Obsessive compulsive disorder in an adult patient with Gilles de la Tourette syndrome and expressed behavioral disorders (clinical case).

The article des­cribes the clinical case of obsessive-compulsive disorder in an adult patient with Gilles de la Tourette syndrome and severe behavioral disorders. The authors demonstrated the comorbidity of Gilles de la Tourette syndrome and obsessive-compulsive disorder. Obsessive thoughts and compulsive actions were diagnosed as the most frequent behavioral disorders in Tourette syndrome. It was indicated on gender as an additional sanctioning factor for the early onset of mental disorders. Obsessive-compulsive disorder in the patient was characterized by mixed obsessive thoughts and actions, had a protracted nature, with prolonged decompensations requiring treatment in a psychiatric hospital. Emotional instability, impulsivity, obsessions and compulsions affecting the social functioning of not only the patient himself, but also those around him, as well as pronounced behavioral disturbances led to social malajustment. When treating the patient, the doctors had to resort to a combination of typical neuroleptics with second-generation antipsychotics, mood stabilizers and antidepressants due to the poor response to pharmacotherapy. Comorbidity of mental disorders determined the complexity of therapeutic measures with the use of psychotherapeutic interventions, which made it possible to achieve an improvement in the mental state and avoid disability of the patient

Obsessive compulsive disorder in an adult patient with Gilles de la Tourette syndrome and expressed behavioral disorders (clinical case)

The article describes the clinical case of obsessive-compulsive disorder in an adult patient with Gilles de la Tourette syndrome and severe behavioral disorders. The authors demonstrated the comorbidity of Gilles de la Tourette syndrome and obsessive-compulsive disorder. Obsessive thoughts and compulsive actions were diagnosed as the most frequent behavioral disorders in Tourette syndrome. It was indicated on gender as an additional sanctioning factor for the early onset of mental disorders. Obsessive-compulsive disorder in the patient was characterized by mixed obsessive thoughts and actions, had a protracted nature, with prolonged decompensations requiring treatment in a psychiatric hospital. Emotional instability, impulsivity, obsessions and compulsions affecting the social functioning of not only the patient himself, but also those around him, as well as pronounced behavioral disturbances led to social malajustment. When treating the patient, the doctors had to resort to a combination of typical neuroleptics with second-generation antipsychotics, mood stabilizers and antidepressants due to the poor response to pharmacotherapy. Comorbidity of mental disorders determined the complexity of therapeutic measures with the use of psychotherapeutic interventions, which made it possible to achieve an improvement in the mental state and avoid disability of the patient. У статті наведено опис клінічного випадку обсесивно-компульсивного розладу в дорослого пацієнта із синдромом Жиль де ла Туретта і вираженими поведінковими порушеннями. Авторами продемонстрована коморбідність синдрому Жиль де ла Туретта й обсесивно-компульсивного розладу. Діагностовано нав'язливі думки й компульсивні дії як найбільш часті поведінкові порушення при синдромі Туретта. Відзначено гендерну приналежність як додатковий санкціонуючий фактор раннього початку психічних порушень. Обсесивно-компульсивний розлад у пацієнта характеризувався змішаними обсесивними думками й діями, мав затяжний характер, з тривалими декомпенсаціями, що вимагали лікування в умовах психіатричного стаціонару. Емоційна нестійкість, імпульсивність, обсесії і компульсії, що торкнулися соціального функціонування не тільки самого пацієнта, але й оточуючих, а також виражені поведінкові порушення призвели до соціальної дезадаптації. При лікуванні пацієнта довелося вдатися до поєднання типових нейролептиків з антипсихотичними препаратами другого покоління, нормотиміками й антидепресантами через погану відповідь на медикаментозну терапію. Коморбідність психічних розладів визначила комплексність терапевтичних заходів з використанням психотерапевтичних втручань, яка дозволила досягти поліпшення психічного стану й уникнути інвалідизації хворого

УДОСКОНАЛЕННЯ СКЛАДУ І РОЗРОБКА ЕКСТЕМПОРАЛЬНОЇ ТЕХНОЛОГІЇ ПЕСАРІЇВ ІЗ ДОКСИЦИКЛІНОМ ХІКЛАТОМ НА ОСНОВІ МАСЛА КАКАО

The aim of the work. To improve the composition and develop of the extemporaneous technology of pessaries with doxycycline hyclate based on cocoa butter. Materials and Methods. Extemporaneous prescriptions for the treatment of vaginal infections have been found to be often represented by polyethylene oxide-based pessaries with doxycycline hyclate. In order to improve them, in addition to doxycycline hyclate, liniment of syntomycin, dimexide and menthol were introduced in their composition. The cocoa butter mixture with beeswax was used as suppository base. The preparation of the pessaries was performed by the method of pouring out, taking into account the requirements of the State Pharmacopoeia of Ukraine 2.0 and the Instruction of the Ministry of Health of Ukraine “Requirements for the preparation of non-sterile medicines in the conditions of pharmacies”. To determine the pharmacotechnological parameters of model samples of the medicine, their description (homogeneity), melting point and resistance to destruction were studied. Results and Discussion. To determine the optimal ratio of cocoa butter and beeswax in the composition of the suppository base, the pharmacotechnological parameters of their model samples were investigated. Components ratios 92.5:7.5 and 95.0:5.0 were selected for further studies. When studying the effect of emulsifiers (emulsifier T-2, lecithin) on some indicators of the quality of pessaries, it was found that only samples of the medicine on the selected suppository base in the ratio of 95.0:5.0 with a content of lecithin in the amount of 2-3 % meet the requirements of SPU in terms of “Description” and “Melting point”. It has been experimentally proven that doxycycline hyclate is mixable with the liniment of syntomycin and glycerol, which promotes its even distribution in the suppository base and improves the quality of pessaries (no sedimentation effect). In the development of extemporaneous technology of the medicine by the method of pouring is determined the inverse coefficient of substitution of doxycycline hyclate in cocoa butter, which is 0.81. The samples of the pessaries prepared according to the proposed technology were analyzed according to the quality indicators in accordance with the requirements of SPU 2.0, current orders, instructions and guidelines of the Ministry of Health of Ukraine. Conclusions. Experimental studies have been conducted to improve the composition of extemporaneous pessaries with doxycycline hyclate for the treatment of infectious vaginitis. In addition to doxycycline hyclate, the liniment of syntomycin, dimexide and menthol was introduced into the medicine. As a suppository base used a mixture of cocoa butter and beeswax in a ratio of 95.0:5.0. Extemporaneous technology of pessaries by pouring method has been developed. It is shown that the obtained samples of pessaries fully meet the requirements of the SPU to this dosage form.Мета роботи. Удосконалення складу і розробка екстемпоральної технології песаріїв із доксицикліном хіклатом на основі масла какао. Матеріали і методи. Встановлено, що рецептурні прописи для лікування вагінальних інфекцій досить часто представлені песаріями із доксицикліну хіклатом на поліетиленоксидній основі. З метою їх удосконалення до складу лікарського засобу, окрім доксицикліну хіклату, введено лінімент синтоміцину, димексид і ментол. Як супозиторну основу використано суміш масла какао із воском бджолиним. Приготування песаріїв здійснено методом виливання з урахуванням вимог ДФУ 2.0 і Настанови МОЗУ «Вимоги до виготовлення нестерильних лікарських засобів в умовах аптек». Для визначення фармакотехнологічних показників модельних зразків лікарського засобу вивчено їх опис (однорідність), температуру плавлення і стійкість до руйнування. Результати й обговорення. З метою визначення оптимального співвідношення масла какао і воску бджолиного у складі супозиторної основи досліджено фармакотехнологічні показники їх модельних зразків. Для подальших досліджень обрано співвідношення компонентів 92,5:7,5 і 95,0:5,0. При вивченні впливу емульгаторів (емульгатор Т-2, лецитин) на деякі показники якості песаріїв встановлено, що лише зразки лікарського засобу на обраній супозиторній основі у співвідношенні 95,0:5,0 із вмістом лецитину в кількості 2–3 % відповідають вимогам ДФУ за показниками «Опис» і «Температура плавлення». Експериментально доведено, що доксицикліну хіклат легко змішується з лініментом синтоміцину, що сприяє його рівномірному розподілу в супозиторній основі. Такий спосіб введення антибіотика значно покращує якість отриманих песаріїв (відсутній ефект осідання). При розробці екстемпоральної технології лікарського засобу методом виливання визначено зворотний коефіцієнт заміщення доксицикліну хіклату на маслі какао, який становить 0,81. Зразки песаріїв, виготовлені за запропонованою технологією, проаналізовано за показниками якості відповідно до вимог ДФУ 2.0, чинних наказів, інструкцій і настанов МОЗ України. Висновки. Проведено експериментальні дослідження з удосконалення складу екстемпоральних песаріїв із доксицикліном хіклатом для лікування інфекційного вагініту. До складу лікарського засобу, окрім доксицикліну хіклату, введено лінімент синтоміцину, димексид і ментол. Як супозиторну основу використано суміш масла какао і воску бджолиного у співвідношенні 95,0:5,0. Розроблено екстемпоральну технологію песаріїв методом виливання. Показано, що отримані зразки песаріїв повністю відповідають вимогам ДФУ до даної лікарської форми

Prospects for the Use of Thermal Extracts of Brucella abortusI-206 in S-and L-Forms in the Diagnosis and Prevention of Brucellosis

Currently, one of the topical areas of research is the development of new antigen preparations for the specific diagnosis and prevention of brucellosis, since indication of the pathogen and prevention of the disease is complicated by the ability of brucella to dissociate, and live vaccines used for specific prevention of brucellosis have residual virulence. Thermal extracts (TE) obtained from Brucella abortus I-206 in the L- and S-form can be used as such promising antigens. It is known that TE in the L- and S-forms have immunogenic properties, as well as a modulating effect on the proliferation of immunocompetent cells, morphological changes in the immunocompetent organs of experimental animals.The aimof the work is to study the effect of Brucella abortus thermal extracts in L- and S-forms on the functional state of the cells of experimental animals.Materials  and  methods. The  study  was  performed  on  100  certified  white  mice.  As  objects  of  study,  we  used  the B. abortus I-206 TE in L- and S-forms. Evaluation of the effect of antigenic drugs on the functional state of phagocytes of laboratory animals in vitro was performed on peritoneal macrophages. The total activity of the respiratory chain enzymes in the NBT-test and superoxide dismutase was determined. Cells of intact animals served as controls. As a positive control, a commercial antigenic LPS preparation Escherichia coli was used. The content of cyclic nucleotides in homogenates of immunocompetent organs was determined using ELISA.Results.This study presents materials on the study of the effect of TE on the bactericidal activity of phagocytes and the level of cyclic nucleotides in immunocompetent organs. It has been established that TEs activate oxygen-dependent bactericidal systems of phagocytes. When studying the effect of TE on the content of cyclic nucleotides in immunocompetent organs of white mice, an increase in their concentration was revealed, indicating an increase in the functional activity of the cells.Conclusion.The obtained data make it possible to substantiate the need for a further detailed study of the immunogenic properties of B. abortus TE in the L- or S-form on the organism of experimental animals

Characteristics of an antioxidant activity of Yersinia pestis with different plasmid spectrum

Experimental data concerning complex study of antioxidant activity of Y. pestis with different plasmid spectrum (wild-type Yersinia pestis subsp. pestis, Yersinia pestis subsp. altaica and their isogenic variants) are represented in the article. Superoxide dismutase activity of the tested Y. pestis strains was from 6.0 to 9.0 x 109 microbe cells. Significant differences between the Y. pestis strains with different plasmid composition were not detected by this parameter. Our results, consistent with the data of other authors, tell that superoxide dismutase activity is a thermo-inducible feature and does not depend on a plasmid spectrum. High peroxide destroying activity was also detected in all tested Y. pestis strains. The differences between the strains regarding their common peroxide destroying activity were found. This parameter of the plague microbe strains lacking pYP plasmid was at least 3 times lower than common peroxide destroying activity in strains with this plasmid in the genome. In our opinion these revealed differences were caused by characteristics of plasmid spectrum. The common peroxide destroying activity's degree of Y. pestis strains can be associated with the presence of pYP plasmid in the genome. The isogenic variants of Y. pestis strains lacking one of the plasmids had smaller pathogenic activity. This fact points to the need for further study of these strains

Immunogenic potency of antigenic preparation Bacillus anthracis Sterne 34F₂ and its combination with metal-containing nanocomposites

The article presents the research results of immunogenic potency of antigen preparation Bacillus anthracis Sterne 34F on the guinea pig model. It was found that a single inoculation of this preparation, before the contamination of virulent B. anthracis strain, protects 60-80 % of experimental animals. The metal-containing nanocomposites were used to improve the immunogenicity of this antigen preparation. The combined use of antigenic preparation S-2 with argentogalactomannan increases its immunogenic potency and conduces to the survival of experimental animals. Argentogalactomannan exhibits adjuvant properties enhanced the immunogenic features of the S-2 B. anthracis 34F2 Sterne that may indicate its availability as an adjuvant in the construction of chemical vaccines

Profile of cytokines in aqueous humor and trabecular meshwork cell culture in patients with pseudoexfoliation glaucoma

Glaucoma is one of the leading causes of irreversible blindness worldwide, being an age-related disease. Its pathogenesis still is not fully understood. A particular interest is attracted to evaluation of the cytokine concentrations in the trabecular meshwork cell culture, and in the aqueous humor (AH) taken from the same patient, since such data may allow to describe more completely the glaucomatous trabecular changes and to clarify the mechanisms of intercellular interactions in pseudoexfoliative (PEX) glaucoma. The purpose of this study was a comparative analysis of cytokine contents in AH and in trabecular tissue (TT) supernatants in the patients with PEX glaucoma. The study included 23 eyes of patients with PEX glaucoma. The material studied was AH and supernatant of TT cell culture. The cytokine concentration was measured using a flow cytofluorimeter FacsCantoII (BD, USA) using the CBA method. SPSS version 19 software (IBM, USA) was used for the statistical data processing. Concentrations of cytokines (TNFα, IFNγ, IL-1β, IL-6, IL-8, IL- 10, VEGF, GM-CSF) were determined in AH and in the TT supernatant for each of the patients with PEX glaucoma. Only IL-6 and VEGF concentrations in AH were higher than those in the TT supernatant in patients with PEX glaucoma. The IL-6 concentration positively correlated with the VEGF and IL-8 concentrations in the TT supernatant. Correlations between other cytokines in the TT supernatant and AH were also identified and analyzed. Multiple regression analysis revealed that the duration of glaucoma and the IFNγ and TNFα concentrations in AH may have a significant influence on the corneal endothelial cells, being associated with density reduction in patients with PEX glaucoma. The correlation analysis did not reveal any links between other clinical data (corneal thickness in the optical center, IOP level, age) and the cytokine concentrations in the studied tissues. The obtained results suggest that only simultaneous analysis of the cytokine concentrations in the TT supernatant and AH taken from the same patient may provide a more complete description of the cytokine imbalance and pathological processes occurring in the trabecular meshwork in PEX glaucoma patients. It has been shown that the changing cytokine ratios observed in PEX glaucoma may be associated with development of uniform structural and functional changes in all tissues of the anterior eye segment

ВОЗМОЖНОСТИ СТЕРЕОТАКСИЧЕСКОЙ РАДИОХИРУРГИИ ПРИ ЛЕЧЕНИИ БОЛЬНЫХ С МЕТАСТАТИЧЕСКИМ ПОРАЖЕНИЕМ ПЕЧЕНИ

The introduction of innovative technical developments: the three-dimensional planning, using multileaf collimator, simulated by the intensity radiation therapy, improved methods of fixation significantly improved ability of accurate delivering and escalating of doses of ionizing radiation to the selected volume of tissues. This has changed the perception of the role of radiation therapy in the treatment of liver metastases. Foreign authors data suggest the possibility of reaching 95% local control one year after stereotactic radiotherapy, 92% - after two years (and 100% for tumors smaller than 3 cm.) with the development third or higher degree of radiation damage near in 2%. In 2011, after the technical upgrading of Blokhin Cancer center, the method of stereotactic radiosurgery (SBRS) was introduced in clinical practice for the treatment of patients with liver metastases. This method allows to create a high-dose ionizing radiation in metastatic tumor and cause the destruction of the tumor. This is a promising direction in the treatment of metastatic liver cancer significantly expanded the capabilities of the combined treatment. The article provides an overview of the literature on the treatment of liver metastases, and we publish the results of the use of stereotactic radiosurgery at thirty-five patients with liver metastases and clinical case of successful application of this method in patient with significant co-morbidity.Появление инновационных технических разработок: трёхмерного планирования, использование многолепесткового коллиматора, моделированной по интенсивности лучевой терапии, более совершенных методов фиксации — значительно повысили возможности точного подведения и эскалации дозы ионизирующего излучения к выбранному объёму. Это изменило представление о роли лучевой терапии в лечении метастатического поражения печени. Данные зарубежных авторов свидетельствуют о возможности достижения 95 % локального контроля че-рез год после проведения стереотаксической радиотерапии, 92 % — через два года (и 100 % для опухолей раз-мерами менее 3 см.) при развитии лучевых повреждений третьей и выше степени всего в 2 % случаев. В 2011 году, после технического перевооружения ФГБУ РОНЦ им. Н. Н. Блохина РАМН, в клинической практике для лечения больных с метастатическим поражением печени стала внедряться методика локальной стереотаксической радиохирургии (SBRS). Методика позволяет создать локально в метастатическом опухолевом узле высо-кую дозу ионизирующего излучения и вызвать разрушение опухоли. Это перспективное направление в лечении метастатического рака печени значительно расширило возможности комбинированного лечения. В статье приведен обзор литературы по лечению метастатического поражения печени, также мы публикуем результаты использования стереотаксической радиохирургии у тридцати пяти пациентов с метастатическим поражением печени и клинический случай успешного применения данной методики у соматически отягощенной пациентки

FEATURES OF CHORIORETINAL BLOOD FLOW IN PATIENTS WITH OPEN-ANGLE GLAUCOMA

The purpose of the study was to evaluate the features of hemodynamics in patients with intraocular pressure (IOP) fluctuations, to reveal differential diagnostic criteria for adequate monitoring of glaucoma course according to optical coherence tomography (OCT) with the function of angiography. Material and methods. 25 patients (25 eyes) with hypertensive POAG were examined. The study included OCT of the retina and optic disk with the function of angiography. Patients of the clinical group underwent a non-penetrating fistulizing operation followed by laser goniopuncture. The examination was performed before the operation, in the early postoperative period, 1 and 3 months after the surgical intervention. The control group was 12 people (24 eyes) without ophthalmic pathology of the corresponding age and sex. Results and discussion. The obtained results testify to the role of regional hemodynamics in the formation of glaucoma neuroopticopathy. The revealed hemodynamic disturbances in the form of the decrease in the thickness of the choroid, decrease in the density of the radial peripapillary, superficial vascular plexus, and the corresponding glaucomatous changes in the optic disk, the layer of nerve fibers and the ganglionic retina complex, allow speaking about hypoperfusion caused by the decrease in the metabolic needs of atrophied tissue. Surgical interventions used in the treatment of patients with glaucoma lead to an improvement in blood flow parameters. Retinal and choroidal vessels respond differently to intraocular pressure fluctuations, which indicate different mechanism of adaptation of the eye’s vascular system in response to the change in the ophthalmotonus. In this connection, the question arises of the need to determine the individual intraocular pressure