Archive of Clinical Medicine <p>The Journal of Research and Practice “Archive of Clinical Medicine” is a journal covering innovative research and practice in medicine. It publishes the results of original clinical research, review papers, case reports <span>and the results in sphere of medical education.</span></p><div class="page" title="Page 2"><div class="layoutArea"><div class="column"><p>The Journal is on the <a href="" target="_blank">List of Specialized Editions</a> in which the main results of theses are allowed to be published (The Order of Ministry of Education and Science of Ukraine of 16.05.2016, No 515) </p></div></div></div><p><span>p-ISSN <span><strong>2312-7007 (<span lang="EN-GB">Ukrainian ed. Print)</span></strong></span></span></p><p><span>e-ISSN <strong><span lang="EN-US">2414-9853 (<strong><span lang="EN-GB">English ed. Online)</span></strong></span></strong></span></p> Ivano-Frankivsk National Medical University en-US Archive of Clinical Medicine 2312-7007 Authors who publish with this journal agree to the following terms:<br /><ol type="a"><li>Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a <a href="" target="_new">Creative Commons Attribution License</a> that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</li><li>Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</li><li>Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See <a href="" target="_new">The Effect of Open Access</a>).</li></ol> Calcium Metabolism Indicators in Patients with Generalized Periodontitis and Hypertension <p>The objective of the study is to determine the level of calcium in patients with hypertension of the II degree and generalized periodontitis of the II degree.</p><p>There were examined 30 patients with hypertension of the II degree with generalized periodontitis of the II degree. Patients’ age ranged from 35 to 54 years.  These patients were in the main group. Treatment of patients included taking the medicine “Ca-D<sub>3</sub> NIKOMED”.</p><p>The control group included 10 patients without general somathic pathology and with healthy periodontitis of the same age.  The results obtained were subject to variational and statistical processing.</p><p>The analyses were carried out before and 3 months after the treatment. The level of general Ca in patients with generalized periodontitis of the II degree and hypertension of the II degree before the treatment was 1.66±0.03 mmol/l (p&lt;0.001) (norm 2.15-2.5 mmol/l). In the patients of control group this figure was 2.33±0.04 mmol/l (p&lt;0.001).</p><p>After 3 months the level of general Ca in patients with generalized periodontitis of the II degree and hypertension of the II degree was 1.87±0.03 mmol/l (p&lt;0.001).</p><p>The level of ionized Ca in patients with generalized periodontitis of the II degree and hypertension of the II degree before the treatment was 0.36± 0.01 mmol/l (p&lt;0.001); after the treatment the level of ionized Ca was 0.41±0.01 mmol/l (p&lt;0.001). The level of ionized Ca in control group patients was 1.03±0.02 mmol/l (p&lt;0.001).</p><p>We can conclude: according to the analysis of levels of general and ionized calcium in serum of patients with generalized periodontitis of the II degree and hypertension of the II degree we can conclude that these indexes are lower than normal; patients with generalized periodontitis of the II degree and hypertension of the II degree have increased levels of general calcium and ionized calcium in serum after taking the drug “Ca-D<sub>3</sub> NIKOMED”during 3 months.</p> T I Vivcharenko M M Rozhko ##submission.copyrightStatement## 2018-06-05 2018-06-05 1 1 10.21802/acm.2018.1.1 Efficiency of Using Mastication Test with Food Stimuli While Performing Electromyographic Studies in Dental Patients <p>The relevance of the topic is related to the necessity for a more detailed study of the effectiveness of surface electromyography as a method for diagnosis of pathological conditions of the teeth-and-jaws system and estimation of the orthopaedic treatment results. The objective of the study was to investigate the effectiveness of using a mastication test while performing surface electromyography in dental patients. We studied and analysed the output of surface electromyograms of m.masseter and m.temporalis obtained from a functional test of the maximum jaw clenching and a mastication test with a food stimulus in 54 persons. The results of the study showed a slight difference in the absolute values between the data of the functional test of the maximum jaw clenching and the mastication test. However, the comparative data of the tests after editing (removal of fragments representing the maximal mouth opening during the mastication from electromyograms in the "Neuro-MSP" program) showed no significant difference in data ($&gt;$0.05) and the maximum approximation of the absolute values of the functional and mastication tests in all cases. Thus, it has been established that in practice the mastication test while performing electromyography in dental patients should be determined and carried out as an additional one in order to clarify the results of treatment. Further studying and establishment of the most effective methods for electromyography is considered to be promising in dentistry.</p> Oksana Kinash Mycola Rozhko Andryyi Kostyshyn ##submission.copyrightStatement## 2018-06-05 2018-06-05 1 1 10.21802/acm.2018.1.3 Alexithymia and Quality of Life in Adult Patients with Juvenile Idiopathic Arthritis <p>Patients with chronic pain disturb not only quality of life (QL) but also develop difficulties in describing their feelings. Prolonged pain, stress, pathological conditions and related emotions can alter the perceived sensation of pain. The aim of our study was to study the QL and the level of alexithymia in adult patients with different types of juvenile idiopathic arthritis (JIA).</p><p><strong>Materials and methods</strong>. 173 young people aged 18-40 years old were examined: 118 adult patients with different ILAR variants of JIA, 30 patients with ankylosing spondylitis (AS) and 25 healthy young people. The QL was assessed using the Short-Form-36 questionnaire (SF36) with further assessing the level of alexithymia by Toronto alexithymia scale (TAS-20).</p><p><strong>Results</strong>. The analysis of QL shows that PCS (44.8±9.9) was significantly lower (p=0.001) in patients with JIA than in healthy subjects (55.7±6.9) of the corresponding age and sex, but did not differ from patients with AS (42.3±7.5). Patients with JIA had lower physical (p=0.001), role functioning (p=0.001) and bodily pain (p=0.001) compared with healthy, with no difference from patients with AS. In the distribution of patients with JIA in groups by the level of alexithymia, differences in QL were not revealed by MCS or PCS and scales related with them. The relationship analysis between the alexithymia and QL in patients with JIA shows, that elevated and high levels of alexithymia were related with low levels of MCS (p&lt;0.05), role functioning (p&lt;0.05), mental health (p&lt;0.05). PCS and physical functioning did not affect the level of alexithymia in adult patients with JIA. PCS, role functioning, bodily pain, and general health were the lowest in patients with poly-articular JIA. However patients with oligo-, poly-articular, enthesyte-related JIA had no differences on scales related to PCS. Patients with poly-JIA with elevated and high levels of alexithymia revealed significantly lower social (p&lt;0.05) and role (p&lt;0.05) functioning, mental health (p&lt;0.05) compared to patients without alexithymia. The presence of low bodily pain in alexithymic patients was found. Signs of alexithymia were found in 90% and 85% of adult patients with the oligo-arthritis and enthesyte-related JIA, respectively. The comparison of the QL in patients with oligo-arthritis and enthesitis-related JIA with different levels of the alexithymia shows no significant differences.</p><p><strong>Conclusions.</strong> 85.2% of adult patients with different variants of JIA have elevated and high levels of alexithymia. Adult patients with JIA have lower physical functioning than healthy individuals of the same age and sex, although they do not differ from the control group and AS group on psychological functioning and related vitality, social and role functioning, and mental health. The presence of alexithymia is related with a low level of psychological functioning, role functioning, mental health. However, physical functioning did not affect the level of alexithymia in adult patients with JIA. Patients with poly-JIA have the lowest physical, role function, bodily pain and general health, but according to the psychological functioning there were no differences between different variants of JIA in adulthood. Patients with poly-JIA with elevated and high levels of alexithymia have significantly lower social (p&lt;0.05), role (p&lt;0.05) functioning and mental health (p&lt;0.05) compared to patients without signs of alexithymia.</p><p> </p> Marta Dzhus ##submission.copyrightStatement## 2018-06-05 2018-06-05 1 1 10.21802/acm.2018.1.4 Differentiated Antiplatelet and Hepatoprotective Therapy in Patients with Stable Coronary Heart Disease on the Background of Nonalcoholic Fatty Liver Disease in Stage of Steatosis <p><strong>The </strong><strong>objective</strong><strong> of the </strong><strong>research</strong> was to evaluate the effectiveness of long-term antiplatelet and hepatoprotective differentiation therapy in patients with postinfarction cardiosclerosis and co-existent non-alcoholic fatty liver disease in stage of steatosis.</p><p><strong>Materials and methods.</strong> There were examined 72 patients with stable coronary heart disease functional classes II-III and co-existent non-alcoholic fatty liver disease in stage of steatosis. All the patients underwent a complete clinical examination; the functional state of their liver and platelet haemostasis were assessed. All patients received standard therapy the effectiveness of which was assessed 3 and 6 months after treatment.</p><p><strong>Results.</strong> The effectiveness of antiplatelet therapy was found to depend on treatment duration, the functional state of the liver and the scheme of antiplatelet and hepatoprotective differentiation therapy. In particular, 6 months after treatment, a positive dynamics of platelet haemostasis was observed in all the patients of Group I. However, the target value of its indicators was achieved in 60.5% of patients. In Group II, the target level of platelet aggregation activity was achieved in 38.3% of patients. The level of liver enzymes was within the control limits in 52.8% of patients. In 47.2% of patients, however, an increase in their level was observed, which necessitated the administration of appropriate hepatoprotective therapy.</p><p><strong>Conclusions.</strong> The developed concept of differentiation treatment of patients with coronary heart disease and co-existent non-alcoholic fatty liver disease in stage of steatosis envisages the need for monitoring the indicators of platelet haemostasis and liver function every three months after the administration of antiplatelet therapy with the possibility of its intensification and the inclusion of hepatoprotective drugs.</p> Iryna Vakalyuk Nataliya Virstyuk ##submission.copyrightStatement## 2018-06-05 2018-06-05 1 1 10.21802/acm.2018.1.6 Mastering the Central Line Placement Techniques Through Effective Resident Training Environment <p>Catheterization of the central vein is one of the fundamental procedures in anesthesiology. Mastering different methods of central venous access is an important part of resident training. At the initial stage residents should master the way of high medial access to the right internal jugular vein that is one of the simplest techniques with the lowest risk of complications for a patient. The operating room can be an optimal training environment where first independent puncture attempts are performed in a stable patient undergoing surgical intervention under general anesthesia. The next stage of training should involve access to other central veins as well performing the procedure in a conscious patient.</p> V V Protas ##submission.copyrightStatement## 2018-06-05 2018-06-05 1 1 10.21802/acm.2018.1.2 Pedagogical Aspects of Adaptation of First-Year Ukrainian and Foreign Russian-Speaking Students of the Department of Medicine Timely adaptation of first-year students to new living conditions and educational activities is one of the most important challenges of high school. The objective of the research was to study and analyze the problems of adaptation to high school experienced by Ukrainian and foreign first-year students of the Department of Medicine. The questionnaires offered to students showed that the main adaptation difficulties arise in the educational sphere. At the end of the first term, most students positively assessed the degree of their adaptability and noted the leading role of groupmates and friends in its formation. The possible directions of higher educational institution activity facilitating the process of adaptation of first-year students to high school were analyzed. According to the results of the questionnaire survey which indicated that the main difficulties were a lack of leisure time and academic overload, there is a need to optimize academic overload, as well as to inform psychologists, curators and lecturers about the formation of students’ ability to rationally schedule their time and the development of independent working skills. Elena Ivanchenko Oksana Melnikova Svetlana Malakhova Alexander Prokopchenko ##submission.copyrightStatement## 2018-06-05 2018-06-05 1 1 10.21802/acm.2018.1.5 Questionnaire of Third-Year Medical Students of the Ivano-Frankivsk National Medical University Undergoing Shortened Course of Study About Delivered Lecture in Clinical Anatomy and Operative Surgery <p>The educational process in Ukraine, that is undergoing reform due to the introduction of the European Credit Transfer System, requires the improvement of the basic forms of education, namely lectures. This is due to the dynamic development of scientific advances in medicine, the appearance of innovative technologies, the growth of requirements for the formation of a competitive specialist, a doctor who constantly needs to improve his/her knowledge and practical skills in particular. The questionnaire of student audience helps clarify the advantages and disadvantages of the teaching material presented during the lecture and the level of mastering the key moments of the lecture by students. We present the results of a questionnaire of students about the lecture delivered at the Department of Cinical Anatomy and Operative Surgery.</p> Vasyl Kavyn ##submission.copyrightStatement## 2018-06-05 2018-06-05 1 1 10.21802/acm.2018.1.7