Сравнительная оценка эффективности иммуномодулирующей терапии при инфекционном мононуклеозе смешанной этиологии (Эпштейна – Барр и цитомегаловирусной) у детей

Objective: to conduct a comparative assessment of the effectiveness of immunomodulatory drugs in infectious mononucleosis of mixed etiology (EBV and CMV) in children, using the principles of evidence-based medicine.Materials and methods: a comprehensive comparative assessment of the effectiveness of immunomodulatory drugs in children with infectious mononucleosis EBV+CMV-etiology in 3 groups: group I-20 patients receiving recombinant interferon α-2β, group II-20 children receiving interferon – meglumin inducer acridonacetate and group III-20 children treated with a synthetic immunomodulator-inosin pranobex. The comparison group (IV) consisted of 20 children who received basic therapy.Results: Analysis of key intervention indicators for the outcome «fever Duration less than 5 days» showed the highest effectiveness of recombinant interferon α-2β, less effective were meglumina  acridonacetate and inosine pranobex. According to the outcomes «Reduction of lymph nodes by 2 or more times» and «Reduction of the liver and spleen by 2 or more times», data on the advantage of meglumin acridonacetate were obtained. The recombinant interferon α-2β was the second most effective. All the studied drugs do notsignificantly affect the severity of the hematological syndrome. The expediency of using immunomodulatory therapy in infectious mononucleosis of EBV+CMV-etiology is shown, the deviation from the norm of the integral outcome indicator is significantly higher in the group of children who were on symptomatic therapy. The overall effectiveness of the studied immunomodulatory drugs with all clinical outcomes does not have statistically significant differences.Conclusion: the obtained data allow us to rationally approach the choice of immunomodulatory therapy, taking into account the effectiveness of clinical outcomes and the overall effectiveness of the drug.Цель: провести сравнительную оценку эффективности иммуномодулирующих препаратов при инфекционном мононуклеозе смешанной этиологии (Эпштейна – Барр и цитомегаловирусной) у детей, используя принципы доказательной медицины.Материалы и методы: проведена комплексная сравнительная оценка эффективности иммуномодулирующих препаратов у детей с инфекционным мононуклеозом смешанной этиологии (Эпштейна – Барр и цитомегаловирусной) в 3 группах детей, которые на фоне базисной терапии (патогенетической и симптоматической) получали иммуномодуляторы: I группа – 20 пациентов, получавших рекомбинантный интерферон α-2β, II группа – 20 детей, получавших индуктор интерферона – меглюмина акридонацетат, и III группа – 20 детей, лечившихся синтетическим иммуномодулятором – инозином пранобексом. Группу сравнения (IV) составили 20 детей, получавших только базисную терапию.Результаты: анализ ключевых показателей вмешательства по исходу «Длительность лихорадки менее 5 дней» показал наибольшую эффективность рекомбинантного интерферона α-2β, менее эффективными были меглюмина акридонацетат и инозин пранобекс. По исходам «Сокращение лимфатических узлов в 2 и более раз» и «Сокращение печени и селезенки в 2 и более раз» получены данные о преимуществе меглюмина акридонацетата. На втором месте по эффективности оказался рекомбинантный интерферона α-2β. Все исследованные препараты не оказывают существенного влияния на выраженность гематологического синдрома. Показана целесообразность применения иммуномодулирующей терапии при инфекционном мононуклеозе смешанной этиологии (Эпштейна – Барр и цитомегаловирусной), отклонение от нормы интегрального показателя исхода значимо выше в группе детей, которые находились на симптоматической терапии. Общая эффективность исследуемых иммуномодулирующих препаратов при всех клинических исходах не имеет статистически значимых различий.Заключение: полученные данные позволяют рационально подойти к выбору иммуномодулирующей терапии с учетом эффективности по клиническим исходам и общей эффективности препарата

Features of laboratory diagnostics of undifferentiated connective tissue dysplasia in women with genital prolapse

Introduction. The issues of connective tissue dysplasia are currently highly urgent, particularly when it comes to the increase in a woman’s life expectancy and high incidence rates of the disease. According to various sources, the incidence of undifferentiated connective tissue dysplasia (uCTD) reaches 80%.The purpose and objectives. Determine laboratory criteria for the diagnosis of undifferentiated connective tissue dysplasia (UCTD) in women with genital prolapse.Relevance. In clinical practice, a point-based approach to the UCTD is widely used, when each phenotypic sign is evaluated by a certain number of points, the sum of which allows you to rank the manifestations of the pathology by severity. At the same time, implicit phenotypic manifestations of UCTD, which are accompanied by failure.Material and research methods. We conducted a survey of 204 women with genital prolapse, who were divided into 2 groups. The main group consisted of 97 women with signs of UCTD, a comparison group of 107 patients without UCTD. The age of women in the main group was on average 54.2(2.5) years, in the comparison group 56.3 (1.9) years (p > 0.05). At the time of the survey, all women were in menopause from 3 to 6 years. In addition to registering phenotypic stigmas, methods for diagnosing UCTD included determining the content of amino acids in the blood serum that are involved in the synthesis of collagen and elastin, estradiol, and hormonal parameters of the thyroid system. To evaluate changes in laboratory parameters: the content of amino acids in blood serum, estradiol, the hormonal profile of the thyroid gland.Results. We analyzed the serum levels of amino acids (Proline, lysine, and hydroxyproline) involved in the synthesis of collagen and elastin.in women with undifferentiated connective tissue dysplasia, deviations in their content from the norm were detected. Conclusion. In women with prolapse of the genitals, it is necessary to diagnose UCTD, which must be confirmed by the amino acid profile, densitometry and hormonal diagnostics of the state of thyroid function

Features of the health status of women with genital prolapse

Introduction. In recent years, more and more attention has been paid to the issues of genital prolapse. This is largely due to the increase in women life expectancy and the need to provide them with a decent quality of life, as prolapse is quite often accompanied by dysfunction of the pelvic organs. In recent years, there has been an increasing amount of literature on undifferentiated connective tissue dysplasia (UCTD). However, most of these studies consider therapeutic or vertebro-neurological problems, while the high prevalence rates of this pathology call for additional research on the pathogenetic mechanisms of the effect of UCTD on pelvic organ prolapse, which will allow us to decide on the choice of subsequent treatment.The purpose and objectives. Asess the effect of undifferentiated connective tissue dysplasia (UCTD) on the formation of disorders of the somatic, gynecological and reproductive health status in women with genital prolapse.Materials and methods. To achieve this goal, we examined 204 women with genital prolapse in the POP-Q classification of stage 2–3, of which 97 were diagnosed with UCTD (the main group), and the remaining 107 patients made up the comparison group.Results. To evaluate the influence of UCTD on the formation of somatic, gynecological and reproductive health disorders in women with genital prolapse. We analyzed anamnestic indications for somatic, gynecological and reproductive pathology of women, as well as assessed the current state of health of patients with genital prolapse. It was found that it is UCTD that determines the development of a particular form of gynecological pathology and affects the formation of genital prolapse.Conclusion. UCTD manifests as various forms of somatic and gynecological health disorders throughout the life of women with genital prolapse

Comparative evaluation of the effectiveness of immunomodulatory therapy for infectious mononucleosis of mixed etiology (Epstein Barr and cytomegalovirus) in children

Objective: to conduct a comparative assessment of the effectiveness of immunomodulatory drugs in infectious mononucleosis of mixed etiology (EBV and CMV) in children, using the principles of evidence-based medicine.Materials and methods: a comprehensive comparative assessment of the effectiveness of immunomodulatory drugs in children with infectious mononucleosis EBV+CMV-etiology in 3 groups: group I-20 patients receiving recombinant interferon α-2β, group II-20 children receiving interferon – meglumin inducer acridonacetate and group III-20 children treated with a synthetic immunomodulator-inosin pranobex. The comparison group (IV) consisted of 20 children who received basic therapy.Results: Analysis of key intervention indicators for the outcome «fever Duration less than 5 days» showed the highest effectiveness of recombinant interferon α-2β, less effective were meglumina  acridonacetate and inosine pranobex. According to the outcomes «Reduction of lymph nodes by 2 or more times» and «Reduction of the liver and spleen by 2 or more times», data on the advantage of meglumin acridonacetate were obtained. The recombinant interferon α-2β was the second most effective. All the studied drugs do notsignificantly affect the severity of the hematological syndrome. The expediency of using immunomodulatory therapy in infectious mononucleosis of EBV+CMV-etiology is shown, the deviation from the norm of the integral outcome indicator is significantly higher in the group of children who were on symptomatic therapy. The overall effectiveness of the studied immunomodulatory drugs with all clinical outcomes does not have statistically significant differences.Conclusion: the obtained data allow us to rationally approach the choice of immunomodulatory therapy, taking into account the effectiveness of clinical outcomes and the overall effectiveness of the drug