bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of the Algorithms for Diagnostics and the Possibilities of Treating Patients with a Penile Dysmorphie Disorder
Authors: Kornyenko Oleksii , Scherbak Mariia , Turchak Mykola 
Published: July 2021

The article discusses issues related to the choice of diagnostic algorithms and planning tactics for treating patients with penile dysmorphophobia. The psychological characteristics of this group of patients, methods of diagnosis, psychotherapy correction and the choice of surgical tactics are sounded.
The manifestations of penile dysmorphophobia and dysmorphomania, as disorders of a deeper level, are considered as an integrative problem solved from the standpoint of urology, psychotherapy, and aesthetic surgery. In conjunction with an andrologist, the involvement of a psychotherapist and, if necessary, a psychiatrist is required. At the initial stages of working with a patient, narrowly focused psychotherapy is used. The next level of correction is cognitive behavioral psychotherapy (CBT) with the technique of “exposure and prevention of reactions” or “cognitive restructuring”. The “mindfulness CBT” technique is considered important for teaching the patient the ability to stop subjective perception of personal experiences.
To consolidate the result, individual hypnosuggestational therapy and group (family) psychotherapy are used. The indications for surgical enlargement of the penis are divided into medical, functional and aesthetic. Penile dysmorphophobia is an aesthetic indication for surgery. Contradictions in carrying out such interventions include the lack of standardized methods with a high positive prognosis, overestimated patient expectations, and the lack of a result to improve a man’s self-esteem even with a positive result of the operation.
The clinic of the Department of Sexopathology and Andrology of the State Institution «Institute of Urology of the National Academy of Medical Sciences of Ukraine» uses a ligamentotomy technique to lengthen the penis and implant a polypropylene mesh under the superficial fascia of the penis to thicken it. For patients with manifestations of penile dysmorphophobia simultaneously with severe forms of erectile dysfunction, a number of operations have been proposed for the simultaneous installation of penile implants and augmentation of the tunica albuginea using a graft: corporoplasty with a circular graft, Sliding Technique, modification of the sliding technique (MoST), Multiple-slid-Technique (MuST) augmentation technique.
These techniques are not included in the list of recommendations offered by the urological community; they have high predictable risks of complications requiring urgent explantation of the prosthesis and irreversible loss of penile length.
Analysis of the Effectiveness of Different Types of Shock Wave Therapy for the Treatment of Patients with Chronic Prostatitis
Authors: Migov Vitalii 
Published: July 2021

The article provides a comparative assessment of various methods of shock wave therapy used to treat patients with chronic calculous prostatitis and the presence of chronic pelvic pain syndrome. The mechanism of action of the radial pressure wave and focused shock wave therapy is analyzed in detail.
The treatment was carried out in 648 patients divided into 4 groups. In groups 1, 3 and 4, focused shock wave therapy was used using Piezo Wave devices from Richard Wolf of various generations with a piezoelectric generator G-4 (the source of shock waves is a piezoelectric self focusing hemisphere with an energy flux density in the focus area of up to 0,4 mJ/mm2 and pressure up to 82,2 mPa, shock wave pulsation frequency of 8 Hz) and G-10 (the source of shock waves is a piezoelectric self-focusing hemisphere with an energy flux density in the focus area of up to 0,6–2 mJ/mm2 and a pressure of up to 100,0 mPa, shock wave pulsation frequency 8 Hz).
The second group used a BTL-6000 SWT Topline radial pressure wave apparatus with a pressure of up to 5 bar and a frequency of up to 20 Hz. The treatment was carried out according to the method developed on the basis of the Research Institute of Urology of the National Academy of Medical Sciences of Ukraine. The technique includes: the use of shock wave therapy, transrectal photo-electrostimulation and electrophoresis of the rectal preparation fermencol. The technique has long established itself as an effective way to combat chronic pelvic pain syndrome.
The study was conducted in order to establish the most effective method of shock wave therapy and the optimal number and power of impulses per session, as well as the required number of sessions to achieve the maximum effect in relation to pain and in relation to a decrease in the area of prostate gland lesions by secondary changes: fibrosis and calculi, in order to further improve the technique, in connection with the emergence of new models of shock wave therapy devices with improved characteristics on the medical equipment market, article provides a comparative assessment of various methods of shock wave therapy used to treat patients with chronic calculous prostatitis and the presence of chronic pelvic pain syndrome. The mechanism of action of the radial pressure wave and focused shock wave therapy is analyzed in detail.
Perioperative Chemotherapy in the Complex Treatment of Patients with High-grade Bladder Cancer
Authors: Yakovlev Pavlo 
Published: July 2021

Chemotherapy (CT) is a method of treating patients with muscle-invasive bladder cancer, most of which present as high-grade cancer, in neoadjuvant or adjuvant setting, to treat or prevent metastatic cancer.
The objective: to determine the place of perioperative PCT in the algorithm of complex treatment of patients with high-grade bladder cancer (HGBC) and its influence on survival rates.
Materials and methods. We performed retrospective analysis of medical histories of 522 patients with HGBC, who were treated in 1998-2016. Using the Kaplan-Mayer statistical method, we did a comparative analysis of the survival of HGBC patients who did and did not undergo perioperative CT as part of a comprehensive treatment.
Results. Perioperative CT was performed in 97 (18.6 %) patients, including neoadjuvant CT in only 4 (0.8 %) patients. Only among stage IV HGBC patients the adjuvant CT demonstrated significant differences towards better survival compared to patients without CT (p=0.004), with a 5-year survival rate of 18 % vs. 4 % in relevant groups. In the treatment of patients with stages I, II and III, no statistically significant differences in survival rates were found. The highest average survival rates of patients receiving PCT were found in patients treated with salvage cystectomy (68 months). Survival of patients after TUR, resection, RCE were similar (37-43 months) and do not differ statistically. The worst survival rates were in patients who did not receive surgical treatment and were treated with CT and radiotherapy only (9 months).
Conclusions. Postoperative chemotherapy significantly improved the survival of Stage IV HGBC patients after surgery, with 5-year survival of 18 % vs. 4 %. The best average survival rates (68 months) were demonstrated in the group of patients after salvage cystectomy.
Modern Algorithm for Diagnosis and Treatment of Diseases in Men That Lead to Infertility
Authors: Nikitin Oleh , Yasynetsky Mykola 
Published: July 2021

The problem of sterile marriage provides great importance throughout the world. Infertility is a condition that is accompanied by a number of diseases of the genital organs and systemic diseases of the male or female organism. According to various literary sources, about 50–100 million people suffer from infertility in the world, that is, one out of 5–7 couples of reproductive age suffers from infertility.
The problem of infertility in marriage is of particular importance in the context of the demographic crisis in Ukraine, where the frequency of infertile marriage among married couples of reproductive age is 10,0–15,0 %, and in some regions this indicator is close to 20,0 %. In Ukraine, there are more than 1 million infertile married couples, the male factor in the structure of infertility is about 40-50 % of cases. Most authors point to the polyetiology of male infertility. In its development, a significant role is assigned to such factors as neuropsychic, infectious toxic, congenital and genetic reasons, exogenous and habitual intoxications, ionizing radiation, dysfunctions of the endocrine glands and other internal organs, exposure to temperatures, vascular disorders, damage to the genital organs and their autoimmune lesions.
Infertility is a complex and multifaceted problem, and there are a lot of different questions which need to solve. Particular difficulties arise in determining the treatment tactics in cases where there is a combination of various causes of infertility in a married couple. Opportune examination of partners with using modern hardware, laboratory and genetic methods is very important, and it allows to prescribe an effective treatment.
The use of reproductive technologies significantly expands the possibilities for solving the problem of infertility. However, their main purpose is the birth of a child; treatment of diseases that have led to infertility requires additional efforts.
In this regard, the development of modern methods of diagnosis and treatment of sterile marriage remains one of the actual problems.
Vaginismus: Frequency, Definitions, Diagnostic Criteria, Formation
Authors: Kocharyan Garnik 
Published: July 2021

The article deals with the frequency of vaginismus, its definitions and criteria, which are presented in encyclopaedical sources, the International Classification of Diseases, 10th and 11th Revisions (ICD-10 and ICD-11), the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (USA) (DSM-V), as well as in publications made by some authors. It is reported that while ICD-10 presents psychogenic and biogenic variants of vaginismus separately, in ICD-11 the differentiation of sexual disorders into psychogenic and organic ones is cancelled. ICD-11 considers the brain and body as a unity, sexual dysfunctions being caused by an interaction of physical and psychological factors. In this way, a difference between the organic and inorganic is eliminated, organic and inorganic disorders being united.
In ICD-11 vaginismus is reclassified into sexual pain-penetration disorder without dividing it into organic and inorganic forms and has its united code, HA20. The diagnosis “dyspareunia” in ICD-11 is preserved, but it is not divided into inorganic and organic variants. DSM-V uses the term “genito-pelvic pain/penetration disorder”. In this case it means a combined diagnosis, which unites vaginismus and dyspareunia. The decision about expediency of using such a generalized diagnosis in this classification is taken on the ground of the fact that both above sexual dysfunctions are highly comorbid and hardly differentiated from each other. Also the article lists the muscles, involved in the process of contraction in vaginismus, and discusses the possibility of existence of the phenomenon of capture of penis (penis captivus) in people. Besides, sociogenic, psychogenic and somatic factors, which can participate in the formation of the characterized pathology, are listed in detail.
Opportunities for Unsalted Management of the Postoperative Period in Patients with Uncomplicated Ureterolithiasis
Authors: Nikitin Oleh , Roshchyn Yurii , Komisarenko Ihor , Fukszon Oleksandr , Smikhun Sviatoslav 
Published: July 2021

When performing surgeries for ureteral stones, ureteral stenting is traditionally performed to avoid obstruction of the ureter in the postoperative period due to edema or stone fragments. Modern technical advances allow ureteroscopy to be performed relatively atraumatically and to avoid routine ureteral stenting, which makes it possible to exclude exacerbations of pyelonephritis caused by reflux, reduce stent costs, improve the quality of life in the postoperative period, and avoid cystoscopy for dentition.
The objective: studying the possibility of non-drainage management of the postoperative period, identifying risk factors for postoperative complications in patients with uncomplicated ureteral stones.
Materials and methods. The analysis of the results of treatment of 198 patients with uncomplicated ureterolithiasis, in whom it was decided to refuse stenting after ureteroscopy, was carried out.
Results. The analysis of the condition of patients in the postoperative period was carried out. To identify the factors influencing the decision on non-drainage management of the patient in the postoperative period, as well as factors that could be predictors of postoperative complications, we analyzed various indicators.
Conclusions. In the case of uncomplicated ureterolithiasis, in most cases (in 68.2 % of patients) in the postoperative period, there is no need to drain the upper urinary tract using a stent. At the same time, in a number of cases – namely in 31.8 % of patients – upon refusal to install a stent, complications arose that significantly influenced the duration and cost of treatment, in some cases requiring an increase in the volume of therapy, additional procedures – installation stent and puncture nephrostomy.
Peculiarities of circulation of interleukins of different classes in multiple pregnancy depending on the method of fertilization and the term of gestation
Authors: Poladich I.V. , Avramenko S.O.  , Malanchuk O.B.  , Kostenko O.Yu.  
Published: July 2021

The article is devoted to the detection of interleukin circulation of different classes in women with multiple pregnancies depending on the method of fertilization and gestational age.The study found that the concentration of pro-inflammatory cytokines IL-1 (126.8 pg/mg) and IL-8 (176.4 pg/mg), determined in the 22nd week of pregnancy in the serum of patients with multiple pregnancies due to using ART, probably exceeded the control group (48.7 and 39.3 pg/mg) and spontaneous multiple pregnancy (49.3 and 40.6 pg/mg). Concentrations of cervical IL-1 and IL-8 were also elevated in pregnant women receiving ART compared with women with spontaneous multiple births and controls. These changes were observed in the dynamics of pregnancy. Under the influence of our recommended therapy, there was a gradual decrease in IL-1 and IL-8, which no longer differed from those of women with spontaneous multiple pregnancies and the control group. Administration of natural micronized progesterone for immunosuppression (normalization of the cytokine profile) to patients with multiple pregnancies due to the use of ART, reduced the incidence of preterm birth (from 83.3 to 43.7%), weakness of labor (33.3 and 21.9%, respectively), PRPO (22.2 and 12.5%, respectively), to reduce perinatal morbidity from 45.5 to 19.7% and mortality from 43.1 to 9.5%, which was not detected in patients with spontaneous fertility.Determining the features of cytokine imbalance in women with multiple pregnancies depending on the method of fertilization provides new approaches to the prevention and treatment of miscarriage, which will benefit mothers in different clinical situations.
Analysis of the results of a retrospective cohort study of the course of pregnancy, childbirth and the postpartum period in high-risk patients to identify factors of unfavorable outcomes and build a predictive model of fetal loss
Authors: Оshovskyy V.I.  
Published: July 2021

Prenatal prognosis is an important part of obstetric care, which aims to reduce fetal and neonatal losses. A differentiated approach to the management of different risk groups allows you to optimize existing approaches.The objective: to identify antenatal factors that correlate with perinatal losses, by conducting a retrospective cohort study of women at high perinatal risk, to build a multifactorial prognostic model of adverse pregnancy outcomes.Materials and methods. A retrospective cohort study was conducted from 2014 to 2016 on the basis of the medical center LLC «Uniclinic», Medical Genetics Center «Genome», Clinic of Reproductive Genetics «Victoria», Kyiv City Maternity Hospital №2. 2154 medical cards of pregnant women from the group of high perinatal risk were selected and analyzed. Of these, 782 pregnant women were included in the final protocol after verification of compliance with the criteria.Results. Cesarean delivery occurred in 115 cases (14.7%). In 50 cases (6.4%) the caesarean section was performed in a planned manner, in 65 (8.3%) – in an emergency. In 39 (5%) cases, the indication for surgical delivery was acute fetal distress. Antenatal fetal death occurred in 11 (1.4%) cases: one case in terms of <34 weeks and <37 weeks of gestation, the remaining 9 cases – in terms of> 37 weeks. Intranatal death of two fetuses (0.3%) was due to acute asphyxia on the background of placental insufficiency. In the early neonatal period, 14 (1.8%) newborns died. Hospitalization of the newborn to the intensive care unit for the first 7 days was registered in 64 (8.2%) cases.The need for mechanical ventilation was stated in 3.96% (31/782) of newborns. The method of construction and analysis of multifactor models of logistic regression was used in the analysis of the relationship between the risk of perinatal losses (antenatal death, intranatal death, early neonatal death) and factor characteristics.Conclusion. Signs associated with the risk of perinatal loss: the presence of chronic hypertension, preeclampsia in previous pregnancies, type of fertilization (natural or artificial), the concentration of PAPP-A (MoM), the concentration of free β-HCG (MoM) in the second trimester, average PI in the uterine arteries in 28–30 weeks of pregnancy, PI in the middle cerebral arteries in 28–30 weeks of pregnancy, episodes of low fetal heart rate variability in the third trimester of pregnancy, episodes of high fetal heart rate variability in the third trimester of pregnancy. The model, built on selected features, allows with a sensitivity of 73.1% (95% CI: 52.2% – 88.4%) and a specificity of 72.7% (95% CI: 69.3% – 75.9%) to predict risk perinatal loss.
Human milk bank in Ukraine – relities and perspectives
Authors: Zahorodnia O.S.  , Bila V.V. , Chernyak I. , Lazo I.I. 
Published: July 2021

Premature birth complicates 5 to 8% of pregnancies worldwide. The efforts of the medical world are aimed at improving the care of premature infants, which is much more successful – increasing the proportion of extremely premature surviving infants, improving the health and quality of life of premature infants. Such measures include, in particular, the early start of enteral feeding. It is its early initiation that is complicated by the delay in establishing lactation in the mother. To overcome this contradiction, it is proposed to use donor breast milk, for the procurement and storage of which human milk banks have been created. The objective: to analyze the activities of the human milk bank of the Kyiv Perinatal Center in 2020. Materials and methods. To evaluate the activity of the breast milk bank the main indicators of its work for 2020 were analyzed – the total number of donors, their distribution by age, total milk volume, average milk volume per woman, duration of donor milk to newborns. Results. During 2020, 65 donors took part in the breast milk donation program, who received 8,603 portions of milk and 8,220 portions were given to recipients for consumption. It is established that the main source of information for breast milk donors is the staff of the Perinatal Center, and therefore – the main motivation to participate in the program is the desire to help in the care of premature infants. The main pool of recipients (67.1%) are patients of the intensive care unit. A small part of the donor milk was consumed by patients of the postnatal care department and the second stage of nursing. Among patients receiving donor breast milk in the intensive care unit, preterm weight categories of 1000–1499 g (49.3%) and 1500–1999 g (32.7%) dominated. Conclusions. 1. The main source of information about the breast milk donation program is the staff of the Perinatal Center of Kyiv (32.3%), which determines the main motivation of the study participants. The prospect of developing the idea of ​​breast milk donation in Ukraine is popularization in the media in order to expand the audience and encourage women who have given birth in other obstetric facilities. 2. The main pool of DHM recipients in the Perinatal Center of Kyiv are premature patients of the intensive care unit. The largest proportion of patients receiving DGM were in the weight category of 1000–1499 g. The average duration of consumption of DGM by patients in this department is 6.5±0.9 days.
Detection of Pyrogens in Hormonal Implants Using the LAL Test
Authors: Neugodova N. P. , Shapovalova O. V. , Sapozhnikova G. A. , Stepanyuk E. O. 
Published: July 2021

The State Pharmacopoeia of the Russian Federation, 14th edition states that implants are a sterile dosage form, and have to be tested for pyrogens. However, it does not provide details on how the test should be performed for this dosage form.The aim of the study was to develop a LAL test procedure for detection of bacterial endotoxins (BE) in implants, using the example of a goserelin product.Materials and methods: BE extraction from the implant surface into an aqueous medium was performed with subsequent BE detection in the extract by turbidimetric kinetic test. The implant was then dissolved in dimethyl sulfoxide, and the obtained goserelin solution was tested for BEs using the gel-clot test.Results: the analysis of the Russian and foreign pharmacopoeial approaches to pyrogenic substance detection in hormonal implants helped to develop two sample preparation procedures for determination of BE content (in the extract and the implant solution). It was demonstrated that the BE content in the water extract did not exceed 0.01 EU/mL and was less than 0.07 EU per implant. The BE content in the implant solution was less than 8.3 EU per 1 mg of goserelin, which is almost eleven-fold lower than the theoretically-derived limit.Conclusions: the authors developed two test procedures for BE detection in hormonal implants using the LAL test, which could be included in manufacturers’ product files. The first procedure involves testing of the water extract from the implant surface and establishes the BE limit of no more than 20 EU/product. The second procedure involves complete dissolution of the implant in dimethyl sulfoxide and establishes the limit of not more than 97.22 EU per 1 mg of goserelin.
Aktarlardaki Bitkisel Droglar ve Kullanımları: Isparta Örneği
Authors: KARA Nimet , ALTINTAŞ Halil , ŞİRİKÇİ Bekir Sıtkı , GÜL Mevlüt 
Published: July 2021

Araştırma, Isparta’da aktarlarda halk arasında kulanılan bazı ilaç ve baharat bitkilerinin kullanım alışkanlıklarını incelenmek amacıyla yürütülmüştür. Veriler, toplam 16 aktar (15 erkek, 1 kadın) ve 200 tüketici ile yüz yüze görüşülerek elde edilmiştir. Elde edilen sonuçlara göre, en çok drog satın alımı yapan yaş grubunun 30 ile 45 arasında olduğu ve en yaygın sağlık probleminin diyabet ve tansiyon olduğu belirlenmiştir. Tüketicilerin %42.5’i lise, %35’i lisans, %15.5’i ortaokul, %5’i lisansüstü ve %2’i ise ilköğretim mezunudur.
Isparta’da aktarların 350’den fazla ürün çeşidine sahip oldukları, en fazla talep gören bitkilerin ise ıhlamur, adaçayı, kekik ve kuşburnu olduğu saptanmıştır. Aktarların %75.0’ının tüketicilere tedavi tavsiyesi vermediklerini ve %25.0’ının ise tedavi tavsiyesinde bulunduklarını beyan etmişlerdir. Tüketicilerin %84’ü alternatif tıp ile ilgili bilgilerinin olmadığını ve edinilen bilgilerin ise internet ve televizyondan (%71.2) öğrendiklerini belirtmişlerdir.
Araştırmada, bilinçli bir işletmecilik ve tüketim alışkanlığının olmadığı, tıbbi ve aromatik bitkiler ve ürünleri uzmanların önerileri doğrultusunda kullanılmalıdır. Ayrıca droglar daha uygun koşullarda muhafaza edilmeleri ve son tüketim tarihlerinin yazılarak tüketiciye sunulması gerektiği soncuna varılmıştır.