UDC 577.615.324-027.2.615.076

   Creation of novel remedies efficient in supporting wound healing remains an actual task in pharmacology. Hydrogels showed high efficiency in wound healing and tissue regeneration due to viscosity, elasticity and fluidity that provide them with functional characteristics similar to that in extracellular matrix. The aim of the study was to create chitosan-based hydrogels functionalized with different components (chondroitin-6-sulfate, hyaluronic acid, N-stearoylethanolamine) and to estimate their biocompatibility and biodegradability in vitro. For the first time, a lipid substance N-stearoylethanolamine (NSE) known as suppressor of pro-inflammatory cytokines expression was used as hydrogel component (1.95 mg/g). FTIR analysis confirmed the complexation of chitosan molecule with hyaluronate, chondroitin-6-sulfate, NSE. MTT-test and Trypan blue exclusion test were used to study hydrogels cytotoxicity towards human cells of different tissue origin. Biodegradability of hydrogels was evaluated using direct hydrogel contact with cells and cellindependent degradation. It was shown that chondroitin-6-sulfate (<2 mg/ml), hyaluronic acid (<2 mg/ml) and NSE (26 μg/ml) did not demonstrate significant toxic effects towards pseudonormal human cells of the MCF10A, HaCat, HEK293 lines and mouse cells of the Balb/3T3 line. The studied hydrogels were stable in saline solution, while in a complete culture medium containing 10% fetal bovine blood serum they underwent degradation in >24 h. The identified biodegradability of the chitosan-based hydrogels is important for the release of noncovalently immobilized NSE into biological medium. Further studies on laboratory animals with experimental wounds are expected to explore the potential of created hydrogels as anti-inflammatory
and wound-healing agents.
K e y w o r d s: chitosan hydrogels, chondroitin-6-sulfate, hyaluronic acid, N-stearoylethanolamine, FTIR analysis, human pseudonormal cells, toxicity, biodegradability

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.