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A UNIQUE CASE OF BILATERAL VOCAL FOLD PARALYSIS FOLLOWING SPINAL ANAESTHESIA
Get PDFCranial nerve palsies are potential but rare complications of spinal anaesthesia. Most of the literatures support upper cranial nerve palsies like VI, IV and III cranial nerve palsies. Intrathecal hypotension resulting in tractional injury of the cranial nerves is the likely mechanism of injury. As on date, some cases of unilateral vocal fold paralysis and very little bilateral vocal fold paralysis have been described in case reports. We have described a patient who developed hoarseness and dysphagia 7 days after receiving spinal anaesthesia for fixation of inter-trochanteric fracture femur. The patient was diagnosed with bilateral vocal fold paralysis. He was managed conservatively and exhibited complete spontaneous recovery as has been described in the previously reported cases. Any patient presenting with idiopathic vocal fold paralysis should be enquired about the history of spinal or epidural anaesthesia. If the history is affirmative, then it points towards transient intrathecal hypotension as a potential etiology of the cranial nerve palsy
CYTOKERATIN-18 AS A MARKER OF NON-ALCOHOLIC FATTY LIVER DISEASE IN OBESE ADOLESCENTS
Get PDFIn parallel with the obesity epidemic in the world, the prevalence of non-alcoholic fatty liver disease among children and adolescents is growing. Current data suggest that insulin resistance is one of the main factors in the pathogenesis of non-alcoholic fatty liver disease, and the content of fragments of caspase-cleaved cytokeratin-18 in the blood serum may be one of the informative indicators of non-alcoholic fatty liver disease progression.
The aim. To determine mechanisms of formation and progression of non-alcoholic fatty liver disease in obese children and adolescents by evaluating the level of cytokeratin-18.
Materials and methods. The study involved 46 adolescents with obesity and non-alcoholic fatty liver disease aged 12–17 years: 19 boys (41.3 %) and 27 girls (58.7 %). Clinical (weight, height, waist and hip circumference), laboratory (glucose, immunoreactive insulin, lipid metabolism, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, cytokeratin-18) parameters were studied and instrumental examination (abdominal ultrasound) was performed. To assess insulin resistance the triglyceride-glucose index was calculated.
Results. Depending on the presence of insulin resistance patients were divided into two groups: 21 (45.7 %) of adolescents with insulin resistance and 25 (54.3 %) of adolescents without insulin resistance. Blood tests in patients with insulin resistance revealed significantly higher levels of total cholesterol, triglycerides, very low-density lipoprotein cholesterol, fasting immunoreactive insulin, cytokeratin-18 and gamma-glutamyl transpeptidase. All adolescents were divided into 2 groups depending on the level of cytokeratin-18: patients with cytokeratin-18 >233 mIU/ml and <233 mIU/ml (15 (32.6 %) and 31 (67.4 %) respectively). It was found that there were significantly more patients with insulin resistance in the group with the level of cytokeratin-18 >233 mIU/ml.
Conclusion. In obese adolescents with non-alcoholic fatty liver disease insulin resistance is associated with more pronounced disorders of lipid and carbohydrate metabolism and higher levels of markers that characterize the state of the liver such as cytokeratin-18 and gamma-glutamyl transpeptidase. Adolescents with obesity and non-alcoholic fatty liver disease with a threshold level of cytokeratin-18, which indicates the transformation of steatosis into steatohepatitis, two times more often have present insulin resistance
INFLUENCE OF THE ACUTE INFLAMMATION AND ENDOTHELIAL DYSFUNCTION ON THE RETINAL VEIN OCCLUSION FORMATION AFTER CARDIO-SURGICAL INTERFERENCES WITH THE USE OF CARDIOPULMONARY BYPASS
Get PDFAcute inflammation and endothelial dysfunction (EDF) are typical pathological processes, which determine the development of retinal vein occlusion (RVO) during cardio-surgery with the use of cardiopulmonary bypass (CB), but the connection of seromarkers according to the terms of occlusion appearance remains undefined.
The aim – to determine the influence of the acute inflammation and EDF for RVO formation after cardio-surgical interferences with the use of CB according to the terms of occlusion appearance.
Material and methods. There were selected for the research the data of 137 eyes (126 patients, the main group) with RVO after the surgery with CB. The comparison group contains the data about examination of 86 eyes (43 patients), who had not any occlusion during all term of examination. The control group consisted of 10 eyes (5 patients) without occlusion, which were examined before surgery. An ophthalmologist 2, 7, 30, 60, 90 and 180 days after cardio-surgical interference, examined patients. The content of IL-6, IL-8 and VE-cadherin in blood serum was determined by immunoenzyme technique (Bender Medsystems, Austria). Statistical data processing was performed with the use of Statistica 10 program (StatSoft, Inc., USA), regression analysis – with the use of the program package GLZ.
Results. The conduction of cardio-surgeries with the use of CB caused an increase of the interleukins content in the early period (IL-6 on the 2nd and 7th days, and IL-8 up to 30 days), while the content of VE-cadherin (VE-C) was slightly increased during almost all period of monitoring. With the availability of RVO, the content of IL-6 during all terms of occlusion appearance was significantly higher, the content of IL-6 was up to 30 days, and the content of VE-C in a greater degree was after the 7th day.
The regression analysis showed that after 1-2 days RVO appearance was directly related with the content of IL-6 and IL-8 in the blood, on the 3rd and 7th days – only with the content of IL-8, on the 8th and 30th days – with the content of all markers, and then with the content of IL-6 and VE-C. The accuracy of the prediction of the presence or absence of RVO at the appropriate period according to the calculated regression model is at least 78 % (p <0.001), what proves the influence of markers on the development of RVO.
Conclusions. The undertaken study shows the meaning of the acute inflammation and EDF by appearance of RVO with the use of CB, what justifies the application of the preventive measures - at the early stages the restriction of activity of the inflammatory process, at the later stages – prevention of EDF development
PATHOMORPHOLOGICAL CHANGES IN THE SKIN OF THE GUINEA PIGS IN THE COURSE OF MICROSPORES
Get PDFDuring the course of microspores on the skin, the balance between the species of saprophytic microorganisms and hypersensitivity as an integral part of the inflammatory reaction resulting from the presence of the pathogen in the skin is disturbed. The degree of expression of inflammation varies. Clinical manifestations of microsporia are manifested by erythema, alopecia, scaly and crust formation.
The aim. Histological studies were performed to determine pathomorphological changes in the skin of guinea pigs during microsporia. The studies were conducted on clinically healthy and sick guinea pigs during the acute course of the disease, during regeneration and during recovery.And also carry out a description and characterization of the identified changes in the skin.The obtained research results showed that patients with microsporia had changes in the morphological composition of the skin, which were characterized by thickening and keratinization of the epidermis, there were small-focal polymorphic cell infiltrates, there was a violation of the microvasculature and the formation of micellar formations.
Materials and methods. The material for histological examination(pieces of guinea pig skin) was fixed in a 10–12 % cooled solution of neutral formalin, followed by pouring into paraffin according to the scheme proposed by G.A. Merkulov (1969). Histomic sections 5–7 μm thick were made on the MC-2 dome microtome. Hematoxylin and eosin staining were used for the morphological evaluation of cells and tissue. Microscopy was performed using an OLIMPUS CX-41 microscope.
Results. Signs of superficial inflammation with hyperkeratosis and desquamation of cells of the stratified epithelium, microcracks of the epidermis were found in the skin of the patient with microsporia of the tentacle during the acute course. Signs of inflammation of the follicles and surrounding tissues are visualized. Round-cell and plasma connective tissue infiltrates of the connective tissue of the skin were detected by lymphoid, histiocytic and other cellular elements. There is moderate leukocyte infiltration in the dermis. Signs of inflammation by type of infiltration around the hair follicles, enlargement of the blood capillaries and the presence of microabscesses.
In the stage of regeneration during recovery, a clear contoured layer of epithelial cells is established. There are no signs of inflammatory reaction in the dermis.
Conclusion. In microspores, inflammatory processes occur in all layers of the skin. The skin of sick animals loses its barrier function due to pathomorphological changes. The long-term consequences of the pathological process during the course of microspores can provoke the development of chronic dermatitis with scleroderma.
During the course of microspores on the skin, the balance between the species of saprophytic microorganisms and hypersensitivity as an integral part of the inflammatory reaction resulting from the presence of the pathogen in the skin is disturbed. The degree of expression of inflammation varies. Clinical manifestations of microsporia are manifested by erythema, alopecia, scaly and crust formation.
The aim. Histological studies were performed to determine pathomorphological changes in the skin of guinea pigs during microsporia. The studies were conducted on clinically healthy and sick guinea pigs during the acute course of the disease, during regeneration and during recovery.And also carry out a description and characterization of the identified changes in the skin.The obtained research results showed that patients with microsporia had changes in the morphological composition of the skin, which were characterized by thickening and keratinization of the epidermis, there were small-focal polymorphic cell infiltrates, there was a violation of the microvasculature and the formation of micellar formations.Materials and methods. The material for histological examination(pieces of guinea pig skin) was fixed in a 10–12 % cooled solution of neutral formalin, followed by pouring into paraffin according to the scheme proposed by G.A. Merkulov (1969). Histomic sections 5–7 μm thick were made on the MC-2 dome microtome. Hematoxylin and eosin staining were used for the morphological evaluation of cells and tissue. Microscopy was performed using an OLIMPUS CX-41 microscope.
Results. Signs of superficial inflammation with hyperkeratosis and desquamation of cells of the stratified epithelium, microcracks of the epidermis were found in the skin of the patient with microsporia of the tentacle during the acute course. Signs of inflammation of the follicles and surrounding tissues are visualized. Round-cell and plasma connective tissue infiltrates of the connective tissue of the skin were detected by lymphoid, histiocytic and other cellular elements. There is moderate leukocyte infiltration in the dermis. Signs of inflammation by type of infiltration around the hair follicles, enlargement of the blood capillaries and the presence of microabscesses.
In the stage of regeneration during recovery, a clear contoured layer of epithelial cells is established. There are no signs of inflammatory reaction in the dermis.
Conclusion. In microspores, inflammatory processes occur in all layers of the skin. The skin of sick animals loses its barrier function due to pathomorphological changes. The long-term consequences of the pathological process during the course of microspores can provoke the development of chronic dermatitis with scleroderma
COMPARING OF FAECAL CALPROTECTIN LEVELS IN PATIENTS WITH OSTEOARTHRITIS TAKING NSAID TREATMENT AND PATIENTS WITHOUT NSAIDS THERAPY
Get PDFFaecal calprotectin (FC) level can be increased in several conditions, which are characterised by neutrophilic inflammation. Some medications, particularly NSAIDs, can elevate its level as well. NSAIDs are taken by patients in many chronic conditions, including osteoarthritis (OA).
On the other hand, there is growing evidence that osteoarthritis is not only a degenerative disease, but it has a significant inflammatory component. The role of systemic inflammation is well-known in inflammatory joint diseases, but there is some evidence that it can play an essential role in the OA as well. It can suggest that in the OA, the inflammatory changes could be found in the different organs and systems.
The aim of this study was to investigate the FC level in patients with osteoarthritis depending on the NSAIDs intake and to compare it to the FC levels in healthy adults.
Materials and methods. In this small observational study, we evaluated the FC levels in patients suffering from OA (36 persons), divided them into two groups depending on their NSAIDs intake, and compared it to FC levels in healthy participants (12 persons). We compared the FC levels depending on the selectivity of the NSAIDs taken by our participants, as well.
Results. The median calprotectin level in our patients was 72.57 (IQR 20.55-221.57) mg/kg, 95 %CI 26,18-109.01. OA patients had higher levels than the healthy group (p<0.001). OA patients who took NSAIDs had the highest FC levels – 221.57 (IQR 91.56-448.61) – higher, than those who did not take it – 72.57 (IQR 35.26-164.79) (p=0.03) and than healthy participants, who has normal FC levels (p<0.001); the FC levels of patients who did not take NSAIDs also exceeds healthy subject’s levels (p<0.001). The FC levels in the collective group have a sufficient positive correlation with the duration of NSAIDs intake, VAS score and strong correlation with Lequesne index values. We found that both NSAIDs groups have a significantly greater prevalence of elevated or high FC levels than the control group (p<0.001) and that NSAIDs patients significantly more often have high FC levels than those who do not take NSAIDs (p=0.035). When comparing FC levels in patients depending on the type of NSAIDs they take, we found that those who take non-selective NSAIDs has significantly higher FC levels than those who do not take NSAIDs – 264.1 (IQR 89.72-464.67) to 25.65 (IQR 19.5-75.33) (p=0.0003). The FC levels of who take selective NSAIDs – 98.53 (91.56-105.5) – did not differ significantly to non-selective NSAIDs taker’s group values and non-selective NSAIDs taker’s values (p>0.05).
Conclusions. Patients who suffer from OA have higher FC levels than healthy individuals, and patients with OA who take NSAIDs regularly have higher FC levels than those who do not. The intake of non-selective NSAIDs is associated with higher FC levels, than the intake of high-selective NSAIDs. FC levels of those who take high-selective NSAIDs do not differ statistically from those who do not intake NSAIDs. Further research is needed in this area
GENETIC (RAPD-PCR) VARIABILITY OF STAPHYLOCOCCUS AUREUS STRAINS EXTRACTED FROM LOCUS MORBI AND INTAKT SKIN OF PATIENTS WITH ALLERGODERMATOSIS
Get PDFThe article presents data on the study of genetic relatedness of S. aureus strains growing on the skin and nasal passages of patients with allergodermatoses. A study of the possible correlation between the genotype of the pathogen and the burden of allergodermatoses using the RAPD-PCR method was done.
The aim of the research: determination by RAPD-PCR analysis (Random Amplified Polymorphic DNA) of genetic variability and affinity of S. aureus strains extracted from locus morbi, intact areas of skin and nasal mucosa of patients with allergodermatoses (AD and IE).
Materials and methods. RAPD-PCR was used to genotype 111 strains of Staphylococcus aureus extracted from the skin and nasal passages of patients with allergodermatoses (AD and IE), as well as 11 strains isolated from the skin of almost healthy individuals to identify genetic links between these strains. These strains were removed from patients with AD and IE who sought medical help in the dermatological department of the State Institution "Institute of Dermatology and Venereology of the National Academy of Medical Sciences of Ukraine" during 2016-2019.
Results. When comparing the RAPD spectra of strains extracted from the affected and intact areas of the skin of patients with mild and severe AD, the degree of genetic relatedness of the strains was 75.1±4.4 % and 98.8±0.8 %, (P˂0,001), respectively, indicating a high level of affinity of the strains. Strains of S. aureus removed from the nasal passages of patients with AD had a high level of genetic affinity with strains removed from the affected areas of the skin – 79.5±1.6 %, which indicates the auto-origin of strains growing on the skin of patients. The affinity of strains isolated from patients with IE with the reference culture of S. aureus ATCC 25923 was 27.4±1.8 % and 52.0±5.2 % for strains isolated from patients with AD, indicating their low genetic relatedness.
Conclusions. In the study of RAPD spectra of S. aureus strains isolated from patients with both AD and IE, no genotype was identified that would be associated with the disease or its severity. A high level of genetic affinity of strains extracted from locus morbi with strains extracted from the nasal passages of patients with AD, indicating the auto-origin of strains that grow on the skin of patients. It is shown that with increasing severity of AD, the genetic monotype of isolated pathogens increased: in patients with mild AD, 3 genetic clusters of the microorganism were identified, with moderate – 2, and with severe only one
EVALUATION OF THE MINERALIZING POTENTIAL OF ORAL FLUID IN CHILDREN WITH DOWN SYNDROME DEPENDING ON THE LEVEL OF THE CARIOGENIC PROCESS
Get PDFEarly diagnosis of dental caries in children is difficult. This fact is applied to children with Down syndrome. In order to identify predictors of dental diseases, a crystallographic method is widely used for studying oral fluid.
The aim of the work is to evaluate the mineralizing potential of oral fluid in children with Down syndrome before and after the course of preventive measures.
Material and methods. We examined oral fluid in children with Down syndrome. Children and adolescents at the age of 8 months to 17 years (n=21) were divided into groups depending on the age and the level of caries intensity. The results were compared with the data of 55 children without chromosomal pathology.
Results. The group of children with Down syndrome (MG), during the initial examination includes type II – 11 people (53 %) and type III – 7 people (33 %) microcrystallization of saliva, which generally corresponds to the situation in the group of children without chromosomal pathology (CG), where type II included 62 % (34 people) and type III – 22 % (12 people). The average value of the mineralizing potential of saliva in the main group was 2.78±0.22, and in the control group – 2.89±0.17.
Conclusions. After preventive measures during the re-examination of children with Down syndrome, there was a tendency to an increase in the level of parameters of the mineralizing potential of saliva while maintaining this level after 6 months
DEVELOPMENT AND VALIDATION OF METHODS FOR QUANTITATIVE DETERMINATION OF SODIUM HYALURONATE IN THE COMPOSITION OF COMBINED DENTAL GEL
Get PDFAccording to the EP monograph "Sodium hyaluronate" for identification they use the infrared transmission spectrum of the substance, quantification is carried out by spectrophotometry.
The aim of the work was to develop a method for quantitative determination of hyaluronic acid in the gel in the presence of other substances and its validation.
Materials and Methods. The object of the study were samples of combined dental gel of the following composition: metronidazole benzoate 16 mg/g, miramistin 5 mg / g, sodium hyaluronate 2 mg / g. Identification and quantification of sodium hyaluronate was performed by liquid chromatography (SPhU, 2.2.29, 2.2.46). The test solution and the reference solution were chromatographed, obtaining the number of parallel chromatograms not less than when checking the suitability of the chromatographic system. Chromatography is performed on a liquid chromatograph with a diode-matrix detector under the following conditions: chromatographic column PL-aquagel-OH, Agilent size 300 mm × 7.5 mm, with a particle size of sorbent 8 μm; mobile phase A: 0.1 M sodium sulfate solution; mobile phase B: acetonitrile for chromatography P; detection at a wavelength of 210 nm.
Results. The retention time of sodium hyaluronate on the chromatogram of the test sample of the gel coincides with the peak and the retention time on the chromatogram of the comparison solution of the standard sample of the substance. The suitability of the chromatographic system for 3 parallel determinations was checked: the relative standard deviation (RSD) is equal to 0.25, the number of theoretical plates is 980, the symmetry coefficient is 1.293. The validation characteristics of the developed methodology meet the established eligibility criteria. The spectral purity coefficients (Fp) of the sodium hyaluronate peak on the chromatograms of the model solution are Fp1=997.665 and Fp2=997,802. The method is linear in the range of sodium concentration of hyaluronate 80–120 %, the calculated linear dependence of the reduced area of the chromatographic peak on the reduced concentration of sodium hyaluronate is |a|=1.9490≤Δa=2.56. The confidence interval of the unit value for the sample of relations is found / entered Δz=1.08, which corresponds to the condition Δz≤1.6 %. The value of the systematic error is equal to δ=0.12, which satisfies the condition δ≤0.51 %.
Conclusions. The method of quantitative determination of sodium hyaluronate by the method of high-performance liquid chromatography has been developed and investigated. The method allows the identification and quantification of sodium hyaluronate in the composition of the dental gel, in the presence of metronidazole benzoate and miramistin. Validation of the methodology was performed and the main validation characteristics were determined. In terms of specificity, linearity, correctness, convergence of the method meets the eligibility criteria established by the SPhU
PROSPECTS OF STUDYING OF VOLATILE OILS OF TANACETUM PARTHENIUM (L.) SCHULTZ BIP. FOR ISSUES IN CHEMOSYSTEMATICS OF TANACETUM GENUS
Get PDFThe search for new sources of biologically active substances is an actual issue of pharmaceutical science. Feverfew is a prospective member of the Tanacetum genus. Recently an interest to this plant has grown. Sesquiterpene lactones and phenolic compounds are known to be cause its anti-inflammatory and antimigraine activity. The study of volatile compounds and chemosystematics of the feverfew in this group of BAS has not been conducted before.
The aim of the research was to obtain the volatile oil from the feverfew herb, studying of the component composition, an identification of compounds, that can be used for chemosystematics of the genus and establishing of the pharmacological activity according to the chemical content of volatile oil.
Materials and methods. The object of research was the samples of the feverfew herb grown and collected in the period of its mass flowering. The volatile oil obtained by steam distillation from the feverfew herb was studied using gas chromatography–mass spectrometry.
Results. The comparative characteristic of the representatives of the genus Tanacetum according to chemosystematic features was carried out. As a result of the research of the volatile oil 44 compounds were found, from which 40 were identified. According to the research, the raw material contained 34.71 % of camphor, this is a typical feature of all species of the genus Tanacetum. Fenchyl acetate was identified in a high enough content – 7,44 % in the domestic raw material, but this compound was not identified in the foreign samples. Chrysanthenyl acetate is accumulated in representatives of the genus Tanacetum in the form of a cis or trans isomer. In our study, the content of trans-chrysanthene acetate was 23.30 %. In the domestic raw materials, monoterpenes – α- and β- thujone – were not identified, which are associated with the toxicity of the raw material.
Conclusions. In the volatile oil 44 compounds were found, from which 40 were identified. Monoterpenes prevailed among terpenes, namely camphor, trans-chrysanthenyl acetate and fenchyl acetate, which are typical and can be used for chemosystematic issues of the genus Tanacetum.
The identified compounds require anti-inflammatory, antiseptic, antispasmodic, analgesic activities of the volatile oil, therefore creation of the medicinal herbal remedy based on the volatile oil of the feverfew herb is prospective
THE INFLUENCE OF NANO-SILVER ON FORMATION OF MICROBIAL BIOFILMS IN CASES OF TRAUMATIC LESION OF THE AUXILIARY APPARATUS OF THE EYE
Get PDFPyoinflammatory complications remain an acute problem in the post-operative period of traumatic lesions of the auxiliary apparatus of the eye (AAE). Silver both in the ionic form and in composition of chemical compounds is highly toxic for microorganisms, and as a result, it shows bactericidal effect to many bacterial strains, including gram-negative microorganisms. The peculiarity of AgNPs is efficiency of influence on the wide array of microorganisms, significant anti-biofilm effect and absence of resistance reaction.
The aim of the research. To study the influence of the colloidal nano silver on formation of biofilms by microorganisms discharged from the wounds of patients with traumatic lesions of the auxiliary apparatus of the eye.
Materials and methods. During 2018-2019, we examined 60 patients with traumatic lesions of the auxiliary apparatus of the eye. For evaluation of the influence of colloid nano silver solution on the processes of formation of the biofilm, we selected microorganisms which were cultured most frequently (Staphylococcus aureus, Acinetobacter spp., Klebsiella ozenae) from the patients.
Results. The obtained data suggest that colloid nano silver inhibits efficiently formation of biofilms at the early stages (initiation, the 0 day of incubation) of their formation by all the three microorganisms, and the degree of inhibition of the biofilm formation did not depend on the silver concentration.
The effect of colloid silver in the concentrations used by us at later stages of biofilm formation (the 3rd and the 7th day) with respect to К. ozenae is less efficient – the growth of cell biomass was observed (p≤0.05), and it did not depend on the silver concentration. At the same time, the effect of the colloid nano silver on S. aureus and Acinetobacter spp. on the 3rd and the 7th days was more efficient than at the early stage (p≤0.05).
Conclusions. Nanoparticles of colloid silver are an efficient means to combat biofilms, as well as to prevent their formation