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Acupressure as a method of Rehabilitation and Treatment of patients with gastroduodenal pathology
(Wydawnictwo Aluna, 2022) Hutsalenko, O. O.; Katerenchuk, I. P.; Kostrikova, U. A.; Tsyganenko, I. V.; Yarmola, T. I.; Tkachenko, L. A.; Ovcharenko, L. K.; Гуцаленко, Ольга Олексіївна; Катеренчук, Іван Петрович; Кострікова, Юлія Анатоліївна; Циганенко, Ірина Володимирівна; Ярмола, Тетяна Іванівна; Ткаченко, Лідія Афанасіївна; Овчаренко, Людмила Костянтинівна
Aim: To assess the effectiveness and safety of acupressure in the complex rehabilitation and treatment of patients with gastroduodenal pathology. Materials and methods: A retrospective analysis of the results of examination and treatment of 40 patients with gastroduodenal pathology was carried out. For treatment, the author’s protocol of acupressure (AP) was used based on the recommendations of F.M. Houston. Statistical processing of the results was carried out according to the qualitative data analysis algorithm using the MedCalc 2022 software package. The frequency of occurrence of qualitative binary variables was analyzed with the calculation of 95% CI. To determine the effect of AP on the change in the frequency of clinical syndromes, the McNemar test for related groups was used. The assessment of the risk of side effects of AP was carried out on the basis of determining the significance level of 95% CI for the share, taking into account the binomial distribution of the characteristic. Formulated null and alternative statistical hypotheses. Results: After two weeks of treatment with the using of AP against the background of the disappearance of endoscopic signs of gastroduodenal pathology, statistically significant changes in the frequency of manifestations of all clinical syndromes were detected. AP not only relieves pain, but also shortens the duration of the illness, eliminates functional disorders of the motility of the upper parts of the digestive tract, allows to achieve clinical and endoscopic recovery and provides stable and long-term remission. Tolerability of AP was good. No side effects were registered. It has been proven with a probability of 95% that the risk of a side effect does not exceed 9%. Conclusions: Using of AP is effective, safe, which corresponds to the alternative statistical hypothesis.
Anticholinergic burden in aging patients and its role in the development of bladder decompensation
(Полтавський державний медичний університет, 2022) Pustovoit, G. L.; Sarychev, L. P.; Savchenko, R. B.; Sarychev, Y. V.; Ustenko, R. L.; Sukhomlin, S. A.; Пустовойт, Ганна Леонідівна; Саричев, Леонід Петрович; Савченко, Роман Борисович; Саричев, Ярослав Володимирович; Устенко, Роман Леонідович; Сухомлин, Сергій Адольфович
Антихолінергічне навантаження розглядають як кумулятивний ефект від прийому препаратів з антихолінергічною активністю. У статті наведено дані про роль антихолінергічного навантаження в розвитку декомпенсації сечового міхура у хворих на доброякісну гіперплазію передміхурової залози. Обстежено 381 пацієнтів із доброякісною гіперплазією передміхурової залози в стадії субкомпенсації та декомпенсації сечового міхура. Антихолінергічне навантаження у пацієнтів літнього віку може розвиватися як в результаті прийому препаратів з високою потенційною антихолінергічної активністю, так і в результаті тривалого застосування препаратів з низькою потенційною антихолінергічної активністю. Препарати з високою потенційною антихолінергічною активністю зменшують симптоми гіперактивного сечового міхура у пацієнтів з доброякісною гіперплазією передміхурової залози, але антихолінергічне навантаження стає фактором поглиблення декомпенсації сечового міхура, що погіршує результати хірургічного лікування.
Aspects of pharmacotherapy in cardiac emergencies
(2025) Vasova, O. V.; Moisieieva, N. V.; Ryabushko, M. M.; Власова, Олена Вікторівна; Моісєєва, Наталія Віталіївна; Рябушко, Микола Миколайович
The handbook shows optimal methods of pharmacotherapy of emergency conditions of cardiac diseases. The textbook presents basic information on emergency treatment of cardiovascular diseases depending on the form, stage, course and presence of concomitant pathology. Disease diagnoses are based on the 2020 ICD. Typical clinical manifestations and criteria for diagnosing emergency conditions are presented in a concise manner. The handbook presents in detail the material of the main stages of intensive care. The authors have considered the basic issues of emergency care depending on the clinical variant of the disease and the stage of its development. The material is presented taking into account the personal clinical experience of the authors and data from modern literature. Much attention is paid to the pathogenetic mechanisms of action of drugs. The authors review the most commonly used medications as well as promising new drugs. Modern schemes of combined drug therapy for various emergencies in patients with cardiac diseases are also given. Despite the fact that the manual is mainly concerned with the pharmacological correction of cardiac emergencies, it also describes such treatment methods as cardioversion - for fatal heart rhythm disorders and electrocardiostimulation - for heart blocks. The book is intended for doctors of various specialties, residents and students of medical and stomatological faculties of higher medical educational institutions. Швидка та точна діагностика невідкладних станів у хворих з серцево-судинними захворюваннями надання у цих випадках адекватної екстреної допомоги – особлива галузь кардіології, яка потребує глибоких знань, і є необхідною не тільки кардіологам та лікарям швидкої допомоги, але й лікарю будь-якої іншої спеціальності. У навчально-методичному посібнику висвітлені питання надання швидкої та невідкладної медичної допомоги при різних невідкладних станах у хворих із серцево-судинними захворюваннями. Детально розглянуті особливості надання швидкої і невідкладної медичної допомоги на різних етапах (догоспітальному та госпітальному). Основна увага у навчально-методичному посібнику приділена особливостям фармакотерапії невідкладних станів. Авторами описані сучасні ефективні методи фармакотерапії невідкладних станів. Навчально-методичний посібник розраховано на широке коло лікарів різних спеціальностей та студентів вищих навчальних закладів.
Assessment of adhesion to treatment of patients being on kidney replacement therapy taking into account the presence of type 2 diabetes mellitus
(Полтавський державний медичний університет, 2021) Katerenchuk, I. P.; Rustamian, S. T.; Катеренчук, Іван Петрович; Рустамян, Сатєнік Тігранівна
This article presents the results of the analysis of adherence to treatment of patients on renal replacement therapy, taking into account type 2 diabetes. It was found that the adherence index to treatment is directly proportional to the patient's age and does not depend on the article and duration of treatment on programmed hemodialysis. In turn, the presence of a history of diabetes increases patient compliance, which, in turn, has a positive effect on disease control by both the doctor and the patient. Patients with stage I-II chronic kidney disease have a low level of adherence, which may be an additional risk factor for renal failure progression
Assessment of quality of life of patients after surgery made by the in-house devices and methods
(Wiadomości Lekarskie, 2020) Riabushko, N. О.; Riabushko, R. М.; Riabushko, M. М.; Riabushko, O. B.; Рябушко, Наталія Олексіївна; Рябушко, Роман Миколайович; Рябушко, Микола Миколайович; Рябушко, Олена Борисівна
To estimate the patients’ quality of life after surgery made by the in-house devices and methods. Materials and methods: According to the peculiarities of surgical treatment, the set of instruments used and the methods of its application during surgery, all patients were assigned into two groups: group І (comparison group, or retrospective group) involved 48 (58.5%) patients who received treatment at the Vascular Surgery Department and had contraindications to endovascular laser and radiofrequency ablation, as evidenced by ultrasonographic color angioscanning (USCAS). These patients underwent typical phlebectomies, which were performed using a standard set of instruments; group ІІ (prospective) involved 34 (41.5%) patients treated in the Surgery Department. Patients of this group also had contraindications to endovenous laser and radiofrequency ablation, which was confirmed by USCAS data.
Chronic obstructive pulmonary disease and comorbidities: management of somatoform disorders
(Aluna Publishing, Польща, 2021) Burya, L. V.; Kapustianska, A. A.; Moiseieva, N. V.; Vakhnenko, A. V.; Rumiantseva, M. O.; Zviagolska, I. M.; Буря, Лілія Володимирівна; Капустянська, Анна Анатоліївна; Моісєєва, Наталія Віталіївна; Вахненко, Андрій Вікторович; Рум'янцева, Марія Олександрівна; Звягольська, Ірина Миколаївна
The aim: To perform a comprehensive evaluation of the effect of paroxetine on the degree of somatoform disorders in exacerbation of severe COPD in women. Materials and methods: The study involved 53 female patients with severe COPD (Group D), confirmed by instrumental methods of study. At hospitalization, patients were divided into 2 groups. Patients of Group 1 (n = 21; aged 52.5 ± 0.8 years old) underwent basic exacerbation therapy. Patients of Group 2 (n = 22; aged 57.9 ± 0.4 years old) underwent basic exacerbation therapy supplemented with paroxetine for 14 days, 1 tablet (0.20 g) once a day. Results: The basic therapy for treatment of COPD exacerbations, supplemented with paroxetine, led to a positive clinical effect, confirmed by increase in skeletal and respiratory muscular system, increased parameters of pulmonary ventilation, increased tolerance to physical load, increased oxygen saturation, decreased heart rate and breathing rate. Conclusions: The strategy for choosing an antidepressant to provide multidisciplinary care for somatoform disorders in women with exacerbation of severe COPD (group D) should take into account the efficacy and favorable safety profile and personalization of the drug. In exacerbation of severe COPD, the degree of somatoform disorders in patients correlates with the severity of the main criteria: FVC1, the distance walked during the 6-minute step test, oxygen saturation after the 6-minute step test, end-expiratory pressure in the oral cavity.
Churg-strauss syndrome: clinical case and its feautures
(Wydawnictwo Aluna, 2019) Katerenchuk, Ivan P.; Tkachenko, L. A. ; Yarmola, T. I.; Rustamyan, S. T.; Pustovoyt, A. L.; Katerenchuk, O. I.; Катеренчук, Іван Петрович; Ткаченко, Лідія Афанасіївна; Ярмола, Тетяна Іванівна; Рустамян, Сатєнік Тігранівна; Пустовойт, Ганна Леонідівна; Катеренчук, Олександр Іванович
Introduction: Autoimmune uveitis (AU) is an inflammation of the uvea due to an autoimmune reaction to self-antigens. There are no standardized treatment protocols for AU. A new class of drugs called biologics, that target the various mediators of the inflammation cascade, may potentially provide more effective and less toxic corticosteroids treatment of AU. The aim: The aim of this review was to make the evaluatation of the interleukins influence on intraocular inflammation in available literature and summarize the expediency of using anti-interleukins agent in case of AU. Material and methods: This article is a review and summary of the up-to-date results of pivotal experimental and clinical trials targeting the Interleukins (IL), including IL-6, IL-10, IL-17, IL-22, IL-23, and tumor necrosis factor alpha (TNF-α). Also reviews focus on the potential use of anti-interleukin therapy for the treatment of autoimmune diseases (AD). Conclusions: AU is an inflammation of the uvea due to an autoimmune reaction to self-antigens. The most important IL in the pathogenesis of AU are IL-6, IL-10, IL-17, IL-22, IL-23 and TNF-α. Anti-interleukin therapy is partially described. Future randomized controlled trials are urgently needed to be conduct.
Clinical, pharmacotherapeutic and biorhythmological peculiarities of depressive disorders, comorbid with cardiovascular pathology
(м. Тбілісі, 2021) Hryn, K.; Sydorenko, A.; Vlasova, O.; Kolot, E.; Martynenko, Y.; Гринь, Катерина Вікторівна; Сидоренко, Антоніна Григорівна; Власова, Олена Вікторівна; Колот, Еліна Георгіївна; Мартиненко, Яніна Павлівна
The spread of depressive disorders is extra high nowadays. Depressive disorders are widespread mental disorders in the structure of mental pathology, both causes of psychiatrists’ visit, and causes of medical aid. The presence of depressive syndrome in patients with cardiovascular system leads to deterioration patient’s condition and adaptive abilities and aggravates somatic abnormality. Adequate therapy causes their reduction, prevention of recurrence and decompansation of comorbid somatic pathology, and eliminates severe medical and prevents social consequences. The study of clinical aspects of depressive conditions which are accompanied with pathology is one of the direction not only psychiatric, but also common pharmacotherapeutic investigations. The aim of the investigation was to determine clinical, pharmacotherapeutic and biorhythmic peculiarities of depressive disorders in patients with comorbid cardiac pathology. And also assessment of efficacy of complex therapy based on chronotherapy principle was used. 50 patients (female patients) with depressive disorders were involved in this investigation. This was performed based on “Depressive disorders of organic genesis, characterized by somatic pathology” (F 06.35), “Somatoform disorder” of heart and cardiovascular system (F 45.30), “Mild depressive episode” (F 32.00), and also comorbid arterial hypertension confirmed by physician. Clinical, laboratory, clinical and psychopathological investigations using psychodiagnostic scales (scale HAMD-21, CGI-S, CGI-І) were used. Individual biorhythmic status was established and it requires medicamentous therapy. Comparing patients of both groups, it has been detected a group of patients in whom principles of chronotherapy, especially antihypertensive and antidepressive therapy were prescribed, dynamics of patient’s improvement was better than in the investigated group where the principle of chronotherapy was observed.
Collection of test tasks «Fundamentals of internal medicine (rheumatology)»
(Полтавський державний медичний університет, 2022) Talash, V. V.; Kostrikova, Yu. A. ; Pustovoit, A. L.; Талаш, Вікторія Володимирівна; Кострікова, Юлія Анатоліївна; Пустовойт, Ганна Леонідівна
Recommended by the Central Methodical Commission of Poltava State Medical University as a textbook for applicants for higher education in medical faculties of higher educational institutions of the Ministry of Health of Ukraine who study in English (minutes of the Central Methodical Commission № 1, 29.09.2022)
Comparative analysis of clinical manifestations of anxiety and depression in patients undergoing renal replacement therapy with concomitant type 2 diabetes mellitus
(Полтавський державний медичний університет, 2021) Rustamian, S. T.; Katerenchuk, I. P.; Катеренчук, Іван Петрович; Рустамян, Сатєнік Тігранівна
This article presents the comparative analysis results on clinical manifestations of anxiety and depression in patients undergoing renal replacement therapy, namely programmed hemodialysis, taking into account the concomitant type 2 diabetes mellitus. Patients undergoing renal replacement therapy, namely, program hemodialysis, have a higher risk of anxiety and depressive disorders than patients with chronic stage I-II kidney disease undergoing conservative therapy. Concomitant diabetes mellitus in patients undergoing renal replacement therapy causes an increase in the frequency of anxiety and depression.
Comparative assessment of quality of life parameters in rural and urban residents with comorbid hypertension
(Полтавський державний медичний університет, 2022) Katerenchuk, I. P.; Cherkun, M. P.; Катеренчук, Іван Петрович; Черкун, Маргарита Петрівна
The study highlights the results of a comparative analysis of the quality of life of 152 patients with hypertension and its combined course with type 2 diabetes and coronary heart disease living in urban and rural areas. Quality of life parameters were determined using the SF-36 questionnaire. It was found that the patient's quality of life worsens with increased comorbidity. A clinically significant difference in the quality of life parameters depending on territorial affiliation was established. Thus, the level of quality of life in patients from rural areas is mainly reduced due to the mental component, manifested by a decrease in an emotional state and a decrease in vital activity, while in urban residents – due to the physical part of health, which led to the impossibility of performing everyday tasks
COVID-19: клінічний випадок пацієнта з післяковідним міокардитом
(Видавництво «Новий Світ - 2000», 2022) Катеренчук, Іван Петрович
Current issues in diagnosing the respiratory manifestation of gastroesophageal reflux disease
(Полтавський державний медичний університет, 2021) Osyodlo, G. V.; Bychkova, S. A.; Katerenchuk, I. P.; Seliuk, M. M.; Kazmirchuk, A. P.; Осьодло, Галина Василівна; Бичкова, С. А.; Катеренчук, Іван Петрович; Селюк, Михайло Миколайович; Казмірчук, А. П.
The purpose of the study was to determine the leading extraesophageal symptoms, disturbance of spirometric indices, changes in the immune system and production of nitric oxide in patients with gastroesophageal reflux disease. Bronchopulmonary manifestation of gastroesophageal reflux disease was a cough syndrome, which was characterized by the presence of non-intensive, unproductive cough with a small amount of mucous sputum and was combined, in most cases, with the hoarseness of the voice. Cough syndrome during gastroesophageal reflux disease was characterized by a lack of obstructive changes in the study of external respiration indices and elevated levels of proinflammatory cytokines in the blood serum. It was determined the higher nitric oxide content in platelets in patients with respiratory manifestations of gastroesophageal reflux disease.
Current strategy for treatment of comorbid states: complicated community-acquired pneumonia with arterial hypertension
(Wydawnictwo Aluna, Polska, 2020) Burya, L. V.; Vakhnenko, A. V.; Moiseieva, N. V.; Kapustianska, A. A.; Zviagolska, I. M.; Буря, Лілія Володимирівна; Вахненко, Андрій Вікторович; Моісєєва, Наталія Віталіївна; Капустянська, Анна Анатоліївна; Звягольська, Ірина Миколаївна; Буря, Лилия Владимировна; Вахненко, Андрей Викторович; Моисеева, Наталья Витальевна; Капустянская, Анна Анатольевна; Звягольская, Ирина Николаевна
The aim: To optimize the treatment of CAP patients with hypertension, complicated by exudative pleuritis. Materials and methods: The study included 43 CAP patients, aged 46 to 65 years, with viral lesions along with hypertension. The average age of the patients was 52.5 ± 4.5 years. Veri cation of the CAP diagnosis and its formulation was performed in accordance with the order of the Ministry of Health of Ukraine No. 128 of 19.03.2007 “On the approval of clinical protocols of medical care in “Pulmonology” in all patients, pneumonia was complicated by exudative pleuritis, which was con rmed by X-ray examination. Results: The use of combination drugs, namely, torasemide with prolonged e ect and tivortin aspartate in the treatment of patients with community-acquired pneumonia, complicated by exudative pleuritis, combined with hypertension led to more signi cant positive changes in the values of saturation, blood biochemical parameters, as well as accelerated recovery of patients, which was con rmed by the positive dynamics of X-ray examination. Conclusions: As a result of the treatment, all parameters of the quality of life of the patients were greatly improved, which resulted in a signi cant reduction in functional limitations and high social activity of the patients, which signi cantly reduced the cost of treatment.
Early cardiac rehabilitation in acute myocardial infarction patients and its features
(Полтавський державний медичний університет, 2021) Teslenko, Y. V.; Myakinkova, L. O.; Teslenko, M. M.; Тесленко, Юрій Віталійович; М'якінькова, Людмила Олександрівна; Тесленко, Марина Миколаївна
Patients that have undergone myocardial infarction require inclusion in the treatment program of cardiac rehabilitation as a component of secondary prevention. Rehabilitation potential in patients with myocardial infarction was investigated according to a mathematical model that included indicators of hospital mortality, myocardial reperfusion, anxiety and depression, myocardial contractility, comorbidity and prehospital physical activity. The individual rehabilitation program according to the level of rehabilitation potential contributed to the early expansion of the physical exercise mode to the ward mode in patients of the experimental group for 2.83±0.13 days compared with 3.57±0.14 days in the control group, the baseline heart rate was 73.2±1.72 beats per minute, and 78.4±1.13 beats per minute, respectively. According to the results of submaximal testing, the distance in the experimental group was 694.7±38.4 m, in the control group – 584.2±40.7 m (p˂0.05). Assessment of rehabilitation potential provides determination of optimal terms and methods of cardiac rehabilitation.
Effect of atmospheric technogenic emissions on health indicators of child population
(Wydawnictwo Aluna, 2018) Toronchenko, Olha M.; Bredun, Viktor I.; Smoliar, Natalia O.; Торонченко, Ольга Миколаївна
Introduction:The identification of scientifically grounded dependency of the atmospheric pollution effect on the health level of the child population within particular area makes it possible to assess the degree of district environmental safety and provides the possibility for implementation of targeted programs and risk preventing strategies associated with atmospheric emissions. The aim of the study is to assess the dependence of child morbidity rate development caused by atmospheric chemical pollution, which resulted from the stationary and mobile sources activity in terms of the Poltava region (Ukraine) as a model. Materials and methods: Analysis of the general morbidity rate, respiratory diseases and congenital malformations rate was based on statistical data of the Poltava Regional Health Department, the assessment of air pollutant emissions level in cities and districts of the region over 2011-2015 years was performed using data provided by the Main Statistics Department of the Poltava region and the Department of Ecology and Natural Resources of the Poltava Region State Administration; the Microsoft Excel package with Pearson correlation coefficient and two-choice Student’s t-test was used for the data analysis. Results: According to the research data it was determined that each district had its own specific features in environmental hazards formation and common correlation pattern for all 25 administrative districts of the Poltava region was not specified. Ranking of regions by the level of pollutant emission effect on the child morbidity rate makes it possible to distinguish more dangerous ecological regions. Eight areas with significant and moderate relations between the child morbidity rate and air pollution caused by mobile sources and seven areas where air pollution was caused by stationary ones have been revealed. The main sources of air pollution are industrial emissions of the fuel and energy enterprises, manufacturing and extractive industries, vehicle and agriculture emissions. Kremenchuk and Horishni Plavhi cities include more significant factors in formation of child morbidity rate. Conclusions: Considering identified factors and dependencies, the targeted regional program aimed at specification, elimination and prevention of the harmful environmental factor affecting children’s health can be projected.
Efficacy of percutaneous draining operations for simple renal cysts
(Полтавський державний медичний університет, 2021) Sarychev, L. P.; Sarychev, Y. V.; Pustovoyt, A. L.; Suprunenko, S. M.; Savchenko, R. B.; Ustenko, R. L.; Sukhomlyn, S. A.; Саричев, Леонід Петрович; Саричев, Ярослав Володимирович; Пустовойт, Ганна Леонідівна; Супруненко, Сергій Миколайович; Савченко, Роман Борисович; Устенко, Роман Леонідович; Сухомлин, Сергій Адольфович
The relevance of the work is due to the fact that the choice of the optimal method for minimally invasive treatment of simple renal cysts is controversial and there is no consensus. In order to assess the effectiveness of treatment, we carried out both a retrospective and prospective analysis of the documentation of 455 patients with simple renal cysts. Percutaneous draining operations performed in 402 (88.4 %) patients followed by sclerotherapy with 96 % ethanol have proven to be an effective treatment for progressive (>6 cm) and symptomatic simple renal cysts. Bosniak category II simple renal cysts are characterized by a significant increase in drainage time. Symptomatic parapelvical, multichambered, intraparenchymatous (Bosniak category IIFIII) and complicated (Bosniak category IV) simple renal cysts should be a subject for “open” surgical treatment.
Enterococcus faecalis як потенційний інфекційний патоген в кліниці внутрішньої медицини
(Вищий державний навчальний заклад України «Українська медична стоматологічна академія», 2011) Кострікова, Юлія Анатоліївна; Кострикова, Юлия Анатольевна; Kostrikova, Yu. A.
В статті представлені дані щодо особливостей розвитку інфекцій в клінічній практиці лікаря інтерніста, етіологічна роль в яких належить ентерококу. аводяться фактори патогенності мікроорганізму, їх роль у розвитку патології, фактори резистентності до антибіотиків, умови, в яких може розвинутись резистентність. Перелічені захворювання, зумовлені ентерококовою інфекцією, умови їх виникнення. Виділені групи ризику серед населення, фактори, які впливають на розвиток інфекції. Показана фізіологічна роль ентерококів в житті людини. Продемонстровані неоднозначні взаємозв’язки макроорганізму з мікроорганізмом; В статье представлены данные относительно особенностей развития инфекций в клинической практике врача интерниста, этиологическая роль в которых принадлежит энтерококку. Приводятся факторы патогенности микроорганизма, их роль в развитии патологии, факторы резистентности к антибиотикам, условия, при которых может развиться резистентность. Перечислены заболевания, обусловленные энтерококковой инфекцией, условия их возникновения. Выделены группы риска среди населения, факторы, влияющие на развитие инфекции. Показана физиологическая роль энтерококка в жизни человека. Продемонстрированы неоднозначные взаимосвязи макроорганизма с микроорганизмом; The article presents data about the characteristics of infection in the clinical practice of internist, where the etiological role belongs to enterococci. Pathogenicity factors, their role in the development of a disease, antibiotic resistance factors, the conditions under which resistance can develop are paid special attention on. We have listed the diseases caused by enterococci and their predisposing factors, as well as have identified the risk groups of population. Physiological role of enterococci in human life and ambiguous relationship between the host organism and the micro-organism have also been shown in the paper.
Features of prevention acute cardiovascular complications in the patients with multifocal atherosclerosis
(Wydawnictwo ALUNA, 2018) Gutsalenko, O. A.; Kostrikova, Y. A.; Tomenko, V. V.; Salo, L. M.; Manojlo, E. V.; Гуцаленко, Ольга Олексіївна; Кострікова, Юлія Анатоліївна; Томенко, Вячеслав Васильович
Іntroduction: The problem of multifocal atherosclerosis (combined atherosclerotic lesion of the carotid and coronary arteries) is currently extremely actual. Patients with multifocal atherosclerosis (MFA) are at a very high risk of cardiovascular complications development. Such dangerous complications of MFA as myocardial infarction (MI) and cerebral stroke, account for almost 70% of all deaths in the world. The results of the international multicenter REACH register showed an almost triple increase in the risk of MI, stroke or death in patients with MFA. It is well known that a stroke is easier to prevent than to achieve full recovery of lost functions, and even more so of complete cure of the patient. Encouraging is the fact that 80% of premature myocardial infarction and strokes can be prevented, which predetermines necessity of their pathogenetically grounded prevention. The aim: to substantiate the feasibility of prescriptive carotid arteries (CA) screening ultrasound examination with the purpose of timely diagnosis of atherosclerosis and prevention of acute vascular accidents development. Materials and methods: We examined 38 patients with arterial hypertension and concomitant IHD and cerebrovascular diseases aged 40 to 75 years who were on treatment in the neurological department of the 5th city clinical hospital. The presence of carotid atherosclerosis was determined using the CA duplex scanning (DS) method with measurement of the “intima-media” complex and with an assessment of the atherosclerotic plaques presence in the CA. Results: According to the DS CA, carotid atherosclerosis was detected in 36 patients (94.7% of cases). Asymptomatic stenosis of CA was noted in 34 examined patients. It is noted that the development of asymptomatic carotid stenosis in men begins after 40 years, and in women - after 50 years, and often even earlier. Therefore, early diagnosis and timely correction of combined atherosclerotic lesions as a basis for secondary prevention of MFA and acute ischemic vascular complications is very important. Conclusions: MFA is a pathology with a potentially significant risk of death, which causes timely early diagnosis. Therefore, carrying out prescriptive screening DS CA (in men after 40 years, and in women after 50 years) will allow early detection of atherosclerotic lesions of the CA at the preclinical stage or precursors of the disease in people who consider themselves healthy, which gives reason to intervene during the disease in early its stages or before the acute clinical manifestation of atherosclerosis.
Goodpascher’s syndrome - the challenges in a timely diagnosis and treatment in medical practice (clinical case)
(Грузинська асоціація ділової преси, 2018-05) Talash, V.; Bevzenko, T.; Yarmola, T.; Tkachenko, L.; Pustovoyt, H.; Талаш, Вікторія Володимирівна; Бевзенко, Тетяна Борисівна; Ярмола, Тетяна Іванівна; Ткаченко, Лідія Афанасіївна; Пустовойт, Ганна Леонідівна
The article presents a clinical case with intravital diagnosis of Goodpascher’s syndrome in a 22 years old patient. In this work we analyze clinical, laboratory-instrumental, pathologoanatomic and pathomorphological aspects of the disease, which was accompanied by glomerulonephritis with rapidly progressive renal insufficiency, anemia, arterial hypertension and symptoms of lung injury. Article emphasizes on the necessity of timely diagnosis of Goodpascher’s syndrome and following administration of immunosuppressive therapy.

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