Lviv clinical bulletin最新文献

{"title":"Syntropic Lesions of the Cardiovascular System in Patients with Liver Cirrhosis: their Determination; Selected Pathogenetic Mechanisms; Characteristics and Specifics; Clinical Markers, Their Prognostic Value; Justification and Effectiveness of Modified Treatment (Second Notice)","authors":"M. Farmaha, M. Abrahamovych, O. Abrahamovych, O. Fayura, V. Chemes","doi":"10.25040/lkv2020.04.008","DOIUrl":"https://doi.org/10.25040/lkv2020.04.008","url":null,"abstract":"Introduction. Comorbid syntropic lesions of the circulatory system in patients with liver cirrhosis (LC), although often fatal, are poorly studied. The aim of the study. To distinguish syntropic lesions of the cardiovascular system in patients with LC, to determine some of their pathogenetic mechanisms, nature, and characteristics, to determine clinical markers with prognostic value, to justify and evaluate the effectiveness of their modified treatment. Materials and methods. We processed medical records of 603 patients with LC and detected circulatory system lesions in 490 patients. Some of them had only one type of lesions (study groups): 103 patients were diagnosed with cirrhotic cardiomyopathy (CCMP), and 89 patients were diagnosed with arterial hypotension. Patients without the circulatory system lesions (113 patients) formed a comparison group. The purpose of the first step of the study was to determine syntropic comorbid lesions of the circulatory system. The purpose of the second step was to study some pathogenetic mechanisms of their formation. The purpose of the third step was to characterize these lesions, classify them, and determine their specific characteristics related to the severity of LC. The purpose of the fourth step was to determine their clinical markers. The purpose of the fifth step was to justify a modified course of treatment for patients with LC and syntropic cardiovascular lesions as well as to assess its effectiveness. Results. The presence of the combination of such complaints as nausea, jaundice of the skin and sclera in patients with LC and the absence of the “jellyfish head” symptom lets us think with 97.09 % sensitivity, 98.02 % specificity and 97.70 % accuracy about syntropic secondary CCMP. In the presence of the combination of such complaints as pain and heaviness in the right side of the abdomen, ascites, hepato-, splenomegaly and telangiectasia lets us think with 85.39 % sensitivity, 98.61 % specificity and 94.75 % accuracy about syntropic persistent hypotension. Improvement of the comprehensive treatment of patients with LC, syntropic secondary CCMP and persistent hypotension, taking into account the peculiarities of their pathogenesis and clinical course, can improve the quality of life of patients by 44.95 % and 40.39 %, respectively, and significantly increase the effectiveness of treatment. Conclusions. Clinical symptom complexes that indicate the presence of syntropic lesions of the circulatory system – a combination of complaints of nausea, jaundice and sclera in the absence of symptoms of “jellyfish head” indicates CCMP, and a combination of complaints of pain and heaviness in the right hypochondrium, ascites, hepato- and splenomegaly and telangiectasia indicate persistent hypotension. Improvement of the comprehensive treatment of patients with LC and CCMP by adding a β-blocker with α-blocking properties of carvedilol (1 tablet (3.125 mg) twice a day), cardio- and hepatoprotector thiotriazoline (in p","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131194854","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":"Characteristics of Types of Electroencephalograms in Patients with Cerebral Contusion of Mild Severity in the Acute Period with Subarachnoid and without Subarachnoid Hemorrhage","authors":"V. Shevaga, M. Semchyshyn, B. Zadorozhna, A. Zadorozhnyi","doi":"10.25040/lkv2020.01.029","DOIUrl":"https://doi.org/10.25040/lkv2020.01.029","url":null,"abstract":"group with cerebral contusion of the mild severity without hemorrhage, for which they are characteristic, types of EEG were plane, border and normal. Analysis of the results of the study showed that in patients in the acute period of the cerebral contusion of the mild severity with subarachnoid hemorrhage, there was a significant difference with respect to all types of EEG ( р < 0.05) control. In patients with cerebral contusion of the mild severity without subarachnoid hemorrhage in acute period a significant difference was observed only with respect plane ( р 1 < 0.05), normal ( р 1 < 0.05) and border ( р 1 < 0.05) types of EEG compared to control. Changes of polyrhythmic ( р 1 > 0.05) and synchronized ( р 1 > 0.05) types of EEG in patients with cerebral contusion of the mild severity without subarachnoid hemorrhage were unlikely compared to the control. Comparing the studied groups in the acute period of the cerebral contusion of the mild severity among ourselves, we found the significance of differences with respect to polyrhythmic ( р 2 < 0.05), synchronized ( р 2 < 0.05), normal ( р 2 < 0.05) and border ( р 2 < 0.05) types of EEG, and relatively plane types of EEG indicators were unreliable ( р 2 > 0.05). Conclusions. These studies reflect the pathogenesis of trauma, point to the special role of nonspecific brainstem and hypothalamus systems, as triggers that lead to impaired cortical-subcortical and cerebral-spinal neurodynamics. Among the EEG characteristics, the most important for diagnosis is the phenomenon of synchronization, which reflects the phase of brain injury and is expressed by the rise of slow δ (delta) and θ (theta) waves. Pathological processes in the cerebral contusion of the mild severity of EEG are reflected by a combination of focal and cerebral changes in bioelectric activity and can be used for diagnostic and expert purposes. hemorrhage, acute period, types of electroencephalograms.","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123505020","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":"Etiopathogenesis and Histogenesis of Ovarian Tumors","authors":"L. Markin, O. Besedin, K. Isayeva, M. Doroshenko-Kravchyk","doi":"10.25040/lkv2020.01.045","DOIUrl":"https://doi.org/10.25040/lkv2020.01.045","url":null,"abstract":"has undergone the significant changes. Also, several hypotheses have been proposed to explain the epidemiological factors: the continuous ovulation hypothesis, the hypothesis of gonadotropins excessive secretion, the genetic theory, theory of microenvironment and genetic polymorphism. In recent years, the large number of studies are devoted to the study of the immune system state, the process of apoptosis, morphological and molecular cytogenetics. Сonclusions . Thus, according to epidemiological investigations, neoplasms of the ovaries can be regarded as systemic diseases, which occurs on a molecular genetic level with involvement of various endogenous and exogenous factors. However, despite the significant advancements in fundamental science, the causes of tumor appearance and, respectively, the issue of early diagnosis and prophylaxis of the most common neoplasms of the ovaries need further investigations.","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129844930","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":"Cardiotoxicity of Chemotherapeutic Drugs (Literature Review and Clinical Case Description)","authors":"A. Avagimyan, L. Mkrtchyan","doi":"10.25040/lkv2019.04.051","DOIUrl":"https://doi.org/10.25040/lkv2019.04.051","url":null,"abstract":"","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128302426","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":"Diagnostic Value of the Laboratory Markers of Acute Cytomegalovirus Infection in Patients With Systemic Lupus Erythematosus","authors":"U. Abrahamovych, O. Abrahamovych, S. Guta, L. Thyhanyk","doi":"10.25040/lkv2019.04.027","DOIUrl":"https://doi.org/10.25040/lkv2019.04.027","url":null,"abstract":"and lymphopenia in SLE patients can correctly predict the presence of acute CMV infection at 67.50 %. Conclusions. Anemia, leukopenia, lymphopenia, increase in γ-globulin content, increase in antibody titer to two-helical deoxyribonucleic acid, decrease in complement rate are laboratory markers of acute cytomegalovirus infection in patients with systemic lupus erythematosus. A constellation of indicators was found to have the highest sensitivity, specificity, and association coefficient with the presence of acute cytomegalovirus infection, namely: leukopenia and lymphopenia. Considering the presence of these indicators in patients with systemic lupus erythematosus will allow to form groups of risk of acute cytomegalovirus infection, and therefore to examine the patient and to choose the right tactics of treatment.","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"147 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114268521","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":"Substantiation of Principles and Effectiveness of Advanced Complex Differentiated Treatment of Circulatory System Organs Affections in Patients With Liver Cirrhosis","authors":"M. Farmaha, M. Abrahamovych, A. Svintsitskyi, O. Abrahamovych","doi":"10.25040/lkv2019.04.008","DOIUrl":"https://doi.org/10.25040/lkv2019.04.008","url":null,"abstract":"by the doctors-researchers’ complex evaluation of the treatment results. Conclusions. Improved medical complexes for the following-up patients with liver cirrhosis with syntropic cirrhotic cardiomyopathy and persistent arterial hypotension, taking into account the features of their pathogenesis and clinical progression, allow to improve significantly the patients’ life quality and boost the effectiveness of their treatment.","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115608208","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":"Content of Some Endothotelium-Dependent Vasoactive Substances in the Blood of Patients, Depending on the Liver Cirrhosis Severity and the Organism’s Redox System State","authors":"M. Abrahamovych, O. Abrahamovych, O. Fayura, S. Tolopko, M. Ferko","doi":"10.25040/lkv2019.04.014","DOIUrl":"https://doi.org/10.25040/lkv2019.04.014","url":null,"abstract":"Introduction . It is known that liver cirrhosis (LC) is a chronic diffuse liver disease, the severity of which is manifested by the restructuring of its parenchyma in the form of nodular transformation and fibrosis due to necrosis of hepatocytes, the appearance of shunts between the portal and central veins and liver failure. Oxidative stress is one of the primary pathogenetic links of the LC onset. The aim of study . To determine the content of some endothelium-dependent vasoactive substances in the blood of patients, depending on the liver cirrhosis severity and the organism’s redox system state. Materials and methods. 81 patients (26 females (32.1 %), 55 males (67.9 %) aged 27 to 73 years (mean age -46.9 ± 10.8 years) were included in the randomized trial with the preliminary stratification by the presence of LC (experimental group - EG). All of them were hospitalized and treated at the Department of Internal Medicine N 1 at Danylo Halytsky Lviv National Medical University and the Gastroenterology Department of Lviv Regional Clinical Hospital - Lviv Regional Hepatology Center. We also examined 20 practically healthy persons (8 females (40.0 %), 12 males (60.0 %)) aged 19 to 70 years (mean age - 41.8 ± 4.2 years) from which a control group (CG) was formed.All patients underwent a comprehensive clinical laboratory and instrumental examination of all organs and systems in accordance with the requirements of the modern medicine. According to the results of the examinations, all the patients of the EG were divided into 3 groups, according to the LC severity by the criteria of C. H. Child - R. N. Pugh - the first (class A) included 19 persons, the second (class B) - 29, the cGMP, renin, aldosterone, natriuretic peptide in the blood of this category of patients with the LC increasing severity according to the criteria of C. H. Child - R. N. Pugh. Conclusions. The liver significantly influences the endothelium state due to the role of oxidative stress in the metabolisms of NO, endothelin-1, natriuretic peptide, renin-aldosterone system. The cirrhotic patients revealed the increase in malondialdehyde and the decrease in catalase activity with the disease severity increase according to the criteria of C. H. Child - R. N. Pugh. It evidences the significant abnormalities in the redox homeostasis of such patients, and subsequently leads to the endothelial dysfunction with impaired metabolism of vasoactive humoral-metabolic substances in the blood of patients. In particular, they become the prerequisite for the occurrence of extrahepatic comorbid syntropic lesions, that significantly complicate the underlying disease course.","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"306 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114805432","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 Social Functioning of Patients With Vascular Dementia, Complicated by Hallucinator-Paranoid Disorders","authors":"K. Shevchenko-Bitensky","doi":"10.25040/lkv2019.04.033","DOIUrl":"https://doi.org/10.25040/lkv2019.04.033","url":null,"abstract":"in patients with VD of limitations of their vital functions in communication, ability to make purchases, manage finances and use transport was marked. The majority of corrective caregivers in patients with VD, complicated by HPD, were characterized by low fa mily support, moderate and severe troubles about patients’ psychopathological symptoms. Conclusions. The obtained data on the SF of patients with VD, complicated by HPD, will reveal the main problems of their social and occupational functioning and develop individual psychosocial rehabilitation programs for this patient population.","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126584243","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":"Periaural Music Player Daily Use Does Not Significantly Influence the Hearing Thresholds","authors":"N. Saralidze, N. Sharashenidze, M. Tushishvili, Z. Kevanishvili","doi":"10.25040/lkv2019.02.036","DOIUrl":"https://doi.org/10.25040/lkv2019.02.036","url":null,"abstract":"","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124406183","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":"Content of Angioheneze Markers Insulin-Like Growth Factor-1 and Endostatin in Patients With Acute Myocardial Infarction in the Presence or Absence of Comorbid Obesity","authors":"D. Martovytskyi, O. Shelest, P. Kravchun","doi":"10.25040/lkv2019.02.030","DOIUrl":"https://doi.org/10.25040/lkv2019.02.030","url":null,"abstract":"","PeriodicalId":279640,"journal":{"name":"Lviv clinical bulletin","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128781160","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}