Allergy clinical aspects of toxocariasis

Clinica medicală nr. 4, Departamentul Medicină internă, Disciplina gastroenterologie USMF ”Nicolae Testemiţanu”, Spitalul Clinic RepublicanHuman toxocariasis is a helminthozoonosis with different clinical spectrum of the disease – from asymptomatic, especially in adults to heavy and serious health damage. Labeling of these manifestations of separate syndromes or comorbid disease diagnoses creates major problems. Immunopathogenicity innards diversity, perpetual alert immune antigen induces an inadequate anthyparasitic immune response, chronic sufficiency and etiologic treatment inefficiency. Including in the treating formula different pathogenetic and symptomatic medications on the basis of an exact diagnoses the effectiveness of the given drugs essentialy increases. Toxocaroza umană este o zoohelmintoză, manifestată printr-un polimorfism clinic de la asimptomatic pînă la grav cu repercursiuni serioase asupra sănătății. Etichetarea acestor manifestări unor sindroame separate sau ca maladie comorbidă creează probleme diagnostice majore. Diversitatea mecanismelor imunopatogenetice, ”alerta imună” antigenică perpetuă induce un răspuns imun antiparazitar inadecvat cu cronicizarea suferinței și ineficiența tratamentului etiologic. Includerea în formula curativă a diferitor remedii patogenice și simptomatice în baza unui diagnostic sigur și cert amplifică substanțial randamentul medicației

Peculiarities of hormonal profile in patients with cholinergic urticaria

Catedra Medicină Internă nr. 4, USMF „ N. Testemiţanu”, Spitalul Clinic RepublicanThe hormonal balance in patients with cholinergic urticaria is determined by activation of sympathetic and vagal systems, by the decrease of endocrine mechanisms of adaption and antistress protection which need to be considered in the elaboration of the proper treatment algorithm. Statutul hormonal la bolnavii cu urticarie colinergică este determinat de activarea sistemelor simpato-adrenal şi vago-insular, diminuarea mecanismelor endocrine de protecţie antistres şi adaptare, fapt ce necesită a fi luat în consideraţie la elaborarea algoritmului de tratament

Эффективность топической терапии эмолентом «Seсalia ultra» в атопическом дерматите

Summary: The existing evidence for diagnosis and treatment of atopic dermatitis is evaluated using the International and National standard of Guidelines Research and Evaluation. We have learned the efficiency of topical treatment with the use of „Sekalia ultra” emollient in the administration of atopic dermatitis. Researches proved that in certain situations in non-acute stages of atopic dermatitis, the topic therapy plays an important role, although there was a little attention paid to it before and there were aspects causing some disagreements.Резюме: Нами детально анализированы аспекты диагностики и лечения атопического дерматита, изложенные в международных и национальных рекомендациях. Изучена эффективность топической терапии с использованием эмолента „Secalia Ultra” в атопическом дерматите. Исследования показали, что в определенных ситуациях вне острой фазы атопического дерматита, топическая терапия эмолентами играет первостепенную роль, хотя ранее этому аспекту уделялось недостаточное внимание или взгляды содержали некоторые противоречия

Аллергические коморбидности у больных с гастродуоденальной патологией

Laboratorul de gastroenterologie, IP USMF „Nicolae Testemițanu”Au fost evaluate particularitățile comorbidităților alergice, în special ale urticariei cronice (UC), la 80 de bolnavi cu esofagogastroduodenite, ulcere stomacale și duodenale și anamneza alergologică agravată cu estimarea posibilei inter-calări a acestor afecțiuni și factorului alimentar în apariția și evoluția UC. Rezultatele obținute au demonstrat prevalarea exhaustivă a UC la acești pacienți, care erau de vârstă aptă de muncăși în 63,75% cazuri aveau o evoluție moderată a afec-țiunii. Patologia digestivă a fost determinată ca posibil factor de risc în dezvoltarea UC de 87,5% bolnavi, iar produsele alimentare și erori de regim dietetic s-au stabilit ca factori declanșatori ai bolii la 30% urticarieni. Manifestările digestive s-au exprimat în 56,25% cazuri prin acuze dispeptice, în 41,25% - abdomenalgii, iar în 26,25% cazuri – prin dereglări de pasaj intestinal. Examenul paraclinic a elucidat o predominare a gastritei atrofi ce la 31,25% și duodenitelor la 62,5% pacienți ca afecțiuni solitare sau combinatete, a hipo – și anacidității gastrice la 73,33% bolnavi, nivele nemodifi cate ale IgE totale și complexelor imune circulante (CIC) ale imunității umorale versus persoanele sănătoase, iar testarea alergolo-gică concomitentă doar în 6,82% cazuri a stabilit grad ușor sau moderat al dermoreacției la alergeni alimentari. Așadar, în etiopatogenia UC comorbide patologiei gastroduodenale participă mecanisme pseudoalergice de intoleranță alimentară, generată de tulburarea proprietăților de barieră a mucoasei gastroduodenale, iar augmentarea tratamentului complex cu stabilizatori ai membranei mastocitare de rând cu dieta hipoalergică este oportunăюThere were evaluated specific features of allergic comorbidities, in particular chronic urticaria (CU) in 80 patients with esophagogastroduodenitis, gastric and duodenal ulcers with an aggravated allergic anamnesis, possible involvement of these diseases, as well as nutritional factor, in the appearance and evolution of CU. The results showed complete prevalence of CU in these patients, being of working age, who in 63,75% of cases had a mild evolution of the disease. Digestive pathology was identified as a possible risk factor for the development of CU in 87,5% of patients, while food and dietary disorders were defined as triggers in 30% of patients with CU. Digestive manifestations were expressed in 56,25% of cases with dyspeptic complaints, in 41,25% - by abdominal pain, and in 26,25% cases - with intestinal passage disorders. Paraclinic examinations revealed a predominance of atrophic gastritis in 31,25% and duodenitis in 62,5% of patients both in case of solitary and combination disease. Gastric hypo - and an-acidity was determined in 73,33% of patients. The study of humoral immunity revealed unchanged levels of total IgE and circulating immune complexes in comparison to healthy individuals, while simultaneous allergic testing in only 6,82% of cases found light or moderate degree of skin reaction on food allergens. Thus, the pseudo-allergic mechanisms of food intolerance involved in the impairment of barrier properties of the gastroduodenal mucosa participate in the etiopathology of CU comorbid gastroduodenal pathology, and the utilization of complex treatment using the mast cell membrane stabilizers along with the hypoallergenic diet is necessary.Были выявлены особенности аллергических коморбидностей, в частности, хронической крапивницы (ХК) у 80 больных с эзофагогастродуоденитами, язвами желудка и двенадцатиперстной кишки и отягощённым аллергологическим анамнезом, возможной причастности этих болезней и алиментарного фактора в появлении и эволюции ХК. Полученные результаты показали полное превалирование ХК у этих пациентов, которые были трудоспособного возраста и в 63,75% случаев имели среднетяжёлое течение заболевания. Пищеварительная патология была определена как возможный фактор риска развития ХК у 87,5% больных, а продукты питания и нарушения диетического режима были установлены как триггерные факторы у 30% пациентов ХК. Дигестивные проявления выражались в 56,25% случаях диспептическими жалобами, в 41,25% - абдоменальгиями, а в 26,25% случаях – нарушениями кишечного пассажа. Параклинические обследование обнаружило преобладание атрофического гастрита у 31,25% и дуоденитов у 62,5% пациентов в виде солитарной, так в качестве сочетанной болезни. Желудочная гипо – и анацидность определялась у 73,33% больных. Исследование гуморального иммунитета выявило неизменённые уровни общего IgE и циркулирующих иммунных комплексов в сравнении с здоровыми лицами, а одновременное аллергологическое тестирование только в 6,82% случаев констатировало лёгкую или умеренную степень дермореакции на пищевые аллергены. Таким образом, в этиопатогенезе ХК, коморбидной гастродуоденальной патологии, участвуют псевдоаллергические механизмы пищевой непереносимости, обусловленные нарушениями барьерных свойств гастродуоденальной слизистой, а суплинирование комплексного лечения стабилизаторами мастоцитарной мембраны наряду сгипоаллергенной диетой является своевременным

The principles of contemporary management of chronic urticaria

Laboratorul de gastroenterologie, IP USMF Nicolae TestemițanuChronic urticaria (CU) and angioedema are widespread cutaneous diseases that have a negative impact on the quality of life. They are easy to diagnose, but difficult to treat due to the varying severity of the disease, refractoriness to antihistamine and corticosteroid treatment and the presence of other comorbid illnesses that are the primary cause of the skin lesion. Besides, not all specialists are familiar with normative acts of consensus statement of the management of CU and are not able to select individual and correct tactics of management and/or diagnosis in the absence of national clinical protocol in Republic of Moldova. The purpose of this article is the laconic description of the main methods of management of various clinical forms of CU and drug remedies, based on evidence-based medicine in the light of current European clinical consensus recommendations