ВИКОРИСТАННЯ МАЙСТЕР-КЛАСІВ ПІД ЧАС ПРОВЕДЕННЯ ЦИКЛІВ ТЕМАТИЧНОГО УДОСКОНАЛЕННЯ НА КАФЕДРІ ПАТОЛОГІЧНОЇ АНАТОМІЇ

Institutions of postgraduate medical education in the modern paradigm of medical and educational reform should add the latest teaching technologies into the traditional teaching schemes. The task of institutions of postgraduate medical education is to create a competitive educational product that should significantly improve the professional level of doctors. Pathology, as a medical specialty, requires not only deep theoretical knowledge, but also very specific practical skills. Therefore, the established forms of training (lectures, seminars, practical classes) are significantly lower in terms of efficiency for master classes. This form of training combines all the best features of the listed types of classes, without having to waste time and with the maximum level of visualization of the educational process. In addition, taking into account a certain staff famine in the pathology, doctors-pathologists are not always able to spend enough time for a long-term training cycle. While they can choose the themes of the master classes, in familiarizing with the need, dictated by the production necessity. The article conveys the experience of using master classes during postgraduate training of pathologists. It provided information on the legal framework for conducting such classes, the scheme of conducting a master class on an example of a specific topic is given. The authors developed an algorithm for conducting master classes taking into account the specifics of teaching pathological anatomy in institutions of postgraduate education. The feedback from the listeners indicates a very positive perception of this form of learning. This proves that the master class is one of the most effective forms of vocational training of doctors, which must be applied by institutions of postgraduate education. The Department of Pathological Anatomy of KhMAPO intends to constantly increase the arsenal of those master classes, fill them with contemporary content, and also introduce other effective and creative teaching methods.Заклади післядипломної медичної освіти в сучасній парадигмі медичної та освітянської реформи повинні додавати до традиційних схем навчання новітні технології викладання. Завданням закладів післядипломної медичної освіти є створення конкурентного освітнього продукту, який має суттєво поліпшити професійний рівень лікарів. Патологічна анатомія, як медична спеціальність, потребує не тільки глибоких теоретичних знань, а й досить специфічних практичних навичок. Тому усталені форми навчання (лекції, семінари, практичні заняття) значно поступаються за рівнем ефективності майстер-класам. Ця форма навчання поєднує в собі всі найкращі риси перерахованих типів занять, без зайвого витрачання часу і з максимальним рівнем візуалізації навчального процесу. Крім того, враховуючи певний кадровий голод у спеціальності «Патологічна анатомія», лікарі-­патологоанатоми не завжди мають змогу витратити достатньо часу на довготривалий цикл підвищення кваліфікації. Тоді як вони можуть обрати ті теми майстер-класів, в ознайомленні з якими мають потребу, що диктується виробничою необхідністю. Стаття передає досвід використання майстер-класів під час післядипломного навчання лікарів-патологоанатомів. У ній надано інформацію щодо нормативно-правової бази проведення таких занять, наведено схему проведення майстер-класу на прикладі конкретної теми. Автори розробили алгоритм проведення майстер-класів з урахуванням специфіки викладання патологічної анатомії в закладах післядипломної освіти. Дані зворотного зв’язку зі слухачами свідчать про вельми позитивне сприйняття цієї форми навчання. Це доводить, що майстер-клас – одна з найефективніших форм професійного навчання лікарів, яка має обов’язково застосовуватися закладами післядипломної освіти. Кафедра патологічної анатомії ХМАПО має намір постійно збільшувати арсенал тем майстер-класів, наповнювати їх сучасним контентом, а також впроваджувати інші ефективні та креатив­ні методики навчання

Passive smoking and the reduced feeding of pregnant - factors of antenatal programming deviations of somato-sexual development and the structural and functional disorders of the thyroid gland

Today proved that the cause of many diseases are unfavorable conditions for the development of the fetus in the womb, caused by exposure to pregnant the toxicants of exogenous nature, which include nicotine, and a violation of its feeding. However, the literature does not answer the question - what is the impact of smoking on pregnant thyropathies development in the offspring. In an experimental model of the combined effects of passive smoking and to reduce energy intake food rats during pregnancy found that their descendants are characterized by a high percentage of deaths in the first months of life, delay physical and sexual development, and at 6 months of age, one-third of the children observed obesity. At the same time, in the offspring of mothers treated with cigarette smoke and having a reduced power during pregnancy, disturbed the dynamics and character formation histostructure and hormonal activity of the thyroid gland. This characteristic becomes microfollicular type of gland structure with hyperthyroidization during puberty, which is replaced by a hypothyroid state, destruction of the parenchyma, the appearance of lymphoid infiltration.</p

Clinical and morphological features of diffuse gliomas in population of Kharkiv region from 2000 to 2014

Background. Diffuse glioma is one of the most common among tumors of the central nervous system (CNS). Epidemiological and morphological researches of diffuse gliomas allow to find the most prevalent histotypes of these tumors in Kharkiv region. Objective. To study the outer appearance and histological structure of diffuse gliomas in population of Kharkiv region. Methods. The research is based on case histories of patients with tumors of central nervous system and their biopsies in the period from 2000 to 2014. The statistical data was processed with Microsoft Excel. Results. We analysed data from 1540 case histories of patients with primery incidence of CNS tumors in Kharkiv and Kharkiv region from 2000 to 2014. Overall, approximately 42,4% of all tumors are diffuse gliomas (653 cases). Among diffuse gliomas the most common is glioblastoma. It accounts 54,8% of diffuse gliomas and 25% of all primary CNS tumors. This data is higher than the rate of glioblastoma in WHO and CBTRUS reports. There are statistically significant differences in cystic presentation between glioblastoma group and group of other diffuse gliomas (t=2,4). Cysts are more common in glioblastoma group (44,13%) in comparison with other diffuse gliomas (34,9%). The incidence rate for diffuse gliomas is highest among the 30-54 years age group (48%) and lowest among the 75+ years olds (1,7%). The cystic features are more common among the 0-29 years age group (58,9%). The t-value is 3,4. Except multilobar brain lesions diffuse gliomas are most commonly initially located in the frontal (26%) and temporal lobe (21,7%). Conclusion. 1. The cystic features are more common among the 0-29 years age group. 2. Glioblastoma is the most common tumor among diffuse gliomas. It accounts 54,8% of diffuse gliomas and 25% of primary CNS tumors. 3. Cyst are more common in glioblastoma group in comparison with other diffuse gliomas

Influence of maternal infection caused by Klebsialle pneumonia on morphologic and functional state of fetuses’ adrenal glands cortex (experimental research).

Background. Infections of fetuses and newborns caused by Klebsiella themselves and in polymicrobial associations have short incubation period, as well as a high percentage of deaths. Intrauterine infection of fetus and fetal chronic hypoxia should be considered as conditions that require a lot of adaptive changes where one of the most important roles is performed by adrenal glands. Objective: to identify the influence of mother infection caused by K.pneumoniae on fetal adrenal cortex. Methods: During the experiment, laboratory rats were divided into 3 groups. Group 1 - control - pregnant rats lived in physiological conditions. Group 2 - modeling of chronic intrauterine hypoxia - pregnant rats throughout pregnancy (21 days) were subjected to a daily high altitude hypoxia. Group 3 – modeling of infection – using the infective dose of Klebsiella pneumonia was modeled. Then male were tucked to infected female, females got pregnant. All rats were removed from the experiment on the last stages of gestation in order to extract fetus for further study. The adrenal glands of fetuses were examined using histological, morphometric and immunohistochemical methods. Results. Infectious pathology of mother has a more detrimental effect on fetal adrenal glands, than "pure" chronic intrauterine hypoxia. In group 3 hypoplasia is more pronounced in zona glomeruloza. Severe lesions of cytolysis and resorption of cell with increasing of cortisol production are seen in zone fasciculata. In fetal zone there are depletion of functional activity, zone is decreasing and has a tendency to decrease hormone production. Conclusion: when mother is infected by Klebsiella pneumonia in constant and fetal adrenal cortical areas of fetus changes manifested by hypoplasia of zona glomeruloza, hyperactivity of zona fasciculata and depletion of functional activity in fetal zone

Типи мікроструктури щитоподібної залози при затримці внутрішньоутробного розвитку = Types of microstructure thyroid intrauterine growth retardation

Sokolova S. S., Yakovtsova I. I., Sergiyenko L. Yu. Типи мікроструктури щитоподібної залози при затримці внутрішньоутробного розвитку = Types of microstructure thyroid intrauterine growth retardation. Journal of Education, Health and Sport. 2016;6(6):146-154. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.55157 http://ojs.ukw.edu.pl/index.php/johs/article/view/3564   The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 755 (23.12.2015). 755 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Author (s) 2016; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 05.05.2016. Revised 25.05.2016. Accepted: 25.05.2016.   ТИПИ МІКРОСТРУКТУРИ ЩИТОПОДІБНОЇ ЗАЛОЗИ ПРИ ЗАТРИМЦІ ВНУТРІШНЬОУТРОБНОГО РОЗВИТКУ   С. С. Соколова 1,2, І. І. Яковцова 2, Л. Ю. Сергієнко 1   1 ДУ «Інститут проблем ендокринної патології ім. В. Я. Данилевського НАМН України», Харків; 2 Харківська академія післядипломної освіти, Харків     Резюме Метою дослідження було визначення морфологічної будови ЩЗ мертвонароджених плодів та новонароджених дітей з низькою вагою, що є провідним показником ЗВУР, та визначення частоти пов’язаності цього синдрому та загибелі плодів/дітей з тютюнопалінням матері під час вагітності. При гістологічному дослідженні ЩЗ плодів/дітей нами знайдено, що типи будови тироїдної паренхими співпадають з терміном загибелі плодів, гестаційним віком при народженні та тривалістю післянатального життя. Десквамативний тип мікроструктури ЩЗ плодів притаманний загиблим внутрішньоутробно на 23-27-ому тижні гестації. Змішаний тип спостерігається у народившихся живими, як доношеними, так і недоношеними, але прожили від 7 діб до 3-х тижнів. Фолікулярно-колоїдним типом характеризуються ЩЗ доношених дітей, тривалість післянатального життя яких була найбільшою.   Ключові слова: мікроструктура щітоподібної залози, затримка внутрішньо утробного розвитку, типи щитоподібної залози.     TYPES OF MICROSTRUCTURE THYROID INTRAUTERINE GROWTH RETARDATION   S. S. Sokolova 1,2, I. I. Yakovtsova 2, L. Yu. Sergiyenko 1   1 SI “V. Danilevsky Institute for Endocrine Pathology Problems of the NAMS of Ukraine”, Kharkiv; 2 Kharkiv Medical Postgraduate Academy   Clinical and morphological studies have shown that abuse in a state of functional system "mother-placenta-fetus" with the development of feto-placental insufficiency or intrauterine growth retardation (IUGR) of the fetus leading to underdevelopment of the thyroid gland in the fetal period and the occurrence of hypothyroidism in pislyanatalnomu life. But remains unclear what type of structure inherent thyroid fetuses / newborn who died at some stage anti / postnatal life and which had marked by the presence of IUGR. The objective was to study the morphological structure of thyroid stillborn fetuses and newborns with low birth weight, which is the main indicator of IUGR, and determining the frequency of the correlation of this syndrome and death fetuses / bebies with the mother smoking during pregnancy. Histological examination of the thyroid fetuses / bebies we have found that the types of thyroid parenchyma structure coincide with the term of the death of fetuses with a gestational age at birth and duration of postnatal life. Desquamative type of microstructure thyroid fetuses typical for the dead in utero at 23-27-th week. gestation. Mixed observed in live births, both full-term and preterm, but been resident from 7 days to 3 weeks. Follicular colloid-type characterized by thyroid term infants, the duration of which was the greatest life.   Keywords: microstructure of the thyroid gland, intrauterine growth retardation, the types of thyroid gland.           ТИПЫ МИКРОСТРУКТУРЫ ЩИТОВИДНОЙ ЖЕЛЕЗЫ ПРИ ЗАДЕРЖКЕ ВНУТРИУТРОБНОГО РАЗВИТИЯ   Соколова С. С.1,2, Яковцова И. И.2, Сергиенко Л. Ю.1   1ГУ «Институт проблем эндокринной патологии им. В. Я. Данилевского НАМНУкраины», Харьков; 2Харьковская академия последипломного образования, Харьков   Целью исследования было изучение морфологической структуры ЩЖ мертворожденных плодов и новорожденных детей с низкой массой, которая является главным показателем ЗВУР, и определение частоты корреляции этого синдрома и гибели полодов/детей с табакокурением матери во время беременности. При гистологическом исследовании ЩЖ плодов/детей нами выяснено, что типы строения тиреоидной паренхимы совпадают со сроком гибели плодов, с гестационным возрастом при рождении и длительностью постнатальной жизни. Десквамативный тип микроструктуры ЩЖ плодов характерен для погибших внутриутробно на 23-27-й нед. гестации. Смешанный тип наблюдается у рожденных живыми, как доношенными, так и недоношенными, но прожившими от 7 суток до 3-х нед. Фолликулярно-коллоидным типом характеризуются ЩЖ доношенных детей, продолжительность жизни которых была наибольшей.   Ключевые слова: микроструктура щитовидной железы, задержка внутриутробного развития, типы щитовидной железы

Prognostic significance of stromal сomponent in prostate cancer.

Background. Stroma is a crucial factor in the growth and progression of prostate cancer. However, the morphological and molecular biological signs of cancer stroma that define prognosis of the disease have been investigated insufficiently. Objective. To identify relationships between morphological, immunohistochemical (vimentin, smooth muscle actin-α, MMP-9, collagen type IV) characteristics of the cancer stroma and criteria of aggressive clinical behavior, the risk of recurrence of prostate cancer. Metods. Stroma of the tumors was quantified in 112 patients treated with radical prostatectomy for clinically localized prostate carcinoma. Cancers were divided into three risk groups. Immunohistochemical study was conducted on the material of 33 cases of prostate cancer, 10 cases of normal prostate and 11 cases of atypical hyperplasia, in total 54 cases. The 2 test and Spearman rank correlation coefficient where used to compare the studied features. Results. Desmoplasia of prostate cancer occurred in 61.6% of cases, low, moderate and high grade in 29.5%, 25.9% and 6,2% respectively. Expression of vimentin, smooth muscle actin-α, MMP-9, collagen type IV in the cancer stroma where not uniform. Conclusion. Decrease of differentiation of prostate cancer from G1 to G2 was associated with increased degree of tumor desmoplasia, identified tendency to reduce desmoplasia level with decreasing differentiation to G3. Also revealed, the less differentiated tumor, the more expressed peritumoral reactive fibrosis. Absence of desmoplasia typical for low-risk prostate cancer, moderate and severe desmoplasia associated with cancers of the intermediate risk group. Stroma of prostate cancer with decreasing of tumor differentiation and growth of aggressive clinical behavior characterized by the disappearance of the collagen type IV, tendency to decrease smooth muscle actin-α and increase expression of vimentin because of increasing the number of tumor-associated fibroblasts and myofibroblasts. In the stromal cells with decreasing differentiation of prostate cancer and increasing the risk of recurrence has tended to increase of MMP-9 expression

Пассивное табакокурение и редуцированное питание беременных – факторы антенатального программирования отклонений сомато-полового развития и структурно-функциональных нарушений в щитовидной железе потомков = Passive smoking and the reduced feeding of pregnant - factors of antenatal programming deviations of somato-sexual development and the structural and functional disorders of the thyroid gland

Sergiyenko L. Yu., Yakovtsova I. I., Sokolova S. S., Postnikov V. A. Пассивное табакокурение и редуцированное питание беременных – факторы антенатального программирования отклонений сомато-полового развития и структурно-функциональных нарушений в щитовидной железе потомков = Passive smoking and the reduced feeding of pregnant - factors of antenatal programming deviations of somato-sexual development and the structural and functional disorders of the thyroid gland. Journal of Education, Health and Sport. 2016;6(2):64-76. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.45835 http://ojs.ukw.edu.pl/index.php/johs/article/view/3378 https://pbn.nauka.gov.pl/works/713297     The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 755 (23.12.2015). 755 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Author (s) 2016; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 01.01.2016. Revised 12.01.2016. Accepted: 31.01.2016.     Пассивное табакокурение и редуцированное питание беременных – факторы антенатального программирования отклонений сомато-полового развития и структурно-функциональных нарушений в щитовидной железе потомков   PASSIVE SMOKING AND THE REDUCED FEEDING OF PREGNANT - FACTORS OF ANTENATAL PROGRAMMING DEVIATIONS OF SOMATO-SEXUAL DEVELOPMENT AND THE STRUCTURAL AND FUNCTIONAL DISORDERS OF THE THYROID GLAND   Л. Ю. Сергиенко 1, И. И. Яковцова 2, С. С. Соколова 1,2, А. В. Постников 3 L. Yu. Sergiyenko1, I. I. Yakovtsova2, S. S. Sokolova1,2, V. A. Postnikov3   1ГУ «Институт проблем эндокринной патологии им. .В. Я. Данилевского НАМН Украины», Харьков; 2 Харьковская академия последипломного образования, Харьков 3КУОЗ "Областная детская клиническая больница №1"   1 SI “V.Danilevsky Institute for Endocrine Pathology Problems of the NAMS of Ukraine”, Kharkiv; 2 Kharkiv Medical Postgraduate Academy; 3Regional Children's Hospital №1 Ukraine, Kharkiv   Abstract Today proved that the cause of many diseases are unfavorable conditions for the development of the fetus in the womb, caused by exposure to pregnant the toxicants of exogenous nature, which include nicotine, and a violation of its feeding. However, the literature does not answer the question - what is the impact of smoking on pregnant thyropathies development in the offspring. In an experimental model of the combined effects of passive smoking and to reduce energy intake food rats during pregnancy found that their descendants are characterized by a high percentage of deaths in the first months of life, delay physical and sexual development, and at 6 months of age, one-third of the children observed obesity. At the same time, in the offspring of mothers treated with cigarette smoke and having a reduced power during pregnancy, disturbed the dynamics and character formation histostructure and hormonal activity of the thyroid gland. This characteristic becomes microfollicular type of gland structure with hyperthyroidization during puberty, which is replaced by a hypothyroid state, destruction of the parenchyma, the appearance of lymphoid infiltration.   Key words: smoking, pregnancy, thyroid gland, offspring.   Реферат Сегодня доказано, что причиной многих заболеваний являются неблагоприятные условия развития плода в утробе матери, вызванные воздействием на беременную токсикантов экзогенной природы, к которым относятся никотин, и нарушением ее питания. Но в литературе нет ответа на вопрос - каково влияние курения беременных на развитие тиреопатий у потомков. На экспериментальной модели комбинированного воздействия пассивного курения и снижения калоража питания крыс в течение беременности установлено, что для их потомков характерны высокий процент гибели в первые месяцы жизни, задержка соматического и полового развития, а в 6-месячном возрасте у трети потомков наблюдается ожирение. Одновременно, у потомков матерей обработанных дымом сигарет и имеющих редуцированное питание при беременности, нарушается динамика и характер формирования гистоструктуры и гормональной активности щитовидных желез. При этом характерным становится микрофолликулярный тип строения железы с гипертиреоидизацией в перипубертатном периоде, которая сменяется гипотиреоидным состоянием, деструкцией паренхимы, появлением лимфоидной инфильтрации.   Ключевые слова: табакокурение, беременность, щитовидные железы, потомки

Morphological criteria for prognosis in patients with melanoma

Among the morphological criteria of prognosis in patients with melanoma of the skin the most important ones are thickness, depth of invasion, ulceration of the tumor, the presence of microsatellites and metastases in regional lymph nodes, the severity of the proliferative activity of tumor cell invasion into blood vessels. The value of clinical, anatomical and cell-type variant of melanoma, the degree of pigmentation, the severity of her infl ammatory infi ltration, fi broplasia, signs of regression is controversial

Rapid test for the qualitative simultaneous determination of cardiac fatty acid-binding protein and cardiac troponin I in the diagnosis of acute coronary syndrome

Aim. To study the diagnostic characteristics of the rapid test for qualitative simultaneous determination of cardiac fatty acid-binding protein (FABPs) and cardiac troponin I (cTnI) CARD-INFO 1+1 in patients with acute coronary syndrome (ACS).Material and methods. The study included 168 patients undergoing inpatient treatment after ACS, with typical anginal pain lasting at least 20 minutes occurred in the previous 1-24 hours. In addition to routine diagnostic procedures, on admission, we determined FABPs and cTnI concentrations using the high-quality immunochromatographic rapid test CARD-INFO 1 1 (OOO CARDIO-Plus, Russia).Results. The sensitivity of the CARD-INFO 1+1 rapid test was 88,1%, specificity — 89,8%, diagnostic accuracy — 88,7%. The indicators of the diagnostic effectiveness of CARD-INFO 1+1 test in patients with STE-ACS and NSTE-ACS did not significantly differ (p&gt;0,05). The sensitivity of the rapid test reached a maximum in the period from 3 to 6 hours from the onset of pain. Compared with the determination of cTnI performed on admission to the hospital, a higher sensitivity of the CARD-INFO 1+1 test was revealed in patients with STE-ACS (87,7% vs 75,3%; p=0,044), in the first 1-3 hours after the beginning of clinical manifestations (86,8% vs 60,5%; p=0,041) and in the entire sample as a whole (88,1% vs 77,1%; p=0,033), with comparable specificity (89,8% and 93,2%, respectively; p=0,741).Conclusion. Qualitative immunochromatographic CARD-INFO 1+1 rapid test for the simultaneous determination of the content of FABPs and cTnI I is highly effective in the diagnosis of various forms of ACS. The highest diagnostic characteristics of the test were observed in patients in the early stages of the disease (the first 1-6 hours after the onset of pain). Carrying out the CARD-INFO 1+1 test revealed 12 MI cases more (11%) than the first determination of cTnI. Further studies will clarify the place of this technique in the modern algorithm for the management of patients with ACS and evaluate the possibility of using the rapid test in predicting the course of the disease