depending on the etiology, peculiarities of pathogenesis and comorbidities. Purpose of the study is to determine the current state of the problem of abdominal sepsis, to identify problems and discussion issues and to outline possible perspectives for their solution. AS remains one of the important problems of modern urgent abdominal surgery, and ii is characterized by a large variety of etiological factors and polymorphism of the clinical picture. Changing the paradigm of sepsis (Sepsis-1, 2, 3) requires correction of treatment-diagnostic approaches in patients with acute abdominal surgery. Existing methods of diagnosing and treating abdominal sepsis are not effective enough, and therefore there is a need to improve them and develop new, adequate therapeutic approaches.
Experimental justification of the effectiveness of cord blood stem cell transplantation in chronic myocardial injury
Authors: Gabrielyan A. V. , Domansky T. M.
Published: June 2019

Purpose of the study. Determination of transplantation efficiency of cord blood stem cells (CB SC) for damage to the myocardium and assessment of the repair of its disturbed functions in the experiment.

Materials and methods. The experiment was conductedonmiceofthe FVBlineattheageof5 months, with a body weight of 25–30 g. Animals were divided into experimental groups of 5 animals in each. The animals of the study group were derived from the experiment before the SC suspension injection, after 2 days, 4 and 8 weeks after cell transplantation.

Results. Analysis of morphofunctional changes after the introduction of cord blood cells in 4 and 8 weeks compared to the original state (3 weeks after modeling of the isoproterenol induced myocardial injury model) has established a clear tendency to improve the investigated parameters. The confirmed phenomenon of self-referral of cord blood nto the lesion zone proves the expediency of transplantation by intravenous injection of a suspension of CB SC. It has been established that transplantation of CB SC causes a temporary deterioration of morphofunctional features, which may be a manifestation of the body's response to xenotransplantation. The CB SC transplantation has a positive effect on the isoproterenol-induced myocardial injury model.

Conclusions: 1. Accumulation of CBSC in the zone of injury after transplantation, proved by experimental research. 2. CB SC transplantation accelerates the processes of myocardial regeneration on the model of injury in laboratory animals. 3. Intravenous injection of the CB SC suspension to the models of myocardial injury proved to be effective. 4. The experimental results obtained can serve as the basis for further clinical studies in patients with heart failure.
Evaluation of dynamics of inflammatory process in patients with flegmones of shell-facial plants
Authors: Malanchuk V. A. , Sidoryako A. V.
Published: June 2019

Modern and glance at the methods of diagnosis and treatment of patients with odontogenic inflammatory diseases of the maxillofacial area and neck was and remains one of the pressing problems that are frequent complications that lead to disorders in the tooth-jaw system, and can be a direct life-threatening ill.

Purposeofthestudy. Toincreasetheeffectiveness of treatment of phlegmon of maxillofacial area and neck due to the active evaluation of the dynamics of the inflammatory process comparing a specific patient with standard indicatorschanges in the limits of edema of infiltration.

Materials and methods. We carried out diagnostics and complex treatment of 120 patients with odontogenic phlegmons, who were in hospital treatment. The patients were divided into 2 groups: group I – 60 patients, treatment of which was carried out by the traditional method. Group II – 60 patients, modern treatment methods regional administration of attibiotics, vacuum drainage of purulent wound and plasmolifting at the stage of reparation, were added to their standard therapy.

Conclusions: The proposed method is simple, reliable and does not require expensive equipment and makes it possible to predict the development of the disease only by clinical measurements of the volume of inflammation.
Sepsis as a cause of fatal cases after the lower limbs amputation at the hip level due to gangrene in patients with a diabetic foot syndrome
Authors: Kapshitar A. V. , Kapshitar A. A.
Published: June 2019

Purpose of the study. To study frequency of fatal sepsis, the causes and severity of diabetes patients complicated by diabetic foot syndrome of the gangrene limb, after amputation of the lower limb at the hip level.

Material and methods. Amputation of the lower limb at the hip level was performed in 180 patients with diabetic foot, gangrene of the limb. 15 (8,3%) died. Results. From the 15 patients who died, 9 died from sepsis. The age was 54–78 years old. On admission, sepsis was diagnosed in 5 and septic shock – in 4 patients. After examination and preparation, emergency surgeries were performed in 4 patients and urgent surgeries – in 5. Twoand three-step surgeries were performed in 5 patients. They first performed the removal of the toes of the gangrene, osteomyelitis, opened deep phlegmon of the foot and the lower leg was completed by amputation of the lower limb. Primary amputations were performed in 4 patients. Sepsis was the cause of death in 5 patients from 11 to 60 days and the combinations of sepsis with acute myocardial infarction or repeated myocardial infarction – in 4 from 5 to 17 days. During the autopsy, pathological changes of severe diabetes, complicated diabetic foot syndrome, its mixed form, sepsis with manifestations of septicemia or septicopyjemia, and all organs and systems were revealed.

Conclusions. The unsatisfactory organization of medical care for patients with diabetes and diabetic foot syndrome at the pre hospital stage, ineffective sanitary and educational work, systemic pathological changes led to sepsis and death after the amputation of the lower limb at the hip level.
Tactical and technical aspects of complex treatment of patients with acute destructive cholecystitis complicated with peritonitis and billary sepsis
Authors: Zaporozhchenko A. S. , Kravets K. V. , Bondarets D. A. , Zubkov O. B. , Kirpichnikova K. P.
Published: June 2019

Purpose of the study. To clarify the clinical and diagnostic criteria of BS, caused by complicated acute destructive cholecystitis for the development of optimal treatment tactics.

Material and methods. 193 patients with acute destructive cholecystitis and choledocholithiasis, complicated by peritonitis, had surgery on the basis of Odessa regional clinical center in the clinic of surgery № 2. All patients with BS were divided into two groups. In the first group, 115 non-invasive laparoscopic surgical interventions were performed. In the second group, 78 patients were performed laparotomy, cholecystectomy, choledochotomy and external drainage of choledoch duct, as well as external drainage of CAL.

Results. In patients with BS and obstructive jaundice, prior emphasis was placed on active surgical tactics, the use of noninvasive technologies in combination with intensive infusion and antibiotic therapy. Of great importance in the treatment of BS was also given to hemodynamic and respiratory support, detoxification with the use of efferent methods (hemosorption, plasmapheresis), rational antibiotic therapy, immunocorrection, antioxidants, and vitamin therapy.

Conclusions. Adequately initiated treatment with the use of modern methods of diagnosis and conservative therapy, surgical interventions in the early stages, reduces the percentage of development of severe complications and the number of fatal cases in this pathology. In perspective, it is necessary to determine more precise markers of biliary sepsis at an early stage, to improve methods of endoscopic surgery and detoxification treatment.
The wound process variants course in patients with diabetic foot syndrome in the vacuum therapy background
Authors: Gerasymchuk P. O. , Shidlovskyi V. O. , Fira D. B.
Published: June 2019

Purpose of the study. Study the effectiveness of vacuum therapy in the treatment of acute and chronic wound process in patients with diabetic foot syndrome, depending on the pathogenetic form of the lesion.

Materials and methods. The effect of vacuum therapy on the course of acute and chronic wound process in 231 patients with neuropathic and ischemic form of diabetic foot syndrome was studied during 2014–2017. Evaluation of the dynamics of the wound process was carried out on the basis of clinical, planimetric, microbiological, morphological methods, as well as microcirculation indices in the area around the wound.

Results. Vacuum therapy of acute and chronic wounds in patients with different pathogenetic forms of diabetic foot syndrome, allows to stabilize the course of wound process, stimulate regenerative processes in the wound, improve local microcirculation (p < 0,05). This, in turn, allows a shorter time to prepare a wound for closure by one of the methods of plastic surgery or create favorable conditions for its independent epithelization.

Inpatientswithischemiclesions(chronicarterial insufficiency of the third degree), the carrying out of vacuum therapy by standard method leads to an intensification of the pain syndrome. This causes the need to apply an initial negative pressure in the system in the range of 70–80 mm Hg, which makes it possible to stop pain during the day. At 2–3 days of the postoperative period, negative pressure is established at standard values.

Conclusion. Vacuum therapy of wounds in patients with diabetic foot syndrome is an effective method of treatment that allows the doctor to reduce the duration of treatment of patients in hospital with a neuropathic form of diabetic foot syndrome on average 4,3 ± 1,7 bed-days, and patients with ischemic form on average 4,1 ± 1,9 bed-days, which has both medical and social significance.
The clinical evaluation of sepsis-1 and sepsis-3 in patients with acute surgical abdominal pathology
Authors: Matvijchuk B. O. , Korol Y. A. , Pater Y. Z. , Bokhonko R. L. , Tsymbala O. P.
Published: June 2019

Purpose of the study. Comparison Sepsis-1 and Sepsis-3 use in clinical practice at patients with acute surgical abdominal pathology.

Materials and methods. The treatment results of 3302 patients with acute surgical abdominal pathology, which were operated at the clinic of the Chair of surgery and endoscopy at Lviv Danylo Halytskyi national medical university in 2008–2018 are analysed. In 272 (8,2%) cases there were signs of abdominal sepsis (AS). Gram-negative flora (E. coli in 198 (72,8%) of patients) was the most common cause of infection. We evaluated clinical and laboratory characteristics, which are used for stratification of patients according to classifications Sepsis-1 and Sepsis-3.

Results. Patients were stratified using Sepsis-1, of which 227 (83,5%) were diagnosed using Sepsis-3 (SOFA г 2). Mortality among patients with Sepsis-1 was 41,2% (112/272), among those with Sepsis-3 – 45,4% (103/227). Using Sepsis-3, 45 (16,5%) patients were excluded; values of APACHE II and SOFA, as well as length of stay in these patients was significantly lower; no deaths occurred. Therefore, diagnostic criteria of Sepsis-3 significantly reduce the number of patients with acute surgical abdominal pathology, complicated AS, compared with Sepsis-1. Diagnostic value of various factors that allow early detection of sepsis in the absence of an ideal standard is important.

Conclusion. Indicators of Sepsis-3 are informative in the diagnosis and staging of abdominal sepsis.
Orhun Yazıtlarındaki Er- Bar- İkilemesi Üzerine
Authors: UÇAR Erdem
Published: June 2019

Studies about Orkhun inscriptions proceed rapidly today. The approach to the inscriptions should now be more detailed in new researches. There are still problems with translations the inscriptions. Detailed explanations should be made on each word for correct understanding of the sentences in the Orkhun inscriptions. The reduplication är- bar- is found in four places: Köl Tigin East 23 = Bilgä Qaγan East 19, Köl Tigin North 1 and Bilgä Qaγan East 29. The four reproductions, which provide a copy of the inscriptions, have allied with the signs in the reduplication. Therefore, there is no difference in the reading of the reduplication. The article lists the previous interpretations for the reduplication. After the interpretation proposals were analyzed, the meaning of the reduplication in question were re-evaluated.
KHABTAGAEVA, B. Language Contact in Siberia: Turkic, Mongolic, and Tungusic Loanwords in Yeniseian, Brill, Leiden-Boston, 2019, pp. 404, ISBN: 978-90-04-39076-8
Authors: PIISPANEN Peter
Published: June 2019

KHABTAGAEVA, B. Language Contact in Siberia: Turkic, Mongolic, and Tungusic Loanwords in Yeniseian, Brill, Leiden-Boston, 2019.
Orhun Yazıtlarındaki Durum Eklerinin Sentaktik İşlevleri Üzerine
Authors: POLAT Hulusi
Published: June 2019

Case suffixes form various meaning relations in the sentence. The semantic and syntactic functions of the morphological aspects of the case suffixes should also be considered. These suffixes, whose actual functions appear in syntactic structure, serve as subjects, objects and complementary functions in the sentence. Orkhon inscriptions, which is one of the first written documents of Turkish, is an important source in the study of the grammatical development of the Turkish language. In order to determine the usage and functionality of the case suffixes in the historical period, the case suffixes used in the Orkhon inscriptions were examined in this study.