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Hemorrhoids are one of the most widespread diseases of the adult population in industrialized countries. It has been established that in people over 40 years of age, the symptoms of hemorrhoids are found in 60-70% of cases. The share of... more
Hemorrhoids are one of the most widespread diseases of the adult population in industrialized countries. It has been established that in people over 40 years of age, the symptoms of hemorrhoids are found in 60-70% of cases. The share of hemorrhoids, in the structure of coloproctological diseases, accounts for about 40%.In recent years, minimally invasive methods of treating hemorrhoids have already been firmly introduced into the daily practice of coloproctologists. The advantages of these methods over surgical interventions are the possibility of their use on an outpatient basis, without disability; high efficiency in the initial stages of the disease; a small number of complications.The most commonly used minimally invasive methods are:hardware ligation of hemorrhoids with latex rings, sclerotherapy, infrared photocoagulation of hemorrhoids,suture ligation of hemorrhoidal arteries under the control of dopplerometry, electrocoagulation of hemorrhoids.The indication for minimally in...
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Syndromic diagnostic principle includes the recognition of diseases that is based on the mental processes only with that range of pathological conditions and diseases, which manifest themselves with a single leading syndrome, regardless... more
Syndromic diagnostic principle includes the recognition of diseases that is based on the mental processes only with that range of pathological conditions and diseases, which manifest themselves with a single leading syndrome, regardless of affiliation to different nosological units. At the beginning of the examination of a patient, a doctor must actively identify symptoms of the disease. Herewith the researcher does not know which disease is characterized by this or that symptom as a set of the same symptoms may occur in various diseases. At the same time, only complete identification of all clinical symptoms and features of their manifestation gives an opportunity to form isolated syndromes, which make it possible to recognize and substantiate provisional diagnosis. The main syndromes of surgical diseases include pain syndrome of various location, fever, jaundice, motor evacuators disorders of the gastrointestinal tract and other disturbances. In other words, syndrome is a complex ...
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The textbook “Surgery” for English-speaking students includes information on methods and principles of preliminary diagnosis. The following methods of diagnostics are viewed: a) Analogy method, which is possible in case of typical... more
The textbook “Surgery” for English-speaking students includes information on methods and principles of preliminary diagnosis. The following methods of diagnostics are viewed: a) Analogy method, which is possible in case of typical (classical) manifestation of a disease (in uncomplicated external abdominal hernias and acute purulent surgical infection of soft tissues); b) Inductive method, which is based on the initial hypothetical generalization with the findings validation; c) Substantiated diagnosis, based on the doctor’s mentally synthetically activity, who sequentially analyses all the present symptoms and verifies their compliance with the disease d) Method of differential diagnosis (most reliable), which excludes all signs of other similar diseases. To establish a diagnosis, a thorough examination of a patient is required. The more signs of the disease manifestation are revealed, the more probable the accuracy of the diagnosis is. The methodology of the preliminary diagnosis i...
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Introduction: Joint manifestations of inflammatory bowel diseases (IBD) are observed in 30% of cases. Their largest share is in total forms of ulcerative colitis (UC) 85–90% and Crohn's disease (CD) involving the colon 30–35% or large... more
Introduction: Joint manifestations of inflammatory bowel diseases (IBD) are observed in 30% of cases. Their largest share is in total forms of ulcerative colitis (UC) 85–90% and Crohn's disease (CD) involving the colon 30–35% or large and small intestines 60%. The pathogenesis of articular manifestations remains unclear. The importance of increased permeability of the intestinal wall, which is noted in patients with UC and CD, is discussed, as a result of which the components of the membrane wall of bacteria enter the bloodstream. These components act as peptide antigens that can lead to the development of arthritis. Contacting the molecules of histocompatibility complexes and further activating T-lymphocytes, peptides lead to joint inflammation. From the point of view of a rheumatologist, the articular manifestations of IBD are classified as seronegative spondyloarthropathies. Methods: During 2013–2018, we studied the frequency of treatment of patients with IBD with extraintest...
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Introduction: In the absence of a positive response during treatment with 5-ASA drugs and hormones, reserve drugs - immunosuppressant’s are prescribed, which in some cases does not solve the problem of treating refractory forms of... more
Introduction: In the absence of a positive response during treatment with 5-ASA drugs and hormones, reserve drugs - immunosuppressant’s are prescribed, which in some cases does not solve the problem of treating refractory forms of Ulcerative colitis (UC) and Crohn`s disease (CD). In addition, the use of immunosuppressant’s in certain least limited to a wide range of side effects characteristic of cytostatic. The development of refractoriness to treatment is observed on average in 35–40% of patients and leads to severe complications, surgical interventions and disability of young people working age. Currently, in the complex treatment of this category of patients using "biological" drugs. The biological method is based on concept of the leading role of proinflammatory cytokines in the pathogenesis of intestinal inflammation and the possible blockade of their biological effects by anti-inflammatory cytokines. Quite effective and safe with refractory clinical inflammatory bow...
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The most important thing in education is the development of future doctor is method of preliminary diagnosis of any disease, including surgical. The previously used textbooks on surgery has been described mainly the clinical... more
The most important thing in education is the development of future doctor is method of preliminary diagnosis of any disease, including surgical. The previously used textbooks on surgery has been described mainly the clinical manifestations of diseases and their treatment techniques, without clarifying the principles and preliminary diagnosis capabilities for students. After medical education the doctors of the general medical practice tasks determinations basic requirements of scope of knowledge and practical skills for graduating student of institute of higher education of IV level of accreditation: goal-directed methodical algorithm of questioning of the patient (getting anamnesis), physical examination, substantiation of provisional diagnosis, determinate algorithm of additional methods of investigations with analysis of received results, differential diagnosis, forming clinical diagnosis, substantiation of treatment program and it’s realization. In the future the young doctor ca...
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Mini-invasive methods of treating pathology of the anal canal have existed since the very beginning of the development of medicine. Even Hippocrates used high temperatures to cauterize bleeding hemorrhoids, and in ancient China, doctors... more
Mini-invasive methods of treating pathology of the anal canal have existed since the very beginning of the development of medicine. Even Hippocrates used high temperatures to cauterize bleeding hemorrhoids, and in ancient China, doctors applied aggressive chemical mixtures to coagulate them. All this is possible due to the anatomical features of the anorectal zone, in particular, the absence of pain receptors above the dentate line.Purpose of the work: to increase the efficiency of treatment of patients with hemorrhoidal disease using minimally invasive techniques at the clinical base of the Department of Surgery No. 1 of the State Institution "Dnepropetrovsk Medical Academy of the Ministry of Health of Ukraine", where the following methods of treating hemorrhoidal disease are used: low-traumatic (instrumental): - latex ligation of hemorrhoids - the imposition of latex rings on the tissue of internal hemorrhoids, - suture ligation of hemorrhoidal arteries under the control...
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Crohn's Disease (CD) most commonly affects the terminal portion of the small intestine and the large intestine. CD can also affect any other part of the gastrointestinal tract, from mouth to anus. Inflammation of the intestines is... more
Crohn's Disease (CD) most commonly affects the terminal portion of the small intestine and the large intestine. CD can also affect any other part of the gastrointestinal tract, from mouth to anus. Inflammation of the intestines is usually not continuous, areas inflammation (foci of inflamed bowel) interspersed with normal areas intestines (segmental lesion). Depending on the severity of the inflammation the inner layer of the intestinal wall (mucosa) may turn red (erythematous) and swollen (edematous) with ulcers of different sizes and shapes (aphthae’s, superficial, deep, longitudinal), and the mucous membrane can have the appearance of a "cobblestone pavement". These lesions extend throughout the thickness intestinal wall and can lead to complications such as stenosis of the intestinal lumen and / or germination in other organs (penetration), resulting in abscesses (infiltration of intestinal contents into the abdominal cavity) or fistulas (channels that connect the ...
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Joint manifestations of inflammatory bowel diseases (IBD) are observed in 30% of cases. Their largest share is in total forms of ulcerative colitis (UC) 85-90% and Crohn's disease (CD) involving the colon 30-35% or large and small... more
Joint manifestations of inflammatory bowel diseases (IBD) are observed in 30% of cases. Their largest share is in total forms of ulcerative colitis (UC) 85-90% and Crohn's disease (CD) involving the colon 30-35% or large and small intestines 60%. The pathogenesis of articular manifestations remains unclear. The importance of increased permeability of the intestinal wall, which is noted in patients with UC and CD, is discussed, as a result of which the components of the membrane wall of bacteria enter the bloodstream. These components act as peptide antigens that can lead to the development of arthritis. Contacting the molecules of histocompatibility complexes and further activating T-lymphocytes, peptides lead to joint inflammation. From the point of view of a rheumatologist, the articular manifestations of IBD are classified as seronegative spondyloarthropathies. During 2013-2020, we studied the frequency of treatment of patients with IBD with extraintestinal articular manifest...
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Arthritis, or joint inflammation, is the most common complication of ulcerative colitis. Twenty-five percent of people with ulcerative colitis suffer from it, and it is often found in young patients. In addition to joint pain, arthritis... more
Arthritis, or joint inflammation, is the most common complication of ulcerative colitis. Twenty-five percent of people with ulcerative colitis suffer from it, and it is often found in young patients. In addition to joint pain, arthritis also causes swelling and stiffness (stiffness in the joint). With ulcerative colitis, arthritis can manifest itself in two different forms: Peripheral arthritis usually affects large joints of the hands and feet, including elbows, wrists, knees and ankles. Pain can "migrate" from one joint to another and last from a few days to several weeks. The more intense the inflammatory process in the colon, the more pronounced arthritis. To date, there are no special tests to confirm ulcerative colitis-associated arthritis. This diagnosis can be made only by eliminating other causes of pain in the joints. Fortunately, such peripheral arthritis usually does not cause a significant change in the function of the joint. Spondyloarthritis (arthritis of th...
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In the course of the higher medical education of the phrase "study method" it is expedient to understand as set of organizational methods of study to something or receptions of performance something whereas in didactics of... more
In the course of the higher medical education of the phrase "study method" it is expedient to understand as set of organizational methods of study to something or receptions of performance something whereas in didactics of preparation of future doctors of attitude "the study method" is interpreted as a way of the ordered mutual activity between the teacher and the student directed on the solution of concrete educational tasks including in the higher medical education of Ukraine. All this together convincingly testifies that "the study method", is rather difficult, high-quality and multidimensional pedagogical technology in which objective educational regularities, the principles, the purposes, the contents and forms find reflection. Communication of any pedagogical technology with other didactic categories is always shown by the interacting and interconnected characteristics as the principles, the purposes, the contents and forms of education define a c...
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Existing methods of ectomy of chronic anal fissure is now accompanied by a fairly large number of postoperative complications such as pain syndrome, breach urine, bleeding, local edema, which leads to additional suffering patient,... more
Existing methods of ectomy of chronic anal fissure is now accompanied by a fairly large number of postoperative complications such as pain syndrome, breach urine, bleeding, local edema, which leads to additional suffering patient, increases the cost of treatment. The aim is to study the results of treatment of chronic anal fissure through the use of electrocautery generator LigaSure (Covidien) for fissure and vessels that supply blood to them. After dilatation anal sphincters spend revision anal canal. Clip tighten chronic anal fissure from 0,5 to 2,0 cm from anal verge to 3,0 cm on deep recti on top and put on his stretched base, including vascular leg, bent electrode apparatus LigaSure. Spend electric welding grounds unit at intensity 2 or 3 LEDs, after which chronic anal fissure of the clip is removed without firmware vascular legs. Histological research after operation. Applying this method on treatment of 21 patients with a diagnosis of "Chronic anal fissure”. Performanc...
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Currently, Ukraine is developing and phased implementation of medical reform, which involves the organization of work at the primary level of providing qualified medical help by a family medicine doctor. This reform can be accompanied by... more
Currently, Ukraine is developing and phased implementation of medical reform, which involves the organization of work at the primary level of providing qualified medical help by a family medicine doctor. This reform can be accompanied by the development of possible medical and social and financial problems. The transfer of funding to the primary medical level and the possibility of allocating funds allocated to a specific number of residents assigned to a family medicine doctor can lead to the following problems: 1. The examination of patients only by a family medicine doctor in order to save the allocated financial resources and not performing complex laboratory and modern apparatus-instrumental additional researchers can lead to the establishment of an incorrect diagnosis, which will lead to the choice of the wrong treatment tactic and to the patient's serious condition, and in some cases and to death. 2. Treatment of patients only by a family medicine physician in order to sa...
Regional or granulomatous ileitis is a chronic bowel disease (Crohn's disease) that covers all the layers of the intestinal wall (transmural lesions), and sometimes spreads to the mesentery, regional lymph nodes affecting both the... more
Regional or granulomatous ileitis is a chronic bowel disease (Crohn's disease) that covers all the layers of the intestinal wall (transmural lesions), and sometimes spreads to the mesentery, regional lymph nodes affecting both the small and large intestines, but most often localized in the terminal section of a thin guts (regional, terminal ileitis). These diseases can be accompanied by damage to the peripheral joints, spine, or joints and spine. The clinical manifestations of the joint syndrome in both processes are the same. The pathogenesis of the intestinal process and joint damage has not been fully established, but it is believed that many mechanisms participate in it, and in particular, toxic, immune, autoimmune. In the blood of patients, antibodies to the cells of the intestinal mucosa, lymphocytotoxin antibodies, circulating immune complexes, in which, possibly, antigenic components of intestinal microbes, etc., are also present. In Crohn's disease, articular manife...
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Individual plan of a training process for medical students contains: 1. Theme and list of training elements, content modules and modules. 2. Forms of control on individual elements of the educational process. 3. Reference balls for... more
Individual plan of a training process for medical students contains: 1. Theme and list of training elements, content modules and modules. 2. Forms of control on individual elements of the educational process. 3. Reference balls for individual and total elements of the educational process. 4. Actual scores received by the student for his personal control of the level of knowledge for individual learning elements and the total level. 5. The individual plan should become a motivating factor for improving knowledge of the individual components of the curriculum. 6. Its content should be used in self-preparation of the student for the lesson. Medical students in the course of training should analyze the mistakes made and fill in the gaps in their knowledge, as self-control is the basis of cognitive activity, reasonable independence, disciplines the student, develops a critical attitude towards oneself, being motivated to better education. The results indicate increase objectivity in the ...
At the same time, the fact is obvious that if these capabilities are not peculiar to everyone but only to some doctors, it becomes an indicator not for mass professional thinking but personal qualities of a definite person. Broad medical... more
At the same time, the fact is obvious that if these capabilities are not peculiar to everyone but only to some doctors, it becomes an indicator not for mass professional thinking but personal qualities of a definite person. Broad medical activity, which includes a significant amount of both patients and medical personnel, frequency of main diseases (socially significant in many respects) and requirements on rendering high quality medical care demand mass training of clinical thinking. First of all, it is demanded by the training of the diagnosis recognition process. How is the training performed now? Nowadays, the nosological principle of training dominates. A student studies one or another disease using textbooks and lectures. Thus, the student learns symptoms of the given disease in general, without relation to one or another concrete patient. Later at a lecture, a teacher presents a patient with the disease under study to the group of students, explains specific symptoms using pa...