Aim - to study the prevalence of syndromes of anxiety and depression in correlation with major risk factors (RF) of chronic noninfectious diseases among patients of the Samara region considering themselves healthy. Materials and methods. A comparative population-based cross-sectional study was based on a representative selection of patients (95 people) from the Samara region (rural and urban population) at the age of 19-68 years. Results. The study revealed a significant increase in the rates of fatigue, anxiety and depression in outpatients. The syndrome of anxiety of subclinical level was detected in 35.7% of patients, clinical level - in 23.2% of patients; the syndrome of subclinical depression was revealed in 21.0% of patients, and 4.2% had the clinical level. We discovered the correlation between the syndromes of anxiety and depression and the major RF of chronic noninfectious diseases and patient’s satisfaction with quality of medical care in the clinic. High levels of anxiety were more frequent in men, at older age, and were associated with physical inactivity. Severe depression more often occurred at older age and in the presence of hypercholesterolemia. The income level of the patient correlated with the level of stress exposure, physical activity and satisfaction with the work of the policlinics. We did not reveal the relationship between the syndromes of anxiety and/or depression and the level of income, degree of hypertension, social activity, smoking, alcohol consumption, and body mass index. Conclusion. The results indicate that the presence of the syndromes of anxiety and depression increases the risk of occurrence of other independent risk factors of chronic noninfectious diseases. The identified trends can serve as the basis for targeted screening programs for diagnostics and prevention of chronic noninfectious diseases.
В отличие от пороговой лазеркоагуляции, субпороговое микроимпульсное лазерное воздействие (СМИЛВ) является более селективным по отношению к пигментному эпителию сетчатки, поэтому не вызывает осложнений, связанных с повреждением клеток макулярной зоны сетчатки. В настоящее время мы имеем возможность более точного, дозированного и топографически ориентированного использования субпорогового режима лазерного воздействия для лечения диабетического макулярного отека. Субпороговый микроимпульсный режим лазера Navilas 577s дает возможность планирования операции, наложения результатов оптической когерентной томографии на фотографию глазного дна и позволяет сделать лечение точным, быстрым, наглядным и безопасным. Целью работы было оценить эффективность лечения клинически значимого диабетического макулярного отека методом СМИЛВ на навигационной лазерной системе Navilas 577s. Проведено исследование 30 глаз с клинически значимым диабетическим макулярным отеком высотой до 370 мкм после лечения методом СМИЛВ на лазере Navilas 577s. Снижение высоты отека и повышение остроты зрения в сроки 1, 2 и 3 месяца после СМИЛВ. Лечение диабетического макулярного отека методом СМИЛВ на навигационной лазерной системе Navilas 577s увеличивает максимально корригируемую остроту зрения с 0,5 до 0,7 и уменьшает высоту отека в центральной зоне фовеа с 342 до 280 мкм, а следовательно, может быть оправдано и целесообразно в условиях реальной клинической практики. Ключевые слова: клинически значимый диабетический макулярный отек, субпороговое микроимпульсное лазерное воздействие, оптическая когерентная томография, навигационная лазерная система Navilas577s.
Growth of duodenal pathology in patients of different age groups determines the relevance of the study. Causes duodenal disease sufficiently heterogeneous and include celiac disease, gluten allergy and various proteins, autoimmune disease, atopy, and also bacterial, parasitic and viral infection (Helicobacter pylori infection, giardiasis, etc.). One of the characteristics of the mucosal morphofunctional state is its neuroendocrine PDK activity, which is provided enteroendocrine cells, and chromogranin synthesising neuropeptides, in particular, chromogranin A (CgA), ghrelin and serotonin.The aim of our study was to determine whether these markers in the duodenal mucosa with similar morphological manifestations duodenitis of various etiologies in children. The material of the study were 40 distal duodenal biopsies, obtained by fibrogastroduodenoscopy in children aged 6 to 17 years old with morphologically verified chronic gastroduodenitis (CGD).The first group consisted of children with celiac disease, the second group – with Helicobacter pylori infection (NR), the third group consisted of children with giardiasis, in the fourth (the control group) – children with reliably excluded above listed diseases and preserved architectonic duodenal mucosa without morphological features of HD.When immunohistochemical study expression levels were determined Chromogranin A (Abcam 1: 400); Serotonin (Abcam 1:50); Ghrelin (Abcam 1: 100). The intensity of the reaction was assessed by two indicators – the relative area of expression and the optical density.In our study, for the first time we studied enteroendocrine markers in duodenitis of various etiologies. We were looking for a morphological tool that will help differentiate duodenitis with similar clinical and histological features. Increased expression of ghrelin, serotonin and chromogranin A, plays an important role in the mechanisms of duodenum structure disorders in celiac disease. When Hp infections a decrease in all studied markers, while giardiasis is not observed significant changes. All of this allows us to differentiate duodenitis aetiology and, therefore, reasonable to appoint therapeutic measures.
At present about 16.4 million people in the world suffer from retinal venous occlusions (RVO). The pathophysiology of RVO includes changes in the vascular wall, blood flow, blood clotting. The key role in the pathogenesis of this group of diseases is played by ischemia and retinal hypoxia, leading to neovascularization. Macular edema (ME) is the most common complication of retinal vein occlusions. Optical coherence tomography-angiography (OCTA) is considered as an informative and highly sensitive method for diagnosing macular edema (ME) and ischemic zones in RVO. Intravitreal administration of glucocorticosteroids and/or angiogenesis inhibitors is the priority treatment method for macular edema in RVO. The combination of antiangiogenic therapy and laser treatment is promising. The navigation treatment technology is implemented under the conditions of the Navilas 577 system. The Navilas 577 laser navigation system is a laser coagulator with a tracking system and a fundus camera. The possibility of planning the operation, superimposing the results of OCTA on a fundus image makes the treatment faster, more accurate, and minimizes damage to healthy tissues.Purpose: to evaluate the results of target topographically oriented threshold laser coagulation in the treatment of post-thrombotic ME using theNavilas 577 laser navigation system following intravitreal administration of angiogenesis inhibitors.Materials and methods. There was performed a prospective study of the results of navigation laser treatment on the Navilas 577 device after intravitreal injections of angiogenesis inhibitors in 14 patients (14 eyes), aged 51 to 83 years, with macular edema up to 390 μm due to the branch central retinal vein occlusion. Laser treatment was performed within 2 weeks to 1 month following the last injection of angiogenesis inhibitors. The zones of ischemia in the macula were determined according to OCT-A data, imported into the Navilas 577 navigation system and superimposed on a color fundus image. Then the treatment was planned — the position of the future coagulates was marked.Results. In 3 months, there was a decrease in the height of edema from 366.5 (323;390) to 280 (270;300) μm, an increase in light sensitivity in the central retinal zone from 17 to 21.2 dB and an increase in visual acuity from 0.4 (0.3;0.5) to 0.5 (0.45;0.6).Conclusion. The combination of navigation retinal laser coagulation and angiogenesis inhibitors in the treatment of low post-thrombotic edema (less than 390 μm) gives good results; therefore, it can be justified and advisable in real clinical practice.
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