Lviv clinical bulletin最新文献

{"title":"The Relationships between the Problems with Somatic Health in Preschool Children and Disorders of Psychomotor Development","authors":"А. Pushnyk, S. Niankovskyy","doi":"10.25040/lkv2023.01.015","DOIUrl":"https://doi.org/10.25040/lkv2023.01.015","url":null,"abstract":"Introduction. Multiple studies show the presence of interconnection between co-morbidity and psychomotor development disorders in children. The aim of the study. To identify the relationships between the problems with somatic health in preschool children (3-7 years old) and disorders of their psychomotor development. Materials and methods. Clinical and laboratory examination of 70 children was carried out in a randomized manner with preliminary stratification according to the presence of psychomotor development disorders regarding the somatic and infectious diseases and birth defects they had at the time of the examination and in the anamnesis. The examined group consisted of 70 children of preschool age (3-7 years) with psychomotor development disorders. Statistical processing included calculations using R. E. Fisher’s angular transformation and correlation analysis. Results. The results of the multiple conducted researches prove that the frequency of comorbidities, primarily somatic, in children with psychomotor development disorders is higher than in the general population. The combined influence of adverse environmental conditions, perinatal factors, nutritional disorders, nutritional behavior, reduced motor activity, neuroinflammation, immune response disorders, abnormalities in the quantitative and qualitative species composition of the intestinal microbiota, the phenomenon of an abnormally high microbial load on the organism, violations of interaction in the brain-gut axis, autonomic and mitochondrial dysfunctions, oxidative stress, sensory hypersensitivity, behavioral problems, sleep disorders, increased anxiety and irritability inherent in this children, can be the main reason for this. It is also worth to mention the presence of atopy and dyspeptic manifestations in many examined children, which, presumably, can be components of the food allergy complex of symptoms. It is worth noting, that in most of the subgroups we selected, there were children with physical development disorders, in all subgroups cases of infectious diseases were found in the anamnesis of children, as well as burdened family and allergic anamnesis, which can be caused by both adverse environmental factors and peculiarities, inherent in children with psychomotor development disorders. Among somatic diseases, respiratory ailments dominate in all studied subgroups. There is also a significant share of children with a burdened family and allergy history, atopic dermatitis, lesions of the ears and throat. We found full dependence, as well as medium strength and weak direct reliable correlation between somatic and infectious diseases, present in a significant part of the examined children with psychomotor development disorders, burdened allergic anamnesis and burdened family anamnesis (which conforms with a higher susceptibility to allergic diseases in children with psychomotor development disorders, in particular with mental retardation and ASD) in all subgroups, and als","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127896791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Effectiveness of Myocardial Revascularization in Patients After the Transferred Syndrome (Literature Review with Own Research Results)","authors":"V. Denesyuk, O. Barska, O. Bilonko, N. Muzyka","doi":"10.25040/lkv2023.01.073","DOIUrl":"https://doi.org/10.25040/lkv2023.01.073","url":null,"abstract":"Introduction. Acute coronary syndrome (ACS) is an urgent problem in the world. The vast majority of publications indicate the effectiveness of myocardial revascularization in this pathology. However, the effectiveness of this method of treatment in the remote period of GIMeST has not been sufficiently studied. The aim of the study. Analyze the long-term effectiveness of myocardial revascularization in patients after ACS based on literature publications and own results of conducted research. Materials and methods. 42 sources of published literature were used and the results of our own research on increasing the clinical effectiveness of coronary artery stenting by combining it with medical treatment in patients with post-STEMI with cardiovascular events were presented. Results. It has been proven that the 30-month survival rate of a patient with a hemodynamically significant lesion of the coronary artery trunk with drug therapy was 6.4 %, and with CABG – 80.0 %. The best results of myocardial revascularization were observed with CA p-value more than 70.0 % stenosis. It was found that primary coronary intervention in comparison with thrombolytic therapy contributes to a more complete restoration of epicardial impact (III degree according to the TIMI scale). Successful endovascular recanalization of infarct-induced KA helps to limit the area of necrosis and restore the reduced inotropic function of the hibernating myocardium up to 2 hours after the start of ACS. In the later periods of restoration of anterograde blood flow, the beneficial effect is manifested within a year. On the basis of our own research, positive dynamics of improvement in late LV remodeling and reduction of cardiac arrhythmias (SHE, AF, LVPH, and HF) are observed in patients with post-GIMeST after medical treatment. Conclusions. On the basis of the cited literary sources and our own research, it should be noted that in patients who underwent STEMI with cardiovascular events compared to those without cardiovascular events and underwent myocardial revascularization and outpatient drug treatment for two years, there was an increase in LVEF by 12.6 %, respectively, and a decrease in angina attacks by 6.6 %, CHF III and II FC – by 11.9 %, reduces SHE, AF and BLPNH and improves the quality of life. However, mortality 2 years after myocardial revascularization compared with medical treatment did not change significantly, and according to the literature, it decreased after CABG.","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133396511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Criteria for Predicting Cardiovascular Events with Holter Electrocardiogram Monitoring (Literature Review and Results of own Research) in Patients with Heart Disease","authors":"V. Denesyuk, O. Barska, Y. Shushkovska","doi":"10.25040/lkv2023.01.059","DOIUrl":"https://doi.org/10.25040/lkv2023.01.059","url":null,"abstract":"Introduction. This review is devoted to the current state of knowledge regarding the clinical value of Holter electrocardiogram monitoring to identify predictors of predicting future adverse cardiovascular events. The aim of the study. Based on the study of modern sources and the results of own research, analyze scientific studies on the criteria for predicting cardiovascular events with Holter electrocardiogram monitoring in patients with heart disease. Materials and methods. 52 sources of literature and the results of own research were analyzed, in which the role of Holter electrocardiogram monitoring in predicting adverse cardiovascular events was highlighted. Results. The analysis of the literature and the results of our own research prove that the indisputable advantage of Holter electrocardiogram monitoring is the detection of prognostic and unfavorable indicators of the risk of sudden cardiac death, which, of course, is extremely important in modern society. Conclusions. The high informativeness of Holter electrocardiogram monitoring for predicting future adverse cardiovascular events has been proven and the criteria for their prediction have been clarified.","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115264433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Predicting Cardiovascular Events and Other Complications of the Blood Flow System in Patients with Acute Coronary Syndrome (Literature Review and Results of Own Research)","authors":"V. Denesyuk, O. Barska","doi":"10.25040/lkv2023.01.051","DOIUrl":"https://doi.org/10.25040/lkv2023.01.051","url":null,"abstract":"Introduction. More than 15 million cases of AMI are recorded annually in the world, and in Ukraine in 2017 – 41.786 cases. Undoubtedly, acute coronary syndrome (ACS) manifests various complications of blood flow. At the same time, in such patients, significantly fewer works are devoted to predictors of other complications of the cardiovascular system. The aim of the study. Write a literature review and include the results of own research on predictors of predicting cardiovascular events and other complications of the blood flow system in ACS. Materials and methods. We used 49 published articles and our own research results on the study of predictors of predicting cardiovascular events and other complications of the blood flow system after undergoing ACS. The results of our own research are presented in a complex algorithm for predicting SCD in cardiovascular pathology, and our own criteria for cardiovascular events are given. Results. It has been proven that an increase in the thickness of the LV wall in patients with hypertension can be associated with an almost 7-fold increase in the risk of death. In our opinion, LVH in STEMI in combination with hypertension has a negative impact on the development of cardiovascular events. The development of pathological remodeling of the LV leads to further dilatation, deformation of the walls and cavities of the heart, a progressive decrease in the inotropic function of the LV with the development of congestive heart failure. Some authors suggest prognostic predictors of the development of acute left ventricular failure. The prognostic role of endothelial dysfunction in cardiovascular events is poorly understood. Conclusions. In recent years, predictors of the development of cardiovascular events (death, non-fatal MI, stroke, UA), as well as such complications of the blood flow system as acute left ventricular failure, progression of heart failure, development of VE 3-5 grades according to Laun have been established in patients with a transferred STEMI and UA in recent years , severe heart blocks with the occurrence of syncopal states. According to our data, clinical, ECG, and echocardiographic diagnostic criteria are predictors of cardiovascular events. The specified predictors of cardiovascular events and various complications of the blood flow system after a STEMI and UA need to be taken into account by cardiologists, emergency physicians, and family physicians in their practice and to carry out therapeutic measures aimed at preventing their occurrence in patients.","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"110 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126162333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modern Principles of Treatment of Genital Herpes in Women (Literature; review; Results of Own Research)","authors":"L. Markin, O. Matvienko, O. Korytko","doi":"10.25040/lkv2023.01.036","DOIUrl":"https://doi.org/10.25040/lkv2023.01.036","url":null,"abstract":"Introduction. Recently, much attention has been paid to the problem of new approaches in the treatment of genital herpes in women. The problem is extremely important, because this genital infection is very common in the world. The main types of genital infection are herpes simplex virus (HSV-1) and (HSV-2). Worldwide, more than 400 million people have genital herpes caused by HSV-2. In the United States of America (USA), nearly one in five adults (approximately 40 million people) have HSV-2 infection, with approximately one million new infections occurring each year. The aim of the study. To analyze the modern principles of treatment of genital herpes in women, using literary sources and the results of own research. Materials and methods. In total, twelve publications by foreign authors were selected and processed based on their relevance to the chosen topic, and information on the effectiveness of the use of the antiviral agent “Virostat” in one’s own practice was provided. Results. To date, there are several strategies for the use of antiherpetic drugs (acyclovir, virostat (famciclovir), valacyclovir), which have been studied and tested in cases of first infection with genital herpes, episodic and suppressive cure. There are two important priorities for the treatment of genital herpes: the first is to prevent clinical manifestations and relapses, and the second is to prevent transmission to sexual partners. Our clinical experience allows us to recommend the use of the Ukrainian medicine “Virostat” (producer “Kyiv Vitamin Plant”) for the treatment of HSV infection in women with various clinical manifestations. Conclusions. To date, it should be noted that genital herpes remains a very common sexually transmitted disease. The increasing frequency of HSV-1 and HSV-2 is associated with recurrences of genital ulcer disease. HSV-2 plays a key role in the spread of HIV and, although rare, HSV-1 and HSV-2 lead to severe complications if contracted during pregnancy, both among mothers and newborns. A review of the literature on the treatment of sexually transmitted diseases as of 2021 found few significant advances in the treatment of genital herpes infections. The greater availability of nucleic acid amplification tests for the diagnosis of HSV in the presence of genital ulcers improves diagnosis in the acute phase, but serological tests lack diagnostic accuracy, so advances in the diagnostic algorithm as well as new diagnostic tools are needed. Although the symptoms of genital herpes can be controlled and transmission to sexual partners can be prevented with antiviral therapy, new treatments with new mechanisms of action will improve the well-being of patients. Considering our clinical experience of using the Ukrainian medicine “Virostat” for various clinical manifestations, we recommend its wide implementation and use.","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122299195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The difference of anxiety, depression and cortisol levels in patients with acute and chronic vertebrogenic lumbosacral pain syndrome","authors":"A. Payenok, A. Kulyk","doi":"10.25040/lkv2023.01.008","DOIUrl":"https://doi.org/10.25040/lkv2023.01.008","url":null,"abstract":"Introduction. Pain is classified as acute and chronic. Acute pain implies a painful condition with a rapid onset or of a short course, whereas chronic pain is referred to as a painful condition persisting beyond the normal time of healing. Chronic low back pain has also been correlated with stress-induced inflammation. Psychological distress aggravates pain symptoms and pain induces a stress response in the body by releasing cortisol from the adrenal cortex. The aim of the study. To investigate differences in levels of anxiety, depression, and cortisol blood concentration in patients with acute and chronic vertebral-sacral pain syndrome. Our main goal was to encrease our understanding of the development and persistence of acute and chronic back pain, define risk factors and improve treatment strategies for the patients. Materials and methods: We studied cortisol levels in blood plasma, levels of anxiety and depression in patients with back pain and LV-SI intravertebral disk herniation. The group under investigation included 125 patients, including 65 patients with acute, and 60 with chronic pain syndrome. A Visual Analogue Scale (VAS) was used to measure the patient`s pain assessment. Spielbergʼs anxiety test is designed to assess reactive and personal anxiety. Personal anxiety characterizes the degree of a person’s anxiety and emotional tension due to the action of stress factors in general. Reactive anxiety is a patient’s personal condition, which characterizes the degree of his anxiety, and emotional tension in response to the action of a stress factor. The Beck’s Depression Symptoms Questionnaire (BDSQ) includes 21 item, self-report rating inventory that measures characteristic attitudes and symptoms of depression. Results. We found no significant difference according to VAS between groups, at the time of hospitalization, patients in the acute pain group evaluated their pain as 7.15 ± 1.17 points, while in the chronic pain group it was estimated as 6.08 ± 0.96 points (p-value more than 0.05). The concentration of cortisol in blood plasma in the acute pain group patients was 313.3 ± 87.7 mmol/l, and in the chronic pain group – 450.7 ± 121.9 mmol/l, the difference between the groups was insignificant (p-value more than 0.05). The evaluation according to Spielbergʼs anxiety test demonstrated high anxiety levels at the time of examination: in the acute pain group reactive anxiety corresponded to 40.4 ± 12.6 points, in the chronic pain group the same index was 39.5 ± 11.3. Personal anxiety in the group of acute pain was 32.3 ± 13.6, in the group of chronic pain – 41.3 ± 9.7. According to Beck’s Depression Symptoms Questionnaire before the beginning of treatment average score in the acute pain group was estimated as 6.8 ± 1.1 points, while in the chronic pain group this index corresponded to 9.8 ± 0.8 points (probable difference between groups p-value less than 0.05). Comparisons of cortisol concentrations between groups of patients with different ","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121340273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peculiarities of Bone Mineral Density in Men with Ankylosing Spondylitis: Frequency and Nature of Disorders; Content in Blood Serum of Metabolic Indicators of Synthesis and Resorption of Bone Tissue, Vitamin D; Reliable Factors Involved in its Violations","authors":"O. Pavliuk, L. Marynych, L. Denishchich, I. Kuvikova, O. Shevchuk","doi":"10.25040/lkv2023.01.028","DOIUrl":"https://doi.org/10.25040/lkv2023.01.028","url":null,"abstract":"Introduction. Decreased bone mineral density (BMD) and the development of osteoporosis are common and poorly understood complications of ankylosing spondylitis (AS). Increased bone turnover and high inflammatory activity are important in the pathophysiology of AS-associated osteoporosis, and markers of bone remodeling are valuable markers for detecting bone loss The aim of the study. To find out the features of the BMD state in men with AS, based on establishing the frequency and nature of BMD violations, determining the content of metabolic indicators of bone tissue synthesis and resorption, vitamin D in blood serum, as well as identifying reliable factors involved in its violations. Materials and methods. The research group consisted of 83 men with AS, with an average age of 40.7 ± 0.8 years and a disease duration of 8.7 ± 0.5 years. Disease activity was determined by the BASDAI, ASDAS-CRB index. Laboratory examination included determination of C-reactive protein (CRP) and markers of bone tissue metabolism and vitamin D. BMD was measured using dual-energy X-ray absorptiometry Results. In men with AS, osteoporosis is found in 33.7 % of people, osteopenic syndrome in 28.9 % of patients, and normal indicators of BMD in 37.4 % of patients. We showed that low bone mass was closely related to the total indicators of the activity of the inflammatory process according to ASDAS, BASDAI and CRP content. In particular, in the group of patients with a very high degree of activity, the share of people with osteoporosis was equal to 78.6 %, and was 1.8 times higher than in the group of patients with moderate activity of AS. Similar patterns were observed for the BASDAI activity index and the pro-inflammatory marker CRP. In men with AS, the processes of bone resorption prevail over the processes of biosynthesis of bone tissue, as indicated by the preserved concentration of synthesis markers (OC, PINP) and the increase of the bone resorption marker (NTx) in blood serum. In addition, in the group of patients with osteoporosis, a high content of NTx was found in every second patient, and the average concentration was 39.0 % higher than in the group with preserved BMD. Loss of bone mass is closely related to a deficiency of vitamin D. Thus, in the group of patients with osteoporosis, in addition to probably low levels of vitamin D, a high proportion of people (57.2 %) with a severe deficiency was found, the insufficient level was in 43% and the optimal level equal to only 29.0 % of people. Conclusions. Patients with AS have a high frequency (62.6 %) of a decrease in BMD, while OP occurs in every third patient. Loss of bone mass depends on the activity of the inflammatory process, high levels of bone resorption markers and vitamin D deficiency.","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115224126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors and Criteria for Predicting Cardiovascular Events in Patients with Arterial Hypertension by Means of Ambulatory Blood Pressure Monitoring (Literature Review and Own Results Analysis)","authors":"V. Denesyuk, O. Barska, Y. Shushkovska, O. Bilonko","doi":"10.25040/lkv2023.01.066","DOIUrl":"https://doi.org/10.25040/lkv2023.01.066","url":null,"abstract":"Introduction. Studies on the clinical significance of ambulatory blood pressure monitoring in patients with arterial with hypertension as predictor of future adverse cardiovascular events are far from complete. The aim of the study. To analyze current literature database and own results in the evaluation of clinical significance of ambulatory blood pressure monitoring in patients with arterial hypertension as predictors and criteria for predicting adverse cardiovascular events. Materials and methods. As much as 56 sources of literature and results of own research evaluating clinical significance of ambulatory blood pressure monitoring in patients with arterial hypertension predicting adverse cardiovascular events was highlighted. Results. The analysis of available literature and results of our own research prove that ambulatory blood pressure monitoring is a powerful prognostic marker of target organ damage. It is the indisputable advantage of ambulatory blood pressure monitoring with regard to the detection of prognostic unfavorable cardiovascular events in patients with arterial hypertension. Conclusions. The high informative value of ambulatory blood pressure monitoring for predicting future adverse cardiovascular events has been proven and the criteria for their prediction have been clarified.","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116607761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traction Chair for the Spinal Injuries Prevention","authors":"B. Panarin, O. O. Abrahamovych, O. Fayura, O. Burii, O. Yatskevych","doi":"10.25040/lkv2022.03-04.083","DOIUrl":"https://doi.org/10.25040/lkv2022.03-04.083","url":null,"abstract":"Introduction. Timely unloading of the spine, decompression of the intervertebral discs, posture correction allow to prevent spine disorders with subsequent violations of central nervous system сonnections with its target organs and their invalidization. The aim of the study. To present the design of the traction chair for the spinal injuries prevention. Materials and methods. Content analysis, systematic and comparative analysis, the bibliosemantic method of studying current trends in the constructions of traction chair for the prevention of spinal injuries, as well as methods of its application were used. Sources were searched in scientometric information databases: PubMed, Medline, Springer, Google Scholar, Research Gate by the keywords: kinesotraction, musculoskeletal system, traction chair. 11 papers in English and Ukrainian that cover this problem were selected and analyzed. The design of the traction chair for the prevention of spinal injuries is described. Results. The design of the traction chair includes: the chair itself, seat installed on the guides (with the possibility of movement in the vertical plane and fixation in the upper position), supports for the shoulder belt of the upper limbs, fixed on a movable back, which is installed on the guides, a traction headrest, racks, blocks, cable, load. The described construction is used as follows. The patient is placed on the seat, installed on the guides, fixed in the upper position, places the shoulder belt of the upper limbs on the supports, fixed on the movable backrest, which is installed on the guides and connected by a cable-block system with a load, fixed on a rack, places a traction headrest on the head, connected by a cable-block system with a load, releases the seat from fixation, which under the action of the mass the patient’s body is lowered along the guides. Cargo, connected by a cable-block system, fixed on a rack with a movable back and cargo, connected to a traction headrest, the top rises, creating a traction force that is applied to the thoracic and cervical parts of the spine, after which the patient rests his hands and feet on the supports, moves to the top position and the cycle repeats Stretching can be carried out of separately and at the same time of specified sections of the spine, as well as all sections in a static mode, provided that the hips are fixed with a belt to the chair in a sitting position. Cyclical changes in the stretching force with certain dynamics allow the mechanical development of spinal segments, increase their mobility, and stimulate the peripheral nervous system of the stretching zones. Conclusions. Presented construction of the traction chair and its application, directed towards correction of nervous and musculoskeletal systems disorders is an important component of the effective prevention of spinal-related diseases.","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131375639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Soluble Fibrin-monomeric Complexes and D-dimers as Indicators of Acute Pancreatitis Severity","authors":"S. Chooklin, B. Pidhirnyi, R. Barylyak","doi":"10.25040/lkv2022.03-04.026","DOIUrl":"https://doi.org/10.25040/lkv2022.03-04.026","url":null,"abstract":"Introduction. Local and systemic inflammation, disorders in the hemostatic system are among the key components of acute pancreatitis (AP) pathogenesis already in its early stages, and in future development of thrombohemorrhagic complications. The degree of systemic hemostatic disorders in AP varies from subclinical activation of coagulation, which can only be detected using sensitive markers of activation of coagulation factors, to fulminant disseminated intravascular coagulation syndrome, characterized by multiple systemic microvascular thrombosis and profuse bleeding from different sites. It has been proven that D-dimers and soluble fibrin-monomeric complexes (SFMK) are valuable markers of coagulation and fibrinolysis activation. The aim of the study. To study the dynamics of D-dimers, soluble fibrin-monomeric complexes in the blood of patients with acute pancreatitis, depending on the severity of the disease. Materials and methods. A prospective examination of 206 patients with AP was carried out. According to the criteria of the International Classification, mild pancreatitis was verified in 51 patients, moderate – in 98, severe – in 57. The concentration of SFMK, D-dimers was determined in 66 patients with AP on the first, third, seventh and fourteenth days of conservative treatment. The reference values were estimated in 11 healthy individuals. Results. The enhansed concentration of SFMK and D-dimers were detected in the blood of all patients under examination. Their content directly correlated with the severity of AP course as determined by the Ranson and BISAP score, the severity of the patient’s condition by the APACHE II score and organ dysfunction by the SOFA score, and the degree of damage to the pancreas by the Balthazar criteria. The concentration of SFMK and D-dimers significantly increased with the occurrence of respiratory, cardiovascular, renal, and metabolic dysfunction. A reliable direct correlation was determined between the amount of SFMK and the concentration of creatinine and glucose in the blood of patients with AP. The increase in the level of D-dimers significantly directly correlated with the concentration of creatinine in the blood serum. The sensitivity of SFMK determination (cut-of value 137.50 ng/L) for predicting pulmonary dysfunction was 86.20 %, and the specificity was 83.80 %, with positive and negative predictive values of 80.65 and 88.57 % respectively. Conclusions. The course of acute pancreatitis is accompanied by local or systemic inflammation, changes in the hemostatic system, severity of which correlating with the severity of the disease. Characteristic feature for patients with severe acute pancreatitis is the combination of systemic inflammation with procoagulant changes. The severity of acute pancreatitis, the severity of patient’s condition and organ dysfunction, the severity of pancreatic lesions are associated with an increase of fibrin degradation products. The concentration of soluble fibrin-mono","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122088753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}