Diabetic retinopathy occupies a special place among the causes of the progression of decrease and loss of visual acuity, significantly impairing the quality of life and age-related viability, an integral indicator that is considered allostatic load. However, the allostatic load in patients suffering from diabetic retinopathy, as well as in other ophthalmological diseases, has not been practically studied and biomarkers characterizing the allostatic load of patients with diabetic retinopathy remain unknown.Purpose. To study of allostatic load in patients with diabetic retinopathy and the identification of biomarkers that most determine it.Patients and methods. Allostatic load was studied in 78 elderly patients with diabetic retinopathy and in 62 patients with type 2 diabetes mellitus without diabetic retinopathy. Allostatic load was analyzed according to systolic and diastolic blood pressure, body mass index, glycated hemoglobin, total cholesterol, triglycerides, albumins, C-reactive protein, homocysteine in the blood and glomerular filtration rate.Results. The most pronounced and statistically significant excess in patients with diabetic retinopathy compared with patients with diabetes mellitus without diabetic retinopathy was found to be the content of glycated hemoglobin in the blood up to 10.2 % versus 7.4 % and homocysteine up to 15.5 mmol/l versus 7.9 mmol/l, respectively. The value of the allostatic index was significantly higher in patients with diabetic retinopathy, amounting to 4.6 ± 0.4 points, versus 2.9 ± 0.3 points in patients with diabetes mellitus without ophthalmopathology under consideration (p < 0.001). Factor analysis made it possible to identify biomarkers of allostatic load in patients with diabetic retinopathy — glycated hemoglobin, homocysteine, triglycerides and albumins.Conclusion. These biomarkers are proposed to be used in assessing the age-related viability and effectiveness of rehabilitation measures carried out among patients with diabetic retinopathy.
Chronic periodontitis in children and adolescents holds a lead place in morbidity pattern of dental pathology. Development of chronic periodontitis is accompanied by emergence of various complications in the maxillofacial region, leading to bite disturbance being of high relevance for pediatric patients. These and other complications are related to immune system immaturity in children and adolescents as well as virulence of microorganisms. However, the immunological changes developing in children with chronic periodontitis remain poorly studied. The aim of the work was to improve diagnostics of chronic periodontitis in children and adolescents based on informative parameters of systemic immunity and discriminative models taking into account such changes. We examined systemic immunity in 127 children and adolescents with chronic periodontitis, aged 12 to 16 years, by using flow cytometry and enzyme immunoassay. In control group, age-matched 108 patients lacking overt somatic and dental pathology were enrolled. Generation of mathematical models was carried out by using a discriminative approach, whereas informativeness was assessed in accordance with generally accepted formula. Relative and absolute count of peripheral blood CD13+ cells exert the peak informativeness holding the first and second ranking places with marked dominance of informativeness value for assessing relative amount of CD13+ cells are among immunological parameters in children with chronic periodontitis. High informativeness value evidencing about pronounced intensity of developed pathological changes and diagnostic significance for chronic periodontitis in children is intrinsic to the relative percentage of peripheral blood CD8+ cells being slightly lower than that one in absolute count of CD13+ cells. On the other hand, humoral immune-parameters were of lowest informative value among all analyzed immunological parameters in patients with chronic periodontitis serum referring to all antibody classes. Generated discriminative models for the most valuable immunological parameters ensure adequate medical diagnostics for chronic periodontitis in childhood. Diagnostic sensitivity for created mathematical models was high and reached 0.94, whereas diagnostic specificity — 0.92. Immunological examination of patients improves diagnostics of chronic periodontitis. It was found that patients with chronic periodontitis had lowered immune status peaking in decreased absolute and relative count of peripheral blood CD3+ lymphocytes. Finally, parameters of humoral immunity in children with chronic periodontitis were also reduced.
The paper presents the results of mathematical-cartographic simulation study of the incidence of caries and acute apical periodontitis in pediatric population of Belgorod region. The Borisov district was found to be the most unfavorable area of the region with the highest incidence of the diseases. The forecast indicates an increase in the incidence of caries in children by 181.1 cases and acute apical periodontitis by 15.00 cases per 1.000 children annually in the coming years. The incidence of acute apical periodontitis is influenced by the excess of maximum permissible concentration of phenol and soot in atmospheric air, forming a homogenous cluster.
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