CORRELATES OF ATOPIC DERMATITIS CHARACTERISTICS IN MILITARY PERSONNEL.

Atopic dermatitis, despite its relatively wide distribution and low severity, was statistically often a disqualification condition for military service. The aim of our study is to determine correlations between characteristics of atopic dermatitis in military personnel. 144 people with atopic dermatitis were under our observation, 78 of them military personnel, 26 military family members and 40 civilians, 62 men and 82 women. We studied the following characteristics: gender, age, marital status, education, social status, place of service location, genetic anamnesis, recurrence during the year, laboratory indicators of attached infections, focus of localization, other skin diseases, comorbidities, compliance with hygienic conditions, wearing a military uniform, the frequency of changing bed linen. 3-5 times recurrence a year shows a reliable positive correlation with: wearing a uniform for 12-24 hours, SSA/eosinophilia, mycosis, pathology of the respiratory system, military personnel. Staphylococcus aureus is associated with other infections - St. hominis, fungus, also shows a reliable positive correlation: localization on the face and torso, wearing the uniform for 1 week and more. Staphylococcus hominis shows a reliable positive correlation: localization - torso, wearing uniform for 1 week or more,y. Shows a reliable positive correlation with fungus: localization scalp, neck, lower limb, military serviceman; reliable positive correlation with SSA/eosinophilia: increased IgE, localization on the upper limbs, mycosis, change of bed linen - once every 2 weeks; IgE - localization of dermatosis on the upper limbs and torso area, pathology of the digestive system, changing bed linen once every 2 weeks, military serviceman. It shows a reliable positive correlation with helminthiasis: Localization on the genitals, mycosis, pathology of the digestive system, change of bed linen once a month. Development and recurrence of atopic dermatitis in military personnel correlates with living conditions and infections. Determining the differences between civilian and military patient populations will allow clinicians to better investigate the risk factors that predispose to the manifestation of dermatitis in the military.

[THE ROLE OF HELICOBACTER PYLORI IN ROSACEA AND PATHOGENETIC TREATMENT].

Rosacea is a chronic, recurrent skin disease. It may be aggravated by various factors. An increased incidence of rosacea has been reported in those who carry the stomach bacterium Helicobacter pylori. The purpose of this study was determination of the relationship of this infection with rosacea and to investigate effectiveness of eradication therapy of H. pylori. As our results showed, 80.9% of study patients were infected with H. pillory. There was correlation between infection rates and rosacea severity. In most cases the positive test results for H. Pylori was found in patients with moderate to severe form of disease. The results of the treatment of different forms of rosacea confirmed the effectiveness of the eradication therapy of H. Pylori, regarding as one of the pathogenic cause of rosacea and the way in the choice of treatment. More wide studies of pathophysiological aspects of causes of rosacea will be promising and help in treating rosacea. These data indicate the important role of H.Pylori in the development of rosacea and recommend taking into account in the therapy of this dermatosis.

PSYCHOSOMATIC ASPECTS IN PATIENTS WITH DERMATOLOGIC DISEASES.

The aim of our study was to find out the magnitude of anxiety and depression in our common dermatological patients and its correlation with age, sex. For this purpose, we used Hospital Anxiety and Depression Scale HADS. The psychometric validity of HADS has been established by validating the questionnaire against the structured psychiatric interviews. A study of anxiety and depression in patients with dermatologic diseases was conducted on the basis of outpatients department in 211 patients with dermatologic diseases; among them were 107 male and 104 female, aged 16 to 75 years. Among them were patients with Acne, Alopecia Areata, Psoriasis, Vitiligo, Neurodermatitis, Scabies, Eczema and Other diseases (Atopic Dermatitis, Chronic Urticaria, Lichen Planus, Herpes Zoster, Melasma, Warts and Etc.). Based on studies of patients reveals that 65.4% of them are anxiety, depression - 56.2%, both anxiety and depression in 24.7%, there figures higher than the dates of other authorizes. As a result of a direct link research risk disorder depressive spectrum with sex, age; in woman anxiety and depression occurs more frequently than men, and anxiety occurs more frequently in young age. Especially there are hight frequencies of manifestation of abuse in patients with Psoriasis (anxiety - 83.3%, depression - 69.4%, both - 38.8%), Eczema (anxiety - 73.3%, depression - 56.6%, both - 26.7%), Acne (anxiety - 78.4%, depression - 54%, both - 21.6%), Vitiligo (anxiety - 66.7%, depression - 60%, both - 33.3%). Our study noticed higher dates of anxiety and depression than the dates of other outhorizes.

[Advantan for therapy of atopic dermatitis].

Atopic dermatitis is a common, chronic skin disease characterized by dry, itchy and easily irritated skin. It occurs most commonly in infants and young children, but can persist into adulthood. Severe cases can lead to sleep deprivation, chronic bacterial infections, and depression. Along with other allergic diseases, its prevalence has grown significantly in recent years. Topical medicines are the most common and effective treatment for atopic dermatitis. Drugs taken orally and used to suppress the immune system have been converted into an ointment or cream. These topical immunosuppressive agents are being used now to treat eczema. Advantan (0.1% methylprednisolone aceponate) is indicated for the treatment of eczema and other inflammatory skin disorders as a highly effective topical corticosteroid. The effect of Advantan in the treatment of atopic dermatitis was studied. A clinical study of Advantan ointment involved 26 patients aged between 6 and 56 years with atopic dermatitis. Positive therapeutic effect was achieved in the overwhelming majority of the patients (n=25). It was concluded that Advantan ointment produced by Schering AC had marked antiinflammatory and antipruritic action. It was convenient to use and well tolerated by the patients. It is concluded that Advantan may be used for the treatment of patients with atopic dermatitis.

[Efficacy of lamysil dermgel in treatment of tinea versicolor].

The fungi of the genus Malassezia are part of normal mycobiota of human and mammal skin. As a representative of the normal mycobiota skin warm-blooded animals and humans, under certain conditions they can cause pathological process including tinea versicolor - a common skin infection. In spite of existence of broad-spectrum antibiotics and antifungals for the treatment of skin diseases the efficacy of drugs aren't always successful. The aim of the study was to estimate efficacy of lamysil dermgel in comparison with clotrimazole in the treatment of tinea versicolor. The study population included 43 patients of both sex. The diagnosis of tinea versicolor was confirmed by assessment of signs and symptoms, test-positive by Balzer and by microscopy, which revealed the presence of fungus of the Malassezia genus. By the post treatment examination treatment success had been achieved in both groups, but significantly higher percentages was achieved in lamysil dermgel group. Treatment success rate in lamysil dermgel group: clinical cure - 21 patients (95,45%), mycologic cure - 19 patients (86,3%), full - 18 patients (81,81%). In clotrimazole group: clinicaly cure - 17 patients (80,95%), mycologic cure - 13 patients (61,9%), full - 13 patients (61,9%).The results of our study confirm highly antifungal activity of lamysil dermgel against tinea versicolor and suggest that it may be more effective then clotrimazole, therefore it will be approved for treatment of this dermatosis.

[Anxiety state in patients during postinsult period with old cerebral infarction].

According to ICD-10 International Statistical Classification of Diseases anxiety state is different combination of somatic and mental symptoms of anxiety of absence of real menace that is onset attack-like or permanently. Anxious disorder is observed in 5-10% of the population, twice more often at woman than at men. The lengthening of the postinsult period is observed more often in the structure of the patient with old cerebral infarction that is complicated with anxious disorder. Diagnostics, treatment and prevention of anxious disorder in the postinsult period require elaboration of new approaches by the doctors. It is announced that anxious disorder in the postinsult period at such patient may reach 60-70%. Researches have been held on the basis of the clinic "Medina" in Batumi. The main group consisted of 30 out-patients (14 women and 16 men) between 41 and 73 years old who experienced cerebral infarction of 3-18 months prescription. Patients with pancreatic diabetes and unstable accompanying somatic diseases were excluded. Computer or magnetic - resonant tomography of the brain was performed to all patients during insult in order to verify the diagnosis; the clinical-and-psychological and neurological check up was also performed using neurological scale NIH NINDS in order to identify severity of insult as well as using the scale "Renkin" to assess the degree of impairment of vital functions. Depression was assessed with the help of HDRS (Hamilton depression ration scale). The level and presence of anxiety were determined by the scale that assesses the level of reactive and personal - anxiety. The following initial data were received as a result of research from the patients of the comparing groups before treatment: an average age of patients was 55,1+/-1,9 years; prescription of cerebral infarction was 6,35+/-1,0 months; severity of cerebral infarction on scale NIH NINDS was 2,7+/-0,25 points; invalidation degree on "Renkin" scale was 1,95+/-0,25 points. Personal anxiety was 85,4+/-7,27 points according to self assessment scale, reactive anxiety equaled 86,3+/-7,1 points. Depression evidence in comparing groups turned out to be initially high and equaled 14,5+/-2,1 points. The study revealed cognitive functions according to MMSE at 4 men. Therefore, a long effecting social stress leads to development of depression. Unemployed people working under constant pressure, living in overpopulated areas are the most subject to stress as well as those whose mutual relation with associates are broken and who more often gets in disputed situations. The first condition in treatment of the anxious disorders is detailed knowledge of the patient and his understanding the essence of illness. The necessary information and the elementary receptions of treatment for overcoming anxiety and panic attacks are given by the doctor. Frequently, the relief comes only that the patient realizes that it not illness that is unknown and dangerous to a life, but curable anxious disorder. Whenever possible the doctor will advise a relevant method of psychotherapy which will help to cope with the problems caused by prolonged panic disorder.

[Cryotherapy in treatment of skin demodecosis].

Demodecosis is wide spread chronic skin disorder caused by the mite - Demodex folliculorum. It frequently involves the mid facial region: nasolabial folder, the nose, the chin and eyes. The treatment depends on the severity of the inflammatory skin disorder and includes complex of oral and topical drug treatment. The aim of the study was to determine the efficiency of criotherapy in complex treatment of demodecosis. We have observed 38 patients of both sexes aged 19-54. The patients were divided into two groups - "A" and "B". Patients with erythematosquamose form of the disease were treated with Trichopol peros and oral antibiotics in case of inflammatory lesions. For topical treatment in group "A" Rosamet cream was used. In group "B" Rosamet cream and criotherapy were used. The results of our study have demonstrated effectiveness of criotherapy in combination with Rosamet cream. A significantly faster decrease of inflammatory lesions and reduce the erythema was observed in group "B". Therefore the usage of criotherapy with Rosamet cream is recommended to get quick therapeutic effect.

[Perolen cream for therapy of rosacea].

Acne rosacea belongs to the most common inflammatory dermatoses of the face. Current treatments for this disease remain unsatisfactory, that's why searching for new methods and remedy are very important. For the topical therapy we have used a new cream perolen ("New Pharma", Georgia). The main component of the creme is the water extract of gastric mucous membrane of cow, which is the source of proteolytic ferments. Another main component is a Perilla oil which contains unsaturated fatty acids--linolenic and linol, presented in the highest amounts. The cream is characterized by bactericidal, bacteriostatical, anti-inflammatory and anti-oxidant effects, it also assists to tissue regeneration, make blood vessels more elastic and decreases penetration. We have observed 40 patients with papulo-pustular subtype of rosacea (25 females and 15 males). Patients were divided into two groups. For oral therapy in both groups we used Tetracycline and Trichopol. For topical treatment in the first group of patients was used rosamet cream and in the second group--perolen cream. Both of these creams were applied once daily during 2 months. Reduction of comedones, inflammations, papules, pustules and small nodules occurred after one month. Erythema, oedema, desquamation improved significantly during the treatment, but the positive effects were more prominent in the second group of patients. In conclusion, the study shows that topically used cream perelon represents a new approach in the management of acne rosacea.

[Spontaneous infection of ixodes ticks with salmonella]. / Spontannoe zarazhenie iksodovykh kleshchei salmonellami.

An epizootological study of the ticks gathered from the cattle and ground surface in the Dedoplistskaroisky and Dushetsky districts of Eastern Georgia has identified 5 Salmonella a typhimurium strains. The strains were isolated from the ticks Haemaphysalis punctata, Rhipicephalus bursa, Hyalomma plumbeum. They were found to be resistant to 10 of 16 antibiotics. The strains showed a high sensitivity only to 3 antibiotics, such as gentamicin, cirpofloxacin, and nitrofurantoin and 3 strains were highly sensitive to chloramphenicol. The above ticks seem to have been spontaneously infected with the pathogen Salmonella on the animals at the moment of bacteremia.

[Detection of the tularemia zoonosis in the territory of the Kartlian Plain]. / Obnaruzhenie prirodnogo ochaga tularemii na territorii Kartliiskoi ravniny.

The natural focus of tularemia was found to cover the whole territory of the Kartlian plain. Epizooty occurred mainly among common voles with the involvement of insectivorous voles. Hard ticks, gamasids and fleas infected with Francisella tularensis were detected. Rodents highly sensitive to tularemia can be affected by this infection. Water rats were not involved into the enzootic process. Further studies are necessary for the final solution of this problem.