Comparison of the diagnostic efficiency of various noninvasive methods for diagnosing liver fibrosis in patients with chronic viral hepatitis C

Summary: the article presents the results of the examination of patients with chronic viral hepatitis C namely the study of the informativeness of instrumental (fibroelastography) and serological (the content of hyaluronic acid in serum) of markers of fibrosis by assessing their predictive value by ROC- analysis. The purpose of the study: to find out the possibility of non-invasive methods for diagnosing liver fibrosis in patients with chronic viral hepatitis C (CHC). Materials and methods 66 patients with CHC with the 1-st genotype of the virus were examined, which were at the dispensary observation and ambulatory treatment at DCC CCH №1 in Vinnitsa and in the clinical department of viral hepatitis at the Institute of Epidemiology and Infectious Diseases named after L.V. Gromashevsky NAMS of Ukraine. All patients received fibroelastography (FEG) with a METAVIR score. All patients with CHC and group of control determined the content of hyaluronic acid (GA) in blood serum (ELISA using the Hyaluronic Acid (Corgenix, Inc., USA)). Research results Sensitivity of determination of GA in blood serum of patients with CHC with degree of fibrosis of liver F0-F2 was 91.23%, and specificity - 90.46%. For the FEG method, respectively: 74.33% and 77.25%. In the group of patients with degree of fibrosis F3 sensitivity of the definition of GA in blood serum was 72.21%, and specificity - 74.71%. The corresponding qualitative characteristics for FEG were: 98.32% and 91.45% respectively. The sensitivity of the determination of the content of GA in serum of patients with CHC with the degree of liver fibrosis F4 was 88.23%, and the specificity was 92.12%. For these patients the sensitivity and specificity of determining the degree of fibrosis by the FEG method were 87.78% and 91.45% respectively. Conclusions High diagnostic efficiency of determination of the content of GA in serum was established for assessing the degree of liver fibrosis in patients with CSF (AUC = 0,720-0,917, p˂0,01). Relatively higher sensitivity and specificity of the diagnosis of liver fibrosis was observed in determining the content of GA in serum compared with the FEG method (AUC = 0.914 vs. AUC = 0.817 (p˂0.05)) in the group with a lack or initial signs of liver fibrosis (F0-F2)

ДОСВІД ПОЗААУДИТОРНОЇ РОБОТИ ЗІ СТУДЕНТАМИ НА КАФЕДРІ ТЕРАПЕВТИЧНОЇ СТОМАТОЛОГІЇ

The aim of the work – to  analyze the essence of the student’s independent work as an integral part of the professional training of future dentists, and also to highlight the experience of its organization and carrying out at the Department of Therapeutic Dentistry of the Ukrainian Medical Stomatology Academy.The main body. To improve the educational level of training highly qualified specialists and rise up their intellectual and creative potential, the educational process should be constantly rationalized by enchanced the content, forms and methods of educational and cognitive activity of students of higher educational institutions. With the restriction of classroom time, there is a need for training in out-of-class work. Measures of out-of-class work on the development of the personality of the future doctor and the training of a professional-oriented specialist are the selection of conduct of Ukrainian student competition for the best practical work “Specialist”, as well as individual and group phantom studies.Conclusion. Practically oriented type of out-of-class work allows each student to develop manual skills, promotes the maximum development of individual creative abilities and finally leads to improving the quality and level of training of future specialists.Мета роботи – проаналізувати сутність позааудиторної самостійної роботи студентів як складової професійної підготовки майбутніх лікарів-стоматологів, а також висвітлити досвід її організації та проведення на кафедрі терапевтичної стоматології ВДНЗУ “УМСА”.Основна частина. Для підвищення освітнього рівня підготовки висококваліфікованих спеціалістів та збагачення їх інтелектуального та творчого потенціалу слід постійно раціоналізовувати навчальний процес шляхом удосконалювання змісту, форм і методів навчально-пізнавальної діяльності студентів вищих навчальних закладів. При обмеженні навчального аудиторного часу виникає необхідність навчання в позааудиторний час. Заходами позааудиторної роботи з розвитку особистості майбутнього лікаря і підготовки професійно-орієнтованого фахівця є проведення відбіркового туру Всеукраїнського студентського конкурсу на кращу практичну роботу “Фахівець”, а також індивідуальні та групові фантомні заняття.Висновок. Практично спрямований вид позааудиторної роботи дозволяє кожному бажаючому студенту напрацювати мануальні навички, сприяє максимальному розвитку індивідуальних творчих здібностей і в кінцевому підсумку приводить до поліпшення якості та рівня підготовки майбутніх фахівців

Effect of ultrasound on s. Epidermidis museum culture

The aim o f the present research project was to study the effect o f ultrasonic waves on the S. epidermidis ATCC 14990 museum culture. Materials and methods: A bibliosemantic method - for analyzing previous research based on scientific literature, electronic resources. empirical methods of scientific research (observation, comparison, measurement, experiment) - to study the effect o f ultrasound on the strain o f S. epidermidis ATCC 14990. Results: A study showed that when exposed to ultrasound for four and a h alf minutes on a culture o f microorganisms S. epidermidis in glass tubes, the number o f viable cells in the suspension decreases. Conclusions: The influence o f ultrasound on the culture o f S. epidermidis, studied in the work, showed that the selected and used parameters o f ultrasound treatment cause destructive changes in microorganisms. These changes are not fatal for the entire bacterial culture used in the study, but they have a reliable antimicrobial effect

Possibilities for treating patients with chronic generalized periodontitis

В статті дано оцінку підвищення ефективності лікування хворих на хронічний генералізований пародонтит з урахуванням сучасної стратегії та тактики курації пацієнтів із хронічним генералізованим пародонтитом. Нами було проведено обстеження 204 пацієнтів із хронічним генералізованим пародонтитом І, ІІ, ІІІ ступенів тяжкості. Результати всебічного обстеження стали основою для складання плану лікування з урахуванням зазначеної стратегії та тактики лікування хворих на генералізований пародонтит. Оцінку ефективності курації пацієнтів проводили через 6, 12 місяців, 2 та 3 роки. Отримані результати свідчать про виправданість проведеного лікування пацієнтів із генералізованим пародонтитом з урахуванням етіологічного, патогенетичного, симптоматичного підходу та дотриманням принципів комплексності, поєднаності, індивідуалізації, диференціації та курсовості.В статье дана оценка повышения эффективности лечения больных с хроническим генерализованным пародонтитом с учетом современной стратегии и тактики курации пациентов с хроническим генерализованным пародонтитом. Нами было проведено обследование 204 пациентов с хроническим генерализованным пародонтитом I, II, III степеней тяжести. Результаты всестороннего обследования стали основой для составления плана лечения с учетом указанной стратегии и тактики лечения больных генерализованный пародонтит. Оценку эффективности курации пациентов проводили через 6, 12 месяцев, 2 и 3 года. Полученные результаты свидетельствуют об оправданности проведенного лечения пациентов с генерализованным пародонтитом с учетом этиологического, патогенетического, симптоматического подхода и соблюдением принципов комплексности, объедененности, индивидуализации, дифференциации и курсовости.The approach to the treatment of periodontal diseases is one of the most important problems in theoretical, clinical and preventive medicine. The aim of our study was to increase the effectiveness of treatment of patients with chronic generalized periodontitis, taking into account the current strategy and tactics of curation of these patients. The clinical study involved 204 patients with chronic generalized periodontitis, which were divided into three groups depending on the severity of periodontitis. The first group included 68 patients with I degree, the second - 90 with II degree and the third - 46 people with III degree of severity of inflammatory-dystrophic periodontal changes. Evaluation of the effectiveness of curation of patients was performed after 6, 12 months, 2 and 3 years. Based on the results of a comprehensive examination of patients in the long term dispensary observation 3 years in each group were formed subgroups with positive (1-A, II-A, III-A) and negative (I-B, II-B, III-B) dynamics of treatment. The obtained results testify to the justification of the treatment of patients with generalized periodontitis, taking into account the etiological, pathogenetic, symptomatic approach and adherence to the principles of complexity, combination, individualization, differentiation and course. The earlier the disease is detected, a qualitative comprehensive examination of the patient is carried out, the more effective preventive and curative measures. Negative results of curation of patients with chronic generalized periodontitis can also be significantly reduced, taking into account the additional functionality of the periodontal complex

Comparative evaluation of rehabilitation of patients with chronic generalized periodontitis with included dentition defects in the lateral area

Результаты проведенного исследования свидетельствуют о целесообразности замещения включенных дефектов зубных рядов у пациентов с хроническим генерализованным пародонтитом I степени тяжести с помощью двухэтапной имплантации при отсутствии у пациента общих и местных противопоказаний к ее проведению. Имплантация в области отсутствующих зубов позволяет максимально правильно распределить нагрузку в области зубов, ограничи¬вающих дефект, тем самым предупредить прогрессирование развития хронического генера¬лизованного пародонтита. Альтернативным вариантом является изготовление съемных кон¬струкций, которые позволяют равномерно перераспределить жевательное давление между опорными зубами и альвеолярным отростком в области отсутствующего зуба. Неприемлемым является использование несъемных конструкций зубных протезов. Как показывают результаты исследования, данные конструкции приводят к перегрузке опорных зубов и к дальнейшему прогрессированию заболеваний тканей пародонта; The results of the study indicate the expediency of replacing the included dentition defects in patients with chronic generalized periodontitis of the first degree with the help of a two-stage implantation, in the absence of general and local contraindications to its conduct. Implantation allows the most correct distribution of the load in the area of teeth adjacent to the defect, thereby preventing the progression of the development of chronic generalized periodontitis. An alternative option is to produce removable structures that allow evenly redistribute the chewing pressure between the supporting teeth and the alveolar process in the area of the missing tooth. It is unacceptable to use non-removable structures of dentures. As the results of the study show, these designs lead to overload of supporting teeth and further progression of periodontal tissue diseases

Prevalence and diagnostics aspects of akantolytic pemphigus in dentisn's practice

The article presents investigation of spreadness and clinic-morphologyc forms of pemphigus structure among the population of Poltava region and aspects of cytological diagnostics on the early stages of diseases. Objects and methods of investigation: analysis of medical carts of patients with acantolytic pemphigus, which had treatment on base of regional dermatologyc-venerologic dyspancery and person which came to department of therapeutic stomatology without diagnose are made. Patients had general clinical examination and cytology investigation. Morphological features of acantholytic cells are round or oval shape, size a smaller that in normal epithelial cells. This cells characterized of basophilic nucleus and cytoplasm, presence in nucleus of 2-3 big nucleolus and light-blue perinuclear area. Cytoplasm is unevenly painted. Along the periphery of the cell-thickening of color in the form of the intense blue of the rim - a zone of concentration of the dye. Our research shows that the acantholytic cells can form cells symplast that contain multiple cores. Methods of determining the acantholytic cells is relatively simple and minimally invasive, but not reliable. Since the primary stage at diagnosis and remission phase of the disease to determine the acantholytic cells are very difficult. Тhe phenomenon of acantholysis, degenerative changes plasmolemma and vacuolization of the cytoplasm of epithelial cells, which are an intermediate stage of degenerative changes in the formation of Tsank's cells. In particularly difficult clinical situations, recommend dynamic of three cytological observation and highly specific methods of using lektinogisto-chemistry

Range of the t--J model parameters for CuO2_{2} plane: experimental data constraints

The t-J model effective hopping integral is determined from the three-band Hubbard model for the charge carriers in CuO$_{2}$ plane. For this purpose the values of the superexchange constant $J$ and the charge-transfer gap $E_{gap}$ are calculated in the framework of the three-band model. Fitting values of $J$ and $E_{gap}$ to the experimental data allows to narrow the uncertainty region of the three-band model parameters. As a result, the $t/J$ ratio of the t-J model is fixed in the range $2.4 \div 2.7$ for holes and $2.5 \div 3.0$ for electrons. Formation of the Frenkel exciton is justified and the main features of the charge-transfer spectrum are correctly described in the framework of this approach.Comment: 20pp., REVTEX 3.0, (11 figures), report 66

Fas/FasL-mediated apoptosis and inflammation are key features of acute human spinal cord injury: implications for translational, clinical application

The Fas/FasL system plays an important role in apoptosis, the inflammatory response and gliosis in a variety of neurologic disorders. A better understanding of these mechanisms could lead to effective therapeutic strategies following spinal cord injury (SCI). We explored these mechanisms by examining molecular changes in postmortem human spinal cord tissue from cases with acute and chronic SCI. Complementary studies were conducted using the in vivo Fejota™ clip compression model of SCI in Fas-deficient B6.MRL-Fas-lpr (lpr) and wild-type (Wt) mice to test Fas-mediated apoptosis, inflammation, gliosis and axonal degeneration by immunohistochemistry, Western blotting, gelatin zymography and ELISA with Mouse 32-plex cytokine/chemokine panel bead immunoassay. We report novel evidence that shows that Fas-mediated apoptosis of neurons and oligodendrocytes occurred in the injury epicenter in all cases of acute and subacute SCI and not in chronic SCI or in control cases. We also found significantly reduced apoptosis, expression of GFAP, NF-κB, p-IKappaB and iba1, increased number of CD4 positive T cells and MMP2 expression and reduced neurological dysfunction in lpr mice when compared with Wt mice after SCI. We found dramatically reduced inflammation and cytokines and chemokine expression in B6.MRL-Fas-lpr mice compared to Wt mice after SCI. In conclusion, we report multiple lines of evidence that Fas/FasL activation plays a pivotal role in mediating apoptosis, the inflammatory response and neurodegeneration after SCI, providing a compelling rationale for therapeutically targeting Fas in human SCI

Deformation properties of mastoid area skin

The mechanical properties of the skin have been studied in vivo and in vitro using various test methods. It has been found that with age, the skin undergoes considerably less deformation at the same voltage, which is probably due to the change of collagen and elastin nets. Two-dimensional biomechanical behavior and the content of collagen in human skin samples from different areas of topical localization were studied. The minimum and maximum reduction axes were determined after removal and their connection with Langer’s lines. The experimental equipment was designed to keep the geometry and measure loads acting perpendicular to the circle of skin samples. Using in vivo geometry of samples as a base, various deformations were applied. After the voltage relaxation, the final values of the voltage were taken and compared with the deformations. It was found that the axes of maximum and minimum stress do not coin-cide with the Langer’s lines, and rotated 10°. This article describes the structure of the mastoid area skin. After the objective morphological studies, we came to the conclusion that during the surgery on the mastoid region, namely cosmetic otoplasty and lower rhytidectomy, the length of stretching skin-fat grafts must be taken into account. No visible lesions were found in their deformation in the range of 5-10 mm. This is the optimal minimum and maximum limit of biomechanical parameters in such interventions. Patho-logical changes primarily in the form of balloon degeneration were observed at the 15-20 mm flap tension, indicating a greater likelihood of necrosis in the postoperative period. Deformation of the skin-fat grafts of 25 mm leads to irreversible changes and hemodynamic disorders, thus flap stretching within these parameters is unacceptable. The aim of this study was to investigate the morphological features of skin-fatty grafts of mastoid area at various stages of deformation. In the experiment we used 30 skin-fatty grafts taken from the patients with roughness during cosmetic otoplasty. These pieces were elongated at 5, 10, 15, 20, 25 mm respectively; they were colored by hematoxylin-eosin as well as van Gieson stai

Dental probes

Статья представляет информацию о наиболее часто применяемом стоматологами инструменте ‒ зонде. Знания разновидности имеющихся современных стоматологических зондов, их характеристик должны быть основой правильного выбора одного из главных инструментов врача на этапе объективизации заболевания, ранней его диагностики. Особенно актуален и важен в данном аспекте вопрос применения пародонтальных зондов, в том числе в составе автоматизированных диагностических систем.Стаття представляє інформацію про інструмент, який стоматологи найбільш часто застосовуюсь в своїй практиці ‒ це зонд. Знання різновидів наявних сучасних стоматологічних зондів, їх характеристик повинні бути основою правильного вибору одного з головних інструментів лікаря на етапі об'єктивізації захворювання, ранній його діагностиці. Особливо актуальний і важливий в даному аспекті питання застосування пародонтальних зондів, в тому числі в складі автоматизованих діагностичних систем.This article provides information about the most frequently used dentist's instrument, which is a probe. Knowledge of the variety of available modern dental probes, their characteristics should be the basis for the right choice of one of the most important tools for a doctor during the objectification of the disease and its early diagnostics. Especially relevant and important issue in this aspect is the periodontal probes usage including automated diagnostic systems