Dear scientists, doctors, students
and other specialists and readers of the journal "Medicni Perspektivi"!

 

Despite the very difficult political and military situation in our country, the development of scientific opinion and publication activity of scientists on the pages of the journal does not stop. The editorial board and editors present the announcement of the next issue of the journal – No.3, 2022. We are sure that this issue will be interesting and useful for many scientists, teachers, doctors, students, etc.

Thus, the review article, devoted to the issue of the organization of medical and psychological assistance to women with perinatal losses, as well as  some rare cases from clinical practice, is important in terms of subject matter.

The theoretical section of the issue contains a number of experimental articles on the effects of model sepsis, blast injury, and the action of various pharmacological drugs to reveal new links in the mechanism of pathogenetic processes.

Among the clinical articles, the article on the dynamics of blood pressure in patients who have suffered a myocardial infarction, taking into account the polymorphism of the angiotensin receptor gene, as well as articles on the issues of the renal resistance index as a predictor of acute hydronephrosis, modeling of the prognosis of acute heart failure, and other definitely important and useful articles deserve attention.

Recently, the attention of many scientists has been drawn to vitamin D, to which 2 articles are devoted in the issue regarding the importance of vitamin D for the reproductive health of adolescent girls and its role in the development of atopic dermatitis.

A number of publications present new scientific data that are devoted to public health problems – public assessment of health risks of the COVID-19 pandemic, organization of forensic medical examination in Ukraine, hygienic regulation of man-made pollution of water sources, hygienic assessment of new architectural and planning solutions of modern projects hospitals and others.

So, wait for the release of the issue of the jpurnal.

The editors try to maintain high standards of the quality of publications, and your opinion, dear readers, is important and necessary for this. Therefore, send your impressions, comments, wishes, and suggestions regarding the journal to the editors.

Astakhov V.M., Batsylyeva O.V., Puz I.V., Shudrikova N.V. Features of the organization of medical and psychological assistance in the cases of perinatal losses (literature rewire)

  The article reveals the organization of medical and psychological assistance in cases of perinatal losses in modern conditions. The paper presents the peculiarities of perinatal loss, psychological condition of women’s health during the onset of subsequent pregnancy as well as experiences of the women who have lost a child at different stages of pregnancy. The article notes that the majority of pregnant women with a history of perinatal loss are in a state of chronic stress, which can lead to the emergence and development of various medical and psychological complications. The peculiarities of the experience of grief in the situation of perinatal loss, as a serious mental trauma for the woman's psyche were analyzed. It has been substantiated that the experience of perinatal loss is a non-normative crisis in marital relations, and the process of providing psychological assistance should be directed not only to the woman, but also to the married couple as a whole, which will reduce the risk of getting out of relationships, promote their harmonization, which can be considered as an effective resource for a constructive experience of the situation of loss. The main tasks of psychologists and medical staff during the organization of medical and psychological assistance for women and married couples experiencing perinatal loss are also revealed. It is crucial to comprehend the feelings women experience in such cases, which makes medical and psychological care more effective in the process of working with those who are through child loss or have had such an experience previously. The conclusion notes the priority of organizing and providing comprehensive medical and psychological assistance not only to women, but also to married couples in a situation of perinatal loss; the need for special training for medical psychologists, obstetricians and gynecologists to provide complex assistance to women experiencing perinatal losses.  

Kolesnyk T.V., Fursa O.V. Features of the daily profile of blood pressure, taking into account polymorphism of the angiotensin II type 1 receptor gene in patients with arterial hypertension after myocardial infarction

   The article presents the results of a study of the daily blood pressure profile, taking into account the polymorphism of the angiotensin II type 1 receptor gene in patients with arterial hypertension after myocardial infarction. The study involved 36 men with stage III hypertension, grade 1-3 arterial hypertension, who had had myocardial infarction. The average age in the study group was 57.0 (52.0; 64.0) years, the experience of hypertension was 6.3 (4.0; 15.0) years. The mean period after a heart attack was 48.0 (12.0; 144.0) months. The study of the type 1 angiotensin II receptor gene on the DNA-sorb-B test system was carried out by the polymerase chain reaction method with the restriction of products by endonuclease. A 24-hour blood pressure monitoring was performed according to the standard method. It was found that in general in the group the levels of systolic and diastolic blood pressure according to the median corresponded to the target ones. But the blood pressure load indicators both for the day and separately during the day and at night exceeded the normal range. In an intergroup analysis, significantly higher blood pressure figures and pressure load indices were registered in patients with the CC genotype of the angiotensin II type 1 receptor gene. In addition, this group of patients showed a high incidence of adverse variants of circadian fluctuations in blood pressure. In accordance to the daily monitoring data, only 13 (34.2%) patients achieved the target level of blood pressure: with the AA genotype – 6 (15.9%) patients, with the AC genotype – 6 (15.9%) patients and 1 (2.6%) patient with CC genotype of the angiotensin II type 1 receptor gene. In 4 (10.5%) patients with the AA genotype and in 3 (7.9%) patients with the AC genotype of the angiotensin II type 1 receptor gene, achievement of the target level of blood pressure was registered in the normal range of blood pressure load indices. In other cases, the target level of arterial pressure was accompanied by an increase in pressure load indices, which indicates incomplete daily control of arterial hypertension.

Dynnik V.O., Dynnik O.O., Druzhinina A.E. Role of vitamin D in the development of abnormal uterine bleeding of the puberty period

  The problem of the participation of vitamin D in the pathogenesis of various diseases has attracted the attention of scientists in recent years. Vitamin D deficiency is regarded as a global problem that increases the risk of many chronic diseases. More recently, the emphasis has shifted to the non-skeletal effects of vitamin D. A lot of literature sources suggest that vitamin D plays an important role in the regulation of processes in the ovaries that determine female fertility, female reproductive potential. Vitamin D receptor enzymes involved in its metabolism are expressed in both the central and peripheral reproductive organs (hypothalamic-pituitary system, ovaries, uterus, placenta). All of this suggests that vitamin D is involved in the regulation of menstrual function. The aim of the study is to identify the relationships between gonadotropic and steroid hormones with the content of vitamin D in menstrual disorders in adolescent girls by type of abnormal uterine bleeding (AUB). 167 adolescent girls with AUB were examined. The levels of LH, FSH, PRL, total estradiol (E2), testosterone (T), cortisol (C), vitamin D were determined. It was revealed that 92.1% of girls with AUB have a decrease in the level of vitamin D, and 53.9% of them – a sharp decrease in it. A factorial model of the relationship between pituitary-gonadal hormones and vitamin D was developed, on its basis it may be assumed that vitamin D makes a significant contribution to the formation of AUB in adolescence. Vitamin D participates in the mechanisms of stimulation of gonadotropins, affects the activity of sex hormones through the promoters of receptors located both in the hypothalamic-pituitary region and in the periphery in the ovaries. This is evidenced by factor loads, which serve as analogues of the correlation ratios and show the degree of interconnection between the variables in the factors selected. The changes in the content of vitamin D revealed indicate the need and expediency of its determination in the blood of patients with AUB during puberty for early diagnosis of its abnormalities and timely prevention of serious complications in the future.

Garaibeh E., Bondаr S.А., Tokarchuk N.I., Vyzgha Y.V. Charactirestics of vitamin D level in patients with atopic dermatitis

  The peculiarity of the skin is that it acts not only as a place of synthesis of vitamin D, but also as an organ targeted for its biologically active form. The aim of our study was to analyze the level of vitamin D in patients with atopic dermatitis. Methods. There were examined 48 people aged 18 to 55 years,  residents of Vinnytsia and Vinnytsia region. Serum levels of vitamin D, total IgE and eosinophilic cationic protein (ECP) were determined in the subjects. The average level of vitamin D in the serum of patients with atopic dermatitis was 19.2 [11.3-25.4]ng/ml, which corresponded to a deficiency. Among those surveyed, vitamin D deficiency was found in 68.4±4.7% (n=26) while vitamin D insufficiency in 31.6±4.5% (n=12). The severe course of the disease prevailed among patients aged 18 - 40 years (63.33±8.79 %) more than in the age group of 41 years and older, (36.67±8.8%, p<0.05; OR=2.98, S=0.53, 95% CI: 1.04-8.52). The proportion of people with vitamin D deficiency and moderate severity of atopic dermatitis was 62.5% (n=10) with a median level of 14 [8.3–19] ng/ml, and patients with severe atopic dermatitis made up 90.9% (n=20) (χ²=4.6; p=0.023), in which the median level of vitamin D was 14 [8.3–19] ng/ml. Serum vitamin D levels were in the zone of deficiency in patients with atopic dermatitis with moderate-severe and severe disease course. Vitamin D deficiency was significantly more common in the group of patients with elevated levels of allergic inflammation markers. A positive correlation of medium strength between the level of vitamin D and ECP in the serum of patients with atopic dermatitis (rs=0.53, p<0.001) was revealed.

Dorohan S.B., Shevchenko A.A., Kulagin A.A., Liashchenko O.V., Lobas V.M., Mikriukova N.G., Kostetsky I.V. Perception of the epidemic risks of the COVID-19 pandemic by the population of Ukraine

   In the social network Facebook from April 2020 to October 2020 an online survey using the "Google Form" was conducted to study the perception of the COVID-19 pandemic by the residents of Ukraine. The study involved 550 participants residing in the Ukraine-controlled territory and the city of Kyiv. The data are as follows: the coronavirus is considered a serious danger by 33.3±2.0% of respondents and 11.6±1.4% agree with certain doubts (in total – Σ44.9±2.1%); 21.1±1.7% believe that the coronavirus is not serious and 17.3±1.6 % believe that it is probably not serious (Σ38,4±2.1%). COVID-19 is recognized as a pandemic by 73.6±1.9% of respondents, of them 45.6±2.1% of respondents completely agree with this statement. Different views towards the severity of the problem show little but reliable correlation with age (rc =0,23; p<0.001), gender (rc =0,21; p<0,001) of the respondents, as well as with the size of the locality where respondents live (rc =0.30; p<0.001). It was revealed that men (47.2±3.6%), persons over 50 years of age (47.5±5.0%) and residents of small towns with a population of 3,000 to 10,0000 residents (47.7±4.3%) are more skeptical about this issue. The majority of respondents have a moderate level of epidemiological vigilance – 299 (54.4±2.1%); this means that a person emphasizes the seriousness and real threats of coronavirus infection, perceives and adheres to the adopted measures, but with certain hesitations. A high level of epidemiological vigilance characterized by confidence in the real situation and the adopted measures is found in 119 (21.6±1.8%) respondents. A low level of epidemiological vigilance is in 121 (22.0±1.8%) respondents. Only 11 people (2.0±0.6%) have the overall sum of points, which indicates the absence of epidemiological vigilance.

Polka N.S., Makhniuk V.M., Chorna V.V., Podolian V.M., Yurchenko S.T. Hygienic assessment of new architectural and planning solutions of psychiatric health care facility buildings

  Aim: to conduct a hygienic assessment of new architectural and planning solutions of psychiatric health care facility buildings in Ukraine and give a comparative description of the sanitary standards of the latter in the EU. The study was conducted based on the analysis of DBN B.2.2-10:2019 “Buildings and structures. Health care facilities” (draft, final revision), scientific sources of domestic and foreign scientists. A survey of the chief physicians of psychiatric hospitals of Ukraine concerning safe sanitary and hygienic, anti-epidemic conditions for the functioning of psychiatric health care facilities was conducted. We consider it necessary to present more carefully architectural and planning solutions in the relevant section of DBN B.2.2-10:2019 (draft, final revision) or to use the opportunity specified in the introduction to these Norms, and to supplement them with the Manual on the design of psychiatric health care facilities, taking into account the experience of the European Union. To create an appropriate “therapeutic environment” in new domestic mental health care facilities, it is necessary to implement European requirements in the design of these facilities with the involvement of multidisciplinary groups: (from architects to nurses, from construction contractors to patients) and supplement DBN B.2.2-10:2019 “Buildings and structures. Health care Facilities” of Ukraine with a guide for designing facilities of a new type of “Mental Health Centers” as in the Republic of Poland. We have developed and sent to the chief physicians of psychiatric hospitals of Ukraine «Questionnaire for scientific sanitary and epidemiological assessment of the conditions of placement of a psychiatric health care facility”. Based on the analysis of the block of questions on sanitary and antiepidemic and sanitary and hygienic parameters that characterize the buildings of domestic psychiatric hospitals, the location of medical structures and auxiliary units on the land plot, i.e. the design of buildings is determined. In particular, 50% of psychiatric hospitals are housed in combined buildings, 25% have a pavilion system (separate buildings), 12.5% each have a centralized system (all in one building) and a block system. The number of stories of psychiatric hospitals up to 2 is 50%, up to 3 - 37.5% and up to 5 stories in those which have been under construction since 1960 – 12.5%. Analysis of the questionnaire block on the conditions of stay, treatment, rehabilitation of the mentally ill revealed the possibility of organizing occupational therapy in 12.5% of psychiatric hospitals, where special workshops are equipped  and patients can acquire professional skills. Physiotherapy rooms are equipped in 50% of psychiatric hospitals. Low provision of patients with furniture was revealed: 25% of patients partially have proper desk, 75% do not have it; 50% are provided with proper chairs; 62.8% use proper bedside tables and 25% – closets for storing personal clothes.