First Group Research Articles

Dishomeostatic phenomena in acute pancreatitis of variable severity

Acute pancreatitis remains one of the most dangerous pathologies in the structure of emergency abdominal surgery. This is due to many reasons, including an increase in the frequency of destructive forms of the disease, high mortality, and frequent unfavorable outcomes. The aim of this study was to investigate a number of leading components of homeostasis in patients with acute pancreatitis of varying severity. A retrospective study was conducted on 50 patients with acute pancreatitis of diff erent severity levels who were hospitalized at the Republican Clinical Hospital named after S.V. Katkovа (Saransk, Russia). The patients were divided into groups: the fi rst group (control, n = 30) consisted of patients with mild acute pancreatitis, and the second group (main, n = 20) consisted of patients with severe acute pancreatitis. The study evaluated the endogenous intoxication syndrome, the activity of lipid peroxidation and phospholipase systems, microcirculation status, liver function, and the activity of the coagulation-lytic blood system. The results showed that in the early stages of acute pancreatitis, several pathological processes were observed: the development of endotoxemia syndrome, activation of lipid peroxidation and phospholipase systems, microcirculation disorders, changes in the coagulation and fibrinolytic links of the hemostasis system, and liver function suppression. The severity of these disorders was associated with the severity of the pathology. In cases of mild severity, the changes in the parameters studied were reversible, while in severe cases they were stable and oftenirreversible. The presence of toxemia, oxidative stress, dysmicrocirculation, and hemostatic disorders should be considered as risk factors for disease progression and complications.

Comparison of Response First Technique with Reversal First Technique for Quality of Extubation in Patients Undergoing Transsphenoidal Pituitary Surgery: A Randomized Clinical Trial.

Early and smooth extubation following anesthesia is an important concern in patients undergoing transsphenoidal pituitary surgery to permit early neurological evaluation and prevent complications. The aim was to compare the RESPONSE FIRST and REVERSAL FIRST techniques for quality of extubation (QOE) in patients undergoing endoscopic transsphenoidal pituitary surgery. Fifty-six patients aged 18-60 years, with American Society of Anesthesiologists Physical Statuses I-II, and undergoing transsphenoidal surgery for pituitary tumors were randomized into either the RESPONSE FIRST group, in which neuromuscular reversal was given following the patient's response to oral commands, or the REVERSAL FIRST group, in which reversal of neuromuscular blockade (NMB) was given at the return of spontaneous respiration. QOE was the primary outcome. Hemodynamic response, jugular venous oxygen saturation (SjVO2), time to extubation, and awareness during emergence were assessed as secondary outcomes. The QOE in the RESPONSE FIRST group was significantly better than the REVERSAL FIRST group (mean (interquartile range (IQR)), 18 (17-19) vs 14 (12-14.75), P < 0.001). Heart rate (HR) and mean arterial pressure (MAP) were better in the RESPONSE FIRST group when compared to the REVERSAL FIRST group at the time of extubation, at 5 minutes, and 15 minutes following extubation (P < 0.05). SjVO2values were higher in the REVERSAL FIRST group as compared to the RESPONSE FIRST group during extubation and at 5 minutes after extubation (P < 0.01). There was no significant difference in the time to extubation between the groups (P = 0.73). The RESPONSE FIRST technique is associated with better QOE and preservation of systemic and cerebral hemodynamics during extubation in patients undergoing transsphenoidal pituitary surgery when compared to the REVERSAL FIRST technique.

Assessment of arterial rigidity and daily profile of arterial pressure in women with newly detected breast cancer

Research objective: to evaluate arterial stiff ness indicators and its correlation with parameters of 24-hour ambulatory blood pressure monitoring (ABPM) in women with newly diagnosed breast cancer (BC).Material and methods: a prospective cohort study in 158 women aged 27 to 64 years with a median age of 45.4 years and newly diagnosed BC at stage IIA–IIIB before chemotherapy was conducted. The first group included 109 patients with normal or high-normal office blood pressure (BP), and the second group included 49 women with previously diagnosed stage 1– 2 essential hypertension (EH) with low or moderate cardiovascular risk. All patients underwent indirect arteriography and ABPM. Results. According to ABPM data, “masked” arterial hypertension (MAH) was diagnosed in 54 (49.5%) women in the fi rst group. In patients with MAH, the mean daily level and diastolic BP time index exceeded the corresponding indicators in EH, and the magnitude of the morning rise in systolic BP was significantly lower. In 35.4% of the examined patients with EH, the pulse wave velocity (PWV) was increased, and in 17.4% it was pathological. With MAH, these changes were recorded in 28.5% and 14.1% of cases, respectively. The odds ratio showed that in women with normal BP, the probability of an increase in PWV &gt;10 m/s increased by 1.6 times, and in the presence of comorbidity with MAH and EH, it increased by 2.2 and 2.4 times, respectively. The risk of an increase in central systolic BP &gt;125 mm Hg and pulse BP &gt;60 mm Hg was highest in patients with EH.Conclusion: Among young and middle-aged women with newly diagnosed BC, a significant number of cases of MAH and EH are detected, which determines the need to evaluate arterial stiff ness and daily BP profiles before starting antitumor therapy.

FEATURES FUNCTIONING OF THE DETOXIFICATION SYSTEM AT THE THREAT TERMINATION OF PREGNANCY AS A CONSEQUENCE OF ACCUMULATION OF 137CS

To date, there is no consensus on the pathogenesis of miscarriage. In modern life, human health is signifi cantly infl uenced by environmental factors. In this regard, 37 years after the accident at the Chornobyl nuclear power plant, the question of remote cytogenetic and hereditary eff ects in the off spring of parents aff ected by radiation remains relevant. Ecosystems contaminated with radioactive substances are a source of exposure for humans. Internal irradiation is the cause of reproductive losses. Radiation stress aff ects the course of redox processes in the body. Biochemical indicators are markers of the infl uence of environmental factors on a person. The study is dedicated to determining the state of peroxide hemostasis in the case of miscarriage. Aim: to determine the peculiarities of the functioning of the detoxification system in case of miscarriage due to the accumulation of 137Cs.Material and methods. The fi rst (research) group included women with reproductive losses in anamnesis and signs oftermination of the current pregnancy; the second (control) group included women with an uncomplicated history and course of pregnancy. Additionally, the fi rst group was divided into subgroups according to pregnancy outcomes: А – 38 women who gave birth at 37-40 weeks, despite the complicated course of the current pregnancy, В – 13 women who gave birth at 28-36 weeks + 6 days, С – 9 women who birth at 22-27 weeks + 6 days. The state of peroxide hemostasis in women was studied using biochemical studies. Accumulation of 137Cs with diff erent activity was detected in the placentas of the examined women of both groups using β-spectrometry. Morphological examination of placentas was performed according to the protocol. The severity of placental damage was studied by Olympus BX51 and Axioskop 40 microscopes. Analyzing the results revealed a relationship between biochemical indicators, the activity of 137Cs, and pregnancy scenarios. Statistical data analysis was performed using Microsoft Excel (2016) and Fisher angular transformation. The diff erence between comparative values was considered signifi cant at p &lt; 0.05 (probability index greater than 95 %). Permission to conduct research was obtained from the Medical Ethics Committee of the SI «Institute of Pediatrics, Obstetrics, and Gynecology named academic Elena M. Lukyanova of the National Аcademy of Мedical Sciences of Ukraine» (protocol No 3 of 07.06.2017).Scientifi c research work is to «Develop the latest and improve existing technologies for diagnosis, prevention, and treatmentof premature termination of pregnancy in women with miscarriage taking into account the passport of the placenta» (2018-2020). Code VN.20.00.02.18, state registration number 0118U000039, KPKV 6561040.Results. It has been confi rmed that the state of the environment plays a decisive role in the pathogenesis of miscarriage. Ithas been proven that placental dysfunction caused by abnormal oxidative stress due to the action of incorporated 137Cs leads to pregnancy termination. As a result of the depletion of the antioxidant reserve, the compensatory capabilities of the placenta decrease. It was established that activity in the placenta up to 1.0 Bq/kg of 137Cs does not aff ect the course of gestation. The compensatory capacity of the placenta remains preserved even with the accumulation of 1.1 to 4.4 Bq/kg of 137Cs. At the same time, it is possible to prolong the pregnancy until the term of timely delivery. Internal irradiation with an activity of 4.5-10.4 Bq/kg of 137Cs causes damage to the stroma of the maternal surface of the placenta and premature birth at 28-36 weeks + 6 days. At the same time, newborns are viable due to the preservation of compensatory reactions in the placenta. Accumulation of more than 10.4 Bq/kg of 137Cs causes antenatal death of the fetus and early premature birth due to damage to maternal and fetal structures of the placenta. An increase in the content of malondialdehyde and a decrease in the activity of superoxide dismutase in the blood indicate the severity of radiation damage.Conclusions. Internal exposure to 137Cs disrupts the architecture and functional capacity of the placenta. Extreme eff ectsdepend on the activity of 137Cs, the compensatory capabilities of the placenta, and the pregnant woman’s body. Activation of lipid peroxidation acts as a biochemical amplifi er of radiation exposure. An increase in the blood of malondialdehyde, diene conjugates, and free SH groups is associated with the severity of radiation damage. An early marker of primary placental dysfunction, premature birth, and antenatal fetal loss is an increase in MDA content in the blood by 12.0 % and a decrease in SOD by 6.5 % relative to permissible values. An early marker of exhaustion of the compensatory reserve is an increase in the content of MDA in the blood by 23.3 % and a decrease in SOD by more than 18.2 % relative to the permissible values. Decompensation of adaptation mechanisms in the system «mother- placenta-fetus» leads to antenatal losses.

ARIMA-Profile of the Inflation Forecasting in the Tomsk Region Problem

The inflation forecasting task is one of the key tasks for the Central Bank. Today it especially needs new approaches designed not only to serve as a tool for future inflation values predicting but also to expand knowledge about the structure of the process under study. Traditionally the Central Bank uses ARIMA time series models as a tool for infl ation forecasting. In this paper the concept of an ARIMA-profi le is introduced for the fi rst time as a set of suitable for solving a specifi c problem ARIMA-models general characteristics. Experimental confirmation of the ARIMA-profi le existence for the Tomsk region Consumer Price Index forecasting task is presented. To do this a series of experiments was conducted in each of which the models were ranked according to their predictive power. Then using heat maps and probability density diagram it was shown that all models can be divided into two groups — "suitable" and "not suitable" for the inflation forecasting problem. The ARIMA-profile was presented as a set of rules separating the fi rst group of models from the second. Such a set of rules was obtained as a result of solving the problem of classifying models into "suitable" and "not suitable" by the method of decision trees. The main template of models suitable for forecasting inflation in the Tomsk region has the ARIMA(*,*,*)(2,*,1)12 scheme. A common feature of the "best" models is the non-zero seasonal parameters P and Q and the structure of the series is such that the current inflation value is best described by the value of inflation which was observed a year ago and two years ago as well as the value of last year’s shock.

BODY COMPOSITION OF FULL-TERM NEWBORNS AGAINST THE BACKGROUND OF INCREASED PROTEIN INTAKE IN THE INTENSIVE CARE UNIT

To evaluate the eff ects of increased protein and L-carnitine supplementation in the feeding program of term infants withperinatal conditions on improving physical development outcomes, changes in body composition and hospital outcomes.The aim is to evaluate the eff ect of short-term increased protein intake in term infants and L-carnitine supplementation onbody composition and key indicators of physical development in children.Material and methods. To test the proposed hypothesis of neonatal nutrition, we studied the vital signs of 59 term infantsrandomized into two groups. The fi rst group (n = 30) received standard breastmilk (BM) or formula feeding, and the second group (n = 29) received a protein- fortifi ed (PF) formula and L-carnitine supplementation during the hospital stay. At the beginning and end of treatment, the children’s physical development and body composition were assessed using bioelectrical impedance.The study protocol was agreed and approved by the Regional Bioethics Committee of the Zaporizhzhia State Medical andPharmaceutical University. The study was conducted in accordance with the moral and ethical standards of the IGH/GCP, theDeclaration of Helsinki (1964 with amendments of 1975, 1983, 1989, 1996, 2000), the Convention of the Council of Europe onHuman Rights and Biomedicine, and the legislation of Ukraine. Written informed consent was obtained from the parents of the patients before the start of the study. All statistical analyses were performed using the software Statistica 13.0, TIBCO Software Inc (licence number JPZ804I382130ARCN10-J) and Microsoft Excel 2013 (licence number 00331-10000-00001-АА404). The probability of the diff erence in the absolute values of the means was determined using non-parametric methods of statistical analysis: the Mann-Whitney test (U) for unrelated groups and the Wilcoxon signed rank test (T) for related groups. Statistical signifi cance was defi ned as p &lt; 0.05. The study was conducted within the framework of the research work of the Department of Anaesthesiology and Intensive Care Medicine of the Zaporizhzhia State Medical and Pharmaceutical University of the Ministry of Health of Ukraine – «Optimization of diagnosis and intensive care of multi etiological lesions of the brain, gastrointestinal tract, kidneys in newborns and older children», state registration number 0118U007142.Results. Infants in both groups had similar characteristics of weight, length and head circumference at baseline. Theproportions of infants of both sexes were within the 50 % percentile. In general, the proposed feeding strategy contributed to better indicators of infant physical development and a statistically signifi cant, faster recovery of body weight in the fortifi ed group. Thus, the generalised indicator of body weight of children in the GZ group was 3966.90 ± 439.08 g, compared to 3554.62 ± 452.28 g in the SC group, p = 0.0033. In general, the children who consumed more protein were transferred out of intensive care sooner – 10.00 (8.00, 12.00) days vs. 12.00 (11.00, 16.00) days, U = 235.00; p = 0.0024; discharged from hospital sooner – 21.00 (19.00, 27.00) days vs. 26.50 (22.00, 31.00) days, U = 267.00, p = 0.0109. This strategy proved to be safe, as evidenced by normal phenylalanine and urea levels at all stages of the children’s examination. Percentage analysis of body composition showed an increase in the formation of more dry mass in children on the standard diet, without protein fortifi cation and without carnitine supplementation. Thus, the percentage of FFM in the children on the standard diet was 84.71 (83.27; 85.47) % at the end of the study, compared with 83.09 (81.93; 83.96) % in the GZ group, U = 117.00; p = 0.0020. The total cohort indicator was infl uenced by the changes in body composition found in the women: in the GZ group, the percentage was 82.21 (81.55;83.10) % versus 84.71 (83.65;85.30) % in the SC group, U = 8.0; p = 0.0051. Thus, increased protein supplementation in term girls was associated with greater accumulation of fat mass, even with short-term supplementation.Conclusions. Consumption of more protein and carnitine supplementation in term neonates in the intensive care unitpromotes better growth against a background of body composition with higher fat content in females, a fact that limits the use of this strategy without further studies.

Quality of life in patients after treatment of deep vein thrombosis with regional catheter thrombolysis

The aim of the study was to compare the quality of life in patients after treatment of deep vein thrombosis with regional catheter thrombolysis using alteplase and urokinase, and to compare the results with clinical examination data. Material and methods. The assessment of quality of life and data from a control objective examination were conducted in 32 patients with deep vein thrombosis, divided into two statistically homogeneous groups of 16 individuals each. Alteplase was used for thrombolysis in the fi rst group, while urokinase was used in the second group. The quality of life in patients was evaluated using two questionnaires: SF-36 and CIVIQ-20. The severity of venous disease was determined based on the clinical assessment of venous return impairment. Results. In the fi rst group, the physical component of health according to the SF-36 questionnaire was 56 (49.5; 56.3), the psychological component was 54 (50; 68.8), while in the second group it was 34 (33; 34) and 38 (31.3; 45) respectively. The overall health assessment according to the CIVIQ-20 questionnaire was 20 (10.8; 30) in the fi rst group and 40 (32.8; 43.8) in the second group. In the clinical examination, venous return impairment was absent or mild in 75% of patients in the fi rst group, and equally distributed between mild and severe in 50% of patients in the second group. Conclusion. Alteplase thrombolysis has a more positive impact on the quality of life in patients compared to urokinase.

FEEDING OF THE FISH OF BLAGODATNOE LAKE (ITURUP Island, KURIL ISLANDS) IN SUMMER

The feeding of mass fi sh species is described according to the data of ichthyological samples in June- August 2001 from Blagodatnoye Lake (Iturup Island, Kuril Islands):whitebaits of Oncorhynchus keta, Hypomesus nipponensis, Pungitius spp., Gasterosteus nipponicus, Salvelinus malma curilus, S. leucomaenis, Cottus amblystomopsis, Gymnogobius urotaenia and Tridentiger brevispinis. Whitebaits of Oncorhynchus keta, Pungitius spp. and Gasterosteus nipponicus formed the basis of catches in terms of abundance and biomass in the coastal zone of the lake. Hypomesus nipponensis is typical of shallow lake waters and has been constantly observed in the coastal area. Four ecological groups of fi sh are distinguished by the type of food. The fi rst group includes whitebaits of Oncorhynchus keta only, which are the most separated from other species in terms of the ecological spectrum of feeding. The basis of the diet of whitebaits of chum salmon (85 %) is non-aquatic insects consumed from the surface of the water. Salvelinus malma curilus and Hypomesus nipponensis exerted the greatest competitive pressure on juvenile salmon, 11 and 10 % of their diet also consisted of extra- aquatic insects, respectively. Hypomesus nipponensis is a plankto- benthophage and belongs to the second group. The basis of the ecological food spectrum of this species was formed by zooplankton (43 %) and zoobenthos (30 %). A signifi cant contribution was also characterized by fi sh eggs (17 %). The third group includes the Japanese three- spined sticklebacks, the main food of which is fi sh eggs (59 %) and zoobenthos (34 %). All other fi sh species are included in a single group of predominant benthophages. The contribution of zoobenthos in the ecological spectrum of nutrition of these fi sh varied from 57.4 % in Gymnogobius urotaenia to 100 % in Tridentiger brevispinis.

The Potential Protective Eff ects of Pirfenidone on Diclofenac Sodium Induced Gastric Ulcer in a Rat Model

Introduction: Non-steroidal anti-infl ammatory drugs (NSAIDs), are widely prescribed in clinical practice because of their ability to reduce pain, fever, and infl ammation. However, NSAID-induced gastric mucosal damage is the major side eff ect of these medications. This study aims to reduce gastric mucosal lesions caused by NSAIDs by using pirfenidone by investigating their eff ect on histological, gastric gross mucosal damage. Method: 30 healthy male albino rats were divided into 3 groups each of ten (N=10). A single oral dose of diclofenac sodium (150 mg/kg body weight) was used to induce ulceration for all groups except fi rst. The vehicle (tween 80+NS) was given to the fi rst group, while diclofenac sodium was given to the second group and to all pre-treated groups. The third group were pre-treated with pirfenidone (300 mg/kg). At the end of the experiment, histological examination, and antioxidant and antiinfl ammatory parameters by immunohistochemistry method were evaluated. Results: Diclofenac sodium at a dose (150 mg/kg) produces a signifi cant increment (p &gt; 0.01) in gastric damage score, the expression of tumor necrosis factor-alpha (TNF-α), myeloperoxidase, malonaldehyde, and the ulcer formation percent, compared to the healthy rat’s group. Pirfenidone at a dose of (300 mg/kg) pretreatment in diclofenac induced-ulcer in rats produces a signifi cant reduction (p &gt; 0.01) in gastric damage score, the expression of TNF-alpha, myeloperoxidase, the expression of TNF-alpha, myeloperoxidase, malonaldehyde, and in the ulcer formation percent, yet, less eff ectively than omeprazole and pirfenidone. Conclusion: Diclofenac can be reduced or prevented by the pretreatment of pirfenidone. Pirfenidone showed similar results to the standard treatment (Omeprazole), the protective eff ect of pirfenidone was mainly through their antioxidant and anti-infl ammatory activity by reducing oxidation markers like MPO and MDA, and also reducing infl ammatory cytokines like TNF-alpha

Brain-derived neutrophic factor, glutamate and markers of apoptosis in the blood of patients with prolonged disorders of consciousness

Aim of the work was to analyze the content of factors with neuroprotective, neurotoxic and apoptotic eff ects in the blood of patients with prolonged disorders of consciousness (pDOC), depending on the level of consciousness disorder and neuroprotective therapy.Material and methods. Research included 53 patients with pDOC, who were divided into 2 groups. Group 1 included 19 vegetative state/unresponsive wakefulness syndrome (VS/UWS) patients, group 2–34 minimally conscious state (MCS “minus” and “plus”) patients. Firstly at admission and then at the end of treatment course (after 1 month on average), plasma concentrations of brain neurotrophic factor (BDNF), apoptosis antigen (APO-1), apoptosisinducing ligand (Fas-L) and glutamate were studied. Control group consisted of 16 patients without measured once.Results. Decrease of BDNF serum level was revealed in patients with pDOC,which was less pronounced those who had TBI as a etiological factor of pDOC. BDNF level signifi cantly increased after a month against the background of neuroprotective therapy. Glutamate level was higher in the fi rst group (VS/UWS). No signifi cant diff erence in the content of apoptosis factors was observed.Conclusion. In patients with pDOC, decrease serum BDNF level was observed, less pronounced in TBI as etiology of pDOC. In patients who matched MCS criteria at the admission, there was a signifi cant increase of BDNF serum level during treatment course, which could indicate that patients with a higher initial level of consciousness have better potential for realizing the eff ect of neuroprotective therapy. Levels of apoptosis factors did not correspond to the consciousness level.

SCHOOL FIGHT AS A PREDICTOR OF BULLYING IN ELEMENTARY SCHOOL

The problem of bullying at school does not lose its signifi cance. It is important to identify its causes already in the primary school. Relationships between children are formed during this period. The purpose of the study is to identify the causes of school fi ghts as a predictor of bullying in the classroom. Methods included conversation with the class teacher, observation, sociometry, color relationship test, unfi nished sentence method. The sample of the study was represented by rd grade primary school students at school No.  in Pskov (N=). The class is characterized by an increased tendency to fi ghts and bullying. Results. ) % of children show a positive attitude towards fi ghting. Of these, % are girls and % are boys. ) % of children are characterized by a positive attitude towards fi ghts and school, % show a negative attitude towards school with a positive attitude towards fi ghts. ) % of children show a negative attitude towards the teacher and a positive attitude towards fi ghts, % express a positive attitude towards both the teacher and fi ghts. Among those who like fi ghts there are the “star” of the class and  people out of  “preferred”. Two groups of children also positively related to fi ghts are formed around them. The fi rst group consists of girls, the second group includes boys. The reasons for fi ghts are verbal aggression (% is name-calling), phone and games (%), misunderstandings and differences of opinion between pupils (%) but there are also reasons such as unwillingness to share, arguments, the desire to protect a friend and fi ghts without causes. Bullying begins with fi ghts with the teacher’s observations. Thus, the factors provoking fi ghts and bullying are a positive attitude towards fi ghts among children with high sociometric status in the group, verbal aggression and misunderstanding between children, as well as unwillingness to share games on the phone.

TREATMENT INJURY OF THE INFERIOR ALVEOLAR NERVE DURING IMPLANT PLACEMENT USING MAGNETIC-LASER THERAPY

Objective: The aim of this study was to assess the effectiveness of magnetic-laser therapy in complex treatment of neuropathy after dental implantation Materials and methods: The present study is based on the results of the analysis of clinical, instrumental and radiation studies of 27 patients, with post-traumatic neuropathy inferior alveolar nerve. Diagnosis of damage to the inferior alveolar nerve was based on the clinical manifestations of neuropathy (pain, paresthesia, loss of sensation, etc.). The study of the sensitivity of the skin of the lower lip and chin in the segment of the inferior alveolar nerve dysfunction and in the symmetrical segment performed using sensory tests. Conservative treatment included: Anti-infl ammatory, analgesics, antioxidants, B complex of the vitamins group. Magnetic-laser therapy included in a conservative treatment complex for patients. To conduct a comparative analysis of effectiveness of magnetic-laser therapy, two groups were formed: Patients fi rst group (n= 14), whose treatment complex included magnetic- laser therapy, Patients second group (n= 13), whose treatment complex did not include magnetic-laser therapy. Results: Most patients after implant placement complained of pain of varying degrees, a decrease or lack of sensitivity of the lower lip, chin skin, and the mucous membrane of the alveolar process of the lower jaw, paresthesia or hyperesthesia. Some patients did not have pain, however noted that sensitivity disorders have a negative effect ongeneral well-being and interfere with work. When comparing 2 group the best pain relief was patients first group. The average area of skins sensory impairment in patients was mean 9.4cm2. Patients first group complete recovered function of inferior alveolar nerve within mild 1 month, patients in the second group, whose treatment complex did not include magnetic laser therapy, fully recovered function of inferior alveolar nerve within mild 2 months. Conclusion: Thus, the inclusion of magnetic laser therapy in the post-implantation traumatic neuropathy treatment shows the biostimulation effect, complex allows to reduce the recovery time of functional disorders of the inferior alveolar nerve, to reduce the area of skins sensory impairment and increase the effectiveness of treatment.

Исследование прочности 3D-печатных изделий при варьировании технологических параметров в процессе печати

The technology of additive manufacturing of parts makes it possible to signifi cantly reduce the cost of machinery repair. However, the property formation laws of such parts have not been suffi ciently studied. The authors have studied the relationship between the ultimate strength of 3D-printed samples and the number of wall layers and infi ll density. Samples produced according to GOST 11262-2017 by 3D printing using FDM technology from ABS plastic were tested for static stretching. Two groups of samples, diff erent in technological parameters of 3D-printing, were made. In the fi rst group the wall of the samples was formed in four layers, the density of the sample fi ll varied in the range of 20 to 100%. In the second group, the number of wall layers varied from 2 to 10, the infi ll density of the samples corresponded to 33%. When samples were made, extruder temperature was 230°C, table temperature - 110°C, layer height - 0.15 mm, and printing speed - 60 mm/s. An analysis of the yield strength of the samples showed an increase in strength with an increase in the number of wall layers. Signifi cant diff erence of strength values was observed in samples with six layers and more. Signifi cant variation of yield strength values can be explained by the presence of defects in the samples after printing. When infi ll density exceeded 40%, a signifi cant increase in strength was observed due to the densifi cation of polymer molecule bonds. In the range of 20 to 40%, the strength index did not change, because the same structural changes occurred in this range. It was found that the number of wall layers should not exceed the number of inner perimeter layers and the infi ll density of the parts should be 100% to produce polymeric parts of agricultural machinery by 3D printing using FDM technology with maximum strength characteristics.

Gender characteristics of patients with arterial hypertension

Despite the prevalence of arterial hypertension among both sexes, there are data on the presence of gender diff erences in its formation and course.The purpose of the study: to identify gender characteristics in the clinical and biochemical status of patients suff ering from stage 1 and 2 of arterial hypertension.Material and methods. 80 patients of the second mature age with confi rmed arterial hypertension were examined. The patients were divided into 2 groups: the fi rst group consisted of 44 patients with stage 1 arterial hypertension (11 men and 33 women), the second group consisted of 36 patients with stage 2 disease (25 men and 11 women). All patients underwent a biochemical blood test; the glomerular fi ltration rate, the thickness of the Intima-media complex of the common carotid artery with the processing of the results by the Smirnov–Kolmogorov test were determined.Results. With the stage I arterial hypertension in both sexes, the level of blood pressure was corresponding to it. With stage II, the blood pressure in men corresponded to the level of the 1st stage, and in women to the level of the 2nd stage arterial hypertension. The level of total cholesterol and low-density lipoprotein cholesterol in all cases exceeded the normal level, prevailing in both groups in women. This was accompanied by an imbalance in the levels of thromboxane B2 and 6-ketoprostaglandin F1α at stage I hypertension, which was more pronounced in women and increased with the higher stage of the disease. The glomerular fi ltration rate in men of both groups was intact. In women, it was reduced at the onset of the disease, and kept decreasing at stage II. The width of the intima-media complex in women prevailed over this indicator in men at stage I and further increased at stage II.Conclusion. From the start of the development of arterial hypertension, women have had more pronounced and faster progressive lipid, hemostatic, renal and sclerotic changes compared to men.

Comparative Evaluation of Biomechanical Characteristics of Acellular Dermal Matrix for Hernioplasty

Background. With the introduction of synthetic mesh implants into clinical practice, the recurrence rate of postoperative ventral hernias was signifi cantly reduced. The extensive use of synthetic implants led to the development of specifi c complications. The development of biological implants, based on extensively purifi ed decellularized collagen matrix of xenogeneic origin is highly relevant due to the fact that, unlike synthetic analogues, they have a biological origin and biodegrade in a natural way, gradually being replaced with newly formed connective tissue. The use of bioprostheses reduces the risk of complications.Objectives. To conduct a comparative evaluation of the biomechanical characteristics of acellular dermal matrix, obtained by detergent-enzymatic decellularization, and commercially distributed Permacol™ matrix.Methods. Acellular dermal matrix (ADM) was created by using samples of native skin of pig of Landras breed aged 4 months. The dermis was processed by means of detergent-enzymatic method. In order to evaluate and compare the mechanical properties of acellular dermal matrix, the biological samples were divided into 2 groups of 15 samples each. The fi rst group included acellular dermal matrix samples, the second group — native samples of pigs unprocessed dermis. The control group consisted of samples of PermacolTM Surgical Implant, xenotransplant for hernioplasty approved for use in the Russian Federation (Covidien, France). All samples were tested wet using universal testing instrument Instron 1122. MedCalc Statistical Software (Belgium) was used for statistical processing of the study results.Results. In the present study, pig dermis was processed using a detergent-enzymatic method to produce ADM. Routine histological examination confi rmed the removal of all cellular elements, and at the same time it was proven that the native structure of the dermis remained intact during its processing. The mechanical characteristics of xenogenic ADM were further determined. Its tensile strength was 9.1 ± 0.6 MPa (910 N/cm2 ), elongation to break was 21.1 ± 2.3%, and elastic modulus was 50.0 ± 1.6 MPa. These characteristics largely corresponded to the strength characteristics of native pig dermis and far exceeded the necessary physiological parameters. PermacolTM control was tested in two directions (longitudinal and transverse). In the longitudinal direction, the sample had higher mechanical characteristics: strength — 12.0 ± 1.7 MPa, elongation to break — 29.7 ± 2.4%, stiffness modulus — 47.2 ± 6.5 MPa. In the transverse direction, all indicators were 1.5–2 times lower.Conclusion. The developed xenogeneic biological implant in the form of ADM demonstrates rather good characteristics of plasticity, tensile strength and elasticity, to be used as a biological endoprosthesis for plasty of hernia defects of the abdominal wall of any size and shape.

THE MODEL OF RESEARCH POST-CHOLECYSTECTOMIC PAIN SYNDROME IN EXPERIMENT

The number of surgeries performed by the laparoscopic method is constantly increasing due to the low trauma and fast patients recovery after surgery. However, despite the small surgery traumatism, most patients have the distinct pain syndrome, felt in the post-operative period and directly aff ects the post-operative prognosis. Despite the low trauma, pain after laparoscopic cholecystectomy has two pathways: parietal (somatic) and visceral. Given all the diffi culties in assessing the visceral component of post-operative pain, there is an urgent need to create a research model. The mucosa of the rabbit’s cheek was selected to model the visceral component of post cholecystectomy pain. The pain syndrome in the post-operative period was modeled on rabbits due to the formation of a burn wound on the mucosa of the left and right cheeks. The eff ectiveness of its treatment was studied with the help of combinations of analgesics. The burn wound was created by electrocoagulation EHVCH-300 «ELEPS» on the mucous surfaces of the right and left cheeks, under general anesthesia with propofol at a rate of 7.5 mg/kg. On the experimental (left) side, the studied combinations of analgesics were introduced: 1st group application mixture of 2.0 ml 0.5% bupivacaine with 2.0 ml with 5% dexketoprofen; Group 2 with a mixture of 2.0 ml of 0.5% bupivacaine with 0.5 ml of 1% nalbuphine; Group 3 was injected under the mucosa a mixture of 2.0 ml of 0.5% bupivacaine with 0.5 ml of 1% nalbuphine. The wound on the right cheek was a control, used for comparison. Pain syndrome was assessed by the reaction to fi nger pressure on the outside of the right and left cheeks separately, and refusal to eat (based on the dynamics of the daily diet). Pain control was performed in 6, 12, 24, 48, and 72 hours after surgery. Additionally, there was made an analysis of the dynamics of maintaining the daily diet.The first group there were revealed distinct diff erences in the severity of pain between the controlled (right) and left (experimental) parts for 6 (p˂0.01) and 12 (p˂0.05) hours after surgery, which indicates the clinical signifi cance of local use of a combination of bupivacaine with dexketoprofen. In the 2nd group, there were distinct diff erences in the severity of pain test between the right controlled cheek and left parts for 6 (p˂0.01), 12 (p˂0.01), and 24 (p˂0.05) hours. That is, the inclusion of a narcotic analgesic prolonged the analgesic effect by 100% (from 12 to 24 hours). In the 3rd group, there were distinct diff erences in the severity of pain for 6 (p˂0.01), 12 (p˂0.01), 24 (p˂0.01), and 48 (p˂0.05) hours. On the third day, all animals (20) did not show pain eff ect on the left (experimental) side. However, the resorptive eff ect of the studied combination of bupivacaine with nalbuphine was revealed by submucosal injection.Analysis of the frequency and duration of rabbits’ refusal to eat revealed this criterion in 16 (80%) animals of the fi rst group, and in 17 (85%) animals of the second group. Thus, the application methods of local anesthesia acted locally but had an insu ffi cient analgesic eff ect. In the third group, the refusal to eat was not detected in the majority (60%) of rabbits during this period. This indicates a greater strength and resorptive mechanism of analgesic action in the third group.Therefore, in clinical use, to block the visceral mechanism of suppression of pain impulses in laparoscopic cholecystectomy, it’s prognostically better to use the application method, which provides a certain local analgesic eff ect and clinically insignifi cant resorptive eff ect. This requires an additional and further study of the quantity and quality of analgesics for recommendations on local clinical use.

High-intensity laser photocoagulation and cryodestruction in the treatment of patients with skin scars

Purpose: to assess the effects of combined application of high-level laser photocoagulation and simultaneous cryodestruction at pathological scars on the skin.Material and methods. Two groups included patients of both genders aged 18 and older. Patients from the fi rst (main) group (n = 60) had simultaneous high-level laser irradiation and cryodestruction on scar tissue; patients from the second (control) group (n = 30) were treated separately with laser irradiation and cryodestruction. For laser irradiation, laser devise CO2-laser AKHIL with wavelength 10.6 μm, pulsed frequency 10–20 Hz and power 5–15 W was used. For cryodestruction, apparatus “KRIO-RM-01” was used: tip cooling speed of 220 °C/min, the temperature of 180 °C on the tip working part, exposure time – 15–20 sec. The treated patients had hypertrophic and keloid scars. Etiologically, scars were of post-traumatic, postoperative, post-eruptive types. Evaluation criteria were histological examination of biopsy material with eosinhematoxylin, patients’ quality of life, examination of scar zone.Results. The obtained results demonstrate that the combined application of two physical factors (laser + cryo) at scar tissue increases satisfactory outcomes in patients with hypertrophic scars by 75 % and by 53.4 % in the control group. Relapses were seen in both groups: 25 % in the main group and 46 % in the control group. Morphologically, one can see positive changes in degradation of rough fi brous tissue.Conclusion. A combined application of high-intensity laser photocoagulation and simultaneous cryodestruction has been proven to be effective in patients with pathological skin scars.

The effectiveness of rehabilitation of patients after covid pneumonia with osteopathic methods

Introduction. The new coronavirus infection (COVID-19) pandemic has affected the lives of many people. Any infectious and infl ammatory process in the lungs can lead to adverse consequences for the whole organism. The pathological process affecting the respiratory structures of the lungs, bronchi leads to disruption of various links of the external respiration system; therefore, timely effective rehabilitation for such patients can improve the quality of life, reduce the period of temporary disability, and most importantly, restore the function of external respiration.The aim was to prove the effectiveness of the osteopathic methods application in the rehabilitation of patients after coronavirus pneumonia.Materials and methods. On the basis of the Primorsky Institute of Vertebroneurology and Manual Medicine (Vladivostok) the rehabilitation of patients with coronavirus pneumonia was carried out using osteopathic methods. 63 patients after suffering from coronavirus pneumonia were randomly divided into 2 groups comparable in terms of clinical and functional characteristics. The fi rst group (main) consisted of 34 people (average age 65.5±1.5 years), of which 44.1 % were men and 55.9 % were women. Group 2 (control) included 28 patients (mean age 64.1±1.6 years), of which 32.1 % were men and 67.9 % were women. To assess the function of external respiration, spirometry was performed and the main indicators of the vital capacity of the lungs were assessed (vital capacity — VC, and FVC — forced vital capacity). To measure the saturation of hemoglobin in arterial blood with oxygen (SpO2), pulse oximetry was performed. Rehabilitation included in the main group osteopathic correction (2 procedures), breathing exercises (4 procedures) and chest massage (4 procedures); in the control group there were breathing exercises (4 procedures) and chest massage (4 procedures). The rehabilitation course lasted 14 days. For the statistical analysis of the obtained data the Statistica-10 software package was used.Results. The studies revealed a pronounced change in the function of external respiration in patients who had undergone coronavirus pneumonia. According to the results of spirometry, more than 90 % of patients showed a statistically signifi cant (p=0.006) decrease in VC compared to the physiological norm — both in the main group (VC down to 80.7 %) and in the control group (VC down to 87.6 %), as well as a signifi cant (p=0.0001) decrease in FVC to 77.7 % in the main group and to 79.1 % in the control group. After rehabilitation, patients in the main group showed a statistically signifi cant improvement in the function of external respiration, manifested in an increase in VC by 12.3 % (p&lt;0.0001), FVC by 12.1 %. In patients in the control group (without osteopathic correction), after the rehabilitation, the main indicators of the function of external respiration also improved, but the changes were not statistically signifi cant. As a result of rehabilitation, the patients of the main group showed a statistically signifi cant SpO2 increasing (from 96.6±0.2 to 97.5±0.2 %, p=0.0013); in the control group, there was also a positive dynamics of these indicators, but the changes were not statistically signifi cant.Conclusion. The results of the study allow to conclude that the inclusion of osteopathic correction methods in the rehabilitation of patients after coronavirus pneumonia has a positive effect on their state, improves the external respiration function indicators — VC and FVC, and also increases the SpO2. The obtained results allow to recommend the inclusion of osteopathic methods in the rehabilitation programs for patients who have undergone coronavirus infection.

Optical coherence tomography angiography for choroidal neovascularization in pathological myopia and neovascular age-related macular degeneration in combination with axial myopia in comparative analysis

Background. Optical coherence tomography angiography (OCTA) is currently an important method of visualization and assessment of fundus pathology in various diseases. The study of combined pathologies is not well covered.The aim: to compare OCTA features during choroidal neovascularization (CNV) in pathological myopia (PM) and in neovascular age-related macular degeneration in combination with axial myopia (nAMD + M) against the background of anti-VEGF therapy.Materials and methods. A prospective study included 70 eyes with active CNV. Comparative analysis of parameters was carried out between two groups: with PM – 47 eyes; with nAMD + M – 23 eyes.Results. 4 OCTA patterns were established in both groups: dense, loose, mixed and unidentifi able. With PM, dense pattern was found in 28 (59.57 %) eyes, loose pattern – in 16 (34.04 %), mixed pattern– in 2 (4.26 %), unidentifi able pattern – in 1 (2.13 %). In the nAMD + M group, dense pattern was rare – in 1 (4.35 %) eye, loose pattern – in 7 (30.44 %), mixed pattern – in 9 (39.13 %), unidentifi able pattern – in 6 (26.08 %). The fi rst group was characterized by a dense pattern that was found at a younger age, the second group was characterized by dense and mixed patterns. The greatest area and density of CNV were found with a loose pattern in both groups (p &lt; 0.05). The observation period until the stabilization of CNV was achieved was longer in the loose and mixed patterns in the PM group, and in the loose and unidentifi able – in the nAMD + M group (p &lt; 0.05). Loose and unidentifi able patterns require more injections. The halo was determined by the presence of intraretinal fluid in the retina. Conclusion. OCTA showed common features and distinctive features in the course of CNV in patients with PM and nAMD + M during anti-VEGF therapy. OCTA can be useful in assessing CNV activity and predicting the eff ect of treatment.

Соціально-економічна характеристика родин Миргородського полку (за даними Генерального опису Лівобережної України 1765–1769 років)

&nbsp;The article, based on the analysis of the General Description of the Left Bank of Ukraine in 1765–1769, reveals some aspects and features of the socio-economic life of the families of the Myrhorod Regiment of the 1760s. The article emphasizes social stratifi cation of the population: wealthy, poor Cossack and peasant families. The property status of families of widows, commonwealths and neighbors is described. The main source used: the General description of Left-bank Ukraine of 1765–1769. The materials of separate census books of the Myrhorod Regiment were used for the fi rst time in Ukrainian historiography, which determines the scientifi c novelty of the publication. The article aims to study the socio-economic characteristics of individual families in the specifi ed geographical region. In preparing the article, the choice of research methods was made taking into account the main trends in the humanities: systematization, anthropologization and interdisciplinary links, taking into account the current state of scientifi c development of the outlined issues. The study used 4 groups of methods (traditional and innovative). The fi rst group includes general scientifi c methods, namely: historical, terminological and systemic, which are characterized by analysis and evaluation of historical events. The second group is characterized by interdisciplinary approaches, using statistical and mathematical methods. General historical methods make up the third group, among which comparative-historical and retrospective are used. The fourth group – source methods: identifi cation, selection, classifi cation, textual study, which made it possible to establish the objective value of sources for a particular study, to determine their information potential. Conclusions. When considering the socio-economic development of the families of the Myrhorod Regiment, it was concluded that belonging to a certain social group, the number of household members determined the level of their wealth. In determining the criteria of wealth, the following factors were considered: the number of property (movable and immovable), the condition of residential and commercial premises. The list of family members was important, indicating their status, which depended on age and mental factors. It was determined that the wealthiest were Cossack families, and the poorest were widow’s families; the majority of the peasantry lived in poverty. The category of landless peasants turned out to be the least prosperous.