, , ,

<<


 >>  ()
Pages:   || 2 | 3 | 4 | 5 |   ...   | 8 |
-- [ 1 ] --

̲Ͳ ’

в ̲

ϲί ² Ȼ

Ͳ

ί

80

1

1

, 2013

ISSNͲߠίȠ.2013.80..1..1

: 616-005:616.89-07-085

: , , , Helicobacter pylori.

.

(7 14 ), .

Helicobacter pylori () 1982 . 30 , , [1]. . [2, 3]. , (), - [4]. , [5].

. pylori [1,2]. , , . , , , .

ISSNͲߠίȠ.2013.80..1..1 , , 25,8% [6]. 60 , , , . .

pylori [7,8]. T. Borody . , , 4 - . pylori [9,10]. , , .

.

: 68 . 37 . 18 80 , 43,26,3 . 25 , . (48,470,82 ) (12 13 ) . .

1 () .

A. Boyum (1968) - ( 1,077 /) [11]. [12], D- Sorbent Ltd , -8. - ( D3+), - (D4+), - (D8+), (D16+) D4+/D8+.

H. pylori . I , 7 . II 34 , 4 ISSNͲߠίȠ.2013.80..1..1 14 . , ( 40 /, 4-6 ), . (-4, 2011 .) . (20 2 ) :

(500 2 ), (1 2 , 7 14 ), - ( - 4, 2010). , ( H.

pylori 4 ) ( 4 12 ) .

7 14 4 (2010 ). 4 ( 20 1 ). 4 (40 2 ) 14 .

. , 87 % , 3 5 . , , 97 % ( ) 2-5 .

, 7- 14- 28 (83,3 %) 34 , 29 (85,7 %) , ( 1 ) . - 13,3 -, 12,4 -, . H.pylori 4 (-4, 2011).

1.

ISSNͲߠίȠ.2013.80..1..1 . 1. , 7- 67,3 % (27 ). 14- , 92,4 % (34 ). , -4 (2010 ).

, , -4, . , , .

, 14- 53,4% , . :

(21,4%), (17,8%), (14,3%), (28,6%), (21,4%). 7 20% .

, (. 1).

1 (n=68) , 1 n = 25 (n=34) (n=34) / 5,93 0,25 6,28 0,13* 6,06 0,11* % 30,1 1,8 27,8 1,4* 28,2 1, / 1,78 0,11 1,68 0,12 1,72 0, 6 ISSNͲߠίȠ.2013.80..1..1 D 3 % 55,9 1,9 57,2 1,4* 58,6 1,3* / 1,00 0,06 0,95 0,07 1,01 0, D 4 % 39,2 1,2 43,2 1,3* 42,3 1, / 0,70 0,04 0,76 0,04 0,72 0, D 8 % 18,5 1,1 21,2 1,3 22,4 1, / 0,33 0,02 0,37 0,02 0,35 0, D 16 % 20,1 1,2 25,5 1,3* 23,1 1, / 0,36 0,03 0,45 0,02* 0,39 0, 03* D 22 % 16,18 1,1 18,1 1,2 17,9 1, / 0,30 0,02 0,33 0,03 0,32 0, в (D 4/D 8) 2,12 0,05 2,04 0,05* 1,98 0, :

*- ( 0,05);

- 1 ( 0,05).

, 1 CD 4 CD 22. , D8 (CD 16).

1 . , . ( 0,05). 2 , CD 3, CD4 CD 22, , .

3 D 8 - (CD 16). , - , D 8 D 16 . 2 . CD8, .

. 23,3% , 7- , ( 0,05) - 46,4% , ISSNͲߠίȠ.2013.80..1..1 14- . , , - 76,6% 7- 53,4% 14- .

.

14- . (7 14-) . 3 , D 8 D 16.

. , , .

1. Malfertheiner P. Management of Helicobacter pylori infection: the Maastricht IV: Florence Consensus Report /Malfertheiner P., Megraud F., OMorain C., et al.

//Gut 2012. V.61. P. 646664.

2. .. IV - 2010: / .. , .. // . 2011. - 6(62). . 133-136.

3. .. /.. , .. , .. , .. // . 2012. - 3(65). . 41-45.

4. .. / .. , .. // . 2009. - 3. . 9-14.

5. .. , H.pylori // . 2011. - 3. . 9-14.

6. OFarrelly C., Doherty D.G. Basic immunological terms and concepts: a short primer of fundamental immunology / OFarrelly C., Doherty D.G., Eds. Gershwin M.E., et al. //Liver immunology Hanlly & Belfus, Inc., 2003. P. 113.

7. .. //. 2008. - 4. . 4-13.

8. .. : , 1999. 603 .

8 ISSNͲߠίȠ.2013.80..1..1 9. .. / .. , .. , .. , .. //.

. 2012. - 1. . 75-79.

10. .. . //. - 2009. - 1. - . 5055.

11. Wilson K.T. Immunology of Helicobacter pylori: insights into the failure of the immune response and perspectives on vaccine studies. /Wilson K.T., Crabtree J.E.

//Gastroenterology. - 2007. - V.133. . 288308.

12. .. //.

. 2006. . 12, 1. . 3-8.

: 27.05.

˲ Ͳ ί в ² : ﳿ.

: 68 (35 33 ). ³ 43,2 6,3 . 25 . .pylori . ϳ H. pylori- ﳿ (7 14-). 1 () .

. , , , 䳿 . , D3 (-). D4- D22- (-) .

7 - 14 - 72,3% (24 ) 92,4% (32 ) . ϳ ﳿ ISSNͲߠίȠ.2013.80..1..1 , . ﳿ.

. ﳿ 14- .

: , , , Helicobacter pylori.

: : 68 (35 33 ).

43,2 6,3 . 25 . .pylori . H. pylori (7 14-). 1 () .

. , , , . , D3 (-). D4 - D22- (-) .

7- 14 - 72,3 % (24 ) 92,4 % (32 ) . 10 ISSNͲߠίȠ.2013.80..1..1 , . .

. 14 .

: , , , Helicobacter pylori.

Akermi Jafar State Institution "Zaporozhye Medical Academy of Postgraduate EducationMinistry of Health of Ukraine" STATE OF CELLULAR IMMUNITY IN PATIENTS DIFFERENT AGE GROUPS WITH DUODENAL PEPTIC ULCER Purpose: to study the features of a state of cellular immunity in patients with duodenal ulcer in the background of the standard eradication therapy.

Materials and Methods: We examined 68 patients with duodenal ulcer in the course of moderate and severe (35 men and 33 women). The age of the patients was on average 43,2 6,3 years. The control group consisted of 25 healthy middle-aged persons. The study included patients with H. pylori - positive duodenal ulcers. After an initial examination, all patients with H. pylori-associated duodenal ulcer were divided into groups depending on the duration of therapy of H. pylori (7 and 14-day).

All patients were twice at an interval of one month study conducted esophagoendoscopy (EGD) with biopsy of the coolant in the ulcer and determination in peripheral blood lymphocyte subpopulations.

The results of the study. When analyzing immunograms in the acute phase of the disease, it was found that middle-aged people, patients with duodenal ulcer in the acute stage there was a trend to higher levels of circulating lymphocytes. In the group of elderly and senile patients with duodenal ulcer showed a trend toward relative and absolute lymphopenia, due to the absolute number of CD3 population of lymphocytes (T-cells). CD4 subset of T-lymphocytes and CD22-population (B-lymphocytes) was at the test control group.

By the end of the 7 - and 14 - day course of treatment of H. pylori eradication was achieved in 72,3% (24 patients) and 92,4% (32 patients) cases, respectively.

After the treatment, and the re-examination after three months, most patients immunological parameters close to the physiological boundaries of normal subjects, indicating that subsided inflammation and scarring in the digestive tract ulcers in the duodenum. A clear-cut dependence of the results of treatment of duodenal ulcer duration of therapy of H. pylori.

ISSNͲߠίȠ.2013.80..1..1 Conclusions: All patients with duodenal ulcer Helicobacter pylori infection in combination with systemic violations occur cellular immunity. When comparing two standard schemes of eradication therapy is more effective 14-day scheme.

Key words: cell-mediated immunity, peptic ulcer disease, eradication therapy, Helicobacter pylori.

616.716.8-018.46-002-036.12 : 616-097-008.64+616.089-008.441.13.

.. , .. , .. , ..

: , , , .

.

- , , . , , , , , ( .) [6, 100].

, , , , , [2, 51;

6,100]. , [1, 117].

, , , .

: , .

:

12 ISSNͲߠίȠ.2013.80..1..1 2010 2012 . 108 .

69,5% (75), - 30,5% (33 ), 20 30 33 ( 30,5 %) ;

31 40 (64,0 %), 41 6 ( 5,5%).

37 (34,3 %) »

ѻ.

(108 ) . I- 55 (50,1 %) , - . - 50- (46,3%) , 5- (4,7%) . II- 2(1,8%) , ;

III- 31(28,7 %) , , - ;

IV 20(18,5 %)

, .

() 64(59,2%) 108 ( 1).

I- 19 (34,5%) , II- , . III- - (80,6%);

IV- - 20 (100% ) .

1. , () .

ISSNͲߠίȠ.2013.80..1..1 , II- I- III- , (34,4% 80,6% ). IV , , .

, , , , -.

, [7, 75], , , [3]. .

, , , .

83(76,8%) : 50- (46,3%) ;

2- (1,8%) ;

31- (28,7%) - . , , 20 IV-, 100% , 10(32,2%) III ,1- (1,8%) I- ). 3(9,7%) III - ( .1). , , (.2). - , , (. 3).

(0,9 %) II - .

.1. 14 ISSNͲߠίȠ.2013.80..1..1 .2. III- . III- . - 3. III- ,

. 2 . . : , , . .

:

2011-2012 108 49 (45,4%) 24 (22,2%) . 73(67,6%) 108 . .

37 (50,7%) I , (1,4%) II ;

19 (26,0%) III , 16 (22,0 %) IV-.

52 (71,2%) : 37(100% ) I- , 8( 42,1 %) - III-, 6 (37,5 %) IV-.

(50%) II- , . - . ISSNͲߠίȠ.2013.80..1..1 , - - , , , .

- . .

21- (28,8 %) (. 4), , - , , (.5).

10( 62,5 %) IV- 11(57,9%) - III- , 3 (4,1%) IV , 18,7% .

. 4. .5. (.6,), ;

. , . 16 ISSNͲߠίȠ.2013.80..1..1 1,5 : - , - [3,4]. 846 20.12.06.[5].

. 6. ) . (36 ),/ 2023 . . 6. ) 20 . . 3.

( ) ISSNͲߠίȠ.2013.80..1..1 ( 3).

, III- IV- ( ) 57,9% 62,5% , I- II- , 34,5% 0%.

1. 28,8% , 4,1%.

2. , , 71,2% .

3. 47,2 % , .

1. .. . ./ .. , .. , ..

. // . ..,2007 - 4 (60) - .111117.

2. .. . ./ .., .. // . - - . , 2010. . 5153.

3. 645 10.11.2008. .

4. 200 27.03.2012. .

5. 846 20.12.2006. - .

6. .. . - , ./ .., .. // , 2007. - . 100104.

7. ... , ./ .. , ..

// , 2009 - 5 - . : 14.03. 18 ISSNͲߠίȠ.2013.80..1..1 .. , .. , .. , .. 㳿

² ˲ ֲҲ ̲˲ Բֲ ˲ Ҳ 73 쳺 , , 4,1%, - 28,8%. , ﳿ, 쳺 : 쳺 , , , .

.. , .. , .. , ..

.

73 , , 4,1%, 28,8%. , , .

: , , , .

N.G. Barannik, Varzhapetyan, A.A. Moseiko, O.N. Manuchina State Institution "Zaporozhye Medical Academy of Postgraduate EducationMinistry of Health of Ukraine" THE EXPERIENCE OF TREATMENT OF PATIENTS WITH OSTEOMYELITIS OF THE JAWS AND SECONDARY IMMUNODEFICIENCY ON A BACKGROUND OF NARCOTIC DRUGS The Introduction. Among all the purulent - inflammatory diseases of the maxillofacial region most severe in the clinical course osteomyelitis of the jaw is.

ISSNͲߠίȠ.2013.80..1..1 Individuals who use drugs, which are used in the manufacture of red phosphorus, developed atypical osteomyelitis of jaws with a heavy, prolonged course, is not amenable to conventional methods of treatment. In this regard, the development of treatment methods that provide a stable clinical effect is very relevant.

The Aim of the Investigation. Determine the optimal treatment of patients with osteomyelitis of the jaws, taking narcotic medications according to the results of the treatment.

The Materials and Methods. We observed in the period from 2010 to 2012.

108 patients taking the drug, and osteomyelitis of the jaws. 50 people had a complication of osteomyelitis of the jaws in the form of ulcers face, among 5 people diagnosed purulent maxillary sinusitis, among 2 patients sepsis, among 20 observed - remission of the disease. In the hospital all patients underwent clinical, radiological methods of examination, blood chemistry, determination gepatomarkerov, revealed the presence of TB and HIV infection.

The treatment consisted in the appointment of the anti-inflammatory, antibacterial, bracing, symptomatic therapy and surgical intervention: of surgical treated 83 patients: 50 patients of vskrytli festering pockets face, 2 - performed maxillary sinusotomy;

31 sequestrectomy. One patient with sepsis and abscess of the brain - has died. Among 3 observed performed disarti.

After discharge from hospital patients referred for treatment to the immunologist and the dentist. We conducted medical check-up.

The findings and the discussion of them. The positive dynamics during the complex treatment of chronic "atypical" osteomyelitis in drug-dependent patients was noted in 28.8% of cases, and clinical improvement was observed in 4.1%. The negative dynamics within the jaws of osteomyelitis in patients taking narcotic drugs was noted in 71.2% of cases. "Atypical" osteomyelitis of the jaws in 47.2% of drug dependent patients proceeded less aggressively, against pre-immune corrective therapy.

Keywords: osteomyelitis of the jaw, pervintin, addicting drug, and phlegmons.

378 (07) .. , .. , .. , .. , ..

: , , , .

20 ISSNͲߠίȠ.2013.80..1..1 -. .

.

. . ( ) 3-4 , - [7]. . , , , ().

, [4]. , , , , , , .

() , (, , , , ) [2]. , [3, 4, 5]. - ( , -, ), , , Internet , , .

, . .

, [2, 6]:

ISSNͲߠίȠ.2013.80..1..1 1) ( , , , );

2) ( , );

3) ( ).

3 4 [6]. , . , , 40 60 % , [3, 6].

- . - , , .

, , [7].

( ) . 10 , 8.

-, - , . -, , , , .

. : (87% );

, (99% );

(100% );

(75% );

Internet - (50% ).

22 ISSNͲߠίȠ.2013.80..1..1 , . , - , , , - , , Internet . , , .

- [1, 3, 6]. ( , - ). , . : , , - . , . . () , , .. , . , ( ). -, , ( ) .


- , , , . .

? , , : ;

- ;

- , ;

, .

, ISSNͲߠίȠ.2013.80..1..1 , . . , . , , . .

1. ³ . , . . // . 2004. - 1. . 92 99.

2. .. : : . .: - ... , 2004. 167 .

3. .. . .:

- , 2005. 192 .

4. .. // . 2008. 17. . 3 4.

5. .., .., .. / . .. . ., , 2006. 52 .

6. : . .

. . . / .. , .. , .. ;

. .. // ., , 2004. 416 .

7. () III - IV . , , 2006. 52 .

: 15.03. .. , .. , .. , .. , ..

ֲ ϲͲ ²Ҳ Ͳ-ò 24 ISSNͲߠίȠ.2013.80..1..1 , 㳿. , . ' . -, , . . . , , . . . , . , , .

, .

: , , , 㳿.

.. , .. , .. , .. , ..

, . , . . -, , . . ISSNͲߠίȠ.2013.80..1..1 . , , . . . , . , , . , .

: , , , .

N.M. Buchakchiyska, A.V. Klimenko, V.V. Serga, L.V. Bakhareva, E.A. Kravchenko DISTANCE EDUCATION PROSPECTS IN NEUROPATOLOGISTS INTERNS POSTGRADUATE EDUCATION The paper focuses on the issues of the current postgraduate education of doctors specializing in Neurology. Medical care of high quality can be provided only by specialists trained in accordance with up-dated requirements. Further improvement and spread of distance education by using computer technologies is considered to be perspective in accordance with up-to-date requirements. The scientific article covers prospects of the distance education in Ukraine of neuropatologists-interns, including their questioning, are analysed. Its implementation integrated factors and possibility are determined. The characteristics of different types of information technologies for distance education were presented.

Wide use of distance methods of learning by means of Internet gives opportunity for qualification upgrade in the system of postgraduate education, including medical sciences, without distracting attendees from working places. This fact gives way to improve the quality of teaching. The use of modern pedagogical technologies enables one to activate trainees cognitive interest and contributes to the development of their communicative and creative skills. In contemporary circumstances in Ukraine distance method of learning appear as a real opportunity for Ukrainian specialists to further advance and check their knowledge, to determine requirements and the ways of required improvement in the system of postgraduate education depending on practical needs and demands of the time. This is an important problem that should be 26 ISSNͲߠίȠ.2013.80..1..1 further studied as well as supported in organization and financially. The home system of postgraduate education should create conditions for distance education motivation which is to be a controlled process.

Key words: postgraduate education, distance education, internship, information technologies.


616.71:616-056.3-053.4/.5- ..

: , , , , .

4-10 , D3 3 , . , 3 , , , , , 1 . , ( , , ) - [1]. ( ) .

, ISSNͲߠίȠ.2013.80..1..1 . , - , , - . .

: , ( ).

60 () 4 10 .

( ) : ( ) (/) = (/) + 0.02*(40 (/)) [3]. - ( ).

. 3 (25()3), ECLIA Elecsys 2010 (Roche Diagnostics GmbH).

. , , (2008), (GCP).

- - . . .

1. , 3. , 3 - 20 [5]. , 28 ISSNͲߠίȠ.2013.80..1..1 3 , , - [4], 3 , 60 , 40 , 60 , 90 .

2. . 20 . 10 [10].

3. . - , , ( 400 ) , [2].

4. 3. , 40- ( ), [7], . [6], 1-18 600 D . 3000 , 9-12 4000 [8].

5. . (2011) 4-8 1000 2500 , 9-10 3000 [8].

, , 3 [9]. . 25()3 (2011) 25()3 / 30 /, 21-29 / , 20 / [6].

1 3 1.

ISSNͲߠίȠ.2013.80..1..1 30 ISSNͲߠίȠ.2013.80..1..1 , , 1 , , 25()3. , , - , .

, .

, 3 , , , , 1 , .

, , - ( ) ( ), 3. , , , , 3 . , , - , .

4-10 , , 3 , , 3 , . , 3 , , , , , 1 , .

1. .. / .. , ..

// . . . 2010. - 3. .22-27.

ISSNͲߠίȠ.2013.80..1..1 2. . . / . . , . . , . . // . . 2008. . 6. 2. .1826.

3. Accuracy of Methods to Estimate ionized and "Corrected" Serum Calcium Concentrations in Critically Ill Multiple Trauma Patients receiving Specialized Nutrition Support / R.N. Dickerson, K.H. Alexander, G. Minard [et al.] // J. Parenter.

Enteral. Nutr. 2004. Vol. 28 (3). P. 133-141.

4. Adherence to vitamin D recommendations among US infants / C.G. Perrine, A.J. Sharma, M.E.D. Jefferds [et al.] // Pediatrics. 2010. Vol. 125 (4). P. 627 632.

5. Diffey B. Modelling the seasonal variation of vitamin D due to sun exposure / B. Diffey // Br. J. Dermatol. 2010. Vol. 162. P. 13421348.

6. Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline / M.F. Holick, N.C. Binkley, H.A. Bischoff Ferrari [et al.] // The Journal of Clinical Endocrinology & Metabolism. 2011. - Vol.

96 (7). P. 1911-1930.

7. Holick M.F. The deficiency vitamin D pandemic and consequences for non skeletal health: mechanisms of action / M.F. Holick // Mol. Aspects Med. 2008b. Vol. 29. P. 361368.

8. Institute of Medicine. Dietary Reference Intakes for Vitamin D and Calcium.

Washington, DC: National Academies Press;

2011.

9. Wagner C.L., Greer F.R. for the American Academy of Pediatrics Section on Breastfeeding and the American Academy of Pediatrics Committee on Nutrition.

Prevention of rickets and vitamin D deficiency in infants, children, and adolescents // Pediatrics. 2008. Vol. 122. P. 1142-1152.

10. Weeks B. K. Eight Months of Regular InSchool Jumping Improves Indices of Bone Strength in Adolescent Boys and Girls: The POWER PE Study / B. K. Weeks, C. M. Young, B. R. Beck // Ibid. 2008. Vol. 23. P.10021011.

: 15.03. ..

̲ ղ̲ ʲ ֲ- Υ IJ ղ ˲ Բֲ 4-10 , 䳺 D3 3 , . , 3 32 ISSNͲߠίȠ.2013.80..1..1 , , , , , 1 .

: , , , , .

..

4-10 , D3 3 , . , 3 , , , , , 1 .

: , , , , .

AA Vertegel State Institution "Zaporozhye Medical Academy of Postgraduate EducationMinistry of Health of Ukraine" THE DYNAMIC OF BIOCHEMICAL PARAMETERS OF CALCIUM PHOSPHORUS OSTEOGENESIS ENSURE IN CHILDREN WITH RECURRENT BRONCHITIS RESULTING FROM LIFESTYLE AND DIET MODIFICATION Multifactorial genesis of bone formation disorders in children suffering o recurrent bronchitis (osteoresorbtive effect of repeated inflammation, osteotoxic action of used drugs, reducing the amount of time children spend in the sunlight, fresh air and physical activity) determines the need for a combination of therapeutic and preventive strategies.

The aim: to increase the effectiveness of therapy of bone formation disorders in children suffering of frequent repeated (recurrent bronchitis).

ISSNͲߠίȠ.2013.80..1..1 Materials and methods. In trial take part 60 children in ages of 4 and 10 years with recurrent bronchitis (RB). Therapeutic effect comprising: providing an optimum degree of necessary insolation, increasing physical activity, dietary patterns modification with the supplement of 1000 mg calcium and 600 IU vitamin D3 per day.

Results. Research conducted at 3 months after the start of therapeutic interventions, demonstrated progressive improvement of the studied parameters and reliable metabolic changes regarding serum levels of total calcium, alkaline phosphatase, osteocalcin, parathyroid hormone, the products of degradation type collagen and urine calcium.

Conclusion. The use in children aged 4-10 years old with recurrent bronchitis the modification of nutrition, supplementation of calcium and vitamin D3 for at least 3 months can restore metabolic processes to ensure optimum levels of calcium and phosphorus to ensure bone formation and prevents the development of secondary bone abnormalities.

Keywords: children, bronchitis, bone formation, vitamin D, calcium.

616. 65 006.55 - .., .., .., .., ..

(. . . . . . .. ) : , , , , , , .

() . , 20% 40 , 40% - 50 60 , 70% 61-70- 80% 71-80 . (-, ) , : , , , .

, , , 34 ISSNͲߠίȠ.2013.80..1..1 . , : , , ., , . I-PSS QL, .

:

1. .

2. .

3. .

:

734 .

, 26 .

: , I-PSS QL, , , PSA ( ) . : - , , (, R-, .).



Pages:   || 2 | 3 | 4 | 5 |   ...   | 8 |
 
 >>  ()





 
<<     |    
2013 www.libed.ru - -

, .
, , , , 1-2 .