Actual problems of modern medicine最新文献

{"title":"Medical-social risk factors of cervical cancer development among women of reproductive age","authors":"","doi":"10.26565/2617-409x-2019-3-04","DOIUrl":"https://doi.org/10.26565/2617-409x-2019-3-04","url":null,"abstract":"Cervical cancer is one of the widespread diseases that have a negative impact on the reproductive health. However, medical-social risk factors which provoke this pathology aren't studied sufficiently yet.\u0000\u0000We have identified the most significant medical-social risk factors of cervical cancer's development and progression based on data analysis of a sociological study.\u0000\u0000Thus, it was found that cervical cancer can't be associated with predominantly late reproductive age of women in conditions of the Republic of Belarus: most of the patients with this pathology (more than 53%) were under the age of 35 years old.\u0000\u0000The group of patients suffered from cervical cancer was quite homogeneous in their social status, which was average and relatively stable in a large majority of them (more than 90%), despite employment in various sectors of the national economy.\u0000\u0000Social functioning of these patients wasn't significantly different from the main population of women in reproductive age. Thus, early sexual activity and random early sexual relations weren't characteristic for the majority of them: 86.1±4.46% (the control group – 87.3±5.51%, the comparison group – 78.2±3.96%) and 83.5±4.72% (the control group – 89.1±4.28%, the comparison group – 75.2±2.36%). Moreover, the married patients of the main group had the most ordered sexual behavior (p<0.01; tau=0.572) which determined the low prevalence of artificial abortions among them, including menstrual cycle regulation (less than 8%).\u0000\u0000However, the revealed different defects of health-saving behavior in the main group of patients (more than 70%), including an insufficient level of valeological knowledge, the presence of common harmful habits and low medical activity, indicate that there are significant reserves for improvement of the preventive activities of medical stuff in the field of primary medical care for the development of a healthy lifestyle among female population of reproductive age and providing clinical examination among this contingent of females in reproductive age with the purpose of cervical cancer prevention.","PeriodicalId":372609,"journal":{"name":"Actual problems of modern medicine","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121809592","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":"Conceptual basis of organization of medical care for school students in the period of reforming healthcare and education systems","authors":"","doi":"10.26565/2617-409x-2021-7-07","DOIUrl":"https://doi.org/10.26565/2617-409x-2021-7-07","url":null,"abstract":"Negative trends in the health status of the child population, the spread of non-communicable diseases require optimization of the system of their medical support. According to WHO, an educational institution can become a powerful tool for the preservation and strengthening of children's health through the rational use of human and material potential, opportunities for intersectoral interaction between education and medicine systems, and support for actions at the legislative level. The aim of the work is to develop a conceptual model of medical support for students of general secondary education institutions to prevent the spread of non-infectious diseases and the formation of health-oriented behavior of schoolchildren. Materials and methods: Analytical assessment of regulatory documents and scientific foreign and domestic publications on the health status and medical support of school-age children. Results and discussion. In the context of the innovative transformation of the health care system, the problematic issues of medical support for children in educational institutions are the issues of ensuring algorithms for monitoring the health of children, determining the influence of intraschool and medico-social factors on health and the formation of health-oriented behavior; systems for improving the skills and knowledge of school health workers on the issues of maintaining children's health, assessing health indicators and the results of preventive interventions.The solution of these issues is possible by introducing a unified coordinating structure of medical support for students of general secondary education institutions, with the development of its structural and functional model and defining the functions of all participants / performers to ensure an adequate system of medical support preserve the health of children in school conditions. The proposed Conceptual Model with substantiation of the functions and composition of specialists, elements of communication is aimed at preventing the spread of non-communicable diseases among students, the formation of a value attitude towards health in schoolchildren, will contribute to the formation of health-oriented behavior.","PeriodicalId":372609,"journal":{"name":"Actual problems of modern medicine","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128699015","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":"Special aspects of the course and diagnosis of neurosyphilis on the example of a clinical case","authors":"Kharina Kateryna, Shepel Veronika, Sazonova Taisiia","doi":"10.26565/2617-409x-2021-7-13","DOIUrl":"https://doi.org/10.26565/2617-409x-2021-7-13","url":null,"abstract":"Neurosyphilis is an infectious disease caused by Treponema pallidum and characterized by damage of the central nervous system. This disease may be asymptomatic or have an atypical clinical course, which leads to late diagnosis. The most informative diagnostic methods for this disease are specific serological reactions to syphilis, MRI of the brain and cerebrospinal fluid analysis. Aim. To show the features of the course, treatment and diagnosis of neurosyphilis using the example of a clinical case. Materials and methods. Patient S., born in 1963, complained about significant memory impairment, difficulties with orientation in time and space, mood swings, verbosity and exaggeration, and was hospitalized at the State Institution “Institute of Neurology, Psychiatry and Narcology of the National Academy of Medical Sciences of Ukraine”. Neurological status: eye slits and pupils were uniform. The movements of the eyeballs were painless. Insufficiency of the act of convergence was found. Corneal reactions were reduced. The patient felt pain after the palpation of supra- and infraorbital points. There was an asymmetry in the facial innervation. The tongue was on the midline, swollen, with tooth imprints. There were no pathological signs, sensitive violations. Shaking movements were noticed during the Romberg test. During the examination of the cognitive function using the Mini-Mental State Examination (MMSE) scale, the patient scored 21 points, which corresponds to mild dementia. Results. 1. According to the results of MRI examination of the brain, there was an MR-picture of areas of cystic-gliosis transformation of the poles of the temporal lobes and structural changes of the hippocampal gyrus (most likely, caused by the chronic inflammatory process); vascular foci of the brain as manifestations of dyscirculatory changes, moderate external hydrocephalus. 2. A serological examination for the presence of the antigen of the Treponema pallidum pathogen was performed, the result was positive. 3. Cerebrospinal fluid analysis revealed the following results. Cytosis was 1x106/l, protein was 0.21 g/l, glucose 3.4 mmol/l, Pandy test positivity. Based on the obtained data, the patient was diagnosed with neurosyphilis. The patient underwent etiopathogenetic treatment with benzylpenicillin sodium. After treatment the patient's condition gradually improved. Conclusions. Specific serological reactions to syphilis, MRI of the brain and cerebrospinal fluid analysis are mandatory tests for the diagnosis of neurosyphilis. Early detection of Treponema pallidum and rational therapy can prevent the development of severe consequences and improve the patient's condition. Syphilis is a multidisciplinary problem today and needs the attention of general practitioners, dermatologists and neurologists.","PeriodicalId":372609,"journal":{"name":"Actual problems of modern medicine","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114399500","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":"Specific features of pathology of gastro-duodenal zone organs in children of preschool and junior school ag","authors":"","doi":"10.26565/2617-409x-2021-7-01","DOIUrl":"https://doi.org/10.26565/2617-409x-2021-7-01","url":null,"abstract":"Pathology of organs of gastrointestinal tract - one of constituents of serious problem of health of child's population, that has certain features in the different age-related groups. The aim of this study was to analyse structure and features of pathology of organs of gastro-duodenal zone for the children of preschool and junior school age in the conditions of work of general somatic permanent establishment. Materials and methods. The results of child's gastroenterologist’s and endoscopist’s cabinet’ work at the SI “Institute of children and adolescences health care of National Academy of Medical Science” of Kharkiv were analysed for the last five years. 107 children were inspected in age from 5 to 10 years for this time. Upper endoscopy and intragastric pH-metry were conducted to all children. Results. Peculiarities of the clinical picture in children were the presence of abdominal pain of moderate intensity with localization in the epigastric region. When analyzing the nature of sex-dependent pain, it was found that early pain was predominant in boys, while late pain was more common in girls. Of the dyspeptic complaints, nausea was the most frequent, with 37.4 ± 4.6% of children complaining. When analyzing the endoscopic picture, it should be noted that pathological changes were more often registered in the age group of 8-10 years. When performing intragastric pH-metry hyperacidity was detected 2 times more often than normoacidity. Functional disorders of the gastrointestinal tract predominated in preschool children. According to the results of ultrasound of the gallbladder, the presence of gallbladder inflection was found in almost all subjects, and also more than half of this inflection was combined with bladder enlargement. Conclusions: 1. the children of preschool age have atrophic and destructive forms of defeat of mucous membrane of stomach and duodenum considerably rarer; 2. for children 7-8 years old, mainly children who study at school first year, more often there are agile violations, atrophic and destructive forms of defeat of mucous membrane of stomach and duodenum, that, probably, it is related to influence of stress factor; 3. children of preschool and junior school age have the united character of motion, that it is important to take into account at the choice of further tactics of conduct and treatment of patient.","PeriodicalId":372609,"journal":{"name":"Actual problems of modern medicine","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115541767","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":"Pathogenetic substantiation of preterm births prevention methods","authors":"","doi":"10.26565/2617-409x-2021-7-03","DOIUrl":"https://doi.org/10.26565/2617-409x-2021-7-03","url":null,"abstract":"The study of the pathogenesis of premature birth is one of the important issues of modern obstetrics. This could contribute developing a scientifically sound program for predicting and preventing this complication of pregnancy. The aim of the study was to investigate the blood variables of the immune system and connective tissue metabolism in women with preterm birth at 23-36 weeks of gestation. Materials and methods. A total of 227 pregnant women were examined, 190 of whom had clinical signs of threatened preterm birth. Group I included 48 women with a threatened preterm delivery resulted in childbirth between 23 and 27 weeks. In group II, 142 women at risk of preterm birth were observed from 28 to 36 weeks. Group III included 37 women with a healthy pregnancy, completed at 38-41 weeks. Result. The number of lymphocytes and their subpopulations, the content of connective tissue metabolites in the blood of the examined patients were studied. In women of group, I relatively to women of group III there was an evident (p < 0.001) decrease in blood level of CD3 + -marker of T-lymphocytes by an average of 23 %, which suggests the presence of immunodeficiency and considered as a stress response. In women with preterm birth at 28-36 weeks of gestation (group II), the relative level of CD3 + in the blood, on the contrary, slightly but probably (p = 0.014) increased compared to women with healthy pregnancy by an average of 13%. A significant decrease in the immunoregulatory index in women of group I is associated with the suppression of the T-helper component and emphasizes the presence of T-cell immunosuppression. The decrease in the index in women of group II occurred due to cytotoxic T-lymphocytes. Сonclusions. Thus, the work confirms the opinion of R. Romero on the role of immune \"rejection\" in the third trimester, associated with the HLA-incompatibility of mother and fetus. In women of group I, compared with women of group III, there was a more pronounced increase in serum free oxyproline - a marker of collagen breakdown than bound oxyproline - a marker of collagen synthesis. Group II women also had a simultaneous increase in the level of the two oxyproline fractions, but more pronounced for the protein-bound fraction. This suggests that the violation of the metabolism of connective tissue leads to the destruction of the collagen matrix of the cervix and its shortening. Studies suggest that cerclage or insertion of pessary should be used to prevent cervical incompetence in the second trimester due to metabolic disorders in the connective tissue. The use of progesterone is appropriate for prevention of \"short cervix\" syndrome, as well as the possible immunosuppressive effect of the latter. The established signs of autoimmune processes require screening for antiphospholipid syndrome and the appointment, if confirmed, of anticoagulants.","PeriodicalId":372609,"journal":{"name":"Actual problems of modern medicine","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128470482","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":"Level of the exercise tolerance in healthy adolescents","authors":"","doi":"10.26565/2617-409x-2021-7-09","DOIUrl":"https://doi.org/10.26565/2617-409x-2021-7-09","url":null,"abstract":"Recently, much attention is paid to a comprehensive assessment of the adaptive capacity of the body, namely the respiratory and cardiovascular systems. Exercise tests are used for this purpose. Exercise tolerance reflects the patient's degree of physical fitness and his ability to tolerance to the imposed physical activity. This indicator is one of the main characteristics of the cardiovascular system. To assess the tolerance to exercise, recently used to estimate the walking distance, which allows to determine the adaptive capacity of the body in response to minimal exercise. Currently, the 6-minute walking test is widely used in cardiology and pulmonology in adults, who have correlated the walking distance with indicators of their quality of life and with the functional class of heart failure. Also in adults, the walking distance in 6 minutes is used as a good predictor of death and disability in various cardiopulmonary diseases. In recent years, this test is increasingly used in pediatrics. This test has a number of advantages: it is easy to perform, reflects daily activity, does not require special equipment and a separate room, which makes it accessible and inexpensive to use. The aim of the study was to examine the literature data on a 6-minute walking test in healthy adolescents and compare them with the performance of Ukrainian peers. Materials and methods. 11 publications were analyzed, where the results of the six-minute walking test in children from different countries of the world and different age categories are presented. This test was performed on 46 healthy adolescents and analyzed depending on gender, age and body mass index. Result. A study of the literature showed that the 6-minute walking test is also used in paediatrics. Its data vary in children around the world and depend on weight, sex and age. The high enough value of the 6-minute walking test to assess exercise tolerance is emphasized. Conclusions. The indicators of the six-minute walking test in Ukrainian adolescents correspond to the world average, correlate with age, does not depend on gender and can be used to compare with the results of sick children.","PeriodicalId":372609,"journal":{"name":"Actual problems of modern medicine","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132878049","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":"Features of the clinical course of measles infection during the measles outbreak in 2018-2019 in Ukraine","authors":"","doi":"10.26565/2617-409x-2021-7-02","DOIUrl":"https://doi.org/10.26565/2617-409x-2021-7-02","url":null,"abstract":"Measles is an infectious disease characterized by an acute onset, a short prodromal period, presence of febrile, catarrhal and intoxication syndromes, as well as the development of typical enanthema and exanthema. Despite the active work of WHO to eliminate measles and the introduction of a vaccination program in developing countries, measles remains an urgent problem and the cause of high mortality rates among both children and adults. One of the dangerous complications of measles infection is the respiratory tract involvement in yhe form of out-of-hospital pneumonia, which occurs in 10-34% of patients. The out-of-hospital pneumonia was one of the main complications among the patients with measles who were treated in the Kharkiv regional clinical hospital and was registered both in patients with severe and moderate disease. That is why it was interesting to study the clinical and laboratory features of the course of measles infection in the adult population at the present stage. Objective: to determine features of the clinical course of measles infection and the factors that are prerequisites for the development of complications. Materials and methods. The study included 65 patients who were treated in the Kharkiv regional clinical infectious hospital in 2018-2019. Based on the clinical course of the disease, the severity and the presence of complications, the patients included in the study were divided into 4 groups. The control group consisted of 20 healthy voluntary donors who did not have exclusion criteria. On the day of admission to the hospital and on the 10th day of stay in the hospital, based on the data of a clinical blood test, we calculated the cellular reactivity leukocyte indices (CRLI) – the white blood cell shift index (WBCSI), the white blood cell index (WBCI) and the D. A. Ivanov immunoreactivity index (IRI). Results and discussion. The study shows that the patients from groups 1 and 2 on the 10th day of hospitalization showed a complete clinical recovery and was discharged from the hospital, whereas patients from groups 3 and 4 on the 10th day showed a clinical improvement and were transferred for further treatment to the general department. When assessing the CRLI on the day of admission to the hospital, an increase in the WBCSI in patients from groups 2, 3 and 4 was found, with the greatest increase observed in patients from group 4. In patients from group 1, on the contrary, a decrease in the WBCSI and and an increase in WBCI were determined, which indicates the activation of the lymphocytic link of the immune response. Conclusions. The development of measles infection in the adult population is characterized by changes in the leukocyte indices of cellular reactivity, which are markers of the functional activity of the immune system. The moderate course of the disease is accompanied by a tendency to normalization of the indices that characterize the activity of the inflammatory process, while its severe course is characteri","PeriodicalId":372609,"journal":{"name":"Actual problems of modern medicine","volume":"192 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123399581","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}