RESUMO
Allergic diseases have been recognized as one of the global health issues and affect about a third of the worldwide population. COVID-19 pandemic has raised concerns about the risk of infection and the severity of COVID-19 infection in patients with asthma and allergic rhinitis. The aim of our study was to define the relationships between pollen exposures and SARS-CoV-2 infection rates in Georgia, as well as to characterize the Covid-19 autoimmune and antiviral responses in Georgian allergic patients with different sensitization patterns. Data on daily COVID-19 positivity rates, case fatality rates, and pollen concentrations from February 2020 to November 2022 were collected in Tbilisi, Kutaisi, and Batumi. Diagnostic parameters, including total IgE, specific IgE, eosinophil counts, anti-nuclear antibodies, and Covid-19 antibodies, were assessed in 181 atopic patients and 24 healthy controls with confirmed SARS-CoV-2 infection. Laboratory findings revealed significant variations in eosinophil counts and total IgE levels among the groups. ANA positivity did not exhibit substantial differences between atopic patients and healthy controls. Individuals with indoor allergies displayed lower SARS-CoV-2-specific antibody levels, potentially explained by variations in adaptive immune responses. There was no correlation between pollen concentration and COVID-19 epidemiological characteristics, indicating that pollen had no effect on virus epidemiology.
Assuntos
COVID-19 , Hipersensibilidade Imediata , Rinite Alérgica , Humanos , Pandemias , COVID-19/epidemiologia , República da Geórgia/epidemiologia , SARS-CoV-2 , Pólen , Imunoglobulina E , AlérgenosRESUMO
Allergic rhinitis is the most common chronic disease worldwide. Treatment guidelines have improved the knowledge on rhinitis and have had a significant impact on AR management. In 20 years, ARIA has considerably evolved from the first multi-morbidity guideline in respiratory diseases to the digital transformation of health and care. Allergic rhinitis in Georgia, Next-generation ARIA-GRADE guidelines and ARIA, 2020 care pathways for Allergen Immunotherapy have been discussed in this review.
Assuntos
Asma , Rinite Alérgica Perene , Rinite Alérgica , Asma/terapia , Dessensibilização Imunológica , República da Geórgia , Humanos , Rinite Alérgica/terapia , Rinite Alérgica Perene/terapiaRESUMO
The aim of our study was to investigate sensitization pattern to food allergens in different age groups of atopic patients in Georgia and reveal the associations between food sensitization and clinical manifestations of allergic disease reflecting the development of atopic march. 1000 patients (children-783, adult-217) with different clinical manifestations were involved in the study. Specific IgE antibodies to food mix, cow's milk, casein, egg, wheat, fish, nuts mixture and inhalant allergens were measured by using ImmunoCap (Phadia, Uppsala, Sweden). The prevalence of positive specific IgE to food mix was - 7.08%, cow's milk-4.61%, casein - 4.68%, hen's egg - 2.72%, fish mix - 0.77%, wheat -1.57% and to nuts mixture - 2.86%. The frequency of atopic dermatitis (p<0.0017), urticaria (p<0.0223) and anaphylactic shock (p<0.001) were significantly increased in patients with specific IgE to food mix. Allergic skin manifestations to ingested food were age-dependent, more frequent in children groups. Cow's milk and hen's egg are the commonest food allergens in the age group of <2 years. Sensitization to food mix, cow's milk, casein, hen's egg and wheat were predominated in male patients. Egg allergy was significantly associated with atopic dermatitis, fish allergy to bronchial asthma and severe milk allergy to anaphylactic shock. Present study is a first comprehensive investigation, providing unique data of the prevalence of food allergies in Georgian population. The results of this study are contributing to a better understanding of the disease, serving as a basis for the development of strategies for preventing and treating food allergies.
Assuntos
Hipersensibilidade Alimentar/fisiopatologia , Adolescente , Fatores Etários , Criança , Pré-Escolar , Feminino , Hipersensibilidade Alimentar/epidemiologia , República da Geórgia/epidemiologia , Humanos , Masculino , Prevalência , Fatores SexuaisRESUMO
Arterial hypertension is the most common risk factor in patients with metabolic disorders. In the selection of antihypertensive therapy it is necessary to consider not only the anti-hypertensive and organoprotective effects of drugs and their metabolic effects, which has prognostic value. Calcium antaginists, along. Lercanidipine related to the third generation dihydripyridine calcium antagonist, has been much more selective for the so-called slow calcium channels of vascular smooth muscle cells, which is associated with a good hypertensive, organo and metabolic action. Combination therapy with an ACE inhibitor and a calcium channel blocker is also a justified tactic for the management of patients with high-risk cardiovascular and metabolic disorders. Attention is paid new fixed combinations, including angiotensin converting enzyme inhibitors and calcium antagonists.
Assuntos
Bloqueadores dos Canais de Cálcio/uso terapêutico , Di-Hidropiridinas/uso terapêutico , Hipertensão/tratamento farmacológico , Doenças Metabólicas/tratamento farmacológico , Inibidores da Enzima Conversora de Angiotensina , Cálcio/metabolismo , Quimioterapia Combinada , Humanos , Hipertensão/complicações , Hipertensão/patologia , Doenças Metabólicas/complicações , Doenças Metabólicas/patologia , Fatores de Risco , Resultado do TratamentoRESUMO
Food allergy has become a serious health concern especially in developed countries in the past two decades. In general population approximately 4-6% of children and 1-3% of adults experience food allergy. The article reviews IgE-mediated food hypersensitivity disorders. Epidemiology, Mechanism, Clinical manifestations, Genetically modified crops (GMOs), Diagnosis, Prevention and Treatment of IgE-mediated food allergies are discussed. The investigations show that over 90% of IgE-mediated food allergies in childhood are caused by: cow's milk, hen's egg, soy, peanuts, tree nuts, wheat, fish and shellfish. Also the causes of food allergy are food additives, genetically modified crops. Risk factors for food-dependent exercise-induced anaphylaxis include asthma and previous allergic reactions to the causative food. Food allergy is one of the most common causes of systematic anaphylaxis and anaphylactoid reactions, with an annual incidence of four cases per million populations and estimated 500 deaths annually. In addition to gastrointestinal symptoms, individuals may experience urticaria, angioedema, atopic dermatitis, oral syndrome, asthma, rhinitis, conjunctivitis, hypotension, shock and cardiac arrhythmias, caused by the massive release of mediators from mast cells and basophiles. Diagnosis of food allergy is based on history, detailed dietary analysis, skin testing, measuring specific IgE in blood serum and challenge tests. Treatment and prevention includes: avoidance diet, application of auto-injectable epinephrine, H1 and H2 antihistamines, corticosteroids, antileukotrienes, prostaglandin synthetase inhibitors, cromolyn sodium, etc.
Assuntos
Hipersensibilidade Alimentar/imunologia , Imunoglobulina E/imunologia , Hipersensibilidade Alimentar/epidemiologia , HumanosRESUMO
UNLABELLED: Thyroid dysfunction as an important cardiovascular risk factor, is not well characterized among cardiology patients of Georgia. Further, a consensus has not been reached about the relationships between thyroid function markers and plasma lipids. We investigated these risk factors among 250 cardiology patients admitted to the Emergency Cardiology Center. A cross sectional study was conducted using in-person interviews, medical records, physical exams and laboratory studies. Thyroid stimulating hormone, free thyroxine 3, free thyroxine 4 and plasma lipids were measured using standardized assays. Overall, thyroid dysfunction was detected among 28.6% of the study population (19.5% males and 39.6% females). Overt hypo- and hyperthyroidism were present among 12.4% and 6.0% of patients, while, subclinical hypo- and hyperthyroidism were present among 2.8% and 6.4% of patients respectively. Both clinical and subclinical hypothyroidism were associated with elevated total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) concentrations (p-values for trend <0.005). Further, TC and LDL-C were highly correlated with thyroid function markers (all p-values <0.000). Triglycerides and high-density lipoprotein cholesterol concentrations were not associated with thyroid function status. Hyperthyroidism was not associated with plasma lipid variation. IN CONCLUSION: thyroid dysfunction was prevalent among cardiology patients in Georgia. Hypothyroidism was associated with elevated TC and LDL-C concentrations. Future studies that examine the clinical relevance of observed differences in lipid profiles among this population are needed.
Assuntos
Doenças Cardiovasculares/epidemiologia , Lipídeos/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue , Adulto , Idoso , Estudos Transversais , Feminino , República da Geórgia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Glândula Tireoide/metabolismoRESUMO
It is well known that endothelial dysfunction as a nontraditional risk factor is an important early event in the pathogenesis of coronary atherosclerosis, contributing to plaque initiation and progression. In order to assess endothelial function plasma nitric oxide (NO) concentrations were determined. A total of 157 patients (119 men and 38 women, mean age 57+/-5,4 years) with coronary atherosclerosis were enrolled in the research. The study was cross-sectional in design. Most of the patients (n=127) had undergone myocardial revascularization procedures. There was statistically significant difference in mean values of plasma nitric oxide levels between patients with coronary atherosclerosis and healthy subjects (11,1+/-2,52 mkmol/L and 22,3+/-3,27 mkmol/L, respectively. p<0,01). Among all 157 patients only 17% had normal NO concentrations. In 59% cases low and in 24% cases high nitric oxide levels were found. Extent of coronary artery disease was associated with severity of endothelial dysfunction. The patients with three-vessel disease had the lowest mean plasma NO concentration. There was statistically significant negative correlation between mean plasma NO level and extent of coronary artery disease. Measurement of plasma nitric oxide concentration will give useful information for cardiologists, modification of abnormal levels of this parameter may delay progression of aggressive atherosclerotic process and thus, may prevent recurrent coronary events in patients with coronary atherosclerosis.
Assuntos
Doença da Artéria Coronariana/fisiopatologia , Endotélio Vascular/fisiopatologia , Ponte de Artéria Coronária , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/cirurgia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Óxido Nítrico/sangue , Índice de Gravidade de DoençaRESUMO
In order to assess efficacy of one of natural antioxidants--coenzyme Q10 (90 mg daily) and its combination with simvastatin (10 mg daily) 44 outpatients with coronary atherosclerosis were examined. Twenty four patients had undergone coronary artery bypass surgery, 12--coronary angioplasty and in 8 coronary heart disease was confirmed by angiography. Duration of treatment was 12 weeks. Positive effects of coenzyme Q10 was particularly expressed in relation to antiatherogenic fraction of cholesterol which increased by 23%. Index of atherogenicity decreased by 27%. At the background of coenzyme Q10 treatment 30% reduction in plasma lipoperoxide levels occurred demonstrating potentially independent role of coenzyme Q10 in positive modification of oxidative stress. Coenzyme Q10 revealed antiaggregatory ability. It was not related to the improvement of endothelial function. Normalization of plasma nitric oxide concentrations was achieved only with combination of coenzyme Q10 and simvastatin. This fact may be explained by positive action of statins on endothelial function.
Assuntos
Antioxidantes/uso terapêutico , Doença da Artéria Coronariana/tratamento farmacológico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Sinvastatina/uso terapêutico , Ubiquinona/análogos & derivados , Adulto , Idoso , Coenzimas , Angiografia Coronária , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/diagnóstico por imagem , Citoproteção , Quimioterapia Combinada , Feminino , Seguimentos , Humanos , Peróxidos Lipídicos/sangue , Masculino , Pessoa de Meia-Idade , Óxido Nítrico/sangue , Estresse Oxidativo/efeitos dos fármacos , Resultado do Tratamento , Ubiquinona/uso terapêuticoRESUMO
The problem of thyroid dysfunction is very actual in cardiac patients. The aim of the present study was to evaluate lipid profile parameters in 73 hypo-, hyper- and euthyroid cardiology patients visited the Emergency Cardiology Center. Most of the patients had coronary artery disease. Thyroid dysfunction was diagnosed on the basis of patients' clinical status and blood thyroid stimulating hormone. In hypothyroid patients blood levels of total cholesterol, low-density lipoprotein cholesterol and triglycerides were increased. In contrast, the patients with hyperthyroidism had normal concentrations of these parameters. Exception was antiatherogenic fraction of lipid profile - high-density lipoprotein cholesterol, which mean levels were normal in all patients' groups. It is noteworthy that the highest levels of atherogenic fractions were observed in the groups of patients who had hypothyroidism in combination with diabetes mellitus. In conclusion, the results of present study showed that thyroid dysfunction may play a potential independent role in changes of atherogenic lipid profile.
Assuntos
Colesterol/sangue , Doença da Artéria Coronariana/epidemiologia , Hipertireoidismo , Hipotireoidismo , Triglicerídeos/sangue , Feminino , Humanos , Hipertireoidismo/epidemiologia , Hipertireoidismo/metabolismo , Hipertireoidismo/fisiopatologia , Hipotireoidismo/epidemiologia , Hipotireoidismo/metabolismo , Hipotireoidismo/fisiopatologia , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de DoençaRESUMO
In order to evaluate some pleiotropic effects of cardilopin (Amlodipine, EGIS Pharmaceuticals) 33 ambulatory patients were examined. During the 2-month study period on the background of cardilopin treatment there were positive changes in some parameters of coronary atherosclerosis. Pleiotropic effects of cardilopin were particularly expressed in restoring of endothelial function and inhibition of platelet aggregation. There was found tendency to reduce the degree of hyperlipoperoxidemia related to oxidative stress. Obtained results of the present trial support the use of cardilopin in all coronary heart disease patients with or without myocardial revascularization and arterial hypertension.
Assuntos
Anlodipino/uso terapêutico , Bloqueadores dos Canais de Cálcio/uso terapêutico , Doença das Coronárias/tratamento farmacológico , Vasodilatadores/uso terapêutico , Anlodipino/administração & dosagem , Anlodipino/farmacologia , Pressão Sanguínea/efeitos dos fármacos , Monitores de Pressão Arterial , Bloqueadores dos Canais de Cálcio/administração & dosagem , Bloqueadores dos Canais de Cálcio/farmacologia , Doença das Coronárias/sangue , Doença das Coronárias/metabolismo , Doença das Coronárias/fisiopatologia , Endotélio Vascular/fisiologia , Frequência Cardíaca , Humanos , Peróxidos Lipídicos/sangue , Óxido Nítrico/sangue , Estresse Oxidativo , Agregação Plaquetária/efeitos dos fármacos , Fatores de Tempo , Vasodilatadores/administração & dosagem , Vasodilatadores/farmacologiaRESUMO
The goal of the present research was to assess the efficacy of combination treatment with antioxidant coenzyme Q10 and simvastatin as well as coenzyme Q10 without statin therapy in order to prevent coronary atherosclerosis. 42 outpatients were divided into 2 groups: receiving coenzyme Q10 (Hasco-Lek, Poland) 60mg daily and its combination with simvastatin (zocor, vasilip) 10mg daily for an 8-week period. The treatment with coenzyme Q10 demonstrated its potential independent role in positive modification of oxidative stress, antiatherogenic fraction of lipid profile, atherogenic ratio, platelet aggregability. Taking into consideration the obtained results the study supports the use of coenzyme Q10 in combination with statins. Suggested attractive approach may result in complete correction of dislipidemia, reverse of endothelial dysfunction, reduce degree of oxidative stress and platelet aggregability. Consequently such a combination may be beneficial in preventing of further development of atherosclerosis in native coronary arteries as well as in bypass grafts in all coronary heart disease patients with or without myocardial revascularization.
Assuntos
Antioxidantes/uso terapêutico , Doença da Artéria Coronariana/prevenção & controle , Hipolipemiantes/uso terapêutico , Sinvastatina/uso terapêutico , Ubiquinona/análogos & derivados , Ubiquinona/uso terapêutico , Antioxidantes/administração & dosagem , Coenzimas , Ponte de Artéria Coronária , Doença da Artéria Coronariana/sangue , Doença das Coronárias/sangue , Doença das Coronárias/tratamento farmacológico , Doença das Coronárias/cirurgia , Interpretação Estatística de Dados , Quimioterapia Combinada , Feminino , Humanos , Hipolipemiantes/administração & dosagem , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Óxido Nítrico/sangue , Estresse Oxidativo , Agregação Plaquetária , Sinvastatina/administração & dosagem , Fatores de Tempo , Resultado do Tratamento , Triglicerídeos/sangue , Ubiquinona/administração & dosagemRESUMO
The goal of the present study was to evaluate the safety and efficacy of the third generation calcium antagonist -- modipin (amlodipin, Asfarma, Turkey) in 29 patients with coronary atherosclerosis and arterial hypertension. In addition, some pleiotropic actions were examined. On the background of 5-10 mg/day modipin monotherapy during the 3-month study period the target systolic and diastolic blood pressure were achieved in 64 and 51% of cases. Modipin revealed some antiatherogenic efficacy as well. Pleiotropic effects of the drug were particularly expressed in restoring endothelial function reducing degree of hyperlipoperoxidemia and inhibition of platelet aggregation. There were positive changes in functional class of angina. Clinical safety was good. Consequently the present trial supports the use of modipine in all coronary artery disease patients with moderate or severe arterial hypertension.
Assuntos
Anlodipino/análogos & derivados , Anlodipino/uso terapêutico , Bloqueadores dos Canais de Cálcio/uso terapêutico , Doença das Coronárias/complicações , Doença das Coronárias/tratamento farmacológico , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Anlodipino/administração & dosagem , Bloqueadores dos Canais de Cálcio/administração & dosagem , Esquema de Medicação , Humanos , Agregação Plaquetária , Resultado do TratamentoRESUMO
The efficacy of a new method of treatment, endovascular blood irradiation with He-Ne laser, developed by the authors, was studied in 295 patients with primary acute transmural myocardial infarction (MI). Twenty-four-hour Holter monitoring findings before and after laser irradiation suggested the possibility of preventing sudden death in the acute period of MI owing to the high anti-arrhythmic efficacy of the method with respect to high-grade ventricular arrhythmias. Precodial ECG mapping and serial determination of blood enzyme activities (CPK and MB-CPK) showed that irradiation performed within the first hours of MI development contributed to effective limitation of the infarction area and restricted the spread of the area of myocardial ischemic damage.
Assuntos
Terapia a Laser/métodos , Infarto do Miocárdio/cirurgia , Arritmias Cardíacas/etiologia , Arritmias Cardíacas/prevenção & controle , Creatina Quinase/sangue , Eletrocardiografia Ambulatorial , Feminino , Humanos , Isquemia/prevenção & controle , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/sangue , Infarto do Miocárdio/complicaçõesRESUMO
In 80 patients with acute transmural myocardial infarction (30 patients with anterior infarction and 50 with posterior infarction), endovascular irradiation of blood with helium-neon laser was studied for effects on the time-course of the processes of ischemic lesion and myocardial necrotization from the data on precordial mapping of 35 leads ECG (epsilon ST, nST, nQS) and serum creatinine phosphokinase and its MB fraction (maximal activity peak attainment time, level normalization, summary Q ejection and activity increase rate, delta E/delta t) were measured. The irradiation initiated no later than 4 hours after the development of anginal pains was found to contribute to a more rapid formation of a necrotic zone and to a decrease in extension and relapses of myocardial infarction.
Assuntos
Sangue/efeitos da radiação , Coração/efeitos da radiação , Terapia a Laser , Infarto do Miocárdio/radioterapia , Miocárdio/patologia , Adulto , Idoso , Biomarcadores/sangue , Creatina Quinase/sangue , Hélio , Humanos , Isoenzimas , Pessoa de Meia-Idade , Infarto do Miocárdio/sangue , Infarto do Miocárdio/patologia , Miocárdio/enzimologia , NeônioRESUMO
An analysis of 25 cases of anaerobic paraproctitis has shown that in most cases they were people over 60 having severe concomitant diseases. Primary necrotic proctitis should be distinguished as a special morphological form. Sepsis was found to develop mostly in necrotic forms and ascending anaerobic lymphadenitis. An urgent wide opening of paraproctitis with a radical dissection of the tissues suspected of a damage is thought to be a necessary condition for the favourable outcome of the disease.
Assuntos
Infecções por Bacteroides/cirurgia , Celulite (Flegmão)/cirurgia , Infecções por Clostridium/cirurgia , Proctite/cirurgia , Infecções Estreptocócicas/cirurgia , Adulto , Idoso , Infecções por Bacteroides/etiologia , Celulite (Flegmão)/etiologia , Infecções por Clostridium/etiologia , Clostridium perfringens , Humanos , Masculino , Pessoa de Meia-Idade , Proctite/etiologiaRESUMO
The authors made an analysis of their experience with treatment of sepsis in a specialized center. Typical errors in treatment of the disease in the general public health service are: insufficient sanitation of septic foci, inadequate antibacterial therapy. Not all main possibilities of complex therapy are always used. The problem of struggle against sepsis can not be solved without organization of antiseptic centers.
Assuntos
Infecções Bacterianas/diagnóstico , Toxemia/diagnóstico , Infecção dos Ferimentos/diagnóstico , Infecções Bacterianas/terapia , Erros de Diagnóstico , Febre/diagnóstico , República da Geórgia , Humanos , Qualidade da Assistência à Saúde , Toxemia/terapia , Infecção dos Ferimentos/terapiaAssuntos
Enteropatias/terapia , Infecções Estafilocócicas/terapia , Staphylococcus aureus , Staphylococcus epidermidis , Doença Aguda , República da Geórgia/epidemiologia , Humanos , Enteropatias/complicações , Enteropatias/epidemiologia , Recidiva , Estudos Retrospectivos , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/epidemiologiaAssuntos
Infecções Bacterianas/cirurgia , Histerectomia/efeitos adversos , Nefrectomia/efeitos adversos , Peritonite/cirurgia , Infecção da Ferida Cirúrgica/cirurgia , Adulto , Idoso , Infecções Bacterianas/etiologia , Drenagem/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Lavagem Peritoneal , Peritonite/etiologia , Cuidados Pós-Operatórios , Reoperação , Infecção da Ferida Cirúrgica/etiologiaAssuntos
Queilite/cirurgia , Departamentos Hospitalares/organização & administração , Mastite/cirurgia , Sepse/etiologia , Infecções Estafilocócicas/cirurgia , Infecções Cutâneas Estafilocócicas/cirurgia , Centro Cirúrgico Hospitalar/organização & administração , Infecção da Ferida Cirúrgica/etiologia , Adulto , Erros de Diagnóstico , Feminino , República da Geórgia , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade da Assistência à Saúde , Sepse/terapia , Infecções Cutâneas Estafilocócicas/diagnóstico , Centro Cirúrgico Hospitalar/normas , Infecção da Ferida Cirúrgica/terapiaRESUMO
Subclinical form of hypothyroidism was not associated with considerable changes in Ca(2+) content in osteoblasts and blood plasma and in the content of ATP and prostaglandin E2. Activation of prostaglandin E2 synthesis in response to binding of extracellular Ca(2+) in osteoblasts in the absence of ATP was less pronounced (by 11%) compared to the control. Progression of hypothyroidism and development of clinical signs of the disease were accompanied by a decrease in Ca(2+) content in osteoblasts and plasma by 45 and 12%, respectively, and ATP content in osteoblasts by 30%, and by activation of prostaglandin E2 synthesis by 117%. Moreover, the synthesis of prostaglandins in response to binding of extra- and intracellular Ca(2+) also considerably changed. Hyperthyroidism (2 months) was characterized by a moderate decrease in plasma content of Ca(2+) by 15% and ATP by 25%, together with an increase in prostaglandin E2 level by 55.5%. The release of prostaglandin E2 in response to chelation of extracellular Ca(2+) increased even more markedly, but somewhat decreased in response to addition of 5 mM ATP due to compensation of metabolic acidosis.