Individual psychological and gender peculiarities of patients with liver cirrhosis

Introduction. Liver cirrhosis (LC) is a chronic disease characterized by destruction of liver cells, changes in its lobular structure and vascular system, enlargement of connective tissue and irreversible dysfunction of the organ, with severe mental and psychological complications. Not only the treatment and prevention of complications, but also the psychological support of the patients with liver cirrhosis and their families are important. The objectives of the study. To explore empirically the individual psychological features of patients with LC, as well as to identify the gender peculiarities of the personality of the patient with LC. Material and methods. The study was conducted in the gastroenterology department of Chernivtsi Regional Clinical Hospital, Ukraine, from September 2017 to April 2018. The research involved 24 patients (9 women and 15 men). The average age of patients was 64 years. Methods as observation, conversation, R. Cattell’s Multi-Factor Questionnaire were used to diagnose individual psychological peculiarities. Results. As indicated by the results of the study of the communicative qualities of patients with LC, high levels were detected in such factors as Dominance (54%) and Vigilance (83%). As for the group of intellectual qualities, the average level prevails. Concerning the group of emotional qualities, the average level of internal stress, emotional sensitivity, anxiety, self-control, courage and organization in social contacts prevails among the patients with LC disease. According to the results of the study of the regulatory qualities of patients with LC, the vast majority of respondents demonstrated a high level of self-discipline (79%). Conclusions. A comparative analysis of gender peculiarities has shown that women with LC tend to demonstrate sociability, internal stress; they are more self-disciplined than men, whereas men with LC are more open to the perception of new things. It is worth paying attention to the fact that both men and women of this sample were found to have a low level of emotional sensitivity

Electrophysiological identification of nerves of the larynx among the tissuesof operative wound in goiter surgeries

The objective of the study was to analyze the technology of electrophysiological identification of laryngeal nerves in goîter surgeries. Methods: The technology of electrophysiological identification of laryngeal nerves in goiter surgeries was developed. It is based on the recording of changes in the sound vibrations generated by the passage of air through the voice gap, the area of which changes in the event of a change in the tension of vocal cords from electrostimulation of the laryngeal nerves. The greatest changes in the frequency and amplitude of sound vibrations occur when electrostimulation of tissues near the nerve and the nerve itself. This phenomenon allows to determine the location of the nerve and prevent its injury. Results: The method was tested in 173 patients who had been operated for goiter. There were no cases of temporary or permanent disorders of phonation. Conclusions: The developed technology of electrophysiological identification of laryngeal nerves in goiter surgeries is reliable, easy to apply, and is not expensive. The influence of other factors on its results was not noted

INFLUENCE OF THE CTLA-4 (RS231775) GENE POLYMORPHISM ON THE DEGREE OF THE THYROID GLAND ENLARGEMENT IN PATIENTS OPERATED FOR NODULAR GOITER SECONDARY TO AUTOIMMUNE THYROIDITIS

Objectives: To analyze the influence of the CTLA-4(+49G/A)rs231775 gene polymorphism on the degree of thyroid gland enlargement in patients operated for nodular goiter secondary to autoimmune thyroiditis (NGAIT) and thyroid adenomas (TA). Also, to analyze the clinical course of the disease, depending on the genotype of this gene. Methods: The CTLA-4 (rs231775) genes' polymorphism were studied by Real-Time Polymerase Chain Reaction in 95 patients with NGAIT, 30 patients with TA and 25 healthy individuals. Results: It has been found that, in patients with nodular goiter secondary to autoimmune thyroiditis, hyperplasia of the thyroid gland is associated with the wild A allele of the CTLA-4 gene (AA- and AG-genotypes): IB and III levels of hyperplasia are more likely to occur in carriers of the AA genotype by 30.13% and 26.35%, and the second degree of the thyroid gland enlargement- in patients with the AG-genotype by 33.52% and 34.04%, respectively. Conclusions: The incidence of the hypertrophic form of autoimmune thyroiditis is associated with AA- and AG-genotypes of the CTLA-4 gene, characterized by a particular severity, with the rapid development of an "aggressive" proliferative process in the thyroid tissue, according to sonographic findings. The carrier of the GG genotype is associated with an atrophic origin of autoimmune thyroiditis; the tissue is characterized by a high content of cells in which there are atypical or follicular changes of an unclear genesis

Clinical application and results of the electrophysiological laryngeal nerves identification in surgeries in case of goiter

Background. Analysis of the results of clinical application of the developed method of laryngeal nerves electrophysiological identification. Material and methods. Electrophysiological identification of the recurrent and superior laryngeal nerves was performed intraoperatively in 200 patients operated on goiter. A total of 354 studies of laryngeal nerves were conducted to identify them. Among them, there were 45 unilateral researches and 308 bilateral. Results. In the first region, nerves were identified in 327 cases and unidentified – in 27 cases. In the second region, among the tissues of the surgical wound, nerves were identified in 337 studies and unidentified – in 17. Regarding unidentified nerves in 3 patients on both sides, there were two cases of thyroid cancer and one – multinodular recurrent goiter. In the third section among 354 patients, the external branch of the superior laryngeal nerve was identified in 329 (92.9 %) and unidentified in 25. Unidentified nerves are those cases where the nerves are not electrophysiologically isolated among the tissues of the surgical wound, but clearly defined their places of passing. There were no intraoperative injuries of the laryngeal nerves. Conclusions. The technology of intraoperative identification of the laryngeal nerves can identify both the recurrent and superior nerves of the larynx, or determine the probable areas of its passage and prevent their injuries during the surgery

Remote results of hemithyroidectomy and their prognostication in patients with unilateral nodular goiter combined with autoimmune thyroiditis

As a result of the histological examination of the removed thyroid tissue, autoimmune thyroiditis has been diagnosed in 10.4% of patients. During the surgical treatment and while choosing the surgery volume, the pathogenetic mechanisms of the onset and progression of autoimmune processes in the thyroid tissue are not taken into account