Навчально-науковий медичний інститут (НН МІ)
Permanent URI for this communityhttps://devessuir.sumdu.edu.ua/handle/123456789/40
Browse
32 results
Search Results
Item Interdisciplinary interaction in maintaining the reproductive health in women with uterine leyomyoma(ALUNA Publishing, 2021) Karacharova, I.Yu.; Kozarenko, T.M.; Flaksemberg, M.A.; Kornatska, A.G.; Kondratiuk, V.K.; Нікітіна, Ірина Миколаївна; Nikitina, Iryna MykolaivnaThe aim: Optimizing the interdisciplinary approaches in the diagnosis and monitoring the dynamics of uterine leiomyoma treatment by high-intensity focused ultrasound ablation. Materials and methods: In the course of scientific research we conducted a survey 72 women of reproductive age were diagnosed with leiomyoma. All patients underwent bimanual gynecological examination, ultrasound and MRI to determine the condition of the pelvic organs, assess the structure, location, number of myomas, as well as assess the possible acoustic pathway of high-intensity focused ultrasound. During monitoring, dynamic contrasting was used to determine the zone of node necrosis. Methods of control in the postoperative period: ultrasound, MRI of the pelvic organs using paramagnetic, were performed after 1, 3, 6 months. Ultrasound ablation of uterine fibroids was performed using the JC extracorporeal treatment system (Chongqing HAIFU (HIFU) Technology Co. Ltd., China) with a built-in ultrasound system (Italy). Controlling the direct result was based on gray scale changes during real-time ultrasound examination on the monitor of the JC device. Since HIFU is a non-invasive method of treatment, in the future, the diagnosis was limited to using the ultrasound and MRI paramagnetic. Indicators such as: uterine body size were considered as indicators that characterize the effectiveness of treatment; specific volume of myoma; regression of uterine body size; regression of the myoma; regression of the node, calculated on its specific volume, because one patient could have several nodes. Results: Analyzing the obtained results, it should be noted that for a month the average volume of leiomatous hives that were exposed to HIFU, almost did not change and was 122 cm³, while three months after treatment it was – 98 cm. The nodes underwent a significant reduction 6 months after the treatment, their volume averaged 61 cm³. The dynamics analysis results of uterine body volume reduction, which is no less important expected result, showed the following: in the first month after the intervention the uterine volume almost did not change and, compared to the average size before treatment 342cm³, was 300cm³. In three months after treatment, the body volume of the uterus decreased to 264 cm³, and in six months – to 200 cm³. When assessing the node 6 months after the procedure, it was found that during this period there was a significant reduction in the volume of leiomyoma, which was positively correlated with the clinical manifestations of the disease. Conclusions: An interdisciplinary approach with the widespread introduction of modern organ-preserving techniques is an important direction in maintaining the reproductive health of women with uterine leiomyoma. Positive dynamics of leiomatous node volume regression depends on its location, volume and MR type. The terms 1 and 3 months after ultrasound ablation are insufficient for objective radiological evaluation of the treatment outcome, but are important for the choice of further tactics in observing and treating the uterine leiomyoma.Item Prognostic criteria for the selection of individuals with different heat sensitivity(Aluna Publishing, 2022) Vadzyuk, S.N.; Kharkovska, T.V.; Huk, V.O.; Dzhyvak, V.H.; Papinko, I.Ya.; Нікітіна, Ірина Миколаївна; Nikitina, Iryna MykolaivnaThe aim: To establish criteria for individual thermal sensitivity in almost healthy individuals aged 17-20 years. Materials and methods: We surveyed 150 people aged 17-20 years. Heat sensitivity was previously assessed using our adapted questionnaire «Levels of heat sensitivity», in which according to the scale the number of points 0-6 indicates reduced heat sensitivity, 7-16 points - increased). All respondents underwent thermal testing. The subjects had auscultatory determination of pulse rate and blood pressure, after which the hands of both hands were immersed in a container with warm water (45° C) for 3 minutes. At the 2nd minute, pulse rate and blood pressure were determined. this procedure was repeated after the hands were removed from the water, and every 2 minutes until the pulse and blood pressure recovered over time. Before and after the heat test, a mathematical analysis of heart rate was performed using a computer software package, according to the manufacturer›s instructions. Results: After conducting a thermal test in people with hypersensitivity, an increase in the average values of heart rate and blood pressure. In the group of people with lower sensitivity to heat, heart rate and blood pressure after the heat test decreased or did not change. As a result of statistical processing of data from mathematical analysis of heart rate, it was found that in persons with hypersensitivity after the thermal test increased activity of the sympathetic nervous system, while in subjects with reduced sensitivity to heat showed a slight advantage of parasympathetic nervous system. Conclusions: Increased activity of the sympathetic nervous system in response to heat in people with hypersensitivity indicates the development of stress, and given the current trend towards long-term and constant increase in average annual temperature, this will lead to overstrain of regulatory mechanisms, depletion of functional reserves and reduced adaptability . Therefore, people with high heat sensitivity are particularly vulnerable to global climate change.Item Clinical and pathogenetic causes of developing complications in multiple pregnancy(Івано-Франківський національний медичний університет, 2020) Нікітіна, Ірина Миколаївна; Nikitina, Iryna Mykolaivna; Бойко, Володимир Іванович; Boiko, Volodymyr Ivanovych; Бабар, Тетяна Володимирівна; Babar, Tetiana Volodymyrivna; Калашник, Наталія Володимирівна; Kalashnyk, Nataliia Volodymyrivna; Іконописцева, Наталія Анатоліївна; Ikonopystseva, Nataliia Anatoliivna; Бойко, Алеся Валеріївна; Boiko, Alesia Valeriivna; Bolotna, M.To assess the role of the placental growth factor in the development of gestational complications during multiple pregnancy, there was conducted a study of this indicator in serum of 320 pregnant women with multiple pregnancy in the first trimester and 40 pregnant women with singleton pregnancy (the control group). The objective of the research was to study the effect of placental growth factors on the gestational process in multiple pregnancy. Materials and Methods. There was conducted a prospective study of pregnancy and childbirth in 320 females with multiple pregnancy (the main group) and 40 healthy women with singleton pregnancy. The level of serum placental growth factor was determined by enzyme-linked immunosorbent assay using monoclonal antibodies in the first trimester of pregnancy. The indicators of the hemostasis system (vascular, platelet and coagulation components) were evaluated according to generally accepted methods. Doppler ultrasound of the placental and fetal blood flow was performed in the uterine arteries, the umbilical artery and vein, the fetal middle cerebral artery. Results. Women with multiple pregnancy were at high risk of developing gestational complications such as preterm deliveries (67.8%, p < 0.01), placental dysfunction, pre-eclampsia (17.5%, p < 0.05). The disorders of the vascular platelet and coagulation hemostasis in the first trimester of pregnancy were the main risk factors for early termination of pregnancy. Low level of serum placental growth factor in pregnant women with multiple pregnancy in case of preterm delivery, placental dysfunction and pre-eclampsia (111.23 ± 8.4, 203.24 ± 6.4 and 305.86 ± 7.4 pg/ml), in comparison with the corresponding indicators in singleton pregnancy (418.2 ± 10.4 pg/ml), was proven to be a prognostic marker for the development of gestational complications. Conclusions. Timely correction of gestational complications in multiple pregnancy with micronized progesterone, low molecular weight heparins, angio-protective agents allowed us to prolong pregnancy with monochorionic placentation type for 3.2 weeks (up to 34.2 ± 2.4 weeks) and provide full-time delivery of dichorionic twin pregnancy.Item Neurological disorders in pregnant women in low- and middle-income countries - Management gaps, impacts, and future prospects: A review perspective(SAGE Journals, 2023) Debrah, A.F.; Adebusoye, F.T.; Shah, M.H.; Awuah, W.A.; Tenkorang, P.O.; Bharadwaj, H.R.; Wellington, J.; Ghosh, S.; Abiy, L.; Fernandes, C.; Abdul-Rahman, Т.; Личко, Володимир Станіславович; Lychko, Volodymyr Stanislavovych; Бабар, Тетяна Володимирівна; Babar, Tetiana Volodymyrivna; Нікітіна, Ірина Миколаївна; Nikitina, Iryna MykolaivnaNeurological disorders during pregnancy are a substantial threat to women’s health, particularly in low- and middleincome countries. Furthermore, a critical shortage of mental health workers and neurologists exacerbates the already pressing issue, where a lack of coordination of respective healthcare among multidisciplinary teams involved in managing these conditions perpetuates the current state of affairs. Financial restrictions and societal stigmas associated with neurological disorders in pregnancy amplify the situation. Addressing these difficulties would necessitate a multifaceted approach comprising investments in healthcare infrastructure, healthcare professional education and training, increased government support for research, and the implementation of innovative care models. Improving access to specialized treatment and coordinated management of antenatal neurological diseases will precipitate improved health outcomes for women and their families in low- and middle-income countries.Item Pathogenetic aspects of metabolic syndrome in experimental animals(Aluna Publishing, 2022) Dziubanovskyi, I.Y.; Prodan, A.M.; Pidruchna, S.R.; Melnyk, N.A.; Dzhyvak, V.G.; Нікітіна, Ірина Миколаївна; Никитина, Ирина Николаевна; Nikitina, Iryna MykolaivnaThe aim: Was to study the state of the nitric oxide system, LPO and antioxidant system in the body of experimental animals in simulated metabolic syndrome. The aim of the study was to study the state of the nitric oxide system, lipid peroxidation and antioxidant system in the body of experimental animals in simulated MS. Materials andmethods: The study was performed on 20 white male Wistar rats. Male control rats (n = 10) were fed a normal control diet. Male rats of the main group (n = 10) were fed a diet high in fat (over 60 % energy from fats) for 16 weeks, thus modeling the development of MS. The indicators of the prooxidant and antioxidant system, as well as the nitric oxide system were determined by photospectrographic method. Results: In animals with simulated MS, intensification of lipoperoxidation (statistically significantly higher level of TBA-active products 1.84 times), depletion of antioxidant protection (statistically significantly lower level of superoxide dismutase 2 times), activation of nitric oxide system (statistically significantly higher NO-synthase level 2.15 times) were found compared with intact animals. Conclusions: In animals with simulated MS, activation of lipid peroxidation processes, depletion of antioxidant protection and increased levels of nitrooxidative stress were found.Item Condition of fetures and newborns from women with infertility treated with assisted reproductive technologies and with concomitant intrahepatic cholestasis(Aluna Publishing, 2021) Ekom Nsed, E.N.; Boichuk, O.H.; Heryak, S.M.; Нікітіна, Ірина Миколаївна; Никитина, Ирина Николаевна; Nikitina, Iryna Mykolaivna; Khmil, S.V.; Myhovych, V.V.The aim: Improving the effects of pregnancy on the fetus and newborn through early diagnosis and timely comprehensive therapy of pregnant women with intrahepatic cholestasis. Materials and methods: We have conducted a complex examination of 60 women who got pregnant owing to assisted reproductive technologies, with concomitant intrahepatic cholestasis, and 20 practically healthy women with a physiological course of pregnancy and labor (reference group), aged between 18 and 42. The research did not involve pregnant women with chronic liver diseases, viral hepatitis, skin diseases. Womens who underwent the suggested complex drug therapy with Ursofalc, L-arginine and Omega 3, with peroral administration for 14 days according to the following scheme: Ursofalc – 250 mg once a day, L-arginine – 5 ml 3 times a day, Omega 3 – 1 capsule a day. The complex examination of pregnant women with IHC was conducted before and after treatment. We analyzed the data of anamnesis, carried out anthropometric measurements, clinical biochemical examinations of the women with IHC, including the measurement of the levels of alanine aminotransferase, aspartate aminotransferase, total and direct bilirubin, total and placental alkaline phosphatase, leucine aminopeptidase, 5’-nucleotidase, cholic, deoxycholic and chenodeoxycholic acids as wells as their total level. Results: Almost 40 % of women with intrahepatic cholestasis gave birth to babies with asphyxia, including severe one in 11.1 % of cases, 1/3 of the newborns were premature, 40% had signs of hypotrophy, and 66.7 % experienced a disturbed course of early neonatal adaptation. There was also a higher level of perinatal mortality. The newborns from women who had undergone the suggested complex therapy presented no cases of hypotrophy, prenatal infection or cerebral circulation disorder. Conclusions: Thus, functional hepatic disorders in women with infertility play a certain role in the carrying of pregnancy after ART, in the development of pregnancy complications and adverse consequences for women and their newborns. The conducted research shows that early diagnosis and timely complex therapy of pregnant women with intrahepatic cholestasis makes it possible to influence the pathogenesis of perinatal complications and improve the consequences of pregnancy for the fetus and the newborn.Item Lung ultrasound during COVID-19 pandemics: why, how and when?(Aluna Publishing, 2021) Pronyuk, K.O.; Kondratiuk, L.O.; Vysotskyi, A.D.; Golubovska, O.A.; Нікітіна, Ірина Миколаївна; Никитина, Ирина Николаевна; Nikitina, Iryna MykolaivnaThe aim: To optimize diagnostic of pathological processes in lungs affected by COVID-19, dynamic monitoring and clinical decision making using lung ultrasound in limited resources settings. Materials and methods: Between the onset of pandemics and January 2021, approximately 9000 patients have been treated for confirmed COVID-19 in the Olexandrivska Clinical Hospital. Assessment of all hospitalized patients included hematology, chemistries and proinflammatory cytokines – IL-6, CRP, procalcitonin, ferritin. Diagnosis was confirmed by PCR for SARS-CoV-2 RNA. Chest X-ray was performed in all hospitalized cases, while CT was available approximately in 30% of cases during hospital stay. Lung ultrasound was proactively utilized to assess the type and extent of lung damage and to monitor the progress of disease in patients hospitalized into the ICU and Infection Unit (n=135). Ultrasound findings were recorded numerically based on scales. Results: In the setting of СOVID-19, bedside lung ultrasound has been promptly recognized as a tool to diagnose and monitor the nature and extent of lung injury. Lung ultrasound is a real time assessment, which helps determine the nature of a pathologic process affecting lungs. In this paper the accuracy of bedside LUS, chest X-ray and computer tomography are compared based on clinical cases, typical for COVID-19 lung ultrasound appearance is evaluated. Described in article data is collected in one of the biggest facility that deals with COVID-19.Chest X-ray was performed in all hospitalized cases, while CT was available approximately in 30% of cases during hospital stay. The cases presented in the paper indicate potential advantages to the use of ultrasound in limited resource healthcare settings, especially when the risk of transportation to CT outweighs the value of information obtained. Conclusions: Grading of ultrasonographic findings in the lungs was sufficient for both initial assessment with identification of high risk patients, and routine daily monitoring. Hence, lung ultrsound may be used to predict deterioration, stratify risks and make clinical decisionsItem The state of reproductive health of women with hyperproliferative pathology of the endometrium(Aluna Publishing, 2021) Нікітіна, Ірина Миколаївна; Никитина, Ирина Николаевна; Nikitina, Iryna Mykolaivna; Horban, N.Ye.; Микитин, Ксенія Вадимівна; Микитин, Ксения Вадимовна; Mykytyn, Kseniia Vadymivna; Kondratiuk, K.O.; Сміян, Світлана Анатоліївна; Смиян, Светлана Анатольевна; Smiian, Svitlana Anatoliivna; Калашник, Наталія Володимирівна; Калашник, Наталия Владимировна; Kalashnyk, Nataliia Volodymyrivna; Gerevich, N.V.The aim: To study and analyze the dynamics of women’s reproductive health in Ukraine as a factor in population reproduction and to study the features of menstrual disorders in Ukraine in 2010-2019. In women of reproductive age with hyperproliferative pathology of the endometrium without atypia. Materials and methods: A descriptive epidemiological study was conducted using data from the departmental statistical reporting of the Ministry of Health of Ukraine on the number of cases of gynecological pathology for 2010–2019. The peculiarities of menstrual function in patients of reproductive age with atypical hyperproliferative pathology of the endometrium were studied. We examined 84 patients of the gynecological department of the Sumy Regional Clinical Perinatal Center with a diagnosis of hyperproliferative pathology of the endometrium without atypia, who sought medical help during 2017-2020 for hyperplastic processes of the endometrium in reproductive age (18 to 49 years). All patients were divided into three groups, up to group I women with endometrial hyperplasia without atypia (HGE) (n = 30); Group II – patients diagnosed with endometrial polyps (n = 30); group III included patients with combined hyperproliferative pathology (uterine body polyps and endometrial hyperplasia without atypia) (n = 24). Results: As a result of the conducted systematic analysis it was established: the higher the prevalence of PMC, the higher the frequency of diseases of the genitourinary system and some gynecological diseases. This is confirmed by the calculated coefficients of correlation of the prevalence of PMC with the frequency of diseases of the genitourinary system (r = 0.75, p<0.001), salpingitis (r = 0.63, p<0.001) and endometriosis (r = 0.42, p<0, 05). The assessment of the relative risk of gynecological diseases has shown that the greatest attention needs to be paid to improving the diagnosis of infertility and endometriosis, as well as the prevention and treatment of salpingitis and uterine cancer. When women with menstrual disorders go to the gynecologist, it is necessary to pay attention to the presence of hyperproliferative pathology, and if women have other chronic diseases, offer rehabilitation of these foci, which can further have a positive effect on reproductive health. Conclusions: The highest rates of menstrual irregularities were found in women with endometrial hyperplasia without atypia and a combination diffuse hyperplasia with endometrial polyps in contrast to patients with only endometrial polyps. Menstrual irregularities can be considered as a marker and indicator of dysfunction of the genitourinary system and the presence of a hyperproliferative process at the prehospital stage.Item Fetal infections optimization of pregnancy and delivery introduction(Aluna Publishing, 2021) Herevych, N.V.; Nochvina, O.A.; Нікітіна, Ірина Миколаївна; Никитина, Ирина Николаевна; Nikitina, Iryna MykolaivnaThe aim: Improving perinatal outcomes in pregnant women at high risk of intrauterine infection by developing diagnostic criteria and algorithms for managing pregnancy and childbirth. Materials and methods: The study of pregnancy and childbirth was conducted in 72 patients at high risk of IUI, which formed the main group. The control group consisted of 64 patients with a low infectious risk of IUI. Culture, bacterioscopic and biochemical methods were used to identify microorganisms. Peculiarities of infection in the examined women were investigated by determining the concentration of Ig M and IgG in the blood serum and performed polymerase chain reaction for measles virus, cytomegalovirus, parvovirus B19. Serum for the presence of specific immune globulins to these pathogens was examined by ELISA. Comprehensive ultrasound examination in B-mode was performed to determine the feto metry of the fetus and assess its development with the determination of the estimated mass, location, size and structure of the placenta, the amount of amniotic fluid. To determine the condition of the fetus, a Doppler study of blood flow in the uterine arteries, umbilical artery, middle cerebral artery of the fetus and venous duct. Results: Analyzing the course of this pregnancy in women of the studied groups threatened miscarriage and the threat of premature birth occurred in 24 (33.3%) cases, with signs of isthmic-cervical insufficiency were diagnosed in 13 (18.1%) patients. In the control group of patients, the threat of abortion was diagnosed in 15 (23.4%) patients. According to ultrasound examination, patients in the main group in 12 (16.7%) cases were diagnosed with fetal growth retardation, in 25 (34.7%) patients at high risk of IUI there were changes in the placenta, namely, hyper echogenic inclusions in the placenta occurred in 7 (9.7%) cases, dilation of the intervillous space in 8 (11.1%) cases, placental hyperplasia in 7 (9.7%) cases, polyhydramnios was diagnosed in only 5 (6), 9%) cases, with 1 (1.4%) acute polyhydramnios in patients with signs of acute respiratory viral infection during pregnancy. Conclusions: Women at high risk for IUI require close monitoring of the fetus due to the increased frequency of hemodynamic changes in uteroplacental-fetal circulation, including fetal-placental – 22.2% and the occurrence of intrauterine growth retardation. Women with suspected cytomegalovirus infection require determination of seroconversion; in case of immunologically confirmed infection, it is desirable to recognize PCR for cytomegalovirus in the amniotic fluid in order to determine further management and monitoring of this pregnancy.Item Morphological changes of the endometrium in hyperplastic process in women of reproductive age(Aluna Publishing, 2021) Vereshchahina, T.V.; Boychuk, A.V.; Yakymchuk, Y.B.; Нікітіна, Ірина Миколаївна; Никитина, Ирина Николаевна; Nikitina, Iryna Mykolaivna; Datsko, T.V.The aim: To conduct a morphological study of endometrial tissue to identify changes characteristic of viral lesions to develop improved antirelapse treatment of HPE in women of reproductive age. Materials and methods: We surveyed 90 patients of the gynecological department who sought medical for hyperplastic processes of the endometrium in reproductive age. All women underwent hysteroscopy, the resulting material was subjected to morphological examination. Results: It became known that the virus is involved in the pathogenesis of endometrial hyperplasia. It is likely that it exists in epitheliocytes not only as a “passenger”, but also as an etiological factor. It became known that it was in complex hyperplasia with atypia that the percentage reached the highest level, which is a precancerous condition. Conclusions: Typical morphological change of the endometrium – multinucleation, multinuclearity and koilocytotic atypia in women of childbearing age with HPE – was revealed. The presence of infectious pathogens in the endometrium of patients with HPE can be regarded as one of the possible triggers for the development of hyperplastic processes.