Medical perspectives (Medicni perspektivi)

4-9

Authors: Nefyodov O.O., MamchurV.I.

Multiple sclerosis (MS) is the most common demyelinating disease affecting mainly young people of the working age (16-45 years) and quickly leading to disability. Available data constitute that up to 80% of MS patients suffer from pain at different disease periods. Pain management and the analgesic drug choice in MS patients may be difficult. Anticonvulsant drugs possess an analgesic activity and are widely used in patients presenting painful neuropathic symptoms. Based on that, we aimed to investigate the nociceptive potential changes as well as the research-oriented behavior using the "open field" test in rat. An experimental animal equivalent of multiple sclerosis has been modeled, based on the methylprednisolone (M) administration. Animals were also administered anticonvulsants (carbamazepine, topiramate, sodium volproat, pregabalin and gabapentin). The study showed advantages of gabapentin and pregabalin use in simulated disease treatment. This statement is based on the "open field" test results, where the motor-oriented rats’ behavior was evaluated. Administration of M+gabapentin and M+pregabalin showed positive dynamics of the motor activity: the number of squares crossed increased by 80.86% (p<0.05) and 81.73% (ɪ<0.05) respectively. Maximum recovery of the research activity (peeking in "mink") was registered in animals administered M+pregabalin: the increase rate was 300% (r<0.05) comparing with the 12th day of experiment. It was shown, that 5-days administration of M+gabapentin and M+pregabalin caused muscle tone improvement by 190% (p<0.05) and 200% (p<0.05) respectively, comparing with animals with untreated multiple sclerosis. A significant increase of analgesic activity of M+pregabalin and M+gabapentin combinations used together with methylprednisolone by 4.1 (p<0.05) and 3.6 (p<0.05) times was registered comparing with the initial methylprednisolone background.

16-22

Authors: Pertseva Т.А., Mykhailychenko D.S.

Recently, much attention is devoted to systemic inflammation in patients with chronic obstructive pulmonary disease (COPD). The aim of our study was to determine the relationship between clinical and anthropometric data with systemic inflammation in stable COPD patients. According to the study CRP levels were raised in 44% of patients (7.9 [7,1-10,9). Serum CRP was significantly higher in stable COPD patients than in control subjects (p=0.04). CRP correlated well with the pack/years index(p = 0,032) and disease duration (p=0,01). It wasn’t established link between CRP levels and height, weight, stage, disease category. CRP level affected the frequency of exacerbations (r=0,50; p=0,01). Patients with high CRP level had significantly more exacerbations in the past year (p=0.01). Patients who received any type of therapy for a long period of time had lower CRP levels, than patients who did not reseive any therapy.

29-34

Authors: Urbanovych A.M.

To explore the relationship between leptin and resistin content in plasma and parameters of ambulatory blood pressure monitoring (ABPM) in patients with diabetes mellitus (DM) type 2 and arterial hypertension (AH) I and II degree and without hypertension. The study involved 137 patients with type 2 diabetes with hypertension I and II degree and without hypertension (72 women and 65 men). Patients with type 2 DM and AH were 1st group (n=51, mean age=53,32±0,77, BMI=32,14±0,78 kg/m2 ), and patients with type 2 DM without AH - 2nd group (n=86, mean age=52,79±0,69, BMI=30,31±0,62 kg/m2 ). Control group consisted of 32 practically healthy individuals, including 16 women and 16 men (mean age=51,00±0,97, BMI=30,77±1,17 kg/m2 ). The groups were comparable by age and BMI (P>0.05). All patients underwent clinical and laboratory examination and ABPM. The level of leptin in the blood plasma of patients in two groups and the control one was not statistically different (p>0.05). Instead, resistin content was the highest in patients with type 2 DM and AH, the lowest – in the control group (4,51±0,34 ȣ 2,64±0,20 ng/ml, p=0.0007); also differed significantly in the 1st and 2nd groups of patients (p=0.0009). The distribution of patients depending on the daily profile of AH (Dipper, Non-dipper, Night-peaker) found no significant changes in the contents of leptin in patients with type 2 DM with AH or without AH. Resistin level was significantly higher in all groups of patients with type 2 DM and AH with different types of daily profile as compared to the groups without AH (p<0.05). In the group of patients with type 2 DM and AH changes in levels of resistin differed significantly in non-dipper and night-peaker groups (p=0.01). Relationship between leptin levels in plasma and ABPM parameters in patients with type 2 diabetes were not set. Instead, resistin levels in blood plasma can be considered as a prognostic marker of cardiovascular disease, including hypertension, in patients with type 2 diabetes.

39-50

Authors: Shidlovs’ka T.A., Petruk L.G.

The incidence of acoustic trauma is growing in our country in connection with the situation in the east of Ukraine. Increased number of auditory system damage resulting from mine blast and other types of acoustic trauma, including those received in real combat conditions, makes the demand to provide quick and timely support to such patients. Also it is important to prevent the development of severe lesions and disability of acoustic analyzer. In this context it is important to study not only the state of various parts of the auditory system, but also the data of the organs and systems activity, that influence the auditory analyzer - extra-aural violations. The article presents the characteristics of auditory function of 59 patients with acoustic trauma who were in the ATO zone. Cerebral blood flow and brain activity was studied by methods of rheoencephalography (REG) and electroencephalography (EEG) with the help of a computer analyzing system «DX - system" (Ukraine). Researches have shown that patients with acoustic trauma who were in the ATO zone had pronounced violations in the bioelectrical brain activity and cerebral hemodynamics. Studies evidenced the presence of pronounced changes in the state of brain activity in the examined patients. According to the obtained data, all patients with acoustic trauma who were in the ATO zone had the cortical brain structures irritation, pronounced irritative biocurrent changes and disruption of basic EEG rhythms. In the surveyed patients there were identified processes of cortical rhythms desynchronization, their disorganization and tendency to zonal difference smoothness, percentage distortion of basic EEG rhythms as compared to the norm, reduction of the alpha-rhythm and growth slow of wave activity, especially in the front projections; is testifies to dysfunction primarily of stem-diencephalic brain structures. Diencephalic structures irritation was detected in 54,2%, stem-diencephalic - in 30,5% of cases. According to REG in the studied patients with acoustic trauma who were in the ATO zone, we found significant changes in cerebral blood flow. Along with difficulty of the venous outflow, increased cerebral vascular tonus, vasoconstriction phenomena typical to SHL, instability cases (47,5%) and decrease (42,4%) of cerebral vascular tonus, were revealed, this distinguishes this SHL type from other ones. The obtained data will be useful in the diagnosis and target treatment of patients with acoustic trauma because they takes into account extra-aural changes and help to improve therapeutic and preventive measures effectiveness. The results of this work demonstrate the advisability of the rheoencephalography and electroencephalography methods in examining patients with acoustic trauma who were in the ATO zone with the aim of further integration during the treatment. Usage of such survey results allows to prove targeted and timely treatment of patients with acoustic trauma and to provide its effectiveness. The findings deepen our knowledge about the role of cerebral circulation and brain activity in the development of sensoneural hearing impairment in acoustic trauma in real combat conditions.

57-61

Authors: Yaroshevskaya T.V., Sapa N.B., Kramarenko N.N., Degtyar S.P.

The article deals with the problem of antisecretory therapy in children with erosive gastric and duodenal lesions using proton pump inhibitors. Taking into account low potential of side effects and drug interactions, pantoprazole was used for antisecretory therapy. Administration of preparation in two doses, one of which is in the form of intravenous infusion, from the first day of patients’ hospital stay led to the rapid relief or significant reduction of pain. In 86% of patients pain was completely controlled by day 7 of hospital stay. More than 90% of patients during therapy showed improvement of appetite and general well-being, reduction of dyspeptic symptoms (nausea, vomiting, belching). The proposed scheme of pantoprazole administration showed high efficacy and safety in chronic erosive gastroduodenitis therapy in children with severe pain.

65-71

Authors: Pavlichenko P.P.

The purpose of the investigation was the analysis of the functional status of professional football players during the special functional testing procedure (shuttle test). We used different testing methods such as an ergometry, gas analyzing, pulsemetry, and biochemical blood lactate level measuring for checking up physical conditioning. The technique “PHAZAGRAF” was used for assessment of the functional status of players by measuring the ȕɌ -index of symmetry of T-wave in standard ECG and for testing of vegetative system tonus. We used mathematic methods for data processing. The test of physical readiness showed 11 players with high level capacity to aerobic work with the result of more than 885 seconds. Low result was fixed when the player`s run-time was less than 820 seconds.The findings showed that functional status failures are attendant with ȕɌ -increasing and lowering of total aerobic readiness. This is revealed in lowering of the maximum oxygen consumption that showed lowering of total aerobic capacity. There was also found that increasing of the standard deviation of ȕɌ -index could accompany lowering of the running time in the shuttle test. Therewith, vegetative tonus failures in the form of prevailing of sympathetic system activity are not obligatory followed with failures of special or total capacity to work.

80-90

Authors: Zagorodniuk K.Yu., Omelchuk S.T., Zagorodnyuk Yu.V., Vanat P.M., Nikulin M.I., Grinzovskyy A.M., Chyzhyk O.A.

At the modern stage of development humanity is on the verge of the pandemic of non-communicable diseases. It is not an exception for the population of the Ukraine, among which more than 2/3 of the total morbidity incidences is non-communicable diseases: desieses of cardiovascular system, cancer, chronic respiratory diseases, diabetes. To the mind of experts in the field of public health and environment protection, the first place among factors affecting the level of population’s health in Ukraine is given to the water that is ahead of air and food products in this aspect. Taking into consideration the fact that after annexation of the Crimea by the Russian Federation in March of 2014 and uncertainty in the military-political situation on the East of the Ukraine, Zaporizhzhya Priazovye is becoming a recreational zone, and with each year it will be used by more and more Ukrainian citizens. The objective of our research was to investigate nascent, stages of development and nowadays problems of region’s water supply as well as hygienic substantiation of complex ways of nowadays problem of Zaporizhzhya Priazovye water supply. As a result of conducted researches it was found that single economically feasible way of providing population of Zaporizhzhya Priazovye with water with normative total hardness and general mineralization is supply of the Dnipro water carried out by operation of Western group water conduit. To reduce the formation of chlorination by-products in the process of water purification it is necessary to use iron-containing chlorine-sulfate coagulant "Aula" of brand A according to the technical requirements TR U 24.1-33075701-002: 2011. For utilization of flush water of contact clarifiers, it is necessary to retool water purification facilities by clarifiersrecirculators with sediment recirculation in “inner contour”. It was proved that corrosive aggressiveness is an indicator of water quality which will determine further development of the group water conduits of Ukraine. At the same time it was established that stabilization and correction of water corrosive aggressiveness with chemical SeaQuest allows to supply normative quality water through extended water supply systems to the end consumers, to significantly slow down the process of senescence, particularly in pipelines and in tanks of clean water as well.

98-102

Authors: Fedorenko V.I., Biletska E.M., Panyshko Yu.M.

Academician Lev Ivanovych Medved’ (to his 110-th birthday)