Age-related relationship between the development of hyperplastic processes and VEGF expression in endometrial cells

The existence of a clear tendency to increase the prevalence of hormone-dependent diseases and endometrial cancer against the background of increasing the frequency of their occurrence and rejuvenation of the age of manifestation leads to the search for new possible markers of diagnosis and prognosis of the development of pathological process. Angiogenesis is one of the forms that lead to the formation of new blood vessels, with an increased metabolic need for perfusion of existing vessels. The vascular endothelial growth factor family (VEGF) is a protein that is the major inducer of angiogenesis. The objective: To study the expression of VEGF in endometrial cells in proliferative, hyperplastic, atrophic states at women’s different ages. Materials and methods. A retrospective analysis of medical records of the pathohistological bureau for the period 2014-2016 was conducted. 2196 pathomorphological findings of endometrial tissue specimens have been examined. Estimation of VEGF expression was performed in 417 endometrial specimens, in the cohorts of the study: in the reproductive, perimenopausal, postmenopausal periods, respectively, in groups with physiological endometrial proliferation phase, hyperplastic, atypical, atrophic endometrium. The results were statistically processed. Results and discussion. Analyzing the data presented, higher VEGF expression was detected in atypical hyperplasia in all age categories, but it was likely that higher rates were established in the postmenopausal period, with atypical endometrial hyperplasia, suggesting physicians' alertness to the process in this category. Probably low were indexes found at atrophic endometrium in this age category, which confirms the endometrial preservation of its growth factors, and in the presence of processes that stimulate the proliferation of the organ, they can trigger at the molecular-genetic level, neoplastic mechanisms. The data of the retrospective analysis confirm the growth of atypical form of hyperplastic processes and their maximum detection in the age categories 41 - 45  and 46 - 50 years old, and the beginning of detection of endometrial malignancy from the age of 46 - 50 years old, with a gradual increase with age. Conclusions. Expression of VEGF level in endometrial tissue cells as an inducer of angiogenesis can be a promising marker for the diagnosis of the risk of proliferative conditions and their prognosis, especially in relation to other markers characterizing immunohistochemical and molecular genetic cellular parameters

Echographical features and fetal biophysical profile at pregnancy complicated by rhesus-factor immunization

Department of Obstetrics and Genecology No 2, National Medical University of Odessa, UkraineBackground: High perinatal morbidity and mortality at newborn hemolytic disease needs new effective diagnostics and prophylactic methods development. Material and methods: 115 pregnant women with Rh-immunization, complicated with fetal anemia development as a main group and 50 pregnant Rh-negative women without antibodies as a control group were examined using ultrasound (Philips HD-11), doppler (100 mHz filter, 3.5-5.0 mHz probe) methods, fetal biophysical profile in real time mode (11AM-2PM). According to immunization severity grade the main group was divided into three groups due to diagnostic cordocentesis results. Results: Most informative non-invasive criterion of fetal anemia diagnostics is the bloodstream maximum systolic speed in medium brain artery increase. These changes accurately correlate with an average or a heavy degree of newborn anemia presence. Sensitivity for the average degree anaemia makes 94%, and specificity – 98%, and the heavy degree anaemia 100% and 99% respectively. Ductus venosus bloodstream change at heavy form hemolytic disease reflects fetal condition deterioration developing on heavy anemia background. Reversed values occurrence speaks about fetal circulatory dynamics decompensation and considerably worsens the forecast for a newborn. The characteristics of the light, average, severe and edematous hemolytic disease forms are described. Conclusions: The obtained results are necessary for perinatal pathology forecasting and early diagnostics at pregnancy, complicated by Rh-factor immunization

Prenatal diagnostics comparative aspects of congenital developmental malformations and chromosomal anomalies with the help of ultrasonic and biochemical screening

Результаты проведенных исследований свидетельствуют, что ультразвуковые маркеры занимают ведущее место в ранней диагностике врожденных пороков развития и хромосомных аномалий. При проведении анализа структуры ультразвуковых маркеров в 1,9 раза чаще отмечено сочетание нескольких по сравнению с изолированными изменениями, хромосомные аномалии выявлены в 13,3 % при изолированных ультразвуковых маркерах и в 9,4 % при сочетании нескольких. Наибольший удельный вес в структуре всех ультразвуковых маркеров принадлежит врожденным порокам сердца (11,7 %), среди них отмечен высокий уровень хромосомных аномалий — 57,1 % при изолированных врожденных пороках и 20,7 % при сочетании их с другими ультразвуковыми маркерами. Полученные результаты необходимо учитывать при разработке алгоритма прогностических мероприятий у женщин с факторами риска.In recent decades there is a tendency of the inherited diseases and congenital abnormalities increase in world population. Due to WHO data the inherited diseases and congenital abnormalities are registered in 5–5.5% of the newborns, 1.5% of them are due to the unfavourable exogenic reasons during pregnancy, others are of mainly genetic nature. The research objective — to study the comparative aspects of the ultrasonic and biochemical screening in fetal congenital developmental and chromosomal abnormalities. Materials and methods. 251 pregnant women and their fetuses were under observation (163 — main group with different fetal congenital anomalies diagnosed during pregnancy or just after labours, comparative group — 88 women with the risk of congenital anomalies but delivered healthy children and 59 — control group — women without risk of congenital anomalies) to perform clinical obstetrical examination, ultrasonic feto- and placentometry in 10–14th, 20–24th and 32–34th weeks of gestation, serum levels of AFP, PAPP and HCG

Academic progress dependence from the students' group unity degree – new effective tool of enhancement

Teaching methods in modern society are constantly updated and improved. Since 2014, the new training exercise “The Human Body” (authored by O.M. Tsilmak and V.V. Artyomenko) was introduced into the educational process of the Odessa State University of Internal Affairs and the Odessa National Medical University. The indicators of academic performance were analyzed in all 44 study groups before the exercise and one year after. The results of the study showed that in 11 experimental groups of students of the University of Internal Affairs, the learning success increased by 23%, and among students of the Medical University by 18%. At the same time, in the control groups of students of the University of Internal Affairs, the success of studies decreased by 5%, and of the Medical University by 9%. Interviewing students about the reasons for improving academic performance, it was found that one of these reasons is group unity around the result of learning activities. Conclusion: The new learning tool — training exercise «The human body" confirmed the hypothesis put forward by us and showed effectiveness and efficiency

Emotional burnout syndrome and medical professions: experience and elevation - evaluation at psychological medical training

The emotional burnout syndrome as a consequence of the individual psychological protection in response to stressful situations is formed gradually over a continuous period of work. Objective: The emotional burnout syndrome occurrence frequency comparative evaluation during psychological medical training of health professionals, residents and students. Materials and methods: The emotional burnout syndrome evaluation was carried out at psychological training during medical simulation with complete anonymity and voluntariness. The training was attended by 327 people with the emotional burnout syndrome diagnosis in 297 persons (91%), using developed by ourselves questionnaire «Evaluation of emotional burnout syndrome». The emotional burnout syndrome levels as a result of responses processing were determined as absence, low, medium and high. The questionnaires were performed in three groups: the first one - 174 sixth year medical students; the second group - 83 different specialities residents; the third one - 70 various specialities physicians. Results: The emotional burnout syndrome absence was surveyed in 122 of the students (70,1%) of the first group; low level - in 43 (24,7%); average level - in 9 (5,2%) of the first group students. In the second group, the emotional burnout syndrome absence was observed only in 19,3% - 16 residents; the low level in 61 persons - 73,5%; the average level was detected in 3,6% - 3 residents. There was no significant difference between the obtained data from the first and second group. The highest level of emotional burnout syndrome with the significant differences when comparing to both the first and second groups was shown among various specialities physicians with high level in 7 of them - 10%; average - in 46 persons (65,7%); low - in 17 physicians (24,3%). During the last several years we studied the subject of health care workers’ efficiency improvement due to the modern training technologies introduction. The medical professionals’ emotional burnout syndrome prevention should be conducted early during undergraduate education at the Medical University. Our experience shows the real possibility of stress-resistance improvement as one of the important professional qualities of a future specialist. Conclusion: Questioning during the psychological medical simulation training is an effective method of emotional burnout syndrome level detection. The emotional burnout syndrome often occurs in practical physicians and is associated with a variety of internal and external factors that require further detailed study. Our experience of psychological training in simulation study shows that it is an effective tool to help physicians who are at risk of emotional burnout syndrome

СИСТЕМА ОЦІНКИ ЛАПАРОСКОПІЧНИХ ЗНАНЬ ТА ЇХ ЗАСТОСУВАННЯ ПРИ СИМУЛЯЦІЙНОМУ НАВЧАННІ

Узагальнені результати навчання з використанням віртуального ендоскопічного симулятора — модуля "Базові лапароскопічні навички" 36 студентів останніх курсів Одеського національного медичного університету. Визначали коефіцієнт самооцінювання (КСО) за анкетами, коефіцієнт практичних умінь (КПУ) за оціночними чек—листами, результуючий коефіцієнт практичних умінь для кожної групи. Ці коефіцієнти виявилися ефективними для загального оцінювання і достовірного обчислення тривалості існування практичних умінь

The new aspects of the fetal growth retardation pathogenesis

Результаты проведенных исследований свидетельствуют, что установленные новые аспекты патогенеза задержки развития плода позволяют объяснить увеличение данной патологии в последние годы, а также недостаточную эффективность общепринятых прогностических и лечебно-профилактических мероприятий. Изменения в продукции ангиогенных факторов роста и вазоактивных компонентов при задержке развития плода выявляются еще на доклинической стадии, задолго до клинической манифестации этого акушерского осложнения и могут служить его скрининговыми маркерами. Полученные результаты являются научным обоснованием для усовершенствования тактики прогностических и лечебно-профилактических мероприятий при задержке развития плода.Results of our research testify that the established new aspects of fetal growth retardation pathogenesis allow us to explain the increase of mentioned pathology during last years, and also insufficient standards in forecasting, treatment and prophylactic methods. The angiogenic growth factors and vasoactive components production changes in fetal growth retardation come to light for preclinical stages, long before obstetrical complications clinical demonstration and can serve as screening markers. The received results are scientific substantiation for tactic improvement at fetal growth retardation forecasting, treatment and prophylactic actions

The medical residents’ communicative competence development: new approach

Nowadays, psychological and simulation training is one of the most advanced technologies to develop and improve existing skills. More and more countries are moving into the training and examining of its medical specialists on a mandatory basis using stated technologies. The important part of those trainings is the non-technical skills development, which are the main tools in establishing contact and trust between physician and patient. Objective: To establish the new complex training efficiency for the medical residents’ communicative competence development

The retrospective analysis results of the endometrial tissue pathological conditions development

Hyperplastic processes of endometrium are one of the most common pathologies of the uterus mucosa, an interest in its study is due to an increase in the frequency of occurrence, the ability to both self-healing and malignancy. Purpose of the study: to investigate the detection rate of endometrial proliferative changes  depending on the age of woman. Materials and methods. A retrospective medical documentation analysis of the Department of Pathology was conducted. 2196 pathologic findings of endometrial tissue samples were investigated. 1404 specimen were hyperplastic states, 688 were endometrial polyps, and 104 others were endometrial states after total or subtotal uterine removal after surgery. Histological conditions were distributed according to patients’ age categories. Results of the study were processed statistically using variation statistics with Student's criterion, using standard computer systems. Results. The analysis shows an increase in frequency of endometrial proliferative changes in perimenopausal patients on the background of endometrial pathological changes detection in all age categories. Atypical forms of simple and complex hyperplasia of the endometrium can be traced in all age categories, with a maximum frequency of manifestation in similar age-related periods – 41–45 years and 46–50 years. Morphological signs of endometrial tissue malignancy were first established in the age group of 46–50 years, which coincides with the age of the onset of menopause in the Odesa region, with subsequent relative increase in the frequency and aggressiveness of the process with age. These age groups focus doctors to be more careful about pathological manifestations. Conclusion. As a result of retrospective analysis of histopathological examinations it was found that the main factor in detecting pathological conditions of the endometrium is a woman's age of perimenopausal period, which can be considered as an early marker of diagnosis, leading to treatment prospects and general therapeutic tactics, for the future diagnostics and detection of others immunohistochemical and molecular genetic markers in women with hyperplastic processes in endometrial tissue

Personality-oriented motives characteristics’ specialties of today’s medical students professional activity

To provide the medical industry with competent specialists, it is important to train motivated applicants in higher medical education institutions who aspire to be highly qualified medical doctors. Educational activity is depended and determined by certain individual psychological characteristics of its subjects, among which the leading place is occupied by motivation