International Journal of Medicine and Medical Research

4

Authors: N. Vasylieva, Yu. Kravchuk

Background. Ternopil region is endemic on leptospirosis. Its natural conditions (slightly alkaline or alkaline soils, air temperature, sufficient rainfall) contribute to the existence of major natural reservoir of the pathogen–mouse-like rodents. In the region, different serovariants of leptospira are exuded by rodents and farm animals. Objective. The materials of the Department of Highly Infectious Diseases of Ternopil Regional Laboratory Centre of the State Sanitation and Epidemiological Service of Ukraine, Ternopil Regional Laboratory of Veterinary Medicine, Clinic of Infectious Diseases of TSMU were studied. Leptospiras were detected by dark ground microscopy (DFM) of blood of patients, trapped rodents and examined farm animals. Results. The circulating of pathogens between different sources (rodents, animals) and annual disease incidence evidences that new leptospira serovar are carried onto endemic area mostly by farm animals; humans are infected from them through the environment sometimes in 3-5 years intervals; the further diffusion to the new areas of this pathogen serovars in all kinds of the examined mouse-like rodents is noticed. It is established that farm animals and rodents are competing reservoirs. To predict the future epidemiological situation of leptospirosis among the humans and to improve its diagnosis the constant monitoring of the population, infection and leptospira carriage among mouse-like rodent and farm animals and expanding of the panel of diagnostic leptospira strains including new pathogen variants in animals is necessary. Conclusions. The development of additional reservoirs in animals, with circulating of other pathogen serovars among them, such as mouse-like rodents, which were previously absent in the main natural reservoir, cause the change of etiological structure in human leptospirosis at the endemic areas. The range of human leptospirosis pathogens and its further spreading among all kinds of rodents increased during our research. The results of detection of leptospirosis pathogens among the various contingents which were studied evidence that the farm animals and rodents are competing reservoirs that cause human infection through environment.

4

Authors: S. Heryak, N. Petrenko, I. Kuziv, O. Stelmakh, N. Bagniy, I. Korda, V. Dobryanska, L. Bagniy

Background. Currently, miscarriage is considered to be a multietiological disorder with trombofilic violations and hormone deficiency as the leading factors. Despite the achievements in treatment of miscarriage, the frequency of preterm termination of the wanted pregnancies is still high and the number of perinatal losses is significant. Therefore, pathogenetically based therapy, safe for the foetus, is very important in management of pregnancy interruption in the first trimester. A proper drugs administration provides optimal concentration of active ingredients and fast action. The aim is to improve effectiveness of the early threatened abortion treatment in cases of subchorionic hematoma (SCH) by combination of sublingual natural micronized progesterone and tranexamic acid Objective. We examined 50 pregnant women with early threatened abortion with SCH. We studied system of haemostasis, basic hormonal markers and ultrasound criteria of threatened abortion. We compared efficacy of treatment between traditional (supportive) therapy (sedation, spasmolytic, haemostatic drug) and combination of supportive therapy in combination with tranexamic acid and natural micronized progesterone. Results. The result of lab tests showed minimal signs of hypercoagulation, hyperfibrinogenemia and platelet hyperactivity, a significant β-hCG level decrease and approximate decrease in progesterone and free estriol production. Sonographic examination showed presents of local myometrial hypertonus, deformation of fertilized egg, hypoplasia of chorion, low location of fertilized ovum, retarded growth of CRL.The research proved that combined administration of sublingual micronized progesterone and tranexamic acid for the treatment of threatened abortion with SCH has more significant positive effect for pregnancy maintenance due to clinical, biochemical, hormonal and ultrasound results if compared with the group which underwent supportive therapy. Conclusions. Complex application of natural micronized progesterone 100 mg three times a day sublingually and 500 mg of Tranexamic acid dissolved in 200 ml normal saline solution improves the dynamics of the main hormonal, haemostatic and ultrasound markers of abortion and significantly reduces reproductive losses. Tranexamic acid treatment proved a rapid and effective action on hematoma and absence of embryotoxical and сoagulopathyc influence. Tranexamic acid does not cause any significant disorders of hemostatic system. This is very important at the early gestation because of intravascular coagulation, physiological hypercoagulable condition during pregnancy that can cause microthrombosis and disrupt placentation. On the other hand, it is dangerous for the mother’s health because of the increased risk of thrombosis.

5

Authors: M. Marushchak, I. Krynytska, G. Gabor, O. Yaremchuk

Background. In contemporary life science research development most attention is paid to mechanisms of many human diseases that are associated with the violation in cell death. One of the main causes of cell thanatologic disregulation program is the changes in their production and activation of the biological effects of tumor alpha necrosis factor. Objective is to summarize current scientific data about role of activated oxygen and nitric metabolites in the system of lung pathogenetic injuries. Methods: analysis of the research data on mechanisms of lung injury. Results and conclusions. The topical issue of lung pathogenetic injury is to understand the signs and mechanisms responsible for regulation of free radical oxidation and antioxidant defense system, the role of pro- and anti-inflammatory molecules, the influence of active metabolites on the process of restoration and survival of the respiratory tract cells in cases of acute lung injury. The studies of this processes will help to obtain more knowledge on lung pathology.

5

Authors: M. Marushchak, I. Klishch, Yu. Bondarenko, L. Mazur

Background. Current data suggest systemic autoimmune activation in the pathogenesis of bronchopulmonary diseases. The imbalance in the system of pro- and anti-inflammatory cytokines is very important in immunopathogenesis. Objective. The aim of our research was to determine the caspase-3 rate in the dynamics of experimental acute lung injury and to study the relationship between their level and the number of cells carrying membrane binding TNF receptor type 1 to define the main mechanisms of cell death. Results. The analysis of the results of caspase-3 rate in lung homogenate showed that this cysteine proteinase was uniformly increasing in all experimental groups during simulating of ALI induced by administration of hydrochloric acid (p<0.001). When comparing the results of caspase course of apoptosis it was defined that, despite the progressive increase in caspase-3 rate in lung homogenate, cysteine proteinase rate in plasma did not change. The receptor mechanism of apoptosis was studied by establishing correlation relationships with the number of cells carrying membrane binding TNF type 1 (TNF-R1) receptor. A strong positive correlation relationship between the number of neutrophils with TNF-R1 and caspase-3 rate in lungs of all research groups was determined. Conclusions. The implementation of neutrophils death by apoptosis is caused by change of activity of caspase cascade effector components, such as caspase-3, in cases of ALI induced by intratracheal administration of hydrochloric acid. One of the potential mechanisms responsible for the activation of caspase course is excessive generation of active forms of oxygen and increase in the number of neutrophils carrying membrane binding TNF receptor type 1.

5

Authors: K. Baranski, J. Zejda

Background and objective. In Poland, the sale of antihypertensive drugs has significantly increased since 2000. According to that fact, the aim of our study was to determine if the increased use of antihypertensive drugs correlates with the decreasing mortality due to cardiovascular diseases (CVD) including hypertension (HT). Methods. The analysis is based on data on annual national sales (million units) of four types of antihypertensive drugs in 2000–2010. For the same period standardized mortality rates were calculated based on the data available from the Central Statistical Office in Poland. Data analysis involved correlation analysis between annual mortality rates due CVD and HT and country-wide annual sales of antihypertensive drugs (2000–2010). Results. In the period 2000–2010, standardized mortality rates of CVD in the whole population followed a decreasing trend. Analysis of correlation of CVD with specific drug provided the following findings: diuretics (r=-0.97; p<0.0001) beta-blockers (r=-1.0; p<0.0001) renin-angiotensin system (RAS) inhibitors (r=-0.72 p=0.01) calcium-channel blockers (r=-0.82; p=0.001) Standardized mortality rates for the HT showed fluctuating trend. Correlations of that mortality with global sale of these drugs were no longer negative: r=0.54; p=0.08, r=0.56; p=0.08 r=0.55; p=0.07; r=0.63; p=0.03, respectively. Conclusions. In Poland, in 2000–2010, an improved access to pharmacological control of HT was associated with an apparent reduction in mortality from CVD but not from HT. The latter findings might reflect imprecise definition of HT as a cause of death or the fact that HT leads to other cardiologic events usually reported as a cause of death.

7

Authors: N. Burmas, L. Fira, P. Lyhackyy

Background. Currently, the growing incidence of toxic lesions of the liver is associated with industrial chemicalization and uncontrolled use of hepatotoxic drugs in everyday life. There are about one thousand drugs with high or low hepatotoxicity, such as anti-TB drugs. Objective. In this research we studied the intracellular enzymes activity and bile formation function of the liver in rats of different ages in cases of tuberculostatic (isoniazid and rifampicin) affection and chromium (potassium dichromate) intoxication. Methods. The experimental affection of rats of different ages was performed by combined injection of hexavalent chromium compounds (a solution of potassium dichromate, 3 mg/kg), isoniazid (0.05 g/kg) and rifampicin (0.25 g/kg). On the 7th and 14th days the rats were injected with enterosorbent Sorbex (150 mg/kg). Enzyme markers activity of the liver was evaluated due to alanine and aspartate aminotransferases (ALT and AST) and alkaline phosphatase (ALP) rates. Bile formation function of the liver was evaluated by total bilirubin and bile acids content in blood. Results. The disorders in hepatocytes plasma membranes permeability were defined by the increased rates of ALT, AST and alkaline phosphatase in blood serum which were decreased in the liver. It was determined that total bilirubin and bile acids content in blood serum of the affected animals increased. It influenced hepatocytes excretion in bile capillaries and caused cholestasis and revenues decrease in bile. Conclusions. The most significant metabolic disorders in cases of chrome-isoniazid-rifampicin affection were defined in immature and senior animals in comparison with mature animals.