Репозитарій

УДК: 616.24.002.5-085/2/.3

Анотація. З метою виявлення інформативних біохімічних маркерів контролю за ефективністю проведення лікування і визначення прогностичних критерії успішності її проведення у 123 хворих на туберкульоз легень до і під час хіміотерапії проведено визначення показників ключових ланок метаболічних процесів. Серед обстежених – 58 осіб зі збереженою чутливістю збудника, 65 – з мультирезистентністю. Порівняння динаміки величини і характеру виявлених змін з клініко-рентгенологічною і бактеріологічною картиною дозволило визначити величину фактору впливу ХТ і виявити прогностичні маркери сприятливого / чи несприятливого перебігу специфічного процесу. Запропоновані біохімічні критерії дозволяють здійснювати прогноз ефективності хіміотерапії хворих на мультирезистентний туберкульоз легень ще до призначення лікування, а також обґрунтовують доцільність проведення корекції лікування на стаціонарному етапі.

Abstract. In order to identify informative biochemical markers for monitoring the effectiveness of treatment and to determine prognostic criteria for its success in 123 patients with pulmonary tuberculosis before and during chemotherapy, indicators of key metabolic processes were determined. Among the examined, 58 people with preserved sensitivity of the pathogen, 65 with multiresistance. Comparison of the dynamics of the magnitude and nature of the detected changes with the clinical, radiological and bacteriological picture made it possible to determine the magnitude of the chemotherapy influence factor and identify prognostic markers of afavorable / unfavorable course of a specific process. The proposed biochemical criteria make it possible to predict the effectiveness of chemotherapy for patients with multi-resistant pulmonary tuberculosis even before treatment is prescribed, and also justify the feasibility of correction of treatment at the inpatient stage.

УДК 615.2:576.895

Анотація. Протипедикульозні засоби, які реалізуються в Україні, мають 100 % інсектицидну дію, овіцидна дія спостерігається лише при троєкратному застосуванні. Для лікування педикульозу доцільно застосовувати зареєстровані медичні препарати.

Abstract. Antipediculosis products sold in Ukraine have 100 % insecticidal effect, the ovicidal effect is observed only with three times application. For the treatment of pediculosis, it is advisable to use registered medical preparations.

Metabolic syndrome (MеtS) is a combination of clinical and laboratory abnormalities that increase the risk of cardiovascular diseases and type 2 diabetes mellitus.

Purpose - to detect and identify peculiarities of MetS and its criteria in children depending on gender.
MetS was estimated in 89 (5.9%) children from 1520 examined children: in 39 (2.6%) girls and 50 (3.3%) boys (p>0.05) aged from 9 to 18 years. Children were selected for examination of anthropometric data, blood pressure, total cholesterol, HDL-C, LDL-C, triglycerides, fasting glucose and insulin, index HOMA-IR, glucose/insulin ratio and QUICKI. Heart rate variability (HRV) study and echocardiography were done. Diagnosis of MetS was provided according to IDF Consensus (2007).
Abdominal obesity was diagnosed in all children with MetS. Boys had essentially more large body mass, height, body surface area, neck and waist circumferences, weight/height ratio than girls (p<0,001). Blood pressure in boys was higher than in girls, arterial hypertention in boys (72,0%) was diagnosed more often than in girls (46,2%). Insulin resistance was identified 1,5 falled more often in girls than in boys (p<0,05). Statistically significant difference in lipid metabolism in boys and girls was not estimated. According to HRV boys had higher activity of the autonomous nervous system than girls. Left ventricular (LV) myocardial mass and thickness of the LV posterior wall in boys were significantly larger than in girls that proved a higher risk of LV hypertrophy and concentric remodeling.
Attention to gender differences of MetS must be paid and gender-specific strategies for the prevention of cardiovascular diseases and type 2 diabetes mellitus should be formulated.

UDC 618.14-006-089+616.346.2-002

Tumor formations of the tubes, hydrosalpinxes, pyosalpixes have a number of discrepancies in outpatient service examinations and intraoperative clinical diagnosis.
Purpose - to report a unique case with discrepancies between the preoperative diagnosis (pyosalpinx, hydrosalpinx) and the intraoperative and postoperative definitive findings (appendicular tumor, mucocele).
Clinical case. A 50-year-old woman, a 3-year-old Mirena IUD wearer, applied for examination for pain in the right iliac region and a slight rise in temperature to 37-37.5 over the past 10 days. The examination showed the movement of the tumor on the right up to 7-4 cm, sensitive on palpation, uterine fibroids, and appendices on the left without features. Other history, physical examination, and laboratory tests were not remarkable, and there was no leukocytosis as in inflammatory processes. Ultrasound and MRI showed neoplasms of the right appendages of 7-5-4 cm, avascular and uterine fibroids — 3 subserosal nodes of 10-5 mm each. Intraoperatively Intact 2 fallopian tubes were detected, a tumor formation of the appendix 3-2-3 cm without adhesions was isolated. Laparoscopic appendectomy was performed along with conservative myomectomy and bilateral salpingectomy. Histopathology showed mucocele without atypia, myomas nodules, and fallopian tubes without features.
Conclusions. In the formation of the right appendages of the uterus, a thorough preoperative diagnosis is required, which does not always give a definitive answer to the clinical diagnosis. Diagnostic laparoscopy, visual and operational clinical experience of the surgeon, cytological and histological examination of intra- and postoperative results make it possible to carry out adequate surgical treatment. Patients should be informed about doubts between outpatient and intraoperative diagnosis, possible changes in the intraoperative surgical plan. Prompt care should be provided in institutions with appropriate teams and equipment.
The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies.

Introduction: The cervical screening goal is to detect and treat precancers before cancer. We wanted to understand why errors in the clinical diagnostic and management of patients with persistence of human papillomavirus (HPV); infection occur in gynecological practice.
Aim: Aim of the study was to evaluate 3 clinically important complications of situations for women aged 18-45 years. The study aimed to assess the diagnostic accuracy by colposcopy visualization, cytology and biopsy results, and presence of HPV infection. We aimed to analyze the false-negative (FN) cytology diagnoses inpatients with presence of HPV, colposcopy visualization, histologically proven cervical intraepithelial neoplasia (CIN) 2-3.
Material and Methods: A retrospective analysis of errors in the management of patients was carried out, in treatment methods, especially with the use of cryodestruction, colposcopy pictures, results of cytological and histological conclusion, results of examination for oncogenic types of papillomavirus were presented.
Discussion: After analyzing all errors in the management of patients with persistence of papillomavirus and preliminary cryotherapy of the cervix, the main reasons that led to the progression of the disease up to cervical cancer were noted.
Conclusion: In the presence of papillomavirus, cryodestruction of the cervix is not advisable, even if no cervical dysplasia was detected by histological conclusions