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7. Shyshkina OO. Poyednannya riznykh vydiv fitnesu v navchalno-trenuvalnomu protsesi zi studentskoyu moloddyu: zbirn. nauk. Prats. Fizychne vykhovannya, sport i kultura zdorovya u suchasnomu suspilstvi. Skhidnoyevrop. nats. univer.im. L. Ukrayinky. 2013; 1(21): 127-130. [in Ukrainian]
8. Shuba LA. Fitnes-tekhnolohiyi v systemi rozvytku fizychnykh yakostey studentskoyi molodi / Fizychne vykhovannya, sport i kultura zdorovya u suchasnomu suspi'stvi. 2016; 4(36): 45-52. [in Ukrainian]
Реферат
ФУНКЦЮНАЛЬНИЙ СТАН СЕРЦЕВО-СУДИННО1 I ТРАВНО1 СИСТЕМ ОРГАН1ЗМУ У СТУДЕНТ1В П1Д ЧАС ЗАНЯТЬ Ф1ТНЕСОМ Согоконь О.А., Донець О. В., Донець I. М. В робот проведено дослщження студен™, що займаються сучасними фтес-технолопями та встановлено, що заняття фiзичними вправами впливають на ага™защю роботи внутрiшнiх систем органiзму. Аналiз взаемозв'язку оздоровчого фiтнесу з ращональним харчуванням студентiв, дае можливiсть виявити перспективи покращення дiяльностi серцево-судинно! та травно! систем, покращення самопочуття та досягнення бажаних спортивних результата студенев. За результатами дослiдження було встановлено, що 92,5 % студенев позитивно вщнеслися до нового змюту занять за сучасними фтес-технолопями i лише 7,5 % свое ставлення назвали невизначеним. Щд час проведення експериментально! роботи тдтвердилась динамiка змiн параметрiв функцiонального стану серцево-судинно! та травно! систем (експериментальна /контрольна групи): середнш показник маси тiла зменшився на 2,8 кг / 1,5 кг, пульс в сташ спокою знизився до 65,25 уд./хвл. + 0,25 / 74,46 уд./хвл. +0,64; систолiчний тиск знизився до 112,75 мм рт.ст.+0,35 / 118,21 мм рт.ст.+0,79; дiастолiчний тиск знизився до 72,21 мм рт.ст. +0,39 / 76,57 мм рт. ст. +0,43 ; життева емшсть легень збшьшилась на 0,4 л / 0,2 л, що е свщченням економiчно!' дiяльностi серцево-судинно! системи та тдтверджуе доцшьшсть використано! методики оздоровчих фтес-технологш. Щодо доцiльностi змiн у харчуванш: 77% студентiв висловились за необхщшсть змiн, тодi як 21% назвали змши бажаними i лише 2% виявили небажання змшювати свш режим харчування.
Ключовi слова: фтес-технологи, рацiональне харчування, фiзичне виховання, здоров'я, серцево-судинна i дихальна системи.
Стаття надiйшла 14.03.2019 р.
ФУНКЦИОНАЛЬНОЕ СОСТОЯНИЕ СЕРДЕЧНОСОСУДИСТОЙ И ПИЩЕВАРИТЕЛЬНОЙ СИСТЕМ ОРГАНИЗМА У СТУДЕНТОВ ВО ВРЕМЯ ЗАНЯТИЙ ФИТНЕСОМ Согоконь Е.А., Донец А.В., Донец И.Н.
В работе проведено исследование студентов, которые занимаются современными фитнес-технологиями и установлено, что занятия физическими упражнениями влияют на активизацию работы внутренних систем организма. Анализ взаимосвязи оздоровительного фитнеса с режимом питания студентов, дает возможность выявить перспективы улучшения деятельности сердечнососудистой и пищеварительной систем, улучшения самочувствия и достижения желаемых спортивных результатов. По результатам исследования установлено, что 92,5 % студентов позитивно отнеслись к новому содержанию занятий за современными фитнес -технологиями и только 7,5 % свое отношение назвали неопределенным. Что касается изменений в режиме питании: 77% высказались за необходимость изменений, тогда как 21% назвали изменения желаемыми и только 2% выявили нежелание изменять свой режим питания.
При проведении эксперимента подтвердилась динамика изменений параметров физического состояния организма: средний показатель массы тела снизился на 2,8 кг, пульс в состоянии покоя снизился до 65,25 + 0,25 уд. /мин.; систолическое давление снизилось до 112,75 мм рт.ст.+0,35; диастолическое давление снизилось до 72,21 мм рт.ст. +0,39, что является показателем экономной деятельности сердечно-сосудистой системы.
Ключевые слова: фитнес - технологии, рациональное питание, физическое воспитание, здоровье, сердечно-сосудистая и пищеварительная системы.
Рецензент Срошенко Г. А.
DOI 10.26724/2079-8334-2020-1-71-141-145 UDC 616.31.006
R.V Sh;i(llinsk;i>;i A/eibaijan Medical I niveisily. Baku. Azerbaijan
EVALUATION OF ORAL HYGIENE AND DENTAL CARIES STATUS IN PATIENTS WITH
BETA THALASSEMIA
e-mail: nauchnayastatya@yandex.ru
The study involved 321 patients with a homozygous form of thalassemia and 382 somatically healthy individuals. For the objective evaluation of teeth hard tissues and oral hygiene, the following clinical tests were performed: Simplified Oral Hygiene Index (OHI-S) (Green J.C., Vermillion, J. R., 1960), index by Yu.A. Fedorov and V.V. Volodkina (1971), DMFT index. Comparative analysis revealed a significant difference between the indices of the DMFT index and the index of OHt-S in the groups. There was a tendency to deterioration of the hygienic index with advancing age of patients with thalassemia. The highest values were found in the group over the age of 18 (3.60±0.11). Thus, preventive dental care is a top priority for patients with P-thalassemia.
Key words: P-thalassemia, oral hygiene, prevention of dental diseases, dental caries.
The study is initiative.
Thalassemia belongs to the most common genetic diseases in the group of blood pathologies. According to the World Health Organization (WHO), there are more than 250 million thalassemia carriers in the world and about 300,000 thalassemia patients [5, 6, 8]. At present, in Azerbaijan, P-thalassemia major is one of the main medical and social problems of the public healthcare. According to the results of genetic studies presented to "Unisef", the frequency of thalassemia among the population in Azerbaijan is
© R.V. Shadlinskaya, 2020
quite significant, and it occupies one of the first places (15%) among the numerous hemoglobinopathies. Based on genetic heterogeneity, clinical and hematological variability, P-thalassemia can be homozygous (P-thalassemia major), heterozygous or complex heterozygous. The heterozygous form of the disease is the most common form with minimal clinical manifestations [1, 2].
The main pathogenetic factor of the homozygous form - P-thalassemia major - is the reduction or complete inhibition of P-globin chains. The main symptoms of this disease include, first of all, severe anemia with intense but inefficient erythropoiesis, excessive bone marrow activity and extramodular hematopoiesis causing pronounced changes in the development of bones, including those of the face and skull [3, 4].
It should be noted that in the performed studies, the authors observed deforming expansion of the upper jaw, protrusion of the frontal teeth, distal and open bite in patients with P-thalassemia major [5, 11, 13]. A number of studies report that patients with P-thalassemia major have a higher level of tooth demineralization than the normal population. The low concentration of phosphorus and IgA in such patients' saliva makes them more prone to the dental caries development [7, 12, 14].
It should be noted that in modern clinical practice the opinion has arisen that numerous dental problems in patients with P-thalassemia major are due to the lack of proper attention to preventive measures and hygienic care of the oral cavity, the negligence of patients and insufficient attention of their parents to the necessary measures for the main disease [3, 6, 10]. Therefore, it is possible that pathogenetic involmemt of thalassemia major can play an important role in the development of dental deases.
The purpose of the study was to determine the oral hygiene indices and the dental caries intensity, depending on the age of patients with P-thalassemia major.
Materials and methods. The study was carried out at the Department of Dentistry of the Azerbaijan State Medical University and at the Thalassemia Center in Baku.
The study involved 321 patients with P-thalassemia major and 382 healthy persons. The study groups were divided into 4 age groups: 1- group from 3 to 5 years of age; 2- group aged from 6 to 12; 3-group aged from 13 to 17 and group 4 aged from 18 to 35. To determine the oral hygiene status, the Fedorov-Volodkina hygiene index (1971) and the simplified hygiene index (GreenJ.C., VermillionJ.R., 1960) were applied. To assess the caries intensity of tooth with DMFT, deft indices were used. PBI (Papillary Bleeding Index) were used for in assessing changes ingingival health.
The obtained digital data were subjected to statistical processing by the methods of variational (U-Mann-Whitney) and discriminant (Chi-Square) analyzes by the electronic table EXCEL-2010 and SPSS-20.
Results of the study and their discussion. When analyzing the oral cavity hygienic status according to Fedorov-Volodkin in the younger age group (3-5 years), no statistically reliable differences were noted. In the control group, the index was 2.19±0.09 versus 2.25±0.05 in the main group, which indicates unsatisfactory oral hygiene in the both groups of patients (table 1).
Table 1
Oral cavity hygiene index according to Fedorov Volodkin
^^Indices Age\ group N. Group under study hygiene index in points Index assessment, number in %
Good (1.1-1.5) Satisfactory (0.6-1.5) Unsatisfactory (2.1-2.5). Bad (2.6-3.4) Very bad (3.5-5.0)
3-5 years of age Main group (n-59) 2.25±0.05 2 (3.4±2.4) 20 (33.9±6.2) 19 (32.2±6.1) 18 (30.5±6.0) -
Control group (n-33) 2.19±0.09 2 (6.1±4.2) 15 (45.5±8.7) 11 (33.3±8.2) 4 (12.1±5.7) 1 (3.0±3.0)
Note: * - statistically significant with values (p <0.05); ** - statistically significant with values (p <0.01); *** - statistically significant with values (p <0.001).
In assessment of the deft index, reliably different results were obtained. Thus, the mean value of the index in the main group was by 1.4 times higher than the mean value in the control group (p <0.05).
When assessing the level of oral cavity hygiene in the age group of 6-12 years, a reliable increase of the index in the group of patients with P-thalassemia major (p <0.001) was established. Meanwhile, if a satisfactory oral hygiene index was observed in 12.8% of the patients in the control group, in the main group this index was determined in 4.3% (x2 = 15.23, p <0.01); by calculating the same DMFT/deft index, their increase was noted be doubled in patients with P-thalassemia major (p <0.001) (table 2).
Comparing the mean indices of oral hygiene in patients with P-thalassemia major with somatically healthy persons in the third age group (13-18 years), a significant increase in the OHI-S index by 1.9 times (p <0.001) was observed. Meanwhile, satisfactory hygiene in the control group was observed in 54.1%, and in the main group only in 10.5% of the patients. Unsatisfactory oral hygiene in the control group was in 35.3% versus 24.6% in the main group.
Table 2
Simplified Oral Hygiene Index |- OHI-S
Indices Age group Group under study Hygiene index in points OHI-S assessment, number in %
Good (0-0.6) Satisfactory (0.7-1.6) Unsatisfactory (1.7-2.5) Bad (2.6-6.0)
6-12 years Main group (n-140) 2.98±0.07 - 6 (4.3±1.7) 43 (30.7±3.9) 91 (65.0±4.0)
Control group (n-179) 2.56±0.07 1 (0.6±0.6) 23 (12.8±2.5) 74 (41.3±3.7) 81 (45.3±3.7)
13-18 years Main group (n-57) 3.11±0.15*** - 6 (10.5±4.1) 14 (24.4±5.7) 37 (64.9±6.3)
Control group (n-85) 1.62±0.09 5 (5.9 ±2.6) 46 (54.1±5.4) 30 (35.3±5.2) 4 (4.7±2.3)
18-35 years Main group (n-65) 3.60±0.11*** - 2 (3.1±2.1) 5 (7.7±3.3) 58 (89.2±3.8)
Control group (n-85) 2.13±0.10 1 (1.2±1.2) 28 (32.9±5.1) 31 (36.5±5.2) 25 (29.4±4.9)
Note: * - statistically significant with values (p <0.05); ** - statistically significant with values (p <0.01); *** - statistically significant with values (p <0.001).
The "poor hygiene" criterion index was observed in 64.9% in the first group, and in the second group - only in 4.7% cases (x2 = 65.16, p <0.001). The mean value of the DEF index in the group of patients with ^-thalassemia major also differed reliably and was by 1.8 times higher than in the healthy group (p<0.001).
When interpreting the OHI-S hygiene index values in the fourth age group (18-35 years), it was found that only 2 patients among 65 of the main group (3.1%) had satisfactory and 5 people (7.7%) unsatisfactory indicators, and the remaining 89.2% showed a poor hygienic condition of the oral cavity, which is by 2.3 times more than in somatically healthy individuals (x2 = 53.72, p <0.001).
As for the DMFT index, its mean value in the main group was 9.18±26, which is by 1.5 times higher than the mean value in the control group (p <0.001). (table 3)
The data obtained indicate a more pronounced degree of oral hygiene index in all the main groups. Thus, it is obvious that one of the factors causing high carious injuries of teeth in talassemic patients is unsatisfactory oral hygiene.
Table 3
Intensity of the carious process
Age groups deft/DMFT index records
Main group Control group
3-5 (deft) 9.41±0.62*** 6.82±0.75
6-12 (DMFT/ deft) 9,75±0,35*** 4,84±0,25
13-17 (DMFT) 6.84±0.25*** 3.91±0.30
18 -35 (DMFT) 9.18±0.26*** 6.31±0.31
Note: * - statistically significant with values (p <0.05); ** - statistically significant with values (p <0.01); *** - statistically significant with values (p <0.001).
The DMFT indices and the index of oral hygiene in the second age group are higher than those of the other age groups. Studies of the age-related dynamics of oral hygiene showed that a more favorable situation was found in somatically healthy individuals.
In the group of patients with B-thalassemia major, the level of individual oral cavity hygiene is decreasing with age (fig. 1).
As it is known, bacterial plaque resulting from poor oral hygiene is the cause of chronic inflammatory periodontal diseases. The earliest sign of inflammatory periodontal disease is the gum bleeding.
A comparative analysis of the results of the bleeding index in patients of the main and control groups aged 6-12 years revealed that mild inflammation was observed in 14.4%±3.0 of the
Fig. 1. Values of OHI-S hygiene index depending on age (C- Patients of the main, 46.8%±4.0 of the children control group, M-main group) in the control groups. The moderate degree of
C2 M2 C3 M3 C4 M4
m Good m Sati factory m Unsatisfactory m Bad
inflammation is present in 52.5±4.2% of the main group and in 46.8±4.0% of the control group. Severe inflammation is observed in the main and control groups, respectively, in 33.1±4.0% and 6.3±1.9%.
At the age of 13-17 years, a mild inflammation was detected in 1.8±1.8% in the main group and 63.4±5.3% in the control group, the moderate degree of inflammation was 25.0±5.84% in the main and 35.4±5.3% in the control while severe degree of inflammation was observed in 73.2±5.9% of the main and 4.3±2.9% of the control groups. In the main group of the adult population of 18-35 years old, mild inflammation was observed in 1.5±1.5%, moderate in 26.2±5.5%, and severe in 72.3±5.6% of patients. In the control group, mild inflammation was observed in 32.9±5.1%, moderate inflammation was observed in 43.5±5.4% of patients, and severe inflammation was detected in 23.5±4.6% of patients.
The results of the work of Yousif A. et al. did not show a statistical difference in the indicators of the hygiene index, the value of the DMFT index and the gingivitis index between thalassemic patients and healthy group in the younger age group [9]. However, these indicators were significantly high in thalassemic patients in the adolescent age group. The results of our study are not consistent with the results of the study by Tirumala K. et al. The study of children with P-thalassemia major revealed a low level of dmft index in young children and a low level of the DMFT index in teenagers [12, 14]. Dama S. et al. also did not reveal a statistically significant difference between the degree of dental caries in patients with P-thalassemia major and healthy group [5]. Authors Karayilmaz H., Manali A. reported higher rates of oral hygiene indices, DMFT in patients with thalassemia major compared with similar readings of the healthy group [11, 12]. The age group range in our work, absorbs shorter ranges of foreign researchers and is distinguished by a larger sample, which obviously explains the different results. Thus, our data suggest that one of the factors of high prevalence of dental caries and inflammation of periodontal tissues in patients with P-thalassemia major is poor oral hygiene. The provision of dental care should be considered as a necessary component of the healing of the body and the favourable course of such a complex pathology as major P - thalassemia.
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Thus, the study of the oral hygiene index and the dental caries indices in patients with P-thalassemia major permits to control the level of individual hygienic care, early detection of demineralization and destruction of dental hard tissues, prevention of secondary dental arch deformities and occlusion disorders. In a comprehensive study of patients with P-thalassemia, the importance of dentist involvement and the provision of dental care should be considered a necessary part of the body's recovery and a favorable course of such complex pathology as P-thalassemia major.
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2. Asadov C. Genotype - Phenotype correlations of P-thalassemia mutations in Azerbaijani population. Turk J Haematol. 2017; 34: 258-263.
3. Qali^kan UT, Tonguf M.O, Qiri§ M. The investigation of gingival iron accumulation in thalassemia major patients. Journal of Pediatric Hematology/Oncology. March 2011; 33(2): 98-102. doi: 10.1097/MPH.0b013e3182025058
4. Colah R., Gorakshalar A., Nadlarni A. Global burden, distribution and prevention of P - thalassemias and hemoglobin E disorders. Expert Rev. Hematol. 2010; 3(1): 103 - 117.
5. Dama SB, Dama LB. Prevalence of orofacial complications in thalassemic patients from Solapur. India DAV International J. of Science. 2013; 2(1): 60 - 64.
6. Galanello R, Origa R. Beta - thalassemia. Orphanet J. Rare Dis. 2010; 5; 5 - 11.
7. Gumu§ P, Kahraman-Qeneli S, Akcali A, Sorsa T. Association of thalassemia major and gingival inflammation: A pilot study. Arch Oral Biol. 2016 Apr; 64:80-4.
8. Gupta DK, Singh SP, Utreja A, Verma S. Prevalence of malocclusion and assessment of treatment needs in P-thalassemia major children. Progress in orthodontics. 2016; 17, 7. doi:10.1186/s40510-016-0120-6
9. Hattab FN. Patterns of physical growth and dental development in Jordanian children and adolescents with thalassemia major. J Oral Sci. 2013 Mar; 55(1):71-7.
10. Helmi N, Bashir M, Shireen A, Ahmed IM. Thalassemia review: features, dental considerations and management. Electron Physician. 2017; 9(3):4003-4008. doi:10.19082/4003
11. Karayilmaz H, Yalfin-Erman H, Erken-Gungor O. Evaluation the oral hygiene conditions, oral Candida colonization and salivary Streptococcus mutans and Lactobacilli density in a group of P-thalassemic children and adolescence. Med Oral Patol Oral Cir Bucal. 2019; 24 (6):e712-8.
12. Manali A, Nayeemuddin S, Ghatak S. Growth impairment and dental caries in thalassemia major patients. Indian Journal of Clinical Anatomy and Physiology. 2014; 1(1): 15-21.
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ISSN2079-8334. Ceim медицини та бюлогп. 2020. № 1 (71)
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ОЦ1НКА ППеНШНОГО СТАНУ порожнини РОТА ТА ИНТЕНСИВНОСТ1 КАР1ССУ ЗУБ1В У ПАЦ1еНТ1В З В-ТАЛАСЕМ1СЮ Шадлiнська Р. В.
У дослщженш брали участь 321 пащента з гомозиготною формою Р-таласемп i 382 соматично здоровi особи. Для об'ективно! оцiнки твердих тканин 3y6iB i гiгiени порожнини рота використовувалися клтачш тести: гiгiенiчний шдекс Грiна-Вермiлльона (Green J.C., Vermillion J.R., 1960), iндекс Ю.А. Федорова i В.В. Володкiноi (1971) i показник штенсивност карiесу КПУ. При порiвняльному аналiзi в групах виявлена достовiрна рiзниця мiж показниками iндексу КПУ i iндексу OHt-S. Спостерiгалася тенденщя до погiршення гiгiенiчного iндексу зi збiльшенням вiку пацiентiв з Р-таласемiею. При цьому, найбiльше значення виявлено в груш старше 18 роюв (3,60 ± 0,11). Бшьш високий ризик розвитку карiесу був виявлений в групi з P-таласемiею в порiвняннi з обстежуваним контингентом без соматичних захворювань. Профшактична
стоматологiчна допомога е першочерговою необхщшстю для пацiентiв з великою P-таласемiею.
Ключовi слова: р - таласемiя, карiес, гiгiена порожнини рота, профшактика стоматологiчних захворювань.
Стаття надiйшла 10.01.2019 р.
ОЦЕНКА ГИГИЕНИЧЕСКОГО СОСТОЯНИЯ ПОЛОСТИ РТА И ИНТЕНСИВНОСТИ КАРИЕСА ЗУБОВ У ПАЦИЕНТОВ С В-ТАЛАССЕМИЕЙ Шадлинская Р. В.
В исследовании принимали участие 321 пациента с гомозиготной формой Р-талассемии и 382 соматически здоровые лица. Для объективной оценки твердых тканей зубов и гигиены полости рта использовались клинические тесты: гигиенический индекс Грина-Вермилльона (Green J.C., Vermillion J.R., 1960), индекс Ю.А. Федорова и В.В. Володкиной (1971 г.) и показатель интенсивности кариеса КПУ. При сравнительном анализе в группах выявлена достоверная разница между показателями индекса КПУ и индекса OHt-S. Наблюдалась тенденция к ухудшению гигиенического индекса с увеличением возраста пациентов с Р-талассемией. При этом, наибольшее значение обнаружено в группе старше 18 лет (3,60±0,11). Более высокий риск развития кариеса был обнаружен в группе с большой Р-талассемией по сравнению с обследуемым контингентом без соматических заболеваний. Профилактическая
стоматологическая помощь является первостепенной необходимостью для пациентов с большой Р-талассемией.
Ключевые слова: р - талассемиия, кариес, гигиена полости рта, профилактика стоматологических заболеваний.
Рецензент Срошенко Г. А.
DOI 10.26724/2079-8334-2019-4-70-145-149 UDC 616-071+616.13+616.72-002.77
O.V . Shleliuk. R.I. Yitsyshyn. P.R. Herych. Yu.Yi. kiirpyuk'. V.ll. Boychuk USEE "I\ino-Frinki\sk nitionil medicil university". I\;ino-lr;inki\sk 1Viisyl Stelinyk I'liciiipiilliiiin nitionil university. I\;ino-lr:inki\sk
FEATURES OF THE RAYNAUD'S SYNDROME COURSE IN PATIENTS WITH
RHEUMATOID ARTHRITIS
e-mail: shtefiuk.sasha@gmail.com
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Often, patients with rheumatoid arthritis develop secondary Raynaud's syndrome, which is a prognostically unfavorable symptom of its course. Raynaud's syndrome is more common in patients with an existing rheumatoid factor in the blood serum. In patients with rheumatoid arthritis there is an impaired endothelium dependent vasoregulation in the shoulder artery, indicating the endothelial function disorder. In patients with rheumatoid arthritis with secondary Raynaud's syndrome, there are more pronounced signs of endothelial dysfunction, indicating a high risk of atherosclerosis and cardiovascular complications. The index of open capillaries permits to objectively assess the Raynaud's syndrome severity in patients with rheumatoid arthritis.
Key words: rheumatoid arthritis, Raynaud's syndrome, endothelial dysfunction.
The study is a fragment of the research project "Clinical and immunological aspects of the internal organs major diseases course and their correction ", state registration No. 0119U002040.
Rheumatoid arthritis (RA) is an autoimmune disease of unknown etiology with the development of symmetrical erosive arthritis (synovitis) and a wide range of extra-articular (systemic) manifestations [9]. This is the most common and disabling connective tissue disease (affects about 1% of the world and 0.4% of Ukrainian population) [10]. In 58.7-72% of patients with RA, comorbid conditions such as Raynaud's syndrome (RS) and arterial hypertension, which can significantly modify the course of the disease, impair the treatment efficacy and reduce the life expectancy of patients [10].
An important pathogenetic link of RA is the microcirculation system impairment, and the microvasculature serves as the target organ in which the immune, inflammatory and metabolic mechanisms of the pathological process are implemented. Disorders in the microcirculation system are associated with the systemacity of lesions, duration of the disease, antioxidant protection disorders, endothelial dysfunction indices and reliably play a leading role in the pathogenesis of RA systemic manifestations. As of today, the endothelium is known to be the target of oxidative stress, which reduces endothelium dependent vasodilatation of blood vessels, promotes the increase of cellular processes course rate and accelerates their apoptosis.
© O.V. Shtefiuk, R.I. Yatsyshyn, 2020
