| Introduction. The invasion of Ukraine by Russian troops on February 24th, 2022, and the beginning of the full-scale war had huge humanitarian consequences. The major challenges facing the Ukrainian health care system included the disruption of medical infrastructure and logistics, the termination of the supply of expendable materials, significant migration and a dramatic increase in high-velocity blast and gunshot injuries among combatants and civilians. The aim of the present study was to analyze the challenges and solutions in patient care faced by the Ukrainian system of maxillofacial surgery during the war in different regions of the country. Materials and Methods. A cross-sectional study was designed and implemented as an
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The goal of the study is to explore the changes of vitamin D, hormonal indices, fat, and carbohydrate metabolism in the blood of women with polycystic ovary syndrome (PCOS), as well as to define the appropriateness of prescribing cholecalciferol in the complex treatment of this pathology. To achieve this goal, we have examined 80 women, aged 1835 years, with PCOS and underlying overweight and obesity, who were divided into four phenotype groups, according to the consensus of the PCOS Workshop Group in Amsterdam (2011). All women underwent a general medical examination, having measured their anthropometric parameters, body mass index (BMI) and clinical manifestations of hyperandrogenemia. Their serum was checked for the content of 25-hydroxyvitamin D (25(OH)D) , LH, FSH, progesterone, estradiol, androstenedione, dehydroepiandrosterone sulfate, 17-hydroxyprogesterone, anti-Müllerian hormone, insulin, and leptin. The study results found a decrease in vitamin D in the blood of women with PCOS in all clinical phenotypes, which lowered with the progression of obesity. Cholecalciferol
deficiency was associated with insulin resistance, hyperinsulinemia and hyperleptinemia. The correlation between the vitamin D content and hormonal indices in women with PCOS showed an inverse correlation between 25(OH)D and AMH levels, positive between insulin and 25(OH)D, and negative between vitamin D level and hirsutism score. Prescription of vitamin D in the complex treatment of women with PCOS leads to stabilization of hormones, decrease of HA signs, normalization of the menstrual cycle and restored ovulation.
The aim: To detect the ultrasonographic signs of necrotizing fasciitis (NF) suitable for its early diagnosis. Materials and methods: Eigty two patients with soft tissue infection, including 14 with necrotizing faciitis, were examined by ultrasonography at the admission. Ultrasonografic features were compared to intraoperative findings by the same surgeon.
Results: The thickening of subcutaneous tissue had high sensitivity (100%), but low specificity (5.8%). The hypoechoic and hyperechoic zones had the shape of “cobblestone” with sensitivity – 78.5%, specificity – 33.8%. Higher specificity (69.1%) had sign of “cobblestone separation” on two layers. The presence of fluid above the fascia (sensitivity – 71.4%; specificity – 69.1%), thickening of the fascia (sensitivity – 85.7%; specificity – 58.8%), indistinctness of the fascia edges (sensitivity – 85.7%; specificity – 66.1%) and loss of fascial homogeneity (sensitivity – 71.4%, specificity – 66.1%) were noted in early stages of NF. Advanced cases of NF were accompanied by the dissection of thickened fascia with a strip of fluid (sensitivity – 57.1%, specificity – 92.6%) and accumulation of a fluid under the fascia (sensitivity – 28.5%, specificity – 95.5%). The muscles thickening (sensitivity – 28.5%; specificity – 67.6%), skin thickening (sensitivity – 57.1%; specificity – 58.8%), and loss of the skin’s lower edge clarity (sensitivity – 57.1%; specificity – 63.2%) don’t have diagnostic value without other signs of NF.
Conclusions: Point-of-care ultrasonography allows visualization of soft tissue changes that may be hidden in the initial stages of necrotizing fasciitis and should be recommended for implementation as mandatory method of examination in patients with suspected surgical soft tissue infection.
UDC 616-001.4-085.262.1:612.015.11]-092.9
Introduction. The development of the inflammatory process is always accompanied by the activation of lipid peroxidation, which is caused by tissue hypoxia. This, in turn, catalyzes a change in the physiological parameters of the antioxidant system.
The aim of the study is to analyze the dynamics of the antioxidant balance of wounds in an experiment using hydrogels saturated with silver ions and an antioxidant drug for the local treatment of inflammatory processes.
Object and research methods. The experimental study was carried out on 80 Wistar rats weighing 150 to 200 grams. Animals were removed from the experiment. for 3, 7, 10, 14 days. Catalase activity in the dynamics of the wound process was determined.
Research results and their discussion. The content of catalase on the 7th day in the third experimental group is 0.51±0.03 μKat/l. On the 10th day, the indicator of the antioxidant system in the second (0.44±0.05 μKat/l) and third experimental groups was 0.42±0.02 μKat/l. At the final stage of the study on the 14th day, the analysis of catalase content showed that in all animals with a simulated inflammatory process, the indicator of antioxidant activity had no significant differences between themselves and, importantly, with the indicators of intact animals (0.33±0.01 μKat /l). The indicators of the control (0.33±0.04 μKat/l) and experimental groups were as follows: the first experimental group – 0.32±0.06, the second experimental group – 0.36±0.04, the third experimental group – 0, 38±0.06 μKat/l. Antioxidant protection was supplemented by local release of a drug with antioxidant action from the hydrogels, which contributed to a reduction in the intensity of free radical oxidation processes. That is, in almost all groups of animals, which were simulated purulent-inflammatory wounds, indicators of catalase activity approached the level of intact animals already on the 14th day.
Conclusions. Application for local treatment of hydrogel bandages saturated with an antioxidant drug, which is released into the wound surface for a long time, promotes the activation of antioxidant protection and suppresses the processes of free radical formation.
INTRODUCTION: Odontogenic inflammatory processes constitute a significant part among maxillofacial disorders, as well as among all inflammatory processes in organism. The author used hydrogels saturated with silver ions and an antioxidant drug for local treatment of odontogenic abscesses and phlegmons.
AIM OF THE STUDY. To conduct cytological assessment when applying hydrogels saturated with silver ions and an antioxidant drug for local treatment of odontogenic abscesses and phlegmons.
STUDY SUBJECT AND STUDY METHODS. 50 patients with odontogenic abscesses and phlegmons of maxillofacial area had been examined. To study the dynamics of the inflammatory process, cytology was performed on days 1, 3, 5, 7, 10.
STUDY RESULTS AND THEIR DISCUSSION. No differences were found in both groups of patients on the first day of treatment. On the second or third day, there was a higher number of red blood cells and a significant decrease in the number of neutrophilic granulocytes in the study group than in the comparator group. In the fibrin strands, accumulation of single macrophages, histiocytes, fibrocytes and monocytes were noted. During analysis of cytograms, an increase in the number of erythrocytes, histiocytes, fibroblasts, almost complete absence of neutrophilic granulocytes and single macrophages in the main group were observed on the 4-5 day, indicating the formation of granulation tissue and accelerated onset of proliferation. On the sixth day, patients of the study group had almost no neutrophils and no signs of inflammation, unlike patients in comparator group.
CONCLUSIONS. Cytology results has shown that application of hydrogels saturated with silver ions and an antioxidant drug for local treatment of odontogenic abscesses and phlegmons accelerates the healing time of postoperative wounds.