Pathology Of Other Organs Research Articles

Neuropathology of deaths due to acute alcohol toxicity in Australia, 2011–2022

BackgroundA major alcohol-related harm is structural pathology affecting the brain. The study aimed to: 1. Determine the frequency and nature of neuropathology amongst cases of death due to acute alcohol toxicity; 2. Compare diagnoses of brain atrophy with pathology in other organs; 3. Determine the demographic, clinical and organ pathology correlates of brain atrophy. Methods:Retrospective study of 500 cases of death attributed to acute alcohol toxicity in Australia, 2011–2022. Data on clinical characteristics, toxicology, neuropathology and other organ pathology were retrieved from police reports, autopsies, toxicology and coronial findings. ResultsMean age was 49.5 years, 69.4 % were male, with alcohol use problems documented in 70.2 %. Brain atrophy was diagnosed in 60 cases (12.0 %), most commonly in the cerebellum (32 cases, 6.4 %). Atrophy at other sites was present in 37 (7.4 %). The presence of brain atrophy was lower than other major pathologies: cardiomegaly (32.6 %, p<.001), nephro/arteriosclerosis (30.2 %, p<.001), and chronic obstructive pulmonary disease (21.8 %, p<.001) but not hepatic cirrhosis (11.9 % p=1.0). Those diagnosed with atrophy were older (53.4v 49.0 years, p<.001), more likely to have documented alcohol problems (85.0v 68.2 %, Odds ratio: OR 2.53) and seizure history (10.0v 3.0 %, OR 2.92), to have cardiomegaly (43.3v 31.0 %, OR 1.90, COPD (48.3v 18.2 %, 3.57) and nephro/arteriosclerosis (50.0 v 27.4 %, OR 2.27). Conclusions:Despite the majority of cases having a history of alcohol problems, the level of neuropathology amongst cases of death due to acute alcohol toxicity was comparatively low.

The Scope of Mendelian Cardiomyopaties Genes

The review is devoted to the analysis of the scope of the genes of Mendelian cardiomyopathies (CM), specifically hypertrophic, dilatational, arrhythmogenic, and restrictive cardiomyopathy. According to Simple ClinVar, pathogenic/probably pathogenic variants of 75 genes lead to the development of one or more types of CM. At the same time, these genes are characterized by their expression in various tissues and organs (not only in the heart and blood vessels, but also in various parts of the brain, gastrointestinal tract, etc.), as well as by their involvement in a variety of metabolic pathways and biological processes. These data are generally consistent with the results of genome-wide association studies (GWAS). Polymorphisms of the CM genes are associated with various types of CM and other cardiovascular diseases, as well as obesity, various diseases of the musculoskeletal and nervous systems, mental, oncological, infectious diseases, and others. In addition to pathological conditions, common variants of the CM genes contributed to the variability of a wide range of quantitative traits, including pathogenetically significant for various multifactorial diseases. The non-randomness of the identified associations of CM genes with a wide range of diseases is evidenced by: comorbidity of CM with GWAS-associated diseases or the involvement of the latter as a symptom, a risk factor for the development of myocardial pathology, a modifier of the clinical presentation; overlapping of the affected organ systems and the spectrum of pathologies associated with common variants (according to GWAS) and to which rare pathogenic variants (according to OMIM) of the CM genes lead; confirmation of the involvement of CM genes in the pathogenesis of pathologies of other organ systems at the molecular level. Thus, the data presented in the review indicate the wide scope of the genes of primary CM, which goes beyond the cardiovascular system. That indicates the relevance of conducting comprehensive studies aimed at determining the cause-and-effect relationships between the CM and pathologies of other organs, including with the involvement of molecular genetic data.

Myocardial infarction in a young woman without cardiovascular risk factors: a case report

Myocardial infarction usually occurs in people over 50 years of age, but younger patients can also be affected. The article presents a case of a young patient, 34 years old, who was admitted to the cardiology department with a diagnosis of lowrisk non-ST segment elevation acute coronary syndrome. The patient complained of anginal pain that occurred for the first time. However, she did not have typical risk factors for cardiovascular diseases. Coronary angiography showed a critical stenosis of 99% in the proximal third of the 2nd segment of the right coronary artery. A case clearly demonstrates the importance of a thorough examination of young patients with complaints of chest pain, which is often mistakenly interpreted as a pathology of other organs and systems other than the cardiovascular one. No risk factors in a patient does not guarantee low risk of myocardial infarction, and a detailed examination of the patient will help to avoid underdiagnosis of acute coronary syndrome.

Distribution of micro-sized range solid particles in the human airways: field experiment

Introduction. Ambient air pollution is a widespread and pressing issue. This necessitates the development of methods for estimating and predicting progression of pathologies on the base of evolutionary mathematical models. Adaptation of the theoretical model to practice requires identification and verification procedures in real conditions of contamination of inhaled air with dust particles of various compositions.&#x0D; The purpose of the work was to investigate regularities of distribution of dust particles with a different disperse, component and morphological structure in the human airways after inhalation from ambient air. The study involved performing a field experiment.&#x0D; Materials and methods. We accomplished several investigations in 3 zones with different levels and structures of ambient air pollution. Disperse, component, and morphological structures of particles occurring in ambient (inhaled), deposited in various sections of the human airways, in exhaled air and blood were examined by electronic microscopy.&#x0D; Results. Air quality in zones 1 and 2 did not comply with hygienic standards for suspended particles, PM10, PM2.5, metal compounds, etc. (up to 3.29 MPCm.s., 3.2 MPCav.s., 2.91 MPCav.y.) and formed increased hazard quotient for manganese, copper, nickel and their compounds, inorganic fluorides, suspended particles (up to 5.48 HQac, 3.42 HQch), respiratory and other hazard indices (up to 5.48 HIac, 8.59 HIch). The degree of sedimentation of small particles (PM2.5 or less) in different parts of the respiratory tract is uneven, they are able to penetrate into the lower airways and lungs of humans. More than 65% of all the particles deposited in the upper airways had a diameter bigger than 10 µm. PM2.5 accounted for more than 60 % in sputum in the lower airways and the share of PM1.5 reached 46.7 %. Particles smaller than 1.5 μm (90.5%) were predominantly recorded in blood biosubstrates, of which up to 88.1% of the particles had a sphericity of 0.9–1.0.&#x0D; Limitations. Limited degree of precision of location of the examined sections in the respiratory system.&#x0D; Conclusion. Common deposition regularities are mostly determined by sizes and morphology of dust particles. The component structure of inhaled air has practically no effects on regularities of particle deposition in various sections of the respiratory system; however, it can have substantial influence on types of pathologies progressing in the body. High shares of PM1.5 identified in inhaled air, the lower airways and blood require considering levels of PM1.5 and smaller particles in ambient air in settlements to be covered by hygienic standards. In future, the study results will be used in numeric modelling of accumulation of functional respiratory disorders and associated pathologies of other organs and systems and in predicting development of pathologies based on evolution mathematical models.

Коморбидность синдрома повышенной эпителиальной проницаемости

Syndrome of increased epithelial permeability is one of the most studied pathogenic syndromes in the 21st century. In the English literature, the term “the leaky gut syndrome” is widely used to refer to Syndrome of increased epithelial permeability. The participation of Syndrome of increased epithelial permeability in the development of diseases and pathological conditions of the gastrointestinal tract, as well as the pathology of other organs and systems, is widely discussed. In early 2021, the first multidisciplinary national consensus “Syndrome of increased epithelial permeability in clinical practice” was published, and in 2022, practical recommendations for physicians were published on one of the topical aspects of Syndrome of increased epithelial permeability – epithelial protective therapy. Of the epithelial protectors used in gastroenterology, only rebamipide has a universal positive effect on the barrier function of the gastrointestinal tract throughout its entire length and at three structural levels (preepithelial, epithelial, and subepithelial). As part of the review, experimental and clinical studies, systematic reviews on Syndrome of increased epithelial permeability and the use of rebamipide, published in domestic and foreign literature in 2022, were considered. Separately, the issues of the use of rebamipide in diseases of the cardiovascular system, its protective effect and the ability to level possible problems associated with drug therapy in terms of increasing its safety in the practice of internists (cardiologist and therapist) and surgeons (cardiac surgeon and vascular surgeon) are considered. The data presented in the review demonstrate the comorbidity of the Syndrome of increased epithelial permeability, which takes a certain part in the development of diseases not only of the digestive system, but also of non-gastroenterological diseases, in particular, the pathology of the cardiovascular system, which suggests the formation of new therapeutic strategies, the use of which will improve the clinical prognosis.

Патогенетические и клинико-функциональные параллели формирования когнитивных расстройств при хронических риносинуситах

Introduction. In the context of optimizing the treatment of chronic rhinosinusitis, it is important to study the pathogenetic mechanisms of the development of inflammation in the paranasal sinuses and its influence on the development or maintenance of comorbid pathology of other organs and the body as a whole. Objective. To search and systematically analyze publications on the manifestations of comorbid pathology and pathogenetic relationship with the symptoms of chronic rhinosinusitis. Materials and methods. A literature search has been carried out over the past five years in the Russian Federation and in the world using the databases Medline, PubMed, Scopus, CyberLeninka; the electronic catalog of publishing houses Elsevier, Springer Medicine, Biomed Central, Media Sphera and scientific electronic library elibrary.ru were used. An interdisciplinary approach in the analysis of literature data was based on a single symptom complex of manifestations of chronic rhinosinusitis, combined with manifestations of diseases of organs and body systems that have similar pathogenetic and functional mechanisms. Results. The results of the analysis of the presented scientific studies are systematized in accordance with the identified commonality of pathogenetic, microbiological, immunological, and clinical characteristics of chronic rhinosinusitis. A comprehensive assessment of scientific research data on the interrelated processes of the impact of nasal obstruction on cognitive impairment and lifestyle confirmed the regulatory role of the limbic and autonomic nervous systems in understanding the commonality of pathogenetic mechanisms that occur in the identified nosology. Conclusions. A systematic analysis of publications showed the presence of the impact of comorbid manifestations of nasal obstruction in chronic rhinosinusitis on the central parts of the brain with the formation of latent neuroinflammation manifested by cognitive disorders.

GENERAL CHARACTERISTICS OF PATIENTS WITH COPD DEPENDING ON THE PRESENCE OF METABOLIC SYNDROME IN THEM

Chronic obstructive pulmonary disease (COPD) is a disease that is widespread throughout the world. As a nosological unit, COPD took shape only a few decades ago, and currently causes 2.9 million deaths per year (1). According to the World Health Organization, COPD is considered one of the leading causes of death among noncommunicable diseases (2). Occurring in a group of people older than 40 years, COPD is often combined with the pathology of other organs and systems (4). According to the definition of COPD, which is included in the main COPD management document - the Global Initiative for Chronic Obstructive Lung Disease (GOLD), 2014, the huge role of comorbidities in increasing the severity of COPD is emphasized , impact on quality of life (QoL), prognosis and survival. Among the numerous comorbidities considered are cardiovascular diseases, metabolic syndrome (MS) and diabetes mellitus (DM) (3,5). In the available literature, there are practically no clinical studies performed using a systematic approach to assessing the effect of MS components on clinical and instrumental characteristics and quality of life in COPD patients.

Pathophysiology of hepatic insufficiency

The liver is a unique and complex functioning organ, which is central in the metabolism of proteins, carbohydrates, fats and plays an important role in digestion, hematopoiesis, hemocoagulation, and detoxification processes. The pathology of the liver is complex and diverse, often accompanied by the pathology of other organs. Liver diseases are often encountered by doctors of various specialties, and for the clinician, knowledge of this pathology of this organ is essential. Currently, there is a steady increase in the number of patients with liver diseases, mostly people of working age. The development of acute and chronic liver pathology in the vast majority of cases is accompanied by the occurrence of various complications, up to the appearance of liver failure. The lecture contains up-to-date information about the etiology and pathogenesis of hepatic pathology. Pathological processes in the liver are considered taking into account the complexity of its structural and functional organization. The main symptoms and syndromes of liver pathology are described, their pathophysiological assessment is given. Modern classifications of jaundice, hepatitis, liver failurea regiven.

#43 Fungal colonization by Pneumocystis is highly frequent in the human placenta at birth.

Abstract Background Pneumocystis is well-known as a pathogen of the severily immunocompromised host. However, this fungus is also, a frequent colonizer of immunocompetent hosts inducing subclinical characteristic histologic features of Th2-type lung inflammation, and is associated to asthma. The pathology that Pneumocystis induces in the lung of non-severily immunocompromised hosts warrants exploring whether it colonizes and induces pathology in other organs. Physiologically immunosupressed pregnant women display increased nasal carriage of Pneumocystis and, of interest, Pneumocystis pneumonia were reported in neonates or still-born infants before the AIDS epidemic, and Pneumocystis-DNA has recently been identified in formalin fixed fetal organs. In addition, transplacental transmission has been documented in rabbit does that have an hemo-monochorial placenta similar to humans. Moreover, fungal species are a frequent cause of chorioamnionitis and fetal death in farm cattle. Motivated by these observations, we undertook a search for Pneumocystis in the placenta of full term pregnancies in Santiago, Chile. Method 106 prospective volunteer mothers were approached during early labor at the San Jose Maternity Hospital in Santiago. After signed informed consent, the placenta of 91 full-term deliveries (37-42 weeks) was collected in a sterile bag and transported at 4°C to the research laboratory for immediate surgical removal of 0.5 cm of surface of each cotyledon at the maternal side in a laminar flow hood before sampling. The exposed cotyledons were then dissected to obtain approx 2 g (1.02-2.2 g) tissue from each cotyledon and samples from 3-4 cotyledons were pooled in two samples of approx. 7 (5.34-8.06) grams per each placenta. A 2 gram aliquot from each sample was homogeneized and DNA was extracted using QIAmp DNA extraction kit (QIAGEN) with an additional bead beating step. Pneumocystis was diagnosed by nested-PCR amplifying the mtLSUrRNA and the beta-tubulin loci of P. jirovecii. Pneumocystis was additionally examined by microscopy immunofluorescence in a subset of DNA-positive samples using immunofluorescence kit (Meridian). Results Pneumocystis jirovecii-DNA was detected by amplification of the two loci in 35 (38.5%) of 91 placentas; In 25 after analysis of the first sample tissue pool, and the other 10 after analysis of the second pooled sample. Characteristic Pneumocystis cyst forms were documented by IF microscopy in 4 P. jirovecii DNA positive samples. Conclusion Pneumocystis colonization of the placenta at full term is highly frequent and can be detected by DNA amplification and, more laboriously, by immunofluorescence microscopy. Placental colonization is focal, similar to what occurs in the lung during primary infection. Data suggests transplacental as a route of transmission of Pneumocystis in addition to the aerial route in humans. It also warrants exploring placental inflammation associated to Pneumocystis as documented in the colonized lung. Further studies are needed to determine the significance of placental colonization by Pneumocystis in the placental unit.

Mapping the spatial biology of COVID-19 immunopathology in placenta tissues

Abstract The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that emerged in late 2019 has spread globally, causing a pandemic of respiratory illness. The virus primarily affects the lungs, where it induces respiratory distress syndrome ranging from mild to acute. However, a growing body of evidence shows COVID-19 pathology in other organs that also carry the ACE-2 receptor, including the placenta. Most newborns delivered from COVID-19 positive mothers test negative following delivery, suggesting that there are protective mechanisms within the placenta. In this study, we compared a unique collection of placental tissue samples from COVID-19 positive and gestational age-matched non-COVID-19 samples. Using AKOYA’s ultrahigh-plex Phenocycler assay, we mapped dozens of protein biomarkers in situ with single-cell and subcellular spatial resolution to produce unbiased and comprehensive spatial biomarker maps of potential placental pathobiology associated with COVID-19 infections. Our antibody panel was aimed at in-depth identification of immune cell lineages, activation states, immune checkpoints, and tissue structures; infected cells were identified via the deployment of two antibodies directed at COVID-19 spike and capsid proteins, as well as an antibody directed against the ACE-2 receptor. All imaging data were obtained at single-cell resolution across whole tissue samples, and cellular phenotypes were subsequently identified via unsupervised clustering methods. These data are the first of their kind and will provide additional insight into the pathobiology of COVID-19.

Результати хірургічної корекції або консервативного ведення кіст селезінки в дітей за даними віддалених моніторингових змін

Treatment of splenic cysts (SC) in children is variable and controversial. Depending on the size and location of these formations in the spleen, surgical correction is possible in open or laparoscopic surgery, or conservative (non-invasive) management. The result of SC treatment should be the complete elimination of the cyst cavity. Purpose - to evaluate the results of surgical correction or conservative management of CS in children according to remote monitoring changes. Materials and methods. We conducted the study on 265 children aged 0-17 years (mean age 11.25±4.21 years), who were examined and treated for SC. One hundred seventy-five (66.04±2.91%) children underwent surgery, and 90 (33.96±2.91%) patients received conservative treatment. We subjected all the information recorded in the medical records to statistical processing. The mentioned information could characterize the situation with the treatment process and with dynamic monitoring of this pathology to some extent. Results. The most common localizations of cysts were the upper (33.21±2.89%) or middle segments of the spleen (29.81±2.81%). Almost every fourth patient (27.92±2.76%) with SC had pathology of other organs or systems, and every tenth (9.81±1.83%) had other diseases of the spleen. We detected residual cyst in 46.42±3.06% of patients; it underwent complete regression within 1-3 years. Residual cyst of small size (which persisted after surgical correction) regressed much faster after surgery compared with regression of cystic formation of small size in the spleen with conservative management (p&lt;0.05). Conclusions. Therapeutic tactics for SC in children involve different options for individual surgical correction or conservative management, depending on the location, size, relationship to the architecture of the main vessels and the variant of damage to the parenchyma of the spleen. The outcome of treatment of children with SC depends on the volume, location, etiology of the lesion, the method of correction and compliance with all recommendations in the postoperative period against the background of comorbidities. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors. Key words: splenic cyst, children, surgical treatment, conservative management, results.

A 31-year-old female patient with chronic kidney disease presenting with persistent cough

Can you diagnose this 31-year-old woman with end-stage renal disease and a persistent cough? https://bit.ly/3s7n5VU.

Del22q11.2 Syndrome in the pediatric practice

SummaryDel 22q11.2 syndrome is one of the most frequent ge-netic syndromes with clinical manifestations of immune deficiency, congenital heart defect, including aplasia or hypoplasia of thymus, and pathology of other organs. Disseminating knowledge about this syndrome among practicing pediatricians will allow not only to timely dia gnose, but also to increase the life span of patients thanks to adequate management. In most cases, 22q11.2 deletion is detected during the study, of those 93% are sporadic cases, and only 7% inherited from parents, the incidence being from 1:3,000 to 1:6,000 of newborns, and 1:1,000-2,000 for some types of populations. More than 190 clinical variants of Di George syndrome symptoms have been described in all. Usually, DiGeorge syndrome is a combination of three most frequently observed forms: congenital heart defect, aplasia or hypoplasia of thymus, hypocalcaemia due to hypoplasia of parathyroid gland. The objective of therapy is to correct life-threatening conditions and improve quality of life by correcting mor-phological defects, infectious complications treatment and immunity defects compensation. Two clinical cases are presented in the article. First case: 3 year old, linked to care due to retardation of speech development, brain cyst, relapsing bronchial obstruction, choking when con-suming solid food, one-time precedent of febrile seizure and hypocalcaemia, which was diagnosed by accident but turned out to be a key to diagnosis. Second case: 9 year old, tetralogy of Fallot surgery at 3 months. Observed due to relapsing bronchial obstruction and frequent but mild respiratory infections. No hypocalcaemia, no seizures. Hy-poplasia of thymus was diagnosed but focused upon only at age of 9 years

Idiopathic omentum infarction in children — the law of "paired cases": cases report

BACKGROUND: One of the rare causes of abdominal pain in children is an omental infarction. In the literature, there are few descriptions of this pathology in childhood. The disease is often diagnosed only intraoperatively because of its nonspecific clinical picture. Therefore, the clinical cases presented in the article may be of interest to pediatric surgeons.&#x0D; CASES REPORT: In the pediatric surgical department of our clinic, two patients aged five and six years old were treated after being admitted with abdominal pain syndrome, the clinical picture of which did not allow to exclude an acute surgical pathology. A laparoscopy was performed to clarify the diagnosis. Isolated lesions of the segments of the greater omentum were revealed without signs of torsion and pathology of other organs. The operations were completed by resection of the altered omental sections. Histopathological examination revealed hemorrhages and tissue necrosis.&#x0D; DISCUSSION: The localization of pain in the right abdomen necessitates differentiating the disease from acute appendicitis, cholecystitis, and acute gynecological pathology. In the treatment of patients with omental infarction, there are supporters of conservative and surgical strategies. We performed a resection of the affected omental segment, which enabled us to achieve complete recovery in both cases.&#x0D; CONCLUSION: Laparoscopy in unclear diagnostic situations permits the timely diagnosis of an omental infarction, and surgical minimally invasive intervention leads to a successful cure.

Organization of Cardiosurgical Care for Children with Congenital Heart Diseases in Children Under One Year with Determination of Risk Factors of Surgical Treatment

Background: Congenital heart defects are represented by numerous nosological forms. Today is known to be more than 90 variants of congenital heart defects (СHD) and their combinations. In the structure of the CHD 1st place occupies the defect of the interstitial septum, which according to various authors is 30-50% of all congenital defects of the heart, 2nd place - open arterial duct (10%), defect of the interstitial artery, interstitial defect, tetrad Fallo, transposition of main vessels, atrioventricular communication do not exceed 5-7% of each defect. The share of the remaining congenital malformations of the heart is less than 1-2%. Aim: To study the factors of the condition and organization of cardiac surgery to children with congenital heart defects Center for Perinatology and Pediatric Cardiac Surgery. Methods: From November 20, 2011 to December 29, 2018, the Center for Perinatology and Pediatric Cardiac Surgery treated 1,098 children aged 1 year, 175 of whom were newborns (15.9%). Of the last 27 were restricted to conservative treatment. Eight (29.6%) of these patients died from hypoxia and / or cardiac insufficiency, which were incompatible with life, as well as from congenital pathology of other organs and systems. In the remaining 148 (81.7%) cases, various surgical interventions were performed. Results: The comparison of the risk group shows that there was no difference between them in the structure of the main critical CHD. He drew attention to the fact that the increase in the number of risk factors (RF) was associated with an increase in the number of obstructive lesions of the left ventricle and aortic arch. The difference between the groups RF (0) -RF (3), RF (0) -RF (4), RF (2) -RF (3) and RF (2) -RF (4) according to the number of these patients was reliable (r) <0.05). Thus, this pathology was the most dangerous in relation to the accompanying problem. As the number of risk factors increased naturally, the number of patients in the corresponding groups decreased, and the level of mortality increased. Considering all the variants of the outcome (recurrence of postoperative complications, lethality), the most weighted isolated risk factors were “artificial ventilation”, “ intrauterine infection” and “Inconsistency”, with the exception of the 2nd, 2nd and 3rd versions, respectively. 5- 9.9 times. The most dangerous in this aspect are “Syndromes”, “GIEP”. Conclusion: Risk factors are predictors of specific postoperative complications: outbreaks of encephalopathy occur in cerebral complications in 5.4% of newborns, intrauterine infection, 30%, and 30% of coronary heart disease. Assessment of the significance of the origin of non-surgical factors determines the most “weak link”, and proves the necessity of the mandatory use of algorithms and protocols of individual congenital anomalies of congenital heart disease and congenital heart disease.

Peculiarities of the postoperative period and postoperative consequences of left hemicolectomy in patients with obesity

Annotation. Obesity is considered a risk factor for postoperative complications and postoperative mortality. The aim of the study was to assess the impact of obesity on the postoperative period and the level of postoperative mortality after left hemicolectomy. A retrospective analysis of the medical records of 217 patients who underwent left hemicolectomy for colon tumors was performed. Assessment of comorbid conditions was performed using the Charlson index. Postoperative complications were assessed according to the Clavien-Dindo classification. The calculation of postoperative survival was performed by the Kaplan-Mayer method. Database formation and statistical analysis were performed using Microsoft Excel and STATISTICA 10.0. It was determined that the mean values of the Charlson index did not differ significantly between the two groups (6,31 ± 2,07 and 6,33 ± 2,08 respectively), but there was a significantly higher level of endocrine diseases in the group of obese patients. Non-disseminated (I-II) stages of the tumor process predominated in patients of both groups (60% and 57.5%, respectively). Among non-obese patients n = 107 (51.8%) patients had an uncomplicated postoperative period and n = 59 (28.5%) patients had mild complications that were not associated with the surgical site, but were associated with concomitant chronic pathology of other organs and systems, and did not require any invasive interventions. In contrast, among obese patients n = 6 (60%) patients had severe early postoperative complications requiring surgery, and n = 2 (20%) patients underwent relaparotomy. The rate of early postoperative mortality differed significantly between the two groups and was significantly higher among obese patients (40% vs 6.8% among non-obese patients). This study showed a significantly higher percentage of postoperative mortality and severity of postoperative complications in the group of obese patients. The prospect of further research is to study and analyze the course of the postoperative period in obese patients undergoing extended, multi-visceral and multi-stage surgery for cancer of the left half of the colon.

Possibilities and organizational problems of diagnostics and treatment of patients with the syndrome of temporomandibular joint pain dysfunction

The relevance of research in the field of organization and provision of medical care to patients with the temporomandibular joint pain dysfunction syndrome (TMJ PDS) is determined by the prevalence of this disease not only among the pathologies of the maxillofacial region, but also among the pathologies of other organs and systems in general. Patients with the pathology of this joint are treated by doctors of various specialties. Therefore, there is often inconsistency not only in diagnostic algorithms, comprehensive examination and organization of medical care, but also in the terminological aspects of the TMJ PDS. The purpose of this review is to systematize the existing methods of diagnostics and treatment of TMJ PDS and to formulate possible options of osteopathic correction inclusion in the complex treatment of patients with this pathology. The review of literature sources on the problem of diagnosis and organization of treatment of TMJ PDS and masticatory muscle dysfunctions showed, on the one hand, a scientifically grounded spectrum of diagnostic and therapeutic capabilities of modern medicine, a trend in the development of highly informative digital technologies for diagnostic purposes, the development of various diagnostic and treatment protocols, a desire for an integrated approach involving specialists of different profiles. On the other hand, there is disunity between doctors of different specialties and the absence of a single algorithm for the diagnosis and treatment of TMJ PDS. Due to the variety of etiopathogenetic mechanisms of this disease development, further in-depth study of this issue is promising.

RESULTS OF INSPECTION AND TREATMENT OF PATIENTS WITH STENOSIS OF CAROTIDS IN COMBINATION WITH PATHOLOGIES OF OTHER SYSTEMS

Summary. An aim of work is an analysis of results of inspection and treatment of patients with the hemodynamically meaningful defeat of carotids in combination with pathology of other organs and systems. Materials and methods. The results of treatment are analysed 187 patients with hemodynamically by meaningful stenosis of carotids in SI «Zaycev V.T. IGUS of NAMSU» from 2015 for 2018 on a background forthcoming surgical treatment of chronic ischemia of lower limbs, ischemic heart or pathology of gastrointestinal tract trouble. Patients are divided into 3 groups. The first group was made by patients with the chronic ischemia of lower limbs of 2-Д degree - 167 patients. 7 patients entered a group with pathology of gastrointestinal tract. 3 a group was made by 13 patients with ischemic heart trouble. Results and discussion. The direct results of operation we estimated complex on the basis of degree of change of clinical status and presence of postoperative complications. At 161 the patients of the first group in a postoperative period are not educed complications, for a 2th patient thrombosis of anastamosis and ischemic stroke, at 4th paresis of n. Hypoglossuss. In the second group for all operated patients concerning stenosis of carotid, complications were not in a postoperative period. For one patient with the cancer of stomach, that was not execute a reconstructive operation on a carotid an ischemic stroke developed in connection with bleeding. In 3 cases in a postoperative period observed symptomatology of stroke for patients operated concerning ischemic heart, carotid endarterectomia was not executed these patients. Conclusions. To the patients with general atherosclerosis and stroke in anamnesis it is necessary to conduct carotids screening. At hemodynamically meaningful stenosises patients with heart diseaseby and pathology of abdomen of must execute carotid endarterectomia of the first stage, that reduces the risk of ischemic stroke in a postoperative period at treatment of basic pathology.

Distinct signals and immune cells drive liver pathology and glomerulonephritis in ABIN1[D485N] mice.

We report that TLR7, IL-6, and the adaptive immune system are essential for autoimmunity and glomerulonephritis but not for liver pathology in mice expressing the ubiquitin-binding-defective ABIN1[D485N] mutant. The blood and organs of ABIN1[D485N] mice have exceptionally high numbers of patrolling monocytes (pMo), which develop independently of IL-6 and the adaptive immune system. They are detectable in the blood months before autoimmunity and organ pathology are seen and may have diagnostic potential. The splenic pMo, inflammatory monocytes (iMo), and neutrophils of ABIN1[D485N] mice expressed high levels of mRNAs encoding proteins released during NETosis, which together with the high numbers of monocyte-derived dendritic cells (MoDCs) may drive the liver pathology in ABIN1[D485N] mice, and contribute to the pathology of other organs. The splenic iMo of ABIN1[D485N] mice displayed high expression of mRNAs encoding proteins controlling cell division and were actively dividing; this may underlie the increased pMo and MoDC numbers, which are derived from iMo. An orally active IRAK4 inhibitor suppressed all facets of the disease phenotype and prevented the increase in pMo numbers.

Engilen: from different therapeutic possibilities to effective clinical use

Composition of the Engilen preparation, medicinal properties of plants that make up the preparation, indications for its prescription are analyzed in detail in the article. Particular attention is paid to the advantages of Engilen, such as: optimal doses and ratio of active ingredients, wide range of indications, effectiveness upon combined diseases of the digestive system and with the concomitant pathology of other organs and systems. The results of our own study are presented, showing the effectiveness of Engilen upon chronic acalculous cholecystitis and non-alcoholic steatohepatitis in patients with excessive body mass or obesity. In addition, an effective correction of various types of the gall-bladder dysfunction has been obtained.