Clinical and Preventive Medicine最新文献

{"title":"EVALUATION OF THE EFFECTIVENESS OF UNILATERAL BIPORTAL ENDOSCOPIC DISCECTOMY IN COMPARISON WITH INTERLAMINAR MICRODISCECTOMY IN THE TREATMENT OF HERNIATED INTERVERTEBRAL DISCS OF THE LUMBAR SPINE","authors":"Volodymyr S. Balan, I. Fishchenko, Lyudmila D. Kravchuk, Yevhenii E. Shcheholkov","doi":"10.31612/2616-4868.1.2024.07","DOIUrl":"https://doi.org/10.31612/2616-4868.1.2024.07","url":null,"abstract":"The aim of the study is to conduct a comparative analysis of the effectiveness of the methods of unilateral biportal endoscopic discectomy and interlaminar microdiscectomy among patients operated on for herniated intervertebral discs of the lumbar spine. \u0000Materials and methods. The study was conducted at the Department of spine and spinal cord neurosurgery of the Regional Clinical Hospital of the Ivano-Frankivsk from May 2021 to August 2022. The sample consisted of 99 patients with intervertebral disc herniation (at the level of L2-L3, L3-L4, L4-L5, L5-S1), including 44 men and 57 women. Criteria for intergroup distribution: group 1 (n = 43) – removal of the intervertebral disc herniation was performed by the method of unilateral biportal endoscopic discectomy; group 2 (n = 56) – interlaminar microdiscectomy was performed. Examination methods - VAS (cm), Oswestry questionnaire after 1 month, 6 and 12 months, respectively. Statistical processing of the results was carried out using Microsoft Excel and Statistica 8.0 (StatSoft Inc.). \u0000Results. In the preoperative period, the back pain index was 6,9±1,1 and 6,7±1,4 in groups 1 and 2, respectively. In the postoperative period in group 1, the back pain index according to VAS decreased from 6,9±1,1 cm to 1,9±0,5 cm the next day, with positive dynamics remaining during the year of observation of 0,2±0,2 cm, respectively. In group 2, at the time of discharge, the pain index was noted at the level of 3,5 ± 0,9 cm with a gradual improvement to 0,7 ± 0,5 cm. Assessment of the severity of radicular pain in the leg in the postoperative period after 1 month showed a significant improvement in both groups: in group 1 from 7,2±0,6 cm to 0,5±0,5 and in group 2 from 7,8±0,5 cm to 0,5±0,3 cm. Significant differences between observation groups during the last survey was not detected. The duration of the operation when using endoscopic access was lower than during microdiscectomy (35,7±15,2 min (M±SD)) and (45,8±13,7 min (M±SD)), respectively (р≤0, 05). The amount of blood loss was 3,8 times less determined during endoscopic access ((35,4±18,9 ml (M±SD)) and (122,2±90,9 ml (M±SD)), respectively (р≤0,05). The length of stay in the hospital was shorter in the endoscopic discectomy group. \u0000Conclusions. The method of unilateral biportal endoscopic microdiscectomy, due to its low trauma, allows the patient to return to an active lifestyle more quickly compared to open microdiscectomy. No significant differences were found according to VAS and Oswestry indicators at the remote stage of observation.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"35 137","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140237070","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 USE OF MEDICINAL PREPARATION GINKGO BILOBA IN THE PROCESS OF PROVIDING COMPLEX PSYCHOCORRECTIVE ASSISTANCE TO FAMILIES WITH THE CONSEQUENCES OF WAR PSYCHOTRAUMA","authors":"I. Hrubnyk, Anzhela B. Olkhovska, Nina V. Koliadenko, M. Shopsha, Olena L. Shopsha, Khrystyna S. Zhyvaho","doi":"10.31612/2616-4868.1.2024.14","DOIUrl":"https://doi.org/10.31612/2616-4868.1.2024.14","url":null,"abstract":"Introduction. The prolonged extreme crisis situation of the full-scale war in Ukraine has a negative impact on the institution of the family, the structure and functions of the modern Ukrainian family. Therefore, the development of effective approaches to the psychocorrection of family relations in wartime is an urgent topic of research. \u0000The aim. The purpose of the work is to develop and test a model of complex psychocorrection of family relations using the drug Ginkgo biloba in wartime conditions. \u0000Materials and methods. Analytical, psychodiagnostic, statistical research methods and the method of conceptual modeling are used in the work. The methodological basis of the study was the understanding of a person as a whole multi-level biopsychosocial living system and an empirical approach. The research sample consisted of 44 young couples (88 people), temporarily displaced from the zone of active hostilities. The subjects were randomly divided into two groups: experimental (21 couples, 42 people) and control (23 couples, 46 people). Psychodiagnostic methods were used in the work: Questionnaire \"Diagnosis of personality behavior in a conflict situation\" (O.S. Kocharyan); Methodology \"Settings in a married couple\" (Y.Ye. Alyoshina); Communication in the family (Y.Ye. Alyoshina, L.Ya. Gozman, O.M. Dubovska); Marriage satisfaction test questionnaire (V. V. Stolin, T.L. Romanova, G.P. Butenko); Connor-Davidson resilience scale-10. Complex psychocorrective intervention was carried out in both groups for three weeks based on the author's model, which contained four groups of factors: individual, family, group, social, and consisted of seven content blocks: 1) correction of individual mental states of each spouse and development of resilience; 2) correction of communication skills and internal and external communication styles of spouses; 3) correction of family attitudes and values; 4) correction of the educational function of the family; 5) correction of the protective function of the family; 6) increasing the vitality of the family and forming its psychotherapeutic function; 7) formation of satisfaction with marriage and determination of constructive prospective directions for the development of family relations. In addition, the respondents of the experimental group received the Ginkgo biloba drug in the form of a standardized leaf extract (Ginkgo biloba-F capsules 400 mg No. 60 of the domestic manufacturer PTF LLC Pharmacom) for three weeks. \u0000Results. A complex model of psychocorrection of family relationships using the drug gingko biloba was theoretically substantiated, developed and tested, and its effectiveness in providing medical and psychological assistance to families with the consequences of war psychotrauma was demonstrated. \u0000Conclusions. It has been proven that the developed and tested comprehensive psychocorrective technique is effective in increasing the resilience of families with the consequences of war psychotrauma. A statistically rel","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"18 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140238780","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 INFLUENCE OF BIOCOMPATIBILITY OF THE EXTRACORPOREAL OXYGENATOR CIRCUIT ON THE DEGREE OF HEMOLYSIS AND OPTIMIZATION OF OXYGEN STATUS IN MINIMALLY INVASIVE CORONARY ARTERY BYPASS GRAFTING","authors":"V. Cherniy, L. O. Sobanska, Pavlo O. Topolov, Arina V. Grygorieva","doi":"10.31612/2616-4868.1.2024.08","DOIUrl":"https://doi.org/10.31612/2616-4868.1.2024.08","url":null,"abstract":"Introduction. A distinctive feature of cardiopulmonary bypass in minimally invasive coronary artery bypass grafting (CABG) is the significantly longer perfusion time, involving active blood drainage from the vein to the cardiotomy reservoir, which carries the risk of hemolysis development. In this context, mechanical hemolysis disrupts the gas transport function of the blood. \u0000The aim of the research. Reducing hemolysis and optimizing oxygen status of patients during minimally invasive coronary artery bypass grafting surgeries. \u0000Materials and methods. The study included 60 patients, who underwent minimally invasive coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) under moderate hypothermia. The patients were divided into two groups of 30 individuals each. To improve the biocompatibility of the oxygenator, the circuit in Group 1 (Gr1) was treated with an adaptive composition, while in Group 2 (Gr2), the oxygenator circuit remained untreated. The following parameters were examined: hemoglobin (Hb), hematocrit (Ht), red blood cell count (RBC), oxygen delivery index (DO2I), oxygen consumption index (VO2I), oxygen extraction ratio (O2ER%), oxygen extraction index (O2EI%), venous (SpvO2), and arterial (SpaO2) oxygen saturation, oxygen tension in arterial (PaO2) and venous blood (PvO2), acid-base status of the blood (pH, pCO2,HCO3ˉ, BE), and the degree of hemolysis. \u0000Results. Before initiation of cardiopulmonary bypass (CPB), an insignificant increase in O2IE% was observed in Gr1 (26.07±1.57) and Gr2 (27.11±0.81); p=0.875, indicating an increase in tissue oxygen consumption. At the hypothermic stage CPB, both Gr1 and Gr2 demonstrated a statistically significant decrease in Hb, Ht, and RBC levels (p<0.05) due to hemodilution, accompanied by a decrease in IDO2, IVO2, O2IE%, and O2ER% in both groups due to hypothermia. After rewarming, O2ER% in Gr1 (22.91±2.68) and Gr2 (24.59±2.02); p=0.191, and O2EI% in Gr1 (22.92±2.44) and Gr2 (24.61±2.01); p=0.215, were in the normal range. After weaning off cardiopulmonary bypassin Gr2, O2EI% was 27.34±1.97, indicating an increase in oxygen consumption and oxygen extraction. Upon separation from CPB, Gr2 showed a tendency to mild compensated metabolic acidosis, mainly due to HCO3ˉ 21.9±0.3. During the rewarming stage, the hemolysis value was 0.36±0.09in Gr1 and 0.45±0.17 in Gr2 (p<0.001). After CPB, hemolysis was 0.41±0.15 in Gr1 and 0.61±0.22 in Gr2 (p<0.001). \u0000Conclusions. Improving the biocompatibility of the extracorporeal oxygenatorcircuit makes it possible to reduce hemolysis and optimise the patient's oxygen status after cardiopulmonary bypass in minimally invasive coronary artery bypass grafting.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"44 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140238920","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":"CORRECTIVE AND PREVENTIVE MEASURES FOR THE PREVENTION OF MYOPIA IN STUDENTS IN A UNIVERSITY ENVIRONMENT","authors":"V.I. Horoshko, Yevheniia G. Khomenko, Andrii I. Horoshko","doi":"10.31612/2616-4868.1.2024.13","DOIUrl":"https://doi.org/10.31612/2616-4868.1.2024.13","url":null,"abstract":"Introduction. The relevance of the conducted research is determined, on the one hand, by the unfavorable epidemiological situation regarding myopia among students, and on the other hand, by extremely incomplete knowledge of the mechanisms that mediate its development, progression, and stabilization. \u0000The aim of this study is to carry out a comprehensive analysis of factors that contribute to the development of myopia, as well as the development of methods for assessing the risk of its occurrence, prevention of progression and psychological correction of myopia, research on the role of physical exertion in the prevention of visual fatigue and psychological correction of myopia with the help of therapeutic exercises. \u0000Materials and methods. The study covered a representative sample of students from different regions of Ukraine. The number of participants was determined on the basis of statistical calculations to achieve sufficient representativeness of the results – 62 first- and second-year students of the Yuri Kondratyuk Poltava Polytechnic National University. The study of the peculiarities of the stability of attention and the speed of attention switching of myopic and normally ophthalmologically healthy students using the \"Correction test\" method by B. Burdon. \u0000Results and discussion. Analyzing the results of the projective method, we can note that myopic individuals have more often (25%) the influence of the family in their lives, in contrast to healthy individuals (10%). Differences are also observed in the indicators of anxiety, in particular, myopic people show more anxiety in relation to society and feel insecurity (41%), in contrast to healthy people (23%). At the same time, there are insignificant differences in openness to communication – myopic people show a high level (56%) in contrast to healthy people (67%). Among students with a reduced relative reserve of accommodation, a decrease in the static endurance of the back muscles was more often observed. It was 17.74% for boys and 22.58% for girls. 32.25% of boys and 77.41% of girls had incorrect postures. To increase the static endurance of the muscles of the back, neck, and press, a technique was developed that included two repetitions of 2-3 exercises for each muscle group with a short interval between repetitions. \u0000Conclusions. 1. Refractive disorders corresponding to mild and moderate myopia include restructuring of function at the level of the retina, visual pathways, and cerebral cortex. 2. Under conditions of the presence of myopia in a person, changes occur in the functioning of both the visual sensory system and higher nervous activity, in particular, attention. 3. The presence of myopia is also related to the psychological characteristics of the individual, in particular, the level of anxiety, the degree of independence and the feeling of attachment to the family, the search for protection from society and a safe environment for self-development. 4. Corrective and preventive","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"23 36","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140240383","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":"ATRIAL FIBRILATION IN CORONARY ARTERY DISEASE PATIENTS: PLATELETS CHARACTERISTICS AND ECHOCARDIOGRAPHY INDEXES","authors":"I. Melnychuk","doi":"10.31612/2616-4868.1.2024.06","DOIUrl":"https://doi.org/10.31612/2616-4868.1.2024.06","url":null,"abstract":"The aim: To reveal the connections between platelets morphological and biochemical characteristics and echocardiography (TTE) indexes in patients with coronary artery disease (CAD) and atrial fibrillation (AF). \u0000Materials and methods: 300 patients were divided into 3 groups: first (CAD) – 149 patients with CAD but without arrhythmias, second (CAD+AF) – 124 patients with CAD and AF paroxysm and control group – 27 patients without CAD and arrhythmias. TTE was done by ALOKA SSD-5000. Platelets count (PC), mean platelet volume (MPV), platelets distribution width (PDW) and platelet-to-leucocyte ratio (PLR) was obtained by common blood count. Platelets amino acids spectrum was detected by method of ion exchange liquid column chromatography. \u0000Results: II group patients had significantly lower PC (12.20%) and higher MPV (9.30%) and PLR (41.12%) then in I group, P<0.05. II group patients had significantly higher levels of platelets isoleucine (10.73%), leucine (12.63%) and lower threonine (23.05%), serine (5.06%), glycine (32.21%), valine (30.83%) levels then in I group, P<0.05. II group patients had significantly higher levels of left atrium diameter (10.03%), left atrium volume (15.40%) and left atrium volume index (11.48%) then in I group, P <0.05. Left atrium volume and left atrium volume index were corelated with PC (r=-0.315 and r=-0.444 consequently), MPV (r=0.327 and r=0.331 consequently), PLR (r=0.313 and r=0.303 consequently) and platelets serine (r=-0.302 and r=-0.310 consequently), alanine (r=-0.306 and r=-0.355 consequently) and leucine (r=0.346 and r=0.311 consequently), P<0.05. Left ventricular mass and left ventricular mass index were corelated with MPV (r=0.308 and r=0.301 consequently), PLR (r=0.307 and r=0.305 consequently) and platelets arginine (r=0.366 and r=0.305 consequently), threonine (r=-0.474 and r=-0.383 consequently), serine (r=-0.387 and r=-0.361 consequently), alanine (r=-0.342 and r=-0.326 consequently), isoleucine (r=0.355 and r=0.328 consequently) and tyrosine (r=0.307 and r=0.321 consequently), P<0.05. \u0000Conclusions: Left atrium size and left ventricular mass are connected with MPV, PLR and platelets amino acids content: serine, threonine, alanine, leucine, isoleucine and tyrosine levels.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"19 74","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140237113","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":"PATIENTS WITH HEMIPARESIS AND MYOFASCIAL PAIN SYNDROME DURING THE IMPLEMENTATION OF THE PHYSICAL REHABILITATION PROGRAM","authors":"Andrii S. Kravec, Zinoviiy M. Yashchуshуn, V.I. Horoshko","doi":"10.31612/2616-4868.1.2024.11","DOIUrl":"https://doi.org/10.31612/2616-4868.1.2024.11","url":null,"abstract":"Introduction. Hemorrhagic stroke causes significant deviations in the psycho-emotional, moral-volitional and social spheres. Kinesiotherapy is a new effective method used in rehabilitation and physical therapy programs for post-stroke patients with myofascial pain syndrome. This publication presents the results of the study of the quality of life of post-stroke patients before and at different times after complex kinesiotherapy, as well as the characteristics of the answers related to the quality of life after the program of combined rehabilitation and physical therapy are given. \u0000The aim of the study is to substantiate the inclusion of kinesiotherapy in the basic rehabilitation and physical therapy programs for post-stroke patients with myofascial pain syndrome. \u0000Materials and methods. The study included 105 patients aged 57 to 64 with a verified diagnosis of hemorrhagic stroke complicated by myofascial pain syndrome.\" The SF-36 general questionnaire was used to assess the quality of life. \u0000Results. It was established that indicators of the quality of life of post-stroke patients before implementation programs of rehabilitation and physical therapy are significantly reduced on most scales of physical, mental and social functioning; the quality of life profile of patients is characterized by compression and deformation. Conducting kinesiotherapy with acupuncture is accompanied by a marked improvement in quality of life indicators of post-stroke patients with myofascial pain syndrome. Responses related to the quality of life, in the form of improvement or stabilization, were registered in the majority of post-stroke patients with myofascial pain syndrome after complex kinesiotherapy – in 96% of patients after a combined program of rehabilitation and physical therapy and in 87% of patients after kinesiotherapy. \u0000Conclusions. The profile of the quality of life of patients with hemiparesis indicates its compression and deformation, which is caused by a significant decrease in indicators that characterize the physical, mental and social scales of functioning. Long-term monitoring of such patients after the implementation of the author's physical rehabilitation program indicates a stabilization of the quality of life, which is manifested by a pronounced improvement in the profile of 96% of post-stroke patients with myofascial pain syndrome after complex and in 87% of patients in combination with acupuncture.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"46 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140237585","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":"POPULATION'S RADIATION ANXIETY STRUCTURE ANALYSIS FOR THE PRE-COVID-19 PERIOD","authors":"S.B. Dorohan, Oleksandr A. Shevchenko, Valeria M. Lekhan, Oleksiy V. Sheviakov, N. I. Operchuk, Natalya G. Mikryukova, Oleksiy M. Cherednichenko","doi":"10.31612/2616-4868.1.2024.09","DOIUrl":"https://doi.org/10.31612/2616-4868.1.2024.09","url":null,"abstract":"Introduction. A considerable amount of conflicting reports creates conditions for concern about the effects of radiation on health. The adequacy of the assessment of problems and responses to these challenges depends on the sources used by a person, his culture and education level, as well as the emotional overtone of this assessment. \u0000The aim of the study is to determine dynamic changes in the prevalence and structure of population’s radiation anxiety states under stable social conditions based on a psychological and hygienic assessment. \u0000Materials and methods: In order to research and assess the perception of Kropyvnytskyi residents about the degree and prevalence of radiation anxiety states, a survey was conducted on Facebook and Instagram social networks from February to December 2019 using Google Form. For assessment of dynamic changes in radiation anxiety, data from our own studies in 2014 were used [9]. The questionnaire methodology was based on the principles of the previously tested and patented \"Methodology for determining radiation anxiety among the population\" and the monograph \"Radiation anxiety among the population\". Three hundred and twenty four residents of Kropyvnytskyi aged 18 to 73 were included in the study, 155 (47.8%) men and 169 (52.2%) women. The average age of the interviewees (Me (LQ; HQ)) was 27 (20; 33) years old. \u0000Results. A specific psycho-emotional state is developed and maintained at some level in the residents of cities with nuclear power plants – radiation anxiety, which is manifested by a complex of neuropsychological and somato-physiological disorders against the fear of ionizing radiation sources background. At the same time, such a psychogenic effect may not be related to the degree of actual effects of ionizing radiation on human health. It was determined that in 2019, before the COVID-19 pandemic and Russia's full armed aggression against Ukraine, more than 90% of the surveyed residents of Kropyvnytskyi, regardless of gender and age, were concerned about potential radiation pollution of the environment and foodstuffs, medium level of radiation anxiety was in 34,9%, and high level in 14.8% . Low radiation anxiety was detected in 41.4% of respondents, and in 8.9% it was absent. \u0000Conclusions. Over 5 years (from 2014 to 2019), there were noticeable negative changes in the structure of the radiation anxiety states among the surveyed urban residents, namely: the amount of people without signs of radiation anxiety halved (8.9% vs. 16.0%) and respondents with the high level of this psycho-emotional state increased almost four times (14.8% versus 3.9%). The obtained results encourage the authors to future studies of specific radiation anxiety states among the population to clarify their dynamics.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"126 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140237816","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":"PROTECTION OF THE RIGHTS OF HEALTHCARE WORKERS IN THE LIGHT OF EUROPEAN INTEGRATION PROCESSES","authors":"O. Strelchenko, Ihor Pastukh, Oleksandr S. Dotsenko, Iryna G. Bukhtiyarova, S. Koshova","doi":"10.31612/2616-4868.1.2024.15","DOIUrl":"https://doi.org/10.31612/2616-4868.1.2024.15","url":null,"abstract":"The aim of the article is to thoroughly characterize the rights of all health care workers in accordance with the current legislation of Ukraine, as well as to identify problems that arise in the process of protecting the rights of health care workers and to propose ways to eliminate them. \u0000Materials and methods. In the course of the research 1,000 healthcare workers were interviewed and surveyed regarding the violation of their fundamental rights in the city of Kyiv and medical and preventive institutions of the Kyiv region. Evaluating the violation of the rights of health care workers, it was found that every fifth medical worker notes the violation of his rights by patients, which is 70%, and by health care institutions – 25%; from colleagues – 3%; the other 2% refrained from answering. \u0000The results. As of January 1, 2024, according to the statistical data of the National Health Service of Ukraine, it is stated that from January 1, 2022 to December 31, 2023 in Ukraine: the number of specialist doctors increased by 5.2% (+4667), by 4.9% (+1280) – primary care physicians (PHC), by 6.7% (+9961) – secondary medical personnel [1]. Thus, the number of medical workers (doctors, middle and junior staff (without pharmacists)) in the Electronic Health Care System as of January 1, 2022 was more than 288000, as of January 1, 2024 – 345000, and medical institutions – 7,393. In July 2023, the number of medical workers was already 396000, and the number of medical institutions was 6559. Whereas in December, the number of medical workers increased to almost 520000, and medical institutions – to 8444 [2]. \u0000Conclusions. In order to improve the protection of the rights of healthcare workers, it is necessary to implement at the legislative level the concept of medical neutrality, which should apply in all democratic countries, regardless of the situations that arise in society. The authors formulated the main principles of medical neutrality, in particular: protection of medical workers, patients, health care institutions and other medical formations, medical vehicles from attacks or from illegal interference; free access to medical care, in particular treatment, as well as necessary medicines and medical devices; humane treatment of the entire civilian population; lack of discrimination in the treatment of the sick or injured; observance of the rights of patients, in particular, to keep a secret about the state of health, to refuse treatment.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"65 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140238415","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":"DYNAMICS OF THE LEVELS OF ASYMMETRIC DIMETHYLARGININE AND PLASMINOGEN ACTIVATOR INHIBITOR TYPE 1 IN PATIENTS WITH ACUTE ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION AND TYPE 2 DIABETES MELLITUS DEPENDING ON THE REPERFUSION STRATEGY","authors":"D. Minukhina, Pavlo G. Kravchun, D. Minukhin, D. A. Yevtushenko, Vasyl V. Kritsak, Volodymyr V. Tkachenko","doi":"10.31612/2616-4868.1.2024.03","DOIUrl":"https://doi.org/10.31612/2616-4868.1.2024.03","url":null,"abstract":"Introduction. Despite the major successes achieved in the treatment of acute coronary syndromes (ACS), acute myocardial infarction (AMI) remains the main cause of death among the working-age population of Ukraine. The means of treatment of interventional cardiology can actually reduce the mortality of patients with ACS, improve the course of the acute period of the disease and ensure less reduction in the functional capabilities of the heart in the future. Among the many pathogenetic mechanisms of vascular inflammation in coronary heart disease and type 2 diabetes, endothelial dysfunction is the determining factor. \u0000The aim of the study. To evaluate the levels of plasminogen activator inhibitor type 1, asymmetric dimethylarginine and endothelial nitric oxide synthase on the 10-14th day in patients depending on the presence or absence of concomitant diabetes type 2 and the type of reperfusion therapy. \u0000Materials and methods. 130 patients with acute myocardial infarction were examined, who were divided into 2 groups: 1 group consisted of patients with acute myocardial infarction with accompanying type 2 diabetes (n=73), 2 group – patients with acute myocardial infarction without type 2 diabetes (n =57). The quantitative content of the plasminogen activator inhibitor type 1 (PAI-1) was determined by the immunoenzymatic method using a commercial test system manufactured by Technoclone PAI-1 ELISA Kit (Austria), endothelial nitric oxide synthase (NOS) – Enzyme-Linked Immunosorbent Assay (ELISA) Kit For Nitric Oxide Synthase Endothelial, asymmetric dimethylarginine (ADMA) – Immunodiagnostik ADMA ELISA Kit (Austria). \u0000Results. Percutaneous coronary intervention (PCI) contributes to a more significant decrease in the content of the marker of endothelial dysfunction – ADMA and an increase in NOS on the 10-14th day of acute myocardial infarction in comparison with standard therapy. During PCI, the level of PAI-1 did not reliably change during treatment due to post-inflammatory and post-traumatic activation of platelets in the vascular wall. \u0000Conclusions. In patients with acute myocardial infarction with type 2 diabetes mellitus, percutaneous coronary intervention contributes to a significant decrease in the content of asymmetric dimethylarginine and an increase in NOS on the 10-14th day of acute myocardial infarction, but was not accompanied by a significant decrease in the level of PAI-1, which in general indicates positive effect of performed myocardial revascularization.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140240928","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":"MULTIMODAL ANESTHESIA AS AN IMPORTANT COMPONENT OF ERAS","authors":"V.I. Chernii","doi":"10.31612/2616-4868.1.2024.12","DOIUrl":"https://doi.org/10.31612/2616-4868.1.2024.12","url":null,"abstract":"Introduction. The ideology of Fast Track-Surgery (FTS) and Enhanced Recovery After Surgery (ERAS) represents modern trends in global surgical practice. Anesthesiology aims to provide ideal and universal solutions for protecting patients from surgical aggression. A multimodal approach, which includes multilevel, multifaceted antinociception, is well-founded, where maximum effectiveness is combined with minimal side effects. \u0000The aim. To analyze the issue of multimodal pain management as an important component of ERAS (Enhanced Recovery After Surgery) from modern sources of literature for optimizing perioperative care in the minimally invasive surgery department. \u0000Materials and methods. Bibliosemantic, comparative, and systemic analysis methods were employed. The proposed recommendations were developed based on an analysis of modern literature, the results of randomized trials and meta-analyses, as well as our own studies dedicated to the study of perioperative pain issues. \u0000The results. It has been proven that the use of opioids in anesthesia practice is decreasing. New and modern methods of continuous monitoring of vital organs in patients are being introduced as supplements to classical monitoring protocols. These methods are used to avoid excessive or inadequate dosing of anesthetics, adjust the concentration of substances used, reduce post-anesthesia complications, and improve patient comfort. The method of perioperative energy monitoring significantly complements the \"International Standards for Safe Anesthetic Practice\", WFSA (2010), and enhances perioperative patient safety by detecting metabolic disturbances and implementing appropriate pathogenetic correction. The importance of regional anesthesia under ultrasound control, nociception-antinociception balance management, and the impact of these methods on opioid consumption, patient satisfaction, and postoperative recovery have been proven. \u0000Conclusions. The most commonly used combination of drugs for multimodal analgesia often includes acetaminophen and NSAIDs (strong recommendation). It has been proven that deep and prolonged sedation in intensive care unit (ICU) patients is associated with worse outcomes, longer mechanical ventilation duration, extended ICU and hospital stays, and higher rates of complications, including infections and sometimes even death.","PeriodicalId":502404,"journal":{"name":"Clinical and Preventive Medicine","volume":"16 46","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140240490","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}