Clinical and Preventive Medicine最新文献

{"title":"DEPENDENCE OF THE DEVELOPMENT OF HISTOLOGICAL CHANGES IN THE TISSUES OF THE FALLOPIAN TUBES IN ADOLESCENT GIRLS AND YOUNG WOMEN WITH INFLAMMATORY GENITAL DISEASE ON THE TAXONOMIC AFFILIATION OF PATHOGENS","authors":"A.V. Rudenko, O.V. Romashchenko, A.M. Romanenko, M. Spivak, Lyudmila F. Yakovenko, M. Mitchenko","doi":"10.31612/2616-4868.5.2023.08","DOIUrl":"https://doi.org/10.31612/2616-4868.5.2023.08","url":null,"abstract":"The aim. To conduct a comparative analysis of the fallopian tubes' clinical, microbiological and histological characteristics in adolescent girls and young women with inflammatory genital disease. Materials and methods. The etiological diagnosis of inflammatory disease was established with the help of complex microbiological and cytological studies of biomaterial from the vagina of teenage girls and the cervical canal of young women before hospitalization and histological examination fragments of fallopian tube – after surgery. The microbiological examination included the cultural detection of bacteria of various taxonomic groups, fungi, mycoplasmas, and ureaplasmas from the biomaterial. A set of methods described in the article was used to detect chlamydia [13]. The degree of bacterial infection of the fallopian tube fragments was assessed by determining the microbial count. Histological examination of biopsy specimens of fallopian tube tissues removed during surgery was performed by the conventional method [9]. Results. In the examination of 29 adolescent girls and young women hospitalized for surgical treatment, a comparative analysis was conducted between the clinical manifestations of inflammatory genital disease, identifiable factors, and histological signs of damaged fallopian tubes.When studying the spectrum of factors in the inflammatory focus (fallopian tube biopsies) in adolescent girls (n=12), enterobacteria (33.3%), staphylococci (33.3%), streptococci (8.35%), and Pseudomonas aeruginosa (8.35%) were detected; in 16.7% of adolescent girls, the cultures were sterile. In young women (n=17), microbiological examination of fallopian tube tissues revealed chlamydia (29.4%), mycoplasma (11.6%), ureaplasma (5.8%), gonococci (5.8%), enterobacteria (5.8%), fungi (5.8%); in 6 (35.8%) of the examined women, no bacterial growth was detected. Among young women who had been operated on for tubo-ovarian inflammatory diseases and ectopic pregnancy, chlamydia were most often (29.4%) found in the tissues of the fallopian tubes. Conclusions. The studies have shown that in the development of acute purulent salpingitis in young women, sclerotic changes and signs characteristic of the productive process prevailed in the tissues of the fallopian tubes against the background of genital inflammation, and in adolescent girls, an exudative process was observed against the background of genital inflammation. The peculiarities of the course of genital inflammation depend on the biological properties of pathogens of different taxonomic affiliations.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139250173","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":"PSYCHOTHERAPEUTIC TOOLS IN DEALING WITH NEGATIVE PSYCHOEMOTIONAL STATES BY EXAMPLE OF ONLINE GAMES \"TETRIS\" AND \"FARM\"","authors":"Olga V. Puchyna, Valeriia V. Liulko","doi":"10.31612/2616-4868.5.2023.07","DOIUrl":"https://doi.org/10.31612/2616-4868.5.2023.07","url":null,"abstract":"Introduction: The war has exacerbated the negative psycho-emotional states of people living in Ukraine and abroad. Right now, there is an urgent need for quality mental health care. The search for new effective and at the same time simple methods of providing relevant psychological and psychotherapeutic assistance determines the relevance of this research. The aim: To investigate and prove the effectiveness of the dosed daily use of an online game as a psychotherapeutic tool in dealing with the negative psychoemotional states of people living abroad during the war in Ukraine. Materials and Methods: 500 people took part in the experimental research - Ukrainian immigrants in China, the USA, Portugal and Germany – 267 women and 233 men aged 18-35, who were randomly divided into control and experimental groups of 250 each. The research continued for 13 months. Methods: psychological counselling, psychoeducation, dosed daily using online games «Tetris» and «Farm» in the control and experimental groups, respectively. Diagnostic methods: Questionnaire for the detection of psychosomatic disorders, Depression Self-Assessment Scale and Anxiety Self-Assessment Scale. Results: In the primary diagnosis, the following results were obtained: high rates of psychosomatic disorders in 70,8% of the control and 66,7% of the experimental groups; depression in 63,3% of the control and 66,7% of the experimental groups; high rates of anxiety in 66,7% of the control and 70% of the experimental groups. After using the online games «Tetris» and «Farm» in the control and experimental groups, respectively, the following results were obtained: high rates of psychosomatic disorders decreased to 37,5% of people in the control group and 33,3% in the experimental group; 33,3% of people in the control group and 30% in the experimental group have depression; high rates of anxiety were found in 33,3% of people in the control group and 26,7% in the experimental group, which is half as much as the previous indicators. Conclusions: the results of the experimental research suggest that the dosed daily use of the online game «Farm» is an effective psychotherapeutic tool in dealing with negative psycho-emotional states, proven by the authors.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139248664","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":"IMPLEMENTATION OF ENHANCED RECOVERY AFTER SURGERY (ERAS) IN PATIENTS WITH COLORECTAL CANCER AND CONCOMITANT METABOLIC SYNDROME","authors":"I. M. Todurov, O. I. Plehutsa, Oleksandr V. Perekhrestenko, Sergey V. Kosiukhno, Alexander O. Kalashnikov, A. Trots, V. O. Kyryk, A. A. Hrynevych","doi":"10.31612/2616-4868.5.2023.04","DOIUrl":"https://doi.org/10.31612/2616-4868.5.2023.04","url":null,"abstract":"Introduction. Implementation of enhanced recovery after surgery protocol (ERAS) is becoming more and more widespread due to their effectiveness and safety. At the same time, there is a rather limited number of studies focusing on the opportunities of ERAS in the context of its association with metabolic syndrome in patients with colorectal cancer. This study represents the results of our early experience implementing elements of the ERAS program in the perioperative management of patients with colorectal cancer associated with metabolic syndrome. The aim. To conduct a comparative analysis and evaluate the results of surgical treatment using the enhanced recovery after surgery protocol in patients with colorectal cancer and accompanying metabolic syndrome. Materials and methods. This study included 106 patients with colorectal cancer and accompanying metabolic syndrome, divided into two groups: the first group with the use of elements of the ERAS protocol in colorectal surgery from 2018 – 56 patients, and the second group in which the principles of ERAS were not used (50 patients). Results. In the first group, with a statistically significant difference, a less severe pain syndrome was observed according to VAS (p<0.001), as well as a lower necessity for prescribing opioid analgesics in the postoperative period. Activation of patients, restoration of enteral nutrition and peristalsis occurred earlier in first group (p<0.001). Mean hospital stay in the first group was 5.7±1.5 days, and in second group – 7.7±1.7 days (p<0.001). In the 2nd group, the percentage of complications such as: postoperative wound seroma, abdominal organ eventration, and anastomotic leaks in the 30-day postoperative period were higher than in the group with ERAS elements included. Conclusion. The implementation of elements from the Enhanced Recovery After Surgery (ERAS) protocol for the treatment of patients with colorectal cancer and concomitant metabolic syndrome is effective and safe. It is associated with a decreased duration of hospitalization, less postoperative pain, earlier return to enteral nutrition, quicker patient mobilization, and restoration of peristalsis. Additionally, it reduces the frequency of postoperative complications and readmission rates.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"56 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139246701","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":"DEVELOPMENT OF METHODOLOGY AND TOOLS FOR REGULAR MONITORING, ASSESSMENT OF THE QUALITY OF WORK OF THE ELECTRONIC HEALTHCARE SYSTEM AND IMPROVEMENT OF THE WORK OF EXISTING SERVICES","authors":"Ivan M. Soroka","doi":"10.31612/2616-4868.5.2023.11","DOIUrl":"https://doi.org/10.31612/2616-4868.5.2023.11","url":null,"abstract":"Introduction. Medical information systems have become an important tool in the complex of providing medical care. They allow storing the patient's medical data, analyzing information at many levels, and using modern electronic and telemedicine technologies. The glossary of the concept of health care informatization defines a medical information system as a type of system characterized by a complex of methodological principles, technical means, management algorithms designed for the collection, storage, analysis, forecasting and transmission of medical information in health care institutions. The aim: To analyze the level of satisfaction of medical workers regarding the functioning of the electronic health care system and medical information systems in all areas of medical activity, by evaluating the data of the electronic questionnaire. Materials and methods: A group of 213 user experts from 11 regions of Ukraine and the city of Kyiv was formed to assess the overall quality of the electronic health care system. Informational, analytical-statistical, graphic, and system analysis methods were applied. Results. The information entered into the medical information systems is subsequently widely used by doctors, other medical personnel, patients, and the administration of the health care facility. However, numerous functional deficiencies, and user wishes were identified. Assessing them will contribute to the improvement of e-Health. Conclusions: Medical information systems (MIS) have become an integral attribute of the practical activity of all doctors. The development of MIS in Ukraine continues in intensive and extensive ways. The first MIS were autonomous and responded to local clinical and administrative needs. The problems of the country's health care management can be corrected through the wide and rational use of MIS, their integration into a single electronic system. This will make it possible to analyze medical data at the level of the country, region, institution and thus be able to apply the correct management decisions. Informatization of health care is a global trend, and in Ukraine it is developing at an unusually fast pace. Therefore, the assessment of convenience, efficiency, and interoperability of MIS should become a permanent tool for monitoring and prompt response by both doctors and health care managers. Medical workers are quite satisfied with the functioning of medical information systems in Ukraine, but the issues between technical solutions and practical use of the application remain unresolved.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"181 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139247150","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":"RESEARCH OF THE QUALITY OF LIFE OF PATIENTS WITH DIABETIC RETINOPATHY","authors":"Hanna S. Zdelova","doi":"10.31612/2616-4868.5.2023.10","DOIUrl":"https://doi.org/10.31612/2616-4868.5.2023.10","url":null,"abstract":"The aim of the research: To determine effective techniques for researching the quality of life of patients with diabetic retinopathy, conduct surveys, and analyze the obtained results. Materials and Methods: Bibliosemantic and analytical methods, sociological and statistical methods were employed. A standardized quality of life questionnaire, SF-36, was used. The study population consisted of 30 outpatient patients (22 females and 8 males) who are affiliated with the State Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administrative Department, suffering from diabetes with diabetic retinopathy. Results and Discussion: In medical practice, \"health-related quality of life\" (HRQL) refers to the comprehensive characterization of a patient's physical, psychological, social, and emotional well-being, as assessed based on their subjective perception. Key requirements for modern questionnaires include universality, reliability, sensitivity to changes in the health status of each patient, reproducibility, and ease of use. Additionally, these questionnaires should be standardized, meaning they have a consistent set of standard questions and response options for all respondents, and they should allow for quantitative assessment of psychophysical well-being. In Europe, the most commonly used general-type questionnaire is the EuroQol (EQ-5D), while in the United States, the American questionnaire SF-36 and its variations (SF-22, SF-20, SF-12) are widely recognized. During our research, the assessment of health-related quality of life (HRQL) was conducted using the SF-36 questionnaire, which patients filled out by hand. The study population consisted of 30 outpatient patients (22 females and 8 males) suffering from diabetes with diabetic retinopathy of the second and third degree of severity (preproliferative and proliferative). Conclusions: The only element of self-perception of the disease that was found to be prognostically favorable for health-related quality of life (HRQL) is anosognostic attitudes oriented towards continuing an active way of life and a drive for self-realization. The pronounced maladaptive component of self-perception of the disease is associated with a decrease in HRQL both overall and in specific areas. It is not excluded that the tendency to attach excessive significance to the disease creates a favorable ground for the emergence of emotional problems and the development of intra- and interpersonal conflicts, both related and unrelated to the illness.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139246905","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 MORPHO-FUNCTIONAL MYOCARDIUM STATE AND RELATIONSHIP WITH GALECTIN-3 IN PATIENTS WITH CHRONIC HEART FAILURE OF ISCHEMIC ORIGIN ON THE BACKGROUND OF METABOLIC PATHOLOGY","authors":"K. Borovyk, Nataliia G. Ryndina, O. Kadykova, Pavlo G. Kravchun, Volodymyr D. Babadzhan, Oleksandra S. Yermak","doi":"10.31612/2616-4868.5.2023.01","DOIUrl":"https://doi.org/10.31612/2616-4868.5.2023.01","url":null,"abstract":"The aim. To evaluate the presence and nature of changes in the morpho-functional state of the myocardium in patients with coronary heart disease (CHD) with concomitant type 2 diabetes mellitus (T2DM) and obesity, depending on the functional class (FC) of chronic heart failure (CHF) and the relationship with the concentration of galectin-3 in blood serum. Materials and methods. The study involved 75 patients with CHD with concomitant metabolic diseases such as T2DM and obesity, who were treated in the cardiology department of the State Clinical Hospital No. 27. Patients were divided into groups according to the FC of CHF. Group 1 included 30 patients with CHF FC II, group 2 – 24 patients with CHF FC III, group 3 – 21 patients with CHF FC IV. Results. In patients with СHD and metabolic disorders with CHF FC III, the levels of end-systolic dimension (ESD) and end-diastolic dimension (EDD) were higher by 16.3 % and 17.9 %, respectively, compared with FC II, end-systolic volume (ESV) and end-diastolic volume (EDV) also increased significantly in patients of this cohort with FC III compared with CHF FC II by 35.8 % and 16.5 %, respectively. Significantly increased ESV, EDV by 42.9 % and 37.8 %, respectively, as well as the size of the left atrium by 14.3 % in patients of the study group who had CHF FC IV compared with FC III. The ejection fraction (EF) index decreased in patients of this cohort with CHF FC IV by 14.4 % compared with FC III. The size of the right ventricle was larger by 10.8 % in CHF FC IV than in FC III in patients with CHD on the background of comorbid metabolic pathology. Indicators of the thickness of the LV posterior wall, LV relative wall thickness and intraventricular septum were lower in patients with FC IV compared with FC II, left ventricle mass (LVM) and left ventricle mass index (LVMI) increased by 32 % and 33 %, respectively. Сomparing the levels of Ea/Es in patients with CHF FC II and IV in СHD with concomitant T2DM and obesity, a significant increase in this indicator was found in FC IV (p<0.05). The level of galectin-3 in patients with CHF FC III and IV of ischemic origin against the background of concomitant metabolic disorders was higher than in patients with FC II. Сomparing the concentration of galectin-3 in patients with CHF FC III and IV in patients with CHD with comorbid metabolic pathology, significantly higher levels were found in FC IV (p<0.05). The study of the relationship between the fibrosis factor galectin-3 and cardiohemodynamic parameters revealed probable links, namely direct links between galectinemia and ESV (r=0.52; p<0.05), EDV (r=0.58; p<0.05), Еа/Es (r=0.51; p<0.05). Conclusions. The growth of the functional class of chronic heart failure is accompanied by dilatation of the left cavities of the heart, a decrease in the inotropic function of the left ventricle, an increase in myocardial-arterial stiffness, and an increase in the levels of the galectin-3 fibrosis factor in the studied patients.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139248511","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 MODEL FOR THE AUDIT SYSTEM OF MEDICAL SERVICE QUALITY IN HEALTHCARE INSTITUTIONS","authors":"Valerii I. Dovhan, Anatolii M. Hrynzovskyii, S. Bielai, Dariia A. Arziantseva, N. Zakharkevych, M. Tovma","doi":"10.31612/2616-4868.5.2023.12","DOIUrl":"https://doi.org/10.31612/2616-4868.5.2023.12","url":null,"abstract":"Introduction. Audit of medical services is essential means for provision of the qualified medical care to civilian population. The laws and regulations of a particular country should be considered when this means is implemented. The aim. We have researched the theoretical and methodical approaches to audit system organization of medical service quality in healthcare institutions of Ukraine. Materials and methods. We have analyzed the ideas of experts according to their clinical effect; goals; results and purposes before and after the implementation and receiving the primary feedback. We have described the precise selection of indices according to their effectiveness, taking into account the theories and empiric investigation of the latest researches and articles. The process assessment would be employed in order to define the most effective components of the audit. Results. We have distinguished the criteria of medical care in relation to the quality constituents, such as: patient’s orientation, effectiveness, safety, accessibility, economical effectiveness, timeliness. The results of the indicators are entered into the reporting form. In addition, problems which were identified at the stage of processing the results, and prevent the correct interpretation of the obtained indicator values, should be recorded in the reporting form. Definitely, conducting a clinical audit requires significant administrative resources and high motivation of the healthcare institution staff. The personal traits of the head of institution, including abilities to motivate a team, to use the newest data of analytical systems and registries, to know the background of audit, play a key role in this process. Conclusions. The expediency of regular audits once every 6-12 months was proved. It is suggested that clinical audit be implemented in healthcare institutions in order to ameliorate the procedure and effectiveness of medical care to patients via in-depth analysis of the aid’s constituents in comparison to the defined criteria and implementation of necessary changes.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"219 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139248339","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":"MEDICAL AND SOCIAL REASONING FOR IMPROVING THE ORGANISATION OF PREVENTING AND FIGHTING SKIN CANCER IN THE CONDITIONS OF THE PUBLIC HEALTH SYSTEM DEVELOPMENT","authors":"N. M. Kalashnykova, T. Gruzieva","doi":"10.31612/2616-4868.5.2023.13","DOIUrl":"https://doi.org/10.31612/2616-4868.5.2023.13","url":null,"abstract":"Introduction. Scientific reasoning for improving the organisation of cancer prevention and the providing onco-dermatological care to the population in the conditions of the public health system development. Materials and methods. The article includes the method of system approach as well as bibliosemantic, epidemiological, medical and statistical, sociological, expert assessment, content analysis, structural and logical analysis, modelling methods. Sources of information are the data from scientific literature, the Center for Medical Statistics of the Ministry of Health Care of Ukraine, the National Cancer Registry of Ukraine, the sociological research among various groups of participants in providing healthcare services and strategic documents of the national and international levels. Results. Unfavourable trends in skin malignancies spread, an increase in their contribution to the burden of the disease and the imperfection of the organisation of skin cancer prevention and the onco-dermatological care to the population were revealed. According to the principles of the state policy and the recommendations of the international organisations the directions of improving the preventive, therapeutic and diagnostic services were reasoned out on the basis of the data from the scientific literature, epidemiological research, spread, locational, gender and age peculiarities of skin cancer among the population, risk factors for their development, estimating the health care resource support, scale and results of the activities, studies of the patients, doctors and health care professionals' opinions. The modern functional-organisational model of the prevention system and control of skin cancer in the conditions of the public health system development with the definition of its principles, structures and functions was reasoned and worked out. Conclusions. The practical implementation of the measures for improving the prevention organisation and therapeutic and diagnostic work to fight skin cancer and the developed functional and organisational model of the system of prevention and control of onco-dermatological pathology in conditions of the public health development will effectively prevent onco-dermatological diseases, reduce the burden of skin cancer, improve people’s health and health care performance indicators and contribute to the health care sustainable development and the population’s well-being.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139248755","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":"FACTORS THAT INFLUENCE THE NEGATIVE RESULTS OF TREATMENT OF COMBATANTS' PAIN AFTER MINE-BLAST WOUNDS DURING THE WAR IN UKRAINE","authors":"I. Kuchyn, H. I. Posternak, D. Govsieiev, R. Gybalo","doi":"10.31612/2616-4868.5.2023.05","DOIUrl":"https://doi.org/10.31612/2616-4868.5.2023.05","url":null,"abstract":"Introduction: In 83.3% of cases, pain in combatants who sustained mine-blast injuries during the war in Ukraine becomes chronic. Chronic pain leads to a number of negative aspects that affect the quality of life of combatants, and when they return to military service after treatment for professions that require people to act under pressure, it increases the risk not only for them but also for their teammates and the mission. Therefore, the issue of pain chronicity in this category of patients requires further study, and the identification of factors that influence the frequency of chronicity can potentially improve the results of treatment of this category of patients. The aim: to identify factors that influence the negative results of pain treatment in combatants after mine-blast wounds during the war in Ukraine Materials and methods: We analyzed the treatment of 660 combatants with mine-blast wounds. Treatment outcomes were assessed using a visual analog scale (VAS). Groups were compared using the Mann-Whitney test and the chi-square test with a continuity correction. To analyze the association of the risk of a negative treatment outcome with the factor characteristics, we used the method of building univariate and multivariate logistic regression models. The quality of the models was assessed by the area under the ROC curve (AUC). The odds ratio was calculated to quantify the degree of influence of the factor attribute. Results: It was found that the factors of negative results of pain treatment in combatants with mine-blast wounds are: 1) method of pain treatment (p<0.001), OR=0.06 (95% CI 0.04-0.09); 2) high intensity of pain according to VAS on admission (p<0.001), OR=3.16 (95% CI 2.52-3.98); 3) anesthetic risk according to ASA (p=0.049) OR=0.67 (0.45-0. 99); 4) number of injured anatomical body parts (p=0.015), OR=1.17 (95% CI 1.03-1.32); 5) a combination of indicators: method of pain treatment, patient age and number of injured anatomical body parts AUC=0.82 (95% CI 0.79-0.85). Conclusions: Our study demonstrates that if combatants with mine-blast wounds use a method of pain treatment that does not provide reliable control over the intensity of pain, then during evacuation to a medical facility, such pain becomes high-intensity pain. In addition, the conditions of the injury (combat conditions) and the injury itself cause a significant anesthetic risk according to the ASA. Such patients are associated with a higher risk of chronic pain. In the future, in-depth studies are needed to demonstrate the effectiveness or benefits of combining pain management with regional anesthesia methods. High-quality pain control during the medical evacuation of wounded from the battlefield to a medical facility could potentially improve the treatment outcomes of these combatants and reduce the incidence of pain chronicity.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"33 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139247602","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":"DEPENDENCE OF THE DURATION OF SURGICAL INTERVENTION AND FUNCTIONAL ACTIVITY OF THE PATIENT IN THE POSTOPERATIVE PERIOD ON THE TECHNICAL PARAMETERS FOR PARTIAL RESECTION OF THE MEDIAL MENISCUS OF THE KNEE JOINT","authors":"Bogdan Y. Gryshchuk, Igor V. Boiko","doi":"10.31612/2616-4868.5.2023.02","DOIUrl":"https://doi.org/10.31612/2616-4868.5.2023.02","url":null,"abstract":"Introduction. The study of the duration of surgery and the course of the postoperative period in 38 patients with damage to the medial meniscus of the knee joint who underwent partial meniscus resection in the traditional way was conducted and the analysis of the dependence of the duration of surgery and patient activity in the postoperative period on such technical parameters as the number of resection cycles and the frequency of intraoperative instrument change was performed. The aim of the study. To determine the dependence of the duration of surgery and functional activity of the patient in the postoperative period on the technical parameters of partial resection of the knee meniscus. Materials and methods. The study involved 38 patients aged 21 to 53 years with unstable damage to the medial meniscus of the knee joint of III or IV degree according to Stoller, who underwent partial meniscus resection. To assess functional activity, patients underwent periodic clinical examination and questionnaires using the Tegner activity scale from the first day to 6 weeks after surgery. Statistical processing of the study data was performed using the licensed software IBM SPSS Statistics Base v 22. MedCalc (Healthcare Technology, USA). Results. A direct strong correlation (ρ=0.857) was found between the number of meniscus resection cycles performed during surgery and the number of intraoperative instrument change (p<0.05). A direct strong correlation (ρ=0.725) was found between the number of meniscus resection cycles performed during surgery and the duration of surgery (p<0.05), as well as a direct strong correlation (ρ=0.723) between the number of intraoperative instrument changes and the duration of surgery (p<0.05). There was no correlation between the duration of surgery and the subjective assessment of activity according to the Tegner scale in the period from 0 to 6 weeks postoperatively (ρ is not statistically significantly different from zero, p>0.05). Conclusions. The need for intraoperative instrument change is directly related to the number of resection cycles required to perform partial resection of the medial meniscus. The duration of the surgical intervention is related to the need for intraoperative instrument change and the number of resection cycles required for partial resection of the medial meniscus. However, the functional activity of the patient in the early and medium-term postoperative period is not directly related to the duration of the operation.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139247338","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}