RESUMO
OBJECTIVE: To increase the effectiveness of the treatment of laryngeal pathology associated with gastroesophageal reflux disease (GERD), to determine the indications for the appointment of anti-inflammatory therapy to these patients. MATERIAL AND METHODS: 120 patients were examined and treated, 58 of them men and 62 women, aged 30 to 82 years with GERD-associated laryngeal pathology. Three groups of patients were formed, comparable in age and gender, in accordance with the type of pachydermia in interarytenoid region; type 1 (40 patients) - pachydermia did not go beyond the middle of the interarytenoid cartilage (according to G.F. Ivanchenko), less than 3 mm, without signs of perifocal inflammation; type 2 (40 patients) - pachydermia of large size, extending beyond the middle of the interarytenoid cartilage with a spread to the entire interarytenoid region (according to G.F. Ivanchenko), often in combination with hyperkeratosis or epithelial dysplasia; type 3 (30 patients) - pachydermia of large size in combination with severe perifocal inflammation. All patients received antireflux therapy. Each group is divided into two subgroups: patients who did not receive anti-inflammatory therapy, and patients who received anti-inflammatory therapy, the basis of which was inhalation with degassed alkaline mineral water, as well as according to indications acetylcysteine, benzyldimethylammonium chloride 0.01% or hydroxymethylquinoxalindioxide, with severe swelling of the mucous membrane - budesonide. All patients completed the questionnaire "Reflux Symptoms Scale" before and after treatment. RESULTS: In group 2 patients (with type 2 pachydermia), the effectiveness of anti-inflammatory therapy was 75%. Of the 20 patients in this group, after inhaled therapy, 4 patients had pachydermia in interarytenoid region disappeared, 11 patients had type 1 pachydermia visualized, 5 (25%) patients had no pronounced dynamics. In group 3 patients (with type 3 pachydermia), the effectiveness of inhaled treatment was 100%, out of 15 patients after inhaled therapy, type 2 pachydermia was diagnosed in 8 patients, type 1 pachydermia - in 7 patients. In 4 patients, complex therapy led to the complete disappearance of reflux-associated laryngeal granulomas without surgical treatment. The effectiveness of inhaled therapy in relation to patient complaints after a month was 87%, while the effectiveness of treatment of patients without inhalation was 45%. CONCLUSIONS: Indications for the appointment of inhaled anti-inflammatory therapy in patients with reflux-associated pathology of the larynx are the presence of complaints of hoarseness, dryness, tickling, lump in the throat and chronic cough, endolaryngoscopic signs of exacerbation of chronic inflammation of the mucous membrane of the posterior larynx.
Assuntos
Refluxo Gastroesofágico , Laringe , Masculino , Humanos , Feminino , Refluxo Gastroesofágico/complicações , Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/tratamento farmacológico , Rouquidão/complicações , Inquéritos e Questionários , InflamaçãoRESUMO
OBJECTIVE: To improve the diagnosis of laryngeal disease in patients with gastroesophageal reflux disease (GERD). MATERIAL AND METHODS: 171 patients (89 (52%) men, 82 (48%) women) with non-erosive (39 (23%) people) and erosive (132 (77%) people) forms of GERD were examined. None of the patients made active complaints about the condition of the larynx and pharynx. The examination included a questionnaire, examination by an otorhinolaryngologist, and videoendolaryngoscopy. RESULTS: The survey revealed the presence of symptoms of otorhinolaryngological pathology in 74% of patients. Videolaryngoscopy revealed no laryngeal pathology in 55 (32%) patients, and signs of GERD-associated laryngitis were detected in 116 (68%) patients. The most common pathology was pachydermia in interarytenoid region - in 89 people, laryngeal granuloma was detected in 7 patients, leukoplakia - in 2 patients, chronic edematous polypous laryngitis - in 2 patients, benign laryngeal formations - in 9 patients. In patients with GERD (erosive and non-erosive forms), an asymptomatic course of chronic laryngitis associated with this pathology was observed in 44% of cases. In 52% of patients, pachydermia in interarytenoid region was diagnosed, of which every second had pronounced hyperplasia and folding of the mucous membrane in interarytenoid region, which must be differentiated from laryngeal cancer (in this case, patients should be under the dynamic supervision of an otorhinolaryngologist). Other precancerous formations of the larynx (granulomas and leukoplakia) were found in 5% of patients. Benign neoplasms of the larynx (polyps and cysts) were also detected in 5% of cases. CONCLUSIONS: Despite the high frequency of detection of otorhinolaryngological diseases in the examined patients with gastroesophageal reflux disease, none of the patients presented complaints related to the pathology of the larynx, which indicates the need for active detection of this pathology in this category of patients by questioning, questioning, as well as examination by an otorhinolaryngologist.
Assuntos
Refluxo Gastroesofágico , Doenças da Laringe , Edema Laríngeo , Neoplasias Laríngeas , Laringite , Laringe , Masculino , Humanos , Feminino , Laringite/diagnóstico , Laringite/epidemiologia , Laringite/etiologia , Doenças da Laringe/diagnóstico , Doenças da Laringe/epidemiologia , Doenças da Laringe/etiologia , Refluxo Gastroesofágico/complicações , Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/epidemiologia , Laringe/patologia , Neoplasias Laríngeas/diagnóstico , Leucoplasia/complicações , Leucoplasia/patologiaRESUMO
A larger, lab-scale photocatalytic suspended-bed reactor using TiO2 sol-gel-coated expanded clay granules as a bed material was evaluated for oxidative removal of the persistent pharmaceuticals doxycycline, prednisolone, amoxicillin, and sulfamethizole, as well as their mixture, in ppm concentrations. The photocatalytic degradation potential of drug molecules increases as their adsorption affinity increases towards TiO2-containing coatings. The performance of the photocatalytic reactor in the removal of drugs was improved by optimizing the fluidization process parameters. The reactor operation at high bed loadings is determined by the abrasion resistance of the catalyst coating. The long-term stability of the coated bed was enhanced by optimal loading, achieving a higher removal rate while placing moderate mechanical stress on the coated granules. The photocatalytic pretreatment decreased the toxicity of doxycycline solutions to several bacterial strains, including the environmental bacterium Pseudomonas putida and bacterial strains freshly isolated from the activated sludge. The treatment of doxycycline-containing water with a combination of photocatalytic treatment and bio-oxidation resulted in 98% removal of the target in the bioreactor outlet, with no deterioration in the operation of the biological process.
Assuntos
Eliminação de Resíduos Líquidos , Purificação da Água/métodos , Adsorção , Catálise , Luz , Oxirredução , Fotoquímica , Titânio/química , Purificação da Água/normasRESUMO
UNLABELLED: Human Y chromosome is used as a tool in male infertility and population genetic studies. The aims of this research were to analyse the prevalence of Y chromosome microdeletions among infertile Latvian men, and to identify possible lineages of Y chromosome that may be at increased risk of developing infertility. A study encompassed 105 infertile men with different spermatogenic disturbances. Deletions on Y chromosome were detected in 5 out of 105 (approximately 5%) cases analysed in this study. Three of them carried deletion in AZFc region and two individuals had AZFa + b + c deletion. Study of Y chromosome haplogroups showed that N3a1 and R1a1 lineages were found less frequently in the infertile male group compared to ethnic Latvian group, however K* cluster was predominantly found in infertile male Y chromosomes. CONCLUSIONS: 1) Our study advocates running Y chromosome microdeletion analyses only in cases of severe form of infertility; 2) Y chromosome haplogroup analysis showed statistically significant tendencies that some haplogroups are more common in ethnic male group, but others are more common in infertile males.
Assuntos
Cromossomos Humanos Y/genética , Infertilidade Masculina/genética , Deleção de Sequência , Adulto , Loci Gênicos , Haplótipos/genética , Humanos , Letônia , Masculino , Pessoa de Meia-Idade , Proteínas de Plasma Seminal/genética , Adulto JovemRESUMO
INTRODUCTION: Phenylketonuria (PKU) is an inborn error of metabolism characterized by pathogenic variants of the phenylalanine hydroxylase (PAH) gene with a resulting accumulation of phenylalanine (Phe) to neurotoxic levels. Diagnosis of PKU in the Latvian population began in 1985 and the present study's aim was to evaluate the available data on all PKU patients in Latvia. MATERIALS AND METHODS: The medical records of 116 - DNA sample was available in 110 patients (102 nonrelated individuals) diagnosed with PKU in Latvia were obtained. Phe concentrations were measured in dried blood spots. Genomic DNA was analyzed for pathogenic variants in the PAH gene. Biochemical data were available through follow-up visits of the 83 patients. RESULTS: In 97% of patients (99 of 102), pathogenic variants were detected on both alleles. With an occurrence of 69.6%%, the most common pathogenic variant was the severe pathogenic variant p.Arg408Trp. The available data for 83 patients revealed that metabolic control was better in younger age groups and worse in adults. CONCLUSION: Latvia exhibits a relatively homogeneous pool of disease-causing PKU alleles with a high prevalence of the classical severe form of PKU. Dietary compliance in all patients' groups is lower than expected, especially it is poor in adult age group.
RESUMO
AIM: To evaluate effects of recurrent herpetic infection on functional activity of regulatory cell subpopulations in patients with rheumatoid arthritis. MATERIAL AND METHODS: We studied in vitro production of marker cytokines of type 1 T-helpers (IL-2), type 2 T-helpers (IL-4), type 3 T-helpers TGFbeta and type 1 T-regulators (IL-10) and counted CD4+CD25+ T-cells in the blood of patients with recurrent herpetic infection and having no clinical manifestations of Herpes virus reactivation. RESULTS: Patients with recurrent herpes had more active production of IL-10, but reduced count of CD4+CD25+ lymphocytes. CONCLUSION: IL-10 hyperproduction observed in recurrent herpetic infection may contribute to progression of rheumatoid arthritis.
Assuntos
Artrite Reumatoide/imunologia , Infecções por Herpesviridae/imunologia , Linfócitos T/imunologia , Adulto , Artrite Reumatoide/complicações , Artrite Reumatoide/fisiopatologia , Infecções por Herpesviridae/complicações , Humanos , Interleucina-10/biossíntese , Interleucina-10/imunologia , Interleucina-2/biossíntese , Interleucina-2/imunologia , Interleucina-4/biossíntese , Interleucina-4/imunologia , Pessoa de Meia-Idade , Recidiva , Fator de Crescimento Transformador beta/biossíntese , Fator de Crescimento Transformador beta/imunologiaRESUMO
Herpesvirus infection is accompanied by imbalance of peripheral mononuclear production of cytokines, by polarizing an immune response by the Th2 pathway. The homozygous TT genotype of T330G polymorphism in the IL-2 gene is an immunogenetic factor that has a protective activity against susceptibility to herpesvirus infection. The risk of progression, the recurrent course of the infection and its poor outcome is positively associated with the heterozygous TG genotype in the IL-2 gene T-330G promoter region and with the homozygous CC type and C allele in the IL-4 gene C-590T promoter region.
Assuntos
Alelos , Predisposição Genética para Doença , Infecções por Herpesviridae/genética , Interleucina-2/genética , Interleucina-4/genética , Polimorfismo Genético , Adolescente , Adulto , Estudos de Casos e Controles , Feminino , Infecções por Herpesviridae/imunologia , Infecções por Herpesviridae/virologia , Heterozigoto , Homozigoto , Humanos , Interleucina-2/sangue , Interleucina-4/sangue , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Regiões Promotoras Genéticas , Linfócitos T/imunologia , Adulto JovemRESUMO
Characterization of the molecular basis of phenylketonuria (PKU) in Latvia has been accomplished through the analysis of 96 unrelated chromosomes from 50 Latvian PKU patients. Phenylalanine hydroxylase (PAH) gene mutations have been analyzed through a combined approach in which R158Q, R252W, R261Q, G272X, IVS10-11G>A and R408W mutations were first screened for by PCR or restriction generating PCR amplification of PAH gene exons 5, 7, 11 and 12 followed by digestion with the appropriate diagnostic enzyme. Subsequently 'broad range' denaturing gradient gel electrophoresis analysis of the 13 PAH gene exons has been used to study uncharacterized PKU chromosomes. A mutation detection rate of 98% was achieved. 12 different mutations were found, with the most frequent mutation, R408W, accounting for 76% of Latvian PKU alleles. Six mutations (R408W, E280K, R158Q, A104D, R261Q and P281L) represent 92% of PKU chromosomes. PAH VNTR and STR alleles have been also identified and minihaplotype associations with PKU mutations were also determined.
Assuntos
Fenilcetonúrias/epidemiologia , Fenilcetonúrias/genética , Substituição de Aminoácidos/genética , Testes Genéticos/métodos , Testes Genéticos/estatística & dados numéricos , Genética Populacional/métodos , Genética Populacional/estatística & dados numéricos , Humanos , Letônia/epidemiologia , Mutação , Fenilalanina Hidroxilase/genética , Fenilcetonúrias/enzimologiaRESUMO
Intracellular carbonic anhydrases (CA) in aquatic photosynthetic organisms are involved in the CO2-concentrating mechanism (CCM), which helps to overcome CO2 limitation in the environment. In the green alga Chlamydomonas reinhardtii, this CCM is initiated and maintained by the pH gradient created across the chloroplast thylakoid membranes by photosystem (PS) II-mediated electron transport. We show here that photosynthesis is stimulated by a novel, intracellular alpha-CA bound to the chloroplast thylakoids. It is associated with PSII on the lumenal side of the thylakoid membranes. We demonstrate that PSII in association with this lumenal CA operates to provide an ample flux of CO2 for carboxylation.
Assuntos
Proteínas de Algas/metabolismo , Carbono/metabolismo , Anidrases Carbônicas/metabolismo , Chlamydomonas reinhardtii/enzimologia , Fotossíntese , Complexo de Proteínas do Centro de Reação Fotossintética/metabolismo , Animais , Benzoquinonas/farmacologia , Bicarbonatos/metabolismo , Western Blotting , Dióxido de Carbono/metabolismo , Membrana Celular/enzimologia , Membrana Celular/metabolismo , Chlamydomonas reinhardtii/genética , Chlamydomonas reinhardtii/metabolismo , Cloroplastos/enzimologia , Cloroplastos/metabolismo , Transporte de Elétrons/efeitos dos fármacos , Etoxzolamida/farmacologia , Concentração de Íons de Hidrogênio , Luz , Mutação , Oxigênio/metabolismo , Complexo de Proteína do Fotossistema IIRESUMO
Removal of the thyroid gland in puppies in the early postnatal period (10--20 days) suppressed the hemodynamics and the glomerular filtration, increased concentration of urine in the tubules of the kidney and reduced spontaneous diuresis. Two months after the operation, a progressive disturbance of the osmotic concentration of urine occurred, and the diuresis increased. Thyroidectomized puppies at different age are unable to react to water deprivation, to develop osmotic diuresis; the elimination of water load is lesioned. In the first 6 months the introduced water is retained in the organism. The thyroid hormones are essential for the water elimination and concentrating functions of the kidney, for its adequate hemodynamics.
Assuntos
Rim/fisiologia , Glândula Tireoide/fisiologia , Fatores Etários , Animais , Desidratação/fisiopatologia , Diurese , Cães , Taxa de Filtração Glomerular , Rim/irrigação sanguínea , Capacidade de Concentração Renal , Concentração Osmolar , Tireoidectomia , Tiroxina/fisiologia , Fatores de Tempo , Tri-Iodotironina/fisiologiaRESUMO
It was already shown that antifreeze glycoproteins isolated from the blood of fish occurring in circumpolar regions inhibited the growth of ice crystals both in vitro and in vivo. When the spermatozoa were frozen to liquid nitrogen temperature, addition of antifreeze glycoproteins to cryoconserving media made it possible to decrease twofold the concentration of the synthetic cryoprotector dimethylsulfoxide without the loss and even with a certain increase in the number of viable spermatozoa. This effect was observed in the case of combined, rather than separate, addition of the fraction of weakly active (low molecular weight) and active (high molecular weight) antifreeze glycoproteins. Here, we studied the effect of antifreeze glycoproteins on the survival of carp spermatozoa under storage at +4 degrees C for varying periods of time. In the presence of total fraction of low and high molecular weight antifreeze glycoproteins (2 and 10 mg/ml) added in a physiological proportion (3:1), the survival of spermatozoa increase but this increase did not depend linearly on the medium concentration of protein. Low and high molecular weight antifreeze glycoproteins added separately (10 mg/ml) either did not affect or slightly affected the preservation of cells. The hypothermic effect of antifreeze glycoproteins in water was significantly higher than in a medium with salt activator.
Assuntos
Proteínas Anticongelantes/farmacologia , Criopreservação/métodos , Peixes , Espermatozoides/efeitos dos fármacos , Espermatozoides/fisiologia , Animais , Proteínas Anticongelantes/química , Carpas , Meios de Cultura , Masculino , Peso Molecular , Fatores de TempoRESUMO
The paper proposes a method of the CO2 transfer intensity analysis in membrane oxygenators of the "MOCT" type. The dependence of the CO2 elimination rate on the liquid flow and oxygen blow-down rates for various oxygenators have been studied on a closed loop circuit. It has been established that the elimination rate depends not only on the transfer through membrane and the liquid layer, but also on the CO2 hydration-dehydration rate.