Activation of chronic inflammation and comorbidity in end-stage renal disease patients treated with continuous ambulatory peritoneal dialysis.

The aim of the work was to determine the blood serum pro-inflammatory cytokine profile and to study their relationship with comorbidity and mortality in end-stage renal disease (ESRD) patients treated with continuous ambulatory peritoneal dialysis (CAPD). Ninety three ESRD patients treated with CAPD during 2012-2019 were included in the cohort prospective open study. The study was conducted in two stages. At the first stage, the determination of TNF-α and IL-6 levels was conducted and study of comorbidity, its quantitative assessment, baseline clinical and laboratory parameters was made. A modified polymorbidity index (MPI) which determined the quantitative assessment of comorbidity was calculated as the number of diseases per one patient excluding ESRD and its reasons. At the second stage, considering the baseline values of the studied cytokines, a prospective study of the dynamics of the prevalence of comorbid pathology, the value of MPI and mortality rate was carried out. The average duration of prospective follow-up was 26.4±6.8 months. Serum cytokines levels were determined by ELISA. Statistical analysis was performed by using "MedCalc", version 19.1.7. (Ostend, Belgium). Serum levels of TNF-α and IL-6 were significantly higher in PD-patients with 5 or more comorbid diseases. Levels of TNF-α>13.0 pg/ml have a negative effect on the dynamics of prevalence of heart failure (HF) and coronary heart disease (CHD), number of comorbid conditions in CAPD-patients. The proportion of the dead with a level of TNF-α>13.0 pg/ml was by three times higher, and deaths from cardiovascular events are almost by 10 times higher than patients who had a level of TNF-α≤13.0 pg/ml. Serum levels of IL-6>23.4 pg/ml are associated with a significant increase in number of comorbid conditions, prevalence of bacterial infections and overall and infectious mortality. Independent predictors of comorbidity and overall mortality in patients with ESRD who are treated with CAPD are serum levels of TNF-α, IL-6 and albumin. Serum levels of TNF-α and albumin are predictors of fatal cardiovascular events, and serum levels of IL-6 are predictors of fatal infectious events

TREATMENT OF EXPERIMENTAL PERIODONTITIS BY TERPENE-CONTAINING MEDICATION

Therapeutic effect of terpenoidisobornylacetate-containing preparation Antiran on the inflammatory process in paradontium in 56 white outbread rats was researched. Animals of control group wasn't provide the treatment, animals of treatment group had antibiotic dialysis from 1st till 3rd day, ultrasound curettage with Antiran solution on the 4th day, Antiran dialysis in the paradontium tissues for 20 minutes OD from 5th to 14th day. Inflammatory process was studied using morphological methods. It was showed that Aniran arrests an inflammation, prevents secondary alteration of tissues, promotes reparative processes and recovery of damaged tissues

LEVELS ANTIINFAMMATORY CYTOKINES (ІL-4, ІL-10) IN MAINTENCE HEMODIALYSIS PATIENTS DEPENDING ON EXPRESSED ANAEMIA AND CHARACTER DEFEAT OF KIDNEY

Aims: The purpose of the present study was to compare the levels of anti-inflammatory cytokines in patients with chronic kidney disease, prolonged sessions of hemodialysis, depending on the severity of anemia. Materials and methods: We investigated 155 patients with chronic kidney disease, prolonged sessions of hemodialysis and anemia (mean age 46.4±12.4). Patients were divided into 4 groups depending on expressed of anemia: in the I-st (n=22) group – patients with the level of hemoglobin over 110g/l, in the II (n=66) group hemoglobin 90 - 110g/l, in the III (n=44) group hemoglobin 70-89 g/l, in the IV (n=22) group hemoglobin <70 g/l. Results: We have defined that level of IL-4 was clinically significantly lower (p <0.001) in patients, who have getting hemodialysis by comparison to control group. Levels of IL-4 had a significant differences between all of group of patients and controls (p <0.05). IL-10 had a positive correlation with the level of Hb (r=0.2405; p=0.003). ІL-4 had a negative correlation with the level of Hb (r=-0.4842; p <0.001). The average level of IL-4 was significantly increased in diabetic patients compared with non-diabetic patients 92±17.7 vs 48.3±28.1 (p <0.05). Conclusions: All of studied patients have had an increased level of anti- inflammatory cytokines. Serum IL-4 was higher in patients with diabetes. The levels of anti-inflammatory cytokines (IL-4 and IL-10) have had a significant correlation with the severity of anemia

Search interactive regional game as a metod of developing general competencies

The article presents the possibility of using regional interactive quest game as the pedagogical technology aimed to formation of the general competences of studentsВ статье рассматривается возможность использования краеведческой интерактивной игры-квеста, как педагогической технологии, направленной на формирование общих компетенций обучающихс

КЛІНІЧНА ЕФЕКТИВНІСТЬ НЕФРОТЕКТА У ГЕМОДІАЛІЗНИХ ПАЦІЄНТІВ

Пациенты на гемодиализе составляют большую группу, которая получает искусственное питание. Нутриционная программа для этих пациентов рассматривает не только метаболические нарушения, связанные с почечной недостаточностью и сопутствующими осложнениями, а и нарушения нутриционного баланса, обусловленные процедурой гемодиализа

Clinical estimation of efficiency of application of terpene-containing preparation in complex treatment of chronic generalized parodontitis

The article presents the comparative analysis of application of terpene-containing medicine Antiran (1:3 solution) and 0.06% chlorhexidine bigluconate solution in a complex therapy of patients with chronic generalized parodontitis. According to the curative effect, these drugs are comparable with antibacterial and antiseptic agents, but they act more gently and, as a rule, do not cause side effects. Currently, as a etiotropic therapy of periodontitis, a wide range of drugs affecting the parodontal pathogenic microflora, irrational use of antibacterial agents has acquired the status of a global problem of modern medicine, since it leads to the emergence of resistant strains of microorganisms that are poorly sensitive or resistant to treatment. The medicaments were used in ultrasonic scaling and for passive ultrasonic irrigation of periodontal pockets during curettage process. The results were evaluated according to the PMA, SBI, PI indexes, an extravazation time formation and periodontal pockets depth. The first total time period of clinical observation established that inflammation process was eliminated earlier when Antiran was used. Thus our study demonstrated and substantiated the successful experience of Antiran application in periodontal practice

THE PRACTICAL VALUE OF OXIDANT-ANTIOXIDANT PARAMETERS INPATIENTS TREATED WITH HEMODIALYSIS

The work is dedicated to the practical application of oxidant-antioxidant parameters and the possibility of using them for monitoring and optimize the treatment hemodialysis

ANALYSIS OF THE MORTALITY STRUCTURE IN HEMODIALYSIS PATIENTS

Studies of the mortality structure in patients receiving hemodialysis (HD) remain relevant and are the basis for developing measures and recommendations directed to increase the lifetime of patients. Aim. The aim was to study the assessment of death causes in patients who received programmed hemodialysis, based on the demographic and gender characteristics, the duration of dialysis treatment. Methods. Mortality causes in 137 patients who received programmed hemodialysis from 2007 to 2011 years in Kyiv City Scientific and Practical Center of Nephrology an Dialysis were analyzed. Results. The leading cause of death was cardiovascular complications, but their decreasing has been observed since 2008. Fatality rate in young and middle- aged women with cardiovascular diseases (CVD) was almost two times higher than that of men. At the same time CVD is a predominant cause of men’s death at the age older than 44. Cerebrovascular complications were permanently in the second place of the mortality structure. About 30% of deaths occurred during the first 90 days of HD treatment, 72,5% of them were among males. Conclusion. Gender characteristics influence the structure of death causes in patients received programmed hemodialysis depending on age

Results of application of terpenoid-containing drugs in therapy of chronic parodontitis

The therapeutic effect of the drug Antiran containing terpenoid isobornyl acetate on the inflammation in the parodontium in 30 patients with chronic parodontitis of mild severity was investigated. It was used a 30% solution of the drug Antiran as the irrigating liquid with ultrasound scaling and closed curettagein the main group (15 patients), and 0.06% chlorhexidine solution in the comparison group (15 patients). Then, all patients were dialyzed by the solution of the drug Antiran in the parodontal tissues for 20 minutes daily. The dynamics of treatment was assessed by index and functional indicators. It was found that on the 7 th day of treatment, almost all the measurable indicators were differed statistically significantly in the study groups and indicated the best result of treatment in the main group.Исследовано терапевтическое действие препарата Антиран, содержащего терпеноид изоборнилацетат, на воспалительный процесс в пародонте у 30 пациентов с хроническим пародонтитом легкой степени тяжести. Основной группе (15 пациентов) в качестве орошающей жидкости при ультразвуковом скейлинге и закрытом кюретаже применяли 30% раствор препарата Антиран, а группе сравнения (15 пациентов) — 0,06% раствор хлоргексидина. Затем всем пациентам проводили диализ раствора препарата Антиран в ткани пародонта по 20 минут ежедневно. Динамику лечения оценивали по индексным и функциональным показателям. Установлено, что на 7-е сутки лечения почти все измеряемые показатели в исследуемых группах отличались статистически значимо и свидетельствовали о лучшем результате лечения в основной группе