Medical perspectives (Medicni perspektivi)

13-19

Authors: Biletska E.M., Shtepa O.P., Kalinicheva V.V., Valchuk S.I.

In recent years the steady trend to growth of the technogenic load of the environment closely correlates with deterioration of the health status of the population, chronic diseases and worsening of demographic indicators. One of the main threats to human health from contamination with heavy metals is associated with the influence of lead, which contributes to the development of chronic diseases of the nervous, hematopoietic, endocrine, renal and bone systems. In the process of studying the properties of zinc, its use as an osteoprotective agent is becoming more actual. In connection with the foregoing, the aim of our study was to study the content of zinc in bone tissue in low-dose isolated and combined effects of various forms of lead and zinc under the experimental conditions. For the experiment, sexually mature Wistar rats with a body weight of 150-170 g were selected, with the following randomization into six experimental and one control group, eight rats in each one. The data obtained and their comprehensive analysis allow to fully suggest the formation of a bioantagonistic relationship between lead and zinc in the bone at the level of the latter, observed both in the isolated action of lead and in combination with zinc. Along with this, our results correspond with the data of other researchers on the osteoprotective properties of zinc under the action of even low-dose levels of lead, especially of its nanoacqualate form (zinc citrate).

25-32

Authors: Volosovets A.O.

Arterial hypertension can cause a pronounced negative influence on the state of the cerebral vascular system and lead to significant microtraumatization of the walls of the vessels and disruption of vascular autoregulation. This predictor has the greatest influence on the onset of ischemic stroke of atherothrombotic and lacunar subtypes, however, hypertension occurs almost in all patients with acute cerebral ischemia. Interesting and not at all presented in modern scientific literature is the question of the relationship of oscillation of blood pressure with the period of the onset of the focus of ischemia, which predetermined the purpose of our work. The purpose of our study was to determine the relationship between deformation of the profile of fluctuations in blood pressure of patients in the acute period of ischemic stroke, depending on the time of the occurrence of cerebrovascular accident. We examined 300 patients who suffered acute ischemic stroke (men - 196, women - 104) aged 42 to 84 years (average age - 65.2 ± 8.7 years). All patients were divided into 3 groups according to the period of the day when an ischemic stroke occurred: 1 group (n=146), patients suffering from cerebral ischemia during the day (8.00-14.59); In group 2 (n=107), patients stroke was observed in the evening (15.00-21.59); Group 3 (n=47), patients had an ischemic stroke at night (22.00-7.59). For the 1st group of patients who have had ischemic stroke during the day and as a rule with an increase in blood pressure, a marked increase in blood pressure was at 12.00 and 15.00 and a tendency towards compensatory parasympathetic effect in the form of blood pressure decrease at night (over-dipper) was typical. At the same time, in the 2nd group of patients with stroke in the evening, elevated blood pressure at 18.00 and 21.00 and parasympathetic activity disorders with prevalence of insufficient reduction of blood pressure in the evening and during sleep (non-dipper) was observed. For patients with a nocturnal stroke (3rd group), there were two peaks of elevated blood pressure at 9.00 and 21.00 and a significant increase in night-peaking at night, which usually resulted in a cerebrovascular catastrophe. Sharp changes in human biorhythm significantly affect the violation of the regulation of the vegetative-vascular system and lead to a breakdown in the regulation of vascular tone with the emergence of phenomena of "vegetative storm" and sharp increase in blood pressure by the type of "night peacker". This effect is also caused by chronic alcohol intoxication, presumably due to the toxic damage of the hypothalamic-pituitary complex due to the high permeability of the blood-brain barrier in this area of the brain due to over-active hormonal-regulatory diffusion.

40-48

Authors: Pysarevska K.O., Zharinov O.I.

The aim - to create a model for predicting long-term sinus rhythm retention after electrical cardioversion (ECV) based on individual patients characteristics. 141 patients with persistent AF who were planning to have sinus rhythm restoration, underwent general clinical examination, ECG and transthoracic echocardiographic. In 6 months after ECV patients were divided into two groups: 83 patients maintained sinus rhythm for 6 months (group I), recurrence of AF was observed in 58 patients (group II). The results of the ROC analysis determined statistically significant parameters that contribute to long-term retention of the sinus rhythm: non-modifiable (age, history and duration of the last episode of arrhythmia, combination of background diseases), modifiable (smoking, antiarrhythmic therapy, severity of heart failure by NYHA). A multifactorial prognostic model is created with the help of the modern approach of creating scorecards. This allowed in the form of a numerical characteristic to determine the probability of a long retention of the sinus rhythm. The selection of factors for the scoring model was in accordance with the criteria of the power of their influence on the retention of the sinus rhythm. The scoring model was created for predicting long-term retention of sinus rhythm after electrical cardioversion based on the individual characteristics of a patient with a persistent form of AF. The model has a high sensitivity (92.77%) and specificity (70.69%) and allows to predict the further course of the disease and to correct the therapy on time.

56-61

Authors: Tsarev A.V., Usenko L.V.

The article presents the results of a comparative study of control and safety of two technologies of therapeutic hypothermia in intensive care in patients with TBI: an estimate of the rate of its induction, control of its maintenance, dynamics of attaining normothermia. A total of 24 patients with a severe TBI divided into 2 groups were examined: I (n=12) – therapeutic hypothermia with "Blanketrol II" (CSZ) with the use of non-invasive technology to achieve the target core body temperature (Tco) of 34-34.50C; II group (n=12) – carrying out therapeutic hypothermia «Blanketrol - II» with the use of an esophageal device for hypothermia to achieve Tco - 34-34,50С. The mean time from the moment of induction to achievement of the target Tco in group I was 9.5±2.39 hours, in group II – 9±2.70 hours (p>0.05). The maintenance period Tco at the level of ≤34.50C in the II group was greater – 10.5±5.78 compared with 6.83±3.95 hours in patients of the I group (p<0.05). Control of the warming process was significantly higher in group II, which was reflected by a lower mean of Tco value at 24, 28 and 32 hours. There were no clinically significant adverse effects in therapeutic hypothermia.

68-73

Authors: Krishtafor D.A., Klygunenko O.M.

The aim of the study was to determine the effect of quantitative and qualitative changes in fluid resuscitation on the dynamics of markers of the shock state in patients with multiple trauma. 73 patients with multiple trauma were divided into two groups, depending on the fluid resuscitation type (liberal or restrictive). The parameters of hemodynamics, hourly diuresis, general blood test, coagulogram, acid-base and gas composition of blood were studied. A decrease in the infusion volume in traumatic blood loss due to the restriction of the crystalloids and colloids volume allowed to effectively reduce such manifestations of shock as hypotension, tachycardia and acidosis, to provide an adequate rate of diuresis. In restrictive infusion group the duration of vasopressor support was shorter, the fluctuations in peripheral blood parameters were less pronounced, coagulation normalized earlier, positive water balance was significantly lower, mortality and the number of complications were reduced. Restriction of fluid resuscitation volume allows to successfully treat shock and decrease multiple organ dysfunction, number of complications and mortality.

81-86

Authors: Schevchenko-Makarenko O.P., Schostakovych-Korets'ka L.R., ChykarenkoZ.O., Tkachenko V.D., Lisnicha O.O.

The article presents the adap­tation data of the quality of life questionnaire (QOL) in patients with chronic viral hepatitis C (CVHC). Ball score of QOL of patients with CVHC was 5.09±1.04, 2nd group (with co-infection with HIV / HCV) - 4.60±1.13, control group - 5.92±0.52 (p<0.05)). The results of the analysis show that co-infection HIV / HCV is a serious problem for patients and significantly affects QOL. The use of the QOL questionnaire for chronic liver disease is a sensitive tool for measuring QOL in patients with CVHC and co-infection HIV / HCV. This informative and economical method can be implemented to assess the patient's health both at the group and individual levels in patients with chronic liver disease in the population of Ukraine.

92-97

Authors: Zakharov S.V.

A comparative analysis of the sensitivity and specificity of immunoblotting against other non-treponemal and treponemal reactions was carried out in 215 patients with early forms of syphilis. A high diagnostic efficiency of immunoblotting in patients with early latent syphilis was established. It was found that only in case of primary syphilis, immunoblotting is inferior to Immunofluorescence reaction; this test can be used for differential diagnosis between hidden syphilis and false positive reactions to syphilis.

99-103

Authors: Loskutov O.Ye., Oleinik O.Ye., Synegubov D.A.

Friendship lasting for 20 years (to the jubilee of Ukrainian-German Association of Orthopedist Traumatologists)

11-16

Authors: Mamchur V.I., Kryvoruchko T.N., Makarenko O.V.

Parkinson's disease is traditionally viewed as a disease which affects the human motor sphere. Besides motor manifestations in the clinical picture of the disease, non-motor manifestations with dementia as the most common are present. The purpose of the work – experimental evaluation of the possible antiparkinsonian action of glycine in terms of experimental models of Parkinson's disease equivalents (akinetic-rigid and tremor forms) on the background of antiparkinsonian correction by amantadine. Methods: catalepsy model (inhibition of dopaminergic transmission, equivalents of hypokinesia and rigidity states) and model of arekolyn tremor (activation of cholinergic transmission that corresponds to parkinsonian tremor) on the background of amantadine administration (50 mg/kg), glycine (100 mg/kg and 200 mg/kg) and their combined introduction. The research results show a positive dynamic in combined using of amantadine with glycine at a dose of 100 mg/kg and 200 mg/kg, which was is determined by the low percentage of animals with symptoms of catalepsy (50-70%) with evaluation criteria of 0.5-1.8 points with maximum possible 6 points. Similar results were obtained in terms of activation of the cholinergic system (arekolyn tremor). Glycine at a dose of 100 mg/kg and 200 mg/kg facilitated to optimization of antitremor action of amantadine, that is registered in increased latent period of tremor, reduction of its duration and intensity attenuation almost by 2,1 times in comparison with indicators of the control group. Thus, studied combinations of amantadine with glycine at a dose of 100 mg/kg and 200 mg/kg are promising in studying of their influence on dementia in Parkinson's syndrome, and this study will be continued.

25-32

Authors: Kuryata O.V., Zabida A.A., Chvora D.L.

The importance of the problem of heart failure for modern medicine is due to its growing prevalence and poor prognosis, despite a tendency to decrease of deaths from major cardiovascular diseases: coronary heart disease (CHD) and arterial hypertension (AH). Objective: to evaluate the risk factors, the state of cardiac hemodynamics and kidney function in patients with chronic heart failure (CHF) and acute myocardial infarction (AMI) in history. A retrospective analysis of 144 case histories of patients with CHF with preserved systolic function, aged 40 to 80 years and with disease duration from 1 year to 10 years was made. The patients were divided into 2 groups depending on the presence of anamnestic data in favor of past AMI: group 1 – 35 patients (24%) with CHF and AMI in anamnesis, 2 group, 109 patients (75,7%) with CHF without AMI in anamnesis. It was found that prevalence and severity of hypertension as well as arrhythmia were not significantly different in patients of both age groups. Among patients with stable angina and CHF with preserved ejection fraction there was established a high prevalence of hypertension, diabetes and obesity. The presence of AMI in anamnesis was associated with worse control of hypertension on the background of normal indicators of lipidogram, compared to patients with CHF without AMI in anamnesis. There was established a higher incidence of revealing patients with impaired renal function among patients with CHF with a trend to increase of manifestations of chronic renal failure and hyperuricemia among patients with postinfarction cardiosclerosis, regardless of patients’ age.

41-45

Authors: Kutovoy A., Rodinskaya G., Balyk D.

The paper presents the results of the use of minimally-invasive methods in the diagnosis and treatment of choledocholithiasis. The results of treatment of 595 patients aged from 24 to 92 years with the diagnosis of choledocholithiasis were evaluated. In 552 (93,0%) patients, clinical ma­nifestations of mechanical icterus were noted. In 508 (85,3%) patients, choledocholithiasis was combined with the presence of gallstones, in 15 (2,5%) cases – with calculous cholecystitis, in 69 (11,6%) cases - choledocholithiasis was residual. For the diagnosis of choledocholithiasis, ultrasound of the abdominal cavity, computed tomography, endoscopic retrograde cholangiopancreatogy, percutaneous fistulocholangiography, intraoperative cholangiography or cholangiography were used. Surgical treatment included both mini-invasive interventions and traditional operations. 227 (38,1%) patients underwent endoscopic papillosphincterotomy, which was effective in a size of concrement up to 7 mm in 83,7%. The percutaneous drainage of the bille ducts was performed in 88 (14,7%) patients, the efficacy was achieved in 82,9%. 313 (52,6%) patients subsequently underwent the second stage of surgical treatment of choledocholithiasis by laparoscopy – 263 (84,0%) and laparotomy – 50 (16,0%) with cholecystectomy with choledocholithoextraction and subsequent external or internal drainage of choledochus. Comparison of different methods of investigation showed that none of the diagnostic techniques had 100% of accuracy and informative value. The efficacy of transpapillary manipulation directly depended on the size of the stones.

52-59

Authors: Sirko A.G., Dzyak L.A., Balashova O.I., Berdova T.L., Donchenko G.N., Skljar N.V., Shestakova N.N., Romanukha D.N.

Glial tumors are the most common primary neoplasms of the central nervous system. Their proportion in the total structure of primary brain tumors is 50-65%. In Ukraine, according to the statistical data of the cancer-registry of the year 2014, 49,3% of patients with primary diagnosed malignant neoplasms of the brain did not live for one year. The aim of the study was to improve the survival rates of patients with low-grade glial tumors (LGT) (grade III-IV) by determining optimal treatment strategy and main prognostic survival factors. A prospective study of the results of treatment of patients with LGT from 2009 to 2014 was conducted. The study consistently included 100 operated patients with LGT (anaplastic astrocytoma (AA) and glioblastoma (GLB)). The median survival in the total group of patients (n=100) was 363.5 days (12 months). The main statistically significant prognostic factors of survival were: the completeness of tumor removal (p=0.00000000007) and the character of adjuvant therapy (p=0.000012). With the removal of LGT III-IV grade aplasias, which do not spread to functionally important areas and deep areas of the brain, one should try to perform Gross-total resection (GTR), which ensures long-term survival. The median survival of patients after GTR was 22.3 months. An integrated approach to the treatment which includes surgery, adjuvant radiotherapy and monochemotherapy with temozolamide showed the best survival rates – 20.5 months.

69-72

Authors: Borodulya V.L., Grechka E.M., Stepakhina M.E., Derbina E.A.

Prolonged and conti­nuous lacrimation (symptom of epiphora) causes discomfort, inclination to conjunctiva infect, reduces visual acuity and ultimately the quality of life of the patient. Despite the fact that there is a large number of various surgical interventions to restore tearing in patients with chronic dacryocystitis, the problem of lacrimation remains relevant. We have studied the operation of endonasal dacryocystorhinostomy and its long-term consequences. Surgical intervention in endonasal dacryocystorhinostomy is aimed at eliminating lacrimation by eliminating stenosis and forming a new combination of the cavity of the laryngeal canal with the nasal cavity, as well as the sanation of purulent foci of infection in the throat. There were 8 surgical interventions. Period of observation of patients in the postoperative period by ophthalmologist and ENT-doctor is from 1.5 to 2 years. The evaluation of the result was carried out in 6 months or more after the operation. A complete recovery with the recovery of the tear excretion in the nasal cavity has been achieved in all patients. The formed rhinostoma was wide, well functioning. Thus, endonasal dacryocystorhinostomy is a highly effective and should be a method of choice for inflammation of the lacrimal sac at any stage of development.

81-88

Authors: Shostakovych-Koretskaya L.R., Volikova O.O., Lytvyn K.Y., Gubar I.O., Kushnerova O.A., Sheveleva O.V.

In the research data on the study of interconnection between polymorphism of HLA DRB1 genes and the risk of HIV infection and co-infection and HIV/tuberculosis are presented. The cohort of observation was HIV-infected individuals with different clinical stages aged from 24 to 58 years, average age being 38 years. 90 patients (89.2%) received HAART. There were 32 (31.4%) HIV-infected patients with manifestations of tuberculosis, 70 (68.6%) HIV patients without manifestations of tu­ber­culosis. Among the cohort of HIV-infected patients with manifestations of tuberculosis, pulmonary forms of tuberculosis was in 32 (100%), of which extrapulmonary forms of tuberculosis were in 12 (37.5%) patients. The majority of cases of tuberculosis occurred in HIV-infected patients in the IV clinical stage. Among HIV-infected patients, the following alleles of the HLA gene DRB1 *01 (10%) *04 (10%) *07 (13%), *11 (15%), *13 (13%), *15 (10%) occurred more often, HLA DRB1 *03 *08 *09 *10, *12, *14, *16, * 17, *18 were rarely found (1-7%). Similar distributions of DRB1 genes were noted among residents of the region with the dominance of HLA DRB1 *01 *04 *07 *11 *13 and *15. With the presence of alleles of the locus DRB1 *13, DRB1 *03 and DRB1 *08, the greatest probability of co-infection of tuberculosis was observed in HIV-infected patients. The risk of tuberculosis is by 2 times higher with a significant difference in HIV-infected patients with DRB1 *13 locus alleles, DRB1 *03 – by 4.4 times and DRB1 *08 – by 5.4 times. Significant chances of tuberculosis occurrence are higher – by 2.6 times in HIV-infected patients with DRB1 *13 locus alleles, DRB1 *03 – by 5.1 times and DRB1 *08 – by 6.4 times. Thus, the variability of the HLA DRB1 locus alleles may play a predisposing or protective role in the occurrence of tuberculosis in HIV-infected patients.

93-98

Authors: Shynkarenko T.V.

Intermediate filament proteins play an important role in maintaining a stable shape, as well as the possible movement of cells, including neoplastic cells. However there, are few works dedicated to the investigation of these proteins expression in diffuse gliomas and they are quite contradictory. The authors studied the expression of intermediate filaments (glial fibrillar acid protein GFAP, vimentin) in diffuse gliomas of the brain. 52 postoperative samples with the diagnosis of astrocytic and oligodendroglial brain tumors were examined. Primary antibodies against GFAP, vimentin, Ki-67 were used. The proliferative index and the expression area were calculated using the tools ImageJ 1.47v. The statistical Fisher test was included. Most samples with moderate expression of GFAP (62.5%) are rated to oligodendroglial tumors. Part of oligodendroglial tumors (58.3%) showed no expression of vimentin by tumor cells, this was not observed in astrocytomas. Meanwhile, a high level of expression of intermediate filament proteins - GFAP (100%) and vimentin (87%) is characteristic for diffuse gliomas. The expression level of GFAP and vimentin is higher in astrocytic tumors than in oligodendroglial (p<0.05). Levels of GFAP and vimentin expression are differential feature of astrocytic and oligodendroglial tumors.

104-112

Authors: Ieltsova L.B., Omelchuk S.T.

Actual nutrition state indicates a significant prevalence of polynutrient deficits in Ukraine. One of the key issues in the fight against alimentary-dependent diseases is monitoring of population’s nutrition status. Only reliable methods for assessing actual nutrition can provide reliable information about the nature of nutrition and establish a relationship with health state. Taking into account the abovementioned, the aim of our study was to compare the existing methods of studying nutrition and nutrition status of individuals or population groups to substantiate and develop a new universal, effective method for assessing nutrition and its subsequent approval. It has been found that existing methods for assessing human food consumption have its disadvantages and advantages and provide the opportunity to receive certain types of nutrition information. There is no single universal method that would allow to make comprehensive assessment of population’s nutrition, including student youth. To solve this issue, we have substantiated and developed a questionnaire for assessing the nutrition of different population groups, including student youth, which has been evaluated and approved by specialists from leading in­stitu­tions in the field of nutrition hygiene, gastroenterology and dietetics. Created survey questionnaire is a universal tool for collecting primary information and providing an opportunity to assess the social and welfare standards of respon­dents, working conditions and living conditions, the presence of hazard factors and bad habits, involvement in sports, anthropometric indicators, as well as it allows to assess the diet, drinking regime, main food product groups consumption, weight of portions, food handling methods, priority and benefits when choosing food, food intake places, which will be taken into account in the future to develop effective measures for the prevention of alimentary and alimentary-dependent diseases.

116-121

Authors: Stavnichenko P.V., Antonenko A.M., Bardov V.G.

In the general structure of occupational diseases, a large proportion belongs to acute poisoning with pesticides (mainly group cases). However, today it is impossible to drop the use of pesticides in agriculture. Their application ensures high biological and economic efficiency of the latter, reduces losses of the yield. The purpose of the work was to predict the possibility of acute toxic effects in agricultural workers when working with combined formulations based on difenoconazole. Materials and methods. To assess the influence on the organism of the workers of the above-mentioned substances and formulations on their basis, the coefficient of inhalation poisoning possibility (CIPP), the coefficient of selective action of the pesticide in inhalation effect (CSAing) and the selective action of the pesticide in the dermal effect (CSAderm) were calculated. Results. Calculated values of CSAing (103.4-4701.2) and CSAderm (237.4-12345.7) for all investigated active substances were more than 100, this indicates to a rather high selectivity of their action. By the CSAing value formulations Celeste Top, Celeste Trio, Dinali, Cydeli Top belong to pesticides with a relatively low selectivity of action when they are inhaled by workers in the process of crops treating, the remaining formulations have a sufficient selectivity of action in inhalation intake. In addition, it should be noted that in general, for all combined preparations CSA values are significantly lower than for separate active ingredients, in addition to the above assumption, can be explained by the presence of other formulants in the preparation that may have not significant but toxic effect on the body of workers. All investigated substances in the probability of occurrence of acute poisoning with the use of combined preparations on their basis are related to the 4th grade of danger according to State Standards 8.8.1.002-98. There was proved relative safety in case of penetration into the organism of agricultural workers by percutaneous and inhalational way of all studied active ingredients and most of the formulations on their basis.

9-13

Authors: Rodynsky A.G., Demchenko E.M, Kondratieva E.J., Golubka A.J., Yaroshenko D.S.

In experiments on young rats there were stu­died changes in the fatty acid spectrum of fraction of free fatty acids (FFA) of neocortex and hippocampus in con­ditions of thyroid dysfunction. Elevated levels of thyroid hormones caused accumulation of polyunsaturated linoleic and linolenic acids in the neocortex by 2 times, in the hippocampus – by 52%. State of hypo­thyroidism also contributed to the increase of C18: 2,3 in the neocortex by 74.4%. Growth of share of unsaturated fatty acid fraction in the content of fatty acid spectrum of neocortex also was accompanied by decrease in saturated C16:0 and C21:0 by 25% and 36% res­pectively. Increase of the level of unsaturated fatty acids fraction of the cerebral cortex is possibly associated with the decrease in "unsaturation" structure of lipids, which in its turn may enhance serotonergic synaptic activity. Research of concentration of neuromediator amino acids in neocortex showed increase of serotonin content both in conditions of hyperthyroidism and hypothyroidism. In conditions of hyperthyroidism increased content of GABA was observed. Activity of serotonin- and GABA- ergic neurotransmitter systems of the brain in conditions of hyperthyroidism can be considered as increase of inhibitory processes in the effect of feedback. In conditions of experimental hypothyroidism activation of the inhibitory effects of CNS serotonergic system may be one of the ways to reduce the metabolism.

20-23

Authors: Chorna Ju.V.

The article examines the main aspects of postgraduate education of junior specialists with medical or pharmaceutical education in Dnipropetrovsk region. Pedagogical innovations involves active learning, competency approach and introduction of new subjects into the educational process.

31-36

Authors: Abaturov AE, Nikulina AA.

The growing obesity incidence in adolescents on the background of insufficiently studied genetic markers of formation of impairments of carbohydrate metabolism associated with the lactase gene polymorphism (SNP LCT), necessitates studying life quality particularly in this age group. Associations of 13910 C>T polymorphism of lactase gene with the quality of life in 60 adolescents aged 14-18 with obesity using the MOS-SF-36 technique (MOS 36-item Short-Form Health Survey) were studied. It was established the presence of associations of the genotype C/C 13910 of the LCT gene (p<0,05) with decrease of role functioning due to physical condition of young men and decrease of the overall health of girls. Prevention of obesity should start from birth of the newborn to gether with the rational organization of alimentary behavior in the family as a whole, depending on the phenotype and formation of a certain psychotype of adolescent’s personality, defined by the lactase gene polymorphism.

44-51

Authors: Zamkovyi A.D., Tymchenko A.S.

The main research results substantiating the system of transfusion supply of military medical facilities of the Armed Forces of Ukraine during peacetime and in the special period are presented. It was proved that the aim of development of blood bank is to create the system of provision with blood, its components and protein preparations of blood plasma of hospitals both in terms of daily activity and at the time of their usage.

60-66

Authors: Vozianov S.A., Koval D.V., Rudenko A.V., Zheltovska N.I.

The aim of the study was to as­certain the role of U.urealyticum in formation of phosphates and oxalates in kidneys and factors promoting this pro­cess. The work represents the author’s conception of this process. There were fully examined 79 patients with nephro­lithiasis with the aim to determine the species difference of pathogenic agents of the accompanying inflammatory process and there was compared the chemical structure of the removed concrements. There was stated the role of the urease-producing bacteria (P.mirabilis and U.urealyticum) in the process of phosphate and oxalate lithogenesis and the accompanying factors, which initiate these reactions (urinary pH, endogenic urease, index of oxalic acid concentration). The work presents the comparative analysis of lithogenesis in the presence of accompanying bacteria of different taxonomic position. The authors’ conception of the role of U.urealyticum and P.mirabilis in lithogenesis has been elaborated.

71-78

Authors: Khmel O.S., Rodionova V.V.

Objective: to investigate the heart rate variability in patients with HT and OA under the influence of antihypertensive therapy. Materials and Methods: The study involved 60 persons, main group – 25 patients with HT stage II, 2nd degree, combined with knee OA of the II stage according to the Kellgren-Lawrence. The group of comparison consisted of 20 patients with HT stage II, 2nd degree. The control group consisted of 15 almost healthy individuals. During the study patients received antihypertensive therapy: Amlodipine 5 mg and Lisinopril 5 mg 1 time per day per os. The survey was carried out before and after the treatment. Results: in hypertensive patients with OA the influence of the sympathetic system and LF / HF index were reduced (before treatment – 5,64 [4,87–7,56], after treatment – 3,95 [3,74–4,54]; p<0,05); this indicates to decrease of influence of the sympathetic system on the organism. Conclusions: The presence of OA in patients with HT provides additional negative effect on the heart rate variability, which may testify to increasing mortality risk in these patients. Antihypertensive therapy with Lisinopril, 5 mg and Amlodipine, 5 mg in patients with HT and OA leads to improvement of hypertension course due to influence on sympathic system.

85-90

Authors: Il'chenko S.I., Fialkovskaia A.А., Kramarenko N.N., Makukh G.V.

The purpose of research – to study the role of allelic polymorphism of genes of the I and II phases of xenobiotics biotransformation in the development of reccurent and chronic diseases of the respiratory system in adolescent-smokers. There was carried out molecular-genetic study of the polymorphic locus Т3801С of gene CYP1A1 and polymorphic locus A313G of gene GSTP1 in adolescent-smokers with recurrent and chronic bronchitis. It is established that TТ genotype of the polymorphic locus Т3801С of gene CYP1A is a marker of resistance to the development of this pathology in adolescent-smokers. The presence of CC genotype of the polymorphic locus Т3801С of gene CYP1A1 and GG genotype of polymorphic locus of A313G GSTP1 gene may be considered as a possible risk factor for the development of chronic inflammatory process in bronchopulmonary system. Thus, the introduction of molecular-genetic methods of research opens up new possibilities in diagnosis of recurrent and chronic diseases of the respiratory system. Based on the analysis of genetic factors in children and adolescents, it will be possible to predict the risk of COPD developing in the future; this will allow doctors to carry out the necessary preventive activities among risk groups.

95-103

Authors: Gudaryan А.А., Kuznyak N.B., Shostenko AA.

The article presents the results of a complex treatment of 82 patients with generalized catarrhal gingivitis at the stage of chronic and exacerbated course through the use of scientifically based programs for the step-by-step application of occupational hygiene measures, antibacterial and immunocorrective therapy. The performed step-by-step treatment of generalized catarrhal gingivitis contributes to rapid elimination of possible causative agents of the disease, provides elimination of the deficiency of local humoral immunity, imbalance in the cytokine system, leads to the elimination of inflammatory phenomena in the gum in 93.3% of patients with chronic course and in 96.3% of patients with exacerbated manifestation of the disease.

111-118

Authors: Gudaryan А.А., Struk V.I., Vatamanyuk N.V.

The article presents the results of comprehensive rehabilitation of 92 patients with generalized catarrhal gingivitis by creating differentiated programs for prevention and treatment of the disease, depending on the absence or presence of laboratory signs that have not been detected by X-ray, early destructive processes in the bone structures of periodontal tissues. It was revealed that appearance in gums tissue of representatives of the major periodontal bacteria is a precursor to the development of initial stage of generalized periodontitis in it. It was established that the earlier 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 cytokine IL-4.

126-132

Authors: Grebnyak N.P., Schudro S.A., Fedorchenko R.A.

Reform of higher education in the conditions of deep social and economic transformations determines both optimization of professional training and development of functional capacity of the organism for future work. The initial stage of training is of particular importance due to incorporation into a complex new system of educational environment. The aim of the work - to study the characteristics of adaptation process in the first-year students. Functional state of students’ organism was studied by visual-motor response, function of attention, speed, of information processing, tepping-test. This cross-sectional study included 179 first-year medical students. Students with a history of hearing or visual disorder, smoking, alcoholism, cardiovascular and respiratory disease and on medication which affects cognitive performance were excluded from the study. Participation in the test was voluntary and informed written consent was taken from each participant. Academic performance was analyzed. Pearson correlation has been used to find the significance of relationship between the speed of thought processes, function of attention, factor of motometria, volume of visual memory and academic performance. Adaptation of students to training is based on the functional system of the body. Expressed correlation between the speed of thought processes (r=0,63, р<0,01), function of attention (r=0,47, р<0,05), ratio of motometry (r=0,45, р<0,05), volume of visual memory (r=0,43, р<0,05) and academic performance was established. The distribution of these indicators demonstrates the feasibility of using Standard deviation to assess the degree of adaptation.

141-151

Authors: Pisarenko Yu.G.

The second part of the essay about zemstvo doctor, V.T. Skrylnikov elucidates his fruitful activity in the field of balneology: study and popularization of therapeutic properties of the so-called "Timofeev clay", publication of his "Seasonal Bulletin of Slaviansk mineral water ". We describe recent years of the doctor’s life, complicated with the disease and severe family affairs. The grateful memories of his fellow doctors about him are listed.

10-19

Authors: Podpletnyaia E.A., Khomiak N.V., Sokolova E.V., Kaydash S.P., Khomiak E.V.

The article analyzes characteristics of chemical composition and pharmacodynamics of phytotherapeutic agents (monopreparations and complexes), used in the treatment of kidney and urinary tract diseases. Analysis of main pharmacological effects of medicinal plants and their complexes was made, comparative characteristics of herbal remedies by indications for use in acute and chronic diseases of the kidneys and urinary tract (pyelonephritis, cystitis, urethritis, glomerulonephritis, nephrolithiasis) and edematous syndrome of various etiologies was carried out. Pharmacological characteristics of diuretic, nephroprotective and nephrolitholytic action of watermelon lyophilized powder according to its composition (flavonoids, macro- and micronutrients, vitamins and so on.) was analyzed. On the basis of data on a wide range of biological activity, sufficient clinical efficacy as adjuvant therapy drugs, as well as good tolerability of herbal remedies, appropriateness and prospects of search for new plant nephroprotective drugs was concluded.

25-32

Authors: Loskutov A.E., Digtiar A.V., Stepanskiy D.A.

In our study there is presented information on the research of antagonistic activity of medications octenidine, decamethoxine, dioxydine, myramistin, povidone-iodine, chlorhexidine in standard dosage form and in dilution (1:1 and 1:5) on microorganisms: S. aureus, S. epidermidis, S. haemolitycus, P. aeruginоsa, E. agglomerans, E. coli isolated from patients in revision hip arthroplasty. A considerable bacrteriostatic and bacreticidal activity of investigated medications on microorganisms was shown. The investigation of antagonistic activity of medications was conducted by the “well” method according to methodological guidelines for experimental (pre-clinical) investigation of medicinal products for local treatment of purulent wounds. As a solid nutrient solution there was used Mueller-Hinton agar, in which we made cavities with diameter of 8 mm where experimental medications (0,01 ml) were put. As experimental test-cultures there were used main clinical strains of microorganisms (S. aureus, S. epidermidis, S. haemolitycus, P. aeruginоsa, E. agglomerans, E. coli) isolated from patients, receiving treatment in the department of orthopaedics N 2, I.I. Mechnikov regional clinical hospital. 0.9% physiologic saline was used as a control. Chlorhexidine, octenidine, dioxydine, decamethoxine and povidone-iodine undiluted and in dilution 1:1, cause bactericidal effect on staphylococcus, in dilution 1:5 – bacteriostatic effect. Myramistin has practically no effect on staphylococcus. Dioxydine and octenidine in initial dilution have a steady bactericidal effect on E. coli and P. aeruginosa and in dilution 1:1 only dioxydine has bactericidal effect. Chlorhexidine and povidone-iodine have bacteriostatic effect on E.coli and P. aeruginosa. In dilution 1:5 only dioxydine has a bactericidal effect on E. coli and P. aeruginosa. For E. agglomerans only dioxydine in standard dosage form and in dilution 1:1 and 1:5 has bactericidal effect 36mm, 33mm and 25 mm accordingly. But octenidine in a standard dosage form has bactericidal effect on E. agglomerans and in dilution 1:1 – bacteriostatic. Other medications have no effect on E. agglomerans. Antimicrobal effect in a standard dosage form on the greatest amount of experimental microorganisms strains was in octenidine and dioxydine; in dilution 1:1 – in octenidine and dioxydine on enterobacteria, on staphylococci – chlorhexidine, octenidine and dioxydine; in dilution 1:5 – the maximal effect on enterobacteria was in dioxydine and on staphylococci in chlorhexidine.

38-43

Authors: Yegudina Ye.D., Synyachenko О.V., Khanyukov О.О., Suiarko V.І., Тaktashov G.S.

Changes in the lungs, heart and kidneys are found in all animals with experimental systemic autoimmune rheumatic disease and respectively in 47%, 47% and 40% of cases of intact rats in a hostile environment with xenobiotics air pollution (ammonia + benzene + formalin), herewith in every third or fourth individual lesions of visceral vessels developed. The negative environmental situation increases the frequency of morphological signs of the disease, such as proliferation of endothelial vessels of the heart by 68% and renal arterioles by 52%, in addition, there are direct correlations of angiopathy degree in individual organs; this depends on the nature of pathological process modeling and demonstrates air pollution as a risk factor of disease in humans. The impact of pulmonary vessels sclerosis on the development of bronhosclerosis, perivascular infiltration of the heart muscle on the lymphocyte-macrophage infiltration of the stroma of the myocardium and sclerosis of renal arterioles on the degree of nephroslerosis of stroma is directly associated, with the model of systemic autoimmune rheumatic diseases whereas air pollution by xenobiotics determines dependences of the degree of cellular infiltration of alveolar septa from perivascular pulmonary infiltration, the development of cardiomyocytes hypertrophy from proliferation of the heart endothelial vessels, increase of kidney mesangial matrix from the proliferation of endothelial glomerular capillaries.

50-54

Authors: Sakovich V.N., Grechka E.M., Stepakhina M.E., Derbina Е.А., Guzenko N.V.

In spite of treatment provided in anterior ischemic neuropathy, a prognosis for visual functions is poor and depends on severity of affection of vascular system of the body. We have studied the exposure to cortexin and diprospan in subtenon administration on the eye hemodynamics in 18 patients experiencing anterior ischemic neuropathy(18 eyes) who have been treated operatively (administration of cortexin and diprospan into the subtenon space of the affected eye) against the background of complex conservative prevention. The control group was constituted of 16 patients (16 eyes) who have not been treated operatively. As a result of provided treatment the patients of the basic group showed increase of vision acuity, field of view limits and eye ground state.

61-68

Authors: Savenkov Y.F., Koshak Y.F., Malcev I.A., Korpusenko I.V., Bakulin P.E.

The were studied pathological features of combined forms of tuberculosis and non-small cell lung cancer in 72 patients who underwent radical surgical resection interventions from transsternal access with mediastinal lymph node dissection, with predominance of pneumonectomy - 63.9%. There were identified three main categories of pathological changes: cancer on the background of post-tuberculosis changes, cancer in tuberculoma, cancer in the wall of the active cavity. Post-tuberculosis changes were presented by dense centers, fibrosis, cirrhosis areas, sanitized cavities with histological predominance of coarse fiber connective tissue with giant cell granulomas, with areas characterized by the appearance of the lung tissue with atypical proliferation and metaplasia of bronchopulmonary epithelium, which is a precancerous condition. This malignant tumor process was presented mainly by adenocarcinomas and squamous cell cancer and differred by polymorphic macro- and microscopic picture. Cancer in tuberculoma and fibrous wall cavity differed by pronounced activity of tuberculosis process in the form of lymphohistiocytic infiltration, foci of caseous necrosis and presence of expressed granulation layer of Pirogov-Langhans’ cells. The basic morphological causes of carcinogenesis due to secondary changes of lung tissue in patients with tuberculosis were determined. The features of metastasis of malignant tumors on the background of specific tuberculous and post-tuberculosis changes in regional lymph nodes and the interrelation between the frequency of metastatic lesions with severity of tuberculosis and post-tuberculosis changes in them were studied; this has clinical significance in the surgical treatment of patients with concomitant forms of tuberculosis and lung cancer.

76-80

Authors: Stepanchenko K.A.

The aim of our study was to investigate the value of myofascial disorders in adolescents with tension-type headaches and evaluation of effectiveness of their treatment using non-drug therapies. A total of 320 adolescents with tension-type headache have been under study. Research of intensity of headache and pain muscle dysfunction was performed. The treatment period was 1 month. We compared treatment by individual adaptive biofeedback based on heart rate variability and pharmacotherapy. Also patients performed the complex of techniques of isometric muscle autocorrection. It was established that with the increase of incidence of headache episodes, the intensity of the local muscle tenderness and the number of muscles, involved in the formation of a painful syndrome increases. Usage of individual adaptive biofeedback was more effective in reducing the severity of muscle dysfunction, than usage of pharmacotherapy, especially in patients with chronic tension-type headache.

89-96

Authors: Mamchur V.Y., Nosivets D.S., Nalotov S.V., Palamarchuk V.I., Guryanov V.G., Ogol A.J.

The authors studied the efficacy of combined drug Fanigan (paracetamol 500 mg and diclofenac sodium 50 mg) (production of "Kusum Pharm" (Ukraine) or "Kusum Heltker PVT. LTD" (India) in tablets for symptomatic treatment of patients with pain syndrome. A pronounced clinical efficiency of its application in patients with pain syndrome of various genesis in a daily dose from 2 to 3 tablets for 3 to 7 days was established. The obtained data on the clinical efficacy of the drug. Fanigan in the treatment of patients with pain syndrome of various genesis allow to recommend it for application in wide clinical practice.

102-106

Authors: Alekhina Т.А., Turkina V.А., Grushka О.І.

The study was conducted to detect possible changes in embryogenesis and negative effects of third generation antihistamine – desloratadine – after intranasal administration of 1.3 mg/m3 and 13.0 mg/m3 of the substance to laboratory animals during their prenatal period. In these circumstances, desloratadine does not cause any significant changes of embryogenesis parameters. Macroscopic examination of the fetus and placenta in animals of experimental groups did not reveal any pathology or physiological deviations from the norm. 13.0 mg/m3 concentration of the drug caused a decrease in the weight of embryos in comparison with control group of animals and physiological data, despite a well developed, without visible pathology, placenta. This neces­sitates an in-depth study of possible teratogenic effects of intranasally administred desloratadine to laboratory animals.

111-114

Authors: Primary toxicological evaluation of nitroxoline on laboratory animals

Nitroxoline is an effective antibacterial agent that is industrially produced by chemical and pharmaceutical enterprises in Ukraine. Parameters of its toxicity are determined under conditions of acute and subchronic toxicological experiments on 3 kinds of laboratory animals, by administering the drug orally and by application onto the skin and mucous membranes. The duration of acute experiment was 14 days, subchronical - 24 days. It was found that median lethal dose (DL50) for white female rats is 980 (852:1127) mg/kg, of white male rats – 835 mg/kg, white male mice– 660 mg/kg, by this parameter the drug can be attributed to 3 class of hazard – moderately hazardous substance. Average effective time of death (ET50) for albino rats is 28 hours. Species sensitivity of laboratory animals to nitroxoline is slightly expressed. The death of the animals starts on the first day after the injection and is recorded during three days of the experiment. In application on intact skin, locally-irritant and skin-resorptive effects are absent. After contact with the mucous membrane of the eye the drug causes weak irritant effect. Nitroxoline has a moderate cumulative activity.

130-140

Authors: Pisarenko Yu.G.

For the first time the article introduces to the reader biography of one of the founders of the Yekaterinoslav Medical Society, a local doctor, author of numerous scientific papers on medicine and hygiene Vasiliy Timofeevich Skrylnikov. The first part provides previously unknown details about his origin, the work as the head of the free zemstvo clinic, highlights his proposals in the field of sanitary service of the city Yekaterinoslav, wide publishing activities. The aspects of V.T. Skrylnikov’s service on guardianship of orphans, and the initiative to create Yekaterinoslav Department of Russian society of public health are touched upon.

146-151

Authors: Kozlova Yu.V., Dovgal M.A., Koldunov V.V., Silkina Yu.V., Klopotskiy G.A., Khudyakov A.E., Khmel S.I., Bibikova V.N., Tryasak N.S., Anisimova O.V.

The article presents historical information about the deve­lopment of the department of Pathological Physiology of Dnepropetrovsk medical academy, about chiefs of the depart­ment and their contribution to the development of the department from its foundation (1918) up to the present (2016). The areas of scientific research, the most significant achievements as well as changes in the provision of educational process are described.