109 research outputs found
Cognitive impairment in patients with type 2 diabetes mellitus: prevalence, pathogenetic mechanisms, the effect of antidiabetic drugs
In recent years, a large amount of data has been accumulated on the relationship between cognitive impairment, dementia and diabetes mellitus. This article presents an overview of modern literature, including the definition of cognitive functions, the modern classification of cognitive impairment, pathogenetic mechanisms of diabetes mellitus influence on the development of cognitive impairment and dementia (neurogenesis, integrity of the blood-brain barrier, systemic inflammatory reactions, hyper- and hypoglycemia, insulin resistance, vascular dysfunction of the microvasculature and increase in glucocorticosteroids). The influence of anti-diabetic medications on cognitive functions has been examined in detail: insulin preparations, oral hypoglycemic agents of the biguanide group (metformin), thiazolidinediones (rosiglitazone and pioglitazone), sulfonylurea derivatives (glycazide, glipizide), a-glucosidase (acarbose) inhibitors, incretin-directed therapy (receptor agonists glucan-like peptide (exenatide and liraglutide) and inhibitors of dipeptidylpeptidase type 4 (sitagliptin, vildagliptin and alogliptin)), sodium glucose inhibitors cotransporter type 2. The data demonstrating a multidirectional effect on the cognitive functions of various antidiabetic drugs is presented, the possible influence on the rate of progression of cognitive impairment and the risk of dementia of intensive control of plasma glucose level in comparison with the standard decrease in patients with type 2 diabetes is analyzed
Molecular Diagnostics of Histoplasmosis
Histoplasmosis is a systemic fungal disease that occurs worldwide. The highest incidence of the disease is reported on the American continent. It also occurs in China, India, South-Eastern Asia, Africa, Australia and Europe. Clinical syndromes of histoplasmosis are not specific and in most cases immunocompetent individuals are asymptomatic or present mild influenza-like disease. Immunocompromised patients especially individuals with AIDS, can develop a severe and fatal disease due to fungal dissemination to many organs. Etiological agent of histoplasmosis is the dimorphic fungus Histoplasma capsulatum, which inhabits the soils contaminated with bird or bat droppings. Three biological varieties are considered for this fungus: H. capsulatum var. capsulatum, H. capsulatum var. duboissii and H. capsulatum var. farciminosum. Genetic differences are observed among H. capsulatum strains from diverse regions of the world. The main molecular methodologies for genetic typing of fungi are based on DNA fingerprinting. They have been an important instrument to identify possible sources of infection in outbreaks of histoplasmosis. Genetic profiles of H. capsulatum, isolated from bats and humans, helped to understand the distribution of the disease in certain endemic regions. The con-ventional diagnosis of histoplasmosis is performed by means of cultural and microscopic examination of samples from the respiratory tract and biologic fluids. However, these techniques yield positive results in only 50 % of cases. In the last two decades, approaches for the detecting of H. capsulatum in clinical samples, using different molecular targets, based on PCR assay have been developed. Their use can shorten the time span of analysis for diagnosis confirmation. Molecular methods have high specificity and sensitivity and reduce the risk of infection for the laboratory personnel. In this study we reviewed the recently published data on the use of main molecular methods for diagnosis of histoplasmosis
Psychosocial aspects of the usage of modern technologies in diabetes mellitus
This article represents a review of trials on the relationship between the use of modern technologies in the treatment of diabetes, such as continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM), and the psychological characteristics of patients. The review includes Russian studies and foreign publications. The analysis showed that the psychological aspects of using CSII are considered more often than CGM. Most Russian authors agree that the use of technology is associated with an increased psychological well-being of patients. Foreign researchers generally agree with the same point of view but also report a weaker correlation. One of the most significant conclusions of this analysis is that the use of modern technologies itself does not guarantee an improved quality of life (QOL) and psychological well-being, but technologies such as CSII and CGM provide patients with opportunities to achieve greater effectiveness in treating diabetes, improving clinical and metabolic parameters and therefore improving QOL. However, the use of these devices, as well as many other technological tools, is associated with certain psychological problems, both in terms of their acquisition and influence on patients’ subjective well-being. Early diagnosis and prevention of such problems should be one of the tasks in preparing patients for the use of modern technologies. A positive effect on both clinical and metabolic indicators as well as on the mental sphere and social life of patients can be achieved only by combining complete training (optimally—according to specialised programmes) with medical support
ΠΠ°ΡΠΊΠ΅ΡΡ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠΊΠ·ΠΎΠ³Π΅Π½Π½ΡΡ ΠΈΠ½ΡΠ΅ΡΡΡΠΈΡΠΈΠ°Π»ΡΠ½ΡΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ Π»Π΅Π³ΠΊΠΈΡ
The aim of this study was to investigate values of pulmonary fibrosis markers alveomucin and KL-16 and the airway damage marker CC-16 for evaluating activity and progressing of extrinsic interstitial lung diseases (ILD) in dependence on etiology. Methods. Levels of Krebs von den Lungen-6 glycoprotein (KL-6), alveomucin and Clara cell protein (CC16) were measured using the ELISA method. The study involved 13 patients with pneumoconiosis, 26 patients with extrinsic allergic alveolitis (EAA) and 20 patients with extrinsic toxic alveolitis (ETA) both in active and stable status. Results. KL-6 and alveomucin were found to be more valuable markers for assessing activity of extrinsic fibrosing alveolitis compared to CC16. Alveomucin had higher specificity but lower sensitivity compared to KL-6. Conclusion. Alveomucin could be used as a screening test in cases with clinical susceptibility for extrinsic alveolitis. On contrary, KL-6 and alveomucin could be used for assessing therapeutic efficacy of EAA and ETA.Π£ΡΠΎΠ²Π΅Π½Ρ Π³Π»ΠΈΠΊΠΎΠΏΡΠΎΡΠ΅ΠΈΠ½Π° Krebs von den Lungen-6 (KL-6), Π°Π»ΡΠ²Π΅ΠΎΠ»ΠΎΠΌΡΡΠΈΠ½Π° ΠΈ Π±Π΅Π»ΠΊΠ° Π±ΡΠ»Π°Π²ΡΠ°ΡΡΡ
ΠΊΠ»Π΅ΡΠΎΠΊ (club cells) β Π‘Π‘16 ΠΏΡΠΈ ΡΠΊΠ·ΠΎΠ³Π΅Π½Π½ΡΡ
ΠΈΠ½ΡΠ΅ΡΡΡΠΈΡΠΈΠ°Π»ΡΠ½ΡΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡΡ
Π»Π΅Π³ΠΊΠΈΡ
Π±ΡΠ» ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΈΠΌΠΌΡΠ½ΠΎΡΠ΅ΡΠΌΠ΅Π½ΡΠ½ΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·Π°. ΠΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Ρ Π±ΠΎΠ»ΡΠ½ΡΠ΅ ΠΏΠ½Π΅Π²ΠΌΠΎΠΊΠΎΠ½ΠΈΠΎΠ·ΠΎΠΌ (n = 13), ΡΠΊΠ·ΠΎΠ³Π΅Π½Π½ΡΠΌ Π°Π»Π»Π΅ΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΌ (n = 26) ΠΈ ΡΠΊΠ·ΠΎΠ³Π΅Π½Π½ΡΠΌ ΡΠΎΠΊΡΠΈΡΠ΅ΡΠΊΠΈΠΌ (n = 20) Π°Π»ΡΠ²Π΅ΠΎΠ»ΠΈΡΠΎΠΌ Π² ΠΏΠ΅ΡΠΈΠΎΠ΄ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΈ ΡΠ΅ΠΌΠΈΡΡΠΈΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ. Π£ΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΎ, ΡΡΠΎ KL-6 ΠΈ Π°Π»ΡΠ²Π΅ΠΎΠ»ΠΎΠΌΡΡΠΈΠ½ ΡΠ²Π»ΡΡΡΡΡ Π±ΠΎΠ»Π΅Π΅ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠ²Π½ΡΠΌΠΈ ΠΌΠ°ΡΠΊΠ΅ΡΠ°ΠΌΠΈ Π΄Π»Ρ ΠΎΡΠ΅Π½ΠΊΠΈ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠΊΠ·ΠΎΠ³Π΅Π½Π½ΡΡ
ΡΠΈΠ±ΡΠΎΠ·ΠΈΡΡΡΡΠΈΡ
Π°Π»ΡΠ²Π΅ΠΎΠ»ΠΈΡΠΎΠ² ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Ρ Π‘Π‘16. ΠΠ»ΡΠ²Π΅ΠΎΠ»ΠΎΠΌΡΡΠΈΠ½ ΠΎΠ±Π»Π°Π΄Π°Π΅Ρ Π±ΠΎΠ»Π΅Π΅ Π²ΡΡΠΎΠΊΠΎΠΉ ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡΡΡ, Π½ΠΎ ΠΌΠ΅Π½ΡΡΠ΅ΠΉ ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡΡ, ΡΠ΅ΠΌ KL-6, ΠΈ ΠΌΠΎΠΆΠ΅Ρ ΠΏΡΠΈΠΌΠ΅Π½ΡΡΡΡΡ Π΄Π»Ρ ΡΠΊΡΠΈΠ½ΠΈΠ½Π³ΠΎΠ²ΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΏΡΠΈ ΠΏΠΎΠ΄ΠΎΠ·ΡΠ΅Π½ΠΈΠΈ Π½Π° ΡΠΊΠ·ΠΎΠ³Π΅Π½Π½ΡΠ΅ Π°Π»ΡΠ²Π΅ΠΎΠ»ΠΈΡΡ. ΠΠ»Ρ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΡΠΊΠ·ΠΎΠ³Π΅Π½Π½ΡΡ
Π°Π»Π»Π΅ΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈ ΡΠΎΠΊΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π°Π»ΡΠ²Π΅ΠΎΠ»ΠΈΡΠΎΠ² ΡΠ΅Π»Π΅ΡΠΎΠΎΠ±ΡΠ°Π·Π½ΠΎ ΠΌΠΎΠ½ΠΈΡΠΎΡΠΈΡΠΎΠ²Π°ΡΡ ΡΡΠΎΠ²Π΅Π½Ρ KL-6 ΠΈ Π°Π»ΡΠ²Π΅ΠΎΠ»ΠΎΠΌΡΡΠΈΠ½Π° ΡΡΠ²ΠΎΡΠΎΡΠΊΠΈ ΠΊΡΠΎΠ²ΠΈ
CHARACTERISTICS OF AUTOIMMUNE INFLAMMATION IN THE PATIENTS WITH LUNG TUBERCULOSIS
Tuberculosis is a granulomatous disease caused by Mycobacterium tuberculosis, being characterized by the development of caseous granulomas in various organs, mainly in lungs. M. tuberculosis is known to be a trigger for autoimmune inflammation, due to the possible mimicry of bacterial proteins as autoantigens. Recently, a significance of mesenchymal vimentin as an autoantigen in mycobacterial infections has been actively discussed. The aim of the present study was to determine autoantibodies for various vimentin modifications in the patients with tuberculosis.The study was performed in 2014-2017 and included 28 patients with pulmonary tuberculosis (group I), 30 patients with nonspecific lung diseases (group II): 15 with granulomatous polyangiitis, and 15 with different alveolites. Control group consisted of healthy subjects (n = 40). Concentration of antibodies to mutated citrullinated vimentin (anti-MCV) was measured using ELISA (ORGENTEC, Germany). The patients with elevated anti-MCV levels were tested for antibodies to cyclic citrullinated peptide (anti-CCP) using ELISA technique (EUROIMMUN, Germany). Statistical analysis was carried out using GraphPad Prism 6 (GraphPad Software, USA), Statistica 10 (Statsoft, USA) using nonparametric analysis of samples with Mann-Whitney and Chi-square criteria, and Spearman method for correlation analysis. The differences were considered statistically significant at p < 0.05.The anti-MCV concentrations were significantly higher in patients with tuberculosis (group I, 60.7% of cases, 17/28) than in group II, and control group (23.6 and 25.0% of cases, respectively). No statistically significant differences were revealed between the results of anti-MVC and anti-CCP levels in comparison group with the control group (p = 0.18).High levels of anti-MCV antibodies in the patients with pulmonary tuberculosis reflect an opportunity of developing autoimmune process in the disease pathogenesis. Measurement of plasma anti-MCV antibody concentrations may be important for correction of the therapy, especially upon administration of immunosuppressive and hormonal corticosteroid drugs. It has been shown that anti-CCP are not characteristic to the lung diseases
Balloon Dilatation of Esophageal Strictures in Children With Bullous Epidermolysis: Description of Case Series
Esophageal strictures are the most common complications of bullous epidermolysis in children. Strictures cause the developmentΒ of dysphagia that prevents oral alimentation and receipt of an adequate amount of nutrients that is accompanied by a violation ofΒ nutritional status, weight loss, and delayed physical development of a child. Disturbed swallowing can also cause aspiration syndrome,Β pneumonia, and airway obstruction. To eliminate dysphagia and reduce the risk of complications, it is necessary to restore esophagealΒ patency. The article describes the results of X-ray with assisted balloon dilatation in 19 children with bullous epidermolysis andΒ dysphagia. It is shown that this method of esophagus recanalization allows to effectively and safely restore oral alimentation of childrenΒ already in the first day after intervention with a gradual expansion of the diet
ΠΠΠΠΠΠΠΠΠ‘Π’Π ΠΠΠΠΠ Π‘Π’ΠΠΠΠΠΠ Π’ΠΠ ΠΠΠΠ ΠΠΠΠ ΠΠΠΠ-ΠΠΠΠΠ’ΠΠΠΠΠΠ Π ΠΠΠ ΠΠΠΠΠ§ΠΠΠ ΠΠΠΠΠΠ«
There are some types of breast cancer (BC) that depend on their molecular characteristics. However, latelyΒ researchers provide date regarding the presence of additional receptors of triple negative breast cancerΒ (TNBC). One of them is LA R-subtype that has androgen receptors (AR) on breast cancer cells. The role ofΒ AR in the development of this pathology is still controversial. According to some authors, stimulation of ARΒ leads to the proliferation suppression, in the opinion of others β to the activation and potentiation of tumorΒ invasion. There is also a version of the dichotomous effect of androgens that depends on the concentrationΒ of this hormone. The various effects of LA R-subtype therapy of BC are also explained by the presence ofΒ many other regulator proteins that interact with AR. The first attempts to treat BC with androgen have begunΒ since the 40s of the last century, but in those years it did not have the desired effect and was not used untilΒ recently. Currently, the basic mechanisms of the effect of androgens on BC cells on the molecular level areΒ known, and researches try to use androgen therapy, also in combination with aromatase inhibitors to increaseΒ the concentration of endogenous testosterone. The effects of selective androgen receptor modulators andΒ anabolic steroids are being studied. However, in the last decade, the largest number of studies focused onΒ the study of anti-androgen therapy. Patients receive AR antagonists, such as enzalutamide, bicalutamide,Β that are prescribed for prostate cancer. Enzalutamide blocks both androgen- and estrogen-mediated tumorΒ growth, and therefore can be used regardless of the presence of estrogen receptors (ER), in contrast toΒ bicalutamide. The results showed a significant increase in disease free survival up to 16.5 months in patientsΒ with hormone positive BC.Π‘ΡΡΠ΅ΡΡΠ²ΡΠ΅Ρ Π½Π΅ΡΠΊΠΎΠ»ΡΠΊΠΎ ΡΠΈΠΏΠΎΠ² ΡΠ°ΠΊΠ° ΠΌΠΎΠ»ΠΎΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ (Π ΠΠ) Π² Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ ΠΈΡ
ΠΌΠΎΠ»Π΅ΠΊΡΠ»ΡΡΠ½ΡΡ
Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊ. Π ΠΏΠΎΡΠ»Π΅Π΄Π½ΠΈΡ
ΠΏΡΠ±Π»ΠΈΠΊΠ°ΡΠΈΡΡ
ΠΌΠΈΡΠΎΠ²ΠΎΠΉ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ ΠΏΡΠΈΠ²ΠΎΠ΄ΡΡΡΡ Π΄Π°Π½Π½ΡΠ΅ ΠΎ Π½Π°Π»ΠΈΡΠΈΠΈ Π΄ΠΎΠΏΠΎΠ»Π½ΠΈΡΠ΅Π»ΡΠ½ΡΡ
Β ΠΏΠΎΠ΄ΡΠΈΠΏΠΎΠ² ΡΡΠΎΠΉΠ½ΠΎΠ³ΠΎ Π½Π΅Π³Π°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π ΠΠ. ΠΠ΄Π½ΠΈΠΌ ΠΈΠ· Π½ΠΈΡ
ΡΠ²Π»ΡΠ΅ΡΡΡ laR-ΠΏΠΎΠ΄ΡΠΈΠΏ, ΠΊΠΎΡΠΎΡΡΠΉ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΡΠ΅ΡΡΡΒ Π½Π°Π»ΠΈΡΠΈΠ΅ΠΌ Π°Π½Π΄ΡΠΎΠ³Π΅Π½ΠΎΠ²ΡΡ
ΡΠ΅ΡΠ΅ΠΏΡΠΎΡΠΎΠ² (ΠΠ ). Π ΠΎΠ»Ρ ΠΠ Π² ΡΠ°Π·Π²ΠΈΡΠΈΠΈ Π ΠΠ Π΄ΠΎ ΡΠΈΡ
ΠΏΠΎΡ ΠΎΡΡΠ°Π΅ΡΡΡ ΡΠΏΠΎΡΠ½ΠΎΠΉ. ΠΠΎΒ ΠΌΠ½Π΅Π½ΠΈΡ ΠΎΠ΄Π½ΠΈΡ
Π°Π²ΡΠΎΡΠΎΠ², ΡΡΠΈΠΌΡΠ»ΡΡΠΈΡ ΠΠ ΠΏΡΠΈΠ²ΠΎΠ΄ΠΈΡ ΠΊ ΠΏΠΎΠ΄Π°Π²Π»Π΅Π½ΠΈΡ ΠΏΡΠΎΠ»ΠΈΡΠ΅ΡΠ°ΡΠΈΠΈ, ΠΏΠΎ ΠΌΠ½Π΅Π½ΠΈΡΒ Π΄ΡΡΠ³ΠΈΡ
, β ΠΊΒ Π΅Π΅ Π°ΠΊΡΠΈΠ²Π°ΡΠΈΠΈ ΠΈ ΠΏΠΎΡΠ΅Π½ΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΈΠ½Π²Π°Π·ΠΈΠΈ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ. Π‘ΡΡΠ΅ΡΡΠ²ΡΠ΅Ρ Π²Π΅ΡΡΠΈΡ ΠΎ Π΄ΠΈΡ
ΠΎΡΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠΌ ΡΡΡΠ΅ΠΊΡΠ΅Β Π°Π½Π΄ΡΠΎΠ³Π΅Π½ΠΎΠ² Π² Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΠΈ Π³ΠΎΡΠΌΠΎΠ½Π°. Π’Π°ΠΊΠΆΠ΅ Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΠ΅ ΡΡΡΠ΅ΠΊΡΠ° ΡΠ΅ΡΠ°ΠΏΠΈΠΈ laRΠΏΠΎΠ΄ΡΠΈΠΏΠ° Π·Π°Π²ΠΈΡΠΈΡ ΠΎΡ ΠΌΠ½ΠΎΠΆΠ΅ΡΡΠ²Π° Π΄ΡΡΠ³ΠΈΡ
Π±Π΅Π»ΠΊΠΎΠ²- ΡΠ΅Π³ΡΠ»ΡΡΠΎΡΠΎΠ², Π²Π·Π°ΠΈΠΌΠΎΠ΄Π΅ΠΉΡΡΠ²ΡΡΡΠΈΡ
Ρ ΠΠ . Π 1940-Ρ
Π³Π³.Β ΠΏΡΠΎΡΠ»ΠΎΠ³ΠΎ Π²Π΅ΠΊΠ° Π±ΡΠ»ΠΈ ΠΏΡΠ΅Π΄ΠΏΡΠΈΠ½ΡΡΡ ΠΏΠ΅ΡΠ²ΡΠ΅ ΠΏΠΎΠΏΡΡΠΊΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ Π ΠΠ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ°ΠΌΠΈ Π°Π½Π΄ΡΠΎΠ³Π΅Π½ΠΎΠ²ΠΎΠ³ΠΎ ΡΡΠ΄Π°,Β ΠΎΠ΄Π½Π°ΠΊΠΎ Π±Π΅Π· Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΡΡΡΠ΅ΠΊΡΠ°, Π² ΡΠ²ΡΠ·ΠΈ Ρ ΡΠ΅ΠΌ ΠΎΠ½ΠΈ Π±ΠΎΠ»ΡΡΠ΅ Π½Π΅ ΠΏΡΠΈΠΌΠ΅Π½ΡΠ»ΠΈΡΡ Π΄ΠΎ Π½Π°ΡΠ°Π»Π° XXi Π²Π΅ΠΊΠ°.Β Π Π½Π°ΡΡΠΎΡΡΠ΅Π΅ Π²ΡΠ΅ΠΌΡ ΠΈΠ·Π²Π΅ΡΡΠ½Ρ ΠΎΡΠ½ΠΎΠ²Π½ΡΠ΅ ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΡ Π΄Π΅ΠΉΡΡΠ²ΠΈΡ Π°Π½Π΄ΡΠΎΠ³Π΅Π½ΠΎΠ² Π½Π° ΠΊΠ»Π΅ΡΠΊΠΈ Π ΠΠ. Π ΡΠ°ΠΌΠΊΠ°Ρ
Β Π½Π°ΡΡΠ½ΡΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΠΏΡΠ΅Π΄ΠΏΡΠΈΠ½ΠΈΠΌΠ°ΡΡΡΡ ΠΏΠΎΠΏΡΡΠΊΠΈ Π°Π½Π΄ΡΠΎΠ³Π΅Π½ΠΎΠ²ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ, Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅ Π² ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΠΈ ΡΒ ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΡΠ°ΠΌΠΈ Π°ΡΠΎΠΌΠ°ΡΠ°Π·Ρ Ρ ΡΠ΅Π»ΡΡ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΡ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΠΈ ΡΠ½Π΄ΠΎΠ³Π΅Π½Π½ΠΎΠ³ΠΎ ΡΠ΅ΡΡΠΎΡΡΠ΅ΡΠΎΠ½Π°. ΠΠ·ΡΡΠ°ΡΡΡΡΒ ΡΡΡΠ΅ΠΊΡΡ ΡΠ΅Π»Π΅ΠΊΡΠΈΠ²Π½ΡΡ
ΠΌΠΎΠ΄ΡΠ»ΡΡΠΎΡΠΎΠ² ΡΠ΅ΡΠ΅ΠΏΡΠΎΡΠΎΠ² Π°Π½Π΄ΡΠΎΠ³Π΅Π½ΠΎΠ² ΠΈ Π°Π½Π°Π±ΠΎΠ»ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΡΠ΅ΡΠΎΠΈΠ΄ΠΎΠ². ΠΠ΄Π½Π°ΠΊΠΎ Π² ΠΏΠΎΡΠ»Π΅Π΄Π½Π΅Π΅ Π΄Π΅ΡΡΡΠΈΠ»Π΅ΡΠΈΠ΅Β Π½Π°ΠΈΠ±ΠΎΠ»ΡΡΠ΅Π΅ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½ΠΎ Π½Π° ΠΈΠ·ΡΡΠ΅Π½ΠΈΠ΅ Π°Π½ΡΠΈΠ°Π½Π΄ΡΠΎΠ³Π΅Π½ΠΎΠ²ΠΎΠΉΒ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π°Π½ΡΠ°Π³ΠΎΠ½ΠΈΡΡΠ°ΠΌΠΈ ΠΠ , ΡΠ°ΠΊΠΈΠΌΠΈ ΠΊΠ°ΠΊ ΡΠ½Π·Π°Π»ΡΡΠ°ΠΌΠΈΠ΄ ΠΈ Π±ΠΈΠΊΠ°Π»ΡΡΠ°ΠΌΠΈΠ΄. ΠΡΠΈ ΡΡΠΎΠΌ ΡΠ½Π·Π°Π»ΡΡΠ°ΠΌΠΈΠ΄ Π±Π»ΠΎΠΊΠΈΡΡΠ΅ΡΒ ΠΊΠ°ΠΊ Π°Π½Π΄ΡΠΎΠ³Π΅Π½-, ΡΠ°ΠΊ ΠΈ ΡΡΡΡΠΎΠ³Π΅Π½-ΠΎΠΏΠΎΡΡΠ΅Π΄ΠΎΠ²Π°Π½Π½ΡΠΉ ΡΠΎΡΡ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ, Π² ΡΠ²ΡΠ·ΠΈ Ρ ΡΠ΅ΠΌ ΠΌΠΎΠΆΠ΅Ρ ΠΏΡΠΈΠΌΠ΅Π½ΡΡΡΡΡ Π²Π½Π΅ Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ Π½Π°Π»ΠΈΡΠΈΡ ΡΡΡΡΠΎΠ³Π΅Π½ΠΎΠ²ΡΡ
Β ΡΠ΅ΡΠ΅ΠΏΡΠΎΡΠΎΠ² (Π Π) Π² ΠΎΡΠ»ΠΈΡΠΈΠ΅ ΠΎΡ Π±ΠΈΠΊΠ°Π»ΡΡΠ°ΠΌΠΈΠ΄Π°. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΎΠ΄Π½ΠΎΠ³ΠΎΒ ΠΈΠ· ΠΊΡΡΠΏΠ½Π΅ΠΉΡΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΡΠ½Π·Π°Π»ΡΡΠ°ΠΌΠΈΠ΄Π° Π² ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΠΈ Ρ ΡΠΊΠ·Π΅ΠΌΠ΅ΡΡΠ°Π½ΠΎΠΌ ΠΏΠΎΠΊΠ°Π·ΡΠ²Π°ΡΡ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠ΅Β ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ Π±Π΅Π· ΠΏΡΠΎΠ³ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΊ Ρ Π³ΠΎΡΠΌΠΎΠ½-ΠΏΠΎΠ·ΠΈΡΠΈΠ²Π½ΡΠΌ Π ΠΠ β Π΄ΠΎ 16,5 ΠΌΠ΅ΡΒ (ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Ρ 4,3 ΠΌΠ΅Ρ Π² ΠΊΠΎΠ½ΡΡΠΎΠ»ΡΠ½ΠΎΠΉ Π³ΡΡΠΏΠΏΠ΅)
ΠΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½Π°Ρ ΠΎΡΠ΅Π½ΠΊΠ° ΡΠ΅ΡΠ΅Π²ΠΎΠ³ΠΎ ΡΠ°Π·Π²ΠΈΡΠΈΡ Π΄Π΅ΡΠ΅ΠΉ, Π·Π°ΡΠ°ΡΡΡ Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΡΠΊΡΡΡΠ°ΠΊΠΎΡΠΏΠΎΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΎΠΏΠ»ΠΎΠ΄ΠΎΡΠ²ΠΎΡΠ΅Π½ΠΈΡ
Introduction. The high frequency of the use of assisted reproductive technologies and the inconsistency of information about the parameters of the cognitive development of IVF children determined the formulation of the research problem.The purpose of the work is to assess the originality of the speech development of children and adolescents conceived using the IVF procedure. The age of the children at the time of the survey was from 5 to 15 years.Methods and materials. A sample of 51 children (29 boys), mean age (7.9Β±2.8) years, 14 children had psychiatric diagnoses (ASD, mental retardation, etc.). Research methods: speech therapy assessment of speech development, neuropsychological diagnostics according to L.S. Tsvetkova, WICS, descriptive statistics, correlation analysis.Results. 41% of children had mild variants of speech development delay under 3 years old, 59 % of children had normal speech development. With age, the frequency of detected deviations in speech development decreases, so that in older age group (from 11 to 15 years old), 85 % have normotypical development of speech. Correlation analysis showed the originality of the correlations of the parameters of speech development, neuropsychological assessment, and scores on Wechsler subtests.Conclusions. An unambiguous conclusion about the violation of speech development in children conceived by IVF cannot be drawn, however, in the presence of mental pathology and taking into account the age of the mother and the number of ART procedures, attention should be paid to the provision of speech therapy and neuropsychological correction from an early age.ΠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅. ΠΡΡΠΎΠΊΠ°Ρ ΡΠ°ΡΡΠΎΡΠ° ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ Π²ΡΠΏΠΎΠΌΠΎΠ³Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΡΠ΅ΠΏΡΠΎΠ΄ΡΠΊΡΠΈΠ²Π½ΡΡ
ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΉ (ΠΠ Π’) ΠΈ ΠΏΡΠΎΡΠΈΠ²ΠΎΡΠ΅ΡΠΈΠ²ΠΎΡΡΡ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΈ ΠΎ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠ°Ρ
ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΡΠ°Π·Π²ΠΈΡΠΈΡ Π΄Π΅ΡΠ΅ΠΉ, Π·Π°ΡΠ°ΡΡΡ
Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΡΠΊΡΡΡΠ°ΠΊΠΎΡΠΏΠΎΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΎΠΏΠ»ΠΎΠ΄ΠΎΡΠ²ΠΎΡΠ΅Π½ΠΈΡ (ΠΠΠ) ΠΎΠΏΡΠ΅Π΄Π΅Π»ΠΈΠ»Π° ΠΏΠΎΡΡΠ°Π½ΠΎΠ²ΠΊΡ ΠΏΡΠΎΠ±Π»Π΅ΠΌΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ.Π¦Π΅Π»Ρ ΡΠ°Π±ΠΎΡΡ β ΠΎΡΠ΅Π½ΠΊΠ° ΡΠ²ΠΎΠ΅ΠΎΠ±ΡΠ°Π·ΠΈΡ ΡΠ΅ΡΠ΅Π²ΠΎΠ³ΠΎ ΡΠ°Π·Π²ΠΈΡΠΈΡ Π΄Π΅ΡΠ΅ΠΉ ΠΈ ΠΏΠΎΠ΄ΡΠΎΡΡΠΊΠΎΠ², Π·Π°ΡΠ°ΡΡΡ
Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΏΡΠΎΡΠ΅Π΄ΡΡΡ ΠΠΠ ΠΈ Π½Π°Ρ
ΠΎΠ΄ΡΡΠΈΡ
ΡΡ Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ½ΠΎΠΌ ΠΈΠ½ΡΠ΅ΡΠ²Π°Π»Π΅ ΠΎΡ 5 Π΄ΠΎ 15 Π»Π΅Ρ.ΠΠ΅ΡΠΎΠ΄Ρ ΠΈ ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ. ΠΡΠ±ΠΎΡΠΊΠ° ΠΈΠ· 51 ΡΠ΅Π±Π΅Π½ΠΊΠ° (29 ΠΌΠ°Π»ΡΡΠΈΠΊΠΎΠ²), ΡΡΠ΅Π΄Π½ΠΈΠΉ Π²ΠΎΠ·ΡΠ°ΡΡ β (7,9Β±2,8) Π³ΠΎΠ΄Π°, 14 Π΄Π΅ΡΠ΅ΠΉ ΠΈΠΌΠ΅Π»ΠΈ ΠΏΡΠΈΡ
ΠΈΠ°ΡΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Ρ (ΡΠ°ΡΡΡΡΠΎΠΉΡΡΠ²Π° Π°ΡΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠΏΠ΅ΠΊΡΡΠ°(Π ΠΠ‘), ΡΠΈΠ·ΠΎΡΠΈΠΏΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΡΠ°ΡΡΡΡΠΎΠΉΡΡΠ²ΠΎ (Π¨Π’Π ) ΠΈ Π΄Ρ.). ΠΡΠΈΠΌΠ΅Π½ΡΠ»ΠΈ Π»ΠΎΠ³ΠΎΠΏΠ΅Π΄ΠΈΡΠ΅ΡΠΊΡΡ ΠΎΡΠ΅Π½ΠΊΡ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠ΅ΡΠΈ, Π½Π΅ΠΉΡΠΎΠΏΡΠΈΡ
ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΡΡ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΡ ΠΏΠΎ Π.Π‘. Π¦Π²Π΅ΡΠΊΠΎΠ²ΠΎΠΉ, Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΡ IQ ΠΏΠΎ ΠΠ΅ΠΊΡΠ»Π΅ΡΡ, ΠΎΠΏΠΈΡΠ°ΡΠ΅Π»ΡΠ½ΡΡ ΡΡΠ°ΡΠΈΡΡΠΈΠΊΡ, ΠΊΠΎΡΡΠ΅Π»ΡΡΠΈΠΎΠ½Π½ΡΠΉ Π°Π½Π°Π»ΠΈΠ·.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π£ 41 % Π΄Π΅ΡΠ΅ΠΉ ΠΈΠΌΠ΅Π»ΠΈΡΡ Π»Π΅Π³ΠΊΠΈΠ΅ Π²Π°ΡΠΈΠ°Π½ΡΡ Π·Π°Π΄Π΅ΡΠΆΠΊΠΈ ΡΠ΅ΡΠ΅Π²ΠΎΠ³ΠΎ ΡΠ°Π·Π²ΠΈΡΠΈΡ Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ Π΄ΠΎ 3 Π»Π΅Ρ, Π½ΠΎΡΠΌΠ°ΡΠΈΠ²Π½ΠΎ ΡΠ°Π·Π²ΠΈΠ²Π°Π»Π°ΡΡ ΡΠ΅ΡΡ Ρ 59 % Π΄Π΅ΡΠ΅ΠΉ. Π‘ Π²ΠΎΠ·ΡΠ°ΡΡΠΎΠΌ ΡΠ°ΡΡΠΎΡΠ° Π²ΡΡΠ²Π»ΡΠ΅ΠΌΡΡ
ΠΎΡΠΊΠ»ΠΎΠ½Π΅Π½ΠΈΠΉ Π² ΡΠ΅ΡΠ΅Π²ΠΎΠΌ ΡΠ°Π·Π²ΠΈΡΠΈΠΈ ΠΏΠ°Π΄Π°Π΅Ρ, Π² ΡΡΠ°ΡΡΠ΅ΠΉ Π²ΠΎΠ·ΡΠ°ΡΡΠ½ΠΎΠΉ Π³ΡΡΠΏΠΏΠ΅ (ΠΎΡ 11 Π΄ΠΎ 15 Π»Π΅Ρ) Π½ΠΎΡΠΌΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠ΅ΡΠΈ Π²ΡΡΡΠ΅ΡΠ°Π»Π°ΡΡ Ρ 85 % ΠΈΡΠΏΡΡΡΠ΅ΠΌΡΡ
. ΠΠΎΡΡΠ΅Π»ΡΡΠΈΠΎΠ½Π½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΏΠΎΠΊΠ°Π·Π°Π» ΡΠ²ΠΎΠ΅ΠΎΠ±ΡΠ°Π·ΠΈΠ΅ ΠΊΠΎΡΡΠ΅Π»ΡΡΠΈΠΎΠ½Π½ΡΡ
ΠΏΠ»Π΅ΡΠ΄ Ρ Π΄Π΅ΡΠ΅ΠΉ, Π·Π°ΡΠ°ΡΡΡ
Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΠΠ, ΠΏΡΠΈ ΡΠΎΠΏΠΎΡΡΠ°Π²Π»Π΅Π½ΠΈΠΈ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΎΠ² ΡΠ΅ΡΠ΅Π²ΠΎΠ³ΠΎ ΡΠ°Π·Π²ΠΈΡΠΈΡ, Π½Π΅ΠΉΡΠΎΠΏΡΠΈΡ
ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΎΡΠ΅Π½ΠΊΠΈ, Π±Π°Π»Π»ΠΎΠ² ΠΏΠΎ ΡΡΠ±ΡΠ΅ΡΡΠ°ΠΌ ΠΠ΅ΠΊΡΠ»Π΅ΡΠ°.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠ΄Π½ΠΎΠ·Π½Π°ΡΠ½ΠΎΠ³ΠΎ Π²ΡΠ²ΠΎΠ΄Π° ΠΎ Π½Π°ΡΡΡΠ΅Π½ΠΈΠΈ ΡΠ΅ΡΠ΅Π²ΠΎΠ³ΠΎ ΡΠ°Π·Π²ΠΈΡΠΈΡ Ρ Π΄Π΅ΡΠ΅ΠΉ, ΡΠΎΠΆΠ΄Π΅Π½Π½ΡΡ
Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΠΠ, ΡΠ΄Π΅Π»Π°ΡΡ Π½Π΅Π»ΡΠ·Ρ, ΠΎΠ΄Π½Π°ΠΊΠΎ ΠΏΡΠΈ Π½Π°Π»ΠΈΡΠΈΠΈ ΠΏΡΠΈΡ
ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΈ Ρ ΡΡΠ΅ΡΠΎΠΌ Π²ΠΎΠ·ΡΠ°ΡΡΠ° ΠΌΠ°ΡΠ΅ΡΠΈ ΠΈ ΡΠΈΡΠ»Π° ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΏΡΠΎΡΠ΅Π΄ΡΡ ΠΠ Π’ ΡΠ»Π΅Π΄ΡΠ΅Ρ ΠΎΠ±ΡΠ°ΡΠΈΡΡ Π²Π½ΠΈΠΌΠ°Π½ΠΈΠ΅ Π½Π° ΠΎΠΊΠ°Π·Π°Π½ΠΈΠ΅ Π»ΠΎΠ³ΠΎΠΏΠ΅Π΄ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΈ Π½Π΅ΠΉΡΠΎΠΏΡΠΈΡ
ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΊΠΎΡΡΠ΅ΠΊΡΠΈΠΈ Ρ ΡΠ°Π½Π½Π΅Π³ΠΎ Π²ΠΎΠ·ΡΠ°ΡΡΠ°
Π§Π°ΡΡΠΈΡΠ½Π°Ρ ΠΈ ΠΏΠΎΠ»Π½Π°Ρ ΡΠΏΠΎΠ½ΡΠ°Π½Π½Π°Ρ ΡΠ΅Π³ΡΠ΅ΡΡΠΈΡ ΡΠ΅ΠΌΠΈΠ½ΠΎΠΌΡ ΡΠΈΡΠΊΠ°: ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ
Spontaneous tumour regression is a rare phenomenon in which there is a complete or partial regression of the primary tumour, clinically manifested by metastatic lesions. We report a case of a 34-year-old male with partial spontaneous regression of testicular seminoma detected by a supraclavicular lymph node biopsy. He underwent inguinal orchifunicolectomy. Based on the results of histological examination, against the background of multiple complexes of intratubular germ cell neoplasia in situ, foci of invasive growth and involution were identified, indicating a spontaneously regressing testicular tumour. We report the second case of a 52-year-old male with total spontaneous regression of testicular seminoma detected by a spermatic cord biopsy. Based on the results of histological examination, against fibrosis and proliferation of Leydig cells, there are atrophy of seminiferous tubules and complexes of intratubular germ cell neoplasia in situ in part of them.Π‘ΠΏΠΎΠ½ΡΠ°Π½Π½Π°Ρ ΡΠ΅Π³ΡΠ΅ΡΡΠΈΡ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ β ΡΠ΅Π΄ΠΊΠΎΠ΅ ΡΠ²Π»Π΅Π½ΠΈΠ΅, ΠΏΡΠΈ ΠΊΠΎΡΠΎΡΠΎΠΌ ΠΏΡΠΎΠΈΡΡ
ΠΎΠ΄ΠΈΡ ΠΏΠΎΠ»Π½Π°Ρ ΠΈΠ»ΠΈ ΡΠ°ΡΡΠΈΡΠ½Π°Ρ ΡΠ΅Π³ΡΠ΅ΡΡΠΈΡ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠΉ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ, ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈ ΠΏΡΠΎΡΠ²Π»ΡΡΡΠ΅Π΅ΡΡ ΠΌΠ΅ΡΠ°ΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΡΠΌΠΈ. Π ΡΡΠ°ΡΡΠ΅ ΠΎΠΏΠΈΡΠ°Π½Ρ 2 ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ»ΡΡΠ°Ρ. Π 1-ΠΌ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠΈ ΡΠ°ΡΡΠΈΡΠ½Π°Ρ ΡΠΏΠΎΠ½ΡΠ°Π½Π½Π°Ρ ΡΠ΅Π³ΡΠ΅ΡΡΠΈΡ ΡΠ΅ΠΌΠΈΠ½ΠΎΠΌΡ ΡΠΈΡΠΊΠ° Π²ΡΡΠ²Π»Π΅Π½Π° ΠΏΡΠΈ Π±ΠΈΠΎΠΏΡΠΈΠΈ Π½Π°Π΄ΠΊΠ»ΡΡΠΈΡΠ½ΠΎΠ³ΠΎ Π»ΠΈΠΌΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ·Π»Π°. Π£ 34-Π»Π΅ΡΠ½Π΅Π³ΠΎ ΠΌΡΠΆΡΠΈΠ½Ρ Π±ΡΠ»Π° ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° ΠΏΠ°Ρ
ΠΎΠ²Π°Ρ ΠΎΡΡ
ΠΈΡΡΠ½ΠΈΠΊΡΠ»ΡΠΊΡΠΎΠΌΠΈΡ. ΠΠΎ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ°ΠΌ Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ Π½Π° ΡΠΎΠ½Π΅ ΠΌΠ½ΠΎΠΆΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠΎΠ² Π²Π½ΡΡΡΠΈΠΊΠ°Π½Π°Π»ΡΡΠ΅Π²ΠΎΠΉ Π³Π΅ΡΠΌΠΈΠ½ΠΎΠ³Π΅Π½Π½ΠΎ-ΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠΉ Π½Π΅ΠΎΠΏΠ»Π°Π·ΠΈΠΈ Β in situ Π²ΡΡΠ²Π»Π΅Π½Ρ Π½Π΅Π±ΠΎΠ»ΡΡΠΈΠ΅ ΠΎΡΠ°Π³ΠΈ ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΠΎΠ³ΠΎ ΡΠΎΡΡΠ° ΠΈ ΠΈΠ½Π²ΠΎΠ»ΡΡΠΈΠΈ, ΡΠΊΠ°Π·ΡΠ²Π°ΡΡΠΈΠ΅ Π½Π° ΡΠΏΠΎΠ½ΡΠ°Π½Π½ΠΎ ΡΠ΅Π³ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π²ΡΡΡ ΠΎΠΏΡΡ
ΠΎΠ»Ρ ΡΠΈΡΠΊΠ°. ΠΠΎ 2-ΠΌ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΌ ΡΠ»ΡΡΠ°Π΅ ΠΏΠΎΠ»Π½Π°Ρ ΡΠΏΠΎΠ½ΡΠ°Π½Π½Π°Ρ ΡΠ΅Π³ΡΠ΅ΡΡΠΈΡ ΡΠ΅ΠΌΠΈΠ½ΠΎΠΌΡ ΡΠΈΡΠΊΠ° Π²ΡΡΠ²Π»Π΅Π½Π° ΠΏΡΠΈ Π±ΠΈΠΎΠΏΡΠΈΠΈ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠ°Ρ
ΠΎΠ²ΠΎΠ³ΠΎ ΠΊΠ°Π½Π°ΡΠΈΠΊΠ° Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° 52 Π»Π΅Ρ. ΠΠΎ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ°ΠΌ Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π»Π°, ΠΏΠΎΠ»ΡΡΠ΅Π½Π½ΠΎΠ³ΠΎ ΠΏΡΠΈ ΠΏΠ°Ρ
ΠΎΠ²ΠΎΠΉ ΠΎΡΡ
ΠΈΡΡΠ½ΠΈΠΊΡΠ»ΡΠΊΡΠΎΠΌΠΈΠΈ, Π² ΡΠΊΠ°Π½ΠΈ ΡΠΈΡΠΊΠ° Π½Π° ΡΠΎΠ½Π΅ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΠΎΠ³ΠΎ ΡΠΈΠ±ΡΠΎΠ·Π° ΡΡΡΠΎΠΌΡ Ρ ΠΏΡΠΎΠ»ΠΈΡΠ΅ΡΠ°ΡΠΈΠ΅ΠΉ ΠΊΠ»Π΅ΡΠΎΠΊ ΠΠ΅ΠΉΠ΄ΠΈΠ³Π° ΠΎΡΠΌΠ΅ΡΠ°Π»ΠΈΡΡ Π°ΡΡΠΎΡΠΈΡΠ½ΡΠ΅ ΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ ΠΊΠ°Π½Π°Π»ΡΡΡ, Π² ΡΠ°ΡΡΠΈ ΠΊΠΎΡΠΎΡΡΡ
ΠΈΠΌΠ΅Π»ΠΈΡΡ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΡ Π²Π½ΡΡΡΠΈΠΊΠ°Π½Π°Π»ΡΡΠ΅Π²ΠΎΠΉ Π³Π΅ΡΠΌΠΈΠ½ΠΎΠ³Π΅Π½Π½ΠΎ-ΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠΉ Π½Π΅ΠΎΠΏΠ»Π°Π·ΠΈΠΈ in situ
ΠΠ°ΡΡΠΈΠ½ΠΎΡΠ°ΡΠΊΠΎΠΌΠ° ΠΏΡΠ΅Π΄ΡΡΠ°ΡΠ΅Π»ΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ: ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠ΅ ΠΈ ΠΎΠ±Π·ΠΎΡ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ
Carcinosarcoma is a rare type of prostate neoplasms and accounts for less than 1 % of all malignant tumors of the prostate.Β This kind of tumor is characterized by the absence of prostate-specific antigen elevation in most cases, which leads to diagnosis of metastatic disease in a quarter of patients.Β Moreover, carcinosarcoma of the prostate has an extremely poor clinical prognosis. From the morphological point of a view, biphasicity is a typical feature for these tumors. As a rule, epithelial component is represented by poorly differentiated acinar adenocarcinoma. However, in some literature cases adenogenous component was represented by ductal or neuroendocrine carcinoma. Sarcoma component can be represented by any sarcoma type. Currently, pathogenesis of carcinosarcomas isnβt clear. In this report, we describe a clinical case of carcinosarcoma of the prostate in a 72-year-old male.ΠΠ°ΡΡΠΈΠ½ΠΎΡΠ°ΡΠΊΠΎΠΌΠ° ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΠ΅Π΄ΠΊΠΈΠΌ ΡΠΈΠΏΠΎΠΌ Π½Π΅ΠΎΠΏΠ»Π°Π·ΠΈΠΈ Ρ ΡΠ°ΡΡΠΎΡΠΎΠΉ Π²ΡΡΡΠ΅ΡΠ°Π΅ΠΌΠΎΡΡΠΈ ΠΌΠ΅Π½Π΅Π΅ 1 % ΡΡΠ΅Π΄ΠΈ Π²ΡΠ΅Ρ
Π·Π»ΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ ΠΏΡΠ΅Π΄ΡΡΠ°ΡΠ΅Π»ΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ. ΠΠ°Π½Π½ΡΠΉ ΡΠΈΠΏ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ Π² Π±ΠΎΠ»ΡΡΠΈΠ½ΡΡΠ²Π΅ ΡΠ»ΡΡΠ°Π΅Π² ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΡΠ΅ΡΡΡ ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ΠΌ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΡ ΡΡΠΎΠ²Π½Ρ ΠΏΡΠΎΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°Π½ΡΠΈΠ³Π΅Π½Π°, Ρ ΡΠ΅ΠΌ ΡΠ°ΡΡΠΎ ΡΠ²ΡΠ·ΡΠ²Π°ΡΡ Π½Π°Π»ΠΈΡΠΈΠ΅ Ρ ΡΠ΅ΡΠ²Π΅ΡΡΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΌΠ΅ΡΠ°ΡΡΠ°Π·ΠΎΠ² Π½Π° ΠΌΠΎΠΌΠ΅Π½Ρ ΠΏΠΎΡΡΠ°Π½ΠΎΠ²ΠΊΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π°. ΠΠ°ΡΡΠΈΠ½ΠΎΡΠ°ΡΠΊΠΎΠΌΠ° ΠΏΡΠ΅Π΄ΡΡΠ°ΡΠ΅Π»ΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ ΠΈΠΌΠ΅Π΅Ρ ΠΊΡΠ°ΠΉΠ½Π΅ Π½Π΅Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΡΠΉ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΏΡΠΎΠ³Π½ΠΎΠ·. Π‘ ΠΌΠΎΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΎΡΠΊΠΈ Π·ΡΠ΅Π½ΠΈΡ Π΄Π»Ρ Π΄Π°Π½Π½ΠΎΠ³ΠΎ ΡΠΈΠΏΠ° ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠ½Π° Π±ΠΈΡΠ°Π·Π½ΠΎΡΡΡ. ΠΠΏΠΈΡΠ΅Π»ΠΈΠ°Π»ΡΠ½ΡΠΉ ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½Ρ, ΠΊΠ°ΠΊ ΠΏΡΠ°Π²ΠΈΠ»ΠΎ, ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ Π½ΠΈΠ·ΠΊΠΎΠ΄ΠΈΡΡΠ΅ΡΠ΅Π½ΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ Π°ΡΠΈΠ½Π°ΡΠ½ΠΎΠΉ Π°Π΄Π΅Π½ΠΎΠΊΠ°ΡΡΠΈΠ½ΠΎΠΌΠΎΠΉ. ΠΠ΄Π½Π°ΠΊΠΎ Π² Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΠ΅ ΡΠ°ΠΊΠΆΠ΅ ΠΎΠΏΠΈΡΠ°Π½Ρ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ, Π² ΠΊΠΎΡΠΎΡΡΡ
Π°Π΄Π΅Π½ΠΎΠ³Π΅Π½Π½ΡΠΉ ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½Ρ Π±ΡΠ» ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ ΠΏΡΠΎΡΠΎΠΊΠΎΠ²ΠΎΠΉ ΠΈΠ»ΠΈ Π½Π΅ΠΉΡΠΎΡΠ½Π΄ΠΎΠΊΡΠΈΠ½Π½ΠΎΠΉ ΠΊΠ°ΡΡΠΈΠ½ΠΎΠΌΠΎΠΉ. Π‘Π°ΡΠΊΠΎΠΌΠ°ΡΠΎΠΈΠ΄Π½ΡΠΉ ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½Ρ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ ΠΌΠΎΠΆΠ΅Ρ Π±ΡΡΡ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ Π»ΡΠ±ΡΠΌ ΡΠΈΠΏΠΎΠΌ ΡΠ°ΡΠΊΠΎΠΌΡ. ΠΠ° ΡΠ΅Π³ΠΎΠ΄Π½ΡΡΠ½ΠΈΠΉ Π΄Π΅Π½Ρ ΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅Π· ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΊΠ°ΡΡΠΈΠ½ΠΎΡΠ°ΡΠΊΠΎΠΌ ΠΎΡΡΠ°Π΅ΡΡΡ Π½Π΅ΡΡΠ½ΡΠΌ. Π Π½Π°ΡΡΠΎΡΡΠ΅ΠΉ ΡΡΠ°ΡΡΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠ΅ ΠΊΠ°ΡΡΠΈΠ½ΠΎΡΠ°ΡΠΊΠΎΠΌΡ ΠΏΡΠ΅Π΄ΡΡΠ°ΡΠ΅Π»ΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° 72 Π»Π΅Ρ
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