Polymorbid Pathology Research Articles

Age Peculiarities of the Pro-inflammatory Component of Cytokine Profile in Chronic Odontogenic Infection Affected by Polymorbid Pathology

Aim: This study aimed to study the features of pro-inflammatory component of the cytokine profile in chronic odontogenic infection affected by polymorbid pathology. Materials and Methods: The study included 251 people: 125 middle-aged people (40–49 years) and 126 elderly people (60–69 years). All the people included in the study were divided into groups: Group 1 - apparently healthy people (33 patients of middle age and 31 of elderly age); Group 2 - patients suffering from chronic apical periodontitis (CAP) in granulating form (31 middle-aged patients and 33 elderly age patients); Group 3 - patients with CAP and coronary heart disease (CHD) (30 patients of middle age and 32 of elderly age); and Group 4 - patients suffering from CAP, CHD, and type 2 diabetes (31 middle-aged patients and 33 elderly patients). In all patients of different ages, cytokine profile was studied in blood serum, oral fluid, and crevicular gingival fluid. Results: The level of tumor necrosis factor alpha (TNF-α) in the blood serum depends significantly on the presence of a combination of CAP and CHD, CAP, CHD, and type 2 diabetes. A significant increase in the level of TNF-α in the oral and gingival fluids was noted when associated with polymorbid background in people of both the age groups. In the isolated course of CAP in elderly patients, unlike middle-aged patients, there was a significant increase in the concentration of interleukin (IL)-1β in blood serum. The level of IL-6 in the oral and gingival fluids is indicative of the characteristics of the inflammatory immune response in patients with CAP. The serum levels of IL-8 in elderly people are significantly higher than in middle-aged people. The increase in polymorphism leads to a significant increase in the degree of IL main in terms of IL-8. Conclusion: Concentration of TNF-α in blood serum with CAP can serve as an integral measure of immune inflammation. The level of IL-1β in blood serum, oral fluid, and gingival fluid can be considered as an additional factor characterizing the pathological process in polymorbid pathology. The level of IL-6 in the oral and gingival fluids is indicative of the characteristics of inflammatory immune response in patients with CAP. The severity of proinflammatory reaction by concentration of IL-8 is age dependent with a tendency of significant increase in the transition from middle to elderly age

Diseases of civilization: liver and polymorphic metabolic continuum

The paper presents considerations of the role of liver in the lipoproteins’ exchange and possibilities of correlation of its disturbances within metabolic syndrome as the most typical manifestation of polymorbid pathology of the modern civilization.

Case of successful treatment of a high risk acute tele with hypothony in a patient with polymorbid pathology

The presented article features the management of a high-risk patient with polymorbid pathology: cancer, stroke and venous thromboembolism. In spite of anticoagulant therapy with heparin, unilateral deep vein thrombosis of the lower leg was complicated by a primary episode of verified acute bilateral pulmonary artery thromboembolism of high-risk with hypotension and bilateral infarct-pneumonia. After urgent diagnosis of PE had been made, the following management of the patient in the acute phase was suggested: timely modern replacement artificial ventilation of the lungs for eight days, vasopressor support for six days, anticoagulant therapy, fluid replenishment and effective in its results, enteral nutrition. The pattern of evolving pulmonary hypertension and acute right ventricular dysfunction, coagulation disorders was tracked down. Residual thrombosis proved to linger by detection of steep D-dimer rise on the ninth day of the acute period. The signs of thrombosis persisted despite anticoagulant therapy, with the simultaneous complete disappearance of blood clots according to computed tomography. That was accompanied by severe disorders of the heart rhythm recalcitrant to antiarrhythmic and electropulse therapy. Further treatment in the settings of a specialized center revealed occult extra routes of impulse conducting that justified necessity of catheter ablation. On the ninetieth day the patient was alive and stable. Presented approach of diagnostic and therapeutic steps proved to be effective.

The trans-system polymorbid states and their relationship with social status of patients of therapeutic clinic

The article presents result of analysis of indicator of polymorbidity in sampling of 9871 patients of therapeutic clinic of the research institute of experimental and clinical medicine (Novosibirsk)during 2003-2011. The study was carried out using archive method with statistical analysis of all nosologic forms, groups and classes of ICD-10 irrespective of particular diagnosis being main or concomitant. The gender differences of indicator trans-systemic polymorbidity during 2003-2011consisted in that in males its increasing was more dynamic than in females. The trans-systemic polymorbidity is correlated with social economic indicators considering as stressors having significant importance for its occurrence and development. These regularities are more specific for males due to direct correlation between trans-systemic polymorbidity and level of payroll salary in contrast with females. Hence, necessity to take into account impact of social economic factors on development of polymorbid pathology for improving system of secondary and tertiary prevention, diagnostic, treatment and rehabilitation of concomitant nosologies in patients. The development of new medical economic standards of treatment of patients with polymorbid pathology to implement principles of personified medicine is required.