Проблеми екології та медицини, Том 28, № 1
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Документ Patients' chronotype influence in treatment efficiency of placenta cryerxtract changes in maxillofacial phlegmons(Полтавський державний медичний університет, 2024-04-30) Lokes, K.; Pérez Sayáns, M.; Lychman, V.; Steblovskyi, D.; Boiko, I.; Avetikov, D.; Локес, Катерина Петрівна; Перес Саянс М.; Личман, Віталій Олександрович; Стебловський, Дмитро Валерійович; Бойко, Ігор Васильович; Аветіков, Давид СоломоновичAmong acute odontogenic inflammatory diseases, a significant subset comprises purulent processes in soft tissues, including abscesses and phlegmons. Methods. The study encompassed 90 patients (both male and female) diagnosed with maxillofacial phlegmons, aged between 35 and 60 years. These patients were divided into three clinical groups, each comprising 30 individuals, further categorized into two subgroups based on circadian rhythms. Analyzing the obtained data, it can be asserted that the most significant changes in markers of lipid peroxidation in patients with superficial phlegmons of maxillofacial localization were experienced in both experimental groups when used against the background of treatment according to standard protocols of intravenous injections of the cryopreserved placenta without and in combination with local injection of the cryopreserved placenta as part of "Levomekol" ointment, in contrast to the control group. It was proved that the markers of lipid peroxidation underwent the most significant changes in both clinical groups compared to the control group, but the largest changes were visualized in the second clinical group. On the 5th day of treatment, SOD activity reliably increases by 15.7% in patients with the morning chronotype and 14.9% - with the evening chronotype. A significant decrease in erythrocyte catalase activity by 51.5% was noted in patients with the evening chronotype and 56.1% - with the morning chronotype. In the control group, significant changes were noted only in the late stages of treatment. The dependence of lipid peroxidation markers on the timing of surgical intervention on the patient's circadian rhythm was established, which is most clearly observed in the 2nd clinical group. Optimal healing of a purulent wound helps to reduce the duration of treatment, accelerate the rehabilitation of patients, and improve the formation of a postoperative scar. Conclusion. Thus, aligning the timing of surgical intervention for maxillofacial phlegmons with the patient's circadian rhythm, particularly when combined with intravenous injections and local application of placenta cryoextract alongside standard treatment, contributes to an optimal modulation of lipid peroxidation markers. Серед гострих одонтогенних запальних захворювань значну групу становлять гнійні процеси в м’яких тканинах, такі як абсцесс та флегмона. Методи. Було обстежено 90 пацієнтів з флегмонами щелепно-лицевої локалізації віком 35-60 років. Усі пацієнти були розподілені на 3 клінічні групи по 30 осіб у кожній, які були поділені на 2 підгрупи (за добовими ритмами). Аналізуючи отримані дані, можна стверджувати, що найбільш суттєві зміни маркерів перекисного окислення ліпідів у пацієнтів з поверхневими флегмонами щелепно-лицевої локалізації спостерігалися в обох дослідних групах при застосуванні внутрішньовенного введення кріоконсерванту. плаценти без та в поєднанні з місцевим введенням кріоконсервованої плаценти у складі мазі «Левомеколь» на тлі лікування за стандартними протоколами, на відміну від контрольної групи. Доведено, що маркери перекисного окислення ліпідів зазнали найбільш суттєвих змін в обох клінічних групах порівняно з контрольною групою, але найбільші зміни візуалізувалися у другій клінічній групі. На 5-ту добу лікування активність СОД достовірно підвищується на 15,7 % у хворих ранкового хронотипу та на 14,9% — вечірнього. Достовірне зниження активності каталази еритроцитів на 51,5 % відзначено у хворих вечірнього хронотипу та на 56,1% — ранкового. У контрольній групі істотні зміни відзначалися лише на пізніх термінах лікування. Встановлено залежність маркерів перекисного окислення ліпідів від терміну оперативного втручання від добового ритму хворого, що найбільш чітко проявляється у 2-й клінічній групі. Оптимальне загоєння гнійної рани сприяє скороченню термінів лікування, прискоренню реабілітації пацієнтів, покращенню формування післяопераційного рубця. Висновок. Таким чином, відповідність термінів оперативного втручання з приводу флегмон щелепно-лицевої локалізації добовому ритму пацієнта при комбінованому лікуванні внутрішньовенними ін’єкціями та місцевим застосуванням кріоекстракту плаценти на тлі стандартного лікування забезпечує оптимальну динаміку маркерів перекисного окислення ліпідів.Документ Chronotype and daily functioning of patients with different motor subtypes of parkinson disease(Полтавський державний медичний університет, 2024) Shkodina, A. D.; Bardhan, M.; Tarianyk, K. A.; Delva, M. Yu.; Шкодіна, Анастасія Дмитрівна; Бардхан, Майняк; Таряник, Катерина Анатоліївна; Дельва, Михайло ЮрійовичIntroduction. Sleep and circadian rhythm disturbances can occur at any stage of Parkinson disease (PD) and significantly affect quality of life. Chronotypes of patients with PD are associated with different phenotypes, in particular with the motor subtype. Thus, we hypothesized that patients with different motor subtypes of PD may have differences in the distribution of chronotypes and patterns of daily activity. Methods and materials. We conducted clinical research on the basis of the Centre for Parkinson Disease and Neurodegenerative Diseases of the Department of Neurological Diseases of Poltava State Medical University. PD was verified according to the recommendations of the International Movement Disorders and Parkinson's Disease Society. The motor subtype of PD was determined by the Stebbin method, which is based on the calculation of the Stebbins coefficient by the sum of the Unified PD Rating Scale scores. The examined patients were divided into 3 groups according to the motor subtype of PD: group 1 (n = 38) - patients with PD subtype with the predominance of postural instability and gait disorders (PIGD); group 2 (n = 26) - patients with PD subtype with the predominance of tremor and mixed subtype; control group (n = 30) - conditionally healthy individuals without CNS lesions. Circadian patterns were analyzed using the Munich Chronotype Questionnaire (MCTQ). Results. It was found that in PD patients sleep onset and time of getting out of bed was later (p<0.001 and p=0.042, respectively), sleep latency was longer (p<0.001), sleep duration was shorter (p=0.001), the mid-sleep corresponded to a later time (p<0.001). Patients with the PIGD subtype had a later time of getting out of bed (p=0.038), longer sleep inertia (p<0.001), shorter sleep duration (p<0.001), and later mid-sleep time (p=0.028). We have shown the tendency of patients with PD, mostly in the PIGD subtype, to later chronotypes (p<0.001). Light exposure indirectly moderately correlated with mid-sleep in all study groups. It was found that both the motor subtype (p<0.001) and the level of light exposure during the day (p<0.001) statistically significantly affect the mid-sleep. Conclusion. Thus, we have found that patients with PD differ from age-matched controls without neurodegenerative diseases by chronotype and circadian pattern of functioning. The motor subtype of the disease is associated with circadian differences, namely, the PIGD subtype is associated with shorter sleep duration, a predisposition to a later chronotype, and longer sleep inertia.Документ The mediating role of poor sleep quality in the relationship between posttraumatic stress disorder and aggression in combatants(Полтавський державний медичний університет, 2024) Boiko, D. I.; Zhyvotovska, L. V.; Chopra, H.; Бойко, Дмитро Іванович; Животовська, Лілія Валентинівна; Чопра, ХітешIntroduction. Stress-related mental disorders pose a significant risk to a patient's social, emotional, and physical well-being. One of the most vulnerable categories of the population to the development of stress-related mental disorders, including post-traumatic stress disorder, in wartime is military personnel who are constantly faced with events that threaten their lives and health. The most common complaints of combatants with PTSD include sleep disturbances and aggression. Therefore, we hypothesized that poor sleep quality may mediate the association between PTSD and aggression in combat veterans. Methods and materials. We conducted a clinical study of 45 combatants, who were divided into the following groups: group 1 (n=24) – combatants with PTSD, and group 2 (n=21) – combatants without stress-related mental disorders. We measured sleep quality by the Pittsburgh Sleep Quality Index and aggression by the Buss-Perry Aggression Questionnaire. Statistical analysis was performed using Jamovi Desktop. The mediation analysis was performed using the medmod 1.1.0 and advanced mediation models 1.0.5. Results. We found a strong statistically significant effect of PTSD on physical aggression (p<0.001). However, the mediating role of sleep was not found (p=0.264), as the effect of sleep disturbance on physical aggression was not confirmed (p=0.257), despite the strong effect of PTSD on sleep disturbance (p<0.001). It was found that the indirect effect of mediation through poor sleep quality accounted for 74.1% of the mediation of the relationship between PTSD and hostility. We established a partial mediation of the relationship between PTSD and aggressiveness by poor sleep quality. The direct effect accounts for 47.6% of the mediation, and the indirect effect through sleep disturbances accounts for 52.4%, which confirms the role of poor sleep quality as a mediator in this model. Concluions. Our findings emphasize that sleep disturbance is a significant symptom of PTSD that can affect other aspects of the disease in combatants. In this study, we demonstrate that poor sleep quality mediates hostility fully and general aggression partially in combatants with PTSD.