Kharkiv National Medical University Research Articles

COMPARATIVE ASSESSMENT OF VISUAL COLOR MATCHING FOR ARTIFICIAL AND NATURAL TEETH BY STUDENT OF DENTAL FACULTY AT KHARKIV NATIONAL MEDICAL UNIVERSITY

The purpose of this study was to conduct a comparative assessment of dental students’ ability to match the color of patients’ teeth with aesthetic restorations. Materials and Methods. The study was conducted from 2021 to 2024 with participation of 2nd- and 3rd-year students at the Faculty of Dentistry, Kharkiv National Medical University, Kharkiv, Ukraine. Results. Accurate determination and reproduction of natural tooth color is a challenging task in aesthetic dentistry, as color plays a crucial aesthetic role. This process depends heavily on the experience and perception of dentists and can be approached subjectively (visual analysis) or objectively (special devices). Although shade determination is a routine task for dentists, errors are still common. The study revealed that 2nd-year students struggled significantly with color matching, especially for natural teeth, with error rates of 66.6% for artificial teeth and 80.8% for natural teeth, indicating a need for more training. Students performed better using the VITA Classic shade guide, which is simplified, but matching the color of natural teeth requires additional practice. The results confirm that clinical training improves students’ color-matching skills. After training, 3rd-year students showed a marked decrease in error rates: 35.8% for artificial teeth and 53.3% for natural teeth. The Vita 3D Master scale proved more accurate due to its broader color-matching capabilities. Overall, the accuracy levels improved significantly, highlighting the effectiveness of the training program. Conclusion. The results of the study demonstrate that training significantly improves students' ability to accurately determine tooth color. The 3rd year students who underwent clinical training showed better results in matching the color of both artificial and natural teeth, reducing the number of errors by 35.8% and 53.3%, respectively. The Vita 3D Master scale proved to be more accurate due to a wider selection of colors and more evaluation parameters. The 81.5% increase in the overall score confirms the effectiveness of the training in improving the accuracy of tooth color determination in the educational process.

MODERN VIEWS OF USE OF TELEREHABILITATION IN URINARY TRACT DYSFUNCTION IN PATIENTS WITH MULTIPLE SCLEROSIS

Multiple sclerosis is a chronic disease of the nervous system that often leads to various disorders, including urinary tract dysfunction. This significantly affects the quality of life of patients, causing physical and psychological complications. The term "bladder rehabilitation" summarizes treatment options aimed at restoring its function in patients with neurourological symptoms. A strong contraction of the sphincter of the urethra and/or pelvic floor, as well as anal dilatation, manipulation of the genital area, and physical activity reflexly inhibit urination. A comprehensive physical therapy program for patients with pelvic disoders includes pelvic floor vibration massage, training in proper breathing patterns, pelvic floor muscle relaxation and stabilization exercises and should last several months, during which the patient regularly visits the doctor. The pandemic and war have created barriers that affect almost every aspect of life, treatment and rehabilitation, especially for people with chronic neurological conditions. Traditional rehabilitation methods used to correct urinary tract dysfunction have their limitations, including difficulties in accessing specialists, especially in remote areas. This stimulates the development and implementation of telerehabilitation as an alternative approach. Telerehabilitation involves the use of digital technologies for the remote provision of medical services and patient monitoring. It allows doctors to monitor the condition of patients, provide recommendations and adjust treatment without the need for personal visits. Considering the existing data and our own clinical experience, we consider it appropriate to use telerehabilitation for the correction of disorders of the lower urinary tract, especially in the conditions of war, when access to rehabilitation centers may be difficult. In the department of medical rehabilitation of the University Clinic of the Kharkiv National Medical University, we successfully conducted telerehabilitation using Google Meet video conferencing for 10 patients with urinary incontinence on the background of multiple sclerosis, whose EDSS was no more than 4.0. When conducting online classes under the guidance of a physical therapist, patients noted a desire to strictly follow the recommendations and perform regular exercises. All patients kept a urination diary, according to which the frequency of urination was reduced by an average of 20-25%, which had a positive effect on their quality of life. Although our observations are not representative, in combination with existing studies, we consider telerehabilitation to be a promising direction in complex therapy and rehabilitation of this pathology. Conclusion The use of telerehabilitation for urinary tract dysfunction in patients with multiple sclerosis is a promising direction that requires further research. This approach can significantly improve the quality of life of patients, reduce the burden on the health care system and provide a more affordable and convenient treatment. A multidisciplinary team should be involved, including a neurologist, a urologist, a gynecologist, and a physical therapist to select the optimal tactics of drug treatment and physical therapy. A promising direction of further research is the development of standard protocols for conducting telerehabilitation for patients with lower urinary tract dysfunction against the background of multiple sclerosis and other pathologies.

Vasyl Yakovych Danylevskyi's lecture on science, university and faculty selection (1921): annotated translation

Kharkiv National Medical University has the honor to present a series of lectures by the outstanding doctor of Kharkiv region Danylevskyi V.Ya., which for 100 years have not lost their relevance and can be a guideline for modern doctors and students of medical universities. In this abstract, we will briefly outline the advice of the author of the lecture to young doctors. Without a general scientific education, even a good practicing doctor will remain a narrow empiricist with a limited mental horizon. The student must complete the entire curriculum, because he cannot yet understand the suitability of the academic subjects in his future profession. The formalistic system of educational institutions suppresses higher educational interests, logic and scientific truth. Scientific successes bring people together and promote international communication based on knowledge and art, work and peace. True, mutual understanding covers only the cultural top of the population. Therefore, the democratization of science is necessary for the universal sharing of spiritual and material benefits. That is why they fought so hard for the development of the education of their people in European countries after the wars, and that is why the general rise of the cultural and political power of Japan began with the development of public education. Our physical and mental health depends on all conditions of human existence, starting with the mental and social state. That is why in all matters of physical, mental and social life, their organization and reform, the voice of the doctor should be highly respected. To earn such respect, the doctor must have great tact, understanding of people, and most importantly, great scientific knowledge. What should someone do who has already spent 2–3 years at medical school and then became convinced of his worthlessness? Of course, leaving medicine. Keywords: medical university, medical education, history of medicine.

Peculiarities of the shape and size of the mandible and the lower dentition with taking into account gender and craniotype

The aim of the study: establishment of actual intravital craniometric characteristics of the shape and dimensions of the mandible and lower dentition of an adult person depending on gender and craniotype. Research materials and methods: the work used dry bone preparations of whole or fragmented human skulls of both sexes in the amount of 39 units, from the collection of the Department of Human Anatomy of the Kharkiv National Medical University, and the results of CT studies of the head of adult people without existing bone tissue pathologies, totaling 85 observations. The basis of establishing a craniotype is the principle of calculating the general facial or facial index, which allows classifying anatomical objects according to the shape of the head structure. Research results: the straight length of the mandible in adult leptoprosops males is from 88.5 mm to 102.4 mm, for women - from 86.3 mm to 100.7 mm; in mesoprosops men, this parameter gradually decreases to the level - from 81.3 mm to 95.7 mm, in women - from 80.7 mm to 94.9 mm; in euryprosops, the index is the smallest and ranges from 79.7 mm to 91.5 mm in males and from 78.5 mm to 90.8 mm in females. The opposite trend with significant ranges of variation is established for the angular width of the bone. Thus, in male leptoprosops, this parameter was determined from 84.6 mm to 97.5 mm, in female representatives - from 83.6 mm to 96.3 mm; in mesoprosops men, it increased from 89.1 mm to 105.3 mm, in women - from 87.9 mm to 103.1 mm; in euryprosops, regardless of sex, it reached its peak values, from 94.5 mm to 116.1 mm and from 92.7 mm to 114.1 mm, respectively. The height of the mandibular body also showed a certain dependence on the type of skull structure, in leptoprosops men it tended to the highest values ​​and was fixed at the level from 29.1 mm to 38.9 mm, as well as in women - from 27.5 mm to 37.8 mm; at the same time, in mesoprosops men, the size decreased from 25.9 mm to 36.3 mm, in women, in turn, from 24.6 mm to 35.1 mm; in euryprosops men, this parameter ranged from 22.3 mm to 33.1 mm, and next to women - from 21.9 mm to 31.9 mm, it was at the level of the lowest indicators. When analyzing such a complex and multidirectional parameter as the arch of the mandible, it was also possible to obtain a characteristic of its dependence on the type of structure of the facial department of the skull. It was established that the range with the smallest values ​​of the length of the arc is characteristic of leptoprosops, ranging from 135.8 mm to 149.4 mm in males and from 133.5 mm to 147.3 mm in females; average indices are characteristic of men - from 139.1 mm to 154.6 mm and women - from 136.4 mm to 151.2 mm with a mesoprosopic craniotype; in euryprosops of both sexes, the index tends to the greatest values ​​at the level of 141.2 mm to 158.3 mm and from 139.7 mm to 155.7 mm, respectively. Conclusions: the main craniometric parameters of the mandible are significantly dependent on the type of structure of the facial department of the skull. Thus, the leptoprosopic craniotype is characterized by maximum values ​​of longitudinal and height dimensions with minimal indicators of width and arc length. Mesoprosops are characterized by the definition of intermediate, averaged values ​​equidistant from marginal, terminal forms. In representatives with the euryprosopic type of skull structure, a significant decrease in the length and height of the jaw with a significant increase, up to the maximum values, width and length of the arch was observed. At the same time, unlike leptoprosops, which had a shortened and pointed arch, in euryprosops, the arch tended to be smoothed and lengthened. The assessment by sex leads to the fact that all sizes of the lower jaw predominate in men, but, nevertheless, a certain number of differences in indicators were within the limits of statistical error, which does not allow making absolute conclusions in this matter

Вихованці німецької вищої медичної школи у витоках Харківського національного медичного університету: до 220-річчя заснування університету (1804–2024)

The article is devoted to the 220th anniversary of the Kharkiv National Medical University and the contribution of the first heads of the university’s departments, in particular professors, graduates of the German Higher Medical School of that time, in the formation of the Kharkiv Higher Medical School. Key words: History of medicine, Kharkiv National Medical University, German medical professors.

Видатні випускники Харківського університету. До 100-річчя з дня народження професора Володимира Вікторовича Бобіна

The School of Medicine of Kharkiv University is famous for its students. This faculty was home to outstanding pioneering scientists in many areas of medicine, who were also educators and humanists. The names of professors V.F. Grube, L.L. Hirschman, V.Y. Danilevsky, V.P. Vorobyov, and many others are widely known in the history of medicine and brought well-deserved fame to Kharkiv. This essay is dedicated to the Bobin doctors, who have been serving people and the cause of public health with their knowledge and medical work for over 160 years. Volodymyr Pavlovych Bobin (1858–1925) graduated from the Medical Faculty of Kharkiv University in 1881. In 1884, after working for the first years after graduation at the Department of General Pathology of Kharkiv University, he was elected as a medical administrator of the free hospital of the D.O. Donets-Zakharzhevsky Kharkiv Medical Society. In November 1884, Volodymyr Pavlovych was elected correcting physician-manager of the KMT hospital. Viktor Bobin was born in Kharkiv on March 28, 1890. His choice of profession was made consciously, and after graduating from high school, Viktor entered the medical faculty of Kharkiv University. From the very fist brilliant lectures of Professor V.P. Vorobyov, Bobin decided to study anatomy. For many years, Viktor Bobin headed the Crimean Society of Anatomists, Histologists and Embryologists and was a member of the Presidium of the Ukrainian Republican Society of AGE. The Bobin medical dynasty continues. The third representative of the Bobin’s dynasty is Volodymyr Viktorovych Bobin (1924–2016), son of Viktor Volodymyrovych. This year marks the 100th anniversary of the birth of Professor, Doctor of Medicine, Academician of the International Academy of Integrative Anthropology, Academician of the Ukrainian Academy of Sciences for National Progress, Head of the Department of Normal Anatomy at Kharkiv National Medical University (KhMU) in 1971–1992. A worthy representative of the Bobin’s medical dynasty, he taught many students of anatomy, wrote numerous textbooks for students, thoroughly researched the macromicroscopic anatomy of the nervous system, and made a significant contribution to science. Key words: Bobin, professor, doctor, Kharkiv University, Society of Anatomists.

Мої спогади про батька Володимира Вікторовича Бобіна. До 100-річчя з дня народження

The article presents not only official data about the professor of the Department of Normal Human Anatomy of the Kharkiv National Medical University, academician of the Ukrainian Academy of Sciences of National Progress, honorary academician of the International Academy of Integrative Anthropology, Doctor of Medical Sciences Volodymyr Viktorovych Bobin, but also the memories of his daughter Iryna. The portrait of a scientist, intellectual, teacher, loving son, father and grandfather, who was Professor V.V. Bobin, is shown. Key words: anatomy, anthropology, normal anatomy, history of medicine, medical dynasty, Volodymyr Bobin.

Віктор Володимирович Бобін — видатний представник анатомічної школи України. До 100-річчя з дня народження його сина професора Володимира Вікторовича Бобіна.

The article presents not only official data about Viktor Volodymyrovych Bobin, professor of the Department of Normal Anatomy of the Crimean Medical Institute, but also shows his scientific activities in his native city Kharkiv in 1919-1922. Works on anthropology are also highlighted, in particular the scientist’s monograph "Artificially deformed skulls found during excavations in the Crimea" (1957). The article is devoted to the 100th anniversary of the birth of his son, Professor of the Department of Normal Human Anatomy of the Kharkiv National Medical University, Academician of the Ukrainian Academy of Sciences of National Progress, Honorary Academician of the International Academy of Integrative Anthropology, Doctor of Medical Sciences Volodymyr Viktorovych Bobin. Key words: anatomy, anthropology, normal anatomy, history of medicine, medical dynasty, Viktor Bobin

Dynamics of clinical and laboratory parameters of patients with COVID-19 on the background of treatment

The article presents the results of the analysis of the dynamics of the main indicators of the blood coagulation system and cytokines (IL-6, D-dimers, C-reactive protein and procalcitonin) on the background of thromboprophylaxis in patients with COVID-19. The aim of our study was to determine the dynamics of the main indicators of the blood coagulation system and cytokines in the setting of thromboprophylaxis. The study was conducted at the Department of Infectious and Pediatric Infectious Diseases, Parasitology, Phthisiology and Pulmonology of the Kharkiv National Medical University and at the Municipal Non-Profit Enterprise "Kharkiv Regional Infectious Diseases Hospital" of the Kharkiv Regional Council, in 2020–2024 with compliance of the existing recommendations of bioethical norms and rules. All patients singed informed consent. We examined 179 patients aged 20–88 years (average age of [58.75±13.82] years) with COVID-19. The diagnosis of COVID-19 was confirmed by enzyme-linked immunosorbent assay and polymerase chain reaction. Medical and statistical calculations were performed using the SPSS 25.0 software package. The mean value and standard square deviation were calculated. The probability of differences was determined using the Mann-Whitney U-test with a threshold value of statistical significance of p=0.05. According to the results of the study, a significant (p<0.001) dynamic of restoration of D-Dimers’ levels was noted against the background of the applied therapy (on days 9–10, a decrease of 166.3 Fibrinogen Equivalent Unit (FEU), ng/ml, and on days 12–15 – of 376.7 FEU, ng/ml) and procalcitonin (on days 6–7 the content was by 0.04 ng/ml, p=0.006; on days 10–11 – 0.01 ng/ml, p<0.001; on days 12–15 – also 0.01 ng/ml, p=0.027). Keywords: D-dimers, C-reactive protein, procalcitonin.

Correlations between clinical, laboratory and instrumental characteristics of patients with COVID-19 infection

Background. COVID-19 is a leading disease in terms of prevalence (more than 100 million cases) and mortality (more than 10.0%). Most often, COVID-19 is accompanied by hemostatic disorders (manifestations of COVID-19-associated coagulopathy) and blood coagulation. Aim. To determine the levels of correlation between clinical and laboratory characteristics of hemostatic and coagulation disorders (according to the characteristics of ThromboElastoGraphy, TEG) in patients with COVID-19 infection. Materials and Methods. The study was performed at the Department of Infectious and Pediatric Infectious Diseases, Parasitology, Phthisiology and Pulmonology of Kharkiv National Medical University in accordance with the existing recommendations of bioethical norms and rules. All patients signed an informed consent. 179 patients with COVID-19 were examined. The levels of correlation between laboratory and instrumental characteristics were determined using Spearman's rank correlation coefficient. The probability of differences was determined using the Mann-Whitney U-test. Results & Conclusions. According to the results of the study, significant direct and inverse correlations were found. The identified correlations determined the possible interaction between TEG parameters and the characteristics of the systemic inflammatory response. The obtained results play a significant role for patients with COVID-19, because they can predict shifts in inflammatory systemic response parameters, which characterize the severity of the disease, based on the characteristics of TEG. The interrelationships of hemostatic and coagulation system disorders have been reliably determined by the presence of significant correlations between the characteristics of the inflammatory systemic response of patients with COVID-19 and TEG values. The obtained significant correlations were mostly weak, but there were also interdependencies of medium strength. In particular, Interleukin-6 and some other indicators on days 5–6 after hospitalization. Keywords: thromboelastography, TEG, coagulation system disorders.

Pathophysiological features of the mechanisms of cognitive function and their relationship with the emotional state in medical university students

Relevance: cognitive processes play an important role in our lives. Intelligent mechanisms of thought: processing and processing information to make decisions helps us in many areas of everyday life. And in the optimization process, knowledge about cognitive processes helps to thoroughly develop methods for initiating and illuminating programs, allowing them to become more effective and efficient, in the normal pathogenesis of illness, in Puppy memory and creativity and the key to developing psychological well-being: A study of cognitive processes help to improve our understanding of psychological well-being and kindness. It allows us to understand what factors influence our thoughts, emotions and behavior. By focusing on cognitive processes, it is possible to improve the results of learning, healing and the emotional state of students during the learning process. It appears that advertising and marketing widely rely on the influence of the emotional warehouse with the help of information and mental mechanisms. Therefore, the infusion of positive emotions into memory can help psychologists and consultants develop more effective strategies for helping people with pathological conditions. Systematization and updating of data due to the influx of positive and negative emotions, sleep deprivation during the memory process. We also took into account the infusion of the emotional spectrum into the memory process among students of the Kharkiv National Medical University. Conclusions: Varying the pathophysiological features of the mechanisms of cognitive function and their relationship with the emotional state, the influx of positive and negative emotions on the process of memorizing an important topic, oskol How emotions flow into our memory and other cognitive processes. Following the results of the conducted research among students of the Kharkiv National Medical University, the best results in the remembered students will be noted as information from the city, as there is a wine city, and there is no significant marking, as when trained and students feel positive emotions. This knowledge can be of practical importance in education, psychological practice, advertising, marketing and many other matters

Peculiarities of the parietal bones of the vault of the human skull structure and shape, taking into account sex and craniotype

The development of neurosurgery and the increase in requirements for the performance of surgical approaches performed through the bones of the skull vault lead to the formation of new requests for detailing and clarification of the craniometric characteristics of the parietal bones. The purpose of our study is to establish the features of the shape and other spatial indicators of the parietal bones of the skull of a mature person, taking into account sex and certain types of craniotype. The study was conducted on 130 studied preparations of bone structures of the head of adults from the collected collection of the Department of Normal Anatomy of the Kharkiv National Medical University, in the amount of 82 bone preparations, including isolated parietal bones, as well as 48 tomograms obtained during the examination of patients. The basis for establishing a craniotype is the principle of calculating the cranial index. For statistical analysis, we used the programs Statistica 13.5.0.17 (trial version) and Microsoft Excel of the corporate package MS 365. To establish the peculiarities of the structure and shape of the parietal bones, the following craniometric indicators were determined: the length and width of the parietal tubers, the parietal chord and the arch, calculated the curvature index of the parietal bone. The obtained data were analyzed for mature people of different genders and three established craniotypes. It has been established that brachycephals are characterized by an expanded and expanded form of the parietal bones, which is associated with the predominance of the transverse dimensions of the entire cerebral skull. For mesocephals, the most typical intermediate- average form depending on the values of the cranial index. Dolichocephals have an elongated and narrowed form of the parietal bones, which is combined with general changes in the cerebral skull. Additional linear parameters of the parietal bones are directly dependent on the established craniotype. The dolichocephalic type is characterized by maximum length values of parietal tubers: ¯x =18.43 mm (right) and ¯x =18.24 mm (left) with minimum width parameters: up to ¯x =15.71 mm and ¯x =15.02 mm. Representatives of the brachycranic type are characterized by the minimum indicators of the length of the parietal tubers: from ¯x =12.73 mm to ¯x =12.81 mm and the maximum indicators for the width - ¯x =23.52 mm (right) and ¯x =23.04 mm (left). The parietal chord, like the parietal arch, had a similar trend in the distribution of indicators, namely: an increase from dolichocrania to brachycrania. In men with a dolichocephalic type of skull structure, the average values of these parameters were at the level of ¯x =108.2 mm (right) and 107.6 mm (left) for the parietal chord, and ¯x =114.2 mm and ¯x =113.2 mm for the parietal arcs In men with brachycranic type, the parietal chord reached - ¯x =116.6 mm (right) and ¯x =115.8 mm (left), and the parietal arch reached - ¯x =127.8 mm (right) and ¯x =126.9 mm ( left). In women, a similar principle of size distribution has been established, taking into account a small, 2-3 mm, general decrease in indicators compared to men. The curvature index of the parietal bones was determined: the maximum average values ¯x =83.00-83.58 were obtained in dolichocephals, the minimum values were ¯x =80.56-81.64 in brachycephals. This indicates an increase in the curvature of bones in brachycephals, given that the absolute value of the index is inversely proportional to the degree of curvature. Thus, the obtained data indicate a stable relationship between the craniotype of the skull and additional parameters of the parietal bones.

Особливості ліпідного та вуглеводного обмінів у пацієнтів з гастроезофагеальною рефлюксною хворобою на тлі цукрового діабету 2-го типу залежно від наявності ожиріння

Особливості ліпідного та вуглеводного обмінів у пацієнтів з гастроезофагеальною рефлюксною хворобою на тлі цукрового діабету 2-го типу залежно від наявності ожиріння

Correlated interdependences of characteristics of carbohydrate metabolism and lipid profile and batokines levels in patients with coronary heart disease and obesity

Research of comorbid coronary heart disease (CHD) and obesity in recent years often rely on the study of inflammatory mediators, among which the first and foremost are batokines, in particular on fibroblast growth factor (FGF-21) and vascular endothelial growth factor A (VEGFa). The aim of our study was to determine the correlational interdependencies of indicators of carbohydrate metabolism and lipid profile and levels of batokines in the comorbidity of CHD and obesity. 70 people aged from 25 to 85 were examined with CHD on the background of obesity. The average age was (63.6±8.8) years. The research do not violate the principles of bioethics, which is confirmed by the conclusion of the Bioethics Committee of the Kharkiv National Medical University. All patients who participated in the study signed an informed voluntary consent. Based on the results of research probable direct strong correlations of total cholesterol (TC) with low-density lipoprotein (LDL) were determined (ρ=0.889; p=0.000); triglycerides (TG) with very low-density lipoprotein (VLDL) (ρ=0.810; p=0.000). The average strength of correlation was determined: glycosylated hemoglobin (HbA1c) with vascular endothelial growth factor A (VEGFA) (ρ=0.374; p=0.001); TC and LDL and AI (respectively ρ=0.615; p=0.000, and ρ=0.648; p=0.000); VLDL with atherogenic index (AI) (ρ=0.367; p=0.002). Probable direct weak correlations of blood glucose levels with TG (ρ=0.253; p=0.034) and VLDL (ρ=0.277; p=0.020) and VEGFA (ρ=0.225; p=0.061) were found; TG and VLDL with VEGFA (ρ=0.256; p=0.032 and ρ = 0.273; p = 0.022, respectively). Inverse interdependencies were recorded: medium strength – high-density lipoprotein (HDL) and AI (ρ=-0.583; p=0.000) and weak – hemoglobin levels with HDL (ρ=-0.251; p=0.036); HbA1c with LDL (ρ=-0.241; p=0.044); HDL with VLDL (ρ=-0.293; p=0.014). Keywords: comorbidity of coronary heart disease and obesity, batokines, FGF21, VEGFA.

Medical education through an invasion: insights from an elective programme for Ukrainian medical students at the University of Cambridge.

Medical students in Ukraine have faced extraordinary disruption to their clinical studies with both the COVID-19 pandemic and subsequent Russian military invasion forcing a majority of their learning to be conducted remotely. Over the summer of 2022, the School of Clinical Medicine, University of Cambridge hosted 20 medical students from Kharkiv National Medical University for a seven-week intensive clinical elective programme. The aim was to provide an immersive clinical placement that would help students to attain the necessary knowledge and experience to become competent and confident practising doctors. This perspective piece aims to support the development of future equivalent exchanges through outlining the placement's context, its planning and implementation, evidence of placement impact, and finally reflections and learning points.

TRAJECTORIES OF SERUM 25(OH)D IN CHILDREN WITH PARALYTIC SYNDROMES WHEN USING VITAMIN D FROM DIFFERENT MANUFACTURERS AND IN DIFFERENT DOSES

The prevalence of vitamin D deficiency and insufficiency varies significantly in different subpopulations of children depending on age and diseases, and recommendations for their correction in children with paralytic syndromes are limited.Aim. Empirical determination of blood 25(OH)D trajectory in children with paralytic syndromes when using vitamin D from different manufacturers and in different doses.Material and methods. The 25(OH)D (ng/ml) of blood serum was analyzed by immune-enzymatic method "Labline-90" (Austria) with the test system "Monobind Inc." (ELISA, USA) in 77 children with paralytic syndromes aged 1-18 years, a repeat study after vitamin D3 supplementation was conducted in 36 children. The rate of increase in 25(OH)D concentration per month was calculated. Methods of descriptive statistics, non-parametric correlation analysis and Kaplan-Meier survival analysis were used with MedCalc Statistical Software (Belgium).This study was approved by the Ethics Committee (protocol No. 5, October 2021), which was conducted with the involvement of minor patients and did not contain measures that could harm their health.The research was carried out within the framework of the Department of Pediatrics of Kharkiv National Medical University "Medical and social aspects of adaptation of children with somatic pathology in modern conditions" (state registration number 0120U102471, 2020).Results. Vitamin D insufficiency was diagnosed in 17% of children with paralytic syndromes, and vitamin D deficiency in 73%, so daily doses of 2000-4000 IU of vitamin D3 from different manufacturers were recommended at the discretion of the parents for 6 months. In reality, children received doses from 500 to 5000 IU randomly, from 2 to 7 months. Doses were stratified as greater than 2000 IU and less than 2000 IU. If the child received a dose of 2000 IU or more, the rate of increase of 25(OH)D in the blood in children was 3.6 ng/ml per month, if the dose was less than 2000 IU - 1.6 ng/ml per month.Conclusions. Children with paralytic syndromes should be screened and monitored for serum 25(OH)D levels. With a serum 25(OH)D level of less than 20 ng/ml, daily administration of vitamin D3 in a dose of at least 2000 IU for at least 6 months allows reaching a 25(OH)D level of 30 ng/ml in most of them. Further large-scale studies are needed to supplement current recommendations for vitamin D3 supplementation in children with paralytic syndromes.

CHALLENGES IN DIFFERENTIAL DIAGNOSIS OF COELIAC DISEASE AND GLUTEN INTOLERANCE IN CHILDREN

CHALLENGES IN DIFFERENTIAL DIAGNOSIS OF COELIAC DISEASE AND GLUTEN INTOLERANCE IN CHILDREN

FETAL AND NEONATAL STATUS IN WOMEN WITH CEREBRO-VASCULAR DISORDERS AND RISK FACTORS FOR THEIR DEVELOPMENT

Introduction. Cerebrovascular diseases in pregnant women are one of the most important problems of modern obstetrics and perinatology due to the steady increase in maternal and neonatal morbidity. Diabetes mellitus and hypertensive disorders are two of the most common complications of pregnancy, which negatively affect both short-term and long-term outcomes for the mother, fetus and newborn.The aim of the study was to determine the state of the fetus and the newborn in pregnant women with cerebral disorders, taking into account risk factors (hypertension, diabetes mellitus).Material and methods. 92 pregnant women were examined, of which the main group (77 pregnant women) consisted of women with extragenital pathology, in particular, cerebrovascular disease - 20 (21.7%), hypertension - 23 (29.8%), diabetes mellitus - 34 (44.1%), the control group consisted of 15 pregnant women (16.3%) with physiological pregnancy and their newborns.Scientific research passed the bioethics commission, no violations were found (Protocol No. 7 of 05.04.2023).Statistical processing of the data obtained during the study was carried out using Microsoft Office Excel 2016 (Microsoft, USA) and Statistica 10.0 (StatSoft, USA). The significance of differences in the characteristics of dependent groups with signs of normal distribution was assessed by the paired Student's t-test (t-test of dependent samples).This work is a fragment of the complex research work of the Department of Obstetrics and Gynaecology №2 of Kharkiv National Medical University "Optimisation of diagnostics, treatment of diseases of the reproductive system and pregnancy complications in women with extragenital pathology", state registration number 0121U11923).Results. Cerebrovascular disease was represented by the consequences of traumatic brain injury in 8 (40%) cases, acute cerebrovascular accident (ischaemic, haemorrhagic) - in 5 (25%), epilepsy - in 5 (25%), encephalopathy in cerebral palsy - in 3 (15%), arteriovenous transformation, angiomatous cavity - in 2 (10%) cases. Among women of the hypertension group, pre-eclampsia was found in 11 (47.8%), gestational hypertension - in 8 (34.7%), and chronic hypertension - in 4 (17.4%) cases. Pre-gestational diabetes was detected in 8 (23.5%) pregnant women in the diabetic group, and gestational diabetes in 26 (76.5%).Doppler flowmetry examination of blood flow in the middle cerebral artery (MCA) revealed a significant decrease (p<0.05) in the pulsatile index in pregnant patients of the main group (1.24±0.09) compared with women with a physiological course of the gestational process (1.82±0.11). There was a difference in the systolic-diastolic ratio in the SMA between women of the main and control groups (2.4±0.2 and 3.5±0.3, respectively) (p<0.05).When analysing the acid-base status of newborns, it was noted that the pH values in the groups with extragenital pathology had a shift to the acidic side. These shifts were most pronounced in the group with placental dysfunction due to diabetes mellitus, where the pH averaged 7.18±0.05, against the background of increased PCO2 to 56.3±3.4 mm Hg (p<0.05), indicating the presence of respiratory acidosis in fetuses. A decrease in the deficit of alkaline bases in the fruits of this group to an average of -7.1±0.69 mmol/l (p<0.05) indicated the occurrence of manifestations of metabolic acidosis in them.Conclusions. Cerebrovascular disease was more common in pregnant women over 30 years of age, mostly residents of the region (80%), which may be due to high trauma, insufficient examination and treatment, housewives, due to the underlying disease, as well as with Rh-negative blood type (35%), hypertensive disorders, diabetes mellitus, placental dysfunction, and early delivery, which increases the risk of neonatal complications and perinatal morbidity. Hypertensive disorders and diabetes mellitus can be considered risk factors for the development of cerebrovascular disorders in pregnant women and perinatal complications.

Life histories of the founders of Kharkiv school of hygiene

This article describes the life history of the founders of Kharkiv school of hygiene Arkadiy Ivanovich Yakobiy (1827–1907) and Ezro Musiyovych Kahan (1887–1948). It is dedicated to the 150th anniversary of the Department of Hygiene and Ecology No.1 of Kharkiv National Medical University (KhNMU) and the 100th anniversary of Research Institute of Occupational Hygiene and Occupational Diseases. Both of these talented individuals left their places of birth, secondary and higher education at some point, due to certain unfavorable consequences of regional life, and arrived in prosperous Kharkiv. Having a wide range of knowledge, both worked in a wide aspect of science and practice that relate to the general well-being of various categories of the population, including environmental, household, epidemic, production, family and other statuses of human life. Both came to the conclusion that identifying and overcoming risk factors for health deterioration is a very promising direction for achieving global well-being of humanity. Based on this, both became the founders of the Kharkiv School of Hygiene. Yakobiy A.I. founded the first department of hygiene at Kharkiv University оn February 1, 1873, and headed it for the following 12 years. Kahan E.M. headed specialized institute for workers' health problems (the first on the territory of the USSR), namely the Institute of Occupational Medicine, іn May 1923, and managed it until 1931. During the term of their work at Kharkiv hygienic institutions, these professors provided a methodological basis for the multi-decade development of the corresponding scientific, pedagogical and practical field of state health care. Keywords: historical aspects, scientific research, health care, lifestyle, professor Yakobiy A.I., professor Kahan E.M.

Present-day features of maladjustment states in English medium students

Background. During studying, international students require integration into a new linguistic and socio-cultural environment, an unusual climate, large volumes of rather complex new information, new forms and methods of educational process organization, emerging problems outside the educational process, separation from relatives and friends, all this inevitably causes students have new emotional experiences and mental states. The aim of the research was to study the modern features of the states of psychological maladjustment of international medical English medium (EM) students. Materials & Methods. 372 international year 1-6 EM students of Kharkiv National Medical University (223 men and 149 women) with an average age of (19±3) years were examined. All the examinees were divided into three groups: Group 1 – 194 students from India; Group 2 – 96 students from other Asian countries (Pakistan, Lebanon, and Syria); Group 3 – 82 students from African countries (Sudan, Tunisia, Morocco, Egypt, Namibia, and Israel). Results & Conclusions. The conducted psychodiagnostic study showed that students with a high and moderate level of maladjustment have clinical manifestations of anxiety according to Hamilton Anxiety and Depression Rating Scales (29.8% of students of Group 1, 30.1% of Group 2, 29.9% of Group 3) and subclinical manifestations of anxiety (36.2%; 39.5% and 41.1% of students, respectively). Clinical manifestations of depression were typical for 12.4% of students of Group 1, 14.2% of students of Group 2, and 13.4% of students of Group 3; subclinical manifestations of depression – for 21.1%, 19.6% and 19.9%, respectively. The analysis of the expressiveness of the manifestations of hypotensive states allowed distinguishing asthenodepressive (23.1% of the examined Group 1, 15.8% of Group 2 and 25.6% of Group 3), hypersthenic (29.9%; 29.8% and 22.2% of the examinees, respectively), anxious (25.5% of the students of Group 1, 18.9% – of Group 2, 31.1% – of Group 3) and dysphoric (21.5%; 35.5% and 21.1%, respectively) syndromes. Keywords: maladaptation, international students of higher education, anxiety, depression.