Studying the significance of the immune response to damage and adipokine levels is urgent regarding the development of both chronic pancreatitis and type 2 diabetes mellitus. Our objective was to study the indices of tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), adiponectin, leptin, and resistin as links for triggering the mechanisms of development and progression of the low-grade chronic systemic inflammatory response in chronic pancreatitis (CP) patients with type 2 diabetes mellitus (T2DM). The study groups consisted of 87 patients: 47 patients with isolated CP (group I), 40 with CP combined with T2DM (group II), and 41 practically healthy persons. It has been established that in patients with isolated CP, the TNF-α concentration showed a reliable 1.57-fold (p <0.05) increase compared to practically healthy persons (PHP) and a 1.32-fold increase in patients who also had T2DM (p<0.05). CP patients with type 2 diabetes mellitus had the highest CRP indices (5.5-fold, p <0.05. TNF-α and C-reactive protein indices were higher in patients with chronic pancreatitis and T2DM than those with isolated chronic pancreatitis, characterizing the persistence of chronic systemic inflammation in case of the combined clinical course of these diseases.
The aim: To examine the features of the clinical course of osteoarthritis in combination with type 2 diabetes on the background of obesity and hypertension. Materials and methods: 116 patients who were in the inpatient stage of treatment in the rheumatology department of the Chernivtsi Regional Clinical Hospital during 2015-2017 were examined. The epidemiological and clinical features of osteoarthritis in patients with type 2 diabetes mellitus were also analyzed. Results: It was found that the course of osteoarthritis is extremely severe with limited range of motion in the joints, their deformation and significant deteri¬oration of functional capacity, duration of pain, periodic prolonged exacerbations, the predominance of knee and hip injuries (64.8%) and 14.8 persons - small joints. This showed the progression and generalization of processes in various joints, aggravation of the course and prognosis of osteoarthritis, especially in women. Their prevalence was registered at II radiological stage (59.27% and 74.0%, respectively). Conclusions: The authors emphasize that such a clinical course indicates the worst prognosis. This multimorbidity of diseases requires treatment, observation and consultation with a traumatologist, rheumatologist and endocrinologist, due to the multisystem approach to the treatment and rehabilitation of such patients with an emphasis on individual clinical features (including gender) and the course of comorbidities or syndromes.
INTRODUCTION: The effect of hormonal status on the functional state of the liver and endocrine disfunction caused by liver diseases are beyond doubt for most authors. OBJECTIVES: The aim was to assess thyroid homeostasis in patients with chronic hepatitis and analyze the association between serum thyroid parameters and A/C polymorphism of the deiodinase type 1 (DIO1) gene. METHODS: The study was conducted on 50 patients with chronic hepatitis and 20 healthy controls. The serum free thyroxine (fT4), free triiodothyronine (fT3) and thyroid stimulating hormone (TSH) were measured and fT3/fT4, fT4/fT3, TSH/fT3, TSH/fT4 ratio, thyroid index and total thyroid index were calculated. The alleles of the polymorphic A/C sites in the DIO1 gene were studied. RESULT: The level of fT3 was reduced and fT4 level was increased in patients with chronic hepatitis. The fT3/fT4 ratio decreased below the reference range and fT4/fT3 ratio increased by 24,1%. Elevation of the TSH level and TSH/fT3 ratio were determined. The titres of tyroglobulin autoantibodies and antithyroid peroxidase antibodies significantly exceeded the control values. It has been established that the carriage of the C-allele DIO1 was associated with an increasing fТ3 level and fТ3/fТ4 ratio, and a decreasing fТ4/fТ3 ratio and fТ4 level, while the presence of А-allele resulted in a decrease in the fТ3/fТ4 ratio and serum fТ3 with the increase in Т4 level in patients with chronic hepatitis.CONCLUSIONS: Chronic hepatitis is accompanied by the development of non-thyroidal illness syndrome. Pathologycal changes in thyroid metabolism are associated with A/C polymorphism of the DIO1 gene. UDC Classification: 616.3; DOI: http://dx.
Thyroid nodules are common, occurring in 50–60% of healthy patients. Currently, there are no effective conservative treatment options for nodular goiter, and surgery can have limitations and potential complications. The purpose of this study was to evaluate the efficacy, tolerability, and long-term results of using sclerotherapy and laser-induced interstitial thermotherapy (LITT) to treat benign thyroid nodules. A retrospective analysis was conducted on 456 patients with benign nodular goiter who received LITT. The volume of the nodular goiter was measured at 1, 3, 6, and 12 months post-treatment, and a repeated fine needle aspiration (FNA) with the cytological examination was performed to verify the structure of the nodular goiter in the long term. The results showed that LITT was an effective method for treating nodular mass (nodules), as evidenced by a decrease in the volume of NG by 51–85% after 6–12 months. FNA results 2–3 years after LITT showed no thyrocytes, only connective tissue, indicating the efficacy of LITT for benign thyroid nodules. LITT is highly effective in most cases, often resulting in the disappearance or significant decrease in nodular formations.
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