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Introduction: Studies show an increase in pro-inflammatory cytokines in the initial phase of sleep. Nevertheless, inflammatory mediators have increased levels in situations of sleep deprivation. The increase in these levels is due to influences of the central nervous system disorder on the immune response. Objective: Review of the literature on the relationship between sleep and the immune system. Method: An active search was carried out on Scielo, EbscoHost and PubMed using the keywords “sleep and immune system”; “sleep and immunity”; “sleep-wake cycle and immunity” and “sleep and immune system”. Original articles published between 2007 and June 2021 were selected. Results: 25 articles were found, of which 15 were selected to compose the work. Discussion: Sleep deprivation causes loss of immune system integrity, with immunosuppression, decreased action of NK cells, helper T cells and phagocytic action. In addition, individuals who suffer from insomnia have an increase in pro-inflammatory cytokines, leading to an inflammatory process. The immune system produces several sleep-regulating substances, including IL-1 and TNF-a, components of innate immunity, which exert a significant influence on the sleep-wake cycle acting as somogenic molecules and modulating non-REM sleep. Conclusion: It is possible to perceive a relationship between the immune system and sleep, in which the first has sonogenic capacity and the second maintains the integrity of the immune system. Sleep deprivation triggers a decrease in the action of the immune system and exacerbation of inflammation. Introducción: Los estudios muestran un aumento de las citoquinas proinflamatorias en la fase inicial del sueño, sin embargo, los mediadores inflamatorios tienen niveles elevados en situaciones de privación del sueño. El aumento de estos niveles se debe a influencias del trastorno del sistema nervioso central sobre la respuesta inmunitaria. Objetivo: Revisión de la literatura sobre la relación entre el sueño y el sistema inmunológico. Método: Se realizó una búsqueda activa en Scielo, EbscoHost y PubMed utilizando los descriptores “sueño y sistema inmunológico”; “sueño e inmunidad”; “ciclo sueño-vigilia e inmunidad” y “sueño y sistema inmunológico”. Se seleccionaron artículos originales publicados entre 2007 y junio de 2021. Resultados: se encontraron 25 artículos, de los cuales 15 fueron seleccionados para componer el trabajo. Discusión: La privación del sueño provoca pérdida de la integridad del sistema inmunológico, con inmunosupresión, disminución de la acción de las células NK, células T auxiliares y acción fagocítica. Además, las personas que sufren de insomnio tienen un aumento de citoquinas proinflamatorias, lo que lleva a un proceso inflamatorio. El sistema inmunitario produce varias sustancias reguladoras del sueño, entre ellas IL-1 y TNF-a, componentes de la inmunidad innata, que ejercen una influencia significativa en el ciclo sueño-vigilia actuando como moléculas somogénicas y modulando el sueño no REM. Conclusión: Es posible percibir una relación entre el sistema inmunológico y el sueño, en que el primero tiene capacidad sonogénica y el segundo mantiene la integridad del sistema inmunológico. La privación del sueño desencadena una disminución de la acción del sistema inmunitario y una exacerbación de la inflamación. Introdução: Estudos mostram o aumento de citocinas pró-inflamatórias na fase inicial do sono Não obstante, os mediadores inflamatórios apresentam níveis aumentados em situações de privação de sono. O aumento nesses níveis se deve a influências da desordem do sistema nervoso central sobre a resposta imunológica. Objetivo: Revisão de literatura sobre a relação entre sono e sistema imunológico. Método: Foi realizada uma busca ativa na Scielo, EbscoHost e PubMed através dos descritores “sono e sistema imunológico”; “sono e imunidade”; “ciclo sono-vigília e imunidade” e “sleep and immune system”. Foram selecionados artigos originais publicados entre 2007 e junho de 2021. Resultados: Foram encontrados 28 artigos dos quais 20 foram selecionados para compor o trabalho. Discussão: A privação do sono provoca perda da integridade do sistema imune, com imunossupressão, diminuição da ação de células NK, de células T auxiliares e da ação fagocítica. Além disso, indivíduos que sofrem de insônia apresentam aumento de citocinas pró-inflamatórias, levando a um processo inflamatório. O sistema imunológico produz diversas substâncias regulam o sono, dentre elas IL-1 e o TNF-a componentes da imunidade inata, que exercem influência significativa no ciclo sono-vigília agindo como moléculas sonogênicas e modulando o sono não-REM. Conclusão: É possível perceber uma relação entre o sistema imune e o sono, em que o primeiro tem capacidade sonogênica e o segundo mantem a integridade do sistema imunológico. A privação do sono desencadeia diminuição da ação do sistema imune e exacerbação da inflamação.

COVID-19 has expanded across the world since its discovery in Wuhan (China) and has had a significant impact on people’s lives and health. Long COVID is a term coined by the World Health Organization (WHO) to describe a variety of persistent symptoms after acute SARS-CoV-2 infection. Long COVID has been demonstrated to affect various SARS-CoV-2-infected persons, independently of the acute disease severity. The symptoms of long COVID, like acute COVID-19, consist in the set of damage to various organs and systems such as the respiratory, cardiovascular, neurological, endocrine, urinary, and immune systems. Fatigue, dyspnea, cardiac abnormalities, cognitive and attention impairments, sleep disturbances, post-traumatic stress disorder, muscle pain, concentration problems, and headache were all reported as symptoms of long COVID. At the molecular level, the renin-angiotensin system (RAS) is heavily involved in the pathogenesis of this illness, much as it is in the acute phase of the viral infection. In this review, we summarize the impact of long COVID on several organs and tissues, with a special focus on the significance of the RAS in the disease pathogenesis. Long COVID risk factors and potential therapy approaches are also explored.

In the study, on the basis of statistical analysis of the complex of clinical-laboratory, anamnestic and immunological parameters of 495 patients, predictors of pneumonia were determined and a logistic model of the prediction of the occurrence of pneumonia in patients with immune disorders on the background of oncohematological pathology was developed, which included indicators that are characteristics of the course of oncological diseases of the blood, as well as indicators of immune reactivity.

In the study, based on the statistical analysis of a complex of clinico-laboratory, anamnestic and immunological indices of 495 patients, the predictors of pneumonia development were determined and a logistic model of the prognosis of pneumonia emerged in patients with impaired immunity against the background of oncohematological pathology, which included indicators that are characteristics of the oncological blood disease, as well as indices of immune reactivity.

Mast cells (MCs) bear many receptors which allow them to respond tAs far as treatment of MC-derived diseases is concerned, allergen immunotherapy as well as other attempts to reduce MC-activation will be outlined according to the recent data. Finally, in agreement with current literature and our own data polyphenols have been demonstrated to attenuate type I allergic reactions and contact dermatitis in response to nickel. The use of polyphenols in these diseases will be discussed also in view of MC involvement.o a variety of exogenous and endogenous stimuli. However, MC function is dual since they can initiate pathological events or protect the host against infectious challenges.:The role of MCs in disease will be analyzed in a broad sense, describing cellular and molecular mechanisms related to their involvement in auto-inflammatory diseases, asthma, autoimmune diseases and cancer. On the other hand, their protective role in the course of bacterial, fungal and parasitic infections will also be illustrated.:Mast cells (MCs) bear many receptors that allow them to respond to a variety of exogenous and endogenous stimuli. However, MC function is dual since they can initiate pathological events or protect the host against infectious challenges.

Pneumonia is often life threatening infectious complication on a back ground of software treatment in patients with acute lymphoblastic leukemia (ALL). The existing consensus documents on the treatment of pneumonia in patients with impaired immunity focuses on antibac terial therapy, at the same time, questions about the need for correc tion of the immune status of patients remain poorly understood. A promising direction is the use of glutamyl cysteinyl glycine sodium in the treatment of pneumonia in patients with OL to enhance the activ ity of the immune system and improve the anti infective protection. The aim of the study : was the analysis of indicators of cellular and humoral immunity in the process of applying immunocorrigirutee drug glutamyl cysteinyl glycine sodium (Glutoxim) in patients with pneu monia, which arise on the background of ALL optimization approach es in the treatment of pneumonia in patients with impaired immunity. Materials and methods . Study group of 87 patients with pneumonia on the background of ALL that took place a software based treatment of hematological centre «SE City Multidisciplinary Clinical Hospital No. 4» (str) for 2014 2015, the average age of patients was from 28 to 39 years old. ALL diagnoses of pneumonia was verified in accordance with generally accepted clinical and morphological criteria. Patients from the main study group (n=57) was additionally appointed glu tamyl cysteinyl glycine sodium to 2 ml of 3% (60 mg), N 10, in the morning, intravenous, total dose of 600 mg. All patients investigated indicators immunogram: T lymphocytes, b lymphocytes and indicators subpopulation composition (CD3+, CD4+, CD8+, CD19+, CD19 , CD16+, CD56+). The study was conducted using flow through laser cytofluometry (BeckmanCoulter, USA) and calculated the derived indices. Indicators of immunogram in patients of study groups were evaluated in the dynamics of treatment. Statistical processing was per formed using packages of applied programs «Excel» and «Statistic 10». Results . The analysis of indicators of cellular and humoral immunity of patients with pneumonia accompanied by АLL in the process of applying glutamyl cysteinyl glycin sodium showed significant activation of phagocytosis and anti infective protection of the results of increasing the relative amount of T helpers (CD4 +), PC cells, increased immunoregu latory index, FA and FC. The results of the dynamics of humoral immu nity also confirm the positive influence of the use of glutamyl cysteinyl glycine sodium on the immune reactivity of patients with reliable change indices of IgA and IgM, which are responsible for neutralizing infectious agents, bacterial toxins and indirectly activate phagocytosis. Conclusion . The use of immunomodulatory therapy with the drug glu tamyl cysteinyl glycine sodium (Glutoxim) in patients with pneumo nia on the background of ALL leads to improved clinical manifesta tions of the disease, reduces the duration of ABT improves the quality of life and leads to earlier return (average 3 4 days) to the program treatment АLL. The results of the research prove the possibility of optimizing the treatment of pneumonia by the using of immunomodu latory therapy glutamyl cysteinyl glycine sodium (Glutoxim) patients with pneumonia on a background of АLL.

Purpose To describe factors associated with the utilization of dental services in a long-term care facility (LTCF) in Western New York. Methods and materials A descriptive cross-sectional study reviewed the dental and medical records of residents of an LTCF discharged between January 1, 2008 and December 30, 2012. Information on demographic and health variables at admission was extracted from electronic health records. Information on oral health variables was extracted from patient charts. Results A total of 2,516 residents were discharged between 2008 and 2012. From those, 259 (10.3%) utilized dental services at least once during their stay. Those who utilized dental services were significantly older at admission (78.5 vs. 82.0 years, p < 0.001), stayed longer (1.6 vs. 3.9 years, p < 0.001), more likely to be female (63.6 vs. 75.6%, p = 0.008), and less likely to be married (37.7 vs. 14.0%, p = < 0.001) compared to those who did not. Patients with endocrine, nutritional, metabolic, and immunity disorders, mental disorders, and circulatory system diseases were more likely to receive dental services. Conclusions Dental services appear to be underutilized by residents of LTCF. Significant differences exist in demographic and health variables between residents who utilize these services compared to those who do not.

Objectives To determine rates and primary discharge diagnoses of hospitalisation in a cohort of patients with incident primary Sjogren’s syndrome (pSS) compared to the general population. Methods This was a retrospective population-based cohort study focused on Olmsted County, Minnesota. The pSS cohort consisted of patients with incident pSS in the 1976–2015 period and was compared with a cohort of individuals without pSS matched 3:1 for age, sex and calendar year, randomly selected from the same population. Hospitalizations in 1995–2016 were examined. Discharge diagnoses were categorised using the Clinical Classifications Software for ICD-9-CM. Results A total of 385 hospitalizations occurred in the 160 patients with pSS during 1592 person-years of follow-up. Among 466 comparators, there were 899 hospitalizations during 4660 person-years of follow-up, resulting in a significantly higher rate of hospitalizations in patients with pSS (rate ratio [RR]:1.25, 95% CI:1.11–1.41). Rates of hospitalisation were increased among patients with pSS for endocrine, nutritional and metabolic diseases and immunity disorders (RR:1.82, 95% CI:1.08–2.98), diseases of the musculoskeletal system and connective tissue (RR:1.49, 95% CI:1.05–2.05), and for injuries and poisoning (RR:1.46, 95% CI:1.01–2.06). While not significantly increased overall, hospitalizations for diseases of the circulatory system were significantly increased in patients with pSS aged ≥75 years (RR:1.54, 95% CI: 1.11–2.11). Conclusions Patients with pSS experienced higher rates of hospitalisation than the general population. Hospitalizations for endocrine/metabolic disorders, diseases of the circulatory system, diseases of the musculoskeletal system and connective tissue disorders, and injuries were more common among patients with pSS than comparators. Disclosure of Interest None declared

В исследовании на основе статистического анализа комплекса клинико-лабораторных, анамнестических и иммунологических показателей 495 больных с нарушениями иммунитета на фоне онкогематологической патологии определены предикторы развития пневмоний и создана регрессионная логистическая модель прогноза развития пневмоний, куда вошли показатели, которые характеризуют течение онкогематологического заболевания и состояние иммунной системы., У дослідженні на підставі статистичного аналізу комплексу клініко-лабораторних, анамнестичних та імунологічних показників 495 хворих з порушеннями імунітету на тлі онкогематологічної патології визначені предиктори розвитку пневмоній і створена регресійна логістична модель прогнозу розвитку пневмоній, куди увійшли показники, які характеризують перебіг онкогематологічного захворювання і стан імунної системи., In the study, on the basis of statistical analysis of the complex of clinical-laboratory, anamnestic and immunological parameters of 495 patients, predictors of pneumonia were determined and a logistic model of the prediction of the occurrence of pneumonia in patients with immune disorders on the background of oncohematological pathology was developed, which included indicators that are characteristics of the course of oncological diseases of the blood, as well as indicators of immune reactivity.

Objective To determine rates and primary discharge diagnoses of hospitalisation in a cohort of patients with incident primary Sjogren’s syndrome (pSS) compared with the general population. Methods This was a retrospective population-based cohort study focused on Olmsted County, Minnesota. The pSS cohort consisted of patients with incident pSS in the 1976–2015 period and was compared with a cohort of individuals without pSS matched 3:1 for age, sex and calendar year, randomly selected from the same population. Hospitalisations in 1995–2016 were examined. Discharge diagnoses were categorised using the Clinical Classifications Software for International Classification of Diseases, 9th revision, Clinical Modification. Results A total of 385 hospitalisations occurred in the 160 patients with pSS during 1592 person-years of follow-up. Among 466 comparators, there were 899 hospitalisations during 4660 person-years of follow-up, resulting in a significantly higher rate of hospitalisations in patients with pSS (rate ratio (RR): 1.25, 95% CI: 1.11 to 1.41). Rates of hospitalisation were increased among patients with pSS for endocrine, nutritional and metabolic diseases and immunity disorders (RR 1.82, 95% CI 1.08 to 2.98), diseases of the musculoskeletal system and connective tissue (RR 1.49, 95% CI 1.05 to 2.05) and for injuries and poisoning (RR 1.46, 95% CI 1.01 to 2.06). While not significantly increased overall, hospitalisations for diseases of the circulatory system were significantly increased in patients with pSS aged ≥75 years (RR 1.54, 95% CI 1.11 to 2.11). Conclusions Patients with pSS experienced higher rates of hospitalisation than the general population. Hospitalisations for endocrine/metabolic disorders, diseases of the circulatory system, diseases of the musculoskeletal system and connective tissue disorders, and injuries were more common among patients with pSS than comparators.

У дослідженні на підставі статистичного аналізу комплексу клініко-лабораторних, анамнестичних та імунологічних показників 495 хворих визначені предиктори розвитку пневмоній та створена логістична модель прогнозу виникнення пневмоній у хворих з порушеннями імунітету на тлі онкогематологічної патології, куди увійшли показники, які є характеристиками перебігу онкологічного захворювання крові, а також показники імунної реактивності., В исследовании на основании статистического анализа комплекса клинико-лабораторных, анамнестических и иммунологических показателей 495 больных определены предикторы развития пневмоний и создана логистическая модель прогноза возникновения пневмоний у больных с нарушениями иммунитета на фоне онкогематологической патологии, куда вошли показатели, которые являются характеристиками течения онкологического заболевания крови, а также показатели иммунной реактивности., In the study, based on the statistical analysis of a complex of clinico-laboratory, anamnestic and immunological indices of 495 patients, the predictors of pneumonia development were determined and a logistic model of the prognosis of pneumonia emerged in patients with impaired immunity against the background of oncohematological pathology, which included indicators that are characteristics of the oncological blood disease, as well as indices of immune reactivity.

Мета дослідження: оптимізувати підхід до лікування пневмоній у хворих на тлі гострих лейкозів з позицій імунорезистентності на основі застосування глутаміл-цистеинил-гліцин динатрію методом екстракорпоральної фармакотерапії.Дослідження проводилося на базі КЗ «Міська багатопрофільна клінічна лікарня № 4» м. Дніпро. Хворим основної групи вводили глутаміл-цистеинил-гліцин динатрію. Дослiджували показники імунної вiдповiдi.Удосконалений спосіб лікування довів можливість оптимізації лікування пневмонії у хворих з порушеннями імунітету з позицій імунорезистентності, Aim of research: to optimize the approach to the treatment of pneumonias in patients on the background of acute leucosis from positions of immunoresistance based on using disodium glutamyl-cysteinile-glycine by the method of extracorporal pharmacotherapy.Materials and methods. Research group – 39 patients with pneumonia on the background of acute leucosis, who underwent the treatment according to the form and stage of the disease on the base of the hematological center “MI city multi-profile clinical hospital No. 4» Dnipro city, 2015–2016. Mean age of patients 31,5±6,5 years, 11 women and 38 men. Patients of the main group were additionally administered with disodium glutamyl-cysteinile-glycine in 2 ml of 3 % solution (60 mg) i/v No. 5 each second day. The parameters of the immune response were studied: Т and В-lymphocytes and their subpopulational composition (CD3+, CD4+, CD8+, CD19+, CD16+, CD56+) by the method of flow laser cytoflourometry (BeckmanCoulter–USA). There were additionally determined; immunoregulatory index, leuco T-cellular index, leuco B-cellular index and index of leucocytes activation; phagocytosis state was assessed by the parameters: phagocytic number, phagocytic indicator, NBT-tests. The state of humoral immunity was assessed by levels of immunoglobulins of classes A, M and G by the method of immunoturbidimetry (BeckmanCoulter–USA).Results. The analysis of parameters of cellular and humoral immunity of patients with pneumonias on the background of AL by the improved method of treatment of pneumonia using the immunomodeling preparation disodium glutamyl-cysteinile-glycine proved the positive influence on the immune reactivity of patients’ organism, manifested by the reliable increase of the relative quantity of the pool of T-helpers (CD4+), NК-cells, increase of immunoregulatory index, PI, PN and increase of humoral immunity indices.Conclusions. The improved method of pneumonia treatment on the background of AL using the immunomodeling preparation disodium glutamyl-cysteinile-glycine by ECPT method proved the positive influence of the immune reactivity of patients’ organism, manifested by the reliable activation of phagocytosis and anti-infectious protection, manifested by the more expressed effect of pneumonia treatment: improvement of the clinical course of disease; decrease of the prognosticated number of ABT days and earlier return to the program treatment of AL. The obtained effects of the improved method of pneumonia treatment in patients with acute leucosis at using the immunomodeling preparation disodium glutamyl-cysteinile-glycine by ECPT method proves the pathogenetic validity of the possibility of optimization of pneumonia treatment from positions of immunoresistance

The influence on date change of a cell in systematic immunity has been studied. The research implies 52 patients with different forms of traumatic disorders aged 16-69 (on average 37, 914, 28). The focus group was made up of 16 patients, who have been performed non-urgent operations not linked to musculoskeletal disorders. All focus group patients were splitted in 3 groups in accordance with their health condition. The cell system analysis of immunity was conducted by identifying of sub-populations of T-lymphocytes and antibodies CD3, CD4, CD8, and CD22. The most vivid changes of a cell systematic immunity (II-III immunity disorders grades) were observed among patients with severe traumatic disorders. Operational intervention, even without trauma – significantly influences the cell systematic immunity, though patients with traumatic immune disorders, apart from immunoregulatory index were more significant than those of the focus group patients.

An immune deficiency state, along with continuously increased intravascular coagulation, are shown to develop in puerperal women after Caesarian section complicated by endometritis. Complex therapeutic schedules aimed for endometritis treatment, including thymic peptides (thymalin or thymogen) are accompanied by more rapid correction of these disorders and favorable clinical effect. ( Med. Immunol., 2011, vol. 13, N 2-3, pp 279-284 )

Pneumonia is often life threatening infectious complication on a back ground of software treatment in patients with acute lymphoblastic leukemia (ALL). The existing consensus documents on the treatment of pneumonia in patients with impaired immunity focuses on antibac terial therapy, at the same time, questions about the need for correc tion of the immune status of patients remain poorly understood. A promising direction is the use of glutamyl cysteinyl glycine sodium in the treatment of pneumonia in patients with OL to enhance the activ ity of the immune system and improve the anti infective protection.The aim of the study: was the analysis of indicators of cellular and humoral immunity in the process of applying immunocorrigirutee drug glutamyl cysteinyl glycine sodium (Glutoxim) in patients with pneu monia, which arise on the background of ALL optimization approach es in the treatment of pneumonia in patients with impaired immunity.Materials and methods. Study group of 87 patients with pneumonia on the background of ALL that took place a software based treatment of hematological centre «SE City Multidisciplinary Clinical Hospital No. 4» (str) for 2014 2015, the average age of patients was from 28 to 39 years old. ALL diagnoses of pneumonia was verified in accordance with generally accepted clinical and morphological criteria. Patients from the main study group (n=57) was additionally appointed glu tamyl cysteinyl glycine sodium to 2 ml of 3% (60 mg), N 10, in the morning, intravenous, total dose of 600 mg. All patients investigated indicators immunogram: T lymphocytes, b lymphocytes and indicators subpopulation composition (CD3+, CD4+, CD8+, CD19+, CD19 , CD16+, CD56+). The study was conducted using flow through laser cytofluometry (BeckmanCoulter, USA) and calculated the derived indices. Indicators of immunogram in patients of study groups were evaluated in the dynamics of treatment. Statistical processing was per formed using packages of applied programs «Excel» and «Statistic 10».Results. The analysis of indicators of cellular and humoral immunity of patients with pneumonia accompanied by АLL in the process of applying glutamyl cysteinyl glycin sodium showed significant activation of phagocytosis and anti infective protection of the results of increasing the relative amount of T helpers (CD4 +), PC cells, increased immunoregu latory index, FA and FC. The results of the dynamics of humoral immu nity also confirm the positive influence of the use of glutamyl cysteinyl glycine sodium on the immune reactivity of patients with reliable change indices of IgA and IgM, which are responsible for neutralizing infectious agents, bacterial toxins and indirectly activate phagocytosis.Conclusion. The use of immunomodulatory therapy with the drug glu tamyl cysteinyl glycine sodium (Glutoxim) in patients with pneumo nia on the background of ALL leads to improved clinical manifesta tions of the disease, reduces the duration of ABT improves the quality of life and leads to earlier return (average 3 4 days) to the program treatment АLL. The results of the research prove the possibility of optimizing the treatment of pneumonia by the using of immunomodu latory therapy glutamyl cysteinyl glycine sodium (Glutoxim) patients with pneumonia on a background of АLL., Пневмония часто становится угрожающим жизни инфекционным осложнением на фоне програмного лечения у больных острыми лимфобластными лейкозами (ОЛЛ). В существующих согласительных документах по лечению пневмонии у больных с нарушениями иммунитета внимание фокусируется на антибактериальной терапии (АБТ), при этом вопросы о необходимости коррекции иммунного статуса больных остаются малоизученными. Перспективным направлением является использование глутамил-цистеинил-глицин-натрия при лечении пневмонии у больных с ОЛ для усиления активности иммунной системы и улучшения антиинфекционной защиты.Цель исследования: анализ динамики показателей клеточного и гуморального иммунитета в процессе применения иммунокорригирующего препарата глутамил-цистеинил-глицин-динатрия (глутоксим) у больных пневмониями, которые возникают на фоне ОЛЛ для оптимизации подходов лечения пневмоний у больных с нарушениями иммунитета.Материалы и методы. Группа исследования 87 больных пневмонией на фоне ОЛЛ, которые проходили программное лечение на базе гематологического центра «КЗ городская многопрофиль ная клиническая больница No 4» (г. Днепр) в течение 2014–2015 г. Средний возраст пациентов от 28 до 39 лет. Диагнозы ОЛЛ и пневмонии были верифицированы в соответствии с общепринятыми клиническими и морфологическими критериями. Больным основной группы исследования (n=57) дополнительно назначали глутамил-цистеинил-глицин-динатрия по схеме 2 мл 3% (60 мг) No 10 в утренние часы, внутривенно, суммарная доза – 600 мг. Всем больным исследовали показатели иммунограм: Т лимфоциты, В лимфоциты и показатели их субпопуляционного состава (CD3+, CD4+, CD8+, CD19+, CD19 , CD16+, CD56+). Исследование про водили с помощью проточной лазерной цитофлоуметрии (BeckmanCoulter–USA) и рассчитывали производные индексы. Показатели иммунограмм больных групп исследования оценивали в динамике лечения. Статистическую обработку проводили с помощью пакетов прикладных программ «Excel» и «Statistic 10».Результаты. Анализ динамики показателей клеточного и гуморального иммунитета больных пневмонией, протекающих на фоне ОЛЛ, в процессе применения глутамил-цистеинил-глицин-динатрия продемонстрировал достоверную активацию фагоцитоза и антиинфекционной защиты по результатам повышения относительного количества Т хелперов (CD4 +), NК клеток, показателя иммунорегуляторного индекса, ФА и ФЧ. Результаты динамики показателей гуморального иммунитета также подтверждают положительное влияние применения глутамил-цистеинил-глицин-динатрия на состояние иммунной реактивности организма больных по достоверным изменениям показателей ІgА и ІgМ, которые отвечают за нейтрализацию инфекционных агентов, бактериальных токсинов и опосредовано активируют фагоцитоз.Заключение. Использование иммуномодулирующей терапии с помощью препарата глутамил-цистеинил-глицин-динатрия (глутоксим) у больных пневмонией на фоне ОЛЛ приводит к улучшению клинических проявлений заболевания, обеспечивает сокращение сроков АБТ, улучшает качество жизни и обуславливает более раннее возвращение (в среднем на 3–4 сут) к программному лечению ОЛ. Результаты исследования доказывают возможность оптимизации подходов лечения пневмонии путем использования иммуномодулирующей терапии глутамил-цистеинил-глицин-ди- натрия (глутоксим) у больных пневмонией на фоне ОЛЛ., Одним із найбільш загрозливих інфекційних ускладнень щодо виникнення фатальних наслідків у хворих на гострі лімфобластні лейкози (ГЛЛ), є пневмонія. В існуючих узгоджуваль них документах щодо лікування пневмонії у хворих з порушеннями імунітету фокусується увага на антибактеріальній терапії (АБТ), відомості щодо необхідності коригування імунного статусу хворих залишаються маловивченими. Перспективним напрямком є використання імуномодулятору глутамілцистеинил гліцин-динатрію при лікуванні пневмонії у хворих на ГЛ для посилення активності імунної системи та покращення антиінфекційного захисту.Мета дослідження: аналіз динаміки показників клітинного і гуморального імунітету у процесі застосування імуномоделюючого препарату глутаміл-цистеинил-гліцин-динатрію (глутоксим) у хворих на пневмонію, що виникали на тлі ГЛЛ для оптимізації підходів лікування пневмоній у хворих з порушеннями імунітету.Матеріали та методи. Група дослідження 87 хворих на пневмонію, яка розвинулася на тлі програмнного лікування ГЛЛ. Дослідження проводилися на базі гематологічного центру «КЗ міська багатопрофільна клінічна лікарня No 4» (м. Дніпро) протягом 2014–2015 р. Середній вік пацієнтів від 28 до 39 років. Діагноз ГЛЛ та пневмонії було верифіковано відповідно до сучасних загальноприйнятих клінічних та морфологічних критеріїв. Хворим основної групи дослідження (n=57) призначали глутаміл-цистеинил-гліцин-динатрію за схемою: 2 мл 3% (60 мг) внутрішньовенно No 10, вранці, сумарна доза – 600 мг. Усiм хворим дослiджували показники iмунограм: Т лiмфоцити, В лiмфоцити та показники їх субпопуляційного складу (CD3+, CD4+, CD8+, CD19+, CD19 , CD16+, CD56+) методом проточної лазерної цитофлоу метрії (BeckmanCoulter–USA) та розраховували похідні індекси. Показники імунограм хворих груп дослідження оцінювали у динаміці лікування. Статистичне оброблення проводили за допомогою пакетів прикладних програм «Excel» та «Statisticа 10».Результати. За результатами аналізу показників клітинного і гуморального імунітету хворих на пневмонію, що перебігали на тлі ГЛЛ у процесі застосування глутаміл-цистеинил-гліцин-динатрію визначено вірогідну активацію фагоцитозу та антиінфекційного захисту за підвищенням показників відносної кількості Т хелперів (CD4+), NК клітин, імунорегуляторного індексу, ФА та ФЧ. Динаміка показників гуморального імунітету також підтверджує позитивний вплив на стан імунної реактивності організму хворих на ГЛЛ за вірогідними змінами ІgА та ІgМ, які відповідають за нейтралізацію інфекційних агентів і бактеріальних токсинів та активують фагоцитоз.Заключення. Використання імуномоделюючої терапії препаратом глутаміл-цистеініл-гліцин-динатрію у хворих на пневмонії на тлі ГЛЛ сприяє покращенню клінічних проявів захворювання, що забезпечує скорочення термінів АБТ, покращує якість життя і зумовлює раннє повернення (у середньому на 3–4 доби) до програмного лікування гострого лейкозу. Результати дослідження доводять можливість оптимізації підходів лікування пневмонії шляхом використання імуномоделюючої терапії глутаміл-цистеинил-гліцин-динатрію (глутоксим) у хворих на тлі ГЛЛ.

Background From mid-1980s to early 1990s, there were several studies evaluating a condition known as “nocturnal sudden death syndrome” among the healthy, young Hmong (immigrants from Laos) individuals who mysteriously died from unknown causes during the night. To date, very little has been reported on the mortality patterns in the Hmong. The purpose of the present study is to examine causes of death (COD) and compare age-adjusted mortality rates (AAMR) in the Hmong with those of non-Hispanic white (NHW) population in California, which may yield useful data for health prevention and planning purposes. Methods This study was based on 2,744 Hmong deaths occurred in California from 1988 to 2002. To calculate AAMR, Hmong population at risk of dying was derived by interpolating Hmong population counts from the 1990 and 2000 decennial censuses. For comparison, AAMR were calculated for both Hmong and NHW, and the statistical test, incidence rate ratio, was used to examine differences in relative mortality risk of each major COD between Hmong and NHW. Results AAMR are highest in neoplasm (184.0/100,000), circulatory (277.9/100,000) and respiratory (100.0/100,000) diseases for both Hmong and NHW. The AAMR for all COD during the entire study time period was 879.5/100,000 in males and 736.0/100,000 in females. AAMR for all other COD range from 4.9/100,000 to 67.2/100,000. Hmong experienced 1.3–1.9 times higher mortality rates for certain COD, compared to NHW. Conclusion The interesting findings of this study are the differences in AAMR observed for lower ranking COD between Hmong and NHW. Hmong were found to be experiencing 1.3–1.9 times higher mortality rates for injuries and poisonings, digestive diseases, prenatal conditions, ENMID (endocrine, nutritional, metabolic, immunity disorders), infections and parasitic illnesses, and congenital anomalies when compared to NHW. However, while Hmong women were found to have statistically significantly higher mortality risk for injuries and poisonings (P-value < 0.05), ENMID (P-value < 0.05), and infections and parasitic ailments (P-value < 0.05) when compare to NHW women, Hmong men were observed to be at statistically significantly higher mortality risk for just infections and parasitic diseases (P-value < 0.05) when compared to NHW men

Інфікування генітального тракту вірусною інфекцією у жінок репродуктивного віку призводить до фонових та передпухлинних захворювань шийки матки та супроводжується розвитком імунопатологічних реакцій. При обстеженні 100 пацієнток репродуктивного віку з генітальною вірусною інфекцією було виявлено достовірні розлади загального імунітету, які проявлялись змінами його гуморальної ланки у вигляді підвищення рівнів lg G, Ід М та Ід А і дисбалансом клітинної ланки за рахунок зниження Т-хелперів і природних кілерів та значного підвищення кількості Т-супресорів. З метою аналізу змін вищезгаданих показників імунної системи пацієнткам призначали комплексне лікування генітальної вірусної інфекції з використанням противірусного імуномодулятора Кагоцел та озонотерапії. Після проведеного лікування діагностували нормалізацію гуморальної та клітинної ланок загальної імунної відповіді у всіх пацієнток, які отримували запропоновану методику на відміну від загальноприйнятої терапії. Доведена висока ефективність призначення кагоцелу та озонотерапії в лікуванні генітальної вірусної інфекції у жінок репродуктивного віку.

Caregiving for elderly patients with dementia is a hard and risky job. It is clear that caregiving has an important impact on mood, quality-of-life, physical and psychological health of the patient’s family members. Frequent episodes of depression, immunity disorders, altered capacity for wound healing, increased consumption of psychotropic drugs, and increased mortality have all been described convincingly (Schulz and Beach, 1999; Belmin, 2003). However, there is insufficient evidence available on how carers can best be supported on the large-scale basis that is needed in this era of highly prevalent dementia. In the research conducted so far, feasibility, individual tailoring of interventions, cultural and social contexts of care, as well as the efficiency (effectiveness and cost) of the interventions are seriously neglected.

keratoacanthoma. J Am Acad Dermatol 1989; 16:1023-4. 18. Street ML, White JW, Gibson LE. Multiple keratoacanthomas treated with oral retinoids. J Am Acad Dermatol 1990;23:862-6. 19. Yell JA. Grzybowski's generalized eruptive keratoacanthoma. J R Soc Med 1991;84:170-1. 20. Laaff H, Mittelviejhans H, Wokalek H, et al. Eruptive keratoacanthome typ Grzybowski und ektropium. Hautarzt 1992;43:143-7. 21. Dangoisse C, Meyvisch K, Ledoux M. Multiple eruptive keratoacanthoma and immunity disorders. Dermatology 1993;186:313-6. 22. Kavanagh GM, Marshman G, Hanna MM. A case of Grzybowski's generalized eruptive keratoacanthomas. Australas J Dermatol 1995;36:83-5. 23. Jaber PW, Cooper PH, Greer KE. Generalized eruptive keratoacanthoma of Grzybowski. J Am Acad Dermatol 1993;29:299-304. 24. Czubak A, Kalbarczyk K, Maciejowska E, et al. Keratoacanthoma eruptivum varietas Grzybowski: coexistence with keratoacanthoma marginatum-centrifugum and typical solitary tumor [abstract]. J Am Acad Dermatol 1996;35:105. 25. Degos R, Bernard J, Delort J, et al. Keratoacanthomes centrifuges dissemines. Bull Soc Fr Dermatol Syph 1967;74:417-9. 26. Job CK. Keratoacanthoma associated with leprosy. Indian J Pathol Bacteriol 1963;6:160-2. 27. Guillot B, Fesneau H, Mourad G, et al. Keratoacanthomes multiples sous ciclosporine [letter]. Presse Med 1990; 19:1286. 28. Walder BK, Robertson MR, Jeremy D. Skin cancer and immunosuppression. Lancet 1971 ;2:1282-3. 29. Sina B, Adrian RM. Multiple keratoacanthomas possibly induced by psoralens and ultraviolet A photochemotherapy. J Am Acad Dermatol 1983;9:686-8. 30. Hendricks WM. Sudden appearance of multiple keratoacanthomas three weeks after thermal burn. Cutis 1991;17:110-2. 31. Shaw JC, Storrs FJ, Everts E. Multiple keratoacanthomas after megavoltage radiation therapy. J Am Acad Dermatol 1990;23:1009-11.

A 68-year-old woman presents multiple keratoacanthoma of the Witten and Zak type associated with immunity disorders. A dramatic regression of the lesions is noticed while the patient is treated with an association of loratadine and ranitidine. Hypotheses are proposed in view of a possible role of ranitidine, an anti-H2 antihistaminic.

Este artigo descreve o primeiro ano de atividades do Centro de Informação sobre Medicamentos da Universidade Federal do Ceará, em Fortaleza, Brasil. O CIM faz parte do GPUIM (Grupo de Prevenção ao Uso Indevido de Medicamentos, do Departamento de Farmácia), sendo operacionalizado por farmacêuticos especializados. O serviço atende à comunidade em geral e aos profissionais da saúde em particular. De dezembro de 1994 a novembro de 1995, 246 pessoas telefonaram ao CIM-UFC, das quais 39% eram usuários de medicamentos, 32% farmacêuticos, 17% parentes e/ou amigos dos usuários, 4,5% estudantes de Farmácia e/ou de Medicina, 4% médicos, 0,8% enfermeiras e 2,8% outros. Os temas mais abordados foram Reações Adversas (28%) Indicações (28%) e Eficácia (18%), sendo os grupos de fármacos mais freqüentes: Vitaminas, Analgésicos e Agentes Antiinflamatórios. O número de solicitações vem aumentando regularmente, variando com a divulgação do serviço através da mídia local e de publicações específicas. Nesse período, o Centro vem esboçando o perfil de um serviço que pode preencher lacunas importantes não só do Sistema de Saúde, como também da formação e prática de médicos e farmacêuticos. Além disso, o Centro está se firmando como uma fonte segura de informações auxiliares nas decisões das pessoas leigas no que diz respeito à automedicação.