УДК 618.17+616-037

The objective: substantiation of differentiated therapeutic approaches to the treatment of combined dyshormonal pathol-ogy of the reproductive organs, taking into account the comorbidity of patients.

Materials and methods. 300 women of reproductive age (20–42 years, mean age – 29.9±5.6 years) with dyshormonal pathology of reproductive organs were examined: the main group included 180 patients who were prescribed complex differenti-ated pharmacotherapy for the treatment of combined dyshormonal pathology of the reproductive organs with correction of comorbid conditions, and the comparison group included 120 patients who received a standard set of measures. The control group included 50 healthy women without somatic and gynecological pathology. All women had ultrasound examination of the pelvic organs, mamma glands, thyroid gland, determination of the levels of pituitary tropic hormones and steroid ovary hormones, thyroid hormones, antibodies to thyroperoxidase, and the level of 25 (OH) D in blood serum.

Results.  Obesity  of  various  degrees  was  observed  in  31.0%  of  examined  patients  with  dyshormonal  pathology  of  the reproductive  system,  the  prevalence  of  autoimmune  thyroiditis  in  patients  was  36.0%,  and  subclinical  hypothyroidism was diagnosed in 21.3%. Among women with autoimmune thyroiditis, the frequency of subclinical hypothyroidism was 59.3%  with  3.7%  of  manifest  hypothyroidism.  Vitamin  D  insufficiency  was  found  in  34.0%  of  patients  with  dyshormo-nal pathology, vitamin D deficiency – in 44.3%, severe deficiency – in 21.7%. Treatment of patients in the main group led to the normalization of the menstrual cycle in 97.2% of cases, in the comparison group – in 73.3%, to a reduction of pain syndrome severity – in 94.7% and 60.6%, respectively, cyclic mastodynia – in 93.9% and 43.9%, manifestations of vegetative-vascular and non-specific symptoms – in 94.8±3.9% and 24.3±16.7% of cases, contributed to achieving the desired pregnancy – in 64.1% and 30.6% of patients, respectively, and also there was a reducing the frequency of relapses during 6 months of observation from 14.5% to 4.1%.

Conclusions. The use of complex differentiated pharmacotherapy for the treatment of combined dyshormonal pathology of the reproductive organs with the correction of comorbid conditions makes possible to achieve higher efficiency, which is manifested in a greater reduction in the frequency of clinical symptoms and disease relapses compared to the usual practice.

Мета дослідження: обґрунтування диференційованих терапевтичних підходів до лікування поєднаної дисгормональної патології репродуктивних органів з урахуванням коморбідності хворих.

Матеріали та методи. Обстежено 300 жінок репродуктивного віку (20–42 роки, середній вік – 29,9±5,6 року) з дисгормональною патологією репродуктивних органів. З них до основної групи увійшли 180 пацієнток, яким призначено комплексну  диференційовану  фармакотерапію  для  лікування  поєднаної  дисгормональної  патології  репродуктивних органів з корекцією коморбідних станів, до групи порівняння – 120 хворих, які отримали стандартний комплекс заходів. До контрольної групи включено 50 здорових жінок без соматичної та гінекологічної патології. Усім жінкам виконано ультразвукове дослідження органів малого таза, грудних залоз, щитоподібної залози, визначення рівнів тропних гормонів гіпофіза та стероїдних гормонів яєчників, тиреоїдних гормонів, антитіл до тиропероксидази, рівня 25(ОН)D у сироватці крові. Результати. Ожиріння різного ступеня спостерігалося у 31,0% обстежених пацієнток із дисгормональною патологією репродуктивної системи, поширеність аутоімунного тиреоїдиту у хворих становила 36,0%, а субклінічний гіпотиреоз діагностовано у 21,3%. Серед жінок з аутоімунним тиреоїдитом частота субклінічного гіпотиреозу становила 59,3% при 3,7% маніфестного гіпотиреозу. Недостатність вітаміну D виявлено у 34,0% пацієнток з дисгормональною патологією, дефіцит вітаміну D – у 44,3%, виражений дефіцит – у 21,7%.Лікування пацієнток основної групи привело до нормалізації менструального циклу у 97,2% випадків, групи порівняння – у 73,3%, до зменшення больового синдрому – у 94,7% та 60,6% відповідно, циклічної мастодинії – у 93,9% та 43,9%, проявів  вегетосудинної  та  неспецифічної  симптоматики  –  у  94,8±3,9%  та  24,3±16,7%  випадків,  сприяло  досягненню бажаної вагітності у 64,1% та 30,6% пацієнток відповідно та зниженню частоти рецидивів під час 6 міс спостереження з 14,5% до 4,1%.

Висновки. Застосування комплексної диференційованої фармакотерапії для лікування поєднаної дисгормональної патології репродуктивних органів з корекцією коморбідних станів дозволяє досягти більш високої ефективності, що про-являється у більшому зниженні частоти клінічної симптоматики та рецидивів захворювання порівняно зі звичайною практикою.

The aim: The purpose of the study is to evaluate the clinical and laboratory features of COVID-19 pneumonia course, the diagnostic significance of laboratory methods for detecting the SARS-CoV-2 virus based on a retrospective analysis.
Materials and methods: We studied the case histories of 96 patients who were treated at the Municipal Non-Profit Enterprise “Lviv Clinical Emergency Care Hospital” for the period from 01/07/2020 to 31/07/2020 with a diagnosis of pneumonia, which corresponded to 5 points on the CO -RADS scale. We analyzed the clinical and laboratory signs of COVID-19 pneumonia depending on the results of the Quantitative Reverse Transcription Polymerase Chain Reaction (RT-qPCR) tests to the SARS-CoV-2 infection (positive result of RT-qPCR was observed in the first group and negative – in the second group).
Results: In both groups, no clinical differences in the course of the disease were found. The most common symptoms of coronavirus pneumonia were found with the same frequency in both patients with a laboratory-confirmed diagnosis and without it. A positive PCR test in nasopharyngeal and oropharyngeal swabs was more often detected during testing up to 10 days, in patients over 60 years of age and in severe COVID-19.
Conclusions: The COVID-19 pneumonia diagnosis should be based on a combination of clinical, laboratory, and radiological signs of this disease. A negative PCR test result does not exclude the diagnosis of coronavirus disease. The test results are influenced by the timing of the sampling, the severity of the disease and the age of the patients

Impact of surgery is examined in individuals with combined stenotic-occlusive lesions of extracranial and femoralpopliteal-tibial arteries to determine its effects on functional recovery and quality of life. A 50-patient prospective cohort study. Men made up 92% of patients. The age distribution between 51 and 70 suggests a demographic background for surgical procedures, however caution is advised. Surgery frequency shows that bypass surgery is 40% common and that angioplasty, angioplasty with stent, and endarterectomy are versatile. After surgery, quality of life improved statistically, demonstrating the efficacy of therapies beyond functional recovery. While weariness during exercise varied, the overall beneficial outcomes suggest that surgical procedures can improve the lives of vascular disease patients. The findings enrich treatment plans and improve knowledge of subtle outcomes in functional recovery and QOL for doctors, researchers, and patients.

Abstract. It has been established that the use of various types of orthodontic appliences for the treatment of maxillofacial anomalies is accompanied by a violation of hygienic status, dysbiotic changes in periodontal tissues, changes in mineralization and structure of bone tissue, hemodynamic and microcirculatory disorders, decrease in the local immune response. Orthodontic treatment, having a double effect on the state of periodontal tissues, significantly improves periodontal health, but at the same time it can have negative consequences on the periodontal status of patients, such as: gum recession, loss of epithelial attachment and formation of gum pockets. This causes the rapid development and progression of inflammatory diseases of periodontal tissues such as catarrhal and hypertrophic gingivitis, as well as generalized periodontitis in young and able to work individuals. That is why the analysis of this problem is relevant and necessary for deeper understanding of the pathogenesis of the development of this pathology in persons having orthodontic treatment, for its timely diagnosis and prevention.

Key words: periodontal disease, orthodontic appłiences, maxillofacial anomalies, ligature and self-ligating bracket systems.

Introduction. The analysis of scientific literature gives the grounds to systematize the peculiarities of periodontal health and periodontal desease in patiens during orthodontal treatment  by modern appliences.

Considering the high prevalence of periodontal diseases in orthodontic patients on one side, spreading of new orthodontic technologies from another side, the approach has to be actualized.

The aim of the work is to review and analyze modern professional literature on the impact of orthodontic treatment of maxillofacial anomalies on the periodontal status of patients, in particular, the subsiqent pathogenetic mechanisms of the development of periodontal diseases in this category of patients.

 Materials and methods.

To write the article, bibliometric and analytical methods, data from international scientific sources in the field of studying the impact of orthodontic treatment on the state of periodontal tissues were used.

This article focuses on the retentive properties of teeth prepared for metalceramic crowns and bridges. A total of 268 teeth prepared for metalceramic restorations were studied, as well as three- and twodimensional images of 3D-scanned plaster models. Results of the study: The minimal preparation cone was 4,5° and the maximum was 51,5°. In general, satisfactory tooth preparation was found in 31 out of 268 teeth or 11,56% of the total number of columns examined. The remaining 237 teeth (88,44%) were characterized by unsatisfactory preparation parameters. Conclusion: In general, acceptable tooth preparation was found in 31 teeth out of 268, which is 11,56% of the total number of examined samples. The remaining 237 teeth (88,44%) were characterized by unsatisfactory preparation parameters. Keywords: Total convergence angle, metalceramic, fixed prosthodontics