The Glaxo volume; an occasional contribution to the science and art of medicine最新文献

{"title":"CHANGES IN THE STRUCTURE OF THE DAILY BLOOD PRESSURE PROFILE IN WOMEN WITH THE METABOLIC SYNDROME WHO HAD CESAREAN SECTIONS UNDER THE INFLUENCE OF PHYSICAL THERAPY","authors":"L. Sheremeta, Z. Ostapiak","doi":"10.21802/artm.2023.2.26.132","DOIUrl":"https://doi.org/10.21802/artm.2023.2.26.132","url":null,"abstract":"Abstract. Purpose: determination of the effectiveness of the use of physical therapy in women with metabolic syndrome who underwent caesarean section, based on changes in the structure of the daily blood pressure profile. \u0000Methods. During the research, 44 women aged 25.5±1.6 years at the end of the late postpartum period (2 months after childbirth) were examined. The control group consisted of 17 women with normal body weight who gave birth vaginally and recovered independently in the postpartum period. The comparison group consisted of 14 women with the metabolic syndrome who independently recovered in the postpartum period. The experimental group consisted of 13 women with metabolic syndrome after caesarean section, who for 3 months performed restorative measures developed as part of a proven physical therapy program. They included classes using therapeutic exercises for the muscles of the back, abdomen, and limbs, functional training with adaptation to household movements and child care taking into account obesity and the postpartum period with caesarean section, aerobic training, pressotherapy and vacuum massage for areas with the greatest deposition of fatty tissue; nutritional recommendations – reducing daily caloric intake. Daily monitoring of blood pressure was carried out to determine its profile by the types \"diрper\", \"non-dipper\", \"over-dipper\", \"night-peaker\". \u0000Results. During the initial examination, it was established that, in general, women with a normal body weight have a \"dipper\" daily blood pressure profile. This most favorable type of decrease in arterial pressure at night was characteristic of almost 70% of representatives of this group. At the same time, in women with metabolic syndrome after caesarean section, such a profile was established in slightly more than half of the cases. On the other hand, in the groups of women after caesarean section, a significant share (about a third) was made up of the \"non-dipper\" and \"over-dipper\" profiles, which have an unfavorable character. One of the signs of adverse daily dynamics of blood pressure in women with metabolic syndrome is the diagnosis of their circadian rhythm according to the \"night-peaker\" profile. \u0000The following results were revealed during the re-survey, which was conducted to assess the effectiveness of the developed physical therapy program. The share of persons with a favorable profile of \"dipper\" systolic blood pressure increased. This redistribution took place due to the reduction of the share of persons with unfavorable \"non-dipper\" profiles and the complete disappearance of persons with the daily blood pressure profile \"night-peaker\" profile. Similar trends were also observed in the analysis of daily diastolic blood pressure profiles. \u0000Analysis of daily blood pressure profiles of women after vaginal delivery revealed that they had a higher percentage of women with normal profiles in the early periods of observation; further dynamics were favorable. Re-examination","PeriodicalId":86625,"journal":{"name":"The Glaxo volume; an occasional contribution to the science and art of medicine","volume":"101 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85706277","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":"AGE FEATURES OF REMODELING OF ARTERIES OF THE PROSTATE GLAND AT ETHANOL INTOXICATION","authors":"M. Hnatjuk, N. Monastyrska, L. Tatarchuk, S. O. Nesteruk","doi":"10.21802/artm.2023.2.26.20","DOIUrl":"https://doi.org/10.21802/artm.2023.2.26.20","url":null,"abstract":"Chronic alcohol intoxication leads to damage of almost all organs and systems, the degree of structural and functional disorders of which in this pathology is different and depends on the duration and severity of intoxication. Organs of the reproductive system are always involved in the pathological process with long-term effects of alcohol on the body. Age-related remodeling of prostate arteries in ethanol intoxication has not been studied enough. \u0000The aim of the study: morphologically study the age-related features of prostate artery remodeling under conditions of ethanol intoxication. \u0000Materials and methods. The prostate arteries of 60 white rats were morphologically studied, which were divided into 4 groups: 1 group – 15 intact animals aged 8 months; group 2 – 15 rats aged 24 months; group 3 – 15 8-month-old animals with ethanol intoxication; Group 4 – 15 24-month-old rats with the indicated simulated pathology. A 30% ethanol solution was injected intragastrically at the rate of 2 ml per 100 g of animal weight for 28 days once a day. Animals were euthanized by bloodletting under anesthesia. The external and internal diameters of small-caliber arteries, the thickness of the intima, media, adventitia, intimo-medial, intimo-adventitous, adventitio-medial, Vogenvort and Kernogan indices, and the relative volumes of damaged endotheliocytes were determined on the micropreparations of the prostate. Quantitative morphological indicators were processed statistically. \u0000Research results. The wall of arteries thickens, their lumen narrows, the thickness of the media and adventitia increases, and the studied indices change significantly in ethanol intoxication in the prostate. The thickness of the media in young animals with a pronounced statistically significant difference increased by 49.2 %, in old animals by 50.2 % (p<0.001), and the Wogenvoort index changed by 1.56 and 1.6 times, respectively (p <0.001). The lumen of the studied vessels in young rats was statistically significantly (p<0.001) reduced by 16.6%, in old rats by 35.0%, the Kernoghan index by 12.7 % and 13.0 % (p<0.001), which indicated a marked decrease in vascular permeability and deterioration of  blood supply to the organ. The relative volume of damaged endotheliocytes in the small-caliber arteries of the prostate gland during long-term ethanol intoxication in young rats was equal to (24.80±0.18) %, and in animals of the older age group – (47.60±0.21) %. Light-optically, pronounced vascular disorders, hemoptysis, expansion of mainly venous vessels, perivisceral and stromal edema, foci of dystrophically, necrobiotically, apoptically altered endotheliocytes, epitheliocytes of glandular structures, focal infiltrates and growth of connective tissue were observed in the prostate gland during chronic alcohol intoxication. Swelling of endotheliocytes, their dystrophy, necrobiosis, desquamation and proliferation were also noted. \u0000Conclusions. Ethanol intoxication leads to thickening of walls o","PeriodicalId":86625,"journal":{"name":"The Glaxo volume; an occasional contribution to the science and art of medicine","volume":"98 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76520973","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":"WAYS TO INCREASE MOTIVATION FOR STUDYING AMONG FOREIGN MEDICAL STUDENTS IN A CLINICAL DEPARTMENT","authors":"О.О. Khaniukov, O. Smolianova","doi":"10.21802/artm.2023.2.26.186","DOIUrl":"https://doi.org/10.21802/artm.2023.2.26.186","url":null,"abstract":"Abstract. During the last decade, there was a constant increase in the share of foreign medical students in Ukrainian higher education institutions. But this trend was disrupted due to military aggression by the Russian Federation. Therefore, the institutions of higher medical education in Ukraine faced an urgent problem – to increase their attractiveness to foreign applicants now and restore the demand for educational services in the future. Among the main factors influencing the attractiveness of a higher education institution on the international market is the satisfaction of the customer's country with the results of training. The latter are determined by the level of the graduate's mastery of the necessary competencies. And among them, professional ones – which are acquired at clinical departments – have a crucial place and are decisive for the profession. It is important to note that motivation is one of the predictors of competencies acquisition. It has been proven that the inspiration for studying in medical students changes due to various factors. Their understanding will allow teachers and educational institutions to affect them to promote the development of positive motivation to study a clinical discipline in foreign learners. \u0000That is why the aim of the study was, based on the literature review, to establish the factors that influence the motivation to study a clinical discipline among foreign medical students, as well as to determine the ways to increase it. \u0000Results. When studying literary sources, it was found that one of the motivation models widely used in education is the self-determination theory, according to which there are three its key components: autonomy, competency, and relatedness (a sense of connection with others in the group). These three components interact and influence each other, forming the motivation to study the discipline. When students feel independent, consider themselves competent in their abilities, and have a supportive social environment, their motivation increases. \u0000To create positive motivation in foreign learners at the clinical department, it is necessary to understand their needs and make an environment that supports learning. And the strategies to implement this should target both changes on the organization's part and the impact on the individual student. Some of the interventions are specific to foreigners, while others do not differ from those used in all students, but this does not make them any less valuable. \u0000To increase motivation to study the clinical discipline in foreign medical students, the following directions of work were identified: to provide language support, ensure the acquisition of multicultural competence, foster the development of a sense of connection in the group, set clear learning objectives, regularly provide constructive feedback, improve access to clinical experience, appoint a mentor or tutor, emphasize the importance of clinical discipline, give examples of role mod","PeriodicalId":86625,"journal":{"name":"The Glaxo volume; an occasional contribution to the science and art of medicine","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78550456","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":"SYNERGISTIC EFFECTS OF RUTA GRAVEOLENS L. EXTRACTS WITH ERYTHROMYCIN AGAINST SKIN ISOLATES OF MLS-RESISTANT STAPHYLOCOCCI","authors":"N.V. Makevych, R. Kutsyk","doi":"10.21802/artm.2023.2.26.72","DOIUrl":"https://doi.org/10.21802/artm.2023.2.26.72","url":null,"abstract":"The aim: to research the synergistic interaction of garden ruta ethanolic extracts with erythromycin against skin isolates of MLS-resistant staphylococci. \u0000Materials and methods. The study of the synergistic interaction of 5 water-ethanol extracts of the garden ruta herb (extractants - 40%, 50%, 70%, 90% and 96% ethanol) with erythromycin was performed on 11 clinical strains of skin isolates of MLS-resistant staphylococci. Determination of MLS-resistance was carried out by the disc-diffusion method. MIC of erythromycin of staphylococcal strains was determined by the method of two-fold serial dilutions in Muller-Hinton broth. A screening analysis of the potential ability for synergistic interaction of ruta herb extracts with erythromycin was carried out by the method of microdiffusion in agar. The validity of the synergistic interaction of the studied ruta herb extracts with erythromycin was confirmed by the сheckerboard assay with the calculation of the Fractional Inhibition Concentration Index (FICI). \u0000Results. Using the qualitative method of microdiffusion in agar, it was established that subbacteriostatic concentrations of erythromycin increased the diameters of the zones of inhibition of the bacterial growth around the wells with all the studied extracts in 50±1.3% of the test strains. The best results were shown by the 96% extract of ruta herb, which increased the diameters of zones by 49.7-75.5%. Around the wells with 70% and 90% extracts, the diameters of zones increased by 32.4-48.3% and 34.6-52.4%, respectively. A decrease in MIC of erythromycin in the presence of efflux pump blockers - reserpine and potassium arsenate was observed in 2-4 times at four strains with R-phenotype, twice - at one strain with Neg-phenotype and one strain with D-phenotype of MLS-resistance.  90% and 96% ruta herb extracts showed a synergistic interaction with erythromycin among the largest number of researched strains, regardless phenotype of MLS-resistance (4-128-fold decrease in MIC of ERY). The least antibiotic potentiating ability was shown by 40% and 50% ruta herb extracts, under the influence of which the MIC of erythromycin decreased by 2-32 and 2-64 times, respectively. \u0000Ruta herb extracts in 90% and 96% ethanol showed a synergistic interaction with erythromycin (average FICI values 0.49±0.42 and 0.42±0.25, respectively). Extracts in 40%, 50% and 70% ethanol were generally characterized by an additive effect (FICI values of 0.72±0.47, 0.63±0.24 and 0.68±0.38, respectively). \u0000It should be noticed, that the synergistic interaction of erythromycin and subbacteriostatic concentrations (1/4, 1/8, 1/16 IPC) of ethanolic ruta herb extracts against the studied skin isolates of MLS-resistant staphylococci had a dose-dependent nature (F=6,9812; F>Fcrit.= 2,8916; p=0,000917). \u0000Conclusions. Therefore, water-ethanol extracts of garden ruta herb demonstrate the ability to 4-128-fold reduction of MIC of erythromycin in MLS-resistant strains of S. epidermidis and S. a","PeriodicalId":86625,"journal":{"name":"The Glaxo volume; an occasional contribution to the science and art of medicine","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73580512","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":"REHABILITATION AND PREVENTION OF THE MEDIAL TIBIAL STRESS SYNDROME IN MILITARY PERSONNEL","authors":"O. Kuprinenko, K. Tymruk-Skoropad","doi":"10.21802/artm.2023.2.26.224","DOIUrl":"https://doi.org/10.21802/artm.2023.2.26.224","url":null,"abstract":"Abstract.Medial tibial stress syndrome is an injury that occurs as a result of cumulative and chronic damage to the lower extremities during excessive physical exertion. It is manifested by pain in the posterior medial part of the tibia, which is caused by microtraumas of the shin muscles and overstrain of their attachment sites, as well as tibial periostitis progressing to a stress fracture. It is most often found among athletes and military personnel and can significantly limit their ability to perform professional physical activities. The risk of receiving this injury is especially high among military personnel in their first year of service, which includes cadets of higher military educational institutions. Persons who have developed medial tibial stress syndrome are prone to relapses of the disease, and without proper treatment and rehabilitation, its chronic form may develop, which leads to deterioration of functioning. In addition, medial tibial stress syndrome is considered a precursor to a tibial stress fracture, requiring longer treatment and recovery. \u0000Based on the results of the analysis of the existing methodical approaches to physical therapy of people with medial tibial stress syndrome in Ukraine, a small number of publications dealing with this problem were found. Also, complex physical therapy programs for servicemen with injuries from heavy workload were not developed and implemented. \u0000Aim. The aim of the research is to analyze approaches to the rehabilitation and prevention of medial tibial stress syndrome among military personnel. \u0000Materials and methods. The publications selected on the basis of a search in the databases PubMed, PEDro, Cochrane Library, Google Scholar, and Vernadsky National Library of Ukraine were analyzed. \u0000Results. It was found that almost all physical therapy methods used in the treatment of the syndrome were part of an individual (standard) treatment program for military personnel with stress syndrome, which also included medication and surgical intervention as indicated. In only one research, after treatment of an acute period of the disease, patients were offered a multidisciplinary rehabilitation program based on therapeutic exercises, which were used to reduce symptoms, improve endurance, and return servicemen to duty. \u0000It has been established that therapeutic exercises, as the main means of physical therapy, are ineffective in the rehabilitation and prevention of medial tibial stress syndrome without combination with other interventions. The insufficient effectiveness of the treatment of the syndrome by combining therapeutic exercises with means of physical therapy was determined. \u0000It has been found that gait retraining in combination with therapeutic exercises accelerates recovery and prevents the occurrence of medial tibial stress syndrome in military personnel. \u0000Conclusions. The data obtained in the analyzed scientific researches, a significant difference in the organization of research, rehabilit","PeriodicalId":86625,"journal":{"name":"The Glaxo volume; an occasional contribution to the science and art of medicine","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87674149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CLINICAL CASE OF RECURRENT NEVUS","authors":"M. Voloshynovych, V. Holotiuk, T.R. Boichuk, N. Matkovska, G. Girnyk","doi":"10.21802/artm.2023.2.26.252","DOIUrl":"https://doi.org/10.21802/artm.2023.2.26.252","url":null,"abstract":"Abstract. Introduction. Recurrent nevus is a benign proliferation of melanocytes that occurs at the site of non-radical removal of a previously existing nevus. Recurrence rates range from 0.3% to 28% and most often occur within 6 weeks to 6 months after removal. Clinically recurrent nevus is characterized by uneven pigmentation with uneven edges in the area of the scar. \u0000Walton et al. began researching the phenomenon of recurrent nevus in 1957. In 1975, Kornberg and Ackerman reported that a pigmented recurrent nevus can resemble superficially spreading melanoma both clinically and histologically, and proposed the term pseudomelanoma to describe this benign phenomenon. Currently, the term is rarely used, but it motivates a thorough examination of patients with such a problem. \u0000Case presentation. Patient A. complained about the presence of a formation in the area of the outer surface of the right forearm, which has existed for many years, it was injured several times, but has recently changed the colour. On examination, a nodule up to 0.5 cm in size, heterogeneously pigmented, with peripheral erythema was found in the indicated place. During dermoscopy, chaotic unevenly distributed pigmentation, consisting of dots, globules, forming a cellular structure in a scattered manner is determined, zones of segmental radial lines are present as well. The vascular pattern in the central part of the formation is not defined, on the periphery it is represented by slightly noticeable point vessels. Digital post-processing using machine learning technology was carried out to improve visualization of blood supply. Multiple point, curved, and convoluted vessels with few branches around the formation, and several central vessels in the pigment cells are determined. Surgical removal of the tumor was performed with involvement of the erythema zone, taking into account the peculiarities of pigmentation and vascular pattern. The pathogistological structure is presented in the photomicrograph. The epidermis has a typical structure, with areas of slight acanthosis; hyperpigmentation of the basal layer is also observed. In the dermis, foci of brown pigment deposition, single lymphocytes, there are areas of intradermal lobular-horizontal fibrosis with angiomatosis and scattered lymphocytic infiltration. Taking into account the clinical data, there is a recurrence of a melanocytic nevus on the background of a skin scar (Recurrent neavus). \u0000Teaching point. Dermoscopy allows obtaining additional data for the differential diagnosis of recurrent nevus and recurrent melanoma. A recurrent nevus is characterized by relative symmetry of formation and a pattern of segmental radial lines. The formation is limited to the area of the scar and does not go beyond it. Also, in the case of recurrent melanoma, a continuous growth in dynamics and a later appearance of recurrence from the moment of intervention will be obvious. \u0000Conclusions. As clinical practice demonstrates, under certain ci","PeriodicalId":86625,"journal":{"name":"The Glaxo volume; an occasional contribution to the science and art of medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88610517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ASSESSMENT OF HAND FUNCTION IN PATIENTS WITH RHEUMATOID ARTHRITIS AS A RESULT OF PHYSICAL THERAPY","authors":"A. Nogas","doi":"10.21802/artm.2023.2.26.98","DOIUrl":"https://doi.org/10.21802/artm.2023.2.26.98","url":null,"abstract":"Assessment of hand function is the great importance in physical therapy for patients with rheumatoid arthritis, as the choice of rehabilitation measures and evaluation of their results depends on the functional capacity of the hand. \u0000The purpose is to evaluate hand function in patients with rheumatoid arthritis as a result of physical therapy using the Sollerman test. \u0000Materials and methods. The research was conducted on the basis of the rheumatology department and the department of rehabilitation treatment using traditional and alternative methods of the Municipal Enterprise “Rivne Regional Clinical Hospital named after Yuriy Semeniuk” in Rivne. The results of the research were accumulated as patients were admitted for inpatient treatment. A total of 188 patients with rheumatoid arthritis were examined, with an average age of 44.9±7.6 years. All patients were randomly assigned to the control (n=92) and main (n=96) groups. Patients of the control group underwent rehabilitation in accordance with the recommendations of the regulatory document of the Ministry of Health of Ukraine. Patients in the main group were treated according to the proposed physical therapy technology, which included the following elements: therapeutic exercises, therapeutic massage, physiotherapy, hydrotherapy, orthotics, kinesiotaping of the upper extremities, mechanotherapy and psychological support. A physical therapy programme was developed for each patient for a long-term period of 6 months. To determine the function of the arm, the Sollerman test was used. The obtained digital material was processed statistically using the Statistica 10 statistical analysis package (Serial Number: STA999K347150-W). \u0000Results. The initial examination revealed the presence of disorders of the basic functions of the hand and deviations from the norm, as well as impaired fine motor skills and various types of hand grip according to the Solleraman test. We analysed the quality of different types of grasping in patients with rheumatoid arthritis, in particular, the greatest difficulties were in performing spherical and cylindrical grasping – in 82.9% of patients and 89.3% of cases, respectively. Forceps grasping was also difficult in 76.5% of patients. During the repeated examination after 3 and 6 months, patients in both groups showed positive dynamics in the performance of individual test tasks. Thus, in patients of the main group, after 3 months, the average Sollerman test scores increased to 65.1±5.3 points, in the control group this figure was significantly lower than 61.8±3.6 points (x ±S) (p<0.05). In 6 months after hospitalisation, the mean values of the Sollerman test in the main group of patients with rheumatoid arthritis increased significantly and were close to normal values. In patients of the control group, the average values of this test also increased, but they were significantly lower than those of the main group. Accordingly, the mean Sollerman test score in patients of the m","PeriodicalId":86625,"journal":{"name":"The Glaxo volume; an occasional contribution to the science and art of medicine","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85120414","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":"FORMATION OF STUDENTS’ MOTIVATION IN MASTERING PATHOMORPHOLOGY DISCIPLINE","authors":"E. Kindrativ, Z. Guryk, N. Chuiko, L. Malofiy, V. M. Kostiuk","doi":"10.21802/artm.2023.2.26.170","DOIUrl":"https://doi.org/10.21802/artm.2023.2.26.170","url":null,"abstract":"Abstract. Motivation is an essential factor of human activity, which, in turn, determines the development and efficiency of activities, including the educational process. A contradiction was revealed between the objective need to form the motivation of cognitive activity of students of a medical higher education institution (HEI) through the introduction of interactive technologies considering both the internal features of learning and external requirements for medical university-educated specialists – on the one hand, and the lack of scientifically grounded technology for forming the motivation of a medical HEI students’ cognitive activity using the latest systems – on the other hand. \u0000The main factor influencing students’ motivation to study is mastering of knowledge, skills and abilities that will lay the groundwork of their future professional activities. Students engaged in research are motivated to self-development and achievement. These are the ones that make students work hard, solve complex problems, engage in self-education, and overcome difficulties to achieve the highest results. \u0000The article presents the ways and methods of formation the students’ motivation when mastering the Pathomorphology discipline. \u0000In order to improve ways and methods of students’ motivating, we analysed scientific sources on the specifics of professional and educational activity motivation, the principles of educational process organisation at the Pathological Anatomy Department. \u0000Under trying circumstances of today, every applicant for higher education has the opportunity to obtain a full range of information on the Pathomorphology discipline on the Pathological Anatomy Department website and in the university repository for productive self-training and mastering practical skills and abilities provided by the discipline’s programme. To increase motivation in the study of pathomorphology and the level of assimilation of the material. The department uses general and special innovative methods that depend on the specifics of studying the discipline: explanatory-illustrative (informational-receptive), contextual, problematic, research, heuristic. Different strategies should be used to encourage students to become more intrinsically motivated, developing their sense of competence and control over their learning, and to motivate students with interesting content. \u0000Under present-day conditions, teaching Pathomorphology requires constant improvement in compliance with medicine development level and the ability to combine classical approaches to teaching with new learning concepts. The decline in traditional teaching methods efficiency, which is observed when considering the peculiarities of students’ learning activities, requires correction and implementation of modern innovative teaching methods. Improving the methods of learning motivation will help to increase the level of study material mastery. Applying new information technology and technical aids in distance ","PeriodicalId":86625,"journal":{"name":"The Glaxo volume; an occasional contribution to the science and art of medicine","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75736662","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":"ПОБІЧНА ДІЯ ТЕРАПІЇ ІНГІБІТОРАМИ ИМУННИХ КОНТРОЛЬНИХ ТОЧОК НА ЩИТОПОДІБНУ ЗАЛОЗУ","authors":"V.I. Starikov","doi":"10.21802/artm.2023.2.26.238","DOIUrl":"https://doi.org/10.21802/artm.2023.2.26.238","url":null,"abstract":"Introduction. Survival of patients with advanced-stage cancers remains poor despite significant successes in targeted and chemotherapy. Immunotherapy is a systemic method of treatment that has expanded the possibilities of drug therapy for malignant tumors. Immunotherapy's side effect significantly differs from chemotherapeutic drugs and targeted therapy. \u0000Research rationale. One of the most common side effects is a toxic effect on the endocrine system, particularly the thyroid gland. \u0000Aim of the research. Conduct a systematic analysis of scientific literature on the side effects of immune checkpoint inhibitors on the thyroid gland. \u0000Materials and methods. A scientific search was conducted in Pubmed, Scopus, and Web of Science databases. The following search terms were used: \"immune checkpoint inhibitors,\" \"immunotherapy,\" \"thyroid gland,\" and \"side effects.\" \u0000Research results and discussion. Both PD-1/PD-L1 inhibitors and CTLA-4 inhibitors can cause thyroid dysfunction (hyperthyroidism or hypothyroidism). One of the meta-analyses reported no difference in the incidence of thyrotoxicity between the two drug groups. However, other meta-analyses have shown that this phenomenon is more common in patients treated with PD-1/PD-L1 inhibitors than with CTLA-4 inhibitors. In addition, scientists proved that hypothyroidism occurred statistically more often (3.8% of patients) than hyperthyroidism (1.7%). Hypothyroidism was more common in PD-1 inhibitor users than hyperthyroidism (7.0% vs. 3.2%, respectively). Patients with a history of autoimmune thyroid disease have a high risk of disease exacerbation after initiating immune checkpoint inhibitor therapy. The side effect of immune checkpoint inhibitors is developed mainly in women. The first laboratory signs of hypothyroidism are observed after 2-4 courses of immunotherapy. In most cases, the disease is asymptomatic, but in rare cases, it turns into permanent hypothyroidism and even thyroid crisis. The leading causes of destruction of the thyroid gland due to immune checkpoint inhibitors are damaged by autoantibodies or the production of thyroid-stimulating antibodies. \u0000Levothyroxine is prescribed at 0.8–1.6 μg/kg/day for treating hypothyroidism with clinical symptoms. For elderly patients and patients with cardiac pathology, the initial dose of the drug should be no more than 25-50 μg. Treatment with immune checkpoint inhibitors is usually continued. Treatment of thyrotoxicosis depends on the pathological mechanism that caused it. Most often, beta-blockers (atenolol and propranolol) are used to eliminate the symptoms of thyrotoxicosis. A feature of thyroiditis is its ability to transition into hypothyroidism, which can become permanent. \u0000Conclusions. The development of thyroid dysfunction is the most common consequence of autoimmune damage. PD-1 inhibitors are the most common cause of this condition. Usually, the disorders are asymptomatic and have the first degree of severity. Timely appointment for horm","PeriodicalId":86625,"journal":{"name":"The Glaxo volume; an occasional contribution to the science and art of medicine","volume":"29 20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82941055","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 CLINICAL PARAMETERS IN THE PATIENT EXAMINATION PROGRAM AS AN OPTIMIZATION MEANS FOR COMPLEX DIAGNOSIS AND PROGNOSIS OF TEMPOROMANDIBULAR JOINT DISEASES","authors":"Z. Ozhogan, A. V. Krokhmal","doi":"10.21802/artm.2023.2.26.104","DOIUrl":"https://doi.org/10.21802/artm.2023.2.26.104","url":null,"abstract":"Abstract. Aim: to optimize the diagnosis and the choice of treatment tactics for temporomandibular joint (TMJ) pathology by evaluating the features of its clinical manifestations. \u0000Materials and methods: in a clinical retrospective randomized cohort dynamic study as part of a comprehensive examination, an assessment of clinical, anamnestic, and physical symptoms was conducted in 325 patients aged 18 to 76 years with TMJ diseases and accompanying pathology, in particular, periodontal diseases, pathological attrition, dentition defects. Data analysis was conducted using classical methods, considering the types of data and their distribution at a critical level of p 0.05. \u0000Results and discussion. Anamnestic and physical indicators show stable trends in patients with TMJ changes and comorbid conditions already long before development to clinically significant dental pathology (by descending informativeness): pain in the TMJ area, pain during wide opening of the mouth, noises in the TMJ area, the desire to find the most comfortable position of the jaws when closing the teeth, disturbances in chewing and diction, asymmetry of the movements of the lower jaw in the horizontal plane, treatment with the use of corrective history of mouth gags, teeth grinding or clenching, chronic pain in the temporal region, pronounced sensitivity in the area of the teeth, cramps in the head or neck and throat, orthodontic treatment or selective grinding of teeth in the anamnesis, history of serious accidents or intubation, disorders of the masticatory muscles, previous dental treatment, pathology of hard tissues of teeth, misalignment of the centers of the tooth rows, mismatch of centers behind bridles, failure of the patient to perceive the seriousness of the condition, violation of posture, absence of the need for treatment in the patient's perception, etc. \u0000A method (algorithm) of assessing the probability of progression of TMJ diseases was developed based on the data of the study of the frequency of individual factors and the prognostic value of each of the criteria. For each clinical indicator, its presence or absence is determined, and the corresponding values of informativeness are added. When the threshold sum of coefficients is reached using the scale, a risk group of progression of TMJ disorders is determined: if the sum is equal to or lower than -19.8, the risk is high; if the sum is greater than -19.8 and less than 19.8, the risk is uncertain; if the sum is equal to or higher than 19.8, the risk is low. \u0000Following conclusions were made: both anamnestic and physical clinical manifestations (bruxism, myofascial pain, palpation data, malocclusion, pathological wear of teeth, periodontopathy, etc.) are important components in the early diagnosis of TMJ pathology and the selection of optimal correction tactics. Taking into account the clinical indicators in general semiotics allows to optimize the diagnosis and the choice of medical care tactics for persons with TM","PeriodicalId":86625,"journal":{"name":"The Glaxo volume; an occasional contribution to the science and art of medicine","volume":"135 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84972562","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}