Objective — to establish the clinical and pathogenetic role of the isolation of the middle mass molecules of different fractions (aminopeptide — AF, peptide — PF, nucleotide — NF, chromatophore — CF) in exhaled breath concentrate (EBC) in pneumonitis in rheumatoid arthritis (RA) patients, their relationship with the parameters of respiratory moisture excretion, spirography and pressure in the pulmonary artery. Materials and methods. EBC (pulmonary expirates) were studied in 31 patients with RA (mean age 46 years, the ratio of men to women 1 : 2), among whom moderate and high degree of disease activity was established in 67.7 % of cases, III and IV stages — in 54.8 %, the extraarticular form of the disease — in 61.3 %, systemic osteoporosis — in 83.9 %, seropositivity for rheumatoid factor — in 80.7 %, for antibodies to cyclic citrullined peptide — in 77.4 %. To determine the middle mass molecules in the expirates and blood serum, a screening method was used with the precipitation of proteins with trichloroacetic acid and the determination of the light absorption spectra of the acidsoluble fraction. Results and discussion. Interstitial pneumonitis was diagnosed in 51.6 % of the number of RA patients, which was accompanied by fibrosing alveolitis in 18.8 % of cases, rheumatoid nodules in the lungs — in 12.5 %, obliterating bronchiolitis — in 6.3 %, with the ratio of restrictive, mixed and obstructive types of dysfunctions of external respiration 6 : 2 : 1, while the disease proceeded with a significant increase in AF indicators in 74.2 % of patients and the ratio «EBC/blood» (e/b) PF level in 77.4 % against the background of a decrease in AFe/b (at 71.0 %), NFe/b (at 54.8 %, CFe/b (at 74.2 %) and the ratio of surface tension caused by high and lowmolecular substances in 83.9 %, and the composition of expirates was closely interrelated with the state of hemodynamics of the pulmonary circulation and bronchopermeability, depended on the rate and volume of respiratory moisture release, longterm use in the complex treatment of patients with an immunosuppressant of cytotoxic action, folic acid antagonist methotrexate. Conclusions. The nature of the respiratory excretion of middle mass molecules of different fractions determines the pathogenesis of pneumopathy in RA patients, which depends on the clinical, radiological and sonographic signs of the disease, and the study of EBC can be used to predict the course of the pathological process and monitor the effectiveness of therapeutic measures.
Infection with comorbid periodontitis due to transient bacteremia in patients with rheumatoid arthritis (RA) can lead to microbial colonization outside the mouth and increase systemic immune inflammation. Periodontitis-induced endotoxemia increases the sensitivity of RA patients to autoantigens by activating membrane proteins, pro-inflammatory enzymes, and cytokines. RA and periodontitis have similar osteoclasia, allelic genes and general imbalance in the state of the cytokine network, and carbamylation of proteins and the formation of extracellular traps of neutrophils are associated with simultaneous autoimmune imbalance in the combination of RA and periodontitis, but the listed pathogenetic mechanisms require further study. The purpose and objectives of the study: to study the properties of the oral fluid in periodontitis in patients with RA, to determine the clinical and pathogenetic significance of changes in physicochemical, enzyme immunoassay and biochemical parameters in the pathology of the oral cavity and joints, to compare the indicators with the nature of the gingival microbiota. Material and methods. The study included 173 RA patients aged 18-76 years (average 46 years), among whom there were 21% of men and 79% of women. The duration from the first manifestation of the disease averaged 10 years. The frequency of RA seropositivity for rheumatoid factor in the blood was 75%, and for antibodies to citrulline cyclic peptide was 73%. The І, ІІ and ІІІ degrees of disease activity, respectively, were stated in 26%, 44% and 30% of cases, and the ratio of I, II, III and IV stages of the pathological process was 1: 6: 5: 3. Results. We studied the physicochemical adsorption-rheological properties of the oral fluid (surface tension, viscoelasticity, relaxation), the levels of pro-inflammatory cytokines in it, the concentration of aminopeptide, peptide, nucleotide and chromatophore fractions of average weight molecules, the ratio with similar parameters in blood serum. To assess the number of aerobic and facultative anaerobic microorganisms vegetating on the gingival mucosa, the method of sterile paper discs was used. Compared with healthy people in the control group, 99% of the number of RA patients has an increase in the concentration of interleukin 1b in the oral fluid (22 times), 98% of tumoronecrotic factor a (7 times), 43% of the average increase in the average weight molecules (by 47%), at the same time, the parameters are associated with the presence of secondary Sjogren's syndrome, with the severity of the course of both articular syndrome, and periodontitis, which is accompanied by a longer relaxation time of oral washings (by 36%), but their lower interfacial activity (by 11%), the ratio of the tumor necrosis factor parameter a with the level of this pro-inflammatory cytokine in the blood (by 70%), and there are dispersion relationships of individual indicators of the oral fluid with the vegetation on the gums of bacterioids, bifidobacteria, Escherichia coli, megaspheres, moraxellas, neisseria, propionibacteria, proteus, pseudomones, sarcins and streptococcus. Conclusions: the obtained data dictate the need to develop new approaches to medical technology for individual pathogenetic therapy of chronic generalized periodontitis, taking into account its etiology in RA patients, identifying criteria that allow assessing the activity of the pathological process, predicting the nature of the course of the disease and the effectiveness of treatment measures.
The branch of historical science of numismatics (from the Latin "numisma" - coin) originated in the 19th century and became closely connected with economics, politics, culture and law, it includes a thematic study of coins, medals and plaque. Best of all, the history of uronephrology is illustrated by various forms of medalist educational art (exonum or paranumismatics), and the medal became the prototype of the memorial coin. This work presents a catalog of more than 400 numismatic materials (including some unique, first cited), reflects the stages of development of the study of the structure and function of the kidneys, methods for diagnosing and treating diseases, there are links to significant historical events, brief biographies of physicians who have made an invaluable contribution are mentioned into the formation of this scientific discipline. The work presents a role in the origin of the study of kidney and urinary tract diseases of ancient physicians (Aretea, Aristotle, Galen, Hippocrates, Rufus, Sushruta, Empedocles) and doctors of the Middle Ages (Avicenna, Da Carpi, Panaskerteli, Paracelsus, Sun Simiao).
Background. Prostate cancer (PC) ranks first in the structure of oncological pathology in men, being the second leading cause of cancer death and having 30 % as the five-year survival rate. Radiation therapy (RT) for prostate cancer has great potential for enhancement. Purpose – to evaluate the efficacy of RT in patients with prostate cancer and highlight the clinical and laboratory factors determining it. Materials and methods. The study enrolled 195 men with prostate cancer aged 52 to 82 years. The duration from the moment of diagnosis of the disease averaged 3 years. The Gleason score parameters were 6 points on average, the ratio of peripheral to central tumor form was 3:1, adenocarcinoma was diagnosed in 94 % of cases, giant cell carcinoma – in 6 %. Results. On average, recurring neoplasm is observed in 40 % of the patients with prostate cancer 2.5 years after radical prostatectomy combined with different methods of radiation therapy, which is associated with the initial indicators of the Gleason score, shape, localization and expansion of the tumor process, the presence of comorbid papillary carcinoma of the urinary bladder, metastases in the lymph nodes, distant viscera and the skeleton, while the power and direction of radiation exposure influence such radiotherapy complications as dermatitis, polyneuropathy, acute vascular insufficiency and tubulointerstitial nephritis. Conclusions. Developing the medical technology for RT in patients with prostate cancer to reduce the effect of prognostically unfavorable treatment factors is essential.
Purpose of the work – to assess the level of tumor markers in the blood of patients with prostate cancer (PC) in the course of their radiation therapy (RT). Material and methods. The study included 195 men with prostate cancer aged 52 to 82 years. The duration from the moment of diagnosis of the disease was 3 years on average. The Gleason score parameters averaged 6 points, the ratio of peripheral to central tumor form was 3: 1, adenocarcinoma was diagnosed in 94% of the cases, and giant cell carcinoma – in 6%. The average tumor stage parameter was 3 relative units, maturity was 3 points. Blood levels of testosterone (TS), luteinizing hormone (LT), insulin-like growth factor 1 (ISF), alkaline phosphatase (AP), acid prostatic phosphatase (APP) and glycosyl hydrolase (GH) activities were evaluated.Results. An increase in the level of tumor markers is observed in 50% - 100% of the patients, which depends on the expansion, size, localization, stage and degree of differentiation of the tumor process, the nature of its metastasis to the lymph nodes, distant organs and skeleton. Radiation therapy in patients with prostate cancer has an effect on integral changes in tumor markers, in particular, on the restoration of blood PSA parameters and APP activity; moreover, in the group of examined patients with an early initiation of RT after prostatectomy, positive changes in the studied parameters are more significant, do not depend on the expansion, size, and the degree of maturity of the neoplasm, but the nature of the dynamics of the levels of PSA, APP and ISF is closely related to the initial indicator of the severity of the tumor process course.Conclusion. The study of the level of tumor markers in the blood will have clinical and prognostic significance for assessing the efficacy of treatment of a tumor process, and contribute to the development of criteria for diagnosing complications of radiation therapy.
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