Objective. To study the effect of peloids Saki Lake and brine, combined with the drug “Berlition® 600” on immunoregulatory processes based on morphological and functional changes of the skin in patients with plaque psoriasis. Materials and methods. The study involved 90 patients with plaque psoriasis mild to moderate severity. The study group included - 45 patients receiving therapeutic mud treatments, and the brine baths in conjunction with the “Berlition® 600” in the control group - 45 patients treated with mud baths and RPMA. All patients using flow cytometry laser defined subpopulations of T-lymphocytes. The concentration of Ig A, M and G in the blood was determined by mikroturbidimetricheskim with monospecific antisera; proinflammatory and anti-inflammatory cytokines (IL-1a, IL-2, IL-8, IL-10, TNF-α) was measured by enzyme-linked immunosorbent assay (ELISA). Immunohistochemistry Skin biopsy were studied with the definition of CD3+, CD4+, CD8+ T-lymphocytes. Results and discussion. Patients in both treatment groups revealed an imbalance of T and B-cell immunity to the reduction in the number of helper-inductor (CD4+) and cytotoxic (CD8+) subpopulations of T-L in peripheral blood and increase in CD3+, with a predominance of CD8+ in psoriatic infiltrate amid overproduction of cytokines. Procedures for medical mud and the brine baths in combination with the drug “Berlition® 600” has a marked immunomodulatory effect due normalitsatsiey of T-cell immunity and reduction of the balance of cytokine profile, “clinical cure” and “significant improvement” reached 45 (100%) patients, the index regression PASI- 96,7 ± 1,3% DLQI-86 ± 2,1%. Conclusions. Peloids, balneotherapy in Lake Saki in combination with the drug “Berlition® 600” has a high clinical efficacy due to immunomodulatory, antiproliferative and anti-inflammatory effects and can be recommended as a differentiated, immunomodulatory therapy in patients with plaque psoriasis mild to moderate severity.
Мониторинг эпидемиологических показателей заболеваемости меланомой кожи и возможности повышения эффективности ее ранней диагностики в Республике Крым о.А. Притуло, д.в. ПроХоров, М.ю. КуЗнецовА Медицинская академия им. С.и. Георгиевского ФГАоу во «КФу им. в.и. вернадского», Симферополь, республика Крым Приведены эпидемиологические показатели заболеваемости и смертности от меланомы кожи в республике Крым. Анали-зируются причины роста заболеваемости, пути совершенствования ранней диагностики и профилактики меланомы кожи. дана оценка реализации онкологической программы, которая направлена на качественное преобразование системы ока-зания первичной и специализированной медицинской помощи, усиление роли и повышение ответственности первичного медико-санитарного звена в раннем выявлении злокачественных новообразований, повышение онкологической насторо-женности и профессионализма медицинских работников в области клинической онкологии. разработка и внедрение про-филактических и скрининговых программ регионального уровня позволяет выявлять больных до стадии манифестации заболевания, существенно повышая шансы на эффективность специфического лечения и благоприятный прогноз. The paper presents the epidemiological indicators of cutaneous melanoma mortality and morbidity in the republic of crimea. It analyzes the reasons for increasing mortality rates and the ways of improving the early diagnosis and prevention of cutaneous melanoma. The implementation of the cancer program aimed to qualitatively transform the primary and specialized healthcare system and to increase the role and responsibility of primary health care in the early detection of malignant tumors and the cancer alertness and professional competence of health workers in clinical oncology is assessed. The elaboration and introduction of prevention and screening programs at the regional level allow identification of patients before the manifestation of the disease, by substantially increasing their chances for the efficiency of specific treatment and for a favorable prognosis.
The article presents review data of domestic and foreign scientific researchers on etiopathogenesis and clinical picture of chronic dermatosis - microbial eczema. Among chronic skin diseases, microbial eczema accounts for about 40%. According to the results of epidemiological studies, the incidence of microbial eczema among the inhabitants of the Russian Federation ranges from 6.0 to 15 cases per 1,000 people, which indicates a wide spread of this disease. The urgency of studying ME is conditioned by the persistent tendency to an earlier debut of the disease, weighting of the clinical picture, an increase in the number of relapses, and the spread of the pathological process on the skin. It should be noted that resistance to traditional methods of treatment used in microbial eczema is becoming more and more common. The above factors are the basis for further in-depth study of dermatosis and search for new effective treatment methods.
Eczema is a polyethyological disease that occurs as a result of the action of infectious and allergic, metabolic, neuroendocrine, vegetative and hereditary factors, clinically manifested by polymorphic rashes with a pronounced inflammatory reaction, accompanied by severe itching. Among all skin diseases of eczema takes the leading position, about 30-40 % of dermatological patients have this diagnosis. At the same time, every year there is a steady increase in the rate of eczema. Clinically effective is the use of complex treatment of eczema, which includes, in addition to standard pharmacological therapy, includes physiotherapeutic methods and spa factors, which together give a lasting positive therapeutic effect.
Quality of life indicators (QL) of patients are widely used in dermatological practice, but the influence of depressive and dissomnic symptoms on QL of patients with gender differences is not sufficiently studied.Objective: to identify depressive and dissominal symptoms in patients with psoriasis and evaluate its impact on the quality of life of these patients taking into account gender differences.Materials and methods: 34 patients with psoriasis were examined. Clinical examination included: analysis of complaints, medical history, assessment of dermatological status. Diagnosis of the presence and severity of depression was performed using a PHQ-9 patient health rating scale. Dissominal symptoms in patients with psoriasis were determined using the index of severity of insomnia ISI. To assess the quality of life, a dermatological index of quality of life (DLQI) was used.Results and discussion. Sleep disorders were detected in 15 patients (44.1%), depressive symptoms were determined in all patients, a negative effect of the disease on the quality of life of patients was found in 32 people (94.1%).Correlation analysis of data from the entire population of patients revealed statistically significant correlations of DLQI with the severity of depressive symptoms (r = 0.45, p = 0.008) and sleep disorders (r = 0.35, p = 0.04). In women, DLQI significantly correlates with the severity of depression (r = 0.48, p = 0.04) and tends to be associated with sleep disturbances (r = 0.43, p = 0.07). In men, the relationship between DLQI and indicators of depression and sleep disturbances is significantly weaker and is not statistically significant ((r = 0.34, p = 0.22) and (r = 0.17, p = 0.55), respectively).Conclusion.depressive symptoms and sleep disorders are interrelated with the quality of life of patients with psoriasis, and this relationship is more pronounced in women. Consequently, it is advisable to include effects aimed at normalizing mood and sleep in the program of complex therapy of psoriasis, taking into account gender differences.
The article outlines the questions of pathogenesis of acne as well as clinical trial data, which indicate that the skin of patients with acne needs comprehensive care with therapeutic cosmetics. Long term use of medical cosmetics has a positive effect on the course of acne disease. The basis of the study is the use of cosmetics line A “Skinormil” including the patented complex Citobiol lRIS, zinc sulfate and vitamin A. Seventy-four patients with acne of the first, second and third severity were monitored and it was recommended them a comprehensive skin care with medical cosmetics. According to the analysis of the clinical picture, it was concluded that on the background of proper care, there is a positive dynamics in the course of acne.
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