Structurall features of the pancreas in patients with type 1 diabetes mellitus

BACKGROUND: Observation of changes in the volume and size of the pancreas has a long history, however, the results of studies are still not unambiguous, the specific causes of changes in pancreatic volume, as well as their consequences, are not clear. According to some data, the decrease of pancreas volume in life expectancy is 35–45% in the population of patients with a long history of type 1 diabetes, and about 20–25% during the first year of the disease. Interestingly, in T1D in 20–45% of cases, the development of exocrine pancreatic insufficiency is noted, one of the manifestations of which is pancreatic atrophy, leading to a decrease in life expectancy.AIM: Assess the volume and size of the pancreas, as well as factors that can influence on their changes.MATERIALS AND METHODS: The study included 78 patients with type 1 diabetes mellitus, the control group consisted of 23 people without previously identified disorders of carbohydrate metabolism, comparable in age and anthropometric parameters with the study group. RESULTS: The volume and dimensions of the pancreas were statistically significantly less in patients with T1D than in the control group. In addition, the influence of the duration of T1D and the age of onset of the disease on these indicators has been proven.CONCLUSION: The volume and size of the pancreas in patients with T1D is less than in healthy individuals. It is necessary to  study the effect of these changes on the function of the pancreas

A clinical case of exocrine pancreatic insufficiency in a patient with type 1 diabetes mellitus

The pancreas belongs to the glands of mixed secretion and simultaneously performs both endo- and exocrine functions. Exocrine pancreatic insufficiency (EPI) is the general name for the malabsorption process caused by inadequate production and decreased activation of the enzymes of the pancreas acinar cells, such as amylase, lipase and protease, which are necessary for digestion. The prevalence of EPI in patients with type 1 diabetes, according to many authors, varies from 25 to 59%, which is determine by the data of pancreatic elastase-1. In this work, we present a clinical case of confirmed exocrine pancreatic insufficiency in a patient with a 6-year history of type 1 diabetes, which became the main cause of the development of episodes of hypoglycemia after meals. In the course of further studies, antibodies to lactoferrin and a reduced prostate volume, determined by MRI data, high levels of antibodies to glutamate decarboxylase and zinc co-transporter 8, as well as residual insulin secretion based on the level of C-peptide on an empty stomach detected

Slowly evolving, immune-mediated diabetes in 14-year-old patient: a case report

Slowly developing immune-mediated diabetes, often called latent autoimmune diabetes in adults, is characterized by the presence of autoantibodies (ATs) to glutamic acid decarboxylase (GADA), the patient's age at the onset over 35 years, and the absence of the need for insulin therapy for 6-12 months to 6 years from the moment of diagnosis, according to the WHO classification of 2019, refers to hybrid forms of diabetes mellitus (DM). In this article, we present a case history of slowly developing immune-mediated diabetes in a 14-year-old boy who was transferred from metformin monotherapy and a diet with restriction of digestible carbohydrates to the intensified insulin therapy only 4 years after the onset of diabetes mellitus with a glycated hemoglobin (HbA1c) level of less than 6.5% throughout the disease. As a result of the studies, the patient was found to have a homozygous genotype highly predisposing to the development of Type 1 Diabetes Mellitus (T1DM), as well as increased levels of ATs to GADA and tyrosine phosphatase (IA-2A). The initially preserved level of basal C-peptide and the clinical course of the disease in this patient do not allow us to classify this case as a classic variant of the course of Type 1 Diabetes Mellitus

Применение озонированного перфторана при остром перитоните

The properties of ozonized perfluorane were first studied in the treatment of experimental generalized peritonitis. Experiments were conducted on albino noninbred rats. The model of acute peritonitis, proposed by S. S. Remennik, was used. After simulating peritonitis, the animals were intraperitoneally injected saline solution (Series 1), perfluorane (Series 2), ozonized saline solution (Series 3), ozonized perfluorane (Series 4). All the animals intraperitoneally given saline solution died on days 1—7 of the experiment. When ozonized perfluorane was used, all the animals survived. The therapeutic effect of ozonized perfluorane in acute peritonitis was due to the activation of phagocytes and to the antibacterial activity of ozone.Впервые изучены свойства озонированного перфторана при лечении экспериментального разлитого перитонита. Опыты проведены на белых беспородных крысах. Использовалась модель острого перитонита по С. С. Ременнику. После моделирования перитонита животным в брюшную полость вводились физиологический раствор (1-я серия), перфто-ран (2-я серия), озонированный физиологический раствор (3-я серия), озонированный перфторан (4-я серия). Все животные, которым в брюшную полость вводили физиологический раствор, погибли на 1—7 сутки эксперимента. При применении озонированного перфторана все животные выжили. Терапевтический эффект озонированного перфторана при остром перитоните обусловлен активацией фагоцитирующих клеток и антибактериальным действием озона

Long-term β-cells autoimmune destruction markers persistence and residual C-peptide secretion in type 1 diabetes mellitus

Backgraund: It believed that autoimmune process maintained only during the first 5 years of diabetes mellitus type 1 (T1D). Recently scientists discovered the high levels of islet autoantibodies (Ab) in long-standing T1D and some of these patients had residual insulin secretion, determined by the level of C-peptide. According to various sources, the prevalence of such observations ranges from 12 to 48%.Aims: The aim of our study was to assess the duration of autoimmune β-cells destruction markers persistence and residual fasting C-peptide secretion in the long-standing T1D, as well as to determine the possible causes and patterns of these processes.Materials and methods: In the study included 237 patients (91 men, 146 women) with T1D. Patients divided in 4 groups, according to disease duration: а — up to 1 year, n=69 (29%); b — 1–5 years, 52 (22%); c — 5–10 years, 57 (24%); d — more than 10 years, 59 (25%). Ab to glutamic acid decarboxylase (GADA), tyrosine phosphatase-like IA-2 (IA2) and zinc T8 (ZnT8A) were detected by Enzyme Immunoassay. Also detected C-peptide levels and retrospectively HbA1с.Results: Antibodies to antigens of β-cell components were detected in 26 (37%) patients in group A, in 17 patients (33%) in group B, in 15 (29%) in group C and in 14 (23%) — G.In the control group (n = 19), an increased level of antibodies was not revealed. Fasting C-peptide levels were as follows: in group «A» — 0.86 ng / ml [0.53; 1.4], «B» — 0.65 ng / ml [0.27; 0.98], « B «- 0.19 ng / ml [0.17; 0.33],» D «- 0.01 ng / ml [0.01; 0.01]. However, in 13 (22%) patients in group D, fasting C-peptide levels were more than 0.09 ng / ml.Conclusion: The data obtained indicate a long-term persistence of markers of the autoimmune process in patients with T1DM. In groups with a long (more than 5 years) course of T1DM, levels of fasting C-peptide more than 30 pmol/L (0.09 ng / ml or 0.03 nmol / L) were noted in 39 (33.6%) cases

Primitive neuroectodermal tumor of the zygomaticoorbital complex: a rare location and ways of surgical repair of the area

Primitive neuroectodermal tumor in the zygomaticoorbital region is a rare neoplasm of the head and neck. Due to the necessity for wide radical excision of a primary tumor, there may be serious functional and cosmetic disorders that substantially affect quality of life in patients. Restoration of this region is one of the challenges of reconstructive surgery because of the specific features of the relief of bone structures. The paper describes a clinical case of the site of primitive neuroectodermal tumor in the zygomaticoorbital complex and a method for repairing postresectional defect and completely recovering the function of the organ of vision and aesthetic parameters of the face

Factors of nonspecific resistance in acute peritonitis against a background of an introduction of ozonized Perftoran

The ozonized Perftoran was tested in the complex treatment of patients with acute peritonitis at first time. A standard treatment was performed in one group of patients. In the other group we combined a standard treatment together with additional intraoperative irrigation of the peritoneum with ozonized Perftoran and intravenous its introduction. We conducted a comparative analysis of the postoperative course in these groups. We compared the factors of nonspecific (innate) resistance in the dynamics of treatment of patients with acute peritonitis. Our study established that ozonized Perftoran has a pronounced effect of immunocorrection, it helps to reduce the indications for relaparotomy.Впервые апробирован озонированный перфторан в комплексном лечении больных острым перитонитом. В одной группе больных проведено стандартное лечение, а в другой - наряду со стандартным, дополнительное интраоперационное орошение брюшины озонированным перфтораном с внутривенным его введением. Проведен сравнительный анализ послеоперационного течения, результатов исследования факторов не-специфической резистентности в динамике лечения больных с острым перитонитом. Установлено, что озонированный перфторан обладает выраженным иммунокорригирующим действием, способствует снижению показаний к релапаротомии

Прогнозування ерозійних процесів ґрунтів на маршрутах прокладки магістральних трубопроводів на основі геоінформаційних технологій і космічних знімків із високою роздільною здатністю зображення

The possibility of forecasting of erosion processes in the soil on the route of the main pipelines (MP), which allows to select the optimal route of the MP with minimal risk, is investigated. Universal Soil Loss Equation (USLE) is compiled, all the variables in USLE are defined. The raster map of USLE model for the selected test area and table estimates of the intensity of soil loss are received.Исследуется возможность прогнозирования эрозионных процессов в грунте на маршрутах прокладки магистральных трубопроводов (МТ), что позволяет выбрать наиболее оптимальный маршрут прокладки МТ с минимальным риском. Составлено Универсальное уравнение потерь почвы (УУПП), определены все переменные, входящие в УУПП. Получена растровая карта модели УУПП для выбранного тестового участка и таблица оценок интенсивности потерь почвы.Досліджується можливість прогнозування ерозійних процесів у ґрунті на маршрутах прокладання магістральних трубопроводів (МТ), що дозволяє вибрати найоптимальніший маршрут прокладки МТ із мінімальним ризиком. Складено Універсальне рівняння втрат грунту (УРВГ), визначено всі змінні, що входять в УРВГ. Отримано растрову карту моделі УРВГ для обраної тестової ділянки і таблиця оці-нок інтенсивності втрат ґрунту