Background. The study of bone tissue includes two directions – the study of patterns of structural reconstruction and clarification of the dynamics of mineral composition. Bone tissue reacts differently to the influence of exogenous and endogenous factors, but there is always a violation of the bone microarchitecture, its density and mineral composition. Purpose. Investigation and comparison of changes in bone density and its mineral composition on the background of experimental diabetes mellitus and long-term opioid influnce. Materials and methods. The study was performed on 25 white sexually mature nonlinear male rats, weighing 160–270 g, aged 5–7 months. The duration of the experiment was 6 weeks. Insulin-dependent form of type I diabetes mellitus was simulated by the administration of streptozotocin. Simulation of the long-term effects of opioids on the body was carried out by administering preparation Nalbuphine (Rusan Pharma LTD, India). Bone density was determined by the means of dental radiovisiography apparatus. The unit of measurement is the conventional unit of grayness. The mineral composition was investigated by atomic absorption spectral analysis of bone fragments on an atomic absorption spectrophotometer using propane-butane-air flame. The content of calcium, phosphorus and magnesium was investigated. The concentration of the elements was expressed in mg/g. Results. The data of radiovisiographic research showed that in experimental diabetes mellitus the density of the bone tissue of the mandible body decreases, and in the cases of long-term opioid use – increases. The decrease in density indicates the development of osteopenia, due to a decrease of calcium quantity and of the Ca/P index on the background of increasing levels of phosphorus and magnesium and Mg/Ca index. The increase in density is due to an increase in the absolute content in bone tissue of Ca, P and Mg, and Ca/P index, which confirms the increased mineralization of bone, the acceleration of metabolic processes of which is stimulated by the Mg content increase. Among all the studied ele-ments, only the ratio of absolute indicators of Ca content coincides with the ratio of its specific shares and bone density indicators. A similar ratio is determined for the Ca/P index. Conclusions. The decrease in bone density of the mandible on the background of experimental diabetes mellitus is likely to develope due to calcium content and Ca/P index decrease with increase in phosphorus and magnesium content and Mg/Ca index; and an increase in bone density on the background of long-term use of opioid drugs is caused by the increase in Ca, P and Mg content, as well as Ca/P index.
Ðåôåðàò Ìåòà. Ïðîàíàë³çóâàòè àëãîðèòì ä³à´íîñòèêè òà äèôå-ðåíö³éíî¿ ä³à´íîñòèêè çàõâîðþâàíü, ÿê³ ïåðåá³ãàþòü ç ñèíäðîìîì àðòåð³éíî¿ ã³ïåðòåí糿, â òîìó ÷èñë³ ñèíäðîìó ìíîaeèííî¿ åíäîêðèííî¿ íåîïëà糿, äëÿ ñâîº÷àñíîãî âñòàíîâëåííÿ ä³à´íîçó òà çä³éñíåííÿ â÷àñíîãî ³ íàëåaeíîãî ë³êóâàííÿ ïàö³ºíò³â. Ìàòåð³àë ³ ìåòîäè. Îïèñàíî âèïàäîê âèÿâëåííÿ, ä³à´íîñòèêè, ë³êóâàííÿ òà ï³ñëÿîïåðàö³éíîãî ñïîñòåðåaeåííÿ õâîðîãî ³ç ñèíäðîìîì ѳïïëà. Ðåçóëüòàòè é îáãîâîðåííÿ. Ïàö³ºíòó 35 ðîê³â ïðîâåäåíî ä³à´íîñòèêó òà ë³êóâàííÿ ñèíäðîìó ìíîaeèííî¿ åíäî-êðèííî¿ íåîïëà糿 2À òèïó. Îñîáëèâ³ñòþ öüîãî êë³í³÷íîãî âèïàäêó áóëè íå÷èñëåíí³ ñêàðãè ïàö³ºíòà, â îñíîâíîìó, íà ïåð³îäè÷í³ ã³ïåðòîí³÷í³ êðèçè, ÿê³ íå ï³äëÿãàëè òðà-äèö³éíîìó ë³êóâàííþ òà ìèíàëè ñàìîñò³éíî. Ïðè îáñòå-aeåíí³ ïàö³ºíòà áóëè çàä³ÿí³ ð³çí³ ìåòîäè îáñòåaeåííÿ (ðåòåëüíèé çá³ð ñêàðã, àíàìíåçó çàõâîðþâàííÿ òà àíàìíåçó aeèòòÿ, îá'ºêòèâíå îáñòåaeåííÿ, ëàáîðàòîðíå îáñòåaeåííÿ, â òîìó ÷èñë³, âèçíà÷åííÿ âì³ñòó ãîðìîí³â ùè-òîïîä³áíî¿ çàëîçè, íàäíèðíèêîâèõ çàëîç, âèçíà÷åííÿ îí-êîìàðêåð³â, ³íñòðóìåíòàëüíå îáñòåaeåííÿ, â òîìó ÷èñë³, óëüòðàçâóêîâå îáñòåaeåííÿ ùèòîïîä³áíî¿ çàëîçè òà íàäíèðíèêîâèõ çàëîç, êîìï'þòåðíà òîìî´ðàô³ÿ ÷åðåâíî¿ ïîðîaeíèíè). Ïðè îáñòåaeåíí³ âèÿâëåíî îá'ºìí³ óòâîðè â îáîõ äîëÿõ ùèòîïîä³áíî¿ çàëîçè òà ë³â³é íàäíèðíèêîâ³é çàëîç³, ÿê³ áóëè îáñòåaeåí³ íà ïðåäìåò ¿õ ôóíêö³îíàëüíî¿ àêòèâíîñò³ òà íàÿâíîñò³ çëîÿê³ñíîãî ïðîöåñó. Ïðîâåäåíî äèôåðåíö³éíó ä³à´íîñòèêó çàõâîðþâàíü, ÿê³ ïåðåá³ãàþòü ç ñèíäðîìîì àðòåð³éíî¿ ã³ïåðòåí糿 äëÿ âñòàíîâëåííÿ ä³à´íîçó. ϳñëÿ óòî÷íåííÿ ä³à´íîçó ïðîâåäåíî ðàäèêàëüíå õ³ðóð´³÷íå ë³êóâàííÿ ïàö³ºíòà äâîìà åòàïàìè: ë³âîá³÷íà àäðåíàëåêòîì³ÿ òà òèðåî¿äåêòîì³ÿ ç ë³ìôà-äåíåêòî쳺þ. Îñòàòî÷íèé ä³à´íîç áóâ âñòàíîâëåíèé ï³ñëÿ ïðîâåäåííÿ ã³ñòîëî´³÷íîãî äîñë³äaeåííÿ îïåðàö³éíîãî ìàòåð³àëó. Â÷àñíå, ïðàâèëüíå òà óñï³øíå õ³ðóð´³÷íå ë³êóâàííÿ ïàö³ºíòà ï³ñëÿ ä³à´íîñòèêè çàõâîðþâàííÿ äîçâîëèëî çàïîá³ãòè íàðîñòàííþ òà ìåòàñòàçóâàííþ çëî-ÿê³ñíîãî ïðîöåñó, çáåðåãòè aeèòòÿ òà ïðàöåçäàòí³ñòü ïàö³ºíòà òà îòðèìàòè õîðîø³ â³ääàëåí³ ðåçóëüòàòè. Âèñíîâêè. Àðòåð³éíà ã³ïåðòåíç³ÿ ÷àñòî ìîaeå áóòè ïîîäèíîêèì ñèìïòîìîì ö³ëîãî ðÿäó çàõâîðþâàíü, â òîìó ÷èñ-ë³, ³ çëîÿê³ñíèõ, òîìó íåîáõ³äíî ðåòåëüíî ïðîâîäèòè äè-ôåðåíö³àëüíó ä³à´íîñòèêó ç ìåòîþ ñâîº÷àñíî¿ ïîñòàíîâêè ïðàâèëüíîãî ä³à´íîçó ³ çä³éñíåííÿ íàëåaeíîãî ë³êóâàííÿ. Êëþ÷îâ³ ñëîâà: àðòåð³éíà ã³ïåðòåíç³ÿ, ñèíäðîì ìíîaeèííèõ åíäîêðèííèõ íåîïëàç³é
Pheochromocytoma (PHEO) manifestation can be triggered by many different factors, including infectious diseases. In 2019, measles continued to spread in global outbreaks around the world. According to WHO data, more than 60 % of all measles cases in European Region were reported in Ukraine, a leader in measles occurrence. Measles is a dangerous viral disease, which remains an overwhelmingly important problem for healthcare system. Measles cause various life-threatening complications, which not only affect patients’ health and decrease quality of their lives, but can also lead to onset of many other medical conditions. Authors provide an example from their own clinical experience, which they have observed during the measles outbreak. Patient D., 22 y.o., female, was admitted to Lviv Infectious Diseases Communal Clinical Hospital because of measles. Condition was followed by severe intoxication, fever, hacking cough, skin rash all over the body. On 4th day after the appearance of rash patient developed atypical hypertensive crisis: in supine position started severe tachycardia, thumping headache, tremor of proximities and whole body, arterial blood pressure increased to 180/110 mm Hg; after changing the sitting position, symptoms started slowly decrease, in this regard patient had to spend a few days crouched in bed, she also complained about exaltation, insomnia, psychic tension, asthenia. Patient has undergone surgical treatment — laparoscopic left adrenalectomy. Perform differential diagnostics of hypertension accurately, paying special attention to determining its’ reason. Take into consideration, that PHEO manifestation and hypertonic PHEO crises can be provoked by multiple reasons. If PHEO is suspected, hormonal, visualization and morphological examination methods should be performed. Keep in mind, that PHEO can be a constituent part of number of hereditary diseases: MEN 2A, MEN 2B, Von Recklinghausen’s Disease (Neurofibromatosis 1), Von Hippel-Lindau syndrome and can be possibly malignant.
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