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Smiyan O.I.,Sumy State University | Mozgova I.A.,Sumy State University | Moschich O.P.,Shupyk National Medical Academy of Postgraduate Education
New Armenian Medical Journal | Year: 2015

Chronic tonsillitis has been a pressing issue for pediatricians. Firstly, it is caused by immaturity of the immune system, particularly the lymphatic system, at a young age. Secondly, possible complications caused by tonsillitis and chronic diseases of other organs and systems may occur. The state of colonization resistance, which can be seriously affected in patients with acute or chronic tonsillitis, plays an important role to protect the tonsils, mouth cavity, and nasopharynx against incursion by pathogens. Cytokines are involved into infectious inflammation of specific immune response and non-specific effector mechanism during chronic inflammatory diseases of the respiratory tract. Besides, they determine clinical course, severity, and clinical outcome of pathologic process. Our aim was to assess the cell-mediated immunity status and the IL-4 and IL-6 levels in children with chronic tonsillitis. The article presents important features of the immune status of children with chronic tonsillitis. We evaluated the levels of lymphocytes, T cells, T helpers, T suppressors, and immunoregulatory balance in serum. We assessed the immune status in children by certain immunological indices including the levels of T lymphocytes, T helpers, T suppressors, B lymphocytes, phagocytal index, phagocytal number; IgG, IgA, IgM, and cytokine profile. We detected T and B lymphocytes and their subsets by the immunofluorescence technique using monoclonal antibodies. The serum cytokine (IL-4 and IL-6) levels were measured by the ELISA technique. Phagocytic activity of the neutrophils was evaluated for their capacity to absorb latex-particles using a light microscope. Thus, the T-cell branch tended to be suppressed while there were higher levels of CD8+ in children with chronic tonsillitis in comparison with relatively healthy children. During the study of the changes in proinflammatory and anti-inflammatory cytokine levels of children with chronic tonsillitis, higher IL-4 level was observed in the period of exacerbation of the disease and after receiving the standard therapy. The level of IL-6 in patients with chronic tonsillitis increased significantly in the first days of hospitalization and decreased after the standard treatment, but these figures did not reach the levels of healthy children. © 2015, Yerevan State Medical University. All rights reserved.

Khalangot M.,Shupyk National Medical Academy of Postgraduate Education | Khalangot M.,Komisarenko Institute of Endocrinology and Metabolism | Kovtun V.,Komisarenko Institute of Endocrinology and Metabolism
Current Diabetes Reviews | Year: 2014

Background: Retrospective evaluations of mortality risks in cohorts of patients with type 2 diabetes (T2D), receiving oral glucose-lowering drugs (OGLDs) gave conclusions about association between certain OGLDs and mortality that do not exactly agree with each other. Different approaches were used: recording the outcomes depending on the first prescription, later changes were ignored or receiving one of OGLDs according to data of last documented visit before the end of observation period; without change of OGLD during the whole observation; treatment intervals - period from onset of treatment to onset of the next drug treatment, or until outcome. Impact of each study approach was not evaluated yet. We conducted such comparative analysis using the database of Ukrainian Diabetes Register. Methods: All-cause mortality in retrospective cohorts of 36 449 type 2 diabetes patients treated with glibenclamide, gliclazide or metformin monotherapy all of which were included at least in one of evaluation models: “first prescription” - 2 862 /257, “last prescription” - 34 818 / 4 224; “unchanged” - 8 786/680 and “treatment intervals” - 13 546/3 142 T2D patients / death cases respectively, were evaluated using Cox regression with gender, age, and diabetes duration adjusting. We compared the mortality risk (Hazard ratios -HRs) associated with Gliclazide or Metformin versus Glibenclamide monotherapy. Results: Gliclazide or metformin-treated patients demonstrated lesser mortality risk than glibenclamide-treated ones in all four evaluation models, but age and duration stratification can influence this phenomenon in case of “first prescription model”. In case of “without change OGLD” model the increase of mortality risk in glibenclamide-treated group is the most evident when comparing to gliclazide-treated, rather than to metformin-treated one. When comparing gliclazide vs metformin mortality risk for this model, gliclazide-treated patients demonstrated lesser mortality risk than metformintreated ones: gender, age and diabetes duration adjusting HR = 0.51 (0.35-0.72), p<0.001. Conclusion: Different approaches used for mortality analysis in observation studies of T2D patients can present discrepant results. © 2014 Bentham Science Publishers.

Aebi-Popp K.,University of Bern | Bailey H.,University College London | Malyuta R.,Perinatal Prevention of AIDS Initiative | Volokha A.,Shupyk National Medical Academy of Postgraduate Education | Thorne C.,University College London
BMC Pregnancy and Childbirth | Year: 2016

Background: Over 3500 HIV-positive women give birth annually in Ukraine, a setting with high prevalence of sexually transmitted infections. Herpes simplex virus Type 2 (HSV-2) co-infection may increase HIV mother-to-child transmission (MTCT) risk. We explored factors associated with HSV-2 seropositivity among HIV-positive women in Ukraine, and its impact on HIV MTCT. Methods: Data on 1513 HIV-positive women enrolled in the Ukraine European Collaborative Study from 2007 to 2012 were analysed. Poisson and logistic regression models respectively were fit to investigate factors associated with HSV-2 seropositivity and HIV MTCT. Results: Median maternal age was 27 years (IQR 24-31), 53 % (796/1513) had been diagnosed with HIV during their most recent pregnancy and 20 % had a history of injecting drugs. Median antenatal CD4 count was 430 cells/mm3 (IQR 290-580). Ninety-six percent had received antiretroviral therapy antenatally. HSV-2 seroprevalence was 68 % (1026/1513). In adjusted analyses, factors associated with HSV-2 antibodies were history of pregnancy termination (APR 1.30 (95 % CI 1.18-1.43) for ≥2 vs. 0), having an HIV-positive partner (APR 1.15 (95 % CI 1.05-1.26) vs partner's HIV status unknown) and HCV seropositivity (APR 1.23 (95 % CI 1.13-1.35)). The overall HIV MTCT rate was 2.80 % (95 % CI 1.98-3.84); no increased HIV MTCT risk was detected among HSV-2 seropositive women after adjusting for known risk factors (AOR 1.43 (95 % CI 0.54-3.77). Conclusion: No increased risk of HIV MTCT was detected among the 68 % of HIV-positive women with antibodies to HSV-2, in this population with an overall HIV MTCT rate of 2.8 %. Markers of ongoing sexual risk among HIV-positive HSV-2 seronegative women indicate the importance of interventions to prevent primary HSV-2 infection during pregnancy in this high-risk group. © 2016 Aebi-Popp et al.

Ahn J.V.,University College London | Bailey H.,University College London | Malyuta R.,Perinatal Prevention of AIDS Initiative | Volokha A.,Shupyk National Medical Academy of Postgraduate Education | Thorne C.,University College London
AIDS and Behavior | Year: 2016

Ukraine has one of the largest populations of persons living with HIV in Europe. Data on 2019 HIV-positive married or cohabiting women enrolled in a postnatal cohort from 2007 to 2012 were analysed to investigate prevalence and factors associated with self-reported non-disclosure of HIV status. Median age at enrolment was 27.5 years, with two-thirds diagnosed during their most recent pregnancy. Almost all had received antenatal antiretroviral therapy and 24 % were taking it currently. One-tenth (n = 198) had not disclosed their HIV status to their partner and 1 in 20 (n = 93) had disclosed to no-one. Factors associated with non-disclosure were: unmarried status (AOR 2.99 (95 % CI 1.51–5.92), younger age at leaving full-time education (AOR 0.41 (95 % CI 0.19–0.88) for ≥19 years vs ≤16 years) and lack of knowledge of partner’s HIV status (AOR 2.01 (95 % CI 1.09–3.66). Further work is needed to support disclosure in some groups and to explore relationships between disclosure and psychological factors in this setting, including depression, lack of support and perception of stigma. © 2015, Springer Science+Business Media New York.

Khalangot M.,Shupyk National Medical Academy of Postgraduate Education | Khalangot M.,Komisarenko Institute of Endocrinology and Metabolism | Gurianov V.,Bogomolets National Medical University | Okhrimenko N.,Komisarenko Institute of Endocrinology and Metabolism | And 2 more authors.
Diabetology and Metabolic Syndrome | Year: 2016

Background: Whereas an increase of neck circumference (NC) had been recently identified as a new independent cardiovascular disease (CVD) and metabolic syndrome risk factor, similar assessments concerning screen-detected diabetes mellitus (SDDM) have not been made. Thyroid gland volume (ThV) can potentially affect NC however the significance of this influence concerning the risk of NC-related disease is unknown. Methods: We performed a ThV-adjusted evaluation of NC within a population-based investigation of SDDM and impaired glucose regulation (IGR) prevalence. This study contains fasting plasma glucose (FPG) and 75 g 2-h glucose tolerance test results (2-hPG) of 196 residents of Kyiv region, Ukraine, randomly selected from the rural population older than 44 y.o. who were not registered as diabetes mellitus patients. Standard anthropometric (height; weight; blood pressure; waist, hip circumferences), NC and ultrasonography ThV measurements were performed, hypotensive medication, CVD events and early life nutrition history considered. HbA1c was measured, if FPG/2-hPG reached 7.0/11.1 mmol/l respectively; HbA1c level 6.5 % was considered to be SDDM diagnostic; IGR if FPG/2-hPG reached 6.1/7.8 but less than 7.0/11.1 mmol/l respectively. Results: Neck circumference among women with normal FPG/2-hPG was 35 (33-36) cm, IGR 36 (34.5-38) cm, SDDM HbA1c < 6.5 % 42 (40-43) cm, HbA1c > 6.5 % 42.5 (40-44) cm, p < 0.001, and for men from the same groups 38.5 (36.5-41.5) cm; 39 (37-42) cm; 42 (40-43) cm; 42.5 (40-44) cm, p = 0.063; medians (QI-QIII). Gender-adjusted logistic regression OR for SDDM HbA1c > 6.5 % vs. normal FPG/2-hPG category depending of NC as a continued variable, equaled to 1.60 (95 % CI 1.27-2.02) per cm. Additional adjusting by ThV, body mass or waist/hip index, high blood pressure, acute CVD events, or starvation history did not significantly influence this risk. Conclusion: Neck circumference is a new risk factor of SDDM that is independent from other indicators of adipose tissue distribution as well as from the ThV. © 2016 Khalangot et al.

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