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Liver Abscesses: a 10-year Vinnytsya University Study

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Liver Abscesses: a 10-year Vinnytsya University Study

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Prognostic Value of Cognitive Tests and Their Combination in Patients with Chronic Heart Failure and Reduced Left Ventricular Ejection Fraction

Impaired cognitive function (CF) is common among patients with CHF and is an additional factor impairing the quality of life, adherence to treatment, and hence the clinical prognosis in this category of patients.The aim of this work was to study the prognostic significance of individual cognitive tests, as well as their combination in patients with CHF with a reduced left ventricular ejection fraction (LV EF).Materials and methods. The study was conducted in the Department of Heart Failure of National Scientific Center "M.D. Strazhesko Institute of Cardiology" National Academy of Medical Sciences of Ukraine, in the period from 01/01/2016 to 04/27/2018. A total of 124 patients with CHF between the ages of 18 and 75 years, II-IV functional classes by NYHA were examined. The cognitive function was assessed using the Schulte test, Mini-Mental State Examination scale (MMSE); HADS scale. Cognitive dysfunction (CD) was considered as MMSE ≤26 points. To construct the survival curves and the onset of the combined critical event (death or hospitalization), the Kaplan – Meier method was used, the significance of the differences between the curves was determined using the log-rank criterion. Differences were considered statistically significant at p <0.05.Results. The MMSE scale was highly informative regarding the prediction of survival and the onset of a combined critical event (death or hospitalization) in patients with CHF and reduced LVEF even after correction of the compared groups by age and functional class according to NYHA (p=0.025 and p=0.049, respectively). Using the same sample, Schulte showed low prognostic significance regarding survival and reliable informativeness regarding the onset of the combined critical event, which, however, was leveled after correcting the compared samples by age and functional class NYHA (p=0.798 and p=0.240, respectively). The inclusion in the prognostic algorithm of estimating the sum of points on the HADS depression scale allowed increasing the degree of reliability of differences between the compared groups of patients with CD and without CD in terms of both long-term survival and the onset of a combined critical event (death or hospitalization) (p=0.006 and p=0.001 respectively).Conclusions. The MMSE scale is informative regarding the prediction of survival and the onset of a combined critical event in patients with CHF and reduced LVEF. Schulte's test does not have the prognostic information indicated above, however, the inclusion in the algorithm of the sum of points on the HADS depression scale allows to increase the degree of statistical confidence in the compared groups.
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Efficacy Evaluation of the Phytotherapeutic Drug Canephron N in the Complex Treatment of Patients with Urolithiasis Using Extracorporeal Shock Wave Lithotripsy

The study objective was to analyse the effect of the herbal drug Canephron N, namely, its ability to potentiate the efficacy of extracorporeal shock wave lithotripsy (ESWL) in the treatment of patients with urolithiasis (UL) and prevent recurrence of stone formation.Aim. To сheck the hypothesis that treatment with Canephron N can potentiate lithotripsy and reduce the risk of re-stone formation. Methodology. Patients at the age of 18 to 65 years had calcium oxalate urolithiasis with the size of the stone from 0.8 to 1.3 cm in the kidneys and from 0.5 to 0.9 cm. in ureters who underwent ESWL procedure. They were randomized into 2 equal groups of 30 people. The treatment group received general recommendations on the management of the patient with UL following ESWL and the herbal drug Canephron N for 6 months. The control group received only general recommendations. Moreover, according to condition, both groups received painkillers and spasmolytics if pain occurred during elimination of fragments. The following parameters were evaluated: the period of elimination of fragments after stone disintegration by ESWL method; the percentage of complete elimination of fragments; the presence of pain syndrome and leukocyturia in the postoperative period; the rate of recurrence of stone formation during one year after the procedure.Results. More complete and rapid elimination of fragments was observed in the treatment group. Thus, up to day 14 elimination of stone fragments was observed in 96.6 % of patients in the treatment group versus 76.6 % in the control group. Fewer cases of pain syndrome during elimination of stone fragments (23 % in the treatment group and 43 % in the control group) and rare cases of leukocyturia within 14 days (10 % versus 23 %, respectively) were observed in the treatment group. Recurrent stone formation within the year was not observed in patients of the treatment group, in the control group – in 23 % of patients. However, because of the small size of the groups, one may talk about a tendency but not about statistically significant patterns.Conclusion. Canephron N is an effective and safe drug in the treatment of patients with urolithiasis who underwent extracorporeal shock wave lithotripsy. Its use contributes to more rapid and safe elimination of fragments of destructed calculi and reduces risk of recurrent stone formation.
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Hemorheological Failure in the Pathology of Cardio-vascular Complications in Patients with Diabetic Foot Syndrome

The literature that includes the study of cardiovascular complications in patients with diabetic foot syndrome was analyzed. The topicality of this problem is caused by the steady growth of diabetes mellitus morbidity among people. For today there are more than 170 mln people throughout the world with diabetes mellitus, among them 65–80 % have cardiovascular complications (myocardium infarction, acute disorder of brain blood circulation and so on).It is established for today, that pathogenesis of diabetic foot syndrome is multi-factor one and the development of purulent-necrotic stages of DFS is connected with the combination of different factors, especially microcirculation disorder. In this article we'll consider the mechanisms of diabetic angiopathy development, the state of platelet-vascular hemostasis link in this category of patients.
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