Journal of Clinical and Experimental Medical Research

6

Authors: Nishanbaev R. T., Takhirova R. N., Umarova M. S., Tashmetova B. R.

Introduction. The complicated pneumonia in children of early age remains serious problem for pediatrics, despite significant achievement in treatment and rehabilitation. Considerable progress was made recently in clinical and experimental membranology to understand pathogenesis of many diseases in children of early age, including pneumonia. Additional medical and rehabilitation measures were proposed. The cellular membranes contain glycocalyx. It is the external surface of erythrocytes’ membranes functioning as antigenic complex of ABO blood system. Our aim was to study the condition and structure of erythrocyte’s glycocalyx in children with complicated pneumonia regarding their blood group using the ABO system. Materials and methods. The children were divided into groups regarding their blood group. We analyzed the levels of hexoses and sialic acids in erythrocytes’ membranes of peripheral blood in children of early age with complicated pneumonia. Diagnosis of complicated out-of-hospital pneumonia was based on data of the anamnesis, objective examination, laboratory analyses and chest X-ray. The blood samples were collected from the peripheral vein on empty stomach in the morning during acute phase of disease. We used heparin (at dose 300 IU per 1 ml of blood) as anticoagulant. Glycoproteins were released from erythrocyte membranes by hyposmotic hemolysis. Quantitative determination of sialic acids was made by the Svennerholm's method; hexoses were detected by the antronic method. Measurement was made regarding to the blood group and clinical signs of extra pulmonary complications of pneumonia (1–2 day of hospitalization and the discharge day from the hospital). Statistical analyses were carried out using Microsoft Excel. Study results were processed using variation statistics methods and the Student’s-test. Discussion. The obtained results showed that certain therapeutic measures should be taken to stabilize glyxocalix of the erythrocytes’ membranes during complicated pneumonia in children of early age.

8

Authors: Shevchenko О. A., Dorogan S. B., Kaniuka H. S., Gubar I. A., Prunkevych О. G., Golovatenko M. К.

Introduction. After the Chernobyl accident radio-anxiety of the population remains one of the most acute psychosocial problems in Ukraine, especially in the regions where uranium is extracted and processed. Uranium raw material – basis of nuclear fuel for nuclear energy – has been processed in Zhovti Vody of Dnipropetrovsk region since 1950s. Zhovti Vody is a unique place. The city is surrounded with the uranium production facilities: the hydrometallurgical factory and the uranium waste tailing damp. Purpose. Our aim was to estimate perceived health status of Zhovti Vody citizens (population category «В») and the employees of the industrial complex «Eastern Mining Processing Plant» (MPP), who work with radiation sources daily (categories «A» and «B»). Materials and Methods. We checked the health status of average Zhovti Vody citizens (102) and industrial complex employees (104), who work with radiation sources daily. The samplings deferred only by the place of employment of respondents. The average age of respondents (M ± m) was 41.6 ± 0.9 years. The gender (р > 0.9) and age (р > 0.7) characteristics were similar for both groups. The applied research methods were developed and tested by the specialists of V. M. Bekhterev Psychoneurological Research Institute (Saint Petersburg). Discussion 1. According to the integral estimation of the perceived discomfort condition: the employees complained less of pain, but citizens who did not work in the industrial complex complained more. 2. Mental health of the population corresponds to the low (by anxiety and frustration indices) and middle assessment levels (on the constriction and aggressiveness scales). However, the employees of the industrial complex showed the lower degree of symptom expression. 3. The majority of population (88.3 %) showed the low level of social frustration regardless to the place of employment. 4. The correlation between physical and mental health statuses (anxiety, constriction, psychological and social frustration) confirmed interaction between pain and psychological symptoms. The employees of the industrial complex showed better estimation of perceived health status comparing with citizens, who work in other institutions. Thus, the employees of any industrial complexes normally express less radio-anxiety, because they work with radioactive sources daily.

8

Authors: Chemych M. D., Malysh N. H.

Salmonellosis and shigellosis are widespread intestinal diseases that bring significant economic blow. Polyetiology, a variety of modes of transmission, universal susceptibility, lack of persistent post-infectious immunity are factors that hinder efficiency of undertaken measures to reduce morbidity. We concluded a retrospective analysis of the incidence (2003–2012) to study the epidemic process of shigellosis and salmonellosis in Sumy region; and defined etiological structure. Besides, certain species of Salmonella were isolated from pathological material of animals and investigated. We employed the descriptive and analytical epidemiological research methods. Statistical analysis of the results was performed using the application package «Statistics for Windows», version 8.0. The incidence rate, dynamics of morbidity trends, Spearman coefficient correlation, and the coefficient of reliability were determined with statistical significance (p < 0.05). Nowadays there is a pronounced tendency to decrease the incidence of shigellosis and moderate growth trend incidence of salmonellosis in Sumy region. In the etiological structure of shigellosis and salmonellosis, S. sonnei (p < 0.05) and S. enteritidis (p < 0.05), are the most prevalent. Risk factors for shigellosis prevalence are contaminated drinking milk, dairy and cooked products. We point out strong to medium direct correlations between isolation frequency of samples, which do not meet sanitary-bacteriological standards, morbidity and the annual dynamics of shigellosis. The incidence of salmonellosis in the population corresponds to the epizootic situation. There is a significant direct correlation between the isolation frequency of S. typhimurium from pathological animal material and the pathogen from clinical material of patients. Neutralizing effect on food processing path should be the basis to prevent from shigellosis and salmonellosis nowadays. Considering importance of the housing conditions for animals in the epidemiology of salmonellosis, so preventive measures must be taken at the basic level of food processing chain; we should use high quality raw materials and meet technological transportation, storage and cooking requirements.

9

Authors: Ohienko M. M., Bumeister V. I.

In modern life trauma, along with cardiovascular and oncological diseases, is one of the three causes leading to mortality. Our aim was to study the reparative regeneration process in young animals (control group); in animals with stimulated severe degree of dehydration (experimental group) and general conditions to correct morphological changes of the injured tibiae caused by severe degree of dehydration (applying "SOLCOSERYL" drug). The experiment was conducted on young male rats aged 4 months, which were divided into 2 groups: control and experimental. The experimental group was subdivided into two subgroups: the rats with severe degree of dehydration (I) and the rats which underwent the corrective treatment of structural changes caused by severe degree of dehydration applying "SOLCOSERYL" drug (II). After 3 days there were changes in the cellular composition in the animals from the subgroup I. On the 15th day, severe hematoma were determined in the immature areas of granulation tissue. We observed that the area of fibroreticulate tissue increased, but the area of coarse-fibered bone tissue reduced by 15.48 % (p ≤ 0.0001) compared with the control group. After 15 days in the rats which underwent correction of structural change occured a positive tendency in histostructure: coarse-fibered bone tissue area decreased by 16.10 % (p ≤ 0.0001), and the plate – up to 14.33 % (p ≤ 0.0001) compared with animals with severe degree of dehydration. After 24 days the structure of the regenerates changed dramatically in the animals with severe degree of dehydration. For example, the area of coarse-fibered bone tissue increased up to 8.05 % (p ≤ 0.0001) and lamellar bone reduced by 22.82 % (p ≤ 0.0001) comparing with the control group. After 24 days firbroreticulate tissue was formed in the animals which underwent corrective treatment. There was more lamellar tissue in the animals which underwent corrective treatment comparing with the animals which had water imbalance, by 24.75 % (p ≤ 0.0001). Accoding to the histological investigation, the results demonstrated that severe dehydration did not change the order of reparative osteogenesis stages, but delayed the restoration of bones. Thus, the corrector had positive effect on the reparative osteogenesis. Applied "SOLCOSERYL" drug, as a corrector, eliminated negative dehydration and accelerated restructuring and maturation of bone structures.

9

Authors: Vynnychenko O. I.

Introduction. There are limited data concerning food transportation through the intrathoracic stomach used for esophageal replacement after resection. Bilateral truncal vagotomy and partial sympathectomy make the stomach transplant act as an inert tube; although, food moves only by gravitation force there. Purpose. After previous application of the basic physical and mathematical model of the intrathoracic stomach, I assumed that further assessment of the gastroplasty model width and diameter of pyloric canal should be performed. Materials and methods. The gastric tube models with the three different diameters of 30 mm (prototype is narrow gastric tube); 60 mm (prototype – wide gastric tube) and 90 mm (prototype – the whole stomach) were produced and connected to the three variants of pyloric canal model (3.5 mm vs 7.0 mm vs 14.0 mm). I calculated the transportation time through physical models for 250 ml of water and 50 % glycerin. I analyzed if additional negative chest pressure and positive intraabdominal pressure had effect on the liquids emptying time. Results. The obtained results showed that the time periods of water emptying for 90 mm gastric tube were 63.3 ± 2.0; 15.0 ± 1.3 and 3.4 ± 1.0 seconds for 3.5 mm; 7.0 mm and 14 mm pyloric canal models respectively; the time periods of water emptying for 60 mm gastric tube were 38.8 ± 1.1; 9.8 ± 0.8 and 2.4 ± 0.8 seconds for 3.5 mm; 7.0 mm and 14 mm pyloric canal models respectively; and the time periods of water emptying for 30 mm gastric tube were 19.7 ± 2.1; 5.3 ± 1.9 and 1.3 ± 0.8 seconds for 3.5 mm; 7.0 mm and 14 mm pyloric canal models respectively. The term of glycerin transportation was significantly higher comparing with water transportation through the model (3.2–3.4 odd). Additional negative chest pressure and positive intraabdominal pressure had no effect on the liquids evacuation time. Discussion: Emptying time equation for intrathoracic stomach model was calculated and compared with data obtained from physical model exploration. I assumed that the width stomach transplant defined the emptying time regardless fluid consistency. I emphasized on the necessity of wide gastric tube esophageal replacement and digital pyloric rupture at clinical setting.

9

Authors: Parkhomenko O. M., Dosenko V. Ye., Ataman O. V., Garbuzova V. Yu.

Introduction. Vitamin K-dependent γ-glutamylcarboxylase (GGCX) is the integral transmembrane protein, which catalyzes the posttranslational carboxylation of glutamic acid to γ-carboxyglutamic acid molecules in the vitamin K-dependent proteins that are synthesized in the liver (clotting factors II, VII, IX, X, protein S, C, and Z), and in other tissues (osteocalcin, protein S, Gas6 and four transmembrane proteins: PRGP1, PRGP2, TmG3, and TmG4). Taking into account importance of coagulant status in the development of coronary disorders, polymorphism of GGCX gene may be associated with them. The data in literature concerning these issues are limited and inconsistent, and absent for Slavic populations. Purpose. Our aim was to establish the frequency of allelic variants of the GGCX gene for Arg325Gln polymorphism in patients with acute coronary syndrome (ACS), who has normal and high blood pressure. Materials and Methods. We used venous blood of 118 patients with ACS (22 % women and 78 % men) aged 40 to 73 years (mean age 55.9 ± 0.89 years) who were hospitalized in the cardiology department of Sumy City Clinical Hospital № 1. The control group consisted of 234 patients. Definition of Arg325Gln polymorphism (rs699664) of GGCX gene was performed using PCR with the following restriction fragment length analysis of the allocation of them by electrophoresis in agarose gel. Restriction endonuclease XmnI was used for restriction analysis. Statistical analysis was performed using the software package SPSS-17. Thus the significance of differences was determined by the χ2-criterion. The value of P < 0.05 was considered as significant. Results. Using the χ2-Pearson criterion did not reveal association between the Arg325Gln polymorphism of GGCX gene and the development of ACS. Distribution of different types of genotype between patients with ACS and healthy patients did not differ statistically significantly. However, using logistic regression led to the conclusion of the association of polymorphism of the 8th exon of the GGCX gene with acute coronary syndrome. In carriers of minor allele (Gln/Gln) ACS risk twice that of homozygotes for the major allele (Arg/Arg). The obtained data on the performance of systolic (SBP), diastolic (DBP), pulse (PBP) and average (ABP) blood pressure in patients in the control group and patients with ACS with different genotypes for the polymorphism Arg325G in GGCX gene indicated that all four types of BP did not differ in carriers of different genotypes inside the control group and in patients with ACS. A comparison between the groups revealed that for the studied polymorphism in members of Arg/Gln and Arg/Arg genotype and DBP and ABP values were significantly higher in patients with ACS than in control. A somewhat different pattern was revealed when the analysis was conducted among females. Women with ACS homozygotes for the minor allele (Gln/Gln), only DBP; in homozygotes for the major allele (Arg/Arg) DBP and ABP, while heterozygotes (Arg/Gln) and SAT were also higher when compared with almost healthy individuals. As for men, the effect of blood pressure on the development of ACS was insufficient. SBP value in the comparison group did not significantly differ among carriers of different genotypes. DBP was higher in patients with genotype Arg/Gln and Gln/Gln, and PAT – with Arg/Arg, and ABP – with Gln/Gln, suffering from ACS. Among persons with high blood pressure significant difference in the ratio of genotypes (Arg/Arg, Arg/Gln, Gln/Gln) existed between main and control groups. In the group with ACS, it accounted for 20.8, 56.9, 22.2 %, and in control – 38.4, 49.3, 12.3% (P = 0.045). Thus, among the people with high blood pressure with genotype Gln/Gln, risk of ACS development was greater. Logistic regression confirmed the conclusion: the minor allele homozygotes had risk of the ACS 3.3 times greater than that of homozygotes for the major allele. Conclusion: In homozygotes for the minor allele (Gln/Gln), the risk of ACS was twice higher than in homozygotes for the major allele (Arg/Arg). Among representatives of Arg/Gln and Arg/Arg genotype, DBP and ABP parameters were significantly higher in patients with ACS than in control. Among people with high blood pressure with genotype Gln/Gln, risk of development of ACS was 3.3 times higher than that of homozygotes for the major allele (Arg/Arg).

12

Authors: Pogorielov M. V., Gusak Ye. V., Babich I. M., Kalinkevich O. V., Kalinkevich A. N., Samokhvalov I. I., Danilchenko S. N., Skliar A. M.

The most important function of enterosorbents is their ability to bind toxins both of exogenous and endogenous origin. Wide range of commercial sorbents applies in various intoxications, poisonings or infections, pathology of liver, pancreas or kidney with chronic renal failure. The toxic trace elements are determined among the most spread toxins. They get into the organism in different ways, including nutritional. Majority of the known sorbents exhibit high absorption properties for this type of toxicants, however development and research of new enterosorbents are relevant biomedical problem. Chitosan – a biologically active heteropolysaccharide consisting of N-glucosamine and N-aceto-glucosamine obtained by deacetylation of chitin, one of the most common natural polymers. Chitosan high sorption activity observed in several studies: so the active centers in sorption processes are amino groups, which form complexes with trace elements’ ions. Furthermore, a certain contribution is OH group (particularly the C3-position.) Adsorption – chelation (ion substitution) – is also discussed as possible mechanisms for the formation of complexes, wherein the interaction depends on the type of solution composition, pH, and the ion types. When cleaning the environment from pollutants, it is important to have not only an effective sorbent, but the sorbent in a convenient form. Powders are hard to remove; films and gels are not applicable for all cases. The most convenient form for sorption, are obviously porous beads or granules. In this regard, the aim of our research was to study the sorption activity of chitosan-apatite complex and lyophilized chitosan against toxic trace elements. Beads were obtained from a 2% solution of chitosan (200 kDa, 82 % deacetylation rates) by dropping the solution through a 2 mm diameter needle in a 5 % sodium hydroxide solution under continuous mixing. The beads were kept in the alkali solution overnight, permanently washed with water and freeze dried. Chitosan beads containing hydroxyapatite were prepared by adding a solution of chitosan in 1 M calcium chloride solution and 1 M solution of calcium dihydrogen phosphate (Ca/P ratio – 1.67). The beads were kept in a 5 % alkaline solution for 24 hours and then washed with water and freeze-dried. To determine sorption activity of samples, we placed 1 gram of each sample in a 100 ml solution (pH – 6.0) containing 5 mg per liter of a trace elements – Mn+2, Cr+3, Fe+2, Cd+2, and Cu+2. The solution was shaken by automatic shaker throughout the experiment at 30 oscillations per minute. We used activated carbon for comparison series. The solution was filtered in each series in 30, 60, 360 and 720 minutes and the content of trace elements was measure in a liquid phase by atomic absorption. It should be noted that for 12 h (720 min) the chitosan-apatite beads absorbed all trace elements almost completely (99–100 %), while the chitosan based absorbed cadmium and copper better exhibiting minimal affinity for iron, chromium and poorly absorbed manganese (Cd> Cu> Fe> Mn> Cr); activated carbon also absorbed cadmium and copper better, to a lesser sorbs iron, manganese and did not absorb chromium (Cu> Cd> Fe > Mn). When we used the chitosan-based beads as sorbents, it was difficult to consider the kinetics of absorption and the releasing of some elements in the solution after polymer restructuring. The chitosan apatite beads were preferably hold in contact with a cleaning medium for 12 h; at the same time during the first 30 minutes that sorbent absorbed about 90 % of copper, manganese, iron, cadmium and 50 % of chromium. Beads of chitosan during the first 30 min absorbed only 90 % of copper and more than 50 % of cadmium, manganese, and about 40 % of chromium.

5

Authors: Dubovyk Ye. I., Garbuzova V. Yu., Prosol D. А., Shimko K. A.

T2255C polymorphism (rs2359612) of vitamin K-epoxidoreductase (VKORC1) gene in 118 patients with acute coronary syndrome (ACS) and in 234 healthy people was determined. It was shown that in patients with ACS interrelation of main homozygotes, heterozygotes and minor homozygotes were 27.1 %, 41.5 % and 31.4 % (in control – 37.2 %, 42.7 %, 20.1 %. P = 0,038 by χ2-test). Thus, there is an association between T2255C polymorphism and the development of ACS: the risk of ACS in homozygotes for the minor allele (C/C) is 2.1 times higher than in homozygous for the major allele.

5

Authors: Popov S. V., Bokova S. I., Bugaenko V. O., Romanova T. O.

The aim of the study was to research the cardiovascular system functional state in healthy teenagers as they had done certain exercise tests. We examined 68 children by the Doppler echocardiography method. The inadequate response of cardiovascular system had 25 % of teenagers. The main factors that had led to the state were: basic high blood pressure and general low level of physical activities. The systolic function of the heart enhanced during the lower dynamics of diastolic function.

6

Authors: Besedinska O. V., Davydenko I. S., Besedinskyi V. I., Andreev S. A.

Peripheral neuropathy is a clinical syndrome that develops as a result of various aetiological factors impacting peripheral nerves. It is distinguished by heterogeneous pathogenetic mechanisms. Polioneuropathies occupy the second place in the structure of diseases of the peripheral nerve system after vertebraginic pathology, but greatly exceed it in the complicated clinical manifestations and crippling consequences. Important role is played by the vessel factors of neuropathy development, which are connected with the involvement of vasa nervorum and combine a big group of diseases. To detect the pathological changes in the microcirculatory blood stream of peripheral nerves advanced pathohistological research of its components on various levels is needed; this research is carried out by pathologists with the use of the whole complex of techniques aimed at the elective detection of various elements of vessel wall. The issue of protocol development enabling the complex multi-factor analysis of great amounts of data is therefore in question. The objective of our research is the development of the systematic list of pathohistological changes in the microcirculatory blood stream of the peripheral nerve. The research protocol for the description of pathohistological changes of some components of the microcirculatory stream of the peripheral nerve was developed based on referenced data and our own observation experience. The systematic list of pathohistological changes was verified in the examination of 220 n. tibialis of diabetes patients and in the control group. The use of the suggested research protocol for the description of pathomorphological changes in vessels will enable objective diagnosis and correct interpretation of the obtained data. The prospects of our research lie in the development of the computer-based morphometric analysis of the haemocirculatory blood stream of peripheral nerves.

8

Authors: Kornienko V. V.

The article is devoted to evaluate dynamics of planimetric indexes of burns. I took rats of different age and applied innovative chitosan membranes on the burns. I modeled IIIb burns on the rats from both experimental and control groups; I used chitosan-based coatings for topical treatment. Planimetric analyses of the affected areas were performed by the “SEO Image lab 2.0” program (Sumy, Ukraine) considering the total affected area (sm2); the relative areas of dead tissue, granulation tissue and epithelization (%). I measured them on 1st, 3rd, 7th, 14th and 21st days after the burn modelling. These days show key phases of skin healing. I determined the rate of burn healing according to certain criteria: average rate of affected area reduction (sm2) per day; reduction in burn area (%) per day. Natural chitosan coatings prevented from repeated infections protecting the burn areas from exogenous factors. Besides, it was applied easily on the affected areas to protect newly formed epithelium. Healing process speeded up during the inflammatory phase as both burn cleaning and granulation tissue formation enhanced. Moreover, gripping of the burn edges occurred during the proliferation and remodeling phases. Due to these results I may claim that period of healing process with rate of epithelization has decreased by 1.5 day.

8

Authors: Smiyan O. I., Kurganska V. O., Sichnenko P. I., Bynda T. P., Romaniuk O. K., Gorbas V. A., Vasylieva O. G.

The influence of quantitative and qualitative composition of intestinal microflora on the state of mineral metabolism and the immune system was study in the 128 children with asthma. The correlation between the number of representatives of the intestinal microbiota, bioelements and indicators of immune status were studied. The dependence of immune parameters, micronutrient content and quality of intestinal microflora detected in children with asthma that manifested significant imbalance of immune and microelement’s homeostasis. The results give reason to consider overgrowth in school age children with asthma as one of the factors that support secondary immunodeficiency, impaired microelement’s metabolism. The reducing of the number of lacto-and bifidobacterias, E. coli colonies and growth of opportunistic microorganisms, staphylococci and fungi have a significant impact on changes in the immune system and the microelement’s composition, supports allergic inflammation in the body of the child, even in remission, which is important and promising in terms of finding new ways of optimal treatment of childhood asthma.

9

Authors: Loboda A. M., Markevych V. E.

The article examines the features of the balance of pro-and anti-inflammatory cytokines in full-term infants with impaired renal function due to asphyxia at birth. The study involved 252 full-term newborns with signs of kidney damage: 102 children who had severe asphyxia and 150 children with moderate asphyxia. The level of interleukin -1β, interleukin -6, tumor necrosis factor α and interleukin -10 in serum determined by on the 1–2nd , 7–8th and 25–30th days of life by ELISA. Interleukin-6 is the most informative cytokine; its level increased in the first days of life in case of impaired renal function and depended on the severity of asphyxia. Determination of interleukin-1β in serum is necessary for retrospective assess severity of the asphyxia in newborns at the end of neonatal period. Serum level of interleukin-10 is closely correlated with the levels of proinflammatory cytokines in the first days of life in children with impaired renal function due to asphyxia. Character of correlation depends on the prevalence of regulatory or suppressive processes.

13

Authors: Dyachenko A. G., Dyachenko P. A., Gorobchenko K. M.

Advances in antiretroviral therapy (ART) have drastically improved the quality of life for people with HIV infection. However, complex therapy leads to suppression of plasma viral loads in HIV-1 patients. Despite this therapy, a low level of viremia in plasma can be frequently detected by sensitive clinical assays. Additionally, many patients experience transient episodes of viremia above the detection limit, even if they have been undergoing highly suppressive therapy for many years. Failure of HAART to eradicate HIV associates with the existence of persistent infection in certain cellular and anatomical reservoirs. The latent reservoir considers being the major hurdle in HIV eradication. In addition, deep suppression of viral replication does not restore the immune status fully that was effected by HIV infection. This is a consequence of chronic immune activation, caused by the increased permeability of the intestinal barrier and translocation of bacteria and products of their decay. Progress in the infection eradication requires new approaches in the fight against latency and immunodeficiency.

4

Authors: Vlasenko E. M., Demikhova N. V.

We determined changes in activity of the prooxidant systems and indicators of inflammation in patients with chronic renocardiac syndrome. Thus, namely 33 patients with arterial hypertension and chronic kidney disease were examined for changes during chronic glomerulonephritis, as well as under the influence of antihypertensive therapy (fosinopril, diltiazem). Comparative evaluation of key indicators (pro-and antioxidant system) was associated with decrease of the prooxidant systems activity and reduction of its activity due to treating with antihypertensive drugs, which reduced the activity of rennin-angiotensin-aldosterone system.

6

Authors: Molodan D. V.

This work studied the effect of uric acid on lipid peroxidation in patients with hypertension combined with obesity. The reserch involved 45 patients with hypertension of I-II stage and 1-3 degree increase of blood pressure. All patients had 1-2 degree obesity. Hyperuricemia was defined when uric acid level > 420 μmol / l in men and > 360 μmol / l in women. I analyzed the state of lipid peroxidation, activity of diene conjugates, malonic dialdehyde and total antioxidant activity of the blood. Besides, a marker of systemic inflammation – C-reactive protein was determined. I have found that the balance of pro- and antioxidant systems deteriorates with the growth of uric acid from the normouricemia to hyperuricemia, and C-reactive protein increases.

7

Authors: Prystupa L. N., Dudchenko I. O.

The article analyzes scientific data concerning alimentary obesity based on genetic characteristics of patients. The research is focusing on the impact of gene polymorphisms Gly389Arg β1-adrenoceptor (RS 1801253) and T393C α-subunit of G-protein (RS 7121) on the development and clinical manifestations of alimentary obesity. We have pointed the principal scopes for further research regarding early diagnostics and prevention of alimentary obesity.

7

Authors: Romanenko O. A.

The aim of the research was to define anamnestic and clinical and diagnostic factors leading to recurrent pyelonephritis. The research studied and analyzed the risk and predisposing factors for complicated infection, the clinical features, diagnostic testing, and causative organisms for recurrent pyelonephritis, concomitant gynecologic pathology and the number of kidney scars within 175 women with recurrent pyelonephritis. The patients were divided into two groups in accordance with the frequency of recurrences. The microbial urogenital system spectrum of 98 women with recurrent pyelonephritis (group 1) was compared with 77 women with sporadic pyelonephritis (up to 2 times per year) (group 2). The frequency of recurrent pyelonephritis is closely connected with predisposing factors and complicated infection (such as postmenopausal age, microlithiasis, and nephroptosis and so on) (R=0.18; p=0.02), frequency of sexual intercourse (χ2=5.05; р=0.03), maternal history of urinary tract infection (χ2=24.9; р<0.001) and genital inflammatory diseases (R=0.16; p=0.04). The risk factor for recurrent pyelonephritis doubles with frequency of sexual intercourse, number of complicating factors, maternal history of urinary tract infection and concurrent inflammatory diseases of genitals (R=0.16; p=0.04). The sensitivity of these features combination for predicting of relapsing course of the disease amounts to 61.8% [95% CI: 50.9; 71.9], specificity - to 50% [95% CI: 39.02; 61.0], which makes them impossible to use. The risk of recurrent pyelonephritis estimates increased with stronger family history indices, suggesting a genetic component for increased susceptibility to urinary tract infection, frequency of sexual intercourse (4–8 times a month) and concurrent inflammatory diseases of genitals. However, these risk factors cannot be considered predominant for recurrent pyelonephritis. Therefore,we should provide further research of recurrent predictors such as immunological and biochemical to predict the course of pyelonephritis.

7

Authors: Vynnychenko O. I.

There are limited data that can explain how food transports through the intrathoracis stomach that is used for esophageal resection. Bilateral vagotomy and partial sympathectomy make the stomach transplant act as an inert tube; although, food moves there only by the gravitation force. Regarding to this, I have made the physical and mathematical model of intrathoracic stomach to determine required terms for transportation of food of various consistency. The model distinguishes roles of the size of stomach implant and performance of the pylor-draining operations; and their effects on the efficiency of food transportation. Using the basic model of stomach (with a diameter 60 mm), I observed water and glycerin transportation though the pyloric canal model/simulator with width of 3.5 mm, 7 mm and 14 mm. I have pointed out that the term of water transportation though the pyloric canal (with width 14 mm) was the shortest. This fact is statistically reliable comparing with the canal width of 7 mm and 3.5 mm. The term of glycerin transportation is significantly higher comparing to water transportation though the model; even despite the width of pyloric canal. The research results confirmed necessity of pylor-draining operations for esophagogastroplasty.

9

Authors: Lasytchyuk O. M.

The article presents the results of examination of pregnant women with polyhydramnios. We study the effects of amniotic fluid on fetus development, pregnancy and labor. We point out some risk factors of polyhydramnios due to the anamneses, clinical signs, functional and laboratory examinations. Besides, we have developed the algorithm to manage and treat this pathology.

10

Authors: Pogorielov M. V., Kornienko V. V., Tkachenko Yu. A., Oleshko O. M.

Nowadays it is impossible to treat the skin defects without certain medicines. These drugs are aimed to normalise the microenvironment, enhance the healing process and prevent further complications. The literature review analyzes the steps how wound therapy develops. It also informs about the widely applied materials in surgery and compares these materials due to their efficiency, side effects and pharmacological and economical features. The part of review is devoted to study chitosan-based materials – a derivative of chitin that is a biologically active polymer. Some commercial and experimental materials have been synthesized from chitin to be later applied in surgery. The references confirm that chitosan derivatives may be widely applied both to optimize and stimulate the healing process, and to prevent complications (infections, scars and the chronic process).

4

Authors: Khukhlina O. S., Zaliavska O. V

The aim of our study was to investigate the cytokine profile due to the etiology, inflammation activity, and presence of HLA-B27 antigen in the patients with reactive arthritis. The study showed a direct dependence of IL-4, IL-6 and the TNF-α on the degree of activity of ReA with chronic pyelonephritis. The presence of HLA-B27 antigen in the patients with reactive arthritis and chronic pyelonephritis accompanied by an increasing of proinflammatory cytokines such as IL-1β, IL-6, PNP-α, IL-1R in comparison with the HLA-B27-negative patients. The results of study demonstrated that maximum serum levels of IL-6 and IFN-γ in the patients with reactive arthritis that occurred on the background of acute urogenital infection were significantly higher than in the other etiological cases of reactive arthritis.

4

Authors: Duzhyi I. D., Shevchenko V. P., Pyatikop G. I., Grushko A. N., Ladnyi M. D., Bratushka V. O., Sobolev Y. I., Mysłowskyi I. A., Svistunov O. V., Popadunec V. M.

This article deals with the experience of treating 2 patients with hemophilia A with severe gastroduodenal bleeding. These patients were admitted to the surgical department of Sumy Regional Hospital in 2011. It is shown that the conservative treatment of severe gastrointestinalhemorrage in the patients with hemophilia has its own peculiarities and can be an effective technique using enough clotting factor VIII, conducting adequate infusion-transfusion, haemostatic and antiulcer therapy.

5

Authors: Vysotskiy I. Yu., Lukyanchyuk V. D., Vysotskiy V. I

The experiments were carried out on 72 white male rodents weighing 150-220 g with ad libitum diet during the light and dark periods. These periods were striped in the ratio of 12:12. The toxic damage of liver was caused during the various day periods (at 6am, 10am, 2pm, 6pm, 10pm and 2am) by the intramuscular injection of CCl4 solution at a dose of 0.5 ml per 100 g body weight. The samples were gathered in 24 hours after the injection of CCl4. It was pointed that the most significant hepatotoxic influence of CCl4 was at 6pm and 10pm. Perhaps, it is connected to large amount of enzymes contained in the membrane, such as cytochrome P450-3A–reductase and succinate dehydrogenase. The low level of diene conjugates was observed during this period of time, which was the evidence for more serious damages and disruption of the endoplasmic reticulum membranes. Later these membranes were slightly able to metabolize CCl4 to active radicals, which normally induce lipid peroxidation. The significant increase of malondialdehyde level was measured on a background of these conditions. It can be considered as the result of antioxidant system activity exhaustion.

5

Authors: Kryvetsky V. V., Moskalenko R. А., Karpenko L. І., Zakorko I.-M. S.

The features of morphological studies of the endocrine testes’ apparatus of rats, the ways of occurrence and prevention of artifacts in the histological studies are examined in this work. Based on our own research and data from the research literature, the phenomenon of spermatogenesis inhibition activating the Leydig cells on the background of adverse factors was described. Activation of the endocrine system can be explained by participation of the Leydig cells in the protective compensatory-adaptive reactions of the body reacting to stress.

5

Authors: Kaduk Yu. H., Laptiy I. V., Ruban L. A.

The article is devoted to study diagnosis, treatment and rehabilitation during the early stages of COPD. The patient with COPD should understand the nature of disease, risk factors leading to the disease development. Besides, one should consider his/her and the doctor’s roles to reach the most effective results during the treatment. The xaminations should be carried during the every stage of disease course using various techniques. Peculiarities and issues of the respiratory organs functional status were distinguished in the patients with chronic obstructive pulmonary disease during the primary inspection.

5

Authors: Demikhova N. V.

115 patients with chronic renocardiac syndrome were examined. They had an excessive increase of pro-inflammatory (IL-1β) and anti-inflammatory (IL-10) cytokines in the serum. In the patients with preserved renal function were revealed the predominance of IL-10. During development of chronic renal failure (CRF), there was the preferential increase of IL-1β. Chronic renal failure was characterized by a change in focus of immunity during the disease progression. In the early stages of chronic glomerulonephritis dominated humoral immunity. Further progression of the disease with predominance of IL-1β on IL-10 indicated the activation of the cellular immune response.

5

Authors: Akermi Jafar, Tokarenko A. I., Andreeva Y. A.

The article presents the survey results of systemic cellular immunity in the acute phase of duodenal ulcer and after the standard eradication therapy. In the article the effectiveness of two eradication schemes (7 and 14 days) is compared. The effectiveness of these schemes to correct immunological disorders in peptic ulcer disease is evaluated.

5

Authors: Pavlyshyn H. A., Kozak K. V.

The key indicators of carbohydrate, lipid and purine metabolism in children with overweight and obesity were pointed. It was done in order to determine correlations between the key indicators and the development of arterial hypertension. The positive correleation between the weight, age, glycemia, uricemia and blood pressure was found.

6

Authors: Kucherenko O. O.

In our research we analyzed the immune response of the patients to Chlamydia pneumonia, bacterial pneumonia and viral pneumonia. If the Chlamydia lesions of lungs in the children had occurred, so cytokins and cellular links of the immunity functioned with the deficit of compensation, but humoral acted in a decompensation manner. Probably, it can be used as a basis for the new diagnostic methods development for treating Chlamydia pneumonia and enhancing the general patient’s treatmnet.

7

Authors: Korytskyy G. I.

The aim of the study was to assess the dynamics of basic health indicators, such as total morbidity, its tructure, disability of children population. This population was affected by the Chernobyl disaster. The rehabilitation work for this category of the patients in Ternopil region within 2003-2011 years was analyzed. The research results pointed on deterioration in children's health. Moreover, the number of Chernobyl affected children has reduced against significant reduction of children population in the region. The children population has decreased by 60848 people over the last five years. However, the annual growth of Chernobyl children’s morbidity has increased more than 2 times in comparison with the total morbidity. Certain medical supervision had been applied in the region and it showed efficiency and effectiveness for this group of children. Such methods of medical supervision as the hospital and ambulatory treatment and rehabilitation in the sanatorium conditions were used.

8

Authors: Smeyanov V. A., Petrenko V. Yu., Tarasenko S. V

This article is devoted to show potential of the author’s quality of care management model on the basis of internal audit principles for the patients with arterial hypertension. This model was implemented in the Polyclinic № 5 of Sumy city. We have analyzed 452 patients’ cards. These patients are considered to be the follow-up one as they have arterial hypertension. We assessed registered data from the patients’ cards in compliance with the protocols and accepted system of indicators. We figured out initial ways of improving the health care service for the patients with arterial hypertension. The specialists should consult the patients with arterial hypertension, examine them using laboratory and instrumental methods, provide information about risk stratification to estimate projections and inform about the target-organs damages etc. We monitored if the patients followed preventive and medical recommendations. Unfortunately, we pointed unsatisfied attitude of the patients with arterial hypertension to their own health. Based on the monitoring results, there were developed and implemented ways to raise awareness of the patients with arterial hypertension using information and communication techniques. The medico-social approach of internal audit gave a possibility of considering and realization management decisions to provide permanent quality of care improving for the patients with arterial hypertension at the mentioned health care facilities.

8

Authors: Grabovyi S. L., Dyachenko A. G., Butenko V. M., Panchenko O. P., Psaryova O. V., Chivanova G. O., Dyachenko P. A.

The objectives were to assess the existing system for recording and management of the health care workers (HCWs) - victims of exposure with blood or other body fluids (BBF) of HIV-infected patients in the health care settings of Sumy region. Reporting, management and analysis of injuries with needles and sharp instruments (NSI) were held in the Regional Center for Prevention and Control of AIDS (CCPA) using EPINet. The program was developed by the Becton-Dickinson (BD) in cooperation with Dr. Janin Jager, Virginia Univ.Results. Besides, Dr. Janin Jager has kindly provided the software. The analyses of incidents that occurred in the medical care settings with HCWs showed that the most dangerous ones were those with the skin damage. The extremely low level of such incidents in the area is a result of underreporting. As might be expected, most NSIs occur with the nurses. Qualifications and professional experience of the HCWs do not affect the level of incidence. Seroconversion among the HCWs as a result of occupational transmission was not observed. Complete reporting of NSIs is a prerequisite for the identification of risky procedures and to ensure optimal management and treatment of the affected health care personnel. The accident insurance doctor must possess a high degree of interdisciplinary competence in order to treat NSI effectively. A list of measures, the implementation of which will reduce the risk of occupational transmission of HIV from patients to workers is proposed.

10

Authors: Prystupa L. N., Kmyta V. V., Savchenko O. V

The article analyzes the research results concerning prevalence of one of the most wide-spread glucocorticoid receptor (GR) gene polymorphisms Bcl1 (rs 41423247) in different populations. Its role in increasing sensitivity to glucocorticoids (GCC) is proved here. The article provides the analysis of Bcl1 polymorphism associations with body mass index, abdominal obesity and fat centralization index as well as with metabolic criteria – blood glucose and insulin level, HOMA index, lipid profile. In spite of contradictory information from the literature sources, Bcl1 polymorphism can serve as a predictor of obesity and metabolic syndrome. Whereas associating polymorphism to the above-mentioned criteria, depends on ecological, alimentary and socioeconomic factors, population inhomogeneity, generation differences and interactions with other gene polymorphisms. Therefore, Bcl1 polymorphism of the GR gene is associated with the change of sensitivity to GCC and phenotypic characters. It can also be partially responsible for genetic determination of body constitution and metabolic state.

4

Authors: Bespalchuk A., Kang L.

Cleft hand is a congenital deformity of the hand consisting of varying absence of the central structures of the hand. One form is the V-shaped cleft in the palm with severe narrowing of the web space and absence of the middle finger. Most peer-reviewed studies in the scientific literature describe surgical treatment during childhood. This study illustrates our experience with treating cleft hand deformity in a skeletally mature patient. We describe a novel surgical technique and the 3 year results using a Z-shaped carpal bone osteotomy reconstruction in a 22 year-old woman results.

5

Authors: Gasanova I. Kh., Pikalyuk V. S.

The article studied age-related peculiarities of morphological cerebral sinus vascular plexus structure of the white rats in their presenile age. There was analyzed dependence on xenogenic spinal fluid frequencies of administration with the following characteristics: animal weight, brain weight, length and width of hemispheres, cephalization coefficient, height and width of choroid ependymocytes. It was pointed that in years typical involutional changes of vascular plexus took place, while exogenic administration of xenogenic spinal fluid had positive influence on the brain biometric data and vascular plexus of cerebral sinus microscopic parameters.

5

Authors: Orlovskiy V. F., Hordina M. A., Rogulska L. O.

Investigated the prevalence of hypovitaminosis D among 135 patients with coronary heart disease (CHD), stable angina pectoris class II-III, who were divided into two groups depending on the presence of metabolic syndrome (MS). The degree of vitamin D deficiency determined by the concentration of 25(OH) D in the blood. 91.9% of participants has deficiency and insufficiency of vitamin D. Patients with CHD associated with MS are significantly more pronounced hypovitaminosis D (p<0.001), the average concentration of 25 (OH) D was 43.8 ± 1.82 nmol/l. Concentration of vitamin D was significantly higher in the summer and autumn months compared with winter. Patients in age 60-70 and older than 70 years has significantly lower concentration 25(OH)D (p<0.001) compared with patients of 40-50 years.

5

Authors: Pavlishin H. A., Sarapuk I. M

The aim of our study was to investigate the apoptotic activity and necrosis of neutrophils of peripheral blood as objectification indicators of clinical course of community-acquired pneumonia in infants. There were examined 73 infants with community-acquired pneumonia. In infants with community-acquired pneumonia intensity of apoptosis increases, with the increase of disease severity apoptotic activity - decreases. Necrotic processes exhibit a positive relationship with the severity of this disease, which may serve for effective objectification of clinical course of community-acquired pneumonia in infants and to predict the severity of the disease in this category of patients

6

Authors: Ryabichenko V. V. , Chemych M. D.

The article presents the current understanding of the сytokine system and genes that encode them, defined the role of single nucleotide polymorphisms in the character of the course of viral hepatitis, the adverse effects of the disease, the effectiveness of antiviral treatment and severity of adverse effects during therapy.

6

Authors: Golubnichaya V. N., Zaytseva T. O., Zaytseva G. S.

The scope of this article was to recommend treatment and prevention measures against pyoinflammatory infections in the newborns and parturient women. The aim is based on spread of infection peculiarities analysis and antibiotic susceptibility of microorganisms gathered in the inpatient maternity facilities. We used bacteriological, epidemiological and statistical research methods. We identified an annual number increase of contaminated samples by microorganisms as well as certain species changed etiological profile. Existence of colonization by opportunistic pathogenic microorganisms of different biotopes was pointed out in every second pregnant woman. Thus, it led to the risk of fetus or newborn contamination possibility. During the research we figured out that the majority of derived microorganisms were multiresistant to antibiotics. The most effective antibiotics against E. coli were laevomycetin and meropenem, against P. Aeruginosa – cefatidime. The majority of gram-positive coсci showed antibiotic sensitivity to amikacin and cefazolin. Antibiotic susceptibility analyze pointed on two ecovariants of P. aeruginosa formation in the Regional Perinatal Center. Derived data can be a key for the development of antibacterial therapy principles and antibiotic rotation in the medical institutions.

6

Authors: Smiyan S. I., Makhovska О.S., Zarudna О. I., Hrymalyuk N. V., Slaba U. S., Husak S. R., Zadorozhna L. V., Legka L. L., Lischyna L. І., Tsydulyak B. Y.

The article presents literature data based on the pleiotropic effects of non-steroidal anti-inflammatory drugs and demonstrated the results of their research on assessment of diclofenac, nimesulide and meloxicam on lipid metabolism, coagulation characteristics of blood, level of uric acid, liver function tests in patients with osteoarthritis, taking into account the presence of cardiovascular risk. It is shown that the most appropriate medication that could serve as a drug of choice in treating a specified group of patients is diclofenac-retard that has sufficient clinical effect and minor hypolipidemic and hypocoagulation action

7

Authors: Grabovyy S. L., Dyachenko A. G., Butenko V. N., Dyachenko P. A.

Epidemic of HIV-infection began in Sumy region in 1996. Rapid growth of morbidity appeared in the early ХХI century, so it increased up to 18.5 cases per 100 thousand population in 2010. Nowadays certain stabilization is pointed like, 14.7 cases per 100 thousand population with the growth rate – 12.7% in 2012. The widest HIV-infection prevalence is observed in Shostka, Romesky and Krolovetsky districts. This is cased by the high traffic network of these districts and closeness to deprived territories of the other regions. If majority of the infected was male in the epidemic beginning, so nowadays number of the new infected by gender is roughly equal. The number of children and persons of ripe years have dramatically increased (up to 27% and 31% respectively). During ten years HIV-infection transferred from infected drug addicts to general human population and these have cardinally turned the viral transmission of sexual and parenteral routes (51.8% and 18.2% respectively in 2012). The problem may occur because of the unregistered HIV-carriers accumulation.

9

Authors: Zadnipryany I. V., Sataieva T. P.

The problem of hypoxia for many years is very relevant and attracts the attention of physiologists and clinicians in terms of the mechanisms of various pathological conditions. Effects of antenatal hypoxia in the infants depend on the severity of exposure, individual tolerance and the age of fetus. In the literature, there is a large amount of data on the effect of antenatal hypoxia during last trimester of pregnancy on the development of the newborn. There is a reduction of oxygen supply to the parts of the body below required for adequate perfusion. At present researchers think about application of a number of regulatory peptides and their constellation to correct the consequences of shock states, including antenatal hypoxia. Cardioprotective effect is achieved due to sufficient energy supply, which helps to maintain normal cardiac contractility. Research and application of new antioxidant drugs in cardiology practice that can enhance the effectiveness of treatment of patients with myocardial infarction are highly relevant.