Microbiological and molecular identification of the anaerobic component of the oral microbiota in patients with cancer of the oropharyngeal region.

A research objective - to study tumor tissues of primary and recurrent patients with cancer of the oropharyngeal region for the frequency of occurrence of four types of anaerobic periodontogens and their associations by two methods: real-time PCR and cultural. There is speculation that bacteria can influence the pathogenesis of cancer. A comparative assessment of the content of four anaerobic periodontogens (Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythensis, Treponema denticola) in the tumor tissue and in the healthy tissue of the oral mucosa of patients with oropharyngeal cancer was carried out. It was found that the identification of odontopathogens by the real-time PCR method is much more informative than the traditional culture method, with the exception of P. intermedia, for the identification of which the traditional culture method was more effective. In 33.3% of patients, both primary and secondary, the composition of microorganisms was the same in both healthy and tumor tissue. In 20% of primary patients and in 13.3% of repeat patients, no associations of microorganisms included in the study were found in healthy tissue. Associations of 4 bacteria were recorded only in tumor tissue in both primary and repeated patients, and in repeated patients - statistically significantly more often. In 53.3% of repeat patients, associations of 4 bacteria were recorded in tumor tissue, whereas in primary patients, only in one case. P. gingivalis from tumor tissue in repeat patients was statistically significantly more often than in primary patients. T. forsythensis in primary patients was found statistically significantly more often in healthy tissues than in repeat patients, in which T. forsythensis was found statistically significantly more often from tumor tissue than in healthy tissue). T. denticola in healthy tissue was detected in both primary and repeated patients in isolated cases. T. denticola in tumor tissue was found statistically significantly more frequently in both primary and repeated patients compared to healthy tissue. P. gingivalis, T. forsythensis, and T. denticola should perhaps be considered risk indicators indicating the level of significance of their associations with oropharyngeal cancer.

[PITUITARY ADENOMA APOPLEXY].

We present 3 cases of pituitary adenoma apoplexy in young women (one microadenoma and two macroadenomas). The possible risk factors, clinical presentation and outcome of pituitary apoplexy are discussed. Diagnostic errors as regards pituitary adenoma apoplexy are analyzed.

[Adiponectin in health and disease]. / Adiponektin v norme i patologii.

Over the past 20 years after the discovery of adiponectin, much knowledge about its effect in health and disease has been gained. Adiponectin has antidiabetic, antiatherogenic, anti-inflammatory, immunomodulatory, metabolic, vasoprotective, and antiapoptotic properties. However, an understanding stems from the given literature review that much remains to be explored. Adiponectin has not yet commonly used in clinical practice, but cardiologists, endocrinologists, pediatricians, oncologists, and physicians of many specialties are interested in its preventive and therapeutic applications.

[The concurrence of diabetes mellitus and gallstone disease]. / O sochetanii sakharnogo diabeta i zhelchnokamennoi bolezni.

The article presents an update on the concurrence of diabetes mellitus (DM) and gallstone disease (GSD), on the mechanisms for the development of GSD in patients with type 2 DM (T2DM), on the risk factors of DM in GSD. The role of diabetic autonomic neuropathy of the gallbladder in the development of cholelithiasis is assessed in patients with T2DM. The impact of impaired secretion of neurohormones in the gastrointestinal tract in the development of DM in GSD is analyzed.

[Thyroid dysfunction in patients with type 2 diabetes mellitus].

The paper gives an update on type 2 diabetes mellitus concurrent with thyroid dysfunction and on the development of vascular events, atherogenesis and evaluates the impact of therapy on the course of both diseases. It points out the need for annual screening for thyroid dysfunction in patients with type 2 diabetes mellitus.

[The ghrelin-obestatin system in health and disease].

The role of the ghrelin--obestatin system in health and disease is multifaceted and new ample evidence has been recently accumulated. Ghrelin was discovered much earlier than obestatin so the biological, physiological and pathophysiological, pharmacological aspects of its activity could be studied far better than obestatin. There is no question that these hormones are not antagonists and they are a uniform system. However, there is a need for further studies of the role of this system in the body's vital functions in health and disease. The paper analyzes the accumulated information on the ghrelin--obestatin system in health and disease, assesses the possibility of their use in clinical practice, and pays attention to the unsolved problems to be explored and solved.

[Ghrelin and its role in health and disease].

The paper provides a review of the present-day literature on the role of the hormone ghrelin discovered in 1999.

[Ghrelin secretion in patients, operated on cholelithiasis].

The grelin blood level was measured on 54 patients, of whom 18 were healthy volunteers; 20 patients with cholecystolithiasis had been measured perioperatively during the cholecystectomy; and the rest 16 patients of the study group had had cholecystectomy 2-15 years ago. All patients demonstrated perioperative hypergrelinemy with the normalization of the grelin level during the long-term follow-up. Grelin is considered to have certain immunomodulating and anti-inflammatory effects, thus improving the postoperative regeneration. Therefore, the increase of grelin blood level during the perioperative period is considered to be a defense reaction.

[Involvement of the organ of vision in Horton's disease].

The paper deals with the diagnosis of optic nerve atrophy caused by temporal giant-cell arteritis (Horton's disease) and shows how difficult to make a differential diagnosis between glaucoma and other non-eye diseases that also induce optic nerve atrophy. It describes a clinical case that illustrates the difficulties in diagnosing optic nerve involvement in Horton's disease.

[Magnesium deficiency in an endocrinologist's practice].

The review concerning a value of magnesium in an organism in healthy persons and cases with endocrine disorders is presented. The causes of magnesium-deficient conditions in cases with type 1 and type 2 diabetes, thyrotoxic goiter, hypothyroidism and obesity were analyzed. Participation of magnesium in secretion of parathormone and a control of calcium exchange is shown. The clinical semiology of hypomagnesemia seems to be nonspecific and manifold, and, therefore, as a rule, in most of endocrine patients magnesium deficiency remains to be undiagnosed. Questions on preventive measures and management of treatment magnesium-deficient conditions are considered.

[Polymyalgia rheumatica and giant-cell temporal arteritis].

The article is dedicated to the contemporary concept of the prevalence, etiology, and pathogenesis of polymyalgia rheumatica and Horton's disease. The author analyzes the features of the pain syndrome, arthritis, fever, and other manifestations of the disease. Taking into consideration the fact that polymyalgia rheumatica and Horton's disease are usually revealed too late, the author pays special attention to their diagnostics and differential diagnostics. An increased ESR is a feature of this disease. Polymyalgia rheumatica is treated with prednisolone. The stages of glucocorticoid therapy, the rules of adjustment and lowering prednisolone doses, combined therapy with glucocorticoids and cytostatics, the effectiveness of therapy, and the prognoses are described in detail.

[Thyroid gland alterations in Perm region residents as observed by means of ultrasonography].

Thyroid gland (TG) ultrosonography, performed in 2000 residents of Perm region (370 men and 1630 women aged 18 to 84 years), showed that only 1/3 of the subjects had no TG abnormalities. Despite mass iodine prophylaxis, resumed in Perm more than 6 years ago, and group iodide prophylaxis that is being actively introduced at present, the prevalence of goitre has not decreased. On the contrary, it has risen from 26.3% to 42.3% in Perm region since 90-s. Nodules were found in one out of five subjects. TG diseases were significantly more frequent in women than in men. The majority of the subjects had no complaints, and any abnormality, including TG cancer (6 cases), was found by chance. The reduction of TG size with age is not typical of Perm population, and the increase of TG volume in the elderly (both men and women) is due to TG nodules formation. Thus, preventive ultrasonography should be introduced widely in order to reveal TG abnormalities at early stages, not only among the population of iodized regions, but also in ecologically unfavourable ones. This diagnostic test must become a necessary procedure in preventive examinations of people exposed to occupational hazards.

[Influence of anthropogenic pollution on thyroid structure in Perm population].

The comparison of the thyroid structure in 73 Perm sitizens who died in the 1960s with that of 59 citizens who died in the 2000s revealed in the latter group symptoms of "tissue maladaptation" (retention of follicular colloid with cystic transformation of the follicles, lymphoplasma cell infiltration with oxyfilic thyrocytes transformation into B-cells, appearance of areas with a rough connective tissue in colloidrhagia and edema with capillary collapse, calcium deposits into the vessels and stroma). It is proven that these morphological changes are due to the effects of xenobiotics. Pronounced increase of heavy metals deposits in the thyroid by the 2000s was reported. Such thyroid pathomorphosis inevitably results in hypothyroidism.

[Trace elements and endemic goiter]. / Mikroélementy i éndemicheskii zob.

The effects of xenobiotics on morphological structure and function of the thyroid gland (TG) were analysed. Salts of heavy metals (zink, lead, copper, cadmium, surma etc.) were measured in TG of 152 citizens of Kama region who had died of trauma in the 1960s (n = 73), 1990s (n = 20) and 2000s (n = 52). TG is shown to accumulate xenobiotics. As the examinees had no occupational contact with heavy metal salts (HMS), their deposits in TG is explained by anthropogenic pollution of the environment. HMS in the thyroid tissue was much lower than in later decades indicating aggravation of environmental pollution in the Urals. Being protoplasmic poisons, HMS bind proteins and provoke immune reaction. All the examinees who died after 2000 had histologically proved deposits of immunocompetent cells in TG tissue--lymphoid and plasmic TG infiltration. In the 1960s these TG alterations were absent. Goiter endemia can be stopped by improvement of environmental protection in each ecopolluted region and mass iodine prophylaxis.

[Trends of mental and somatic diseases during therapy of endemic goiter]. / Dinamika psikhicheskikh i vegetativnykh narushenii na fone lecheniia endemicheskogo zoba.

The trend of mental and somatic diseases was studied in 70 patients with epidemic goiter (EG) treated with L-thyroxine or iodides during 1-5-year follow-up. Borderline mental disorders (diminished memory and attention, emotional and intellectual disorders) were found to be stable in these patients. The most delicate functions of the brain, such as the capacity for analysis and synthesis, are particularly vulnerable. Irrespective of the age of a patient, his/her educational level, occupation, the size of goiter, concrete rather than abstract logic thinking are prevalent in patients with EG. Drug treatment of EG only improves the patients' health status, but fails to eliminate evolving mental disorders even if the sizes of the thyroid can be brought to the normal values, the use of L-thyroxine is more effective that that of iodides.

[Rational antibiotic therapy of pneumonia]. / O ratsional'noi antibiotikoterapii pnevmonii.

The aim of the study was to analyse antibacterial treatment in patients with extrahospital pneumonians in a standard pulmonological department. The analysis covered 80 patients with EHP treated in 2000. In the 100% cases the choice of the antibiotics was random and did not depend on pneumonia severity, age, sex, occupation of the patient, concomitant pathology, the disease duration, previous treatment. Gentamycin was prescribed most frequently. The course doses of the drugs were often violated. The mean hospital stay was 22.5 days, complete resolution was observed only in 8.75% patients.

[Role of thyroid pathology in pathogenesis of arterial hypertension in diabetes]. / Rol' patologii shchitovidnoi zhelezy v patogeneze arterial'noi gipertonii u bol'nykh sakharnym diabetom.

190 patients with diabetes mellitus (DM) were examined: 24 patients with DM type 1 and 166 with DM type 2. Frequency of arterial hypertension (AH) in diabetics is higher than in population. AH in different DM types varies by pathogenesis. Symptomatic renal AH is typical for DM1, essential AH combining with renal one in 1/3 of cases--for DM2. Treatment of AH and DM often provokes hypothyroidism which can be iatrogenic because of continuous intake of sugar reducing and antihypertensive drugs with antithyroid and strumogenic actions. Hypothyroidism aggravates an AH course: arterial pressure becomes high and resistant to hypotensive therapy. DM makes difficulties in selection of hypotensive drugs as many of them alter metabolism and due to negative attitude of the patients to continuous intake of sugar reducing, antihypertensive drugs, thyroid hormones. Therefore, hypertensive diabetics should be prepared for treatment psychologically and receive only prolonged hypotensive drugs. In DM with AH medication of choice is ACE inhibitors as they are nephroprotective, had no negative effect on carbohydrate, fat metabolism and thyroid system.

[Investigation of mutations of BRCA1 and BRCA2 genes in 52 breast cancer patients]. / Testirovanie mutatsii genov BRCA1 i BRCA2 u 52 bol'nykh rakom molochnoi zhelezy.

The proportion of BRCA1/2 genes varies widely among populations. We investigated 52 cases of breast cancer: 24 cases of familial breast cancer, 22--early-onset (till 40 years) and 6--bilateral cancer. The frequency of carriers of mutations among familial cancer cases was 16%, among cases of disease till 40 years--9%. 538insC BRCA1 was the most common genetic mutation among hereditary cases of breast cancer.