Cystic fibrosis is one of the urgent medical and social problems of health care systems in most countries due to fairly high prevalence, development of multi-organ lesions, and poor outcomes.Due to modern advances in the diagnosis and treatment of cystic fibrosis, not only has the average life expectancy of patients increased, but their quality of life has also improved, and it has become possible to maintain pregnancy and childbearing. Since cystic fibrosis can adversely affect the course of pregnancy, childbirth, and health of both mother and child, proper management of women with cystic fibrosis during pregnancy and childbirth is of particular relevance. The presented clinical case is an example of competent supervision at all stages of monitoring of a patient with cystic fibrosis during pregnancy and childbirth.
Purpose. The aim of the study was to investigate the subpopulation composition and prooxidant activity of adipose tissue cells in the big omentum of patients with metabolic syndrome.Material and Methods. A fragment of white adipose tissue obtained from the greater omentum during planned endoscopic cholecystectomy in 37 female patients aged 48 (34; 65) years was used as a material for the study. The main group was represented by patients with metabolic syndrome (n = 31) diagnosed according to current recommendations for management of patients with metabolic syndrome. Six patients without signs of metabolic syndrome, comparable with the main group in terms of age and gender, made up the comparison group. The subpopulation composition of the adipose tissue cells in the greater omentum was determined by immunohistochemical analysis. The content of reactive oxygen species in the isolated cell pools of adipocytes and mesenchymal stromal cells was identified using flow cytometry.Results. Comparison of the mean values in the groups showed a statistically significant prevalence in patients with metabolic syndrome only in the level of cells expressing CD68 (macrophage marker) on their surface (p < 0.05). Correlation analysis allowed to detect a positive relationship between morphometric indicators determining the severity of infiltrative changes of adipose tissue (the number of infiltrates) and the relative number of cells presenting CD3 (r = 0.357, p < 0.05), CD36 (r = 0.575, p < 0.05), and CD68 (r = 0.374, p < 0.05) on their surface, respectively. A comparative analysis of the level of reactive oxygen species in adipose tissue cells showed statistically significantly (p < 0.05) higher values of reactive oxygen species in patients with metabolic syndrome compared with the control group both in adipocytes and in mesenchymal stromal cells.Conclusion. The presence of a positive correlation between the relative numbers of cells presenting CD3, CD36, and CD68 markers and the morphometric parameters reflecting the severity of infiltrative manifestations suggested that the mentioned cell lymphocyte and macrophage populations were involved in the development of infiltration in the adipose tissue in metabolic syndrome. The pro-inflammatory phenotype of adipose tissue in metabolic syndrome was characterized not only by a number of morphological features, but also by enhanced prooxidant activity of the adipocytes and mesenchymal stromal cells.
The review summarizes and analyzes the results of domestic and major foreign studies of recent years concerning gender characteristics of the epidemiology and development mechanisms of metabolic syndrome and urolithiasis as an associated disease. A deep understanding of gender aspects in the pathogenesis of these pathologies can form the basis for development of high-quality diagnostic algorithms and pathogenetically grounded approaches to treatment.
Idiopathic pulmonary fibrosis (IPF) is one of the most common diseases in the group of interstitial lung diseases, which is characterized by persistent progression and poor prognosis. Over the past decade, experts have made significant progress in developing a diagnostic algorithm for IPF patients. This algorithm includes analysis of clinical, laboratory, and instrumental data, primarily the results of high-resolution computed tomography (HRCT). Precise adherence to the diagnostic algorithm and correct interpretation of HRCT data are prerequisites for IPF diagnosis.Specialists of the Tomsk region have developed routing of patients with suspected IPF. The presented clinical case is a successful example of adhering to this algorithm. Wide implementation of modern diagnostic algorithms into diagnosis and treatment of IPF and quality improvement of imaging methods, primarily HRCT, carried out as a part of the differential diagnosis, open up prospects for early diagnosis of this pathology. A timely prescribed antifibrotic therapy (nintedanib, pirfenidone) in IPF allows to slow down pathological progression and improves the prognosis.
Aim. To evaluate the possibility of using lung ultrasound for diagnosing COVID-19 pneumonia in patients of the respiratory hospital of Siberian State Medical University (SSMU).Materials and methods. An analysis of lung ultrasound data was carried out in 39 patients (17 men and 22 women aged 33–78 years) with COVID-19 pneumonia. Lung ultrasound was performed in all patients in addition to radiography performed at the prehospital stage and in 15 patients who underwent computed tomography (CT) of the lungs.Results. In the majority (61.6%) of cases, during the ultrasound examination, COVID-19 pneumonia manifested itself as interstitial lung disease. The white lung phenomenon and a combination of the aforementioned interstitial changes were recorded with the same frequency (5.1%), while pulmonary consolidation in addition to interstitial changes was visualized in 10.2% of cases. Interstitial lung disease was bilateral in 83.3% of patients and unilateral in 16.7% of cases. The inferior lobes of the lungs were affected in 60.0% of cases, middle lobe – in 30.0% of cases, and superior lobes – in 15.0% of patients. The ultrasound examination detected changes in the lungs in 32 patients, while radiographic changes were present in 35 cases. Bilateral inflammation was more often detected by radiography than by ultrasound. When comparing the data of lung ultrasound and CT, the agreement between the methods was found in 66.7% of cases, and the discrepancy between the findings of the two methods was observed mainly in patients with a large number of affected segments of the lungs and localization of the disease in the superior lobes according to CT.Conclusion. Lung ultrasound is a valuable tool that can be used to stratify risk in patients at any stage of diagnosis and treatment in the context of the COVID-19 pandemic due to availability, speed of implementation, and the absence of a need for patient transportation.
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