Medical perspectives (Medicni perspektivi)

4-9

Authors: Apykhtina O.L., Kozlov K.P.

The article presents the results of study of cadmium accumulation in the internal organs of Wistar rats after prolonged intraperitoneal administration of cadmium chloride and cadmium sulphide nanoparticles of 4-6 nm and 9-11 nm in size in a dose of 0.08 mg /kg/day calculated as cadmium. Toxic effects were evaluated after 30 injections (1.5 months), 60 injections (3 months), and 1.5 months after the exposure has been ceased. The results of the study showed that the most intensive accumulation of cadmium was observed in the kidneys and liver of experimental animals, which is due to the peculiarities of the toxicokinetics and the route of administration of cadmium compounds. In the kidneys, spleen and thymus of animals exposed to cadmium sulphide nanoparticles, a greater concentration of cadmium than in the organs of animals exposed to cadmium chloride was found. Cadmium accumulated more intensively in the spleen after exposure to larger nanoparticles, than in the kidneys and thymus. In the liver, heart, aorta and brain significant accumulation was observed after cadmium chloride exposure.

14-20

Authors: Spirina I.D., Rokutov S.V., Fedenko E.S., Shornikov A.V., Holopchenko O.E.

The analysis of the data of the domestic and foreign literature regarding the dynamics of narcotization among children and adolescents is carried out. It has been established that at present the growth rates of the use of psychoactive substances by minors far outstrip those of the adult population. It is also determined that in most cases "adult" drug addiction is formed in a teenage environment and therefore adolescents are a group of high-risk narcotization. Besides, new types of additions are constantly added: non-opioid analgetics, antidepressants, pharmacy products based on medicinal plants with stimulating or sedative properties, new means of perfumery and household chemicals, volatile organic compounds, etc. In this regard, in the clinical picture of drug intoxication, new variations of affective, psycho-organic and psychosomatic effects and complications are noted. In recent years, synthetic cannabinoids has rapidly gained "popularity" among young people that are successfully promoted by marketers. They are the part of the so-called designer drugs, appearing in the markets in the form of bath salts, flavors, fertilizers for indoor plants and "smoking mixtures" - spices. The publications of domestic and foreign authors give a lot of evidence of the ability of these substances not only to cause a state of intoxication, alienation, relaxation, but also leads to dependence on them with severe consequences for the psyche and all organism as a whole. Thus, the powerful anthropogenic damaging effect of designer drugs demonstrates concrete signals of a threat to health, demography and the economy of the society as a result of their use by the population.

24-31

Authors: Pertzeva T.A., Avramenko I.V.

Based on data from the prospective analysis of patients with severe community-acquired pneumonia over the year of observation, the article presents data on the features of laboratory indicators of the course of severe community-acquired pneumonia. Patients included in the study were hospitalized in the pulmonology department (or therapy), and in the intensive care unit of three clinical hospitals in the city of Dnipro, namely, the Dnipropetrovsk City Clinical Hospital N 6, the Dnipropetrovsk City Clinical Hospital N 2, the Dnipropetrovsk City Clinical Hospital N 16, which are the clinical bases of the SE “Dnipropetrovsk medical academy of Health Ministry of Ukraine”. In the course of studies, the dependence of the severity of patients' state on the severity of inflammatory markers and fibrosis markers was shown. The effect of the prognostic significance of the level of the enzyme TGFβ and C-reactive protein (CRP) for the evaluation of possibility of formation of long-term pathological changes after a severe community-acquired pneumonia has been examined. It was established that a high level of CRP (38.3 [11.3, 150.9] mg / L) and TGFβ (20149.1±424.0 pg/ml) in the blood plasma of patients can be considered as an additional marker of the severity of the course of community-acquired pneumonia. The results can be the basis for a more individual approach to the development of diagnostic and therapeutic programs for patients with severe community-acquired pneumonia.

36-43

Authors: Kuryata O.V., Muhammad Muhammad, Mytrokhina O.S.

There are presented and analyzed the most common and important risk factors (RF) in patients with chronic heart failure and atrial fibrillation (AF). The data indicate the need for more careful attention to this group of patients and the need in early diagnosis of AF RF and their active modification, which is very important for the development of effective measures both for the primary prevention of AF and prevention of progression of this disease.

52-59

Authors: Loskutov A.E., Kuryata A.V., Cherkasova A.V.

The prevalence of osteoarthrosis (OA) among adults over 40 years is taking one of the leading places in the common structure of joint pathology. Obesity – is of the comorbidities associated with OA, one of the risk factors of development and progression of OA. The aim of this study was to evaluate the influence of obesity on the structure of knee and hip OA on the stage of total joint replacement, depending on the patient`s gender, age and degree of obesity. The study involved 170 inpatient case histories of patients with OA undergoing treatment in the department of large joints replacement (64 men and 106 women): 95 patients with OA of hip joint and 75 – with OA of knee joint, among whom there were 110 patients with obesity and 60 – without it. The middle age of the patients was by 63,8±7,69 years. High prevalence of obesity among patients with OA of knee and hip joints was found, with significant higher number of obese patients with OA of knee joint and among female patients. It has been demonstrated a significant increase in the frequency of total knee joint replacement associated with the increase of body mass index among patients with OA of knee joint. The presence of obesity was associated with earlier terms of the total joint replacement performing, especially among male patients.

66-71

Authors: Kutovoi А., Kosulnikov S., Zavizion E., Stepanskyi D.

In the work we present comparative results of treatment of patients with generalized secondary and tertiary peritonitis depending on the way of surgery completion. Patients in group I (n=27) underwent only skin suturing after the surgery, in group II –laporostoma was formed with VAC in the abdominal cavity. We have evaluated the level of microbe contamination and condition after wound surgery, intensity of adhesion process in the abdominal cavity, multiple organ failure after surgery. The use of laporostoma combined with VAC at different stages of generalized peritonitis treatment helps to achieve illness rigress, less number of planned saniations of abdominal cavity. Even after the first use of VAC, quicker clearance of operation wound and appearance of new granulation tis­sues occurred. In group II in secondary saniation the frequency of fixing of abdominal cavity is developing 31,9% higher (p<0,05) and in the third saniation the use of VAC therapy resulted in growing number of patients with frozen abdomen.

78-85

Authors: Stepanskyi D.O., Kremenchutskyi G.M., Koshova I.P.

The paper presents data on the study of the antagonistic effect of aerococcus autosymbionts in experimental models of infections caused by staphylococci. To study the antagonistic action of aerococcus autosymbiont on staphylococcus, a model of chronic staphylococcal infection in white mice and rabbits was used. In staphylococcal experimental infection, aerococcus antagonistic action against staphylococcus was tested by subcutaneous injection on white mice. Aerococci survival under the skin was studied. Aerococcus autosymbionts introduced under the skin to staphylococcus in 5 hours and 3 hours after administration of the latter cause antagonist effect and inhibit the development of infiltrates. Similar results were obtained when introducing aerococcus autosymbionts in the focus of infection in 5 minutes, 5 minutes and 3 hours, 1 and 5 hours after infection. Aerococci introduced after 24 and 48 hours shortened terms of disease manifestations as compared to the control group of mice. The therapeutic effect of aerococcus autosymbionts was tested on the experimental model of burns and wounds infected with staphylococcus. In animals with wounds treated with aerococcus autostrains the number of pathogenic staphylococci was 10 times less than in the control group. According to our observations aerococcus autosymbionts showed no irritant effect when applied on the wound surface, helped its healing, sharply reduced the percentage of staphylococcus inoculation from wound secretions.

91-95

Authors: Kryvopustov O.S.

Actual medical and social problem of modern obstetrics is threatening abortion. In its treatment, analogues of progesterone are used. Activation of progesterone receptors induces the production of anti-abortive protein-progesterone-induced blocking factor (PIBF). The dynamics of PIBF in 28 patients with the diagnosis of threatening abortion was analyzed. Women were treated by natural micronized progesterone depending on the features of the clinical course and single nucleotide polymorphism of the progesterone receptor gene rs590688. The quantitative content of PIBF in urine in pregnant women with threatening abortion was determined, namely, the increase in the content of this factor is associated with the prolongation of pregnancy. At the time of initiation of therapy, the concentration of PIBP was 28.8±1.5 (95% CI 26.7-29.2) ng/ml, and on the 7th day of therapy its concentration was 29.4±0.1 (95% CI 29.2-29.5) ng/ml. The increase in PIBF has reached a degree of statistical significance (T-W=15.0, p<0.001). In 27 (96.4%) patients who were pregnant, PIBP levels increased, 1 (3.6%) patient had spontaneous miscarriage on the 9th day of treatment. She had a decrease in concentration of PIBF in urine from 29.18 ng/ml at the time of admission to the hospital to 28.58 ng/ml on the 7th day of therapy. The study of progesterone-induced-blocking factor can be considered as an additional laboratory method of controlling progesterone therapy in women with threatening abortion in specialized research institutions.

104-110

Authors: Gudaryan А.А., Kuznyak N.B., Dronik I.I.

The article presents the results of complex treatment of 98 patients with chronic generalized periodontitis with purulent foci in periodontal tissues by using standard complex treatment in combination with systemic enzyme therapy, which in turn allows to increase the effectiveness of the therapeutic measures and to eliminate etiological and pathogenetic links and regress of clinical symptoms of the disease. Under its influence, clinical and laboratory rehabilitation comes faster by 5.4 ± 0.2 days, and remission throughout the year takes place in 91.7% of cases.

119-125

Authors: Stavnichenko P.V., Novohatska L.O., Antonenko A.M., Vavrinevych O.P.

The aim of our work was to determine ecotoxicological risk of herbicides, insecticides, fungicides of different chemical classes with different mechanisms of action by the method of Melnikov M.M. and leaching potential index by the method of Sergeev S.G. and co-workers. It was established that in soil and climatic conditions of Ukraine ecotoxicological hazard of studied herbicides by (1-6) orders of magnitude, fungicides – by (3-5) orders, insecticides – by (2-3) orders lower than DDT. The least ecotoxic are herbicides of the last generations, then fungicides and the most ecotoxic are insecticides and herbicides of the old first generations. It was proved the high danger of groundwater contamination with studied herbicides, insecticides and fungicides, except for mesotrione, the application of which has moderate danger in the soil and climatic conditions of Ukraine. It was shown that in soil and climatic conditions of Ukraine, ability of migration from the soil into groundwater of metribuzin, thiamethoxam, paclobutrazole is high, topramezone and mesotrione – moderate, for other substances – low; in terms of hygienic standards in the ground itallows to avoid them getting into the soil flow and minimize the danger of groundwater contamination to public health.

133-140

Authors: Vezhnovets T.A.

The aim of the research was to identify the major factors that can positively or negatively effect the state of the socio-psychological climate in the medical team of healthcare institutions. The psychological study of the social-psychologic climate of 152 health care workers of two hospitals of Kherson region (N 1, n=80; N 2, n=72) was conducted. It is established that the level of self-esteem of climate in the institution №1 was significantly lower than in institution N 2 (р<0,007). Moreover, these two institutions differed significantly by experience of joint work of health workers (р<0.05) and length of service of the head physicians. Health care workers with less joint work experience have been working in the institution N 1, and it was headed by the head physician with less leading experience. By the opinion of health workers of both institutions, such factors as "interesting and meaningful work", "attentive head", "relations with colleagues", have the most positive impact on the state of climate the most negative influence — "unsatisfactory management style", "tensions in the team", "lack of financial motivation", "poor working conditions". Each team has its own combination of factors that positively or negatively affect the state of the climate. It is established, that depending on the work experience of the head physician and the work experience of joint work of employees, the main factors that affect the climate in the team are "attentive manager" and "relationships with colleagues". The more work experience of the leader, the more it will affect the state of the climate in the team. The less experience of joint work of employees, the more "relationship with colleagues" will affect its condition. Evaluation of the state of socio-psychological climate and its factors by the personnel may be the indicator of efficiency of personnel management in the health care institution.