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Issue. Articles

№2(61) // 2016

 

Обкладинка

 

1. Scientific researches

 
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Diagnosis and treatment of psoriasis arthropica in view of current data on pathogenesis and clinical course pattern of dermatosis

O.O. Syzon1, V.I. Stepanenko2

1 Danylo Halytskyi Lviv National Medical University  
2 O.O. Bohomolets National Medical University, Kyiv
Оbjective — to improve the diagnosis and differential diagnosis, as well as to increase the efficacy of treatment of patients with psoriasis arthropica (PA) in the view of current data on peculiarities of pathogenesis and clinical course of psoriatic disease (PD).
Materials and methods. 187 psoriasis arthropica patients with the disease duration from 8 to 24 years were comprehensively examined; most of them had concomitant somatic diseases.
Results and discussion. It was found that for the last 20 years (1993—2014) the number of registered cases of psoriasis among the population of Lviv region has increased by 1.9 times. Features of clinical classification of PD were systematized, pathogenically reasonable terminology of defining PA stages was proposed, specific features of PA with pathogenic substantiation of primary localization of damage of joints in areas of increased injury of tendon­ligament apparatus and its correlation with psoriatic damage of nails were identified. Diagnostic criteria and PA differential diagnosis search algorithm were developed. The necessity of using methods of ultrasound and magnetic resonance diagnosis of joints in psoriatic patients due to frequent (10.7 %) cases of enthesopathy in the absence of radiological pathological changes in joints was proved. A significant number (79.8  %) of comorbidity cases were a base for the development of clinical route maps for PA patients to identify the most common comorbid conditions.
In the serum of PA patients we established a significant reduction (p < 0.01) of the number of immune cells with phenotype CD3+ by 50 %, CD 22+ or B­lymphocytes by 46.6 %, moderate decrease of CD4+ by 12.9 %, CD8+ by 19.6 % and increased content of CD16+ by 18.4 %; increased level of cytokines IL­1β by 5—11 times, IL­8 by 60 times, IL­17 by 10 times, IL­22 by 5 times, stress hormone — cortisol by two times, IgG by 5 times, and immunoglobulins IgM, CIC by 3 times, which indicates the intensity of stress mechanisms in patients. Statistically reliable increase of these cytokines concentration in serum (by more than 2—3 times) and synovial fluid (by more than 2—5 times as compared to corresponding values in the serum (p < 0.05)) in patients during the first months since the beginning of PD articular syndrome can serve as an additional diagnostic criterion for early PA diagnosis.
A pathogenically based tactics of step­by­step algorithm of integrated PA therapy in association with non­steroid anti­inflammatory drugs (Arcoxia/ Naklofen Duo), and disease modifying medications (Sulfasalazine EP/Methotrexate) and autohaemotherapy promotes the increase in efficacy of treatment preserving the workability and improving the quality of life of patients, which is testified by the normalization of clinical, laboratory and instrumental parameters.
Conclusions. Only an integrated approach to the examination of psoriatic patients with damaged locomotor system can provide the efficacy of early PA diagnosis and treatment.

Keywords: psoriasis arthropica, comorbid diseases, diagnosis, differential diagnosis, treatment.

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Original language: Ukrainian

2. Scientific researches

 
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The clinical and pathogenetic role of epidermal growth factor in psoriasis

Ya.F. Kutasevych, I.O. Oliinyk, E.M. Soloshenko, O.A. Gavrylyuk

SІ «Institute of Dermatology and Venereology of NAMS of Ukraine», Kharkiv
Objective — to study of the serum level of epidermal growth factor (EGF) in patients with psoriasis, depending on the clinical form, severity and disease activity.
Materials and methods. We observed 152 patients with psoriasis aged from 18 to 69 years. All patients were divided into 2 groups: I (basic) group consisted of 100 patients with severe forms of psoriasis, and II (control) group included 52 patients with psoriasis vulgaris. The control group consisted of 20 healthy volunteers, representative by gender and age.
Results and discussion. With the increase of severity and disease activity, a significant (p < 0.01) increase in the content of EGF epidermal growth factor was found in the serum of patients with psoriasis.
Conclusions. The efficiency of use of EGF for assessment of the severity and activity of the disease and prognosis of its development is shown. The role of EGF in the pathogenesis of psoriasis is determined.

Keywords: psoriasis, keratinocytes, epidermal growth factor, articular syndrome, severe forms of psoriasis.

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Original language: Ukrainian

3. Scientific researches

 
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Incidence among servicemen of the Armed forces of Ukraine of skin and subcutaneous tissue diseases

V.I. Kucher

Ukrainian Military Medical Academy, Kyiv
Objective — to improve the medical security of servicemen of the Armed Forces of Ukraine.
Materials and methods. We investigated ten­year incidence among servicemen of the Armed forces of Ukraine of skin and subcutaneous tissue diseases according to the annual reports of military medical service units. We used conventional methods of statistical computing.
Results and discussion. The primary incidence among servicemen of the Armed forces of Ukraine of skin and subcutaneous tissue diseases tended to increase. The sharp increase in the incidence among servicemen of the Armed forces of Ukraine of skin and subcutaneous tissue diseases at baseline and a slight decrease at the end of the study determined the general tendency to the increase in the primary morbidity confirmed by the trend line (R2 = 0.148). During the observation period, from 2004 to 2013, there was a significant increase in the primary incidence among officers, conscripts and Armed Forces servicemen under contract of skin and subcutaneous tissue diseases.
Conclusions. During the study there was a trend to an increase in the primary incidence among all military servicemen of skin and subcutaneous tissue diseases, as indicated by the trend line (R2 = 0.148). In order to reduce the incidence of skin and subcutaneous tissue diseases among Armed Forces servicemen it is necessary to improve their financial and medical support.

Keywords: diseases of the skin and subcutaneous tissue, morbidity, military servicemen, Armed Forces of Ukraine.

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Original language: Ukrainian

4. scientific researches

 
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Configuration state of some indices of energy metabolism and ionic exchange in patients with diffused psoriasis

А.M. Belovol, V.B. Nikolayeva, L.V. Galuzinska

Kharkiv National Medical University
Оbjective — to observation of some indices of ionic exchange and bioenergetic homeostasis in patients with diffused psoriasis.
Materials and methods. Levels of micro­ and macroelements (ions of sodium, potassium, calcium, magnesium, etc.), enzymes (lactic dehydrogenase (LDH), malate dehydrogenase (MDH), succinate dehydrogenase (SDH), glucose 6­phosphate dehydrogenase (G6PD), isocitrate dehydrogenase (IDH)) were measured in 37 psoriatic patients’ blood plasma and urine with the use of the method of atomic adsorption spectrophotometric analysis.
Results and discussion. Observation of reductive­oxidative processes in patients with diffused psoriasis indicated an activity increase in catalase, glutathione peroxidase, superoxide dismutase, caeruloplasmin. Activity analysis of the enzymes of energy metabolism detected an immense rise in the rates of LDH, MDH, SDH and IDH. In the majority of cases the changes in erythrocytes were directed in the opposite way: the content of ions of К+, Са2+, Мg2+, Р5+, Fe2+, Zn2+, Cu2+, Mn2+ reduced and the content of ions of Na+ increased. The analysis of ions of metals in blood plasma and in urine erythrocytes indicates a considerable elimination of them in humans and retardation of ions of Na+, which can be associated with the development of structural and metabolic abnormalities of different organs and tissues of the human body as well as with accumulation of water in it.
Conclusions. Results of the research indicate a considerable activity of oxidative processes with diffused psoriatic conditions which are associated with the rise of the levels of free radicals, peroxide and hydroperoxide.

Keywords: psoriasic condition, ionic exchange, bioenergetic homeostasis.

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Original language: Ukrainian

5. Scientific researches

 
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Optimisation of approach to treatment of reticular varicose veins and telangiectasia

V.V. Teplyy, Kh.O. Korolova

O.O. Bogomolets National Medical University, Kyiv
Objective — to compare the results of treatment of reticular varicose veins and telangiectasia depending on venous reflux control.
Materials and methods. The study involved 51 patients aged 22 to 68 years who were treated for reticular varicose veins and telangiectasia, depending on venous reflux detection. The results of treatment were evaluated after a year and in a three­year term.
Results and discussion. In the group of patients with venous reflux surgical correction, no relapses in one year, and three­year periods were registered. In patients who had only sclerotherapy, relapse of reticular varices in one year was almost the same regardless of liquid or foam sclerosant use — 4 (33.3 %) and 3 (27.2 %) patients, respectively, (p > 0.1). In 3 years after treatment, the difference increased slightly, but remained statistically insignificant.
Conclusions. The most stable results in treatment of reticular varicose veins and telangiectasia are provided by minimally invasive surgical correction of venous reflux in combination with sclerotherapy. The advantages of the combined approach are small trauma, good cosmetic effect and long lasting result. We need to continue the development of more sensitive and cheap methods for determining the locations of venous reflux which can be used in medical practice.

Keywords: reticular varicose veins, telangiectasia, venous reflux, sclerotherapy.

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Original language: Ukrainian

6. Scientific researches

 
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Influence of rosuvastatin prepatations and omega­-3 polyunsaturated fatty acids on clinical and laboratory parameters of psoriasis with metabolic syndrome

N.G. Virstyuk1, M.M. Nykyforuk2, R.F. Nykyforuk2

1 SHEI «Ivano-Frankivsk National Medical University»
2 PI «Regional Clinical Skin and Venereal Diseases Dispensary»
Objective — to study the effectiveness of treatment of patients with psoriasis of moderate severity coupled with metabolic syndrome (MS), including rosuvastatin and omega­-3 polyunsaturated fatty acids in comprehensive therapy.
Materials and methods. The study involved 100 patients with plaque psoriasis of moderate severity against the backdrop of MS. The control group consisted of 30 healthy individuals. All patients were divided into 4 groups: the patients of I group (n = 26) received basic treatment for psoriasis, the patients of II group (n = 25) — the same therapy as in the first group and rosuvastatin in addition, the patients of III group (n = 25) — the same therapy as in the first group and additional preparation of omega­-3 polyunsaturated fatty acids, the patients of IV group (n = 24) — the same therapy as in the first group and additional rosuvastatin and omega-­3 polyunsaturated fatty acids for 3 months. Index PASI was used to assess the severity of psoriasis. MS was diagnosed according to the recommendations of the International Diabetes Federation (2005). Anthropometric indices, lipid spectrum of blood, indicators of C­reactive protein, adipocytokine of blood and insulin resistance were evaluated.
Results and discussion. Under the influence of complex therapy with rosuvastatin and omega­-3 polyunsaturated fatty acids, the dynamics of clinical manifestations of psoriasis according to PASI, indices of lipid spectrum, adipocytokines of blood, inflammation and insulin resistance has been most pronounced. The level of total cholesterol decreased by 32.4 %, TG — by 45.5 %, LDL — by 21.9 %, VLDL — by 31.9 %, the level of HDL increased by 29.2 %, the level of EI and HOMA­IR decreased by 31.2 and 38 %, respectively, (p < 0.05). The level of leptin decreased by 58.6 %, the level of adiponectin increased by 39.8 % (p < 0.05). Reduction of inflammation was observed according to СРП which fell by 77.3 % (p < 0.05).
Conclusions. The use of rosuvastatin drug and omega­-3 polyunsaturated fatty acid in treatment of patients with psoriasis in combination with MS exhibits a positive impact on the clinical and pathogenetic manifestations of psoriasis and improves the efficiency of the treatment of dermatoses.

Keywords: psoriasis, metabolic syndrome, rosuvastatin, omega­-3 polyunsaturated fatty acids.

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Original language: Ukrainian

7. Scientific researches

 
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Identification of immune status cytokine profile indicators (IFN-­γ, IL-­20, IL-­22) in patients with psoriasis and their significance in determining the pathogenesis of dermatosis

R.L. Stepanenko, S.G. Svirid

O.O. Bogomolets National Medical University, Kyiv
Objective — to determine the levels of cytokines, which play a role in the formation of immune inflammation, particularly IFN-g, IL-­20, IL-­22, in the serum of patients with psoriasis and to assess their implications for the pathogenesis of this dermatosis.
Materials and methods. We determined the levels of proinflammatory cytokines IFN-g, IL­-20, IL­-22 in the serum of patients with psoriasis (n = 139) by the method of enzyme immunoassay before and after a course of systemic immunosupressive therapy.
Results and discussion. Levels of IFN-g, IL-­20, IL-22 in patients with psoriasis were significantly higher compared with those in the control group. After completing the course of systemic immunosupressive therapy with etanercept, all 139 psoriasis patients showed a reduction in IFN-g, IL­-20, IL­-22 and their approximation to the values of the control group.
Conclusion. A significant increase was revealed in the levels of pro-inflammatory cytokines IFN-g, IL­-20, IL-­22 in the serum of patients with psoriasis vulgaris in the progressive or stationary phase as compared to the norm, which indicates the significance of these cytokines in the pathogenesis of this dermatosis.

Keywords: psoriasis, IFN-­g, IL-­20, IL­-22, systemic immunosuppressive therapy.

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Original language: Ukrainian

8. Scientific researches

 
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Role of immunohistochemical study of lymphocytic infiltrate in diagnosis of early stage of mycosis fungoides

L.M. Hamadeh, A.I. Kurchenko, G.V. Fedoruk

O.O. Bogomolets National Medical University, Kyiv
Objective — to study the quality of cellular morphological composition of the inflammatory infiltrate in the skin of patients with mycosis fungoides.
Materials and methods. The material for the study of skin biopsies were taken from 5 patients with mycosis fungoides, which were observed at the department of dermatology and venereology of Bogomolets National Medical University. Immunohistochemical panel included the following antibodies: CD2, CD3, CD4, CD5, CD7, CD8 and CD20 production Dako Cytomation. For visualization of imaging system we used Processor EnVision™ FLEX+, Mouse, High pH (Link), Code K8012 on Autostainer of DAKO Company.
Results and discussion. Histological examination of cell composition of formed subepidermal infiltrates using monoclonal T cell antibodies (CD2, CD3, CD4, CD5, CD7, CD8) and B-cells (CD20) revealed a dominant T-cell character. The highest quantitative density was characteristic of CD4 and CD3+ cells. A smaller density was manifested by cells with CD2 and CD5 positivity. Isolated T cells with CD8 positivity were revealed in the infiltrates. The findings have suggested of selective migration of T helper lymphocyte subpopulation to the affected skin. The emergence of CD8+ T-cell subpopulations of lymphocytes in the area of skin infiltrate may indicate the activation of the tumor process, which in our case is confirmed by the characteristic clinical picture.
Conclusions. Detection of a decrease in the ratio of CD4/CD8 by means of immunohistochemistry may serve as a persuasive criterion of confirming tumor progression considering the difficulties of clinical verification of macroscopic and microscopic manifestations of early stage of mycosis fungoides in the differential diagnosis of dermatitis of various origins.

Keywords: mycosis fungoides, early stage, immunohistochemistry, the ratio of CD4+/CD8+ lymphocytes.

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Original language: Russian

9. TO HELP PRACTICING PHYSICIANS

 
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Prophylaxis of dangerous for life side effects of corticosteroid therapy

A.S. Vladyka1, L.V. Roschenyuk2, V.M. Vorontsov2

1 Odesa National Medical University
2 Kharkiv Regional Clinical Dermatovenerologic Dispensary N 1
Literature was analysed on the side effects of corticosteroid therapy. Data are presented about the side effects of corticosteroid therapy. Toxic doses of glucocorticosteroids are cited. Schedules of treatment and prophylaxis of complications, suggested by the Institute of Dermatology and Venereology of NAMS of Ukraine were substanciated.

Keywords: corticosteroid therapy, side effects, toxic doses, treatment, prophylaxis, metformin, calcium carbonate, cholecalciferol.

List of references:
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2.    Глумчер Ф.С. Анафилактические и анафилактоидные реакции // Мистецтво лікування.— 2009.— № 3.— С. 57—61.
3.    Драговоз С.М. Лекарственная токсикология: учебник-справочник.— Х.: Титул, 2015.— 592 с.
4.    Дроговоз С.М., Рапопорт С.И., Кононенко А.В. и др. Хронофармакология наглядно (Хронофармакология в таблицах и рисунках): справочник— учебное пособие.— Х.: Титул, 2014.— 128 с.
5.    Левченко О.А. Глюкокортикостероидные гормоны в дерматологии: профилактика и лечение осложнений // Дерматол. та венерол.— № 3 (69).— 2015.— С. 64—69.
6.    Ляшук П.М. Актуальні питания сис­темної терапії глю­кокортикоїдними пре­паратами // Міжнар. ендокринол. журнал.— 2009.— № 2 (20).— С. 99—102.
7.    Опека пациента в практике врача и провизора. Руко­водство по применению лекарственных средств: пособие / Под ред. И.А. Зупанца, В.П. Черных.— 2-е изд., испр. и доп.— К.: Украинский медицинский вестник, 2012.— 480 с.
8.    Панькив В.И. Болезнь Иценко—Кушинга: диагностика, клиника, лечение // Новости медицины и фарма­ции.— 2011.— № 16 (379).— С. 27—29.
9.    Приходько У. Фармаконадзор и формулярная система в Украине // Укр. мед. часопис.— 2009.— № 59730.— С. 107—110.
10.    Рижко П.П., Владика А.С., Воронцов В.М. та ін. Інтен­сивна терапія в дерматовенерології / За ред. П.П. Риж­ка.— Х.: Прапор, 2006.— 265 с.
11.    Рощенюк Л.В., Владика А.С., Міненко С.В. та ін. Про­філактика ускладнень, зумовлених побічною дією корти­костероїдної терапії, у хворих на пухирчатку // Укр. журн. дерматол., венерол., косметол.— 2014.— № 4 (55).— С. 56—61.
12.    Рыжко П.П., Владика А.С., Воронцов В.М. Инфузионная терапия в дерматовенерологии / Под ред. А.С. Влады­ки.— Х.: Магда, 2010.— 150 с.
13.    Сіроштан Г.М. Особливості побічної дії лікарських за­­собів у осіб похилого віку // Медична газета.— 2010.— № 4 (269).— С. 2.
14.    Сіроштан Г.М., Плис Т.О. Побічна дія лікарських засобів // Медична газета.— 2007.— № 29 (215).— С. 3.
15.    Стероиды: руководство по применению, побочные эф­­фекты, начало и завершение приема // http://www.journal.airmed.com.ua/?p=1828.
16.    Фомин П.Д., Никишаев В.И. Кровотечения из верхних отделов желудочно-кишечного тракта: причины, факторы риска, диагностика, лечение // http://health-ua.com/pics/pdf/Hirurg_2010_02/8-11.pdf.
17.    Харкевич Д.А. Фармакология: Учебник.— 9 изд., перераб., испр. и доп.— М.: ГЭОТАР-Медиа, 2006.— 736 с.
18.    Цераидис Г.С., Бавыкина Е.А., Подулько Э.С. Диаг­нос­тика, терапия и диспансеризация больных с хронической пузырчаткой (Методические ре­­комендации).— Х.,1972.— 15 с.
19.    Thiel H., Roewer N. Anästhesiologische Pharmakotherapie: Allgemeine und spezielle Pharmakologie in Anästhesie,_Intensivmedicin, Notfallmedicin und Schmerztherapie.— Stuttgart-New York: Georg Thieme Verlag, 2004.— 456s.

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Original language: Russian

10. TO HELP PRACTICING PHYSICIANS

 
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At the intersection of dermatology and nephrology: focus on patients with psoriasis

L.V. Konovalenko

City Dermatovenerologic Dispensary N 4, Kyiv
Key relationships between renal disease and skin, examples of skin manifestations of chronic renal failure and other kidney diseases are discussed in this article. The author examines the problem of risk of chronic kidney disease in patients with psoriasis  and proposes to initiate a pilot project on screening of kidney function in patients with psoriasis at the regional level.

Keywords: chronic kidney disease, skin manifestations, renal failure, risk, psoriasis, screening, dermatology, nephrology.

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Original language: Ukrainian

11. PHARMACOTHERAPY IN DERMATOLOGY AND VENEREOLOGY

 
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New treatment options for patients with lichen planus

I.V. Kadygrob1, 2, N.V. Hitrina1, N.V. Gutsu1

1 Kharkiv City Dermatology and Venereology Dispensary № 1
2 Kharkiv Medical Academy of Postgraduate Education, the Ministry of Health Care of Ukraine
Objective — to evaluate the effectiveness and tolerability of «Clobeskine» drug in patients with lichen planus.
Materials and methods. We observed 84 patients with lichen planus who were divided into 2 groups. Patients of the main group (42 persons) were administered «Clobeskine» drug, patients of the control group (42 persons) — the reference drug «Dermovate».
Results and discussion. We proved the therapeutic effectiveness of the drug in 92.3 % of patients. There was a significant reduction in the severity of rash on the skin, area of skin lesions and severity of itching, especially in the first 14 days of treatment.
Conclusions. «Clobeskine» drug is highly effective in the treatment of lichen planus. It is well tolerated by patients, does not cause adverse reactions, as well as local skin changes and adverse changes in laboratory parameters of blood and urine. The drug contributes to rapid reduction of elements of rash, a decrease in the severity of subjective complaints and the area of skin lesions.

Keywords: lichen planus, «Clobeskine», efficiency, safety.

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Original language: Russian

12. PHARMACOTHERAPY IN DERMATOLOGY AND VENEREOLOGY

 
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Features of therapy of resistant trichomoniasis infection

G.M. Bondarenko, I.M. Nikitenko, I.V. Shcherbakova

SІ «Institute of Dermatology and Venereology of NAMS Ukraine», Kharkiv
The problem of treatment of urogenital trichomoniasis remains relevant, in spite of development of numerous methods of therapy. Insufficient treatment adds to the formation of chronic infectious process with resistance of Trichomonas vaginalis to traditional medicines of imidasol group. The article presents the results of the study of efficiency and safety of using high doses of ornidazole in treatment of resistant forms of trichomoniasis.

Keywords: trichomoniasis, resistance, treatment, ornidazole.

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Original language: Russian

13. PHARMACOTHERAPY IN DERMATOLOGY AND VENEREOLOGY

 
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Teobon­ditiomikocide — modern high-efficiency antimicotic

V.I. Stepanenko1, L.M. Shkaraputa2, L.V. Sologub1, L.O. Tyshchenko2,
L.А. Shevchenko2, Ya.V. Tsekhmister1, V.P. Kukhar2

1 O.O. Bogomolets National Medical University, Kyiv
2 Institute of Bioorganic Chemistry and Рetrochemistry of NAS of Ukraine, Kyiv
In spite of the high­level synthesis of new compounds, Ukraine has been spending tens of millions of dollars and has been a constant importer of effective antifungals since the days of the USSR. Specialists of the Institute of Bioorganic Chemistry and Petrochemistry of National Academy of Sciences of Ukraine and О.О. Bogomolets National Medical University, based on the results of fundamental research, have created a highly efficient domestic product — antifungal «Teobon­ditiomikocide», the production and use of which is based on 15 inventions. High efficiency and safety of randomly selected samples of teobon­ditiomikocide ointments of different series were experimentally proved. It is a highly effective antimy­cotic.

Keywords: antimycotic drug «Teobon­ditiomikocide», toxicological and clinical studies, the efficiency, safety, verification of commercial batches.

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Original language: Ukrainian

14. CLINICAL CASE STUDIES

 
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Psoriasis: rare clinical form and diagnostic mistakes

V.E. Tkach1, M.S. Voloshynovych1, I.I. Kuzenko2, A.D. Muhammad1

1 SHEI «Ivano-Frankivsk National Medical University»
2 CE «Ivano-Frankivsk Regional Skin and Venereal Dispensary»
A rare form of psoriasis — psoriasis rupioides — was described, typical diagnostic mistakes were demonstrated.

Keywords: psoriasis, rare clinical form, diagnostic mistakes.

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Original language: Ukrainian

15. Reviews

 
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Analysis of epidemiological situation of syphilis in the European Union and the United States as background of the public administration of socially dangerous infections

V.V. Korolenko

National Academy of Public Administration under the President of Ukraine, Kyiv
O.O. Bogomolets National Medical University, Kyiv
Objective — to study the role of STIs as the social determinants of public health in the leading countries of the world. For that purpose it is necessary to analyze the epidemiological situation of syphilis in the European Union/European Economic Area (EU/EEA) and the United States, with consideration of the Centers for Disease Control and Prevention in these specific regions which can effectively organize the collection and processing of statistically reliable information on these infections.
Materials and methods. A retrospective analysis has been conducted of the reports of the Centers for Disease Control and Prevention of the European Union and the US of 2014 and other literature resources.
Results and discussion. The epidemiological situation with syphilis in the European Union and the United States is characterized by the increase in levels of morbidity, on account of men, especially men having sex with men (MSM). There are problems of collecting and evaluating statistical information caused by the diversity of national surveillance systems for syphilis. The level of detection of co­infections of STIs remains inadequate. It’s necessary to improve the advocacy and communication program to inform the public about the prevention of STIs.
Conclusions. Syphilis tends to increase in many countries of the EU/EEA and in the US on account of males, in the first place — MSM, most likely associated with possible changes in sexual behavior. In addition, the contribution to this trend is made by more complete reporting and improvement of case detection, for example, greater test coverage of HIV­positive MSM, as recommended in current guidelines to HIV manage. Promotion of safe sexual behavior and increased test coverage among high­risk groups within the targeted prevention campaigns are essential to preventing infection and reduces the risk of complications and transition to the later stages of syphilitic infection. Approaches that use social media and online dating sites for campaigns on prevention can be considered as an effective addition to traditional approaches.
Due to the described new global trends it may be appropriate to study the dynamics of the epidemiological situation of syphilis in Ukraine as an indicator of the dermatovenereological component of the national public health. This will better develop the system of state and public administration of socially dangerous infections as an important risk factor for public health.

Keywords: public health, dermatovenereology, European Union, United States, STIs, syphilis.

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16. Reviews

 
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Pharmacological substantiation of carboxytherapy in dermatology

S.M. Drogovoz, S.Yu. Shtrygol, L.B. Ivantsyk, A.V. Kononenko, N.V. Gryshchenko

National University of Pharmacy, Kharkiv
Carboxytherapy is a method of invasive and non­invasive introduction of CO2 into the epidermis and the soft tissues, which is widely used in cosmetology and dermatology. Pharmacodynamics of CO2 in dermatology includes multiple local and resorptive effects: an increase of oxygen amount in the skin, stimulation of the process of skin regeneration and angiogenesis, the production of collagen, improvement of the results obtained by the methods of rejuvenation. Due to the diverse local and resorptive action, CO2­-therapy is indicated for the treatment of skin diseases (neurodermatitis, acne, scleroderma, psoriasis, eczema, alopecia, complex wounds, scars of different origin, allergic dermatitis), improvement of blood circulation, enhancement of protective properties of the skin, healing of wounds and burns, reduction of itch and skin inflammation. Availability of carboxytherapy in dermatology is provided by its high efficiency, obtainable price, safe and painless treatment.

Keywords: carboxytherapy, neoangiogeneses, hypercapnia, stimulation of fibroblasts.

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17. Reviews

 
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The tools used for teaching dermatology throughout history

C. Diehl

Universitá Degli Studi Guglielmo Marconi, Rome, Italy
Dermatology is the study of skin diseases. This is a full medical specialty since the end of the eighteenth century.  In the course of the nineteenth century the three major schools of dermatology were in London, Paris and Vienna, according to the languages used to teach it. The first textbook of dermatology dates 1572 and was Italian, written by Girolamo Mercuriale. It was followed by the beginning of the eighteenth century by two textbooks written in English by Turner and Willan. In 1817, Bateman’s was the first atlas of dermatology, enriched for the first time by engravings. A while later, Alibert was publishing a similar atlas written in French. In German-speaking countries, the first atlas was only published in 1856 in Vienna by Ferdinand von Hebra. In the meantime, moulages (mouldings) were another popular and very artistic way of teaching dermatology. They were mainly used in Europe, and we still possess various valuable collections in different places. Photography was first described in 1839 and used for the first time in medicine in 1845 by Donné in a textbook of bacteriology. In 1864 photography started to be applied to dermatology, and more and more books were published which were including photographs. From 1935 onward, the invention of diafilms permitted having the dermatological pictures on slides which could be easily projected to a great number of persons at the same time. In 1838 was published the first Journal of Dermatology in German, which was followed by analogues in French, Italian and English languages. The next and last revolution in the tools for teaching dermatology was the occurrence of Internet, mainly in 1995. This permits instantaneous connection, updating and sharing of knowledge all around the world. All the books and journals have now their electronic version, accessible by anybody anywhere. This is also the technical support for teledermatology.

Keywords: Dermatology, teaching, textbook, atlas, moulage, photographs, internet, teledermatology.

List of references:  
1.    McCaw I.H. A Synopsis of the History of Dermatology //Ulster. Med. J.— 1944.— Vol. 13 (2).— P. 109—122.
2.    Mercuriale G. De morbis cutaneis.— Venice: Apud Juntas, 1572.
3.    Pusey W.A. History of dermatology.— New-York: AMS Press, 1979.— 132 p.
4.    Turner D. De morbis cutaneis.— London: Printed for R. and J. Bonwicke, J. Walthoe, R. Wilkin and T. Ward, 1714.
5.    Willan R. On cutaneous diseases.— London: J. Johnson, 1808.— Vol. 1.
6.    Bateman T. A Practical Synopsis of Cutaneous Diseases: According to the Arrangement of Dr. Willan: Exhibiting a Concise View of the Diagnostic Symptoms and the Method of Treatment.— London: Longman, Hurst, Rees, Orme, and Brown, 1813.
7.    Bateman T. Cutaneous disease: exhibiting the charac­teristic appearances of the principal genera and species comprised in the classification of the late Dr Willan.— London: Longman, Hurst, Rees, Orme, and Brown, 1817.
8.    Wallach D. Les Pionniers de la Dermatologie, BIU Santé Paris.— Available: http://www.biusante.parisdescartes.fr/histoire/medica/dermato.php.
9.    Alibert J.L. Description des maladies de la peau observées à l’Hôpital Saint-Louis.— Bruxelles: Wahlen, 1825.
10.    Alibert J.L. Clinique de l’Hopital St Louis ou traité complet des maladies de la peau. Paris: Cormon et Blanc, 1833.
11.    Von Hebra F. Atlas der Hautkrankeiten.— Vienna: Gerold’s Sohn, 1856.
12.    Moulage in Wikipedia.— Captured on May 4th 2016 from https://en.wikipedia.org/wiki/Moulage.
13.    McFall K.J. A critical account of the history of medical photography in the United Kingdom, 2000.
14.    IMI Fellowship submission, University of Wales, College of Medicine.
15.    Donné A. Cours de mIcroscopie complémentaire des études médicales. Paris: JB Baillière, 1845.
16.    Balmanno Squire A.J. (1864—1866) Photographs (coloured from life) of the diseases of the skin. London: J. Churchill and sons.
17.    Balmanno Squire. A manual of the diseases of the skin. London: J. Churchill and sons, 1868.
18.    Hardy A., de Montmeja A. Clinique photographique de l’hôpital St Louis.— Paris: Lib Chamerot et Lauwereyens, 1868.
19.    Kuner N., Hartschuh W. First descriptions in the «Interna­tional atlas of rare skin diseases» of 1886.— Hautarzt, 2003.— Vol. 54 (1).— P. 67—72.
20.    Wallach D., Charansonnet M.C. The establishment of the first journals of dermatology and venereology in the nineteenth century // Hist. Sci. Med.— 1994.— Vol. 29 (4).— P. 359—364.
21.    Perednia D.A., Brown N.A. Teledermatology: one appli­cation of telemedicine // Bull. Med. Libr. Assoc.— 1995.— Vol. 83 (1).


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