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C.
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Editorial
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1
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Contents
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2-8
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Reviews
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THE FORMATION OF
BIOFILMS BY PSEUDOMONAS AERUGINOSA STRAINS, AND METHODS OF ITS CONTROL
(REVIEW)
Sarkis-Ivanova V.V.
The majority of natural bacterial populations exist in the form of
biofilms, highly-structured multicellular communities incorporated in
extracellular polymer matrix of own production. For a considerable part
of clinically significant species this form of existence provides
optimal conditions for reaching of pathogenic and colonizational
potential, and also encourages saving of metabolically inactive part of
population which is characterized by a low level of sensitivity to
antibiotics impact. The latter plays a significant role in formation of
chronic persistent infections resistant to antibiotics treatment.
Members of microbial group are united basing on the principle which
excludes antagonism, determines their nutritional, energetic and
another connections between them and environment. Such a connection of
microorganisms community behavior received a special definition of
“quorum sensing”. Quorum sensing is an ability of some bacteria
(probably, also another microorganisms) to communicate and coordinate
their behavior through secretion of substances which are the signals
for coordination of certain behavior or interaction between bacteria of
the same type or subtype depending on their growth tightness. When the
concentration of excreted signaling agents reaches a borderline value
the group of bacteria starts working as a single organism. Furthermore,
signaling agents for Gram-negative and Gram-positive microorganisms
differ. For instance, for Pseudomonas aeruginosa microorganism a
signaling molecule of quorum sensing is acyl homoserine lactone, and
biofilm created by this pathogen produces pyocyanin which functions as
an electronic transporter in current generation. A large-scale
investigation of P.aeruginosa biofilm morphology,
mechanisms of its production and degradation, peculiarities of
formation under different conditions and impact of various factors are
at the infancy stage. According to undivided opinion of scientists who
investigate this problem the main source of nosocomial diseases and
persistence factor of their causative agents in hospital ecosystems
from air and water to inner surfaces of catheters and body systems are
represented by biofilms. Bacteria of P. aeruginosa type are human
opportunistic pathogens which being a part of biofilm may cause
different nosological forms of pyoinflammatory diseases with severe
course and high fatality in immunocompromised patients. These
microorganisms are able to contaminate external and internal surfaces
of catheters, probes, respiratory tubes, lenses, and form biofilm on
them. The given information determines reasonability of searching the
methods of control of biofilm production in P. aeruginosa cultures
which can be used to increase the effectiveness of antibiotic treatment
in blue pus infection and/or decontamination of medical equipment, and
another objects of hospital environment. One of the methods to control
biofilms produced by P. aeruginosa on abiotic surfaces from different
materials is impact of antiseptics and decontaminants. Modern
decontaminants are represented by a wide spectrum of chemical compounds
of different classes which have a common ability to destroy
microorganisms even in low concentrations. At present the impact of
bacteria on separate elements of biofilm formation is considered to be
one of the most perspective targets for the action of new antimicrobial
medicines. Numerous investigations of recent 40 years demonstrated that
the process of biofilm formation is complex and multistage. Currently
the principal directions of development of new antimicrobial
preparations are the following: development of antiadhesive coatings
and preparations able to interrupt the function of eternal structures
of cells in charge of adhesion (fimbriae, adhesins); development of
preparations that block synthesis or destabilize matrix of biofilm;
development of preparations that cause cell adhesion deficiency in
microcolony, and block cell fission; development of preparations that
block intercellular signaling (quorum sensing), and cause disconnection
of cells from biofilm and their transition into plankton existence or
resist pathogenicity factor expression. Nowadays the influence of
certain physical factors on biological properties of biofilms is
studied as well. At the present time the new technology that is
photodynamic therapy is in intensive progress. Low intensity
electromagnetic radiation has widespread application practically in all
areas of medicine. In fact, under the influence of light emitting diode
radiation metabolic and functional properties of biological system
variety can be significantly changed. According to a number of
investigators a direct method of light emitting diode radiation effect
provides direct influence on cellular structure elements, moreover it
has been proved that membrane structures of cell are the most sensitive
to optical radiation effect. It was found that under influence of light
emitting diode radiation a breakdown of daily biofilms with inhibition
of plankton cells production capacity was observed. All the above
allows to assess current problem of medical science and practice that
is process of biofilm formation in microorganisms particularly in
Pseudomonas aeruginosa strains. Analysis of literature sources shows
practicability of research line of specific subject that is proved by
crisis of antibiotic therapy observed for now and characterized not
only by multitude of resistant microorganisms but also by absence of
preparations and infection pathology therapeutic regimen that have
assuring effectiveness and therefore search for alternative control
methods is critical and challenging.
Keywords: Pseudomonas
aeruginosa, formation of biofilms, antibiotics, physical factors,
photodynamic therapy
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9-13
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PROSPECTS FOR USE OF
CONDENSED GASES AND SUPERCRITICAL FLUIDS
IN PHYTOCHEMICAL PRODUCTION
Demyanenko D. V., Breusova S.
V., Karpenko L. A.
In the given review article analysis of the literature and patent
sources concerning main methods for intensification of extraction
processes of medicinal vegetative raw materials – use of condensed
gases and supercritical fluids (SCF) on more acceptable extractants has
been carried out for last 20 years. Urgency of the specified
technologies consists in need for replacement of traditional extraction
methods on power- and time-saving ones, and also in use of nontoxic,
fire-proof and low-boiling solvents because the most of routine organic
solvents (ethanol, methanol, acetone, chloroform, ethylacetate, etc.)
are toxic and/or flammable or expansive and rather hard to evaporate
out from extracts obtained. The abovementioned trends are the most
universal for intensification of extraction processes and sometimes
purification of final or intermediate products acceptable for
commercial scale of manufacture. The main advantages and disadvantages
of the given methods are compared for different plant species and
groups of biologically active substances (BAS). It has been shown that
in most cases supercritical ÑÎ2 (SC-ÑÎ2) are inferior in its dissolving
ability to number of condensed gases and, besides, such technology is
much more expensive. The range of BAS taken with SC-ÑÎ2 is limited to
mainly lipophilic compounds because of zero electrical dipole moment of
SC-ÑÎ2 and its low polarity. As extractants alternative to SC-ÑÎ2 with
higher dissolving ability SC - ethane, nitrogen monoxide, freons -
R134à, R23, R32, R408 and number of others can be used. Also to enlarge
range of extractable BAS it is possible to add different cosolvents,
mainly ethanol or methanol in quantity up to 20%. At the same time in
phytochemical production prospective alternatives to liquid or
supercritical ÑÎ2 are certain condensed gases with wider range of
physico-chemical properties: fluorinated derivatives of hydrocarbons
(freons), liquid ammonia, dimethyl ether (DME), sulfur hexafluoride
(insulating gas) or their mixtures, etc. Their major characteristics
include lower vapor pressure if compared with liquid ÑÎ2, antimicrobic
activity allowing to solve one the main problem in phytochemical
production – microbial contamination of extracts (and other herbal drug
preparations), possibility to extract not only lipophilic, but also
more polar substances depending on choice of solvents or their mixes
and their higher extraction rate.It has been found that some kinds of
freons (for example, R22) due to their higher polarity are able to take
wider spectrum of BAS than liquid ÑÎ2: essential and fat oils,
fat-soluble vitamins, coumarins, carotenoids, phenolic alcohols,
valrates, iridoids, some alkaloids and flavonoids. Besides, certain
freons (for example, Ñ318) have very high selectivity allowing to
extract essential oils without accompanying fats. Some condensed gases,
such as liquid ammonia, dimethyl ether and difluoromethane (freon R32)
can be used as well for obtaining of hydrophilic BAS (saponins,
alkaloids, flavonoids). Thus such solvents should be polar enough or
can be mixed with polar modifiers. Supercritical fluids and some
subcritical condensed gases are suitable for fractionating of primary
(crude) extracts because their selectivity considerably depends on
temperature, pressure and composition (in case of mixtures with each
other or with cosolvents). Also high selectivity of condensed gas and
SCFs is shown in near-critical areas. Very important property of
most of condensed gases and SCFs is their ability to considerably
reduce microbial contamination of extracts in comparison with initial
plant raw materials. Conclusions. Among existing methods for
intensification of stage of plant extraction the most applicable for
commercial scale is use of condensed gases and supercritical fluids as
extractants. It is found that for today in the world the most
widespread SCF is carbon dioxide. The main lacks of ÑÎ2 as
an extractant are high working pressure and narrow spectrum of
extractable BAS which is limited only to lipophilic substances. This
induces the search for alternative condensed gases and SCF among which
fluorohydrocarbons (freons) are of the greatest interest. Also
perspective methods of extraction intensification are applications of
ultrasound, microwave field and some other methods of raw material
processing, but meanwhile they have not got industrial value because of
insufficient scientific base.
Keywords: condensed
gases, supercritical fluids, plant raw materials, extraction, freons,
carbon dioxide.
Experimental papers
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14-21
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STANDARD TREATMENT
REGIMENS FOR MULTIDRUG-RESISTANT TUBERCULOSIS – ANALYSIS OF
EFFECTIVENESS
Ovcharenko I. A.
Introduction. In recent years, the number of cases of
multidrug-resistant tuberculosis (MDR-TB) has been increasing in
Ukraine and all over the world. The leading factor in fight against
this pathology is the effective treatment of such patients. To increase
the effectiveness of treatment of patients with MRI in 2008 unified
protocols for the provision of medical care to patients were introduced
in Ukraine, which offered standard treatment regimens for such
patients, taking into account the individual sensitivity of pathogen to
antituberculous drugs. Aim. Analysis of effectiveness of various
standard therapy regimens that were used in patients with newly
diagnosed pulmonary MDR-TB. Materials and methods. 68 case histories of
patients with newly diagnosed pulmonary MDR-TB who were treated in the
Kharkov Regional TB Dispensary ¹ 1 in 2009-2014 and received
anti-tuberculosis therapy according to current clinical protocols for
medical care to patients with chemoresistant TB. All patients were
older than 18 years. Patients were divided into two groups. Group I
included 49 people who received treatment according to the Order of
Ukrainian Ministry of Health ¹ 600 of October 22, 2008. "Standard of
medical aid for patients with chemorreistant tuberculosis". Patients
from this group received the following standard therapy regimen:
6EZAm(Km)QEt(Pt) / 12-18EZQEt(Pt); 6EZAm(Km)QPAS / 12-18EZQPAS. In
addition, 19 patients (38.8%) in group I were treated with isoniazid
(H). Thus, in group I there were 2 subgroups: subgroups Ia (with the
use of H) - 19 patients and Ib (without using H) - 30 patients, and the
effectiveness of treatment in them was analyzed. Another 19 people,
group II, received therapy according to the Order of Ukrainian Ministry
of Health ¹ 1091 of December 21, 2012. "On approval and introduction of
medical and technological documents for standardization of care in
tuberculosis" according to the scheme 8ZKm(Am)LfxPt(Et)Cs(Tz,PAS) /
12ZLfxPt(Et)Cs(Tz,PAS). All patients underwent clinical tests (fever,
cough, body weight deficit), x-ray (lung destruction, X-ray dynamics)
and bacteriological (pathogen detection by smear and cultureon solid
and/or liquid media) signs of pulmonary tuberculosis at 2 and 6 months
from the beginning of chemotherapy. Results and discussion. After 6
months of treatment, in group II, fewer patients complained of cough
(15.8% and 44.9% in groups II and I, respectively); presence of
destruction was noted in 47.4% and 67.3% of patients in groups II and
I, respectively, indicating healing of cavities in a larger number of
patients from group II. Effectiveness of treatment of patients in both
groups was almost the same (69.4% and 68.4% in group I and II,
respectively), but in the group I there were by 5.9% more deaths, and
treatment failure by 4.4% than in group II. To identify possible causes
of such differences, we analyzed within group I of subgroups Ia and Ib.
Healing of cavities was noted in larger number of patients in group Ib,
because the destruction in 6 months of treatment was determined in
56.6% and 84.2% of patients from the subgroups Ib and Ia, respectively.
Also, after 6 months of treatment there were more patients with
bacterioexcretion detected by both smear microscopy (10.5% and 0%) and
culture (21% and 10%) in subgroup Ia than in subgroup Ib, respectively.
Effectiveness of treatment was almost the same (68.4% and 70%) in
subgroups Ia and Ib, respectively. There were more deaths in subgroup
Ib by 18.1% than in group Ia (5.2% and 23.3%, respectively). When
comparing groups of patients treated without isoniazid (groups II and
Ib), it was established that in group II, after six months of treatment
there were by 27.5% patients with cough (15.8% and 43.3% respectively)
less than in a smaller patient than in subgroup Ib; also, after 6
months of therapy in this group, there were 9.2% less patients with
destruction of lung tissue (47.4% and 56.6% in groups II and Ib,
respectively). In addition, at the 2nd month of treatment there was
positive X-ray dynamics in more by 10.9% patients in group II than in
group Ib (84.2% and 73.3%, respectively). Also, after 2 months of
treatment, there were less patients with bacterial excision (detected
both microscopically (26.3% and 30%, respectively), and culturally
(42.1% and 60%, respectively)) in group II than in group Ib.
Effectiveness of treatment of such patients was almost the same (70%
and 68,4%, respectively, in groups II and Ib), but the number of deaths
was higher in group Ib than in group II (23.3% and 10.5%,
respectively). Also in group II there were no treatment failures.
Conclusions. Analysis of treatment efficiency criteria for patients
with MDR-TB in various standard schemes showed that in group II the
schemes were most effective. It should be noted that expressed positive
effect of therapy has been already was achieved at the 6th month of
treatment, despite the fact that according to the protocol, duration of
intensive phase was not less than 8 months. But the additional use of
isoniazid had no positive effects, and in general, when comparing the
effectiveness of treatment with regimens with its use, patients from
this group showed the worst positive dynamics from therapy.
Keywords:
Multidrug-resistant tuberculosis, treatment effectiveness, criteria of
treatment effectiveness, standard treatment regimen
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22-27
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SURVIVAL OF
MICROORGANISMS FROM MODERN PROBIOTICS IN MODEL CONDITIONS OF THE
INTESTINE
Kabluchko T.V., Bomko
T.V., Nosalskaya T.N., Martynov A.V., Osolodchenko T.P.
Introduction. The staye of intestinal microflora affects the work
of the whole organism. When composition of normal ibtestine
microflora changes, its restoration is required. In our days a
wide variety of probiotic drugs are available on the market which can
be used to solve this problem. Most bacteria having probiotic
properties represent the families Lactobacillus and Bifidobacterium,
which have poor resistance to acidic content of the stomach and toxic
effects of bile salts. Various studies have clearly shown that in a
person with normal acidic and bile secretion, the lactobacilli and
bifidobacteria are not detected after the passage through the duodenum,
i.e., they perish before reaching the small intestines. In this study
we compared the survival of different microorganisms which are
contained in 9 probiotic drugs in a model of gastric and
intestinal environments. Material and methods. In the laboratory
of SI: “Mechnikov Institute Microbiology and Immunology, National
Ukrainian Academy Medical Sciences" the in vitro experiments have
been evaluated to test the ability of different probiotic
bacteria which were contained in 9 probiotic drugs to survive the
impact of the model environment of the stomach and duodenum.
Bacillus coagulans persistence was evaluated under impact of simulated
environment of the stomach and duodenum, it also was assessed by
the quantity of CFU by incubation on culture medium. The following were
studied: Lactobacillus acidophilus, Lactobacillus rhamnosus,
Lactobacillus reuteri, Lactobacillus casei, Lactobacillus plantarum,
Lactobacillus bulgaricus, Bifidobacterium bifidum, Bifidobacterium
longum , Bifidobacterium breve, Bifidobacterium infantis,
Bifidobacterium animalis subsp. Lactis BB-12, Saccharomyces boulardii,
Bacillus coagulans, Bacillus clausii, Enterococcus faecium.
Microorganisms were incubated for 3 hours in a model environment of the
stomach (pepsin 3 g / l, hydrochloric acid of 160 mmol / l, pH 2.3),
later after centrifugation and washing, they were incubated for 3 hours
in intestinal model environment (bile salts 3% pancreatin 0.1%, pH
7.0). Inoculation was performed before incubation, after incubation in
the gastric medium and after incubation in intestinal medium. We used
the medium corresponding to the studied genus of bacteria -
MRS-environment for lactobacilli, bifidum for Bifidobacterium,
sabouraud medium for the isolation of yeasts and fungi and endo agar
for the isolation of Enterobacteriaceae. We assessed the quantity of
CFU before and after impact. Results and discussion. After incubation
in a simulated gastric environment, bacteria of the type
Lactobacillus and Bifidobacterium did not survive and were not defined.
Only Bacillus coagulans and Saccharomyces boulardii were resistant.
These microorganisms grew after incubation in the same amount as before
incubation - 105-6 and 107-8 CFU respectively. Bacillus clausii also
survived in these conditions, but to a lesser extent: initially - 107
CFU, after incubation - 105 CFU. After staying in model environment of
the duodenum Bacillus coagulans and Saccharomyces boulardii were still
fully viable, and the number of germinating Bacillus clausii bacteria
decreased by an order - up to 104 CFU. Conclusion. The probiotics
containing Bacillus coagulans and Saccharomyces boulardii showed
complete resistance to the impact of the model environment of the
stomach and duodenum, Bacillus clausii was partially resistant. It
leads to conclusion that probiotic drugs containing lactobacilli and
bifidobacteria, cannot withstand the aggressive environmental influence
of the stomach and duodenum and become inactivated under their
influence. Probiotic drugs Enterol containing yeast Saccharomyces
boulardii, and Laktovit Forte containing the spore-forming bacterium
Bacillus coagulans are completely resistant to the action of the model
environment of the stomach and duodenum.
Keywords:
probiotics, intestine, stability to acids and bile
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28-33
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NONTUBERCULOUS MYCOBACTERIOSES: EPIDEMIOLOGY, CLINIC AND
POSSIBILITIES OF LABORATORY DIAGNOSTICS IN MODERN CONDITIONS
Shevchenko O.S.,
Novohatska M.F., Sharapova O.V, Pogorelova O.O.
Introduction. Today there are more than 150 species of nontuberculous
mycobacteria (NTMB) known, of which 99 were registered in Europe. Due
to the similar clinical picture with tuberculosis, mycobacterioses are
difficult to diagnose and often occur with TB as a mixed infection.
Also, there are cases of NTMB detection in the sputum of persons
previously suffered with tuberculosis, which can lead to a false
diagnosis of recurrent disease. Currently, the role of atypical
mycobacteria in human pathology is increasing. Atypical mycobacteria
are characterized by a wide spectrum of sustainability and potential
pathogenicity to humans and animals. It is generally accepted that the
reservoir of infection are animals and the environment (water, soil).
NTMB presence in water can lead to the erroneous diagnosis of
mycobacteriosis due to laboratory contamination of samples with
nontuberculous mycobacteria from the outside. Moreover recently it has
been found the possibility of transferring NTMB from person to person
on the background of existing lung disease. For many types of
infections reservoir still has not been found. Aim of this work was to
study identified in the Kharkiv region cases of non-tuberculous
mycobacterioses, features of their clinical manifestations and
laboratory diagnostic options. Materials and Methods. We examined 32
patients (25 men and 7 women), residents of Kharkiv and Kharkiv region,
Ukraine, who were diagnosed with "non-tuberculous mycobacteriosis of
lungs" during 2014-2016. Patients were examined with routine diagnostic
algorithm for TB. Nontuberculous mycobacteriosis was diagnosed on the
basis of NTMB growth in BACTEC system, after which the diagnosis was
verified by the following criteria: 1. Smear: the absence of formation
of Cord-factor (in the smear NTMB are located scattering); 2. Negative
immunoassay (ID-test); 3. Negative GeneXpert MTB/RIF Then
non-tuberculous mycobacteria were identificated by investigation on
solid media. They were divided on groups of susceptible causative
agents according to Runnyon classification and the modified
classification, approved by the Order Ministry of Health of Ukraine ¹45
from 06.02.2002, which takes into account the NTMB growth rate,
character and color of colonies. Results and discussion. In all 32
reported cases infiltrative changes were identified radiographically.
In 13 patients (40.6%) cavities were found. In addition in smear of 10
patients (31.2%) was found scant bacterial excretion, 2 (6.2%) -
moderate, and 1 (3.1%) - massive. According to the results of culture
NTMB were identified. Chromogenic slow-growing non-tuberculous
mycobecteria prevailed (65,4%). Another causative agents belonged to M.
avium complex. The heaviest lesions were caused by chromogenic
slow-growing non-tuberculous mycobecteria, as 41,1% of these patients
had extensive lung damage, and 64,7%% - destruction of lung tissue.
Radiographic changes correlated with the severity of clinical
manifestations. Also in this group most often was found detectable by
smear bacterial excretion, including moderate and massive. In our
patients prevailed cavernous form which is is typical for smoking
middle-aged men, often develops on the background of previous lung
disease - cystic fibrosis (M. abscessus), COPD, bronchoectatic disease,
tuberculosis in the past, aspergillosis (M. xenopi), as well as on the
background of HIV infection and drug treatment that suppress the immune
system (corticosteroids, TNF-alpha inhibitors). Clinical and
radiographic this form is almost indistinguishable from pulmonary
tuberculosis (infiltrates in upper lobes with formation of cavities),
more severe, often with a syndrome of intoxication, cough, shortness of
breath, sometimes hemoptysis. Without treatment, the disease progresses
rapidly and leads to formation of large cavities in the lungs and
respiratory failure. The most common pathogens that cause such clinical
and radiological picture are M. kansasii, M. xenopi and Mycobacterium
avium complex. Conclusions. In Kharkiv region there is an
increase of non-tuberculous mycobacterioses, but their diagnostics is
difficult due to the lack of diagnostic capabilities: it is impossible
to perform CT examination in all patients, no possibility of reliable
identification of the type of pathogen (no DNA strip technology, tablet
technology, DNA sequencing, high-performance liquid chromatography).
Among the identified cases of mycobacterioses prevailed chromogenic
slow-growing NTMB. Clinical and radiographic pattern was characterized
by severe thoracic (cough, shortness of breath) and intoxication
(fever, weight loss, weakness) complaints and extensive lesions of
pulmonary system. Also in this group was often found detectable by
smear bacterial excretion, including massive one. It was noted that
often mycobacterioses developed on the background of existing pulmonary
disease. Failure to conduct complete laboratory diagnostics,
identification of pathogen and determination of its individual
sensitivity to drugs significantly complicates prescribing of adequate
chemotherapy regimens. In this regard, we consider a priority the
development of standards for diagnosis and treatment of non-tuberculous
mycobacterioses and further strengthening the capacity of laboratory
diagnostics.
Keywords: non-tuberculous
mycobacteria, epidemiology, diagnostics
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34-38
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MOLECULAR BIOLOGICAL RESEARCH AT FATAL
CONSEQUENCES OF VIRAL MYOCARDITIS
Smelyanskaya M. V., Peremot S.
D., Kashpur N. V., Volanskiy A. Y.
Introduction. Diagnosis of viral myocarditis, based on the evidence
base, is still one of the key problems of the heart disease. The
presence of morphological features of the inflammatory process makes it
possible to confirm the diagnosis of myocarditis, but, at the same
time, the absence of these features is not sufficient to remove this
diagnosis. In routine postmortem study of deaths in multidisciplinary
(non-infectious) hospital myocarditis is stated as a cause of death in
0.2-0.4% of all the autopsies. Mortality in myocarditis depends on the
severity of the underlying disease, premorbid background, age and sex
composition of the patients. According to different authors, it is very
different and ranges from 0.03 to 26%. The aim of the work was to carry
out histological and molecular biological studies postmortem material
for confirming the etiologic role of herpesviruses with fatal
consequences of infectious myocarditis during the observation period
2015-2016 years. Material & methods. The material of
pathological heart, vascular endothelium, nerve ganglia, kidneys, liver
and pancreas were investigated. Viral antigen detection was performed
by fluorescent antibody technique with specific sera labeled with FITC
(Dako Corporation, Carpinteria, CA) and detection of the viral genome
by PCR (in SYNEVO Laboratory). Morphological studies have been
conducted in the post-mortem offices of the Kharkov clinical hospitals.
Detection of viral genome was performed by PCR using certified
commercial kits for detection of nucleotide sequences of herpesviruses
«HSV I, II-EPh», «VZV-FL», «EBV-EPh», «CMV-EPh», «HHV VI-Eph»,
(«AmpliSens»). Diagnosis was made in «real time» using modern
six-channel thermocycler «Rotor Gene 6000» (Qiagen, Germany). The first
group consisted of 19 people who died from infectious myocarditis
(group 1). The second group (group 2) consisted of 22 dead from
complications of other cardiovascular disease. Pathoanatomical material
of 11 people was used as a control group. Death in this group occurred
as a result of traumatic injuries. The average age of those groups was
31 ± 3,8 years. All groups were matched by sex and age. Results &
discussion. It has been found, that DNA HSV1,2 turned out in infectious
myocarditis group and in the group with the same frequency
cardiovascular disease. Whereas DNA HHV6 and CMV appeared in infectious
myocarditis group 6-7 times more often. Noteworthy the DNA VZV finding
of a significant percentage of myocardial tissue samples of the dead
from group 1 in relation to other groups. According to our data, which
coincides with the tendency of foreign research, the proportion of
finding enteroviruses, compared with herpesviruses, is insignificant in
all the groups. In all of the dead of the main group (infectious
myocarditis) herpes viruses have been detected in several organs
simultaneously. Also infarction hypertension virus is most often in the
liver, pancreas and nerve ganglia. Thus, when HSV was expected in the
nerve ganglia, kidney and vascular endothelium, the detection of a
relatively high percentage of hypertension HHV6, CMV and, especially,
VZV was quite unexpected in the pancreas and liver tissues. Detection
of different herpes viruses in various organs confirms the pantropism
of viruses of this family. And the persistence of the virus in one of
the bodies makes it possible to its participation in the
etiopathogenesis of infectious myocarditis. Conclusion. In
deceased patients with viral myocarditis HHV6 and CMV, VZV and EBV are
most often found in the myocardial tissue. In all of the dead of the
main group (infectious myocarditis) herpes viruses have been detected
in several organs simultaneously. Also infarction hypertension virus is
most often in the liver, pancreas and nerve ganglia. In the group with
infectious myocarditis 3-4 viruses and 5 or more viruses appeared
significantly more often in comparison with the group with
cardiovascular disease in two and 4,5 times, respectively. This may
increase the virulence of the various representatives of herpesviruses
from general cell receptors.
Keywords: herpesviruses,
myocarditis, PCR
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39-43
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ORGANIZATIONAL AND LEGAL RESEARCH OF
INDICATORS OF INCIDENCE AND PREVALENCE OF DIABETES MELLITUS IN
COUNTRYSIDE AREAS
Zbrozhek S. I., Shapovalova V.
A., Shapovalov V. V., Hmelevskiy N. A.
Introduction. For recent decades in Ukraine populations’ health
indicators became quite serious negative trends: increased mortality
rates among people of working age, morbidity, reduced life expectancy
and more. It should also be noted that one of the main indicators of
the state, its civilization and competitiveness is the degree of
orientation of the state to improve the health of citizens, legal and
organizational improvement of the healthcare sector. The financial and
economic crisis has significantly exacerbated the problems associated
with the provision of medical care in Ukraine, ensuring its
availability and good quality. The current healthcare system is fair
and complaints from the public, and the medical staff, it is still not
able to adequately meet the needs of the population in healthcare, to
ensure the availability, quality and timeliness of health services,
adequate prevention of morbidity, mortality and more. The need for
healthcare reform emphasizes the failure to ensure the proper
conditions existing in state funding and to implement effective schemes
for full competition in the healthcare and pharmaceutical provision in
countryside areas is therefore, in Ukraine implemented new
organizational and legal approaches in reforming the health service.
That is why in Ukraine implementing processes that are transparent,
will reduce unnecessary costs for public administration and improve
accessibility of the medications in countryside areas of different
clinical and pharmacological, classification, nomenclature, legal and
regulatory groups used in the pharmacotherapy of diabetes mellitus.
Materials and methods. The organizational and legal, forensic and
pharmaceutical researches were conducted in countryside areas at the
regional level on example of the Kharkiv region on the basis of 62
public healthcare institutions, 16 public enterprises of healthcare and
health companies of other ownership. Materials of the research were:
the legal framework for the organization of pharmacy of the healthcare
system in countryside areas; forensic and pharmaceutical practice
concerning the complaints on countryside accessibility for their
antidiabetic drugs; regional statistics of incidence and prevalence of
diabetes mellitus. In conducting the research used the following
methods: legal, documentary, bibliography, comparative, forensic and
pharmaceutical, graphical analysis. Results and discussion. In the
limited funding of the healthcare system and low pharmaceutical
ensuring of patients with diabetes mellitus in countryside areas, the
question of the optimal use of funds to avoid negative consequences, as
evidenced presented in the article on an example of forensic and
pharmaceutical practice. Among the possible reasons for such
organizations to ensure pharmaceutical provision for privileged
categories of citizens can point to the constant rise in prices for
antidiabetic drugs and delay in timely registration of wholesale prices
for these drugs. Also during the study was a comparative analysis of
incidence and prevalence of diabetes at the regional level by the
example of Kharkov region. The increase in the prevalence of diabetes
is due to various factors, including stress, obesity, aging population,
quality of food and life. The increase in the prevalence of the disease
may indicate a lack of financing health systems, insufficient
qualifications and training of medical personnel, the remoteness of
rural health facilities and inadequate organization providing
pharmaceutical rural antidiabetic drugs passivity farmers regarding
preventive examinations, treatment their health, compliance with
recommendations and a low level in the chain of relations "doctor -
patient with diabetes mellitus - pharmacist." Conclusions. Diabetes
mellitus treatment should be based on the principles of pharmaceutical
law provided in Art. 4 of the Law of Ukraine "On the basis of
legislation of Ukraine on healthcare" from the state budget. Also in
reforming of the healthcare system must take into account the
experience of the European Union, and the need to propose such changes
to the legislation: - twice increased funding by providing targeted
subsidies from the state budget; - Statement of the Cabinet of
Ministers of Ukraine of 02.07.2014 p. Number 240 "On reference of
pricing for medicines and medical supplies procured for the state and
local budgets"; - Annual review, update and adjust the list of
antidiabetic drugs domestically who can buy HCF regional level in rural
areas, fully or partially financed from state and local budgets
approved by the Cabinet of Ministers of Ukraine dated 05.09.1996,
number 1071 .
Keywords: diabetes
mellitus, incidence, prevalence, circulation, antidiabetic medicines,
pharmacy, forensic pharmacy, pharmaceutical law.
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44-53
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![pdf](../../pdf.jpg) ![](../../doi.jpg) |
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SYRUP AMKESOL REDUCES THE LEVEL OF PRIMARY
AND SECONDARY PRODUCTS OF LIPID PEROXIDATION AND TOXIC METABOLITES OF
NITRIC OXIDE IN BLOOD SERUM OF IMMATURE RATS WITH BRONCHIOLITIS
Storozhenko K.V.
Aim
of this study was to determine the pharmacological effect of syrup
Amkesol evaluating the blood serum levels of primary and secondary
products of lipid peroxidation, activity of AO enzymes and final rates
of NO metabolites in immature rats of different ages with experimental
model of bronchoalveolitis. Materials and Methods: The study was
carried out on 90 WAG immature rats of ages 1, 2 and 3 menthes,
that correlates by morpho-functional features to 4, 10 and 14 years of
human age respectively, on a model of bronchoalveolitis. Experimental
animals in each age series were randomly divided into 5 groups (n = 6):
intact (healthy), 2 groups of control (untreated with
bronchoalveolitis) 7 and 14 days, and two groups with bronchoalveolatis
that received S-AKS daily during 7 and 14 days. The pathological
process implemented by inhalation of irritant (Sephadex A-25 Pharmacia,
Sweden (5 mg/kg)). In the blood serum samples activity of CAT, SOD,
content of DC, TBARS, total NO, nitrates and nitrites were determined.
Probability of the results was evaluated by using GraphPad Prism
Software. The critical level of significance was taken equal to 0.05.
Results. The use of S-AKS on the 7th day in the group of 1- and
3-month-old rats significantly exceeded activity of CAT compared to the
control group of animals of corresponded age. The SOD activity in group
of 2-month-old animals was restored to intact level, the activity of
CAT exceeded the baseline level and amounted to 129% (P≤0,05). The
concentration of DC in 1-month-old rats was lower by 45.3% in 2 monthly
- by 12.5% than in the control group, in the group of 3 month-old
animals - restored to normal (P≤0,05). The level of NO metabolites was
significantly decreased compared to the corresponding control group in
all age series (P≤0,05). After 14 days of treatment with S-AKS in all
age group of animals observed restore the contents of primary and
secondary products of lipid peroxidation compared to the intact level.
Conclusion. Administration of S-AKS reduced the values of primary and
secondary products of lipid peroxidation; restored the activity of
antioxidant enzymes; reduced the level of NO and its stable metabolites
to the physiological level in all studied age groups of animals with
experimental bronchoalveolitis.
Keywords: children's dosage forms, syrup Amkesol, bronhoalveolitis,
prooxidant-antioxidant system, nitric oxide metabolites.
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54-61
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PHARMACOLOGICAL RESEARCH
OF THE DENTAL GEL WITH CARBON DIOXIDE HUMULUS LUPULUS EXTRACT
Melnik A. L., Kazm³rchuk
V. V., Nosalska T. M., Bomko T. V., Dovga I. M., Povolokina I.
V.,
Kuchma I.Y., Martynov A. V.
Introduction. In contemporary pharmaceutical practice
among drugs used in dental gels are most effective, that are easily
applied to the mucous and long held on the gums to form a protective
film and prolonging therapeutic effect. Therefore it developed a new
drug with a carbon dioxide Humulus Lupulus extract antimicrobial action
in gel form for treatment of the oral cavity. The aim of our study was
to investigate the acute and subacute toxicity the gel containing 0.5 %
carbon dioxide Humulus lupulus extract. The toxicity of the gel studied
at the intragastric route of administration, due to the scope of drug –
dentistry. Materials and methods. The object of the research was gel
containing 0.5% carbon dioxide Humulus lupulus extract. Studies of
acute toxicity gel with carbon dioxide Humulus lupulus extract was
performed on white inbred laboratory mice of both sexes, weighing 19–21
gram. Animals received gel single intragastric at maximum tolerated
this route of administration dose – 2.0 g/kg [6]. The experiment used
by 5 mice of both sexes. The criteria of judgment about the toxicity
was the clinical picture of intoxication, animal survival, dynamics of
body weight of mice (raw data, 3, 7, 14 days). Observation of animals
were carried out within two weeks. Subacute toxicity studied on white
inbred laboratory rats of both sexes, weighing 220 – 250 g. Animals
were divided into 3 groups, each experimental group were 5 male and 5
female rats. Total experiment used 30 rats. Rats was injected gel with
carbon dioxide Humulus lupulus extract once a day for 14 days at doses
of 0.2 g/kg and 1.0 g/kg (1/10 and 1/2 of the maximum dose in acute
experiment). Control animals were injected comparison drug Kamistad–H
gel at a dose of 1.0 g/kg. Evaluation of the toxic effects of
investigational gel and reference medicine on the body of the
experimental animals were carried out on the following parameters:
clinical observations, the survival of animals, food and water
consumption, the dynamics of body weight, hematological and biochemical
parameters of blood. Clinical observations of the animals was performed
daily during the experiment, registering changes in their general
condition, behavior, food and water consumption. Clinical and
biochemical parameters studied using a reagent kit of "Felicity
Diagnostics" (Ukraine) and conventional methods. Body weight of animals
recorded in dynamics. The animals were weighed before the experiment,
then 7 and 14 days. Results and discussion. Results of the study
parameters acute toxicity gel with carbon dioxide Humulus lupulus
extract showed that intragastric administration to mice at a dose of
2.0 g/kg caused no clinical symptoms of intoxication. Animals calmly
reacted to the introduction of the sample gel, their general condition
and behavior remained unchanged. Animal deaths and abnormalities in
their general condition and behavior during the observation period were
noted. Impact analysis of the sample of gel on the dynamics of body
mass animal experiments showed that a single injection of a gel to mice
at a dose of 2.0 g/kg did not significantly affect the dynamics of body
weight. In experiments on rats were studied subacute toxicity gel with
carbon dioxide Humulus lupulus extract. The results of 14 days
intragastric introduction gel and reference drug studies at subacute
toxicity showed that daily administration of no effect on the general
condition, appearance (state of the skin and mucous membranes) and the
behavior of rats. Consumption of food and water in animal experimental
and control groups had no differences from each other. During the
experiment animal deaths were not reported. Data characterizing the
dynamics of increase in body weight of rats showed that the animals of
experimental groups and the control group by the end of the experiment
had equivalent, statistically significant weight gain compared with the
output data: males – p ≤ 0. 0001 females – from p ≤ 0.0001 to p ≤
0.0004. During the experiment, the animals of all experimental groups
were observed physiological fluctuations that characterize the pattern
of peripheral blood. Results of biochemical studies showed that overall
the tested parameters: the concentration of total protein, albumin,
thymol test, the activity of alanine and aspartate aminotransferase,
the concentration of glucose and cholesterol in the blood serum of rats
of all experimental groups answered normal values. There have been
fluctuations in biochemical parameters in animals of all experimental
groups compared with baseline data did not go beyond the physiological
norm. Conclusions. 1. Study of acute toxicity after a single
intragastric administration to mice gel with 0.5 % carbon dioxide
Humulus lupulus extract have shown that gel does not cause death of
animals; no toxic effects on the general state, behavior, food
consumption and water weight animals; does not affect the absolute and
relative weight of internal organs; does not cause visible changes of
internal organs. 2. According to the standard classification gel with
0.5 % carbon dioxide Humulus lupulus extract refers to practically
non-toxic substances. 3. Subacute toxicity study results showed that
the gel with 0.5 % carbon dioxide Humulus lupulus extract with 14 daily
intragastric administration to rats at doses of 0.5 g/kg and 1.0 g/kg,
does not cause death of animals; has no toxic effects on the general
state, behavior and dynamics of body weight of the experimental
animals; no negative impact on the performance of blood of animals;
does not change the biochemical parameters characterizing the
functional state of the liver of animals. 4. Pharmacological studies of
dental gel with 0.5 % carbon dioxide Humulus lupulus extract, such as
the results of the study of acute and subacute toxicity found that
designed gel to include low-toxic substances (IV class of toxicity),
has good tolerability and safety of long-term use.
Keywords: gel with carbon
dioxide Humulus lupulus extract, acute and subacute toxicity,
laboratory animals, clinical observations, reference drug –
Kamistad-Gel H
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|
62-66
|
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THE PHARMACOLOGICAL
EFFICACY OF THE EXTEMPORANEOUS GEL DIAVENOL
Martynov AV, Bomko TV,
Nosalskaya TN, Kabluchko TV, Igumnova N.I, Romanova EA, Pogorelaya M.C.,
Sidorenko TA, Shcherbak E .N., Yukhimenko VI, Davidova TV., Batrak EA,
Farber BS, Farber SB
Introduction. Diavenol - new extemporaneous gel for the treatment of
venous ulcers. The gel contains a synergistic combination C. majus
quinolizidine alkaloids and riboflavin. Activate tissue regeneration
shown previously for riboflavin, and ñheleretrin / sanguirythrine. The
combination of the alkaloids and riboflavin pharmacologically fully
justified. The research aim was to check the mechanism action of the
Diavenol gel - through stimulation of the pluripotent cells
growth and determination the effectiveness of the gel for wound healing
at experimental model in rats. Materials and methods. In a study 128
rats were used, of which 38 - in the pharmacological experiment with a
stencil wound healing, and 90 in the experiment to study the influence
of gel on CD34 cells amount in the blood in rats with chemically
induced immunodeficiency. High immunodeficiency caused a five-fold
administration of cyclophosphamide, prednisone and rubomycin. CD34
expression level was determined using flow cytometry FACS Calibur.
Results and discussion. Topical skin application the Diavenol gel
samples in rats helped to accelerate the regeneration process is about
2 times, as evidenced by the excess of blood parameters in experimental
group animals to the 30th day, more than 2 times, while the indicators
in the control group animals came to normal values only on the 60th
day. Increasing the number of pluripotent cells as well as acceleration
of wound regeneration indicates preferential stimulation of stem cell
growth in the periphery, rather than an enhancement of bone marrow
function. The maximum effect of the Diavenol observed on the 60th day
and the restoration of the pluripotent cells physiological level have
been observed on the 10th day after the start of Diavenol application.
Due to the fact, that the gel was applied to intact skin, we can say
that Diavenol had resorptive properties. Treatment of wounds in rats
Diavenol gel resulted in a more rapid removal of inflammation and
significant acceleration of stencil wound healing. In terms of the
granulation appearance and wounds epithelialization the Diavenol gel
has some advantage in relation to the dexpanthenol ointment.
Keywords: diavenol, CD34
+ cells, regeneration, wound healing, riboflavin, Chelidonium majus,
chelidonine, chelerythrine, sangviritrin.
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|
67-70
|
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|
ANTIBACTERIAL AND
ANTIOXIDANT PROPERTIES OF SOME SELECTED EGYPTIAN PLANTS
Hala M. Abushady, Einas H. El-
Shatoury, Al-Shimaa S. Abd-elmegeed
Introduction. Medicinal plants have been used as a source of therapies
since ancient times in Egypt. The present study was designed to
investigate the anti-bacterial and anti-oxidant activity of different
extracts from 20 selected medicinal plants of Egypt. Materials and
methods. The disk diffusion method followed by microbroth dilution were
used to determine minimum inhibitory concentration of the plant
extracts against 10 bacterial strains belonging to 5 species,
Pseudomonas aeruginosa, Klebsiella pneumonia, Escherichia coli,
Staphylococcus aureus, Streptococcus pyogenes. While qualitative
phytochemical screening followed by DPPH
(1,1-diphenyl-2-picrylhydrazyl) assay were used to assess the
anti-oxidant of the extracts. Results. The results indicated that all
studied crude extracts were able to inhibit the growth of at least
three of the tested bacteria. Moreover, all studied plants have various
bioactive phyto-chemicals and were observed to be high to moderate
antioxidant agents. Conclusion. Finally, the target of this paper is to
describe the most interesting plant extracts investigated here to be
alternative medicines.
Keywords: Antibacterial,
Antioxidant, Medicinal plants, Phytochemicals, DPPH.
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|
71-95
|
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|
ANTIMICROBIAL ACTIVITY
OF THE SUBSTANCES RECEIVED FROM RAW MATERIALS OF LAMIACEAE AND
CUCURBITACEAE FAMILY PLANTS
Fedchenkova Iu. A., Savinova Y.
M., Batyuchenko I. I., Andrianov K. V., Gamulya O. V.
Introduction. The search of new sources of raw materials for medicine
creation is one of the pharmacy priorities. In this, our attention was
drawn by the plants which are widely cultivated in Ukraine and have a
sufficient source of raw materials. It is summer squash (Cucurbita pepo
L.) and sowing cucumber (Cucumis sativus L.) of Cucurbitaceae
family and also peppermint (Mentha piperita L.) of two sorts
“Chernolistaya” and “Zgadka” of Lamiaceae family. However the drugs
with antimicrobial action derived from the leaves of these plants in
the market of Ukraine are absent. Spirit, lipophilic and
polysaccharidic fractions were received from the leaves of sowing
cucumber, summer squash and two sorts of peppermint by us.
Antimicrobial activity studying of the received substances derived from
the studied raw materials for expansion of the medicine range is
promising. The relevance of researches is that getting for the first
time due to complex raw material processing the lipophilic, spirit and
polysaccharidic fractions of leaves of a sowing cucumber, summer squash
and two sorts of peppermint “Chernolistnaya” and “Zgadka” are
systemically studied on existence of antimicrobic activity. The purpose
of our research is the studying of antimicrobial activity of getting
substances derived from the leaves of sowing cucumber, summer squash
and two sorts of peppermint “Chernolistnaya” and “Zgadka”. Materials
and methods. Raw materials for substances are the leaves of a sowing
cucumber prepared in June, 2015 in the Kharkiv region, the village
Selection, in the conditions of industrial cultivation (the selection
station of Institute of vegetable-growing and melon-growing of UAAN).
The leaves of summer squash were being prepared also in June, 2015 in
Valkovsky district of the Kharkiv region, the settlement Dobropolye.
The leaves of peppermint of “Chernolistnaya” and “Zgadka” sort were
prepared on the industrial squares of Dnipropetrovsk region,
Sofiyevskiy district, the settlement Ordo-Vasilyevka. Lipophilic
fractions were received in Sokslet's device. As an extractant,
chloroform was used. From the received extraction the extractant was
being deleted in vacuum. Lipophilic fraction represented viscous
substances of black-green color with typical fragrant. For receiving
spirit fractions derived from solvent cake after receiving the
lipophilic fractions it was used a method of fractional maceration at
the general ratio raw materials-extractant 1:15, as an extractant was
50% ethyl alcohol. Extraction was carried out three times. The
integrated extracts were concentrated in vacuum. After a full removal
of an extractant and drying, it had been received the hygroscopic
powders of green-brown color with specific tastes and smells.
From the solvent cake which was remained after receiving lipophilic and
spirit fractions polysaccharidic fractions representing water-soluble
polysaccharides were evolved. They were friable powders of light gray
color. The lipophilic fraction of sowing cucumber leaves,
lipophilic fraction of summer squash leaves, lipophilic fraction of
peppermint leaves of “Chernolistnaya” sort, lipophilic fraction of
peppermint leaves of “Zgadka” sort, spirit fraction of cucumber leaves,
spirit fraction of summer squash leaves, spirit fraction of peppermint
leaves of "Chernolistnaya" sort, spirit fraction of peppermint leaves
of Zgadka sort, polysaccharidic fraction of cucumber leaves,
polysaccharidic fraction of summer squash leaves were being studied.
Test of antimicrobial effect of substances was carried out by method of
serial dilution concerning the following six reference test cultures:
Staphylococcus aureus of ATCC 6538-P, Candida albicans of ATCC 885-653,
Escherichia coli of ATCC 25922, Bacillus subtilis of ATCC 6833,
Bacillus cereus of ATCC 10702, Pseudomonas aeruginosa of ATCC 9027,
according to the State Pharmacopoeia of Ukraine of 1 edition, in the
Department of microbiology and immunology of KMAPQE. Results and
discussion. The obtained data demonstrate that the widest range of
antimicrobial activity was shown by SSL, ChPL and SPZ in the ratio of
E. ñoli, C. àlbicans and P. àeruginosa. Thus, SSL, ChPL, SC and
SPZ had a bactericidal activity in dilution 1:10 and 1:100 concerning
P. àeruginosa and E. coli. PZL - concerning P. àeruginosa. SSL, SC,
SSS, ChPL, PZL, SPCh and SPZ have antimycotic activity concerning C.
albicans. Concerning E. ñoli it was revealed that SSL, ChPL, SPZ had
bactericidal activity, and concerning P. àeruginosa and C. albicans SC,
ChPL, PZL, SPZ had it in dilution 1:10 and 1:100. Among the
polysaccharidic fractions the antimicrobic activity was revealed only
for PC in both dilution concerning B.cereus. As for S. aureus and B.
subtilis, bacteria of these strains were resistant to all studied
fractions. Conclusions. Antimicrobial activity of a number of
substances of sowing cucumber leaves, summer squash and two sorts of
peppermint “Chernolistnaya” and “Zgadka” is studied. Lipophilic
fractions of raw materials (except CL) have an antimycotic activity
concerning C. albicans. Among all the polysaccharidic fractions only PC
have antimicrobial action concerning B. cereus. Strains of
bacteria S. aureus and B. subtilis are resistant to both dilutions of
all studied substances.
Keywords: antimicrobial
activity, leaves, cucumber, summer squash, peppermint, substance.
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|
96-100
|
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EFFICIENCY METHODS OF
PHYSICAL REHABILITATION OF OSTEOCHONDROSIS OF THE LUMBAR SPINE
Êyreev I.V., Zhabotynska
N.V., Kazarinova M.V.
Introduction. Osteochondrosis – the most common disease
of the spine, which affects more than 70% of the population. Important
is the social significance of osteochondrosis, in the structure of
diseases of the musculoskeletal system as a whole the average primary
disability of adult consequence of osteochondrosis – 1,7 to 10 000. It
is important finding the most effective methods of complex treatment,
and most importantly rehabilitation and recovery of patients with
osteochondrosis. Material & methods. We selected 16 patients
with osteochondrosis of the lumbar spine, men aged 29-42 years with
disease duration from 2 to 9 years. To determine the effectiveness of
the methods of physical rehabilitation of patients with lumbar
osteochondrosis outside the period of exacerbation assessed the
dynamics of three indicators: vertebral syndrome, extravertebral
syndrome, subjective assessment of the general condition of patients by
psychological testing. After the examination, the patients divided into
two groups of 8 people. Patients of the first group received physical
therapy (ultrasound therapy and massage therapy). Pharmacotherapy is
not done. Patients of the second group received medications according
to the recommendations received after discharge from hospital. Results
& discussion. After the rehabilitation treatment severity of
vertebral syndrome significantly decreased to 1,1±0,23 points (ð <
0,05) in first group and to äî 1,0±0,33 points in second group (ð <
0,05) with no significant difference between groups of patients. These
figures suggest that all patients there was a reduction in pain to a
weak pain, but some patients even before its termination. After
rehabilitation terms of pain rate in the first group significantly
decreased to 1,1±0,03 (p <0,05) points; in the second group, the
figure dropped significantly to 1,2±0,08 (p <0, 05) points. In
patients who did not receive pharmacotherapy, improvement in
psychological testing "HAM" was slightly higher; reflecting the more
positive assessment by patients of their condition by the end of the
course of rehabilitation, reduce fatigue, increase stamina, optimism,
activity and energy. In the group first patients, unlike the second
groups reducing the intensity of pain occurred against the background
of physiotherapy simultaneously with a reduction in anxiety.
Conclusions. Thus, even an isolated application of physical
rehabilitation of patients with spinal osteochondrosis is effective and
does not always require pharmacological support.
Keywords:
osteochondrosis, physical rehabilitation, conventional methods of
treatment
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|
101-103
|
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