bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-term oncological results of radical prostatectomy in patients with localized prostate cancer
Authors: С. О. Возіанов  , С. М. Шамраєв  , М. Д. Соснін  , А. М. Леоненко  , А. А. Грицаюк
Published: December 2018

The objective: was to perform a comparative analysis of the direct results of a pathomorphological study of the organo-complex removed from radical prostatectomy and the frequency of biochemical recurrence (BCR) in patients with localized prostate cancer (RPP) in the performance of a retropubic radical prostatectomy (PRPD) and endoscopic radical prostatectomy (EDGE) clinics.Materials and methods. The clinical study involved 360 patients who had undergone PRPE or ESRD in the clinic of the Institute of Urology of the National Academy of Medical Sciences of Ukraine during 2012-2016. The patients were divided into two groups. Group 1 (n = 99) – patients who were operated in the clinic in the volume of PRPE from 2012 to 2016 inclusive, who have localized PCa, or the status of pT0. Group 2 (n=261) – patients who were operated in the clinic in the volume of ERSE from 2012 to 2016 inclusive, who have been diagnosed with localized PCa, or the status of pT0.Results. PRP and ESRP, which are performed by patients with localized PCa in a clinic for a five-year period, show comparable oncological outcomes.The conclusion. The implementation of multifocal biopsy and radical prostatectomy (RPE) in the same clinic promotes better comparability, reproducibility and greater consistency of the obtained morphological data. It is necessary to introduce a routine immunohistochemical study of biopsy material for further clinical practice to confirm the diagnosis of prostate cancer before performing RP.
Development and validation of a questionnaire for recurrent urinary tract infection RUTIQ
Authors: Ф. І. Костєв  , Є. І. Лукинюк  , М. В. Шостак
Published: December 2018

The objective: development and validation of a questionnaire for diagnosis, detailing and population assessment of clinical and laboratory symptoms and assessing the quality of life of patients with recurrent UTI RUTIQ (Reccurent Urinary Tract Infection Questionnaire).Materials and methods. To assess the sensitivity of the questionnaire to changes, depending on the severity of clinical changes and the total score, the questionnaires were divided into two groups. Based on the results of testing, the first group included patients with an initially high score of the questionnaire and, accordingly, more pronounced clinical manifestations. The second group included patients with a relapse of the urinary tract infection, indicating moderate changes in the physical and psychoemotional state, with moderate clinical manifestations of the disease. Patients received standard therapy and 10 days after the initial questionnaire completed the questionnaire again. A survey of the validation of the RUTIQ questionnaire was completed by 49 respondents. The age of the patients ranged from 21 to 77 years, the average age was 37.2 ± 3.7 years. The average duration of the disease is 6.1 ± 1.1 years.Results. The results of this study confirm the high psychometric properties of the domains of the questionnaire, their accessibility and informativeness, questions and answers to patients are clear and understandable. Positive and reliable correlations between the obtained test results and comparator questionnaires, UTISA and SF-36, satisfactory sensitivity to changes suggest that RUTIQ domains can statistically reliably reflect the course of the disease, social functioning and changes in the quality of life related to health.The conclusion. The application of the questionnaire allows to significantly optimize the primary and repeated diagnostic tactics in patients of the target group, to study in detail the features of the history of the disease, the details of the medical history, the details of the nature of the transferred therapeutic and diagnostic activities with a high level of reliability.
Scientific-practical conference of sexologists and andrologists of Ukraine «Achievements and perspective of modern sexology and andrology»
Authors: Ю. М. Гурженко  , В. В. Спиридоненко
Published: December 2018

17–18 травня 2018 року в м. Києві на базі Національної медичної академії післядипломної освіти імені П.Л. Шупика відбулася науково-практична конференція сексологів та андрологів України «Досягнення та перспективи сучасної сексології та андрології». Забезпечили проведення конференції фірми-спонсори: представництво «Берлін-Хемі/А.Менаріні Україна ГмбХ» (Німеччина); ТОВ УА «Про-Фарма» (Україна); представництво компанії «Пфайзер Експорт Бі. Ві.» в Україні; ПРАТ «Фітофарм» (Україна); ТОВ «Хербілайфсаєнс – Україна» (Україна); ТОВ «Гармонія Україна» (Україна); представництво «АТ «Нижегородський хіміко-фармацевтичний завод» (Німеччина); ТОВ «Український інститут сексології та андрології» (Україна); ТОВ «Клімед Україна» (Україна); ТОВ «Біонорика» (Німеччина); ТОВ «Фармюніон БСВ Девелопмент» (Україна); ПП «МБ-Сервіс» (Україна). Генеральний інформаційний спонсор – ТОВ «Професіонал-івент». Інформаційні спонсори – журнали «Здоровье мужчины», «Репродуктивное здоровье. Восточная Европа», «Участковый врач», медицинская газета «Здоровье Украины».
Scientific-practical conference with international participation «Urology, andrology, nephrology – 2018. Achievements, problems, ways of solving»
Authors: Ю. М. Гурженко
Published: December 2018

24–25 травня 2018 року в першій столиці України, в місті Харкові, було проведено науково-практичну конференцію з міжнародною участю «Урологія, андрологія, нефрологія – 2018. Досягнення, проблеми, шляхи вирішення». Місцем проведення конференції було обрано гордість харків’ян – стадіон ФК «Металіст».
Experience of application of D-mannosis in inflammatory diseases of the urinary system (Analytical review of literature)
Authors: Ю. М. Гурженко  , В. В. Спиридоненко  , О. Ю. Гурженко
Published: December 2018

The article summarizes and demonstrates the positive experience of using multicomponent drugs with D-mannose content of inflammatory diseases of the urinary system on the basis of scientific works of various researchers.
Features of the composition of hospitalized patients with benign prostatic hyperplasia in the aspect of the outpatient stage of medical care
Authors: С. П. Пасєчніков  , Я. М. Клименко  , Ахмед Моаллім Абдулфатах  , Я. М. Мельничук
Published: December 2018

The objective: analysis of data on the current composition of patients with benign prostatic hyperplasia (BPH) hospitalized for surgical care.Materials and methods. The study involved 266 patients with BPH, who underwent transurethral resection of the prostate in the profile department of the Aleksandrovsky Clinical Hospital in 2015–2016 in order to assess the general condition of the patients at the time of hospitalization and to identify the problematic issues of providing medical care in ambulatory-polyclinic conditions.Results. It was found out that the significant majority was hospitalized urgently (53,0%), more often in the winter-autumn period of the year (60,4%), the age of which differs be a large percentage of patients under 60 years (12,8% versus 10,4% with a planned one). Among them, men were about 70 years old, 10% were newly diagnosed cases, half of them had symptoms of lower urinary tract (LUT) during 5 years at the time of going to the doctor. With rare exceptions, patients were treated conservatively, took α -adrenoblockers (2/3 to 5 years, 1/3 – 5 to 10 and more years). In 27,8% of patients, there were repeated cases of acute urinary retention (AUR), twice as often among urgently hospitalized ones. Practically all the course of the diseases was complicated by concomitant pathology (1227 nosological units of diseases of different organs and systems). There number increases with age: one patient at 44 to 59 years old had in average 3.0; 60–69 – 4.4; 70–79 – 5.2; ≥80 years – 5.6. Cardiovascular diseases prevail, in every forth there is chronic inflammatory, metabolic syndrome (DM, obesity).Conclusion.The findings confirmed a clear relationship between the volume of the prostate and intravesical prostatic protrusion (IPP) – r=0.33, which was more pronounced with a maximum urination rate (r=0.59) with the residual volume. It was revealed that with the increase of IPP the volume of residual urine decreases with a simultaneous deterioration of the quality of life and an increase in the LUT symptomatology. However, they do not depend on the volume of the prostate.
Experience of application of combined treatment patients with chronic non-spectacular prostate with using polycomponent medicine and alpha adrenoblockatоrs
Authors: Ю. М. Гурженко  , В. В. Спиридоненко  , О. С. Федорук
Published: December 2018

The objective: was to analyze the clinical efficacy of the complex treatment of men with chronic prostatitis (CP) using the drugs Pravenor® in capsules and Omiks at 0.4 mg.Materials and methods. Outpatients were 77 men with chronic nonspecific prostatitis, which is accompanied by symptoms of the lower urinary tract. The age of patients ranged from 22 to 36 years, the duration of the disease – from 8 months to 4 years. All 77 patients with CP completed the full course of complex treatment with the use of drugs Pravenor® in capsules and Omiks at 0.4 mg. The duration of treatment was 90 days.Results. As a result of the complex treatment of men with CP with the use of drugs Pravenor® and Omiks, the condition of the patients quickly improved. The use of therapy provided a fairly rapid clinical effect. Painful sensations were eliminated after completion of the course of treatment in 26 (92.9%) of 28 subjects, dysuric phenomena were eliminated in 72 (93.5%) of 77 patients.Conclusion. The use of drugs Pravenor® and Omix in men with chronic prostatitis (CP) is clinically justified. The efficiency was 93.5%. The use of drugs Pravenor® and Omix in men with CP was accompanied by good tolerability and a small number of side effects (5.2%). The results obtained make it possible to recommend the use of the drug Pravenor® and alpha-blocker Omix for complex treatment of CP.
Syndrome of postejaculation pain and tamsulosin: opportunities and prospects of therapy
Authors: І. І. Горпинченко  , Ю. М. Гурженко  , В. В. Спиридоненко
Published: December 2018

The objective: The study is devoted to the evaluation of the clinical efficacy of mono– and combination therapy with tamsulosin in men with chronic prostatitis (CP), both independently and on the background of benign prostatic hyperplasia (BPH) complicated by post-ejaculation pain (PEP).Materials and methods. The study was conducted in the Department of Sexual Pathology and Andrology of the DU «Institute ofUrology of NAMS of Ukraine» for 1 year. The study included results of outpatient treatment in 145 males (mean age 31±2,5 years) who had a chronic abacaviral prostatitis and/or benign prostatic hyperplasia complicated by painful ejaculation. Patients were divided into three groups: in group I (n=41) patients received standard therapy (nonsteroidal anti-inflammatory drugs, phytopreparations); Group II included patients (n=72) who took standard therapy with tamsulosin inclusion (Flosin®, Menarini Group) at a dose of 0,4 mg/day in the morning, after eating. The third group included patients with verified HAP and BPH (n=32) who received Flosin® 0,4 mg/day in monotherapy for 60 days. The examination was carried out before and after 1, 3 and 12 months after the start of treatment.Results. The best results were shown in group II patients, where the indicator quickly reached the norm and remained at a high level for 1 year. In individuals of group I, it was less high and did not remain at the desired level throughout the year, while in group III patients, with a low initial evaluation, showed good data throughout the year.Conclusion. The effectiveness of traditional combined therapy of post-ejaculation pain syndrome was 75,6%, monotherapy of chronic abacterial prostatitis and benign prostatic hyperplasia with tamsulosin – 90,1%, and combination therapy with tamsulosin – 93,1%, which allows us to recommend the use of tamsulosin for the treatment of the above pathology.
Applying of metabolic therapy for correction of endothelial dysfunction manifestations in patients with urolithiasis
Authors: Є. А. Литвинець  , Н. Т. Скоропад
Published: December 2018

The objective: of the study was to investigate the functional state of vascular endothelium in patients with urolithiasis and to evaluate the effectiveness of using arginine in endothelial dysfunction correction in this category of patients.Materials and methods. An analysis of the concentration of endothelin-1 (ET-1) in the blood serum of 60 patients with urolithiasis (calcium-oxalate nephrolithiasis) has been performed.Results. Endothelin-1 levels in serum in patients with urolithiasis, were significantly higher than in healthy subjects. Such changes in the concentration of endothelin-1 indicate endothelial dysfunction in patients with urolithiasis.Conclusion. The elevated level of ET-1 in patients with urolithiasis and its increase with the progression of the disease may be one of the leading pathogenetic factors of the occurrence and progression of pathology in the kidney and confirms the expediency of the use of drugs with metabolic action in complex therapy. The use of arginine in the complex therapy in patients with stone kidney disease after stone removal can reduce the level of ET-1 and prevent the development of complications.
Using supervisors in Vitaprost Forte for correction of eyaculate indicators in men
Authors: Ю. М. Гурженко  , В. В. Спиридоненко
Published: December 2018

The positive experience of the use of the drug Vitaprost Forte by STADA (Russia) for correcting the pathospermia caused by excretorytoxic infertility in 76 men is shown. The drug is well tolerated, has minimal side effects.
Psychodiagnostic and psychotherapy for men with sexual disorders
Authors: І. І. Горпинченко  , М. М. Соколова
Published: December 2018

In a help to the practical doctor the basic questions of psychodiagnostic and psychotherapy of sexual disorders are considered a sexual health specialist for men. Attention applies on the necessity of their use for practice.
Efficiency of phytotherapy in preventing exacerbations of secondary calculous pyelonephritis and metaphylaxis of urolithiasis
Authors: Є. А. Литвинець  , В. Є. Литвинець
Published: December 2018

The objective: to analyse the efficacy and safety of phytopreparation Canephron® N in order to prevent exacerbations of secondary chronic calculous pyelonephritis and metaphylaxis of urolithiasis (MU).Materials and methods. An open monocentric comparative study in which took part 60 patients with MU and secondary chronic calculous pyelonephritis. The age range of patients was from 28 to 70 years (mean age – 46.3 ± 2.6 years). There were 24 men (40.0%) and 36 women (60.0%). All patients who were included in the  study, on the eve had removal of stones and treatment of pyelonephritis. In order to metaphylaxis of MU and prevention of exacerbation of the secondary chronic calculous pyelonephritis on the basis of a random sample patients were divided into two groups. Patients of the main group (n = 30) received Canephron® N 2 pills or 50 drops 3 times a day for 3 months. Patients of the second group (n = 30) took a phyto tincture «Renal» 50 ml 3 times a  day for 3 months.Results. Analysis of patients monitoring results shows that the use of Canephron® N for 3 months after the removal of stones and treatment of secondary chronic calculous pyelonephritis significantly reduces the frequency of recurrences of chronic calculous pyelonephritis and formation of recurrent kidney stones.Conclusion. Canephron® N has no side effects, is well tolerated by patient. And can be recommended for use in preventing formation of recurrent concrements and exacerbations of secondary chronic calculous pyelonephritis.
The results of combined conservative treatment after photoselective laser vaporization of the prostate gland over her benign hyperplasia
Authors: І. І. Горпинченко  , Ю. М. Гурженко  , В. В. Спиридоненко  , А. М. Ситенко
Published: December 2018

The objective: to evaluate the clinical efficacy of combined therapy with Serenoa repens extract (Prostamol Uno) and selective α-adrenoblocker (Flosin) in patients with BPH stage II III after performing Photoselective Laser Vaporization of the Prostate (PLVP).Materials and methods. The patients were divided into four clinical groups. Patients in group 1 (n = 17) did not take medical treatment after FSLVP, follow up was established for them. Patients in the 2nd group (n = 28) received monotherapy with Prostamol Uno, which they took before bedtime 1 capsule daily for 3 years. Patients in 3rd group (n = 27) received Flosin in a dose of 0.4 mg, 1 capsule per day in the morning after eating for 3 years. Persons in the 4th group (n = 29) received combination therapy: Prostamol Uno 1 capsule per day before bedtime and Flosin in a dose of 0.4 mg, 1 capsule per day in the morning, after eating, for 3 years. The examination carried out in the period after 1 and 3 years.Results. As a result of the study, it was found that the best results were observed in patients who received combined conservative therapy with Serenoa repens extract and tamsulosin after PLVP.Conclusions. Rehabilitation in persons with BPH, who under went minimally invasive interventions PLVP require long term therapy with a combination of palm extract Sabal (Prostamol Uno) and selective α-blocker (Flosin). Combination therapy with  Prostamol Uno and Floxin is pathogenetically highly effective and safe, which facilitates the rapid elimination of irritative and obstructive symptoms, with an improvement in the patient’s quality of life.
Intra-cavernous transplantation for treating erectile dysfunction: modification of the adhesive properties by SYT1 / SYT2 molecules enhances the ability of stem cells to restore the contractile and phosphatase activity of cavernous tissue damaged due to h
Authors: І. І. Горпинченко  , А. М. Ситенко
Published: December 2018

The objective: check the assumption that stem cells with modified adhesive properties (SC-m-SYT1/SYT2) should be more pronounced than native SCs, restore the phosphatase and contractile activity of cavernous tissue damaged by hyperglycemia.Materials and methods. A comparative study of the effect on the contractile and phosphate activity of the cavernous tissue of four intra-cavernous injections (ICI) (1106 cells once a week) of native stem cells (SC) and cells, with SYT1/SYT2 molecules, integrated into the cell membrane (SC-m-SYT1/SYT2), was performed in two groups (n=10; 1:1) of sexually mature Wistar rats weighing 160-180 g with induced hyperglycemia (>8 mmol/L).Results. It was found that, at the end of the ICI in the group of animals receiving SC-m-SYT1/SYT2, the median amplitude of contractions was 1.6 times greater (р<0,05, Wilcoxon’s test), and the intensity mediants for ATPase and LF, respectively, 2 and 1 points greater than in the group where native SCs were introduced (р<0,05, Wilcoxon’s test). ICI of native and modified SC did not affect the level of glycemia.Conclusions. Modification of the adhesive properties of SC by SYT1/SYT2 molecules increases their ability to restore contractile and phosphatase activity of cavernous tissue damaged by hyperglycemia. Further research is needed on the processes of homing and differentiation of SC, modified with SYT1 / SYT2 molecules, in intact and pathologically altered cavernous tissue in vitro and in vivo.
Monitoring of sexual satisfaction couples after penile implantation
Authors: М. О. Щербак  , О. М. Корнієнко
Published: December 2018

The objective: analysis of the effectiveness of implantation of the prosthesis of the penis in the treatment of erectile dysfunction (ED) with an emphasis on the satisfaction of both sex partners. Materials and methods. The study involved 80 couples (men were diagnosed with ED of severe degree of organic form), later men underwent penile implantation. Patients were divided into two groups: 1st group - 40 pairs, in which the male was implanted with a plastic implant; 2nd group - 40 pairs, in which the male was fitted with a hydraulic implant. To diagnose the organic form of ED, dopplerography of the penis vessels, a test with local negative pressure, dynamic cavernosography, angiography was used.Results. After the surgical intervention, 5.0% of the patients of the 1st group and 12.5% of the 2-nd group had minor complications that did not require replacement of the implant. Sexual life was resumed no earlier than 6 weeks later. As a result of the study, it was found that the frequency of sexual acts in subgroups 1a and 2a averaged 10 ± 2.2 times a month, in subgroups 1b and 2b – only 4 ± 1.2 times a month.Сonclusion. Psychological counseling increases the possibility of interpersonal adaptation of sexual partners after penile implantation from 65% to 95%.
Pediatric criteria of Rome IV: changes and comparisons with the Roman criteria of III
Authors: С. І. Єсипова  , Б. Я. Дмитришин  , О. А. Бовкун  , О. А. Дмитришин
Published: December 2018

The relevance of the problem of functional gastrointestinal disorders in childhood has determined the purpose of our study. In 2016, new Rome criteria IV functional gastrointestinal disorders in children were introduced. In this article, we present the main changes that have been made in the Rome criteria IV in comparison with the Rome criteria III, their analysis, clinical and diagnostic significance in the practical work of a pediatrician. There is no doubt that the FGID problem requires further study to improve the provision of medical care for children with gastrointestinal pathology.
Risk Factors of cardiovascular diseases in patients with psoriatic arthritis
Authors: Л. В. Хіміон  , А. В. Бойко
Published: December 2018

The performed literature data analysis was carried out to assess the risk of developing cardiovascular events in patients with psoriatic arthritis, taking into account comorbid conditions and mortality in psoriatic arthritis. The increase in mortality is due, in the first place, to myocardial infarction and cerebral circulation disorder. Also, 23 patients with psoriatic arthritis aged 18 to 45 years with their own analysis of traditional risk factors were monitored. Dyslipidemia in psoriatic arthritis is manifested by an increase in the level of total cholesterol, lowdensity lipoprotein cholesterol. These indicators correlate with the inflammatory activity of the disease. Chronic immune inflammation, which underlies this disease, contributes to the development of atherosclerosis and its complications.
EMAP-II in metabolic syndrome
Authors: Л. А. Могильницька
Published: December 2018

The objective: тo determine the serum level of EMAP-II as a marker of endothelial dysfunction in patients with metabolic syndrome, to study its relationship with the other risk factors for cardiovascular disease.Materials and methods. We examined 23 patients with WHO criteria of metabolic syndrome, 30 patient with ATP III criteria of metabolic syndrome, 18 – IDF criteria, 22 healthy control subjects. The content of EMAP-II was determined by an enzyme immunoassay using the Amprer column (Amersham Lifesilence) and the Amersham pharmacia biotech test system (England). Serum levels of EMAP-II were determined by immunoenzyme assay. The data were presented as means±SD. Statistical analysis was performed using the Student test, Person rank correlation coefficient.Results. We found an increased serum level of EMAP-II in patients with WHO, ATP III, IDF criteria of metabolic syndrome compared to control group (4,22±1,96 ng/ml, 3,95±2,04 ng/ml, 3,92±2,04 ng/ml and 1,46±0,65 ng/ml respectively; р<0,05). Also, the level of EMAP-II correlated with key markers of insulin resistance, carbohydrate and lipid metabolism (p<0,05).Conclusion. The revealed changes of EMAP-II serum levels could reflect an endothelial dysfunction in patients with metabolic syndrome. Insulin resistance, hyperglycaemia, dyslipidemia appear to be significant contributing factor to the elevation of EMAP-II.
Rational antibiotic therapy of the first line for the treatment of patients with non-severe lower respiratory infections
Authors: Т. О. Перцева  , Т. В. Кірєєва  , К. О. Бєлослудцева  , Б. О. Басіна
Published: December 2018

In accordance with the European and National guidelines for the management of mild lower respiratory tract infections (LRTIs), macrolides have always played a leading role in the treatment of this pathology.The objective: the purpose of this study was to evaluate the efficacy, safety and rationality of the prescribing of azithromycin (Chemomycin® from the manufacturer Hemofarm AD, Serbia) to patients with nonsevere LRTIs, as well as to determine the optimal dosing schedules for this nosology.Materials and methods. The study was attended by 20 patients with non-severe LRTIs who needed outpatient treatment. After diagnosis, ABT was prescribed for patients. Depending on the treatment regimen, all patients were randomly divided into 2 groups: the main group was 10 patients with non-severe LRTIs who took the azithromycin (Chemomycin®) for the «three-day» schedule – 1, 2, 3 days to 500 mg 1 time per day, comparative group – 10 patients with non-severe LRTIs who took azithromycin for the «six days» schedule – 6 days for 500 mg once a day.Results. All patients included in the study found recovery. At the same time, clinical benefit from the use of a six-day regimen with azithromycin was not observed. In the treatment of patients, there were no apparent clinical side effects of the drug. In patients with the presence of concomitant cardiology, the deterioration of the condition, the appearance of new changes and/or prolongation of the QT interval (clinically and according to the electrocardiogram) was not observed in any case. The economic advantage of treating patients in the main group was evident. So, given the average price for Chemomycin® (100 UAH per 3 capsules), this saved a lot of money for patients.Conclusion. The presence of concomitant pathology and bed habits in patients with chronic diseases in our region is a risk factor for the presence of respiratory pathogens that are resistant to beta-lactams (intracellular and those producing beta-lactamase); this determines the priority choice of macrolides (mainly azithromycin) as firstline ABT drugs (in accordance with the current recommendations), which not only acts on such strains, but also has additional positive effects (including the destruction of the biofilm of the Haemophilus influenzae). The three-day oral azithromycin (Chemomycin®) is not only safe and highly effective in the treatment of non-severe LRTI s, but also has a significant economic advantage over the six-day course. Chemomycin® drug is well tolerated, it may be recommended as a drug of choice for the first line of ABT in patients with CAP of the first and second clinical groups and infectious exacerbation of COPD.
The prediction of pneumonia in patients with immunity disorders on the background of onkolohematological pathology
Authors: І. С. Борисова
Published: December 2018

In the study, on the basis of statistical analysis of the complex of clinical-laboratory, anamnestic and immunological parameters of 495 patients, predictors of pneumonia were determined and a logistic model of the prediction of the occurrence of pneumonia in patients with immune disorders on the background of oncohematological pathology was developed, which included indicators that are characteristics of the course of oncological diseases of the blood, as well as indicators of immune reactivity.
Medical Forum XIII and XXIII medical exhibition «GalMED»
Authors: Л. В. Хіміон
Published: December 2018

Львівський медичний форум – найбільша подія Західної України, куди з’їхались вчені, фахівці з різних галузей медицини, представники відомих фірм-виробників України та Європи.Детальна інформація на: www.galexpo.com.ua, www.facebook.com/Lviv.Medical.Forum/
Determination of frequency dispensary examinations of school-age children with peptic ulcer disease of the duodenum with the help of a formalized model
Authors: О. Г. Шекера  , П. М. Яблонський  , Д. В. Мельник
Published: December 2018

The current state of public health in Ukraine is characterized as a crisis. The article is discussed the frequency of clinical dispensary surveys by mathematical modeling using. Gastrointestinal patients are among those patients for which clinical dispensary surveys should be provided necessarily. Now there are some practical recommendations on the frequency of clinical dispensary surveys based on clinical grounds. At the same time, these recommendations are not possible to determine the quantitative effect of frequency of clinical dispensary surveys on the effectiveness of clinical examinations.The objective: is the study of the frequency of clinical dispensary surveys to ensure maximum efficiency of school children with duodenal ulcer regard to their level of disease, the characteristics of health care, the level of applications for health care, duration of treatment and so on. Patients and methods. The mathematical modeling method; system and process analysis methods.Results. According to the research program, we studied and analyzed the modern mathematical models that can be used to describe a real health care system. Given the peculiarities of dispensary health care system (its formal modeling) for school age children with duodenal ulcer we included the following main considerations: 1) health care of Patients is in the form of mandatory clinical dispensary surveys at regular intervals along the possibility to Patients’ appeal for health care in time intervals between the clinical dispensary surveys; 2) Patients do not always seek treatment for various reasons in the range between clinical dispensary surveys; 3) there are a number of false Patients applications for health care; 4) the Patients’ disease level is one of the main factors that determine the volume as medical care and clinical dispensary surveys; 5) it is important to determine the frequency of clinical dispensary surveys for the average interval between diseases; 6) the actual level of health care quality – namely timeliness and accuracy of diagnostic in Primary Health Care Centers (family medicine clinics) and in hospital; 7) time wasting of Patients’ rehabilitation and spent time on the clinical examination when Patients apply for medical care and clinical dispensary surveys; 8) most of the indicators is random. The health care formalized model of Patients is proposed the various options trajectory random process model is discussed in the article.Conclusions. The results enable General Practitioners – Family Physicians and Health Care Managers to optimize the organization of medical care of gastroenterology patients usage by forecasting a patient and patient groups level of efficiency.
Anemic state of patients with breast cancer with multiple bone metastases during the courses of systematic radionuclide therapy
Authors: М. М. Фірсова
Published: December 2018

Тhe article contains analysis of anemia cases that have been registered in patients with breast cancer with multiple bone metastases during the courses of systematic radionuclide treatment. The anemia cases have been registered in 60 65% of patients, disregarding of exact radiopharmaceutical applied. Average period of anemia appearance was 4-6 weeks. Level of anemia manifestation was dependent on initial medical status of patients and their subjective compensatory abilities. Anemia in this category of patients is to greater extend linked to the prolongation of their main disease. Anemic states are not registered during remission and stabilization processes after steady therapeutic effect is achieved in radionuclide treatment courses.
Prospects of minimally invasive methods of anesthesia for laparoscopic bariatric interventions in patients with morbid obesity, according to the principle of accelerated rehabilitation
Authors: В. І. Черній  , В. В. Євсєєва
Published: December 2018

This clinical article presents clinical examples of the successful implementation of the program for accelerated management of the postoperative period in patients with morbid obesity after laparoscopic stomach longitudinal resection , using combined anesthesia based on intravenous administration of propofol, inhalation low flow anesthesia with sevoflurane, and peri operative multimodal analgesia.The objective. Was optimization of methods of general anesthesia of bariatric surgical interventions in patients with morbid obesity.Patients and methods. 26 patients with a BMI of 36-45 took part in the study, who underwent laparoscopic stomach longitudinal resection with the use of combined low flow anesthesia with sevoflurane and multimodal analgesia. All patients underwent the concept of minimally invasive intraoperative anesthetic monitoring and an accelerated postoperative rehabilitation program.Results. The dynamics of the values of central hemodynamics showed a high hemodynamic stability at all stages of the operation, with a tendency towards normalization of initially elevated blood pressure. The indices of the adequacy of oxygenation and ventilation (SpO2 and EtCO2) corresponded to normal values and did not differ from the level of stress norm. In all patients, recovery of spontaneous breathing occurred on average 8 minutes after the end of the operation. Extubation was performed on the operating table in 8±2 minutes (p=0,05), therefore, prolonged artificial ventilation was not required. At that, the level of postoperative pain on the operating table by VAS was minimal – 0–2 points. In the early postoperative period, the pain level according to the VAS in patients was on average 3±2 points (p=0.05). Accordingly, there was no need for narcotic analgesics. All patients were activated within the first 24 hours after the operation. Patients were discharged on 2,9±0,25 days after the operation (p=0,05).Conclusion. Inhalation low flow anesthesia based on sevoflurane with the use of multimodal analgesia during laparoscopic stomach longitudinal resection in patients with morbid obesity does not require prolonged ventilation and is a worthy alternative to combined epidural anesthesia. Rejection of invasive monitoring allows early activation of patients and a shortened stay in the hospital.
Use of Canephron® N in treatment of acute uncom plicated cystitis in women
Authors: Р. Е. Амдий  , С. Х. Аль-Шукрі  , І. М. Кузьмін  , М. В. Сорокін  , Є. О. Чаплицький  , М. В. Скворцов  , О. С. Алексєєв  , А. Ш. Окунчаєв  , О. А. Турбін  , Г. Р. Тимаєва  , Д. В. Булаєв  , Ю. С. Москальова
Published: December 2018

The objective: of study was to evaluate the efficacy and safety of Canephron ® N with uncomplicated cystitis in women in clinical practice.Patients and methods. In our work was attended by 22 women with a diagnosis of acute uncomplicated cystitis. The mean age was 29,0±1,8 years (from 19 to 51 years. The criteria of effectiveness were changes in symptoms and laboratory parameters according to the urinary tests at Canephron ® N monotherapy.Results. After treating by Canephron ® N there were observed significant improvement in symptoms of acute cystitis. Before treatment the average symptom score was 8,05±0,7 points, on the 3rd day of treatment it significantly decreased to 5,1±1,0 points (p<0,05) on day 7 of treatment it was up to 2,9±1,0 points, in the phase of observation of 37 days after initiation of therapy by Canephron ® N othe average score of symptoms was 0,1±0,3 points. Frequency leukocyturia on the 7 day of treatment according to a study by urine microscopy was 83,3%, and by the 37-th day after the start of Canephron ® N (phase monitoring) significantly decreased to 37,5% (p<0,05). Canephron ® N showed statistically significant antibacterial activity in acute cystitis. Prior to initiating therapy the growth of microorganisms at a titer of more than 100 000 units was detected in 72,7% of patients after 2 weeks of treatment (on day 37 of observation) – in 28,6% of patients (p<0,05). Conclusions. Our results suggest that Canephron ® N can be an effective  and well tolerated alternative treatment of uncomplicated infections of the lower urinary tract in women, allowing to reduce the use of antibiotics. Appointment of the drug as a monotherapy Canephron ® N acute cystitis and duration of treatment requires further study and discussion
Rational use of antibiotics in ambulatory treatment of the respiratory tract infections
Authors: Л. В. Хіміон  , О. Б. Ященко  , С. В. Данилюк  , Т. О. Ситюк
Published: December 2018

The etiology of the community acquired respiratory infections, drug bacterial resistance, modern recommendations about empirical treatment of the community acquired respiratory infections, ambulatory management of the community acquired pneumonia is discussed at the article.
Nonalcoholic fatty liver disease combined with overweight: gender data of functional vessels changes
Authors: О. Д. Терсіна
Published: December 2018

The objective: to determine particular impact of non-alcoholic fatty liver disease/NAFLD (steatosis) combined with overweight on hemodynamic data changes of main neck vessels and their difference among males and females middle age groups.Patients and methods. The investigation involved 82 patients (19 males and 63 females) 45–59 ages (middle age period according to  WHO criteria) that are of high cerebral vascular risk on compare with the other age persons. The data of patients with NAFLD (steatosis) combined with overweight and the data of control groups of normal weight without liver disorders has been compared. Hemodynamic data results of main neck vessels were analyzed with duplex investigation (Color Flow Mapping/CFM regime and doppler).Results. Main neck vessels hemodynamic data changes (low hemodynamic speed rates and high rates of peripheral resistance ) has been revealed during investigation. NAFLD (steatosis) combined with overweight has direct influence on hemodynamic rates of main neckvessels. The gender difference has been revealed among the middle age group patients: hemodynamic speed rates of females were higher (р<0,05) than the male’s ones. Also the gender difference of peripher al resistance rates has been established (р<0,05) with the higher rates in male’s group. The observation has established the correlation connection between Body Mass Index/BMI and the blood flow speed rates (p<0,05) in both groups. Conclusion. Hemodynamic rates disorders of main neck vessels revealed during the complex duplex investigation are the result of NAFLD (steatosis) combined with overweight direct influence with the gender difference (р<0,05) among the middle age group patients.
Optimization combination antihypertensive therapy in patients with hypertension depending on indicators daily monitoring of blood pressure
Authors: Є. Х. Заремба  , О. В. Заремба-Федчишин  , М. М. Вірна
Published: December 2018

The objective: improving the efficiency of the treatment of hypertension ІІ stage 2 3 degrees by studying the performance of daily blood  pressure monitoring and correction of violations through the use of lisinopril with amlodipine and bisoprolol with amlodipine.Patients and methods. The results of daily monitoring of blood pressure in patients with hypertension stage II 2–3 degrees. The study involved 72  patients (34 men and 38 women), mean age was 54,6±8,11 years. Results. The use of combination antihypertensive therapy helps normalize blood pressure during the day, can achieve target levels of blood pressure in most patients. Under the influence of combination antihypertensive therapy is improving daily profile of blood pressure, a significant reduction of pathological types (non dipper, night peaker, over dipper), resulting in increased normal (dipper) degree nocturnal blood pressure reduction.Conclusion. The best treatment efficacy observed in patients who took turns bisoprolol with amlodipine and lisinopril with amlodipine.
Analysis of indicators of 24-h holter monitoring ECG in elderly hypertensive patients with atrial fibrillation
Authors: Л. В. Бевзюк  , Л. М. Єна
Published: December 2018

The prevalence of essential hypertension (EH) defines its significance as the most important population – based risk factor for development  of atrial fibrillation (AF). The heart morphological remodelling – the   development of left ventricular hypertrophy and its diastolic dysfunc  tion, the increase of left atrial sizes is associated with increased risk for the development of atrial and ventricular arrhythmias.The objective: to estimate the rate of arrhythmias in elderly hypertensive patients depending on the form of atrial fibrillation (AF) – persistent or permanent.Patients and methods. Doppler echocardiography and Holter monitoring ECG were investigated in 140 patients aged 60–74 years. The  were 20 patients with uncomplicate EH, 60 patients with persistent (PersAF) and 60 – wits permanent (PermAF) AF.Results. It was established that patients EH have high frequency of single ventricular extrasystoles. The presence of AF in hypertensive patients is associated with the increase of myocardial electrical inhomogeneity, with is most expressed in permanent AF: the high gradation ventricular arrhythmias in patients with uncomplicated EH, PersAF and PermAF were 5%, 28% and 62% respectively. In study population the range of corrected QT interval (QTc) of these patients, 10% in EH, 16% – PersAF and 43% – PermAF, had prolonged QTc  complexes. There were revealed correlations between dispersion of the QT interval (QTd) and parried ventricular extrasystole (r=0,26;  р<0,05), between QTd and grouped ventricular extrasystole (r=0,25;  р<0,05). Conclusions. It was found that groups of patients associated with the increase in the frequency and amount of daily, single ventricular extrasystoles and high gradation ventricular arrhythmias a set of structural and functional changes of the heart in elderly patients with arterial hypertension and atrial fibrillation and their relation to electrical heterogeneity of the myocardium.
Influence of three months therapy with L-arginine on the general clinical conditions of patients with various forms of heart failure
Authors: Т. А. Абдуллаєв  , Я. Р. Ахматов  , I. А. Цой
Published: December 2018

The objective: assessing of the impact of the 3 month course of treatment with L arginine on the clinical and functional and laboratory parameters in patients with various forms of heart failure.Patients and methods. The study included 55 patients with cardiomyopathy: 22 patients with isolated right ventricular dilated cardiomyopathy (RVDCMP) and 33 patients with dilated cardiomyopathy (DCM) with bi ventricular heart failure. The average age of patients 42,1 ± 9,0 year (from 21 to 54 years). Depending on the shape of heart failure patients were divided into two groups. The first group included 22 patients with RVDCMP (average age 45,3 ± 10,2 years), the second included 33 patients with dilated cardiomyopathy (mean age 45,3 ± 13,3 years).Results. It was noted improvement in clinical and functional and laboratory parameters in both groups of patients, but in the case of RVD CMP these changes were more pronounced in comparison with a group of DCM. Different effects of L-arginine in the analyzed group of patients was caused by the presence of irreversible changes in the state of decompensated myocardium in patients with dilated cardiomyopa thy, while in patients with RVDCMP compensatory response of the heart muscle must have been higher.Conclusion. The use of arginine in patients with dilated cardiomyopathy with right ventricular or bi-ventricular lesion improves vascular endothelial function, affecting the flow-dependent vasodilatation.
Diagnostics and treatment of postoperative neuropathies of the trigeminal nerve in its bruises and stretching
Authors: Н. О. Ушко
Published: December 2018

The objective: to study the dynamics of changes in electrophysiological indices of soft tissues innervated by II and III branches of the trigeminal nerve with its bruises and stretching, which arise in patients after surgical remove of tumors and tumor like jaw formations, and also determine the possibility of using the hardware software complex «DIN-1» for the treatment of these neuropathies. Patients and methods. a survey and treatment of neurological complications in 180 patients after surgical remove of tumors and tumor-like formations of the upper and lower jaws was performed.Results. based on the survey, we found that the determination of electrophysiological indices of soft tissues innervated by II and III branches of the trigeminal nerve in cases after performing operations to remove benign neoplasms of the jaws is not only a diagnostic criterion for the severity of damage to the trigeminal nerve in the surgical wound, but also can serve as a prognostic criterion, which indicates the timing of recovery of the nerve.Conclusions. The use of hardware-software complex «DIN-1» in the  treatment allowed to reduce the treatment of all patients with neuropathies caused by bruises of the second and third branches of the trigeminal nerve by a factor of 2, and by 1,5 times the duration of treatment of patients with neuropathies caused by their stretching.
Neurovegetative and cognitive impairments associated with anxiety in middle-aged patients with underlying cerebrovascular diseases
Authors: Т. І. Насонова  , О. В. Кліменко  , Т. В. Колосова  , Г. В. Горєва  , Ю. І. Головченко  , О. В. Тишкевич  , О. М. Гурмак
Published: December 2018

The objective: analysis of the treatment efficacy and safety of neurovegetative and cognitive impairments associated with anxiety in middle-aged patients with underlying cerebrovascular diseases (CVD)by means of Adaptol® medication.Patients and methods. There were examined 60 patients, aged 42 to 58, having neurovegetative as well as light and mild cognitive impairments with underlying anxiety and depressive disorders (30 patients –  main group, treatment with Adaptol® administration, 30 patients –    control group: standard treatment without Adaptol® administration). The study of cognitive, vegetative and neuropsychological disorders  was performed with the use of clinical scales. We determined the cortisol levels: before the treatment,on the 7th day of treatment and afterthis treatment.Results. It was determined that the patients with chronic cerebrovascular diseases CVD of young and middle-age, have mild to moderate cognitive impairments with underlying vegetative and anxiety disorders. Revealed impairments are corrected well by administering promptly of antihypertensive, metabolic, lipid lowering, and glucose–lowering therapy and also by means of minor tranquilizer  Adaptol® produced by Olaynfarm company, at the dose of 300 mg  twice a day for 28 days period. The treatment resulted in a statistically significant decrease of autonomic dysfunction, situational and personal anxiety and in the improved cognitive functions according to MoCa scale in patients taking Adaptol® in comparison to the data before the treatment. The level of cortisol in the blood plasma decreased gradually after 7 days of treatment and on the 28th day reached a statistically significant difference (p<0,05) when we compared the patients’ baseline parameters  in the main group who received Adaptol® to those ones of the control  group patients.Conclusions. Patients with early signs of chronic CVD were diagnosed with cognitive and anxiety disorders with underlying neuroveg etative syndrome which required treatment. Minor tranquilizer Adaptol® produced by Olaynfarm company is recommended for treatment of psycho emotional disorders in middle aged patients with underlying neurovegetative syndrome as a part of an anxiety disorder.
How to improve nasal breathing for better living without using nasal decongestants and surgery
Authors: І. І. Горішній  , В. І. Ткаченко  , О. І. Горішня
Published: December 2018

The article describes causes and effects of difficult nasal breathing on the body, the functioning of organs and systems, the neuropsychiatric sphere, focuses on the physiology and anatomy of the structure of the nose, its participation in nasal breathing, discribes the modern technique for restoring nasal breathing with a booster that can be effectively used in the family practice.