Inter Collegas

Pathomorphosis of eyelid tumor pathology in demodectic infection

Sun, 31 Mar 2024 00:00:00 +0200

Background. Pathological changes in the tissues of the oculo-conjunctival region caused by the activity of the Demodex mite is represented by the development of inflammatory process. On detection of the parasite on eyelashes, the presence of the Demodex mite is diagnosed in half of adult patients seeking ophthalmic care. Pathomorphological descriptions of specific patterns associated with the presence of Demodex infection are practically absent. During pathological examination, in the vast majority of cases it is almost impossible to see the parasite in the test material. There are pathomorphological patterns associated with the presence of the mite as a commensal, not only on the eyelid surface or in the conjunctiva, but also in morphological structures formed against the background of pathological processes in this area.

Aim. To find out the morphological patterns reflecting the pathomorphosis of some tumor processes in the eyelid thickness caused by demodectic invasion, which have not been identified so far in ophthalmopathological studies.

Materials and Methods. We analyzed the archival material from the oculo-conjunctival region submitted to the ocular pathology laboratory within the period of 2020–2023. Surgical and biopsy specimens were processed by standard histologic methods.

Results. One of the pathognomonic patterns of demodecosis are calcifications with fragments of the dead mite and cysts. When a mite rapidly destroys tissue, it leaves the site until it dies without retaining its fragments. Post-demodecosis pathomorphosis in basal cell carcinoma of the eyelids complicates the pathomorphologic diagnosis of the biopsy.

Conclusions. Our results prove the presence of mites in tumor tissues and illustrate their influence on the development of the pathomorphological picture, which should be taken into account in the practical activity of a pathologist.

Keywords: demodex mite, pathomorphology, ophthalmopathological examination, oculo-conjunctival region.

White-coat hypertension: ways of optimizing the provision of medical aid (literature review)

I.V. Letik, Zhuravlyova L.V., M.V. Filonenko, V.O. Klimashevska — Sun, 31 Mar 2024 00:00:00 +0200

In press

Background. White-coat hypertension is a controversial issue of a modern cardiovascular medicine. It is a common condition in clinical practice, in which office blood pressure is elevated while out-of-office measurements (ambulatory or home) are normal.

The aim of this review is to address a number of issues related to white-coat hypertension, in particular, its definition, prevalence, etiology, symptoms, and consequences, emphasizing the need to improve diagnosis, management and prognosis of this disease.

Results. Recent studies demonstrate that white-coat hypertension is associated with cardiovascular risk factors, including the progression to sustained hypertension and the development of target organ damage. Timely and accurate diagnosis of white-coat hypertension is incredibly important as it allows postponing its conversion to sustained hypertension and prevents alterations of target organ structure and function. The need for improved patient-doctor interaction to enhance diagnosis and management of white-coat hypertension cannot be overstated. Other measures include exploring standardized measurements, improving communication and relationship establishing between physicians and patients, as well as investigating innovative interventions such as health education and telemedicine. The importance of the understanding of the emotional components contributing to white-coat hypertension are highlighted and strategies to improve patient outcomes through early diagnosis, reduced anxiety, and optimal healthcare experiences are proposed.

Conclusion. A comprehensive approach, encompassing standardized measurements, improved communication, and innovative interventions, is essential for effectively managing white coat hypertension.

Keywords: blood pressure, cardiovascular risk, communication, healthcare, anxiety.

Plasma and platelets amino acids in coronary artery disease and atrial fibrillation patients – are they linked?

I.O. Melnychuk, M.L. Sharayeva — Sun, 31 Mar 2024 00:00:00 +0200

In press

Introduction. The impact of circulating amino acid levels and their combinations on the pathogenesis of ischemic heart disease and atrial fibrillation is a current issue, otherwise, the platelets amino acid spectrum is still under discussion, despite the known pathogenetic role of platelets in these disorders.

Aim. To compare changes in the plasma and platelets amino acid spectrum in patients with coronary artery disease and atrial fibrillation as well as to find their connections.

Materials & Methods. 300 patients were divided into 3 groups: I group – 149 patients with coronary artery disease without arrhythmias, II group – 124 patients with coronary artery disease and atrial fibrillation paroxysm, and the control group – 27 patients without coronary artery disease and arrhythmias. Plasma and platelet amino acid levels were detected by means of ion exchange liquid column chromatography.

Results & Conclusions. In platelets amino acid spectrum, a significant rise in leucine (12.63%), isoleucine (10.73%), and Fishers’ ratio (6.37%); a decrease in threonine (23.05%), valine (30.83%) levels, glycine (32.21%), serine (5.06%), and glycine+serine sum (20.51%) in group 2 patients was found compared with group 1, p<0.05. In the plasma amino acids spectrum, a significant increase in glutamate, branched-chain amino acids, and Fishers’ ratio and a decrease in glycine in group 2 patients was checked in comparison with group 1, p<0.05. Only 10 moderate strength correlations were revealed between the plasma and platelets amino acid spectrum of investigated patient’s groups. These changes in platelets and plasma amino acids spectrum were not significantly congruent in patients with coronary artery disease and atrial fibrillation. Plasma and platelets amino acid spectrum should be analyzed separately in patients with coronary artery disease and atrial fibrillation for further studies and evaluation of new prognostic markers and pathogenetic clues to their development.

Keywords: myocardial ischemia, heart rhythm violations, proteins, metabolomics.

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

I.V. Andrusovych — Sun, 31 Mar 2024 00:00:00 +0200

In press

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.

Archived: https://doi.org/10.5281/zenodo.12582880

The preventive direction of modern theories of health and health-saving in public health and education

A.S. Shevchenko, V.V. Shevchenko, G.W. Brown — Sun, 31 Mar 2024 00:00:00 +0200

In press

Background. The modern understanding of health is related to the need to prevent diseases caused by infections, lifestyle, environmental and genetic factors. Ukrainian legislation guarantees health care, but the practice of implementing laws is imperfect. The teaching of valeological disciplines in educational institutions is of great importance for the prevention of diseases. But the content of these disciplines requires constant revision from the point of view of evidence-based medicine, and the creation of new preventive programs requires theoretical justification.

Aim. To determine the content and practical significance of the modern understanding of health care in public health care and education.

Materials and Methods. Methods of bibliosemantic and system analysis were used.

Results. The theory of health and health-saving is considered using cross-cultural, discursive, norm-centric, phenomenological, holistic, axiological and integral approaches, from the perspective of evidence-based and "4P" medicine. Health-saving is shown as derived from a healthy lifestyle and valeological competence formed in the population. The best environment for the formation of a healthy lifestyle is shown to be an educational environment, the tools of formation are valeological disciplines and education of medical and social non-government organizations. The need for joint efforts of the population and medical workers to achieve better results in the prevention of socially significant diseases is determined.

Conclusions. Improvement of the preventive direction of valeological education is closely related to the competence approach, in particular, with the formation of valeological competence. The public health system should use the potential of educational valeological programs to form a healthy lifestyle in new generations during their studies at higher education institutions. For the formation of high-quality valeological programs, a permanent partnership of educators and medical professionals is necessary.

Keywords: valeological competence, evidence-based medicine, 4P medicine, Health Pedagogy.

Retrospective analysis of the construction of the national system of hospice and palliative care in Great Britain

V.M. Lekhan — Sun, 31 Mar 2024 00:00:00 +0200

In press

Today, Great Britain has one of the best hospice care systems for palliative patients in the world, which leads to interest in the path of building a Hospice and Palliative Care (НPC) system in this country. The hospice care system is mainly financed by the volunteer sector, which indicates a significant development of the state-society partnership in the organization of НPC. The national НPC system consists of inpatient care, day palliative care, care in the community and emergency hospitals. 2004–2008 is considered the key moment in the formation of the country's НPC system, which will be the focus of this study. For specialist palliative care, the National Health Service of Great Britain allocated almost £50 million a year in those days until 2004. At the same time, volunteer support was about 4 times greater. More than 220 volunteer support groups for palliative patients operated in the country. The success of building a national НPC system is described in the Palliative Care White Paper. A number of interrelated national programs may be used as a standard of palliative care in 20 years by many other countries. The development of the НPC system has influenced the British homes for the elderly, the system of primary care, the attitude to the НPC problem of doctors, local communities and society as a whole, increased the quality and availability of palliative care. Palliative care since those years has been provided 24/7, managed by coordination centers located outside medical facilities and hospices. High national НPC standards and mechanisms for monitoring their compliance have been created. Narcotic analgesia for palliative patients with chronic pain, the necessary medical, psychological, social and spiritual care is mostly available. The public debates the question of a dignified death without restrictions. The value for money of НPC is recognized by British society as acceptable. Therefore, studying the British experience of НPC organization as one of the "best practices" is useful for other countries with less developed НPC systems.

Keywords: "best practices", place of death, palliative care quality standards.