Lviv clinical bulletin最新文献

{"title":"Anxious-depressive Disorders in Patients with Syndrome Chronic Venous Cerebral Dysfunction and Various Levels of Blood Pressu","authors":"O. Kovalenko, N. Prityko","doi":"10.25040/lkv2021.03-04.037","DOIUrl":"https://doi.org/10.25040/lkv2021.03-04.037","url":null,"abstract":"Introduction. The syndrome of chronic venous cerebral dysfunction (SCVCD) - widely studied at present nosology. In the presence of anxiety-depressed disorders, this disease is complicated. Specific clinical manifestations of SCVCD, as pronounced practical experience, are found in people of different age and social groups, usually in conditions of comorbidity, in particular, with different arterial pressure (AP) and accompanying anxiety-depressive disorders, which is reflected in the general intellectual potential of society. In our opinion, it is an interesting and relevant issue that contributes to changes in the emotional-volitional sphere of a person carries out a SCVCD in combination with different indicators of arterial pressure (AP). The aim of the study. To conduct a comparative analysis of the interconnections of the indicators of the emotional-volitional sphere (anxiety and depression), estimated using the scales of the anxiety Ch. D. Spieberger - Yu. L. Hanin and depressions A. T. Beck, in patients with chronic cerebral venous dysfunction syndrome and without it and various indicators of arterial pressure. Materials and methods. 153 patients tested on a series of reactive and personal anxiety and depression. The main group amounted to 125 people who were elected by clinical signs of the existence of the SCVCD and various indicators of AP, and they were distributed to three clinical groups: 33 people - people with increased indicators of AP (157.20 ± 12.20 / 98.30 ± 4.20 mm Hg - hypertonics; 21 person with reduced blood pressure (100.32 ± 7.23 / 65.45 ± 6.40 mm Hg) - hypotonic; 24 people with labile AP with predominantly normal average digits of AP (125.23 ± 12.20 / 82.22 ± 4.14 mm Hg) - \"conditional\" normotonics. For comparison of indicators, 28 patients of the control group were involved - people without clinical signs of SCVCD and various indices of AP, distributed on the same principle: hypertension - eight people, hypotonics - five people, \"conditional\" normotonics - 15 people. The statistical elaboration of the results was carried out using the Medstat application package. Since the law of distribution of indicators differed from normal, for the presentation of data calculated median value and the inter-quatering interval (QI-QIII), for comparison used nonparametric criteria for U. Kruskala A. Wallis, criteria for J. Dannah and Chi-square. Results. The level of personal and reactive anxiety (among persons with chronic cerebral venous dysfunction) in hypertonics was statistically significantly higher than hypotonics. The level of depression (among persons with chronic cerebral venous dysfunction) in hypotonics was statistically significant than in hypertension and \"conditional\" normotonics. In patients in the control group, there is no statistically significant connection between the numbers of personal and reactive anxiety and the level of depression with the digits of arterial pressure. Anxiety is most often an essential part of d","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131099175","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":"Influence of Meldonium on Blood Lipid Spectrum and Echocardiography Parameters in Patients with Coronary Heart Disease and or Withoutconcomitant Arterial Hypertension","authors":"D. Volynskyi","doi":"10.25040/lkv2021.03-04.050","DOIUrl":"https://doi.org/10.25040/lkv2021.03-04.050","url":null,"abstract":"Introduction. Coronary heart disease (CHD) is one of the main causes of high mortality, disability and reduced quality of life for patients in both Europe and Ukraine. Modern drug therapy of coronary heart disease in combination with arterial hypertension (AH) does not always achieve a satisfactory therapeutic effect. The use of meldonium, which has antioxidant properties, has a positive effect on NO release and has a lipid-lowering effect is promising for patients with AH. The aim of the study. To evaluate the influence of meldonium on lipid metabolism and echocardiography parameters in combination therapy in patients with CHD with stable angina and concomitant AH. Materials and methods. We examined 66 patients with CHD, stable angina pectoris II-III functional class, 40 of them with concomitant AH stage II-III. Patients were divided into 2 groups of 40 and 26 patients, respectively. The first group included patients with CHD and concomitant AH, the second - without pre-existing hypertension. Each of the groups was further divided into 2 subgroups: 1) Patients who were prescribed meldonium at a dose of 750.0 mg/d for 6 months in addition to the basic therapy of the underlying disease (n = 20 for CHD + AH and n = 14 for CHD without hypertension). 2) Patients who continued basic antianginal, disaggregating, hypolipidemic therapy (n = 20 for CHD + AH and n = 12 for CHD without hypertension). Serum levels of triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol were assessed. Indicators of cardiac hemodynamics were determined by echocardiography with assessment of left ventricular end systolic and diastolic volumes and diameters (LVESV, LVEDV, LVESD, LVEDD respectively), the thickness of the interventricular septum and posterior wall of the left ventricle (IVST, LVPWT respectively), pulmonary artery pressure (PAP), LV myocardial mass (LVM) and LV myocardial mass index (LVMI). Results. The use of meldonium for 6 months in patients with CHD and concomitant AH led to a decrease in the concentration of total cholesterol from 5.07 to 4.34 mmol/l and LDL from 2.07 to 1.70 mmol/l. In the group of patients without concomitant hypertension there was a decrease in the concentration of total cholesterol from 4.80 to 3.93 mmol/l, LDL from 1.62 to 1.18 mmol/l and an increase in HDL from 1.18 to 1.37 mmol/l. At 6-month administration of meldonium as a part of combination therapy of patients with CHD with concomitant AH, there is a decrease in LVM from 216.90 g to 181.50 g and LVMI from 109.10 g/m2 up to 91.20 g/m2. In patients without concomitant hypertension, a decrease in LVM from 232,20 g to 183.90 g and LVMI from 121.50 g/m2 to 96.40 g/m2 was observed. Conclusions. Our study showed that meldonium has a positive effect on lipid metabolism and echocardiography. In the group of patients with coronary heart disease and concomitant hypertension on the background of additional use of meldon","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133893972","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":"Еfficiency of Basal Cell Diagnosis Skin Carcinomas Using Dermatoscopy in Combination with Ultrasound (Literature Review; Description of Clinical Cases)","authors":"A. Bulinska, Y. Zaychenko, А. Kucher, Í. Mota","doi":"10.25040/lkv2021.03-04.091","DOIUrl":"https://doi.org/10.25040/lkv2021.03-04.091","url":null,"abstract":"Introduction. Basal cell carcinoma of the skin is the most common skin cancer in people with fair skin color. Early detection of basal cell carcinoma and proper surgical approach are crucial to reduce the incidence of this tumor. Visual examination is the first screening tool used by clinicians, but sometimes it is not enough to differentiate and determine treatment tactics. Therefore, non-invasive methods such as dermatoscopy and ultrasonography of the skin have recently become widely used, which provide a clear diagnosis, fully correlate with the pathomorphological diagnosis and allow determining the invasiveness of the process and the scope of surgery. The aim of the study. To establish the effectiveness of the diagnosis of basal cell carcinoma of the skin using dermatoscopy in combination with ultrasound, to clarify and justify the feasibility of using a double diagnostic test \"Dermatoscopy + Ultrasound\" in the diagnosis of skin tumors for future surgery. Materials and methods. Two cases of basal cell basal cell carcinoma in young patients with atypical localization, dermatoscopic and ultrasonographic parameters, correlation with pathomorphological diagnosis are described. Dermatoscopic parameters were evaluated according to G. Kittler's algorithm, skin ultrasound was performed on an expert class device \"ACUSON Juniper Ultrasound System\" with color and energy Doppler modes by a linear multifrequency transducer (5-17MHz) according to the original protocol developed by G.Alakhverdian. Results. A feature of the described clinical cases is the young age of patients (21 and 29 years), which is an atypical phenomenon in relation to the manifestations of BCC and indicates that recently basal cell carcinoma begins to occur at a young age and its typical location changes. The obtained data of dermatoscopic and ultrasonographic examination confirm specific clinical symptoms and are completely correlated with pathomorphological diagnosis. Conclusions. Dermatoscopy in combination with skin ultrasonography are reliable non-invasive techniques that allow real-time detection of clinical and subclinical lesions and should be used to diagnose and monitor for all skin cancers. Keywords: basal cell carcinoma of the skin, dermatoscopy, ultrasonography of the skin.","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"132 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115044108","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 Condition of Cognitive Functions in Patients with Stage 1 and Stage 2 Hypertension of 2-3 Degrees, with Moderate and High Cardiovascular Risk and Gender Characteristics of the Revealed Disorders","authors":"V. Skybchyk, O. Pylypiv","doi":"10.25040/lkv2021.01-02.014","DOIUrl":"https://doi.org/10.25040/lkv2021.01-02.014","url":null,"abstract":"Context. It is known that in addition to transient ischemic attacks and insults, hypertension is often the cause of asymptomatic brain damage, including cognitive impairment (CI). Most of these studies show a positive relationship between midlife hypertension and cognitive decline at the advanced age. CI significantly affect the quality of life of patients, reduce the ability to learn, acquire new knowledge and skills, force them to change their usual way of life and often stop or reduce professional activities. Objective. To analyze the condition of cognitive functions in patients with stage 1 and stage 2 hypertension of 2nd-3rd degrees, with moderate and high cardiovascular risk and evaluate their gender peculiarities. Materials and methods. The study included 90 patients with stage 1 and stage 2 hypertension. The average age of patients with hypertension was 49.66 ± 8.74 years old. The average course of the disease was 7.7 ± 3.9 years. The comparison group consisted of 46 healthy individuals with normal blood pressure levels and without hypertension in anamnesis (the average age - 45.88 ± 3.03 years old). Applied methods included general clinical, methods of neuropsychological testing (MMSE, GPCOG, W. Schulte test), standard general clinical and biochemical laboratory methods (blood lipid spectrum, blood glucose, creatinine with GFR, electrolytes), instrumental (12-lead ECG, ambulatory monitoring of blood pressure, echocardiography in B-, D-modes), and statistical methods. Results. Patients with hypertension scored significantly less on the MMSE scale (26.82 ± 1.41 scores vs. 28.89 ± 0.82 scores, p = 0.001) and GPCOG (6.63 ± 1.88 scores vs. 8.35 ± 0.71 scores, p = 0.001) compared with healthy individuals and spent more time on performing Walter Schulte test (46.51 ± 8.59 seconds vs. 36.69 ± 6.77 seconds, p = 0.001). Moderate CI were detected in 36 patients (40.00 %) among the examined hypertensive patients; it means that the total score of MMSE was 24-26 scores (the norm is 27-30 scores). The total score on the MMSE scale was 25.47 ± 0.88 in hypertensive patients with CI and was significantly lower than in hypertensive patients without CI (р = 0.001). Cognitive functions in patients with CI were characterized by poorer indices of memory, counting and executive functions. It should be noted that the revealed changes had more reliable manifestations in male hypertensive patients. In particular, the total score on the MMSE scale was 26.57 ± 1.37, while in female ones it was 27.19 ± 1.41 scores (p = 0.04). CI on the MMSE scale were diagnosed in 43.4 % (n = 23) of male patients and in 35.1 % (n = 13) of female patients. The total score was also higher on the GPCOG scale in female patients - 6.89 ± 1.85 scores vs. 6.45 ± 1.89 scores, p = 0.26. Instead, the time to complete the tasks according to the Walter Schulte tables was longer in male patients - 47.74 ± 8.85 seconds vs. 47.73 ± 7.99 seconds, p = 0.10, respectively. The parameters of counting fu","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"88 7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116255096","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":"Frequency of Arrhythmias and Conduction and Antiarrhythmic Efficacy of Upstream Therapy in Patients with Acute Myocardial Infarction with Comorbid Metabolic Syndrome and Vascular Endothelial Dysfunction","authors":"M. Shved, I. Yastremskaya, T. Dobriansky","doi":"10.25040/lkv2021.01-02.008","DOIUrl":"https://doi.org/10.25040/lkv2021.01-02.008","url":null,"abstract":"Context. Cardiac arrhythmias and conduction disorders are the most common reperfusion complications in patients with myocardial infarction (MI) in both acute and late postinfarction periods, which significantly complicates the course of the disease and often leads to an unfavorable prognosis for the early and distant periods. Objective. To evaluate the frequency of arrhythmias and conduction and the antiarrhythmic efficacy of upstream therapy in patients with acute MI with comorbid metabolic syndrome (MS) and endothelial vascular dysfunction. Materials and methods. The experimental group consisted of 42 patients with acute myocardial infarction in combination with MS, who underwent urgent coronary angiography followed by balloon angioplasty and stenting of the infarct-dependent coronary artery, as well as standard drug therapy according to the MOH protocol. Patients in the experimental group also received 5 intravenous infusions of arginine-carnitine mixture (4.2 g and 2.0 g, respectively) in 100 ml of solvent. The nature of the clinical course of MI was compared with that in 38 patients with MI in combination with MS (control group), who did not receive additional treatment and were comparable in age (56.64 ± 0.91 and 54.85 ± 0.76 years, respectively). Results. It was found that patients with MI with comorbid MS on percutaneous coronary intervention most often developed reperfusion syndrome with manifestations of arrhythmias and conduction. Under the influence of standard drug treatment in patients of the control group there was a significant clinical and functional improvement, though sinus tachycardia, ventricular extrasystole of high grades and supraventricular extrasystole remained resistant to treatment. There was also a pronounced endothelial vascular dysfunction, which in the process of standard treatment in patients of the control group did not reach the level of healthy individuals (p-value less than 0.05). Conclusions. In patients with acute MI with comorbid MS, who underwent balloon angioplasty and stenting of the infarct-dependent coronary artery, a pronounced vascular endothelial dysfunction and electrical instability is observed, accompanied by reperfusion arrhythmias and arrhythmias. The use of arginine-carnitine mixture as upstream therapy helped to restore endothelial function and showed a pronounced antiarrhythmic effect, which significantly reduced the incidence and severity of complications of acute MI such as reperfusion arrhythmias.","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121313030","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 View on the Problem of Systemic Lupus Erythematosus with and without Comorbid Lesions of the Circulatory System (Literature Review, Clinical Case Description) (first notice)","authors":"L. Kobak, O. Abrahamovych, U. Abrahamovych, V. Chemes","doi":"10.25040/lkv2021.01-02.037","DOIUrl":"https://doi.org/10.25040/lkv2021.01-02.037","url":null,"abstract":"Context. The prevalence and incidence of systemic lupus erythematosus (SLE) in the world is significant. In recent years, there has been a tendency of the SLE prevalence increase. despite the undoubted progress in understanding the etiology and pathogenesis of SLE, its diagnosis and treatment, the mortality of patients, including ones at young and working age, is higher than in the general population, and circulatory system lesions are ones of its main reasons in these cases. Objective. To analyze the literature, dedicated to the modern view on the problem of systemic lupus erythematosus with and without comorbid lesions of the circulatory system, describe the clinical case. Materials and methods. Content analysis, method of system and comparative analysis, bibliosemantic method of studying the current scientific investigations on modern principles of diagnosis and treatment of patients with SLE are used. A clinical case is described. Results. The article presents modern ideas about the etiological factors and pathogenesis of the disease. The clinical manifestations of SLE are very diverse. The problem of comorbidity and syntropy of lesions is relevant. Lesions of the cardiovascular system in the case of SLE can manifest itself in the form of pericarditis, myocarditis, endocarditis, lesions of the heart valves, coronary arteries, aorta, conduction system, pulmonary hypertension occurrence. The basic principles of drug therapy are also briefly considered. Conclusions. The results of the literature review indicate the importance of the problem of systemic lupus erythematosus, due to its widespread prevalence among the young and people of working age, lack of accurate knowledge about the etiology and pathogenesis of the disease, comorbid lesions of many organs and systems, including circulatory system, the development of severe and often life-threatening manifestations, the lack of clear recommendations that would predict the differentiated use of drugs taking into account comorbid syntropic lesions, which is also demonstrated in the described clinical case. Given this, systemic lupus erythematosus needs further in-depth study.","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"254 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132483667","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":"About the Problem of Arterial Hypertension as a Risk Factor in the COVID-19 Pandemic Conditions and its Treatment (Literature Review)","authors":"І. Dunaieva, N. Kravchun","doi":"10.25040/lkv2021.01-02.031","DOIUrl":"https://doi.org/10.25040/lkv2021.01-02.031","url":null,"abstract":"Context. In a pandemic caused by a coronavirus infection, a special risk group are the patients with cardiovascular disease, hypertension and diabetes mellitus in particular, which are the most common risk groups among the general population. The spread of coronavirus disease is particularly dangerous in terms of decompensation of chronic complications, specific damage to the cardiovascular system, especially in cases of severe infection and high risk of adverse outcomes in the above cohort of patients. The combination of coronavirus disease and cardiovascular disease poses additional difficulties in diagnosing, identifying, and prescribing appropriate therapy, including antihypertensive therapy. Therefore, it is important to address the possible risks and complications in people with hypertension and diabetes mellitus in the conditions of coronavirus disease COVID-19 and the features of the antihypertensive therapy prescription. Objective. To investigate the peculiarities of treatment of patients with arterial hypertension in the context of the COVID-19 pandemic, to analyze possible risks and complications based on the results of studying the literature. Materials and methods. Content analysis, methods of systemic and comparative results, as well as bibliosemantic evaluation of current research in the literature on the prescription of antihypertensive therapy in patients with hypertension and diabetes in the conditions of coronavirus COVID-19 were used. Sources of information were searched in scientometric medical databases, namely PubMedNCBI, Medline, Web of Science and Google Scholar, etc. by keywords: diabetes, hypertension, antihypertensive therapy, COVID-19, complications, cardiovascular risk. 174 scientific works in English, Ukrainian and Russian were analyzed and sources were selected, which contain questions about the risks of patients with hypertension and diabetes in the conditions of coronavirus disease, including those related to the appointment of antihypertensive therapy. Results. RAAS inhibitors, which provide better blood pressure control, may partially help to maintain the immune system imbalance in hypertension. In patients with hypertension during a viral infection, blood pressure levels and cardiovascular risk should be monitored. Conclusions. Constant monitoring of hemodynamic parameters, ECG and ECHO-CG – should be under the control according to the indications. The association of RAAS blockers (ACE inhibitors and ARBs) with an increased risk of infection in patients and worsening of COVID-19 has not been established so far, so patients with CVD should continue to take them. Patients who have survived coronavirus disease should be included in the medical rehabilitation programs for faster and better recovery of various systems, primarily respiratory and cardiovascular, as well as to improve quality of life and reduce the risk of disability.","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"127 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123220789","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":"Disturbances of Cardiovascular Activity and Endothelial Function in Pregnant Women with Undifferentiated Connective Tissue Dysplasia and their Correction by Carnitine-arginine Complex Inclusion in the Protocol Treatment Program","authors":"V. Dobrianska","doi":"10.25040/lkv2021.01-02.019","DOIUrl":"https://doi.org/10.25040/lkv2021.01-02.019","url":null,"abstract":"Context. Undifferentiated connective tissue dysplasia (UCTD) has negative impact on myocardial contractility and endothelial microvascular dysfunction and their frequent combination with cardiac arrhythmias suggests an unfavorable course of pregnancy and childbirth due to the formation of uteroplacental dysfunction. Objective. To reduce the incidence of obstetric complications associated with cardiovascular disorders in women with UCTD by including carnitine-arginine complex in the treatment program. Materials and methods. 58 pregnant women with diagnosed signs of UCTD, including mitral valve prolaps (MVP) with and without frequent extrasystoles, and 14 pregnant women of control group were examined. Metabolic support with of 4.2 g of L-arginine and 2.0 g of L-carnitine in the form of a solution for intravenous infusion once a day for 5 days were used for prenatal care of pregnant women with UCTD and prevention of obstetric complications in the experimental group. Results. There are violations of morpho-functional parameters of the heart with the development of moderate systolic-diastolic myocardial dysfunction and endothelial microvascular dysfunction in the initial state of pregnant women with MVP and extrasystolic arrhythmia against the background of UCTD. They were significantly more often diagnosed with miscarriage, late preeclampsia, placental dysfunction, birth defects, birth trauma, postpartum hemorrhage, etc. Echostructural abnormalities of the heart acted as predictors of arrhythmias, the presence of which was associated with more pronounced disorders of intracardiac hemodynamics. The results of a comprehensive study of the clinical and functional status of pregnant women with phenotypic signs of UCTD, MVP and extrasystolic arrhythmia suggest that in most cases they occur with moderate heart remodeling and significant endothelial dysfunction of the microvascular circulation, that was accompanied by significant deterioration of the obstetric situation. The use of standard medication by pregnant women did not significantly restore the incidence of arrhythmias, inotropic capacity of the myocardium and endothelial function of microvessels. Supraventricular and ventricular arrhythmias remained resistant to standard treatment, which justified the use of additional antiarrhythmic drugs. At the same time, there was a significant reduction in the incidence of arrhythmias in the group of patients with MVP and frequent ventricular or mixed extrasystoles – by 90.6 and 77.8 % respectively under the influence of complex drug treatment with the inclusion of L-arginine and L-carnitine. In the group of pregnant women with supraventricular arrhythmias, the antiarrhythmic effect was observed in only 37.5 % of patients, which justified the additional use of nebivolol hydrochloride at a dose of 2.5 mg/day. At the same time, such a comprehensive treatment in pregnant women with MVP and arrhythmia on the background of UCTD contributed to the restoration of the","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123919555","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":"Prevalence of SARS-CoV-2 Infection Among Dentists Public and Private Structures and Factors Influencing the Likelihood of Developing Coronavirus Disease","authors":"L. Horzov, I. Hanhur, I. Sorokopud, P. Tanasiychuk","doi":"10.25040/lkv2021.01-02.026","DOIUrl":"https://doi.org/10.25040/lkv2021.01-02.026","url":null,"abstract":"Context. Coronaviruses are enveloped viruses with single-stranded “plus” RNA, with genome sizes from 25 to 32 thousand nucleotides. Under normal conditions, coronaviruses have a strict species affiliation. Coronaviruses as well as influenza viruses are known to be capable of mutation: a combination of certain factors make animal coronaviruses acquire the ability to infect humans, causing disease, and then become able to be transmitted from person to person. In early January 2020, a new coronavirus was identified. On February 11, 2020, the WHO gave it an official name – COVID-19. The International Committee on the Taxonomy of Viruses has named the new coronavirus SARS-CoV-2. The criteria for the WHO declaration of the International Health Emergency of 30 January 2020 (International Health Emergency) were the rapidity and suddenness of the disease, which “threatens the consequences for the health of the population outside the national borders of the affected state and may require prompt action at the international level”. Because SARS-CoV-2 infection occurs during close contact, dentists are at increased risk, and therefore there is a need to inform them about the factors that affect the occurrence and severity of this disease. Objective. To find out the prevalence of SARS-CoV-2 infection among dentists engaged in public and private structures and the factors influencing the probability of developing coronavirus disease. Materials and methods. A survey of 50 dentists from private and public institutions in different regions of Ukraine was conducted. Statistical analysis of the obtained data was performed to identify the correlation between these factors and the incidence of SARS-CoV-2. Results. The investigation showed that 54.00 % of dentists surveyed did not have SARS-CoV-2, 24.00 % did not know whether they had it, and 22.00 % of dentists had contracted coronavirus disease, which is almost ten times more common (2.30 % of the population of Ukraine was diagnosed with COVID-19 at the time of the study) than among the general population of Ukraine. Among those who relapsed, 72.72 % of respondents had a mild, 18.18 % moderate and 9.09 % severe course of the disease. Among the chronic diseases of dentists in the case histories, autoimmune (27.00 %), cardiovascular (27.00 %) lesions and chronic lung diseases (9.00 %) predominate. There is a positive correlation between the severity of coronavirus disease and the presence of chronic diseases. There is a negative correlation between the level of use of personal protective equipment and the presence of the disease. There is a positive correlation between the severity of the disease and the presence of chronic diseases. There is a negative correlation between the level of use of personal protective equipment and the presence of the disease. Conclusions. The study found that dentists belong to the risk group for SARS-CoV-2 (22.00 % of patients in the population of dentists against 2.30 % in the population ","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131230725","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":"Risk Factors: Method of Determination and Evaluation, Prognosis in Medicine (Literature Review; Examples of Use in Own Clinical Practice) – first notice","authors":"О. Fayura, А. Маksymuk, О. Аbrahamovych, М. Аbrahamovych, L. Tsyhanyk, S. Tolopko, M. Ferko","doi":"10.25040/lkv2021.01-02.051","DOIUrl":"https://doi.org/10.25040/lkv2021.01-02.051","url":null,"abstract":"Context. Despite the latest advances in modern medicine, the direct etiological factors of many diseases remain unknown or it is impossible to determine the significance of each of them in their occurrence, so the theory of risk factors is extremely relevant for both theoretical and practical medicine. Besides, there often occur situations in which it is necessary to determine the optimal tactics of patient care, because preventive, curative and rehabilitation activities of the doctor require timely prediction of the occurrence probability, further course of the pathological process, its complications, recurrences due to certain environmental factors, threatening and terminal conditions, side effects of drugs. Therefore, the need for a practical solution to these problems has become the basis for the theory of risk factors and prognosis methods. Objective. To determine the significance of risk factors and methods of their calculation and evaluation, prognosis in medicine, using literature sources, provide specific examples of their use in one’s own clinical practice. Materials and methods. Content analysis, method of systemic and comparative analysis, bibliosemantic method of studying the current scientific researches concerning the investigation of the importance of risk factors and a technique of their calculation and estimation, prognosis in medicine were used. The sources were searched for in scientometric databases: PubMed, Medline, Springer, Google Scholar, Research Gate by keywords: risk factors, one-way analysis, multi-factor analysis. 54 literary sources in English and Ukrainian, which highlight the importance of risk factors and methods of their calculation and evaluation, prognosis in medicine were selected and analyzed to describe the results of their use in our own clinical practice. Results. The concept of risk, as the probability of an adverse event or outcome, is most often used in analytical studies, which are planned to identify the causes and their prevalence of certain conditions. Risk cannot be measured directly by the results of information evaluation in one person, but is calculated on the basis of selective observation of a group of persons who are under the influence (exposed group) of a certain factor. Risk factors are potentially pathogenic factors, in contact with which a person may develop a disease. A full analysis of pathological processes, assessment of risk factors and actual risks are impossible without prognosis, as well as multivariate analysis, which is often based on the probabilistic method of A. Wald or the survival curves construction. In practical health care, cases of medical and social research and in clinical studies, it is often necessary to identify the trends (predict) in changes of a certain condition. Conclusions. Determining the risk factors, calculating the actual risks and prognosis play an important role in medicine, because in the doctor’s practice there are daily situations that need to dete","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116395135","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}