Diagnosis and Treatment of Chronic Urticaria: The Importance of Autoimmune Aspects and Comorbidity

The study aimed to conduct a comprehensive systematic review of the literature on the autoimmune mechanisms associated with chronic spontaneous urticaria (CSU) in adults, explore the association between chronic urticaria (CU) and autoimmune disorders, analyze two case reports, and develop a diagnostic algorithm considering the autoimmune pathogenesis. Materials and Methods. The literature review was conducted to study the mechanisms underlying autoimmune CU. Two case reports were analyzed and a diagnostic algorithm for patients suspected of autoimmune urticaria was formulated. Results. CU significantly impairs patients’ quality of life, posing problems in daily activities and is often associated with concomitant autoimmune diseases. Though the pathogenesis of CSU remains incompletely understood, in recent years, there has been significant progress in understanding the pathophysiology of this condition, prompting researchers to explore new agents, especially biological ones, in cases with severe refractory urticaria. We have developed a diagnostic algorithm aimed at improving the management tactics for CSU and autoimmune pathology, that involves a thorough collection of complaints, medical history, performing a series of basic laboratory tests for specific markers of autoimmune disorders, and expanding their spectrum with detailed differential diagnostics. Conclusions. CU is an important medical and social issue that requires an interdisciplinary personalized approach to patients. The diagnosis of the condition involves a comprehensive approach, considering potential concomitant autoimmune disorders and detailed laboratory investigations, especially in cases refractory to standard second-generation antihistamine therapy. The treatment of CU, specifically the stepwise therapy protocol based on symptom severity and response to treatment and aimed at reducing symptoms, improving patients’ quality of life, and achieving CU remission, is outlined in various national and international guidelines, and is carried out gradually, involving three lines of therapy

Osteoporosis – a Silent Epidemic of XXI Century: Secondary Forms

The objective of the study was to determine the main causes of osteoporosis in chronic kidney disease, chronic obstructive pulmonary disease, pulmonary sarcoidosis and understand how the disease develops in these conditions. Materials and Methods. To study the mechanisms of developing secondary osteoporosis, a literature review was conducted. Results. Secondary forms of osteoporosis account for approximately 15-20% of reported cases and result mainly from concomitant diseases or from using drugs that have a negative effect on bone tissue. Despite its inert and stable appearance, bone tissue is a metabolically active, continuously renewing system. Throughout life, it continuously undergoes remodeling cycles involving the two main processes: the first one is called bone resorption and involves the breakdown of old bone followed by the destruction and removal of both the mineral substance and the organic matrix from resorption sites; the second one is called new bone formation and involves bone matrix synthesis and its subsequent mineralization. The imbalance between these two processes, the predominance of bone resorption over bone formation, is the key link in the pathogenesis of osteoporosis. Such an imbalance reflects the impairment of the major mechanisms of systemic hormonal and local (cytokine) regulation of cellular activity and occurs in secondary osteoporosis. Conclusions. To date, at the stage of providing medical care to patients with chronic bronchopulmonary diseases and chronic kidney disease, inadequate attention is paid to timely diagnosis and treatment of concomitant osteoporosis. The latter often develops as a secondary condition due to systemic inflammation, severe hypoxia, low physical activity, taking inhaled and systemic glucocorticoids. Its signs are not clinically apparent; hence, it is referred to as the ‘silent epidemic. Since osteoporosis has no pathognomonic symptoms and its clinical presentation is rather vague, in patients with chronic bronchopulmonary diseases and chronic kidney disease, its early diagnosis by determining mineral bone density is recommended to prevent the development of severe complications, including low-energy fractures

Enhanced photorefractive properties of Bi-doped Sn2P2S6

International audienceEnhanced photorefractive properties of tin hypothiodiphosphate (Sn2P2S6) crystals as a result of Bi doping are presented. These new crystals were obtained by the vapor-transport technique using stoichiometric Sn2P2S6 composition with an additional amount of Bi up to 0.5 mol. % in the initial compound. The bandgap edges of the obtained crystals are located at ~750 nm and shift toward the red wavelengths with increasing Bi concentration. Sn2P2S6:Bi crystals are found to exhibit larger two-beam coupling gain coefficients (up to 17 cm−1 at a wavelength of 854 nm) as compared to (i) pure Sn2P2S6 (2.5 cm−1 at 854 nm), (ii) Sn2P2S6 crystals modified by the growth conditions (14 cm−1 at 860 nm), and (iii) Te-doped Sn2P2S6 (8 cm−1 at 860 nm). At the same time, for an intensity of 1.3 W/cm2 at 854 nm, buildup times of 0.9 and 2.5 ms at grating spacings of Λ=9.8 and 1.3 μm, respectively, are found; Bi-doped Sn2P2S6 crystals are the fastest among all the presently known Sn2P2S6 crystals operating at near-infrared wavelengths