48 research outputs found
Growing Prevalence and Incidence of Diabetes in Republic of Macedonia in the Past 5 Years Based on Data from the National System for Electronic Health Records
Introduction. Diabetes is a chronic metabolic disease characterized with a rapid progression of prevalence in last 3 decades, especially in countries with low and middle income. Next three decades this number of diabetes in the world is expected to be doubled. Early diagnosis and appropriate management of diabetes is the primary way to prevent and delay cardiovascular complications.
Patients and methods. In this retrospective study, we used the data from National electronic system e-health which was performed in late 2014, wich gives us nearly precise data, and we made statistical analysis for diabetes in last 5 years (2015-2019).
Results. In 2015 we have registered 103480 patients with DM, in 2016 108130 patients, in 2017 114408, in 2018 119999 and in 2019 124450 patients with DM. 95% of patients are with T2DM and 4, 1% with T1DM. According the data from State statistical office for population of Republic of Macedonia, the prevalence of T2DM for the years 2015-2019 is as follows: 5,66% in 2015, 6.13% In 2016, 6.55% I 2017, 7,06% in 2018 and 7,2% in 2019.
Conclusions. The number of registered patients with diabetes in last 5 years has grown up for 20970 or 20%, in the last 5 years the number of patients with type 2 diabetes has grown up for 18272 patients or 11%. The prevalence of T2DM has increased for 1.54%. Involvement of primary health care professionals has improved the early diagnosis of type 2 diabetes
Gastroesophageal Reflux Symptoms in Patients with Chronic Obstructive Pulmonary Disease
BACKGROUND: It is known that there is some relation between airways obstruction and gastroesophageal reflux symptoms (GER) symptoms in patients with chronic obstructive pulmonary disease (COPD).AIM: The aim was to determine frequency of GER symptoms and correlation with pulmonary function tests in patients with COPD.MATERIAL AND METHODS: The study included 58 patients. First group had 20 patients with mild COPD, second group had 18 patients with moderate COPD and third group had 20 patients with severe COPD. We had also a control group with 12 healthy subjects. All subjects completed their self-reported questionnaire about symptoms like: acid-regurgitation, heartburn, dysphagia, dyspnea and chronic cough.RESULTS: COPD patients with airways obstruction and significant GER symptoms had their respiratory symptoms associated with reflux events. More of COPD patients had significant GER symptoms defined as regurgitation and dysphagia once or more per week. Patients with FEV1 less than 50% showed more prevalent GER symptoms compared to those with values of FEV1 grater then 50%.CONCLUSION: GER symptoms are more prevalent in patients with severe airways obstruction when compared to less airways obstructed group and controls. We could suggest an association between the degree of airways obstruction in patients with COPD and the increased rate of GER symptoms
Spatial patterns of diatom diversity and community structure in ancient Lake Ohrid
[EN] The extraordinary diversity in long-lived
lakes is largely driven by distinct eco-evolutionary
processes. With their unique biota and numerous
endemic taxa, these lakes are key settings for fundamental
studies related to ecology, diversity, and
evolution. Here, we test how the environment shapes
diatom diversity and community patterns over space in
ancient Lake Ohrid. By applying BrayβCurtis similarity
analyses of diatom community data, including
widespread and endemic taxa, we identified two major
zones: littoral and sublittoral. The latter one is being
characterized with higher endemic diversity. The a
and b diatom diversity and community distribution in
the northern and eastern part of the lake are influenced
by the presence of vertical (bathymetrical) and
horizontal barriers. The zonation of the diatom
communities appears driven by two large-scale factors:
(i) water depth, and (ii) water chemistry, primarily,
the concentration of total phosphorus, nitrogen
ammonia, and conductivity. Both drivers appear to
equally influence diatom diversity and community
patterns. We present initial data on diatomβenvironment
relations, where the results support earlier
ecological studies emphasizing the relevance of
ongoing human-induced eutrophication in the northern
lake area. This study provides background information
on the role of the environment in structuring
contemporary diatom diversity. However, future
research needs to focus on the biotic component
including species competition in order to reveal the
mechanisms driving spatial community dynamics in
Lake OhridSIThe presented study would not have been possible without the support of the Western Balkan Environmental Network project (www.newenproject.org
Role and Significance of Markers of Inflammation in the Asthmatic Disease
BACKGROUND: Asthma is characterized by airway inflammation which can be reversible.AIM: Investigation the importance of eosinophils, ECP and IL-5 in asthmatics versus patients with obstructive bronchitis and healthy subjects. We investigated the values before and after the treatment in asthmatics.MATERIAL AND METHODS: We studied 77 subjects divided in three groups as follows: 1) asthma patients; 2) patients with obstructive bronchitis and 3) control group of healthy subjects. In all the subjects there were determined: Total number of eosinophils (Eo), eosinophilic cationic protein (ECP), Interleukin 5 (IL-5) and allergy tests. RESULTS: The total number of eosinophils was significantly increased in the group of asthma patients versus second and third group. We found that the presence of ECP demonstrate an ongoing inflammation, with or without clinical symptoms of asthma patients. There was significant difference between the values of ECP of asthma patients versus second and third group. Our results have shown that IL-5 was significantly increased versus second group and controls (p < 0.01). We also found the decrease of the values of inflammatory markers after the treatment with corticosteroids. CONCLUSIONS: Eosinophils, ECP and IL-5 could be useful markers for selecting allergic patients and could be the monitors of treatment effects
Π¦-ΡΠ΅Π°ΠΊΡΠΈΠ²Π΅Π½ ΠΏΡΠΎΡΠ΅ΠΈΠ½ ΠΈ cΠΎΠΎΠ΄Π½ΠΎΡΠΎΡ Π½Π° Π½Π΅ΡΡΡΠΎΡΠΈΠ»ΠΈ-Π»ΠΈΠΌΡΠΎΡΠΈΡΠΈ ΠΊΠ°ΠΊΠΎ ΡΠ°ΠΊΡΠΎΡΠΈ Π·Π° ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΈΠ²Π½ΠΎΡΡ Π½Π° ΡΠ΅ΠΆΠΈΠ½Π°ΡΠ° Π½Π° ΠΊΠ»ΠΈΠ½ΠΈΡΠΊΠ°ΡΠ° ΡΠ»ΠΈΠΊΠ° ΠΊΠ°Ρ COVID-19
COVID-19 is an infectious disease that can manifest quite differently. In this study we examined the relationship between the value of serum CRP(C-reactive protein) andneutrophil-lymphocyte ratio (NLR) as predictor factors for the development of a severe clinical manifestation in COVID19 patients. Materials and methods: We followed 95 COVID-19 positive patients who were hospitalized at the University Clinic for Eye Diseases - COVID Center. We analyzed the initial laboratory parameters of white blood cells and CRP on admission of the patients and the results of laboratory analyses performed before they left the Clinic, or the last parameters before the lethal outcome in those patients who died. Several models of logistic regression were tested to analyze the predictive value of these markers of inflammation for lethal outcome in patients hospitalized for COVID-19. Results: Bivariate analysis demonstrated that the length of hospital stay was significantly shorter in patients with lethal outcome (p=0.001). The NLR was significantly higher in patients with lethal outcome at both times (p=0.005; and p=0.017). Leukocyteβs count (p=0.046, and p<0.001) and CRP (p=0.013,and p=0.005) were also significantly higher in patients with lethal outcome at both times. The increase on the NLR scale both at hospitalization and at discharge (or the last analysis before death) leads to increase in the odds of lethal outcome (T1:40.4% increased odds; T2:36% increased odds). Conclusion: CRP and NLR are laboratory parameters that can predict the severity of the clinical manifestation in patients with COVID-19.COVID-19 Π΅ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎ Π·Π°Π±ΠΎΠ»ΡΠ²Π°ΡΠ΅ ΠΊΠΎΠ΅ ΠΌΠΎΠΆΠ΅ Π΄Π° ΡΠ΅ ΠΌΠ°Π½ΠΈΡΠ΅ΡΡΠΈΡΠ° Π΄ΠΎΡΡΠ° ΡΠ°Π·Π»ΠΈΡΠ½ΠΎ. ΠΠΎ ΠΎΠ²Π°Π° ΡΡΡΠ΄ΠΈΡΠ° Π½ΠΈΠ΅ ΡΠ° ΠΈΡΠΏΠΈΡΡΠ²Π°Π²ΠΌΠ΅ ΠΏΠΎΠ²ΡΠ·Π°Π½ΠΎΡΡΠ° ΠΏΠΎΠΌΠ΅ΡΡ Π²ΡΠ΅Π΄Π½ΠΎΡΡΠΈΡΠ΅ Π½Π° CRP (Π¦-ΡΠ΅Π°ΠΊΡΠΈΠ²Π΅Π½ ΠΏΡΠΎΡΠ΅ΠΈΠ½) ΠΈ ΡΠΎΠΎΠ΄Π½ΠΎΡΠΎΡ Π½Π΅ΡΡΡΠΎΡΠΈΠ»ΠΈ-Π»ΠΈΠΌΡΠΎΡΠΈΡΠΈ (NLR) ΠΊΠ°ΠΊΠΎ ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΈΠ²Π½ΠΈ ΡΠ°ΠΊΡΠΎΡΠΈ Π·Π° ΡΠ°Π·Π²ΠΎΡ Π½Π° ΡΠ΅ΡΠΊΠ° ΠΊΠ»ΠΈΠ½ΠΈΡΠΊΠ° ΡΠ»ΠΈΠΊΠ° ΠΊΠ°Ρ ΠΏΠ°ΡΠ΅Π½ΡΠΈΡΠ΅ ΡΠΎ COVID-19. ΠΠ°ΡΠ΅ΡΠΈΡΠ°Π»ΠΈ ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈ:Π‘Π»Π΅Π΄Π΅Π²ΠΌΠ΅ 95 COVID-19 ΠΏΠΎΠ·ΠΈΡΠΈΠ²Π½ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΠΊΠΎΠΈ Π±Π΅Π° Ρ
ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·ΠΈΡΠ°Π½ΠΈ Π²ΠΎ Π£Π Π·Π° ΠΎΡΠ½ΠΈ Π±ΠΎΠ»Π΅ΡΡΠΈ - COVID ΡΠ΅Π½ΡΠ°Ρ Π²ΠΎ Π‘ΠΊΠΎΠΏΡΠ΅. ΠΠΈ Π°Π½Π°Π»ΠΈΠ·ΠΈΡΠ°Π²ΠΌΠ΅ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠΈΡΠΊΠΈΡΠ΅ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΈ Π½Π° Π»Π΅ΡΠΊΠΎΡΠΈΡΠΈΡΠ΅ ΠΈ CRP ΠΏΡΠΈ ΠΏΡΠΈΠ΅ΠΌ Π½Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ Π²ΠΎ ΠΠ»ΠΈΠ½ΠΈΠΊΠ°ΡΠ° ΠΈ ΡΠ΅Π·ΡΠ»ΡΠ°ΡΠΈΡΠ΅ ΠΎΠ΄ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠΈΡΠΊΠΈΡΠ΅ Π°Π½Π°Π»ΠΈΠ·ΠΈ ΠΈΠ·Π²Π΅Π΄Π΅Π½ΠΈ ΠΏΡΠ΅Π΄ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ Π΄Π° ΡΠ° Π½Π°ΠΏΡΡΡΠ°Ρ ΠΠ»ΠΈΠ½ΠΈΠΊΠ°ΡΠ° ΠΈΠ»ΠΈ ΠΏΡΠ΅Π΄ Π½ΠΈΠ²Π½ΠΈΠΎΡ Π»Π΅ΡΠ°Π»Π΅Π½ ΠΈΡΡ
ΠΎΠ΄, ΠΊΠ°Ρ ΠΎΠ½ΠΈΠ΅ ΡΡΠΎ ΠΏΠΎΡΠΈΠ½Π°Π°. ΠΠ΅Π° ΡΠ΅ΡΡΠΈΡΠ°Π½ΠΈ Π½Π΅ΠΊΠΎΠ»ΠΊΡ ΠΌΠΎΠ΄Π΅Π»ΠΈ Π½Π° Π»ΠΎΠ³ΠΈΡΡΠΈΡΠΊΠ° ΡΠ΅Π³ΡΠ΅ΡΠΈΡΠ° ΡΠΎ ΡΠ΅Π» Π΄Π° ΡΠ΅ ΡΡΠ²ΡΠ΄ΠΈ ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΈΠ²Π½Π°ΡΠ° Π²ΡΠ΅Π΄Π½ΠΎΡΡ Π½Π° ΠΎΠ²ΠΈΠ΅ ΠΌΠ°ΡΠΊΠ΅ΡΠΈ Π½Π° ΠΈΠ½ΡΠ»Π°ΠΌΠ°ΡΠΈΡΠ° Π·Π° Π»Π΅ΡΠ°Π»Π΅Π½ ΠΈΡΡ
ΠΎΠ΄ ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ Ρ
ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·ΠΈΡΠ°Π½ΠΈ ΠΎΠ΄ COVID-19. Π Π΅Π·ΡΠ»ΡΠ°ΡΠΈ: ΠΠ½Π°Π»ΠΈΠ·Π°ΡΠ° ΠΏΠΎΠΊΠ°ΠΆΠ° Π΄Π΅ΠΊΠ° Π΄ΠΎΠ»ΠΆΠΈΠ½Π°ΡΠ° Π½Π° ΠΏΡΠ΅ΡΡΠΎΡ Π²ΠΎ Π±ΠΎΠ»Π½ΠΈΡΠ° Π±Π΅ΡΠ΅ Π·Π½Π°ΡΠΈΡΠ΅Π»Π½ΠΎ ΠΏΠΎΠΊΡΠ°ΡΠΊΠ° ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ ΡΠΎ Π»Π΅ΡΠ°Π»Π΅Π½ ΠΈΡΡ
ΠΎΠ΄ (=0,001). NLR Π±Π΅ΡΠ΅ Π·Π½Π°ΡΠΈΡΠ΅Π»Π½ΠΎ ΠΏΠΎΠ²ΠΈΡΠΎΠΊ ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΡΠΎ Π»Π΅ΡΠ°Π»Π΅Π½ ΠΈΡΡ
ΠΎΠ΄ ΠΈ Π²ΠΎ Π΄Π²Π΅ΡΠ΅ Π²ΡΠ΅ΠΌΠΈΡΠ° (p = 0,005; ΠΈ p = 0,017). ΠΡΠΎΡΠΎΡ Π½Π° Π»Π΅ΡΠΊΠΎΡΠΈΡΠΈΡΠ΅ (p = 0,046, ΠΈ p <0.001) ΠΈ CRP (p = 0,013, ΠΈ p = 0,005), ΠΈΡΡΠΎ ΡΠ°ΠΊΠ°, Π±Π΅Π° Π·Π½Π°ΡΠΈΡΠ΅Π»Π½ΠΎ ΠΏΠΎΠ²ΠΈΡΠΎΠΊΠΈ ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΡΠΎ Π»Π΅ΡΠ°Π»Π΅Π½ ΠΈΡΡ
ΠΎΠ΄ Π²ΠΎ Π΄Π²Π΅ΡΠ΅ Π²ΡΠ΅ΠΌΠΈΡΠ°. ΠΠΎΠ²ΠΈΡΠΎΠΊΠΈ Π²ΡΠ΅Π΄Π½ΠΎΡΡΠΈ Π½Π° NLR ΠΈ ΠΏΡΠΈ Ρ
ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΡΠ° ΠΈ ΠΏΡΠΈ ΠΎΡΠΏΡΡΡΠ°ΡΠ΅ (ΠΈΠ»ΠΈ ΠΏΠΎΡΠ»Π΅Π΄Π½Π° Π°Π½Π°Π»ΠΈΠ·Π° ΠΏΡΠ΅Π΄ Π½Π°ΡΡΠ°ΠΏΡΠ²Π°ΡΠ΅ Π½Π° ΡΠΌΡΡΡΠ°) Π΄ΠΎΠ²Π΅Π΄ΡΠ²Π° Π΄ΠΎ Π·Π³ΠΎΠ»Π΅ΠΌΡΠ²Π°ΡΠ΅ Π½Π° ΡΠ°Π½ΡΠΈΡΠ΅ Π·Π° Π»Π΅ΡΠ°Π»Π΅Π½ ΠΈΡΡ
ΠΎΠ΄ (Π’1: 40,4% Π·Π³ΠΎΠ»Π΅ΠΌΠ΅Π½ΠΈ ΡΠ°Π½ΡΠΈ; Π’2: 36% Π·Π³ΠΎΠ»Π΅ΠΌΠ΅Π½ΠΈ ΡΠ°Π½ΡΠΈ). ΠΠ°ΠΊΠ»ΡΡΠΎΠΊ: CRP ΠΈ NLR ΡΠ΅ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠΈΡΠΊΠΈ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΈ ΠΊΠΎΠΈ ΠΌΠΎΠΆΠ°Ρ Π΄Π° ΡΠ° ΠΏΡΠ΅Π΄Π²ΠΈΠ΄Π°Ρ ΡΠ΅ΡΠΈΠΎΠ·Π½ΠΎΡΡΠ° Π½Π° ΠΊΠ»ΠΈΠ½ΠΈΡΠΊΠ°ΡΠ° ΡΠ»ΠΈΠΊΠ° ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΡΠΎ COVID-19.
Patient with Antineutrophil Cytoplasmic Antibody Associated Small Vessel Vasculitis, Acute Renal Failure, and Coronavirus Disease-19 Pneumonia: A Diagnostic and Therapeutic Challenge
BACKGROUND: Antineutrophil cytoplasmatic antibody (ANCA)-associated vasculitis (AAV) has a predilection for the kidney and more than three quarters of patients have renal involvement with rapidly progressive glomerulonephritis. Small-vessel systemic vasculitis may present as pulmonary-renal syndrome and is characterized by necrotizing glomerulonephritis and pulmonary hemorrhage. Diagnosis and therapy for AAV in coronavirus disease (COVID) COVID-19 pandemic require multi-disciplinary collaboration due to the affection of multiple systems and risks associated with immunosuppressive medications.
CASE REPORT: A 69-year-old non-smoker, non-diabetic female presented in the outpatient unit at the department of pulmonology with dry cough, malaise, and sub-febrile temperature, lasting for 1 month. The patient had a high suspicion of severe pulmonary-renal syndrome, ANCA-AAV, and acute renal failure requiring hemodialysis. She was treated with corticosteroids, cyclophosphamide, and plasma exchange. The treatment led to temporary improvement. Infections with COVID-19, Enterococcus in the urine, and Acinetobacter in the tracheal aspirate further complicated the clinical picture and despite antibiotic treatment, use of tocilizumab and convalescent plasma, the outcome was lethal.
CONCLUSION: It is important to establish the diagnosis and distinguish accurately between vasculitis and infection to provide adequate and timely therapy
Π£Π»ΠΎΠ³Π°ΡΠ° Π½Π° Π½Π΅ΠΊΠΎΠΈ ΠΈΠ½ΡΠ»Π°ΠΌΠ°ΡΠΎΡΠ½ΠΈ ΠΌΠ°ΡΠΊΠ΅ΡΠΈ, ΡΠΈΡΠΎΠΊΠΈΠ½ΠΈ ΠΈ ΡΡΠΌΠΎΡ ΠΌΠ°ΡΠΊΠ΅ΡΠΈ Π²ΠΎ Π΄ΠΈΡΠ°Π³Π½ΠΎΠ·Π° Π½Π° Π΅Π½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ·Π°ΡΠ°
Endometriosis is a multifactorial disease which etiopathogenesis has not been elucidated. One of the theories of etiopathogenesis is the inflammatory theory. Aims of the study: To develop a practical non-invasive test for the diagnosis of endometriosis by examining some inflammatory markers and cytokines; to compare the highly sensitive C-reactive protein (hsCRP), cytokines (interleukin-6-IL-6 and tumor necrotizing factor alpha) and the tumor marker cancer antigen 125 (CA-125) among healthy patients and patients with endometriosis; to determine the sensitivity and specificity of each biomarker separately in the diagnosis of endometriosis and to determine their role in the diagnosis of endometriosis. Materials and methods: In a prospective study conducted at the University Clinic for Gynecology and Obstetrics, Ss. Cyril and Methodius University in Skopje, North Macedonia 138 patients were included of a reproductive age between 18-50 years (83 with diagnosis endometriosis operated laparoscopically or with laparotomy) and a control group of 55 healthy women, in a period between 01.09.2018 to 01.05.2021. Serum levels of IL-6, TNF-Ξ±, hs-CRP and tumor marker CA-125 were evaluated in both groups. Results: Serum levels of CA-125, IL-6 and TNF-Ξ± and hs-CRP were significantly higher in patients with endometriosis compared to the control group. The surface under the ROC curve (AUC) for IL-6, CA-125, hs-CRP, and TNF-Ξ± has shown that as individual markers they all have a discriminatory capacity to diagnose patients with endometriosis. Conclusions: Results obtained in our study showed statistically significantly higher serum concentrations of CA-125, IL-6 and TNF-Ξ± and hs-CRP in patients with endometriosis compared to the control group of patients. However, none of these biomarkers showed a high sensitivity for diagnosis of endometriosis. It is necessary to find a panel combination of biomarkers with a high sensitivity of about 100% that will enable early diagnosis of endometriosis.ΠΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ·Π°ΡΠ° Π΅ ΠΌΡΠ»ΡΠΈΡΠ°ΠΊΡΠΎΡΠ½ΠΎ Π·Π°Π±ΠΎΠ»ΡΠ²Π°ΡΠ΅, ΡΠΈΡΠ° Π΅ΡΠΈΠΎΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅Π·Π° Π½Π΅ Π΅ ΡΠ°Π·ΡΠ°ΡΠ½Π΅ΡΠ°. ΠΠ΄Π½Π° ΠΎΠ΄ ΡΠ΅ΠΎΡΠΈΠΈΡΠ΅ Π·Π° Π΅ΡΠΈΠΎΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅Π·Π°ΡΠ° Π΅ ΠΈΠ½ΡΠ»Π°ΠΌΠ°ΡΠΎΡΠ½Π°ΡΠ° ΡΠ΅ΠΎΡΠΈΡΠ°. Π¦Π΅Π»ΠΈ Π½Π° ΠΈΡΡΡΠ°ΠΆΡΠ²Π°ΡΠ΅ΡΠΎ: ΠΠ° ΡΠ΅ ΡΠ°Π·Π²ΠΈΠ΅ ΠΏΡΠ°ΠΊΡΠΈΡΠ΅Π½ Π½Π΅ΠΈΠ½Π²Π°Π·ΠΈΠ²Π΅Π½ ΡΠ΅ΡΡ Π·Π° Π΄ΠΈΡΠ°Π³Π½ΠΎΠ·Π° Π½Π° Π΅Π½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ·Π°ΡΠ° ΡΠΎ ΠΈΡΠ»Π΅Π΄ΡΠ²Π°ΡΠ΅ Π½Π°Π½Π΅ΠΊΠΎΠΈ ΠΈΠ½ΡΠ»Π°ΠΌΠ°ΡΠΎΡΠ½ΠΈ ΠΌΠ°ΡΠΊΠ΅ΡΠΈ ΠΈ ΡΠΈΡΠΎΠΊΠΈΠ½ΠΈ; Π΄Π° ΡΠ΅ Π½Π°ΠΏΡΠ°Π²ΠΈ ΡΠΏΠΎΡΠ΅Π΄Π±Π° Π½Π° Π²ΠΈΡΠΎΠΊΠΎΡΠ΅Π½Π·ΠΈΡΠΈΠ²Π½ΠΈΠΎΡ Π¦-ΡΠ΅Π°ΠΊΡΠΈΠ²Π΅Π½ ΠΏΡΠΎΡΠ΅ΠΈΠ½ (hsCRP), ΡΠΈΡΠΎΠΊΠΈΠ½ΠΈΡΠ΅ (ΠΈΠ½ΡΠ΅ΡΠ»Π΅ΡΠΊΠΈΠ½ 6 βIL-6 ΠΈ ΡΡΠΌΠΎΡ-Π½Π΅ΠΊΡΠΎΡΠΈΠ·ΠΈΡΠ°ΡΠΊΠΈ ΡΠ°ΠΊΡΠΎΡ Π°Π»ΡΠ° - TNF-Ξ±) ΠΈ ΡΡΠΌΠΎΡΡΠΊΠΈΠΎΡ ΠΌΠ°ΡΠΊΠ΅Ρ cancer antigen 125 (CA-125) ΠΊΠ°Ρ Π·Π΄ΡΠ°Π²ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠΈ ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠΈ ΡΠΎ Π΅Π½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ·Π°; Π΄Π° ΡΠ΅ ΡΡΠ²ΡΠ΄ΠΈ ΡΠ΅Π½Π·ΠΈΡΠΈΠ²Π½ΠΎΡΡΠ° ΠΈ ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡΠ° Π½Π° ΡΠ΅ΠΊΠΎΡ Π±ΠΈΠΎΠΌΠ°ΡΠΊΠ΅Ρ ΠΏΠΎΡΠ΅Π±Π½ΠΎ Π²ΠΎ Π΄ΠΈΡΠ°Π³Π½ΠΎΠ·Π°ΡΠ° Π½Π° Π΅Π½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ·Π°ΡΠ° ΠΈ Π΄Π° ΡΠ΅ ΡΡΠ²ΡΠ΄ΠΈ Π½ΠΈΠ²Π½Π°ΡΠ° ΡΠ»ΠΎΠ³Π° Π²ΠΎ Π΄ΠΈΡΠ°Π³Π½ΠΎΠ·Π° Π½Π° Π΅Π½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ·Π°ΡΠ°.
ΠΠ°ΡΠ΅ΡΠΈΡΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈ: ΠΠΎ ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½Π° ΡΡΡΠ΄ΠΈΡΠ° ΡΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° Π½Π° Π£Π½ΠΈΠ²Π΅ΡΠ·ΠΈΡΠ΅ΡΡΠΊΠ°ΡΠ° ΠΊΠ»ΠΈΠ½ΠΈΠΊΠ° Π·Π° Π³ΠΈΠ½Π΅ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ° ΠΈ Π°ΠΊΡΡΠ΅ΡΡΡΠ²ΠΎ, Π£Π½ΠΈΠ²Π΅ΡΠ·ΠΈΡΠ΅Ρ βΠ‘Π². ΠΠΈΡΠΈΠ» ΠΈ ΠΠ΅ΡΠΎΠ΄ΠΈΡβ Π²ΠΎ Π‘ΠΊΠΎΠΏΡΠ΅, Π‘Π΅Π²Π΅ΡΠ½Π° ΠΠ°ΠΊΠ΅Π΄ΠΎΠ½ΠΈΡΠ° Π±Π΅Π° Π²ΠΊΠ»ΡΡΠ΅Π½ΠΈ 138 ΠΈΡΠΏΠΈΡΠ°Π½ΠΈΡΠΊΠΈ Π½Π° ΡΠ΅ΠΏΡΠΎΠ΄ΡΠΊΡΠΈΠ²Π½Π° Π²ΠΎΠ·ΡΠ°ΡΡ ΠΏΠΎΠΌΠ΅ΡΡ 18-50 Π³ΠΎΠ΄ΠΈΠ½ΠΈ (83 ΡΠΎ Π΄ΠΈΡΠ°Π³Π½ΠΎΠ·a Π΅Π½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ·Π°, ΠΎΠΏΠ΅ΡΠΈΡΠ°Π½ΠΈ ΡΠΎ Π»Π°ΠΏΠ°ΡΠΎΡΠΊΠΎΠΏΠΈΡΠ° ΠΈΠ»ΠΈ Π»Π°ΠΏΠ°ΡΠΎΡΠΎΠΌΠΈΡΠ°) ΠΈ ΠΊΠΎΠ½ΡΡΠΎΠ»Π½Π° Π³ΡΡΠΏΠ° ΠΎΠ΄ 55 Π·Π΄ΡΠ°Π²ΠΈ ΠΆΠ΅Π½ΠΈ, Π²ΠΎ ΠΏΠ΅ΡΠΈΠΎΠ΄ ΠΎΠ΄ 01.09.2018 Π³ΠΎΠ΄ΠΈΠ½Π° Π΄ΠΎ 01.05.2021. Π‘Π΅ΡΡΠΌΡΠΊΠΈΡΠ΅ Π²ΡΠ΅Π΄Π½ΠΎΡΡΠΈ Π½Π° ΠΈΠ½ΡΠ΅ΡΠ»Π΅ΡΠΊΠΈΠ½ 6 (IL-6), ΡΡΠΌΠΎΡ-Π½Π΅ΠΊΡΠΎΡΠΈΠ·ΠΈΡΠ°ΡΠΊΠΈ ΡΠ°ΠΊΡΠΎΡ Π°Π»ΡΠ° (TNF-Ξ±), Π²ΠΈΡΠΎΠΊΠΎΡΠΏΠ΅ΡΠΈΡΠΈΡΠ΅Π½ Π¦-ΡΠ΅Π°ΠΊΡΠΈΠ²Π΅Π½ ΠΏΡΠΎΡΠ΅ΠΈΠ½ (hsCRP) ΠΈ ΡΡΠΌΠΎΡΡΠΊΠΈΠΎΡ ΠΌΠ°ΡΠΊΠ΅Ρ CA-125 Π±Π΅Π° Π΅Π²Π°Π»ΡΠΈΡΠ°Π½ΠΈ Π²ΠΎ Π΄Π²Π΅ΡΠ΅ Π³ΡΡΠΏΠΈ. Π Π΅Π·ΡΠ»ΡΠ°ΡΠΈ: Π‘Π΅ΡΡΠΌΡΠΊΠΈΡΠ΅ Π²ΡΠ΅Π΄Π½ΠΎΡΡΠΈ Π½Π° CA-125, IL-6 ΠΈ TNF-Ξ± ΠΈ hsCRP Π±Π΅Π° ΡΠΈΠ³Π½ΠΈΡΠΈΠΊΠ°Π½ΡΠ½ΠΎ ΠΏΠΎΠ²ΠΈΡΠΎΠΊΠΈ ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠΈΡΠ΅ ΡΠΎ Π΅Π½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ·Π° Π²ΠΎ ΡΠΏΠΎΡΠ΅Π΄Π±Π° ΡΠΎ ΠΎΠ½ΠΈΠ΅ Π²ΠΎ ΠΊΠΎΠ½ΡΡΠΎΠ»Π½Π°ΡΠ° Π³ΡΡΠΏΠ°. ΠΠΎΠ²ΡΡΠΈΠ½Π°ΡΠ° ΠΏΠΎΠ΄ ROC ΠΊΡΠΈΠ²Π°ΡΠ° (AUC) Π·Π° IL-6, CA-125, hs-CRP ΠΈ TNF-Ξ± ΠΏΠΎΠΊΠ°ΠΆΠ° Π΄Π΅ΠΊΠ° ΠΊΠ°ΠΊΠΎ ΠΏΠΎΠ΅Π΄ΠΈΠ½Π΅ΡΠ½ΠΈ ΠΌΠ°ΡΠΊΠ΅ΡΠΈ ΡΠΈΡΠ΅ ΠΈΠΌΠ°Π°Ρ Π΄ΠΈΡΠΊΡΠΈΠΌΠΈΠ½Π°ΡΠΎΡΠ΅Π½ ΠΊΠ°ΠΏΠ°ΡΠΈΡΠ΅Ρ Π·Π° Π΄ΠΈΡΠ°Π³Π½ΠΎΠ·Π° Π½Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠΈ ΡΠΎ Π΅Π½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ·Π°. ΠΠ°ΠΊΠ»ΡΡΠΎΡΠΈ: ΠΡΠ»Π΅Π΄ΡΠ²Π°ΡΠ°ΡΠ° Π²ΠΎ Π½Π°ΡΠ°ΡΠ° ΡΡΡΠ΄ΠΈΡΠ° ΠΏΠΎΠΊΠ°ΠΆΠ°Π° ΡΡΠ°ΡΠΈΡΡΠΈΡΠΊΠΈ ΡΠΈΠ³Π½ΠΈΡΠΈΠΊΠ°Π½ΡΠ½ΠΎ ΠΏΠΎΠ²ΠΈΡΠΎΠΊΠΈ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΠΈ Π½Π° CA-125, IL-6 ΠΈ TNF-Ξ± ΠΈ hs-CRP ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠΈΡΠ΅ ΡΠΎ Π΅Π½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ·Π° Π²ΠΎ ΠΎΠ΄Π½ΠΎΡ Π½Π° ΠΊΠΎΠ½ΡΡΠΎΠ»Π½Π°ΡΠ° Π³ΡΡΠΏΠ° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠΈ. ΠΠ΅ΡΡΡΠΎΠ°, Π½ΠΈΡΡ Π΅Π΄Π΅Π½ ΠΎΠ΄ ΠΎΠ²ΠΈΠ΅ Π±ΠΈΠΎΠΌΠ°ΡΠΊΠ΅ΡΠΈ Π½Π΅ ΠΏΠΎΠΊΠ°ΠΆΠ° Π²ΠΈΡΠΎΠΊΠ° ΡΠ΅Π½Π·ΠΈΡΠΈΠ²Π½ΠΎΡΡ Π·Π° Π΄ΠΈΡΠ°Π³Π½ΠΎΠ·Π° Π½Π° Π΅Π½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ·Π°ΡΠ°. ΠΠΎΡΡΠ΅Π±Π½ΠΎ Π΅ Π΄Π° ΡΠ΅ Π½Π°ΡΠ΄Π΅ ΠΏΠ°Π½Π΅Π» ΠΊΠΎΠΌΠ±ΠΈΠ½Π°ΡΠΈΡΠ° Π½Π° Π±ΠΈΠΎΠΌΠ°ΡΠΊΠ΅ΡΠΈ ΡΠΎ Π²ΠΈΡΠΎΠΊΠ° ΡΠ΅Π½Π·ΠΈΡΠΈΠ²Π½ΠΎΡΡ ΠΎΠ΄ ΠΎΠΊΠΎΠ»Ρ 100% ΠΊΠΎΠΈ ΡΠ΅ ΠΎΠ²ΠΎΠ·ΠΌΠΎΠΆΠ°Ρ ΡΠ°Π½Π° Π΄ΠΈΡΠ°Π³Π½ΠΎΠ·Π° Π½Π° Π΅Π½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ·Π°ΡΠ°
Analysis of Plasma Concentrations of Theophylline in Smoking and Nonsmoking Patients with Asthma
BACKGROUND: While dosing theophylline in asthmatics, we should consider that a lot of medicines, substances, conditions and diseases affect the clearance of theophylline, such as smoking, macrolide antibiotics, barbiturates, oral contraceptives, heart and liver insufficiency, alcohol, calcium-antagonists, pneumonia, viral infections, hypoxemia, etc.AIM: The aim of the study is to investigate the concentrations of theophylline during the day in smoking and nonsmoking patients with asthma.MATERIAL AND METHODS: We have estimated the concentrations of theophylline 6 times daily by the HPLC method (Keith Muir, J Chromatography) in 20 smoking and 20 nonsmoking asthmatic patients, who were treated with theophylline sustained-release tablets 175 mg twice daily.RESULTS: In the first group of 20 nonsmoking patients we obtained constant therapeutic and optimal concentrations of theophylline. In the second group of 20 smoking asthmatics the concentration of theophylline in plasma, in 8pm and 8am the next day was very low.CONCLUSION: Because in smokers we have increased clearance and the decreased half- life of theophylline, and in order to prevent the night time life-threatening attacks, it is necessary to recommend maximal doses of theophylline, especially in the evening. According to the study, dosage should be individualized in order to optimize the treatment based on the measurement of theophylline concentration in plasma
ΠΡΠΎΡΠ΅Π½ΠΊΠ° Π½Π° ΠΎΡΡΠ΅ΠΎΠΏΠΎΡΠΎΠ·Π°ΡΠ° ΠΈ ΠΏΠΎΡΠ°Π²Π° Π½Π° Π²Π΅ΡΡΠ΅Π±ΡΠ°Π»Π½ΠΈ ΡΡΠ°ΠΊΡΡΡΠΈ ΠΊΠ°Ρ ΠΏΠΎΡΡΠΌΠ΅Π½ΠΎΠΏΠ°ΡΠ·Π½ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠΈ ΡΠΎ ΡΠ΅Π²ΠΌΠ°ΡΠΎΠΈΠ΄Π΅Π½ Π°ΡΡΡΠΈΡΠΈΡ ΡΡΠ΅ΡΠΈΡΠ°Π½ΠΈ ΡΠΎ ΠΌΠ°Π»ΠΈ Π΄ΠΎΠ·ΠΈ Π½Π° Π³Π»ΠΈΠΊΠΎΠΊΠΎΡΡΠΈΠΊΠΎΠΈΠ΄ΠΈ
Osteoporosis (OP) is a serious extracorporeal manifestation that occurs in patients with rheumatoid arthritis (RA). One of the risk factors is long-term use of glucocorticoids (GC). Osteoporosis together with the increased risk of vertebral (VF) and non-vertebral fractures (non-VF) in particular has a negative impact on quality of life in patients with rheumatoid arthritis. The aim of the study was to detect the occurrence of OP and VF in postmenopausal patients with RA and their association with long-term use of small doses of glucocorticoids. Material and methods: A total of 46 patients were analyzed. All respondents underwent imaging for osteoporosis evaluation with a DXA scanner (Lunar iDXA, GE) and VF with incorporated Vertebral Fracture Assessment (VFA). Results: The values of bone mineral densities (BMD) were significantly smaller in the group that received glucocorticoids. According to VFA, 37,0% of patients were registered to have a fracture of middle degree, a mild fracture was registered in 19.6% of patients, and severe fractures were registered in 3 patients (6.5%). Conclusion: In postmenopausal patients with RA receiving GC therapy, a more common occurrence of osteoporosis and vertebral fractures was reported compared with the remaining group of RA patients. All patients with RA in menopause need to be screened for timely detection and treatment of osteoporosis and prevention of its complications.ΠΡΡΠ΅ΠΎΠΏΠΎΡΠΎΠ·Π°ΡΠ° (OP) Π΅ ΡΠ΅ΡΠΈΠΎΠ·Π½Π° Π²ΠΎΠ½Π·Π³Π»ΠΎΠ±Π½Π° ΠΌΠ°Π½ΠΈΡΠ΅ΡΡΠ°ΡΠΈΡΠ° ΠΊΠΎΡΠ° ΡΠ΅ ΡΠ°Π²ΡΠ²Π° ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ½Π΅ΡΠΊΠΈ ΡΠΎ ΡΠ΅Π²ΠΌΠ°ΡΠΎΠΈΠ΄Π΅Π½ Π°ΡΡΡΠΈΡΠΈΡ (RA). ΠΠ΄Π΅Π½ ΠΎΠ΄ ΡΠΈΠ·ΠΈΠΊ-ΡΠ°ΠΊΡΠΎΡΠΈΡΠ΅ ΠΏΡΠ΅ΡΡΡΠ°Π²ΡΠ²Π° Π΄ΠΎΠ»Π³ΠΎΡΡΠ°ΡΠ½Π°ΡΠ° ΠΏΡΠΈΠΌΠ΅Π½Π° Π½Π° Π³Π»ΠΈΠΊΠΎΠΊΠΎΡΡΠΈΠΊΠΎΠΈΠ΄ΠΈ (GC). ΠΡΡΠ΅ΠΎΠΏΠΎΡΠΎΠ·Π°ΡΠ° Π·Π°Π΅Π΄Π½ΠΎ ΡΠΎ Π·Π³ΠΎΠ»Π΅ΠΌΠ΅Π½ΠΈΠΎΡ ΡΠΈΠ·ΠΈΠΊ ΠΎΠ΄ Π²Π΅ΡΡΠ΅Π±ΡΠ°Π»Π½ΠΈ (VF) ΠΈ Π½Π΅Π²Π΅ΡΡΠ΅Π±ΡΠ°Π»Π½ΠΈ ΡΡΠ°ΠΊΡΡΡΠΈ (non-VF) ΠΈΠΌΠ° Π½Π΅Π³Π°ΡΠΈΠ²Π½ΠΎ Π²Π»ΠΈΡΠ°Π½ΠΈΠ΅ Π²ΡΠ· ΠΊΠ²Π°Π»ΠΈΡΠ΅ΡΠΎΡ Π½Π° ΠΆΠΈΠ²ΠΎΡ ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠΈΡΠ΅ ΡΠΎ ΡΠ΅Π²ΠΌΠ°ΡΠΎΠΈΠ΄Π΅Π½ Π°ΡΡΡΠΈΡΠΈΡ. Π¦Π΅Π»ΡΠ° Π½Π° ΡΡΡΠ΄ΠΎΡ Π±Π΅ΡΠ΅ Π΄Π° ΡΠ΅ Π΄Π΅ΡΠ΅ΠΊΡΠΈΡΠ° ΠΏΠΎΡΠ°Π²Π°ΡΠ° Π½Π° OP ΠΈ VF ΠΊΠ°Ρ ΠΏΠΎΡΡΠΌΠ΅Π½ΠΎΠΏΠ°ΡΠ·Π½ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠΈ ΡΠΎ RΠ ΠΈ Π½ΠΈΠ²Π½Π°ΡΠ° ΠΏΠΎΠ²ΡΠ·Π°Π½ΠΎΡΡ ΡΠΎ Π΄ΠΎΠ»Π³ΠΎΡΡΠ°ΡΠ½Π°ΡΠ° ΠΏΡΠΈΠΌΠ΅Π½Π° Π½Π° ΠΌΠ°Π»ΠΈ Π΄ΠΎΠ·ΠΈ Π³Π»ΠΈΠΊΠΎΠΊΠΎΡΡΠΈΠΊΠΎΠΈΠ΄ΠΈ. ΠΠ°ΡΠ΅ΡΠΈΡΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈ: ΠΠ΅Π° Π°Π½Π°Π»ΠΈΠ·ΠΈΡΠ°Π½ΠΈ 46 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠΈ. ΠΠ°Ρ ΡΠΈΡΠ΅ Π±Π΅ΡΠ΅ Π½Π°ΠΏΡΠ°Π²Π΅Π½o ΡΠ½ΠΈΠΌΠ°ΡΠ΅ Π·Π° Π΅Π²Π°Π»ΡΠ°ΡΠΈΡΠ° Π½Π° ΠΎΡΡΠ΅ΠΎΠΏΠΎΡΠΎΠ·Π° ΡΠΎ Π°ΠΏΠ°ΡΠ°Ρ Π·Π° Π΄Π²ΠΎΡΠ½ΠΎ-Π΅Π½Π΅ΡΠ³Π΅ΡΡΠΊΠ° x-Π·ΡΠ°ΡΠ½Π° aΠΏΡΠΎΡΠΏΡΠΈΠΎΠΌΠ΅ΡΡΠΈΡΠ° - DXA ΡΠΊΠ΅Π½, βLunar iDXAβ, ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΡΡΠ²ΠΎ Π½Π° GE, ΡΠΎ Π²Π³ΡΠ°Π΄Π΅Π½ ΡΠΎΡΡΠ²Π΅Ρ Π·Π° ΠΏΡΠΎΡΠ΅Π½ΠΊΠ° Π½Π° VF, VFA (Vertebral Fracture Assessment). Π Π΅Π·ΡΠ»ΡΠ°ΡΠΈ: ΠΡΠ΅Π΄Π½ΠΎΡΡΠΈΡΠ΅ Π½Π° ΠΊΠΎΡΠΊΠ΅Π½ΠΈΠΎΡ ΠΌΠΈΠ½Π΅ΡΠ°Π»Π΅Π½ Π΄Π΅Π½Π·ΠΈΡΠ΅Ρ (BMD) Π±Π΅Π° ΡΠΈΠ³Π½ΠΈΡΠΈΠΊΠ°Π½ΡΠ½ΠΎ ΠΏΠΎΠΌΠ°Π»ΠΈ Π²ΠΎ Π³ΡΡΠΏΠ°ΡΠ° ΠΊΠΎΡΠ° ΠΏΡΠΈΠΌΠ°Π»Π° Π³Π»ΠΈΠΊΠΎΠΊΠΎΡΡΠΈΠΊΠΎΠΈΠ΄ΠΈ. Π‘ΠΏΠΎΡΠ΅Π΄ VFA, ΠΊΠ°Ρ 37,0% ΠΎΠ΄ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠΈΡΠ΅ Π±Π΅ΡΠ΅ ΡΠ΅Π³ΠΈΡΡΡΠΈΡΠ°Π½Π° ΡΡΠ°ΠΊΡΡΡa ΠΎΠ΄ ΡΡΠ΅Π΄Π΅Π½ ΡΡΠ΅ΠΏΠ΅Π½, ΠΊΠ°Ρ 19,6% Π»Π΅ΡΠ½a ΡΡΠ°ΠΊΡΡΡa, a ΡΠ΅ΡΠΊΠ° ΡΡΠ°ΠΊΡΡΡΠ° Π±Π΅ΡΠ΅ ΡΠ΅Π³ΠΈΡΡΡΠΈΡΠ°Π½Π° ΠΊΠ°Ρ ΡΡΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠΈ (6,5%). ΠΠ°ΠΊΠ»ΡΡΠΎΠΊ: ΠΠ°Ρ ΠΏΠΎΡΡΠΌΠ΅Π½ΠΎΠΏΠ°ΡΠ·Π½ΠΈΡΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠΈ ΡΠΎ RA ΠΊΠΎΠΈ ΠΏΡΠΈΠΌΠ°Π° ΡΠ΅ΡΠ°ΠΏΠΈΡΠ° ΡΠΎ GC Π±Π΅ΡΠ΅ ΡΠ΅Π³ΠΈΡΡΡΠΈΡΠ°Π½Π° ΠΏΠΎΡΠ΅ΡΡΠ° ΠΏΠΎΡΠ°Π²Π° Π½Π° OP ΠΊΠ°ΠΊΠΎ ΠΈ VF ΡΠΏΠΎΡΠ΅Π΄Π΅Π½ΠΎ ΡΠΎ ΠΎΡΡΠ°Π½Π°ΡΠ°ΡΠ° Π³ΡΡΠΏΠ° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠΈ ΡΠΎ ΡΠ΅Π²ΠΌΠ°ΡΠΎΠΈΠ΄Π΅Π½ Π°ΡΡΡΠΈΡΠΈΡ. ΠΠ°Ρ ΡΠΈΡΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΠΊΠΈ ΡΠΎ RA Π²ΠΎ ΠΌΠ΅Π½ΠΎΠΏΠ°ΡΠ·Π°, ΠΏΠΎΡΡΠ΅Π±Π½ΠΎ Π΅ Π½Π°Π²ΡΠ΅ΠΌΠ΅Π½ΠΎ Π΄Π΅ΡΠ΅ΠΊΡΠΈΡΠ°ΡΠ΅ ΠΈ ΡΡΠ΅ΡΠΌΠ°Π½ Π½Π° ΠΎΡΡΠ΅ΠΎΠΏΠΎΡΠΎΠ·Π°ΡΠ° ΠΈ ΠΏΡΠ΅Π²Π΅Π½ΠΈΡΠ°ΡΠ΅ Π½Π° Π½Π΅ΡΠ·ΠΈΠ½ΠΈΡΠ΅ ΠΊΠΎΠΌΠΏΠ»ΠΈΠΊΠ°ΡΠΈΠΈ
The Effect of Combined Therapy ICS/LABA and ICS/LABA plus Montelukast in Patients with Uncontrolled Severe Persistent Asthma Based on the Serum IL-13 and FEV1
BACKGROUND: IL-13 is one of many cytokines responsible for the chronic inflammation of asthma.AIM: The aim of this study was to determine the effect of combined therapy ICS/LABA and ICS/LABA plus Montelukast in patients with uncontrolled severe persistent asthma by analyzing of serum IL-13 and FEV1 before the treatment and after 6 months of therapy.MATERIAL AND METHODS: In study we included two groups. First group with 27 patients were treated with ICS/LABA. Second group with 29 patients were treated with ICS/LABA plus Montelukast. In each of them were measured serum IL-13 levels by the ELISA method and FEV1 before and after 6 months of treatment. Results were statistically analyzed according to the Wilcoxon Pairs Test and T-test.RESULTS: The obtained results in both groups showed that the serum IL-13 before the start of therapy were much higher and after 6 months of treatment significantly reduces their value, which in the second group were more expressed. The difference in the average value of FEV1 in both groups before and after therapy was statistically significant.CONCLUSION: Treatment with ICS/LABA plus Montelukast proved superior compared to therapy of ICS/LABA in patients with uncontrolled severe persistent asthma and allows achievement of well controlled of asthma with subjective clinical improvement