The aim: The study was aimed to compare the efficiency of intrathyroid steroid injection to oral steroid intake in patients with subacute thyroiditis. Materials and methods: 32 patients with subacute thyroiditis with insufficient result from NSAIDs treatment were randomly divided into two groups. The 1st group received two intrathyroid steroid injections, the 2nd group received oral prednisone. The results of the treatment were evaluated via ultrasound and evaluation of ESR and CRP at 0, 2, 4, 8 and 16 weeks of treatment. Results: Patients of the 1st group showed much faster result at the ultrasound compared to the 2nd group: mean decrease in hypoechogenity area 44,42% vs 16,35% at week 2, p < 0,001; 93,29% vs 75,98% at week 4, p < 0,001; 97,8% vs 95,24% at week 8, p = 0,4; mean decrease in ESR 66,34% vs 51,92% at week 2, p = 0,023; 84,43% vs 74,94% at week 4, p = 0,023; mean decrease in CRP 26,53% vs 20,77% at week 2, p = 0,024, 33,77% vs 29,98%, at week 4, p = 0,026. No side effects were noted during the treatment of patients of the 1st group. Conclusions: Compared to oral steroid intake intrathyroid steroid injection is faster, safer and generally better tolerated by patients.
Introduction: Chronic hyperglycemia as the main link in DM pathogenesis leads to systemic vessels and nerves lesion with chronic bone complications development consequently. The aim: To evaluate influence of hyperglycemia on reparative osteogenesis after perforated tibial fracture in rats. Materials and methods: A total of 30 white adult rats were subdivided into two groups: 15 healthy rats in Group 1 (control) and 15 rats with alloxan induced hyperglycemia in Group 2 (investigated) and were carried out of experiment on the 10th, 20th and 30th day after the fracture. Hyperglycemia in rats was verificated as the postprandial glycemic rate ≥ 8,0 mmol/l. Tibia diaphysis fracture was modeled by a cylindrical defect with a diameter of 2 mm with portable frezer. Morphological evaluation. A complex morphological studies included histological, morphometric and immunohistochemical examination. Results: This is confirmed by an increase in MMP-9 expression in connective tissue, a decrease in TGF-β expression in all phases, an increase in the expression of CD3 and CD20 and a marked decrease in the expression of all vascular markers. During hyperglycemia, incomplete blood supply to the tissues occurs, necrosis of bone and soft tissues develop in the area of the fracture, the reparative reaction slows down considerably and manifests itself in the development of fibrous and, less commonly, cartilage tissue. Conclusions: In hyperglycemia rats, there was a delay in the callus formation, a decrease in proliferation and ossification, and a slowdown in the processes of angiogenesis.
In Ukraine more than 13,000 lower limb amputations are performed per year, of which about 8,000 are due to vascular lesions, and more than 3,000 are associated with diabetes mellitus (DM). The effectiveness of photodynamic therapy (PDT) in group 1 was assessed by the VCSS-1 and VCSS-2 scales. At baseline, the total score of clinical severity of CVI was 20.9 points, and two weeks later – 15.71 points, which shows an improvement by 24.83% (p≤0.05). The effectiveness of PDT in group 2 was assessed by the S(AD) SAD-1 scales at baseline and S(AD) SAD-2 at 2 weeks. The overall score on the scale S(AD) SAD-1 was 13.91 points, two weeks later it improved by 11.65% (12.29 points), which shows a much slower rate of normalization of the clinical picture in patients with diabetes compared with CVI. The effectiveness of plasma therapy in group 1 was assessed by the VCSS-1 and VCSS-3 scales. The total score of clinical severity of CVI after 6 weeks of treatment was 9.72 points, indicating an improvement in clinical status by 53.49% from baseline (20.9 points) (p≤0.05). In group 2, the evaluation of the effectiveness of plasma therapy was based on a comparison of the scales S(AD) SAD-1 and S(AD) SAD-3. The overall score of clinical severity at 6 weeks was 6.39 points, indicating an improvement by 54.06% from baseline (13.91 points). Analysis of the ulcer healing dynamics in group 1 revealed 0 points (no active ulcers) in 87.5% of patients (28 patients), while in the remaining 4 patients the size of active ulcers was 1 point. In group 2, the dynamics of the area reduction showed slower results: in 74.2% of patients the TU area was 2 points, 0 points were achieved in 12.9% patients, in the remaining patients (12.9%) – 4 points. Due to using of combined scheme of basic therapy, supplemented with PDT at the initial stage and plasma therapy in the granulation phase, it was possible to improve the dynamics of the rate of healing of TU and reduce the duration of treatment.
* The study was conducted as part of a scientific program «Scientific justification for improving health care and public health quality», state registration number 0110U07572. Institution, which financed the research: Ministry of Health of Ukraine.
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