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

{"title":"THE INFLUENCE OF MEDICINAL AND AROMATIC PLANTS EXTRACTS ON THE ANTIFUNGAL EFFECT OF FLUCONAZOLE REGARDING C. ALBICANS AND C. TROPICALIS ISOLATED FROM PATIENTS WITH DENTURE STOMATITS","authors":"R. Kutsyk, T. Ohiienko, A. O. Cheliy, Ya. V. Pyuryk, O. B. Haioshko","doi":"10.21802/artm.2023.2.26.51","DOIUrl":"https://doi.org/10.21802/artm.2023.2.26.51","url":null,"abstract":"Candida albicans is one of the most common and virulent representatives of Candida fungi which causes fungal lesions of the mucous membranes predominantly in people with compromised immune system. Candida resistance to classical antifungals such as polyenes, azoles, allylamines is a serious practical problem. Imidazole and triazole are the most commonly used antifungal agents for candidiasis today. Their mechanism of action lies in the inhibition of ergosterol biosynthesis which is indispensable for maintaining the structural integrity of fungal cell membranes. Activation of elimination systems is often associated with changes in the structure of fungal membranes, leading to a decrease in the supply of azoles into the fungal cell Screening of antifungal activity and synergism of antifungal activity of 166 aqueous-ethanol plant extracts with Fluconazole in relation to 2 clinical strains of Candida fungi (C.) (C. albicans and C. tropicalis) with different mechanisms of azole resistance isolated from patients with prosthetic stomatitis was conducted by means of agar diffusion method. The expressed direct antifungal activity of extracts of Calendula officinalis L. inflorescences, flowers of Limonium platyphyllum Lincz., flowers of Grataegus monogyna Jacq., roots of Potentilla repens L., the grass of Melilotus albus Medik, leaves of Peucedanum ruthenicum Bieb, leaves of Rhus coriaria L. and aerial part of Polythridum commune Hedw was determined in reference to the tested strains. Synergism of antifungal action with 1/4, 1/8 and 1/32 of Fluconazole MIC (minimal inhibiting concentration) in relation to both test strains of yeast-like Candida fungi was demonstrated by the flowers of Calendula officinalis L, aerial part of Melilotus albus Medik. The main purpose of the screening was to discriminate extracts in order to select those that would be promising for further testing by a more accurate сheckerboard titration method. The efflux mechanism of resistance to triazoles (in C. tropicalis test strain) is more susceptible to modification by biologically active compounds of medicinal plants. Regarding C. albicans test strain which combines the efflux mechanism of resistance with mutation(s) of ergosterol biosynthesis enzymes, the modifying effect of plant extracts is much less frequent and less pronounced. Therefore, it may be assumed that mutations of ergosterol biosynthesis enzymes provide high stability of the phenotypic manifestation of Candida azole resistance. Should that be the case, determining the azole resistance mechanism of Candida clinical isolates may be important for clinical practice. Combination therapy is more beneficial than monotherapy because it may provide more effective destruction or suppression of pathogens. The combined action of synergistic agents is quite easy to achieve in case of localized superficial lesions (which occur on the mucous membranes of the prosthetic bed in candidal prosthetic stomatitis): for example, using a syst","PeriodicalId":86625,"journal":{"name":"The Glaxo volume; an occasional contribution to the science and art of medicine","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91497414","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":"RETIFANLIMAB-INDUCED THYROID GLAND DYSFUNCTION AND COLITIS (CASE REPORT)","authors":"M. Kononenko, I. Duzhiy, Y. Moskalenko","doi":"10.21802/artm.2023.2.26.260","DOIUrl":"https://doi.org/10.21802/artm.2023.2.26.260","url":null,"abstract":"Immunotherapy is a modern and effective method of treating malignant neoplasms. Retifanlimab is a humanized and stabilized immunoglobulin G4κ monoclonal antibody that binds to PD-1. The drug has been proven to effectively treat cervical cancer and squamous cell tumors of the anal canal caused by the human papillomavirus. Phase III studies of the effectiveness and safety of this monoclonal antibody in patients with non-small cell lung cancer is currently underway. \u0000Patients treated with immunotherapy have an increased risk of developing immune-related adverse events. The most common immune-related side effects in the patient after taking retifanlimab were thyroid gland disorders, itching, pneumonitis and skin rash. In this article, we would like to present a case report of a combined immune-related thyroid and colon dysfunction induced by retifanlimab. \u0000Materials and methods. We collected clinical data and laboratory results of a patient with advanced stage of non-small cell lung cancer. A 59-year-old male patient had disease progression after first-line chemotherapy. He received retifanlimab as second-line therapy at 375 mg intravenously every three weeks. \u0000The results. The first laboratory symptoms of thyroid gland dysfunction began after 36 weeks of taking retifanlimab. After 42 weeks, a laboratory picture of hyperthyroidism was observed with a critically low level of TSH and a high level of T4. In addition, the patient reported diarrhea 7–8 times a day for the last seven days. Immune-related adverse events (colitis grade 3 and hyperthyroidism grade 1) were suspected. The administration of retifanlimab was temporarily discontinued. 750 mg of methylprednisolone was administered once over 60 minutes. The patient's general condition was significantly improved the next day, and prednisolone was prescribed orally at a dose of 2 mg/kg/day. On the second day, diarrhea recurred twice; on the third, the stool returned to normal. Hormone levels were gradually normalized until week 46. \u0000Discussion. Immune-related adverse events may occur as a result of taking any monoclonal antibodies. Early diagnosis and therapy of immune-related adverse reactions is the key to the safe and effective use of PD-1/PD-L1-blocking antibodies. \u0000Immune-related colitis occurred in 1.6% of patients treated with retifanlimab. Hyperthyroidism was observed in 4.3%. \u0000Thyroid disorders that correspond to 1 or 2 grades of severity are common. Therefore patients do not require any medication therapy, or endocrine therapy can be used. However, 13% of patients required systemic corticosteroid therapy. Antihyperthyroidism therapy or corticosteroids (oral prednisolone 1–2 mg/kg/day) are prescribed only when clinical symptoms appear and, accordingly, the severity of the disease is 2 or 3. It is possible to prescribe high-dose steroid therapy. \u0000The appointment of loperamide is sufficient for the initial symptoms of colitis. Therefore, monoclonal antibodies are not discontinued. However, more","PeriodicalId":86625,"journal":{"name":"The Glaxo volume; an occasional contribution to the science and art of medicine","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88435457","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":"КОРЕКЦІЯ РУХОВОГО СТЕРЕОТИПУ ЖІНОК З ЦУКРОВИМ ДІАБЕТОМ І ТИПУ, ЯКІ ПЕРЕНЕСЛИ КЕСАРІВ РОЗТИН, ЗАСОБАМИ ФІЗИЧНОЇ ТЕРАПІЇ","authors":"I. Grygus","doi":"10.21802/artm.2023.2.26.24","DOIUrl":"https://doi.org/10.21802/artm.2023.2.26.24","url":null,"abstract":"Abstract. The Purpose is to determine the effectiveness of the use of physical therapy for the correction of the motor stereotype of women with type I diabetes that underwent cesarean section in the postpartum period. \u0000Methods 35 women with type 1 diabetes who underwent abdominal delivery (caesarean section) 1 month before the initial examination took part in the study. The control group consisted of 17 women, who recovered in the postpartum period without rehabilitation interventions or according to self-selected methods. 18 women of the comparison group were engaged in a physical therapy program, the effectiveness of which is presented in this study, which lasted 1 month. Within its framework, kinesitherapy was performed with women (therapeutic exercises for the upper and lower limbs, back, abdomen, chest; functional training to correct the movements of habitual activities and those that take care of a child); manual massage (back, abdomen, lower limbs). Means of physical therapy were used to improve the physical qualities of women - flexibility, strength, endurance, dexterity, speed; normalization of psycho-emotional status, which can be changed due to the risk of postpartum depression; improvement of peripheral blood circulation, changed due to diabetic angiopathy; improvement of sensitivity of peripheral tissues and neuromuscular control, altered due to diabetic neuropathy; improvement of tissue sensitivity to insulin and normalization of glucose utilization by tissues. \u0000The effectiveness of physical status correction was performed according to the standard Functional Movement Screen technique. \u0000Results The movement capabilities of women with diabetes according to the Functional Movement Screen in the postpartum period were relatively low, which was due to a long period of reduced physical activity, changes in the biomechanics of the body, and postpartum reorganization of the body. \u0000During the re-examination, the improvement in exercise performance was (respectively in the control group and the comparison group): \"deep squat\" – 11.9% and 49.2%; \"hurdle step\" – 17.2% and 31.7%; \"in-line lunge\" – 35.4% and 86.8%; \"shoulder mobility\" – 14.0% and 50.3%; \"active straight leg raise\" – 24.1% and 47.0%; \"trunk stability push-up\" – 20.0% and 60.4%; \"rotary stability\" – 34.0% and 67.1%. This is evidenced by the results of FMS in women of the control group, which were statistically significantly better (p<0.05) compared to the original data, but the number of women with low scores was still significant. At the same time, the determination of FMS parameters in women of the comparison group during the repeated examination showed the feasibility of using physical therapy to improve the condition of women with diabetes in the postpartum period, since in this group the repeated results were better not only the initial levels, but also the corresponding indicators of the control group upon re-examination (p<0.05). \u0000Conclusions After the implementation of a p","PeriodicalId":86625,"journal":{"name":"The Glaxo volume; an occasional contribution to the science and art of medicine","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88497461","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":"OCCUPATIONAL THERAPY AND PHYSICAL THERAPY IN INCLUSIVE EDUCATION","authors":"O. Kuzenko, O. Petryk, O. Tymoshchuk, O. Vaida, O. Yaniv, N. Golod, O. M. Kitayhorodskaya","doi":"10.21802/artm.2023.2.26.214","DOIUrl":"https://doi.org/10.21802/artm.2023.2.26.214","url":null,"abstract":"In the context of solving the tasks of inclusive education, the competencies of physical therapists and occupational therapists, defined by the Standard of Higher Education of the second (master's) level of higher education in the field of knowledge 22 Health care, specialty 227 Physical therapy, occupational therapy, in particular effective cooperation with all members of the multidisciplinary rehabilitation team and other health, education and social policy professionals involved in providing services to patients/clients. \u0000The purpose of the research is to reveal the content and tasks of physical therapy, occupational therapy in an inclusive educational space. In order to achieve the set goal, the following research tasks must be solved: to reveal the state of scientific study of the problem of using methods of physical therapy, occupational therapy in inclusive education; to analyze the task of the team of psychological and pedagogical support of a child with special educational needs; determine the types of health-preserving technologies in educational institutions with an inclusive form of education; to analyze the content, forms and methods of adaptive physical education in an inclusive educational space. \u0000Conclusions: \u0000 \u0000The introduction of an inclusive form of education in Ukraine significantly actualized the need for the use of occupational therapy and physical therapy in corrective and developmental assistance for children with disabilities of different age and nosological groups. At the same time, the support of children with special educational needs in the implementation of the tasks of the individual development program by a multidisciplinary team of specialists in an inclusive educational space has become an important direction of ensuring their special educational needs. \u0000The use of various types of health-preserving technologies is an important condition for the effective functioning of inclusive education. In order to preserve, strengthen and increase the physical, mental and social health of pupils of inclusive groups of special education, such main groups of health-preserving technologies are used as: organizational-pedagogical, psychological-pedagogical and educational-educational. Organizational and pedagogical ones are used to determine the structure of the educational process, which is able to prevent overwork, hypodynamia, etc. \u0000Among the types of health-preserving technologies that are used in the inclusive educational space of primary schools, it is appropriate to single out: physical culture and health, medical and preventive technologies, and technologies for ensuring optimal mental and social health of preschoolers. \u0000The effectiveness of the introduction of AFV in the work with pupils of special educational institutions who have normative development and their peers with special needs of different nosological groups depends on ensuring an optimally favorable, barrier-free educational environment in special educationa","PeriodicalId":86625,"journal":{"name":"The Glaxo volume; an occasional contribution to the science and art of medicine","volume":"103 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73113740","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 MARKERS OF HYPERTENSION IN THE LEFT RENAL VEIN SYSTEM","authors":"I. R. Nestetenko, V. Nesterenko, A. Pavliak","doi":"10.21802/artm.2023.2.26.91","DOIUrl":"https://doi.org/10.21802/artm.2023.2.26.91","url":null,"abstract":"Introduction. Hypertension in the left renal vein (LRV) system is usually a consequence of aorta mesenteric clamp (the so-called “nutcracker syndrome”) and leads not only to venous stasis of the left kidney, but also to the development of pelvic congestion syndrome. The frequency and severity of the “nutcracker syndrome” (NS) symptoms varies from asymptomatic microhematuria to severe forms of pelvic venous congestion. Some patients indicate distinct and constant clinical symptoms, some patients, especially children, note an asymptomatic course \u0000The objective was to study the prevalence and degree of hypertension clinical symptoms manifestations in the LRV system. \u0000Materials and methods. The study included 248 patients (156 men and 92 women, an average age constituted 28.24±2.74) with suspicion of NS who underwent examination and treatment from 1999 to 2022. All patients were interviewed for specific complaints, pain syndrome in particular (questionnaire according to VAS) and underwent laboratory diagnostic tests, color Doppler ultrasound of the reno-caval segment, kidneys, pelvis, and CT angiography, if necessary. \u0000Results. According to the conducted patient questionnaire, one third of patients with AMC without critical LRV stenosis did not have a pain syndrome, and when present, mild and moderate pain prevailed. However, pain syndrome was indicated by 93.1% of respondents in the group of patients with critical LRV stenosis (II group) and the structure of its intensity also changed. \u0000Apparently, macrohematuria lasting more than 2 years with a frequency of more than 2 times in 2 months (32.84%) prevailed in the patients with critical LRV stenosis (group II), whereas this indicator in the patients of groups I and III constituted 4.26% and 4 .56%, respectively. \u0000Evidently, a significant decrease in BMI was observed in the patients with critical LRV stenosis (16.2±1.08 vs. 23.8±1.12 and 24.7±2.38 in the patients of groups I and III, respectively). As a result of the examination, a distinct correlation was established between the decrease in BMI and the pain syndrome intensity according to VAS in the patients of group II: Spearman’s rank correlation coefficient was 0.948, P<0.0001, CI 95% for Rs from -0.972 to -0.906 constituted 18.2% in group I, 46.3% in group II, 12.4% in group III, respectively. \u0000Left sided varicocele was diagnosed in 48 (54.5%) examined men of groups I and II: stage I was diagnosed in 12 (25%) cases, stage II was observed in 31 (64.5%) cases, stage III was found in 5 (10.5%) patients and in 12 (13.4%) patients of group III (control). \u0000However, analysis of the varicocele frequency, taking into account its stage, found no connection between the degree of varicocele and the presence of LRV critical stenosis. \u0000Conclusions. NS is characterized by distinct polymorphism of clinical manifestations and a variety of clinical forms. The main hypertension markers in the LRV system are pain syndrome and hematuria. Color Doppler ultrasound of t","PeriodicalId":86625,"journal":{"name":"The Glaxo volume; an occasional contribution to the science and art of medicine","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75393011","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":"METHODS OF APPLICATION OF CALCULATION PROBLEMS STUDYING ANALYTICAL CHEMISTRY","authors":"A. Stetskiv, L.V. Stetskiv, N.I. Rushchak, U. Sikoryn","doi":"10.21802/artm.2023.2.26.175","DOIUrl":"https://doi.org/10.21802/artm.2023.2.26.175","url":null,"abstract":"Analytical chemistry is the science of research methods for the qualitative and quantitative composition of substances. Recently, physico-chemical experimental methods of research, characterized by speed, accuracy and high sensitivity, have been widely implemented - these are chromatography, polarography, potentiometry, spectrophotometry, etc. In all these methods, we use various calculation problems. \u0000The ability to solve calculation problems in analytical chemistry is one of the important components of the professional competence of students, because it is a general theoretical basic discipline in the system of training future pharmacists. The use of calculation problems is one of the constituent parts of pharmaceutical education, along with the study and assimilation of theoretical material and the mastery of experimental techniques. The introduction of calculation problems into the educational process makes it possible to implement the following didactic principles of education: ensuring the independence and activity of students, achieving the unity of knowledge and skills, establishing connections between learning and everyday life. At the same time, it is ensured: the development of the optimal method of approach to the theoretical substantiation of the condition of the problem; consolidation of rules, terms, laws, equations; understanding the connection of physical quantities, polytechnic training of students' knowledge; specification, systematization, strengthening and verification of students' knowledge; the combination of theory and practice, the ability to put one's knowledge into practice. \u0000The article presents the experience of using calculation problems in analytical chemistry at the Department of Chemistry, Pharmaceutical Analysis and Postgraduate Education for the second-year students of the Faculty of Pharmacy. The main attention is paid to the method of solving problems. The main stages of solving the problem are considered, namely: \u0000 \u0000Determination of the standard of actions (classification of calculation problem systems, their analysis, solution plan and solution design). \u0000Trial tasks (semi-independent work on solving problems with proposed algorithms, instructions, some indicative actions). \u0000Independent work of an educational nature (problems and benchmarks of their solutions are proposed, which students can use after completing the independent work stage). \u0000Thematic independent work (the ability to solve complex problems and the level of the student's mastery of the relevant competence are tested). \u0000 \u0000The use of calculation problems on the example of various topics of practical classes with different types of control and the scheme for evaluating student activity are described. It is shown that the use of calculation problems in the educational process contributes to the improvement of students' perception of the educational material in the discipline, encourages them to perform independent work, and forms the competencies n","PeriodicalId":86625,"journal":{"name":"The Glaxo volume; an occasional contribution to the science and art of medicine","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80747450","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":"IMPACT OF THE WAR ON THE MENTAL HEALTH OF UKRAINIANS: FACTORS IN FORMATION OF NEUROTIC AND STRESS-ASSOCIATED MENTAL DISORDERS. CURRENT STATE OF THE ISSUE","authors":"O. Yurtsenyuk, B. Sumariuk","doi":"10.21802/artm.2023.2.26.248","DOIUrl":"https://doi.org/10.21802/artm.2023.2.26.248","url":null,"abstract":"The article provides an overview of the main stressogenic factors affecting the development of non-psychotic mental disorders in Ukrainians during the war. Special attention is paid to statistical data indicating the prediction of prevalence of mental disorders and open sources with statistical data. \u0000Aim. To investigate and study the modern view of the development and formation of neurotic and stress-related mental disorders during the war. \u0000Materials and methods. Open scientific sources of the last five years on the impact of war on the mental health of the population were used. Scientific data were analyzed by methods of review, system and content analysis. The material was searched using the Google Scholar, PubMed, and open sources of the World Health Organization (WHO), the Ministry of Health of Ukraine (MOH), International Organization for Migration (IOM), United Nations and other government web portals of Ukraine. \u0000War is a powerful psychosocial stress factor that affects the mental health of Ukrainians and leads to the formation of neurotic and stress-related mental disorders. There is a trend towards an increase in the number of people who need psychiatric or psychological help. Neurotic and stress-related mental disorders caused by the war in Ukraine are becoming one of the most widespread problems of Ukrainians, which prevent them from fully functioning, adapting to new living conditions, and also constitute significant obstacles for the economic state of the state in connection with the increase in the number of people with temporary disability. The important issue of timely diagnosis, prevention, and correction of neurotic and stress-related disorders are topical issues today. Having analyzed the modern literature on mental disorders among Ukrainians as a result of the full-scale invasion of russia on the territory of Ukraine, we can conclude that this topic requires detailed study and analysis. Since many questions remain open regarding the influence of the war on the formation and development of mental disorders during the russian-Ukrainian war. Statistics from the World Health Organization (WHO) show that as a result of armed conflicts, one in five people who have experienced them may have mental health problems. This amounts to about 9.6 million Ukrainians who are potentially at risk of developing neurotic disorders such as depression, anxiety disorder, and stress-related disorders, including post-traumatic stress disorder. \u0000The development and formation of mental disorders during the war is influenced by a number of psychosocial reasons, the constant action of stressogenic factors of various nature, psychotraumatization of the population caused by news of a negative nature (a sense of loss of relatives, home, sense of security) and socio-economic difficulties. \u0000Conclusions. As a result of hostilities, the number of people who need psychiatric or psychological help is increasing. There is a tendency to increase the number of neur","PeriodicalId":86625,"journal":{"name":"The Glaxo volume; an occasional contribution to the science and art of medicine","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87309513","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":"CORRECTION OF CHANGES IN LIPID METABOLISM AND REDOX SYSTEM IN PATIENTS WITH STEMI IN THE SETTING OF INSULIN RESISTANCE","authors":"M. Shved, I. Yastremska, R.M. Ovsiichuk","doi":"10.21802/artm.2023.1.25.77","DOIUrl":"https://doi.org/10.21802/artm.2023.1.25.77","url":null,"abstract":"Myocardial infarction (STEMI) remains one of the most important problems of modern Cardiology both in Ukraine and worldwide due to its recalcitrant indices of incidence, disability and mortality. The prevalence of metabolic syndrome (MS) and DM2 in Ukraine is quite high, accounting for 20-28% in the general population and over 50% in certain demographics. In persons with abdominal obesity, metabolic syndrome and DM2, there is a 30% total risk of developing MI in the next 8 years, and their mortality rate is double thatof persons without metabolic disorders. The unfavorable prognosis in such patients is attributed to insulin resistance as an additional risk factor for CAD progression and the development of ACS, which determines the need to develop methods for correction of these abnormal processes. \u0000The aim of the research: to explore the efficacy of correcting the disorders of lipid profile and prooxidant/antioxidant system balance in patients with STEMI in a setting of insulin resistance and high risk of reperfusion complications by using dapagliflozin, a SGLT2 inhibitor. \u0000The methods of the research. The basis of the work has been underlain by the analysis of a comprehensive assessment and surgical treatment (percutaneous coronary intervention) in 73 patients with STEMI in the setting of insulin resistance in MS and DM2. The parameters of lipid profile and the activity of the components in the prooxidant/antioxidant system were determined by spectrophotometric methods; the absorbancy was measured on a Biomat 5 spectrophotometer (United Kingdom).The diagnosis of ACS was verified according to ESC Guidelines in the presence of a typical anginal attack, ACS-specific ECG changes with time (reciprocal ST displacement) and the signs of necrosis-resorption syndrome.The diagnosis was subsequently confirmed by the results of urgent coronary angiography. The diagnosis of MS and type 2 DM was made according to the recommendations of the WHO Expert Committee (2013) and the updated ADA/EASD consensus (2018). \u0000Results. In order to improve lipid profile and redox system balance in pre- and postoperative period, the patients were prescribed dapagliflozin at the dose of 10 mg/day, which allowed compensation of hyperglycemia, reduction of insulin resistance and stabilizing the activity of prooxidant/antioxidant system, preventing post-PCI reperfusion complications and stabilizing the clinical condition of comorbid patients in the postoperative period owing to a 40.4% reduction in the incidence of rhythm and conductivity disorders, and a 55.3% reduction in manifestations of acute heart failure. There has been a substantial reduction in free radical oxidation in the setting of dapagliflozin treatment, as suggested by a 1.3-fold reduction (р<0.05) in active products of thiobarbituric acid in the serum and a simultaneous restoration of functioning of enzymatic antioxidant systems, a 1.5-fold reduction (p<0.05) in the degree of superoxide dismutase blockage with an in","PeriodicalId":86625,"journal":{"name":"The Glaxo volume; an occasional contribution to the science and art of medicine","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82531857","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 PARAMETERS OF THE METABOLIC SYNDROME IN OBESE WOMEN WHO HAVE UNDERGONE CAESAREAN SECTION UNDER THE INFLUENCE OF PHYSICAL THERAPY","authors":"L. Sheremeta, Z. Ostapiak","doi":"10.21802/artm.2023.1.25.83","DOIUrl":"https://doi.org/10.21802/artm.2023.1.25.83","url":null,"abstract":"Purpose: to determine the effectiveness of restoring the health status of obese women who underwent cesarean section, based on the dynamics of metabolic syndrome parameters. \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 obese women who independently recovered in the postpartum period. The experimental group consisted of 13 obese women who, for 3 months, performed a physical therapy program (therapeutic exercises for the muscles of the back, abdomen, upper and lower limbs, functional training; pressotherapy; vacuum massage; nutritional recommendations. The criteria for metabolic syndrome were studied: abdominal obesity, fasting hyperglycemia, impaired glucose tolerance (according to the results of a 2-hour loading test), total cholesterol, high triglyceride content, decreased high-density lipoprotein content. \u0000Research results. During the observation period (3 months), the women of the control group increased their body weight by 0.61 kg on average, the comparison group - by 1.66 kg, while the women of the experimental group decreased their body weight by 2.57 kg, which was reflected in the dynamics body mass index. In the women of the research group, it was possible to achieve a statistically significant decrease in waist circumference (p<0.05), which can be explained not only by the decrease in the amount of abdominal fat, but also by the toning of the muscles of the anterior abdominal wall, weakened by overstretching during pregnancy. Such dynamics influenced the parameters of the ratio of waist circumference to hip circumference in the direction of its improvement, although normalization was not achieved. Under the influence of physical therapy, the expressiveness of biochemical manifestations of metabolic and dyslipidemic manifestations in the women of the research group decreased relative to the parameters of the first examination. Fasting glucose parameters reached the normal range, tissue sensitivity to glucose was restored. Positive changes in the concentrations of lipid fractions in the direction of decreasing atherogenicity were observed. At the same time, women in the comparison group showed a tendency to increase body weight, worsening of atherogenic dyslipidemia, i.e. signs of metabolic syndrome. In women of the control group with normal body weight, there were no changes in the studied indicators. \u0000Conclusions. Obesity as an independent pathological process increases the risks during pregnancy and childbirth for both the mother and the child, leading to an increase in the frequency of abdominal delivery with appropriate postpartum rehabilitation in such women. The improvement of anthropometric indicators and the reduction of dysmetabolic and dyslipidemic manif","PeriodicalId":86625,"journal":{"name":"The Glaxo volume; an occasional contribution to the science and art of medicine","volume":"131 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74561690","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":"A CASE OF INTRAOPERATIVE DISCOVERY OF ABERENT SUBVESICAL BILE DUCT DURING LAPAROSCOPIC CHOLECYSTECTOMY","authors":"S. Filip, Y. P. Skrypynets, V. M. Voronych, A. I. Shitev, H. Alzubaidi","doi":"10.21802/artm.2023.1.25.115","DOIUrl":"https://doi.org/10.21802/artm.2023.1.25.115","url":null,"abstract":"Introduction. Subvesical bile ducts (Lyushka ducts) are tubular aberrant anatomical anomalies of the biliary tree, in which the intrahepatic bile ducts drain into the lumen of the gallbladder at different levels. \u0000According to various sources, this variant of the anatomical architecture of the bile ducts occurs in 1.7 - 3% of clinical cases. \u0000The relevance of knowing the anatomical features of the biliary tree is due to the fact that routine preoperative methods of examination in most cases do not allow to verify them, and unnoticed damage to such courses at the stage of extraction of the bile duct can lead to intraoperative and postoperative complications. \u0000Therefore, knowledge of the presence of such anatomical options is a condition for safe laparoscopic cholecystectomy (LC). \u0000Goal. To represent a clinical case of aberrant subvesical bile duct during LC. \u0000Presentation of a clinical case. The 41-year-old patient was hospitalized for acute biliary pancreatitis of mild severity according to the Ranson scale against the background of gallstone disease. In cooperation with related specialists, the patient underwent complex conservative treatment according to the updated recommendations for the management of acute pancreatitis (AP). After the normalization of basic laboratory indicators, exclusion of local parapancreatic complications, the patient was prepared for LC. Intraoperatively, a subvesical aberrant bile duct with a diameter of 1 mm was found, connecting the lumen of the gallbladder with the intrahepatic ducts of the IV segment of the liver. Coagulation of the bilious source was performed. A diagnostic tubular drainage was installed. No complications were observed in the early and late postoperative period. \u0000Discussion. Subvesical bile ducts, or \"Lyushka's ducts\" - anatomical variants of biliary tracts that flow directly into the gallbladder, perforating its wall at different levels. \u0000The etiology of Lyushka's movements is a subject of debate. The first theory describes them as an embryological abnormality of development in the early stages of embryogenesis. In our clinical case, it is quite likely that subvesical bile ducts could have arisen according to the second theory - hypertrophy of parenchymal branches as a result of previous local inflammation against the background of chronic cholecystitis and periodic exacerbation of cryptogenic hepatitis. \u0000Due to their small size, these movements can go unnoticed, causing various postoperative complications. Therefore, such ducts are of great clinical importance for surgeons. Their preoperative identification is often impossible, so they can be damaged intraoperatively. \u0000Bile leakage due to damage to aberrant ducts usually manifests itself clinically within the first postoperative week. In severe cases, the development of biliary peritonitis with subsequent sepsis is possible. \u0000In our case, cholelithiasis from the subvesical course was eliminated by coagulation. In cases of postoperative complica","PeriodicalId":86625,"journal":{"name":"The Glaxo volume; an occasional contribution to the science and art of medicine","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83425049","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}