ВІЙСЬКОВА ЕПІДЕМІОЛОГІЯ З ЕПІДЕМІОЛОГІЄЮ НАДЗВИЧАЙНИХ СИТУАЦІЙ : ПІДРУЧНИК / М. А. АНДРЕЙЧИН, О. Д. КРУШЕЛЬНИЦЬКИЙ, В. С. КОПЧА, І. В. ОГОРОДНІЙЧУК ; за ред. М. А. Андрейчина. – Тернопіль : ТДМУ, 2015. – 320 с.

У разі виникнення природних і техногенних катастрофбудуть потрібні значні людські сили й засоби. Тому в лік-відації природних і соціальних катаклізмів провідна рольналежить війську, що діє у тісній співпраці з цивільнимиформуваннями

Influence of mandibular fracture on the dynamics of cytolytic and hepatodepressive syndromes among wounded people with massive external bleeding and usage of a tourniquet

Introduction. Injuries in today's urban society are an urgent problem. In modern trauma, along with the lesion of various anatomical parts of the body increases the frequency of damages of the extremities main vessels with the development of massive external bleeding. Under these conditions, the only way to escape is to apply a tourniquet lasting up to two hours. At the same time in the structure of militant trauma and injuries in peacetime there is a tendency to increase the frequency of injuries of the maxillofacial area. The main cause of the injured people death is the development of systemic disorders with secondary lesions of tissues and organs remote from the site of direct injury. However, the role of mandible fracture in the development of systemic disorders in the case of acute blood loss and ischemia-reperfusion of the limb is insufficiently studied.Purpose: to establish peculiarities of the liver dysfunction indicators among wounded people under conditions of mandible fracture, gunshot damage of the lower extremity soft tissues with massive external bleeding.Materials and methods. Extracts from the electronic database of Medical Cards of inpatients military personnel who were treated at the National Military Medical Clinical Center "General Military Clinical Hospital" and were injured during the anti-terrorist operation / joint force operation from 2014 to 2019 were retrospectively analyzed. Among them the results of examinations and treatment of 10 wounded patients were selected, they had isolated gunshot wounds of soft tissues of the thigh with massive external blood loss and 8 wounded patients with similar gunshot wounds, and they had additional non-gunshot fractures of the mandible. All the wounded people were immediately provided with hemostatic tourniquet proximal on the injured hip.Shock index, indicators of cytolytic syndrome (activity of serum alanine and aspartate aminotransferases (ALT, AST), the content of total and conjugated serum bilirubin) and hepatodepressive syndrome (serum total protein and albumin) were taken into account from the medical records. Indicators were recorded at the time of admission to the hospital, after 6-7 days and at the time of discharge from the hospital. Additionally, the duration of patients staying in the hospital in each of the examination groups was analyzed.Research results and their discussion. At the time of admission to the hospital wounded patients of both observation groups had a significant increase of the shock index, serum activity of ALT and AST, the content of total and direct bilirubin. During treatment of the wounded patients with additional mandible fractures up to 6-7 days, serum activity of ALT, AST and direct serum bilirubin was significantly higher, and total serum protein content was lower compared to wounded patients without mandible fracture.Conclusion. Additional mandible fracture among wounded people with gunshot damage of the thigh, massive blood loss and ischemia-reperfusion of the limb significantly impairs the functional state of the liver with a maximum of 6-7 days in hospital and is an important factor in systemic manifestations of traumatic disease, which should be considered in clinical conditions

The microscopic and ultramicroscopic changes of the white rats’ thyroid gland 7 days after experimantal thermal burn injury under nacl systemic adminastration

The conducted microscopic and ultramicroscopic examinations revealed that 7 days after experimental burn injury the thyroid gland exhibits alterations of the follicular structure, thyroid epithelium, blood vessels and stroma. Most of such alterations are the signs of thyroid destruction. In the central regions of the lobules there are small follicles containing small amount of colloid; the latter is rarefied, fine, slightly oxyphilic and contains large resorption vacuoles. The cells of the thyroid epithelium are columnar or cuboidal; their characteristic features are intracellular edema, hypochromic nuclei and irregular cell borders. The stromal interfollicular connective tissue is swollen, containing leukocyte infiltrates, mainly in its perivascular regions. Both thyroid arteries and veins are blood-filled, and their walls are swollen. he tunica media of the arteries is enlarged; its smooth muscle cells exhibit intracellular edema and contain intensely basophilic nuclei. Impaired thyroid hemodynamics is also manifested by the changes in the vessels of the microvascular bed: most venules are bloodfilled, the walls of arterioles are thickened and swollen, containing perivascular leukocyte infiltrates. All human studies were conducted in compliance with the rules of the Helsinki Declaration of the World Medical Association "Ethical principles of medical research with human participation as an object of study". Informed consent was obtained from all participants

Невідкладні стани військовослужбовців з хірургічною бойовою травмою

Мета. Дослідження актуальних невідкладних станів поранених військовослужбовців та обгрунтування необхідності застосування адаптованих алгоритмів і протоколів НАТО для організації хірургічної допомоги в медичному забезпеченні військ. Матеріали і методи. Досліджено дані історій хвороб військовослужбовців, які проходили лікування в Національному військово-медичному клінічному центрі «Головний військовий клінічний госпіталь», із застосуванням статистичного, бібліографічного, проспективного та ретроспективного методів аналізу. Результати. Проведеним дослідженням встановлено основні невідкладні стани військовослужбовців, що потребують медичної допомоги за сучасними алгоритмами і стандартами. Структуру невідкладних станів у військовослужбовців аналізували, порівнюючи показники до і після початку збройного конфлікту в Україні. Доведено, що кількість військовослужбовців, доставлених у тяжкому і вкрай тяжкому стані, після початку збройного конфлікту збільшилась на 48% за рахунок бойової хірургічної травми. Висновки. Визначені актуальні невідкладні стани поранених, що є пріоритетними на догоспітальному етапі. Для вдосконалення організації хірургічної допомоги пораненим необхідні розробка і впровадження сучасних алгоритмів і протоколів за стандартами НАТО

Mineral waters, metabolism, neuro-endocrine-immune complex, s. 252.

Dedicated to the 75th anniversary of Volodymyr Illich Kozyavkin with gratitude for the support of the Truskavetsian Scientific School of BalneologyThe monograph systematizes these writers and highlights the results of their own priority experimental and clinical-physiological studies of the impact of drinking mineral waters of Ukraine on neuroendocrine regulation, metabolism and immunity of healthy rats and patients in the process of rehabilitation of chronic pyelonephritis and cholecystitis in remission. In line with the concepts of functional-metabolic continuum and neuroendocrine-immune complex using the methods of factor, discriminant and canonical correlation analysis, it is demonstrated that mineral waters have both similar and specific physiologically favorable modulating effects on the parameters of the studied body systems. For specialists in medical rehabilitation, endocrinologists, immunologists, biochemists, pathophysiologists

Experience with the use of oral probiotic Streptococcus salivarius K12 for the prevention of recurrence of pharyngotonsillar

Relevance. Pharyngotonsillitis (PhT) is one of the most common recurrent upper respiratory tract diseases. Viruses are the most common cause of disease (Respiratory viruses, Enterov iruses, Herpesviruses), 30% are of bacterial origin. The most serious types of PhT are associated with group of β-hemolytic streptococcus (GAS) - Streptococcus pyogenes, in which antibiotic therapy is the first choice of therapy. In order to reduce the use of antibiotics, to prevent relapses of pharyngotonsillar episodes, a specific probiotic therapy was carried out using Streptococcuss alivarius K12 (SsK12). K12 (SsK12) is a probiotic strain that inhibits the growth of Streptococcus pyogenes, Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis in vitro. Materials and methods. A study was conducted in 90 patients with recurrent pharyngotonsillitis (PhT) of bacterial origin, in whom Streptococcus pyogenes was isolated during bacteriolog ical examination. The course of treatment for patients of all groups was 30 days. Patients of group 1 (30 people) were treated with standard methods. In 30 patients of group 2 (30 people), in addition to standard therapy, the respiratory probiotic "Bactoblis" was used for a course of 30 days. In 30 patients of group 3, standard therapy was carried out with the use of the respiratory probiotic drug "Bactoblis" and additional sanitation of the lacunae of the palatine tonsils by vacuum extraction. As a result, in patients of groups 2 and 3, the frequency of PhT episodes significantly decreased, and the use of antibiotics decreased too. The most persistent effect of treatment was in patients of group 3 - the quality of treatment and prevention increased, the number of exacerbations decreased, the severity of clinical manifestations, and the drug load decreased. Individual intolerance to the components of the drug has not been identified. However, 6 months after the observation was started, the clinical and laboratory parameters of the main groups began to deteriorate, approaching those of the control group, and more stable therapeutic effect was observed in patients of group 3. Conclusions. The authors consider it expedient to perform tonsil sanitation twice a year, with further use of the drug "Bactoblis" in patients suffering from PhT. All human studies were conducted in compliance with the rules of the Helsinki Declaration of the World Medical Association "Ethical principles of medical research with human participation as an object of study". Informed consent was obtained from all participants

Uric acid, metabolism, neuro-endocrine-immune complex, 258 s.

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The structure of urgent conditions of servicemen of the Armed Forces of Ukraine in modern conditions

Purpose: to study the structure of urgent conditions of servicemen with combat injuries and diseases in modern conditions in order to substantiate the development of promising algorithms and medical aid protocols adapted to NATO standards.Materials and methods. The paper presents the results of analysis of the structure and nature of urgent conditions of modern combat pathology and diseases among military personnel who were on treatment at the National Military Medical Clinical Center “Main Military Clinical Hospital” from 1999 to 2018 (191 731 disease histories).Results. The article analyzes the structure of emergency conditions for servicemen of the Armed Forces of Ukraine, who were admitted the National Military Medical Clinical Center “MMCH” in the period from 1999 to 2013 compared with the corresponding indicators for 2014–2017 years. The trends in the dynamics of the indicators of the structure of emergency conditions of servicemen with injuries (including combat ones) and diseases during the period of armed conflict compared to the previous period (1999–2013) were studied. The most urgent conditions of servicemen with combat trauma and serious illnesses are identified, which are the priority for the development and implementation of modern algorithms and protocols for the provision of medical assistance in combat conditions in the Armed Forces of Ukraine. A list of algorithms and protocols for the provision of medical assistance to servicemen of the Armed Forces of Ukraine under the main emergency conditions in today's conditions is proposed.Conclusions. The basic nosological forms of combat injuries and illnesses of military personnel are established in which emergencies are formed: the ХІХ class – injuries and head and brain injuries (27.3 %), abdominal injuries (18.2 %), chest injuries and ribs (12.9 %); X class – pneumonia (75.9 %); ІX class – strokes (40.1 %), myocardial infarction (30.1 %) and hypertensive disease (12.5 %). The main classes, whose nosological forms are accompanied by severe and extremely serious conditions, are the ХІХ class – traumas, poisonings and some other consequences of external causes (48.5 %), class X – respiratory diseases (12.1 %), class IX – Diseases of the circulatory system (7.4 %) and class V – disorders of the psyche and behavior (6.1 %). Identified urgent conditions of servicemen, arising from appropriate nosological forms and included in the described classes of diseases, are priority for the development of priority algorithms and protocols for the provision of medical assistance to servicemen in combat conditions according to NATO standards

Аналіз структури невідкладних станів військовослужбовців Збройних Сил України в сучасних умовах

Purpose: to study the structure of urgent conditions of servicemen with combat injuries and diseases in modern conditions in order to substantiate the development of promising algorithms and medical aid protocols adapted to NATO standards.Materials and methods. The paper presents the results of analysis of the structure and nature of urgent conditions of modern combat pathology and diseases among military personnel who were on treatment at the National Military Medical Clinical Center “Main Military Clinical Hospital” from 1999 to 2018 (191 731 disease histories).Results. The article analyzes the structure of emergency conditions for servicemen of the Armed Forces of Ukraine, who were admitted the National Military Medical Clinical Center “MMCH” in the period from 1999 to 2013 compared with the corresponding indicators for 2014–2017 years. The trends in the dynamics of the indicators of the structure of emergency conditions of servicemen with injuries (including combat ones) and diseases during the period of armed conflict compared to the previous period (1999–2013) were studied. The most urgent conditions of servicemen with combat trauma and serious illnesses are identified, which are the priority for the development and implementation of modern algorithms and protocols for the provision of medical assistance in combat conditions in the Armed Forces of Ukraine. A list of algorithms and protocols for the provision of medical assistance to servicemen of the Armed Forces of Ukraine under the main emergency conditions in today's conditions is proposed.Conclusions. The basic nosological forms of combat injuries and illnesses of military personnel are established in which emergencies are formed: the ХІХ class – injuries and head and brain injuries (27.3 %), abdominal injuries (18.2 %), chest injuries and ribs (12.9 %); X class – pneumonia (75.9 %); ІX class – strokes (40.1 %), myocardial infarction (30.1 %) and hypertensive disease (12.5 %). The main classes, whose nosological forms are accompanied by severe and extremely serious conditions, are the ХІХ class – traumas, poisonings and some other consequences of external causes (48.5 %), class X – respiratory diseases (12.1 %), class IX – Diseases of the circulatory system (7.4 %) and class V – disorders of the psyche and behavior (6.1 %). Identified urgent conditions of servicemen, arising from appropriate nosological forms and included in the described classes of diseases, are priority for the development of priority algorithms and protocols for the provision of medical assistance to servicemen in combat conditions according to NATO standards. Цель работы – исследовать структуру неотложных состояний военнослужащих с боевыми травмами и заболеваниями в современных условиях для обоснования разработки перспективных алгоритмов и протоколов медицинской помощи, адаптированных к стандартам НАТО.Материалы и методы. В работе приведены результаты анализа структуры и характера неотложных состояний современной боевой патологии и заболеваний у военнослужащих, которые находились на лечении в Национальном военно-медицинском клиническом центре «Главный военный клинический госпиталь» с 1999 г. до 2018 г. (191 731 история болезни).Результаты. Проведен анализ структуры неотложных состояний военнослужащих Вооруженных сил Украины, которые поступили в Национальный Военно-медицинский клинический центр «ГВКГ» в период с 1999 по 2013 г. в сравнении с соответствующими показателями за 2014–2017 гг. Исследована тенденция динамики показателей структуры неотложных состояний военнослужащих с травмами (в том числе боевыми) и заболеваниями за время ведения вооруженного конфликта по сравнению с предыдущим периодом (1999–2013). Установлены наиболее актуальные неотложные состояния военнослужащих с боевой травмой и тяжелыми заболеваниями, которые являются приоритетными для разработки и внедрения в Вооруженных Силах Украины современных алгоритмов и протоколов оказания медицинской помощи в боевых условиях. Предложен перечень алгоритмов и протоколов для оказания медицинской помощи военнослужащим Вооруженных Сил Украины при основных неотложных состояниях в современных условиях.Выводы. Установлены основные нозологические формы боевых травм и заболеваний военнослужащих, при которых формируются неотложные состояния: ХІХ класс – ранения и травмы головы и головного мозга (27,3 %), травмы органов брюшной полости (18,2 %), травмы грудной клетки и ребер (12,9 %); X класс – пневмонии (75,9 %); ІX класс – инсульты (40,1 %), инфаркты миокарда (30,1 %), гипертензивная болезнь (12,5 %). Основными классами, нозологические формы которых сопровождаются тяжелыми и крайне тяжелыми состояниями, являются ХІХ – травмы, отравления и некоторые другие последствия воздействия внешних причин (48,5 %), класс X – болезни органов дыхания (12,1 %), класс IX – болезни системы кровообращения (7,4 %), класс V – расстройства психики и поведения (6,1 %). Неотложные состояния военнослужащих, которые возникают при соответствующих нозологических формах и входят в названные классы болезней, являются приоритетными для разработки первоочередных алгоритмов и протоколов оказания медицинской помощи военнослужащим в боевых условиях по стандартам НАТО. Мета роботи – дослідити структуру невідкладних станів військовослужбовців із бойовими травмами та захворюваннями в сучасних умовах.Матеріали та методи. У роботі наведені результати аналізу структури,  характеру невідкладних станів сучасної бойової патології та захворювань у військовослужбовців, які перебували на лікуванні в Національному військово-медичному клінічному центрі «Головний військовий клінічний госпіталь» із 1999 р. до 2018 р. (191 731 історія хвороби).Результати. Виконали аналіз структури невідкладних станів військовослужбовців Збройних Сил України, які надійшли до Національного Військово-медичного клінічного центру «ГВКГ» у період з 1999 до 2013 р.  порівняно з відповідними показниками за 2014–2017 рр. Дослідили тенденції динаміки показників структури невідкладних станів військовослужбовців із травмами (зокрема бойовими) і захворюваннями за час ведення збройного конфлікту порівняно з попереднім періодом (1999–2013). Виявлено найбільш актуальні невідкладні стани військовослужбовців із бойовою травмою та тяжкими захворюваннями, що є пріоритетними для розробки, впровадження у Збройних Силах України сучасних алгоритмів і протоколів надання медичної допомоги в бойових умовах. Запропоновано перелік алгоритмів і протоколів для надання медичної допомоги військовослужбовцям Збройних Сил України при основних невідкладних станах в умовах сьогодення.Висновки. Встановили основні нозологічні форми бойових травм і захворювань військовослужбовців, коли формуються невідкладні стани: ХІХ клас – поранення та травми голови, головного мозку (27,3 %), травми органів черевної порожнини (18,2 %), травми грудної клітки й ребер (12,9 %); X клас – пневмонії (75,9 %); ІX клас – інсульти (40,1 %), інфаркти міокарда (30,1 %), гіпертензивна хвороба (12,5 %). Основними класами, нозологічні форми яких супроводжуються тяжкими і вкрай тяжкими станами, є ХІХ – травми, отруєння та деякі інші наслідки дії зовнішніх причин (48,5 %), клас X – хвороби органів дихання (12,1 %), клас ІX – хвороби системи кровообігу (7,4 %), клас V – розлади психіки і поведінки (6,1 %). Виявлені невідкладні стани військовослужбовців, що виникають при відповідних нозологічних формах і входять до названих класів хвороб, є пріоритетними для розроблення першочергових алгоритмів і протоколів надання медичної допомоги військовослужбовцям у бойових умовах за стандартами НАТО.

Features of students mental health indicators during the academic year under pandemic conditions of COVID-19

The coronavirus disease 2019 (COVID-19) outbreak has rapidly transitioned into a worldwide pandemic. This development has had serious implications for public institutions and raises particular questions for medical universities. The article presented the results of original study the effect of distance learning during COVID-19 pandemic period in the psychological and physical indicators of students who study in medical university. Conducting survey in the pre-session period, which is characterized by the relative stability of the psychoemotional state of students and moderate mental and physical stress, established that the physical and psychological state of the studied group is satisfactory. The study showed that during the session period and quarantine, many students faced a number of negative factors affecting their normal mental health is an increase in the level of stress, anxiety, anxiety, which in turn led to the development of sleep problems in some of the students, which also contributed to decrease in attention, memory, general performance, strengthening, emotional lability. We can assume that distance learning during the COVID-19 pandemic period has led to an increase in the stress effect on the nervous system, which in the future may cause the development of diseases of various genesis. All human studies were conducted in compliance with the rules of the Helsinki Declaration of the World Medical Association "Ethical principles of medical research with human participation as an object of study". Informed consent was obtained from all participants