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Item Bioethical issues of clonning and stem cell modification(KhNMU, 2015-11) Woldu, Sara; Kochubiei, Oksana; Кочубей, Оксана Анатольевна; Кочубєй, Оксана АнатоліївнаDo we have the ‘right’ to mess with nature, or is it our responsibility to improve the quality of life for others? Or what would we do if there were different therapeutic approaches to the same disease other than genetic technology? To the present day, genetic engineering and modification continue to present tremendous amount of intriguing and difficult challenges. It encompasses ethical, moral religious as well as legal issues. In the past there have been many debates over the ethics of both cloning and stem cell research with some claiming that scientists are “playing God” by using cloning in their research. It does not correlate with the Sanctity of Life, which says “only God can create, give and take away life, which is sacred”. Many stem cells are harvested from umbilical blood, therefore certain groups and religions believe that this is unethical and harmful to the value of life. In addition, some religions believe that both cloning and the use of gene technology are unnatural, and therefore are not in agreement with the natural order. Some people are challenging to ban cloning all together because it interferes with the process of creation. Some say that it should be banned because it kills life (embryo), and others feel that it should be banned because it will lead to unethical and immoral practices. Supporters of cloning and gene technology, on the other hand, appreciate that it is a new and effective advancement in the ability to cure a number of diseases and injuries. They understand it is good because it can be used to cure any birth defects, which could be detected during the pregnancy cycle, as well as, provide cure to many chronicle diseases. Further research is essential to determine the full potential of both adult and embryonic stem cells in this exciting new field. However, until we as a society or, perhaps, as a global entity can agree on what being a “human or otherwise” are worthy of moral and legal status and respect, we can expect intense cross-disciplinary debate and discussion as new life forms are created through science and medicine.Item Модифікація факторів ризику у хворих на гіпертонічну хворобу з ожирінням та дисглікемією(ТДМУ ім. І. Я. Горбачевського, 2014-04) Візір, Марина Олександрівна; Визир, Марина Александровна; Vizir, MarinaДисглікемія та ожиріння є найважливішими предикторами серцево-судинної захворюваності та смертності (ССС). Загальновідомо, що глюкометаболічні порушення набагато частіше виявляються у хворих з гіпертонічною хворобою (ГХ) та ожирінням, ніж у хворих ГХ та нормальними індексом маси тіла. Активно досліджується вплив гормонально-активних речовин крові, жирової тканини (нейромедіатори, адіпокіни) на розвиток усіх ланок порушень метаболізму. Останнім часом увага вчених прикута до предіабету, попереднього етапу розвитку цукрового діабету, та методів корекції метаболізму. Серед методів модифікації факторів ризику ССС першочергову роль відіграють дієта та фізична активність пацієнтів. За останні роки було проведено декілька довгострокових рандомізованих досліджень (тривалістю до 13,5 років), впродовж яких спостерігалися зміни вуглеводного метаболізму у пацієнтів під впливом дотримання дієти та/або виконання адекватного фізичного навантаження. Враховуючи отримані дані, встановлено, що серед пацієнтів з предіабетом (тобто з гіперглікемією натще та/або, переважно, з порушеною толерантністю до глюкози) показники дисглікемії зменшувалися у позитивній кореляції зі зменшенням ступеню ожиріння. Таким чином, розвиток цукрового діабету 2 типу сповільнювався або навіть не відмічався протягом дослідження. Незважаючи на простоту методів впливу на образ життя пацієнтів, найбільшою складністю завжди є мотивація пацієнтів, а також необхідність тривалого періоду контролю. Це зумовлює необхідність пошуку додаткових методів корекції метаболізму у хворих з високим ризиком. Тому перспективними вважаються напрямки регулювання глюкометаболічного профілю шляхом екзогенного впливу на рівень активних субстанцій крові, що приймають участь у розвитку ожиріння та дисглікемії.Item Euthanasia In India(2015-03) Takhi, Komal; Honchar, Oleksii; Гончарь, Алексей Владимирович; Гончарь, Олексій Володимирович; Ashcheulova, Tetyana; Ащеулова, Татьяна Вадимовна; Ащеулова, Тетяна ВадимівнаPassive euthanasia is legal in India. On 7 March 2011 the Supreme Court of India legalised passive euthanasia by means of the withdrawal of life support to patients in a permanent vegetative state. The decision was made as part of the verdict in a case involving Aruna Shanbaug, who has been in a vegetative state for 37 years at King Edward Memorial Hospital. In March 2011, the Supreme Court of India, passed a historic judgement-law permitting Passive Euthanasia in the country. This followed Pinki Virani’s plea to the highest court in December 2009 under the Constitutional provision of “Next Friend”. It’s a landmark law which places the power of choice in the hands of the individual, over government, medical or religious control which sees all suffering as “destiny”. The Supreme Court specified two irreversible conditions to permit Passive Euthanasia Law in its 2011 Law: (I) The brain-dead for whom the ventilator can be switched off (II) Those in a Persistent Vegetative State (PVS) for whom the feed can be tapered out and pain-managing palliatives be added, according to laid-down international specifications. The same judgement-law also asked for the scrapping of 309, the code which penalises those who survive suicide-attempts. In December 2014, government of India declared its intention to do so. And on December 23, 2014, Government of India endorsed and re-validated the Passive Euthanasia judgement-law in a Press Release, after stating in the Rajya Sabha as follows: that The Honble Supreme Court of India in its judgment dated 7.3.2011 [WP (Criminal) No. 115 of 2009], while dismissing the plea for mercy killing in a particular case, laid down comprehensive guidelines to process cases relating to passive euthanasia. Thereafter, the matter of mercy killing was examined in consultation with the Ministry of Law and Justice and it has been decided that since the Honble Supreme Court has already laid down the guidelines, these should be followed and treated as law in such cases. At present, there is no proposal to enact legislation on this subject and the judgment of the Honble Supreme Court is binding on all. The Health Minister, Shri J P Nadda stated this in a written reply in the Rajya Sabha. The high court rejected active euthanasia by means of lethal injection. In the absence of a law regulating euthanasia in India, the court stated that its decision becomes the law of the land until the Indian parliament enacts a suitable law. Active euthanasia, including the administration of lethal compounds for the purpose of ending life, is still illegal in India, and in most countries. The following guidelines were laid down: 1. A decision has to be taken to discontinue life support either by the parents or the spouse or other close relatives, or in the absence of any of them, such a decision can be taken even by a person or a body of persons acting as a next friend. It can also be taken by the doctors attending the patient. However, the decision should be taken bona fide in the best interest of the patient. 2. Even if a decision is taken by the near relatives or doctors or next friend to withdraw life support, such a decision requires approval from the High Court concerned. 3. When such an application is filled the Chief Justice of the High Court should forthwith constitute a Bench of at least two Judges who should decide to grant approval or not. A committee of three reputed doctors to be nominated by the Bench, who will give report regarding the condition of the patient. Before giving the verdict a notice regarding the report should be given to the close relatives and the State. After hearing the parties, the High Court can give its verdict.Item Problems Of Family Planning In India(2015-11-12) Parappil, Ashiq; Honchar, Oleksii; Гончарь, Алексей Владимирович; Гончарь, Олексій Володимирович; Ashcheulova, Tetyana; Ащеулова, Татьяна Вадимовна; Ащеулова, Тетяна ВадимівнаIntroduction. Family planning is the planning of when to have children and the use of birth controland other techniques to implement such plans. Other techniques commonly used include sexuality education, prevention and management of sexually transmitted infections, preconception counseling and management, and infertility management. Background. Family planning in India is based on efforts largely sponsored by the Indian government. In the 1965-2009 period, contraceptive usage has more than tripled (from 13% of married women in 1970 to 48% in 2009) and the fertility rate has more than halved (from 5.7 in 1966 to 2.4 in 2012), but the national fertility rate is still high enough to cause long-term population growth. India adds up to 1,000,000 people to its population every 20 days. Contraceptive usage. Low female literacy levels and the lack of widespread availability of birth-control methods is hampering the use of contraception in India. Awareness of contraception is near-universal among married women in India. However, the vast majority of married Indians (76% in a 2009 study) reported significant problems in accessing a choice of contraceptive methods.In 2009, 48.4% of married women were estimated to use a contraceptive method, i.e. more than half of all married women did not. About three-fourths of these were using female sterilisation, which is by far the most prevalent birth-control method in India. Condoms, at a mere 3% were the next most prevalent method. Meghalaya, at 20%, had the lowest usage of contraception among all Indian states. Bihar and Uttar Pradesh were the other two states that reported usage below 30%.Comparative studies have indicated that increased female literacy is correlated strongly with a decline in fertility. Studies have indicated that female literacy levels are an independent strong predictor of the use of contraception, even when women do not otherwise have economic independence. Female literacy levels in India may be the primary factor that help in population stabilisation, but they are improving relatively slowly: a 1990 study estimated that it would take until 2060 for India to achieve universal literacy at the current rate of progress. Conclusion. The Ministry of Health and Family Welfare is the government unit responsible for formulating and executing family planning related government plans in India. An inverted Red Triangle is the symbol for family planning health and contraception services in India. In my opinion, the local government should focus on increasing educational level.Item Диагностическое значение уреазного теста при выявлении helicobacter pylori(2015-04) Кулакова, Екатерина; Амбросова, Татьяна; Ащеулова, Татьяна ВадимовнаВ настоящее время Helicobacter pylori является наиболее частой причиной гастрита, гастродуоденита и язвенной болезни. Helicobacter pylori — спиралевидная грамотрицательная микроаэрофильная бактерия, инфицирующая слизистую оболочку желудка и двенадцатиперстной кишки. Диагностика инфекции Нelicobacter pylori возможна при микроскопическом исследовании биоптата слизистой оболочки, взятого при эзофагогастродуоденоскопии (ЭГДС). Эзофагогастродуоденоскопия - это современный метод визуализации и последующего обследования стенок слизистой оболочки верхних путей пищеварительного тракта, а именно: пищевода, желудка и проксимальной части двенадцатиперстной кишки. Для проведения ЭГДС специальной подготовки не существует, но для лучшей визуализации необходимо, чтобы желудок и просвет двенадцатиперстной кишки были полностью свободны от остатков какой-либо пищи, поэтому на исследование необходимо приходить натощак. Определить наличие Helicobacter pylori возможно путем исследования фрагментов слизистой желудка, полученной путем биопсии во время эндоскопического исследования. Наиболее оптимальной манипуляцией является уреазный тест. Уреазный тест - это экспресс анализ, позволяющий быстро и недорого определить присутствие в верхних отделах пищеварительного тракта Helicobacter pylori. Основой теста является свойство H. pylori выделять фермент уреазу, которая катализирует процесс преобразования мочевины в аммиак и углекислый газ. В результате реакции кислотно-щелочный баланс желудка (рН среды) сдвигается в щелочную сторону, что фиксируется с помощью индикатора. Полученный биоптат помещается в специальную ячейку с готовыми растворами. Быстрота изменения окраски индикатора с жёлтого на ярко-красный зависит от уреазной активности, которая, в свою очередь, зависит от количества бактерий. Интерпретация результата: количество Helicobacter pylori в биоптате оценивается по интенсивности окраски биоптата. Таким образом, +++ - значительное инфицирование Нelicobacter pylori (Hp), малиновое окрашивание теста появляется в первый час от начала исследования, ++ - умеренное инфицирование Нp, тест становится малиновым спустя 2-3 часа, + - незначительное инфицирование Нp – появление малиновой окраски в течение 24 часов. Отрицательным считается результат, если окрашивание появляется после 24 часов от начала исследования. Основное назначение метода — первичная диагностика наличия Helicobacter pylori у пациентов. Чувствительность и специфичность данного метода составляет 90 %. Метод позволяет получить заключение быстро — от нескольких минут до нескольких часов. Его использование не предполагает наличие специального лабораторного оборудования или подготовленных специалистов и выполняется непосредственно эндоскопистом. Достаточно бюджетный метод диагностики при массовом и индивидуальном применении. В настоящее время разработано большое количество промышленно изготовленных уреазных тестов.Item Using the method of video-assisted thoracoscopic surgery in various spheres of medicine(2014) Okwu-Boms, Omasirichi C.; Pytetska, NatalyaPulmonology is a medical specialty that deals with diseases involving the respiratory tract. The term is derived from the Latin word pulmō, pulmonis ("lung"). Pulmonology is synonymous with pneumology, respirology and respiratory medicine. Pulmonology is known as chest medicine and respiratory medicine in some countries and areas. Pulmonology is considered a branch of internal medicine, and is related to intensive care medicine. Pulmonology often involves managing patients who need life support and mechanic ventilation. Pulmonologists are specially trained in diseases and conditions of the chest, particularly pneumonia, asthma, tuberculosis, emphysema and complicated chest infections. Treatment and surgery of the most modern methods and equipment (ultrasound, video-endoscopic examinations, laser, radiofrequency) Examination of lungs includes: • inspection, palpation, percussion, auscultation; • electrical impedance tomography (EIT); • computed tomography (CT); • video assisted thoracic surgery (VATS). Video-assisted thoracoscopic surgery (VATS) is a minimally invasive surgical technique used to diagnose and treat problems in your chest. During a video-assisted thoracoscopic surgery procedure, a tiny camera (thoracoscope) and surgical instruments are inserted into your chest through several small incisions. The thoracoscope transmits images of the inside of your chest onto a video monitor, guiding the surgeon in performing the procedure. Surgeons use the video-assisted thoracoscopic surgery technique to perform a variety of operations, such as: • biopsy to diagnose lung cancer, mesothelioma and other chest cancers; • esophagus surgery (esophagectomy); • hiatal hernia; • lungs surgery, such as surgery to treat lung cancer and lung volume reduction; • thymus gland removal surgery (thymectomy); • procedures to remove excess fluid or air from the area around the lungs; • surgery to relieve excessive sweating.Item Systemic lupus erythematosus(ХНМУ, 2016-11) Кочубей, Оксана Анатольевна; Кочубєй, Оксана Анатоліївна; Kochubiei, Oksana; Kumah, R.J.; Ashcheulova, Tetyana; Ащеулова, Татьяна Вадимовна; Ащеулова, Тетяна ВадимівнаItem Evolution of examination methods in gastroenterology (Colonoscopy)(2014-04-01) Kafiyaro Sukba, Philip; Ashcheulova, TetyanaItem Сучасні методи діагностики в клініці внутрішніх хвороб та їх етичні аспекти(2018) Ащеулова, Тетяна Вадимівна (ред.); Ащеулова, Татьяна Вадимовна (ред.); Ashcheulova, Tetyana (ред.); Амбросова, Тетяна Миколаївна (ред.); Амбросова, Татьяна Николаевна (ред.); Ambrosova, Tetyana (ред.); Компанієць, Кіра Миколаївна (ред.); Компаниец, Кира Николаевна (ред.); Kompaniiets, Kira (ред.); Питецька, Наталя Іванівна (ред.); Питецкая, Наталья Ивановна (ред.); Pytetska, Natalia (ред.); Ситіна, Ірина Василівна (ред.); Сытина, Ирина Васильевна (ред.)Item Трехмерное ультразвуковое исследование(2015) Пасечник, Анна; Питецкая, Наталья