The Markers Of Bone Metabolism And System Inflammation In Patients With Osteoarthritis Depending On Body Mass, The Influence Of Symptomatic Slow Acting Drugs

Aim. To assess the levels of markers of the bone synthesis and system inflammation in patients with osteoarthritis (OA) in combination with obesity and their dynamic under the influence of basic treatment.Materials and methods. The research included 40 women with OA, 46–78 years old (mean age – 59,8±1,5 years). Duration of the disease varied from 3 to 36 years (mean duration – 10,0±1,1 years). Mean body mass index (BMI) among patients was 30,6±0,7 [22,3; 39,5]kg/m2, according to which patients were divided in 3 groups: patients with OA without obesity (n=17), patients with OA with 1 degree of obesity (n=14), patients with OA with 2 degree of obesity (n=9). The level of osteochondral metabolism was assessed using quantitative measuring of the levels of procollagen IC-terminal propeptide (РІСР), (Cloud-CloneCorp. “procollagen IC-Terminal Propeptide”, USA) and osteocalcin (Roche Diagnostics «N-MID Osteocalcin», Switzerland) on analyzer «ELECSYS 2010» by the method of immune-enzyme analysis; the level of the system inflammation was assessed by the level of C-reactive protein (CRP) by the method of immunoturbidimetry. The clinical efficacy was assessed by the dynamics of intensity levels of pain syndromes at physical load and at rest by the visual-analogue scale (VAS). The measuring of РІСР, osteocalcin and CRP levels and also the assessment of clinical efficacy as to the decrease of pain syndrome were carried out twice – at the beginning and at the end of observation. The period of observation is 2 months.Results. The presence of direct correlation between РІСР and BMI (r=0,62; р=0,008) among patients with OA in combination with the normal body weight was established at the research, whereas among patients with OA in combination with obesity the analogous correlation was demonstrated between SRP and BMI (r=0,43; р=0,04) on the background of correlation of PICP and OC levels (r=0,46; р=0,03).Obesity in patients with OA was associated with the reliably higher levels of pain at both rest and physical load from the side of knee joints, with maximal intensity of the pain syndrome among patients with OA and 1 degree of obesity.Statistical analysis did not reveal the reliable dependence of РІСР and OC in patients with OA from the initial CRP level on the background of tendency to the higher РІСР level and lower OC level among patients with initially increased CRP level comparing with ones with normal CRP level. The therapy with basic preparations at OA during 2 months among patients with OA with increased CRP level led to the reliable decrease of РІСР level (р=0,0076) and the tendency to increase of OC level (р˃0,05), without the reliably significant difference between the initial and final РІСР and OC levels among patients with OA and normal CRP level.At the end of observation period the maximal analgesic effect was demonstrated as to the articulate pain at rest from the side of knee joints (р˂0,001) among patients with OA, who received diacerein, with clinically comparable effect from the side of other aticulate zones (р˂0,05), that was associated with reliable decrease of CRP level (р=0,013).Discussion. The received results testify that the control of the system inflammation level at OA is a target not only relative to the decrease of pain syndrome but also conditions the stable state of subchondral bone (SCB), providing the compensation of processes of destruction and synthesis in bone tissue. The significance of procollagen IC-terminal propeptide (РІСР) and osteocalcin (OC) as the markers of bone synthesis that are able to reflect metabolic processes in SCB at OA, and also the discordant influence of CRP level on PICP level at the relative stability of OC level were demonstrated at the research.The received results allow consider the inflammatory process at OA as a target for preservance of the bone tissue, conditioning the expedience of taking into account the ability of OA basic preparations to realize the control influence on the level of system inflammation. Diacerein that in ESCEO recommendations (2014) is related to the preparations of the 1 step of treatment of patients with OA provides the control on inflammation and stability of osteocalcin level that testifies to the balance of catabolic processes in SCB.Conclusions. At OA the levels of procollagen IC-terminal propeptide (РІСР) and osteocalcin (OC) were not associated with obesity and did not depend on the initial CRP level at the presence of correlation between РІСР level and BMI among patients with OA with the normal body weight and BMI and CRP level among patients with OA in combination with obesity.The absence of reliable dynamics from РІСР side and maintenance of the stable OC level on the background of the reliable anti-inflammatory effect at using diacerein in patients with OA can testify to the compensatory adequacy of reparation processes in SCB

Labour Safety

ОХРАНА ТРУД

Laboratory classes on environmental medicine

ПОСОБИЯЛАБОРАТОРНЫЕ РАБОТЫЭКОЛОГИЯЭКОЛОГИЧЕСКАЯ МЕДИЦИНАМЕДИЦИНАОКРУЖАЮЩАЯ СРЕДА И ЗДРАВООХРАНЕНИЕОКРУЖАЮЩЕЙ СРЕДЫ ЗАГРЯЗНЕНИЕОКРУЖАЮЩЕЙ СРЕДЫ ВОЗДЕЙСТВИЕ, БОЛЕЗНИОКРУЖАЮЩЕЙ СРЕДЫ МОНИТОРИНГВ пособии содержатся лабораторные занятия по экологической медицине

Laboratory classes on environmental medicine

ПОСОБИЯЛАБОРАТОРНЫЕ РАБОТЫЭКОЛОГИЯЭКОЛОГИЧЕСКАЯ МЕДИЦИНАМЕДИЦИНАОКРУЖАЮЩАЯ СРЕДА И ЗДРАВООХРАНЕНИЕОКРУЖАЮЩЕЙ СРЕДЫ ЗАГРЯЗНЕНИЕОКРУЖАЮЩЕЙ СРЕДЫ ВОЗДЕЙСТВИЕ, БОЛЕЗНИОКРУЖАЮЩЕЙ СРЕДЫ МОНИТОРИНГВ пособии содержатся лабораторные занятия по экологической медицине

Laboratory classes on hygiene

ГИГИЕНАЛАБОРАТОРНЫЕ ЗАНЯТИЯГИГИЕНА ПИТАНИЯГИГИЕНА ПОМЕЩЕНИЙПОСОБИЯИНОСТРАННЫЕ СТУДЕНТЫЛабораторные занятия предназначены для иностранных студентов и включают 35 тем по гигиене

Environmental medicine

ПОСОБИЯЭКОЛОГИЯЭКОЛОГИЧЕСКАЯ МЕДИЦИНАМЕДИЦИНАОКРУЖАЮЩАЯ СРЕДА И ЗДРАВООХРАНЕНИЕОКРУЖАЮЩЕЙ СРЕДЫ ЗАГРЯЗНЕНИЕОКРУЖАЮЩЕЙ СРЕДЫ ВОЗДЕЙСТВИЕ, БОЛЕЗНИПИЩЕВЫХ ПРОДУКТОВ ЗАГРЯЗНЕНИЕВ пособии освещены вопросы влияния загрязнения окружающей среды на здоровье человека

Radiation medicine

ПОСОБИЯРАДИАЦИОННАЯ ГИГИЕНАTUTORIALRADIATION MEDICINEThe content of the tutorial "Radiation medicine" for students of high medical educational establishments corresponds with the basic educational plan and program, proved by Ministry of Health Care of the Republic of Belarus. The tutorial is prepared for students of medical, pharmaceutical, stomatological, medical-preventive, medical-diagnostic faculties of institutes of higher education. Соответствует основному учебному плану и программе, утвержденным Министерством здравоохранения Республики Беларусь. Для студентов медицинских, фармацевтических, стоматологических, лечебно-профилактических, лечебно-диагностических факультетов высших учебных заведений

Ionization constants and structure of seven- and eight-membered cyclic phosphorous acid derivatives

The spectral characteristics and ionization constants of some five-, seven-, and eight-membered cyclic arylenephosphorous acids were determined, and a conclusion regarding the effect of the size of the ring on the tautomerism of these compounds was made on their basis. © 1978 Plenum Publishing Corporation

Temperature effects in low-frequency Raman spectra of corticosteroid hormones

Experimental Raman spectra of the corticosteroid hormones corticosterone and desoxycorticosterone are recorded at different temperatures (in the range of 30–310 K) in the region of low-frequency (15–120 cm−1) vibrations using a solid-state laser at 532.1 nm. The intramolecular vibrations of both hormones are interpreted on the basis of Raman spectra calculated by the B3LYP/6-31G(d) density functional theory method. The intermolecular bonds in tetramers of hormones are studied with the help of the topological theory of Bader using data of X-ray structural analysis for crystalline samples of hormones. The total energy of intermolecular interactions in the tetramer of desoxycorticosterone (−49.1 kJ/mol) is higher than in the tetramer of corticosterone (−36.9 kJ/mol). A strong intramolecular hydrogen bond O21-H⋯O=C20 with an energy of −42.4 kJ/mol was revealed in the corticosterone molecule, which is absent in the desoxycorticosterone molecule. This fact makes the Raman spectra of both hormones somewhat different. It is shown that the low-frequency lines in the Raman spectra are associated with skeletal vibrations of molecules and bending vibrations of the substituent at the C17 atom. The calculated Raman spectrum of the desoxycorticosterone dimer allows one to explain the splitting and shift of some lines and to interpret new strong lines observed in the spectra at low temperatures, which are caused by the intermolecular interaction and mixing of normal vibrations in a crystal cell. On the whole the calculated frequencies are in a good agreement with the experimental results

Clinical case of community-aquaired pneumonia on the background of previously undiagnosed occupational pulmonary fibrosis. Is occupational history important?

Interstitial lung disease is a systemic concept, which is understood as a group of progressive diseases, characterized by non-infectious inflammation in the wall of the alveoli and interstitial lung tissue and may result in pulmonary fibrosis. The publication deals with the clinical case of community-acquired pneumonia on the background of previously undiagnosed occupational pulmonary fibrosis. The complaints, anamnesis, clinical and instrumental data have been analyzed, special attention is paid to the professional history, which indicates long-term contact with toxic substances and negative factors of the industrial process. The data of pathomorphological research are given. Timely prevention and screening of workers involved in heavy work and work with harmful or hazardous working conditions, even after the cessation of work in a production environment, may contribute to early detection of interstitial lung disease and contribute to a positive prognosis for acute respiratory diseases occurring on its background