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> en-US 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> (Popadynets O.H.) (Taras Kotyk) Sun, 30 Dec 2018 18:39:32 +0200 OJS 60 Specific Characteristics of Bioelectric Activity of the Brain in Women with Placental Dysfunction Considering the Type of Psychological Component of Gestation Dominant <p>&nbsp;The study of the influence of the autonomic nervous system on the course of pregnancy, childbirth and fetal state remains relevant. Changes in the parameters of electroencephalography may be detected long before the onset of clinical symptoms in the complicated course of pregnancy.&nbsp;</p> <p><strong>The objective of the research&nbsp;</strong>was to evaluate electroencephalography in women with placental dysfunction and gestational complications taking into account the type of psychological component of gestation dominant.&nbsp;</p> <p><strong>Materials and methods.</strong>&nbsp;Electroencephalography was performed in 60 pregnant women at the age of 19 to 45 years with gestational hypertension and fetal distress during pregnancy. The main group included 40 patients, who were stratified according to the type of psychological component of gestation dominant: 10 patients with euphoric type, 20 pregnant women with anxious and depressive type, 10 patients with hypogestognostic type. The comparison group comprised 20 patients with optimal type of psychological component of gestation dominant and normal course of the first half of pregnancy. The assessment of psychological component of gestation dominant was carried out according to the method proposed by Dobriakov I.V. - "Pregnant woman attitude test". Registrations, spectral and coherent analysis of electroencephalography were performed using BrainTest-24 hardware and software complex.&nbsp; \textbf{Results and discussion. }Electroencephalography of the patients of the comparison group was in line with current concepts regarding the physiological norm. In the main group, there were the following changes in electroencephalography: non-sinusoidal forms of alpha-oscillations (77.5%), high index of fast rhythms, flashes of spike waves under load, disturbances of the frontal occipital gradient with the focus on the anterior sections of the hemispheres.&nbsp;</p> <p><strong>Conclusions.</strong> The use of electroencephalography in women with different types of psychological component of gestation dominant in case of progressive placental dysfunction and preeclampsia on its background allows identifying characteristic changes, modifying the program of therapeutic measures, differentiating obstetric tactics and terms of delivery.</p> Nataliya Henyk, Nataliya Yakumchuk ##submission.copyrightStatement## Mon, 03 Dec 2018 08:54:54 +0200 The Use of Rentgenological Methods of Diagnostics in Surgical Treatment of Atrophy of the Alveolar Process of the Upper Jaw and Part of the Lower Jaw in Women of Postmenopausal Age <p><strong>The </strong><strong>objective</strong><strong> of the study</strong> is to evaluate the condition of the alveolar part of the upper jaw and the part of the mandible according to X-ray studies in postmenopausal women before and after surgical treatment of the atrophy of jaw bone tissue using osteoplastic material and an ossein-hydroxyapatite compound.</p> <p><strong>Materials and </strong><strong>m</strong><strong>ethods: </strong>There were observed 24 women in the postmenopausal period, aged from 51 to 58 years, with atrophy of the alveolar process of the upper jaw and the part of the lower jaw who were surgically treated.</p> <p><strong>R</strong><strong>esults</strong><strong> of the study</strong><strong>.</strong> On the basis of the obtained results of the X-ray examination, we can assume that the developed by us technique of surgical treatment of atrophy of the alveolar process of the upper jaw and the part of the lower jaw by the use of bone material of animal origin in combination with the ossein-hydroxyapatite compound allows us to intensify bone tissue regeneration processes, which further will contribute to the increase of the volume of bone tissue.</p> <p><strong>Conclusions</strong><strong>.</strong> The use of modern X-ray methods, in particular orthopantomography and cone-beam computerized tomography in the diagnosis and surgical treatment of atrophy of the alveolar process of the upper jaw and the part of the lower jaw, are highly informative, and also provide the possibility of work with a roentgenographic image in a digital format that allows a more detailed assessment of the area of surgical intervention before and after the treatment.</p> Yurii I Solodzhuk, Mykola M Rozhko, Oleksanr G Denysenko, Iryna R Yarmoshuk ##submission.copyrightStatement## Fri, 28 Dec 2018 12:53:37 +0200 The Prognostic Value of the Change in the Concentration of C–Reactive Protein in the Oral Liquid of Patients with Acantholytic Pemphigus, in Varying Degrees of the Acantholytic Process Severity on the Mucous Membrane of the Oral Cavity <p>The interconnection of changes in the concentration of C – reactive protein with the severity degree of the acantholytic process on the mucous membrane of the oral cavity in patients suffering from acantholytic pemphigus is described in the article.</p> <p><strong>Objective of the study </strong>– is to determine the correlation between the concentration of C – reactive protein in the oral liquid of patients with acantholytic pemphigus with the severity degree of the acantholytic process during the period of exacerbation of the disease in order to predict the assessment of general and local therapy, as well as the dynamics of the course of pathological processes on the oral mucous membrane.</p> <p><strong>Materials and methods. </strong>A complex of studies was performed in patients with acantholytic pemphigus, aged from 45 to 63 years, which included oral liquid examination in order to determine the CRP level, and determination of the acantholytic process severity degree on the mucous membrane of the oral cavity (utility model patent №101844).</p> <p><strong>Results and discussion. </strong>There was a clear correlation between the level of CRP concentration in the oral liquid of patients with acantholytic pemphigus with the severity degree of acantholytic process on the mucous membrane of the oral cavity, during different periods of the disease exacerbation. During the first day of exacerbation, the level of CRP was 384 (mg/ml), or higher in 41 individuals, with the third (III) severity degree of the acantholytic process on the mucous membrane of the oral cavity, which was a 73.21% of the total number of examined patients. During the 7<sup>th</sup> day, the CRP concentration level decreased to values of ≥24 and ≥48 (mg/ml), and during the 14<sup>th</sup> day – to the values of ≥12 and ≥24 (mg/ml).</p> <p><strong>Conclusions. </strong>The obtained results showed that the change in the concentration of CRP in the oral liquid of patients with acantholytic pemphigus has a reliable prognostic value and is an important characteristic of local and general diagnostic parameters of the disease.</p> Bogdan Genyk ##submission.copyrightStatement## Sun, 30 Dec 2018 18:25:37 +0200 Ultrasound Characteristics of the Nutcracker Syndrome <p>The article presents the results of color Doppler ultrasonography of the left renal vein and gonadal vein with the determination of the peak systolic velocity of blood flow and abnormal blood reflux in patients with left-sided varicocele.</p> <p><strong>The objective </strong>of the research was to compare preoperative ultrasound characteristics of the left renal vein, left gonadal vein, peak systolic velocity of blood flow and the presence of abnormal blood reflux, the formation of ultrasound criteria for the selection of patients for surgical correction of phlebohypertension.</p> <p><strong>Results.</strong> Ultrasound signs of aorta mesenteric compression were absent in 24 (24.5%) patients; the signs of aorta mesenteric compression without critical left renal vein stenosis were observed in 64 (65.3%) patients; critical stenosis of the left renal vein was diagnosed in 10 (10.2 %) patients. The patients with critical stenosis of the left renal vein underwent left renal vein transposition.</p> <p><strong>Conclusions. </strong>Ivanissevich surgery with prognostically low risk of relapse is recommended for the patients with left-sided varicocele without any signs of aorta mesenteric compression. Patients with the signs of aorta mesenteric compression require clear determination of the degree of left renal vein stenosis. We consider the transposition of the left renal vein to be indicated in case of critical stenosis when the correlation of the diameters of the distal and proximal segments of the left renal vein is ≥ 3 and the ratio of peak systolic velocities in the proximal and distal segments is ≥ 6. Thus, the diagnosis of phleborenohypertension in the patients with varicocele by means of color Doppler ultrasonography with the determination of blood flow velocity indicators in the left renal vein circulation and the determination of the critical stenosis of the left renal vein is decisive in choosing the surgical method of treatment. This provides an opportunity to evaluate the cause of varicocele occurrence and choose the optimal method of surgical treatment.</p> <p>&nbsp;</p> Ihor Kobza, Irena Nesterenko, Volodymyr Nesterenko ##submission.copyrightStatement## Sun, 30 Dec 2018 18:28:26 +0200 Clinical diagnostics of patients with acute purulent mediastinitis <p><strong>The </strong><strong>objective</strong><strong> of the study</strong>. To conduct an analysis of clinical diagnosis, symptoms and purulent mediastinal syndromes in patients with acute purulent mediastinitis (APM).</p> <p><strong>Materials and methods of research</strong>. During 2000-2018 there were 65 patients with APM in the thoracic department of the Ivano-Frankivsk Regional Clinical Hospital.</p> <p><strong>Research result</strong><strong>s</strong>. Clinical picture of APM consists of symptoms of the main disease and local manifestations of purulent process in the mediastinum: chest pain - in 62 (95.4%) patients, iPNiltrative changes and hyperemia of the thoracic wall were observed in 13 (20%), mediastinal emphysema at 29 ( 44.6%); general symptoms of endogenous intoxication: increased body temperature in 100% of patients, pallor of the skin in 34 (52.3%), cyanotic changes - in 24 (36.9%), shortness of breath - 37 (56.9%), tachycardia in 100% patients; clinical symptoms of damage to other organs of the mediastinum and chest: upper respiratory tract syndrome in 11 (16.9%), dysphagia in 9 (13.8%), hiccup in 2 (3.1%), hoarseness of voice in 6 (9.2%), cough - 23% (35.4%), exudative pleurisies ­- 6% (78.4%)&nbsp; and purulent pericarditis - in 18 (27.6%) patients.</p> <p><strong>Conclusions</strong><strong>.</strong></p> <ol> <li>Knowledge of the symptoms and syndromes of acute purulent mediastinitis is the basis for timely diagnosis of this disease.</li> <li>A clear clinical interpretation of the symptoms of acute purulent mediastinitis allows suspect this disease already at the initial stages of providing medical care.</li> <li>Early diagnosis of acute purulent mediastinitis is one of the decisive factors in the successful treatment of patients.</li> </ol> Sergiy Snizhko ##submission.copyrightStatement## Sun, 30 Dec 2018 18:35:33 +0200 Pseudarthrosis of the Carpal Scaphoid Treated with Non-Vascularized Corticocancellous Bone Graft <p><strong>Objectives:</strong> To carry out an epidemiological study and to assess the evolutionary profile of patients with scaphoid non-union treated by anterior non-vascularized corticocancellous bone graft.</p> <p><strong>Introduction:</strong> The non-union is a serious complication of carpal scaphoid fractures. Untreated, it leads to instability and osteoarthritis of the carp. The most used technique is that of Matti-Russe employing a corticocancellous graft.</p> <p><strong>Materials and methods:</strong> We report in this retrospective study the experience of the department of Orthopaedic Surgery &amp; Traumatology II, Mohamed V Military Hospital, Rabat, in the treatment of non-unions of the carpal scaphoid by anterior non-vascularized corticocancellous graft in nine cases collected between January 2012 and March 2016. We identified six cases of stage IIA and three cases of stage IIB. All our patients were operated by the Matti-Russian technique followed by an immobilization by plaster cast cuff on three months.</p> <p><strong>Results:</strong> All our patients achieved a union within an average of three months. The Mayo Wrist score was excellent in 66.6% of cases. Our results were very satisfying in 90% of cases, satisfying in 10%.</p> <p><strong>Conclusion:</strong> The treatment of non-unions of the carpal scaphoid without necrosis or osteoarthritis, using anterior non-vascularized bone graft remains the most widely used technique. The presence of initial instability is a factor of poor prognosis, its correction reduces the risk of arthritis.</p> Omar Mourafiq, Valery Kamenan, Youssef Benyias, Jalal Boukhriss, Bouchaib Chefry, Driss Bencheba, Ahmed Salim Bouabid, Moustapha Boussouga ##submission.copyrightStatement## Sun, 30 Dec 2018 18:38:16 +0200 The Prevalence of Caries of First Molars and Its Role in the Occurrence of Occlusal Disorders <p>To study the caries lesion of the first molars we used the results of our research about the prevalence of tooth decay in young people, who live in the districts with low level of fluoride. 300 students of first 3 years of study at Ivano-Frankivsk National Medical University at the age of 17 to 20 were examined for the research of prevalence of tooth decay. They were the citizens of Ivano-Frankivsk city, Nadvirna districrt, Verhovyna district and Rivne region. Clinical examination included medical history and oral cavity examination with the help of dental probe and detection device diagnodent (Kavo). We found that, regardless of the place of residence, the prevalence of acute and chronic tooth decay of the first molars was the highest. Occlusal decay was observed most commonly (38,3%). The established regularities of the prevalence of caries lesions in the first molars point to the necessity of development and realization of treatment measures for the prevention of occlusal disorders.</p> Khrystyna Oleksyn, Mykola Rozhko ##submission.copyrightStatement## Sun, 30 Dec 2018 18:38:47 +0200 Substantiation, Development and Implementation of Person-Centered Assessment of Psychosocial Significance of Chronic Dermatosis at the Stage of Primary Healthcare <p>High prevalence and incidence of chronic dermatoses among different age groups of Ukrainian population in combination with their multifactorial etiology and the progredient clinical course determine the need for the provision of general family medicine physicians with simple and accessible at the stage of primary healthcare technologies of medical care delivery to such patients. Patients with chronic dermatoses are known to be characterized by certain metabolic features, clinicopathologic cutaneous manifestations, as well as the development of special mental state associated with psychological trauma due to chronic dermatoses.</p> <p><strong>The objective of the research</strong> was to substantiate, develop and implement person-centered assessment of psychosocial significance of chronic dermatoses at the stage of primary healthcare delivery by general family medicine physicians.</p> <p><strong>Materials and methods. </strong>The study was carried out according to a specially developed program for collecting, accumulating and analyzing the results and included 114 patients with chronic dermatoses at the age of 29-58 years. Patients were divided into 2 groups: Group I included patients with chronic dermatosis duration of &lt;10 years and Group II comprised patients with chronic dermatosis duration of over 10 years. Medical and psychological examination of patients with chronic dermatoses was performed using the method of differentiated self-assessment of the functional state - the WAM (well-being, activity, mood), the Spielberger State Anxiety Scale modified by Khanin Yu.L., the personality questionnaire of the Bekhterev Institute (LOBI) etc.</p> <p><strong>Conclusions. </strong>The prognostic value of the decrease in strength and energy is an adverse effect on a relatively long clinical course of the disease. The diagnostic value of work/study limitations is 0.896 bit, and the prognostic value of this factor is a psychological limit of psychosocial functioning of an individual due to long-term clinical course of the disease. The presence of chronic skin disease was found to affect the patients’ daily lives; taking (physical, aesthetic, intellectual, etc.). The diagnostic value of work/study limitations is 0.896 bit, and the prognostic value of this factor is a psychological limit of psychosocial functioning of an individual due to long-term clinical course of the disease. The presence of chronic skin disease was found to affect the patients’ daily lives; taking (physical, aesthetic, intellectual, etc.). This indicated greater (p&lt;0.050) psychosocial limitation in individuals with long-term clinical course of chronic dermatoses being an indicator of the need for psycho-educational activities at the stages of clinical manifestations of chronic dermatoses.</p> Lidiya Cherkashyna ##submission.copyrightStatement## Sat, 08 Dec 2018 15:10:44 +0200 State Regulation of Public Health in the Precarpathian Region during the Period of the Austro-Hungarian Empire (1772-1918) <p>On the basis of archival documents, published historical documents and other available information sources, there was clarified the state of state regulation of public health (preventive medicine) in the Precarpathian region during the period of the Austro-Hungarian Empire, that is a relevant experience for building a modern health care system in Ukraine.</p> <p>Frequent changes in various socio-economic formations and the transition of the Precarpathian region from one state to another were found to significantly influence the nature of social relations in the region. Medical and sanitary care in this region was organized according to and influenced by the laws of the state that included the Precarpathian region in the relevant historical period.</p> <p>Trying to expand medical care and educational work among the population in order to prevent illness and increase life expectancy during the period of the Austro-Hungarian Empire (1772-1918), the authorities and public institutions in the field of health care initiated systematic and purposeful work on the formation of the basis for preventive medicine and, in fact, broke grounds in the field of public health. Their experience and practice are not only of scientific interest, but also of practical significance for the construction of a modern health system.</p> Oksana Soroka ##submission.copyrightStatement## Thu, 27 Dec 2018 18:46:32 +0200 Use of Case Problems When Training Family Physicians in Surgical Departments <p>At all the stages of a young specialist formation, the teaching staff of higher medical schools should work to improve the educational level of the future physician. For this purpose, various methods and forms of medical pedagogical practice are used. Together with the traditional approaches to training a doctor with the involvement of patients, they help educate future professionals. Case problems are one of such modern alternative methods being effective in practical classes of surgical disciplines. The use of case problems when teaching surgery of many pathological conditions to family physicians enables to expand the existing arsenal of teaching methods, contributes to the development of students’ clinical thinking, reorients them to an independent level of specialist training. Such method of conducting practical classes intensifies the educational process and organizes qualitative educational activity of students.</p> Rostyslav Sabadosh ##submission.copyrightStatement## Sun, 02 Dec 2018 00:08:47 +0200