Nevin Manimala

Diagnosis (Berl). 2021 Jun 4. doi: 10.1515/dx-2021-0007. Online ahead of print.

ABSTRACT

OBJECTIVES: Quality control of ultrasonography markers is necessary to ensure greater efficacy of prenatal aneuploidy screening. The aim of this study was to assess the quality of the crown-rump length (CRL) and nuchal translucence (NT) measurement accuracy by the laboratory according to quality indicators.

METHODS: Retrospective observational study on 4,908 single-foetus pregnant women who underwent prenatal aneuploidy screening in the first trimester of pregnancy. Euploid foetuses with CRL between 45 and 84 mm were included, while those with NT≥3.5 mm were excluded. CRL measurement was considered to be accurate if the median multiples of the median (MoM) for pregnancy-associated plasma protein A (PAPP-A) was between 0.90 and 1.10. Fifteen sonographers participated in the study, six of whom comprised the control group. Systematic error for a sonographer was considered when CRL measurement was greater than ±2 mm with respect to the control group. Quality for NT was assured by means of the WHIRI method and each sonographer cumulative sum control chart (CUSUM).

RESULTS: For CRL accuracy, five sonographers underestimated the measurements, while another four overestimated them, with no statistical differences. For smaller sized foetuses, all sonographers met the established specifications. Regarding NT control, three sonographers did not meet the quality criteria for the median MoM. All sonographers met the specifications for the logarithmic standard deviation of the NT MoM levels. Thirteen sonographers met the CUSUM specifications.

CONCLUSIONS: Evaluation of a quality control of ultrasonography parameters by laboratory professionals is necessary to avoid under- or overestimation tendencies for CRL and NT measurements. CUSUM is a useful tool for the immediate correction of errors in NT measurements.

PMID:34090321 | DOI:10.1515/dx-2021-0007

Wiad Lek. 2021;74(5):1256-1261.

ABSTRACT

OBJECTIVE: The aim: Of this research was to investigate the impact of quarantine restrictions on the health care system in Ukraine, quality of providing and accessibility of health care services for population during quarantine; analyze the influence of economic and social outcomes of epidemy on state of health care.

PATIENTS AND METHODS: Materials and methods: For this paper was made a retrospective analysis of COVID-19 morbidity statistics, economic indicators and governmental decrees aimed at resolving the problem of the spreading of coronavirus and ensuring the proper work of medical institutions at all levels of health care. This work includes analysis of data for the period since the beginning of quarantine on the territory of Ukraine in March 2020 till present time.

CONCLUSION: Conclusions: The complexity of the socio-political and economic situation in Ukraine and the conduct of hostilities in the east of the country have significantly complicated the fight against the spread of coronavirus in the country. Negative changes in the indicators of hospital security were observed both at the secondary level – treatment of patients with COVID-19, and the primary level – primary contact with the patient, primary care, prevention measures. In the long run, this will have significant implications for the individual health of those who have not been able to receive quality care, as well as for public health in general.

PMID:34090301

Wiad Lek. 2021;74(5):1241-1244.

ABSTRACT

OBJECTIVE: The aim: The aim of the research is to determine and systematize administrative and medical measures aimed at curbing cholera in the city of Kharkiv in the time of the Russian Empire, to assess the relevance of the experience in fighting the disease, to determine the impact of epidemics and anti-epidemic measures on Kharkiv residents’ public health.

PATIENTS AND METHODS: Materials and methods: General scientific and specific historical methods were used, and methods of related sciences were applied as well. The main methods of historical research included, in particular, historical analytical, chronological and comparative historical; methods of medical statistics, etc. The historiography of the issue was analyzed, unpublished archival materials, local press were studied.

CONCLUSION: Conclusions: Despite the progress made, mortality remained high in general, proving the public health system had to be reorganized. The death rate shocked the local community so much that the authorities had to apply an information blockade. Anti-epidemic components included explanatory work by priests and police, sanitary measures, measures on strict compliance with observation and quarantine, food supplies to the blocked city and free medicine dispensation, involvement of all available medical institutions, and the establishment of special temporary facilities, actual mobilization of medical personnel. It was impossible to act in the other way, because the treatment methods seemed to be ineffective, like today, under the COVID-19 pandemic. When the medical component is proved ineffective in fighting the epidemic, relatively effective administrative measures, tried and tested over the centuries reasonably seem to be useful, and this experience has not lost its relevance.

PMID:34090298

Wiad Lek. 2021;74(5):1229-1236.

ABSTRACT

OBJECTIVE: The aim:TostudyandanalyzeSumy region population morbidity dynamics taking into account current stage of medical reform. Sumy region here is represented as one of the main agricultural regions of Ukraine. The prevalence of ENT disorders (otolaryngologic diseases) was studied.

PATIENTS AND METHODS: Materials and methods: During the study we used data of statistical report of Public Health Board, Sumy State Administration for the period from 2015 to 2019 years by administrative territories. Obtainedresults wereprocessed, usinggeneral statistics methodsandanalyzed, usingstructural-logicalanalysis.

CONCLUSION: Conclusions: The study found that the morbidity rates of ENT disorders in adult population during the study period increased and had levels of 2113.0 and 122.1 per 100 thousand adult population, respectively, and the prevalence rates and the prevalence rates ofENT disorders among the adult population decreased , respectively to 167.7; 2113,0; 665.1 and 389.9. All indicators have reliable differences in terms of administrative territories of the region. The results of the study should be taken into account in the process of reforming the otolaryngological service in the region.

PMID:34090296

Wiad Lek. 2021;74(5):1222-1228.

ABSTRACT

OBJECTIVE: The aim: Conducting a comprehensive analysis on ensuring the mechanism of state regulation of the development of medical emergency response as an element of the civil protection system of Ukraine in the context of dynamic changes of external and internal factors of its functioning.

PATIENTS AND METHODS: Materials and methods: The data of the state statistical reporting for the period 2010-2019 and the legislative acts of Ukraine on medical emergency response were used as the materials of study. Bibiliosemantic and statistical method and the method of structural-and-logical analysis were applied in the course of study.

CONCLUSION: Conclusions: The sustainable socio-economic development of Ukraine should be accompanied by the formation of a safe environment for the society and each individual, guaranteeing an acceptable level of risk and a modern security system based on the principles of international law. The high degree of the Ukrainian industry concentration is currently in a conflict with the low technological discipline of production, which creates objective preconditions for the growth of man-made and technologically-environmental disasters, catastrophes, and other emergencies. Outbreaks of particularly dangerous and infectious diseases, which are of concern not only because of their prevalence but also because of the potential danger to the health of the nation, its economy and international reputation of the state can pose a significant threat to the socio-political and socioeconomic stability of the state. Ukraine is a potentially vulnerable area for epidemics due to a number of natural, geographical and geopolitical factors. Therefore, the health consequences (real and potential) of any emergency are certainly a threat to the national security of Ukraine both directly and due to the extremely negative impact on the socio-economic, socio-political and psychological conditions of the population. Increasing the level of public administration for medical emergency response will increase the effectiveness of emergency response measures.

PMID:34090295

Wiad Lek. 2021;74(5):1219-1221.

ABSTRACT

OBJECTIVE: The aim: Study and analysis of the epidemiological situation of malignant neoplasms of the respiratory system at the regional level during 2015-2019.

PATIENTS AND METHODS: Materials and methods: The study was based on the analysis of data from the state statistical reporting(forms №7, №35 – healthy) and the database of the National Cancer Registry during 2015 – 2019, which was approved by the conclusion of the bioethics commission of Uzhhorod National University (protocol №2/2 of 15.02.2021).

CONCLUSION: Conclusions: The study found an increase in the level of malignant neoplasms of the respiratory system by 17,28%, as well as the uprise in the proportion of malignant neoplasms of the respiratory system in the structure of all tumours, by 11,98%; detection of malignant neoplasms of the respiratory organs in the late stages; the predominance of the death rate of men from MT over women, as well as mortality rate of the respiratory organs MT up to 1 year from the moment of diagnosis among men is higher over women.

PMID:34090294

Wiad Lek. 2021;74(5):1213-1218.

ABSTRACT

OBJECTIVE: The aim: To clarify the importance of the need to involve medical professionals, as experts, in the conduction of the investigative actions during the pre-trial investigation of certain types of crimes.

PATIENTS AND METHODS: Materials and methods: This research is based on the general laws and categories of the Cognition theory and on the framework of materialistic dialectics; it uses a comprehensive approach to the study of the problems under consideration, applies systematic, statistical, historical, legal and comparative legal methods.

CONCLUSION: Conclusions: The need to use specialized medical knowledge depends not on a certain type of crime, but on the specific circumstances of the committed criminal offense. Based on theoretical and practical frameworks, the reasonable practical significance of using specialized medical knowledge during a pre-trial investigation expands and deepens the possibilities of procedural evidence, contributes to the rapid and complete crime disclosure, exposing the wrongdoers and making the right decisions in criminal proceedings.

PMID:34090293

Wiad Lek. 2021;74(5):1200-1203.

ABSTRACT

OBJECTIVE: The aim: The objective of the study was to analyze the frequency of Arg16Gly polymorphism in the β2 -adrenoceptor (β2 -АR) gene in patients with bronchial asthma (BA) and to assess the association of the polymorphism with BA risk.

PATIENTS AND METHODS: Materials and methods: We examined 553 BA patients and 95 apparently healthy individuals. Arg16Gly polymorphism in the β2 -АR gene (rs1042713) was determined using polymerase chain reaction-restriction fragment length polymorphism analysis. Statistical analysis of obtained results was performed using SPSS-17 program.

RESULTS: Results: It was established that distribution of Arg/Arg, Arg/Gly, and Gly/Gly genotypes for Arg16Gly polymorphism in the β2 -АR gene was 44.2%, 40.0%, 15.8% in the control group vs. 31.3%; 45.7% and 23.0 among BA patients, respectively (χ2 = 6.59; р = 0.037). No significant difference was observed with regards to the distribution of genotypes for Arg16Gly polymorphism in the β2 -АR gene in men and women controls (χ2 = 4.05; р = 0.13) and BA patients (χ2 = 4.34; р = 0.11). BA risk was 1.74 times higher in the minor allele carriers (Arg/Gly + Gly/Gly genotypes) for Arg16Gly polymorphism in the β2 -АR gene.

CONCLUSION: Conclusions: Analysis of Arg16Gly polymorphic variants in the β2-AR gene showed a statistically significant difference in the distribution of Arg/Arg, Arg/Gly, and Gly/Gly genotypes in patients with BA and apparently healthy individuals due to the higher frequency of Arg/Arg genotype in controls and higher frequency of Gly/Gly genotype in patients with asthma. No difference with regard to gender was found in the distribution of genotypes.

PMID:34090290

Wiad Lek. 2021;74(5):1196-1199.

ABSTRACT

OBJECTIVE: The aim: Is the analysis of chronic kidney disease risk in patients with arterial hypertension and coexistent hyperuricemia.

PATIENTS AND METHODS: Materials and methods:We observed 40 patients with arterial hypertension and coexistent hyperuricemia (I group), 35 – with arterial hypertension (II group) and 30 practically healthy people (control). The duration of hypertension was 4,3 ± 2,31 years and 4,0 ± 2,11 years (p = 0,9247) for I and II group respectively, of hyperuricemia – 4,1 ± 0,35 years for I group. Categories of albuminuria (А1, А2, А3) and glomerular filtration rate (G1, G2, G3A, G3B, G4, G5) were determined in all observed patients. Clinical, anthropometric, biochemical, immunoassay, statistical (SPSS 21, Graph Pad) methods were used.

RESULTS: Results:The categories of albuminuria and glomerular filtration rate in patients from the I group demonstrated that A1G1 was confirmed in 3 persons, A1G2 – 5, A2G1 – 7, A2G2 – 20, A1G3A – 1, A1G3B – 1, A2G3A – 2, A2G3B – 1. Among patients from the II group category A1G1 was defined in 7, A1G2 – 2, A2G1 – 16, A2G2 – 10 persons. The percent of low chronic kidney disease risk was on 5,7 % higher in hypertensive persons comparable with comorbid persons. High and very high risk was confirmed in 10 % persons from I group and nobody from the ІІ group.

CONCLUSION: Conclusions:Chronic kidney disease risk is increased in patients with arterial hypertension and coexistent hyperuricemia. This indicates an association between elevated uric acid levels and chronic kidney disease progression.

PMID:34090289

Wiad Lek. 2021;74(5):1174-1179.

ABSTRACT

OBJECTIVE: The aim: The work was aimed to study the histological, morphometric and planimetric features of skin regeneration in mature rats with chronic hyperglycemia under the influence of platelet-rich plasma.

PATIENTS AND METHODS: Materials and methods: 60 mature white laboratory rats were used. The animals were divided into three groups (I – control with mechanical skin injuries; II – rats with chronic hyperglycemia and modeled mechanical skin injuries; III – animals with the chronic hyperglycemia and modeled mechanical skin injuries which were injected with the platelet-rich plasma). The samples were studied using light microscopy.Statistical data processing was performed using SPSS-17.

RESULTS: Results: On the 21st day, the epithelialization of control mature rats wound was almost complete. The epithelium contained all layers without pathological changes. The new dermis has been reorganized into papillary and reticular layers. On the 21st day, the wound of rats with chronic hyperglycemia was not completely covered with the epidermis. The connective tissue of the dermis was disorganized. On the 21st day, the wound epithelialization was also more complete in mature rats with chronic hyperglycemia received platelet-rich plasma compared to the rats with chronic hyperglycemia. The dermis contained a large number of blood vessels with normal, full-blooded lumens.

CONCLUSION: Conclusions: The chronic hyperglycemia leads to disruption of epithelialization processes, angiogenesis, a delay in the reorganization of dermis connective tissue, and vascular remodeling. The injections of autologous platelet-rich plasma promote faster angiogenesis, reduce inflammation, and accelerate wound epithelialization.

PMID:34090286