ScienceRise: Medical Science

Characteristics of acoustic signals in healthy children using the new device "Trembita-Corona"

Olha Khomych — 2023-07-31

In 2016, the last revision of the nomenclature of breathing sounds took place at the Congress of the European Respiratory Society in Amsterdam.

Purpose: to determine the features of the acoustic signal in healthy children using the new "Trembita-Corona" device.

Materials and methods. 100 healthy children aged from 1 month to 18 years were examined. We have distinguished 3 main groups. The 1st research group included 700 acoustic signals that are characteristic of the vesicular type of breathing, the 2nd group - 100 acoustic signals that are characteristic of the tracheal type of breathing, the 3rd group - 200 acoustic signals that are characteristic of the bronchovesicular type of breathing.

The results. With the help of the new "Trembita-Corona" device, a reference computerized database of acoustic signals for lung condition monitoring in healthy children was created. The parameters of the acoustic signal during different types of breathing in healthy children were formalized. Differences were found between the vesicular and the tracheal type of breathing in the average signal power in 0.1, 2, 3, 4, 5, 7, 8 and 9 octaves, in the frequency of the acoustic signal - in 0, 4, 5, 8 octaves, amplitude of the acoustic signal - in 0,3,4,5, 8 octaves. Differences between the vesicular and the bronchovesicular types of breathing were found in the average signal power in 0, 1, 2, 4, 5, 6, 7, 8 and 9 octaves, in the frequency of the acoustic signal - in 0, 3.5, 6 and 7 octaves, amplitude of the acoustic signal - in all 8 octaves.

Conclusions. The "Trembita-Corona" acoustic monitoring device makes it possible to describe sound phenomena that normally occur in healthy children depending on the type of breathing based on the average signal power, amplitude and frequency of the acoustic signal in 11 octaves

Study of children's health of preschool age

Olena Dolzhykova — 2023-07-31

A strategically important and priority task of the state in the field of health care is to preserve the life and health of children.

The aim is to analyze the state of health of preschool children during 2014-2018 to determine the main diseases and influencing factors.

Materials and methods. The analysis of medical records of children aged 2-6 years was carried out in a preschool educational institution (PEI) in the city of Kharkiv (Shevchenkivskyi district) for the period 2014-2018. The analysis was carried out in accordance with the current legislation of Ukraine.

Results. The maximum percentage of children with chronic pathology was recorded in 2014. During the next 4 years, a decrease in the percentage of children with pathologies was observed, but this indicator remained at a high level. Among the pathologies, speech defects, whose frequency were recorded, which were evenly distributed among children aged 3-6 years. On the part of the organs of vision, isolated cases of strabismus, astigmatism and hypermetropia were recorded. Pathological conditions of the respiratory system - adenoid vegetations were registered in children aged 4-6 years. The maximum percentage among pathologies was anemia, which was noted more often in children aged 4-5 years. Pathologies of the digestive system - gastritis, hernia, and liver diseases were registered to the maximum in 2014, and then a decrease in their number was observed. Obesity, as a pathology associated with endocrine dysfunction, tended to increase but did not depend on the age of children. During preventive medical examinations, posture disorders and flat feet were more often registered among diseases of the musculoskeletal system. From the genitourinary system, pyelonephritis was registered.

Conclusion. A comparison of the morbidity of preschool children revealed an increase in the number of pathologies from the endocrine (obesity), nervous, genitourinary (pyelonephritis) and circulatory systems (anaemia)

Immunopathological response of the body in patients with chemosensitive and drug-resistant pulmonary tuberculosis

Manana Sakhelashvili — 2023-07-31

Immunological methods are important for diagnosing tuberculosis, evaluating the process activity, and forecasting the course of the disease and recovery.

Materials and methods. 47 patients with first diagnosed destructive sputum smear-positive pulmonary tuberculosis underwent a complex immunoassay. The patients were divided into two groups based on the sensitivity/resistance of mycobacterium tuberculosis to antimycobacterial agents. The first group consisted of 22 patients with first-diagnosed chemosensitive tuberculosis with preserved sensitivity to antimycobacterial agents. The second group consisted of 25 patients with multi-drug resistant tuberculosis pulmonary tuberculosis (MDR-TBP). The research was conducted during the 2018-2021 years.

Results Specific cell response disorders in patients with pulmonary tuberculosis are associated with the multi-structural T-cell protection misbalance caused by the quantitative changes of its components, the increase/decrease in the quantity of certain lymphocyte pools specifying the immune response vector.

In cases of tuberculosis, phagocytosis plays an important role. Phagocytosis might release cells from the tuberculosis pathogen. To achieve this, the activation of cells should reach a certain level. However, the initial protective nature of cell activation might become aggressive.

The T-cell immunity disorders were more evident in patients with MDR-TBP versus donors and patients with chemosensitive tuberculosis. The apparent decrease in СD3+СD56+, СD3+СD4+ pools and the increase in СD3+СD8+ were revealed in cases of MDR-TBP tuberculosis versus chemosensitive tuberculosis. The difference in СD3+СD4+, СD3+СD8+, СD3+СD4+/СD3+СD8+, CD3+СD8+HLA-DR+, СD16/56+8+ between the study and observational groups was statistically confirmed. The evident specific cell immunity disorders in patients with MDR-TBP aggravate the clinical course of the disease, causing destructive changes and acute and extensive processes.

Conclusions Changes in different components of the immune system might occur during pulmonary tuberculosis (in T- and B-cells, phagocytic cells), specific and enzymatic processes are activated, and autoimmunization is evident. The intensity of the changes varies at different stages of the disease. Most immune disorders caused by the specific inflammation process require immune correction.

X-ray diagnostics of gunshot wounds of main vessels of the limbs: theoretical analysis

Mykola Rudenko — 2023-07-31

The analysis of damage to the main vessels of the limbs was considered for the formation of further organizational and tactical instructions for the provision of emergency medical care at the stages of evacuation of the injured to specialized wartime departments. It was determined that with the help of MSCT-angiography, signs of damage to main vessels can be accurately diagnosed, and additional information about damage to bone structures, neighbouring organs and tissues can be obtained. It is emphasized that MSCT is an effective and accurate method in the assessment of clinically significant arterial injuries of the lower extremities in case of gunshot injury. It was noted that timely diagnosis of vessels gunshot wounds can contribute to the preservation of the functionality of the limbs and the life of patients, reducing the risk of bleeding, infections and other complications. It was noted that the correct medical decisions, in particular, the correct diagnosis of gunshot injuries to blood vessels will help doctors make informed decisions regarding emergency surgical care, the choice of treatment methods and preoperative preparation.

The aim. The aim of the work is the theoretical substantiation of gunshot injuries of the main vessels of the limbs and the definition of practical diagnostic methods.

Materials and methods: analysis of theoretical sources, comparison, induction of isolated analytical data. The study was conducted based on the database of the State institution "National Institute of Cardiovascular Surgery named after M. M. Amosov of the National Academy of Medical Sciences of Ukraine".

Results. It was determined that with the help of MSCT-angiography, signs of damage to main vessels can be accurately diagnosed, and additional information about damage to bone structures, neighboring organs and tissues can be obtained.

Conclusions. Radiological diagnosis of gunshot injuries of the main vessels of the limbs demonstrates the importance of using radiological diagnostics in the detection and analysis of vascular injuries in gunshot injuries of the extremities. The study confirms the high efficiency of this method, its accuracy and reliability in determining the nature of damage. In addition, radiological diagnostics allows timely and accurate determination of the extent and nature of injuries, which is important for making informed clinical decisions and providing adequate medical care to the injured

Modern technologies for studying the genome of mycobacteria

Olga Shapovalova — 2023-07-31

Molecular technologies play a leading role in the laboratory diagnosis of tuberculosis and mycobacteriosis. The successes in studying the genome of Mycobacterium have contributed to significant progress in understanding the evolution, variability, and genetic diversity of pathogens, as well as the development of diagnostic technologies, including research into resistance to anti-tuberculosis drugs.

The aim of this research is to conduct a comparative study of the spectrum of modern technologies for studying the genomes of mycobacteria and their impact on the efficiency of the laboratory diagnosis of tuberculosis.

Materials and methods: a search for sources of information was carried out in the PubMed, Medline, Web of Science, and Google Scholar databases. Materials related to the technology of molecular diagnosis of tuberculosis and mycobacteriosis and for determining the susceptibility of pathogens to anti-tuberculosis drugs were selected.

Results: it was determined that the modern methods for studying the genome of mycobacteria include amplification technologies (PCR analysis), hybridization, restriction, spoligotyping, sequencing, and their various combinations. The main methods are standard and modified protocols of PCR (RAPD-PCR, AP-PCR, rep-PCR, Real-time PCR, Inverse PCR, TB-LAMP, HIP, LM-PCR). Genomic Restriction Analysis can be used in studies of MTBC and NTM strains (RFLP, AFLP analysis, MIRU-VNTR genotyping). The most effective method for genome analysis is WGS. Complex methods that utilize a combination of molecular technologies allow for the direct detection of mycobacteria in clinical samples.

Conclusions: the widespread application of genomic technologies in the study of mycobacteria will contribute to the effective implementation of the global WHO strategy for the prevention, treatment, and control of tuberculosis and mycobacteriosis