LOCAL HYPOXIA AND IMMUNODEFICIENCY. EFFECT OF OBESITY ON REDUCING THE EFFECTIVENESS OF TREATMENT FOR BACTERIAL VAGINOSIS

Проведен анализ результатов обследования 143 больных бактериальным вагинозом с учетом наличия у них алиментарного ожирения. Все женщины, принимавшие участие в нашем исследовании, дали письменное информированное согласие на участие в нем. Исследование проводили до начала лечения бактериального вагиноза. В зависимости от наличия алиментарного ожирения больных разделили на 2 группы. В I группу вошли 97 с нормальным весом телом, без признаков алиментарного ожирения. Во II группе у 46 больных отмечалось увеличение массы тела, соответствующее алиментарному ожирению II степени. Критериями для анализа являлись результатами бактериоскопического исследования мазков из влагалища, окрашенных по Грамму и выявления в них количественных показателей «ключевых клеток» и показатели оксиметрии, определение интегративного коэффициента Кслиз%, отражающий содержание кислорода в слизистой оболочке, по отношению к показателям, зарегистрированным на II пальце кисти, позволяющего прогнозировать результативность лечения. Таким образом, на фоне алиментарного ожирения еще до начала лечения интенсивность патологического процесса при бактериальном вагинозе была более выражена, чем без него. При этом локальные гипоксия и иммунодефицит свидетельствовали о риске снижения эффективности лечения The analysis of the results of examination of 143 patients with bacterial vaginosis, taking into account the presence of alimentary obesity, was carried out. All women who took part in our study gave written informed consent to participate in it. The study was carried out before starting treatment for bacterial vaginosis. Depending on the presence of alimentary obesity, the patients were divided into 2 groups. Group I included 97 people with normal body weight, without signs of alimentary obesity. In group II, 46 patients showed an increase in body weight corresponding to alimentary obesity of the II degree. The criteria for the analysis were the results of bacterioscopic examination of vaginal smears stained according to Gram and the identification of quantitative indicators of "key cells" in them and oximetry indicators, determination of the integrative coefficient Cmucous membrane% , reflecting the oxygen content in the mucous membrane, in relation to the indicators recorded on the second finger of the hand, which allows predicting the effectiveness of treatment. Thus, amid alimentary obesity, even before the start of treatment, the intensity of the pathological process with bacterial vaginosis was more pronounced than without it. At the same time, local hypoxia and immunodeficiency indicated the risk of a decrease in the effectiveness of treatment.

THE NEGATIVE IMPACT OF ALIMENTARY OBESITY ON THE STATE OF LOCAL IMMUNITY OF THE VAGINAL MUCOSA AND THE EFFECTIVENESS OF THE THERAPY OF BACTERIAL VAGINOSIS

Проведен анализ результатов стандартного лечения бактериального вагиноза у 143 больных с учетом наличия у них алиментарного ожирения. Все женщины, принимавшие участие в нашем исследовании, дали письменное информированное согласие на участие в нем. Лечение БВ проводилось по общепринятой методике метронидазолом и клиндамицином. В зависимости от наличия алиментарного ожирения больных бактериальным вагинозом разделили на 2 группы. В I группу вошли 97 без алиментарного ожирения. Во II группе у 46 больных отмечалось увеличение массы тела, соответствующее алиментарному ожирению II степени. Исследования проводили до начала лечения и через 14 суток после его завершения. Сравнительный анализ результатов лечения БВ в исследуемых группах показал, что на фоне АО II степени отмечались достоверно более выраженные увеличение количества «ключевых клеток» (P<0,05) и смещение pH в щелочную сторону (P<0,05) во II группе. При этом эффективность лечения у больных II группы, где отмечалось алиментарное ожирение II степени была достоверно меньше, чем в I (P<0,05), что свидетельствовало о негативном влиянии алиментарного ожирения на состояние локального иммунитета слизистой оболочки влагалища и результативность проводимой терапии бактериального вагиноза. The results of standard treatment of bacterial vaginosis in 143 patients were analyzed, taking into account the presence of alimentary obesity in them. All the women who took part in our study gave written informed consent to participate in it.BV was treated according to the generally accepted method with metronidazole and clindamycin. Depending on the presence of alimentary obesity, patients with bacterial vaginosis were divided into 2 groups. Group I included 97 people without alimentary obesity. In group II, 46 patients had an increase in body weight corresponding to alimentary obesity of the II degree. Studies were conducted before the start of treatment and 14 days after its completion. A comparative analysis of the results of BV treatment in the study groups showed that against the background of grade II AO, there was a significantly more pronounced increase in the number of "key cells" (P<0.05) and a pH shift to the alkaline side (P<0.05) in group II. At the same time, the effectiveness of treatment in group II patients with grade II alimentary obesity was significantly less than in group I (P<0.05), which indicated a negative effect of alimentary obesity on the state of local immunity of the vaginal mucosa and the effectiveness of the therapy of bacterial vaginosis.

Pathophysiological characteristics of the development of arterial hypertension in Yorkshire Terriers with alimentary obesity

Relevance. The study of the pathogenesis of obesity in domestic animals is an urgent problem in veterinary medicine, which is associated with the high prevalence of this pathological condition and a significant risk of complications from the cardiovascular system. The aim of the study was to present the pathophysiological characteristics of the development of arterial hypertension syndrome in obesity in Yorkshire Terrier dogs.Methods. In a comparative aspect, clinical, tonometric, electrocardiographic, echocardiographic and biochemical parameters were studied in obese patients (n = 13) and clinically healthy dogs (n = 7).Results. Our study shows the negative role of obesity in the development of arterial hypertension syndrome in Yorkshire Terrier dogs. It was also found that obesity in dogs is accompanied by impaired lipid metabolism, oxidative stress, the development of arterial hypertension and a tendency to the development of concentric hypertrophy of the left ventricular myocardium and hepatopathy.

Correcting eating disorders in obese adolescents

The relevance of the study is conditioned by the need to study the way of eating as a method of correct in geating disorders in adolescents.Objective. To evaluate the correction potential of the nutrition method in adolescents with eating disorders by alimentary obesity type. Characteristic of children and research methods. At the first stage of the study the research sampling was based on the criteria for body mass index assessing in adolescents. The total size of the research sample was 69 adolescents aged13–16 years with alimentary obesity. The group was equalized by gender. At the second stage, the adolescents were surveyed to assess the rules for the use and content of food consumed, including energy value. At the third stage, all patients were divided into three research groups, two groups had a separate program for the correction of eating disorders, taking in to account the measured parameters.Results. The study confirmed the effectiveness of the nutritional disorders method by changing the eating rules and using object-mediated consumption of food (using cutlery – forks, knives, sticks). At the same time, the content, volume and frequency of food intake were preserved. The average weight loss with an indirect way of eating was up to 2 kg per week. In addition, they recorded a decrease in body mass index. The time of food intake significantly increased, which affects the control of the amount of food consumed, transferring eating actions from an involuntary level with a lack of fixation on taste sensations to an arbitrary one.Conclusion. The technique is recommended for use as part of the eating disorders correction, since it can be easily integrated into any methodological complex and has no contraindications.

CIRCADIAN RHYTHM AND INDICATORS OF SYSTEMIC INFLAMMATION IN PATIENTS WITH PSORIASIS AND CONCOMITANT ALIMENTARY OBESITY

Psoriasis is one of the most common dermatoses, affecting from 2% to 4% of the world's population, according to the statistics from WHO. The recent increase in the incidence of comorbid psoriasis and obesity leads to severe, atypical, disabling, and treatment-resistant forms of dermatosis, which significantly impair the quality of life of patients, reduce the efficiency and social activity of patients, thus acquiring not only a medical but also a social significance. There is a theoretical justification for a possible role of circadian rhythm disorders, manifested by changes in eating behavior, reduced sleep duration, and individual chronotype of patients in the development of obesity, chronic low-intensity inflammation, and some chronic autoimmune diseases such as psoriasis. However, this issue remains understudied and insufficiently substantiated. Therefore, the aim of our research was to identify the correlation between the circadian rhythm in terms of changes in the chronotype of human working capacity and indicators of systemic inflammation in patients with extensive psoriasis and concomitant alimentary obesity. The results of correlation analysis showed a high negative correlation between the working capacity chronotype in patients and the level of IL-33, as well as a medium negative correlation between the working capacity chronotype in patients and the level of IL-6 and CRP. Therefore, changes in the circadian rhythm to the evening type of human working capacity chronotype may increase the level of systemic inflammation in patients with extensive vulgar psoriasis and concomitant alimentary obesity. Thus, further in-depth study of the relationship between systemic inflammation and circadian rhythm changes in patients with extensive vulgar psoriasis and concomitant alimentary obesity is promising and essential for the development of scientifically substantiated principles for early prevention and timely correction of these comorbidities.

Pioglitazone in treatment of patients with comoribidity of psoriatic disease and alimentary obesity

An indisputable link between psoriasis and obesity has recently been proven. Alimentary obesity exacerbates systemic inflammation in patients with psoriasis, complicating the course of dermatosis, causing deterioration of the dermatological index of quality of life of patients and frequent exacerbation of psoriasis, which leads to ineffectiveness of standard treatments. PPAR-activated receptors are the link between lipids and inflammation because lipids stimulate the chronic form of systemic inflammation and are ligands that activate PPAR. Thus, PPAR can be used as the main target when choosing a treatment for this comorbidity. To date, the literature has accumulated a large number of prospective observations indicating a positive effect of pioglitazone (PG) on systemic inflammation. The mechanism of action of this drug is aimed at suppressing chronic systemic delayed inflammation of low intensity. The anti-inflammatory effect of PG is associated with its activating effect on nuclear transcription factors of PPAR. Objective — to determine the effectiveness of the inclusion of different doses of pioglitazone in the complex treatment of patients with advanced psoriasis vulgar with concomitant alimentary obesity of I—II degree. Materials and methods. Clinical and immunological study of systemic inflammation. Results and discussion. The results of the study showed the effectiveness of this method of treatment, which depended on the dose of PG and the duration of treatment. The use of PG in the complex treatment of patients with vulgar psoriasis of moderate severity with concomitant alimentary obesity of I—II degree for 26 weeks led to a decrease in inflammation both locally, according to the Psoriatic Area and Severity Index, and at the systemic level due to reduction in the level of systemic inflammation, namely the level of interleukin-33, interleukin-6 and highly sensitive C-reactive protein in the blood serum.Conclusions. Long-term use of PG can be recommended for the personalized and comprehensive treatment of patients with comorbidity of psoriasis and alimentary obesity of I—II degree.

The conception of the probable role of the biological active chromium in the emergence of insulin resistance and alimentary obesity

The conception of probable alimentary chromium role in connection with metabolic reasons emergence of insulin resistance in the alimentary obesity and type 2 diabetes is represented. The violation of insulin receptors structural organization and conformation with these pathological conditions in connection with redox states of chromium is supposed. Based on information from general chemistry and chromium metabolism, higher biological activity of hexavalent chromium when compared to the activity of trivalent chromium is assumed in insulin-resistant conditions. Aim. To analyze the literature data on the a supposed participation of chromium in food and chromium nutraceuticals in connection with insulin resistance at the metabolic level. Material and methods. The analysis of the literature was carried out by the method of manual search and selection of the most important and significant for the analyzed issue monographs and articles up to 60 years in depth. The search criteria were works directly related to the association of food chromium with the insulin-dependent metabolic response of cells and the activity of insulin receptors. No works published over the past 10 years that introduce principled novelty and are of principled importance for the present problem have not been identified. Results and discussion. The concept of the supposed participation of chromium as an essential element in connection with the metabolic reasons for the formation of insulin resistance and the structural organization of insulin receptors depending on the redox state of chromium is presented. Keywords: hexavalent and trivalent chromium, insulin resistance, redox state, insulin receptor, alimentary obesity, diabetes.