scholarly journals Differentiated Approach to the Diagnosis and Treatment of Tuberculous Spondylitis in Adults

2021 ◽  
Author(s):  
Primkul Nazirov ◽  
Alfiya Fakhridinova ◽  
Zulfiya Makhmudova ◽  
Bakhtiyar Djuraev
Keyword(s):  
Immune System ◽  
Clinical Laboratory ◽  
Medical Center ◽  
Spinal Tuberculosis ◽  
Spinal Column ◽  
Response To Treatment ◽  
Immunological Study ◽  
Immunological Parameters ◽  
Spinal Disorders ◽  
Functional Changes

The purpose of this study is to generalize the results of a complex clinical-laboratory, radiological and immunological study of patients with spinal tuberculosis. A comprehensive examination analysis was carried out in 192 patients with tuberculous spondy litis who were in the department of surgery for osteoarticular tuberculosis of the Republican Specialized Scientific and Practical Medical Center of Tuberculosis and Pulmonology in Tashkent, Uzbekistan. Severe degrees of spinal disorders were found in 48.7% of patients. Magnetic resonance imaging (MRI) and multi-slice spiral computed tomography (MSCT) allow establishing the stage and activity of a specific process in the spine, as well as complications. Spinal column instability was detected in 143 (74.5%) patients, paravertebral abscesses in 116 (60.4%) patients, and epidural abscesses in 75 (39.0%) patients. Changes in immunological parameters in patients with spinal tuberculosis were associated both with impaired regulation of immunogenetic and with the direct influence of the immune system at various stages of the process. The detection of certain patterns of immune system disorders in patients with tuberculous lesions of the spine allowed us to make a differentiated approach to their treatment in order to increase the effectiveness of the treatment. It can be concluded that at present, tuberculosis of bones and joints, especially the spine, is detected in an advanced stage in 50-80% of cases and has a widespread and complicated character with profound anatomical and functional changes and the presence of severe spinal disorders in 48.7% patients in Uzbekistan. Regarding spondylitis, it is immensely important to make an accurate diagnosis based on the clinical presentations, laboratory, radiological and immunological findings and by periodic assessment of the response to treatment, which is essential in atypical cases.

scholarly journals The Potential of Computational Modeling to Predict Disease Course and Treatment Response in Patients with Relapsing Multiple Sclerosis

Cells ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. 586 ◽  
Author(s):  
Francesco Pappalardo ◽  
Giulia Russo ◽  
Marzio Pennisi ◽  
Giuseppe Alessandro Parasiliti Palumbo ◽  
Giuseppe Sgroi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Immune System ◽  
Computational Modeling ◽  
Response To Treatment ◽  
Oligoclonal Bands ◽  
Host Immune System ◽  
Immunological Parameters ◽  
Disease Modifying Drugs ◽  
Magnetic Resonance Imaging Mri ◽  
Relapsing Multiple Sclerosis

As of today, 20 disease-modifying drugs (DMDs) have been approved for the treatment of relapsing multiple sclerosis (MS) and, based on their efficacy, they can be grouped into moderate-efficacy DMDs and high-efficacy DMDs. The choice of the drug mostly relies on the judgment and experience of neurologists and the evaluation of the therapeutic response can only be obtained by monitoring the clinical and magnetic resonance imaging (MRI) status during follow up. In an era where therapies are focused on personalization, this study aims to develop a modeling infrastructure to predict the evolution of relapsing MS and the response to treatments. We built a computational modeling infrastructure named Universal Immune System Simulator (UISS), which can simulate the main features and dynamics of the immune system activities. We extended UISS to simulate all the underlying MS pathogenesis and its interaction with the host immune system. This simulator is a multi-scale, multi-organ, agent-based simulator with an attached module capable of simulating the dynamics of specific biological pathways at the molecular level. We simulated six MS patients with different relapsing–remitting courses. These patients were characterized based on their age, sex, presence of oligoclonal bands, therapy, and MRI lesion load at the onset. The simulator framework is made freely available and can be used following the links provided in the availability section. Even though the model can be further personalized employing immunological parameters and genetic information, we generated a few simulation scenarios for each patient based on the available data. Among these simulations, it was possible to find the scenarios that realistically matched the real clinical and MRI history. Moreover, for two patients, the simulator anticipated the timing of subsequent relapses, which occurred, suggesting that UISS may have the potential to assist MS specialists in predicting the course of the disease and the response to treatment.

scholarly journals IMMUNOMODULATORY AND CLINICAL EFFECTIVITY OF THE DRUG "LAZOLEX" IN TREATMENT OF RECURRENT APHTHOUS STOMATITIS (RAS)

2021 ◽  
Author(s):  
MARIAM GOGOTISHVILI ◽  
NINO ABASHIDZE ◽  
NINO KORSANTIA ◽  
NATO KORSANTIA
Keyword(s):  
Immune System ◽  
Clinical Laboratory ◽  
Recurrent Aphthous Stomatitis ◽  
Aphthous Stomatitis ◽  
Patient Treatment ◽  
Clinical Activity ◽  
Dental Practice ◽  
Immunological Parameters ◽  
Traditional Therapy

The purpose of this study was to study the immunomodulatory and clinical properties of the Georgian drug “LAZOLEX” in patients with Recurrent Aphthous Stomatitis (RAS). Clinical and Immunological parameters were studied in 50 patients, the results showed the correlation between the condition of immune system and the severity of the RAS, i.e., the most severe immunosuppression was recorded in patients with severe stomatitis. 5% Gel of “LAZOLEX” compared to traditional therapy, showed the same high clinical activity, but the presence of immunocorrective properties in LAZOLEX manifested itself in an improvement in the quality of patient treatment: decrease of time of epithelization and a significant increase in the duration of remission. Conducted clinical, laboratory and immunological studies allow us to recommend LAZOLEX for active use in dental practice for RAS.

scholarly journals Structural and functional state of blood lymphocytes in patients with infectious mononucleosis with different course

Pathologia ◽  
2021 ◽  
Vol 18 (3) ◽  
pp. 286-294
Author(s):  
Ya. V. Kolesnyk ◽  
T. O. Briukhanova ◽  
M. Yu. Sliepchenko ◽  
O. A. Nakonechna ◽  
O. H. Sorokina
Keyword(s):  
Immune System ◽  
Infectious Mononucleosis ◽  
Cytoplasmic Membrane ◽  
Clinical Laboratory ◽  
Initial Period ◽  
Relative Content ◽  
Immunological Parameters ◽  
Paramagnetic Resonance ◽  
Blood Lymphocytes ◽  
Cell Immunity

The article presents the results of our own studies. The aim was to determine the structural and functional status of blood lymphocytes in patients with acute and prolonged course of infectious mononucleosis (IM) in children. Materials and methods. 102 children were under clinical and laboratory-instrumental supervision, the children were divided into groups: group 1 – 65 children with IM with an acute course of the disease; group 2 – 37 children with a prolonged course of the disease. All children underwent standard clinical laboratory and instrumental laboratory examinations. The diagnosis of IM was confirmed by PCR (detection of EBV DNA in the blood) and ELISA (anti-EBV IgM and IgG). Research results. In the study of the structural state of the cytoplasmic membrane of the lymphocytes in the blood of patients with MI in the onset of the disease, it was found that the average values of penetration rate of the electron paramagnetic resonance of spin probes (PR EPR s. p.) in children of both groups were significantly higher than normal (P < 0.001). There are also differences between groups of patients. In this case, the value of PR EPR s. p. in patients with a prolonged course by 15.8 % exceeded those in patients with acute IM (P < 0.001). According to the rate of microviscosity of the intracellular content (MV IC), its values were reduced compared with the control – by 22.1 % (P < 0.001) in patients with acute course of the disease and by 25.1 % – with a prolonged course of IM). In addition, in patients with a prolonged course of the disease, the values were 9 % lower than in the group with acute infectious mononucleosis. When considering immunological parameters, it was found that the indicators of the T-immune system for patients with a prolonged course of the disease in comparison with the alternative group was characterized by a decrease in the content of CD3 <50 % (respectively in 51.3 % and 26.2 % of patients; P < 0.05); CD4 <31 % (62.1 % and 32.4 %, respectively; P < 0.05) and CD8 <15 % (37.8 % and 10.8 %, respectively; P < 0.01). With regard to the cytokine profile, the level of IL-1 <20.0 pg/ml was determined 3.5 times more often in patients with a prolonged course of the disease compared to the acute course (64.8 % and 18.5 % of patients, respectively); TNFα <20.0 pg/ml 1.9 times more often (48.6 % and 24.6 %, respectively) and a very high (>30.1 pg/ml) level of IL4 in 40.5 % and 20 %). From the B-system of immunity in patients with a prolonged course of IM in comparison with the acute course increased content of CD22 was more often determined, as well as low levels of IgA, IgM <1.1 g/l and IgG <10.0 g/l. Conclusions. According to the results of observations, the pathogenetic role of the violation of the structural organization of blood lymphocytes in the formation of IM is established. It was found that these disorders in the form of increased permeability of their cytoplasmic membrane and reduced viscoelastic properties of their intracellular environment are more pronounced with a prolonged course of the disease, which is a factor in the prolongation of the disease. It is determined that the indicators of cellular and humoral parts of the immune system affect the course of IM. During formation of an acute course of IM in children already in the acute period of a disease activation of both cellular and humoral links of immunity, which is shown in the form of increase in relative content of CD3+, CD4+, CD8+ and CD22+ and levels of immunoglobulins M, A, is noted. For the prolonged course of the disease depression of T-cell immunity in the form of a decrease in the relative content of CD3+, CD4+ and CD8+ lymphocytes and an increase in CD22+, as well as inhibition of antibody genesis are characteristic. It was found that the variant of IM depends on the type of reaction of T-helper clones, namely – in the initial period of manifestation of IM with its acute course there is activation of T1 and T2 helper response, which manifests itself in a significant increase in IL-1, TNFα and moderate IL-4. Prolonged course of the disease is formed against the background of weak activation of pro-inflammatory interleukins (IL-1, TNFα) and significant – anti-inflammatory IL-4.  

scholarly journals THE EFFECTS OF ALUMINUM EXPOSURE ON IMMUNE STATUS IN CHILDREN WITH FUNCTIONAL CARDIOVASCULAR SYSTEM DISORDERS

2019 ◽  
Vol 8 (3) ◽  
pp. 29-35
Author(s):  
О. V. Dolgikh ◽  
I. N. Alikina ◽  
A. V. Shabaldin
Keyword(s):  
Cardiovascular System ◽  
Heart Development ◽  
Analytical Study ◽  
Clinical Laboratory ◽  
Control Group ◽  
Study Group ◽  
Immunological Parameters ◽  
Chemical Changes ◽  
Aluminum Exposure ◽  
Functional Changes

Aim To estimate the prevalence of functional cardiovascular system disorders and immunological parameters in children living in the Irkutsk Region, a technogenic region of Southern Siberia.Methods A set of clinical, laboratory and instrumental, statistical and analytical methods were used in the study. Immunological parameters and the presence of functional cardiovascular system disorders were assessed in 63 children aged 5–11 years living in the technogenic region with aluminum exposure. The study group included children (n = 31) with functional changes in the cardiovascular system. Children (n = 32) without any functional changes in the cardiovascular system were enrolled in the control group. The functional status of the cardiovascular system was evaluated with the electrocardiography and physical examination. The immune parameters were measured with the flow cytometry and enzyme allegrosorbent testing. The analytical study of the chemical changes in the biomedia induced by aluminum exposure followed the national guidelines.Results Children permanently residing in the technogenic region with aluminum exposure suffer from mild anomalies of the heart development. These anomalies are associated reliably with the diseases of the blood and blood-forming organs involving the immune mechanism. The analytical study of the chemical changes in the biomedia showed that the study group has significantly elevated aluminum levels in blood and urine. Immune alterations have been found in the study, including a significant increase in the TNFR receptor, Bcl-2 protein, Treg cell differentiation clusters (CD4+CD25+CD127-) and CD3+CD25+. A significantly increased level of specific sensitization by the IgG criterion was established.Conclusion The study reported that functional cardiovascular system disorders among children living in the technogenic region with aluminum exposure are associated with alteration in the immune system. These alterations suggest the presence of the imbalance between apoptotic regulation and the initiation of adjuvant sensitivity to man-made haptens (aluminum).

scholarly journals The Potential of Computational Modeling to Predict Disease Course and Treatment Response in Patients with Relapsing Multiple Sclerosis

2020 ◽  
Author(s):  
Francesco Papparlardo ◽  
Giulia Russo ◽  
Marzio Pennisi ◽  
Giuseppe Alessandro Parasiliti Palumbo ◽  
Giuseppe Sgroi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Immune System ◽  
Computational Modeling ◽  
Response To Treatment ◽  
Oligoclonal Bands ◽  
Host Immune System ◽  
Immunological Parameters ◽  
Disease Modifying Drugs ◽  
Magnetic Resonance Imaging Mri ◽  
Relapsing Multiple Sclerosis

As of today, 20 disease modifying drugs (DMD) have been approved for the treatment of relapsing multiple sclerosis (MS) and, based on their efficacy, they can be grouped into moderate-efficacy DMDs and high-efficacy DMDs. The choice of the drug mostly relies on the judgement and experience of neurologists and the evaluation of therapeutic response can only be obtained by monitoring clinical and magnetic resonance imaging (MRI) status during follow up. In an era where therapies are focused on personalization, the aim of this study is to develop a modeling infrastructure to predict the evolution of relapsing MS and the response to treatments. We built a computational modeling infrastructure named UISS (Universal Immune System Simulator) able to simulate the main features and dynamics of the immune system activities. We extended UISS to simulate all the underlying MS pathogenesis and its interaction with the host immune system. This simulator is a multi-scale, multi-organ, agent based simulator with an attached module capable of simulating the dynamics of specific biological pathways at the molecular level. We simulated six MS patients with different relapsing-remitting courses. These patients were characterized on the basis of their age, sex, presence of oligoclonal bands, therapy and MRI lesion load at onset. The simulator framework is made freely available and can be used following the links provided in the availability section. Even though the model can be further personalized employing immunological parameters and genetic information, based on the available data we generated a few simulation scenarios for each patient, including those who matched the real clinical and MRI history. Moreover, for two patients, the simulator anticipated the timing of subsequent relapses, which really occurred, suggesting that UISS may have the potential to assist MS specialists in predicting the course of the disease and the response to treatment.

scholarly journals DISORDERS OF THE IMMUNOREACTIVITY AS A MARKER OF PROFESSIONAL RISK TO THE HEALTH OF WORKERS IN THE PRODUCTION OF VINYL CHLORIDE

2018 ◽  
Vol 97 (9) ◽  
pp. 840-843
Author(s):  
Galina M. Bodienkova ◽  
V. S. Rukavishnikov
Keyword(s):  
Immune System ◽  
Occupational Health ◽  
Vinyl Chloride ◽  
The Body ◽  
Organic Chemical ◽  
Immune Reactivity ◽  
Immunological Study ◽  
Immunological Parameters ◽  
Effective Prevention ◽  
Prevention Programmes

Production of vinyl chloride (VC) is one of the largest world production of volume organic chemical intermediates, consumption of which, according to estimates from 2015 to 2020 will grow. Currently, the VC production involving more than 2 million people, the risk of formation of occupational and industrial-caused diseases might be significant. The purpose of this study was to evaluate the status of the immune reactivity of the organism of workers of different professional and experienced groups in the modern VC production to justify informative immunological criteria of the occupational health risk. There were performed the laboratory and immunological study of 77 men working in the VC production. The paper considers the regularities of formation of compensatory-adaptive immune responses in working in the VC production depending on the intensity and duration of exposure to adverse production factors. There is a more pronounced imbalance in the immune system workers of the main occupations (operatives, technicians) with long (10 or more years) experience. It characterized by a decrease in IL-2, IL-4, IgM and increased the production of IL-8, INF-α, TNF-α. The engineering staff experiencing less stress by toxicants, showed the compensatorily increased production of IL-1β and decrease of IgA and also unidirectional, but less pronounced changes in the content of IL-8, INF-γ. There is the relationship between the development of disorders in the immune system of workers in various occupational groups and the level of occupational risk for these specialties. Substantiated informative immunological parameters for the early detection of functional disorders of immune regulation underlying the formation of various diseases are necessary for the timely implementation of effective prevention programmes. Thus, the state of the immune reactivity of the body reflects the level of the adaptation potential of employees of various professions and experienced groups and may be an integrated assessment of the risk of violations of occupational health. The implementation of methods of immunodiagnostics will as predict and identify the disease at the early stages of its development that can optimize the resistance of the organism involved in the VC production as reducing the incidence.

scholarly journals Predictive Factors of the Responses to Treatment of Mycoplasma pneumoniae Pneumonia

2021 ◽  
Vol 10 (6) ◽  
pp. 1154
Author(s):  
Eun Lee ◽  
Yun Young Lee
Keyword(s):  
Pleural Effusion ◽  
Mycoplasma Pneumoniae ◽  
Predictive Factors ◽  
Respiratory Virus ◽  
Clinical Laboratory ◽  
Poor Response ◽  
Response To Treatment ◽  
Slow Response ◽  
Response Group ◽  
Time Of Admission

The prevalence of refractory Mycoplasma pneumoniae (MP) pneumonia is increasing. The present study aimed to identify the predictive factors of responses to treatment of MP pneumonia in children. A total of 149 children were diagnosed with MP pneumonia, of whom 56 were included in the good response group, 75 children in the slow response group, and 18 children in no response or progression group. Data on the clinical, laboratory, and radiologic features were retrospectively obtained through medical chart reviews. The severity of pneumonia, based on the extent of pneumonic lesions on chest x-ray (adjusted odds ratio (aOR), 10.573; 95% confidence intervals (CIs), 2.303−48.543), and lactate dehydrogenase (LDH) levels (aOR, 1.002; 95% CIs, 1.000–1.004) at the time of admission were associated with slow response to treatment of MP pneumonia. Pleural effusion (aOR, 5.127; 95% CIs, 1.404–18.727), respiratory virus co-infection (aOR, 4.354; 95% CIs, 1.374–13.800), and higher LDH levels (aOR, 1.005; 95% CIs, 1.002–1.007) as well as MP-specific IgM titer (aOR, 1.309; 95% CIs, 1.095–1.564) were associated with no response or progression of MP pneumonia. The area under the curve for the prediction of no or poor response in MP pneumonia using pleural effusion, respiratory virus co-infection, LDH levels, and MP-specific IgM titer at the time of admission was 0.8547. This study identified the predictive factors of responses to treatment of MP pneumonia in children, which would be helpful in establishing a therapeutic plan and predicting the clinical course of MP pneumonia in children.

Factors predicting length of stay in patients hospitalized for acute parotitis

2020 ◽  
pp. jim-2020-001506
Author(s):  
Avinoam Markovich ◽  
Ohad Ronen
Keyword(s):  
Clinical Laboratory ◽  
Medical Center ◽  
White Cell Count ◽  
Acute Infection ◽  
Retrospective Chart Review ◽  
Significant Treatment ◽  
Patient Age ◽  
Factors Affecting ◽  
Patient Âgé ◽  
Length Of Hospitalization

Acute suppurative parotitis (ASP) is an acute infection of the parotid gland that necessitates hospitalization in some patients. The aim of this study was to evaluate clinical laboratory values including hydration, nutritional status, inflammatory markers and age, and to compare them with duration of hospitalization of patients with ASP. This is a retrospective chart review in a tertiary academic center. We investigated the factors affecting length of hospitalization in patients admitted to Galilee Medical Center with a diagnosis of ASP between 2010 and 2018. Of the 60 patients with ASP included in the study, 24 were male. The average age of patients was 60, ranging from 18 to 99. We found statistically significant correlations between length of hospitalization and patient age (r=0.3), C reactive protein (r=0.3), white cell count (WCC) at presentation (r=0.3), blood urea nitrogen to creatinine ratio (BUN:Cr) (r=0.2), and platelet levels at discharge (r=0.4). Examination of these factors on multivariate analysis found hospitalization duration was exclusively affected by patients’ level of dehydration as represented by BUN:Cr. Patient age, WCC levels at presentation, and platelet levels were not found to be statistically significant. Treatment and interventions should be planned accordingly.

scholarly journals AB1119 U9: A NOVEL CLINICALLY ORIENTED ULTRASONOGRAPHIC SCALE AS A USEFUL MARKER FOR MONITORING THERAPEUTIC RESPONSE IN RHEUMATOID ARTHRITIS (MULTI CENTERS STUDY)

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1848.2-1849
Author(s):  
M. A. Mortada ◽  
H. Eitta ◽  
R. Elmallah ◽  
A. Radwan ◽  
A. Elsaman
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Clinical Laboratory ◽  
Pearson Correlation ◽  
Response To Treatment ◽  
P Value ◽  
Clinical Parameters ◽  
Biologic Dmards ◽  
Das 28 ◽  
Significant Difference

Background:Musculoskeletal Ultrasonography (MSUS) is now a widely used tool for monitoring of rheumatoid arthritis (RA). Although there are many proposed sets of composite scores, a fixed set of joints may not be an ideal tool to assess a disease like RA, which affects many joints and tendons in different presentations. In previous study (1) U9 score was proven to be correlated with disease activity parameters.Objectives:To determine whether US assessment using U9 score is useful for monitoring response to treatment for RA or not?Methods:A prospective, multicenter study were conducted in period from July 2019 to December 2019. All recruited RA patients were subjected to: Disease activity assessment by clinical disease activity indices (CDAI and DAS28 ESR). Functional status assessment by (HAQ) and ultrasonographic assessment using U9 score which include 8 joints (bilateral wrists,2ndMCP,3RDMCP and knees) plus most clinically affected joint or tendon (one joint or one tendon). Most clinically affected joints from 48 joints. Any affected tendons could be choosing. All targeted joints were evaluated according to EULAR guidlines and by EULAR/ OMERACT combined score (0-3). Targeted tendons were scored (0-3).All patients received their treatment (biologic and non biologic DMARDs) according to the decision of the treating physicians. No specific therapy is needed. CDAI and DAS28 ESR, HAQ and U9 score were repeated after 3 months to detect the response to change after receiving the therapy.Results:One hundred and forty patients (23.6% were male) with mean age 39.26±11.30 were recruited from 4 tertiary referral university hospitals.There was a significant difference (<0.001) between the first and second visits as regards clinical, laboratory and ultrasonographic parameters. DAS 28 decreased form (5.29±1.21) to (3.95±0.99), ESR decreased from (42.12±15.24) to (26.84±12.32), HAQ2 improved from (0.652±0.350) to (0.510±0.237) and U9 total US score decreased from (13.56±5.18) to (8.02±4.28).There was significant correlation between U9 ultrasonographic score and clinical parameters at both visits (table 1).Table 1.correlation between U9 ultrasonographic score and clinical parameters.U9 at 1stvisitU9 at 2ndvisitDAS-28Pearson Correlation(P value)0.806<0.0010.790<0.001CDAIPearson Correlation(P value)0.787<0.0010.773<0.001HAQPearson Correlation(P value)0.431<0.0010.317<0.001We found that the most suitable cut-off value of U9 score to predict high disease activity was 11.5 (sensitivity 85.7% and specificity 80.6%), cut off value for moderate disease activity was 5.5(sensitivity 83.2% and specificity 88%) and cut off value for low disease activity was 3.5 (sensitivity of 83.3% and specificity 57.1%). These results are summarized in the following table:Conclusion:U9 ultrasonographic score is very useful method for evaluating the monitoring the response of treatment.References:[1]Mortada, et al. Annals of the Rheumatic Diseases 2019;78:1009.Disclosure of Interests:None declared

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