Medical perspectives (Medicni perspektivi)

04-09

Authors: Biletska E.M., Onul N.М.

Heavy metals are the second major environmental pollutants. Especially toxic is lead, increased content of which in the body of a pregnant determines the development of pregnancy, childbirth and postpartum period complications and is potentiated by deficiency of essential trace elements - zinc and copper. Article presents the results of impact of solutions of lead acetate and citrate in experimental models. Solutions of metals were injected into the stomach through a tube once a day during 19 days of pregnancy in the dose of 0,05 mg/kg in the form of inorganic compound - lead acetate and in organic form – lead citrate. The content of trace elements - lead, cadmium, copper and zinc were determined by stripping voltamperometry. In addition, indices of placental and fetal accumulation, as well as index of transplacental migration were calculated. Effect of lead during pregnancy in all biosubstrates is increased by 1,3-1,9 times as compared with the control group. This causes imbalance of essential trace elements due to significant reduction in zinc content in all the studied biological substrates. Prolonged contact with lead during pregnancy leads to disruption of placenta, inability of the placenta to fully protect the fetus from excessive intranatal influence of xenobiotics.

15-18

Authors: Galagan V.O.

Objective of the study was to review the anamnesis, pheno - and genotype in patients with rare chromosome disorders such as 9p deletion syndrome. Genetic methods of investigation (clinical and genealogical, cytogenetic, FISH- method), paraclinical and instrumental methods of examination were used. Karyotyping was performed by the G-method of differential staining of chromosomes. Only three cases of pathology were diagnosed in the Medical Genetics Center over the last 10 years. By anamnesis data nobody in the probands’ families had bad habits, was exposed to occupational hazards, took part in the elimination of the Chernobyl accident or lived in contaminated areas. Clinical signs of diseases have not been identified in probands’ parents. All probands had trigonocephaly, bilateral epicanthal folds, ocular hypertelorism, downslanting palpebral fissures, long philtrum, flat face and nasal bridge, low set ears with malformed auricles. Two patients of three ones had exophthalmos, contracture of the second and third fingers, abnormal external genitalia. In all three cases there was monosomy of chromosome 9 of critical segment p 24. Normal karyotypes were seen in all parents, so there were three cases of new mutations of 9p deletion syndrome. Retardation of physical, psycho-spech, mental development in proband with or without congenital anomalies requires medical genetic counseling in a specialized institution. Cases of reproductive loss in anamnesis require cytogenetic investigation of fetal membranes and amniotic fluid.

23-29

Authors: Potapov V.A., Donskaya Yu.V., Medvediev M.V.

The study involved 155 women, of which 30 healthy women were in the control group. 125 women with uterine leiomyomas and endometrial hyperplasia constituted the main groups. In all women with uterine leiomyoma myomectomy was performed. Further treatment included randomized study of a new regimen of GnRH agonists together with COCs after myomectomy using comparison techniques: monotherapy with a-GnRH, progestins (dydrogesterone) or COCs. The treatment using different medication regimens of endometrial hyperplasia after myomectomy convincingly demonstrated significantly greater efficacy of GnRH-a and COCs com¬bination in reducing frequency of symptoms of these diseases, volume of menstrual blood loss and improvement quality of life through the entire observation period. Greater efficacy of COCs and a-GnRH combination, to our opinion, is associated with a greater degree of suppression of cell proliferation and angiogenesis as a result of local (COCs), and systemic effects (a-GnRH).Thus, the proposed method of adjuvant therapy after myomectomy for women with as¬sociated endometrial hyperplasia has significant clinical benefits with minimal impact on bone mineral density and other menopausal signs caused by a-GnRH monotherapy.

36-43

Authors: Pertseva N.O.

In the article defining relationship between endothelial dysfunction, the degree of renal and lipidemic profile damage in 234 patients with type 2 diabetes mellitus with hypertension was carried depending on the quality of glycemic control. It is shown that the deepening of endothelial dysfunction in patients with insufficient and poor compensation tightly correlates with the degree of renal and lipidemic disorders. In these patients there was a significant increase in the level of albuminuria, reduction in glomerular filtration rate, increase of concentrations of urea and creatinine. Against the background of poor hyperglycemia, compensation total cholesterol, low density lipoprotein content increases by 73,3% (p<0.05), hype¬rtriglyceridemia twice exceeds the control values. In patients with type 2 diabetes mellitus with poor compensation the most significant correlation links were observed between the concentration of endothelin-1 and the level of microalbuminuria (r=+0,79), as well as the content of low density lipoprotein cholesterol (r=+0.81). Thrombomodulin concentration is in direct correlation with microalbuminuria (r=+0.76), hypercholesterolemia (r=+0.80) and hypertriglyceridemia (r=+0.83), indicating to increasing interaction between the pathogenetic mechanisms which cause depression of endothelial dysfunction, renal and dyslipidemic disorders with increasing hyperglycemia.

51-56

Authors: Tsymbaliuk V.I., Dzyak L.A., Sal'kov N.N., Rodinsky A.G., Tkachenko S.S.

The tasks were to investigate the effect of topical electroneurostimulation, cortexin and methy¬lprednisolone in acute spinal cord injury in electrophysiological experiments on laboratory rats. The animals un¬derwent half transection of the spinal cord in the lower-thoracic area to simulate Brown-Sequard’s syndrome. Drugs were administered subdurally once daily in the dose of 0.03 mg for cortexin and 0.7 mg for methylprednisolone during 72 hours. Electrophysiological studies were carried out using standard electrophysiological apparatus. Reliable changes of bioelectric indicators in neuromuscular complex during topical application of electrical stimulation, as well as in administered methylprednisolone, failed to be found. However, local application of cortexin in terms of traumatic spinal cord injury due the antioxidant and neurotrophic effect results in improvement of bioelectrical indicators; this is manifested in reliable (p<0.05) increase of amplitude of the background electromyogram impulses at rest by 33% and increase of spontaneous oscillations frequency by 29.82%.

62-65

Authors: Porokhnya N.G.

To determine the most informative prognostic signs of infectious endocarditis development in children with heart pathology on the background of bacterial infections clinical course of 15 cases of infective endocarditis in children aged from 1 month to 17 years was performed. The comparison group consisted of 40 children aged 5 - 17 years with mitral valve prolapse. Of 19 analyzed clinical-anamnestic predictive diagnostic features for the development of infective endocarditis in children, presence of febrile fever during infusion therapy, the operated congenital heart disease, treatment in an intensive therapy unit with mechanical ventilation, intravenous infusions through a catheter lasting more than three days, a positive blood culture during the disease course, diagnostic catheterization of large vessels were of high informative value. In a positive prognosis of infective endocarditis development with a probability of 95% and more, children underwent complex of therapeutic measures with the following observation of pediatric cardio-rheumatologist.

71-75

Authors: Grizodub D.V.

Purpose of the work was to explore the possibilities of forecasting adverse reactions based on the study of the immune system of the potential denture user and features of its interaction with potential materials of future depture. Methods: The author conducted study of cellular immunity components in patients with complaints on intolerance of dentures. Results: The most pronounced negative dynamics of cellular immunity was observed in patients with cobalt-chromium alloys: marked reduction of T-lymphocytes, change in subpopulation ratio towards predominance of T-helper cells, which led to the development of cellular intolerance reactions, higher content of Ig E, increased histamine release in response to denture material. Comprehensive assessment of allergic history data, im¬une status parameters allows to carry out a preliminary assessment of materials biocompatibility and their individual selection in each case both in healthy subjects and in patients with allergic diseases. Identification of materials which have the ability to cause adverse reactions in particular patient caused by the action of histamine on the cells and tissues, allows to replace the material or not to use it in a particular patient.

81-85

Authors: Makarenko M.V.

A high percentage of prevalence of inflammatory periodontal diseases in young age causes urgency of treatment and prevention of inflammatory diseases of periodontal tissue in young age. Therefore, the research purpose was to investigate the hygienic condition and identification of the main risk factors for gingivitis in patients aged 18-30 years. 286 people aged from 18 to 30 years were observed in the study. To assess hygienic condition of the oral cavity and to determine the thickness of plaque indices OHI-S (simplified oral hygiene index Green Vermilyona) and Silness Loe were used. Studies of oral hygiene status suggests that in patients with different etiologies of periodontal tissue inflammation, oral hygienic condition ranged from "satisfactory" to "poor." Therefore the results of study of hygiene and periodontal indices and samples confirmed presence of moderately expressed inflammation in the gums in young adults with chronic catarrhal gingivitis. Most often inflammation in the gums, namely, chronic catarrhal gingivitis was determined in patients with fixed prosthesis designs in the mouth or in violation of the bite, related to the major risk factors for periodontal disease occurring in young adults aged from 18 to 30 years.

92-97

Authors: Khomenko I.M.

Analysis and evaluation of the most used measures of radiological protection in the country and levels of irradiation of the population dwelling on the most radioactively contaminated territories due to the Chernobyl catastrophe was conducted. The levels of cumulative and committed doses of irradiation were evaluated by the results of their reconstruction. Data of the regional sanitary and epidemiological station on detection of the content of radionuclides in the body were also used. They were detected by means of the radiation meter of a person. Primary information on morbidity was analysed by changes in the dynamics of observation of certain territories. Based on the analysis of the existing national data it was shown that in certain centres of population of Ovruch district of Zhytomyrska oblast irradiation doses in 1986-2013 exceeded the specified by national legislation criterion of the dose of 70 mSv within the life. During this period in population there were realized about 92% from the committed calculated dose of irradiation within the life and irradiation with small closes continues. Only a small part of respondents uses countermeasure to get radioactively non-polluted foodstuffs. The defined peculiarities indicate the necessity to continue taking protective measures from ionizing radiation of the population.

105-111

Authors: Tymchenko O.I., Mykytenko D.O., Koba O. P., Lynchak O.V.

The aim of the research: estimation of morbidity and prevalence, risks of female and male infertility among the different regions of Ukraine. Materials and methods. The Morbidity and prevalence of female and male infertility were calculated according to Ministry of Public Health official statistics (2002-2012) per 1 000 of population of reproductive age (15-44). Relative risk including 95% confidence interval was calculated for each region in comparison with whole Ukraine. Results. In Ukraine infertility level grows. Over the years interrelation of female infertility prevalence to male decreases. In 2002-2012 prevalence of infertility was 400,1±0,59 per 100 000 of women and 87,41±0,28 per 100 000 of men aged 15-44 years, including infertility morbidity - 122,8±0,33 and 33,63±0,17 per 100 000 accordingly. It was detected the increased risk of female and male infertility deve¬lopment in Odessa, Dnipropetrovsk and Zaporozhzhye regions, and decreased risk in Lviv, Rivne, Kyiv, Cherkassy, Kirovograd, Mykolaiv, Sumy, Kharkiv, Lugansk and Donetsk regions.