[IMPACT OF OPISTHORCHIS INVASION ON THE COURSE OF A SKIN PROCESS IN PATIENTS WITH ROSACEA].

The authors give the data-and results of their investigations of 47 patents with rosacea concurrent with chronic opisthorchiasis (Group 1) and 40 patients with rosacea without opisthorhiasis (Group 2): It is found that the severer clinical manifestations of rosacea are, the lower the quality of life is in patients. The patients with rosacea concurrent with chronic opisthorchiasis were found to have severe clinical forms. Rosacea diagnostic rating scores was 1.1-fold higher than in the patients without helminthiasis, suggesting a severer course. Quality-of-life dissatisfaction in patients with rosacea concurrent with chronic opisthorchiasis was significantly higher than in those with rosacea only.

[The state of the digestive system in psoriasis].

Many authors emphasize the close relationship between skin lesions and digestive disorders in the patients suffering from psoriasis. The present literature review is focused on the results of investigations carried out in the recent years. The most detailed information concerns lesions in the stomach, small and large intestines, pancreas, and hepatobiliary system of psoriatic patients. The data obtained indicate that the treatment of skin pathology associated with psoriasis should be prescribed with due regard for the state of the digestive system.

[Clinical and functional disorders of the stomach-in patients with psoriasis in the presence of chronic opisthorchiasis].

OBJECTIVE: to study the clinical and functional status of the stompach in patients with psoriasis in the presence of chronic opisthorchiasis (CO). Subjects and methods. Ninety patients with psoriasis concurrent with CO (a study group (Group 1)), 70 with psoriasis (a comparison group (Group 2)), 70 with CO (Group 3), and 30 healthy individuals were examined. All the patients underwent fractional gastric secretory studies and esophagogastroduodenoscopy (EGDS). RESULTS: The study group showed a reduction in stimulated hydrochloric acid output (4.25+/-0.38 mmol/hour), which was significantly less than that in Groups 2 and 3 and healthy individuals [5.87+/-0.51 (p<0.001); 6.86+/-0.59 (p<0.05), and 10.73+/-0.84 mmnol/hour (p<0.001), respectively]. In the study group, stimulated pepsin output (4.87+/-0.49 mmol/hour) was also significantly less than that in the other groups. Reduced basal hydrochloric acid output was found in 65.5% of the study group patients, whose number was significantly larger than that in the comparison group [44.3% (p<0.05)] and its stimulated output was less in 80 and 62.9% in the study and comparison groups, respectively (p < 0.05). A reduction in pepsin output in the basal secretion phase was revealed in 57.8 and 37.1% of the patients in the study and comparison groups, respectively (p<0.05) while that in the stimulated phase was in 63.3 and 34.3% (p<0.001). Thus, gastric secretory function in psoriatic patients is characterized by reduced hydrochloric acid and pepsin outputs and it is more impaired in patients with mixed pathology, which necessitates anthelmintic therapy in this category of patients.

[The clinical and functional state of the liver in patients with psoriasis in the presence of chronic opisthorchiasis].

OBJECTIVE: to study the clinical and functional state of the liver in patients with psoriasis concurrent with chronic opisthorchiasis (CO). SUBJECTS AND METHODS: Twenty-eight patients with psoriasis concurrent with CO, 15 patients with CO, 15 patients with the enlarged liver, and 15 healthy individuals were examined. Serum biochemical study and ultrasonography of the liver and gallbladder were used. RESULTS AND DISCUSSION: The patients with comorbidity were found to have hepatomegaly with syndromes of cytolysis, cholestasis, and mesenchymal inflammation of more degrees than those from Groups 2 and 3. CONCLUSION: The found clinical and functional liver changes in patients with psoriasis concurrent with CO make it necessary to perform anthelmintic therapy in this category of patients.

[Left ventricular diastolic dysfunction in patients with psoriasis in the presence of chronic opisthorchiasis].

Left ventricular diastolic function was studied in patients with psoriasis concurrent with chronic opisthorchiasis (CO). Seventy-five patients with psoriasis concurrent with CO, 50 patients with CO, and 20 healthy individuals were examined. Echocardiographic study (EchoCG) in the M-, B-, and Doppler modes was made in all the patients, by using the standard methods. All the examinees were found to have impaired active left ventricular relaxation that manifested itself as a longer isovolumic relaxation time, which was more pronounced in patients with psoriasis concurrent with CO. Left ventricular systolic function in these patients was preserved. In the psoriatic patients, diastolic dysfunction was characterized by impaired relaxation and it was more evident in patients with comorbidity.

[Diastolic dysfunction of left ventricle in psoriatic patients with concomitant opisthorchiasis before and after antihelminthic therapy].

The aim of the study was to evaluate left ventricular diastolic function in psoriatic patients with chronic opisthrochosis (CO) before and after antihelminthic therapy. It included 75 patients with psoriasis and CO, 50 with psoriasis alone, 50 with CO, and 20 healthy subjects. All patients underwent standard echocardiographic examination in the M-, B-, and Doppler mode. The study revealed impaired active relaxation of the left ventricle manifest as increased isovolumic relaxation time more pronounced in patients with concurrent CO and psoriasis than in those with psoriasis alone. Antihelminthic therapy did not cause deterioration of the diastolic function in these patients and should be recommended in case of combined pathology.

[Clinical and functional changes in the biliary tract in patients with psoriasis concurrent with chronic opisthorchiasis].

OBJECTIVE: to study the clinical and functional changes in the biliary tract in patents with psoriasis concurrent with chronic opisthorchiasis (CO). SUBJECTS AND METHODS: 60 patients with psoriasis concurrent with CO, 45 patients with psoriasis without helminthism, 30 with CO, and 15 healthy individuals were examined. Chromatic fractional duodenal intubation, dynamic hepatobiliscintigraphy, and ultrasound study of the liver and gallbladder were used. The concentrations of cholesterol, bile acids, bilirubin, total lipids and phospholipids in bile were measured. A number of relative indices, such as cholate-cholesterol coefficient (CCC), Thomas-Hofmann index, and Rubens index were calculated. RESULTS AND DISCUSSION: The patients with psoriasis with CO were found to have signs of mainly hypermotor dyskinesia of the biliary tract, as well as increased bile lithogenicity (lower CCC, and increases in the Rubens index and Thomas-Hofmann index). CONCLUSIONS: The clinical and functional changes found in the biliary tract of the patients with psoriasis concurrent with CO show it necessary to perform antihelminthic therapy in this group of patients.

[Study of the emotional-and-personality sphere in patients with psoriasis concurrent with chronic opisthorchiasis].

The study was undertaken to evaluate the emotional-and-personality sphere in patients with psoriasis concurrent with chronic opisthorchiasis (CO). A hundred and fifty patients with psoriasis concurrent with CO, 100 psoriatic patients without helminthiasis, 100 patients with CO, and 30 healthy individuals were examined. The SMOL test was used to evaluate the emotional-and-personality sphere. Clinical and psychological studies of patients with psoriasis alone and in combination with CO revealed unidirectional psychoemotional (mainly hypochondriacal) changes in patients in these groups. However, anxiety and hypochondriac disorders were clinically significant in patients with comorbidity (psoriasis + CO). This suggests that Opisthorchis invasion is of considerable importance in the genesis of these changes and requires medical correction of helminthiasis.

[Estimation of the levels of reactive and personality anxiety in patients with psoriasis concurrent with chronic opisthorchiasis].

The purpose of the study was to evaluate reactive and personality anxiety in patients with psoriasis concurrent with chronic opisthorchiasis (CO). Seventy-five patients with psoroasis concurrent with CO, 70 psoriatic patients without helminthism, 70 patients with CO, and 30 healthy individuals were examined. The level of anxiety at the moment of the study and that of personality anxiety were determined by the procedure described by Ch.D. Silberger, which was modified by Yu.L. Khanina (1976). In patients with psoriasis concurrent with CO, the level of reactive and personality anxiety was 51.60+/-0.89 and 51.30+/-1.26 scores, respectively, which was significantly greater than those in the group of healthy individuals (35.53+/-1.27 and 36.77+/- 1.27 scores, respectively) and psoriatic patients (47.10+/-1.27 and 44.45+/-1.29 scores, respectively). The findings suggest that Opisthorchis invasion is of considerable importance in the genesis of these changes and requires medical correction of helminthism.

[Impact of dehelminthization on pancreatic incretory and excretory functions in patients with psoriasis concurrent with chronic opisthorchiasis].

A hundred and thirty patients, including 60 patients with psoriasis concurrent with chronic opisthorchiasis, 40 with psoriasis without helminthiasis, and 30 with chronic opisthorchiasis, and 15 healthy individuals were examined. To evaluate the pancreas, its incretory and excretory functions were studied. In patients with psoriasis concurrent with chronic opisthorchiasis, the pancreatic level of hormones and enzymes was significantly lower than those in patients with psoriasis without helminthiasis. Twelve months after dehelminthization, a follow-up of the parameters of the incretory function revealed their significant increase in 43 patients. Following dehelminthization, the excretory function in terms of amylase and lipase was significantly greater than that before dehelminthization. By taking into account steatorrhea, pancreatic excretory dysfunction showed significantly less fecal fat losses after a course of anthelminthic therapy. Malabsorption diminished in patients after anthelminthic therapy, as confirmed by increased urinary D-xylose excretion. Pancreatic proteolytic activity improved after dehelminthization, as supported by a significant increase in urinary PABA excretion. No improvement was observed in patients receiving no anthelminthic therapy; on the contrary, deterioration was established in half of them. Therefore, a year after dehelminthization, helminthological cure in patients with psoriasis concurrent with chronic opisthorchiasis causes a significant improvement in pancreatic incretory and excretory functions and promotes regression of psoriatic manifestation.

[Disturbances of the incretory and excretory pancreatic functions in patients suffering from psoriasis in combination with chronic opisthorchosis].

The aim of the study was to evaluate the incretory and excretory functions of the pancreas in patients suffering from psoriasis in combination with chronic opisthorchosis (CO). The subjects were 30 patients with psoriasis and CO, 20 patients with psoriasis without helminthiasis, 20 patients with CO, and 12 healthy individuals. The incretory pancreatic function was studied by measuring serum levels of pancreatic hormones (insulin, glucagon, and C-peptide) using radioimmunoassay with standard sets; the excretory function was studied by means of measuring serum levels of pancreatic enzymes (amylase and lipase) using a biochemical technique. Proteolytic capacity was evaluated using PABA test (per cent of the renal excretion of paraminobenzoic acid); amylolytic capacity was evaluated using coprogram results. The study revealed disturbances in the incretory and excretory functions of the pancreas in patients suffering from psoriasis or psoriasis with CO. The latter subgroup had more prominent disturbances.

[Clinical analysis of autonomic nervous system disorders in patients with psoriasis concurrent with chronic opisthorchiasis].

The study was undertaken to detect the characteristics of autonomic nervous system disorders in patients with psoriasis concurrent with chronic opisthorchiasis and, on their basis, to develop therapeutic manipulations. Examinations were made in 150 patients with psoriasis concurrent with chronic opisthorchiasis, 100 psoriatic patients without helminthiasis, 100 patients with chronic opisthorchiasis, and 30 healthy individuals. The questionnaire method developed and recommended for use by the All-Union Center of Autonomic Nervous System Diseases was employed for the screening diagnosis of vegetative dystonia syndrome and for the estimation of its severity. The vegetative dystonia syndrome was observed in all patients with psoriasis concurrent with chronic opisthorchiasis. There was an association of the vegetative dystonia syndrome with the area of skin involvement, the severity of psoriasis, the duration of the latter and opisthorchiasis.

[The clinical and functional status of the pancreas in patients with psoriasis concurrent with chronic opisthorchiasis].

Seventy patents including 30 with psoriasis concurrent with chronic opisthorchiasis, 20 with psoriasis without opisthorchiasis, and 20 with chronic opisthorchiasis, were examined. Structural changes in the pancreas and its endocrine and exocrine functions were evaluated. Patients with psoriasis alone or in combination with chronic opisthorchiasis were found to have signs of pancreatic lesion with its impaired endocrine and exocrine functions. These impairments are more pronounced in the group of patients with mixed pathology.

[Gastrointestinal function in patients with psoriasis concurrent with chronic opisthorchiasis before and after antiparasitic therapy].

The impact of antihelminthic therapy on gastrointestinal function was studied in 150 patients with psoriasis concurrent with chronic opisthorchiasis, 100 patients with psoriasis without helminthiasis, and 30 healthy individuals. A fractional study of gastric secretion was conducted in its both phases, by using histamine stimulation; carbohydrate absorption was investigated by the 5-g D-xylose test; fat absorption by the Kamer procedure; the bioelectrical activity of the small bowel was examined by electric enterography. These indices were followed up for 2-3 years. There were negative changes in gastric function in patients with 2-year persistent Opisthorchis invasion as compared with those recovered from this condition, in the latter, the pathological process becoming stable. After 3 years of the follow-up, negative changes were found in the values of fat and D-xylose absorption in patients with psoriasis as compared to the cured patients in whom the indices did not significantly become worse, However, in the cured patients, the absorption of fat and Dxylose did not normalize. The 3-year follow-up indicated that the patients with psoriasis concurrent with chronic opisthorchiasis had significantly decreased amplitudes of propulsive and non-propulsive waves (p < 0.05 and p < 0.01, respectively) while the latter indices were significantly increased in the cured patients (p < 0.01 and p < 0.05, respectively), but failing to reach the normal values. Effective dehelminthization in patients with psoriasis concurrent with chronic opisthorchiasis improved gastrointestinal function, making the course ofpsoriasis better (there were no exacerbations for 2 years).

[Clinical effectiveness of dehelmintization in patients with psoriasis accompanied by chronic opisthorchosis].

The purpose of the study was to prove the appropriateness of dehelmintization in patients with psoriasis accompanied by chronic opisthorchosis (CO). The authors examined 150 patients with psoriasis accompanied by CO, 100 patients having psoriasis without helminthiasis, 100 patients with psoriasis and 30 healthy individuals. Gastric secretion was evaluated by means of the fractional test (both phases) with histamine stimulation; other diagnostic procedures included carbohydrate absorption evaluation (5-gram D-Xylose absorption test), Kamer test of fat absorption and evaluation of small intestine bioelectric activity by means of electromyography. The patients were followed up within 2 to 3 years. The study found negative dynamics in the parameters of gastric secretion, fat and D-xylose absorption and small intestine bioelectric activity in patients with psoriasis and CO within the 2-3-year follow-up, while the group of dehelmintized patients displayed significant improvement of these parameters. Thus, effective dehelmintization allowed improvement of alimentary tract functional condition and the clinical course of psoriasis.

[Morphofunctional changes in gastrointestinal tract in patients with psoriasis accompanied by chronic opisthorchosis]. / Morfofunktsional'nye izmeneniia zheludochno-kishechnogo trakta pri sochetannom techenii psoriaza i khronicheskogo opistorkhoza.

The paper covers clinical, morphological and functional aspects of gastrointestinal tract condition in patients with psoriasis accompanied by chronic opisthorchosis (CO). The authors examined 150 patients with psoriasis accompanied by CO, 100 patients having psoriasis without helminthiasis, 100 patients with CO and 30 healthy people. The gastric secretion was evaluated by means of the fractional test (both phases) with histamine stimulation; other diagnostic procedures included carbohydrate absorption evaluation (5-gram D-Xylose absorption test) and Kamer test of fat absorption. The morphological condition of the gastric and intestinal mucosa was investigated by means of light and electron microscopy. The study revealed gastric secretory dysfunction and malabsorption in small and large intestines in patients with psoriasis and CO, clarified the relation between the duration of psoriasis and opisthorchosis and gastric secretory dysfunction and determined dependence of small intestine malabsorption on such factors as stage, severity, degree of skin involvement and duration of psoriasis. The authors also established interrelation between the above malfunctions and gastric and intestinal structural abnormalities.

[Morphofunctional alterations of the small intestine in patients with psoriasis and concomitant chronic opisthorchiasis]. / Morfofunktsional'nye izmeneniia tonkoi kishki u bol'nykh psoriazom v sochetanii s khronicheskim opistorkhozom.

To characterize the small intestine clinically and functionally in psoriasis combination with chronic opisthorhiasis, 60 patients were examined with this combination, 45 with psoriasis but no helminthosis, 30 patients with chronic opisthorchiasis and 15 healthy subjects. Small intestinal absorption was studied by fat and carbohydrates absorption; bioelectric small intestinal activity--by electroenterography. Absorption in the small intestine of patients with mixed pathology was impaired. Pathogenetic mechanisms of such impairment were the following: low amplitude of bioelectrical activity of the small intestine, subnormal concentration of bile acids in the vesical bile, defects in microbial biocenosis of the intestine, structural disorders of the upper small intestine. Abnormal absorption in the small intestine correlated with psoriasis clinical picture (stages, duration, size of the lesion, disease severity).

Ultrastructural characteristics of cell populations in the gastric and duodenal mucosa during psoriasis.

In biopsy specimens of the gastric and duodenal mucosa from patients with psoriasis we revealed severe degenerative and dystrophic changes in cells of the surface and glandular epithelium with destruction of functionally important cytoplasmic organelles. The stroma of the gastric mucosa was characterized by hyperplasia of the lymphoid tissue, formation of numerous lymphoid follicles, and destruction of the endothelium in microvessels. These changes are interpreted as the syndrome of regenerative and plastic insufficiency.

Psoriasis concomitant with chronic opisthorchiasis: ultrastructural changes in cell populations of gastroduodenal mucosa.

Pathological changes based on degeneration of epithelial structures predominantly with preserved typical cell differentiation, but with unstable epithelial secretory function were detected in biopsy specimens of gastroduodenal mucosa from patients with psoriasis associated with chronic opisthorchiasis. The progress of the disease led to atrophy of glandular components and augmented stromal sclerosis. The compensatory adaptive reactions were realized via hyperplasia and hyperfunction of preserved glandulocytes, appearance of mix-cells with polypotent secretory cycle, and high functional activity of capillaries.