LUNG VESSELS THROMBOSIS IN HOSPITALIZED PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA: ROLE OF ENDOTHELIAL FUNCTION, HEMOSTASIS, FIBRINOLYSIS AND INFLAMMATION ON DIFFERENT PHASES OF TREATMENT

2019 ◽  
Vol 72 (8) ◽  
pp. 1463-1465
Author(s):  
Mariia A. Krykhtina ◽  
Kseniia O. Bielosludtseva ◽  
Larysa A. Botvinikova ◽  
Nataliia M. Matikina
Keyword(s):  
Endothelial Dysfunction ◽  
Initial Point ◽  
Community Acquired Pneumonia ◽  
Main Group ◽  
Antibacterial Treatment ◽  
Control Group ◽  
The Mean ◽  
Lung Vessels ◽  
Definition Of

Introduction: There are limited data on the relationship between the severity of community-acquired pneumonia (CAP), biomarkers of inflammation and coagulation as well. The aim was to evaluate the association between the severity of CAP and risk of thrombosis in patients with moderate and severe CAP. To estimate the role of parameters of systemic inflammation, endothelial dysfunction, hemostasis, coagulation on different phases of treatment. Materials and methods: The main group was 75 patients CAP. We divided the main group according severity: subgroup 1 – 41 patients with moderate CAP, subgroup 2 – 34 patients with severe CAP. Blood coagulation test, determination of biomarkers was performed at admission before starting of antibacterial treatment and after clinical stability on 7–10 day after hospitalization. Results: We found that in both subgroup 1 and subgroup 2 the mean levels of CRP and fibrinogen were higher than in control group. Moreover, the mean level of D-dimer was significantly higher and protein C (PC) was significantly lower in both subgroups in comparison with control group. Normalization of PC is coming after 7–10 days of antibacterial treatment, vice versa ET-1, which reflects prolong endothelial dysfunction in patients with severe CAP. Conclusions: patients with severe CAP have the high risk of thrombosis which can be associated with endothelial dysfunction; definition of such parameters as ET-1 and PC can be useful for establishment of different coagulant disorders in patient with mild and moderate CAP, and their dynamic changes could be the initial point of prescribing or cancelling of anticoagulant treatment.

scholarly journals DIAGNOSTIC ROLE OF SYSTEMIC INFLAMMATION, BLOOD COAGULATION AND PADUA PREDICTION SCORE IN LUNG THROMBOSIS RISK ESTIMATION IN HOSPITALIZED PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA

2019 ◽  
Vol 72 (2) ◽  
pp. 149-153
Author(s):  
Tetyana Pertseva ◽  
Tetyana Kireieieva ◽  
Mariia Krykhtina ◽  
Kseniia Bielosludtseva ◽  
Kateryna Dyagovets
Keyword(s):  
Prothrombin Time ◽  
Blood Coagulation ◽  
Systemic Inflammation ◽  
Main Group ◽  
Hospitalized Patients ◽  
Control Group ◽  
The Mean ◽  
Old Men ◽  
D Dimer

Introduction: Some coagulation and thrombotic disorders during severe CAP could lead to some intravascular disorders and even be the reason of lethal end in hospitalized patients with CAP. But this fact hadn’t been established to the end yet. The aim was to study the intravascular changes in patients with severe CAP and to estimate the role of parameters of systemic inflammation (procalcitonin (PCT), C-reactive protein (CRP)), blood coagulation test (fibrinogen, D-dimer, heparin time, prothrombin time) and risk of thrombosis in patients with moderate and severe CAP. Materials and methods: The main group was 63 patients with moderate to severe CAP. The mean age was 54.0 [37.0–63.0] years old, men – 46 (73.0%)). Depending on the severity all patients of the main group were divided into 2 subgroups: subgroup 1 – 36 patients with moderate CAP (the mean age was 51.0 [32.5–62.5] years old, men – 29 (80.5%)), subgroup 2 – 27 patients with severe CAP (the mean age was 56.0 [46.0–68.0] years old, men – 17 (63.0%). Subgroups had no significant difference according to age (p=0,348) and sex (p=0,237). Received results were compared with values in control group. The control group was 10 healthy people (the mean age was 52.0 [35.6–62.0] years old, men – 5 (50.0%)). Results and conclusions: Patients with severe CAP had significantly higher levels of PCT, CRP, D-dimer, prothrombin time, heparin index and the lowest level of heparin time. This fact shows the highest risk of thrombosis in patients with severe CAP on the background of severe systemic inflammation. The mean level of scores by Padua scale in patients with severe CAP was 5.0 [5.0–6.0] scores, which was significantly higher than in patients with moderate CAP, who had 1.0 [1.0–2.0] scores. On autopsy of 5 died patients with severe CAP we found thrombosis of lung vessels which differ from embolism or post-mortem blood clots. These changes maybe reflect systemic thrombosis at patients with severe CAP and could be the reasons of increased mortality in this category of patients.

scholarly journals Early Neuromuscular Blockade in Children with Pediatric Acute Respiratory Distress Syndrome

2020 ◽  
Vol 09 (03) ◽  
pp. 201-206
Author(s):  
Surabhi Chandra ◽  
Sahil Goel ◽  
Ritika Dawra
Keyword(s):  
Mechanical Ventilation ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Neuromuscular Blockade ◽  
Distress Syndrome ◽  
Control Group ◽  
Case Group ◽  
The Mean ◽  
Mean Time

AbstractPediatric acute respiratory distress syndrome (PARDS) is a challenging problem with high mortality. Role of neuromuscular blockade in the management of ARDS to date has been controversial, and this study was done to study the role of neuromuscular blockade in children having PARDS and development of associated complications, if any. This was a prospective, case–control study conducted in the pediatric intensive care unit (PICU) of a tertiary care teaching hospital, over a period of 24 months. Patients of age 1 to 18 years who presented with or developed PARDS during their course of hospitalization were included after written informed consent was obtained from their parents and/or guardians. Patients with PARDS requiring invasive mechanical ventilation were partitioned into a case group and a control group. Case group patients were sedated and paralyzed using midazolam (1 µg/kg/min) and vecuronium (1 µg/kg/min), respectively, along with institution of definitive management. Control group patients were given definitive and supportive therapy, but no neuromuscular blocking agents (NMBAs). All patients were followed up for signs and symptoms of myopathy or neuropathy during the entire duration of hospital stay and up to 3 months after discharge. During the study period, 613 patients were admitted to the PICU of which 91 patients qualified as having PARDS. Sepsis was the main etiology in 67 of the 91 patients (73.6%) with PARDS. Fifty-nine patients were included in the study, of which 29 patients were included in the case group and 30 patients were included in the control group. Among the 29 case group patients, 25 patients (86.2%) were successfully extubated. Four patients from the case group expired, while 14 out of 30 control group patients (46.7%) expired. Hypotension was present in 26 case group patients (89.6%), of which all showed resolution within 48 hours of definitive treatment. The mean time to resolution of hypotension was 41.6 hours (standard deviation [SD]: 5.759; range: 24–48) for case group patients, significantly lower (p < 0.0001) than the mean time to resolution of 103 hours (SD: 18.995; range: 90–126) for the 10 control group patients with hypotension that survived. Mean oxygenation index (OI) following 48 hours of vecuronium therapy was significantly lower (p < 0.0001; 95% confidence interval: 5.9129–9.9671) than mean OI at admission for case group patients. None of the patients receiving vecuronium exhibited neuromuscular deficit during their hospital stay, at time of discharge, or at follow-up evaluation up to 3 months after discharge. In this study, pediatric cases diagnosed with PARDS and managed with mechanical ventilation and vecuronium therapy had improved mean OI following 48 hours of NMBA therapy and a lower mortality when compared with matched control group patients. Incidence of NMBA-related weakness was not commonly observed in these patients.

scholarly journals Chronic cerebrovascular disease: the role of venous disorders and the possibility of pathogenetic correction

2020 ◽  
Vol 4 (9) ◽  
pp. 544-551
Author(s):  
I.A. Schukin ◽  
◽  
M.S. Fidler ◽  
I.A. Koltsov ◽  
◽  
...  
Keyword(s):  
Cerebral Ischemia ◽  
Cerebrovascular Disease ◽  
Venous Insufficiency ◽  
Main Group ◽  
Duplex Scanning ◽  
Control Group ◽  
Chronic Cerebral Ischemia ◽  
Venous Disorders ◽  
Tinetti Test

Aim: to evaluate the efficacy and safety of the L-lysine escinate venotropic drug in the treatment of cephalgic, atactic and asthenic syndromes in patients with chronic cerebral ischemia, mainly caused by venous disorders. Patients and Methods: the study involved 60 patients with a diagnosis of chronic cerebral ischemia with signs of chronic venous insufficiency. All patients were randomly divided into two groups consisting of 30 people. Patients in the main group received L-lysine escinate, and the control group received Vinpocetine. The drugs were administered by intravenous drip for 10 days. A dynamic assessment was performed using a modified subjective scale of asthenia evaluation (MFI-20), 100 mm long visual analogue scale (VAS) for headache, subjective neurological impairment scale (SNIS), and Tinetti test. An ophthalmic examination with an assessment of the fundus vessels and an ultrasound duplex scanning of head vessels (veins) were also conducted. Results: it was shown that L-lysine escinate therapy showed a statistically more significant reduction in the severity of headache (according to VAS) and an improved stability measured by Tinetti test versus during Vinpocetine treatment. There were no significant differences in the level of asthenia (MFI-20), the severity of emotional disorders, and the SNIS score. Also, the number of patients with dilated fundus veins significantly decreased during treatment in the main group (p<0.05), which was not the case in the control group. According to ultrasound duplex scanning data, the venous flow velocity through the veins of Rosenthal and angular veins during L-lysine escinate therapy was significantly higher (p<0.05) than in patients receiving Vinpocetine. Conclusion: the inclusion of vasotropic drugs (in particular, the L-lysine escinate venotonic drug) in the treatment regimen of patients with chronic brain ischemia seems appropriate, especially if there are signs of venous insufficiency. KEYWORDS: systemic venous insufficiency, chronic cerebrovascular disease, venous dyscirculation, glymphatic system, L-lysine escinate, Vinpocetine. FOR CITATION: Schukin I.A., Fidler M.S., Koltsov I.A. Chronic cerebrovascular disease: the role of venous disorders and the possibility of pathogenetic correction. Russian Medical Inquiry. 2020;4(9):544–551. DOI: 10.32364/2587-6821-2020-4-9-544-551.

scholarly journals Vasculotoxicity of Chemotherapy: Assessment оf Endothelial Dysfunction Biomarkers’ Levels in Gastric Cancer Patients

Kardiologiia ◽  
2020 ◽  
Vol 60 (5) ◽  
pp. 35-40
Author(s):  
Yu. Yu. Kirichenko ◽  
Yu. N. Belenkov ◽  
E. V. Privalova ◽  
Yu. I. Naymann ◽  
E. P. Gitel ◽  
...  
Keyword(s):  
Endothelial Dysfunction ◽  
Healthy Volunteers ◽  
Stomach Cancer ◽  
Specific Treatment ◽  
Study Groups ◽  
Main Group ◽  
Control Group ◽  
Instrumental Evaluation ◽  
Oncological Patients ◽  
Before And After

Aim To evaluate dynamics of biomarkers for endothelial dysfunction (ED), including endothelin-1 (ET-1) and von Willebrand factor (VWF) in patients with stomach cancer (adenocarcinoma) before and after polychemotherapy (PCT); to compare these results with respective values in healthy volunteers and patients with cardiovascular diseases (CVD); to study correlations of the ED biomarkers with indexes of instrumental evaluation of endothelial dysfunction.Material and methods The study included 75 participants, including 25 healthy volunteers (control group), 25 patients with documented CVDs (arterial hypertension + ischemic heart disease), and 25 patients of the main group with histologically documented stage II-IV stomach cancer (adenocarcinoma) who received different courses of PCT with platinum-based agents (oxaliplatin, cisplatin) and fluoropyrimidines (5 fluorouracil, capecitabin). Laboratory measurement of ED biomarkers, computerized nailfold video capillaroscopy (CNVC), and finger laser photoplethysmography (PPG) (methods for noninvasive evaluation of vascular wall and ED), electrocardiography, 24-h ECG Holter monitoring, and echocardiography (EchoCG) were performed for all patients of the main group prior to PCT and within one months after the last course completion. This evaluation was performed once for healthy volunteers and patients of the CVD group upon inclusion into the study.Results In the main group, ET-1 levels were non-significantly lower than normal and did not change during the courses of antitumor treatment (0.95 [0.6; 1.4] and 0.94 [0.7; 1.4] pg /ml (р<0.9) before and after PCT, respectively). Statistically significant differences were found between the control group and oncological patients after the treatment (р<0.04). Levels of VWF remained within the normal range in all examined participants and did not significantly differ between study groups, including oncological patients before and after the specific treatment (р>0.05 for all comparisons). The correlation analysis detected significant correlations of ET-1 levels with functional disorders of microcirculation, ET-1 with the occlusion index (rs=0.56; p=0.005), ЕТ-1 with percentage of capillary restoration (PCR, rs= –0.72; p=0.018) and with the incidence rate of supraventricular extrasystole (rs=0.48; p=0.032).Conclusion The dynamics of ED biomarkers was studied for the first time in patients with stomach cancer receiving a specific antitumor therapy. Although no significant changes in ЕТ-1 and VWF were observed during the PCT (probably due to exhaustion of the endothelial system and a small patient sample), these indexes can be considered as early vasculotoxicity markers due to the presence of significant correlations with indexes of impaired endothelial function according to the results of instrumental evaluation.

scholarly journals USE OF THE SPEECH PASSPORT IN REHABILITATION OF CHILDREN WITH CONGENITAL MAXILLOFACIAL MALFORMATIONS

2019 ◽  
Vol 15 (2) ◽  
pp. 79-83
Author(s):  
Павел Токарев ◽  
Pavel Tokarev ◽  
Алексей Шулаев ◽  
Aleksey Shulaev ◽  
Ринат Салеев ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Speech Therapy ◽  
Cleft Lip And Palate ◽  
Main Group ◽  
Speech Development ◽  
Control Group ◽  
Speech Activity ◽  
Speech Therapist ◽  
Rehabilitation Measures ◽  
Definition Of

Subject. The article describes the child's speech passport, as one of the important mechanisms of the rehabilitation and speech recovery in children with congenital cleft lip and palate. Purpose of the study ― evaluation of the treatment outcome in children with cleft palate with the use of a speech passport at the stage of rehabilitation. Materials and methods. The article presents the experience of the rehabilitation of more than 2,000 patients with congenital maxillofacial defects from 1998 to 2017. Results. The features of speech development were studied in 93 patients divided into two groups. The main group consisted of 56 people, in whom the definition of the algorithm of medical and logopedic aid was carried out using a speech passport, then the rehabilitation measures complex developed by us for restoring and correcting the speech function was applied. The control group included 37 people: patients who did not receive medical and speech therapy in the postoperative period, and patients who underwent rehabilitation measures in outpatient clinic at the place of residence. The speech activity indicators in patients of the compared groups had significant differences (p = 0,026), due to a more pronounced positive dynamics of speech activity recovery in the main group - the percentage of patients increased 3,6 times ― from 17,9 to 64,3 %, while in the control group the rate increased only 1,9 times ― from 21,6 up to 40,5 %. Conclusion. The developed speech passport involves a multidisciplinary approach to the child, early detection, treatment and rehabilitation. It is also can be defined as a link between health care, speech therapy and pedagogy. The child's speech passport data can be filled by a pediatrician, neurologist, maxillofacial surgeon, orthodontist, speech therapist and speech therapist defectologist at various stages of treatment and rehabilitation.

scholarly journals Definition of the upper reference limit of glycated albumin in blood donors from Italy

2017 ◽  
Vol 56 (1) ◽  
Author(s):  
Chiara Bellia ◽  
Martina Zaninotto ◽  
Chiara Cosma ◽  
Luisa Agnello ◽  
Bruna Lo Sasso ◽  
...  
Keyword(s):  
Blood Donors ◽  
Glycated Albumin ◽  
Specific Reference ◽  
Reference Limit ◽  
Percentile Method ◽  
The Mean ◽  
Definition Of ◽  
Upper Reference Limit ◽  
Mean Glucose

AbstractBackground:Glycated Albumin (GA) has been proposed as a short-term indicator of glycemic homeostasis. The aim of this study is to describe the distribution of GA in a large sample of blood donors from Italy to evaluate whether demographic features, namely age and sex, could influence GA levels and define specific reference limits.Methods:The study included 1334 Italian blood donors. GA was measured using an enzymatic method (quantILab Glycated Albumin, IL Werfen, Germany). The upper reference limit (URL) was calculated using the non-parametric percentile method.Results:A modest, although significant, increase of GA was observed in relation to age (p<0.001), especially in males, where the differences were more pronounced (p<0.001 in males, p=0.003 in females). Slight differences were documented based on sex (12% [11.3–12.8] in males; 12.2% [11.4–13.1] in females; p=0.01). After excluding individuals with fasting plasma glucose ≥7 mmol/L, the calculated GA URL was 14.5% (95% CI: 14.3–14.7). Subjects with GA>14.5% presented a mean age of 48.4±12.2 years, 66.7% were males and the mean glucose was 6.88±2.5 mmol/L.Conclusions:GA in Caucasians shows a similar increasing trend at older ages documented in other ethnicities. The definition of the URL in this population could be useful for both clinical studies, which will clarify the role of GA for diagnosing and monitoring diabetes, and will encourage the introduction of GA in clinical practice.

Prevalence of allelic and genotypic variants of the rs1143627 polymorphism in the IL1β gene among patients with typhoid

2020 ◽  
Vol 18 (3) ◽  
pp. 126-130
Author(s):  
D.B. Mirzajonova ◽  
◽  
H.Ya. Karimov ◽  
G.K. Abdukhalilova ◽  
K.T. Boboev ◽  
...  
Keyword(s):  
Typhoid Fever ◽  
Key Words ◽  
Main Group ◽  
Minor Allele ◽  
Control Group ◽  
Healthy Individuals ◽  
Allele Detection ◽  
Generic Structure

Objective. To evaluatethe role of allelic and genotypic variants of gene IL1β polymorphism rs1143627 in susceptibility to typhoid fever (TF). Materials and methods. 41 patients with TF and 84 chronic carriers of S. typhi were endrolled in the study. Control group included 91 healthy individuals, All of the individuals under study were Uzbeks. DNA samples were isolated from peripheric blood with the kit Ribo-sorb (AmpliSens®, Russia). Genotyping of polymorphism rs1143627 of gene IL1β was carried out by the standard PCR using kits “SNP-Express” (LLC NPF “LITECH”, Russia) according to the instruction of manufacturer. Results. The domination of allele 31T was found in the main group (patients and carriers). Its frequency was significantly lower in comparison with the control group (51.2% and 67.0%, respectively; χ2 = 10.8; p = 0.001). Minor allele -31С cytokine IL1β, on the contrary was detected more frequently in patients with TF (48.8%), than in the control group (33.0%) in χ2 = 10.8 and p = 0.001. Calculated relative chance of this allele detection in the main group in comparison with control group was OR = 1.9 in 95% CI 1.304-2.88. Conclusion. Genotypic variant C/C of polymorphism rs1143627 of the gene IL1β made a certain contribution into forming of generic structure of susceptibility to S. typhi. Risk of susceptibility of macro organism to pathogen in the presence of this genotype is higher more than 2.5 times (χ2 = 4.3; p = 0.04; CI 95% 1.037–7.359). Key words: Typhoid fever, bacteria carrier, bacteria S. typhi, polymorphism rs1143627 of the gene IL1β

Aspects of the Wound Process in the Choice of Surgical Treatment of the Ventral Hernias

10.12737/5900 ◽  
2014 ◽  
Vol 21 (3) ◽  
pp. 62-65
Author(s):  
Агаларян ◽  
A. Agalaryan ◽  
Ротькин ◽  
E. Rotkin ◽  
Хохлова ◽  
...  
Keyword(s):  
Standard Method ◽  
Infectious Complications ◽  
Main Group ◽  
Control Group ◽  
Macrophage Activity ◽  
Hernial Sac ◽  
Effective Activity ◽  
Bed Days ◽  
The Mean ◽  
Ventral Hernias

The examination of the wound process in 140 patients after the alloplasty, according to the standard method «on-lay» and developed method with the use of the flaps of the hernial sac was carried out. All patients were divided into 2 groups. The main group was consisted of the patients treated by the developed method using the flaps of the hernial sac, the control group of patients – by means of the standard method «on-lay». According to the data of the cytological study of the exudates in the both groups it has been found that the flaps of the hernial sac situated in the subprosthetic space contribute to the high content of the cells having the macrophage activity (neutrophils, macrophagocytes) in the surgical intervention field. In the main group, the mean volume of the secretion was 113ml, it was in 2 times less than the volume of the serous drainage in the patients of the control group. Decrease of the exudates volume in the main group influenced to the drainage terms (3 days average) and to the hospital stay (as many as 8 bed-days average). The absence of the infectious complications in the patients treated by method with the use of the hernial sac flaps is explained by the effective activity of the cells immunity factors in the wound.

scholarly journals The Role of Mannose-Binding Lectin Serum Level in Tubotympanic Chronic Suppurative Otitis Media

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Anton Budhi Darmawan ◽  
Marsetyawan H. N. E. Soesatyo ◽  
Ratna Dwi Restuti ◽  
Agus Surono
Keyword(s):  
Serum Level ◽  
Otitis Media ◽  
Control Group ◽  
Suppurative Otitis Media ◽  
Mannose Binding ◽  
The Mean ◽  
And Control ◽  
Binding Lectin ◽  
Mbl Deficiency

Background. Chronic suppurative otitis media (CSOM) is a common public health problem worldwide and a major cause of hearing impairment especially in developing countries. The role of Mannose-Binding Lectin (MBL), a component of innate immunity, in CSOM has not been studied. The aim of the study was to examine whether MBL deficiency was more frequently present in cases group of tubotympanic CSOM patients rather than healthy subjects. Material and Methods. This was an analytic observational study. Subjects were enrolled in the Otorhinolaryngology Clinic at Margono Soekarjo Hospital, Purwokerto, Indonesia. An independent t-test was used to compare the mean of MBL serum concentration between tubotympanic CSOM subjects and control. Results. From 36 tubotympanic CSOM patients, there were 8 (22.22%) patients with MBL deficiency (MBL level < 100 ng/ml), while no deficiency was found in the control group. The mean of MBL level in cases group was 354.88 ng/ml, with the lowest level being 0.001 ng/ml and the highest level 690.24 ng/ml, while in the control group MBL level mean was 376.27 with the lowest level being 188.71 and the highest level 794.54 ng/ml. Conclusion. There was no significant difference of MBL serum level between tubotympanic CSOM and control group. However, the presence of subjects with MBL deficiency in the tubotympanic CSOM group might be considered as playing a role in the tubotympanic CSOM.

scholarly journals Optimization of pharmacotherapy of patients with prostate adenoma with hormonal and metabolic disordes: correction of vitamin D deficiency with “Aquadetrim”

2019 ◽  
Vol 5 (4) ◽  
pp. 57-67
Author(s):  
Oleg I. Bratchikov ◽  
Igor A. Tyuzikov ◽  
Sergey O. Artishchev
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Metabolic Disorders ◽  
Main Group ◽  
Integrative Approach ◽  
Control Group ◽  
Practical Algorithms ◽  
Prostate Adenoma ◽  
Local Parameters

Introduction: Modern studies demonstrate an epidemiological and pathogenetic role of systemic hormonal and metabolic disorders in men with prostate adenoma (PA), so it is obvious that a pharmacotherapeutic correction of these disorders can increase the efficacy of the traditional therapy of the disease. Aim of study: To investigate the frequency, relationships among themselves and with PA local parameters of key systemic hormonal and metabolic disorders (obesity, insulin resistance, testosterone deficiency, vitamin D deficiency) and to develop practical algorithms for optimizing diagnosis and management based on an integrative approach. Material and Methods: The results of a comprehensive examination of 160 patients with PA (main group; average age 62.3 ± 4.2 years) and 30 healthy men without PA of the same age (control group), including: collection of anamnesis and complaints; questionnaires; physical, hormonal and sonographic studies, – are presented. Pharmacotherapeutic correction methods were tested in some patients of the main group. The data was processed using descriptive and comparative statistics. Results and Discussion: In the patients with PA, a significantly higher frequency of concomitant systemic hormonal and metabolic disorders formed at a younger age was established, compared to the men without PA, and significantly worse local characteristics of PA compared to the patients with PA without such (p &lt; 0.05). Reliable connections of some studied systemic hormonal and metabolic disorders with one another and with local parameters of PA (p &lt; 0.05) were revealed. A more severe vitamin D deficiency in the patients with PA compared to the control group was revealed, and the safety and a significant positive effect of its drug compensation on the parameters of hormonal and metabolic status and PA in D-deficient men with PA were shown (p &lt; 0.05). Conclusion: The results of the study confirm an important role of the studied systemic hormonal and metabolic disorders in the pathogenesis of PA and the need for their diagnosis and pharmacotherapeutic correction in all patients with PA on the basis of an integrative approach, according to the proposed algorithms.

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