120 лет кафедре дерматовенерологии Сибирского государственного медицинского университета

A 120-years history of the Dermatovenerology Chair of SibirianStateMedicalUniversityis presented. The contribution of the scientists into the theory and practice in dermatovenerology and traning of specialists is described. The advances of the last 10 years are shown.Представлена история становления и развития кафедры дерматовенерологии лечебного факультета СибГМУ за 120 лет. Описан вклад ученых в теорию и практику дерматовенерологии, подготовку кадров. Обозначены достижения последнего десятилетия

Цитокины как индукторы постперфузионной системной воспалительной реакции у кардиохирургических больных с различной продолжительностью коронарной патологии

Aim. The changes of blood cytokine profile in patients with ischemic heart disease (IHD) with different development rates and formation of systemic inflammatory response (SIR) after coronary artery bypass grafting by using cardiopulmonary bypass (CPB) are analyzed in this article.Materials and methods. The patients with slowly progressive of IHD (20 patients) and rapidly progressive of IHD (20 patients) were examined. The concentration of interleukine (IL) 1β, IL-1ra, IL-4, IL-6, IL-8 and tumor necrosis factor (TNF) α in blood plasma were evaluated by ELISA at patients with IHD before surgery and at 6 and 24 h after surgery.The results of the study showed that concentration of IL-1β, IL-6, IL-8, TNF-α and IL-1ra in blood plasma increases in patients with IHD of both groups before surgery. The concentration of IL-4 in the blood saved in the normal range before the operation in the case of slow disease progression, but maximum increase in content of proinflammatory (TNF-α, IL-6) and anti-inflammatory (IL-4, IL-1ra) cytokines in the blood and the IL-1ra/IL-1β ratio was detected in a rapidly developing of IHD. It was noticed that after coronary artery bypass grafting in patients with long history case of IHD the content of IL-1β, IL-8, TNF-α, IL-1ra, IL-4 increased with a normalization of the IL-6 concentration in the blood; in patients with a short period of IHD increase of IL-1 concentration and high content of IL-6 are combined with remaining unchanged level of IL1β, IL-8, IL-4 and negative dynamics of the TNF-α concentration in the blood. Thus, the operation in the СРВ in the case of IHD with prolonged course induces the formation of SIR, typical for acute inflammation, and coordinated anti-inflammatory response, and in the case of short period of coronary disease progress this operation causes SIR, characteristic for chronic inflammation, and uncoordinated anti-inflammatory response. Цель исследования – определить характер изменений цитокинового профиля крови при формировании системной воспалительной реакции (СВР) у больных ишемической болезнью сердца (ИБС) с разными темпами развития заболевания после коронарного шунтирования с применением искусственного кровообращения (ИК).Материал и методы. Обследованы больные с медленно прогрессирующей ИБС (20 человек) и быстро прогрессирующей ИБС (20 человек). У больных ИБС до операции и через 6 и 24 ч после оперативного вмешательства оценивали концентрацию цитокинов – интерлейкина (IL)-1β, IL-1ra, IL-4, IL-6, IL-8 и фактора некроза опухоли (TNF) α в плазме крови методом иммуноферментного анализа.Результаты исследования показали, что до операции у больных ИБС обеих групп отмечалось повышение плазменной концентрации IL-1β, IL-6, IL-8, TNF-α и IL-1ra. При этом в случае медленного прогрессирования заболевания концентрация IL-4 в крови сохранялась в пределах нормы, в то время как при быстро развивающейся ИБС обнаруживалось максимально выраженное увеличение содержания провоспалительных (TNF-α, IL-6) и противовоспалительных (IL-4, IL-1rа) цитокинов в крови и соотношения IL-1rа/IL-1β. После коронарного шунтирования у больных ИБС с длительным анамнезом заболевания отмечалось увеличение содержания IL-1β, IL-8, TNF-α, IL-1rа, IL-4 при нормализации концентрации IL-6 в крови; у пациентов с коротким периодом развития ИБС – рост концентрации IL-1rа, высокое содержание IL-6 при сохраняющемся без изменений уровне IL-1β, IL-8, IL-4 и отрицательной динамике концентрации TNF-α в плазме крови.Таким образом, при длительном течении ИБС выполнение операции в условиях ИК вызывает формирование СВР, свойственной острому воспалению, и координированный противовоспалительный ответ, а при коротком периоде коронарной болезни – СВР, характерную для хронического воспаления, и некоординированный противовоспалительный ответ.

Половые различия в клинических особенностях антипсихотикиндуцированной гиперпролактинемии у больных шизофренией

The goal was to identify gender differences in the clinical features of antipsychotic-induced hyperprolactinemia in patients with schizophrenia.Materials and methods. 98 patients from the Department of Endogenous Disorders of the Research Institute of Mental Health Clinic in Tomsk were examined. Persons aged 18–50 were included with followup treatment for at least 1 year, whose condition corresponded to the ICD-10 schizophrenia criteria. Prolactin levels were determined by ELISA using the PRL Test System reagent kit (MonobindInc., USA). The base map of sociodemographic and clinical-dynamic features for patients with schizophrenia was used. Statistical processing of data was performed using the Statistica 12.0 software package. Mann–Whitney U test, Pearson’s χ² criterion, including Yates correction, and Fisher’s two-sided test were used for comparing small samples.Results. The average serum concentration of prolactin in women was 52.4 ± 39.1 ng/ml, in men it was 26.7 ± 19.7 ng/ml. Hyperprolactinemia was detected in 23 (47.9%) women and 25 (50%) men. Among women with hyperprolactinemia, statistically significant “Weight Gain” and “Headache” parameters were more common (p = 0.044 and p = 0.005, respectively). Men with hyperprolactinemia had higher BMI rates (p = 0.0066). For the rest of the UKU paragraphs, no significant differences were found in both men and women. Men presented fewer complaints and were less willing to discuss sexual dysfunction.Conclusion. Antipsychotic-induced hyperprolactinemia in patients with schizophrenia does not always have a full range of specific clinical manifestations and needs careful examination of patients with account of gender characteristics, as well as regular monitoring of the prolactin level in the serum of patients. Цель – выявление половых различий в клинических особенностях антипсихотик-индуцированной гиперпролактинемии у больных шизофренией.Материалы и методы. Обследованы 98 больных из отделения эндогенных расстройств клиники НИИ психического здоровья г. Томска. Включались лица 18–50 лет с давностью катамнеза заболевания не менее 1 года, состояние которых соответствовало критериям шизофрении по МКБ-10. Определение пролактина проводили иммуноферментным методом с использованием набора реагентов PRL Test System (Monobind Inc., США). Применялись Базисная карта социодемографических и клиникодинамических признаков для больных шизофренией, шкала UKU в адаптированной русской версии. Статистическую обработку проводили с использованием пакета программ Statistica 12.0. Применяли непараметрический U-критерий Манна – Уитни, χ² Пирсона, в том числе с учетом поправки Йейтса, для сравнения малых выборок был использован двухсторонний критерий Фишера.Результаты. Средние показатели концентрации пролактина в сыворотке крови у женщин зафиксированы на уровне (52,4 ± 39,1) нг/мл, у мужчин – (26,7 ± 19,7) нг/мл. Гиперпролактинемия была выявлена у 23 (47,9%) женщин и 25 (50%) мужчин. У женщин с гиперпролактинемией статистически значимо чаще встречались показатели «прибавка в весе» и «головная боль» (р = 0,044 и р = 0,005 соответственно), у мужчин с гиперпролактинемией – более высокие показатели индекса массы тела (p = 0,0066). По остальным пунктам UKU значимых различий не выявлено как у мужчин, так и у женщин. Мужчины предъявляли меньшее количество жалоб и были менее доступны для обсуждения сексуальной дисфункции.Заключение. Антипсихотик-индуцированная гиперпролактинемия у больных шизофренией не всегда проявляется полным спектром специфических клинических симптомов и нуждается в тщательном обследовании пациентов с учетом пола, а также в регулярном мониторинге уровня пролактина в сыворотке крови больных.

120 anniversary of the Dermatovenerology Chair of Sibirian State Medical University

A 120-years history of the Dermatovenerology Chair of SibirianStateMedicalUniversityis presented. The contribution of the scientists into the theory and practice in dermatovenerology and traning of specialists is described. The advances of the last 10 years are shown

Phycoemotional state of the patients with severe acne associated with isotretinoin therapy

Progression of phycoemotional state of 22 patients with severe acne was assessed based on changes in rates of CADI, APSEA, DSQL. Monotherapy with isotretinoin (Acnecutan) is effective in treating severe acne resistant to therapy providing stable remission which is shown by decrease in rates of CADI, APSEA, DSQL

Cytokines as inducers of postperfusion systemic inflammatory reaction in cardiosurgical patients with different duration of coronary pathology

Aim. The changes of blood cytokine profile in patients with ischemic heart disease (IHD) with different development rates and formation of systemic inflammatory response (SIR) after coronary artery bypass grafting by using cardiopulmonary bypass (CPB) are analyzed in this article.Materials and methods. The patients with slowly progressive of IHD (20 patients) and rapidly progressive of IHD (20 patients) were examined. The concentration of interleukine (IL) 1β, IL-1ra, IL-4, IL-6, IL-8 and tumor necrosis factor (TNF) α in blood plasma were evaluated by ELISA at patients with IHD before surgery and at 6 and 24 h after surgery.The results of the study showed that concentration of IL-1β, IL-6, IL-8, TNF-α and IL-1ra in blood plasma increases in patients with IHD of both groups before surgery. The concentration of IL-4 in the blood saved in the normal range before the operation in the case of slow disease progression, but maximum increase in content of proinflammatory (TNF-α, IL-6) and anti-inflammatory (IL-4, IL-1ra) cytokines in the blood and the IL-1ra/IL-1β ratio was detected in a rapidly developing of IHD. It was noticed that after coronary artery bypass grafting in patients with long history case of IHD the content of IL-1β, IL-8, TNF-α, IL-1ra, IL-4 increased with a normalization of the IL-6 concentration in the blood; in patients with a short period of IHD increase of IL-1 concentration and high content of IL-6 are combined with remaining unchanged level of IL1β, IL-8, IL-4 and negative dynamics of the TNF-α concentration in the blood. Thus, the operation in the СРВ in the case of IHD with prolonged course induces the formation of SIR, typical for acute inflammation, and coordinated anti-inflammatory response, and in the case of short period of coronary disease progress this operation causes SIR, characteristic for chronic inflammation, and uncoordinated anti-inflammatory response

Chronic kidney disease in patients with psoriasis, chronic opisthorchiasis and at their combination

The aim of the investigation was to study of features of сhronic kidney disease in patients with chronic opisthorchiasis (CO), psoriasis (Ps) and their combination. Examination was performed on 360 patients with CO, 100 patients with Ps, 50 patients with Ps combinated CO and 30 healthy subjects. In addition to complete clinical and instrumental examination accepted in specialised clinic, biopsy of kidney was conducted. The interrelation of intensity of sclerous processes in kidneys and renoprival syndrome with duration of CO and activity of Ps was found. Dehelmintization with biltricid promoted improvement of functional state of kidneys

THE EFFECT OF GOLIMUMAB ON ARTERIAL STIFFNESS IN PATIENTS WITH RHEUMATOID ARTHRITIS

Objective: to evaluate the effect of golimumab (GLM) on arterial stiffness in patients with different clinical and immunological subtypes of rheumatoid arthritis (RA).Material and methods. Examinations were made in 48 patients with RA meeting the 1987 ACR/2010 EULAR classification criteria. The investigators visualized carotid arteries with determination of local vessel wall stiffness and studied regional arterial stiffness with assessment of contour pulse wave analysis before and 52 weeks after initiation of therapy.Results and discussion. Young and middle-aged RA patients without any concomitant cardiovascular diseases were found to have subclinical great artery involvement that was characterized by increases in intima-media thickness (IMT) and stiffness index β of the common carotid artery (CCA); by rises in peripheral augmentation index (AIp), stiffness index (SI), and reflection index (RI), the intensity of a change in which was associated with high DAS28 and seropositivity for rheumatoid factor (RF) and/or anti-cyclic citrullinated peptide (antiCCP) antibodies. GLM treatment in patients with RA was accompanied by a statistically significant decrease in DAS28 and a reduction in CCA IMT and local (carotid) stiffness of the vascular bed. More significant correction of the investigated parameters was achieved in patients with the seronegative subtype of the disease; in this group of patients, CCA IMT decreased by 29% by the end of observation (p=0.01), CCA SI β reduced by an average of 28.7% (p=0.0001). At 52 weeks after GLM therapy initiation, contour pulse wave analysis indicated that this subgroup of patients was observed to have decreases in AIp, SI, and RI to the control level; in RA seropositive for RF and/or anti-CCP, they reduced by an average of 1.8 (p=0.0001), 1.2 (p=0.005) and 1.6 (p=0.001) times, respectively.Conclusion. Along with high anti-inflammatory activity, GLM therapy in patients with RA has a vasoprotective effect on the walls of large elastic-type vessels (decreases in CCA IMT and SI β, AIp, and SI) and small muscular-type arteries (a reduction in RI)