Medical perspectives (Medicni perspektivi)

5-7

Authors: SE "Dnipropetrovsk medical academy of Health Ministry of Ukraine"

GEORGIY VICTOROVYCH DZYAK – GREATNESS OF PERSONALITY AND LIFE

15-18

Authors: Breydak O.A.

Evaluation of gonadotoxic effect of diazolin was conducted according to the methodical recommendations. "Methods of experimental studies to establish thresholds of action of industrial poisons on the generative function for the purpose of hygienic regulation". Experiments were carried out on nonlinear white male rats. The preparation was introduced intragastrically within 72 days in a dose of 100 mg / kg (experimental group 1) and 20 mg / kg (2 experimental group), which made up 1/100DL50 and 1/500 DL50. For the assessment of sexual glands microscopic studies of the testes (external examination, weight, size), functional and morphological parameters were used. The parameters obtained during experiments were compared with the results of the control group and values of standards in laboratory animals. Influence of diazolin in the dose of 100 mg/kg (1/100 DL50) resulted in the increase in the total number of sperm cells with simultaneous decrease of their mobility, redox processes, osmotic and acid resistance. However, these changes did not reach statistical significance. Number of dead sperm cells and their pathological forms and indicators of semen-forming epithelium were within the control. Diazolin in the dose of 20 mg/kg (1/500 DL50) and 100 mg/kg (1/100 DL50) shows no gonadotoxical action.

23-27

Authors: Kulbashna Ya.A., Gudaryan O.O., Nikonov V.V., Idashkina N.G.

The article deals with the problem of identifying specific com­petencies of Master in dentistry. The results of the analysis of domestic and foreign scientific literature, legal documents regulating the implementation of competence-based approach in higher medical education is presented, international experience in the modernization of higher education, including medical, on the basis of changes in the educational paradigm on competence approach is studied. In the process of identifying set of special competences of Master of dentistry, the main ideas of the existing professional Standards in Dentistry were used. A worked out set of special competences reflects peculiarities of the profession in accordance with the algorithm, aimed to help dental patient in a vicious circle from disease prevention to rehabilitation after diseases, the latter includes legal, methodical, social and managerial aspects of the professional activities of a dentist.

33-38

Authors: Andryushkova N.G., Turchin N.S., Dolinchuk L.V., Ponyatovskyy V.A., Melnik V.V., Shyrobokov V.P., Trepet L.N.

Objective of the study was determination of enterovirus genom presence in the blood serum of patients with acute stroke by polymerase chain reaction (PCR). The blood serum of 72 patients with acute stroke and control group of 30 patients with another vascular disease was studied to reveal genom of enteroviruses. Detection of enterovirus RNA was performed by PCR using the reverse transcription. Viruses were isolated on HeLa and HEp-2 cell lines. The enterovirus genom detected by PCR was in 17 of 72 samples of the tested serum in the research group (23,6±5,0%). In the control group only one serum was PCR-positive for enteroviruses (3,3±3,2%). Cytopathogenic agents were isolated in HEp-2 and HeLa cell lines from 11 PCR-positive samples of blood serum from the experimental group of patients. No viruses were isolated from the remaining PCR-positive and PCR-negative sera. The presence of enteroviruses in the blood of patients with acute stroke suggests etiopathogenetical link between them. The introduction of PCR to detect enteroviral agents in patients with acute stroke can complement existing methods of diagnosis.

45-49

Authors: Yur’yeva L.N., Shusterman T.Y., Leonov S.F., Varshavskij Ya.S.

The article describes a one-year follow-up study of the clinical case of organic hallucinosis that we have described in the previous article in the patient with pituitary macroadenoma. At primary admission to the hospital (one year earlier) the likelihood of permanent or recurrent nature of hallucinosis and absolutely poor prognosis for recovery and life without removal of the tumor was pointed out to the patient and his family. However, the patient and his relatives flatly refused to undergo neurosurgical intervention. The article describes the dynamics of psychopathological and somatic statuses of the patient during his readmission to a psychiatric hospital. The exciting cause of death on the 25th day of hospital stay was phenomenon of cerebral edema. By results of post-mortem studies the underlying cause of death was small cell chromophobe pituitary adenoma. There was a complete accuracy between clinical and post-mortem diagnosis. Absolutely unfavorable prognosis made before has been confirmed. The conclusion about the need of psychoeducational interventions with this contingent of patients and their relatives for prevention of an adverse disease outcome is made.

54-62

Authors: Filippova A.Yu.

Aim - to study charac­teristics of indicators of lipid peroxidation (LPO) and antioxidant system (AOS), depending on the body mass index (BMI) in patients with non-alcoholic steatosis (NASP) in combination with obesity (OB) and pathology of the biliary tract (BT). The study involved 100 patients with NASP in combination with OB and BT pathology, who at the time of sonographic and morphological study of liver biopsy presented signs of hepatic steatosis. Among the patients there were 19 men and 81 women. The average age of patients - (53,67 ± 1,11) years. The control group consisted of 20 practically healthy persons (PHP). BMI is determined by the formula Quetelet. Depending on the degree of BMI increase all patients with NASH and obe­sity were divided into three groups: 1 group – with BМI 25-29,9 kg/m2– ex­cessive body mass; 2 group – with BMI 30-34,9 kg/m2– obesity of I degree; 3 group – with BMI 35–39,9 kg/m2– obesity of ІІ degree. Status of LPO system was assessed by the concentration of malondialdehyde in plasma and red blood cells and the content of lipid peroxidation intermediates in the two phases of the lipid extract – isolated double bonds, diene conjugates, oksidien conjugates and the final LPO products – schiff bases. Factors of antioxidant defense activity were assessed by ceruloplasmin (CP), superoxide dismutase (SOD) and catalase in erythrocyte hemolysate. All LPO indicators have been activated in the two phases of lipid extract (from p<0,05 to p<0,001 when compared with a group of PHP and p<0,05 as compared to other groups of patients) and depended on increasing BMI. Indicators of AOS – SOD and catalase in all NASP groups practically did not differ from PHP parameters and did not depend on the increase of BMI. From the CP side a compensatory increase in its activity in response to the intensification of LPO was revealed. In NASP patients in combination with OB and comorbid disorders of BT the course of the disease was associated with significant violations of the oxidant-antioxidant balance, which depended on increasing BMI parameters.

67-71

Authors: Stepansky D.A., Kremenchutsky G.N., Koshevaya I.P., Velychko Ye.A.

Adhesion is the major stage of interaction of microorganisms with macroorganism, important factor with the help of which microflora colonizes different biotypes of macroorganism, thus providing colonization resistance, preventing adhesion and pathogenic invasion. In our study data about adhesive features of Aerococcus viridans autophytes of rats, mice and human are presented. Aerococcus viridans autosymbionts have higher performances of adhesion in the condition of heteroadhesion. Among performance of homoadhesion the highest microorganisms adhesive index (MAI) was in human autosymbionts – 5,78±0,04, in rats – 4,49±0,06 and mice – 4,29±0,04. On the account of greater adhesive features, using of autosymbionts of Aerococcus viridans theoretically can be justified for correction of disbiotic conditions of a human and animals, this requires further study.

78-84

Authors: Mashchenko I.S., Kuznyak N.B., Shostenko AA.

The paper presents the results of a comparative study of features of gingival tissues microbiocenosis and local immunity in 60 patients with chronic and exacerbated chronic generalized catarrhal gingivitis. We found that in patients with exacerbated generalized catarrhal gingivitis there exist more significant differences in terms of local humoral immunity as compared with a group of patients with chronic manifestation of the disease, characterized by a large decrease in levels of sIgA and IgM and to a lesser extent, an increase in IgG. It was established that conditionally-pathogenic streptococcal microflora leads in the etiology of chronic generalized catarrhal gingivitis and staphylococcus and fungi of the genus Candida play the dominant role in formation of exacerbations of inflammation in the gingival tissue.

91-97

Authors: Mashchenko I.S., Struk V.I., Vatamanyuk N.V.

The article presents the results of a comparative study of the microbial landscape and violations of local immunity in patients with generalized periodontitis at preclinical-radiological stage of development in 60 patients. It was revealed that appearance of representatives of the major periodontal bacteria in the gum tissue is a precursor of development of initial stage of generalized periodontitis in them. It has been established that the early objective indicators of bone resorptive process in periodontal tissues in patients with generalized catarrhal gingivitis is an overproduction of proinflammatory cytokines IL-1.beta and TNF-alpha and the lack of anti-inflammatory IL-4, which persists for a long time during the observation period.

106-115

Authors: Yakovenko L.N., Iefymenko V.P., Makarevich A.Yu., Kovtun T.A.

A retrospective analysis of 1147 patients’ records from the clinic of the department of surgical dentistry and maxillofacial surgery of childhood of NMU Bogomolets and 944 case histories of patients with traumatic injuries of maxillofacial region in the clinic of the department of pediatric dentistry of SE «Dnepropetrovsk medical academy of Health Ministry of Ukraine» has shown that traumatic damages to teeth make up 18.8% of all injuries in maxillofacial region. It was found that in most cases the cause of injury is fall of a child - 60%, punching on the face - 19%, other causes – 21%. Most often maxillary central incisors are affected - about 70-80%, lateral - 10-20% both in temporary and in shift bite. Lower incisors are injured only in 1-6% of cases. Injuries of the temporary teeth were observed in 30-45% of cases. The aim of the study was to determine the major diagnostic methods and therapeutic measures that have been used in trauma of permanent and temporary teeth in children of different ages. Diagnostic measures included clinical and instrumental studies. Of the additional survey methods of dental trauma in 90% of cases back-side X-ray, in 7-8% – orthopanto­mography, in 1-2% - CT were performed. In dislocations of temporary teeth X-ray examination was carried out only in impacted dislocation. Algorithm of treatment tactics for almost all kinds of temporary teeth dislocations was to remove it, not taking into account the degree of formation of the tooth root and functional ability of the tooth, that involves the development of the indications for their preservation. Most often, for the immobilization of the injured permanent teeth a smooth splin-clamp (85%) was used, it is cheap, easy to manufacture, reliable for fixing, individual as for adaptation, but when applied it leads to injury of periodontal tissues, the development of inflammatory processes in them. Alternative methods of fixation were splint systems, splint-caps and tooth-gum splints. There remains the question of development of non-invasive fixing systems, which would be less traumatized for the tooth and periodontal tissue.

123-129

Authors: Biletska E.M., Onul N.M., Kalinichevа V.V.

Chemical aggression of technogenic pollution of the environment, according to experts, is the leading risk factor for population health. A systematic entry of contaminants in the related life-supporting environments – air, water, plant and animal food products by direct and indirect migration chains creates both integrated and combined effect on the body. It should be noted that a chemical factor, on the one hand, is the least studied in this respect, on the other hand it represents the most significant and rapidly growing environmental threat to human health. In the human body bone tissue has the highest cumulative properties against many xenobiotics, in particular to heavy metals, among which lead is the leader in relationship to the bone tissue. In this regard, the goal is to study peculiarities of different forms of zinc on calcium content in bone tissue in lead intoxication. As a result of researches it is established that low dosed effect of lead during subacute experience causes a significant decrease of calcium content in the bone tissue by 28% in comparison with those of control group of animals, this reduces its density and becomes a risk factor for the development of osteopenic and osteoporotic state of the organism. Combined effect of lead and organic and inorganic forms of zinc zeliably increases calcium content by 16.43% and 22,04% respectively, as compared with lead group, suggesting protective properties of zinc in lead intoxication due to the effect of bioantagonism. In the isolated introduction of organic and inorganic forms of zinc, calcium content in the bone tissue increases by 1.4 and 2.04 times respectively, as compared with the control group. The obtained results confirm osteoprotective action of zinc, particularly of organic forms in lead intoxication and give reason to believe that in the system "lead – zinc" effect of biological antagonism is formed.

136-145

Authors: Korshun M.M., Ruda T.V., Blagaia А.V, Antonenko A.M.

It is well known that despite an actual efficiency pesticides can have a negative impact on humans, animals and the environment. So, new pesticides must be regulated at the stage of their registration in order to prevent such a harmful effect of chemical crop protection agents (CCPA). In this context, the aim of our study was to assess the danger by using toxicological criteria and substantiate acceptable daily intake (ADI) of pymetrozine for humans. It was performed the expert-analytical study of the primary and secondary sources of information during study of its toxicity on laboratory animals. It was established that pymetrozine is related to 2 class of hazard (limiting indication is inhalation toxicity). In chronic study the lowest NOAEL on rats was set at 10 ppm (0,337 mg/kg) for systemic toxicity, which made it possible to substantiate ADI of pymetrozine for a human at 0,003 mg/kg. The definition of this criterion will allow to set a series of hygienic standards to be followed, without any harmful effect on a human.

150-156

Authors: Kramarenko N.N., Ivanus S.H.

36 children with cystic fibrosis are inspected. Certain modern problems of children’s cystic fibrosis and questions related with warning and slowing down unfavorable consequences of illness in the future are determined. Data of cystic fibrosis prevalence and morbidity in Dnepr for the last 5 years are analyzed. Epidemiology of disease, clinic-anamnesis data, laboratory instrumental indexes of our patients are analyzed. Anthropometric measuring of body mass, height, chest circumference, somatoscopic research, calculation of trophic index is conducted. Features of physical development and nutritional state of children with cystic fibrosis, which consist in the substantial decline of body weight in disharmonized development are found. Certain degrees of protein-power insufficiency are determined. The relationship of these features with the function of the external breathing, duration and severity of disease is analyzed.

164-168

Authors: Chekan M.K., Loskutova T.A., Fomicheva Ye.V.

Gastric or duodenal ulcer with perforation - a heavy, death threa­tening, complication of peptic ulcer disease, especially in pregnant or postpartum. The occurrence of this complication in the postpartum period is a common cause of late diagnosis, delayed surgical treatment and poor outcome for the patient. There are several problems that contribute to the late diagnosis of perforated ulcer: rare incidence, difficulty in identifying common signs, stiff muscles of the anterior abdominal wall and localization of pain in the stomach due to abdominal extension by a pregnant uterus, pain due to caesarean section, absence of ulcer history, the young age of patients, an unusual course of the disease. Complaints and clinical presentation are often regarded by physicians as complications of carried out obstetric surgery, which leads to late diagnosis. The paper describes a clinical case of duodenal ulcer with perforation, which occurred on the second day after a planned caesarean section, as a rare but life threatening complications. The patient underwent laparotomy with suturing of the perforation and drainage of the abdominal cavity. It should be noted that, despite the fact that complications of peptic ulcer disease is a rare phenomenon among women in labor, it should be in anamnesis taking to pay special attention to information that may indicate the presence of disorders of the diseases of gastrointestinal tract. In case of unfavorable postoperative course after abdominal labor an acute surgical pathology should not be excluded.

172-173

Authors: SE "Dnipropetrovsk medical academy of Health Ministry of Ukraine"

Mokiya-Serbina Svitlana Oleksiivna

177-179

Authors: Savyna R.V.

From the history of preventive medicine

183-184

Authors: SE "Dnipropetrovsk medical academy of Health Ministry of Ukraine"

Syahailo Petro Trokhymovych. To commemoration of a talented scientist is devoted.