15 research outputs found
Microcirculatory Status and Metabolic Activity of Tissues after Local Administration of Autologous Plasma on the Model of Explosive Soft Tissue Wound in Rats
Background. The possibility of local application of autologous blood plasma (ABP) in soft tissue injuries is currently of particular interest.Objectives. Evaluation of the effects of peri-wound (perifocal) administration of ABP on red blood parameters, microcirculation and oxygen supply of soft tissues of the limb in experimental explosive wound (EW) in rats.Methods. EW was simulated on male Wistar rats (n=146) using a firecracker with a pyrotechnic mixture (patent RU No. 2741238 dated 22.01.2021). Animals were divided into 4 groups: control (2), comparison (1), main (1). The volume of blood loss in explosive wounds was 8 and 15% of the estimated circulating blood volume (CBV) of the animal. Blood was drawn from the rat tail to obtain ABP. 3 hours after the injury, ABP or 0.9% sodium chloride solution was injected intramuscularly into the explosive wound area at a rate of 2.0 ml/kg of animal weight. After 3, 7, 14, 28 days, the number of red blood cells, haemoglobin content, haematocrit were determined in the blood, and microcirculation and oxidative metabolism parameters were determined in the skeletal muscles of the injured area. The data were processed using Microsoft Excel 2013 (Microsoft, USA) and Statistica 10.0 (StatSoft Inc., USA).Results. Blood loss of 8% of the CBV in injured animals did not lead to changes in the quantitative composition of peripheral red blood. After an explosive wound with a blood loss of 15% of the CBV, there was a moderate decrease in the number of red blood cells (from 8.3Γ1012/l to 6.5Γ1012/l, p < 0.02), haemoglobin level (from 149.5 g/l to 118 g/l, p < 0.01), haematocrit (from 43.8% to 33.6%, p < 0.01) with recovery by day 7 of observation. The explosive soft tissue wound was characterized by marked post-traumatic microcirculatory disorders irrespective of the amount of blood loss. Perifocal intramuscular administration of ABP in animals with an explosive wound and blood loss of 15% CBV reduced the severity of post-traumatic microcirculatory and oxidative metabolic disorders mainly in the early post-traumatic period, as evidenced by an increase in the perfusion variation coefficient Kv by 1.2β1.3 times (p < 0.05), tissue oxygen consumption U by 20β22% (p < 0.05) and fluorescent oxygen consumption by FPC by 48% (p < 0.05).Conclusion. With an experimental explosive wound of the soft tissues of the thigh in rats, a single early (3 hours after the injury) peri-wound intramuscular administration of ABP reduces the severity of local post-traumatic microcirculatory and metabolic disorders in skeletal muscle
The efficiency of replenishment of acute blood loss by an experimental blood substitute comprising humanβs umbilical cord blood red blood cells
Π’ΠΎ assess the effectiveness of the experimental blood substitute containing erythrocytes of human umbilical cord blood, were analyzed the dynamics of indicators of cardiovascular and respiratory systems, quantitative indicators of red blood, the severity of hemolysis in dogs within 24 hours after equivalent replenishment of acute blood loss for about 50% of the volume of circulating blood. The comparative drug was the adult human packed RBCs, used in clinical practice. It was found that after replenishment of blood loss in dogs, hemolytic anemia developed less pronounced after transfusion of the blood substitute with erythrocytes of human umbilical cord blood. Indicators of cardiovascular and respiratory systems were restored to the baseline in 24 hours after replenishment of acute blood loss by an experimental blood substitute with human umbilical cord blood erythrocytes with persistent changes after transfusion of the adult human packed RBCs. The relatively higher efficiency of the experimental blood substitute is due to the structural and functional stability of erythrocytes in the umbilical cord blood. A conclusion was made about the prospects of development of blood substitutes-oxygen carriers containing human umbilical cord blood erythrocytes.Π‘ ΡΠ΅Π»ΡΡ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠΊΡΠΏΠ΅ΡΠΈΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΊΡΠΎΠ²Π΅Π·Π°ΠΌΠ΅Π½ΠΈΡΠ΅Π»Ρ, ΡΠΎΠ΄Π΅ΡΠΆΠ°ΡΠ΅Π³ΠΎ ΡΡΠΈΡΡΠΎΡΠΈΡΡ ΠΏΡΠΏΠΎΠ²ΠΈΠ½Π½ΠΎΠΉ ΠΊΡΠΎΠ²ΠΈ ΡΠ΅Π»ΠΎΠ²Π΅ΠΊΠ°, ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ Π°Π½Π°Π»ΠΈΠ· Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠΈ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΠΎΠΉ ΠΈ Π΄ΡΡ
Π°ΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌ, ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ ΠΊΡΠ°ΡΠ½ΠΎΠΉ ΠΊΡΠΎΠ²ΠΈ, Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΠΎΡΡΠΈ Π³Π΅ΠΌΠΎΠ»ΠΈΠ·Π° Ρ ΡΠΎΠ±Π°ΠΊ Π² ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ 24 ΡΠ°ΡΠΎΠ² ΠΏΠΎΡΠ»Π΅ Π²ΠΎΡΠΏΠΎΠ»Π½Π΅Π½ΠΈΡ ΠΎΡΡΡΠΎΠΉ ΡΠΊΡΠΏΠ΅ΡΠΈΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΠΎΠΉ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΠΈ ΠΎΠΊΠΎΠ»ΠΎ 50% ΠΎΡ ΠΎΠ±ΡΠ΅ΠΌΠ° ΡΠΈΡΠΊΡΠ»ΠΈΡΡΡΡΠ΅ΠΉ ΠΊΡΠΎΠ²ΠΈ. ΠΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠΌ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ ΡΠ»ΡΠΆΠΈΠ»Π° ΡΡΠΈΡΡΠΎΡΠΈΡΠ°ΡΠ½Π°Ρ ΠΌΠ°ΡΡΠ° ΡΠ΅Π»ΠΎΠ²Π΅ΠΊΠ°, ΠΈΡΠΏΠΎΠ»ΡΠ·ΡΠ΅ΠΌΠ°Ρ Π² ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅. Π£ΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΎ, ΡΡΠΎ ΠΏΠΎΡΠ»Π΅ Π²ΠΎΡΠΏΠΎΠ»Π½Π΅Π½ΠΈΡ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΠΈ Ρ ΡΠΎΠ±Π°ΠΊ ΡΠ°Π·Π²ΠΈΠ²Π°Π»Π°ΡΡ Π³Π΅ΠΌΠΎΠ»ΠΈΡΠΈΡΠ΅ΡΠΊΠ°Ρ Π°Π½Π΅ΠΌΠΈΡ, ΠΌΠ΅Π½Π΅Π΅ Π²ΡΡΠ°ΠΆΠ΅Π½Π½Π°Ρ ΠΏΠΎΡΠ»Π΅ ΡΡΠ°Π½ΡΡΡΠ·ΠΈΠΈ ΠΊΡΠΎΠ²Π΅Π·Π°ΠΌΠ΅Π½ΠΈΡΠ΅Π»Ρ Ρ ΡΡΠΈΡΡΠΎΡΠΈΡΠ°ΠΌΠΈ ΠΏΡΠΏΠΎΠ²ΠΈΠ½Π½ΠΎΠΉ ΠΊΡΠΎΠ²ΠΈ ΡΠ΅Π»ΠΎΠ²Π΅ΠΊΠ°. ΠΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ Π΄Π΅ΡΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΠΎΠΉ ΠΈ Π΄ΡΡ
Π°ΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌ Π²ΠΎΡΡΡΠ°Π½Π°Π²Π»ΠΈΠ²Π°Π»ΠΈΡΡ Π΄ΠΎ ΠΈΡΡ
ΠΎΠ΄Π½ΠΎΠ³ΠΎ ΡΡΠΎΠ²Π½Ρ ΡΠ΅ΡΠ΅Π· 24 ΡΠ°ΡΠ° ΠΏΠΎΡΠ»Π΅ Π²ΠΎΡΠΏΠΎΠ»Π½Π΅Π½ΠΈΡ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΠΈ ΡΠΊΡΠΏΠ΅ΡΠΈΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΡΠΌ ΠΊΡΠΎΠ²Π΅Π·Π°ΠΌΠ΅Π½ΠΈΡΠ΅Π»Π΅ΠΌ Ρ ΡΡΠΈΡΡΠΎΡΠΈΡΠ°ΠΌΠΈ ΠΏΡΠΏΠΎΠ²ΠΈΠ½Π½ΠΎΠΉ ΠΊΡΠΎΠ²ΠΈ ΡΠ΅Π»ΠΎΠ²Π΅ΠΊΠ° ΠΏΡΠΈ ΡΠΎΡ
ΡΠ°Π½ΡΡΡΠΈΡ
ΡΡ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡΡ
ΠΏΠΎΡΠ»Π΅ Π²Π»ΠΈΠ²Π°Π½ΠΈΡ ΡΡΠΈΡΡΠΎΡΠΈΡΠ°ΡΠ½ΠΎΠΉ ΠΌΠ°ΡΡΡ ΡΠ΅Π»ΠΎΠ²Π΅ΠΊΠ°. Π‘ΡΠ°Π²Π½ΠΈΡΠ΅Π»ΡΠ½ΠΎ Π±ΠΎΠ»Π΅Π΅ Π²ΡΡΠΎΠΊΠ°Ρ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΡΠΊΡΠΏΠ΅ΡΠΈΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΊΡΠΎΠ²Π΅Π·Π°ΠΌΠ΅Π½ΠΈΡΠ΅Π»Ρ ΠΎΠ±ΡΡΡΠ½ΡΠ΅ΡΡΡ ΡΡΡΡΠΊΡΡΡΠ½ΠΎ-ΡΡΠ½ΠΊΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠΉ ΡΡΠ°Π±ΠΈΠ»ΡΠ½ΠΎΡΡΡΡ ΡΡΠΈΡΡΠΎΡΠΈΡΠΎΠ² ΠΏΡΠΏΠΎΠ²ΠΈΠ½Π½ΠΎΠΉ ΠΊΡΠΎΠ²ΠΈ. Π‘Π΄Π΅Π»Π°Π½ΠΎ Π·Π°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅ ΠΎ ΠΏΠ΅ΡΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠ°Π·ΡΠ°Π±ΠΎΡΠΊΠΈ ΠΊΡΠΎΠ²Π΅Π·Π°ΠΌΠ΅Π½ΠΈΡΠ΅Π»Π΅ΠΉ-ΠΏΠ΅ΡΠ΅Π½ΠΎΡΡΠΈΠΊΠΎΠ² ΠΊΠΈΡΠ»ΠΎΡΠΎΠ΄Π°, ΡΠΎΠ΄Π΅ΡΠΆΠ°ΡΠΈΡ
ΡΡΠΈΡΡΠΎΡΠΈΡΡ ΠΏΡΠΏΠΎΠ²ΠΈΠ½Π½ΠΎΠΉ ΠΊΡΠΎΠ²ΠΈ ΡΠ΅Π»ΠΎΠ²Π΅ΠΊΠ°
Vitamin D (steroid hormone) and the nervous system diseases (literature review)
The present review aims to summarize the activities of vitamin D effects on the nervous system and to clarify a vitamin D role in brain diseases, in the pathogenesis or as a serum biomarker for the disease development and severity. Objective: correlation between chronic nervous system diseases and vitamin D level. Methods: a literature research in PubMed and in Russian electronic resources by keywords: vitamin D, brain diseases, chronic nervous system diseases. Results. Vitamin D as a neurosteroid hormone stimulates cerebral activity in both adult and embryonic brain regulates the activity of neural circuits which are responsible for locomotor, reward-dependent and emotional behavior. Patients with autism spectrum disorders, schizophrenia, Alzheimer disease, multiple sclerosis, Parkinson disease and sleep disorders have been shown to have low level of vitamin D. Discussion. Data are controversial, a further study of vitamin D hypovitaminosis significance is essential for the nervous system chronic diseases manifestation and evaluation of the vitamin D dietary supplement efficiency in patients with the nervous system pathology
Π’ΠΎ the question about the requirements of translation of medical organizations on a strict anti-epidemic regime
The paper presents an overview of the legislative and regulatory framework, on the basis of which is the translation of multidisciplinary healthcare organizations on a strict anti-epidemic mode. Reviewed the list of guidance documents that are working in medical organizations in identifying patients (corpses) infectious diseases, which are categorized vysokochastotnykh, particularly hazardous and quarantine infections.Π ΡΡΠ°ΡΡΠ΅ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ ΠΎΠ±Π·ΠΎΡ Π·Π°ΠΊΠΎΠ½ΠΎΠ΄Π°ΡΠ΅Π»ΡΠ½ΠΎΠΉ ΠΈ Π½ΠΎΡΠΌΠ°ΡΠΈΠ²Π½ΠΎΠΉ Π±Π°Π·Ρ, Π½Π° ΠΎΡΠ½ΠΎΠ²Π΅ ΠΊΠΎΡΠΎΡΠΎΠΉ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΡΡΡ ΠΏΠ΅ΡΠ΅Π²ΠΎΠ΄ ΠΌΠ½ΠΎΠ³ΠΎΠΏΡΠΎΡΠΈΠ»ΡΠ½ΡΡ
ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΉ Π½Π° ΡΡΡΠΎΠ³ΠΈΠΉ ΠΏΡΠΎΡΠΈΠ²ΠΎΡΠΏΠΈΠ΄Π΅ΠΌΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠ΅ΠΆΠΈΠΌ ΡΠ°Π±ΠΎΡΡ. Π Π°ΡΡΠΌΠΎΡΡΠ΅Π½ ΠΏΠ΅ΡΠ΅ΡΠ΅Π½Ρ ΡΡΠΊΠΎΠ²ΠΎΠ΄ΡΡΠΈΡ
Π΄ΠΎΠΊΡΠΌΠ΅Π½ΡΠΎΠ², ΠΎΡΡΠ°Π±Π°ΡΡΠ²Π°Π΅ΠΌΡΡ
Π² ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΡΡ
ΠΏΡΠΈ Π²ΡΡΠ²Π»Π΅Π½ΠΈΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ
(ΡΡΡΠΏΠΎΠ²) ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΎΠ½Π½ΡΠΌΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡΠΌΠΈ, ΠΊΠΎΡΠΎΡΡΠ΅ ΠΎΡΠ½ΠΎΡΡΡΡΡ ΠΊ ΠΊΠ°ΡΠ΅Π³ΠΎΡΠΈΠΈ Π²ΡΡΠΎΠΊΠΎΠΊΠ°Π½ΡΠ°Π³ΠΈΠΎΠ·Π½ΡΡ
, ΠΎΡΠΎΠ±ΠΎ ΠΎΠΏΠ°ΡΠ½ΡΡ
ΠΈ ΠΊΠ°ΡΠ°Π½ΡΠΈΠ½Π½ΡΡ
ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΉ
ΠΠ΅Ρ Π°Π½ΠΈΠ·ΠΌΡ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡ ΡΡΠΈΡΡΠΎΡΠΈΡΠΎΠ² ΠΏΡΠΈ ΡΠΎΠΊΡΠΈΡΠ΅ΡΠΊΠΎΠΌ Π΄Π΅ΠΉΡΡΠ²ΠΈΠΈ ΠΌΠ΅ΡΠ³Π΅ΠΌΠΎΠ³Π»ΠΎΠ±ΠΈΠ½ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°ΡΠ΅Π»Π΅ΠΉ
Structural properties of lipid component of erythrocyte membrane of Wistar rats with methemoglobinemia were investigated after one injection of sodium nitrite and phenylhydrazin chloride in DL50 dose. It was shown that in methemoglobinemia cholesterol, lysophosphatidylcholine, sphingomyelin, phosphatidylserine levels are increased and phosphatidylcholine and phosphatidyletanolamine levels are decreased, and an increase of microviscousity of erythrocyte membrane lipid matrix was elevat-ed. The degree of the elucidated changes depends on a xenobiotic and a time of methemoglobinemia period.ΠΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Ρ ΡΡΡΡΠΊΡΡΡΠ½ΡΠ΅ ΡΠ²ΠΎΠΉΡΡΠ²Π° Π»ΠΈΠΏΠΈΠ΄Π½ΠΎΠ³ΠΎ ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½ΡΠ° ΡΡΠΈΡΡΠΎΡΠΈΡΠ°ΡΠ½ΠΎΠΉ ΠΌΠ΅ΠΌΠ±ΡΠ°Π½Ρ Ρ ΠΊΡΡΡ Π»ΠΈΠ½ΠΈΠΈ Wistar ΠΏΡΠΈ ΠΌΠ΅ΡΠ³Π΅ΠΌΠΎΠ³Π»ΠΎΠ±ΠΈΠ½Π΅ΠΌΠΈΡΡ
, ΠΈΠ½Π΄ΡΡΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΎΠ΄Π½ΠΎΠΊΡΠ°ΡΠ½ΡΠΌ Π²Π²Π΅Π΄Π΅Π½ΠΈΠ΅ΠΌ Π½ΠΈΡΡΠΈΡΠ° Π½Π°ΡΡΠΈΡ ΠΈ ΡΠΎΠ»ΡΠ½ΠΎΠΊΠΈΡΠ»ΠΎΠ³ΠΎ ΡΠ΅Π½ΠΈΠ»Π³ΠΈΠ΄ΡΠ°Π·ΠΈΠ½Π° Π² Π΄ΠΎΠ·Π°Ρ
DL50. ΠΠΎΠΊΠ°Π·Π°Π½ΠΎ, ΡΡΠΎ ΠΏΡΠΈ ΠΌΠ΅ΡΠ³Π΅ΠΌΠΎΠ³Π»ΠΎΠ±ΠΈΠ½Π΅ΠΌΠΈΡΡ
ΡΠ²Π΅Π»ΠΈΡΠΈΠ²Π°Π΅ΡΡΡ ΡΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΠ΅ Ρ
ΠΎΠ»Π΅ΡΡΠ΅ΡΠΈΠ½Π°, Π»ΠΈΠ·ΠΎΡΠΎΡΡΠ°ΡΠΈΠ΄ΠΈΠ»Ρ
ΠΎΠ»ΠΈΠ½Π°, ΡΡΠΈΠ½Π³ΠΎΠΌΠΈΠ΅Π»ΠΈΠ½Π°, ΡΠΎΡΡΠ°ΡΠΈΠ΄ΠΈΠ»ΡΠ΅ΡΠΈΠ½Π°, ΡΠ½ΠΈΠΆΠ°Π΅ΡΡΡ ΡΡΠΎΠ²Π΅Π½Ρ ΡΠΎΡΡΠ°ΡΠΈΠ΄ΠΈΠ»Ρ
ΠΎΠ»ΠΈΠ½Π° ΠΈ ΡΠΎΡΡΠ°ΡΠΈΠ΄ΠΈΠ»ΡΡΠ°Π½ΠΎΠ»Π°ΠΌΠΈΠ½Π°, Π² ΠΌΠ΅ΠΌΠ±ΡΠ°Π½Π΅ ΡΡΠΈΡΡΠΎΡΠΈΡΠΎΠ² Π²ΠΎΠ·ΡΠ°ΡΡΠ°Π΅Ρ ΠΌΠΈΠΊΡΠΎΠ²ΡΠ·ΠΊΠΎΡΡΡ Π»ΠΈΠΏΠΈΠ΄Π½ΠΎΠ³ΠΎ ΠΌΠ°ΡΡΠΈΠΊΡΠ°. Π‘ΡΠ΅ΠΏΠ΅Π½Ρ Π²ΡΡΠ²Π»Π΅Π½Π½ΡΡ
ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ Π·Π°Π²ΠΈΡΠΈΡ ΠΎΡ Π²ΠΈΠ΄Π° ΠΊΡΠ΅Π½ΠΎΠ±ΠΈΠΎΡΠΈΠΊΠ° ΠΈ ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΠΏΠ΅ΡΠΈΠΎΠ΄Π° ΠΌΠ΅ΡΠ³Π΅ΠΌΠΎΠ³Π»ΠΎΠ±ΠΈΠ½Π΅ΠΌΠΈΠΈ
The list of potentially hazardous biopathogens affecting the functioning of the hospital phase medical evacuation
The article analyzes the biopathogenic, which can be used by medical evacuation hospital stage diversion for terrorist purposes.Π ΡΡΠ°ΡΡΠ΅ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ Π°Π½Π°Π»ΠΈΠ· Π±ΠΈΠΎΠΏΠ°ΡΠΎΠ³Π΅Π½ΠΎΠ², ΠΊΠΎΡΠΎΡΡΠ΅ ΠΌΠΎΠ³ΡΡ ΠΏΡΠΈΠΌΠ΅Π½ΡΡΡΡΡ ΠΏΠΎ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΡΠ½ΠΎΠΌΡ ΡΡΠ°ΠΏΡ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΡΠ²Π°ΠΊΡΠ°ΡΠΈΠΈ Π΄ΠΈΠ²Π΅ΡΡΠΈΠΎΠ½Π½ΡΠΌ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ Ρ ΡΠ΅ΡΡΠΎΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅Π»ΡΡ
Local treatment of chloasma in pregnant women
Goal. To assess the efficacy and safety of Azelic (15% gel of azelaic acid for topical administration) for the treatment of chloasma in pregnant women. Materials and methods. The study involved 28 pregnant women aged 18-36 (mean age: 24.7) with a normal course of pregnancy. The patients consulted a doctor in the spring, summer or fall complaining of focal skin hyperpigmentation on the face, chin and chest area. Ten patients (35.7%) developed hyperpigmentation prior to their pregnancy and 18 women (64.3%) - during the pregnancy. As of the consultation date, the pregnancy terms in all of the patients were 18-20 weeks. Chloasma was diagnosed by using dermatoscopy and skin examination with the Woodβs lamp. The patients were informed about the content and procedure of the study and gave their consent to take part in the study. Thin layers of Azelic (15% gel of azelaic acid for topical administration) were applied to the hyperpigmented skin of the patients and gently rubbed twice a day (in the morning and evening) as topical treatment for four months. The treatment results were assessed taking into consideration the patientβs subjective assessment, study group structure depending on the clinical efficacy, percentage of adverse events, and survey results based on the Dermatology Life Quality Index questionnaire. To reveal any potential general toxicological effects of the treatment, hepatic samples, total blood count and coagulogram results were analyzed as a part of obstetrical and gynecologic care for pregnant women. Key findings. Positive dynamics of the following characteristics was revealed: subjective assessment of treatment results by the patients, clinical efficacy of treatment and life quality index. Therapeutic results were observed as early as after one month but not later than three months after the treatment began. The therapeutic efficacy was recorded in 92.9-96.4% of all cases after four months of treatment: pigment spots disappeared or became paler, and their dimensions and their contrast as compared to the healthy skin reduced, the skin texture and life quality improved (the Dermatology Life Quality Index reduced from 15.5 Β± 1.8 to 6.7 Β± 0.5 points against the background of the treatment efficacy: from severe to moderate impact of the disease on the patientβs life, respectively). Five women (17.9%) developed erythema and burning sensations in the drug application site within the first two weeks immediately after the gel application (one of the patients had the same symptoms for six weeks of the treatment); the symptoms were weak and transient and did not require any additional treatment. Hepatic samples, total blood count and coagulogram results were within physiological standards during the treatment. Conclusion. Topical application of Azelic (15% gel of azelaic acid for topical administration) twice a day for four months is an efficient and safe method to treat chloasma in pregnant women