ХАРАКТЕРИСТИКА ЗУДА И НЕКОТОРЫХ НЕЙРОПЕПТИДОВ ПРИ ПСОРИАЗЕ, АССОЦИИРОВАННОМ С ПСИХИЧЕСКИМИ РАССТРОЙСТВАМИ

The aim of this research was to investigate the macro- and microelements composition in the cerebrospinal fluid and in the blood serum of patients, with different consequences of TBI before and after complex treatment, with the use of endolumbal and intracystal introduction of ozone and pyracetam in dynamics.Macro- and microelements composition was investigated in the cerebrospinal fluid and serum of 83 patients. State of neurological disorders in patients evaluated by the Glasgow Outcome Scale was extended. Thus, positive changes may be noted in the metabolism of macro- and microelements in the blood serum and cerebrospinal fluid of patients who were treated according to our suggested methods – endolumbal introductions of nootropic ozone mixture and endocystal introductions of ozone.

Osteoarthritis (OA), a common multifactorial disease of musculoskeletal system, is one of the leading causes of disability in the population. One of the most important pathogenetic factors of OA is a shift of cytokine profile towards pro-inflammatory state. Their increased levels lead to dysfunction of cartilage tissue cells with its damage. Purpose of the present study was to evaluate diagnostic significance of the most important cytokine and chemokine levels involved in pathogenesis of OA. The study involved 50 patients undergoing inpatient treatment at the “Hospital for War Veterans” (Vladivostok) with an established OA of the knee joints. The following mediators involved in the development of inflammation have been determined: interleukins IL-1â, IL-6, chemokine CXCL17, tumor necrosis factor TNFá and heat shock proteins HSP27, HSP70 in blood serum of patients being analyzed by ELISA test systems. It has been shown that the levels of interleukins IL-1â and IL-6, TNFá and CXCL17 in patients with OA exceeded those for healthy individuals. The levels of cytokines IL- 1â, IL-6, chemokine CXCL17 and TNFá in blood serum of OA patients were 7.4 (6.4-8.9), 33.7 (26.5-68.4); 33.8 (29.8- 61.0) and 6.5 (4.94-8.59) pg/ml, respectively, thus significantly exceeding the values for healthy person s (1.3 (1.2-1.4), 5.8 (4.2-6.3), 24.9 (19, 1-29.9) and 2.7 (2.1-3.1) pg/ml, p 0.05). In OA patients, the concentration of TNFá had a direct relationship with the chemokine CXCL17 (r = 0.83, p 0.05). The concentrations of heat shock proteins HSP27, HSP70 and their ratio were significantly lower in patients with OA compared to the control group (respectively: z = -3.06, p = 0.002; z = -4.41, p = 0.00001; z = -2.05, p = 0.04), thus allowing us to suggest the tolerance of chondrocytes to the influence of cytokines. At the same time, the concentration of HSP70 decreased as the disease progressed, while the level of HSP27 did not change significantly. Thus, determining the level of systemic intercellular mediators enables usage of these indexes as potential biochemical markers for predicting severity of the disease and assessing their fundamental role in pathogenesis of knee OA.

Introduction. Acute venous thrombosis is a socially significant pathology, and therefore the molecular basis of its pathogenesis is attracting close attention from modern scientists. At the same time, the adhesive function performed by CD62P, CD62E and CD62L molecules has not been sufficiently studied, especially under conditions of changes in the synthesis of nitric oxide (II). The aim. To evaluate the effect of nitric oxide on changes in the expression of intercellular adhesion molecules CD62P, CD62E and CD62L, based on markers of nitrosylating stress in the blood serum of patients with acute venous thrombosis. Material and methods. Guided by the design of the study, two groups were formed: control – 30 clinically healthy donors and experimental – 30 pa-tients with acute venous thrombosis of the lower extremities. The ELISA sandwich method was used for quantitative analysis of blood serum for CD62P, CD62E and CD62L and nitric oxide (II) synthases, the competitive ELISA method for the determination of nitrothyrosine (NT). Nitric oxide metab-olites (nitrates and nitrites) were evaluated using the Metelskaya V.A. method. The formation of bityrosine crosslinking was recorded by the intensity of fluorescent glow. Results. The concentration of CD62P in the blood serum of healthy donors and patients with acute venous thrombosis was 51.83 [35.13; 80.35] and 131.18 [110.70; 164.32], respectively (p=0.001), which was statistically significantly lower than in healthy individuals; CD62E and CD62L tended to de-crease. The concentration of nitric oxide metabolites was 43.15[33.50; 51.12] and 122.8 [71.21; 164.79], respectively (p=0.001), other markers of ni-trosylating stress showed multidirectional changes. A direct positive correlation of average strength was found between CD62L and the concentration of nitrates and nitrites. Conclusion. Nitrosylating stress affects the adhesive function of the endothelium during the formation of a blood clot in the veins, which is accompa-nied by decreased expression of CD62P, CD62E and CD62L and a multidirectional change in the concentration of marker molecules HC – nitrothyrosine and bityrosine. At the same time, an increase in NOx is noted, which acts as an auxiliary pathway for the synthesis of NO (II). The noted transfor-mations confirm the integration of nitric oxide metabolism and the expression of CD62L, CD62E and CD62L in hypercoagulation.

BACKGROUND: The steady increase in the number of patients with comorbid pathology in large industrial cities necessitates the study of the immune response in this category of patients. AIM: To investigate the cytokine profile of residents of a large industrial city (using Chelyabinsk as an example) depending on the presence of comorbid pathology (type 2 diabetes mellitus, obesity, hypertension). MATERIALS AND METHODS: The cross-sectional study included 61 people, including 39 people with type 2 diabetes mellitus and 22 clinically healthy volunteers. The multiplex assessment method was used to evaluate the concentrations of 11 cytokines in the blood serum: GM-CSF, IFN-γ, IL-2, IL-4, IL-5, IL-8, IL-12p70, IL-13, IL-17A, MIP-1β, TNF-α (pg/ml). RESULTS: Determination of the concentration of cytokines in the blood serum of patients with comorbid pathology in Chelyabinsk revealed a number of features, consisting in the predominance of proinflammatory cytokines and chemokines (IFN-γ, TNF-α, IL-8, MIP-1β, IL-12p70, IL-17A) and a shift in the Th1/Th2 balance towards the proinflammatory phenotype Th1. CONCLUSIONS: The obtained results confirm the presence of inflammation in comorbid pathology (type 2 diabetes mellitus, obesity, hypertension) in the population of Chelyabinsk.

E-selectin, an early mediator of leukocyte-endothelial adhesion, is expressed on activated endothelium. Soluble E-selectin is present in the supernatant of cytokine-activated endothelial cells and elevated serum levels are found in a variety of inflammatory conditions. We documented elevated E-selectin serum levels in 119 critically ill medical ICU patients (log transformed mean E-selectin level, measured by ELISA, was 5.28 ng/ml) compared to normal volunteers (1 ng/ml). Forty-three patients with culture-positive sepsis had higher (p < 0.05) E-selectin levels (15.39 ng/ml) than 24 patients with culture-negative sepsis (4.87 ng/ml), 44 with noninfectious SIRS (2.33 ng/ml), and eight without SIRS (1.97 ng/ml). E-selectin levels related strongly to the degree of hemodynamic compromise (p < 0.0001). Further analysis demonstrated microbiological status and hemodynamic status to be independent variables related to E-selectin level. Day 1 E-selectin levels correlated positively with peak organ failure score over the course of ICU hospitalization (r = 0.30, p = 0.001) and were higher (p < 0.05) for nonsurvivor (10.61 ng/ml, n = 26) than survivors (4.35 ng/ml, n = 93). We conclude that soluble E-selectin levels are higher in serum of patients with microbiologically documented sepsis than in other critically ill medical ICU patients. Day 1 E-selectin levels correlate highly with hemodynamic compromise and modestly with subsequent organ dysfunction and survival.

Aim . In the framework of the database of patients with atrial fibrillation established in the Kursk region, to study the clinical and anamnestic indicators, the structure of the combined and concomitant diseases in the patients under study, and also to evaluate the usefulness of the diagnostic methods of the study and drug therapy of this pathology. Material and methods . The regional study (REKUR-AF) included patients with atrial fibrillation (AF) from 18 years of age and older living in the city of Kursk and seven districts of the Kursk region. Recruitment of patients to the study was conducted from September 2015 to August 2016. When analyzing the outpatient charts of the studied patients, demographic data, the type and duration of AF, cardiovascular diseases (CVD), concomitant noncardiac pathology, laboratory and instrumental examination data, information about hospitalizations for the last year, pharmacotherapy were recorded. Results . The research included 896 patients with AF. Mean age of patients was 69 (62-77) years, women were significantly older than men (p<0.001). When analyzing the most common CVD in patients with AF (chronic heart failure, stable exertional angina, arterial hypertension), it was found that comorbid pathology was found in 99.3% of patients. 22.7% of patients had myocardial infarction (MI) in the past, 12.3% – acute cerebrovascular accident. From concomitant noncardiac diseases, patients with AF most often suffered from chronic kidney disease, obesity, type 2 diabetes, diseases of the gastrointestinal tract. On the average, one patient had 4 (3-4) diagnoses of CVD, and together with concomitant pathology – 5 (4-6). The medical examination was not in line with required level in the existing diseases. The high risk according to CHA2DS2-VASc scale was revealed in 96.3% of patients and according to HAS-BLED scale – in 52.8%. Patients with AF most often received antiplatelet agents, angiotensinconverting enzyme inhibitors, β -blockers, statins and diuretics. Anticoagulants were only used in 18.3% of patients. The average number of prescriptions of drugs in all patients with AF was 5 (4-6) and was significantly (p<0.001) higher in the group of patients with MI in the past (6 [4-6]) compared with the cohort of patients without MI (5 [4-6]). Conclusion . Patients included into the REKUR-AF study were characterized by a high incidence of combined cardiovascular pathology, a high risk of thromboembolic complications. In most patients, anti-platelet drugs were used as antithrombotic therapy, although they are significantly inferior to anticoagulants in their ability to prevent thromboembolic complications. Anticoagulants were used only in every fifth patient, warfarin was a significant part (52.6%) among all anticoagulants. Patients with AF also had an insufficient frequency of laboratory and instrumental examinations, that is required according to current guidelines.

Special Report: Women’s Reproductive Mental Health—A Clinical Framework

The complex link between mental disorders and re-offending in sexual offenders: Why we need to learn more.

Our objective is to explore the effects of levetiracetam on the levels of neuropeptides, serum activity and concentrations of oxidative stress and inflammatory response proteins, and levels of brain injury marker in patients with refractory epilepsy. Seventy-two patients with refractory epilepsy received levetiracetam treatment. Neuropeptides galanin (GAL) and neuropeptide Y (NPY) in plasma and cerebrospinal fluid (CSF) were detected using double-antibody sandwich immunoassay and radioimmunoassay, respectively. Enzyme-linked immunosorbent assay was used to detect serum activity of paraoxonase (PON1) and serum concentrations of oxidized low-density lipoprotein (ox-LDL) and S100B. Arylesterase (ARE) activity was measured by colorimetric assay, and immune scatter turbidimetry was used to detect a high-sensitivity C-reactive protein (hs-CRP). After treatment, NPY and GAL in plasma and CSF of the patients were significantly decreased as compared to concentrations before treatment (P<0.05). Levetiracetam reduced serum activities of PON1 and ARE (P<0.05) and led to markedly increased serum levels of ox-LDL (P<0.05). Serum concentrations of hs-CRP and S100B protein were significantly lower after levetiracetam administrations than before treatment (P<0.05). Levetiracetam treatment had a clear beneficial effect on the overall quality of life (QOL) scores of the patients, as indicated by significantly improved cognitive functioning, behavior problems, emotional conditioning, physical condition, social functioning, self-assessed life quality score, self-assessed health score, and the total QOL score (P<0.05). Levetiracetam can improve life quality of patients with refractory epilepsy, decrease NPY and GAL in plasma and cerebrospinal fluid, serum PON1 and ARE activities, and serum levels of ox-LDL, hs-CRP, and S100B. Levetiracetam therefore may be considered a drug of choice for treating refractory epilepsy.

Background: The link between psoriasis and psychiatric disorders is crucial due to their bidirectional relationship and shared biological mechanisms. Due to the chronicity, psoriasis often leads to psychological distress and exacerbation of conditions such as depression and anxiety, while stress and emotional factors can trigger psoriasis flares. The visible nature of psoriasis lesions can cause social stigma, embarrassment, and negative body image, which may exacerbate psychiatric symptoms. This interplay can have an impact on treatment outcomes, necessitating a comprehensive approach to care that addresses both physical and psychological components, thereby enhancing overall well-being and quality of life (QoL) for people affected. Aims and Objectives: We aimed to collect and study the sociodemographic profile of patients with psoriasis in a tertiary care hospital and to estimate common psychiatric comorbidities in them. The study also aims to assess the severity of psoriasis and QoL of individuals living with psoriasis using standardized assessment tools. Subsequently, the correlation between the severity of psoriasis symptoms and the presence of psychiatric comorbidities and their combined effect on QoL was assessed. Materials and Methods: A cross-sectional study was conducted on patients diagnosed with psoriasis vulgaris who presented to the dermatology department of a tertiary care hospital in Goa between July 2023 and December 2023 using a sociodemographic questionnaire, the MINI plus scale, the WHOQOL scale, and the Psoriasis Area and Severity Index scale. Results: Nearly half of the patients in the study experienced psychiatric comorbidities. The study revealed significant correlations between psychiatric comorbidities and QoL in all domains, including physical, psychological, social, and environmental. In addition, associations were observed between psychiatric comorbidities and current illness status. Conclusion: Psoriasis impacts all aspects of a person’s QoL and increases the likelihood of acquiring a psychiatric disease, further lowering the affected person’s QoL.

During the COVID-19 pandemic, US emergency department (ED) visits for psychiatric disorders (PDs) and drug overdoses increased. Psychiatric disorders and substance use disorders (SUDs) independently increased the risk of COVID-19 hospitalization, yet their effect together is unknown. To assess how comorbid PD and SUD are associated with the probability of hospitalization among ED patients with COVID-19. This retrospective cross-sectional study analyzed discharge data for adults (age ≥18 years) with a COVID-19 diagnosis treated in 970 EDs and inpatient hospitals in the United States from April 2020 to August 2021. Any past diagnosis of (1) SUD from opioids, stimulants, alcohol, cannabis, cocaine, sedatives, or other substances and/or (2) PD, including attention-deficit/hyperactivity disorder (ADHD), anxiety, bipolar disorder, major depression, other mood disorder, posttraumatic stress disorder (PTSD), or schizophrenia. The main outcome was any hospitalization. Differences in probability of hospitalization were calculated to assess its association with both PD and SUD compared with PD alone, SUD alone, or neither condition. Of 1 274 219 ED patients with COVID-19 (mean [SD] age, 54.6 [19.1] years; 667 638 women [52.4%]), 18.6% had a PD (mean age, 59.0 years; 37.7% men), 4.6% had a SUD (mean age, 50.1 years; 61.7% men), and 2.3% had both (mean age, 50.4 years; 53.1% men). The most common PDs were anxiety (12.9%), major depression (9.8%), poly (≥2) PDs (6.4%), and schizophrenia (1.4%). The most common SUDs involved alcohol (2.1%), cannabis (1.3%), opioids (1.0%), and poly (≥2) SUDs (0.9%). Prevalence of SUD among patients with PTSD, schizophrenia, other mood disorder, or ADHD each exceeded 21%. Based on significant specific PD-SUD pairs (Q < .05), probability of hospitalization of those with both PD and SUD was higher than those with (1) neither condition by a weighted mean of 20 percentage points (range, 6 to 36; IQR, 16 to 25); (2) PD alone by 12 percentage points (range, -4 to 31; IQR, 8 to 16); and (3) SUD alone by 4 percentage points (range, -7 to 15; IQR, -2 to 7). Associations varied by types of PD and SUD. Substance use disorder was a stronger predictor of hospitalization than PD. This study found that patients with both PD and SUD had a greater probability of hospitalization, compared with those with either disorder alone or neither disorder. Substance use disorders appear to have a greater association than PDs with the probability of hospitalization. Overlooking possible coexisting PD and SUD in ED patients with COVID-19 can underestimate the likelihood of hospitalization. Screening and assessment of both conditions are needed.

The blood serum of patients with coronary atherosclerosis possesses an ability to induce the accumulation of cellular lipids in primary cultures of human aortic intimal cells. Factors responsible for this property of the atherosclerotic patients' sera are represented by modified (desialylated) low density lipoprotein (LDL) and a nonlipid factor interacting with LDL. It was assumed that the nonlipid factor was antibodies against LDL. Total immunoglobulin G (IgG) fraction was isolated from the sera of atherosclerotic patients, and IgGs interacting with LDL (anti-LDL) were then purified by affinity chromatography on a sorbent with immobilized LDL. From the sera of patients, a 30-fold greater amount of anti-LDL has been isolated than from the sera of healthy donors. The affinity constant of anti-LDL to the lipoprotein obtained from the blood of healthy donors was 2 x 10(7) M-1. The affinity of anti-LDL to the lipoprotein from the blood of atherosclerotic patients, as well as to LDL desialylated in vitro with neuraminidase, was much higher. Anti-LDL increased the uptake of LDL by cultured aortic cells by approximately 2.5-fold and substantially increased intracellular lipid accumulation. The obtained data suggest that autoantibodies against LDL are an essential factor of blood plasma responsible for its atherogenic potential.

Blood sera of 46 patients with diffuse toxic goiter (DTG) and of 48 ones with Hashimotos thyroiditis (HT) were tested for antibodiescomplement-mediated cytotoxicity carriers (ACMMC). ACMCC targets were isolated DTG cells and cells of euthyroid nodular goiter (ENG) perinodular tissue. Antimicrosomal antibodies were assayed in the sera by indirect immunofluorescence and antibodies to all thyrocyte surface antigens isolated from both tissue samples were determined by solid-phase enzyme immunoassay. When DTG cells were targets, DTG patients' sera detected ACMCC in 36 % of cases and HT patients sera in 73% of cases (p0.001).&#x0D; In ENG cells the sera of patients of both groups detected ACMCC equally frequently (in more than 70% of cases). Of the 27 DTG patients sera tested with both tissues app. roximately a half detected ACMCC in only ENG tissue. There was no difference in HT patients sera effects on ACMCC detection in both tissue samples. This has brought the authors to a conclusion about DTG cells deficiency for ACMCC mediating antigens. Moreover, DTG cells bound much less antibodies from sera of patients with autoimmune thyropathies, than ENG cells (p0.001), this confirming a deficiency of surface antigen on DTG cells. No correlation between the presence in the sera of antimicrosomal cells and of ACMCC was detected. A conclusion has been made about heterogeneity of antimicrosomal antibody population and about the presence of ACMCC in blood sera of patients with autoimmune thyropathies, these antibodies not belonging to antimicrosomal ones. ACMCC also may be heterogenous and differ in DTG and HT patients.

Recently we have shown the presence of catalytically active IgGs, capable to cleave histone H1 and bovine myelin basic protein (MBP), in blood serum of SLE patients. Here we present data that demonstrate the correlation between a) proteolytic activity towards histone H1 and MBP of IgG-antibodies from blood serum of SLE patients and b) disease severity level in these patients. IgGs were isolated from blood serum by chromatography on protein G-sepharose. Commercial preparations of bovine myelin basic proteins (MBP) and calf thymus histone H1 were used as substrates. Analysis of the proteolytic activity showed that 16 of 38 lgG-preparations (42,1%) obtained from blood serum of SLE patients were capable of cleaving both histone H1 and MBP with different efficiency. It was revealed that the presence in blood serum of lgGs possessing proteolytic activity towards both histone H1 and bMBP closely correlates with manifestation of the disease severity in SLE patients.

The need to analyze the phenomenon of a combination of diseases of various nature is dictated by its high prevalence and insufficient knowledge; it is known, that their comorbidity aggravates the course of the underlying disease, worsening its prognosis. Information about comorbidity is insufficiently systematized, materials about particular combinations of certain mental disorders with somatic ones prevail, there is clearly not enough information about the coexistence of mental and somato-neurological pathology recorded in children and adolescents. Objective: to study the prevalence and nosological distribution of chronic somatic, neurological, infectious comorbid diseases detected in children and adolescents suffering from mental disorders; analyze the social adaptation of these patients. Material and methods. We examined 602 patients, 410 boys (68%) and 192 (32%) girls, who were observed on an outpatient basis in one of the neuropsychiatric dispensaries in Moscow. The study included only cases of a combination of mental and chronic somatic, neurological, infectious and other diseases. To rank patients according to the level of social functioning in adolescence, the «Map of registration of social skills and abilities of adolescents with chronic mental disorders» was used. Research methods: clinical-psychopathological, statistical. Results. The most common comorbid pathology was orthopedic diseases, in the second place was the pathology of vision, in the third place was endocrine pathology, the fourth place was taken by neurological diseases, the fifth place was the pathology of the ENT organs. In combinations of mental and comorbid disorders, pathogenetic variants were observed: 1. comorbid diseases accompanied mental disorder; 2.comorbid and mental disorders were pathogenetically associated with each other, or occurred as a result of a single primary disorder or disease; 3. somatic diseases were mental complications; 4. The occurrence of somatic diseases was explained by the side effects of psychotropic therapy. The severity of social inadequacy depended both on the severity of mental pathology and on the severity and number of somatic diseases. A comorbid disorder can cause more significant difficulties in certain areas of life than the underlying disease. Conclusion. Comorbidity is a multicomponent negative phenomenon. To reduce the incidence of comorbid pathology and achieve its maximum compensation, a multidisciplinary approach is required.