Медицина сьогодні і завтра最新文献

{"title":"Problem of differential diagnostics of neurodegenerative pathology","authors":"M. Chernenko","doi":"10.35339/msz.2019.84.03.08","DOIUrl":"https://doi.org/10.35339/msz.2019.84.03.08","url":null,"abstract":"The differential diagnosis of multiple sclerosis and Wilson–Konovalov’s disease is an important clinical task, the timely appointment of adequate therapy depends on the correct solution of which. With the seemingly simple differential diagnosis of these diseases, in some cases, especially atypical, there are certain difficulties in making the correct diagnosis. Magnetic resonance imaging is a mandatory study in the structure of a comprehensive examination of patients with multiple sclerosis and Wilson–Konovalov’s disease. Conducting standardized magnetic resonance imaging scans performed on a high-field tomograph is mandatory in all cases of differential diagnosis in patients with demyelinating pathology of the central nervous system and neurodegenerative diseases. An analysis of the topography of focal changes in dynamics, an assessment of the rate of increase of atrophic changes is of great importance for the timely appointment of adequate treatment, which in turn directly affects the prognosis of the disease. The brain magnetic resonance imaging data from 30 patients with multiple sclerosis and 10 patients with Wilson–Konovalov’s disease who were treated at the GU INPN NAMS of Ukraine (Kharkov) were described. It is concluded that both multiple sclerosis and Wilson–Konovalov’s disease are chronic partially controlled diseases in which dynamic monitoring is extremely important, an integral part of which is the conduct of adequate neuroimaging. None of the methods for diagnosing multiple sclerosis and Wilson–Konovalov’s disease has independent diagnostic value, and diagnosis is possible only with a comprehensive analysis of clinical, laboratory, genetic and neuroimaging data.","PeriodicalId":404961,"journal":{"name":"Медицина сьогодні і завтра","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121539569","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":"Types of interaction in the triad mother–child–father at the threat of preterm birth at the last trimester of pregnancy and after the birth as a criterion of differentiation of the measures of their medical-psychological support","authors":"M. Markova, N. Grinko","doi":"10.35339/msz.2019.84.03.13","DOIUrl":"https://doi.org/10.35339/msz.2019.84.03.13","url":null,"abstract":"The study involved 150 women at 23–37 weeks of pregnancy: 120 women with the threat of premature birth (main group, MG), 30 women with the physiological course of pregnancy (comparison group, CG) and their husbands. The types of interaction in the mother–child–father triad with the threat of premature birth and after childbirth have been studied. A psychodiagnostic study revealed a reliably high level of the average value of reactive and personal anxiety in women with MG. The average indicator of the level of depression is higher in the MG, where there are cases of subdepressive state and severe depression, in the CG the latter was not revealed. According to the Cranley scale, at the first stage of the study, the level of attachment to the fetus in women from MG was (71,0±1,0) points (attachment disorder), in women from CG was (51,0±2,0) points (sufficient level of attachment), p<0,05. With the help of the «Pregnant Attitude Test», the prevailing type of woman’s attitude to her unborn child was determined in terms of the course of pregnancy. It was found that in 20,8 % of women, the euphoric type predominates, 9,17 % had the optimal type, 9,17 % had hyponosognosic type, 2,5 % had anxious type, 3,33 % had depressive type. In 26,7 % of women, CG has the optimal type. There are no other types of attitudes towards pregnancy. In women with MG, disorientation prevails at all stages of the examination (41–46 people), the dependent type (35–36), autonomous (23–29), and avoidance of proximity much less often was (14–16), in women with CG, the autonomous type dominates (10–13), dependent type (8–10), and avoidance of proximity (4–9) little less often were and disorientation (3–4) much less often was. At each stage of the survey, the level of social support in the MG is reduced relative to that in the CG. It is noted that in both groups the level of social support on two scales such as the support of colleagues at work and public organizations is reduced.","PeriodicalId":404961,"journal":{"name":"Медицина сьогодні і завтра","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134414549","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":"Motor development of children born prematurely with perinatal hypoxic-ischemic damages of the central nervous system","authors":"O. Vareshniuk","doi":"10.35339/msz.2019.84.03.07","DOIUrl":"https://doi.org/10.35339/msz.2019.84.03.07","url":null,"abstract":"A comprehensive examination of 79 children of middle age (3,2±1,3) years old with perinatal hypoxic-ischemic damage to the central nervous system who were born prematurely was performed. The clinical features of impaired motor functions in premature infants who underwent perinatal hypoxic-ischemic brain damage complicated by intraventricular hemorrhages were studied. It was shown that cerebral palsy was diagnosed in 20,3 % of sick children, which was accompanied by severe motor disorders of levels IV–V according to the classification of motor functions GMFCS; 37,9 % have spastic diplegia with II–III level of motor disorders; 27,8 % have a hemiplegic form of cerebral palsy with motor disorders corresponding to level II of the GMFCS classification. Acquired posthemorrhagic hydrocephalus was diagnosed in 14,0 % of the examined children, while the vast majority of children who were operated on before 6 months of age did not have motor deficiency (level III according to the GMFCS classification); 1 child (9,1 %) was not operated on and had a V level of motor disorders according to GMFCS. It has been established that the most significant factors that form a severe motor prognosis are: gestational age of 27–30 weeks, peri-intraventricular hemorrhages of II–IV degrees, periventricular leukomalacia of III degree and signs of periventricular ischemia.","PeriodicalId":404961,"journal":{"name":"Медицина сьогодні і завтра","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115503066","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":"Comparative analysis of biophysical parameters of oral fluid depending on the condition of dental hard tissue","authors":"S. Yarova, I. Zabolotna, V. Petukhov, О.A. Kobtseva, O.P. Reva","doi":"10.35339/msz.2019.84.03.04","DOIUrl":"https://doi.org/10.35339/msz.2019.84.03.04","url":null,"abstract":"The pH, buffer capacity, salivation rate, impedance, micellarity and mineralizing ability of the oral fluid have been determined by the indices of the dispersion coefficient. The dispersion coefficients impedance of oral fluid in patients with a wedge-shaped defect and precervical caries were significantly lower than in patients with intact hard tissues (p=0,004). The greatest steepness of dispersion coefficient was typical for the oral fluid of individuals without any precervical pathology, which corresponds to a high degree of its liquid crystal phase, greater dispersion and micellarity. The strong indirect correlation between impedance and pH and buffer capacity has been revealed and the vivid direct correlation with salivation rate and dispersion coefficient has been found. The interconnections between biophysical parameters of oral fluid require further research in order to diagnose precervical pathology and monitor the effectiveness of preventive measures.","PeriodicalId":404961,"journal":{"name":"Медицина сьогодні і завтра","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129973970","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":"Assessment of psychosocial support in the family with cancer patient","authors":"T. Krivonis","doi":"10.35339/msz.2019.84.03.12","DOIUrl":"https://doi.org/10.35339/msz.2019.84.03.12","url":null,"abstract":"Oncology patients experience high levels of stress both physically and psychologically, which can cause a lack of personal psychological resources. Psychosocial help is able to compensate the lack and be the basis for the recovery of patients in the future. On the base of informed consent, 286 cancer patients examined: 174 women and 114 men. Patients examined at different stages of the treatment process, namely, 78 women and 51 men were examined at the first episode of the disease, and 96 women and 63 men were examined after return of the disease or its relapse. Methods FACES-3, MSPSS were used in the study. It was shown, that in general women evaluated their own psychosocial resource more positively than men. The main source of support for patients, especially women, was family in comparison to significant others and friends. Families with a sufficient level of family adaptability characterized by high levels of psychosocial support, whereas impaired family functioning resulted in reduced external resources. Psychosocial help is an important component of complex psychological help for patients with cancer. The development of medical-psychological help measures should take into account the actual level of psychosocial support in patient and his / her perception by the participants of the treatment.","PeriodicalId":404961,"journal":{"name":"Медицина сьогодні і завтра","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121034960","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":"Clinical typology and mechanisms of psychogenesis of states of psychological maladaptation of internship doctors","authors":"V. Vyun","doi":"10.35339/msz.2019.84.03.09","DOIUrl":"https://doi.org/10.35339/msz.2019.84.03.09","url":null,"abstract":"A comprehensive examination of 213 interns of both sexes was carried out. A system of psychotherapeutic correction of maladaptive states and psycho-preventive support of interns during the period of professional training has been developed. Levels of adaptation of internship doctors for professional activity were emphasized: high (14,1 %), average (20,2 %) and low level (65,7 %). It was described the asthenical (25,8 % of men and 22,5 % of women), hypersthenic (20,6 % of men and 23,2 % of women), anxiodepressive (11,3 % and 20,6 % respectively), psychosomatic (14,5 % of men and 18,1 % of women), asthenic-apathetical (12,3 % and 11,2 % respectively) and addictive (15,5 % of men and 4,4 % of women) variants of maladaptive reactions among the internship doctors. The developed model of the formation of disorders of adaptation of internship doctors is presented by a complex of pathogenic factors. It was established that the basis for the formation of maladaptive reactions among the internship doctors is the presence of somatic pathology, craniocerebral injury and neuroinfection in the anamnesis and the tendency to addictive behavior. Prognostically important factors in the formation of adaptation disorders are conflicts of family and professional relations, disturbing suspiciousness, low communicativeness, difficult working conditions, lack of positive emotions, awareness of inadequate level of competence, low level of motivation, and imperfectiveness of mechanisms of psychological protection. Triggers for the development of maladaptive states are the high level of professional stress, depletion of adaptation, prolonged mental stress, frustration of significant basic needs, and high rates of clinical scale of anxiety and depression HDRS. An individualized three-stage system of medical and psychological support during the professional training period, which involves the application of complex psychodiagnostic, psychotherapeutic, psychoeducational and psychoprophylactic influences, has been developed and tested.","PeriodicalId":404961,"journal":{"name":"Медицина сьогодні і завтра","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121870168","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}