ScienceRise: Medical Science

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ISSN / EISSN : 2519-478X / 2519-4798
Published by: Private Company Technology Center (10.15587)
Total articles ≅ 421
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Olga Dubenko, Victoria Anysienkova
ScienceRise: Medical Science pp 16-21; https://doi.org/10.15587/2519-4798.2021.241147

Abstract:
The aim of this study is to evaluate serum level biomarkers of atherosclerosis lipoprotein-associated phospholipase A2 and E-selectin in patients with atherosclerotic carotid stenosis with different clinical manifestation in associated with vascular risk factors. Materials and methods: A total 106 patients with atherosclerotic carotid stenosis (74 men and 32 women, aged from 31 to 74 years, mean 62.6±0.9) were included: with acute ipsilateral atherothrombotic stroke (35), history of stroke and carotid endarterectomy (41) and 30 patients with asymptomatic carotid stenosis. The control group consist of 20 health subjects without cardiovascular disease. All participants underwent duplex sonography. Lipoprotein-associated phospholipase A2 and E-selectin was measured using commercially available (ELISA) kit. Results: The level of lipoprotein-associated phospholipase A2 was in general 55.664±3.537 ng/ml, which was significantly higher (M-W U=10, p=1.023136´10-11 70 % was greater in this group. The level of E-selectin in the study patients was significantly higher (7.653±0.246 pg/ml) than in the control group (3.101±0.503 pg/ml) p<0.05. No association the serum level of lipoprotein-associated phospholipase A2 and E-selectin with common stroke risk factor such as hypercholesterinemia, smoking and body mass index were found, but positive correlation of lipoprotein-associated phospholipase A2 with E-selectin was significant (p=0.00085). Conclusions: Increasing plasma level lipoprotein-associated phospholipase A2 and E-selectin in patients with the carotid atherosclerotic stenosis were observe. Statistically significant correlation between the level of lipoprotein-associated phospholipase A2 and E-selectin were found in symptomatic carotid atherosclerotic stenosis
Marine Georgiyants, Volodymyr Korsunov, , Oleg Loskutov, Nataliia Bohuslavska, Vadim Nikonov, Lidiya Cherkashyna, Oleksiy Oparin, Pavel Nartov, Maksym Holianishchev
ScienceRise: Medical Science pp 4-9; https://doi.org/10.15587/2519-4798.2021.241456

Abstract:
The aim of the research. The aim of this work was to summarize the scientific literature data on the pathogenesis and intensive care of the severe course of coronavirus infection. Materials and methods. Databases such as PubMed, Google Scholar, Scopus and Web Of Science 2020-2021 were used for literary searches. Results. An intense inflammatory response against the SARS-CoV-2 virus in COVID-19 patients causes a cytokine storm and hypercoagulability with the development of acute respiratory distress syndrome (ARDS) and multiple organ failure. Approximately 17 % to 35 % of hospitalized patients with COVID-19 are treated in the intensive care unit, most often due to hypoxemic respiratory failure and the development of ARDS, and between 29 % and 91 % of patients in intensive care units require invasive ventilation. In addition to acute respiratory failure, hospitalized patients may have acute renal failure (9 %), liver dysfunction (19 %), coagulation disorders (10 %–25 %), and septic shock (6 %). More than 75 % of hospitalized patients require additional oxygen therapy. Respiratory support could vary from the need for oxygen supplementation through a nasal catheter to invasive ventilation or extracorporeal membrane oxygenation in patients with the most severe ARDS. The uncontrolled inflammation and coagulation seen in COVID-19 patients is similar to multifactorial ARDS, where a plethora of evidence has demonstrated the ability of long-term corticosteroid therapy (CST) to reduce inflammation-coagulation-fibroproliferation and accelerate recovery. With regard to the assessment of the benefits of therapeutic anticoagulation in patients with elevated D-dimer, the question has not yet been finally resolved, and research devoted to this is still ongoing. Conclusions. The approaches to respiratory, anticoagulant, anti-inflammatory therapy in critically ill patients with COVID-19 require further research to determine the optimal treatment tactics
Vita Skoryk
ScienceRise: Medical Science pp 22-27; https://doi.org/10.15587/2519-4798.2021.241013

Abstract:
The aim of the study. To compare the effectiveness of methylprednisolone, dexamethasone and tocilizumab in patients with severe coronavirus disease. Identify the most appropriate treatment option. Materials and methods. Patients of group 1 (n=20) received for anti-inflammatory purposes tocilizumab at a dose of 600–800 mg. Patients in group 2 (n=82) received pulse therapy with methylprednisolone. Patients in group 3 (n=20) received dexamethasone 6 mg / day. Data are presented as M [25–75]. Statistical analysis of the results was performed using the program "Statistica 10". Significance of differences in indicators was assessed using the nonparametric Wilcoxon test. The results were considered reliable at values of p 0.05). The level of IL-6 in group 1 was 61.8 pg / ml, in group 2 – 64.6 pg / ml, and in group 3 – 46.5 pg / ml without significant differences between groups (p> 0.05). The level of ferritin in all groups exceeded normal values. Conclusions The most favourable result was obtained when using methylprednisolone: it was possible to reduce the mortality rate to 59.8 %. The relative risk of developing VTE was significantly higher in groups 1 and 3 (RR12 6.8 [2.7–16.8] p12 <0.0001, RR23 0.15 [0.06–0.35] p23 <0.0001), which gives grounds to confirm the presence of anticoagulant activity in methylprednisolone
Viktoriia Olkhovska, Zalina Yeloyeva, Yevhen Olkhovskyi
ScienceRise: Medical Science pp 28-31; https://doi.org/10.15587/2519-4798.2021.240151

Abstract:
The aim of the work was to study the characteristics of the response of non-specific protective factors in tonsillitis of streptococcal etiology in children infected and uninfected with HHV-6 infection at different periods of the disease. Materials and research methods. In 78 children aged 3–15 years, inflammation markers and phagocytic activity of peripheral blood neutrophils (PAN) were determined using the nitroblue tetrazolium reduction test. The studies were carried out in the acute period and in the period of convalescence. Mathematical and statistical processing of the data obtained was carried out using Microsoft Excel 2003 and Statistica 6.0 programs. The significance of differences between the mean values was determined using the Student's test (t). Results. It was found that infection of children with HHV-6 leads to a decrease in the functional activity of neutrophils in the onset of streptococcal tonsillitis compared with uninfected patients (p<0.05). Also, the acute period of streptococcal tonsillitis in patients with co-infection is accompanied by a violation of the functional reserve of the oxygen-dependent mechanism of bactericidal neutrophils: minimal opportunities were found in tonsillitis on the background of HHV-6 infection (p<0.05). By the period of convalescence, a decrease in the indicators of the functional activity of neutrophils, increased in the acute period, was recorded, but in children infected with HHV-6, a complete recovery of indicators to the physiological norm did not occur. One of the features of streptococcal tonsillitis in children with HHV-6 infection is an increase in serum gamma globulin level (p˂0.05), lack of significant dynamics of decrease in the ASL-O indicator. Conclusions. The presence of VHL-6t infection in a child with streptococcal tonsillitis adversely affects the state of nonspecific protective factors, in particular PAN. The obtained data must be used to optimize the management of patients at different periods of the disease, including at the stages of dispensary observation
Vira Tseluyko, Tetyana Pylova
ScienceRise: Medical Science pp 10-15; https://doi.org/10.15587/2519-4798.2021.241534

Abstract:
The aim of the study to evaluate the effect of supplementation of basic therapy by ranolazine in patients with INOCA on exercise test parameters and Holter ECG monitoring. Materials and methods. 53 patients with stable coronary heart disease were examined, including 18 men (33.9 %) and 35 (66 %) women, the average age of patients was 57 (±9.68) years. According to the results of coronary angiography all patients had non-obstructive coronary arteries. In addition to physical and laboratory examination, bicycle ergometry, Holter ECG monitoring and echocardiography were included in the examination of patients. Patients were divided into 2 groups: group I - patients who in addition to standard therapy received ranolazine at a dose of 1000 mg twice a day for 6 months, and group II patients with standard coronary heart disease therapy. After 6 months from the beginning of the observation an objective examination, echocardiography, exercise test, Holter ECG monitoring were repeated. Results. The study found that patients receiving ranolazine in addition to standard therapy had a statistically significant increase in exercise duration after 6 months compared with baseline and group II. Before treatment in group I, the duration of the exercise test was 356.51±180.24s, and after treatment 414.32±142.10s (p=0.03). In group II, the duration of the test before treatment was 361.4±160.24 c, and after 380.5±152.2 s (p=0.15). It was also found that the duration of the test differed significantly in group I after treatment of patients from group II after treatment of patients with a standard treatment regimen (p=0.04). According to the results of Holter ECG monitoring in group I found a positive effect of ranolazine on the frequency of ventricular arrhythmias: before treatment n=1142 [30; 2012], after treatment n=729 [23; 1420], while in group II a significant difference between the number of extrasystoles before treatment and after not detected (n=1026 [17; 1920], n=985 [15; 1680], respectively) p=0.18. Conclusions. The addition of ranolazine to the basic therapy of patients with non-obstructive coronary arteries disease helps to increase exercise tolerance (according to the loading stress test) and contributes to a significant reduction in the number of ventricular arrhythmias (according to Holter-ECG) compared with both baseline and group II
Iuliia Lozova, , , Tatiana Pochuеva
ScienceRise: Medical Science pp 32-40; https://doi.org/10.15587/2519-4798.2021.241951

Abstract:
Otitis media is one of the most common infectious diseases of the middle ear in preschool age, but its relationship with vestibular dysfunction remains controversial. The aim of the study was to carry out a comparative analysis of stabilometric indicators of preschool children with suppurative and non-suppurative otitis media. Materials and methods: 22 children with suppurative otitis media and 22 children with non-suppurative otitis media at the age from 4 to 7 years were examined by the method of static stabilometry on the device “MPFI Stabilograph 1” (LLC "ASTER IT", Kharkov, Ukraine). We took into account the indices of variation and distribution of the center of pressure, spectral and correlation indices of the stabilogram, as well as integral indices of stability (length, velocity and angle of postural oscillations) and the quality of the balance function in two sensory states (open and closed eyes), which were calculated in the software providing StabiliS. Results. In children with non-suppurative otitis media, the coordinates of the center-of-pressure corresponded (7.04 [2.16–10.09]; -1.14 [-28.90–9.11]), and with suppurative otitis media – (7.04 [3.30–16.16]; -13.72 [(-25.17)–(-10.30)]) with closed eyes. The averaged figure of the projection of the center-of-pressure in the test with eyes closed is actually represented by a circle in both groups, but with open eyes it is represented by an ellipse, which, in case of non-suppurative otitis media, is stretched along the sagittal axis, and in case of suppurative otitis media, along the frontal axis. In both sensory states, children with non-suppurative otitis media were characterized by large (p≤0.05) values of KurtosisX, Length and lower (p≤0.05) values of CC0X, Pup2Sigma compared with non-purulent otitis media. Conclusions: In preschool age, suppurative otitis media more significantly disrupts the balance function compared with non-suppurative otitis media, which was manifested by a significant decrease in the stability of the main stance and the predictability of oscillatory movements compared with non-suppurative otitis media
Amit Mittal, Manoj Kumar Singh, Rajeev Kumar, Deepti Mandsorwale
ScienceRise: Medical Science pp 48-51; https://doi.org/10.15587/2519-4798.2021.238014

Abstract:
Coronavirus disease 2019 (abbreviated “COVID-19”) is an emerging respiratory disease that is caused by a novel coronavirus and was first detected in December 2019 in Wuhan, China. The cases of COVID-19 infection since then were showing increasing trend in all over the world. The aim: to study the epidemiological distribution and determinants of COVID-19 pandemic. Methods: it is a descriptive study carried out at a tertiary care hospital of India. The population comprised of patients admitted in the hospital. Sample size comprised of all the subjects admitted in the hospital with established COVID 19 +ve cases. The duration of study was April 2020 to June 2020. The study was approved by the Institutional Ethical committee and Informed consent was obtained from each subject before the conduct of the study. Data collection was done by a pre-structured questionnaire. Data entry and analysis was done using SPSS version 20 software. Results: out of total 38 COVID-19 +ve cases, 95 % were male and 5 % female ant the maximum numbers of cases ranges between 36–40 years of age group with the median age of 32 years.53 % of cases were Muslim and 47 % Hindu by religion. The median duration of stay in hospital of all COVID-19 +ve cases was11 day that on further differentiation with co-morbidity was 15 days and 11.5 without any co-morbidity. The median duration taken between 1st sample taken and report provided was 2 days, between 2nd sample taken and report provided 1 day and between 1st and 2nd sample taken was 11 days. Conclusions: present study concluded that middle age persons were affected in majority which may be due to more exposure to public places. Co-morbidities are strong predictors of requirement for admission and duration of stay at hospital
Mariia Ievtushenko, Olena Koshova, Svitlana Kryzhna
ScienceRise: Medical Science pp 41-47; https://doi.org/10.15587/2519-4798.2021.241983

Abstract:
The aim of the research: to experimentally study at the histological and morphological level the degree of the corrective effect of bacterial lysate of the disturbed non-specific defense of the body on the model of periodontitis based on the Central Research Laboratory of the National University of Pharmacy. Materials and methods: prospective study has been conducted on experimental periodontitis in 42 rats for 90 days. The animals were treated with «Respibron» and the reference drug «Imudon». Histological and morphometric studies were carried out according to standard methods. Micropreparations were viewed under a Granum DCM 310 digital video camera. All interventions and euthanasia of animals were carried out in compliance with the European principles. Results: by the end of 90 days of experimental periodontitis at the local level in the homogenate of animal gum tissue compensatory mechanisms are depleted and differed from the norm by 397 times. The dynamics of the studied morphometric and histological parameters of "Respibron" was similar to the "Imudon", but the magnitude of destruction was less pronounced and differed at the end of the experiment by 17.2 times in comparison with the intact control, and in the control group the results improved by 23.1 times. Conclusion: the obtained data from the study indicate a high decompensation of experimental periodontitis. It is characterized by the formation of periodontal pockets and inflammatory bone loss. The magnitude of destruction differed from the norm by 397 times. Applying of bacterial lysates led to the compensation of bacterial dysbiosis, restoration of the tissues of paradont. The therapeutic effect of "Respibron" can be assessed as more powerful in comparison with "Imudon" in terms of the studied morphometric and histological parameters: the magnitude of improvement "Respibron" was 3.72 times higher than the indicators of "Imudon". We should continue the study of experimental periodontitis as mechanisms of development, protection, and restoration of tissues under conditions of pharmacological correction by bacterial lysate "Respibron"
Nataliya Moyseyenko
ScienceRise: Medical Science pp 35-40; https://doi.org/10.15587/2519-4798.2021.237821

Abstract:
Optic neuropathy is a group of diseases of the optic nerve. Using diagnostic techniques such as ophthalmoscopy and perimetry diagnosis are insufficient, as the found abnormalities are not specific for either inflammation or ischemia. Establishing the predominant factor in the pathogenesis of neuropathy is crucial in determining the method of treatment. The aim of the study: to investigate the features of optic nerve damage using optical coherent tomography (OCT) in optic neuropathy in the acute period. Materials and methods: two patients with visual impairment were examined. Result. Patient G. had concomitant rheumatoid arthritis with unregulated Methotrexate therapy. OCT revealed edema of the nerve fibre layer convinced of the predominance of inflammatory neuropathy (atypical neuritis). Pulse therapy with corticosteroids was prescribed, which gave a positive functional effect. A patient O. with pneumonia on the background of Covid-19 with a history of OST showed a decrease in the thickness of the layer of nerve fibres in the lower segment, and in the angio mode – drusen of the optic disc. Conclusions. Thus, the use of OCT for the diagnosis of optic neuropathies in the acute period showed that under conditions of inflammatory lesions is more characteristic of edema and an increase in the thickness of the layer of nerve fibres. In ischemic neuropathy, on the contrary, a decrease in the thickness of nerve fibres is more characteristic, which correlates in location with the localization of scotoma in the field of view. Therefore, the use of OCT of the optic nerve will help in understanding the pathogenesis of forms of optic neuropathy. This will help in the choice of treatment tactics
Yevheniia Lukianets
ScienceRise: Medical Science pp 17-21; https://doi.org/10.15587/2519-4798.2021.238027

Abstract:
Osteoporosis is the fourth most common disease after cardiovascular, cancer and endocrine diseases. With an increase in life expectancy, it becomes one of the main causes of deterioration in health and an increase in mortality. The aim of the study. To identify women with low bone density using ultrasound densitometry and assess the risk of osteoporotic fractures. Materials and methods. The study was based on a survey of 31 women in the Odessa region, the average age of the subjects was 57±9.1 years, the average body weight was 75.74±12.5 kg, height 162.8±0.1 cm, the average BMI was 28.57±4.5. All women were divided into groups by age with a ten-year interval and by densitometry indices. Results. Decrease in bone density was found in 51.6 % of examined women. The lowest BMD was in the age group of 70–79 years, and the largest numbers of respondents with osteopenic changes were at the age of 50–59. A linear correlation was found between BMD and age at the level of significance p=0.007. The linear regression equation is: t=-0.03968 *age+1.268, (r=-0.473). In women with osteopenia, a significant increase in indicators was found for almost all algorithms for assessing the 10-year risk of fractures at p<0.05 (except for FRAX Hiр without BMD (p=0.087)) and a significant decrease in ultrasound densitometry indicators compared with women with normal BMD. Women with fractures had significantly higher scores according to the FRAX Total algorithms without BMD (p=0.002), FRAX Hiр without BMD (p=0.004) and Q-fracture Hiр (p=0.044). Conclusions. Most women had osteopenic manifestations according to ultrasound densitometry. Age significantly correlates with BMD parameters. The numbers of women with changes in the structure of bone tissue increases with age, and, after 70 years, all women have osteopenic manifestations. The algorithms for assessing the 10-year risk of fractures FRAX and Q-Fracture reliably correlate with densitometry indicators. The combination of ultrasound densitometry with algorithms for assessing the risk of osteoporotic fractures significantly increases the diagnosis of osteoporosis
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