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2.
Georgian Med News ; (295): 13-16, 2019 Oct.
Artículo en Ruso | MEDLINE | ID: mdl-31804191

RESUMEN

The aim of the study is to evaluate the effectiveness of transforaminal endoscopic microdiscectomy in patients with herniated intervertebral discs at the L3 - S1 level of the lumbar spine. A retrospective analysis of the treatment of 468 patients with hernias of intervertebral discs of the lumbar spine was conducted, of them: 262 patients were treated in the Rivne Regional Clinical Hospital; 206 patients in the spinal surgery department of the State Institution "Institute of Traumatology and Orthopedics of the National Academy Medical Sciences of Ukraine". The study was conducted in the period from April 2016 to January 2019. In the preoperative period, all patients underwent an MRI or CT scan - examination of the lumbar spine, functional radiographs, and general clinical examinations were performed. According to the results of studies in the postoperative period, a significant improvement in the quality of life of the operated patients was revealed in accordance with the Oswestry Disability Index (the average for the group was 35,9%, which corresponds to a good result). There was a positive dynamics of pain in VAS (in the preoperative period - 8,8 ± 0,7 points; 6 months after the operation - 1,2 ± 0,5 points, with a predominance of lumbodynia and with an almost complete absence of radicular syndrome). In 28 (6,0%) patients, a hernia recurred within 6 months, however, in the remaining 440 (94,1%) patients, positive results of neurological symptoms were observed in dynamics. The obtained results confirm the high efficiency of ETD and the low risk of postoperative complications.


Asunto(s)
Desplazamiento del Disco Intervertebral , Disco Intervertebral , Humanos , Desplazamiento del Disco Intervertebral/terapia , Calidad de Vida , Estudios Retrospectivos , Resultado del Tratamiento , Ucrania
3.
Georgian Med News ; (295): 20-24, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31804193

RESUMEN

Objective - The search of effective approaches to Peyronie's disease treatment remains an urgent problem. In this study we had evaluated the efficiency of platelet-rich plasma therapy, low-intensity shock wave therapy, local negative-pressure therapy. On a basis of Men's Health Clinic (Kyiv, Ukraine), 23 patients with PD (ICD-10: N48.6) aged from 29 to 47 (mean age of 37.1±4.8) were examined using a questionnaire International Index of Erectile Function, Visual Analogue Scale for pain, cavernous bodies ultrasonography and pharmacodopplerography. The assessment of the reliability of the differences in the mean and relative variables carried out by means of standard methods of variation statistics (assessment of the reliability of the differences in the mean and relative variables was carried out by means of standard methods of variation statistics - Student's t-test, chi-squared test). We identified that 44% of patients had more than 2 induration focuses. In general study cohort, we had found 55 focuses of different square size. After 6-month follow-up observation following combined treatment we had identified significant (p≤0.01) decrease in pain intensity during erection - from moderate to low. There was a significant (p≤0.05) improvement of erectile function, increase of satisfaction with sexual intercourse and overall sexual satisfaction. Significant (p≤0.05) decrease in the end-diastolic blood flow velocity was observed. According to the data of ultrasonic examination, morphological effects of combined therapy were presented as a noticeable regress of fibroplastic process, reduction in the fibroplastic induction focuses by square size and density, penile deviations of less than 30о decreased by 6-12о. Follow-up data had shown a sustained therapy effect for all patients in study cohort. The efficiency of platelet-rich plasma therapy, low-intensity shock wave therapy, local negative-pressure combination has been established as promising.


Asunto(s)
Induración Peniana , Humanos , Masculino , Erección Peniana , Induración Peniana/terapia , Pene , Reproducibilidad de los Resultados , Resultado del Tratamiento , Ucrania
4.
Georgian Med News ; (295): 51-56, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31804199

RESUMEN

The transabdominal elastography method requires estimation of liver and pancreatic structure in terms of its stiffness. Whether the results in children may be affected by anthropometric data is still the question. Objective. To evaluate the influence of obesity on liver and pancreatic stiffness parameters in children according to shear wave elastography data and to determine the major factors affecting the liver and pancreatic elasticity. This case-control study included 101 patients aged 6 to 17 years with an average age of patients (11,60±2,30) years. Determination of liver (LS) and pancreatic stiffness (PS) were carried out by shear wave elastography with SONEUS P7 system (Ultrasign, Ukraine- Switherland). Steatometry with the determination of the average ultrasound attenuation coefficient (aUAC) was performed with SONEUS P7 (Ultrasign, Ukraine-Switherland). According to the presence of obesity patients were divided into 2 groups: 1 group - 59 obese children, 2 group - 42 patients without obesity. Baseline descriptive variables included age, gender, body mass index, waist circumference (WC), laboratory data (general blood count and liver/pancreas function test, high density lipoproteins level). Insulin level was assessed by ELISA with calculation of HOMA1-IR. The average values of LS in obese and nonobese children were (4,98±0,83) kPa and (4,83±1,04) kPa, respectively, (p>0,05). Pancreatic stiffness also didn't differ between groups - (3,55±0,81) kPa and (3,60±0,448) kPa in 1st and 2d groups, respectively (p>0,05). LS positively correlated with body weight, WC, HOMA1-IR, aUAC (p<0,05). Also, we determined that liver aUAC had influence on liver stiffness (r=0,25, p<0,05) as well as pancreatic aUAC had influence on pancreatic stiffness (r=0,25, p<0,05). Obesity by itself did not affect the stiffness of the liver and pancreas according to the data of shear wave elastography. Pancreatic and liver stiffness showed association with metabolic changes. Steatometry can be useful tool for differentiation of fibrosis/inflammation and steatosis and so can improve specifity of elastography.


Asunto(s)
Diagnóstico por Imagen de Elasticidad , Hígado , Obesidad , Páncreas , Adolescente , Estudios de Casos y Controles , Niño , Humanos , Hígado/fisiopatología , Cirrosis Hepática , Obesidad/complicaciones , Páncreas/fisiopatología , Reproducibilidad de los Resultados , Ucrania
5.
Georgian Med News ; (295): 67-70, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31804202

RESUMEN

The article presents the results of a comparative analysis of the level of interleukins of children with Shigellosis in different periods of the disease depending on the presents of CMV-infection in patients. To achieve the goal, 63 children aged from three to eight years old with Shigellosis were examined, who were treated at the Regional Children's Infectious Clinical Hospital of Kharkiv, Ukraine. It has been established that the presence of CMV in patients with Shigellosis leads to the development of cytokine imbalance which persists until the period of early convalescence. In the acute period of Shigellosis in children with CMV infection, the level of IL-1ß significantly increases with unreliable fluctuations in the indices of TNF-α and IL-4. In children with Shigellosis without comorbidities, an increase in the level of all cytokines is recorded. In children with monoinfection to the period of convalescence, a significant dynamics of decrease in the levels of all interleukins was observed with their indicators approaching the physiological norm. In case of Shigellosis in children with CMV, the content of IL-1ß and IL-4 was still significantly high. Violation of the normalization of the cytokine profile of patients with Shigellosis on the background of CMV infection may be one of the leading factors in the torpid clinical recovery, the formation of an unfavorable course of the disease. In our opinion, these features of the cytokine response of patients must be considered during the period of rehabilitation and follow-up.


Asunto(s)
Citocinas , Infecciones por Citomegalovirus , Disentería Bacilar , Niño , Preescolar , Citocinas/metabolismo , Infecciones por Citomegalovirus/complicaciones , Infecciones por Citomegalovirus/inmunología , Disentería Bacilar/complicaciones , Disentería Bacilar/inmunología , Humanos , Interleucinas , Ucrania
6.
Georgian Med News ; (295): 171-177, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31804222

RESUMEN

In modern conditions, the use and protection of water is an extremely complex problem. The environmental situation of water resources is relevant for all water basins in Ukraine, since most of the surface and groundwater in Ukraine are polluted. The aim of the research was to study the regulatory normatively-legal base of sanitary, ecolocal, water and urban planning legislation in the field of sanitary protection of water objects and establishing its compliance with the requirements of the European Union Directives with the development of measures to resolve issues of concern. Ukraine's international obligations are enshrined in more than 40 global and regional international acts relating to the sanitary protection and use of water resources.The main requirements of the EU Directive (2008/56/EC, 98/83/EC, 2008/105/EC, 2003/35/EC, 2003/4/EC, 2001/42/EC, 2011/92/EC) are already taken into account new laws in force and domestic regulatory documents. However, the regulatory framework of the legislation of Ukraine in the field of sanitary protection of water objects needs to be improved in terms of focusing on new mechanisms of economic regulation, decentralization of power, the introduction of effective monitoring of the ecological status of the Black and Azov Seas, and the implementation of the requirements of the EU Directives: 2006/7/ЄС, 2007/60/ЄС 91/271/ЄЕС, 91/676/ЄЕС and Regulation No648/2004. In order to improve the sanitary-epidemiological state of water resources in Ukraine, their rational use and protection, it is proposed to carry out: an effective state and legal policy in the field of sanitary protection of waters, focused on: the effective implementation of water, environmental, urban planning legislation of Ukraine; optimal coordination of architectural and planning, water-ecological, sanitary-epidemiological aspects and social interests; priority of drinking water supply and water protection measures; implementation of international treaties with a view to the proper legal, sanitary and epidemiological regime of transboundary water objects; implementation of European standards for the quantitative and qualitative status of waters; the formation of an ecological, sanitary and epidemiological worldview among the population.


Asunto(s)
Agua Subterránea , Higiene , Contaminación del Agua , Unión Europea , Control Social Formal , Ucrania , Contaminación del Agua/prevención & control , Abastecimiento de Agua
7.
Wiad Lek ; 72(11 cz 1): 2069-2075, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31860848

RESUMEN

OBJECTIVE: Introduction: Bloodstream infections (BSIs) are associated with high morbidity and mortality worldwide. However data of BSI from Ukraine are scarce. The aim: To obtain the first national estimates of the current incidence of BSI and antimicrobial resistance of responsible pathogens, and associated mortality in Ukraine. PATIENTS AND METHODS: Materials and methods: A retrospective multicenter cohort study was conducted at the 14 hospitals of Ukraine between January 2013 to December 2015. Definitions of BSIs were adapted from the CDC. The identification and antimicrobial susceptibility of cultures were determined, using automated microbiology analyzer. Some antimicrobial susceptibility test used Kirby - Bauer antibiotic testing. RESULTS: Results: Among 20,544 patients, 3816 (18.6%) BSIs were observed. The rate of health care associated BSI was 92.4%. Death was reported in 68.4% BSI cases. The predominant pathogens were: Klebsiella pneumoniae (25.1%), Escherichia coli (17.5%), Staphylococcus aureus (9.9%), Pseudomonas aeruginosa (8.9%), and Acinetobacter spp.(8.5%). The overall proportion of extended spectrum beta-lactamase (ESBL) production among Enterobacteriaceae was 24.8% and of methicillin-resistance in S. aureus (MRSA) 38.2%. Vancomycin resistance was observwd in 9.2% of isolated enterococci (VRE). Carbapenem resistance was identified in 33.1% of P.aeruginosa isolates and 63.2% of A. baumannii isolates. Resistance to third-generation cephalosporins was observed in 14.2% K. pneumoniae and E.coli 55% isolates. CONCLUSION: Conclusions: Healthcare-associated BSIs and antimicrobial resistance of responsible pathogens together with their associated impact on mortality, presents a significant burden to the Ukraine hospital system. Surveillance of BSIs may help to delineate the requirements for infection prevention and control.


Asunto(s)
Bacteriemia , Infección Hospitalaria , Antibacterianos , Estudios de Cohortes , Farmacorresistencia Bacteriana , Humanos , Estudios Retrospectivos , Staphylococcus aureus , Ucrania
8.
Wiad Lek ; 72(11 cz 1): 2117-2120, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31860858

RESUMEN

OBJECTIVE: Introduction: According to the data of the national statistics, the disease of the musculoskeletal system among the teenagers takes the third place among the main types of diseases. So, we decided to analyze and study the connection between the idiopathic scoliosis of the spine and dentognathic anomalies in children aged 12-15 years old in Uzhhorod (Ukraine). The aim: To determine the characteristic violations of the dentognathic system in adolescents with idiopathic scoliosis of the spine, taking into account the anatomical type of lesion. PATIENTS AND METHODS: Materials and methods: 225 people were examined, including 190 girls and 35 boys. All patients were under the control of an orthopedic physician. RESULTS: Results: The most common type of scoliosis is found to be thoracolumbar, which is noted in 114 patients. As a result of analysis it was found that the most characteristic disorders of the dentognathic system in patients with thoracolumbar scoliosis were distal bite (80 ± 2.0%), sagittal gap (37.5 ± 2.1%), deep bite (22.5 ± 2.3%). In the group of healthy children, without scoliosis, the prevalence of dentognathic anomalies is 2.6 times lower than in patients with idiopathic adolescent scoliosis. CONCLUSION: Conclusions: Regardless of the localization of deformation in the spine under scoliosis, all the groups of patients are characterized by the following signs: sagittal gap, shortening of the upper dentition, distal bite, crowding of the teeth on the lower jaw.


Asunto(s)
Escoliosis , Adolescente , Niño , Femenino , Humanos , Masculino , Prevalencia , Columna Vertebral , Ucrania
9.
Wiad Lek ; 72(11 cz 1): 2128-2134, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31860860

RESUMEN

OBJECTIVE: Introduction: Urolithiasis is one of the most common urological pathologies, which has a significant socio-economic burden on the health care system. The aim: To develop patient pathways based on the current guidelines on urolithiasis, and to assess the effectiveness of kidney stone management within health care system of Ukraine. PATIENTS AND METHODS: Materials and methods: There were analyzed: national and international regulatory documents (12 units); 890 patient records (confirmed urolithiasis) in seven inpatient public health care facilities and private one in Ivano-Frankivsk region; 282 control cards of follow-up examination in seven public outpatient facilities in Ivano-Frankivsk region; 129 patient records in Truskavets health resort (residents of Ivano-Frankivsk region). Used methods: bibliosemantic, epidemiological, modeling, biostatistical, pharmaco-economical analysis and peer review. RESULTS: Results: It was established that national protocols on urgent and scheduled medical care for urolithiasis require renewal. Founded on world, national and personal experience, patient pathways were created as a sequence of outpatient and inpatient care for urolithiasis, which clarified the criteria for hospitalization, the scope and type of facility for delivery the necessary care, taking into consideration the peculiarities of the patient's medical state, the size and location of stone. It was shown that the lack of high-quality clinical protocols of medical care on urolithiasis leads to the irrational use of resources, especially in district health care facilities. CONCLUSION: Conclusion: The proposed patient pathways are an effective tool for assessment of effectiveness and identification the ways of improvement in management of medical care for patients with urolithiasis.


Asunto(s)
Cálculos Renales , Urolitiasis , Humanos , Ucrania
10.
Wiad Lek ; 72(11 cz 1): 2145-2148, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31860862

RESUMEN

OBJECTIVE: Introduction: During last year's, Ukraine and other European countries are facing outbreaks of well-known and emergency infections. Particularly alarming is the increase in the incidence of measles, which may be the result of a sharp decline of immunization that leads to the accumulation of susceptible individuals in the population. The aim was to assess the incidence of measles and the vaccination coverage for measles during last 5 years among children of Sumy region of Ukraine and factors due to which it is unable to be reached the required level of MMR-vaccination.. RESULTS: Review: Statistical data shown the vaccination coverage rates was dangerously low in Sumy region of Ukraine last 5 years. It began to decrease starting from 2013 year. measles vaccination coverage in 2013 was below 50%, reaching a staggering minimum of ~ 30 % in 2014 and 20 % in 2015. According to our research (questioning), the targeted vaccination coverage for measles was unable to be reached due to several factors, such as the active refusal of parents to vaccinate their children or partly the lack of sufficient vaccine supplies. CONCLUSION: Conclusions: MMR-vaccination uptake in Sumy Region is still below World Health Organization target. In the period 2014-2016, the level of children immunization was critically low and the concept of herd immunity was lost. This is the main reason for the ongoing measles outbreak in 2018. It is of the utmost importance that all medical professionals, physicians, researchers, educators, and governments of Ukraine unite to combat the anti-vaccination movement.


Asunto(s)
Sarampión , Niño , Brotes de Enfermedades , Europa (Continente) , Humanos , Sarampión/epidemiología , Vacuna Antisarampión , Ucrania , Vacunación
11.
Wiad Lek ; 72(11 cz 1): 2155-2160, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31860864

RESUMEN

This paper summarizes the scientific discussion on the issue of public-private partnership in healthcare sector. The main purpose of research is to analyze the public-private partnership as the progressive form of innovative and investment mechanism in Ukrainian healthcare sector, taking into the consideration international experience in this sphere. The key methods used in the conducted research are data analysis, summarization and comparison. The data synthesis and analysis are the basic value-added elements of this research, which could help to find out the main prospective of PPP-model use in Ukrainian healthcare sector. The object of research is the group of countries such as USA, UK, Canada, and BRIC countries, because namely they are the most progressive in public-private partnership in health care. Practical importance of the scientific research results lies in defining the general principles of public-private partnerships and a set of criterion for its efficiency estimation. Also, the worldwide experience was analyzed in this research and main challenges for its implementation in Ukrainian healthcare practice were considered. It is important for the further development of the healthcare sphere, and improvement of the healthcare facilities' activity in Ukraine. Further research directions are aimed at study of the specific issue of public-private partnership, such as circumstances for creating alliances between private and public actors from a strategy perspective, explore the impact of incentive mechanisms and risk management procedures on health service performance throughout the extended project life-cycle, and to create conducive environments to foster inter-project learning.


Asunto(s)
Prestación de Atención de Salud , Asociación entre el Sector Público-Privado , Estudios Prospectivos , Gestión de Riesgos , Ucrania
12.
Wiad Lek ; 72(11 cz 1): 2187-2191, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31860869

RESUMEN

OBJECTIVE: Introduction: In Ukraine, more than 2 million citizens need dermatovenerologic care each year. The incidence and prevalence rates of skin diseases and sexually-transmitted infections remain stable and the number of people with disabilities resulting from chronic skin conditions increases annually. Both in Ukraine and across the globe, there is an increasing demand for cosmetic care. Therefore, studying the current state of organizing dermatovenerologic care in the context of healthcare reforming in Ukraine with regard to the domestic and world experience is relevant. The aim: To examine the experience in organizing dermatovenerologic care in Ukraine and the developed countries.. PATIENTS AND METHODS: Materials and methods: We used the methods of systematic approach and system analysis of laws and regulations in Ukraine, the data from the websites of healthcare institutions, materials of sectoral statistical reporting and scientific sources on the subject. CONCLUSION: Conclusions: Given the domestic experience, the elements of world models of organizing dermatovenerologic care are used in Ukraine. However, the general practitioners' contribution to detecting skin diseases is negligible and the statutory regulation of dermatovenerologic and cosmetic care is obsolete. This requires taking measures at all governance levels in order to optimize dermatovenerologic and cosmetic care in Ukraine.


Asunto(s)
Prestación de Atención de Salud , Reforma de la Atención de Salud , Ucrania
13.
Pol J Microbiol ; 68(3): 295-302, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31880874

RESUMEN

The article presents data on serological studies of 573 sera samples of cattle that were collected from the farms affected by leptospirosis in different regions of Ukraine in the period of 2014-2015. Samples were investigated by the microscopic agglutination test (MAT), which was conducted within eight serological groups of Leptospira and nine serovars: Sejroe (serovars polonica and hardjo), Hebdomadis (serovar kabura), Tarassovi (serovar tarassovi), Pomona (serovar pomona), Grippotyphosa (serovar grippotyphosa), Canicola (serovar canicola), Icterohaemorrhagiae (serovar copenhageni), and Australis (serovar bratislava). The circulation of L. interrogans serovar hardjo among cattle has been observed in all 11 regions of Ukraine investigated within 25.8-60.0% of the leptospirosis-positive serum samples in these regions. Antibodies in the cattle sera against serovar hardjo (serogroup Sejroe) were detected in 139 of the 370 cows reacting positively in MAT. Overall, they were detected in 24.3% animals out of the total of 573 cows investigated. These are the preliminary results, however, in our opinion, they should allow to include the serovar hardjo in a standard panel of strains for MAT in Ukraine.The article presents data on serological studies of 573 sera samples of cattle that were collected from the farms affected by leptospirosis in different regions of Ukraine in the period of 2014­2015. Samples were investigated by the microscopic agglutination test (MAT), which was conducted within eight serological groups of Leptospira and nine serovars: Sejroe (serovars polonica and hardjo), Hebdomadis (serovar kabura), Tarassovi (serovar tarassovi), Pomona (serovar pomona), Grippotyphosa (serovar grippotyphosa), Canicola (serovar canicola), Icterohaemorrhagiae (serovar copenhageni), and Australis (serovar bratislava). The circulation of L. interrogans serovar hardjo among cattle has been observed in all 11 regions of Ukraine investigated within 25.8­60.0% of the leptospirosis-positive serum samples in these regions. Antibodies in the cattle sera against serovar hardjo (serogroup Sejroe) were detected in 139 of the 370 cows reacting positively in MAT. Overall, they were detected in 24.3% animals out of the total of 573 cows investigated. These are the preliminary results, however, in our opinion, they should allow to include the serovar hardjo in a standard panel of strains for MAT in Ukraine.


Asunto(s)
Anticuerpos Antibacterianos/sangre , Enfermedades de los Bovinos/sangre , Leptospira interrogans/inmunología , Leptospirosis/veterinaria , Pruebas de Aglutinación , Animales , Bovinos , Enfermedades de los Bovinos/microbiología , Femenino , Leptospira interrogans/clasificación , Leptospira interrogans/genética , Leptospira interrogans/aislamiento & purificación , Leptospirosis/sangre , Leptospirosis/microbiología , Masculino , Serogrupo , Ucrania
14.
Ann Agric Environ Med ; 26(4): 623-629, 2019 Dec 19.
Artículo en Inglés | MEDLINE | ID: mdl-31885237

RESUMEN

INTRODUCTION: Fluorine is a common element in nature; however, the difference between a beneficial dose and a toxic dose for the organisms is small. The main source of fluoride for humans is water in addition to food. OBJECTIVE: The aim of this study was to estimate the degree of severity of pathological changes, namely, caries or fluorosis, in the mineralized tooth tissue of 15-year-old adolescents with respect to their hygienic and nutritional habits, and the content of fluorine in drinking water, soil and plant products. MATERIAL AND METHODS: 100 adolescents aged 15 from schools in Sosnilka, L'viv region, were examined. The condition of mineralized tooth tissue was evaluated by the caries severity, expressed by the mean number D3MFT, caries frequency and value of the SIC index. Fluorine in plant material and soil were determined according to the PN-G-04543:1982 standard, and water according to the PN-EN ISO 10304 - 1: 2009+ AC: 2012 standard. RESULTS: Severity of caries disease expressed by the D3MFT number in the examined group of 15-year-olds was 3.39; in the group of girls - 3.08, and in the group of boys - 3.76. In the examined group, the average number of teeth with fluorosis was 7.59. Value of the SIC index among the examined population of students (n-31) was 6.26: 5.89 (n-18) for girls and 7.31 (n-13) for boys. Fluorine concentration in the water was 0.78 - 1.25(mg·dm-3). In the soil, it also did not vary across the sampled areas and amounted, on average, to 176 mg·dm-3. The biggest fluorine content noted in the dry mass of beetroots was 3.50 (mg F· kg), and the lowest - 3.34 (mg F· kg). CONCLUSIONS: Close to optimal fluorine content lowers caries severity and frequency of fluorosis. Optimal fluorine content in drinking water and food does not require additional diet supplementation.


Asunto(s)
Caries Dental/epidemiología , Agua Potable/análisis , Flúor/análisis , Fluorosis Dental/epidemiología , Adolescente , Calcificación Fisiológica , Caries Dental/etiología , Caries Dental/metabolismo , Higienistas Dentales , Agua Potable/metabolismo , Femenino , Flúor/efectos adversos , Flúor/metabolismo , Fluorosis Dental/etiología , Fluorosis Dental/metabolismo , Humanos , Masculino , Diente/fisiopatología , Ucrania/epidemiología
15.
Georgian Med News ; (294): 10-16, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31687941

RESUMEN

Aim - to evaluate pathogens and their susceptibility to antibiotic therapy (ABT) in combat-related penetrating craniocerebral gunshot wound (PCGW) patients and develop recommendations for treatment of post-traumatic meningoencephalitis. We conducted a prospective analysis of examination and treatment results of 121 patients who were admitted to the Public Institution, Mechnikov Dnipropetrovsk Regional Clinical Hospital, Dnipro, Ukraine, from 25 May 2014, to 31 December 2017, and were successively enrolled in the study. Intracranial purulent-septic complications were diagnosed in 14 (11.6%) patients including eight cases of isolated meningoencephalitis, three cases of meningoencephalitis combined with ventriculitis, two cases of meningoencephalitis combined with ventriculitis and subdural empyema and one case of multiple brain abscesses. In most cases of combat-related craniocerebral wounds, infections are considered nosocomial and typically related to medical procedures and devices. In most cases, the effectiveness of first-line antibiotics was low, and it was often necessary to prescribe broad-spectrum ABT, including those related to second-line antibiotics and reserve drugs, according to the World Health Organisation classification. The use of initial de-escalation of empiric ABT with the broadest-spectrum drugs, mainly as a part of combination therapy for expected gram-positive and gram-negative aerobic and anaerobic infection pathogens, is recommended.


Asunto(s)
Antibacterianos/uso terapéutico , Bacterias/efectos de los fármacos , Infecciones Bacterianas/complicaciones , Absceso Encefálico/tratamiento farmacológico , Traumatismos Craneocerebrales/complicaciones , Infección de la Herida Quirúrgica/complicaciones , Infección de Heridas/tratamiento farmacológico , Heridas Penetrantes/complicaciones , Adulto , Bacterias/clasificación , Bacterias/aislamiento & purificación , Absceso Encefálico/epidemiología , Absceso Encefálico/microbiología , Traumatismos Craneocerebrales/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Infección de la Herida Quirúrgica/tratamiento farmacológico , Infección de la Herida Quirúrgica/epidemiología , Infección de la Herida Quirúrgica/microbiología , Ucrania/epidemiología , Infección de Heridas/diagnóstico , Infección de Heridas/epidemiología , Infección de Heridas/microbiología
16.
Georgian Med News ; (294): 88-91, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31687956

RESUMEN

Plenty of studies demonstrated an association between a Vitamin D deficiency and several autoimmune disorders, such as diabetes mellitus, systemic lupus erythematosus (SLE), and rheumatoid arthritis (RA) in adult patients. This study was aimed to assess probable association between the 25-hydroxyvitamin D [25(OH)D] level and juvenile idiopathic arthritis (JIA) features and the possible relationship between serum vitamin D level and disease activity. 69 patients with JIA were examined and 15 healthy children were chosen as the control group. The mean age of patients was 10 years 8 months ±4 years 6 months (45 female, 24 male). 25 patients with oligoarthicular subtype of disease, 34 with poliarthicular sybtype and 10 patient with undifferentiated arthritis . The total duration of the disease was 4 years 1 month ± 1 year 1 month. Patients got methotrexate therapy (15mg/m2). Any of the patients were not treated by corticosteroids. The serum level of vitamin D was measured through blood test by chemiluminescence method. The relationship between the level of vitamin D and disease activity was analyzed based on juvenile arthritis disease activity score (JADAS27). The average level of vitamin D in serum was 22,69±7,8 ng/ml at the control group the vitamin D status was 28,67±5,06 ng/ml. In spite of the fact that a decrease in vitamin D status was observed in both groups, however in the group of healthy children it was significantly higher (p>0.05). Using the regression method, a significant relationship was established between the number of active joints and the age of patients, duration of disease, the level of vitamin D in serum, the number of injured joints, and disease activity (accordant to JADAS27 score) (number of active joints = - 1,144 + 0,005 x age of patients - 0,007x duration of disease + 0,292 x the number of injured joints + 0,033 x level of vitamin D + 0,077 x the number of points accordant to JADAS27). The monitoring of vitamin D level is advisable to carry out during observing the children with JIA. It can be useful for timely correction of vitamin D deficiency and preventions both skeleton and non-skeleton complications. That may improve the quality of life of patients and their families.


Asunto(s)
Artritis Juvenil , Deficiencia de Vitamina D/sangre , Adulto , Artritis Juvenil/sangre , Artritis Juvenil/complicaciones , Artritis Juvenil/epidemiología , Artritis Reumatoide , Estudios de Casos y Controles , Niño , Femenino , Humanos , Masculino , Calidad de Vida , Ucrania/epidemiología , Vitamina D/sangre , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/epidemiología
17.
Georgian Med News ; (294): 109-113, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31687960

RESUMEN

Malaria is a parasitic disease. It is one of blood infections caused by malaria plasmodia. The disease is transmitted to a human by a bite of a female mosquito of Anopheles genus. Local malaria transmission in Ukraine has not been registered since 1956, however, every year some imported cases occur. In 2017, 45 cases of malaria were imported to Ukraine: 80% of them were caused by P. falciparum. The aim of the research is to present a case of imported tropical malaria in a pregnant woman with the development of malaria coma. An unusual course of the illness made diagnoses difficult due to partial immunity of the patient caused by multiple previous invasions of malaria plasmodia. The diagnosis was confirmed by blood microscopy. A literature on epidemiology, clinical findings and current tropical malaria course has been scanned as well. In the presence of an appropriate epidemiological anamnesis, the patients with fever of unknown genesis should first of all be examined for malaria, the most socially significant tropical disease. It is necessary to define the type of malarial plasmodium by repeated blood parasitoscopy by a thick-blood film and blood smear coloured by Gimza-Romanovsky method. Doctors' vigilance against malaria allows preventing complicated forms and late relapses of this malignant invasion. The countries free of malaria can also face this problem and therefore they should be ready to diagnose and treat this disease effectively. The infectious diseases hospitals of Ukraine should be supplied with antimalarial drugs.


Asunto(s)
Coma/parasitología , Malaria/diagnóstico , Plasmodium/aislamiento & purificación , Animales , Antimaláricos/uso terapéutico , Coma/etiología , Femenino , Humanos , Malaria/tratamiento farmacológico , Embarazo , Mujeres Embarazadas , Viaje , Ucrania
18.
Georgian Med News ; (294): 141-145, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31687967

RESUMEN

General anesthesia may cause damage of the central nervous system and cognitive dysfunction in the postoperative period. A new intranasal form of Noopept (N-Phenylacetyl-L-prolylglycine ethyl ester) was developed by our team at the Department of the medical technology (Zaporizhzhia State Medical University, Ukraine). The objectives of this investigation were the study of neuroprotective action of Noopept and to prove using in the clinic for correction of amnestic and behavioral disorders after ketamine anesthesia. We discovered that the intranasal administration of noopept after ketamine anesthesia significantly decreases anxiety and excitability, raises the animal's activity, shows an intensive antiamnesic effects and increases animal's training ability. Noopept significantly exceeds piracetam and cerebrocurin according to neuroprotective effects.


Asunto(s)
Amnesia/tratamiento farmacológico , Ketamina/efectos adversos , Trastornos Mentales/tratamiento farmacológico , Fármacos Neuroprotectores/uso terapéutico , Amnesia/inducido químicamente , Anestesia , Anestesia General , Animales , Dipéptidos/uso terapéutico , Ketamina/administración & dosificación , Trastornos Mentales/inducido químicamente , Resultado del Tratamiento , Ucrania
19.
Georgian Med News ; (294): 156-165, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31687970

RESUMEN

The present article aims to provide a comprehensive review of the legal basis for and special features of indemnification for damages inflicted by maiming and other personal injuries including death, in particular, due to the doctor's treatment or the denial of medical care. The fulfilment of the aim involved critical analysis of civil legislation of Ukraine, with regard to indemnification for damages inflicted by maiming and other personal injuries including death. It also employs the legal framework governing out-of-court and in-court settlement of disputes with regard to inflicting personal injury to patients due to the provision of medical assistance or failure to provide medical assistance and some aspects of the assessment of damages to be awarded to the injured patient. In order to identify common trends relating to court decisions on damages in personal injury and wrongful death cases in the healthcare setting, 8 decisions made by domestic national courts of Ukraine as well as 17 decisions made by the European Court of Human Rights were considered. The present research employed the comparative legal research method, the integrated system-wide approach, the method of , the inductive method, the method of modelling , etc. Based on the conducted research, both out-of-court and in-court ways of the settlement of disputes with regard to inflicting personal injury to patients due to the provision of medical assistance or failure to provide medical assistance were identified as well as and some aspects of the assessment of the amount of compensation for damages to be awarded to the injured patient. The article provides a critical description of the reasons for liability of healthcare facilities or private doctors for causing maiming or other personal injuries including death to patients as well as the special features of this liability in criminal proceedings. It also outlines common tendencies of making decisions on personal injury cases involving the healthcare sector by the European Court of Human Rights. The article examines the role and special features of forensic medical examination as a sound basis for determining the fact of causing a personal injury.


Asunto(s)
Compensación y Reparación , Derechos Humanos , Legislación Médica , Responsabilidad Legal , Mala Praxis , Derechos del Paciente , Humanos , Ucrania
20.
Georgian Med News ; (294): 165-171, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31687971

RESUMEN

The article explores the issue of human rights protection in the field of health care by the Constitutional Court of Ukraine. The decisions of the Constitutional Court of Ukraine in the case of K. G. Ustimenko (1997), the case of paid medical services (1998), the case of free medical care (2002), the case of judicial control over the hospitalization of incapacitated persons into psychiatric institute are analyzed (2016), as well as the new legislation of Ukraine in the light of radical reform in the healthcare sector. Attention is drawn to the principle of friendly attitude to international law, constitutional complaint, legal positions of the Constitutional Court of Ukraine in the above-mentioned cases and the prospect of their application into the development of new legislation of Ukraine in the context of radical reform of the health care system of Ukraine. It is emphasized that the legal positions of the Constitutional Court of Ukraine, with regard of peculiarities of the national legislature, can serve as a source of inspiration for the courts of other countries. The purpose of the article is to specify the role and place of the Constitutional Court of Ukraine in the system of judicial protection of human and citizen rights, to determine the prospects of applying the legal positions of the Constitutional Court of Ukraine within the development of new legislation of Ukraine in the light of radical reform of the health care system. The object of the study is the social relations that arise during protection of human rights in the field of health care by the Constitutional Court of Ukraine. The methodological basis of the research are general and special methods of scientific knowledge (formal-logical method, comparative-legal, structural-logical). As a result of the conducted research, the role and place of the Constitutional Court of Ukraine in the system of judicial protection of human and citizen rights, the role of the decisions of the Constitutional Court of Ukraine in the case of K. G. Ustimenko, the case of paid medical services, the case of free medical care, the case of judicial control over hospitalization of incapacitated persons into psychiatric institution in the formation and development of domestic constitutional proceedings are defined. It is emphasized that the introduction of the constitutional complaint concept (institution) contributed to the improvement of the national mechanism of human rights protection in the field of health care. Conflicts of constitutional regulation of the human right to free medical care have been identified, and proposals have been worked out regarding possible ways and methods to eliminate them.


Asunto(s)
Prestación de Atención de Salud/legislación & jurisprudencia , Derechos Humanos , Derechos del Paciente , Instituciones de Salud , Hospitalización , Humanos , Ucrania
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