Medical perspectives (Medicni perspektivi)

4-9

Authors: Drozdov A.L., Rodinsky А.G., Zubkovskaya А.G., Demchenko Е.М., Romanenko L.A.

In experiments conducted on white rats neurotropic action of soy lecithin, known as a source of unsaturated fatty acids on the background of the neurotoxic impact of CCl4 was studied. Useage of CCl4 by courses showed a significant inhibitory effect that affected the spontaneous behavior of rats “in the open field” by significant inhibition of mobility (44 - 77%), research activity (81%) and increased emotionality (140%). Such usage of soy lecithin having anti-oxidant activity and membrane-stabilizing effect led to optimization of spontaneous behavior of rats. The infringement of cognitive function is, possibly, due to the prooxydative effect of CCl4 and decrease in the unsaturated fatty acid fraction in the structure of the brain lipids. Level of research, mink instinct, emotionality, vertical mobility were restored, and horizontal mobility even increased by 59%. Thus, soy lecithin may be recommended as a drug with correcting cognitive brain function.

14-21

Authors: Stepansky D.A.

In this research the data on examination of antagonist qualities of bioassotiantes A. viridans and strain B. subtilis 3 towards pathogenic and opportunistic pathogenic microflora isolated from oropharynx and nasopharynx of children who were in contact with patients with pulmonary tuberculosis (MBT +) are submitted. The expressed antagonist activity of autosimbionts A. viridans towards pathogenic and opportunistic pathogenic microflora was shown. Common antagonist activity of A. viridans (k) N 1 and B. subtilis 3 towards diverse strains of test-cultures is 1,5-2 times higher, than separate antagonist activity of A. viridans (k) №1 and B. subtilis 3. Received research data showed the possibility of continuing work on development of probiotic associations, that contain representatives of normal microflora - bioassociants A. viridans and probiotic strains B. subtilis 3 with broadspectrum of antagonistic activity in relation to the various groups of bacterium.

27-34

Authors: Loskutov A.Ye., Olejnik A.Ye., Altanets A.V., Kovbasa Ye.A.

The article represents a comparative roent¬gen¬morphometric analysis of hip joint deformation development in femoral head aseptic necrosis (FHAN) that was done to identify criteria which determine the selection of the acetabular component of the total hip joint endoprosthesis. There were analysed 234 hip joint radiograms of patients with FHAN performed in anterior-posterior plane. Radiograms were subdivided into 3 groups concerning staging of the process: stage II – 18 radiograms, stage III – 84 radiograms, stage IV – 132 radiograms. Analyzing the acetabular retraction (AR) following indices were assessed: sphe¬ricity coefficient α (α = r/d), proportionality coefficient β (β = n/r), compliance coefficient γ (γ = h/r), where r – radius of the acetabulum, n – thickness of the acetabular bottom, h – height of the “Napoleon’s hat”. In addition, there was assessed presense of the major trabecular structures of the supra-acetabular area (A,B,C). Score assessment system, based on the identified indices of changing tendencies in FHAN was offered. There were determined the first level criteria, characterizing the acetabular and supra-acetabular area state. Besides, individual factors of the patient (sex, age) which substantially determine endoprosthesis stability in the remote postoperative period were related to second level criteria. Basing on the assessment of the first and second level criteria algorithm of choice of the total hip endoprosthesis component was developed. Thus, developed system of choice of total hip endoprosthesis component which consider peculiarities of the acetabular deformation formed in the late stages of FHAN assesses the ability of the supra-acetabular area to perceive loading. In addition algorithm takes into consideration individual factors of the patient (sex, age) by the moment of implantation, which determine total hip endoprosthesis stability in the latest postoperative period and consequently the risk for aseptic instability development.

41-48

Authors: Novitskaya-Usenko L.V., Dyomin S.G.

Aim: improving the results of the complex treatment of patients with surgical pathology of abdominal organs by improving prevention and treatment of motor-evacuation disorders of the gastrointestinal tract in the postoperative period. Results: the article presents data on the use of metoclopramide, L- ar¬ginine, simethicone for the prevention of postoperative dysmotility development. It is proved that L-arginine use reduces the effects of peripheral vasospasm by improving microcirculation of the intestinal wall and this leads to a more rapid recovery of motor-evacuation function of the gastrointestinal tract.

55-62

Authors: Duka Yu.M.

Under supervision there were 233 pregnant women with excessive weight aged 18-43 years. Patients were under observation and gave birth on the basis of obstetric units of municipal establishment "Dnepropetrovsk regional perinatal center with in-patient unit of" Dnepropetrovsk regional council". When performing research 2 groups were formed: 120 (51,5%) pregnant women with miscarriage threat against excessive weight being at in-patient treatment since early terms of pregnancy. They underwent in-depth study. 113 (48,5%) pregnant women with obesity with gestation course estimated retrospectively at the time of delivery. As a result of the obtained data in women of prospective group treatment algorithm was developed. This algorithm represented a complex treatment including antiagregant and anticoagulant therapy, co-factor vitamin therapy. Despite a more mature age of women of prospective group, adverse anamnesis by missarriage, high frequency of miscarriage in its first half, low placentation level, this complex allowed to improve course of the second half of pregnancy and to reduce number of gestational complications and perinatal losses.

69-75

Authors: Voronin K.V., Davidenko N.V., Loskutova T.O.

Miscarriage is an actual problem of modern obstetrics. The frequency of miscarriage is 10-25% of all pregnancies, and habitual abortion occurs in 5%. Habitual miscarriage is considered as a typical multifactorial disease, being the result of expression of functionally weakened versions of many genes on the background of adverse external and internal factors. The genetic nature of habitual miscarriage includes groups of genes responsible for hemostatic disorders and endothelial dysfunction. The aim of the study was to determine the frequency and the role of combination of allelic variants of thrombophilia genes and endothelial dysfunction in the development of habitual miscarriage. 109 women with recurrent miscarriage and 34 apparently healthy pregnant women were tested with allele specific polymerase chain reaction and genetic polymorphisms of coagulation factors and fibrinolysis (1691 G → A factor V Leiden, 20210 G → A prothrombin, 5G/4G PAI-1, -455 G → A fibrinogen β) and endothelial dysfunction (192 Q → R PON-1, 677 C → T MTHFR) were identified. The study showed the expediency of examination of women with habitual miscarriage for the presence of an inherited defect in the hemostatic system (gene mutations factor V Leiden, prothrombin 20210G → A, polymorphism of PAI-1 5G / 4G, fibrinogen β -455 G → A) and endothelial dysfunction (MTHFR gene polymorphism 677 C → T). A high frequency of multigene form of thrombophilia (two or more defects) in patients with habitual miscarriage - 80.7% was detected. Pathologic polymorphisms that cause fibrinolysis defects in combination with dysfibrinogenemia were identified the most frequently.

81-85

Authors: Spirina I.D., Leonov S.F., Shusterman T.Yo., Varshavskiy Ya.S.

The article describes a clinical case of organic depressive disorder in the personality who sustained a traumatic brain injury and who abused alcohol, with distinguishing number of clinical and psychopathological features. Depressed mood, slowed thinking process, sleep disturbances, low self-esteem, hypochondriacal tendencies allowed to diagnose depressive disorder. Clinical history on sustained brain concussion, as well as inertness of nervous and mental processes revealed in psychodiagnostic study testified to organic genesis of the disease. Alcohol abuse by the person having an adverse organic background contributed to appearance of psychotic symptoms in clinical picture. Hallucinatory and delusional inclusions relatively quickly stopped on a background of antipsychotic treatment; this testified that they are secondary to the affective (depressive) symptoms.

91-98

Authors: Korpusenko I.V.

Objective of our study was to increase the effectiveness of surgical treatment of bilateral destructive pulmonary tuberculosis complicated by pleural empyema by using VTS-technologies. The study was done in Dnepropetrovsk regional clinical therapeutic and prophylactic association "Phthisiology" in the period from 2008 to 2013. A retrospective analysis of 43 cases of bilateral destructive pulmonary tuberculosis complicated by pleural empyema on one side and dissemination focus or limited destructive process on contralateral side has been performed. Selected cases were divided into 2 groups: main (eighteen cases where the following procedures were done: performed transsternal occlusion of the main bronchus, sanation of empyema cavity using videothoracosopy, in 30-45 days followed by pleuropneumectomy with usage of minithoracothomy) and control (nineteen cases who had undergone drainage of the empyema cavity, sanation, in 45-60 days followed by pleuropmeumectomy with usage of anterolateral access). The distribution of main and control groups for analyzed parameters was representative. Sanation of pleural cavity with videothoracosopy usage compared with Bulau’s drainage provides better antibacterial effect, effective sanitation of the pleural cavity as evidenced by following changes: significant decrease in the number of microbial cells; normalization of total white blood cells count and rod-shaped granulocytes in the peripheral blood 10 days after treatment; normalization of leukocyte intoxication index. The use of minimally invasive surgical treatment allowed to reduce intraoperative complications by 2 times, amount of intraoperative blood loss and hemotrasfusions by 1.5 times, postoperative mortality by 2.5 times. Pleural cavity sanation with videothoracoscopy usage with following pneumoectomy leads to reduce in the incidence and severity of postoperative complications. The most promising is stage-by-stage surgical approach with consecutive use of previous transsternal occlusion of the main bronchus and pulmonary artery branch with videothoracoscopy sanation of empyema cavity.

104-110

Authors: Duka K.D., Mishina N.V., Cherginets V.I.

The article discusses the problem of infants’ feeding connected with the incidence of respiratory diseases. Rationality and duration of breast feeding does not cause doubts. But unfortunately today, only 60-80% of children under the age of 6 months are exclusively breastfed. Naturally, this causes impact on disease incidence of such children. Formation of bronchopulmonary pathology is of particular interest. The basis of modern research is the concept of programmed impact of nutrition in early childhood on health in lateryears. We have determined the dependence of respiratory diseases incidence in children of early age on duration of exclusively breast feeding. Not only frequent respiratory diseases, but formation of bronchitis, pneumonia or other complications of their course is of importance. The study included questioning of mothers and children under 7 years of age, clinical, radiological and laboratory investigations in the hospital in case of respiratory disease. All studies were conducted in accordance with the characteristics of diet quality of the child in the first year of life with the following biostatistical processing. 601 children aged from 3 months to 7 years were examined. It was found that the duration of breast feeding in the region is 89% only to the age of 6-months, and up to 1 year the percentage of breastfed children reduces to 38%. This affected the resistance of children to respiratory infections, especially in the first year of life. Children exclusively breastfed up to 1 year suffer from respiratory diseases 1-2 times per year. In children over one year of age breast feeding does not affect the frequency of respiratory pathology. Increase of respiratory diseases frequency in children aged 3-5 years is due to attending preschool institutions and increasing contacts between children, which significantly reduces their resistance.

116-122

Authors: Sova S.G.

The paper analyzes the differences between domestic and European methodology of hygienic standardization of the local impulse vibration. With the assistance of the vibrometer Octava-101-U there were studied hygienic parameters of pulsed local vibrations in mechanical workshops of the State Enterprise "Antonov" and the State Enterprise "Plant 410 civil aviation" according to the procedure set out in SSN 3.3.6.039-99 "State sanitary norms of general and local production vibration". Levels of pulsed local vibration in the workplace of fitter-assemblers and fitters do not exceed the standards of domestic hygiene standards and, at the same time, ten times higher than the exposure limits of the European system of standards “Health and Sufety Executive” (HSE). Discrepancies between national and European system of regulation and assessment of the harmful effects of local vibration can explain the development of early clinical syndromes in workers of vibration-dangerous enterprises, this makes to pical bringing of Ukrainian hygienic standards to European standards.

128-132

Authors: Koval V.V., Kodratyev A.Yu., Bobrov V.V., Shmatkov V.M., Rublevskaya N.I.

The article presents the characteristics of water consumption by population of a modern industrial city. Results of the study show that the problem of drinking tap water is relevant for the residents of the industrial city. Methods of drinking tap water purification used by population of the industrial city at home in order to improve its quality were identified. It is found that a certain part of the population (5.7%), mostly middle-aged persons with secondary education, consume tap water without pre-treatment or are limited to boiling it before use (6.3%). Considerable part of the population of the industrial city for drinking and cooking every day uses additionaly purified water. Of them, 27.6% prefer additionaly purified pre-packed water, 16.1% of respondents use drinking water from water spill points. The results of the survey indicate that 4.5% of respondents for purification of tap water use intrahouse filters, 20.3% - local (domestic) filters.

140-142

Authors: SE "DMA"

Academician of NAMS of Ukraine, Rector of SE «DMA of Health Ministry of Ukraine» Georgy Viktorovych Dziak is 70.