The Journal of V. N. Karazin Kharkiv National University. Series «Medicine»

5-8

Authors: Alika Korkelia

Іn order to analyse the changes in the structural and functional state of the thyroid gland, a group of 185patients (67.8%) were examined after the surgical treatment of papillary thyroid cancer. Of these, 94patients belonged to the first group –the comparison group where thyroidectomy was performed, and 91 to the second –the main group where, mainly, organ-preserving operations were performed. The average follow-up was 6.5 ± 5.1 years (varied from 2 to 11 years.Hypoparathyroidism in patients receiving replacement therapy was observed in 20 (16.4%) patients after thyroidectomy and only in 4 (6.3%) patients after organ-preserving techniques (the differences are significant, p<0.05). Side effects of replacement therapy were observed in 21 (17.2%) patients after thyroidectomy and only in 4 (6.3%) patients after organ-preserving techniques (the differences are significant, p <0.05). Disease recurrence was detected in 4 (3.3%) patients after thyroidectomy and in 1 (1.6%) patient after organ-preserving techniques (the differences are not significant, р>0.05).The use of organ-preserving approaches in the main group allowed improving functional results by reducing the frequency of hypothyroidism and side effects of replacement therapy, due to the preservation of thyroid secretion and its regulation, without worsening the results of relapse-free survival

15-22

Authors: Sevda Muradova, Sara Gurbanova, Suruya Hadjieva, Mehman Aliyev

Microbial interactions in Staphylococcus aureus–Candida albicans dual-species biofilms is a relevant research topic given the significant contribution of these microorganisms to hospital-acquired infections. Therefore, the purpose of our investigation was to study the interaction of opportunistic C.albicans and S.aureus in vivo and in vitro, both with the participation of normal microflora and in mice with antibacterial dysbiosis.The study of mentioned interactionswas carried out on 100 white male mice weighing approximately 18 gramsin vivo and usingsmears prepared from the grown mixed cultures of C.albicans and S.aureus and the Japan JEM 1400 transmission electron microscope for the purpose of electron microscopic study of microorganismsin vitro. Healthy mice forming control groups and mice with antibiotic-induced dysbiosis (after introduction of vancomycin, gentamicin, ampicillin) were divided into groups to create a mono-and associative infection: Ι group was given 1×107CFU of C.albicans, II group –1×108CFU of S.aureus, and III group –a mixture of specified concentrations of C.albicans and S.aureus in the same proportion. Microorganisms causing monoinfection were being isolated from the body of animals treated with antibiotics till the end of the experiments in large quantitiesunlike in case of the healthy mice.Co-inoculation of these microbes in the same dose to animals (co-infection), which were injected with antibiotics, turned out to be fatal for them, whereas an adhesive bond was seen between thecells of C. albicans vs. S. aureus in vitro.As can be seen, such bacterial-fungal co-infection reduce substantially the effectiveness of antibiotic therapy and the likelihood of successful treatmentand can not be ignoredwhen choosing the appropriate treatment

33-40

Authors: Mikola Shustval, Tetiana Liadova, Olha Volobuieva, Ksenia Pavlikova, Alla Gamilovska

The indicators of the activity of lipid peroxidation and the antioxidant system were studied in dynamics in 158 patients with infectious mononucleosis depending on the severity of the clinical course of the disease.It is proved that lipid peroxidation is significantly activated in patients with infectious mononucleosis as the severity of the disease increases and therefore increases the oxidative activity of blood plasma, the concentration of dyne conjugates and malondialdehyde in the blood, decreases the activity of antioxidant enzymes of erythrocytes (catalase, superoxide dismutase, glutathione peroxidase, glutathione reductase), glutathione peroxidase and glutathione reductase activity in plasma and lowering the concentration of total and reduced glutathione in the blood, as well as reduce the antioxidant activity of blood plasma and erythrocytes

47-51

Authors: Olha Volobuieva, Tetiana Liadova, Tetiana Sevastianova, Daniil Volobuiev

The article presents the epidemiological and clinical data of the modern course of chickenpox. A high incidence among adults with a bright manifestation of the clinical picture was shown. Recurrent episodes of chicken pox were marked

58-62

Authors: MarinaKaravanova, NataliaLisova, MarinaShevchuk

Our clinical case shows patient with worsening clinical signs of angina without obstructive lesions of coronary artery which requires further control. Recommendations for lifestyle modification as well as further treatment tactics are described

72-79

Authors: Julia Ovcharenko,Olena Salenkova

This article is an analysis of scientific publications that reflect the experience of using autologous platelet-rich plasma in patients with androgenic alopecia (AGA), a multifactorial genetically predisposed disease caused by the influence of exogenous or endogenous triggers responsible for the clinical manifestations of pathology. Attention to this topic is due to the significant prevalence of AGA, as well as unsatisfactory results in achieving a positive therapeutic effect

96-102

Authors: Ksenia Veklich

The innate immune response to viral pathogens is crucial in mobilizing defensive reactions of an organism during the development of an acute viral infection. Cells of the innate immunity system detect viral antigens due to genetically programmed pattern-recognition receptors (PRRs), which are located either onthe cell surface or inside the certain intracellular components. These image-recognizing receptors include Toll-like receptors (TLRs), retinoic acid-inducible gene I-like receptors (RIG-I-like receptors), nucleotide oligomerization domain-like receptors (NOD-like receptors), also known as NACHT, LRR and PYD domains of the protein, and cytosolic DNA sensors.The trigger mechanisms for these receptors are viral proteins, and nucleic acids serve as activators. The presence of PRRs that are responsible for thedetermination of viral antigens in cellular components allows the cells of innate immunity to recognize a wide range of viral agents that replicate in various cellular structures, and develop an immune response to them. This article summarizes the disparate data presented in modern English literature on the role of PRRs and the associated signaling pathways. Understanding the recognition of viral pathogens required triggering a cascade of cytokine and interferon production provides insights into how viruses activate the signal paths of PRRs and the effect of the interaction of viral antigens and these receptors on the formation of the antiviral immune response

6-11

Authors: Tkachenko M. O., Gubina-Vakylyuk G. I., Gorbach T. V., Denysenko S. A., Tkachenko A. S., Onishchenko A. I., Zhurba E. P.

The aim of the research was to study the features of the morphofunctional state of the pineal gland, neurohypophysis and adrenal medulla, as well as the сontent of serotonin and catecholamine in the blood serum of rats against the background of energy drink administration during two weeks. In animals that consumed energy drinks during two weeks at a dose of 6 ml per kg of body weight, serum serotonin and catecholamine levels were determined. Histological, including morphometric, studies of the epiphysis, posterior pituitary and adrenal medulla were performed. Against the background of energy drink administration, an increase in the content of blood serum serotonin, norepinephrine and epinephrine was detected. The morphofunctional state of the endocrine glands investigated in the present study is strongly stimulated. Indirect signs of apoptosis of parenchymal cells in the pineal gland, neurohypophysis and adrenal medulla were established. The studied stress-associated endocrine glands in animals against the background of the two-week intake of energy drinks have signs of a sharp stimulation of hormone production (serotonin, norepinephrine, epinephrine, and vasopressin).

18-24

Authors: Golubkina E. O., Yabluchansky M. I.

To determine the effect of the total power (TP) of the heart rate variability (HRV) spectrum on the distribution of high, low and very low frequency waves, 40 patients with arterial hypertension (AH) at the age of 58 ± 9 years were divided into 5 groups according to the degree of TP decrease in the initial stage of the test: 1st – more than 3000 ms2; 2nd – 3000–2000 ms2; 3rd – 2000-1000 ms2; 4th – 1000–500 ms2; 5th – less than 500 ms2. To assess HRV parameters in each group, 3 stages of the paced breathing test with a double (light and sound) metronome were evaluated; the hardware and software complex «Cardiolab» («HAI-Medica») was used. The distribution of the parameters was estimated taking into account the median, 25 and 75 quartiles. To estimate the differences between the statistical samples, the nonparametric Mann-Whitney U-test was used, as well as the Craskell–Wallis criterion. Statistically significant differences were considered between the data at a value of p < 0.05. It was found that the greater is the degree of TP reduction, the more significant is the autonomic imbalance, as well as the decrease in the influence of paced breathing on the regulation of the heart rhythm; at TP values below 1000 ms2 not only the parasympathetic component decrease is observed, but also the transition from sympathicotonia to the neurohumoral factors prevalence.

33-36

Authors: Khvysiuk M. O., Bilchenko O. V., Pavlov S. B.

Coronary artery disease for many years is being the main cause of death in many developed countries. Currently, cardiovascular disease (CVD) plays the main role in the evolution of the total mortality in the world. Most deaths occur as a result of coronary heart disease (more than 300 thousand per year). It is known that chronic inflammation is a marker of global endothelial dysfunction and may be associated with the increased risk of cardiovascular events in patients with coronary artery disease. Nowadays, it is very promising in terms of assessing the prognosis and course of the disease to study P-selectin.

46-56

Authors: Ospanova T. S., Semidotskaya Zh. D., Chernyakova I. O., Avdeyeva O. V., Pionova O. M., Tryfonova N. S.

The study objective is to establish the relationships features between lipid profile and other parameters of homeostasis in case of chronic obstructive pulmonary disease in framework comorbidity with coronary artery disease and arterial hypertension. Materials and methods: the lipid profile, CRP, IgE, НbА1С, FEV1, Tiffno’s index and SpO2 in 35 patients with chronic obstructive pulmonary disease (groups B, C, D), that were studied by standard methods. Results: A large quantity of correlations between different indicators that increased in relation to disease progression and presence of comorbidity was found. Cluster analysis confirmed the affinity between these indicators. Conclusion: A large quantity of correlation links between lipids and other indices of homeostasis and the results of cluster analysis indicate the development of adaptation and disadaptation processes under such circumstances as elevation of hypoxia in chronic obstructive pulmonary disease and these might be evaluated as synthropy of comorbidity with coronary artery disease and arterial hypertension.

61-65

Authors: Tymoshenko O. S., Yabluchansky M. I., Bilchenko O. V.

The frequency of administration of combinations of antihypertensive drugs and its changes at different stages of observation was studied in 60 patients with difficult-to-control arterial hypertension (DTCAH) (32 men and 28 women) aged 59.0 ± 9.4. All patients were randomly divided into two subgroups: biofeedback (BFB) in the loop of paced breathing (PB) and heart rate variability (HRV) (33 patients) – basic subgroup, subgroup of comparisons (27 patients). Determined that patients with DTCAH in the subgroup of patients with the BFB in the loop of PB there has been a reduction of four-component antihypertensive therapy to three-component and in the subgroup of comparisons the frequency of the appointment of a four-component therapy was increased. At the same time, it was found that the addition of drug therapy with regular BFB sessions in the loop of PB contributed to the potentiation of the antihypertensive effect in patients with DTCAH. It is concluded that the BFB in the loop of PB and HRV can be used as a technology to improve the efficiency of control of blood pressure in patients with DTCAH.

72-77

Authors: Zolotarova T. V., Brynza M. S., Yabluchanskiy M. I.

The combination of atrial fibrillation and/or flutter and chronic heart failure is a frequent problem for many patients. Radiofrequency ablation is effective in the strategy for controlling the rhythm of patients with atrial fibrillation and/or flutter, but always requires concomitant therapeutic support. The study involved 70 patients with atrial fibrillation and/or flutter after radiofrequency ablation which were divided into groups according to the functional class of chronic heart failure. Gender and age of patients; types of ischemic heart disease; stages of chronic heart failure; degrees of arterial hypertension; the form of atrial fibrillation and flutter; class EHRA; the presence of diabetes mellitus type 1 or 2 we evaluated. The female sex prevailed in the group of II functional class of chronic heart failure than in I functional class or III functional class. Ischemic heart disease, first of all angina of effort, in patients with III functional class of chronic heart failure was significantly more frequent. In group of III functional class of chronic heart failure there were significantly more patients with 3 degrees of arterial hypertension. Male patients, regardless of functional class of chronic heart failure, more often than females are conducted invasive methods of treatment for atrial fibrillation/flutter. With increasing of functional class of angina the functional class of chronic heart failure is increasing. Among patients II and III functional class of chronic heart failure prevails the arterial hypertension III degree, which may be a predictor of adverse prognosis.

84-88

Authors: Bohun N. Yu., Kushnir I. E., Chernyak A. M., Belal S.

The article demonstrates a clinical case of Crohn’s disease. The clinical manifestation of the disease, a diagnostic approach based on laboratory and instrumental methods with discussion of obtained results, and the up-to-date methods of investigation based on the literature data are shown. The significance of lifestyle modification, optimal drug treatment and regular check-ups for improvement of prognosis is emphasized.

92-96

Authors: Butova T. S., Butov D. O., Martynchyk O. S., Sinichenko O. S., Martymianova L. O.

On an example of a clinical case in a patient with drug addiction, the reviewed clinical and chest X-ray features of community-acquired pneumonia, the diagnostic algorithms and the differential diagnostics are based on the recommendations of the Ukrainian Association of Pulmonology. The treatment strategy of the patient in the conditions of an ambulatory are described.

102-108

Authors: Makharynska O. S., Lebedinska M. M., Skokova N. I., Oktiabrova I. I., Ajewole O. Michael, Aroyewun O. Taofeeek

Immunological mechanisms of appearance and therapeutic treatment strategies were discussed on example of the rare granulomatosis with polyangiitis clinical case in young patient. This vasculitis, formerly known as Wegener’s granulomatosis, is a rare multisystem autoimmune disease with necrotizing granulomatous inflammation and pauci-immune vasculitis in small- and medium-sized blood vessels.

113-117

Authors: Makharynska O. S., Oktiabrova I. I., Kartvelishviliy H. Yu., Okhryamkina O. O.

On the example of the clinical case of newly diagnosed ST-elevation myocardial infarction combination of different reperfution strategies and their benefit was discussed. Recommendations on lifestyle modification and medicament treatment tactics are described.

122-128

Authors: Osman H. A., Golubkina E. O., Silenko I. Y., Yabluchanskiy M. I.

A clinical case of middle age male diagnosed with reactive arthritis developed on the background of multiple bacterial invasions such as Salmonella enterica, Ureaplasma urealyticum, Mycoplasma hominis, Borrelia burgdorferi sensu lato and characterized by chronic persistent course of the disease with destructive-inflammatory changes in the joints. This case illustrates the influence of bacterial pathogens on the course and the progression of reactive arthritis.