■ Keywords: urinary incontinence, nocturia, polyuria, sodium ions, reabsorption.вместе с тем появились данные об эффек-тивном применении в ряде случаев антидиу-ретического гормона [5,6], однако в работах P. Hilton (1982), D. Robinson (2004 оценка функ-ции почек не проводилась. Эффективность ле-чения десмопрессином могла определяться как дефицитом вазопрессина, так и недостаточной чувствительностью почки к уровню этого гор-мона в крови. Действие антидиуретического гормона локализовано не только в собиратель-ных трубках, где связывание с V 2 -рецепторами приводит к реабсорбции осмотически свобод-ной воды [7,8], активация V 2 -рецепторов ва-зопрессином в клетках толстого восходящего отдела петли Генле вызывает увеличение вну-триклеточной концентрации цАМФ, и вслед-ствие этого возрастает реабсорбция ионов на- ВведениеНедержание мочи у женщин является акту-альной проблемой и имеет огромное не только медицинское, но и социально-экономическое и психологическое значение [1][2][3][4]. Несмотря на постоянное совершенствование методов диагностики и лечения данного заболевания, количество женщин, страдающих недержанием мочи, во всем мире не уменьшается.Недержание мочи чаще всего имеет муль-тифакторное происхождение [1][2][3][4]: причины возникновения инконтиненции связывают, как правило, с нарушением функциональных механизмов удержания мочи, анатомо-топогра-фическими особенностями нижних мочевыво-дящих путей или возрастной недостаточностью функции яичников.
Hypothesis/aims of study. Questions of urine incontinence pathogenesis and ways of treatment are actively discussed by gynecologists, urologists and neuropathologists. Urine incontinence often has multifactor origin: the causes of urine incontinence are connected, as a rule, with violation of urine continence functional mechanisms, anatomical and topographical features of the lower urinary tract or an age failure of ovaries function. At the same time changes of kidneys function play part in urine incontinence pathogenesis. In some cases urine incontinence is combined with urine overproduction or inversion of circadian rhythm of renal function due to decrease in a reabsorption sodium ions in the thick ascending limb of a Henle’s loop. The reabsorption of Na+, K+, Ca2+, Mg2+, Cl– in this department of a nephron is increased by vasopressin activation of V2-receptors. In some patients we succeeded to normalize ions transport, diuresis, circadian rhythm of urine production by desmopressin administration, however in some cases significant decrease in a diuresis did not happen. The lack of therapy effect could be connected with local production of substances resisting to effect of this hormone, in particular prostaglandin E2. The current analysis was undertaken to evaluate the clinical efficiency of Diclofenac in incontinent patients with nocturnal polyuria and polyuria. Study design, materials and methods. A total of 44 patients with complaints of urinary incontinence, polyuria (24-urine volume of 40 mL/kg bodyweight or above) or nocturnal polyuria (nocturnal volume/24-h urine volume of 0.33 or above) (Van Kerrebroeck P., 2002) and 14 control subjects were included. Mean patient age was 42.8 ± 4.5 years, in control subjects 39.4 ± 6.3 (p > 0.05). All participants performed 72h-urinecollection to determine the voided volumes and the levels of creatinine, osmolality, sodium, magnesium and potassium for each sample. A blood sample was taken during the 72-urinecollection to determine the levels of creatinine, osmolality, sodium, magnesium and potassium. The examination of patients with polyuria and nocturnal polyuria was performed twice: in the initial state and one month after the start of treatment with optimal dose of Diclofenac. Results. In patients with polyuria and nocturnal polyuria the glomerular filtration rate was normal, whereas diuresis and solute (sodium, magnesium, potassium) clearance in night samples in nocturnal polyuria and both in night and day samples was higher. Diclofenac use had the normalizing effect on transport of ions in a nephron.
Hypothesis/aims of study. Urine incontinence seems to include several pathogenetic forms, as efficient therapy is provided by different medications. Commonly used in the treatment of female patients with overactive bladder and nocturnal polyuria is desmopressin which normalizes the water excretion of the kidney, which is disturbed by a presumed inverted rhythm of vasopressin secretion in these patients. The current analysis was undertaken to evaluate the clinical efficiency of desmopressine in incontinent patients with nocturnal polyuria and polyuria. Study design, materials and methods. A total of 84 patients with complaints of urinary incontinence, polyuria (24-urine volume of 40 mL/kg bodyweight or above) or nocturnal polyuria (nocturnal volume/24-h urine volume of 0.33 or above) and 14 control subjects were included. Mean patient age was 43.6 ± 4.6 years, in control subjects 38.5 ± 6.4 (p > 0.05). All participants performed 24h-urinecollection to determine the voided volumes and the levels of creatinine, osmolality, sodium, magnesium and potassium for each sample. A blood sample was taken during the 24-urinecollection to determine the levels of creatinine, osmolality, sodium, magnesium and potassium. The examination of patients with polyuria and nocturnal polyuria was performed twice: in the initial state and one month after the start of treatment with optimal dose of desmopressin. Optimal dose was established through an open-label dose-titration using 0.1 mg, 0.2 mg and 0.4 mg of desmopressin (Minirin). Safety parameters assessed included incidence of adverse events, vital signs and serum sodium levels. Results. In patients with polyuria and nocturnal polyuria the glomerular filtration rate was normal, whereas diuresis and solute (sodium, magnesium, potassium) excretion in night samples in nocturnal polyuria and both in night and day samples in polyuria were increased. The higher diuresis and the higher solute excretion observed in nocturnal polyuria and polyuria are accompanied by an increase of free water reabsorption. In nocturnal polyuria and polyuria a high correlation was found between the free water reabsorption and solute excretion. This occurs against the background of the high night and day osmotic concentration. The statistically significant recovery of renal function occurred in 12 incontinent women with polyuria and 18 with nocturnal polyuria. In these papients there was a statistically significant decrease in diuresis, osmolar clearance and excretion of sodium, potassium and magnesium. Concluding message. As desmopressin affects cells of the thick ascending limb of Henle’s loop, it is likely that nocturnal polyuria and polyuria result from a disturbed regulation of the function of these cells. Normalization can be achieved by desmopressin administration to stimulate V2-receptors, which increase water permeability and water reabsoption in collecting ducts as well as ion reabsorption by cells of the thick ascending limb of Henle’s loop.
In recent years, using a genome-wide association study (GWAS), a number of single nucleotide polymorphisms (SNPs) have been suggested to be associated with susceptibility to leukemia in cattle. However, all studies have been done with purebred Holstein cows and their hybrids. In this regard, it is important to confirm the functional role of polymorphisms previously identified in a GWAS study in Russian cattle breeds. The aim of this study was to verify the association between rs110861313 in the intergenic region of bovine chromosome 23 and leukemia in the Russian Black Pied cattle. Based on the levels of bovine leukemia virus (BLV)-specific antibodies detected in serum using serodiagnostic techniques, animals were divided into three groups: healthy animals (n = 115), asymptomatic virus carriers (n = 145) and animals with leukemia (n = 107). Genotyping of rs110861313 was carried out using polymerase chain reaction followed by analysis of restriction fragment length polymorphisms. A significant decrease in the frequency of the A/A genotype (11.2 %) was revealed in animals with persistent lymphocytosis compared to virus carriers (27.6 %) (p < 0.002). At the same time, the frequency of animals with the C/C genotype in animals with persistent lymphocytosis (41.1 %) was significantly higher than that of virus carriers (21.4 %) (p < 0.001). In this case, asymptomatic virus carriers can be considered a more suitable control than healthy animals that have not been in contact with the virus. According to bioinformatics analysis, resistance to BLV can be due to the presence of the transcription factor FOXM1 binding site in the region of rs110861313. FOXM1 is expressed in immune cells and can potentially affect the expression of the neighboring genes (LY6G5B, GPANK1, ABHD16A, LY6G6F, LY6G6E, CSNK2B, ApoM). Thus, we found that SNP rs110861313 in the intergenic region of bovine chromosome 23 is associated with the development of leukemia following BLV infection in the Russian Black Pied cattle.
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