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Issue. Articles
¹1(60) // 2016
1. Scientific researches
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Notice: Undefined index: pict in /home/vitapol/ujdvc.vitapol.com.ua/en/svizhij_nomer.php on line 76 Differentiated treatment of acne in females of young and middle age depending on hormonal disordersL.O. Naumova, Ya.O. SulikO.O. Bogomolets National Medical University, Kyiv |
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Objective — to improve the efficiency of acne treatment in women on the basis of new scientific data about the features of endocrine status, hormonal status of the organism and the clinical course of the disease.
Materials and methods. The study involved 126 women with inflammatory form of acne of varying degrees of severity. The patients’ age ranged from 19 to 37 years. The following indicators were determined to evaluate the hormonal female body’s status: free testosterone, follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), thyroid stimulating hormone (TSH), free thyroxine (Ò4â), dehydroepiandrosterone sulfate (DHEAS).
Results and discussion. The prevalence of acne in the age group from 19 to 25 years was 32 %, 25 to 30 years — 39 %, 30 to 37 years — 29 % of women. Easy clinical course — inflammatory process of second degree was established in 53 (42%) patients, moderate severity clinical course of third degree — in 64 (51 %), severe clinical course of the fourth severity — in 9 (7 %) of the women surveyed. Clinically, the condition of hyperandrogenism in women with acne in the presence of hirsutism, androgenic alopecia and acantosis nigricans was diagnosed in 57.3 % during the study of blood hormones, hyperandrogenism condition was diagnosed in 88 % of surveyed women with acne. The manifestation of hyperandrogenism syndrome at visual examination was present only in half of the women with confirmed laboratory hormonal disorders.
Conclusions. According to the results of the research, various endocrine disorders, such as hyperandrogenism syndrome, play an important role in the development of acne in women of reproductive age. Clinical examination of women with acne is not enough for establishing the condition of hyperandrogenism. An integrated laboratory and special study is necessary to establish the genesis of hyperandrogenism, which contributes to the development of pathogeneticallybased, individualized treatment of female patients with acne. Complex differentiated systemic and local therapy contributes to interruption of drive links important in the pathogenesis of acne in women, which improves the effectiveness of treatment and prevents relapses.
Materials and methods. The study involved 126 women with inflammatory form of acne of varying degrees of severity. The patients’ age ranged from 19 to 37 years. The following indicators were determined to evaluate the hormonal female body’s status: free testosterone, follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), thyroid stimulating hormone (TSH), free thyroxine (Ò4â), dehydroepiandrosterone sulfate (DHEAS).
Results and discussion. The prevalence of acne in the age group from 19 to 25 years was 32 %, 25 to 30 years — 39 %, 30 to 37 years — 29 % of women. Easy clinical course — inflammatory process of second degree was established in 53 (42%) patients, moderate severity clinical course of third degree — in 64 (51 %), severe clinical course of the fourth severity — in 9 (7 %) of the women surveyed. Clinically, the condition of hyperandrogenism in women with acne in the presence of hirsutism, androgenic alopecia and acantosis nigricans was diagnosed in 57.3 % during the study of blood hormones, hyperandrogenism condition was diagnosed in 88 % of surveyed women with acne. The manifestation of hyperandrogenism syndrome at visual examination was present only in half of the women with confirmed laboratory hormonal disorders.
Conclusions. According to the results of the research, various endocrine disorders, such as hyperandrogenism syndrome, play an important role in the development of acne in women of reproductive age. Clinical examination of women with acne is not enough for establishing the condition of hyperandrogenism. An integrated laboratory and special study is necessary to establish the genesis of hyperandrogenism, which contributes to the development of pathogeneticallybased, individualized treatment of female patients with acne. Complex differentiated systemic and local therapy contributes to interruption of drive links important in the pathogenesis of acne in women, which improves the effectiveness of treatment and prevents relapses.
Keywords: acne, clinical forms of acne, women of reproductive age, hormonal status disorders, hyperandrogenism.
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Original language: Ukrainian
2. Scientific researches
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Notice: Undefined index: pict in /home/vitapol/ujdvc.vitapol.com.ua/en/svizhij_nomer.php on line 76 Investigation of cytokine profile indicators of immune status (TNF-α, IL-17, IL-23) in patients with psoriasis and their significance in pathogenesis of dermatosisR.L. StepanenkoO.O. Bogomolets National Medical University, Kyiv |
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Objective — to investigate the levels of cytokines in patients with psoriasis, which play a role in the formation of immune inflammation FNO-α, IL-17, IL-23, and to determine their significance for the pathogenesis of this dermatosis.
Materials and methods. Performance levels of proinflammatory cytokines, TNF-α, IL-17 and IL-23 in psoriasis patients’ blood (n = 139) by ELISA before and after a course of systemic immunosuppressive therapy were determined.
Results and discussion. Indicators of TNF-α, IL-17 and IL-23 in psoriasis patients were significantly higher than those in the control group. After completing the course the systemic immunosuppressive therapy with etanartsept, all 139 psoriasis patients manifested the reduction in the levels of TNF-α, IL-17 and IL-23, and the approximation of their values to the corresponding parameters in healthy patients (control group).
Conclusions. Significant increase in indicators of FNO-α proinflammatory cytokines, IL-17, IL-23 in the blood of patients with psoriasis vulgaris of progressive or stationary stage in comparison with indicators of healthy individuals indicates their role in the pathogenesis of this dermatosis.
Violation of the levels of immune response mediators, which participate in the formation of immune inflammation, cytokines directly in the body of patients with psoriasis, can serve as an additional test for the prediction of the clinical course of this dermatosis.
Materials and methods. Performance levels of proinflammatory cytokines, TNF-α, IL-17 and IL-23 in psoriasis patients’ blood (n = 139) by ELISA before and after a course of systemic immunosuppressive therapy were determined.
Results and discussion. Indicators of TNF-α, IL-17 and IL-23 in psoriasis patients were significantly higher than those in the control group. After completing the course the systemic immunosuppressive therapy with etanartsept, all 139 psoriasis patients manifested the reduction in the levels of TNF-α, IL-17 and IL-23, and the approximation of their values to the corresponding parameters in healthy patients (control group).
Conclusions. Significant increase in indicators of FNO-α proinflammatory cytokines, IL-17, IL-23 in the blood of patients with psoriasis vulgaris of progressive or stationary stage in comparison with indicators of healthy individuals indicates their role in the pathogenesis of this dermatosis.
Violation of the levels of immune response mediators, which participate in the formation of immune inflammation, cytokines directly in the body of patients with psoriasis, can serve as an additional test for the prediction of the clinical course of this dermatosis.
Keywords: psoriasis, TNF-α, IL-17, IL-23, systemic immunosuppressive therapy.
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Original language: Ukrainian
3. Scientific researches
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Notice: Undefined index: pict in /home/vitapol/ujdvc.vitapol.com.ua/en/svizhij_nomer.php on line 76 Gradual steps for interpretation of itching in atopic dermatitisA.Î. ReznikovaP.L. Shupyk National Medical Academy of Postgraduate Education, the Ministry of Health Care of Ukraine, Kyiv |
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This article presents the selected results of survey of 10 patients with atopic dermatitis. The detailed analysis of allergic history and SCORAD index in various forms of the disease were determined. Interleukin-2, -4 and -6 were defined. Immunological examination was conducted with determination of cellular and humoral immunity by investigating major subpopulations of lymphocytes: T-lymphocytes (CD3), T-lymphocyte helpers (CD4), T-cytotoxic lymphocytes (CD8), Â-lymphocytes (CD20), NK-cells (CD16) aimed at correction of diagnosis and improvement of treatment of atopic dermatitis.
Keywords: atopic dermatitis, itching, interleukin, immunity, immunogram.
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Original language: Ukrainian
4. TO HELP PRACTICING PHYSICIANS
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Notice: Undefined index: pict in /home/vitapol/ujdvc.vitapol.com.ua/en/svizhij_nomer.php on line 76 Experience of use of «Acnetine» in treatment of rosaceaZh.V. Koroliova, V.M. BorovikovP.L. Shupyk National Medical Academy of Postgraduate Education, the Ministry of Health Care of Ukraine, Kyiv |
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Objective — to study the clinical efficacy of «Acnetine» in the treatment of rosacea.
Materials and methods. Patients with rosacea were under the supervision during the period of 4 years. The duration of treatment with «Acnetine» ranged from 16 to 24 weeks.
Results and discussion. Stable clinical remission in all patients under survailance was achieved as a result of treatment with «Acnetine». The drug showed good tolerability with no significant changes in blood test and urinalysis after completion of therapy.
Conclusions. «Acnetine» has been proved to be effective for the treatment of papulopustular, nodulopustular rosacea and rosacea conglobata. It is safe, well absorbed, it does not cause severe side effects during longterm administration. Side effects of the drug are dosedependent, and they can be eliminated completely with the decrease in dosage, symptomatic therapy or in case of cancellation of the drug.
Materials and methods. Patients with rosacea were under the supervision during the period of 4 years. The duration of treatment with «Acnetine» ranged from 16 to 24 weeks.
Results and discussion. Stable clinical remission in all patients under survailance was achieved as a result of treatment with «Acnetine». The drug showed good tolerability with no significant changes in blood test and urinalysis after completion of therapy.
Conclusions. «Acnetine» has been proved to be effective for the treatment of papulopustular, nodulopustular rosacea and rosacea conglobata. It is safe, well absorbed, it does not cause severe side effects during longterm administration. Side effects of the drug are dosedependent, and they can be eliminated completely with the decrease in dosage, symptomatic therapy or in case of cancellation of the drug.
Keywords: rosacea, «Acnetine», isotretinoin, combined treatment schemes, optimization of rosacea therapy.
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Original language: Russian
5. PHARMACOTHERAPY IN DERMATOLOGY AND VENEREOLOGY
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Notice: Undefined index: pict in /home/vitapol/ujdvc.vitapol.com.ua/en/svizhij_nomer.php on line 76 Local treatment of allergic contact dermatitis from perspective of evidencebased medicineL.A. BolotnaKharkiv Medical Academy of Postgraduate Education, the Ministry of Health Care of Ukraine |
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This article provides information about the causes and mechanism of development of allergic contact dermatitis, the principles of evidencebased medicine. We present the means for treatment of dermatitis, and focus attension on the role of modern topical corticosteroids (mometasone furoate) in the treatment of disease.
Approaches to treatment of allergic contact dermatitis are presented with regard to the principles of evidence-based medicine. The analysis of several clinical practice guidelines of European countries, domestic and foreign publications allowed the author to conclude that there is a common coherent opinion about the medical tactics at ACD. Local steroids are the first line of symptomatic treatment of localized ACD lesions not exceeding 20% of the skin. Principles and means of treatment of dermatitis are specified; attention is focused on the role of contemporary topical glucocorticosteroids (mometasone furoate) in the treatment of disease.
Approaches to treatment of allergic contact dermatitis are presented with regard to the principles of evidence-based medicine. The analysis of several clinical practice guidelines of European countries, domestic and foreign publications allowed the author to conclude that there is a common coherent opinion about the medical tactics at ACD. Local steroids are the first line of symptomatic treatment of localized ACD lesions not exceeding 20% of the skin. Principles and means of treatment of dermatitis are specified; attention is focused on the role of contemporary topical glucocorticosteroids (mometasone furoate) in the treatment of disease.
Keywords: allergic contact dermatitis, etiology, pathogenesis, evidencebased medicine, treatment guidelines, mometasone furoate.
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Original language: Russian
6. PHARMACOTHERAPY IN DERMATOLOGY AND VENEREOLOGY
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Notice: Undefined index: pict in /home/vitapol/ujdvc.vitapol.com.ua/en/svizhij_nomer.php on line 76 Drug correction of elevated concentrations of leukocyte adhesins in urogenital chlamydiosiM.R. AnfilovaNational Pirogov Memorial Medical University, Vinnytsya |
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Objective — to evaluate the effect of combined therapy on the dynamics of the content of intercellular adhesion molecules sICAM1 and sVCAM in patients with urogenital chlamydiosis.
Materials and methods. After obtaining informed consent, the study included 60 patients (30 females and 30 males) with a diagnosis of urogenital chlamydiosis and 30 persons without sexually transmitted diseases that composed the control group. The concentration of leukocyte adhesins sICAM1 and sVCAM in serum was determined by enzymelinked immunosorbent assay (ELISA) with the use of standard test systems of company Bender MedSystems GmbH (Austria).
Results and discussion. As a result of research it was found that the concentration of sVCAM was increased by 3.7 times as compared with the control group, and the concentration of ¾²ÑÀÌ1 — by 6.5 times. In order to determine the effectiveness of drug correction of elevated leukocyte adhesins concentration in blood plasma, all the patients before treatment were divided into two equivalent groups: main (n = 30) and comparison group (n = 30). Patients of the main group received comprehensive treatment, which, besides the antibiotics, included lipidlowering drugs and a complex of probiotics, vitamins and minerals that has imunotropic properties. The patients of the comparison group received only an antibiotic. The concentration of soluble molecules of cell adhesion (sICAM1 and sVCAM) in the blood serum of patients with urogenital chlamydiosis, who took only antibiotic therapy, did not change significantly in spite of the treatment. Concentration of sVCAM decreased by 1.1 times, and concentration of ¾²ÑÀÌ1 decreased by 1.2 times. Significantly better results were obtained in patients who, in addition to the antibiotic, took a combined therapy including lipidlowering drugs, and a complex of probiotics, vitamins and minerals. Concentration of ¾²SAM1 decreased by 2.6 times, and concentration of sVCAM — by 1.7 times, respectively.
Conclusions. The proposed comprehensive treatment helps to reduce the concentration of leukocyte adhesins, recover the urogenital barrier epithelial and improve the effectiveness of treatment of urogenital chlamydiosis.
Materials and methods. After obtaining informed consent, the study included 60 patients (30 females and 30 males) with a diagnosis of urogenital chlamydiosis and 30 persons without sexually transmitted diseases that composed the control group. The concentration of leukocyte adhesins sICAM1 and sVCAM in serum was determined by enzymelinked immunosorbent assay (ELISA) with the use of standard test systems of company Bender MedSystems GmbH (Austria).
Results and discussion. As a result of research it was found that the concentration of sVCAM was increased by 3.7 times as compared with the control group, and the concentration of ¾²ÑÀÌ1 — by 6.5 times. In order to determine the effectiveness of drug correction of elevated leukocyte adhesins concentration in blood plasma, all the patients before treatment were divided into two equivalent groups: main (n = 30) and comparison group (n = 30). Patients of the main group received comprehensive treatment, which, besides the antibiotics, included lipidlowering drugs and a complex of probiotics, vitamins and minerals that has imunotropic properties. The patients of the comparison group received only an antibiotic. The concentration of soluble molecules of cell adhesion (sICAM1 and sVCAM) in the blood serum of patients with urogenital chlamydiosis, who took only antibiotic therapy, did not change significantly in spite of the treatment. Concentration of sVCAM decreased by 1.1 times, and concentration of ¾²ÑÀÌ1 decreased by 1.2 times. Significantly better results were obtained in patients who, in addition to the antibiotic, took a combined therapy including lipidlowering drugs, and a complex of probiotics, vitamins and minerals. Concentration of ¾²SAM1 decreased by 2.6 times, and concentration of sVCAM — by 1.7 times, respectively.
Conclusions. The proposed comprehensive treatment helps to reduce the concentration of leukocyte adhesins, recover the urogenital barrier epithelial and improve the effectiveness of treatment of urogenital chlamydiosis.
Keywords: urogenital chlamydiosis, intercellular adhesion molecules, ¾²ÑÀÌ1, sVCAM, drug correction.
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Original language: Ukrainian
7. PHARMACOTHERAPY IN DERMATOLOGY AND VENEREOLOGY
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Notice: Undefined index: pict in /home/vitapol/ujdvc.vitapol.com.ua/en/svizhij_nomer.php on line 76 Experience of using «Lourdes» preparation in treatment of allergic dermatites in adults and childrenZh.V. KorolovaP.L. Shupyk National Medical Academy of Postgraduate Education, the Ministry of Health Care of Ukraine, Kyiv |
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Objective — to evaluate the clinical efficacy and safety of «Lourdes» (pharmaceutical form — syrup with 5 ml of syrup containing 2.5 mg of desloratadine and tablets containing 5 mg of desloratadine) in the treatment of allergic dermatitis.
Materials and methods. We observed 46 patients with allergic dermatitis (18 males and 28 females), duration of 1—3 days.
Results and discussion. Most patients on 2—3-rd day of therapy with «Lourdes» had no complaints, noted good health, regressed inflammatory skin rash, decreased infiltration. Clinical manifestations to 5—7-th days of treatment completely disappeared. The introduction of the drug «Lourdes» in the treatment of patients with allergic dermatitis enabled to achieve clinical cure in all 46 patients.
Conclusions. The pharmacological characteristics of desloratadine, its high therapeutic efficacy and safety, wide range of indications, and the experience of use in the clinical practice allow recommending «Lourdes» as a drug of choice for treatment of allergic dermatitis in children and adults.
Materials and methods. We observed 46 patients with allergic dermatitis (18 males and 28 females), duration of 1—3 days.
Results and discussion. Most patients on 2—3-rd day of therapy with «Lourdes» had no complaints, noted good health, regressed inflammatory skin rash, decreased infiltration. Clinical manifestations to 5—7-th days of treatment completely disappeared. The introduction of the drug «Lourdes» in the treatment of patients with allergic dermatitis enabled to achieve clinical cure in all 46 patients.
Conclusions. The pharmacological characteristics of desloratadine, its high therapeutic efficacy and safety, wide range of indications, and the experience of use in the clinical practice allow recommending «Lourdes» as a drug of choice for treatment of allergic dermatitis in children and adults.
Keywords: desloratadine, allergic dermatitis, «Lourdes» preparation.
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Original language: Russian
8. CLINICAL CASE STUDIES
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Notice: Undefined index: pict in /home/vitapol/ujdvc.vitapol.com.ua/en/svizhij_nomer.php on line 76 Unilateral dermatoses, optimization of treatment with the use of pulse mesotherapyD.S. Polishchuk1, 2, S.I. Polishchuk2, V.S. Komarnytska21 National Pirogov Memorial Medical University, Vinnytsya |
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Generalized literary data about unilateral dermatoses and personal observations of dermatological patients have been offered. For the first time the method of treating acquired unilateral dermatoses by means of the pulse corticosteroid mesotherapy has been suggested.
Keywords: unilateral dermatoses, pulse mesotherapy, Blashko’s lines.
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Original language: Ukrainian
9. Reviews
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Notice: Undefined index: pict in /home/vitapol/ujdvc.vitapol.com.ua/en/svizhij_nomer.php on line 76 New Insights into Rosacea Part II. TreatmentC. DiehlUniversitá Degli Studi Guglielmo Marconi, Rome, Italy |
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Rosacea is a chronic skin disease which often tends to be underdiagnosed or misdiagnosed.
However, rosacea strongly impacts the quality of life of sufferers, both in their social and professional life and for this reason advice is sought from the dermatologist. Rosacea is a treatable, but not curable disease, which implies long term treatments in order to alleviate signs and symptoms and improve the skin appearance. Besides the treatment itself, education of the patient is compulsory, in order to teach the importance of sun protection, skin care and make up, but also avoidance of the well-known triggering factors. Regarding therapies, new options have recently appeared in our armamentarium which are described, along with the clinical evidences supporting them. They must be taken into account at the time of prescribing an adequate treatment to the patient, the prescription being primarily based on the clinical experience.
However, rosacea strongly impacts the quality of life of sufferers, both in their social and professional life and for this reason advice is sought from the dermatologist. Rosacea is a treatable, but not curable disease, which implies long term treatments in order to alleviate signs and symptoms and improve the skin appearance. Besides the treatment itself, education of the patient is compulsory, in order to teach the importance of sun protection, skin care and make up, but also avoidance of the well-known triggering factors. Regarding therapies, new options have recently appeared in our armamentarium which are described, along with the clinical evidences supporting them. They must be taken into account at the time of prescribing an adequate treatment to the patient, the prescription being primarily based on the clinical experience.
Keywords: Rosacea, treatment, metronidazole, azelaic acid, retinoids, ivermectin, brimonidine.
Additional:
Dr. Christian Diehl, Department of Dermatology, Universitá Degli Studi Guglielmo Marconi
Via Plinio, 44, 00193, Rome, Italy
Å-mail: chdiehl@hotmail.com
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Original language: English
10. Reviews
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Notice: Undefined index: pict in /home/vitapol/ujdvc.vitapol.com.ua/en/svizhij_nomer.php on line 76 Urogenital mycoplasmosis: difficult choice of antibacterial therapy (literature review and own research)G.I. Mavrov1, 2, T.V. Fedorovich21 SI «Institute of Dermatology and Venereology of NAMS of Ukraine», Kharkiv |
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The paper presents the current data on the treatment of genital mycoplasmas, especially Mycoplasma genitalium. Review of modern literature and clinical trial data led to the conclusion about high efficacy and safety of josamycin in patients with urogenital mycoplasmosis. This allows us to recommend it for the treatment of urogenital infections caused by M. genitalium.
Keywords: Mycoplasma genitalium, urogenital mycoplasmosis, antibiotic therapy, josamycin.
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Original language: Russian
11. Reviews
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Notice: Undefined index: pict in /home/vitapol/ujdvc.vitapol.com.ua/en/svizhij_nomer.php on line 76 Certain aspects of epigenetic control of inflammation processes in patients with psoriasisI.B. Popova, I.P. KaidashevUkrainian Medical Stomatological Academy, Poltava |
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In clarifying the etiopathogenesis of psoriasis, of special interest is the role of sirtuins — NAD+ (nicotinamide adenine dinucleotide)-dependent protein deacetylases. The results of current research of sirtuins prove that they constitute a complex system which has an impact on many other molecules and pathways. At present, changes in sirtuins under the influence of external factors, as well as their role in the development of certain diseases, such as psoriasis, have not been adequately investigated. Several studies have tried to find out whether there is an association between the genetic variability of sirtuins and health condition. At this time, there is evidence about the possible association of genetic variation of sirtuins and the risk of obesity. The necessity for activation of metabolic processes, lipolysis in psoriatic patients have triggered the need to use sirtuin activators such as resveratrol.
Keywords: åtiopathogenesis of psoriasis, sirtuins, epigenetic control, resveratrol.
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Original language: Ukrainian
12. Reviews
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Notice: Undefined index: pict in /home/vitapol/ujdvc.vitapol.com.ua/en/svizhij_nomer.php on line 76 Dermatitis associated with incontinence of urinary physiological functions: a new approach to the «old» problemS.Î. Galnikina1, I.I. Kogut1, 21 I.Ya. Horbachevsky Ternopil State Medical University |
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The article provides an overview of literature on dermatitis associated with incontinence of urinary physiological functions. The publication aims to introduce the modern terminology of the disease and to highlight the topicality of this problem. The application of special diagnostic tools is reviewed for assesment of dermatitis associated with incontinence of urinary physiological functions and determination of patient surveillance. Best practical guidelines for skin care, prevention and treatment of the disease are presented.
Keywords: dermatitis associated with incontinence of urinary physiological functions; irritative contact dermatitis, geriatrics, medical care, treatment and prevention.
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Original language: Ukrainian
13. History of medicine
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Notice: Undefined index: pict in /home/vitapol/ujdvc.vitapol.com.ua/en/svizhij_nomer.php on line 76 Optimization of teaching skin and venereal diseases in higher medical institutions relying on experience of teaching this discipline at the medical faculty of St. Vladimir university at the end of XIX — beginning of XX centuryK.V. KolyadenkoO.O. Bogomolets National Medical University, Kyiv |
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Data are presented about organization of learning programs on dermatology and venereology for students at the medical faculty of St. Vladimir university at the end of XIX — beginning of XX century. Some aspects of that system could be of interest in our time for optimization of training qualified specialists.
Keywords: skin and veneral diseases, medical students, learning programs.
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Original language: Ukrainian
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