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USAGE OF IMMEDIATE IMPLANTATION METHOD WITH IMMEDIATE LOAD USING OSTEOPLASTIC XENOGENIC MATERIALS

Аuthors: V. M. Chernenko, O. V. Lyubchenko

Pages: 995–1005

Abstract

         

Relevance of this work is the solution to the emerging problems with the help of xenogeneous osteoplastic materials using immediate implantation technique with immediate load.

We used electronic databases PubMed/Medline, Science Direct, Google Scholar, RISC to analyze researches on immediate dental implantation with immediate load and we analyzed osteoplastic materials with their advantages and disadvantages taking into account the process of osteointegration.

The proposed modern methods of implantation have led to new deficiencies associated with poor osteointegration and a negative aesthetic result. Thus, in the method of immediate implantation with immediate load, the problem zone was represented by cervical area. Given tissue deficits, there is much worse restoration of bone tissue in this area and the preservation of the walls of the alveoli, eliminating the possibility of displacement of the muco-periosteal flap, especially from the vestibular surface, where the bone layer is considerably thinned.

The acceleration of osteogenesis with the common resorption of the osteoplastic material is a wishful phenomenon of osteointegration. A more predicted result will be usually with an autogenous material. The disadvantage of its use is the additional surgical intervention, and the impossibility of taking the material in enough quantities in each clinical case. The popularity of the use of xenogeneous materials is due to the presence of osteoinductive properties. There are quite a few different manufacturers involved in the manufacture of xenogeneous materials. But despite the similarity in morphological characteristics, osteoinductive action at the stages of osteointegration in each sample is individual. Existing techniques for directed bone regeneration, namely the combination of soft tissue management and the use of osteoplastic materials, are not always suitable in each individual clinical case. The behavior of the osteoplastic material itself under conditions of permissible threshold of microroughness is also not investigated.

Therefore, there is no consensus on the benefits of this or that xenogenic material. The need for additional morphological and clinical studies is obvious.

Keywords: immediate implantation, osteointegration, xenogeneic osteoplastic material, immediate loading.

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THE RELATIONSHIP BETWEEN SVCAM-1 ADHESION MOLECULES LEVELS WITH LIPID EXCHANGE DISEASE IN PATIENTS WITH HYPOTHYROIDISM

Аuthors: V. S. Vernigorodsky, N. M. Fetysova, M. V. Vernigorodska, R. V. Valentyeva, O. V. Malchenko

Pages: 1006–1012

Abstract

         

Introduction. Hypothyroidism is a disease characterized by polymorphism of clinical symptoms. Hypothyroidism influences absolutely all organs and systems. An important pathogenetic factor in the occurrence of atherosclerosis with hypothyroidism is the vascular cell adhesion molecule (VCAM-1). In this case, the expression of vascular VCAM-1 adhesion molecules in vascular endothelium occurs, which leads to the adhesion of monocytes and blood lymphocytes to activated endothelial cells, their transposition to the subendothelial layers, persistence of the inflammatory process in the vascular wall, and the progression of endothelial dysfunction. There is evidence of the relationship between VCAM-1 and markers of dyslipidemia, a metabolic syndrome. However, the contribution of VCAM-1 to atherogenesis and the formation of vascular lesions in the hypothyroidism conditions has not been practically studied.

The aim of the study. To study the prevalence of dyslipidemia, subclinical inflammatory syndrome (by the levels of C-reactive protein and interleukin-6), the content of sVCAM-1, the study of the relationship between metabolic, proinflammatory factors and the state of vessels in patients with hypothyroidism.

Materials and methods. Determination of lipid profile of serum was carried out by standardized methods: the total cholesterol (CHO) in serum was determined by reaction with acetic anhydride. The study of the content of inflammatory markers (C-reactive protein and interleukin-6) was determined by the immune enzyme method in the sets of «hsCRP ELISA» («DRG», USA), «IL-6 ELISA» (Diaclone, France) according to the instructions of the manufacturer. The content of SVCAM-1 was determined by the immune enzyme method using the «SVCAM-1 ELISA KIT» kit (Diaclone, France) according to the manufacturer's instructions. 101 patients with hypothyroidism were examined.

Results and discussion. It has been established that increasing the sVCAM-1 content in the blood plasma of patients with hypothyroidism is closely associated with the progression of lipid metabolism disorders, which demonstrated the analysis of lipid levels in the ranking of the content of vascular adhesion molecules.

Correlation analysis confirmed the existence of a reliable association between the content of sVCAM-1 and the level of total cholesterol and LDL cholesterol in blood plasma in patients with hypothyroidism, in contrast to other lipid metabolism indices.

Conclusions

1. Increased level of sVCAM-1 in blood plasma is one of the factors for the formation of endothelial dysfunction and atherosclerotic vascular damage in patients with hypothyroidism, especially under conditions of idiopathic form of hypothyroidism.

2. The data provided have shown that dyslipidemia and the increase in blood vessel adhesion molecules in blood plasma are factors of the formation of endothelial dysfunction and vascular damage in patients with hypothyroidism.

3. The main proportion of people with aberrant levels of total cholesterol, LDL, sVCAM-1 predominates among patients with idiopathic hypothyroidism.

Keywords: hypothyroidism, dyslipidemia, vascular cell adhesion molecule.

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СLINICO-PSYCHOPATHOLOGICAL AND PATHOPSYCHOLOGICAL CORRELATES OF SUICIDAL RISK IN PATIENTS WITH DEMENTIA

Аuthors: I. H. Mudrenko

Pages: 1013–1019

Abstract

         

Rationale. Due to increase of duration of life, the number of patients with dementia is increasing in the world and in Ukraine. Dementia has a high affinity to depression, which accordingly determines the high risk of suicide at this mental illness.

The aim of our study is to examine the correlation between clinical and psychopathological, pathopsychological, socio-psychological features of patients with dementia with a high risk of suicide.

Methods and materials. 105 patients with various clinical forms of dementia (vascular, due to Alzheimer's disease, of mixed type) were examined. Clinical and anamnestic, pathopsychological and psychodiagnostic methods of research (the method of determining suicide risk, determining the level of consciousness of death) (Havenko V. L. et al. 2001; The Hamilton Depression Rating Scale (HAMD) (Hamilton M., 1967), Bass-Darkie questionnaire, Los Angeles Suicide Prevention Center Scale (Nechyporenko V. V., Shamrei V. K., 2007), the Method of Statistical Processing of Results were used.

Results of the study. Clinical and psychopathological predictors of suicidal behaviour consisted in the severity of depressive disorders of the inhibitory (r = 0.790) and agitated types (r = = 0.773), in the prevalence of such symptoms of depression as depressed mood (r = 0.730), sleep disturbance (r = 0.616), retardation (r = 0.615), a sense of helplessness and exhaustion (r = 0.338), stress and anxiety (r = 0.554), feelings of guilt (r = 0.473). The presence of productive hallucinatory symptoms, illusions, disorientation and general disorganization of the psyche increased proportionally the risk of suicide (r = 0.419). It is established that the presence of suicidal intentions (r = 0.561) and suicide attempts in the past, as well as the presence of depressive episodes in the past (r = 0.782) are a significant risk factor for committing a suicide in future.

Social predictors of suicidal behavior were represented by the specificities of communication with others, namely: hostile attitude of the patients to the environment (r = 0,514), they influenced the increase of suicidal risk among patients with dementia.

The pathopsychological predictors of suicidal behavior consisted in the presence and severity of high level of aggression and hostility, manifested in verbal (r = 0.472) aggression, feeling of guilty (r = 0.473) and abuse (r = 0.417) and hiding negative emotions in the form of suspicion and irritability (r = 0,413).

It is established that the factors of mental traumatization (the presence of a life-threatening illness (p ≤ 0.0001), loss of work, money or status (r = 0,698), changes in life or in the environment, the loss of a beloved person (r = 0,351), as well their sudden onset (r = 0.483), periodicity and repeatability (r = 0.385) contributed to the increase in suicidal risk among patients with dementia.

Conclusions. Thus, the factors that increase the risk of autodestructive behavior at dementia are identified: the presence and severity of depressive disorders, sudden factors of mental traumatization, increased aggressiveness and hostility, suicidal attempts in the past, and the lack of interpersonal communication.

The obtained data are the symptoms of targets for the prevention of suicide in patients with dementia.

Keywords: dementia, risk of suicide, predictors of suicide, clinical and psychopathological peculiarities.

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THE LATE EFFECTS OF PATHOGENETIC TREATMENT OF GASTRODUODENOPATHIES INDUCED BY NONSTEROIDAL ANTI-INFLAMMATORY DRUGS IN PATIENTS WITH OSTEOARTHROSIS

Аuthors: L. M. Honcharuk, L. D. Kushnir, Ya. M. Teleki, L. V. Mikulets

Pages: 1020–1027

Abstract

         

Rationale. In fact, osteoarthrosis constitutes 70–80 % of the diseases in the structure of the rheumatic diseases. Nonsteroidal anti-inflammatory drugs are commonly used as a basis of the osteoarthrosis therapy. Over 90 % of the nonsteroidal anti-inflammatory drugs side effects comprise gastroduodenal complications. Нelicobacter руlori is also a significant etiological factor causing the damage to the digestive tract. Therefore, the issues of the development of the pathogenetic treatment and prevention of the gastric and duodenal mucosal damage caused by NSAIDs administration in patients with osteoarthrosis, are burning aspects of the advanced clinical medicine, substantiating the actuality of the conducted research.

Material and methods. 70 patients affected by osteoarthrosis with Нelicobacter руlori-associated gastroduodenopathy induced by nonsteroidal anti-inflammatory drugs were investigated. The investigated patients were divided depending on the diagnostic level of the digestive tract damage. Azoalbumin (low molecular weight protein), azocasein (high molecular weight protein) and azocol (collagen) lysis were detected. Subsequently, the patients were subdivided into the subgroups due to the treatment settings, in particular, the conventional eradication therapy in accordance with Maastricht consensus-2015 and conventional therapy + mucogen and amplodipine.

Results and discussion. It has been detected that gastroduodenopathies induced by nonsteroidal anti-inflammatory drugs in patients with osteoarthrosis prevalently was associated with pain syndrome presence, and only in 31.43 % of patients with the different level of digestive tract damage this pain syndrome didn’t manifest. Statistically, the patients who were administered diclofenac, more often suffered from pain syndrome. The increase of unlimited proteolysis has been observed. Use of mucogen in the complex therapy in the investigated patients led to the precise decrease in the proteolytic activity of blood plasma, in particular, the lysis intensity of low molecular weight protein in those patients decreased by 29.8 %, high molecular weight protein – by 31.8 % and in collagenolytic activity of blood – by 39.5 %. The decreased indexes of the proteolytic activity of blood plasma have been detected in 6 months after provided treatment in the groups which were supplementary given mucogen and amplodipine, in particular, the lysis of low molecular weight protein decreased in 33.13 % (р < 0.05), high molecular weight protein – in 31.25 % (р < 0,05) and in collagenolytic activity of blood in 25.00 % in the patients supplementary provided with mucogen and in 33.13 % (р < 0.05), 28.64 % (р < 0.05) and 21.42 % correspondingly in the patients who were supplementary given mucogen + amplodipine.

Conclusion. Use of mucogen in treatment and prophylaxis of Нelicobacter руlori- associated gastroduodenopathies induced by nonsteroidal anti-inflammatory drugs in patients with osteoarthrosis, assists to decrease in the development of gastroduodenopathy relapses, reduces the percentage of the pain manifestation, and induces stable remission with respect to the Helicobacter pylori infection.

Keywords: helicobacter pylori, pathogenesis, osteoarthrosis, nonsteroidal gastroduodenopathies, treatment, prevention.

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CLINICAL FEATURES OF MULTIPLE SCLEROSIS IN SUMY REGION

Аuthors: O. O. Potapov, O. P. Kmyta, V. S. Lychko, D. S. Lytvynenko, Yu. O. Mykolaienko

Pages: 1028–1033

Abstract

         

Purpose of the work was to study clinical features of multiple sclerosis (MS) in Sumy Region and to analyze the therapeutic approach to patients with exacerbation of the disease and evaluation of the results of treatment.

Materials and methods. The analysis of 312 medical records of hospitalized patients with MS in neurological departments in Sumy region for 2014–2016 was made. Expanded Disability Status Scale (EDSS) was used to assess the severity of the disease, progress, and course. The processing of statistical data was performed with the help of the IBM SPSS Statistics 17.

Results. The majority of patients were Sumy city residents – 197 (63.1 %) patients. Women predominated – 213 (68.3 %). Most of the patients belonged to the age group of 30–40 years old – 141 (45.2 %), the average age – 38.7 years ± 2.5. Disease debut – 30.6 years ± 1.8. The cerebrospinal form prevailed – 273 clinical cases (87.5 %) with remitting type – 135 (43.3 %). The leading symptom in 231 patients was movement disorder (74 %). Most of the patients – 144 (46.2 %) were handicapped of the 3rd group. Early manifestation of visual impairment was recorded in 189 (60.6 %) cases. The most common clinical signs – moderate vestibular ataxia in 198 (63.5 %), mild disorders of statics, dynamics and walk – in 190 (60.9 %), mild asthenia in 286 patients (91.7 %). 59 patients (18.9 %) received treatment with pulse therapy of methyl prednisolone during exacerbation, 62 patients (19.9 %) – with dexamethasone. In most patients 20–30 years of age EDSS grade was 3 and 4 points – 15 (4.8 %) accordingly, 30–40 years – 4 points – 54 (17.3 %); after 40 years – 4 and 5 points – 43 (13.78 %) accordingly. Authentically regardless of age at which the disease started, the score of 4 points on the EDSS scale prevailed.

Conclusions. The study of the MS clinical features in Sumy region showed that prevailing majority of patients were women aged 30–40 years. The most common was the cerebrospinal form of the disease with remitting coarse and moderate vestibular ataxia, mild disorders of statics, dynamics and walk, mild asthenia. It was authentically found that patients over 30 had greater severity of motor function impairment. It was reliably established that the severity and clinical progression of the disease did not depend on the age of the MS debut. It was defined that patients who received glucocorticosteroid therapy during exacerbations had a lower propensity to progression of the disease compared with those who received pulse therapy.

Keywords: multiple sclerosis, clinical features, EDSS, hormone therapy, pulse therapy.

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THE PREVALENCE OF IODINE DEFICIENCY IN CHILDREN WITH COMMUNITY-ACQUIRED PNEUMONIA IN TERNOPIL REGION

Аuthors: H. A. Pavlyshyn, O. D. Kibar

Pages: 1034–1043

Abstract

         

Introduction. The severity of the course of community-acquired pneumonia in children is due to concomitant pathology, the state of the endocrine system, and the immunity of the organism, especially among people living in conditions of endemic iodine deficiency. In Ukraine, iodine deficiency disorders (IDD) has been recognized as a serious public health problem for the past years. Today, it still remains a major threat to national health and development. 80 % school-age Ukrainian children are at risk of iodine deficiency.

Purpose of our study was to assess iodine status of school-age children and its relationship with severity of community-acquired pneumonia; to evaluate the effectiveness of preventing program of iodine deficiency in Ternopil region.

Materials and methods. We investigated 53 children with community-acquired pneumonia aged 6–14 years. The severity of pneumonia in children was assessed according to the classification criteria of the disease. By means of questionnaires, families were asked about the effect of iodine deficiency on the body, as well as eating iodine-containing foods. Iodine deficiency was determined by measuring iodine levels in urine samples. Median urinary iodine excretion was calculated. All children were screened for goitre by standard palpation method, ultrasound and were graded according to the criteria recommended by WHO/UNICEF/ICCIDD.

Results. All patients were divided into two groups: I (n = 39) ‒ children with moderate pneumonia (73.6 %), II (n = 14) ‒ with severe course (26.4 %). In each group, the residents of the village and the city were singled out separately. Overall iodine deficiency was detected in 65 % of children, mostly of moderate severity. The median of urine iodine index in each group varied with the severity of pneumonia and the place of residence of patients. Thus, the median in group I was 89.5 μg/L in urban residents and 41.5 μg/L in children from rural area (p ˂ 0.05). The same index in group II was 21.2 and 38.4 μg/L, respectively (p ˃ 0.05). However, the total median of urine iodine content of village residents was significantly lower than of urban residents (38.4 and 71 μg/L, respectively), which corresponds to moderate severity and mild iodine deficiency. The incidence of goiter was: 11.1 % (city) and 41.7 % (village) – I group (p ˂ 0.05). As well as 33.3 % (city) and 36.4 % (village) – II group (p ˃ 0.05). No case of nodular goitre was observed. We have identified insufficient awareness of parents about iodine deficiency in the territory of residence (48.4 % of parents of schoolchildren are informed); the indicator is linked to the place of residence of respondents (p ˂ 0.01). Iodized salt is regularly consumed by 34 % of families. Moreover, all data were compared with the results of children of control group (group III).

Conclusions. The obtained results indicate that the iodine supply was influenced by the permanent place of residence of patients. A direct correlation between the indices of the median of urine iodine index and the severity of the community-aquiared pneumonia course was established (p ˂ 0.05). Prevalence of goitre was high in both group (20.5 % and 35.7 %, respectively) and therefore it constitutes a public health problem in Ternopil region. In this study, we found that about 21 % of the respondents were unaware of iodized salt, and the level of this lack of awareness was high among patients living in rural areas. Voluntary model of iodine prophylaxis of the population has not proved its effectiveness, as evidenced by the persisting iodine deficiency in this region. Observed associations of iodine deficiencies with severity of community-acquired pneumonia in childhood indicated the necessity of eliminating iodine deficiencies from this vulnerable population through strengthening iodine supplementation, in order to prevent diseases and promote health conditions. As well, the decision to develop a regional program for the individual prevention of iodine deficiency by administering potassium iodide in high-risk groups in the development of IDD (children, adolescents, pregnant and lactating women) should become a priority.

Keywords: community-acquired pneumonia, iodine deficiency, median urinary iodine, children.

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THE DYNAMICS OF MARKERS OF SYSTEMIC INFLAMMATORY RESPONSE IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION UNDER THE INFLUENCE OF TREATMENT

Аuthors: I. M. Fushtey, M. Fedi

Pages: 1044–1050

Abstract

         

Rationale. Cardiovascular diseases are the leading cause of death among the worldwide population. Currently, the role of many risk factors for the development and destabilization of ischemic heart disease (IHD) has been determined, however, a complete explanation of the mechanisms of acute coronary complications occurrence is still not provided. To study the inflammatory process in atherosclerosis and various forms of IHD, a number of markers and mediators of the inflammatory process should be examined in modern science. In one way or another, they all reflect the presence, activity, and peculiarities of the inflammatory process course.

It seems to be appropriate to study the status of systemic inflammatory response in patients with acute myocardial infarction. This will give the opportunity to determine the dynamics of markers of systemic inflammatory response in patients with acute myocardial infarction under the influence of treatment.

The purpose of the study: to determine the dynamics of markers of systemic inflammatory response in patients with acute myocardial infarction under the influence of treatment.

Materials and methods. The results of the study are based on data from a comprehensive survey of 103 patients with IHD and AMI, among which 72 subjects had heart rate turbulence (HRT) and 31 patients had no HRT. 31 healthy volunteers were examined on an outpatient basis. All 134 of the surveyed persons were matched in age and social status.

Obtained results. The HS-CRP levels after 48 hours from the onset of clinical manifestations of AMI has made 12.98 [9.99; 35.45] mg/l in the first subgroup and was comparable with the value of 12.92 [9.92; 13.88] mg/l in the second subgroup (p > 0.05). After 2 weeks there was a statistically significant reduction of Δ % = -54.84 % to 8.68 [7.43; 16.90] mg/l in the first subgroup, and of Δ % = -66.57 % to 7.36 [6.63; 9.19] mg/l in the second subgroup. Statistically, after 2 weeks the value of HS-CRP was significantly higher in atorvastatin subgroup 8.68 [7.43; 16.90] mg/l vs. 7.36 [6.63; 9.19] mg/l in rosuvastatin subgroup (p < 0.05).

Conclusion. Rosuvastatin has more pronounced anti-inflammatory properties.

Keywords: ischemic heart disease, myocardial infarction, systemic inflammation, treatment.

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STUDY OF ASSOCIATION OF C+70G POLIMORPHIC SITE OF EDNRA GENE WITH DEVELOPMENT OF ISCHEMIC ATHEROTHROMBOTIC STROKE IN SMOKERS AND NON-SMOKERS

Аuthors: T. B. Oleshko, S. R. Mishchenko, V. S. Yurchenko, O. A. Obukhova, V. Yu. Harbuzova

Pages: 1051–1057

Abstract

         

Ischemic stroke is one of the key problems of healthcare. It is known that endothelial dysfunction (ED) plays a key role in pathogenesis of ischemic atherothrombotic stroke (IAS). Endothelin-1, a potential endogenous vasoconstrictor, is mostly responsible for development of ED. It is generally assumed that smoking is the most significant external factor that causes ED. Endothelin-1 realizes its effects through intercommunication with specific type A receptor. Therefore, endothelin type A receptor refers to key factors that influence the development of many cardiovascular diseases and ischemic stroke in particular.

Purpose. To study association of C+70G polimorphic site of EDNRA gene with development of ischemic atherothrombotic stroke in smokers and non-smokers.

Materials and Methods. For analysis, we used venous blood of 170 patients with IAS (42.4 % were women and 57.6 % were men) aged 40 to 85 years (average age – 64.7 ± 0.73 years) who were on the records in the outpatient department of Sumy Clinical Hospital № 5. The control group consisted of 124 patients (36.3 % were women and 63.7 % were men), average age was 76.7 ± 0.93 years. The groups were matched in sex (P = 0.294 for the χ²-test), but the average age of the first group (76.7 ± 0.93 years) was significantly higher than that of the second one (P < 0.001). Lys198Asn (rs5370) polymorphism of EDN-1 gene was determined by polymerase chain reaction, followed by restriction fragment length analysis of the allocation of them by electrophoresis in agarose gel. Statistical analysis was performed by using the software package SPSS-17. The value of P < 0.05 was considered as significant. Pathogenetic variant of stroke was determined according to the TOAST criteria. Ischemic stroke character was determined with the help of history and clinical information of the disease given by CT brain study.

Results. It was demonstrated that among non-smokers, equilibration of homozygotes by basic allele (C/C), heterozygote (C/G) and homozygotes by minor allele (G/G) in control group comprised 30.1 %, 48.4 %, 21.5 %, and among IAS patients – 26.7 %, 55.0 %, 18.3 % correspondingly (Р = 0.629, χ2 =0.927). In the group of smokers genotype distribution according to studied polymorphism also didn’t significantly differ (25.8 %, 54.8 %, 19.4 % in the control in comparison with 18.0 %, 64.0 %, 18.0 % for IAS patients; Р = 0.657, χ2 =0.840).

Conclusion. C+70G-polymorphic loci of EDNRA gene was not associated with development of IAS neither among smokers nor in the group of non-smokers.

Keywords: endothelin type A receptor, gene polymorphism, ischemic stroke, smoking.

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THE ASSOCIATION BETWEEN VDR GENE BSMI POLYMORPHISM AND СHRONIC GENERALIZED PERIODONTITIS DEVELOPMENT

Аuthors: I. G. Fomenko, E. S. Shershneva, V. V. Khoruzhiy, Y. I. Dubovyk, V. Yu. Harbuzova

Pages: 1058–1065

Abstract

         

Introduction. To date, there is growing evidence about the role of endocrine disorders in the development of periodontal pathologies. The active form of vitamin D, 1,25-dihydroxycholecalciferol (1,25-(OH)2D3), is actively studied in this context. In addition to the leading role of this hormone in homeostasis of calcium and mineral metabolism in bone tissue, its important role in the processes of cell differentiation, cell growth and immunological reactions has been proved. The results of recent studies have shown the association between the density of alveolar bone tissue, osteoporosis and loss of teeth. The biological effects of 1,25-(OH)2D3 are realized through its interaction with the nuclear receptor VDR, which regulates the transcription of more than 500 genes in the cells of human body. The association between VDR gene polymorphisms and osteoporosis, renal osteodystrophy, diabetes mellitus type 2, psoriasis, multiple sclerosis, cardiovascular diseases, tumors of various localizations, and periodontal diseases development has been proved in many studies.

The study was a part of scientific project “The role of single nucleotide polymorphisms in development of pathological processes and diseases”, supported by the Ministry of Education and Science of Ukraine, № 0114U006297.

Purpose. To test the association between VDR gene BsmI polymorphism and сhronic generalized periodontitis development (CGP).

Materials and Methods. The buccal epithelial cells of 116 patients with CGP and 67 control subjects were used. VDR gene BsmI (rs1544410) polymorphism genotyping was performed using PCR-RFLP (polymerase chain reaction with following restriction fragment length polymorphism analysis) method. Statistical analyses were performed using Statistical Package for Social Science software (SPSS, version 17.0, Chicago, IL, USA). An odds ratio (OR) and 95% confidence interval (CI) were obtained from logistic regression for dominant, recessive, superdominant and additive models of inheritance. Multivariable logistic regression was used to exclude the effect of other factors including sex, age, body mass index (BMI), diabetes mellitus type 2 (DMT2), arterial hypertension (AH) and smoking status. All statistical tests were two-sided, the value of P < 0.05 was considered as significant.

Results. Obtained genotype frequencies for BsmI polymorphism did not significantly deviate from Hardy-Weinberg equilibrium expectations both in case and control groups (P > 0.05). However the frequency of VDR BsmI genotypes in CGP patients significantly differed from the control individuals in full cohort (P = 0.046), in male (P = 0.014), non-smokers (P = 0.040) and subjects with elevated BMI (P = 0.008). After adjustment for covariates of sex, age, BMI, DMT2, AH and smoking status significant genotypic association between VDR gene BsmI locus and CGP was revealed under dominant (Padj = 0.040; ORadj = 1.960, 95 % CI =1.033–3.718) and additive (Padj = 0.023; ORadj = 3.129, 95 % CI =1.168–8.385 – for B/B genotype) models of inheritance. Logistic regression analysis in female subgroup did not show any significant link with CGP development neither before nor after adjustment for covariates (P > 0.05). At the same time in male subjects significant association between VDR BsmI polymorphism and CGP was revealed under dominant (Padj = 0.020; ORadj = 3.172, 95 % CI =1.195–8.420), recessive (Padj = 0.042; ORadj = 9.153, 95 % CI =1.087–77.046), and additive (Padj = 0.022; ORadj = 12.626, 95 % CI = 1.446–110.249 – for B/B genotype) models.

Conclusion. VDR gene BsmI polymorphism is associated with chronic generalized periodontitis development in the Ukrainian population. The risk of mentioned disease in B/B genotype carries is higher compared to b/b homozygotes. Male gender and overweight increase the likelihood of the chronic generalized periodontitis occurring in BsmI minor B allele carriers.

Keywords: vitamin D receptor (VDR), gene polymorphism, periodontitis.

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MATHEMATICAL MODEL OF THE SEVERITY OF GASTROINTESTINAL FORM OF SALMONELLOSIS

Аuthors: O. Chemych, T. Zhylenko, I. Shuda, M. Chemych, L. Moroz

Pages: 1066–1076

Abstract

         

Topicality. Every year, around 94 million cases of salmonellosis are recorded in the world. The high incidence of salmonella in Ukraine and the stability of this indicator during the last decade suggest a lack of dynamic changes in the economic-social and preventive-medical spheres. It is well known that such severity criteria as frequency and duration of diarrhea and temperature reactions are not always objective. Diarrhea and temperature cannot be controlled at the prehospital stage and during outpatient treatment, with severe and very severe course these symptoms look like reverse dynamics (hypothermia, lack of diarrhea). That’s why it is necessary to seek more objective criteria for the severity of the gastrointestinal form of salmonellosis.

The purpose of the work is to objectify the severity criteria of gastrointestinal form of salmonellosis by constructing a mathematical model.

Materials and methods. Clinical and laboratory examination of 189 patients with gastrointestinal form of salmonellosis who were treated at the Sumy Regional Infectious Clinical Hospital named after Z. Y. Krasovitsky from 2012 till 2016. A mathematical modeling using the theory of hypotheses, the matrix of ranks, and the griddler drawing was made.

Results. Mathematical model of the severity of gastrointestinal form of salmonellosis was created, which allows to objectivize the determination of the disease severity. Severity of salmonellosis is detected quickly and without economic costs. In addition to the frequency and duration of diarrhea and temperature reaction, objective parameters are also considered (integrative indices of endogenous intoxication – leucocyte intoxication index and leukocyte shift index). The mathematical model is one of the developed method can be used at various stages of providing medical care to patients.

Conclusion. Using the mathematical model of severity of the gastrointestinal form of salmonellosis let to propose objective method for determining the severity of the disease, which can be used at various stages of providing medical care to patients.

Keywords: salmonellosis, clinic, integrative indicators of endogenous intoxication, severity, mathematical model.

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IMMUNOLOGICAL BLOOD PARAMETERS OF ANIMAL AFTER DURAPLASTY

Аuthors: A. V. Kravtcova, L. P. Abramova, V. O. Veckshin

Pages: 1077–1083

Abstract

         

Restoration of form and function to the craniofacial skeleton following trauma, congenital malformations or resection poses a considerable clinical challenge for the plastic surgeon. Materials available to treat these conditions include autografts (tissue from the patient), allografts (tissue from a donor) and synthetic materials such as metals, ceramics and polymers. After cerebral or spinal operative procedures, it is imperative to provide a complete and watertight dural closure to minimize the risks of cerebrospinal fluid fistulas, infections, brain herniation, cortical scarring, and adhesions. In our previous research, we studied use of the chitin-chitosan membrane for dura plasty in experimental model and proved its effectiveness and absence of a reaction from the CSF.

Therefore, the aim of this work was to evaluate the changes in the immunological parameters of peripheral blood after the implantation of material based on chitosan for plasty of the dura mater.

In this research we provide duraplasty for 90 rabbits used autologous fascia, a collagen-based commercial, and an innovative chitosan-based agent. The venous blood was collected from the jugular vein of the animals in amount of 1.5 ml before the operation (control), and also 2 weeks, 2 and 6 months after surgery. The levels of immunoglobulins A, G, M, interleukin-2, percentage of CD4+ and CD8+ cells were determined in blood serum.

Our results have shown that the use of auto- and alomaterials for dura mater plasty led to reactive changes in the immune system at the time of 2 weeks and 2 months after the operation, which was manifested by an imbalance in the immunoglobulins levels and effector T cells balance, as well as an increase in the regulatory IL -2. In animals with the use of a collagen membrane, the content of the latter remained elevated even 6 months after the operation.

Keywords: dura mater, plastics, autofascia, collagen, chitosan.

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PRACTICAL ASPECTS OF RESTORATIVE TREATMENT AFTER TERMINATED ECTOPIC PREGNANCY

Аuthors: K. A. Bugaevsky

Pages: 1084–1089

Abstract

         

The article deals with the peculiarities of using physical rehabilitation after a tubal ectopic pregnancy and spent surgical treatment of this severe gynecological pathology requiring urgent care. The urgency of the application of methods and means of physical rehabilitation after surgical treatment by laparoscopic method of tubal ectopic pregnancy is due to the fact that this operation is performed in women of reproductive age and the number of operations performed annually increases. The purpose of the study was to determine the effectiveness of the proposed set of methods of restorative treatment after surgery for a terminated ectopic pregnancy. The results of the study showed the acceptability of the proposed method of patient recovery in the conditions of outpatient and sanatorium-resort stages of rehabilitation.

Keywords: female patiens, tubal ectopic pregnancy, healing fitness, pelvic massage, foot reflexology, physical rehabilitation, Kegel’s exercises, fitball.

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  2. Mayskova IYu. Recovery of women after surgical treatment of tubal pregnancy: author's abstract. Dis ... Cand. Med. Scien. Moskow, 2008. 132 p.
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RESULTS OF COMPLEX TREATMENT WITH PRESSURE THERAPY FOR WOMEN IN MENOPAUSE SUFFERING FROM OSTEOARTHRITIS OF THE KNEE JOINT

Аuthors: O. Yakimenko, N. Bogdan, V. Klochko

Pages: 1090–1095

Abstract

         

Introduction. The most common articular pathology is osteoarthrosis of the knee joints. More than 10% of the world's population suffers from this disease. Women aged 50–60 years are more susceptible to the disease, after 60 years the disease occurs in almost all people. The osteoarthrosis of the knee joints is one of the main causes of premature disability and invalidization of the population. Female gender, advanced age, endocrine and metabolic disorders, overweight, muscle weakness, joint trauma, overload, surgery and inflammatory joint diseases are the main risk factors for OA development.

Purpose. To find out the effectiveness of complex treatment for the use of presotherapy in women in the menopausal period suffering from osteoarthrosis of the knee joints.

Materials and Methods.60 women were included in research at the age 50–70 (middle age of 62.51 ± 7.67 years old), with the diagnosed osteoarthrosis of knee joints according to the criteria of the American College of Reumatologists (ASR). Patients were divided into 2 groups according to treatment mode. All patients of the 1st group (30 persons) with a standard medicinal anti-inflammatory and anaesthetic therapy were indicated a complex therapy with pressure therapy using the Doctor Life device, the duration of the procedure is 15–30 minutes, the pressure is from 80 to 100 mm Hg using the "running wave" program, when the pressure in the cuff gradually increases from the distal to the proximal ends of the end. All the patients (30 patients) of the 2nd group were treated with non-steroid anti-inflammatory agents (meloxicam in the dose 15 mg every day, once daily) and chondroprotectors (piascledin 300 ones a day, during 3 months).

Discussion. After the conducted complex therapy with the inclusion of pressure therapy in the 2 group there was a reliable improvement in the clinical course of knee joints OA, more pronounced than in the 1st group, where standard medicinal therapy was used. Use of complex therapy with pressure therapy in women suffering from OA in menopausal period improves clinical course of OA: by 40 % (p < 0.05) decreases intensity of pain syndrome and by 51.7 % (p < 0.05) decreases WOMAC index after all the parameters – pain syndrome decreased by 53 %, flexity – by 60 %, functional failure by 36.6 % as compared with the group of patients treated by a standard scheme.

Keywords: pressure therapy, osteoarthritis, women, menopause.

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EDUCATIONAL STRESS AND MECHANISMS OF PSYCHOLOGICAL PROTECTION OF STUDENT YOUTH: PROBLEMATIC ISSUES, PHYSIOLOGICAL AND HYGIENIC ASPECTS

Аuthors: S. Yu. Makarov, O. Yu. Panchuk, I. V. Serheta

Pages: 1096–1105

Abstract

         

During the research, the physiological and hygienic features of changes in the leading characteristics of psychological protection mechanisms of students who are in the conditions of educational stress in a higher medical educational institution were determined. The study was conducted among 247 students (125 girls and 122 youths) of the first, third, and fifth years of dental faculties and of the third year of medical faculty. In order to carry out the diagnosis of the peculiarities of psychological protection mechanisms, the personal questionnaire of Plucchik-Kellermann-Konte waas used to determine the degree of development of such psychological protection mechanisms as mechanisms of displacement, regression, substitution, negation, projection, compensation, hypercompensation, and rationalization. The statistical analysis of the data obtained involved the implementation of descriptive statistics procedures based on the application of the application package of multivariate statistical analysis “Statistica 6.1 for Windows”. In the course of researches aimed at studying the peculiarities of psychological protection mechanisms in students during the period of training in the institution of medical education (permanent component of educational stress), it was established that during the time of observations, the most essential psychological protection mechanisms in girls were of projection, rationalization, displacement and regression, in boys – of rationalization, negation, projection and displacement. In the course of researches that envisaged the study of the peculiarities of the mechanisms of psychological protection in students in the conditions of examination stress (situational (urgent) component of educational stress), it was found that during the time of observations the most essential psychological protection mechanisms in girls were of rationalization, negation, projection and compensation, in boys – of rationalization, negation, and projection. It was determined that the widespread phenomenon is the growth of indicators of mechanisms of psychological protection for its most destructive types, such as projection and displacement, which in the most significant way contribute to the occurrence of distortion phenomena in the processes of professional development of future specialists.

Keywords: students, higher medical educational institutions, stress reactions, mechanisms of psychological protection, physiological and hygienic assessment.

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HEALTH AND FUNCTIONAL ABILITIES OF NON-MIGRANT AND MIGRANT LONG-LIVERS

Аuthors: O. A. Poliakov, O. S. Tomarevska

Pages: 1106–1115

Abstract

         

In Ukraine, the effect of migration on the health of older age groups has been studied. Comparison of the level of migration in two generations – 1900–1916 and 1930's years of birth – shows a tendency to a more frequent change in the residence of the population of Ukraine. It is revealed that people who have changed their place of residence are more radical and active. As for the quality of life and the level of self-service, an inverse relationship is revealed. The significance of these indicators is higher than that of non-migratory subjects. Creative abilities are better preserved and expressed in a group of long-livers who have changed their place of residence from the moment of birth and/or throughout their entire life than in a group of long-livers who have not changed their place of residence since birth. According to the results of the MMSE test, degree of dementia was less often observed in the group of migratory long-livers than in the group that did not change their place of residence. To maintain their health, migrants are more likely to take medications than people from the non-migrant group. By the number of cases of acute cerebral circulation disorders, they are more often observed in the group of long-livers who have changed their place of residence than those who have not migrated. Migrant people, when they reach old age, need more time and more help in daily self-care than the indigenous population of the same age.

Keywords: working capacity, functional abilities, muscle endurance, quality of life, self-care, cognitive capabilities, and cerebral circulation.

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70th ANNIVERSARY OF CORRESPONDING MEMBER OF NAS OF UKRAINE L. F. SUKHODUB

Pages: 1116–1117

Abstract

         

In February 2018, we celebrate the 70th anniversary of Leonid Fedorovich Sukhodub ­– an outstanding scientist in the field of molecular biophysics, molecular physics, and biomedical engineering, Dr. Sci. in Physics and Mathematics, Professor, Corresponding Member of the National Academy of Sciences of Ukraine.

 

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