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.&nbsp;It publishes the results of original clinical&nbsp;research, review papers, case reports&nbsp;and the results in sphere of medical education.</p> <div class="page" title="Page 2"> <div class="layoutArea"> <div class="column"> <p>The Journal is on the <a href="" target="_blank" rel="noopener">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)&nbsp;</p> </div> </div> </div> <p>p-ISSN&nbsp;<strong>2312-7007 (<span lang="EN-GB">Ukrainian ed. Print)</span></strong></p> <p>e-ISSN&nbsp;<strong><span lang="EN-US">2414-9853 (<strong><span lang="EN-GB">English ed. Online)</span></strong></span></strong></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.) (Тарас Котик) Tue, 29 Dec 2020 00:00:00 +0200 OJS 60 Colonic Stoma Creation as the First Stage of Surgical Correction of Total Colonic Aganglionosis in Children <p><strong><em>Abstract.</em></strong> The use of a staged approach in surgical treatment of total colonic aganglionosis is controversial. The creation of a protective colonic stoma as the first stage of surgical correction of total colonic aganglionosis rather than one-stage correction has become an alternative in treatment of such patients. This approach contributes to better survival, reduces the incidence of ileoanal anastomotic failure and improves functional outcomes.</p> <p><strong>The objective of the research</strong> was to study and evaluate the need for colonic stoma creation as the first stage of surgical correction of total colonic aganglionosis in children.</p> <p><strong>Materials</strong> <strong>and</strong> <strong>Methods</strong><strong>. </strong>The analysis of surgical treatment of 41 children with total colonic aganglionosis over the period 1980-2020 was conducted. Protective colonic stoma was created in all the patients, namely 36 children with isolated colonic aganglionosis and 5 children with the involvement of the entire colon and a segment of the small bowel.</p> <p><strong>Results</strong><strong>. </strong>Twenty-four (58.54%) patients were diagnosed and underwent the first stage of treatment in National Specialized Children’s Hospital “Okhmatdyt”. There were 17 (41.46%) patients who were transferred from other clinics after being diagnosed with a pathology and undergoing colonic stoma creation. During staged treatment of children with total colonic aganglionosis, a single-barrel ileostomy (n=10, 24.40%), a double-barrel ileostomy (n=5, 12.19%), or a loop colonic ileostomy (n=26, 63.41%) were created. The periods between creating the protective colonic stoma and performing radical surgery ranged from 4 to 14 months. The colonic stomas were closed 2-4 months after radical surgery. The third stage of surgical correction of total colonic aganglionosis in children was carried out after the state of the neorectum formed and ileoanal anastomosis were assessed for readiness of inclusion in the passage. There were no complications after protective stoma closure. Within the first 3 months, the frequency of bowel movement ranged from 10 to 15 times a day, and, in a year, it was 2-4 times a day. All the children survived. Functional outcomes of treatment were found to be good. Bowel function was satisfactory. The X-ray images demonstrated the rectal reservoir of sufficient size with pronounced colonization.</p> <p><strong>Conclusions. </strong>Surgical correction of total colonic aganglionosis in children involves the three-stage approach consisting in the creation of the protective small bowel stoma (the first stage), radical surgery, namely colectomy with reconstructive plastic formation of functionally advantageous reservoir version of the neorectum (the second stage) and ileostomy closure after adaptation of the small bowel reservoir (the third stage). The creation of the protective small bowel stoma as the first stage of surgical correction of total colonic aganglionosis in children is emergency surgery. The creation of the loop small bowel stoma at 12 cm above aganglionosis level is the most rational type of the first stage of correcting total colonic aganglionosis in children. </p> Oleh Kurtash Copyright (c) 2020 Oleh Kurtash Tue, 29 Dec 2020 00:00:00 +0200 Early Prevention of Occlusal Disorders of Dental Arches <p><strong><em>Abstract</em></strong>. Occlusion is the joining of dental arches or individual groups of teeth over longer or shorter periods of time. Dental caries is one of the main factors of occlusal disorders. In economically developed countries, it affects 95-98% of the population. Dental caries results in changing location of occlusal contact points and is the cause of atypical mandibular movements. As a result, occlusal overloading and trauma are observed.</p> <p><strong>The objective </strong>of the research was to carry out early prevention of occlusal disorders in patients with carious lesions using modern restorative methods.</p> <p><strong>Materials and Methods. </strong>There were examined 90 first-/second-/third-year students of the Ivano-Frankivsk National Medical University at the age of 17-20 years living in the regions with low fluoride level in order to prevent occlusal disorders using the methods of restorations of the affected occlusal surfaces considering functional anatomy and subsequent checking of occlusal relationships with the help of the T-Scan Novus occlusal analysis system. Among them, 45 students were diagnosed with fissure caries of the first molars, 45 students underwent the restoration of the first molars without considering functional anatomy. Treatment was carried out by the methods of direct and indirect restorations.</p> <p><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Results</strong>. The paper contains the results of redistribution of occlusal contacts in carious lesions of the first molar (decrease in the occlusal load on the affected tooth, occurrence of overloading on the tooth with larger chewing area) and restoration of the first molar without considering the principles of functional anatomy (bite force directly on the tooth restored). Further restorations of the chewing surfaces of the first molars considering the occlusal determinants led to an even distribution of the occlusal force on the molars.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <strong>Conclusions</strong>. The results of our study demonstrated the effectiveness of the developed treatment and prevention complex.</p> Khrystyna Oleksyn, Mykola Rozhko Copyright (c) 2020 Khrystyna Oleksyn, Mykola Rozhko Tue, 29 Dec 2020 00:00:00 +0200 Study of Insulin Resistance in Patients with Cancer <p><strong><em>Abstract</em></strong><strong>.</strong> The pro-oncogenic effects of obesity, insulin resistance and hyperinsulinemia have been proven in some types of cancer, as well as in type 2 diabetes mellitus.</p> <p><strong>The objective </strong>of the research was to investigate the state of insulin resistance in patients suffering from oncological diseases and to compare insulin correlations in patients with type 2 diabetes mellitus and those with cancer.</p> <p><strong>Materials and Methods.</strong> The study included the following groups of patients: Group I included healthy individuals (the control group); Group II comprised patients with type 2 diabetes mellitus; Group ІІІ included patients with cancer: subgroup IIIa comprised patients with breast cancer, subgroup IIIb included patients with endometrial cancer, subgroup IIIс comprised patients with colorectal cancer. Fasting blood glucose was determined by glucose oxidase method; hemoglobin A1c was determined by ion exchange chromatography; the levels of insulin and insulin-like growth factor-1 were determined by immune-enzyme method. Insulin resistance was assessed by the homeostatic model assessment for insulin resistance index. The results obtained were analyzed using statistical analysis.</p> <p><strong>Results.</strong> Obesity was confirmed in all the groups of patients with cancer. Significantly higher body mass index, as compared to the control group, was found in patients with endometrial cancer (p = 0.008). In comparison with the control group, the levels of insulin and insulin-like growth factor-1 increased significantly in all groups of patients with cancer (p &lt; 0.001). Fasting blood sugar levels and hemoglobin A1c did not differ from the indicators in the control group (p &gt; 0.05). Direct correlations between insulin and body mass index (p &lt; 0.05), insulin-like growth factor-1 (p &lt; 0.05) and the homeostatic model assessment for insulin resistance index in patients of Group II and Group III were detected (p &lt; 0.05).</p> <p><strong>Conclusions.</strong> In obese patients with breast, uterine and colorectal cancer, there was found a decrease in insulin sensitivity, which might increase the proliferative effects of insulin and insulin-like growth factor-1. Correlation analysis showed a probable association of cancer and diabetes mellitus due to obesity and insulin resistance.</p> Tamara Vatseba Copyright (c) 2020 Tamara Vatseba Tue, 29 Dec 2020 00:00:00 +0200 Wellens’ Syndrome: Focus on Diagnosis and Choice of Myocardial Revascularization Strategy <p><strong><em>Abstract</em></strong><em>.</em> Wellens’ syndrome is an extremely relevant issue in modern cardiology. Wellens’ syndrome is quite often untimely diagnosed, and the patient’s management is the same as in case of unstable angina. Since without myocardial revascularization, widespread myocardial infarction develops within the following days or weeks, myocardial revascularization is needed as soon as possible. Characteristic changes on the electrocardiogram in case of Wellens’ syndrome include biphasic (type A) or inverted (type B) T waves in leads V2-V3, which sometimes are seen in other precordial leads. There must be a history of recent angina in addition to these electrocardiogram changes. Troponin is usually negative; however, it can be slightly elevated. Sometimes, patients with classic electrocardiogram changes and clinical picture typical for Wellens’ syndrome do not show hemodynamically significant stenosis of the left anterior descending artery typical for this syndrome. In such cases, “pseudo-Wellens’ syndrome” is observed. Three cases of angiographically confirmed Wellens’ syndrome and one case of pseudo-Wellens’ syndrome are presented in this paper. All the patients with Wellens’ syndrome had significant lesions of the left anterior descending artery. One patient had a triple-vessel lesion, and the other two had a single-vessel lesion. Troponin I was within normal limits in one patient, and slightly elevated and in the other two. These patients underwent successful myocardial revascularization (percutaneous coronary intervention); pharmacological therapy was prescribed.</p> Nestor Seredyuk, Vitalii Serediuk, Yaroslava Vandzhura, Oleksii Skakun, Viktoriia Parakhoniak Copyright (c) 2020 Nestor Seredyuk, Vitalii Serediuk, Yaroslava Vandzhura, Oleksii Skakun, Viktoriia Parakhoniak Tue, 29 Dec 2020 00:00:00 +0200 Case Report: False-Positive Dengue Non-Structural Protein 1 Antigen in a Patient with COVID-19 Infection <p><em>Abstract: </em> Early diagnosis of dengue fever and COVID-19 is made very easy due to technological advancements. The &nbsp;non-structural protein 1 antigen test strips are widely used in various regions; however, false-positive events have begun to be reported in the dengue-endemic areas with the COVID-19 pandemic, even though statistically non-structural protein 1 antigens are very specific to dengue infection. We reported a case of the false-positive non-structural protein 1 test in a patient with COVID-19 infection.</p> Yohanes Firmansyah, Jessica Elizabeth, Hendsun Hendsun, Darren Gosal Copyright (c) 2020 Yohanes Firmansyah, Jessica Elizabeth, Hendsun Hendsun, Darren Gosal Tue, 29 Dec 2020 00:00:00 +0200 Dental Orthopedic Morbidity Among Drafted Men Residing in Ivano-Frankivsk Region <p><strong>The objective </strong>of the research was to establish the level of dental orthopedic morbidity among draftees in the western region of Ukraine.</p> <p><strong>Materials and Methods.</strong> A clinical dental examination of 294 drafted men residing in Ivano-Frankivsk region was carried out; among them, there were 185 urban residents and 109 rural residents.</p> <p><strong>Results.</strong> There were established a quite high prevalence of dental orthopedic morbidity and intensity of its development, especially among rural residents - 275.7 and 522.9 people per 1,000 population among urban and rural residents, respectively. The amount of orthopedic care in terms of total number of dentition defects and the teeth with destroyed coronal portion requiring orthopedic treatment, was found to be 2.4 times greater among rural residents as compared to urban ones and reached 1899.1 versus 787.6 defects, respectively. There was determined the identical structure of dentition defects among both urban and rural residents; bounded edentulous spaces accounted for 100% of cases, the absence of one tooth was observed in 92.3% of cases.</p> <p><strong>Conclusions. </strong>The urgent need for a radical reform of the system for providing comprehensive orthopedic care to drafted men with a mandatory active dispensary registration was substantiated.</p> Sergey Rachinsky, Olha Labynets, Stanislav Schnayder, Tetiana Dieva, Vasyl Labunets Copyright (c) 2020 Sergey Rachinsky, Olha Labynets, Stanislav Schnayder, Tetiana Dieva, Vasyl Labunets Tue, 29 Dec 2020 00:00:00 +0200 Therapeutic-recreational Jerusalem Artichoke Products and Their Use in Medical Practice <p><strong>Abstract. </strong>Current data on Jerusalem artichoke (topinambour) as a unique plant that has the ability to maximize the use of solar energy to accumulate in the tubers of the polysaccharide inulin in a very high concentration – more than 50% of their weight, are represented in the article. In this regard, topinambour is a record holder in the plant world. Inulin has the property of a prebiotic and promotes the reproduction of the most useful collibacillus – bifidumbacteria, as the second immune system of the human body. However, the composition of the intestinal microflora is normalized, 90% of which are bifidumbacteria. This makes it possible to use Jerusalem artichoke as an edible product in therapeutic practice in the intestinal diseases, immunodeficiency conditions, including diabetes mellitus, because fructose formed from inulin does not need to absorb insulin. For this purpose, the medicine “Biftop” was created in Ivano-Frankivsk Medical University; it includes topinambour powder and bifidumbacteria. Clinical trials performed have shown its high efficiency. In addition, dried Jerusalem artichoke extract can be used in the baking industry for baking diet bread, wheat buns, confectionery. Currently, the construction-and-installation and commissioning work on the production of dried fruits, including Jerusalem artichoke powder, which can be widely used for therapeutic-prophylactic purpose, is almost finished in the Ivano-Frankivsk region.</p> Volodymyr Botsyurko, Vasyl Kasiyanchuk Copyright (c) 2020 Volodymyr Botsyurko, Vasyl Kasiyanchuk Tue, 29 Dec 2020 00:00:00 +0200 Use of Modern Technology When Teaching Chemistry Disciplines to Pharmaceutical Students <p><strong><em>Abstract. </em></strong>The introduction of computer technologies into the educational process creates a special information environment that motivates students to learn chemistry disciplines. This facilitates understanding and solving many intelligent tasks, contributes to better understanding and illustrating chemical laws and phenomena. The use of modern information technologies takes students’ independent work to a new level, where both network resources of the university and publicly available Internet resources play a significant role. Responsible use of gadgets transforms them from cheating tools into the powerful source of obtaining necessary information to solve the tasks.</p> Oksana Melnyk Copyright (c) 2020 Oksana Melnyk Tue, 29 Dec 2020 00:00:00 +0200 Sofia Parfanovych - a Woman Doctor, an Innovator of Medical Education in Ukraine: some actual issues <p><strong>Abstract: </strong>The article analyzes the main milestones of the prominent Ukrainian doctor, public figure, writer of the early to mid-twentieth century Sofia Parfanovych. There are three main aspects of her historical heritage: scientific, educational and literary. New variants of topics of lectures and seminars for studying the history of Ukrainian medicine of the beginning of the XX century in the course of disciplines “History of medicine” and “Development of medical knowledge” are offered.</p> Nataliya Stytsiuk Copyright (c) 2020 Nataliya Stytsiuk Tue, 29 Dec 2020 00:00:00 +0200 Youth Professional Development <p>Professional adaptation is a process of engaging young people in professional activity that is influenced by the right career choice, the level of professional orientation, as well as the type of professional training. Professional adaptation is considered as a special type of social process aimed at engaging the group of people in working life, as they were artificially disconnected from this life during their study.</p> <p>The formation of professional orientation is influenced by several objective and subjective factors. The objective factors include specific socio-economic conditions that will determine the role of an individual in the system of working relations, as well as the nature of work, its stimulation, working conditions and working environment. Nowadays these factors are significantly influenced by economic crisis, unemployment, lack of social protection, as well as the expansion of international contacts, the appearance of new forms of employment, the introduction of information technologies, etc. The subjective factors include personality traits, the interest in performing the activity, the satisfaction from performing the activity, motives and goals inducing this activity.</p> <p>During the preadaptation period, an individual becomes acquainted with new duties and responsibilities that team members and the administration are expected of them to carry out; the individual’s training level and their ability to carry out professional duties are assessed as well. This period can last from a few months to a year. During the next period of inadaptation, an individual assumes a social role of a worker, accepts the goals and tasks of the organization and starts to carry out the planned tasks. In the period of post-adaptation, in case of positive adaptation, the employee’s activity is aimed at creative application of the experience and knowledge acquired.</p> <p>Thus, professional success can serve as the objective criterion for professional adaptation, while job satisfaction can be considered as the subjective one. To assess the results of professional adaptation, the adaptation levels, namely high, moderate and low can be used.</p> Nadiia Skrobach, Oksana Shapoval, Vira Vyshyvanyuk, Vitalii Petryna Copyright (c) 2020 Nadiia Skrobach, Oksana Shapoval, Vira Vyshyvanyuk, Vitalii Petryna Tue, 29 Dec 2020 00:00:00 +0200 Ensuring the Quality of Higher Education Under Current Conditions <p><strong><em>Abstract</em></strong>. In the present conditions, especially during a pandemic, higher education requires academic staff to master and implement innovative methods of teaching and learning based on information programs, knowledge transfer systems. The tasks of interactive educational forms are as follows: awakening students’ interest; motivating students to solve the problem under study; effective mastering educational material; independent searching for the methods and options how to solve the educational task; interactions between students; teamwork skills; tolerance for any point of view; forming students’ own opinion, life and professional skills; reaching the level of student’s conscious competence. After analyzing our research, we can state that interactive learning creates an environment of educational communication, which is characterized by openness, equal-footing interaction of participants, accumulation of mutual knowledge, that provides high motivation, strength of knowledge, creativity, sociability, active life position, preservation of individuality, freedom of expression, mutual respect.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; This paper examined the current problems of innovative technologies and teaching methods in modern higher education, as the tendency to humanization and humanitarization of the content of medical education has intensified, new academic disciplines have been introduced and, consequently, the need for academic staff, who could provide an innovative approach to implementing these trends during the educational process, has been increased. It is significant that today teachers are able to create and implement their own innovative methods. In addition, the paper focused on the safety of the educational environment of higher education. Information security is especially important, as nowadays the information media have an extremely big impact on the student environment.</p> Andriy Kostyshyn Copyright (c) 2020 Andriy Kostyshyn Mon, 21 Dec 2020 23:51:35 +0200