COELIAC DISEASE AND PSORIASIS COMBINATION IN 5-YEAR-OLD CHILD.

The article demonstrates a clinical case of a child observed over 3 years, whose parents initially complained of non-healing crack between the toes, the navel, the vulva and behind the ears in the appointment of traditionaitherapy. The child in the community conducted a full survey of allergy, the results of which were normative, Ineffective treatment of skin diseases, as well as the presence of family history for autoimmune diseases served as the need for hospitalization of the patient survey. The examination at the clinic revealed higher values of antibodies to tissue transglutaminase and gliadin in the blood, duodenojejunal according to the results of endoscopy and active manifestations of chronic enteritis expressed with total villous atrophy on the long section on the results of morphological study of biopsies of the small intestine mucosa. Based on the results diagnosis of coeliac disease. On the background of a gluten-free diet showed normalization of laboratory and morphological parameters, weight and growth rates, the results of densitometry. However, it was only a slight improvement from the skin lesions. When re-examination of the child set accompanying diagnosis of psoriasis.

[MALABSORPTION FAT-SOLUBLE VITAMINS AND PROSPECTS OF THEIR USE IN LIVER DISEASES].

In a review article considers issues of efficiency and tactics of the purpose of fat-soluble vitamins, as in cholestatic and noncholestatic liver disease, as well as water-soluble vitamins, particularly vitamin C cholelithiasis. Oxidative stress due to chronic inflammation is one of the major conversion mechanisms of liver fibrosis in cirrhosis. The imbalance between production of reactive oxygen species and antioxidant defense causes a number of pathophysiological changes in the liver, including activation of hepatic stellate cells. The carriers of the I148M PNPLA3 mutation was not observed concentration reduction in liver vitamin A with increasing severity of the disease, but the observed decrease in the level of circulating retinyl palmitate and retinol-binding protein. To the appointment of vitamin A in liver disease should be approached with caution. Hypervitaminosis A leads to accelerated liver fibrosis and stimulates carcinogenesis. Currently actively studied the possibility of using vitamin E as an antioxidant, in patients with non-alcoholic fatty liver disease. His presence in the membranes phospholipid bilayer allows cells to prevent non-enzymatic oxidation of cell components by free radicals. Vitamin E can suppress the profibrotic processes. In patients with chronic cholestatic liver disease is common, vitamin K deficiency, even when administered, and is associated with the degree of cholestasis and severity of disease. The vitamin D deficiency, liver disease is also associated with the severity of disease correlated with the severity of liver failure and infectious complications. Vitamin D is an independent prognostic parameter for mortality risk in patients with liver cirrhosis.

[Possibilities of arthroscopy in the diagnosis and treatment of rheumatoid arthritis].

Arthroscopy is a technique that can be used in rheumatoid arthritis, regarding for indications with diagnostic purposes--synovial membrane macroscore and biopsy with following histological examination. Changes in the synovium in rheumatoid arthritis are localized in the lateral and anterior parts of the knee, where hyperemia, rheumatoid pannus growth, hypertrophic clavate villus are often seen. It also can be used for therapeutic purposes--synovectomy in combination with flushing of the knee. After the arthroscopy with debridment in patients with rheumatoid arthritis, pain syndrome, swelling and the amount of effusion in the joint is significantly reduced or eliminated, amplitude of movements increases, functional activity of the limbs restores.

[Comparative assessment of methods for identification of overweight and obesity in children].

Obesity in school-aged children is very common in the WHO European Region. However, there is no unified approach to the diagnosis of childhood obesity in the organized collective bodies. It is evident that the physical development of schoolchildren needs regular monitoring. Methods for identification of overweight and obesity were comparatively assessed, by using the data on the physical development of 63 children aged 8 to 16 years, including 33 children diagnosed as having obesity and 30 with normal weight. It has been established that it is expedient to use anthropometric and somatometric methods for mass diagnostic screening for overweight and obesity in the organized collective bodies.

[Changes in the fatty acid composition of blood cell membranes in children with inflammatory diseases].

Fatty acid composition of erythrocyte and leukocyte membranes has been studied in children (with normal body mass and obesity) with inflammatory diseases of the gastrointestinal tract and children with bronchial asthma in comparison with basically healthy children. Fifty seven children aged from 7 to 14 years were examined: 13 with inflammatory diseases of the gastrointestinal tract (IDGIT) (eosophagitis, gastroduodenitis, stomach ulcer), 25 with obesity stages (I-III) complicated by IDGIT, 9 with bronchial asthma and 10 basically healthy children. The study revealed that both IDGIT and bronchial asthma caused significant and similar changes in fatty acid composition of cell membranes. These included accumulation of omega3-eicosapentaenoic acid (EPA) and the decrease of docosahexaenoic acid (DHA); this phenomenon observed in both erythrocyte and leukocyte membranes suggests a common feature of the detected changes in fatty acid composition of cell membranes in inflammation. There was a significant decrease in the level of membrane omega6 polyunsaturated fatty acids (PUFA), first of all arachidonic acid and total omega6 PUFA. Consequently, EPA accumulation in membranes may be a compensatory response to low dietary arachidonic acid supply and/or its increased synthesis of pro-inflammatory eicosanoids (prostaglandins, leukotriens, thromboxans) during inflammatory process.

Accumulation of eicosapentaenoic acid in membranes of erythrocytes and leukocytes during alterative-exudative and allergic inflammation.

Children patients with alterative-exudative (gastrointestinal diseases) and allergic inflammation (bronchial asthma) exhibited similar changes in fatty acid composition of erythrocyte and leukocyte membranes. They included accumulation of considerable amounts of eicosapentaenoic acid and decrease in the content of docosahexaenoic acid (long-chain derivative of eicosapentaenoic acid). The accumulation of eicosapentaenoic acid and decrease in the content of docosahexaenoic acid in cell membranes probably play a role in the pathogenesis of chronic inflammatory diseases. It is related to a possible decrease in the formation of anti-inflammatory eicosanoids (series-5 leukotrienes) and protective compounds (resolvins and protectins) from fatty acids and changes in the physicochemical properties of cell membranes.

[Improvement of pertussis diagnostics in adults with prolonged cough].

AIM: To study clinical and laboratory data and levels of IgG, IgG1, IgG2, IgG3, IgG4, IgA and IgM to Bordetella pertussis complex of antigens in adults with prolonged cough. MATERIALS AND METHODS: Antibody levels to Bordetella pertussis complex of antigens were measured by solid phase immunoenzyme assay. Clinical and laboratory methods included CBC, chest X-ray, measurement of respiratory function, allergologic tests. RESULTS: In 16 out of 75 studied patients (21%) serological signs that are characteristic for current pertussis infection (increased levels of specific IgG and IgA as well as IgG1 - IgG3 - IgG2 - IgG4 type of distribution of specific IgG subclasses) were observed. Clinical and laboratory parameters--course of disease, characteristics of cough, results of CBC--corresponded to diagnosis of pertussis. In other studied patients levels of specific antibodies did not differ from levels observed in healthy persons and observed clinical signs corresponded to other respiratory diseases. CONCLUSION: Obtained results prove the high incidence of pertussis in adults, its essential importance as etiologic factor of prolonged cough and high informative value of serologic tests.

[Assessment of corrected orthogonal ECG system of McFee-Parungao leads in bicycle exercise test in patients with myocardial ischemia]. / Otsenka korrigirovannoi élektrokardiograficheskoi sistemy otvedenii Mak FI-Parungao pri veloérgometrii u bol'nykh ishemicheskoi bolezn'iu serdtsa.

AIM: To assess orthogonal ECG system McFee-Parungao in exercise test performed by patients with ischemic heart disease (IHD). MATERIAL AND METHODS: The trial included 103 patients: 41 patients with IHD, 23 patients with IHD combined with arterial hypertension and 39 control patients free of IHD. All the patients performed bicycle exercise with ECG registration in the corrected orthogonal system of leads modified according to McFee-Parungao. In 11 patients ECG was registered in two systems--orthogonal and standard 12-lead. Sensitivity and specificity in IHD were assessed. RESULTS: Parameters of the bicycle exercise test registered by ECG in the corrected orthogonal system indicated that sensitivity and specificity of this system in IHD patients are not inferior to sensitivity and specificity of the standard 12-lead ECG system. CONCLUSION: The system of orthogonal leads McFee-Parungao is recommended for use in the practice of bicycle exercise tests in IHD patients.

[Organization of reflex sympathetic influence on rate and force of cardiac contraction]. / Organizatsiia reflektornykh simpaticheskikh vliianii na chastotu i silu sokrashchenii serdtsa.

In acute experiments on 21 cats it was proved that the change of afferent impulse on vagus nerves by means of either freeze-block or electrostimulation of their central ends results in differential reflex influences on rhythm and force of the cardiac contractions caused by sympathetic nervous system. The cut of the lower cardiac nerves may cause 'break-up' of the observed reflex, removing or inverting its ino- or chronotropy component. The given phenomenon was revealed in the experiments with high arterial pressure and with absence of tonic chronotropy influences of the left lower cardiac nerve.

[The possibility of using outbred mice for the production of monoclonal antibodies]. / Vozmozhnost' ispol'zovaniia besporodnykh myshei dlia polucheniia monoklonal'nykh antitel.

Outbred laboratory mice, pretreated with an ascites-forming stimulator and an irradiation dose of 6 Gy, can be used for the production of monoclonal antibodies. However, the passage of hybridomas in irradiated outbred mice rapidly leads to the death of the cells. The properties of antibodies obtained from ascitic fluid of outbred mice are no different from those of antibodies obtained from BALB/c mice.

[Synthesis and analysis of conformationally restricted analogs of peptide inhibitors of the angiotensin-converting enzyme]. / Sintez i issledovanie konformatsionno ogranichennykh analogov peptidnykh ingibitorov angiotenzinprevrashchaiushchego fermenta.

To investigate conformations of peptide inhibitors of the angiotensin-converting enzyme in the enzyme-inhibitor complex, the synthesis, studies of inhibitory activity, and conformational calculations of analogues of bradykinin-potentiating peptides with N-methylalanine or D-alanine in place of L-proline or L-alanine residues have been carried out. All the analogues showed a sharp decrease of inhibitory activity in comparison with the natural peptides, that might be considered as an indirect confirmation of the earlier proposed "conformation of inhibition" of the above-mentioned peptides.

Inhibition of leucocyte migration by antigens from human colon and E. coli O 14 in patients with ulcerative colitis.

In 55 patients with ulcerative colitis and in 25 controls the leucocyte migration inhibition test was performed. As antigens the extract from human fetal colon and the lipopolysaccharide antigen from E. coli O 14 were used. The leucocyte migration in patients with ulcerative colitis was significantly inhibited in the presence of the antigens mentioned. In patients with an active form of ulcerative colitis the leucocyte migration was significantly inhibited as compared to the leucocyte migration in patients with a nonactive form of the disease.