Periods Of Exacerbation Research Articles

Vitamin D supplementation in inflammatory bowel disease: a narrative review.

Inflammatory bowel disease is a chronic disorder characterized by exacerbation and remission periods, and its worldwide incidence has increased in recent decades. Vitamin D is involved in immune regulation and improves barrier functions and intestinal microbiota. Studies have observed that high vitamin D levels decrease relapses and improve the clinical course of inflammatory bowel disease. The objective of this review was to analyze the evidence on vitamin D supplementation in adult patients with inflammatory bowel disease. Among inactive patients, the studies administrating less than 2000 international units per day of vitamin D did not find any beneficial effects. However, those supplementing 2000 international units of vitamin D per day increased serum levels and reduced disease activity. In patients with active disease, doses between 5000 to 10 000 international units per day reduced symptomatology. This review showed that vitamin D supplementation above 2000 international units per day among inactive patients with inflammatory bowel disease, and between 5000 to 10 000 international units per day among those in the active stage, shows potential benefits on the disease.

Cheyne-Stokes Breathing as a Predictive Indicator of Heart Failure in Patients With Obstructive Sleep Apnea; A Retrospective Case Control Study Using Continuous Positive Airway Pressure Remote Monitoring Data.

ObjectiveWe conducted a retrospective case control study to examine whether remote monitoring of Cheyne-Stokes breathing (CSB) was useful for predicting the onset of heart failure (HF) in patients with obstructive sleep apnea (OSA) on continuous positive airway pressure (CPAP).MethodsAmong patients with OSA treated at our hospital, 33 patients with HF that occurred between July 2014 and May 2021 [11 patients with acute HF (AHF); 22 patients with chronic HF (CHF) exacerbation] were included in the HF group. Of the 618 stable patients, 149 patients with a 30-days average CSB rate (CSB%) ≧1% were included in the non-HF control group. The chronologic change of CSB% were compared among the AHF, CHF and Control groups. Furthermore, of the 149 patients in the non-HF control group, 44 patients were matched for CSB%, body mass index, and sex in a ratio of 1:2 to 22 patients with CHF. The average cycle length (CL) of CSB was compared among three groups: CHF in stable period (CHF-stable group), CHF in exacerbation period (CHF-exacerbation group), and control group. In addition, according to the status of HF, receiver operating characteristic (ROC) curves were generated to determine the optimal cut-off points for variation of CSB% and CL.ResultsChronological change in CSB% among the three groups was significantly different. Standard deviation of CSB% (SD CSB%) before onset HF was significantly higher in both the AHF and CHF groups than in the control group. The CL of CSB was significantly longer in the CHF group than in the control group and was longer during the exacerbation period than during the stable period. The optimal cut-off value of CL that could differentiate patients with and without the onset of HF was 68.9 s.ConclusionThe HF group demonstrated greater CSB variations and longer CL than the non-HF control group. Furthermore, the CL was longer during the exacerbation period of HF even in the same patient. These results suggest that remote monitoring of CPAP device data for CSB variations and CL might allow early prediction of the onset and exacerbation of HF.

Serum total IgE may be a biomarker among chronic pulmonary aspergillosis patients with elevated serum total IgE levels: A cohort study with pathological evaluations.

High serum total IgE levels are common in chronic pulmonary aspergillosis. This novel study indicated that serum total IgE is a possible biomarker of the disease activity in the aforementioned condition. Immunofluorescence staining indicated a possible role of IgE in disease pathogenesis.

Colon Expression of Chemokines and Their Receptors Depending on the Stage of Colitis and Oat Beta-Glucan Dietary Intervention-Crohn's Disease Model Study.

Crohn’s disease (CD), a condition characterized by chronic inflammation of the gastrointestinal tract with alternating periods of exacerbation and remission, is becoming common around the world. This study aimed to analyze the molecular mechanisms underlying the anti-inflammatory properties of oat beta-glucans of varying molar masses by modulating the expression of chemokines and their receptors as well as other proteins related to both stages of TNBS (2,4,6-trinitrobenzosulfonic acid)-induced colitis, which is an animal model of CD. The experiment involved 96 Sprague–Dawley rats, which were divided into two main groups: control and TNBS-induced colitis. Both groups of rats were further divided into three dietary subgroups, which were fed with standard feed or feed supplemented with low- or high-molar-mass oat beta-glucans for 3 (reflecting acute inflammation) or 7 days (reflecting pre-remission). The gene expression of chemokines and their receptors in the colon wall was determined by RT-PCR, and the expression of selected proteins in the mucosa was determined by immunohistochemical analysis. The results showed that acute and pre-remission stages of colitis were characterized by the increased gene expression of seven chemokines and four chemokine receptors in the colon wall as well as disrupted protein expression of CXCL1, CCL5, CXCR2, CCR5, and OPN in the mucosa. The consumption of oat beta-glucans resulted in decreased expression of most of these genes and modulated the expression of all proteins, with a stronger effect observed with the use of high-molar-mass beta-glucan. To summarize, dietary oat beta-glucans, particularly those of high molar mass, can reduce colitis by modulating the expression of chemokines and their receptors and certain proteins associated with CD.

P455 Aminosalicylates in Ulcerative Colitis: old but gold?

Abstract Background The clinical course of ulcerative colitis (UC) is characterized by periods of exacerbation and remission. 5-aminosalicylic acid (5-ASA) remains the treatment of choice in patients with mild-to-moderate UC, due to its beneficial effect in preventing relapse. Treatment options (immunomodulators [IMM] and biological agents) have increased, so it is important recognizing patients at risk of medical therapy failure that can appropriately optimize treatment escalation for better control of the disease. Little is known about the long-term course of the disease among patients in remission with 5-ASA. Aims To assess long-term efficacy of 5-ASA (no IMM, biological therapy or colectomy) and to identify predictive factors of non-response. Methods An observational, retrospective, single-centre, case-control study was performed. All consecutive patients with UC followed in our Hospital from January 2000 until June 2020 initially treated with 5-ASA (±steroids) with a minimum follow-up of 1 year were screened for eligibility. Exclusion criteria were 5-ASA toxicity/intolerance or initial treatment with IMM/biologic agents.Time until step-up was recorded. Demographic, clinical, endoscopic, biochemical, and histological variables at the diagnosis were recorded and a Cox regression was performed to identify predictive factors for step-up strategy. Results 218 patients (mean age 41,4±14,6 years; 54,5% female; mean follow-up10,1±1,9 years) were analysed, 28% needed treatment with biologics or IMM, mainly due to steroid-dependence. Among “5-ASA responders”, 72% and 48% had sustained endoscopic and histological remission, respectively. The probability of step-up at 1 year, 5 years and 10 years was 10, 18 and 25%, respectively. “Step-up patients” had higher rates of hospitalization, disease extent progression, extraintestinal manifestations and colonic stenosis and/or pseudo-polyps (p<0,05). Montreal E3 (HR:2,31;95% CI: 1,12-4,68), steroids at first flare (HR:3,45;95% CI: 1,26-7,29), lower 5-ASA maintenance dose (HR: 1,97;95%;CI:1,12-3,29), lower haemoglobin level (HR:1,45;95% CI: 1,11-3,24) and DUBLIN Score≥4 (HR:1,81;95% CI: 1,269-4,59) were factors associated with the step-up strategy, in multivariate analysis. Conclusion 5-ASA is an effective maintenance therapy; a satisfactory response was achieved in 72% of the patients after a mean time of follow-up of 10 years. Extensive colitis, higher DUBLIN Score, lower doses of 5-ASA, need for steroid and anaemia can predict a worse prognosis at the initial diagnosis and are associated with higher therapeutic requirements. These findings may be used in our clinical practice to identify patients that might benefit from an early step-up approach and minimize the morbidity associated with uncontrolled disease.

Ефективність комбінованої терапії з використанням мелоксикаму (Локсидолу) і Кокарніту в лікуванні пацієнтів із хронічними захворюваннями опорно-рухового апарату в період загострення

Стаття присвячена питанням лікування хронічних захворювань опорно-рухового апарату в період загострення. Приділено увагу вибору препарату групи нестероїдних протизапальних засобів та препарату метаболічної дії. Наведені дані дослідження ефективності та безпеки комплексного призначення мелоксикаму (Локсидолу) та Кокарніту.

Modern approaches in treatment of helicobacteriosis in patients with peptic ulcer

Peptic ulcer is a chronic recurrent disease, accompanied by alternating periods of exacerbation and remission, its main feature is the formation of an ulcer in the wall of the stomach and (or) duodenum, penetrating – in this difference from superficial damage to the mucous membrane (erosions) – into the submucosal layer. The etiology is the appearance of Helicobacter pylori (H. pylori) falling into favorable conditions with weakened microfl and the presence of aggressive factors from the environment. In the pathogenesis of peptic ulcer disease, thinning of the gastrointestinal mucosa and violation of compensation mechanisms at the local level are of paramount importance. An important role in the diagnosis is given to a carefully collected anamnesis and complaints of the patient, supplemented by physical examinations, laboratory and instrumental examination methods. The treatment of patients is based on modern methods of treatment, where the latest drugs with proven effi and well-proven in clinical practice are used, consistent with the international recommendations of the Maastricht V / Florence Consensus, where anti-helicobacter therapy is mandatory for patients with peptic ulcer and chronic gastritis. Currently, treatment is still based on a combination of antimicrobial agents (amoxicillin, clarithromycin, metronidazole), and antisecretory agents (proton pump inhibitors). Standard triple therapy, which includes PPIs and two antibiotics (clarithromycin and amoxicillin/metronidazole) are widely used as a main-line regimen for the treatment of infection. In addition, the concomitant use of alternative medicine is important for the emergence of adaptive or synergistic effects against H. pylori infection.

Hereditary erythromelalgia in an adolescent. Clinical observation of a rare disease

BACKGROUND: Erythromelalgia is a severe, chronic, progressive disease with periods of exacerbation and remission. A triad of symptoms characterizes the disease: reddening of the extremities, a local increase in skin temperature, and pronounced neuropathic pain syndrome. There are sporadic works in the Russian literature that present data on erythromelalgia, particularly in children. The publications are descriptions of clinical observations with the assessment of the clinical picture of the patient regarding cutaneous manifestations and surgical care at the time of hospitalization, time spent in the hospital, and during the period of his chronic disease exacerbation.
 CLINICAL CASE: A clinical case of hereditary erythromelalgia in a 15-year-old adolescent with a detailed description of the disease course since the initial manifestation is presented.
 DISCUSSION: During three and a half years, despite early diagnosis and application of consistent pharmacotherapy including nonsteroidal anti-inflammatory drugs, antidepressants, anticonvulsants, antihistamines, opioids, hormonal therapy, local use of lidocaine, ointment with silver content, the disease was progressive, with the resistance of pain syndrome to the treatment, with periods of exacerbation and partial remission.
 CONCLUSIONS: The presented clinical observations show the need to assess the patient as a chronic and intractable patient. Considering the lack of understanding of the apparent cause of this disease and its diverse manifestations in the clinical picture, a multidisciplinary approach with a search for new treatment methods, including neurosurgical techniques of chronic pain treatment, is required for patients with erythromelalgia.

The relationship between anthropometric measurements and modified mallampati test in patients with chronic obstructive pulmonary disease

Context: The modified Mallampati test (MMT) is one of the most common examination methods to predict possible intubation problems. Aim: The present study aims to investigate the relationship between anthropometric measurements and the MMT in patients with chronic obstructive pulmonary disease (COPD) during the exacerbation period (COPD-E) and stable period (COPD-S). Materials and Methods: The present study included two groups of participants that consisted of 107 healthy individuals in the control group and 107 patients who were diagnosed with COPD (patient group). Two measurements were taken from the patients during the exacerbation and stable periods. The MMT, body mass index (BMI), face height, thyromental distance, and sternomental distance were measured and recorded. Statistical Analysis Used: Data collected were analyzed using the SPSS Statistics for Windows, version 22.0. Results: In the COPD-E period, the MMT score increased, whereas the face height value decreased (P = 0.030). During the COPD-S period, it was found that the higher BMI values were related to higher MMT scores (P = 0.025). The MMT score increased significantly during the COPD-S period, whereas the thyromental distance values decreased (P = 0.034). Conclusion: It is considered that the low face height value in the COPD-E period, the increase in the BMI, and the decrease in the thyromental distance in the COPD-S period could increase the difficult intubation possibility. The results of the present study which may lead to progression in the COPD database would contribute to the clinicians.

Stable and exacerbation period serum cytokine and periostin levels of the five distinct phenotypes of severe asthma.

The differences in molecular mechanisms during a stable period and the changes in the inflammatory responses during exacerbations between distinct severe asthma phenotypes remain unclear. In this study, we aimed to characterize stable and exacerbation period serum cytokine and periostin levels of 5 different predefined severe asthma phenotypes with real-life data. Changes in the viral infection-induced exacerbations were also analyzed. Serum levels of 8 cytokines and periostin were measured from the sera obtained from the adult patients with five different severe asthma phenotypes based on the presence/absence of aeroallergen sensitivity, peripheral eosinophilia and chronic rhinosinusitis with nasal polyposis (CRSwNP) during stable and exacerbation periods, and from the matched controls. Serum IL-13, IL-25, TSLP, and periostin levels were similar between the patient and the control groups during stable and exacerbation periods. Serum IL-25 and TSLP levels, and peripheral eosinophil count and periostin level showed a strong correlation. Stable period periostin levels were significantly higher in eosinophilic patients, and eosinophilic patients without long-term systemic steroid therapy had higher IL-13 levels. Compared to stable period, exacerbation period serum periostin levels found significantly lower [5853 (2309-8427) pg/mL vs. 4479 (2766-6495) pg/mL; p = 0.05] and periostin levels were much lower in viral infection-induced exacerbations [2913 (893-4770) pg/mL vs. 7094 (4782-9596) pg/mL; p = 0.022]. Our study showed that serum periostin levels were decreased in viral infection-induced exacerbations and increased in the presence of eosinophilia independent from atopy and it can help to differentiate eosinophilia even if the patient is under long-term systemic steroid therapy. Also, serum IL-13 levels may reflect peripheral eosinophilia in patients without long-term systemic steroid use.

Comparative effects of clozapine and risperidone monotherapy on levels of immunoglobulins in patients with schizophrenia – A 12 weeks' longitudinal study

Background: Schizophrenia is among the most puzzling yet disabling of all brain diseases. The finding of immunity-related genes seems to vindicate theories about the involvement of neuroimmunological processes in the pathogenesis of schizophrenia. Moreover, antipsychotics used in the treatment of schizophrenia have been shown to have effects on serum immunoglobulin levels. Aim: The aim of this study was to assess and compare the effect of risperidone and clozapine on the immunoglobulins at 6 weeks and 12 weeks in patients with schizophrenia and its clinical correlation. Materials and Methods: It was an open-label, randomized, comparative, and prospective study. Patients with International Classification of Diseases-11th Revision diagnosis of schizophrenia who were not on any antipsychotic drug for more than 2 weeks, were randomized to two groups, i.e., A (risperidone) and B (clozapine) after baseline assessment of sociodemographic and clinical parameters on the Positive and Negative Syndrome Scale (PANSS). Baseline blood investigations (complete hemogram, liver and renal function tests, lipid profile, and fasting blood sugar) and immunoglobulin estimation were done. Patients were followed at 6 weeks and 12 weeks and levels of immunoglobulin were reassessed at 6 weeks and 12 weeks along with PANSS and Glasgow Antipsychotic Side-Effect checklist. Results: A total of 32 patients were inducted into the study – 16 in the risperidone group and 16 in the clozapine group. There was no statistically significant difference in terms of the duration of illness or period of exacerbation between the two groups though the baseline total PANSS score was significantly higher in the clozapine group. In both the groups, there was no statistically significant difference in the baseline immunoglobulin levels at baseline and over 12 weeks in terms of the immunoglobulin G (IgG), IgM, and IgE levels. Within the clozapine group, a significant difference over 12 weeks was noted in IgG level. Conclusion: It can be concluded from the index study that the immunoglobulin levels in the patients with schizophrenia do not differ much concerning the effect of risperidone and clozapine. Clozapine is associated with a significant increase in IgG levels indicating the immunologic response of clozapine in schizophrenia.

The impact of inflammatory bowel diseases on the quality of life of Saudi pediatric patients: A cross-sectional study.

Inflammatory bowel disease (IBD) is a chronic gastrointestinal tract disorder characterized by periods of exacerbations and remissions that affect multiple aspects of a pediatric patient's quality of life. The purpose of this study is to describe the health-related quality of life of Saudi pediatric IBD patients and to determine the influencing factors which can affect it. This is a single center cross-sectional descriptive study, conducted between December 2019 and December 2021. Patients aged between 9 and 16 years diagnosed with IBD were included; IMPACT III quality of life questionnaire was used. Thirty-eight patients participated in the study, 57.9 % being male, with a mean age of 12.48 ± 2.72 years, and 55.3 % of patients were diagnosed with Crohn's disease (CD). The most frequent medications were aminosalicylic acids derivatives, followed by immune-modulators and biologics. The IMPACT III quality of life questionnaire has shown lower scores in IBD patients in comparison to healthy control groups. Patients with active disease have lower total and sub-domain scores than patients with inactive disease. We found no correlation between health-related quality of life (HrQOL) and the number of medications used, disease duration, or gender. Pediatric IBD patients have significantly lower HrQOL scores than healthy children. Disease activity was found to be a predictor for poor HrQOL outcome.

Хронічна бронхообструкція та ендотеліальна дисфункція: деякі імунологічні аспекти взаємозв’язку

Abstract. According to modern data, systemic inflammatory process with vascular endothelial dysfunction (ED) is the base of chronic obstructive pulmonary disease (COPD) pathogenesis whith chronic bronchial obstruction and the formation of comorbidity. Immunological investigations of relationship with severity of ED and risk of fatal cardiovascular events remain actual at COPD, although many studies of their dependence on the severity of COPD have been conducted. The aim of the study is to evaluate the special features of cellular immunity in patients with COPD in relation to the severity of clinical manifestations of the disease (assessed by the COPD Assessment Test –CAT), and the presence of ED. Methods. 141 patients with COPD stage II-III were examined, at the age of 43-72 years, beyond the period of exacerbation and 24 practically healthy persons as a control group for laboratory indices. Cellular immunity was studied by indirect immunofluorescence reaction using monoclonal antibodies. Dependence of cellular immunity on the value of CAT, the level of the ED laboratory marker — endothelin-1 — and the expressiveness of cardiovascular risk (CVR) were analyzed. Results. At the examined patients immune dysfunction was manifested by suppression of T-lymphocytes, disturbances in their subpopulations ratio, increased readiness of lymphocytes to apoptosis and expression of CD54+, which characterizes the adhesive properties of cells. It was also proposed to calculate the adhesion index (CD54+/CD3+), which links the elevation of the lymphocytes adhesive properties with the development of immune dysfunction. It was shown that the severity of the cellular immune system dysfunction is primarily associated with the intensity of clinical manifestations of COPD, assessed by CAT. At the same time, significantly higher endothelin-1 level in COPD patients served as an objective confirmation of ED presence. It was found that the elevation of endothelin-1 level in serum and the increasing in CVR are accompanied by an increased predisposition of lymphocytes’ apoptosis. These changes contribute to increased immune dysfunction and elevation of lymphocytes’ adhesive properties, assessed by the expression of CD54+ and indirectly confirm the participation of cellular immune mechanisms in the development of ED. Conclusions. Patients with COPD demonstrate increased expression of CD54+ on lymphocytes and elevation of the adhesion index CD54+/ CD3+. It characterizes the activation of lymphocytes adhesive properties and their increased readiness for Fas-dependent apoptosis and related immune dysfunction. These results confirm the participation of cellular immune mechanisms in the development of endothelial dysfunction. Key words: chronic bronchial obstruction, cellular immunity, endothelial dysfunction.

Atrial electromechanical delay, neutrophil-to-lymphocyte ratio, and echocardiographic changes in patients with acute and stable chronic obstructive pulmonary disease.

Atrial electromechanical delay (AEMD) is the time interval between the beginning of P wave on surface electrocardiography and starting of the late diastolic wave on tissue Doppler imaging. We investigated the prolongation of AEMD, echocardiographic changes, and correlation of these findings with neutrophil-to-lymphocyte ratio (NLR) in patients with chronic obstructive pulmonary disease (COPD). The study consisted of 105 (49 females and 56 males; mean age: 65.1 ± 9) patients with COPD exacerbation and 104 (21 females and 83 males; mean age: 64.8 ± 9.6) stable COPD outpatients. Demographics, body mass index, pulmonary function tests, and transthoracic echocardiography of the patients were evaluated. Echocardiography was performed in the first 6 h for stable COPD outpatients and in the first 24 h for COPD exacerbation patients. Diameters of right ventricle (RV), left ventricle (LV) and left atrium, aortic root diameters, left ventricular ejection fraction (LVEF), Emax, Amax, Emax/Amax, tricuspid annular plane systolic excursion (TAPSE), Ea, Aa, Ea/Aa, Emax/Ea, and tricuspid regurgitation velocity (TRV) were evaluated. AEMD measurements were obtained from lateral/tricuspid, lateral/mitral, and septal annulus from apical four-chamber views with tissue Doppler imaging and corrected for heart rate. Complete blood count including NLR was also assessed. The mean age of patients in exacerbation period (65.1 ± 9) was higher than the stable group (64.8 ± 9.6). RV basal and mid diameters (P < 0.001), Amax (P < 0.001), Ea tricuspid (P = 0.040), Aa tricuspid (P < 0.001), TRV, and systolic pulmonary artery pressure (P < 0.001) were higher; TAPSE and tricuspid Emax/Amax (P < 0.001) were significantly lower in patients with COPD exacerbation. LV end-diastolic diameter (P = 0.002) and LVEF (P = 0.005), Emax/Amax mitral (P < 0.001), Ea/Aa mitral (P < 0.001), and Ea/Aa septal (P < 0.001) were significantly lower; Amax mitral (P = 0.002), Aa mitral (P < 0.001), Aa septal (P < 0.001), and systolic motion mitral (P = 0.011) were significantly higher in patients with exacerbation. AEMD lateral/tricuspid (P < 0.001), lateral/mitral (P < 0.001), and septal (P < 0.001) were significantly higher in patients with COPD exacerbation. Neutrophil and lymphocyte count (P < 0.001) and NLR (P = 0.003) were significantly higher in the acute group. A weak correlation of NLR with LV end-diastolic diameter (P = 0.003; r = 0.357), Emax/Ea mitral (P = 0.019; r = 0.285), Emax tricuspid (P = 0.045; r = -0.244), and systolic motion septal (P = 0.003; r = 0.352) was detected in patients with stable COPD. In COPD exacerbation patients, prolongation of AEMD intervals was determined. Acute period of COPD may trigger atrial dysrhythmias including atrial fibrillation and flutter, multifocal atrial tachycardia, premature beats, and both systolic and diastolic dysfunctions frequently.

Chronic Recurrent Multifocal Osteomyelitis (CRMO): An Unusual Presentation of Limb Pain

Chronic recurrent multifocal osteomyelitis (CRMO), known as nonbacterial osteomyelitis, is an autoinflammatory disease with periodic exacerbations, also known as nonbacterial osteomyelitis. It is a rare, noninfectious inflammatory disorder characterized by multifocal bony lesions with pain. Conventional X-ray and CT imaging show multiple osteolytic and sclerotic lesions in the affected limbs. It is a great challenge for pediatricians to diagnose this disease for its rarity. Early diagnosis, regular follow-up and appropriate treatments are mandatory to reduce morbidity and prevent these disease complications. We report here two cases of CRMO who presented with pain, swelling and redness of multiple sites of lower limbs from the Department of Paediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU). Clinical features, laboratory findings, and characteristic radiological findings were strongly suggestive of CRMO.

Качество диспансерного наблюдения детей с атопическим дерматитом с периода манифестации заболевания до возраста 13–17 лет

The purpose — to analyze the quality of dispensary observation of children with atopic dermatitis from the period of the disease manifestation to the age of 13–17 years. Material and methods. 350 children aged 13–17 with atopic dermatitis were examined (observation group). Information for studying the disease history was obtained from the analysis of medical documentation (form No. 025/y-04 «Medical record of an outpatient patient» and form 003/y «Medical record of an in-hospital patient»), as well as by interviewing and questioning patients and their parents. The comparison group consisted of 350 children aged 13–17, health groups I and II, without allergic diseases. Results. Atopic dermatitis in most children manifested in the first year of life. The leading reasons for early manifestation were the transfer to artificial feeding, the introduction of complementary foods. A retrospective analysis of the dispensary observation of children with atopic dermatitis showed that more than half of the children were regularly observed for the disease, followed the recommended diet, and received basic therapy in the first 2 years from the diagnosis. Subsequently, indicators of observation by doctors according to the pathology profile, adherence to a hypoallergenic diet, and compliance with treatment recommendations decreased and were carried out only during the period of AD exacerbation. In children with a mild course of the disease, the rates of compliance with recommendations for therapeutic nutrition, treatment in the first 2 years from the disease manifestation were higher compared to patients with moderate and severe course. The level of sanatorium-and-spa treatment during the period of dispensary observation was low. Conclusion. The conducted analysis testifies that regular observation by doctors according to the disease profile, implementation of recommendations on a hypoallergenic diet, basic therapy in children with atopic dermatitis influence the level of severity of the disease by the age of 13–17 years old. In order to increase the effectiveness of dispensary observation, it is advisable to conduct classes for parents on the disease, the role of following the recommendations for observation by doctors, diet and treatment in preventing the formation of severe forms of the disease.

Окисна модифікація протеїнів плазми крові хворих на вульгарний псоріаз

The aim is to study the state of indicators of oxidative modification of proteins in the blood plasma of patients with psoriasis vulgaris. Materials and Methods. 18 patients with psoriasis vulgaris (average age – 44.4 years) and a group of healthy donors – 22 persons, who made up the control group – were examined. Oxidative modification of proteins was determined in blood plasma by reaction with 2,4-dinitrophenylhydrazine. Results In patients with psoriasis vulgaris, significant violations of the processes of oxidative modification of blood plasma proteins (spontaneous and metal-catalyzed) were detected. Conclusions. In patients with psoriasis vulgaris, the period of exacerbation of the disease, is accompanied by carbonyl stress, which is confirmed by a significant increase in the blood content of aldehyde and ketone phenylhydrazones.

Yoga Intervention for Patients with Systemic Lupus ErythematosusA Research Protocol

Introduction: Systemic Lupus Erythematosus (SLE) is one of the most common systemic autoimmune disease with a wide range of clinical manifestations. SLE patients experience periods of exacerbation or flare and quiescent disease activity. An increase in the frequency of exacerbations or flares causes permanent organ damage, increased morbidity, and early mortality, which are mainly due to the increased activity of immune-mediated inflammatory reactions. Yoga interventions have an immunemodulatory potential that regulates the psycho-neuro-immune axis, moderates disease activity, and improves the Quality Of Life (QOL) for patients. Aim: To report the methodology for the six months specified yoga interventions to reduce the inflammatory markers and enhance health-related QOL among SLE patients. Materials and Methods: A randomised controlled trial will be conducted with a sample size of 128 SLE participants. Newly diagnosed and treatment-resistant SLE participants, patients more than 18 years of age, will be recruited. Participants divided into three groups: newly diagnosed, treatment-resistant SLE, and control; patients diagnosed with SLE within six months, unresponsive to "standard therapy" will be placed in the respective group. Participants in the newly diagnosed and treatment-resistant groups are given yoga sessions, and the effects will be compared with controls. Results: A baseline and postintervention (after six months) assessment will be performed for all the patients. Primary outcomes like anti-double stranded Deoxyribonucleic Acid (anti-dsDNA), complements-C3, C4, and inflammatory markers like Interleukin 6 (IL-6), 10, 17, Interferon-gamma, and plasma micro-RNA will be measured and quantified. The secondary outcome included measurement of health-related QOL using the Lupus-QoL questionnaire. Conclusion: Yoga integration, along with conventional treatment for SLE, as adjunctive therapy might enhance physical functioning and improve psychological health.

Circulating fibrocyte level in children with cystic fibrosis.

This study aimed to evaluate circulating fibrocyte levels in cystic fibrosis (CF) patients during stable and exacerbation periods of the condition. The study group consisted of 39 patients diagnosed with CF and 20 healthy controls. Individuals included in the study were divided into three groups: CF, CF exacerbated, and a healthy control group. Their circulating fibrocyte levels were compared. Findings from a pulmonary function test and high-resolution computed tomography of the lung were evaluated and compared. The circulating fibrocyte count was found to be significantly higher in patients with CF compared with the exacerbated and control groups. No correlation was found between the forced expiratory volume in 1 s and forced vital capacity values in the pulmonary function test and the circulating fibrocyte count. The circulating fibrocyte count in patients (in the CF group) with positive findings in the high-resolution computed tomography was statistically significantly lower. The circulating fibrocyte level in the peripheral blood of the patients with CF was increased.

Clinical, immunomodulating and anti-recidive effects of ozone therapy in persistent allergic rhinitis in children

Research оbjective.To determine the effect of ozone therapy on clinical indicators and the state of immunity in children with moderate persistent allergic rhinitis. Material and methods. The study included children aged 5-10 years with moderate persis-tent allergic rhinitis, which were divided into two groups depending on the therapy. The first group of patients with allergic rhinitis received complex conventional therapy, the second group of patients with allergic rhinitis received complex treatment in combination with ozone therapy. Clinical parameters were studied in patients with allergic rhinitis, parameters of im-munological reactivity were investigated during periods of exacerbation of the disease and clinical remission. Results. It was found that the inclusion of ozone therapy in the complex treatment of patients of the second group ensured a faster onset of complete clinical remission (3.7 days earlier than in the first group of patients) and normalization of most immunity parameters, and also increased the expression of toll-like receptors on leukocyte cells. The duration of complete clinical remission in the group of patients with allergic rhinitis who received complex treatment in combination with ozone therapy (9.3 + 2 months) more than doubled (2.4 times) its duration in the group of patients with allergic rhinitis who received complex conventional therapy (3.9 + 0.3 months).