International Journal of Medicine and Medical Research

4

Authors: O. Fedortsiv, N. Haliyash, S. Nykytyuk

Background. The universality of the general adaptation syndrome and the need to study the impact of general adaptive responses on the occurrence and consequences of pathological processes, as well as detection of early signs of disadaptation, have been proven by numerous works. Objective. The aim of study was to explore the peculiarities of general non-specific adaptive reactions in pediatric population and to discuss the diagnostics effectiveness of general nonspecific adaptive reactions in early detection of health disorders in children of different age. Methods. The paper presents the results of laboratory and clinical tests, conducted in 185 healthy children aged 4-12 years and 42 children of the same age with community-acquired pneumonia. The characteristics and prevalence of general nonspecific adaptative reactions in healthy children of different age were given. Determination of adverse adaptative reactions (stress, training and overactivation) based on analysis of the general blood analysis is an early diagnostic criterion of individual health reduction of children. Results. The features of clinical course, the nature and direction of immune disorders of children with community-acquired pneumonia, depending on their adaptive systems, were revealed. The influence of conventional treatment regimens of children with pneumonia on the state of adaptation processes was determined. Clinical diagnostic criteria for prognosis and treatment efficacy based on diagnostics of nonspecific adaptive responses in the dynamic of pneumonia were established. The proportion of morphometrically different blood lymphocytes in healthy children was determined. It was revealed that the blood of preschool age children dominated with type I cells (61.3±1.7) %. The relative content of lymphocytes (morphological type II) (28.7±1.6) %, type III – (6.1±0.6)%, type IV – (3.9±0.6)% was observed. Conclusions. General nonspecific adaptative reactions of mild and increased activation, as the most conducive to children’s age, demonstrate a balance of the relative content of different types of lymphocytes according to morphometrical data.

4

Authors: I. Galaychuk

Background. In women with breast cancer the significant postop lateral deviation of the nipple-areola complex may occur if the partial breast resection with lymphadenectomy was performed through one-line straight incision from the middle axilla to the edge of areola. Objective. To describe radical oncoplastic breast resection with avoiding of nipple-areola deviation and preservation of the symmetry of breasts. Methods. The study included 16 women, age 32 to 67 years. Breast cancer at the stage I was found in 5 patients, stage IIA – in 4, stage IIB – in 2, and stage IIIA – in 5 patients. We proposed to use curved (broken line) incision with 120° angle instead of linear incision. Oncoplastic breast resection began with incision of skin and soft tissues in axilla, along the pectoral muscle downward to lateral contour of breast, and then direction was changed at an angle of 120° towards areola. The tumor projection was encircled by two semi-oval incisions, and then partial breast resection with axillary lymphadenectomy was done. After morphological confirmation of “clear” surgical margins the wound was sutured along the trajectory of the incision. Results. All women rated the postop cosmetic result as “good” and “satisfactory”. The selected configuration of tissue incisions provided physiological position of the operated breast. Conclusions. Method of “broken line” incision of skin and soft tissue at an angle of 120° allows performing the radical breast resection with axillary lymph node dissection and prevents postoperative lateral deviation of nipple-areola, and maintains symmetry of the breasts.

5

Authors: O. Fedortsiv, J. Zejda, N. Luchyshyn , G. Brozek

Background. Asthma and other allergic diseases as influenced by environmental and familial factors might be targeted using preventive measures. These diseases are a matter of some urgency in Ukraine because of the clinical, social and economic importance of childhood. Objective. The aim of this study was to investigate the relationship between prevalence of asthma, spastic bronchitis, allergic rhinitis, atopic eczema, unspecified hypersensitization and some selected environmental and familial factors in a population sample of 6 to14-yrs old Western Ukraine schoolchildren. Methods. The data set of the study was collected using a questionnaire-based survey, containing the data of 4871 urban and rural children aged 6 to 14 years. Correlation of asthma and allergic disease with familial and environmental factors was examined by means of multivariate logistic regression. Results. Increased risk of asthma (1.7 %) was associated with the urban residence (OR=1.8; p=0.04) and high parental education (OR=1.8; p=0.02); spastic bronchitis (6.2%) – with parental allergy (OR=1.3; p=0.03); atopic eczema (6.2 %) – with younger age (OR=1.3; p=0.03), high parental education (OR=1.3; p=0.03), parental allergy (OR=1.4; p=0.02), tobacco smoke at home (OR=0.7; p=0.01) and household density (OR=0.6; p=0.001); diagnosis of unspecified allergic sensitization (11.8 %) was related to high parental education (OR=1.2; p=0.03), parental employment (OR=0.8; p=0.02) and pets at home (OR=1.2; p=0.06). Conclusions. This study identifies that lifestyle and building factors are associated with an altered prevalence of common childhood allergic disease. Prevention may need to address the minimization of potential risk-factors

5

Authors: A. Roy, R. Dalui, M. Kalinski, A. Bandyopadhyay

Background. Vertical jump test (VJT) is used in some sport disciplines to evaluate an individual’s lower extremity power. However, VJT data is unavailable in young Indian boxers and swimmers. Objective. The given study was aimed to evaluate the VJT, anthropometric profile and body composition in young male Indian swimmers and boxers and compare the data with sedentary control group. The study also explored the relationship of VJT with anthropometric parameters and different components of body composition in the studied groups. Methods. Male boxers (n=40), swimmers (n=40) and sedentary subjects (n=40) with similar socio-economic background with age ranging between 21 and 25 years were sampled for the study from Kolkata, India. Body composition was determined by skinfold measurements and VJT was evaluated by Sargent Jump Test. Results. One way ANOVA shows significant (p<0.001) difference in body mass, %fat, total body fat (TF), lean body mass (LBM) and VJT score in boxers, swimmers and sedentary groups. Significant positive correlation of LBM with VJT score was associated with a greater jumping height in swimmers. On the other hand, VJT had significant negative (p<0.05) correlation with sum of all the skinfolds, individual skinfold and total fat in both athlete group as well as in the sedentary group. Conclusion. Significant intergroup difference was found in the studied parameters. VJT scores obtained in all the groups were well comparable. Higher value of body %fat imposed the unfavourable effect towards achieving higher jumping height mainly in sedentary group.

5

Authors: O. Oleshchuk, K. Posokhova, A. Mudra

Background. Hepatic ischemia-reperfusion (I/R) injury occurs upon restoration of hepatic blood flow after a period of ischemia. Objective. The study establishes that stimulation or blockade of nitric oxide synthesis has a protective effect during ischemia-reperfusion. Methods. Male albino rats which were divided into four equal groups: sham-operated control, ischemia and reperfusion group (0.9 % saline i.p.) for 3 days, group pre-treated with L-arginine (25 mg/kg i.p.), group pre-treated with L-NAME (10 mg/kg i.p.) for 3 days before ischemia-reperfusion maneuver. Complete ischemia of the median and left hepatic lobes was induced by clamping the left branches of the portal vein and the hepatic artery for 45 min. Rats were sacrificed after 3-h reperfusion. Nitric oxide synthase 3 (endothelial) and nitric oxide synthase 2 (inducible) expression, nitric oxide stabile metabolites (NO2, NO3) content, AST and ALT activities were determined. Histological examination of liver tissue was performed. Conclusions. Relative NO deficiency, due to eNOS inhibition, is central in the pathogenesis of hepatic ischemia reperfusion injury. Replacing NO content with either precursors or via donor drugs represents novel methods in ameliorating ischemia-reperfusion injury.

6

Authors: P. Lizis

Background. The surgical removal of heel spur (HS) provokes many controversial opinions, but clinical studies show the risk of complication after operation. An alternative to the surgical removal of HS is Extracorporeal Shock Wave Therapy (ESWT), because it is non-invasive method. Objective. The aim of the study is to compare the short-term analgesic effects of ESWT and conservative treatment (CT) in males with chronic HS. Methods. Sixty patients (mean age 54.9±4.3 years; range 42 to 59 years) were examined who had pain associated with HS. In the shockwave group (group 1) patients received 1000–2000 impulses of shocks to the affected heel in a single session. The patients in this group took a series of 5 ESWT in 1 week intervals. Patients in the control group (group 2) at the same time received CT consisting of nonsteroidal anti-inflammatory drugs (NSAIDs), orthotics and a local cortisone injection. The basic method of research was to evaluate pain according to Visual Analogue Scale (VAS) 0–10. The patients of the two groups were tested before the treatment, after the last treatment and 3 months and 6 months after the treatment. Results. A significant decrease of VAS (p=0.000) was seen in the shockwave group. In the control group no significant decrease of VAS was seen. Conclusions. ESWT reduces pain more effectively than CT in men with chronic HS.

7

Authors: H. Falfushynska, L. Gnatyshyna, A. Shulgai , V. Shidlovski, O. Stoliar

Background. Thyroid disorders are the second most common endocrinopathies found in humans and animals. Determination of their key molecular markers presents a special interest. Objective. We studied iodine and copper accumulation in nodular, paranodular and contralateral (not affected tissue by node) tissues of human thyroid gland in relation to the level of metal-binding proteins, potential antioxidants, and oxidative changes in tissue for this goal. Lower level of organificated iodine and higher level and mass fraction of inorganic iodine and copper in the nodular and paranodular tissue versus contralateral part of thyroid gland was established. Results. The level of both metal-binding and apo-form of metallothioneins was higher. Content of reduced glutathione was lower in node-affected tissue compared to the contralateral part. Signs of oxidative stress (higher activity of superoxide dismutase, catalase, glutathione-transferase and level of oxyradicals) and cytotoxicity (higher cathepsin D activity, higher level of DNA strand breaks and glycolysis activation) in affected tissue were observed. The range of indice variability in paranodular tissue was smaller than in nodule compared to the parenchyma of contralateral part. Conclusions. Excess of copper unbound to metallothionein in goitrous-changed tissue and high level of inorganic iodine could be the reason for elevated DNA fragmentation and increased lysosomal membrane permeability and activation of antioxidant defense. The main criterions of goiter formation were represented by low level of organificated iodine and high level of DNA damage in thyroid gland.