Вісник проблем біології і медицини, 2023, Випуск 1 (168)

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Psychological and pedagogical aspects of planning the educational process in a higher educational institution in relation to age
(Полтавський державний медичний університет, 2023) Havryliev, V. M.; Bukhanchenko, O. P.; Boiko, I. V.; Yatsenko, I. V.; Гаврильєв, Віктор Миколайович; Буханченко, Ольга Петрівна; Бойко, Ігор Васильович; Яценко, Ігор Володленович
Studying in a modern higher education institution requires meeting the specific and individualized educational needs of an individual, focused on the acquisition of knowledge, abilities, skills, personal qualities and value orientations necessary for mastering the prominent social roles and their successful performance, as well as for the development of one's personality, the acquisition of professional skills. The study aimed to improve the quality and efficiency of higher education through the analysis and correlation of existing methods and consideration of andragogic principles. During our research, we analyzed modern trends in medical education in Ukraine by studying well-known literary data. The basis of own research is testing applicants for higher education through questionnaires using the additional qualification program "Teacher of higher education". As a result of our observation, we found out that 75% of higher education students approach learning with high interest and responsibility. However, 25% of them start their studies with low expectations and demands. To meet the specific and individualized educational needs of higher education students and to improve the medical education system, it is necessary to take into account the andragogic approach. It is needed to organize the learning process no longer on a purely pedagogical basis but using andragogic principles and the practical technology of teaching adults.
Epigenetic effects of heavy metals of the environmental by the example of cadmium
(Полтавський державний медичний університет, 2023) Ostrovska, S. S.; Abramov, S. V.; Dychko, E. N.; Vyselko, A. D.; Konovalova, O. S.; Danilchenko, A. K.; Островська, С. С.; Абрамов, С. В.; Дичко, Є. Н.; Виселко, А. Д.; Коновалова, О. С.; Данільченко, А. К.
A review of current research shows the role of noncoding micro-RNAs (miRNAs) of the epigenome in biological processes such as early cell growth, proliferation, differentiation, development, ageing, and apoptosis under environmental factors. Changes in miRNA expression levels depend on the cells' exposure to the toxicant. For example, the expression of miRNA-146a decreases after exposure to Cd but increases after exposure to aluminium. Some of the main epigenetic mechanisms involved in Cd-induced stress responses are described. Current data on epigenetic modifications' role in Cd tolerance development are summarized. They can be used in plant breeding and molecular research to improve resistance to Cd-induced stress. A key direction in this field of epigenetics is understanding the functional significance of changes that occur during embryogenesis to form normal developmental trajectories in adult phenotypes. The facts of how environmental signals trigger the remodelling of embryonic epigenetic configurations, and phenotype changes that can be inherited over several generations are demonstrated. The effect of Cd on miRNA expression in placental samples was evaluated to better characterise intrauterine disorders. In humans, environmental factors, including heavy metals, organic pollutants, and drugs, adversely affect the function of miRNAs in the placenta. Specific miRNAs against the background of oxidative stress are identified as potential biomarkers in human malignant tumours, expanding their potential as therapeutic targets.
The role of screenings in pediatric orthopedic and dental pathology diagnostics
(Полтавський державний медичний університет, 2023) Lytovchenko, S. O.; Pelypenko, O. V.; Malyk, S. V.; Berezan, O. I.; Liublinska, I. O. ; Литовченко, Степан Олександрович; Пелипенко, Олександр Васильович; Малик, Сергій Васильович; Березан, Олексій Іванович; Люблінська, Ірина Олександрівна
Early diagnosis is necessary for successful conservative treatment in pediatric orthopedics and orthodontics.Comorbid conditions in orthopedics and orthodontics are still understudied, although, they can possess high clinicalvalue for early detection.The purpose of the study was to determine the peculiarities of conducting preventive orthopedic examinationsof children and to investigate the prevalence of malocclusions in children with the pathology of the musculoskeletalsystem, in particular in children with scoliosis and flat feet.
Change indicators of caries of temporary teeth, taking into account their odontoglyphics and method of prevention carried out
(Полтавський державний медичний університет, 2023) Kaskova, L. F.; Sadovski, M. O.; Каськова, Людмила Федорівна; Садовські, Марина Олександрівна
According to WHO estimates, dental caries is the most common oral cavity disease. In Europe, from 20 to 90% of children aged six years have dental caries, so its prevention is the most important task of modern pediatric dentistry. Systemic and topical application of fluorides has been recognized as a significant factor responsible for the decline in caries prevalence in recent decades. Numerous scientific studies have proven that sealing molar fissures and deep fluoridation have an undeniable caries-preventive effect. Our study aimed to study the impact of sealing fissures of temporary molars on caries indicators, taking into account their odontoglyphics of the occlusal surface as a risk factor for caries. Sixty children aged 3 to 5 were under our observation for two years and were divided into three groups according to the preventive measures taken. The effectiveness of various prevention methods was established during the examination of the comparison groups. For each molar of the maxilla and mandible, its belonging to a particular chewing surface was determined. In all studied groups, there were children with different patterns of the occlusal surface, the distribution of which did not have a significant difference when comparing the observation groups. The implementation of preventive measures in children of different observation groups proved that the most effective method of preventing caries of temporary molars is sealing, which makes it possible to isolate the tooth from the action of external factors and promote the mineralization of its hard tissues under the influence of fluorides, which diffuses from glass ionomer cement.
Vitamin D and autoimmune thyroiditis
(Полтавський державний медичний університет, 2023) Pivtorak, K. V.; Ivanhuk, O. V.; Півторак, К. В.; Іванчук, О. В.
The primary role of vitamin D is the regulation of bone metabolism and the homeostasis of calcium and phosphorus. Over the past several decades, the importance of vitamin D in a variety of aspects unrelated to the skeletal formation has been studied, including the beneficial effects of vitamin D on endothelial dysfunction, insulin resistance and diabetes prevention, beneficial effects on the immune response in infectious diseases including tuberculosis, and immunomodulatory effects in autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, metabolic syndrome, cardiovascular disease, cancer, and all-cause mortality. Vitamin D prevents and promotes remission in patients with multiple sclerosis and improves the function of the gonads. The extensive range of vitamin D action is due to the presence of its receptors in many tissues. Recent evidence has shown a connection between low vitamin D levels and autoimmune thyroid diseases, such as Hashimoto's thyroiditis. This review aims to follow the role of vitamin D in the course of autoimmune thyroid disease. Vitamin D deficiency is one of the environmental risk factors for autoimmune thyroid diseases. Despite recent evidence that low serum 25-hydroxyvitamin D levels may influence the development of autoimmune thyroid disorders, the relationship between vitamin D deficiency and autoimmune thyroiditis and the incidence of hypothyroidism remains unclear. Further studies are needed to evaluate vitamin D's preventive and therapeutic effects in autoimmune thyroid diseases.
Methods for temporary teeth restoring in preschool children
(Полтавський державний медичний університет, 2023) Berezhnaya, O. E.; Kaskova, L. F.; Lazareva, K. A.; Бережна, Олена Едуардівна; Каськова, Людмила Федорівна; Лазарєва, Ксенія Анатоліївна
Temporary incisors and molars destroyed by caries and their complications need restoration from the point of view of their performance of functions and aesthetics. In children's dentistry, there is a wide range of different methods that are successfully used. The purpose of the study was to study the possibilities of using different restoration methods of the crown of temporary teeth in children, to determine their advantages and to provide recommendations for their use. Treatment was carried out for children aged 2-6 years with a temporary bite with the pathology of the hard tissues of the teeth under general anaesthesia. To restore destroyed teeth, the method of restoration with composite materials was used (63% of cases), and restoration using standard crowns of various types (37% of cases). Observation of children for two years showed positive results and made it possible to save temporary teeth. In addition to composite filling materials, which are most often used to restore tooth crowns in pediatric dentistry, standard crowns are widely used: steel crowns made of stainless steel, steel crowns with plastic lining, and crowns made of zirconium dioxide framework. Each of them has its indications. They make it possible to hermetically close the defect of the temporary tooth's hard tissues, restore the crown part's anatomical shape and chewing efficiency, and prevent the fracture of the remaining walls of the tooth crown. During using crowns, the fixing glass ionomer cement remineralizes the hard tissues due to the release of fluorides. It is possible to combine the use of different methods in one child. In children's therapeutic dentistry, there is a significant range of possibilities for restoring temporary teeth, which have their indications and contraindications, which must be considered in each specific case. All the methods we used showed positive results and allowed the saving of temporary teeth during the observation period.
The way of becoming a specialist
(Полтавський державний медичний університет, 2023) Khmil, T. A.; Hurzhiy, O. V.; Khavalkina, L. M.; Pysarenko, O. A.; Kulay, O. O.; Dubyna, V. O.; Morochkovska, O. V.; Хміль, Тетяна Андріївна; Гуржій, Олена Вікторівна; Хавалкіна, Людмила Михайлівна; Писаренко, Олена Анатоліївна; Кулай, Ольга Олександрівна; Дубина, Віталій Олексійович; Морочковська, Олена Володимирівна
Structural changes in the thymus under the pathogenic factors action
(Полтавський державний медичний університет, 2023) Prykhodko, O. O.; Приходько, О. О.
The thymus is the primary lymphoid (immune) organ in which antigen-independent proliferation and differentiation of T-lymphocytes occur and protects the body against various pathogenic factors. A comprehensive study of the morphological features of the thymus is relevant and one of the primary tasks of theoretical and practical medicine. The goal is to analyze and generalize data from the modern scientific literature on structural changes in the thymus under exposure to various exo- and endoantigens. It is possible to predict its further changes and develop methods for their prevention and correction, having followed the patterns of structural reorganization of the thymus under the influence of specific pathogens. The article analyzes data from the literature on the effects of cyclophosphamide, immunofan, salt extract of Hirudo verbana, tobacco smoke, formaldehyde, staphylococcal toxoid, polyoxypropylenetriol triglycidyl ester aqueous solution, adjuvant arthritis, light stress, reticuloendotheliosis virus, ablation therapy on the structural components of the thymus. Data are presented that emphasize the severity of the age-related clinical picture of COVID-19 and SARS-CoV-2, which is explained by insufficient antiviral immune function and an excessive self-destructive immune reaction, which includes T-cell immunity and is associated with already existing chronic inflammation in the human body of elderly. In addition, there is current information on the structure of the thymus and patterns of changes in its structural organization in age-related involution and atrophy. In most cases, due to the short-term exposure of the research animals to various exo- and endoantigens, changes in the thymus of the type of compensatory-adaptive reaction develop; that is, they are not specific.
Changes in the biochemical indicators of mandibula bone tissue after removal of molars and augmentation of the alveolar process
(Полтавський державний медичний університет, 2023) Kolesnichenko, M. O.; Savchenko, D. V.; Savchenko, V. V.; Ivanyuk, O. S.; Zhivotovskyi, I. V.; Lokes, K. P.; Колесніченко, М. О.; Савченко, Д. В.; Савченко, В. В.; Іванюк, О. С.; Животовський, Ігор Володимирович; Локес, Катерина Петрівна
Dental rehabilitation of patients with secondary adentia is a common problem in modern medicine. Atrophy of the alveolar process after tooth extraction can be a contraindication for the placement of dental implants or worsen the aesthetic result of the placed implant or reconstructive prosthetics. The study aimed to investigate the changes in the biochemical parameters of the connective tissue after removing the mandibular molars using classical and author's methods. The study involved patients who had mandibular molars removed according to the classic method (control group – 25 people), additionally underwent alveolar augmentation with "Cerabone" granules (1 group – 25 people) and the use of "Cerabone" granules in combination with a keratoxenoimplant (2nd group – 25 people). The following biochemical indicators of non-collagenous proteins were investigated: hexuronic acids, chondroitin sulfates, N-acetylneuraminic acid, and non-protein-bound fucose in mandibular bone tissue. At the time of the surgical stage of dental implantation in patients of the first group, a decrease in the content of hexuronic acids was established by 5.4% compared to the first day of the study, for the second - by 3.7%, for the control group - by 11.9%. A decrease in the content of chondroitin sulfates by 8.7%, 13.4% and 15.4% was noted for the first, second and control groups. The level of fucose not bound to proteins significantly increased by 5.1% in the control group. A probable decrease in the content of N-acetylneuramine was noted in all three groups relative to the first observation period by 8.6%, 3.5% and 19.6%, respectively. The content of hexuronic acids and N-acetylneuraminic acid underwent the most significant changes. Using "Cerabone" granules both as a monodrug and combined with a keratoxenoimplant for augmentation of the alveolar process bone defect contributed to a less pronounced decrease in the level of proteoglycans and glycoproteins compared to the control.
Lumbar foraminal stenosis (review article)
(Полтавський державний медичний університет, 2023) Piontkovskyi, V. K.; Zlativ, V. P.; Myronyk, B. M.; Dushnyi, M. M.; Піонтковський, В. К.; Златів, В. П.; Мироник, Б. М.; Душний, М. М.
Foraminal lumbar spinal stenosis has been a social problem relevant for many decades. This pathology usually arises due to degenerative-dystrophic diseases of the spine. It is characterized by a pathological reduction of the intervertebral foramen through which the nerve root of the corresponding segment exits. We conducted a review of the literature on the problems of foraminal stenosis and the methods of its treatment. Knowledge of the anatomy and pathogenesis of this nosology is significant for determining treatment tactics and the scope of surgical intervention. Causes of foraminal stenosis can be both congenital and acquired conditions. The most common are degenerative phenomena of the arcuate joint and intervertebral disc, spondylolisthesis, scoliosis, and intervertebral disc extrusion. The main link of the pathogenesis is the instability of the vertebral-movable segment, which leads to subluxation of the upper articular process and the development of hypertrophy of the arcuate joint. The primary treatment method is conservative therapy, which includes non-steroidal anti-inflammatory drugs, gabapentin and vitamin preparations. However, in the absence of a clinical effect, blockade of steroid drugs or placement of an epidural catheter is indicated. Endoscopic foramenotomy and laminectomy through translaminar access are promising directions of operative surgical techniques. Due to their minimal trauma, small intraoperative blood loss, and early rehabilitation, these techniques are gaining wide popularity among spinal surgeons. It is worth noting that with these techniques, setting up a cage and stabilizing the vertebral-movable segment minimally invasively is possible. Open-type operations lose their relevance due to high trauma; however, in the presence of concomitant central stenosis, spondylolisthesis, and degenerative scoliosis, there is a need for their use.
Clinical characteristic of different types of conservative treatment os pathological scars of head and neck
(Полтавський державний медичний університет, 2023) Tkachenko, P. I.; Lokes, K. P.; Bondarenko, V. V.; Bilokon, S. O.; Ivanytska, O. S.; Rezvina, K. Y.; Ivanicky, I. O.; Ткаченко, Павло Іванович; Локес, Катерина Петрівна; Бондаренко, Валерій Володимирович; Білоконь, Сергій Олександрович; Іваницька, Олена Сергіївна; Резвіна, Катерина Юріївна; Іваницький, Ігор Олексійович
There are a lot of different types of conservative and surgical treatment of pathological scars. The purpose of study was to analyze the result of using of ultraphonophoresis of Contractubex and electrophoresis with lidase in case of conservative treatment of scars of maxillofacial region. The study involved 40 patients of the Department of Maxillofacial Surgery of the Poltava Regional Clinical Hospital with pathological scars of maxillofacial localization. All patients were divided into two clinical groups of 20 people each. Patients of the first clinical group were administered the Contractubex daily using ultraphonophoresis. Patients of the second clinical group underwent electrophoresis with lidase. The nature of the scars was assessed by four clinical signs (type, texture, color and sensitivity), expressed on a 4-point scale. Both methods of conservative treatment of maxillofacial scars have a predominant effect on subjective indicators, such as itching. A more pronounced effect of treatment was noted after the use of ultraphonophoresis of contractubex, in this group of patients there was also a significant improvement in such an objective clinical indicator as the color of the scar. The use of lidase electrophoresis led only to a reliable improvement in subjective feelings (P4), in the absence of such in relation to three objective indicators. Thus, the investigated methods of conservative treatment mainly affect the subjective characteristics of scar tissue. Moreover, the use of contractubex ultraphonophoresis has a more pronounced effect than the use of lidase electrophoresis.
The biographical method as a means of forming the professional personality and professional identity of the future doctor (as exemplified by the integration of the study of human anatomy and the disciplines of the foreign language training cycle)
(Полтавський державний медичний університет, 2023) Bieliaieva, O. M.; Bilash, S. M.; Pronina, O. M.; Lysanets, Yu. V.; Bilash, V. P.; Havrylieva, K. H.; Taran, Z. M.; Бєляєва, Олена Миколаївна; Білаш, Сергій Михайлович; Проніна, Олена Миколаївна; Лисанець, Юлія Валеріївна; Білаш, Валентина Павлівна; Гаврильєва, Ксеня Григорівна; Таран, Зінаїда Михайлівна
Biographies of outstanding personalities serve as both a means and a source of historical knowledge, which acquires special importance in the process of training future doctors, because medicine maintains an inseparable connection between the past and the present, and any scientific discoveries accumulate or nullify the achievements of predecessors. On the one hand, biographical method is aimed at realizing the role of the individual in history, and on the other – at understanding the influence of history, in fact, society, at a specific stage of its existence, social contexts, ethical rules and norms, society on the formation of an individual and his life path, choosing a life position, ideals and values, dialogue between an outstanding personality and contemporaries. Reconstructing the curriculum vitae, the biographical method enables the reproduction of the socio-political and socio-cultural contexts in which scientific discoveries, cultural and other achievements arose and spread, serving as one of means of forming the professional personality and professional identity of the future doctor, in particular, in the process of studying anatomy and disciplines of the foreign language training cycle.
Vestibular paroxysmia (case report, discussion)
(Полтавський державний медичний університет, 2023) Delva, I. I.; Дельва, Ірина Іванівна
Мета. Описати клінічний випадок вестибулярної пароксизмії (ВП) і таким чином продемонстру- вати важливість знання неврологами діагностичних критеріїв цього захворювання. Результати. Чоловік 58 років звернувся зі скаргами на напади раптового, інтенсивного головокружіння тривалістю 15-20 секунд з відчуттям обертання предметів проти годинникової стрілки. Під час нападів хворий відмічає тріск у правому вусі, відчуття нестійкості, профузний піт, нудоту. У наступні 10-15 хвилин після закін- чення нападів хворого турбують відчуття легкості в голові та жару в тілі, серцебиття. Напади виникають спонтанно, без будь-яких тригерів, 5-7 разів на місяць. Перший напад стався 5 місяців тому під час їзди автомобілем в місті, через що хворий ледь не потрапив у дорожньо-транспортну пригоду. Відтоді хворий боїться сідати за кермо. Пацієнт панічно боїться нападів, оскільки вони супроводжуються вкрай неприємним відчуттям голово- кружіння. Крім того, хворий хвилюється, що ці напади можуть бути симптомом якогось важкого, доcі не- розпізнаного захворювання. Окрім вищенаведених скарг пацієнт відмічає постійний шум в обох вухах, що посилюється в тиші. Хворий звертався до невролога, було діагностоване доброякісне пароксизмальне позиційне запаморо- чення. За призначенням невролога пацієнт приймав бетагістин по 24 мг 2 рази на добу протягом 1 місяця, фенібут по 25 мг 3 рази на добу протягом 1 місяця. Лікування ніяк не вплинуло на частоту та інтенсивність нападів головокружіння. 7 років тому був струс головного мозку внаслідок падіння на льоді. Останні 3 роки страждає на артеріаль- ну гіпертензію, приймає бісопролол по 2,5 мг на добу. При неврологічному огляді відхилень не виявлено. Спонтанний та індукований ністагм відсутній. Тест по- штовху голови – негативний. Рівновага і координація – непорушені. Тест Дікса-Холпайка не викликав позицій- ного ністагму. Пацієнт заповнив госпітальну шкалу тривоги та депресії: субшкала тривоги – 18 балів, субшкала депресії – 10 балів. МРТ головного мозку – перивентрикулярний лейкоареоз 1 ступіня за шкалою Фазекас. При аудіометрії діагностована двобічна нейросенсорна недостатність. Електроенцефалографія: епілептиформної активності не виявлено. Консультація отоларинголога: незначна двобічна сенсоневральна приглухуватість. Отримані клінічні дані повністю відповідають діагнозу ВП: A) Принаймні 10 нападів спонтанного системного або несистемного головокружіння. B) Тривалість нападів менше 1 хвилини. В) Стереотипна феноменологія нападів. D) Ефективність лікування карбамазепіном/оксарбазепіном. E) Стан пацієнта не може бути пояснений будь-яким іншим діагнозом. Пацієнту було призначено карбамазепін (200 мг 1 раз на добу протягом 3 днів, потім – 200 мг 2 рази на добу протягом 1 місяця) як патогенетичне лікування ВП та етіфоксину гідрохлорид (50 мг 3 рази на добу про- тягом 1 місяця) як анксіолітичний препарат. Через 1 місяць, під час візиту пацієнт повідомив про відсутність нападів головокружіння протягом усього періоду приймання медикаментів. Госпітальна шкала тривоги та депресії: субшкала тривоги – 10 балів, суб- шкала депресії – 8 балів. Пацієнту рекомендовано приймати карбамазепін по 100 мг двічі на добу протягом наступних 3 місяців. Через 3 місяці, під час контрольного огляду пацієнт повідомив лише про один напад легкого головокру- жіння з моменту попереднього візиту. Було рекомендовано продовжувати прийом карбамазепіну по 100 мг двічі на день протягом 6 місяців з подальшим плановим візитом. Висновки. Неврологам необхідно знати та активно використовувати у своїй практиці діагностичні критерії ВП.
Method of determining indicators connection of the state of periodontal inflammation and oral microbiota
(Полтавський державний медичний університет, 2023) Zaitsev, A. V.; Boychenko, O. M.; Kotelevska, N. V.; Nikolishin, A. K.; Зайцев, Андрій Володимирович; Бойченко, Ольга Миколаївна; Котелевська, Наталія Василівна; Ніколішин, Анатолій Карлович
Резюме. На сьогодення вважається, що порушення рівноваги між мікробним біоценозом і станом слизової оболонки порожнини рота є однією з важливих причин захворювань пародонту. Насамперед це вплив мікробного вмісту зубної бляшки на тканину та локальна тканинна відповідь на це. Інтенсивність цієї відповіді варіює в залежності від проявлення місцевих патофізіологічних реакцій у відповідь на пошкодження та від залучення системних реакцій організму. Для оцінки стану пародонтологічного статусу до та після проведеного лікування користуються різними показниками, що характеризують стан тканин пародонту. Це гінгівальні та пародонт альні індекси: PMA (за модифікацією Parma, 1960), гінгівальний індекс за Silness-Loe (1964), пародонтальний індекс (за Russel, 1956), індекс SPITN та ін. Вищезазначений індекс РМА (папілярно-маргінально-альвеолярний), запропонований Masser і модифікований Parma у 1960 p., використовується для оцінки запального процесу в яснах, тобто, стану патофізіологічної реакції в них. Оцінка стану гігієни порожнини рота здійснюється за допомогою гігієнічних індексів – гігієнічного індексу за Федоровим-Володкіною (1970), гігієнічного індексу за Green-Vermillion (OHI-S) та ін. Спрощений індекс гігієни ротової порожнини OHI-S використовується для виявлення та характеристики зубного нальоту, тобто визначення організації дентальної біоплівки. При терапії запальних захворювань пародонту часом буває важко зорієнтуватися у формуванні стратегії щодо лікування через з’ясування сумісності вищевказаних покажчиків. В цих випадках на допомогу залучаються методи математичного аналізу. Метою дослідження було створення методики, яка дає уявлення щодо сумісності і оцінки показників стану орального мікробіому людини та реакції на нього організму. Матеріалами слугували дані досліджень, які характеризують представників орального мікробіоценозу та проявлення у відповідь на це місцевих патофізіологічних реакцій. Як метод, був обраний математичний аналіз, зокрема це апроксимація, яка здійснена за допомогою комп’ютерної програми Excel 2010. Використана нами методика визначення сумісності і оцінки показників стану орального мікробіому людини та реакції на нього організму дозволяє зробити припущення щодо кореляції цих складових. Графічне відображення дає уявлення за відхилення від стану ремісії. Отримані за допомогою комп’ютерної програми залежності підлягають подальшому розгляду за допомогою математичного аналізу та можливості внесення змін в терапевтичні втручання.
The influence of burnout syndrome on the work efficiency of medicas during the pandemic and martial law
(Полтавський державний медичний університет, 2023) Liakhovskyi, V. I.; Nemchenko, I. I.; Liulka, O. M.; Horodova-Andreeva, T. V.; Krasnov, O. G.; Sydorenko, A. V.; Ляховський, Віталій Іванович; Нємченко, Іван Іванович; Люлька, Олександр Миколайович; Городова-Андрєєва, Тамара Валер'янівна; Краснов, Олег Георгійович; Сидоренко, Архип Володимирович
The article is based on a review of the scientific literature, defines the burnout syndrome and indicates the risks of its occurrence among medical staff, especially during a pandemic and martial law. Clinical symptoms are described with a five-stage model of its clinical course and diagnostic criteria for detection based on test screenings, among which the Maslach Burnout Questionnaire is most often used. In the context of the COVID-19 pandemic and martial law, the psycho-emotional loading and the risk of the emotional stress of healthcare staff are significant increases. Causes of suffering for medics may be related to personal events or bad relationships at work. Therefore, a decisive protective factor for the well-being of the worker at the workplace and throughout life is the sympathy of others. Treatment of burnout syndrome should be based on an assessment severity of symptoms. For severe symptoms of burnout, psychotherapeutic treatment is recommended. Antidepressants can also be used, preferably in combination with psychotherapy. The article indicates problematic issues in the treatment of this syndrome. It has been proven that burnout syndrome among medics is quite harmful. Both for specialists, medical institutions and patients. Therefore, it’s necessary to determine the risks of its occurrence in advance and take preventive actions.
Dynamics cognitive functions recovery in the acute period of different subtypes of ischemic stroke after systemic thrombolytic therapy
(Полтавський державний медичний університет, м.Полтава, Україна, 2023) Havlovska, Ya. Yu.; Lytvynenko, N. V.; Shkodina, A. D.; Havlovskyi, O. L.; Гавловська, Ярослава Юріївна; Литвиненко, Наталія Володимирівна; Шкодіна, Анастасія Дмитрівна; Гавловський, Олександр Леонідович
Stroke is the second leading cause of death worldwide, the leading cause of disability, and a significant financial burden. Currently, 3 to 4% of the total health care costs of countries are spent on stroke treatment. Studies of stroke survivors have shown that approximately 10% may develop dementia within the first year after a stroke. However, today the issue of early recovery of patients with acute cerebrovascular diseases and the phenomenology of the development of complications, in particular cognitive disorders in the acute period, is an acute issue, which would allow optimizing personalized strategies for the treatment of such patients. The goal is to evaluate the dynamic changes in the cognitive sphere in patients in the acute II period with atherothrombotic and cardioembolic subtypes after thrombolysis. We conducted a prospective two-center study of patients in the acute phase of ischemic stroke. 89 patients were included in the study: group 1aA (n=32) – patients with atherothrombotic subtype of ischemic stroke (IS), who were subject to thrombolytic therapy (sTLT); group 1aK (n=16) – patients with cardioembolic subtype IS who were to undergo sTLT; group 2 (n=20) –healthy patients with no history of acute cerebrovascular disorders (control group). Assessment of cognitive functions was carried out using international standardized scales, in particular: Mini Mental State Examination (MMSE). We established statistically significant differences between the examined groups for 1 day according to indicators of time orientation (р=0.007), attention and calculation (р<0.001), perception and memory (р=0.001) and the total MMSE score (р<0.001). Statistically significant differences were found between the examined groups on the 14th day in the indicators of attention and calculation (p<0.001) and in the total MMSE score (p<0.001). No significant differences in ∆MMSE were found between groups 1aA and 1aK (р=0.701). In patients with cardioembolic subtype IS, the presence of positive dynamics in the acute period was established, while in patients with atherothrombotic subtype it was not detected. Along with this, the difference in recovery of various domains of the cognitive sphere in the acute period according to subtype IS was noted. This is how we discovered. that the dynamic changes of cognitive functions in the acute IS period after sTLT vary depending on the clinical subtype.
Clinical thinking аs an important element of effective professional activity of the future medical worker
(Полтавський державний медичний університет, 2023) Bobukh, V. V. ; Andreiko, S. S.; Bilanova, L. P.; Bilash, V. P.; Oliinichenko, Ya. O.; Shkolna, O. V.; Bilash, S. M.; Бобух, Валерія Валеріївна; Андрейко, Світлана Станіславівна; Біланова, Лариса Павлівна; Білаш, Валентина Павлівна; Олійніченко, Ярина Олександрівна; Школьна, Олена Віталіївна; Білаш, Сергій Михайлович
Clinical thinking plays a significant role in training highly qualified medical workers, as it creates the basis for transforming acquired knowledge into the ability to apply it in practical activities. For healthcare workers, the formation of professional competence is significant, a combination of a high level of theoretical knowledge, professional skills, practical skills, the creative potential of an individual and a culture of communication. A significant role in this is played by the ability of medical workers to think "clinically", to learn to express their own opinions, to analyze and think logically, and to react quickly and highly qualified in critical situations. The formation of clinical thinking begins already during training in a medical institution and is further improved during one's professional activity. In addition, various modern teaching methods play a significant role in forming clinical thinking. These include the case method, the business game method, the "brainstorming" method, as well as the use of situational tasks. All these methods aim to teach students to fulfil their professional duties with dignity and apply the acquired knowledge in practical activities. In addition, the combination of these methods contributes not only to the formation of clinical thinking but also has a direct impact on both creative and critical thinking since it is impossible to draw a clear line between these concepts, especially when it comes to medical workers. Therefore, nurses' combination of essential, creative and clinical thinking elements is a crucial element of effective professional activity.
Memory of professor Kuzmenko Yuriy Yuriyovych (1961−2022)
(Полтавський державний медичний університет, 2023) Dzevulska, I. V.; Malikov, O. V.; Дзевульська, І. В.; Маліков, О. В.
Vascular depression and cardiovascular complications of type 2 diabetes
(Полтавський державний медичний університет, 2023) Kostrikova, U. A.; Myakinkova, L. O. ; Pustovoit, G. L.; Yarmola, T. I.; Кострікова, Юлія Анатоліївна; М'якінькова, Людмила Олександрівна; Пустовойт, Ганна Леонідівна; Ярмола, Тетяна Іванівна
The paper highlights the scientific foundations that link the two-way pathophysiological mechanisms of the development of depression with the worsening of type 2 diabetes and coronary heart disease, congestive heart failure, and an increase in cardiovascular risk. The term "vascular depression" is defined as associated with organic changes in the brain characteristic of cerebrovascular diseases and type 2 diabetes; according to magnetic resonance imaging, they are identified as hyperintensity of the white matter of the brain. The development of white matter hyperintensity is facilitated by vascular dysregulation, transient ischemia, inflammation, and ischemic damage. Disturbances in the regulation of vascular tone that occur during the development of depressive states and their connection with somatic pathology, a decrease in cerebral blood flow, and the appearance of affective and cognitive symptoms are described. The importance of increased arterial stiffness and endothelial dysfunction in the development of depression is highlighted. The regulatory mechanisms of the influence of glucose, nitric oxide, pro-inflammatory cytokines, arachidonic acid, and eicosanoids on vascular regulation and their disturbances in patients with depression and type 2 diabetes are described. The features of astrocytic and neuronal homeostasis of the brain, the neurotoxicity of carbohydrate metabolism disorders and glutamate metabolism, their importance in the violation of vasoactive reactions, and the depression development in patients with type 2 diabetes are indicated. The mechanisms of neuro-endocrine, metabolic and enzymatic vascular regulation, their features in patients with type 2 diabetes and depression, their influence on the course, the prognosis of the disease and cardiovascular risk are considered.
Perception of readiness of future doctors for professional activities and determination of key factors affecting readiness to work
(Полтавський державний медичний університет, 2023-03) Kuzmenko, N. V.; Ivanytska, T. A.; Poda, O. A.; Nesina, I. M.; Tanianska, S. M.; Кузьменко, Наталія Валентинівна; Іваницька, Тетяна Анатоліївна; Пода, Ольга Анатоліївна; Несіна, Інна Миколаївна; Танянська, Світлана Михайлівна
The transition from theory to practice is usually associated with stress and uncertainty for a graduate of a higher education institution. In medical education, this problem appears most acutely due to rather stressful and responsible working conditions that a "newly trained" specialist finds himself in. A multifactorial influence on the process of transition of young doctors to independent practice has been proven, which is confirmed by many foreign studies. It is important to note that the most influential factors are personal characteristics, readiness to perform tasks and contextual factors. The development and improvement of essential practical skills in the work of a future doctor begins from the moment of admission to a higher medical educational institution and is regulated by educational programs that medical student masters during the entire study period. However, the acquisition of specific competencies, unfortunately, does not depend on the acquirer's intellectual abilities or the teacher's professional skill, while self-discipline, self-awareness, stress resistance and the ability to learn independently acquire great importance, which is difficult to evaluate and modify. Educational programs mastered by a medical student in obtaining higher education are designed to promote positive learning outcomes and a smooth transition from theoretical or paraclinical training to the clinical environment. In addition, the purpose of educational institutions is to take into account the needs of the industry before graduates begin to perform professional duties, as well as to track their professional fate. In the conducted research, we tried to determine the readiness for professional activity among Poltava State Medical University students. The survey results made it possible to identify gaps in the acquisition of critical skills that are extremely necessary for the future work of medical students and interns, as well as the level of competence development and awareness of readiness to perform professional tasks.

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