Pathological Background Research Articles

РЕТРОСПЕКТИВНЫЙ АНАЛИЗ ПРИЧИН РАЗВИТИЯ ИНФЕКЦИИ В ОБЛАСТИ ХИРУРГИЧЕСКОГО ВМЕШАТЕЛЬСТВА У ПАЦИЕНТОВ СТАРЧЕСКОГО ВОЗРАСТА ПОСЛЕ ЭНДОПРОТЕЗИРОВАНИЯ ТАЗОБЕДРЕННОГО СУСТАВА

Infectious complications of surgical site after hip replacement in elderly and senile patients is one of the most severe complications, occurring from 0.3% to 15.0% of cases. Periprosthetic joint infection (PJI) in patients of this age group with the background of severe concomitant pathology is not uncommon cause of disability and fatal outcomes. The article highlights significant risk factors of periprosthetic infection after modern endoprosthetics. A retrospective analysis of the treatment of 504 patients after primary arthroplasty for femoral neck fracture from 2017 to 2021 was performed. Thirty-eight patients (75%) suffered from local infectious complications in the form of PJI in the postoperative period. The main factors contributing to PJI include male gender, 84-88 years age group, more than 5 concomitant diseases, late hospitalization and surgical treatment (after more than 48 hours).

Evaluation of the influence of single-nucleotide polymorphisms of vitamin D receptor (rs2228570), BDNF (rs6265), and NMDA (rs4880213) genes on gene expression in different tissues

Background. Questions regarding the association of individual and combined gene variations and mutations with thyroid disease and nervous system disorders remain insufficiently researched and require further study to facilitate early diagnosis of nervous system damage on the background of thyroid pathology, disease prognosis, and timely treatment and prevention. An important issue is the identification of the influence of individual polymorphisms in these genes on the functional activity of cells, including gene expression. Currently, gene expression genetics largely depends on the identification of expression quantitative trait loci (eQTL), which are the links between gene expression and genotype at a locus. The purpose of the study was to search for eQTL in single nucleotide polymorphisms (SNPs) of the BDNF gene (rs6265), VDR gene (rs2228570), and NMDA gene (rs4880213). The results were presented as nominal p-values for each SNP of the BDNF, VDR, and NMDA genes. Materials and methods. We use publicly available databases (QTLbase: http://www.mulinlab.org/qtlbase/index.html, GTExPortal: https://gtexportal.org). Results. Using the QTLbase, we identified statistically significant (p≤0.05) associations of rs6265 with the expression of 17 genes (BDNF-AS, BDNF, LDHC, AC104563.1, BBOX1, SPTY2D1OS, YWHABP2, LINC00678, LIN7C, GTF2H1, METTL15, IMMP1L, KIF18A, HPS5, NAV2, LGR4, CCDC34) in various tissues. For rs4880213, we found a significant association with the expression levels of 49 genes (ARRDC1-AS1, TPRN, SSNA1, SAPCD2, UAP1L1, NPDC1, MAN1B1, PTGDS, SNHG7, NDOR1, TRAF2, PHPT1, EGFL7, EHMT1, RNF208, PNPLA7, LCNL1, DPP7, LCN12, STPG3, CCDC183-AS1, ABCA2, RNF224, ENTPD2, PAXX, CLIC3, C9orf163, LCN15, MAN1B1-DT, FAM166A, FAM166A, LRRC26, STPG3-AS1, AGPAT2, ANAPC2, DPH7, ZMYND19, NSMF, MRPL41, EXD3, TUBB4B, NELFB, ARRDC1, EDF1, FBXW5, DIPK1B, MAMDC4, RABL6, TMEM141, TMEM203) in 16 different tissues. Additionally, we identified statistically significant (p ≤ 0.05) associations of rs2228570 with the expression of 29 genes (ASB8, TMEM106C, KANSL2, DDX23, CCNT1, HDAC7, RPAP3, PFKM, SENP1, RND1, PCED1B, AC004466.1, AMIGO2, ZNF641, ENDOU, RAPGEF3, VDR, AC004241.1, AC004801.2, AC121338.1, LINC02354, SNORA2A, LINC02416, AC074029.3, AC004241.5, AC008083.3, COL2A1, CCDC184, SLC48A1) in 17 different tissues. Conclusions. Single nucleotide polymorphisms of the BDNF (rs6265), VDR (rs2228570), and NMDA genes (rs4880213) affect gene expression in various cells and tissues. The use of this extensive eQTL catalog provides an important resource for understanding the molecular basis of common genetic diseases.

Molecular and Physiological Determinants of Amyotrophic Lateral Sclerosis: What the DJ-1 Protein Teaches Us.

Amyotrophic lateral sclerosis (ALS) is an adult-onset disease which causes the progressive degeneration of cortical and spinal motoneurons, leading to death a few years after the first symptom onset. ALS is mainly a sporadic disorder, and its causative mechanisms are mostly unclear. About 5-10% of cases have a genetic inheritance, and the study of ALS-associated genes has been fundamental in defining the pathological pathways likely also involved in the sporadic forms of the disease. Mutations affecting the DJ-1 gene appear to explain a subset of familial ALS forms. DJ-1 is involved in multiple molecular mechanisms, acting primarily as a protective agent against oxidative stress. Here, we focus on the involvement of DJ-1 in interconnected cellular functions related to mitochondrial homeostasis, reactive oxygen species (ROS) levels, energy metabolism, and hypoxia response, in both physiological and pathological conditions. We discuss the possibility that impairments in one of these pathways may affect the others, contributing to a pathological background in which additional environmental or genetic factors may act in favor of the onset and/or progression of ALS. These pathways may represent potential therapeutic targets to reduce the likelihood of developing ALS and/or slow disease progression.

Determination of allergic reaction to denture basis materials in patients with bronchial asthma

Тhis study was conducted in patients with secondary edentulism with a background pathology of bronchial asthma. Due to the fact that this group of patients is prone to a pronounced manifestation of an allergic reaction to the components of dentures, it was advisable to carry out allergology testing before prosthetics. This made it possible to avoid undesirable complications of treatment, save time and money for the patient.

Modeling Chronic Pain Experiences from Online Reports Using the Reddit Reports of Chronic Pain Dataset

Reported experiences of chronic pain may convey qualities relevant to the exploration of this private and subjective experience. We propose this exploration by means of the Reddit Reports of Chronic Pain (RRCP) dataset. We define and validate the RRCP for a set of subreddits related to chronic pain, identify the main concerns discussed in each subreddit, model each subreddit according to their main concerns, and compare subreddit models. The RRCP dataset comprises 86,537 submissions from 12 subreddits related to chronic pain (each related to one pathological background). Each RRCP subreddit was found to have various main concerns. Some of these concerns are shared between multiple subreddits (e.g., the subreddit Sciatica semantically entails the subreddit backpain in their various concerns, but not the other way around), whilst some concerns are exclusive to specific subreddits (e.g., Interstitialcystitis and CrohnsDisease). Our analysis details each of these concerns and their (dis)similarity relations. Although limited by the intrinsic qualities of the Reddit platform, to the best of our knowledge, this is the first research work attempting to model the linguistic expression of various chronic pain-inducing pathologies and comparing these models to identify and quantify the similarities and differences between the corresponding emergent, chronic pain experiences.

Dynamics of index scores after complex treatment of periodontal diseases in persons with general somatic pathology

The purpose of the study was to evaluate the effectiveness of the developed schemes of complex treatment and prevention of periodontal tissue diseases in patients with general somatic pathology according to the dynamics of periodontal and hygienic indices. Treatment was carried out in 134 patients with inflammatory and dystrophic-inflammatory diseases of the perio­dontium against the background of somatic pathologies: two developed schemes of complex treatment of periodontal diseases were used, taking into account the values of the CPITN index. All patients were divided into 2 groups: the main (73 (54.48 %) patients), whose treatment was carried out using the schemes developed by us, and the comparative (61 (45.52 %) patients), in whom the treatment of periodontal pathology was carried out according to generally accepted schemes. The dynamics of the values of PMA, OHI-S indices and the vacuum test of gingival capillary resistance were evaluated according to the method of Kulazhenko V.I. before the treatment of periodontal diseases, 3, 6 and 12 months after it. After 12 months of follow-up, the values of the PMA index remained significantly lower compared to the values before treatment, and the state of oral hygiene remained satisfactory in patients of both groups. In the examined main group, an increase in the time of formation of hematomas on the gums ((62.14±0.38) seconds) was observed by 1.15 times compared to the data before treatment, but in the patients of the comparison group, this indicator was lower than the initial data. Тhe patients of the main group showed an improvement in all index scores, while in the comparison group, the values of these indices were below the initial values. Treatment of periodontal disease with values of the CPITN index ≤ 2 and > 2 points against the background of general somatic pathology, with the use of schemes developed by us, contributed to the elimination of inflammation, improvement of oral hygiene and normalization of hemodynamics in the periodontal tissues, which was confirmed by the positive dynamics of index scores in the near and distant periods of observation. Keywords: treatment of periodontal diseases, somatic pathology, index assessment of periodontal status.

Effect of intragastric administration on the morphology of laboratory rats’ gastrointestinal tract

BACKGROUND: In preclinical studies on laboratory animals, oral administration with special probe for test substances is very in demand. Most studies are devoted to the psychophysiological and clinical-biochemical reaction of the animals body to this effect, but extremely few studies consider the effect of the manipulation itself on the development of pathology in the tissues of the gastrointestinal tract associated with the inevitable mechanical impact of the probe on the mucous membranes.
 AIM: To identify pathological changes in the organs of the gastrointestinal tract of laboratory rats that are associated with the effects of intragastric administration of the tested substances, and compare the data obtained with the frequency of spontaneous diseases.
 MATERIALS AND METHODS: The data of pathomorphological observations obtained from Wistar rats involved in the course of scientific work carried out at NPO Dom Pharmacy in the period from 2018 to 2021 were used. 1400 sentinel animals were analyzed, and the same number of intact rats. Intact animals were gavaged with a control substance (distilled water) for 14 days.
 RESULTS: In less than 5% of clinically healthy animals, inflammatory diseases of insignificant intensity and prevalence in all parts of the intestine can be detected. As a result of the anipulation of intragastric administration, an almost twofold increase in the number of cases of catarrhal esophagitis and gastritis, erosive and ulcerative lesions of the mucous membrane of the esophagus and stomach in its glandular part and hyperkeratosis in its non-glandular part was noted.
 CONCLUSIONS: The type and frequency of occurrence of the background pathology of the gastrointestinal tract of laboratory rats were determined. It has been proven that repeated traumatization of the mucous membrane associated with mechanical contact of a solid metal probe with the epithelium provokes the development of inflammatory diseases of the esophagus and stomach, without affecting the underlying parts of the intestine.

"Lipedema: The use of cultured adipocytes for identification of diagnostic markers".

Lipedema is a progressive disease, diagnosed most often in women, which is characterized by the unproportionate and symmetrical distribution of adipose tissue primarily in the extremities. Despite numerous results from in vitro and in vivo studies, many questions regarding the pathology and genetic background of lipedema have remained unanswered. Adipose tissue-derived stromal/stem cells (ASCs) were isolated from lipoaspirates derived from non-obese and obese lipedema and non-lipedema donors. Growth/morphology, metabolic activity, differentiation potential and gene expression were evaluated using quantification of lipid accumulation, metabolic activity assay, live-cell imaging, RT-PCR, quantitative PCR and immunocytochemical staining. The adipogenic potential of lipedema and non-lipedema ASCs did not rise in parallel with the donors' BMI and did not differ significantly between groups. However, in vitro differentiated adipocytes from non-obese lipedema donors showed significant upregulation of adipogenic gene expression compared to non-obese controls. All other genes tested were equally expressed in lipedema and non-lipedema adipocytes. The ADIPOQ/LEP ratio (ALR) was significantly reduced in adipocytes from obese lipedema donors compared to their non-obese lipedema counterparts. Increased stress fiber-integrated SMA was visible in lipedema adipocytes compared to non-lipedema controls and appeared enhanced in adipocytes from obese lipedema donors. Not only lipedema per se but also BMI of donors impact adipogenic gene expression substantially in vitro. The significantly reduced ALR and the increased occurrence of myofibroblast-like cells in "obese" lipedema adipocyte cultures underlines the importance of attention towards the co-occurrence of lipedema and obesity. These are important findings towards accurate diagnosis of lipedema.

Features of the treatment of children with mild asthma in the context of the COVID-19 pandemic

Our society is still struggling with the spread of the SARS-Cov-2 virus, the cause of the development of the new coronavirus infection (COVID-19). Vaccine prophylaxis of this infection in children under 12 years old is not yet available in Russia. In many children, COVID-19 occurs against the background of concomitant pathology, including bronchial asthma (BA) as the most common chronic disease among children. BA treatment is successfully carried out by pediatricians due to modern clinical guidelines and the availability of medicines. This is one of the examples when the introduction of new methods of diagnosis and treatment made the disease controllable in most cases. Despite the obvious successes, the treatment of asthma is currently undergoing changes, and this applies specifically to mild asthma. When revising the guidelines in 2021–2022, GINA experts drew particular attention to the need for early prescription of anti-inflammatory therapy, mainly with low doses of ICS, regardless of whether asthma progresses with persistent or intermittent symptoms. Since children often suffer from ARVI and viral infections are the most frequent trigger of BA exacerbation in children, basic BA therapy in children is of particular importance, which can reduce the number of virus-induced exacerbations. Along with ICSs, generally recognized leaders in the basic therapy of BA, in the treatment of children with mild asthma with virus-induced exacerbations, montelukast, oral Cysteinyl Leukotriene Receptor Antagonist (LTRA), does not lose its importance. In recent years, additional properties have been described that allow pediatricians to use montelukast for mild asthma in children in the current context of the COVID-19 pandemic.

Оцінка стану тканин пародонта у хворих із соматичною патологією

The purpose of the study was to investigate the influence of concomitant somatic pathology on periodontal tissues. Materials and methods. 104 patients, aged 28–46 years, with diseases of periodontal tissues, who had somatic pathology, were involved in the study. The examined persons were divided into groups: 35 persons (group 1) with pathology of the hepatobiliary system, 37 persons (group 2) with pathology of the gastrointestinal tract, and 32 persons (group 3) with pathology of the cardiovascular system. The comparison group included 30 people with periodontal tissue diseases without somatic pathology. To determine the depth and prevalence of the inflammatory process of the gums the Svrakov’s number indicator was used. Oral hygiene was assessed according to the Silness-Loe and Stallard indices. The papillary-marginal-alveolar index (C. Parma, 1960) was determined to assess the severity of gum inflammation. Bleeding gums were assessed by the gum's papilla bleeding index according to Muhllemann. Statistical processing of the research results was carried out with a computer program for variational and statistical analysis of medical and biological research data “GraphPad Prism 5”. Results and discussion. Patients with diseases of periodontal tissues against the background of somatic pathology had the highest percentage of chronic generalized periodontitis of the II degree, in contrast patients of the comparison group had the highest percentage of chronic generalized periodontitis of the initial – I degree. Svrakov's number in patients with periodontal disease against the background of somatic pathology significantly (р ˂0.05) exceeded the indicators of patients of the comparison group. At the same time, there is no significant difference between the results of groups 1, 2 and 3. The highest values of the indexes of Silness-Loe and Stallard were recorded in patients with the cardiovascular system pathology, which significantly (p<0.05) exceeded the data in the comparison group, but did not significantly differ from the results of patients with pathology of hepatobiliary system and gastrointestinal tract. The papillary-marginal-alveolar index data were the highest in patients with hepatobiliary system pathology (64.25 ± 8.19%), which significantly (p<0.05) exceeded the results of the comparison group and in individuals of groups 2 and 3. The highest indicator of the bleeding index is 1.98 ± 0.22 points in patients of the 1st group, which significantly exceeds the indicators in the group of people without somatic pathology and in the group of patients with pathology of gastrointestinal tract and cardiovascular system. Conclusion. The conducted studies show that the presence of somatic pathology contributes to the development of periodontal tissue diseases, and certainly aggravates their course, which is proven by the results of the index assessment

КЛИНИКО-РЕНТГЕНОЛОГИЧЕСКИЙ АНАЛИЗ СТРУКТУР ПАРОДОНТА ПРИ АНАТОМО-ФУНКЦИОНАЛЬНЫХ НАРУШЕНИЯХ МУКОГИНГИВАЛЬНОГО КОМПЛЕКСА

Subject. Anatomical and functional disorders of the mucogingival complex.
 Objectives. To evaluate microcirculatory, clinical and radiological changes in periodontal tissues in various variants of mucogingival complex disorders.
 Methodology. The study was conducted at the Department of Therapeutic Dentistry of ASMU. In the course of the study, 80 patients (49 women, 31 men) aged 18 to 35 years were examined with a ratio of dentition close to orthognathic bite in the presence of maximum occlusion. Three groups were formed depending on the anatomical and functional state of the mucogingival complex. In the clinical part of the study, an objective assessment of the condition of periodontal tissues was carried out on the basis of a dental examination with a comprehensive analysis of the periodontal status. The X-ray examination included the analysis and description of cone-beam computed tomograms for patients of clinical groups. To assess microcirculation in periodontal tissues, the method of ultrasonic Dopplerography with functional probe breakdown was used.
 Results. In the studied groups, the level of oral hygiene was characterized as good, and the indicators of hygiene indices did not differ significantly, periodontal indices indicated the absence or minimal degree of inflammation in periodontal tissues. Carrying out a functional tension test made it possible to divide patients into subgroups according to the type of reaction: normal, compensated, subcompensated, decompensated. According to the results of the study of CBCT in the comparison group, pathological changes in the bone tissue of the alveolar process of the studied areas were not recorded, in patients of the first clinical group, in most cases (80.2%), pathological changes in the bone tissue of the alveolar process were not observed, in the rest (19.8%), a low level of alveolar bone was noted. In patients of the second clinical group, the phenomena of osteoporosis and an increase in the distance from the dental enamel-cement border to the edge of the outer cortical plate were recorded.
 Conclusions. X-ray changes in bone tissue most often corresponded to the already existing clinical symptoms of periodontal tissue damage against the background of mucogingival pathology. The predictors of prenosological diagnosis in anatomical and functional disorders of the mucogingival complex were changes in microcirculation indicators.

THE ROLE OF PROINFLAMMATORY CYTOKINES INTERLEUKIN 1-Β AND TUMOR NECROSIS FACTOR-Α IN DIAGNOSTICS OF PUBERTAL MENORRHAGES AGAINST THYROID PATHOLOGY

Introduction. During puberty, the reproductive system is vulnerable to the influence of any adverse factors that lead to a disorder of its functional state and to menstrual disorders in particular. Among the numerous factors that provoke menstrual dysfunction is the pathology of the thyroid gland.Cytokines are known to be involved in all aspects of innate and acquired immunity, including the activation of growth and differentiation of immunocompetent cells, inflammation and restoration of the function of the affected organ. Cytokines are characterized by the action of preventing the interaction of cells of the immune, hematopoietic, endocrine and nervous systems. Cytokines of the first generation are conditionally distinguished, which are produced by cells of nonspecific anti-infective protection. The main pro-inflammatory cytokines are IL-1β, IL-2, IL-6, interferons, TNF-α and others. The main factor of inflammatory reactions is multifunctional IL-1β. Tumor necrosis factor-alpha (TNF-α) is a pro-inflammatory cytokine, one of the central regulators of factors and mechanisms of innate resistance. It has many biogenic effects, most of which are similar to the action of IL-1β.Considering the above exactly IL-1β and TNF-α to study their concentration in the blood of adolescent girls with pubertal menorrhagia has been the basis of immunological studies.The aim of the study. Assessment of cytokine status in girls of pubertal age against the background of concomitant thyroid pathology.Material and methods. We examined 70 adolescent girls with pubertal menorrhagia who were treated in the gynecological department of the Chernivtsi Regional Perinatal Center. The girls were divided into two groups: I (main) included 30 adolescent girls diagnosed with pubertal menorrhagia on the background of concomitant thyroid pathology, II group (comparison) - 40 adolescent girls diagnosed with pubertal menorrhagia. Control group III - 25 practically healthy adolescent girls. Pro-inflammatory cytokines, namely interleukin 1-beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) were studied once, after inclusion of patients in the study, by enzyme-linked immunosorbent assay based on a solid-phase ‘sandwich’ variant using mono- and polyclonal antibodies to IL-1β and TNF-α. The tubes with the serum samples were closed with lids and stored in the freezer until analysis at -20 °C.Statistical processing of the material was carried out using the computer program STATISTICA and Microsoft Exel Windows, StatSoft® Inc.The design of the study and all methods used in this study were reviewed and approved by the Bioethics Committee of the Higher Educational Institution “Bukovinian State Medical University” (protocol No. 1, dated 24.01.2011). Research work “Prevention, diagnostics and treatment of perinatal and reproductive system disorders of women and adolescent girls” (№ 201110Н state registration number 0111U006499. Term of realization: 02.2011-12.2015.)Results of the study. The obtained results of the study of the cytokine cascade showed that upon admission to inpatient treatment and examination in the blood of adolescent girls with pubertal menorrhagia without concomitant pathology, the concentration of IL-β increases significantly (by 60.61%) and a tendency to increase (4.09 times) the concentration of TNF-α in the peripheral blood of the examined patients is formed. However, the results of clinical and laboratory examinations obtained during admission for inpatient examination and treatment of adolescent girls with pubertal menorrhagia associated with thyroid pathology showed that patients have a steady tendency to decrease the concentration of IL-1β by 6.96% and TNF-α - by 1.48 times. It was found that the pathology of the thyroid gland contributes to the inhibition of immunocompetent cells production of IL-1β by 1.66 times, TNF-α by 6.04 times.Conclusion. Pathology of the thyroid gland leads to a decrease in immunoregulatory function due to a decrease in the concentration of some important proinflammatory cytokines (IL-1β and TNF-α).

Pathological Background and Clinical Procedures in Oral Surgery Haemostasis Disorders: A Narrative Review

Haemostasis disorders are serious pathologies that could put dental and surgical procedures at risk as they are associated with postoperative bleeding, which in some circumstances could be prolonged and dangerous for the patient. In-depth knowledge of the problems associated with coagulation pathologies and the suitable specific procedures should be implemented in dental practice. A good awareness of the clinical protocols to be used in these circumstances may help reduce operator stress and increase patient compliance. Collaboration with the haematologist is always recommended to establish an adequate treatment plan, both regarding the administration of therapies that promote haemostasis and for assessing the operative risk. Hereby, we summarize the congenital and hereditary pathologies that lead to haemostasis disorders, which can be found in patients undergoing dental procedures. The purpose of this narrative review is to frame the diseases from a clinical, anamnestic, and etiopathological standpoint, as well as to evaluate an operative approach to the pathology under consideration, with particular attention to anaesthesia manoeuvres and post-surgical haemostasis, to avoid hematoma formation and uncontrolled bleeding which can lead procedure failure up and even death. Of note, it is likewise important to educate the patient about prevention, to keep the oral cavity healthy and avoid invasive procedures, limiting the number of operative sessions.

Methods of physiotherapy for cicatricial complications in dental patients

The article is devoted to one of the topical interdisciplinary problems, since it equally applies to dentistry, dermatology, rehabilitation and, in general, to all practical medicine. Emphasis is placed on the pain syndrome and the psycho-emotional status of dental patients who, against the background of comorbid pathology (diabetes) or in the postoperative period, develop structural changes in the underlying tissues and organ systems. Diagnostic methods for verification of keloid scars are constantly improved. Advancement of modern technologies, including drug-free ones, are crucial for rehabilitation of patients with cicatricial pathology. Modern methods of verification of keloid scars in dental patients with diabetes, taking into account the evidence analysis of indicators of keloid formation, are presented. These methods made it possible to increase the clinical effectiveness of physiotherapy.

Synthesis and structure–activity relationships of pyrazole-based inhibitors of meprin α and β

Targeting metalloproteinases has been in the focus of drug design for a long time. However, meprin α and β emerged as potential drug targets just recently and are linked to several diseases with different pathological background. Nevertheless, the validation of meprins as suitable drug targets still requires highly potent and selective inhibitors as chemical probes to elucidate their role in pathophysiology. Albeit highly selective inhibitors of meprin β have already been reported, only inhibitors of meprin α with modest activity or selectivity are known. Starting from recently reported heteroaromatic scaffolds, the aim of this study was the optimisation of meprin α and/or meprin β inhibition while keeping the favourable off-target inhibition profile over other metalloproteases. We report potent pan-meprin inhibitors as well as highly active inhibitors of meprin α with superior selectivity over meprin β. The latter are suitable to serve as chemical probes and enable further target validation.

Клініко-лабораторні паралелі у хворих з «можливою» сімейною гіперхолестеринемією на тлі порушень вуглеводного обміну

Мета роботи – дослідити клініко-лабораторні паралелі у хворих із «можливою» сімейною гіперхолестеринемією (СГ) залежно від ступеня порушень вуглеводного обміну. Матеріали і методи. Протокол дослідження охопив 97 пацієнтів з ішемічною хворобою серця, артеріальною гіпертензією та дисліпідемією на тлі коморбідної патології (цукровий діабет (ЦД) 2-го типу, ожиріння). Хворі були розподілені на дві групи залежно від супутньої коморбідної патології. Групу з ожирінням було додатково розділено на дві підгрупи (2А та 2Б) залежно від наявності порушення толерантності до глюкози.Результати та обговорення. У групі з ЦД було виявлено прямі кореляційні зв’язки між вуглеводними та ліпідними порушеннями, а також високу залежність рівня атерогенності ліпідного профілю від ступеня дестабілізації ЦД. У групі з ожирінням ІІ–ІІІ ступеня значущої кореляції між показниками індексу маси тіла, окружності талії та порушеннями в ліпідному профілі не виявлено. Після розділення групи з ожирінням на підгрупи 2А та 2Б значущих відмінностей щодо клінічної характеристики та ліпідного профілю не виявлено, також не зафіксовано кореляційних зв’язків між порушеннями вуглеводного обміну та ліпідними порушеннями.Висновки. Група пацієнтів із «можливою» СГ (з рівнем холестерину ліпопротеїнів низької щільності (ХС ЛПНЩ) ≥ 5,0 ммоль/л) є гетерогенною та може містити хворих із вторинною дисліпідемією на тлі дестабілізації коморбідної патології. Частота виявлення «можливої» СГ за критерієм «ХС ЛПНЩ ≥ 5,0 ммоль/л» була більшою в пацієнтів із маніфестацією ЦД 2-го типу і зменшувалася паралельно зі зменшенням порушень вуглеводного обміну. Не виявлено прямого паралелізму і тісних кореляційних зв’язків між рівнем ХС ЛПНЩ та характеристиками глікемічного профілю в пацієнтів з ожирінням та порушеною толерантністю до глюкози, що не виключає можливості впливу на ліпідні характеристики полігенних генетичних мутацій.

CONDITION OF PERIODONTAL TISSUES ON THE BACKGROUND OF HELICOBACTER INVASION: THE CONCEPT OF PATHOGENESIS.

The aim: To analyze the state of periodontal tissues against the background of Helicobacter pylori invasion in dynamics and to propose a possible mechanism of development of inflammatory periodontal diseases in patients with Helicobacter pylori-associated pathology of the gastrointestinal tract. Materials and methods: We examined 43 patients with Helicobacter pylori-associated gastrointestinal pathology and 42 patients of the same age without somatic pathology, including without gastrointestinal pathology associated with Helicobacter pylori. Clinical and laboratory research methods (clinical, instru-mental, biochemical, histological methods) were used. Results: Comparing the data of clinical observations and the results of laboratory studies of patients with inflammatory periodontal disease on the background of Helicobacter pylori-associated gastrointestinal pathology, obtained in different observation periods, we can assume that basic dental treatment of periodontal disease in such patients undergoing eradication therapy does not provide stable anti-inflammatory, antimicrobial and antioxidant effect, which leads to reduced periods of remission and recurrence of periodontal disease, where oral dysbiosis plays a crucial role. Conclusions: Comparing the data of clinical observations and the results of laboratory studies of patients with chronic gingivitis on the background of Helicobacter pylori-associated gastrointestinal pathology, obtained in different observation periods, we can say that they correlate with each other and suggest that the basic dental treatment of chronic gingivatis on the background of H.pylori-associated pathology of the gastrointestinal tract, which is currently undergoing a course of eradication, does not give a stable anti-inflammatory, antimicrobial and antioxidant effect, which leads to recurrence of periodontal disease and shortening remission periods, where oral dysbiosis plays a crucial role.

Difficulties of differential diagnosis of polyneuropathy developed after Gam-COVID-Vac vaccination on the background of combined infectious pathology (clinical case)

The clinical case describes the difficulties of differential diagnosis of polyneuropathy that developed after Gam-Covid-Vac vaccination on the background of combined infectious pathology (HIV infection, tick-borne borreliosis, COVID-19) in a young woman. It is shown that various infectious and non-infectious diseases with similar clinical symptoms (peripheral nervous system affliction) occurring simultaneously in one patient can significantly affect each other’s course and complicate the establishment of the true cause of polyneuropathy. It should be noted that in this example, the establishment of a final diagnosis was carried out collectively, by consensus, and was based on the effectiveness of etiotropic (antibacterial) treatment, which in fact was an ex juvantibus therapy option, which made it possible to establish the most probable etiology of polyneuropathy – tick-borne borreliosis. In turn, HIV infection and possibly vaccination, according to the authors, could cause immunosuppression, which affected the degree of dissemination of Borrelia burgdorferi. It is also likely that the insufficient immune response in combination with the cascade plasma filtration session affected the initial dubious results of the serological tests, which further complicated the diagnosis.

STUDY OF IMMUNE-INFLAMMATORY RESPONSE CHANGES IN ORAL FLUID IN PATIENTS WITH DISEASES OF PERIODONTAL TISSUES IN COMBINATION WITH GENERAL SOMATIC PATHOLOGY.

The aim: To determine the concentration of markers of the immune-inflammatory response (IL-1β, IL-10, IL-1β / IL-10, hsCRP) in oral fluid in patients with diseases of periodontal tissues in combination with general somatic pathology. Materials and methods: The study was conducted at Danylo Halytsky Lviv National Medical University, Department of therapeutic dentistry FPGE, Lviv, Ukraine. The patients were divided into two groups: the main group - 144 patients (with periodontal tissue diseases on the background of general somatic pathology) and the control group - 30 somatically and dentally healthy persons, in whose oral fluid was determined the concentration of IL-1β, IL-10, hsCRP by the enzyme immunoassay method. Results: As a result of our research, it was found that in people with periodontal tissue diseases, against the background of general somatic pathology, there is an activation of the immune-inflammatory response, which aggravates the course of general somatic and dental diseases in this contingent of patients. Conclusions: Therefore, in patients with periodontal tissue diseases on the background of somatic diseases, a significant increase in the level of the pro-in-flammatory cytokine IL-1β and hsCRP was determined against the background of a decrease in the anti-inflammatory cytokine IL-10 in the oral fluid compared to the values in the control group.

Оцінка стану репродуктивного здоров'я жіночого населення Закарпатської області в сучасних умовах

Introduction. The demographic crisis in Ukraine is a socio-medical problem caused by: socio-economic factors; the consequences of the COVID-19 pandemic, which continues in conditions of war; a decrease in the total fertility rate against the background of somatic and gynecological pathology; the increase in the specific weight of reproductive losses; high level of maternal and infant mortality. Goal. To analyze the dynamics of reproductive health indicators of the female population of the Transcarpathian region for 5 years. Determine the priority directions for improving the situation in the region. Materials and methods. Analysis and statistical processing of data by region for 2018-2022. Conclusions of the commission of the health care department on the analysis of cases of maternal and perinatal mortality. The results of a sample survey of the female population. Research results and their discussion. The reasons for the deterioration of reproductive health and the structure of morbidity among women of reproductive age and adolescent girls are determined. The most urgent problems are the increase in miscarriages, high rates of oncogynecological morbidity, the increase in the level of maternal mortality against the background of the consequences of the COVID-19 pandemic, chronic extragenital pathology. When analyzing cases of maternal and perinatal losses, deficiencies in the provision of assistance were revealed. The results of the survey indicate a low level of sanitary education. Two international projects aimed at improving the quality of medical services and perinatal care were launched in the region. Conclusions. Analysis of reproductive health indicators of the female population shows negative trends and requires further development and implementation of effective measures to improve the situation. The implemented medical reform is imperfect in terms of: monitoring; coordinated work of the primary and secondary links of assistance; quality of training of specialists and improvement of their qualifications.