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Mon, 30 Sep 2024 00:00:00 +0300

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Mon, 30 Sep 2024 00:00:00 +0300

Gender dimorphism of the relationships between the cranial and facial skull sections in mature human individuals

L.O. Sosonna — Mon, 30 Sep 2024 00:00:00 +0300

Background. To date, the range of individual anatomical variability of the cranial profile type in mature adults, depending on gender and skull structure type has not yet been adequately established.

Aim. To study gender-specific ratios of the cranial and facial parts of the skull in mature adults.

Materials and Methods. The materials of our study consisted of 115 skulls of mature adults of both sexes, including 35 dry bone specimens of whole or fragmented skulls. For each parameter, the following metrics were calculated: The following parameters were used in the statistical analysis: (arithmetic mean), σ (standard deviation), and m (standard error of the mean).

Results. It was found that in men the skull length is =181.36 with σ=3.31 and m=0.46, while in women it does not exceed =176.57 with σ=3.28 and m=0.47; the skull width in men reaches =141.17 with σ=2.62 and m=0.34, and in women, it does not exceed =134.94 with σ=2.50 and m=0.33; the height parameter of the skull in men also reaches maximum values at the level of =141.38 with σ=3.75 and m=0.52, while in women, it is somewhat lower at =137.24 with σ=3.15 and m=0.55. In mature men, the upper facial width is =94.17 with σ=3.87 and m=0.50, while in women, this parameter averages =90.71 with σ=4.05 and m=0.54; the middle width in men reaches =128.93 with σ=1.53 and m=0.20, while in women, it does not exceed =122.49 with σ=1.44 and m=0.19; the maximum indicators of angular width are established in men, averaging =99.64 with σ=4.15 and m=0.54, while in women, they do not exceed =92.27 with σ=3.78 and m=0.51.

Conclusions. The study identified significant gender-specific differences in the cranial and facial dimensions of middle-aged individuals. Men demonstrated larger average values for skull length, width, and height, as well as upper face width, bizygomatic width, and angular width, compared to women. These findings highlight distinct morphological characteristics between genders.

Keywords: computed tomography, cranial index, face width, face length, face height.

Archived: https://doi.org/10.5281/zenodo.14257424

Theoretical analysis of the intestinal microbiota influence on colorectal cancer development

I.O. Tiuliukin, P.V. Ivanchov — Mon, 30 Sep 2024 00:00:00 +0300

Background. ColoRectal Cancer (CRC) is one of the most common malignant tumors: about a million new cases are diagnosed annually in the world. In Ukraine, the incidence of CRC is 20.5 per 100,000 population. The ratio of mortality and morbidity indicates significant shortcomings in the diagnosis, treatment and prevention of CRC.

Aim. To study theoretical scientific developments regarding the influence of intestinal microbiota on the development of colorectal cancer.

Materials and Methods. In the course of writing the scientific article, a number of modern literary sources and the latest data from scientific Web databases were studied of Science, Scopus, Google Scholar and PubMed, methods of systematic and comparative analysis of the specified problem were applied. Medical and statistical data of scientific publications on morbidity and treatment results in different countries of the world were studied.

Results. According to world statistics, CRC is the third most common in men (10.0% of the total number of malignant neoplasms) and the second most common in women (9.2%). Approximately 45.0% of CRC patients die despite treatment. A high percentage of emergency operations is recorded in elderly patients with chronic accompanying pathology, which is the cause of a large number of postoperative complications ([24.0–80.0] %) and mortality ([11.0–36.0] %). The incidence of CRC in Ukraine is the highest among a number of countries and indicates significant deficiencies in the diagnosis and treatment of patients, as well as in the prevention of this disease. Intestinal microbiota plays an important role in the development of colorectal cancer. Disruption of the functioning of the intestinal microbiota also leads to the development of a significant number of infectious, metabolic, oncological, neurological and endocrine diseases.

Conclusion. The analysis of literary sources and clinical studies of domestic and foreign authors allows us to assert that the microbiota, influencing the immune system, plays an important role in the induction and progression of colorectal cancer.

Keywords: mortality, morbidity, treatment.

Archived: https://doi.org/10.5281/zenodo.14392226

Early physical rehabilitation in intensive care unit and its impact on Post-COVID syndrome manifestations

V. Kovalenko — Mon, 30 Sep 2024 00:00:00 +0300

Background. The COVID-19 pandemic has caused a global health crisis, notably through long COVID, which significantly affects the quality of life of patients’ post-discharge from hospital care. Long COVID is characterized by prolonged symptoms such as fatigue, cognitive impairments, depression, and anxiety. Early physical rehabilitation is a crucial component of patient recovery; however, the optimal frequency and intensity of rehabilitation interventions remain unclear.

Aim. To evaluate the effects of various physical rehabilitation regimens on functional status, cognitive functions, psychosocial state, and manifestations of post-COVID syndrome in patients who underwent severe COVID-19.

Materials and Methods. 102 patients with confirmed COVID-19 requiring treatment in an Intensive Care Unit (ICU) were included in the study. They were divided into groups based on the number of rehabilitation sessions per day: Group I received one session, while Group II received two. Physical rehabilitation included changing the body position in bed, verticalization and breathing exercises. We assessed average values for physical functional status, cognitive functions, and psychosocial condition at discharge, along with post-COVID symptom severity 5–7 days after discharge.

Results. Increasing the number of rehabilitation sessions led to better psychosocial outcomes and reduced manifestations of post-COVID syndrome. However, in the short-term, increasing session frequency did not yield statistically significant improvements in cognitive functions or physical status.

Conclusions. Early physical rehabilitation in ICU is vital for reducing manifestations of post-COVID syndrome in severe COVID-19 patients. Enhanced physical activity not only improves mental health but also helps alleviate physical symptoms. Future research should focus on the long-term effects of rehabilitation and a holistic approach to supporting patient recovery.

Keywords: mobilization of patients, early activation of patient, COVID-19, ICU.

Archived: https://doi.org/10.5281/zenodo.14250339

Eryptosis contributes to gestational diabetes mellitus in maternal obesity

V.V. Lazurenko, O.Yu. Zhelezniakov, V.Yu. Prokopiuk — Mon, 30 Sep 2024 00:00:00 +0300

Background. Obesity is considered to be a risk factor for Gestational Diabetes Mellitus (GDM), which is characterised by hyperglycaemia in pregnant women. Recent studies have demonstrated that glycated erythrocytes are more prone to eryptosis, a unique regulated cell death observed only in mature erythrocytes.

The aim of the current study was to analyse how eryptosis might contribute to GSM in maternal obesity.

Materials & Methods. Eryptosis parameters were assessed in pregnant women enrolled for the study: group 1 consisted of 12 obese pregnant women without the signs of GDM, 15 pregnant women without obesity but with GDM were included in group 2, 14 obese pregnant women with GDM were in group 3, group 4 (control) consisted of 15 pregnant women without the signs of obstetric and extragenital pathology. Phosphatidylserine externalisation was assessed by flow cytometry following Annexin V-FITC staining of circulating erythrocytes isolated from the pregnant women. Additionally, 2',7'-dichlorodihydrofluorescein diacetate (H2DCFDA) staining was used to analyse oxidative stress parameters in circulating erythrocytes.

Results. Groups 1, 2 and 3 of pregnant women showed a higher degree of ROS-dependent eryptosis compared to the control group (IV). There was no statistically significant difference (p>0.05) in the eryptosis of circulating erythrocytes between pregnant women of groups 1 and 2. However, the percentage of phosphatidylserine-dispersed erythrocytes in eryptosis and the level of ROS was statistically significantly higher in pregnant women of group 3 compared to pregnant women of groups 1 and 2.

Conclusions. GSM associated with maternal obesity is accompanied by accelerated ROS-dependent eryptosis. Enhanced eryptosis might act as an additional factor contributing to thrombosis and endothelial dysfunction in obese pregnant women with GDM.

Keywords: pregnancy, phosphatidylserine, flow cytometry, Annexin, erythrocytes.

Archived: https://doi.org/10.5281/zenodo.14423811

Bone resorption marker RANKL in the diagnosis and treatment of patients with maxillary sinus cysts

V.О. Shkorbotun, Y.S. Nachesa — Mon, 30 Sep 2024 00:00:00 +0300

Background. RANKL (Receptor Activator of Nuclear Factor Kappa-B Ligand) is a protein belonging to the tumor necrosis factor superfamily serving as a specific marker for osteoclast activation and osteolysis.

Aim. To determine RANKL levels in the homogenates of Maxillary Sinus Cysts (MSC) at the time of their removal, investigate the correlation of these indicators with the presence of pathology in the upper row of projection teeth in the respective patients, and refine the timing for potential dental implantation or sinus lifting after sinusotomy based on these findings.

Materials & Methods. The study included 25 patients aged 20–65 years who underwent surgical treatment for MSCs located on the inferior wall of the sinus. The research methods comprised general clinical, otorhinolaryngological, radiological, and pathohistological techniques and Enzyme-Linked ImmunoSorbent Assay (ELISA) for RANKL in the tissues of the removed cysts. Pathohistological examination revealed retention cysts in 11 patients and pseudocysts in 14 patients. The presence of dental pathology and active odontogenic processes at the time of cyst removal was established based on prospective clinical and radiological evaluations. The dynamics of mucoperiosteal defect regeneration in the MSC, considering RANKL levels, were assessed 3–6 months post-surgery.

Results. In the postoperative period, 8 (32%) out of 25 patients exhibited odontogenic alteration processes in the tissues of the maxilla adjacent to the cysts. The RANKL concentration in these patients was [80.65±34.22] pg/µg of protein, while in the other 17 patients without signs of bone damage, it was [33.10±4.35] pg/µg of protein (p<0.05). The threshold RANKL concentration distinguishing these groups in this study was 51.50 pg/µg of protein.

Conclusions. In patients with peri-apical bone changes in the maxilla in the projection area of the cysts (alveolar recess), the RANKL level in their homogenates is higher compared to patients without such pathology. Measuring RANKL levels in the homogenates of cysts removed during endonasal maxillary sinusotomy can serve as an additional indicator for planning postoperative dental treatment in these patients.

Keywords: ENT-pathology, endoscopic rhinosurgery, histology, postoperative period, paranasal sinus x-ray, treatment.

Archived: https://doi.org/10.5281/zenodo.14294192

Justification of the model of optimized system of providing palliative and hospice care to the population of Ukraine

V.G. Nesterenko, J. Burzyńska — Mon, 30 Sep 2024 00:00:00 +0300

Background. National systems of Palliative and Hospice Care (PHC) are an important part of holistic systems of public health care. According to ratings (modified Wright М., Lynch T. and Clark D. country rating system, 2008/2011; Quality of Death Index, 2015), the PHC system of Ukraine is such that it does not have signs of systemic organization at the state level, provides low coverage of treatment and care of palliative patients (approximately 30% of the need) and the low quality of treatment (especially analgesia) of predominantly the majority (nearly 80%) of the covered patients.

Aim. To substantiate the model of the optimized PHC system of Ukraine on the basis of the generalized experience of countries with developed PHC systems and the results of own scientific research; evaluate the developed model.

Materials and methods. System analysis and comparative methods were used in the study. To evaluate the developed model, a sociological method was used: a survey of specialists in the organization of health care and PHC was carried out. The results of the survey are evaluated on a quartile scale (Q₁–Q₄).

Results and conclusions. A model of the optimized system of providing PHC to the population of Ukraine was developed, which outlines the subjects and objects of management, the goal, strategy, tactics, functions of the improved management system, directions, methods, measures, resources, and the system of scientific regulation. Scientific, legal, economic and administrative solutions are proposed to improve the existing order of PHC organization. According to the parameters of reasonableness and consistency, the model was recognized by experts as high-quality (the assessment is within Q₄[75–100]%). By parameters predictability, correlativeness and resistance to changes, as well as according to the general assessment, the model is recognized by experts as high-quality (the assessment is within Q₃[50–75]%). The evaluation of the developed model allows us to propose it for use in the organization of health care in the conditions of long-term reform of the health care system and the uncertainty of wartime.

Keywords: health care system reform, qualimetry, expert assessment.

Archived: https://doi.org/10.5281/zenodo.14289493

Motivational and regulatory instruments of valeological education

Mon, 30 Sep 2024 00:00:00 +0300

Background. The competence-based approach is a condition for the implementation of higher education in Ukraine and the world. The list of competences that must be formed in university graduates includes health-saving. But there are obstacles to fulfilling the requirements of the standards in the form of imperfect practical pedagogical realization of competence formation.

Aim. To identify motivational and regulatory tools of non-medical education, the use of which is approved in the scientific-pedagogical environment, regulated by the legislation of Ukraine and effective in achieving the result of forming valeological competence, provided for by the standards of higher non-medical education of Ukraine.

Materials and Methods. The research was conducted using the system analysis method and the bibliosemantic method. The research is based on twenty years’ experience in forming valeological competence in students of non-medical universities in the city of Kharkiv by means of teaching special valeological disciplines. The study does not describe these empirical studies, but only uses their findings.

Results and Discussion. As a result of the theoretical research, it has been established that the competence principle of education is not actually implemented in higher education, and in the course of forming valeological competence in particular. This happens because of the lack of mechanisms for evaluating personal components of competences. It is proposed to consider the student’s main motivation in forming valeological competence as his/her desire to be healthy. Individual and organizational regulatory tools of valeological education are defined. They are as follows: typical curricula and textbooks for valeological education of students at non-medical universities, development of criteria for recalculating the evaluation of forming motivation and other personal components of competences for assessment in ECTS points.

Keywords: valeological competence, health-saving competence, "Health Pedagogy", "Fundamentals of Medical Knowledge and Health-Saving", higher education standards, competences formation assessment.

Archived: https://doi.org/10.5281/zenodo.14181706

Vasyl Yakovych Danylevskyi's lecture on the doctor, the patient, and the successes of medicine (1921): annotated translation

Mon, 30 Sep 2024 00:00:00 +0300

Unlike a mechanic, before a doctor there is a living person with all the manifestations of his rights and feelings, with a painful soul, with aggravated egoistic currents. The public easily forgives major failures and blunders of a quack but it will not forgive a doctor. The doctor's duty is to forget about his personal troubles for the sake of his weak patient and to instill in him cheerfulness, spiritual fortitude, and optimistic expectations. The patient must trust the doctor and respect him already in view of such self-denial for the sake of helping his neighbor. In functional nervous disorders, the doctor can limit himself to psychotherapy only. A family doctor disposes to greater respect and trust. A thorough knowledge of all medicine is absolutely necessary for any specialist doctor. A doctor is obliged to serve public health – to supervise schools, factories, markets, railways, etc. The successes of scientific medicine are not always familiar to the uncultured public due to their insufficient popularization by doctors. But over the past 50 years, scientific medicine and medical practice have made colossal progress: local and general anesthesia for operations has been developed, antisepsis and asepsis are carried out, organ transplant operations are performed, vaccinations against cholera and bubonic plague in humans have been introduced, a new science has been created – medical bacteriology, pathogenic microbes have been studied in many diseases, a successful fight against epidemic contagious diseases is carried out, diagnostic reactions to typhoid fever, syphilis, Pasteur institutes have been established; fluoroscopy is carried out; chemotherapy, salvarsan has been invented for the treatment of syphilis and relapsing fever; the therapeutic use of light rays and electrotherapy has begun; study of immunity, innate and acquired, anaphylaxis, study of immunity, innate and acquired, anaphylaxis, scientific psychiatry and psychotherapy is being developed, etc.

Keywords: patient, social hygiene, superstition, scientific discoveries.

Archived: https://doi.org/10.5281/zenodo.14210834