Taras I. Pupin, Zoriana M. Honta, Ihor V. Shylivskyy, Oksana M. Nemesh, Khrystyna B. Burda

ABSTRACT

This work presents an analysis of the literature data of modern scientific research regarding the assessment of pathogenetic mechanisms of the impact of adaptive stress response on the condition of periodontal tissue. Chronic stress and depression suppress the immune system, predetermine hormonal imbalances, lead to metabolic disorders in tissues and increase the risk of dystrophic and inflammatory processes in periodontal tissues. All this leads to impaired masticatory function, tooth loss, pronounced psycho-emotional instability and significant decline in quality of life. That is why the problem of studying the adaptive stress response of the body requires further research to gain a deep understanding of its role in the etiology and pathogenesis of dental diseases and justify effective treatment and prevention measures.

KEY WORDS: periodontal tissues, generalized periodontitis, psychoemotional stress, adaptation, maladaptation, psycho-emotional disorders.

The study aimed to analyse the adverse drug reactions report form data received by the State Expert Center of the Ministry of Health of Ukraine from healthcare professionals in the Lviv region in 2022. Regarding specific types of medicines, the ones with proven cause-and-effect relationships that caused the highest frequency of adverse drug reactions incidents were chemotherapeutic agents (35.5%), medicines affecting the cardiovascular system (20.3%), and non-steroidal antiinflammatory drugs (8%). Within the penicillin class, amoxicillin potentiated by clavulanate (67%) and amoxicillin (29%) were the dominant drugs showing the highest incidence rate of adverse reactions. Among cephalosporins, ceftriaxone (46%) and cefixime (15%) were found to take the lead in terms of adverse reaction frequency. The highest proportion among all adverse drug reactions caused by penicillins and cephalosporins was attributed to allergic reactions. To confirm or rule out immediate or delayed type allergies in patients, as well as in patients with a history of immediate-type allergic reactions to β-lactams and planned administration of another β-lactam, it is necessary to conduct skin testing (skin prick test, or, in the case of parenteral administration, intradermal test) with the planned β-lactam antibiotic. The second highest proportion of induced adverse drug reactions was attributed to drugs affecting the cardiovascular system (20.3%). The leading medications in the angiotensin-converting enzyme inhibitors category were enalapril (47%) and the combination of lisinopril with hydrochlorothiazide (24%). In the angiotensin II receptor blockers category of medications, valsartan (30%) and telmisartan-hydrochlorothiazide combination (20%) ranked highest. In the category of CCB drugs, amlodipine (66%) and nifedipine (20%) held the leading positions. among angiotensinconverting enzyme inhibitors, enalapril caused the most prevalent and predicted adverse reaction, that of cough, affecting 10.5% of patients, whereas, with the combination therapy of lisinopril and hydrochlorothiazide, the cough was observed in only 5.2% of patients. Angiotensin II receptor blockers have a better safety profile, particularly concerning cough. Analysis of adverse drug reactions reports for angiotensin II receptor blockers showed no cases of cough with valsartan and telmisartan-hydrochlorothiazide combination. Among calcium channel blocker medications, amlodipine emerged to rank highest, causing one of the predicted adverse drug reactions, that of lower extremity oedema in 64% of patients. The second position was taken by the combination of amlodipine with valsartan, which showed a statistically significant reduction of 14.3% (p≤0.05) in the incidence of oedema. Using amlodipine at a dose of 5 mg in combination with sartan medicines as angiotensin receptor blockers is an effective therapeutic alternative not only for enhancing blood pressure control in hypertensive patients but also for improving the safety profile of amlodipine. Among all the non-steroidal anti-inflammatory drugs prescribed to patients in the Lviv region in 2022, the highest number of adverse reactions was associated with the administration of diclofenac, ibuprofen, paracetamol, and nimesulide, causing adverse drug reactions in 22%, 19%, 17%, and 10% of cases, respectively. The most common systemic manifestations of adverse reactions with these non-steroidal anti-inflammatory drugs were allergic reactions (63.4%) and gastrointestinal disorders (26.8%). From an evidence-based medicine perspective, the most justified approach for primary and secondary prevention of gastrointestinal complications is the use of proton pump inhibitors.

Cultural impact on the Polish and Ukrainian results of the TSIDAV vignette (Thrombocytopenia Symptoms Impact on patients Daily Activities Assessment Vignette) was analyzed. The impact of the disease symptoms was assessed using TSIDAV vignette and the main research was followed by the analysis related to the cultural impact on the results. The cultural impact analysis was based on Hofstede’s national culture model.
49 Ukrainian and 61 Polish patients participated. Mean Ukrainian TSIDAV value was 0.31 (SD 0.83). Gender values ranged <0 to -1.0, and according to the key for results interpretation it confirmed high disease impact on daily activities. Higher disease impact among men than among women (mean TSIDAV value 0.18, SD 0.95; and 0.44, SD 0.69 respectively). Mean Polish TDSIDAV value was 0.68 (SD 0.69). Among Polish women mean value was -0.85 (SD 0.54), within men mean -0.35 (SD 0.83). Applying G. Hofstede’s cultural model Ukrainian Power Distance score 92 reflects power holders societal distance. Low scores of Individualism and Masculinity dimensions. Uncertainty avoidance score 95, meaning feeling threatened by ambiguous situations. Long term
orientation dimension score 86 reflects Ukrainian society pragmatism. Polish results shown hierarchical (scoring 68), individualist (score 60), masculine society (score 64). Avoidance dimension scores 93 in Poland, meaning avoid uncertainty preference. Long Term Orientation dimension scored 38, defining more normative than pragmatic society.

This study aimed to assess the antibiotic therapy of community-acquired pneumonia (CAP) in adults. A single-center, retrospective study was conducted in one of Lviv city hospitals, Ukraine. Adults with CAP (n=181) were enrolled. Fluoroquinolones (45.3%), cephalosporins (27.8%), and macrolides (16.1%) were the most common antibiotics. Antibiotic-associated drug-related problems (DRPs) were found in 87.3% (95%CI 81.5%:91.8%) of the participants. 4 items of antibiotic-associated DRPs were identified: potential drug-drug interactions (76.6%), inappropriate dosing (14.0%), inappropriate length of therapy (7.5%), and contraindicated usage (1.9%). Spiramycin, metronidazole, levofloxacin, azithromycin, and cefoperazone were associated with the highest risk of DRPs. Age of patients (p<0.001), number of antibiotics (p<0.001), length of antibiotic therapy (p=0.036), and the total number of antibiotic-associated DRPs (p=0.005) were defined as factors that statistically contribute to the patient’s health status on discharge. Antibiotics should be the drug class most commonly involved in the interventions to improve the safety and quality of CAP therapy.

  Z. M. Honta,   I. V. Shylivskyi, O. M. Nemesh, Kh. B. Burda

The aim of the study is a review of modern home and foreign literature on the influence of the state of the oral cavity and the pathology of periodontal tissues, and in particular generalized periodontitis, on the occurrence and severity of the course of diseases of internal organs and body systems.

Inflammatory-dystrophic periodontal diseases lead to an increase in the level of chronic inflammatory agents due to the systemic spread of inflammatory mediators released during local tissue destruction, as well as the systemic spread of pathogenic microorganisms, which contributes to the development of cardiovascular diseases, atherosclerosis, pathological processes in the gastrointestinal tract, complicates the course of diabetes mellitus and respiratory diseases in patients with periodontal diseases. That is why the study of pathogenetic interrelations of periodontal diseases and comorbid conditions is an urgent problem of modern dentistry.

Conclusions. Considering that certain extraoral pathologies arise as a result of damage by disseminated periodontopathogens may provide new therapeutic opportunities to reduce the risk of developing comorbid conditions etiopathogenetically associated with generalized periodontitis. The data of clinical and experimental studies that are presented in this literature review definitely show the need for timely treatment of periodontal diseases, which provides not only the health of the oral cavity, but also prevents the occurrence of general somatic diseases.

Key words: periodontal disease, generalized periodontitis, cardiovascular diseases, atherosclerosis, diabetes, diseases of the gastrointestinal tract.

РОЛЬ ПАТОЛОГІЇ ПАРОДОНТА ТА СТАНУ РОТОВОЇ ПОРОЖНИНИ У ВИНИКНЕННІ ЗАГАЛЬНОСОМАТИЧНИХ ЗАХВОРЮВАНЬ

З. М. Гонта, І. В. Шилівський, О. М. Немеш, Х. Б. Бурда

Мета роботи – огляд сучасної вітчизняної та зарубіжної літератури щодо впливу стану порожнини рота та патології тканин пародонту, зокрема генералізованого пародонтиту, на виникнення та тяжкість перебігу захворювань внутрішніх органів. і системи організму.

Запально-дистрофічні захворювання пародонта призводять до підвищення рівня хронічних запальних агентів через системне поширення запальних медіаторів, які виділяються при місцевому руйнуванні тканин, а також при системному поширенні патогенних мікроорганізмів, що сприяє розвитку кардіоваскулярних захворювань, атеросклерозу, патологічних процесів в шлунково-кишковому тракті, ускладнює перебіг цукрового діабету та захворювань дихальної системи в пацієнтів із патологією пародонта. Саме тому дослідження патогенетичних взаємозв’язків захворювань пародонта та коморбідних станів є актуальною проблемою сучасної стоматології.

Висновки. Врахування того, що певні позаротові патології виникають внаслідок ураження дисемінованими пародонтопатогенами, може забезпечити нові терапевтичні можливості для зниження ризику розвитку коморбідних станів, етіопатогенетично пов’язаних із генералізованим пародонтитом. Наведені в цьому літературному огляді дані клінічних та експериментальних досліджень безумовно показують необхідність своєчасного лікування захворювань пародонта, що забезпечує не лише оздоровлення порожнини рота, а й запобігає виникненню загальносоматичних захворювань.

Ключові слова: захворювання пародонта, генералізований пародонтит, кардіоваскулярні захворювання, атеросклероз, цукровий діабет, захворювання шлунково-кишкового тракту.