Minimal invasive surgery for patients with urolithiasis with early postoperative rehabilitation in Truskavets

Introduction. Undoubtedly, technological progress, the "conquest" of civilization leads to a deterioration of the environmental situation. It affects the human body, causing a violation of homeostasis, due to disorders in it.The purpose of the work. In view of the above, the task was to study the peculiarities of the process of the use of minimally invasive techniques in patients with urolithiasis treated in the period from 2012 to 2017 in the urological department of the Truskavets City Hospital and in the private office of lithotripsy Ya.V. Feciak in the complex with the use of medical water "Naftusya" during treatment and in the early postoperative period as a means of metaphysics of recurrent stone formation and quicker rehabilitation of patients.Materials and methods of research. The treatment of 1757 patients with urolithiasis in the urological department of Truskavets city hospital and the private office of lithotripsy Ya.V. Fetsiak for the period of 2012 - 2017. The study included 681 patients with kidney stones, 1045 patients - with ureteric stones and 31 patients with urinary bladder specimens. 357 contact nephrolithotripsy, 491 contact ureterolithotripsy (CULT), 27 contact cystolithotripsy and 2074 extracorporeal shock-wave lithotripsy (ESWL) sessions were performed for these patients. Men were 946 (54%), women 811 (46%). The age of the patients ranged from 18 to 84 years. The size of the concretions localized in the ureter ranged from 0.6 cm to 3.4 cm and, as a rule, was 0.9-1.2 cm. The maximum size of the kidney stone was 9.5 cm, and the average size varied within 1 , 4-27cm.ESWL was performed on the Dornier Compact S machine. In the 882 patients, 2074 procedures were carried out for the ESWL, which was 2.35 procedures per patient. In the planned period, 71% of patients, 29% in urgent (at the height of the renal colic or within the next 30 hours) were treated.Results In the contingent of patients treated with ESWL, medical water "Naftusya" was used before the crushing session and exchange course for 2-3 weeks three times a day at a temperature of 17-20 degrees C in an amount of 10 ml per kilogram of weight per day. Patients, who used contact lithotripsy "Naftusya" were prescribed from the second day after the operation, that is, when in the postoperative period, complete peristalsis of the colon was restored. Doses were identical, as in patients with ESWL.Our long experience in treating patients with urolithiasis has shown recurrence of stone formation in 10-15% of patients with urolithiasis within five years of intervention. The latter is much lower compared to the literature without the use of water "Naftusya".Conclusions1. ESWL - an effective out-patient method of removing concretions from the urinary tract.2. Contact lithotripsy, along with ESWL - modern methods for the elimination of concretions from urinary tract with short bed day and minimization of surgical trauma.3. Therapeutic water "Naftusya" - an effective means of metaphysics of urolithiasis.4. Early postoperative rehabilitation of patients with urolithiasis is possible only on the territory of Truskavets.5. The use of water "Naftusya" can significantly reduce the recurrence of stone formation in patients with urolithiasis, which makes this balneotherapy a "gold standard" in metaphilactics and early post-operative rehabilitation of patients with urolithiasis

Long-Term Results of the Etiotropic Therapy of Subcompensed Liver Cirrhosis in the Outcome of Chronic Hepatitis C

Aim. The evaluation of long-term results of antiviral therapy (AVT) with ombitasvir/paritaprevir/ritonavir and dasabuvir in patients with noncompensated liver cirrhosis (LC) in the outcome of chronic hepatitis C.Material and methods. A retrospective analysis included the data from patients with subcompensated liver cirrhosis (LC) of HCV etiology (genotype 1b) (7–9 points of the Child-Pugh score) having received interferon-free antiviral therapy (AVT) with ombitasvir/paritaprevir/ritonavir and dasabuvir during 12 weeks from September to December 2015. In total, 66 patients (27 men and 39 women) received such a therapy, the median age was 56.4 years.Results. 147 weeks (IQR 56–156) following AVT completion, the long-term results were evaluated. At that time, 27 patients were available for observation. The assessment of liver function compensation using the Child-Pugh score showed improvement in 25 (93 %) patients. The assessment of laboratory data revealed a decrease in the median of total bilirubin by 13.6 μmol/l, as well as an increase in the median of serum albumin by 9.7 g/L and the median of platelets by 41,700/μl. Two deaths were reported due to hepatocellular cancer (HCC) and bleeding from esophageal varices. HCC was detected in 8 patients. Two patients underwent liver transplantation.Conclusion. AVT in patients with LC of HCV etiology is associated with a high frequency of virologic response. Longterm follow-up results indicate a significant improvement of liver function, but also a continuing high risk of developing complications of underlying disease, primarily HCC

Liver CT Perfusion Imaging as a Non-Invasive Method for Assessing Hemodynamics of the Hepatic Parenchyma in Patients with Fibrosis and Cirrhosis as a Result of Chronic Viral Hepatitis C

Objective: to determine whether liver computed tomography (CT) perfusion imaging can assess hemodynamics in patients with fibrosis and cirrhosis as a result of chronic viral hepatitis C (CVHC). Subjects and methods. The prospective study conducted at the Department of Radiation Diagnosis, M.F. Vladimirsky Moscow Regional Research and Clinical Institute, enrolled 61 patients with liver fibrosis and cirrhosis as a result of CVHC, of whom 26 patients had received antiviral therapy (AVT) and achieved a sustained virological response (SVR) at 24 weeks after the end of treatment. All the patients underwent liver CT perfusion imaging on a 256-slice Philips ICT computed tomography scanner (Netherlands). The parameters of arterial, portal, general perfusion and hepatic perfusion index were measured in each patient in his/her liver segments III, VII, and VIII, by calculating the slope of a curve. Results. The values of perfusion parameters in patients who had undergone AVT and attained SVR and who had received no specific treatment were compared with those in the fibrosis, compensated, subcompensated, and decompensated liver cirrhosis groups. In the liver fibrosis group, the patients who had achieved SVR after AVT had higher portal and total perfusion values than those who had received no specific treatment (p = 0.001 and p = 0.002; respectively). In the same group, the liver perfusion index was higher in the patients who had not undergone AVT than in the treated patients (p = 0.028). The values of total perfusion were statistically significantly higher in patients with compensated liver cirrhosis who had attained SVR after AVT than in the untreated patients (p = 0.008). In the decompensated liver cirrhosis group, portal perfusion after specific treatment was higher than in the non-AVT group (p = 0.012). The subcompensated liver cirrhosis group showed no statistically significant differences when comparing the values of liver perfusion parameters depending on the availability of treatment. Conclusion. Liver CT perfusion imaging cannot give an idea of how the hemodynamics of liver tissue changes in the presence of fibrosis and cirrhosis in patients with CVHC after AVT

Minimal invasive surgery for patients with urolithiasis with early postoperative rehabilitation in Truskavets

Derkach I. A., Priyma O. B., Loskutov A. E., Fetsyak Ya. V., Irodenko V. M., Petryshyn O. Ya., Bosak M. V., Sumtsova O. O., Zukow W. Minimal invasive surgery for patients with urolithiasis with early postoperative rehabilitation in Truskavets. Journal of Education, Health and Sport. 2017;7(7):101-110. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.823871 http://ojs.ukw.edu.pl/index.php/johs/article/view/4593 https://pbn.nauka.gov.pl/sedno-webapp/works/824464 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.2017). 1223 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Author 2017; 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: 25.06.2017. Revised: 02.07.2017. Accepted: 05.07.2017. Малоінвазивна хірургія хворих на сечокам’яну хворобу з ранньою післяопераційною реабілітацією в Трускавці Minimal invasive surgery for patients with urolithiasis with early postoperative rehabilitation in Truskavets Деркач І. А., Прийма О. Б., Лоскутов А. Є., Фецяк Я. В., Іроденко В. М., Петришин О. Я., Босак М. В., Сумцова О. О., Zukow W. Derkach I. A., Priyma O. B., Loskutov A. E., Fetsyak Ya. V., Irodenko V. M., Petryshyn O. Ya., Bosak M. V., Sumtsova O. O., Zukow W. КЗ «Трускавецька міська лікарня» Приватний кабінет літотрипсії Я. В. Фецяка Wydział Nauk o Ziemi, Uniwersytet Mikołaja Kopernika w Toruniu Truskavets City Hospital Private office of lithotripsy Ya. V. Fetsyak Department of Earth Sciences, Nicolaus Copernicus University in Torun Ключові слова: сечокам’яна хвороба, контактна літотрипсія, дистанційна літотрипсія, метафілактика уролітіаза, лікувальна вода «Нафтуся», рецидив каменеутворення, реабілітація. Абстракт Вступ. Безсумнівно, що технологічний прогрес, «завоювання» цивілізації призводять до погіршення екологічної ситуації. Це впливає на організм людини, зумовлюючи порушення гомеостазу, внаслідок розладів у ньому. Мета роботи. З огляду на вищезгадане було поставлено завдання вивчити особливості перебігу процесу із застосування малоінвазивних методик у хворих на уролітіаз, пролікованих у період 2012 – 2017 рр. в урологічному відділенні КЗ «Трускавецької міської лікарні» та приватному кабінеті літотрипсії Я.В. Фецяка у комплексі з використанням лікувальної води «Нафтуся» під час лікування та в ранній післяопераційний період, як засобу метафілактики рецидивного каменеутворення та скорішої реабілітації хворих. Матеріали та методи дослідження. Проаналізовано лікування 1757 хворих на уролітіаз в урологічному відділенні КЗ «Трускавецька міська лікарня» та приватному кабінеті літотрипсії Я.В. Фецяка за період 2012 − 2017 рр. В дослідження включено 681 хворих з каменями нирок, 1045 хворих - з конкрементами сечоводів та 31 хворий - з конкрементами сечового міхура. Цим хворим виконано 357 контактних нефролітотрипсій, 491 контактних уретеролітотрипсій (КУЛТ), 27 контактних цистолітотрипсій та 2074 сеансів екстракорпоральної ударно-хвильової літотрипсії (ЕУХЛ). Чоловіків було 946 (54%), жінок 811 (46%). Вік хворих коливався від 18 до 84 років. Розмір конкрементів, що локалізувалися у сечоводі коливався від 0,6 см до 3,4 см та, як правило, складав 0,9-1,2 см. Максимальний розмір каменя нирки був 9,5 см, а середній розмір коливався в межах 1,4-2,7см. ЕУХЛ виконувалася на апараті Compact S фірми Dornier. 882 хворим виконано 2074 процедур ЕУХЛ, що склало 2,35 процедури на кожного хворого. В плановому терміні лікувалися 71% пацієнтів, 29% в ургентному (на висоті ниркової коліки або в найближчі 30 годин). Результати. У контингенту хворих лікованних методом ЕУХЛ застосовували лікувальну воду «Нафтуся» перед сеансом дроблення та курсовим прийомом протягом 2-3 тижнів тричі на день температури 17-20 градусів С в кількості 10 мл на кілограм ваги на добу. У хворих, у котрих застосовували контактну літотрипсію «Нафтусю» призначали з другої доби після операції, тобто коли в післяопераційному періоді відновлювалася повноцінна перистальтика кішківника. Дози були ідентичні, як у хворих з ЕУХЛ. Наш тривалий досвід лікування хворих на сечокам’яну хворобу засвідчив рецидиви каменеутворення у 10-15% хворих на сечокам’яну хворобу протягом п’яти років після втручання. Останнє значно нижчим в порівнянні з даними літератури без застосування води «Нафтусі». Висновки. ЕУХЛ – дієвий амбулаторний метод видалення конкрементів з сечових шляхів. Контактна літотрипсія разом з ЕУХЛ – сучасні методи елімінації конкрементів з сечових шляхів з коротким ліжко-днем та мінімізацією оперативної травми. Лікувальна вода «Нафтуся» - дієвий засіб метафілактики уролітіазу. Рання післяопераційна реабілітація хворих на сечокам’яну хворобу можлива виключно на теренах Трускавця. Застосування води «Нафтуся» дозволяє значно знизити рецидив каменеутворення хворих на уролітіаз, що робить цю бальнеотерапію «золотим стандартом» у метафілактиці та ранньої післяопераційної реабілітації хворих на сечокам’яну хворобу. Key words: urolithiasis, contact lithotripsy, distant lithotripsy, urology metaphilia, medical water "Naftusya", relapse of stone formation, rehabilitation. Abstract Introduction. Undoubtedly, technological progress, the "conquest" of civilization leads to a deterioration of the environmental situation. It affects the human body, causing a violation of homeostasis, due to disorders in it. The purpose of the work. In view of the above, the task was to study the peculiarities of the process of the use of minimally invasive techniques in patients with urolithiasis treated in the period from 2012 to 2017 in the urological department of the Truskavets City Hospital and in the private office of lithotripsy Ya.V. Feciak in the complex with the use of medical water "Naftusya" during treatment and in the early postoperative period as a means of metaphysics of recurrent stone formation and quicker rehabilitation of patients. Materials and methods of research. The treatment of 1757 patients with urolithiasis in the urological department of Truskavets city hospital and the private office of lithotripsy Ya.V. Fetsiak for the period of 2012 - 2017. The study included 681 patients with kidney stones, 1045 patients - with ureteric stones and 31 patients with urinary bladder specimens. 357 contact nephrolithotripsy, 491 contact ureterolithotripsy (CULT), 27 contact cystolithotripsy and 2074 extracorporeal shock-wave lithotripsy (ESWL) sessions were performed for these patients. Men were 946 (54%), women 811 (46%). The age of the patients ranged from 18 to 84 years. The size of the concretions localized in the ureter ranged from 0.6 cm to 3.4 cm and, as a rule, was 0.9-1.2 cm. The maximum size of the kidney stone was 9.5 cm, and the average size varied within 1 , 4-27cm. ESWL was performed on the Dornier Compact S machine. In the 882 patients, 2074 procedures were carried out for the ESWL, which was 2.35 procedures per patient. In the planned period, 71% of patients, 29% in urgent (at the height of the renal colic or within the next 30 hours) were treated. Results In the contingent of patients treated with ESWL, medical water "Naftusya" was used before the crushing session and exchange course for 2-3 weeks three times a day at a temperature of 17-20 degrees C in an amount of 10 ml per kilogram of weight per day. Patients, who used contact lithotripsy "Naftusya" were prescribed from the second day after the operation, that is, when in the postoperative period, complete peristalsis of the colon was restored. Doses were identical, as in patients with ESWL. Our long experience in treating patients with urolithiasis has shown recurrence of stone formation in 10-15% of patients with urolithiasis within five years of intervention. The latter is much lower compared to the literature without the use of water "Naftusya". Conclusions 1. ESWL - an effective out-patient method of removing concretions from the urinary tract. 2. Contact lithotripsy, along with ESWL - modern methods for the elimination of concretions from urinary tract with short bed day and minimization of surgical trauma. 3. Therapeutic water "Naftusya" - an effective means of metaphysics of urolithiasis. 4. Early postoperative rehabilitation of patients with urolithiasis is possible only on the territory of Truskavets. 5. The use of water "Naftusya" can significantly reduce the recurrence of stone formation in patients with urolithiasis, which makes this balneotherapy a "gold standard" in metaphilactics and early post-operative rehabilitation of patients with urolithiasis

Роль КТ-перфузии печени в выявлении предикторов тромбоза воротной вены у пациентов с компенсированным и субкомпенсированным циррозом печени

Portal vein thrombosis is one of the most common complications of liver cirrhosis, the risk factors for which are still not fully understood.Purpose: to develop a prognostic model to determine the likelihood of portal vein thrombosis based on anamnestic, etiological factors, the presence of hepatocellular carcinoma, as well as parameters of CT perfusion of liver tissue.Material and methods. 43 patients with compensated liver cirrhosis (58.1% of men) and 38 patients with subcompensated liver cirrhosis (50% of men) were included in the prospective study. The age of patients in the first group was 52.56 ± 9.62 years, in the second group - 50.95 ± 9.94 years. The number of patients with 1 etiological factor of liver cirrhosis in the study groups was 62.8% and 81.5%, respectively. Type 2 diabetes mellitus was exhibited in 23.3% of patients with compensated liver cirrhosis and in 15.8% of patients with subcompensated liver cirrhosis. The diagnosis of hepatocellular carcinoma was established in 27.9% of patients with compensated liver cirrhosis and in 18.4% of patients with subcompensated liver cirrhosis. All patients, after the native study, underwent CT perfusion of the liver using a 256-slice Philips ICT apparatus. As a result of postprocessing, the values of arterial, portal, total perfusion and perfusion index of liver tissue were determined. Statistical analysis of the data was carried out using the binary logistic regression method and the construction of ROC curves.Results. A logistic stepwise multivariate analysis showed that an increase in arterial perfusion (p = 0.002) and a decrease in portal perfusion (p = 0.004) were independently associated with portal vein thrombosis in patients with compensated liver cirrhosis, and a history of primary liver cancer (p < 0.001) was a dependent factor in this model. In patients with subcompensated liver cirrhosis, a history of hepatocellular carcinoma (p < 0.001) and a decrease in portal perfusion (p = 0.001) became independent predictors of portal vein thrombosis, male gender (p = 0.029) was a dependent factor in the developed model.Conclusion. CT-perfusion of the liver makes it possible to determine predictors that can be used together with such factors as the presence of hepatocellular carcinoma and gender in the construction of prognostic models to determine the likelihood of portal vein thrombosis in patients with compensated and subcompensated liver cirrhosis. Age, etiological factor and the presence of type 2 diabetes mellitus in the developed models were not statistically significant.Тромбоз воротной вены является одним из наиболее частых осложнений цирроза печени, факторы риска возникновения которого остаются все еще не до конца изученными.Цель исследования: разработать прогностическую модель для определения вероятности тромбоза воротной вены исходя из анамнестических, этиологических факторов, наличия гепатоцеллюлярной карциномы, а также параметров КТ-перфузии ткани печени.Материал и методы. В проспективное исследование было включено 43 пациента с компенсированным циррозом печени (58,1% мужчин) и 38 пациентов с субкомпенсированным циррозом печени (50% мужчин). Возраст пациентов в первой группе составил 52,56 ± 9,62 года, во второй группе – 50,95 ± 9,94 года. Количество пациентов с одним этиологическим фактором цирроза печени в исследуемых группах составило соответственно 62,8 и 81,5%. Сахарный диабет 2 типа был выставлен у 23,3% пациентов с компенсированным циррозом печени и у 15,8% пациентов с субкомпенсированным циррозом печени. Диагноз гепатоцеллюлярной карциномы был установлен у 27,9% пациентов с компенсированным циррозом печени и у 18,4% пациентов с субкомпенсированным циррозом печени. Всем пациентам после нативного исследования проводилась КТ-перфузия печени на 256-срезовом аппарате Philips ICT. В результате постпроцессинга определялись значения артериальной, портальной, общей перфузии и индекса перфузии ткани печени. Статистический анализ данных проводился с использованием метода бинарной логистической регрессии и построения ROC-кривых.Результаты. Логистический пошаговый многофакторный анализ показал, что повышение артериальной перфузии (р = 0,002) и снижение портальной перфузии (p = 0,004) были независимо связаны с тромбозом воротной вены у пациентов с компенсированным циррозом печени, а наличие первичного рака печени в анамнезе (р < 0,001) явилось зависимым фактором в данной модели. У пациентов с субкомпенсированным циррозом печени гепатоцеллюлярная карцинома в анамнезе (р < 0,001) и снижение портальной перфузии (p = 0,001) стали независимыми предикторами развития тромбоза воротной вены, мужской пол (p = 0,029) оказался зависимым фактором в разработанной модели.Заключение. КТ-перфузия печени позволяет определить предикторы, которые могут использоваться вместе с такими факторами, как наличие гепатоцеллюлярной карциномы и пол обследуемых, при построении прогностических моделей для определения вероятности тромбоза воротной вены у пациентов с компенсированным и субкомпенсированным циррозом печени. Возраст, этиологический фактор и наличие сахарного диабета 2 типа в разработанных моделях не были статистически значимыми

Academic conferences as a tool for language skills development in non-language majoring university students

In our globalized society, one of the key requirements in professional education is development of the communicative competence, including multicultural communication skills, the ability to advance products of intellectual property, and the results of scientific research and innovative developments in the international market. The authors work on a system of continuous education in foreign languages for various categories of students in higher education institutions. One of their research areas lies in finding out how quality may be ensured in educational services for students of a sufficient level of proficiency in foreign-language competence in order to communicate with representatives of other cultures, which is a priority task for any competitive higher education institution. The paper examines organization of students’ conferences, with English as the working language, as an effective means for successful formation of foreign-language communicative competence in natural science students. The authors consider the sequence of forms of student work (group and individual) as the most effective strategy for forming their foreign-language competence. The paper provides the description of different activities involving preparation of reports in English, the results obtained in the process of preparing bachelor’s degree students for participation in conferences, and analysis of their practical experience. The mentioned approach can be applied not only when preparing students for participation in students’ academic conferences, but also in other kinds of activity connected with professional foreign language education (seminars, round tables, webinars, and others) both in higher educational institutions and specialized schools