Medical Perspectives-Medicni Perspektivi最新文献

{"title":"The integrative model of resiliency in higher education seekers in war conditions","authors":"V.V. Ogorenko, A.Ye. Nikolenko, T.Y. Shusterman, V.O. Kokashynskyi","doi":"10.26641/2307-0404.2023.3.289204","DOIUrl":"https://doi.org/10.26641/2307-0404.2023.3.289204","url":null,"abstract":"The article presents the results of the study of “The Integrative Model of Resiliency” in higher education seekers in war conditions. 174 higher education seekers were examined, among them: 144 students of the 4th-6th year of the medical faculty and the faculty of medicine and pharmacy of the Dnipro State Medical University, majoring in 222 “Medicine” (main group) and 30 students of the 4th-5th year of the Ukrainian State University of Science and Technology (comparison group). The aim of the study was to determine the modalities of resiliency in higher education seekers in the war condition. A psychodiagnostic method with the integrative model of resiliency “BASIC Ph” was used in the research. The distribution of modalities, their degree of expression (scoring), gender features of the distribution of modalities and their correlations were studied. In the vast majority of higher education seekers, one modality of resiliency dominated (94% in the main group, 100% in the comparison group), which was cognitive modality (64% in the main group, 67% in the comparison group) as the most mature, adaptive and constructive way of overcoming the crisis, especially during the war. In 6% of the investigated ones in the main group, the dominance of two modalities was found, among which the cognitive strategy was once again the leading one (89%). Some gender features of the use of stress coping strategies were revealed. Thus, a statistically significant difference was observed between the indicators of the modalities “Belief”, “Emotions” and “Social support” among males and females of the main group and “Emotions” and “Imagination” in the comparison group (p<0.05). Analyzing the gender characteristics of the correlations of resiliency modalities, a more multifaceted model was found in medical students of male gender. The obtained data contribute to a deeper understanding of own personal strengths and the involvement of less developed ones by higher education seekers, aimed at strengthening and enriching their resources to overcome resiliency of war crisis. Thus, the results of the study should be taken into account when developing psychoeducational and psychocorrective measures and conducting psychological support for of higher education seekers in the conditions of war and post-war time.","PeriodicalId":41059,"journal":{"name":"Medical Perspectives-Medicni Perspektivi","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135297464","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":"Application of deep oscillation therapy in the treatment of peripheral arterial diseases","authors":"R. Trybulski, G. Biolik, W. Kuczmik, N. Ivasyk, O. Tyravska","doi":"10.26641/2307-0404.2023.3.289207","DOIUrl":"https://doi.org/10.26641/2307-0404.2023.3.289207","url":null,"abstract":"Intermittent claudication is a common symptom of peripheral arterial disease, affecting up to 50% of patients over the age of 50, which is characterized by pain, discomfort, and cramping in the leg muscles during physical activity. Intermittent claudication is a common symptom of lower extremity arterial disease (LEAD), which significantly impacts patients’ quality of life and drives healthcare costs. Current treatments for intermittent claudication are often inadequate, leading to a need for more effective treatments. Developing new treatments is critical to improve outcomes for patients and address the public health implications of LEAD. This study’s aim was to present the impact of comprehensive physiotherapy, conducted independently, with the supervision of a physiotherapist, for 14 weeks, on a patient with intermittent claudication caused by peripheral arterial disease. The therapy included bicycle training in a form of physical therapy at home, combined with deep oscillation therapy. Deep oscillation therapy involved the use of an electrostatic field with a frequency of 5 to 250 Hz. The field was applied following the lymphatic drainage methodology. In the discussed case, a statistically significant and favourable increase in the measured variables was observed, such as the increase of bone-brachial index from 0.65 to 0.8, the increase of tissue perfusion, measured by laser Doppler flowmetry, from 12.3% to 61%, depending on the measurement site, and the increase in pain-free walking distance by 451%. TcPO2 measurement in the affected leg increased from 31 to 48 mmHg. The use of physical therapy at home combined with deep oscillation showed improvements in pain-free walking distance, Ankle Brachial Index, and other measures in patients with peripheral arterial disease. Deep oscillation therapy demonstrated potential analgesic effects but also raised concerns about possible nerve damage. The study indicated that physical therapy at home might serve as an alternative to supervised exercise therapy, but it had limitations like a small sample size and lack of direct comparisons.","PeriodicalId":41059,"journal":{"name":"Medical Perspectives-Medicni Perspektivi","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135297571","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 role of epigenetic modifications in the formation of heterogeneous phenotypes in diabetes mellitus (a literature review)","authors":"O.V. Zinych, A.A. Shuprovych, O.M. Trofymenko, K.P. Komisarenko","doi":"10.26641/2307-0404.2023.3.288928","DOIUrl":"https://doi.org/10.26641/2307-0404.2023.3.288928","url":null,"abstract":"This review article provides a summary and update on the role of epigenetic mechanisms in predisposition and progression of diabetes, analyzes the data concerning the cause-and-effect relationship between epigenetic changes and the emergence of distinct metabolic phenotypes. Extensive genetic research has enabled the isolation of a group of genes associated with a high risk of developing diabetes. However, numerous data point to the key role of so-called epigenetic modifications in the interaction between genes and the environment, which arise during ontogenesis based on the existing genotype under the influence of external factors. These modifications do not affect the primary DNA sequence, but influence gene expression through chemical modification and alteration of the secondary structure of DNA molecules and chromatin. Epigenetic mechanisms can program pathological phenotypes in subsequent generations. The main molecular mechanisms of epigenetic modifications are DNA methylation, histone and miRNA modification. Changes in the expression of genes that ensure the synthesis of key enzymes and regulatory molecules lead to disruption in the main signaling metabolic pathways. Deregulation of genes responsible for inflammatory, atherosclerotic and other pathological processes, in particular, leads to endothelial dysfunction and development of diabetic complications, such as cardiovascular diseases, diabetic nephropathy, retinopathy, neuropathy. Hyperglycemia, oxidative stress, inflammatory factors are known as mediators in the pathogenesis of type 2 diabetes and its complications. Since epigenetic modifications are reversible, the methylation process can be influenced by exercise, dietary, lifestyle changes and pharmacological agents such as methyl group donors. For example, S-adenosylmethionine, through participation in methylation reactions, can modulate the folate cycle function and production of homocysteine, an endothelium-toxic substance. Thus, the study of molecular modifications in chromatin structure and the features of activation and inhibition of various signaling pathways is a pressing task, the resolution of which will enable a deeper understanding of the pathogenesis of diabetes and the development of approaches to correct metabolic disorders.","PeriodicalId":41059,"journal":{"name":"Medical Perspectives-Medicni Perspektivi","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135297746","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":"Artificial intelligence effectivity in fracture detection","authors":"V. Boginskis, S. Zadoroznijs, I. Cernavska, D. Beikmane, J. Sauka","doi":"10.26641/2307-0404.2023.3.288965","DOIUrl":"https://doi.org/10.26641/2307-0404.2023.3.288965","url":null,"abstract":"The scientific study aimed to explore the practical implementation of artificial intelligence (AI) technologies in radiology and traumatology for fracture detection, as well as evaluate their overall effectiveness in modern medicine. In recent years, AI has gained significant traction in the healthcare industry, enabling the analysis of patients' clinical data and facilitating disease diagnosis, monitoring, risk assessment, and surgical intervention possibilities. The relevance of the scientific work is in the gradual expansion of practical applications of artificial intelligence technologies in medicine, particularly in radiology for diagnosing fractures. The study aimed to investigate the practical effectiveness of AI technology in fracture detection on example of Hospital of Traumatology and Orthopaedics in Riga, Latvia. The methodological approach combined system analysis of AI system implementation in modern medical institutions for creating X-ray images with a clinical study of fracture diagnosis experience at the Hospital of Orthopedics and Traumatology in Riga, Latvia. Fractures were detected by radiologists, attending physicians, and the AI program, with comparisons made between them. Results were analyzed to assess the program's efficacy. The results of the study demonstrated the high effectiveness of AI technologies in fracture detection. The application of these systems in clinical practice led to a significant reduction in diagnostic errors (by 2-3 times) and an increase in diagnostic accuracy (from 78.1% to 85.2%). Moreover, AI systems proved to be capable of detecting fractures that were not initially identified during routine examinations by paramedics and medical practitioners. This emphasized the practicality of expanding the use of these systems in clinical practice. The practical significance of the obtained results is in their potential use in the development of software systems based on AI, aimed at enhancing fracture diagnosis in medical institutions. These findings provided valuable insights for further advancements in AI-based technologies for fracture detection.","PeriodicalId":41059,"journal":{"name":"Medical Perspectives-Medicni Perspektivi","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135297752","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":"Supplementary protection of intellectual property rights for medicines","authors":"A.O. Kodynets, O.F. Doroshenko, I.P. Volynets, G.K. Dorozhko, V.O. Petrenko, V.V. Belitsky","doi":"10.26641/2307-0404.2023.3.289223","DOIUrl":"https://doi.org/10.26641/2307-0404.2023.3.289223","url":null,"abstract":"The article discusses the issue of extending the legal protection of intellectual property rights for medicines. The research aims to provide a comprehensive overview of the problems related to the implementation of Supplementary Protection Certificates (SPCs) in national legislation and possible solutions. The study also seeks to draw conclusions and make proposals for improving the regulatory framework for the SPCs of medicines. The work utilizes general scientific and specialized methods of scientific cognition, including dialectical, formal-logical, systemic-structural, comparative legal, as well as modeling, analysis, and synthesis methods, which collectively contributed to the organization, planning, and conduct of the research. The study is based on scientific publications from databases and search systems (PubMed, JAMA, Scopus, Springer, BMC, Oxford Academic), international and national regulatory acts, statistical studies by international organizations (Precedence Research), patents for inventions related to medicines, recommendations by national government bodies, as well as prescriptions and guidelines from international and national experts. Considering the analysis of statistical data on the development and implementation of medicines, it has been determined that original biological medicines are a major factor in the rising prices of treating conditions such as diabetes, oncological diseases, and others. Examples of patents for medicines owned by global pharmaceutical companies (Gilead, Bayer Intellectual Property Gmbh, etc.) that have ensured their commercial success and competitive advantages are examined. It has been established that patent protection provides the right holder with the opportunity to maintain a monopoly in the market, thereby compensating for the time spent on the development and research of original medicinal products. Legislative approaches to regulating relationships concerning the supplementary protection of inventions related to medicines in the form of SPCs in Ukraine and the EU are identified. The exclusivity periods for regulatory data protection for medicines in the EU are outlined. Based on the conducted research, it is concluded that the application of the SPC mechanism is a tool to achieve a balance between the protection of intellectual property rights and access to original medicines. Timely entry of generics and biosimilars to the market contributes to reducing market prices but negatively impacts the profitability of manufacturers of original medicines. Attention is drawn to problematic aspects of the legislative implementation of the SPC mechanism in Ukraine, which leads to incorrect interpretation and implementation of relevant provisions and necessitates updating. In light of the aforementioned, there is an urgent need in Ukraine to implement, update, and improve the legislative mechanism for regulating SPCs.","PeriodicalId":41059,"journal":{"name":"Medical Perspectives-Medicni Perspektivi","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135296729","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 first experience of using the \"Senhance\" robotic surgical system during cholecystectomy","authors":"M.A. Kashtalian, Ie.A. Kvasnevskyi, O.A. Kvasnevskyi","doi":"10.26641/2307-0404.2023.3.289167","DOIUrl":"https://doi.org/10.26641/2307-0404.2023.3.289167","url":null,"abstract":"The aim of our study was to evaluate the differences in intra­operative and postoperative outcomes of cholecystectomy using the Senhance robotic platform and laparoscopic cholecystectomy. A retrospective analysis of medical cases history of patients who underwent cholecystectomy from December 2021 to February 2022 was conducted. The treatment outcomes of patients with chronic calculous cholecystitis who underwent robotic cholecystectomy (RC) were compared with those who underwent laparoscopic cholecystectomy (LC). Robotic cholecystectomy was performed using the Senhance robotic platform. The RC and LC groups were matched for age, sex, body mass index and compared for the duration of the operation and hospital stay. For normally distributed data, the mean and standard deviation, determined using the Shapiro-Wilk test (p-value&gt;0.05), were applied. Median and interquartile range (IQR) were also used. Difference between cohorts - 95% confidence interval (95% Confidence Interval) were estimated for normally distributed data. Data analysis was performed using standard summary statistics on the Jamovi 2.2.5 platform. Data were processed using application program packages. All surgical procedures were performed by two surgeons from Odesa National Medical University. Robotic cholecystectomy was performed on 18 pa­tients and laparoscopic cholecystectomy was performed on 20 patients. There were no statistically significant differences between the groups in terms of length of hospital stay, blood loss or complications. There were no bile duct injuries, intra­operative complications, or conversions in either group. The only statistically significant difference was the total time under anesthesia (p&gt;0.05), which was longer in the robotic cholecystectomy group. Cholecystectomy using the Senhance robotic platform was found to be safe, with an average operative time of 35.2±5.0 minutes, while the duration of laparoscopic cholecystectomy was 32.2±3.3 minutes. The study results showed that robotic cholecystectomy using the Senhance system is safe and effective. The use of robotic systems can improve precision and control during surgery, reduce blood loss and complications.","PeriodicalId":41059,"journal":{"name":"Medical Perspectives-Medicni Perspektivi","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135297747","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":"Determining the effect of drug \"Warfarin sodium\" on toxicity indicators in an acute experiment","authors":"D.O. Hlavachek, O.Ye. Kondratenko","doi":"10.26641/2307-0404.2023.3.288925","DOIUrl":"https://doi.org/10.26641/2307-0404.2023.3.288925","url":null,"abstract":"The drug \"Warfarin sodium\" refers to anticoagulants of indirect action. It contains only one substance - warfarin sodium, the toxicological indicator of which have been studied in many countries. Therefore, the range of indicators for DL50 of warfarin sodium is very large. However, warfarin sodium has not yet been studied in Ukraine, its maximum permissible concentration in the air of the work area has not been established. Significant volumes of production and use of the drug “Warfarin sodium” on the territory of Ukraine necessitate the clarification of its main toxicological indicators and the establishment of the maximum allowable concentration in the air of the working area, which includes several stages. The first of them is the purpose of this work, namely: to establish DL50 upon intragastric administration of the drug \"Warfarin sodium\" to two species of animals in the conditions of an acute experiment. Experimental animals (60 non-linear white rats and 70 non-linear white mice) were divided into 9 groups. Six groups were injected with the drug \"Warfarin sodium\" in different doses: the first group (female rats) – 58 mg/kg per animal, the second (also female rats) – 29 mg/kg, the third (male rats) – 323 mg/kg, the fourth (also male rats) – 161.5 mg/kg, the fifth (mice of both sexes) – 374 mg/kg, the sixth (also mice of both sexes) – 187 mg/kg. Three control groups (the first – 6 male rats, the second – 6 female rats, the third – 14 mice) received distilled water. As a result, the mortality rates of experimental animals were obtained, on the basis of which, using the probit analysis method, the toxicity indicator of DL50 was determined: for female rats – 15.85 mg/kg, male rats – 398.11 mg/kg and mice –645.65 mg/kg. The established DL50 for male rats after intragastric administration of the drug \"Warfarin sodium\" may indicate an increase in their resistance to the drug, and this determines the expediency of periodic repeated acute experiments in order to verify the relevance of previously established DL50 of sodium warfarin. According to DL50 upon intragastric administration to female rats, which are the most sensitive species of animals to it, warfarin sodium belongs to highly hazardous substances.","PeriodicalId":41059,"journal":{"name":"Medical Perspectives-Medicni Perspektivi","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135297750","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":"Functional testing of the lower extremity muscles","authors":"P. Sirenko, I. Storozhenko, J. Žīdens, A. Zuša, O.P. Yuzyk, D. Lietuviete, T. Kolesnyk","doi":"10.26641/2307-0404.2023.2.283388","DOIUrl":"https://doi.org/10.26641/2307-0404.2023.2.283388","url":null,"abstract":"The purpose of the study was to increase the efficiency of diagnostics of the strength indicators of the lower extremity muscles by determining the optimal conditions for the mutual location of segments of kinematic links for the best implementation of contractile capabilities during functional testing. The main focus of the work was to determine the positions for the maximum overlaying of myofilaments in the sarcomeres of the investigated contractile areas of the movable segments of the lower extremities during power loads. 20 experienced football players, whose average age was 26.8±6.2 years, took part in the study. In order to fulfill the set goal, interference electromyography was performed on all athletes. The function of a separate group of muscles was considered in accordance with the endogenous ability to overcome external resistance in a given direction. Dependence of contractile manifestations was coordinated in accordance with the approach or distance of areas of attachment of muscles. The positions of the muscles were regulated by the ventral and sagittal planes, as well as by the average amplitude of rotation. On the basis of the ratio of maximum, average amplitudes and frequency, data regarding the maximum overlaying of myofilaments in sarcomeres (maximum bioelectric activity), in accordance with the position angle of the movable segment of the lower extremity were obtained. It was established that for conducting functional testing, the location of the trunk and lower extremities in the same plane of movement and axis were the optimal positions for the diarticular muscles of the thigh and lower leg; for monoarticular extensors of the lower leg - a position at a right angle between the lower leg and thigh; for rotators of the lower leg and foot - location of these segments in a plane parallel to the sagittal one. On the basis of the obtained data, the optimal conditions for the mutual location of the segments of the kinematic links for the realization of the contractile capabilities of the muscles of the lower extremities have been determined, a protocol for functional testing of the muscles of the lower extremities has been developed, it is presented in graphic form with the possibility of entering data from both limbs, while test points of rotator muscles of the thigh and lower leg have been added.","PeriodicalId":41059,"journal":{"name":"Medical Perspectives-Medicni Perspektivi","volume":"26 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90807090","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":"Vaccination against COVID-19 in patients with allergy: experience of the allergological center in Dnipro","authors":"Y. Dytiatkovska, K. Gashynova, Ye.V. Korietskaia, M. Yevtushenko","doi":"10.26641/2307-0404.2023.2.283163","DOIUrl":"https://doi.org/10.26641/2307-0404.2023.2.283163","url":null,"abstract":"Vaccination against COVID-19 is the main global preventive measure in the fight against SARS-CoV-2. As the COVID-19 vaccine will be administered to billions of individuals worldwide during the pandemic, there exists a reasonable fear of severe adverse reactions requiring constant vigilance and careful treatment, particularly in individuals with a history of severe allergy. The aim of our study was to develop and implement an algorithm for the safe vaccination against COVID-19 in patients with pathology associated with hypersensitivity reactions. From January to June 2022, after signing the informed consent, 126 adult patients with relevant diseases in remission were included in a prospective single-center study. Complaints and case histories were collected from all patients, including comorbidity and medications received, anthropometric data were studied, a standard clinical examination was performed, tryptase in venous blood was measured, the level of control was additionally assessed in patients with asthma using the asthma control test and spirography. According to the results of the study, it was proven that vaccination against COVID-19 in patients with pathology associated with hypersensitivity reactions is safe, on condition of prior consultation with an allergist and performing vaccination in a medical institution. The algorithm developed for preparing for vaccination in the mentioned above persons consists of a careful collection of case history; assessment and, in case of absence – achieving control of the underlying disease; analysis and correction of therapy with temporary replacement of medications that are potential cofactors of anaphylaxis; determination of blood tryptase level. For safe vaccination in patients with severe allergic anamnesis, administration of 20 mg of desloratadine before each dose of the vaccine with observation after vaccination within 30 minutes is suggested.","PeriodicalId":41059,"journal":{"name":"Medical Perspectives-Medicni Perspektivi","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73290317","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":"Increasing the efficiency of osseointegration in dental implantation in patients with diabetic osteopathy by remodeling bone tissue and intensifying its density.","authors":"O.O. Gudarian, D. Cherednyk","doi":"10.26641/2307-0404.2023.2.283365","DOIUrl":"https://doi.org/10.26641/2307-0404.2023.2.283365","url":null,"abstract":"The purpose of the study was to increase the effectiveness of osseointegration of implants in dental implantation in patients with rapidly progressing generalized periodontitis combined with diabetic osteopathy by restoring normal remodeling of bone tissue and intensifying its density. The study included 84 patients aged 30 to 50 years (average 41.9±2.36 years) with type 2 diabetes mellitus associated with generalized periodontitis, among them 56 women and 28 men and 19 volunteer donors without periodontal and detected somatic pathology, identical by gender and age. Surgical intervention for the installation of dental implants was performed in 3 groups of patients identical by gender and age: I, II and III groups. Groups I and II included 52 patients (26 patients in each) with rapidly progressing generalized periodontitis, with type 2 diabetes, complicated by systemic osteoporosis, who differed only in the prescribed treatment complex. Group III was formed by patients with a similar pathology of periodontal tissues, but without background diabetic osteopathy (32 patients), who received an identical treatment complex with patients in Group II. During the surgical intervention, 282 dental implants were installed: 92 implants in group I patients, 89 implants in group II, and 101 dental implants in group III. At the same time, we strove to ensure that the percentage of the performed operations was approximately the same. The analysis of the obtained data of laboratory studies showed that in patients with diabetic osteopathy with rapidly progressing periodontitis and rapidly progressing generalized periodontitis without background pathology, a deeper imbalance of the processes of bone remodeling with high level of both – bone resorption and osteogenesis is observed, which causes acceleration of the destruction of periodontal bone tissue and their loss. At the same time, it was found that with a complex and correct selection of antiresorptive therapy, the level of markers of bone metabolism approaches the norm, which is positively reflected in the dynamics and frequency of osseointegration of dental implants. Our research and received data from laboratory studies showed that in patients with rapidly progressing generalized periodontitis with and without diabetic osteopathy, there is an inhomogeneity and imbalance in the functioning of bone remodeling, which negatively affects the process of osseointegration of dental implants and requires a complex approach in the selection of antiresorptive therapy. Inclusion in the protocol of dental implantation of recombinant morphogenetic protein in patients with diabetes with osteopathology leads to completion of osseointegration of dental implants in the term up to 3 months, and monotherapy with  ossein-hydroxyapatite complex in patients with rapidly progressing generalized periodontitis has a similar effect on the osseointegration process – it accelerates the recovery of bone tissue around dental implants.","PeriodicalId":41059,"journal":{"name":"Medical Perspectives-Medicni Perspektivi","volume":"99 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80576327","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}