[The role of occupational factors in the development and course of respiratory sarcoidosis].

AIM: The aim of the study was to study the frequency of occurrence of exposure to harmful occupational factors in patients with sarcoidosis of the respiratory organs, depending on the course of the disease. MATERIALS AND METHODS: An open prospective study included 121 patients with sarcoidosis of the respiratory system from the age of 21 to 66 years, from 20072019. The diagnosis was histologically confirmed in all patients. Patients underwent a set of laboratory and instrumental examinations, studied profane history. The presence of a history of contact with harmful and dangerous production factors was clarified. To determine the effect of a harmful production factor on the course of sarcoidosis, patients were divided into 2 clinical groups: the first group consisted of 85 (70.2%) patients with a favorable course of the disease, the second group included 36 (29.8%) patients with an unfavorable course sarcoidosis (standardization coefficient between groups 2.4:1). RESULTS AND DISCUSSION: Among the examined patients of working age prevailed (87%). Patient groups were comparable by age, but statistically differed by gender (chi2=9.75, p=0.0018). Frequency analysis of the occurrence of harmful occupational factors in sarcoidosis of the respiratory organs showed that the most frequently encountered factors in all the studied groups were contact with chemical hazards. CONCLUSION: The presence of contact with harmful production factors increases the risk of an unfavorable course of sarcoidosis by more than 2 times.

[Disorders of Vasoregulative Endothelial Function, Echocardiographic Assessment of Myocardial Dysfunction and Hemodynamics of Pulmonary Circulation in Cirrhosis of the Liver].

AIM: to study relationship between parameters of intracardiac hemodynamics assessed by Doppler echocardiography and functional activity of endothelium, hepatic blood flow and severity of portal hypertension in patients with cirrhosis of the liver (CL) of different etiology. RESULTS: We found that changes of structural and functional parameters of the heart in LC depended on the stage of compensation of portal hypertension and were accompanied by rearrangement of parameters of intracardiac hemodynamics. Pulmonary arterial hypertension (PAH) was found in 11.1% of patients with LC. PAH was moderate and was more frequent in patients with end-stage disease (Child-Pugh class C) compared with those with initial stage of LC (21.4% and 6.3%, p<0.05, respectively). CONCLUSION: Disorders of vasoregulating endothelial function in patients with CL were related to parameters of cardiopulmonary hemodynamics and functional state of the right ventricle and were more pronounced in patients with PAH.

[IMMUNOGENETICS AND PROGRESSION OF CHRONIC VIRAL HEPATITES].

AIM OF INVESTIGATION: To estimate the role of polymorphic variants of genes IL4 (C-590T), IL4RA (I50V), TNF (G-308A) and SLC1IAI (D543N) in chronic viral hepatitis progression. MATERIAL AND METHODS: Overall 121 patients with chronic viral hepatitis C and B. RESULTS: Study results have demonstrated, that of all investigated polymorphic variants of genes IL4 (C-590T), IL4RA (150V), TNF (G-308A) and SLC11A1 (D543N) in patients with chronic liver diseases of various etiology the <> IL4RA gene variant (II50Val) is associated with HBV-infection chronization. The allele <> gene TNF-α (G-308A) is protective for chronic viral hepatitis and is associated with a low level of production by mononuclear cells of TNF-α and IL-12, high secretion of IL-4 and low degree of collagenopathy in the liver. Genotype <> of IL4 (C-590T) gene is an adverse marker for progression of chronic viral hepatitis B. There was significant correlation of polymorphic variants TNF (G-308A) and IL4 (C-590T) genes with production of the key interleukins, that determine type of immune response (Th-1, Th-2) and products of collagen metabolism that testifies genetic determination of system immune response and collagen formation processes in the liver at chronic viral hepatitis.

[Somatopsychic manifestations in patients with chronic viral hepatitis].

The aim of the work was to study somatopsychic manifestations in patients with chronic viral hepatitis (CVH). MMPI profiles, state and trait anxiety were assessed in 110 patients. Boundary psychic problems were evaluated using the Beck scale. It was shown that mean MMPI T-score in patients with CVH was above 50; half of them developed "neurotic triad"; hypochondria occurred in 37.3%, depression in 42.7%, and hysteria in 37.1%. The highest level of state anxiety was documented in patients with HCV infection and isolated HBCor At. The CVH-1b genotype was associated with enhanced occurrence of depression in patients having virus-positive blood for 1-5 years. The level of state and trait anxiety in them was lower than in patients with duration of viremia over 5 years.

[Quality of life indices in patients with chronic viral hepatitis].

AIM: to estimate quality of life (QL) indices in patients with chronic viral hepatitis (CVH) and their relationships to the clinical characteristics of the disease. SUBJECTS AND METHODS: One hundred and ten patients with chronic viral hepatitis (CVH), including 58 patients with chronic hepatitis C (CHC), 27 with chronic hepatitis B, and 25 with CHC + HBCor, were examined. The personality psychological profile, reaction and personality anxiety were evaluated; the Beck inventory was used to identify borderline mental disorders. The test developed by the Karelian Research Center, Russian Academy of Medical Sciences, modified by Ya. M. Rutgaizer, and the Nottingham Health Profile were applied to estimate QL indices. RESULTS: Parameters characterizing the social and personality indices of life, such as qualitative performance of paid work, participation in social life, impossibility of adequate rest, and sexual life are most frequently influenced. The main indicators of worse QL were diminished vitality (vital energy), sleep disorders, and emergence of emotional reactions. This was largely seen in patients with active CVH infection and in those who had isolated HBcor antibodies. CONCLUSION: QL is directly related to the duration of viral infection.

[The clinical and endoscopic state of the esophagus in patients with asthma concurrent with chronic opisthorchiasis].

The frequency and pattern of manifestations of gastroesogageal reflux disease were studied in asthma concurrent with chronic opisthorchiasis. One hundred and fifty patients (52 males and 98 females) aged 14 to 60 years (mean age 43.18 +/- 10.6 years) who had atopic asthma of varying severity were examined. Group 1 comprised 74 asthmatic patients without opisthorchiasis; Group 2 included 76 asthmatic patients with opisthorchiasis; Group 3 consisted of 20 healthy individuals. According to the severity of asthma, all the patients from Group 1 and 2 were divided into 4 subgroups: mild, moderate, severe hormone-dependent and severe hormone-independent asthma. The patients with and without concurrent opisthorchiasis did not virtually differ in the severity pattern of asthma and its duration. Those with severe hormone-dependent asthma took systemic glucocorticosteroids in doses of not more than 15 mg/day. The scope of clinicoinstrumental and laboratory studies was determined by the presence of concurrent pathology: asthma and gastroduodenal diseases. Esophageal erosive lesions were encountered in a third of the asthmatic patients with opisthorchiasis and in every four patients in Group 1. In patients with severe asthma with and without opisthorchiasis, esophageal erosive lesions were revealed in 66.7%. The presence of concomitant Opisthorchis invasion in patients with asthma results in a significant increase in the clinical manifestations of gastroesophageal reflux disease and calls for the obligatory performance of therapy with antisecretory agents, prokinetics and necessitates dehelmintization during remitting asthma.

[The diagnostic value of the detection of hepatic fibrosis serum markers in chronic viral hepatitis].

The diagnostic significance of serum markers of fibrosis was investigated in 92 patients with chronic viral hepatitis (CVH) by studying the collagenolythic activity of blood, proteasic inhibitor activity, collagen metabolism products (oxyproline fraction), and fibronectin. At the same time, the patients underwent puncture biopsy of the liver, which made it possible to determine the degree of process activity and the stage of its chronization. As the degree of fibrosis grew, the collagenase serum activity increased significantly, while the alpha1-proteinase inhibitor activity fell, the content of oxyproline (its fractions) increased, and the fibronectin level decreased. Hence, the measurement of the noted parameters allows for noninvasive diagnostics of CVH stages.

[Erosive lesions in the gastroduodenal zone of patients with bronchial asthma].

The purpose of the investigation was to study the frequency and clinicomorphological features of erosive lesions (EL) in the gastroduodenal zone (GDZ) of patients with bronchial asthma (BA). One hundred and sixty-three patients suffering from allergic BA of different degrees of severity were examined. The examination included clinical evaluation of the GDZ, esophagogastroduodenoscopy with gastric and duodenal mucosal biopsy, and subsequent analysis of the biopsy samples using histological, histochemical, morphometric methods, and electron microscopy. The frequency of EL in GDZ in BA patients was high (32.5%). The intensity of clinical symptoms, probably caused by concomitant gastroesophageal reflux disease, was low; dyspeptic syndrome prevailed. The morphological findings demonstrated the presence of gastric mucosal hyperergic inflammatory response to Helicobacter pylori infection, which was one of the factors determining the high frequency of EL in the pyloroantral zone in BA. The development of EL in the GDZ mucosa of BA patients was associated with parietal and endocrinal cell hyperplasia.