RESUMEN
Despite the existing modern high-tech methods of examination and a variety of surgical treatment methods, the problem of diagnosis, treatment and rehabilitation of patients with chronic post-intubation cicatricial stenosis of the larynx and trachea still requires further study. Improving the understanding and correction of cellular, molecular genetic and biochemical disorders in a chronic wound is a key condition for increasing the efficiency of diagnosis, individual prognosis of the clinical course and the conduct of adequate therapeutic and preventive measures for post-intubation cicatricial laryngotracheal stenoses. In this regard, it seemed appropriate to analyze the existing etiopathogenetic factors of pathological wound healing in chronic post-intubation cicatricial stenosis of the larynx and trachea. Our attempt to summarize the available literature data demonstrated that laryngotracheal scars are a fibro-proliferative disease caused by aberrant wound healing after a damaging effect on the tissues of the larynx and trachea. The article describes the most pathogenetically significant healing, repair, and scarring factors in post-intubation laryngotracheal stenoses, including transforming growth factor ß1, vascular growth factor A, type I and III collagen, and matrix metalloproteinases. An assessment of the features of the diagnostic and prognostic significance of these markers will increase the effectiveness of the treatment of patients with chronic cicatricial stenosis of the larynx and trachea, and will also serve as a prerequisite for the development of strategies for diagnostic, treatment, prophylactic and rehabilitation measures that will improve the quality of medical care and the quality of life of patients with chronic cicatricial stenosis of the larynx and trachea.
Asunto(s)
Laringoestenosis , Laringe , Constricción Patológica , Humanos , Intubación Intratraqueal , Calidad de Vida , TráqueaRESUMEN
The modern diagnostic approaches permit to diagnose axial spondylarthrosis (axSpA) at roentgenologic stage corresponding to ankylosing spondylitis (AS). While early diagnostic of non-roentgenologic axSpA (nr-axSpA) is still complicated. This situation conditions a need in searching new laboratory biomarkers for early diagnostic of spondylarthrosis, including auto-antibodies to antigen CD74 described recently. The purpose of study is to evaluate clinical diagnostic significance of auto-antibodies to antigen CD74 in case of axSpA. The technique of quantitative enzyme-linked immunosorbent assay was applied to measure content of auto-antibodies IgA to CD74 in samples of serum from 140 patients with axSpA: 68 with AS, 46 with nr-axSpA, 26 with psoriatic arthritis (PA) and 37 healthy representatives of control group with signs of axSpA totally clinically excluded. The average values of concentration of auto-antibodies IgA to CD74 in patients with axSpA and nr-axSpA made up to 3,5 ± 3,0 and 3,8 ± 2,9 U/ml correspondingly that reliably and significantly differed from patients with PA and healthy individuals - 2,1 ± 1,4 and 1,3 ± 1,4 U/ml correspondingly (p < 0,05). At threshold value of content of auto-antibodies IgA to CD74 higher than 2.0 U/ml in case of axSpA diagnostic sensitivity made up to 64.4%, specificity - 89.2%, risk factor of positive result - 5.9 whereas in patients with nr-axSpA at concentration 1.7 U/ml - 73,1%, 84% and 4,5 correspondingly. The auto-antibodies IgA to antigen CD74 are associated withaxSpA but not with PA that permits to use the given marker for diagnostic of axial spondylarthrosis and also in case of differential diagnostic between axSpA and PA.
Asunto(s)
Antígenos CD/inmunología , Autoanticuerpos/sangre , Sialiltransferasas/inmunología , Espondilitis Anquilosante/diagnóstico , Artritis Psoriásica , Biomarcadores/sangre , Estudios de Casos y Controles , Humanos , Sensibilidad y Especificidad , Espondilitis Anquilosante/sangreRESUMEN
With the aim to determine the influence of the high latitudes on the main indices of the blood and morbidity, physical development of adolescents of 14 years old residing in Kirov (n = 139) and Ukhta (n = 253), the evaluation of basic parameters of their blood, physical development and morbidity has been performed accordingly to standards methods. The inhabitancy of adolescents in high latitudes (Ukhta) in comparison with their peers from temperate latitudes (Kirov) leads to body weight gain of 4.7 kg in girls and 5.8 kg in boys, gives rise to the increase in gender diferences in hemoglobin concentrations and ESR and boosts overall morbidity.