CC BY
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заболеваниях относят к числу вторичных поражений нервной системы. Они объединяют различные по 5йагностик развития и локализации патологические состояния нервной системы, связанные с опухолевыми заболеваниями системы крови. Онкогематологические заболевания составляют 3% всех новообразований у взрослых и 36,6% у детей. Присоединение неврологической симптоматики к основным симптомам заболевания значительно ухудшает тяжесть состояния больных и влияет на результат лечения. Наблюдается неуклонный рост частоты неврологических 5йагности химиотерапии, в основном обусловленный интенсификацией противоопухолевого лечения и широким использованием нейротоксических цитостатиков. Однако, несмотря на существенные достижения 5йагностика и медицины в целом, ряд вопросов 5йагностика и выбора лечебной тактики при онкогематологических заболеваниях окончательно не 5йагно. Коррекция неврологических нарушений должна проводиться на современном уровне, с целью 5йагностика59 нарушений, вызванных непосредственным действием опухолевых клеток и нейротоксичностью препаратов. Таким образом, своевременная 59iагностика неврологических проявлений онкогематологической 59iагност и 59iагностика выбрана лечебная тактика позволяют предотвратить рецидивы заболевания, сохранить жизнь больных и 59iагнос ее качество.
Ключевые слова: гемобластозы, неврологические нарушения, коррекция.
Стаття надшшла 5.01.2016 р.
include the number of secondary lesions of the nervous system. They combine different mechanisms of development and localization of pathological conditions of the nervous system associated with neoplastic diseases of the blood system. Hematologic diseases form 3% of all tumors in adults and 36.6% in children. Joining to the basic neurological symptoms of symptoms of disease significantly impairs severity of the patients state and affects on the outcome treatment.Is observed steady growth of rate neurological complications of chemotherapy, mainly caused by the intensification of anti-tumor treatment and extensive use of neurotoxic cytostatics. However, despite the significant achievements of pharmacology and medicine in general, several questions of diagnosis and choice of treatment strategy in hematologic diseases is not completely resolved. Correction of neurological disorders should be conducted timely with a view to repayment of disorders caused by the direct action of tumor cells and neurotoxicity of drugs.Therefore, timely diagnosis of neurological manifestations of hematologic pathology and rationally chosen medical tactics allows to prevent recurrence of the disease, save lives and improve patients quality.
Key words: hemoblastosis, neurological disorders, correction.
Рецензент Скрипшков А.М.
UDC 611.9:575.191:612.017.1:612:656
GENDER-RELATED CORRELATION BETWEEN COMPUTED TOMOGRAPHY VERTICAL SIZE OF THE LUMBAR SPINE ANATOMICAL STRUCTURES AND ANTHROPO-SOMATOTYPOLOGICAL PARAMETERS IN ADOLESCENTS
When analyzing sexual differences correlations computed tomography sizes of the lumbar spine on median-sagittal sections with anthropometric, somatotypological parameters and indicators component composition of body weight, found that in girls the number of significant relationships, and their power considerably greater than in boys. In addition, in young men found considerably greater amount significant feedback than in girls. The largest number of reliable connections with anthropo-somatotypological indicators in girls set with height of bodies lumbar vertebrae and the average width of the bodies of the lumbar vertebrae, and in boys - with height of lumbar vertebrae body and height of intervertebral discs between the relevant vertebrae.
Key words: lumbar spine, computed tomography, anthropometry, healthy young men and women.
Publication is a fragment of planned RSW "Development of health regulatory criteria of different age and sex groups", state registration number: 0109U005544.
Study of correlations between the size of the components of the lumbar spine and anthropo-somatotypological parameters making a significant contribution to the solution of fundamental problems of the biological nature of man and his intraspecific variability [2, 12, 14]. In addition, constitutional studies of spine allow to use this section as a source of information about group of risk in relation to its pathology [9].
Presented in modern scientific literature data indicate the existence of significant sexual dimorphism spine sizes, as well as informative morphological characters of spine for intergroup comparisons and for individual identification and establishment of relationship [3, 4, 9, 10]. Thus, according to research of V.N. Zvyagin and M.K. Karapetyan [6] all osteometric signs of spine show accurate correlation with high values with sex. Differences between the sexes were more significant than interracial differences, most likely due to differences in body structure between different ethnic groups. Therefore, there is no doubt in informative metric spine characteristics in terms of sex determination and the ability to use them as universal osteometric standards.
Aim of our work - establishing sexual differences relationships computed tomography of the lumbar spine sizes on median-sagittal sections with anthropo-somatotypological parameters healthy population of Podillya adolescents.
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Materials and methods. On the basis of Scientific and Research Center of the Vinnitsa National Medical University named after Pirogov 82 almost healthy boys and 86 girls in the third generation residents of Podilskiy region of Ukraine on spiral X-ray computer tomography Elscint Select SP conducted computed tomography (CT) of the head (11 slices), chest (1 slice) and lumbar ridge (1 median-sagittal slice) within planned prophylactic examinations under voluntary written consent of their parents or investigated. According voltage and current intensity 120kV / 25mA. Measured absorbed dose (data of the Certificates of control of dose forming parameters №352, valid till 22.03.2016) = 15.89 mGy (for 13 slices). Equivalent dose: 15.89 mGy x 1 (radiation weighing factor) = 15.89 mSv. Effective dose: 0.025 x 15.89 mSv (tissue weighing factor) = 0.397 mSv, which have not exceeded the recommended maximum level of medical exposure (1.0 mSv) (Order of the MoH Ukraine of 04.06.2007 № 294 «On approval of the State sanitary rules and regulations», «Hygienic requirements to placement and operation of X-ray rooms and conducting radiological procedures»: paragraph 6.9 - «Recommended maximum levels for medical exposure category GD - people who pass all types of preventive screening and persons examined under health programs «and paragraph 6.21 -« Do not be prophylactic radiological research children under 15 and pregnant...»).
Committee on Bioethics Vinnitsa National Medical University named after Pirogov found that the studies are not contrary to the fundamental bioethical norms of the Helsinki Declaration, the European Convention on Human Rights and Biomedicine (1977), the relevant provisions of the WHO and the laws of Ukraine (Minutes № 8 of 14.04.2010).
Morphometry of the lumbar spine with attraction of precision computer technology and mathematical software tomograph included definition listed below computed tomographic size [8]: anterior, middle, posterior vertebral body height; the average width of the vertebral body, intervertebral disc height; front and back height of the lumbar spine. Anthropometric investigation was conducted by the method of V. Bunak [1]. Component composition of body weight was studied by the method of J. Mateigka [13]. To evaluate the somatotype we used a mathematical scheme by J. Carter and B. Heath [11]. Analysis correlation communications in boys and girls performed using Pearson's statistics in the license package «STATISTICA 5,5».
Results and discussions. When analyzing correlations between the constitutional parameters of human and computed tomography of the lumbar spine size on median-sagittal sections in previous studies [4, 7] we have established: - in young men number of reliable relationships 94 of 1054 possible (8.9%, of which 60 with height of the vertebral bodies (L), 21 with intervertebral disc height, 5 with an average width vertebral body and 8 with height of the lumbar spine), of which direct - 55 (5.2%, of which 16 weak force and 39 medium strength), reversible - 39 (3.7%, of which 37 weak force and the average force 2). Are marked following numerous links - direct weak (r from 0.23 to 0.29) and average force (r from 0.30 to 0.42) communications body height L2, L3 and L5 vertebrae with most longitudinal body size direct weak force (r from 0.23 to 0.28) communications heights bodies L1 and L5 vertebrae with the largest width of the head and reverse, mostly weak force (r from -0.22 to -0.31) communications L4 vertebral body height with circumference of the upper limbs and the chest; reverse mostly weak force (r from -0.23 to -0.31), communications height of most intervertebral discs between the respective lumbar vertebrae with mesomorphic somatotype component and reverse weak force (r from -0.22 to -0.29) communications intervertebral disc height between L1 and L2 vertebrae with most of the upper limb girth and half the diameter of the body; direct weak and average force (r from 0.25 to 0.32) communications medium width bodies of all lumbar vertebrae with the largest width of the head; - in girls number of reliable relationships 357 of 1071 possible (33.3%, of which 178 with height of the vertebral bodies, 16 with intervertebral disc height, 145 with an average width of vertebral body and 18 with height of lumbar spine), including direct - 346 (32.3%, of which 201 poor strength and 145 average force), reversible - 11 (1.0%, of which 8 weak force and 3 with average force). Are marked following numerous communications - direct, mostly weak (r from 0.23 to 0.29) and average force (r from 0.30 to 0.51) communications all body height lumbar vertebrae with the majority of total, longitudinal (except body height L5) body size, width of distal epiphysis, mainly femur and tibia, most pelvic size and most measures of bone and fat body mass components, straight, mostly weak force (r from 0.24 to 0.35), communications height of bodies L1, L2 and L4 vertebrae with half indicators thickness skin-fat folds of the upper limbs, straight weak (r from 0.23 to 0.27) and average force (r from 0.30 to 0.35), communications body height L4 and L5 vertebrae with most of the circumference of the upper and lower extremities; reverse weak (r from -0.23 to -0.24) and average force (r from -0.31 to -0.38) communications height of all intervertebral discs between the respective of the lumbar vertebrae with width of the face; direct weak (r from 0.23 to 0.29) and average force (r from 0.31 to 0.50) communications of medium width lumbar
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vertebrae bodies with all total, majority longitudinal, more than half covering (excluding medium width body L1) body size, most sizes of pelvis, width of distal epiphysis of long bones of the extremities (excluding medium width body L1) and all indicators component composition of body weight (excluding the average width of the body L1), and straight, mainly average force (r from 0.30 to 0.39) communications medium width bodies L2 and L3 vertebrae with most measures thickness skin and fat folds and endomorphic somatotype component; straight, mostly average force (r from 0.32 to 0.40), links of front height of the lumbar spine with most longitudinal body size and straight, mostly weak force (r from 0.23 to 0.31) communications posterior height of the lumbar spine with most measures thickness of skin-fat folds and fat component of body weight.
Thus, in girls number of reliable relationships computed tomography of the lumbar spine sizes on median-sagittal sections with anthropometric, somatotypological component composition and indicators of body weight, and their power considerably greater than in boys. In addition, in young men found considerably greater amount of reliable feedback than in girls. The largest number of reliable connections with anthropo-somatotypological indicators in girls set with height bodies lumbar vertebrae and the average width the lumbar vertebrae bodies, and in young men group - with height of lumbar vertebrae body and height of intervertebral discs between the relevant vertebrae.
1. In girls as the number of reliable relationships of CT of the lumbar spine sizes with anthropo-somatotypological indicators, and their power greater than in boys (under 357 relationships, of which 209 weak force and the average force 148 in girls, compared with 94 relationships, of which 76 weak force and 18 average force in boys). Unlike girls, in young men set greater amount of reliable reverse correlations, preferably with a height of intervertebral discs (39 relationships, 37 of which are weak force and 2 average forces in young men against 11 relationships, of which 8 weak force and 3 average forces in girls).
2. In girls largest number of reliable relationships set with height bodies lumbar vertebrae (49.9% of reliable correlations, of which 56.7% - connection with a high genetically determined anthropometric indicators) and the average width bodies of the lumbar vertebrae (according 40.6%, of which only 37.2% are links with highly genetically determined anthropometric indicators); and in boys - with height bodies the lumbar vertebrae (63.8% of reliable correlations, of which 65.0% - connection with a high genetically determined anthropometric indicators) and height of intervertebral discs (respectively 22.3%, of which 47.6% - connection with a high genetically determined anthropometric indicators).
Prospects for further studies is that the findings will enable complement and expand on the idea of the structure of the musculoskeletal system and the factors contributing to the development ofpathological conditions in the lumbar spine.
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4. Gunas I. V. Morfometrichni kompyuterno-tomografichni parametri poperekovogo viddilu hrebta na medianno-sagitalnih zrizah u praktichno zdorovih yunakiv i divchat Podillya / I.V. Gunas, S.V. Pinchuk, A.V. Shayuk // Ukrayinskiy morfologichniy almanah. - 2013. - Tom 11, No. 4. - S. 18-21.
5. Gunas I. V. Korelyatsiyi kompyuterno-tomografichnih rozmiriv poperekovogo viddilu hrebta na medianno-sagitalnih zrizah z antropo-somatotipologichnimi parametrami zdorovih divchat Podillya / I.V. Gunas, S.V. Pinchuk, A.V. Shayuk // Visnik morfologiyi. - 2015. - T. 21, No. 1. - S. 126-130.
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СТАТЕВ1 ОСОБЛИВОСТ1 ЗВ'ЯЗК1В КОМП' ЮТЕРНО-ТОМОГРАФ1ЧНИХ ВЕРТИКАЛЬНИХ РОЗМ1Р1В АНАТОМ1ЧНИХ СТРУКТУР ПОПЕРЕКОВОГО В1ДД1ЛУ ХРЕБТА З АНТРОПО-СОМАТОТИПОЛОГ1ЧНИМИ ПАРАМЕТРАМИ У ПРЕДСТАВНИК1В ЮНАЦЬКОГО В1КУ Маевський О. е., Пшчук С. В., 1ваниця А. О.
При аналiзi статевих розбiжностей кореляцiй комп'ютерно-томографiчних розмiрiв поперекового вщдшу хребта на медiанно-сагiтальних зрiзах з антропометричними, соматотипологiчними
параметрами та показниками компонентного складу маси тша, встановлено, що у практично здорових дiвчат Подiлля як кiлькiсть достовiрних зв'язюв, так i 1х сила значно бшьш^ нiж в юнакiв. Крiм того, в юнакiв встановлено значно бшьшу кiлькiсть достовiрних зворотнiх зв'язюв, шж у дiвчат. Найбiльша юльюсть достовiрних зв'язкiв з 62iагност-соматотиполопчними показниками у дiвчат встановлена з висотою тiл поперекових хребцiв та середньою шириною тiл поперекових хребщв, а в юнакiв - з висотою тш поперекових хребцiв та висотою 62iагностика62я дискiв мiж вщповщними хребцями.
Ключовi слова: поперековий вщдш хребта, комп'ютерна томографiя, антропометрiя, здоровi юнаки та дiвчата.
Стаття надшшла 14.01.2016 р.
ПОЛОВЫЕ ОСОБЕННОСТИ СВЯЗЕЙ КОМПЬЮТЕРНО-ТОМОГРАФИЧЕСКИХ ВЕРТИКАЛЬНЫХ РОЗМЕРОВ АНАТОМИЧЕСКИХ СТРУКТУР ПОЯСНИЧНОГО ОТДЕЛА ПОЗВОНОЧНИКА С АНТРОПО-СОМАТОТИПОЛОГИЧЕСКИМИ ПАРАМЕТРАМИ У ПРЕДСТАВИТЕЛЕЙ ЮНОШЕСКОГО ВОЗРАСТА Маевский А. Е., Пинчук С. В., Иваница А. А.
При анализе половых различий корреляций компьютерно-томографических размеров поясничного отдела позвоночника на медианно-сагитальных срезах с антропометрическими, соматотипологическими параметрами и показателями компонентного состава массы тела, установлено, что у практически 62iагност девушек Подолья как количество достоверных 62iагнос, так и их сила значительно большие нежели у юношей. Кроме того, у юношей установлено значительно большее количество достоверных обратных 62iагнос нежели у девушек. Наибольшее количество достоверных 62iагнос с 62iагност-соматотипологическими показателями у девушек установлено с высотой 62iаг поясничных позвонков и средней шириной 62iаг поясничных позвонков, а у юношей -с высотой 62iаг поясничных позвонков и высотой межпозвоночных дисков между соответствующими позвонками.
Ключевые слова: поясничный отдел позвоночника, компьютерная томография, антропометрия, здоровые юноши и девушки.
Рецензент Гунас 1.В.
УДК [618.175+616 - 008.63]-08
ЛЕЧЕНИЕ НАРУШЕНИЙ МЕНСТРУАЛЬНОГО ЦИКЛА У ЖЕНЩИН С МЕТАБОЛИЧЕСКИМ СИНДРОМОМ
В статье дана информация об исследовании, посвященном изучению и лечению нарушений менструального цикла у женщин с метаболическим синдромом. В исследование, 62iагности с 2011 по 2013 годы, включены результаты обследования 50 пациентов с метаболическим синдромом до и после лечения, жалующихся на нарушения менструального цикла.
Исследование показало, что нарушения менструального цикла у женщин с метаболическим синдромом в основном связаны с наличием у них синдрома поликистозных яичников. Нарушения менструального цикла были в основном по типу олигоменореи и аменореи. Лечение нарушений менструального цикла у женщин с метаболическим синдромом препаратом Гальвусмет 50/1000 мг дало положительные результаты. Результаты лечения показали, что в течение первых 6-ти месяцев лечения у женщин с 1 и 2 степенью ожирения ИМТ нормализовался. Уровень инсулина натощак в этих группах снизился до нормы, менструальный цикл нормализовался (26 - 31 день). У женщин с третьей 62iагнос ожирения вес снизился до 62iагно степени ожирения, менструальный цикл восстановился (34 - 40 дней). Результаты лечения женщин с нарушениями менструального цикла и метаболическим синдромом (поликистоз яичников с инсулинорезистентностью) показали, что препарат Гальвусмет 50/1000 мг является эффективным средством лечения при данной 62iагност.
Ключевые слова: метаболический синдром, инсулинорезистентность, аменорея.
В последнее десятилетие 621агиост встречаемость метаболического синдрома среди населения. В некоторых развитых странах он 621агнос 26-35% среди взрослого населения [1, 4]. По Н. Лгпе8еп (1992) 621аг метаболическим синдромом понимают сочетание по 621агнос мере двух из 621агн нарушений: резистентность к инсулину со сниженной толерантностью к 621агностик и гиперинсулинемией; дислипопротеидемия с гипертриглицеридемией и сниженным уровнем холестерина липопротеинов высокой плотности; склонность к тромбообразованию и
