Changes in cholinergic and adrenergic regulations of bronchial and biliary ways tones in a combined course of bronchial asthma and chronic cholecystitis

The paper presents data from a study of the neuroendocrine regulation of nonstriated muscles, bronchial tree and the gallbladder tones by means of an assessment of the adrenergic and cholinergic systems state in patients, suffering from bronchial asthma and chronic acalculous cholecystitis. Adrenergic and cholinergic activities as well as cortisol secretion have significantly changed

Changes of erythropoiesis in case of chronic obstructive pulmonary disease and urolithiasis comorbidity

In comorbidity of chronic obstructive pulmonary disease and urolithiasis with oxalic acid stones changes of erythropoiesis were found in 78,3 % of patients, in particular – 52,2 % corresponded to mild iron-deficiency anemia and in 26,1 % of patients – chronic disease anemia or their combination. These changes were accompanied by likely reduction of blood erythropoietin within 2,9-3,5 times less (p<0,05)

The influence of factors of the hemostasis, fibrinolysis and proteolysis systems upon the development and progressing of somatoform vegetative dysfunction and essential hypertension in patients with chronic acalculous cholecystitis

The article presents the data concerning various chains of the blood coagulative system, anticoagulative blood activity, fibrinolysis and systemic plasma proteolysis in correlation with hemorheological parameters with comorbid chronic acalculous cholecystitis (CAC) and somatoform vegetative dysfunction (SVD) or essential hypertension (EH). The objective of the work is to determine reliable mechanisms of progressing these diseases and elaborate the ways to correct disorders found

Structure of anaemic conditions comorbid to alcoholic and non-alcoholic steatohepatitis

The retrospective analysis of 378 medical records of inpatients with steatohepatitis (SH) depending on its etiology was performed to identify and study the type of anaemic conditions (AC). Among patients with SH of mixed (including alcoholic) etiology anaemia was found in 32.2% of cases, in patients with alcoholic (ASH) - in 36.3%, in patients with non-alcoholic SH (NASH) - in 22.0 % of cases. Macrocytic, hyperchromic anaemia prevailed in patients with anaemia of all groups: in patients with SH of mixed etiology - in 47.9%, in patients with ASH - 56.8%, NASH - 71.4%. Normocytic, normochromic anaemia was registered in 52.1% with mixed etiology of SH, in patients with ASH - 43.2%, NASH - 28.6%.The prospective study of 125 patients with SH showed that anaemia was found in 40.0% of patients with ASH, among patients with SH of mixed (including alcoholic) etiology anaemia was found in 32.0%, among patients with NASH the result was 21.7%. The following types of anaemia were found in ASH: vitamin B12 - deficient - in 17.5% of cases, anaemia of chronic disease - in 10.0% of cases and Zieve's syndrome - in 12.5% of cases. Three types of anaemia were found in patients with SH of mixed etiology: vitamin B12 - deficient - in 16.0% of cases, anaemia of chronic disease - in 8.0% and Zieve's syndrome - in 8.0% of patients. The structure of anaemias in patients with NASH accompanied by obesity of I-II degrees is as follows: B12 - deficient anaemia - in 15.0% of cases, anaemia of chronic disease - in 6.7% of people. In patients with NASH, H. pylory contamination was present in 84.6% of patients with anaemic syndrome (AS), including 100% of patients with B12-deficient anaemia. With ASH, H. pylory contamination was present in 80.0% with anaemia, including 100% of patients with B12-deficient anaemia. In patients with SH of mixed etiology, H. pylory contamination was present in 100.0% of people with AS

Administration of l-carnitine in patients suffering from chronic pancreatitis with underlying obesity

Sickness rate of obesity has been 57% increased in recent years, and it occurs in 80% of endocrine patients. Prevalence of chronic pancreatitis (CP) in patients with obesity constitutes from 45% to 80%

Effectiveness of antral in correction of metabolic disorders in patients with non-alcoholic steatohepatitis and chronic obstructive pulmonary disease

The steady increase in the incidence of comorbidity of chronic obstructive pulmonary disease (COPD) and non-alcoholic steatohepatitis (NASH) against the background of obesity in people of working age in Ukraine and the world stipulates the need for investigation of the mechanisms of interconnection and the search for new factors of the pathogenesis of progression of this comorbid pathology

Certain unsolved questions of pathogenetic interrelation between gastroesophageal reflux disease and chronic forms of ischemic heart disease (review of the references)

The article deals with correlation links of developmental mechanisms and progressing of gastroesophageal reflux disease in patients with chronic forms of ischemic heart disease. The problem of treatment under conditions of comorbidity of these diseases is described

Features of iron homeostasis in patients with steatohepatitis of alcoholic and non-alcoholic etiology and its correlation with the intensity of oxidative stress and apoptosis

Topicality. Comorbid course of alcoholic steatohepatitis (ASH) and non alcoholic steatohepatitis (NASH) with dysmetabolic iron overload syndrome (DIOS) is caused by the cascade of interload reactions, which may contribute to the progression of the disease. DIOS is a pathological condition characterized by a quantitative increase in the content of elemental iron in the body, which leads to the damage of organs and tissues due to the toxic effects of excess iron. DIOS formation is associated with congenital or acquired insufficiency of mechanisms of the regulation of iron excretion, accumulation in the population of gene mutations of proteins-regulators of iron metabolism; inefficient erythropoiesis and insufficient utilization of iron in the bone marrow, with the changes in the quality of nutrition (predominant consumption of meat products); increasing life expectancy, living in geozones with high iron content in water bodies, soils, associated both with natural features and industrial production. Other risk factors leading to the development of DIOS include multiple blood transfusions, unreasonable, uncontrolled prescription of iron-containing drugs, alcohol abuse, tobacco smoking, obesity, diabetes mellitus (DM), hormone replacement therapy with steroid hormones and estrogens, and more.The aim of the work is to establish the features of iron homeostasis in patients with steatohepatitis of alcoholic and nonalcoholic etiology, to identify the dependence of steatohepatitis, oxidative-antioxidant homeostasis and the intensity of hepatocyte apoptosis on the presence of iron overload syndrome.Materials and methods. 125 patients were examined, including 60 patients with NASH and 65 patients with ASH, 25 practically healthy persons of the corresponding age and sex. Among the examined patients with NASH, there were 15 male patients (25.0%) and 45 female patients (75.0%). The mean age of the examined patients was (46.3 ± 5.2) years. Among the examined patients with ASH there were 56 male patients (86.2%) and 9 female patients (13.8%). The mean age of patients with ASH was (47.4 ± 5.1) years. The control group consisted of 25 healthy individuals (PHIs), namely male - 11 (44.0%) and female - 14 (56%). The mean age of PHIs was (41.3 ± 2.1) years.The diagnosis of NASH and ASH was established according to the unified clinical protocol approved by the order of the Ministry of Health of Ukraine № 826 from 06.11.2014, in the presence of the criteria for excluding the possibility of chronic diffuse liver disease of viral, hereditary, autoimmune or drug genesis being a cause of cytolytic, cholendoma-cholestatic-melestatic , as well as the results of ultrasonography of the liver with shear wave elastography, Steato-test, ASH-test, NASH-test (BioRedictive, France).Results. The frequency of clinical syndromes in NASH varied depending on the presence of DIOS as follows: under DIOS conditions the frequency of cholestatic syndrome prevailed (3.1 times, p &lt;0.05), abdominal discomfort in the right hypochondrium (3.5 times, p &lt;0 , 05), the incidence of splenomegaly (7.0 times, p &lt;0,05). The analysis of biochemical syndromes in patients with ASH depending on the presence of DIOS indicates a significantly higher incidence of cholestasis (2.7 times, p &lt;0.05), hepatocellular insufficiency (4.3 times, p &lt;0.05), as well as impaired glucose tolerance (2.8 times, p &lt;0.05) in patients with DIOS compared with the incidence of these syndromes in ASH without DIOS. The analysis of the biochemical parameters of ferrokinetics indicates a probable increase in serum iron in patients with NASH with DIOS - 1.7 times (p &lt;0.05) compared with PHIs, and in the absence of DIOS- iron content corresponded to the reference values (p&gt; 0.05). The course of ASH is accompanied by a manifest DIOS in 61.5% of patients, also accompanied by hypersideremia, hyperferritinemia, hypertransferinemia and a significant increase in the percentage of TS (in the range of 1.7-4.3 times), which causes increased activity of cytolytic syndrome compared to ASH without DIOS. A strong correlation was found between the content of iron in the blood and the activity of AST (r = 0.61, p &lt;0.05), the content of transferrin in the blood and AST (r = 0.67, p &lt;0.05), the content of blood ferritin and AST (r = 0.75, p &lt;0.05) in patients in this group. At the same time, patients with ASH without DIOS are also characterized by, but less intense (within 1.3-1.6 times), an increase in blood iron, ferritin and transferrin, the percentage of TS, which confirms the opinion of scientists that the indicators of ferrokinetics should be used as a significant diagnostic criterion for ASH. Among the patients with NASH on the background of obesity, the manifestation of DIOS was registered in 30.0% of patients with hypersideremia, hyperferritinemia, hypertransferinemia, the increase in the percentage of TS (within 1.5-2.7 times). The course of NASH without DIOS was characterized by hyperferritinemia (p &lt;0.05), which can be regarded as a marker of active mesenchymal inflammation.Conclusions. 1. The course of ASH is accompanied by a manifest iron overload syndrome in 61.5% of patients, which is accompanied by hypersideremia, hyperferritinemia, hypertransferrinemia and a significant increase in the percentage of iron transferrin saturation, which causes increased activity of cytolytic syndrome without comparison.2. In patients with NASH on the background of obesity, the manifestation of DIOS was registered in 30.0% of cases, in which hypersideremia, hyperferritinemia, hypertransferrinemia, increase in the percentage of TS, which can be regarded as a marker of inflammatory activity. 3. The course of alcoholic and non-alcoholic steatohepatitis is accompanied by significant oxidative stress, which increases with the accession of DIOS. 4. The main signs of disintegration of the parameters of the antiradical defense system in patients are compensatory, in response to the activation of oxidative stress and endotoxicosis, increased glutathione peroxidase activity and progressive decrease in erythrocytes of reduced glutathione, the depot of which is depleted in proportion to intensity. 5. The presence of DIOS significantly enhances the intensity of hepatocyte apoptosis