bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correction of the acid-alkaline state in patients with asthma
Authors: Bezditko Т.В. , Yeryomenko G.V. 
Published: October 2020

Background. The acid-alkaline state (AAS) in physiological conditions is caused by a certain ratio of acids and alkalis in blood plasma as well as in organs and tissues. Imbalances of the above ratio are observed in patients with asthma (As).
Objective. To study AAS in patients with an uncontrolled course of As.
Materials and methods. The study involved 27 patients having a moderately severe course of As with metabolic acidosis and without any controls. Physical examinations were made; respiratory function and AAS were assessed. The patients were divided into two groups: 13 cases – group 1 and 14 cases – group 2. Their basic treatment included budesonide / formoterol fumarate dehydrate 160/4.5 µg, with use of control questionnaires for As (ACQ-5) and life quality (SF-36). Additionally to their therapy patients from group 1 received 250 ml of 4.2 % sodium bicarbonate intravenously by drop infusions thrice daily every other day.
Results and discussion. All the patients had a reduced control over As from 3.5 to 5 points (4 [3.5; 4.5] in group 1 and 4.5 [4; 5] in group 2). According to spirography data, the level of rate values before treatment in cases from group 1 was as follows: forced expiratory volume in 1 sec (FEV1) = 54.00 % [47.00; 59.00], peak expiratory flow (PEF) 25 % = 52.00 % [49.00; 57.00], PEF 50 % = 51.40 % [41.00; 57.00], PEF 75 % = 50.00 % [43.00; 57.10]. In patients from group 2 their level of rate values before treatment was as follows: FEV1 = 57.00 % [52.00; 61.00], PEF 25 % = 56.10 % [52.00; 59.70], PEF 50 % = 54.40 % [47.00; 59.00], PEF 75 % = 54.00 % [47.30; 60.10]. AAS values in cases from group 1 were: рН = 7.32±0.05, РСО2 = 33.8±1.34 mm Hg, ВЕ = -4,8±0,01 mmol/l; in patients from group 2 these were: рН = 7.31±0.04, РСО2 = 32.3±1.13 mm Hg, ВЕ = -4.25±0.01 mmol/l. After the treatment, the following changes were registered: respiratory function indices improved in both groups, but reliable changes versus pre-treatment results were revealed in 1st group – FEV1, PEF 25 % and PEF 75 % (p<0.05), while in 2nd group it was only in PEF 25 %. Both groups demonstrated positive changes of all AAS indices, but reliable changes in all examined indices were found out in patients from group 1 (р<0,05), whose treatment effectiveness was assessed as good in 8 cases and satisfactory in 4. In patients from group 2 the result of treatment was satisfactory in 9 cases, whereas in 5 patients it was unsatisfactory.
Conclusions. Inclusion of sodium bicarbonate into combination therapy for patients with As is not accompanied with development of any adverse events and is recommended for using in combination therapy for exacerbations of As, particularly if metabolic acidosis develops.
Application of sorbitol based infusion preparation for normalization of water-electrolyte exchange in surgery patients with direct rectal cancer
Authors: Varyvoda Ye.S. , Orishchin I.Ya. , Lutsiv V.M. , Varyvoda V.Ye. , Dzis B.R. , Chaban V.Ye. , Dzis R.P. , Karpovich Ye. Р. 
Published: October 2020

Objective. To study the effect of intravenous infusions of the complex drug Rheosorbilact polyfunctional action on the indicators of water-electrolyte metabolism in operated patients with rectal cancer after anterior resection of the rectum in the early postoperative period.
Materials and methods. Clinical application of the complex drug Rheosorbilact of multifunctional action was carried out in 30 patients with rectal cancer after the operation of anterior resection of the rectum in the early postoperative period. Studies of plasma electrolytes in operated patients were performed before surgery, on the 1st day after surgery, and on the 2nd, 3rd, 5th day after administration of the drug Rheosorbilact.
Results. As a result of studies in patients with colorectal cancer after anterior resection of the rectum in the first days after surgery revealed a decrease in potassium, sodium, calcium in blood plasma. To correct the indicators of water-electrolyte metabolism in operated patients after anterior resection of the rectum immediately after surgery intravenously injected infusion drug Rheosorbilact multifunctional action. After repeated, within 5 days, intravenous infusions of the drug Rheosorbilact, revealed normalization of the concentrations of potassium, sodium, calcium in blood plasma in operated patients with colorectal cancer.
Conclusions. Repeated intravenous infusions of the complex drug Rheosorbilact multifunctional action lead to normalization of water-electrolyte metabolism in patients with colorectal cancer after anterior resection of the rectum in the early postoperative period. Normalization of water-electrolyte metabolism in operated patients is confirmed by the content of potassium, sodium and calcium ions in the infusion drug Rheosorbilact. Rheosorbilact is recommended for widespread medical use in such patients, especially in the early postoperative period.
Features of infusion therapy in therapeutic patients during the COVID-19 pandemic
Authors: Halushko O.A. 
Published: October 2020

Objective. To determine the features of infusion therapy (IT) in therapeutic patients with COVID-19.
Materials and methods. The publications were searched using PubMed and Google Scholar engines by such terms: COVID-19, infusion therapy, crystalloids, colloids. 68 publications were identified, which were published from December 2019 to August 15, 2020.
Results and discussion. Unfortunately, very few publications characterizing the features of IT in patients with COVID-19. The most complete recommendations are set out in the Surviving Sepsis Campaign: guidelines on the management of critically ill adults with COVID‑19. Indications for IT in COVID-19: hemodynamic instability, shock, heart disease and comorbidities (especially diabetes and cardiovascular disease). It is recommended not to use colloids, but buffered and balanced crystalloids for acute resuscitation of adults with COVID-19 and shock. In Ukraine, among balanced buffered crystalloids, the most popular and widespread solution is Rheosorbilact, which has a large number of positive reviews in domestic and foreign publications, including pneumonia and sepsis. Recommendations for the use of colloids: dextrans, gelatin and hydroxyethylated starches in COVID-19 are not recommended; albumin can be used for special indications (eg, severe hypoalbuminemia), but it is not recommended for routine and initial resuscitation; convalescent plasma transfusion appears to be a promising method that can provide passive immunity to SARS-CoV-2-specific antibodies, but is currently not recommended for routine use due to lack of evidence. It is proposed to use a conservative rather than a liberal strategy of fluid administration for the acute resuscitation of adults with COVID-19 and shock. In the meta-analysis of 11 randomized clinical trials (n=2051), it was shown that patients with severe acute respiratory syndrome or sepsis who received fluid according to a conservative strategy had more days without artificial ventilation and a shorter period of stay in the intensive care unit (ICU). At fever at patients with COVID-19 it is offered to use paracetamol. In severe cases, a solution of paracetamol (eg, Infulgan) can be administered intravenously at a dose of up to 4 g per day. Body temperature control does not reduce the risk of death, length of stay in ICU, but is effective for lowering associated symptoms (headache, dizziness, weakness), which is important to increase patient comfort.
Conclusions. In the treatment of patients with COVID-19 of great importance is the use of rational and balanced IT. The infusion program should be calculated not only in terms of hemodynamic effects, but also taking into account the quality of life and maximize patient comfort.
Clinical assessment of homeostasis parameters in evaluation of operation stress
Authors: Hasanov F.J. , Gasimova S.A. 
Published: October 2020

Background. The expansion of the range of clinical and physiological methods, also the development of ideas related with operational stress caused the increase in the number of indicators used to judge the adequacy level of anaesthetic protection.
Objective. The research aim was clinical evaluation of the informational content of homeostasis parameters in determining the adequacy of anaesthesia.
Materials and methods. The research was conducted on 92 patients, aged 21-79, who underwent large-scale surgical operations in abdominal cavity. Continuous monitoring was conducted to identify hemodynamic indicators: systolic, diastolic, medium and pulse arterial pressure, central venous pressure and heart rate. In the course of the anaesthesia the level of anaesthesia and consciousness of the patient were defined with the aid of BIS (Bispectral Index) monitor and the state of myorelaxation was evaluated according to the indicators of frontal muscle electromyography. Cortisol, adrenocorticotropic hormone (ACTH) and prolactin levels were defined in three stages: I – preoperative, II – at the peak of surgical aggression, III – 30 min after the end of the surgery. In addition to continuous monitoring of other indicators of anesthesia adequacy, comparisons were also made with the data obtained during these stages.
Results. At the peak of surgical aggression, which means during the II stage, the level of stress hormones (ACTH, cortisol) were considerably above their upper norm limit despite the fact that the hemodynamics, BIS monitor and electromyography indicators corresponded with the adequate anaesthesia state. At this stage of the operation the attempts to normalize stress hormones values require high doses of analgesics and anaesthetics which can contribute to an increase in anaesthetic risk.
Conclusions. Of all the criteria for assessing the adequacy of the anesthesia, the indicators of hemodynamics and gas exchange together with BIS monitoring data are sufficiently informative and easy to provide in the operating period, which is also very important. These indicators respond fairly quickly to the body stress impact.
Application infusion drugs based on sorbitol for normalization of aminotransferase activity blood cancer patients operated cardia of the stomach
Authors: Dzis B.R. , Prymak S.V. , Dzis R.P. , Novak V.L. , Dzisiv M.P. , Karpovich Ye.P. , Chaban V.Ye. , Ivasyk V.V. 
Published: October 2020

Objective. To study the effect of intravenous infusions of Rheosorbilact on the activity of alanine aminotransferase and aspartate aminotransferase in the plasma of operated patients with gastric cardiac cancer after proximal gastrectomy.
Materials and methods. Alanine aminotransferase and aspartate aminotransferase activity levels were studied in plasma of 40 operated patients with gastric cardiac cancer after proximal gastrectomy immediately after surgery, on the 1st, 2nd, 3rd, 5th day after intravenous infusions of the drug. The infusion of Rheosorbilact was administered intravenously, drip, for 5 days at a rate of 40 drops per minute. The daily dose of the drug was 1000.0 ml.
Results. In patients with gastric cardiac cancer after proximal gastrectomy in the first days after surgery revealed changes in aminotransferases, which are accompanied by an increase in the activity of alanine aminotransferase and aspartate aminotransferase in blood plasma. To correct the activity of plasma aminotransferases in such patients, Rheosorbilact was administered intravenously immediately after surgery. After repeated intravenous infusions of Rheosorbilact for 5 days, a significant decrease in the activity of alanine aminotransferase and aspartate aminotransferase in blood plasma in the operated patients was revealed.
Conclusions. In the first days after proximal gastrectomy in patients with gastric cardiac cancer, an increase in the activity of aminotransferases in blood plasma was revealed. Repeated intravenous infusions of Rheosorbilact normalize the activity of alanine aminotransferase and aspartate aminotransferase in the blood plasma of such patients in the early postoperative period. Infusion drug Rheosorbilact is recommended for widespread medical use in patients with cardiac gastric cancer after proximal gastrectomy, especially in the early postoperative period.
Transfusion surgeries and infusion therapy in patients with malignant non-Hodgkin’s lymphoma after splenectomy
Authors: Yevstakhevych Yu.L. , Semerak M.M. , Yevstakhevych I.Y. , Novak V.L. , Lototskyi R.M. , Lohinskyi V.Ye. 
Published: October 2020

Objective. To present the immediate results of the splenectomy and preferable variants of transfusion therapy performance in patients with malignant non-Hodgkin’s lymphoma (MNHL).
Materials and methods. 109 splenectomies were performed in patients with MNHL at the Department of General and Hematological Surgery of the institute from 1987 to 2020. The surgery was conducted by upper middle laparotomy under general anesthesia with intubation and, in particular cases, under spinal anesthesia.
Results and discussion. The indications for splenectomy in patients with MNHL were as follows: massive splenomegaly, abdominal syndrome, associated hemocytopenia, inefficacy of cytostatic therapy, absence of diagnosis. All patients underwent vaccination against capsular bacteria for prevention of post-splenectomy infection in 10-14 days prior to the surgery. In case of anemia, which has been observed in 55 % of patients, the RBC concentrate was applied. All the patients, who received corticosteroid hormones prior to splenectomy, were administered prednisolone and hydrocortisone in the amount of 3 mg/kg of body mass at similar doses in an hour before the surgery for prevention of adrenal insufficiency during the surgery. The patients, who did not receive those medications, were also intramuscularly administered prednisolone at a dose of 0.5 mg/kg of body mass in an hour before the surgery for the same aim. The patients with PLT value <150.0×109/L were administered 1-2 doses of PLT concentrate immediately before the laparotomy. M-gradient was found in blood serum of 3 patients prior to the surgery. They underwent courses of therapeutic plasmapheresis due to the risk of intraoperative hemorrhage. 2 patients with hyperleukocytosis (WBC >80.0×109/L) underwent two courses of leukapheresis. The patients with concomitant regional portal hypertension and in case of manipulations close to the pancreatic tail were administered somatostatin drugs in the course of the splenectomy. The splenectomy proved to be effective in 100 (92 %) of patients with MNHL: the great tumor mass was removed, the abdominal syndrome and concomitant hemocytopenia were neutralized, the signs of hypersplenism ceased, the hemolysis ceased, the cytostatic therapy became less necessary or unnecessary, the final diagnosis was established. The most serious postsurgical complications were acute adrenal failure (n=3), postsurgical intra-abdominal hemorrhage (n=2), pancreonecrosis (n=6). The postsurgical lethality was 2.7 %.
Conclusions. The splenectomy proved to be effective in 92 % of patients with MNHL. The infusion therapy is individual for each patient and may include transfusion surgeries if indicated. The main objective of the infusion therapy in patients with MNHL is prevention and elimination of intra- and postsurgical complications.
Hypodiploidy in patients with acute lymphoblastic leukemia
Authors: Zotova O.V. , Lukianova A.S. , Valchuk M.O. , Rymar M.M. , Kostyk Kh.Ya. , Shalay O.O. , Loginsky V.O. 
Published: October 2020

Background. Acute lymphoblastic leukemia (ALL) is characterized by different clinical course and different sensitivity to therapy. Taking into consideration their significant prevalence an intensive search for new prognostic criteria is conducted that may determine individual prognosis and choose the most appropriate treatment approach for patients with ALL, who often require transfusion therapy and replacement therapy with blood components.
Objective. To detect the frequency, diagnostic and prognostic significance of hypodiploidy in patients with ALL.
Materials and methods. Standard cytogenetic investigation of bone marrow and/or peripheral bloodcells was performed according to the standard techniques from 57 adult patients with ALL.
Results and discussion. Chromosomal aberrations of various kinds were found in 37 (65 %) patients with ALL. Among them presence of one karyotype abnormality was established in 9 (24 %) patients, two abnormalities – in 10 (27 %) and multiple structural and/or numerical changes (≥3) – in 18 (49 %). Samples from 20 (35 %) patients showed a normal female or male karyotype without cytogenetically visible changes. The most common abnormalities in ALL were: trisomy 8, rearrangements of 7q, 17p and 11q23, translocations t(4;11)(q21;q23), t(9;22)(q34;q11), marker chromosomes, acentric structures, hypodiploidy, hyperdiploidy, complex karyotype (≥3 changes) etc. Hypodiploidy was found in 2 (4 %) patients with ALL. One patient, except for abnormal ones, had normal metaphases in him karyotype. Of two patients with hypodiploidy, one had only numerical abnormalities, whereas other one had also structural cytogenetic aberrations, except the numerical changes, namely t(1;6)(q32;q27), add(12)(q24), del(17)(p11), r(17)(p13q25). Hypodiploidy is an unfavorable marker in ALL and a near haploidy is an extremely unfavorable factor.
Conclusions. Cytogenetic abnormalities of various kinds were found in 37 (65 %) patients with ALL. The frequency of hypodiploidy was 4 %. ALL patients with hypodiploidy were classified into cytogenetic categories of ALL with a poor risk prognosis. Thus, cytogenetic investigations should be included in the standard examination of patients with ALL for diagnosis, prognosis and selection the optimal treatment strategy.
Results of prevention of massive postural bleeding in women with preeclampsy
Authors: Kamilova M.Ya. , Amin-Zade N. 
Published: October 2020

Objective. To evaluate the effectiveness of a tranexamic acid for the prevention of critical bleeding in women with preeclampsia.
Materials and methods. 31 puerperas with postpartum hypotonic bleeding. Inclusion criteria: reproductive age, severe preeclampsia, postpartum hemorrhage, volume of blood loss – 700 ml, voluntary consent to the administration of the tranexamic acid. Exclusion criteria: delivery by the caesarean section. When providing emergency care, along with other standard measures, 14 women (the main group) were injected with the tranexamic acid when blood loss reached 700 ml, 17 women (the comparison group) did not receive the tranexamic acid. Research methods: measurement of the volume of blood loss (by the calculation method and by the method of measuring blood loss), statistical analysis – comparison of populations by qualitative characteristics.
Results and discussion. A bleeding with a blood loss of 700-800 ml was registered in 7 women of the main group and in 6 women of the comparison group, with a blood loss of 800-900 ml – in 6 and 4 women, with the blood loss 900-1000 ml – in 1 and 7 women, respectively. There was a significant difference in outcomes (blood loss – 900-1000 ml) depending on the use of the tranexamic acid (Fisher’s exact test – 0.04537; p<0.05). Evaluation of the strength of the relationship between the frequency of aggravation of bleeding and the use of the tranexamic acid for the prevention of massive bleeding established a relationship of average strength (Cramer’s criterion – 0.387). Pregnant women with severe preeclampsia are at risk of the developing obstetric bleeding, which is associated with secondary changes in the hemostatic system in women with preeclampsia. With obstetric bleeding in women with preeclampsia, the balance between the coagulation, anti-coagulation and fibrinolytic systems is disturbed faster. Fibrinolysis is activated faster due to the limitation of thrombus formation due to the breakdown of fibrin in thrombi and the fibrinolytic properties of the fibrin breakdown products themselves. The use of the tranexamic acid in the obstetric bleeding is justified by the antifibrinolysis effect of the drug. Further research on the use of the tranexamic acid for the prevention of massive bleeding, confirmed by laboratory data, is highly relevant.
Conclusions. The use of tranexamic acid with the onset of obstetric bleeding in women with risk factors for the secondary thrombocytopathy will prevent the aggravation of coagulopathy and reduce the incidence of massive obstetric bleeding caused by a disseminated intravascular coagulation.
Topical issues in the treatment of thrombocytopenia caused by chemotherapy: the view of a hematologist
Authors: Mikhalska L.V. , Kylivnyk O.V. , Yamenko O.O. 
Published: October 2020

Objective. Thrombocytopenia is a common complication of chemotherapy, which is characterized by a decrease in platelet count <150×10⁹/l duration. Early diagnosis and correction of thrombocytopenia are important points in the treatment of patients with cancer. Currently, thromboconcentrate transfusions, recombinant human thrombopoietin, and eltrombopag are used to treat thrombocytopenia.
Materials and methods. 200 patients were treated with recombinant human thrombopoietin in the hematology department from 2019 till 2020.
Results and discussion. Patients were divided into two groups. 150 patients received thrombopoietin to prevent predicted chemotherapy-induced thrombocytopenia at a dose of 300 IU/kg subcutaneously after 4 consecutive days. In 50 patients Rl-TPO was used for therapeutic purposes, in the presence of thrombocytopenia, at a dose of 300 IU/kg subcutaneously daily 10-14 consecutive injections. In the 1st study group, the level of platelets when using Rl-TPO according to the scheme did not decrease by less than 150×10⁹/l. In the 2nd group, the level of platelets from 50-65×10⁹/l when using thrombopoietin for therapeutic purposes in 87 % patients began to rise for 4-5 days after administration, normalized on day 12-13, in 13 % patients began to rise on day 7-8, normalized for 15-16 days.
Conclusions. Prevention of thrombocytopenia due to early administration of recombinant human thrombopoietin to the patient, rather than correction of pre-existing thrombocytopenia, can increase the effectiveness of chemotherapy through strict adherence to the schedule and recommended dosage, to avoid possible side effects directly from the patient.