Inter Collegas

Efficient use of non-steroidal anti-inflammatory drugs for treatment of joint pain in the practice of physicians and pharmacists

V.M. Meretskyi, I.V. Meretska, S.V. Redko — Tue, 31 Dec 2024 00:00:00 +0200

In press

Background. Due to the prevalence of dystrophic degenerative diseases, the annual increase in the number of visits from young and middle-aged patients leading an active lifestyle, and the growing frequency of traumatic injuries of various origins, the problem of joint pain is particularly relevant.

Aim. To investigate the main factors influencing the effective and safe use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) in the treatment of joint pain syndrome.

Materials & Methods. Using the developed questionnaire, patients with articular pain syndrome were interviewed about the safety and rational use of NSAIDs.

Results & Conclusions. It was found that most often, people of working age with moderate intensity of pain syndrome sought medical care for joint pain. In one third of respondents, pain was accompanied by impaired motor activity in the joint. The largest proportion of respondents used oral systemic NSAIDs to reduce pain (46.7%), mainly non-selective сyclooxygenase inhibitors. A small proportion of patients (13.3%) who used NSAIDs topically preferred diclofenac, ibuprofen, and ketoprofen in the form of ointments and gels. 16.7% of respondents increased the dose of the drug on their own to achieve the desired therapeutic effect. 26.7% of patients simultaneously used several drugs from the NSAID group. However, the majority of the surveyed patients (63.3%) were not informed about the possibility of side effects associated with these drugs. A wide range of modern NSAIDs, a variety of dosage forms, high frequency and duration of use, and the potential risk of side effects require individual prescribing of drugs in this group. Prescribing timely and adequate treatment with a fast, effective and safe pain reliever remains an urgent issue in the daily practice of physicians and pharmacists.

Keywords: dosage form, side effects, gastropathy, selectivity.

Archived: https://doi.org/10.5281/zenodo.14756968

Evaluating liver fibrosis: the role of elastography and FibroTest in patients with non-alcoholic fatty liver disease and insulin resistance

O. Kozak — Tue, 31 Dec 2024 00:00:00 +0200

In press

Background. Non-Alcoholic Fatty Liver Disease (NAFLD), a common chronic liver disease, is often associated with Insulin Resistance (IR), which accelerates fibrosis progression. As NAFLD prevalence rises, understanding IR's role in liver damage is crucial. Non-invasive methods like elastography and FibroTest help assess fibrosis severity but remain underexplored in NAFLD patients with IR.

Aim. To compare liver elastography and FibroTest results in patients with isolated non-alcoholic fatty liver disease and NAFLD with insulin resistance, assessing fibrosis differences and the effect of comorbidity on disease progression.

Materials and Methods. NAFLD patients were divided into two groups: isolated NAFLD, and NAFLD with IR. Liver stiffness was measured via elastography, fibrosis levels via FibroTest, and laboratory markers (including ALanineaminoTransferase (ALT), ASpartateaminoTransferase (AST), protein metabolism) were analyzed to evaluate liver function

Results. Patients with NAFLD and IR had significantly higher elastography values (10.5 kPa vs. 6.2 kPa in isolated NAFLD). ALT and AST levels were elevated in the IR group (ALT 65 U/L, AST 59 U/L), while protein metabolism indicators were lower, reflecting greater liver dysfunction. Strong correlations were found between elastography and ALT (r=0.844) and AST (r=0.822). FibroTest scores were higher in the IR group (0.78 vs. 0.58 in isolated NAFLD), indicating more advanced fibrosis.

Conclusions. IR accelerates fibrosis in NAFLD, with elastography and FibroTest effectively differentiating fibrosis severity. These findings support their use in clinical practice for improved assessment and management, particularly in NAFLD patients with IR. Further research is needed to refine treatment strategies.

Keywords: steatosis, metabolic syndrome, sheer-wave elastography, MAFLD.

The problem of managing patients with community-acquired pneumonia combined with COVID-19 in comorbid conditions (literature review)

N.O. Skorokhodova, I.M. Fushtei — Tue, 31 Dec 2024 00:00:00 +0200

In press

Background. The unprecedented in the history of mankind problem of COronaVIrus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2), having raised a huge number of fundamental questions about the pathogenesis of pneumonia.

Aim. To analyse the features of community-acquired pneumonia in COVID-19, markers of inflammation, the impact of comorbidities, and the implications for improving diagnosis and treatment in patients with comorbidities according to the professional literature.

Materials and Methods. We analyzed the literature on community-acquired pneumonia associated with COVID-19 in comorbid conditions. The search for scientific information was carried out using the scientific databases Scopus, Pub Med, Web of Science, Google Scholar.

Results. The analysis of the literature showed that the diagnosis of community-acquired pneumonia in COVID-19 requires the use of modern polymerase chain reaction platforms to verify the SARS-CoV-2 virus, atypical bacterial pathogens, fungal flora and determine drug resistance. SARS-CoV-2 pneumonia is characterized by the development of radiological patterns that can only be detected by Computed Tomography (CT) of the chest. Digital software processing of CT images allows to determine the dynamics and stage of development of pneumonia in COVID-19, to assess the effectiveness of treatment and the presence of residual changes. Community-acquired pneumonia provokes the development of hypercoagulability, but the likelihood of developing thrombosis in pneumonia with COVID-19 is much higher, which requires additional research and medical correction.

Conclusions. The role of the outpatient stage of medical care is important in increasing patient adherence to timely diagnosis, treatment and prevention of chronic diseases, which can contribute to the benign course of community-acquired pneumonia in COVID-19 and reduces the risk of death.

Keywords: inflammatory markers, thrombosis, comorbidities, coronavirus disease.

The study of gastrointestinal distress markers in children of gestational age less than 32 weeks with pathological conditions of the newborn period

O.S. Godovanets, Yu.M. Nechytailo — Tue, 31 Dec 2024 00:00:00 +0200

In press

Background. Feeding intolerance in preterm infants is currently one of the most common clinical problems in neonates, causing a delay in complete enteral absorption of food components and may lead to prolonged hospitalization. Prevention and control of nutritional deficiencies in children play an important role in improving the survival rates of premature babies.

Aim. To study the clinical and paraclinical features of food intolerance in premature babies under 32 weeks of gestation in perinatal pathology.

Materials and Methods. Clinical and paraclinical features of gastrointestinal disorders in perinatal pathology were analyzed in 54 severely preterm infants (group 1); the control group included 50 conditionally healthy newborns at 34–36/6 weeks gestational age (group 2). Laboratory tests included a biochemical analysis of blood serum, which characterizes the functional state of the hepatobiliary system and pancreas, as well as coprofiltrate parameters. Statistical analysis of the data was carried out using Statistica 13.0 (StatSoft Inc., USA). Quantitative values in samples with normal distribution were assessed using Student's t-test, with statistical significance p<0.0001. Approval of the Bioethics Commission of the Bukovinian State Medical University (Protocol No.2 on February 9, 2015).

Results. The clinical criteria for nutritional deficiency, which have shown their significance in the course of studies in newborns, are as follows: residual gastric volume greater than 50%, regurgitation and vomiting, enlarged liver, including hepatolienal syndrome; flatulence, blood in coprofiltrate, acholic stools, jaundice, edema, endotoxemia. The detected changes in blood chemistry parameters confirming enteral nutrition deficiency included: increased levels of Alanine Aminotransferase, Aspartate Aminotransferase and Lactate Dehydrogenase (cytolysis syndrome), Gamma-glutamyl Transferase, Alkaline Phosphatase and Bilirubin (cholestasis syndrome); decreased levels of Total Protein with increased levels of Cholesterol (liver and cell failure syndrome); low levels of Amylase, Lipase, Trypsin, and Leucine Aminopeptidase (pancreatic dysfunction); high levels of Calprotectin, Albumin, Alpha-1-Antitrypsin, and Faecal Elastase-1; decreased levels of PMN Elastase (inflammation of the intestinal mucosa).

Conclusions. Our findings demonstrate that the use of set of clinical and laboratory parameters allows early diagnosis of food intolerance in preterm infants, which enables appropriate correction of treatment in perinatal pathology.

Keywords: preterm infants, food tolerance disorders, clinical and laboratory diagnostics.

The state of local humoral immunity of the oral cavity in children from different regions of Bukovina

O.I. Godovanets, A.V. Kotelban — Tue, 31 Dec 2024 00:00:00 +0200

In press

Background. Saliva is an important protective factor in the oral cavity that maintains dental health, promotes enamel demineralization, reduces enamel demineralization and provides local humoral protection. Important components of this environment are lysozyme and secretory immunoglobulin A. Their levels depend on individual characteristics, hygiene and nutrition and make it an important marker for assessing the risk of caries.

Aim. To investigate the state of local humoral immunity of the oral cavity in children by determining the levels of lysozyme and sIgA in the oral fluid.

Materials and Methods. To achieve this goal, we examined 215 children aged 6 years living in Bukovyna. We divided them into observation groups depending on the region of residence and the level of caries intensity.

The state of local immunity of the oral cavity was determined by the levels of sIgA and lysozyme in the oral fluid. The degree of reliability of the results was statistically assessed.

Results. As a result of immunological studies, it was found that under conditions of varying intensity of carious lesions there is a steady tendency to decrease the concentration of lysozyme in the oral fluid of children. The results are the lowest in children from Vyzhnytsia district. In children of Dniеstr district, lysozyme activity is 7.32% higher, and in children of Chernivtsi district – by 15.35% (p˂0.05). The content of sIgA in children of the Vyzhnytsia district was (0.29±0.002) μg/l, which was 6.45% and 12.12% lower than the values of children of the Dniester and Chernivtsi districts (p˂0.05). A decrease in its concentration in the oral fluid correlates with an unfavourable prognosis of the disease.

Conclusions. Thus, we found that in children with carious lesions there were changes in the system of nonspecific humoral immunity of the oral cavity.

Keywords: children, caries, saliva, lysozyme, immunoglobulin.

Analytical study of the leading causes of death of palliative patients

V.A. Smiianov, A. Hubert-Lutecka — Tue, 31 Dec 2024 00:00:00 +0200

In press

Background. Palliative and Hospice Care (PHC) aims to prevent premature death of patients from complications of serious illnesses and their comorbid impact on vital functions. As well as adequate pain relief, treatment should be aimed at alleviating suffering and improving the quality of life of such patients. The causes of death of palliative patients, which are closely related to the PHC organization, in particular to the package budget financing of inpatient and mobile palliative care for adults and children, the leading needs of palliative patients, remain insufficiently studied.

Aim. Analysis of the main causes of death of palliative patients depending on the diagnosis and determination of their impact on the organization of palliative and hospice care.

Materials and Methods. The method of system analysis, comparative method and bibliosemantic method were used for the research.

Results and Conclusions. Causes of death were studied for diseases listed as palliative in severe cases and in the presence of complications. The analysis allows us to deepen our understanding of the practical aspects of organizing palliative and hospice care in meeting the needs of palliative patients, adults and children. The summary of the causes of death allows us to group these causes into organ and system failure; vascular crises; asphyxia; thromboembolic conditions; infectious complications up to sepsis; chronic intoxication; tumor growth in other organs with disruption of their vital functions, metastasis; malignancy of benign tumors; complications of treatment; brain and spinal cord lesions due to epileptic seizures, injuries, inflammatory processes; endocrine comas; gangrene and bedsores; severe immunodeficiency; underdevelopment or absence of organs in congenital malformations; prematurity; suicides in depressive states.

Keywords: palliative and hospice care, primary palliative diagnosis, comorbidity.

Ethics of valeological research in higher education institutions

Tue, 31 Dec 2024 00:00:00 +0200

In press

Background. Teaching valeological disciplines in non-medical higher education institutions is carried out by teachers with pedagogical education, medical education and medical practice (certified physicians). To successfully form valeological (health-saving) competence, the teacher needs to interview non-medical students not only regarding knowledge and practical skills in solving situational tasks using academic tests, but also to study his behavior models, for which special questionnaires with questions on sensitive topics have been developed.

Aim. To develop an algorithm for reliable storage of confidential information regarding the health and behavior of non-medical students studying valeological disciplines.

Materials and Methods. The research was conducted using the sociological method and the system analysis method.

Results and Conclusions. The openness of answers to sensitive questions is ensured only by the confidential storage of the received questionnaire data. For confidential data storage, paper tests-questionnaires should be divided into three parts: a non-confidential test (contains the personal data of the education seeker), a confidential questionnaire (contains an encryption code instead of the personal data of the education seeker), and a code key (contains the code and personal data of students for their identification if necessary to combine the test and questionnaire data). The forced transition to distance learning accelerated the transition to electronic testing-questionnaires and the digitization of paper test-questionnaire data. For confidential questionnaire data storage, encryption of the students’ personal data and separation of access to confidential and non-confidential data using standard scripts of the Google Forms, which allows using confidential questionnaires instead of anonymous ones. For scientific purposes, the questionnaire data is statistically processed as anonymous. If necessary, use standard scripts allows decoding the key data and identifying the students.

Keywords: valeological competence, trusted doctor, "Health Pedagogy", "Fundamentals of Medical Knowledge and Health-Saving", confidential surveys.

Archived: https://doi.org/10.5281/zenodo.14755070