Наукові праці. Кафедра ультразвукової та функціональної діагностики
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Item Postisometrical relaxation hemodynamic effects in patients with cervicocranialgia and vestibular dysfunction(Acta Balneologica, 2023) Kalashnikov, Valeriy; Vastyanov, Rooslan; Gozhenko, Olena; Andreeva, Tamara; Stoyanov, Olexandr; Chebotareva, Hanna; Ostapenko, Oksana; Калашніков, Валерій Йосипович; Вастьянов, Р.С.; Гоженко, О.А.; Андреєва, Т.О.; Стоянов, О.М.; Чеботарьова, Г.М.; Остапенко, О.О.Aim: To investigate the hemodynamic indexes during the postisometric relaxation in patients with cervicocranial pain and vestibular dysfunction in patients with the cervical spine pathology. Materials and Methods: The clinical examination included 85 patients of the young age with cervical spine instability. We use randomization into 41 patient with cervicogenic cranialgia and 44 patients with vestibular dysfunctions. Postizometric relaxation (PIR) sessions were included into patients treatment. Results: Our results revealed increased time-averaged indexes of maximal blood flow velocity through vertebral and basilar arteries in patients with cervicogenic cranialgia. The same indexes were registered to be decreased in patients on the 2nd group. We found that hperreactivity to flexion-extension was determined in patients of both groups, and in patients of the 1st group to left-right rotation. After postizometric relaxation sessions we registered a decrease in the headache intensity, frequency and duration in patients with cervicogenic cranialgia, and a decrease in dizziness intensity and ringing and tinnitus regression in patients with vestibular dysfunctions. Conclusions: We found that hemodynamic changes in patients with cervicogenic cranialgia were manifested in the form of hyperperfusion through vertebral artery and basilar artery and a half-increase in reactivity indexes on rotatory tests. The hemodynamic effect of PIR was determined in the form of vertebral blood flow indexes through vertebral artery and basilar artery stabilization, as well as indexes of reactivity to rotatory tests normalization.Item Densitometric correlates of degenerative-dystrophic processesin cervical vertebrae of humans and domestic animals(Regulatory Mechanisms in Biosystems, 2023) Andreyeva, T.; Stoyanov, O.; Chebotaryova, G.; Kalashnikov, Valeriy; Vastyanov, R.; Mashchenko, S.; Андреєва, Т.О.; Стоянов, О.М.; Чеботарьова, Г.М.; Калашніков, Валерій Йосипович; Вастьянов, Р.С.; Мащенко, С.С.The cervical spine is the most mobile region with high work activity which constantly receives a heavy load. This region is the least protected from external influences, especially in cases of degenerative-dystrophic changes. A comparative analysis of clinical-morphological and morphometric data in degenerative-dystrophic lesions of the cervical spine in humans and domestic animals with secondary anatomical and physiological abnormalities was performed. The examined contingent of people was of young and middle age (average age equal to 41.5 ± 5.2 years). The examined animals had a similar age range recalculated to human age. The pathological changes in spinal cord configuration were registered in 84.6% of examined humans (n = 65) in the form of angular kyphosis or straightened lordosis (with the analogous relative distribution). In terms of gender, with the exception of the frequency of angular kyphosis, probable differences in the formation of lordosis, which is straightened (2.1 times more often), the indicators were the same while the normal configuration of the spine was more often registered in men against the women (20.0% vs 12.5%). Cervical spine deformations in different breeds of dogs and cats (n = 75) were observed in 34.7% of cases (angular kyphosis – 38.5%; straightened lordosis – 61.5%). Preservation of normal configuration of the cervical spine was recorded more often in cats – 78.6%, and in small breeds of dogs – 78.5%. In large breeds of dogs, these indicators were probably changed: the norm remained only in 26.3%, and the deformations exceeded the corresponding indicators in cats and small breeds of dogs by 2.7 or more times. The significant differences were found in cases of straightened lordosis formation which was registered more often in women than in men. The incidence of angular kyphosis was comparable in patients of both sexes. Cervical spine deformations in different breeds of dogs and cats were observed in 26 animals (34.6% cases: angular kyphosis – 13.3%; straightened lordosis – 21.3%). The density of vertebral bodies in all groups decreased in the caudal direction of the cervical spine. The differences in humans reached 18.1%, being higher in women than in men. Animals had a similar density distribution. This index was minimal in cats (2.7%), in small-breed dogs it increased significantly (7.5%) and in large-breed dogs it reached 14.3%, i.e. 5 times (com-pared to cats) and 2 times higher (compared to small breed dogs). A comparative analysis between humans and animals indicates that the maximal discrepancies in the studied indexes were found in humans and relatively coincided with those in large breed dogs. The presence of neurological deficit with cervical spine pain syndrome with lordosis distortion and the provocation of spinal canal stenosis was found in 73.7% of large adult dogs. The revealed regularities of cervical spine degenerative-dystrophic changes indicate that animals, especially large breeds of dogs, can serve as a model for investigation of etiopathogenetic factors, clinical course, prognosis and other risks of the bone-cartilage apparatus degeneration with both stenosis and vertebrogenic myelopathy development at the cervical level in humans. The obtained clinical and morphometric data from comparative analysis in humans and domestic animals will serve as the basis of methods of prevention of degeneration in the bone-cartilage apparatus and the premature aging of the body in humans.Item Vestibular dysfunctions in chronic brain ischemia in the post COVID period(Wiadomości Lekarskie Medical Advances, 2023) Stoyanov, Alexander; Mashchenko, Serhii; Kalashnikov, Valeriy; Vastyanov, Rooslan; Pulyk, Alexander; Andreyeva, Tamara; Kolesnik, Olena; Стоянов, О.М.; Мащенко, С.С.; Калашніков, Валерій Йосипович; Вастьянов, Р.С.; Пулик, О.Р.; Андреєва, Т.О.; Колесник, О.О.The aim: The aim of the study is the clinical-pathogenetic reasoning of vestibular dysfunctions (VD) development against the background of chronic brain ischemia in the presence of degenerative changes in the cervical spine (CS) in the post COVID period. Materials and methods: 82 patients, in the conditions of the clinical base of the Odessa National Medical University in 2019-2021 were examined. Group I with VD against the background of chronic brain ischemia (CBI) at the compensated phase; Group II with VD against the background of CBI at the subcompensated phase (33 men; 49 women), aged from 18 to 55 years. The control group (CG) consisted of 20 patients of the corresponding gender and age. The condition of the state of the autonomic nervous system, vestibular functions, cervical spine, cerebral arteries and emotional condition were examined. Results: Vestibulo-ataxic disorders were higher compared to CG and increased along with the degree of brain damage. An important aspect of the development of VD is autonomic dysfunction against the background of pathological autonomic characteristics with predominant parasympathetic orientation of autonomic tone, especially in the case of insufficiency of autonomic recativity (AR) and pathological autonomic support of activity. Such changes significantly increased in the presence of subcompensation of CBI. The correlation between psychoemotional disorders and changes in autonomic characteristics with VD against the background of CBI with initial regularities depending on the degree of brain damage was defined. The progression of CBI is facilitated by coronavirus infection and manifested in autonomic and psychoemotional dysfunctions. A characteristic hemodynamic feature in groups with compensated and subcompensated CBI is the presence of reduced perfusion in basilar (BA) and vertebral (VA) arteries. Changes in cerebral vascular reactivity with a decrease in cerebrovascular reactivity indicators were characteristic of the subcompensated phase of CBI. Hyperactivity to rotational functional loads in both clinical groups has a high correlation with the presence of stair descent and, to a lesser extent, isolated instability in CS. Conclusions: 1. The occurrence of VD is facilitated by the presence of autonomic dysfunction and degenerative-dystrophic changes in the CS, especially in case of subcompensation of CBI. 2. Psychoemotional changes were a characteristic feature of patients with VD against the background of CBI and had certain regularities depending on the phase of CBI. 3. Suffered coronavirus infection contributes to the progression of VD and further decompensation of CBI due to direct damage to the autonomic and vascular systems of the brain. 4. Changes in cerebral hemodynamics in the form of reduced perfusion in BA and VA, a decrease in cerebrovascular reactivity, and an increase in reactivity to rotational functional load were determined in patients with VD against the background of subcompensated CBIItem Ultrasound features of the endometrium in women with abnormal uterine bleeding on the background of extragenital pathology(2023) Гаркавенко, Карина Володимирівна; Лазуренко, Вікторія Валентинівна; Абдуллаєв, Різван Ягубович; Васильєва, І.А.; Карпенко, Володимир Геннадійович; Пасієшвілі, Нана Мерабівна; Garkavenko, Karyna; Lazurenko, Viktoriia; Abdullaiev, Rizvan; Vasylieva, I.; Karpenko, Volodymyr; Pasiieshvili, N.The article presents the results of dopplerometry of the uterine vessels in 45 women aged 40-55 years with abnormal uterine bleeding (AUB) – in 25 of them against the background of the metabolic syndrome (MS), which made up the main group and in 20 without MS (comparative group). The control group consisted of 20 women with a normal menstrual cycle. All women with AUB underwent ultrasound of the uterus and appendages on the day of treatment, and women in the control group – on the 5-8th day of the menstrual cycle. Ultrasound in patients with AUB against the background of MS revealed a threefold increase in the thickness and 1.6 times in the volume of the endometrium compared with the control group (p<0.05). The presence of polypoid formations in the uterine cavity was detected in 7 (35%) patients with AUB, in 3 (15%) women with AUB against the background of MS. It was found that in women with AUB, compared with women in the control group, the indices of resistance (P<0.05) and pulsation (P<0.001) significantly decreased in the radial and basal arteries. In women with AUB against the background of MS, the thickness (P<0.05) and volume (P<0.001) of the endometrium significantly increased. The results of the study show that the metabolic syndrome is one of the factors in the development of endometrial hyperplasia, which is the cause of abnormal uterine bleeding. Doppler ultrasound in these women reveals a significant decrease in vascular resistance.Item Evaluation of hemodynamics in vertebral arteries in case of herniated cervical intervertebral discs using functional tests(2023) Абдуллаєв, Різван Ягубович; Вороньжев, Ігор Олександрович; Абдуллаєв, Руслан Різванович; Коломійченко, Юрій Анатолійович; Abdullaiev, Rizvan; Voronzhev, Igor; Abdullaiev, Ruslan; Kolomiichenko, YuriiBackground. Degenerative changes of the vertebral-motor segment occupy an important place among the causes of cervicogenic headache, neck pain with radiation to the shoulder and arm, noise in the head, dizziness. The same symptoms are often found in vertebral artery syndrome, which is a set of disorders of vertebral-basilar dynamics. Dopplerography makes it possible to obtain quantitative parameters of blood flow in the vertebral arteries, thereby assessing the level of pathological changes in blood flow. Purpose. Dopplerographic assessment of blood flow parameters in vertebral arteries in patients with herniated cervical intervertebral discs using functional tests. Materials and methods. An analysis of the results of dopplerography of the vertebral arteries in 42 young patients with herniated cervical intervertebral discs was carried out. Peak systolic velocity (Vs), end-diastolic velocity (Vd), indices of peripheral resistance (RI) and pulsatility (PI), minute volume of blood flow (HOK – Vvol) in the second segment of the VA at the C2-C3 level were determined at functional tests. Results. With a left-sided hernia, the value of Vs in the left VA during contralateral head rotation was 34.1 ± 2.9 cm/s, RI – 0.71 ± 0.03, PI – 1.04 ± 0.06, HOC – 85 ± 9 ml/min, and in the comparison group – 45.3 ± 3.8 cm/s, 0.59 ± 0.02, 0.85 ± 0.04, 118±13 ml/min, respectively. In patients with a right-sided hernia, Vs in the right VA during contralateral head rotation was 32.6 ± 3.2 cm/s, RI – 0.72 ± 0.03, PI – 1.03 ± 0.06, COC – 83 ± 8 ml/min, and in the comparison group – 44.8 ± 4.1 cm/s, 0.60 ± 0.02, 0.87 ± 0.04, 117 ± 12 ml/min, respectively. The difference between Doppler blood flow parameters obtained during contralateral head rotation in patients with disc herniation and the comparison group (persons without disc herniation) was significant (P < 0.05). Conclusion.Hemodynamically significant disruption of blood flow in the vertebral artery occurs when the paramedian and posterolateral hernia is localized on the side of the same name during head rotation to the opposite side. These violations consist in a significant decrease in systolic speed and minute volume of blood flow, in an increase in indices of resistance and pulsatility compared to persons without disc herniation.Item Characteristics of late post-infarction cardiac remodeling(2023) Abdullaiev, Rizvan; Kapustnyk, Valeriy; Markovskiy, Volodymyr; Kulikova, F.; Kyrychenko, A.; Tomakh, N.; Абдуллаєв, Різван Ягубович; Капустник, Валерій Андрійович; Марковський, Володимир Дмитрович; Кулікова, Ф.Й.; Кириченко, А.Г.; Томах, Н.В.The article presents the results of echocardiography in assessing cardiac remodeling in 79 patients 12 months after acute myocardial infarction (MI). 42 (53.2%) patients had Q-positive (Q+), 37(46.8%) Q-negative (Q-) myocardial infarction. After 12 months, chronic heart failure (ChHF) was detected in 32 patients, of which 23 (54.8%) as a result of Q(+), and 9 (24.3%) Q(-) infarction. In patients who underwent Q (+) MI with ChHF in the late post-infarction period, the values of left ventricular end-diastolic dimension (EDD), end-sistolic dimension (ESD), left atrial dimension (LAD), local contractility index (LCI), sphericity index (SI), left ventricular myocardial mass index (LV MMI, g/m2 ) were significantly (P<0.05, P<0.01) higher than in patients with Q ( -) MI and without ChHF. The average value of such EchoCG parameters as ejection fraction (EF, %), degree of shortening of the anteroposterior dimension of the left ventricle (ΔS, %) and the ratio of the total wall thickness and LV EDD (2H/D index) in patients with Q (-) MI was higher than in the group of patients with Q (+) and without ChHF.