No abstract

Своевременная диагностика паразитарных заболеваний опорно-двигательного аппарата представляет определенные сложности, обусловленные редкостью данной патологии. В статье представлено клиническое наблюдение-случай дирофиляриоза влагалища разгибателя пальца кисти у 49-летней женщины, госпитализированной с диагнозом «гигрома тыльной поверхности кисти». правильный диагноз заболевания был поставлен только после извлечения паразита во время операции. Обсуждены проблемы дифференциальной диагностики данного заболевания и гигромы тыла кисти. Для уточнения диагноза предложено использовать предоперационное узИ мягких тканей кисти.

Вестник представлен в научной электронной библиотеке (НЭБ)головном исполнителе проекта по созданию Российского индекса научного цитирования (РИНЦ)

Objective. To assess the role of iron metabolism changes in the pathogenesis of chronic diffuse liver diseases (CDLD). Assessment of the hepatic fibrosis progression and the most significant factors, influencing it, is still an actual target of modern medicine. A certain interest from the point of view of complex approach to studying the mechanism of development and progression of fibrosis is the determination of serum markers of iron metabolism. Materials and methods. The study included 170 patients with CDLD: 150 with chronic viral hepatitis C and 20 with alcohol hepatic cirrhosis (AHC). Iron metabolism indices and functional hepatic biochemical tests were studied. Expression of hepatic fibrosis in hepatitis was estimated by means of the liver density index with the scale METAVIR using the data of ultrasound elastography (Fibroscan 502, Echosens, France); fibrosis development rate was calculated with T. Poynard method. The control group enclosed 100 persons. Results. There was revealed a significant elevation of the blood ferritin concentration among patients with chronic hepatitis up to 107.9 [31; 250] ng/ml compared with the control (22.0 [11; 33] ng/ml) and to 325.8 [209; 401] ng/ml in patients with AHC. Conclusions. Progression of fibrosis into cirrhosis in patients with CDLD is interconnected with iron metabolism disorders in the form of increased ferritin concentration, which correlates with the parameters of liver lesion severity that confirms a direct involvement of iron metabolism disorders in CDLD pathogenesis.

Objective. To assess the role of the main pathogenetically significant molecules, including tumor necrosis factor alpha (TNF-) and transferrin, as an inflammatory protein, in the progression of chronic diffuse liver diseases (CDLD). Material and methods. The study involved 86 patients with cirrhosis of the liver (LC) of viral, alcoholic and mixed etiology. Inflammatory parameters were studied, including tumor necrosis factor alpha (TNF-), indicators of iron metabolism, -fetoprotein (AFP), vasculoendothelial growth factor (VEGF), and functional liver biochemical tests. The control group consisted of 70 persons. Results. It was revealed that the LC severity class is interrelated with the clinical manifestations of the disease, the severity of biochemical syndromes as well as a significant increase in the concentration of -globulins, CRP, the amount of TNF- up to 3.5 (2.64.7) pg/ ml (p 0.001) and ferritin up to 325.8 (209; 401) ng / ml (p 0.001) compared to the control group. An increase in TNF- and ferritin as inflammatory protein in LC confirms the growth of the activity of inflammation in the liver and correlates with other parameters involved in the pathogenesis of LC: with VEGF, as a marker of endothelial dysfunction, which is involved in the activation of fibrosis and neoangiogenesis, and AFP, reflecting regeneration processes in the liver. Conclusions. The progression of liver damage in cirrhosis is based primarily on the secondary inflammation caused by portal hypertension with the entry of intestinal antigens and toxins into the central bloodstream. At the same time, the perverse circle of the development of the disease is closed.