The aim: Make complex study of bone density in patients with primary osteoarthritis and exocrine pancreatic insufficiency and patients with primary osteoarthritis without exocrine pancreatic insufficiency. Materials and methods: There were examined 140 patients with primary osteoarthritis without exocrine pancreatic insufficiency and combination osteoarthritis and exocrine pancreatic insufficiency. Diagnosis of osteoarthritis was based on diagnostic X-Ray criteria – according to J.H. Kellgren and J.S. Lawrence. The level of exocrine pancreatic insufficiency was based on result of Elisa test. State of mineral bone density was examined by using dual-photon densitometry. Results: It was established that there was a progressive, statistical, significant increase of mineral density of bone tissue in the 1-st group patients with osteoarthritis. Patients in the 2-nd group, with osteoarthritis in the comorbidity with exocrine pancreatic insufficiency, the densitogram rates were statistically significantly lower than in patients in the 1-st group. Conclusions: The changes of bone tissue can be explained by the formation of trophological insufficiency as a result of exocrine pancreatic insufficiency. One of the symptoms of trophic failure is bone and mineral changes, in particular, the decrease of bone density.

The trophological status of patients with osteoarthrosis and excretory insufficiency of pancreas Abstract. Background. Studies found a high incidence of the gastrointestinal tract (GI) diseases in patients with OA, especially those that are accompanied by a violation of the excretory insufficiency of pancreas (EIP), which also contributes to the activation of proteolysis. The EIP in patients with OA is formed at the comorbid pathologies: chronic pancreatitis (CP) with EIP and incretory insufficiency in the form of diabetes mellitus (DM), functional biliary disorders, diseases of the liver and bile-excreting system, diseases of the gastroduodenal zones, enterocolitis and colon dysbiosis (CD); as a result of long-term treatment of OA using the non-steroidal anti-inflammatory drugs, steroids, chondroprotectors and chondrostimulators, etc. The purpose of the work was to study the state of the proteolysis system and immune status (IS), the presence and depth of the CD in patients with primary OA against a violation of their EIP. Materials and methods. There were 64 outpatients with primary OA (group 1) and 74 patients with primary OA in combination with diseases associated with EIP (group 2). The control group consisted of 30 healthy people. Results. It was proved that there is a deeper excitation of the excretory function of the pancreas (severe) in patient with OA and comorbid pathologies of the gastrointestinal tract with EIP, as well as the presence of EIP in patients with mild OA without the clinically available EIP. In patients with primary OA that went through the isolation or in combination with the diseases accompanied by the EIP, a statistically significant activation of the total proteolysis by the level of PRA was established. Also, the analysis showed the presence of an increase in specific proteolysis, or kininogenesis, by the level of proteolytic enzyme KK. In the examination of patients, dysbiotic changes of varying degrees were detected in both groups of the study: group 1 in 25 (39.06%) patients, the CD was 1 gr., in 18 (28.13%)-CD was 2 gr. In group 2 CD 1 gr. was in 35 (47.30%) patients, in 24 (32.43%)-CD 2 gr. In group 2, dysbiotic changes were significantly deeper than in group 1. This indicates a statistically weaker course in patients with the comorbidity conditions of the primary OA and gastrointestinal tract diseases and with EIP. The obtained results indicate the presence of secondary immune deficiency in the patients under study (T-lymphocytopenia was detected in ²-²² degrees with a decrease in all subpopulations of T-lymphocytes) and non-specific activation of the humoral part of the immune system and the inflammatory process (depletion of the total hemolytic activity of the complement, statistically significant increase of B-lymphocytes level with growth of level of all classes Ig (more Ig A and Ig M), circulating immune complexes). However, statistically more significant changes were observed in group 2, indicating the progression of the detected changes in comorbidity conditions.

Introduction: In this publication we analyzed the specific aspects of clinical course in case of combination of chronic pancreatitis and concomitant viral hepatitis C. The aim: Discover the clinical course of chronic pancreatitis with concomitant viral hepatitis C . Materials and methods: 57 patients with chronic pancreatitis and concomitant viral hepatitis c were examined. Diagnosis of chronic pancreatitis and viral hepatitis c was verified based on disease history, clinical symptoms and the results of clinical-instrumental tests. Clinical and biochemical investigations in people with chronic pancreatitis were done in exacerbation and unstable remission phases and for people with viral hepatitis C - in stable remission phase. Results: In patients, who have chronic pancreatitis with concomitant hepatitis C, pain, dyspeptic syndromes and defecation disturbances take the major place in clinical course of the disease. These symptoms were more severe than in the control group (possible difference in numbers in the group of patents with isolate viral hepatitis C (p<0,05). Conclusions: According to the studies data-the negative influence of concomitant viral hepatitis C in clinical course of chronic pancreatitis was identified.

Основываясь на данных корреляционно-регрессионного анализа, доказали, что возраст больных, длительность заболевания, функциональная способность поджелудочной железы по уровню фекальной α-эластазы и ее структурное состояние (по критериям УЗИ в баллах и методом ЭСВ) являются предикторами развития анемии, дефицита железа, гипопротеинемии и витаминной недостаточности у больных хроническим панкреатитом билиарного генеза.

The aim: Was to investigate the status of endotoxicosis parameters in patients with chronic pancreatitis depending on the presence of a combination with type 2 diabetes mellitus, as well as their impact on the functional capacity of the pancreas. Materials and methods: 87 outpatients with CP with concomitant type 2 diabetes and without it were examined. The main group consisted of 62 patients with CP in the phase of therapeutic exacerbation in combination with diabetes mellitus in a state of sub- or full compensation, the comparison group – 25 patients with isolated CP, the control group consisted of 30 healthy individuals. The content of malonic aldehyde in the blood was determined by reaction with thiobarbituric acid, the levels of medium-molecular peptides MMP1 and MMP2 – by the method of Gabrielyan, circulating immune complexes – by precipitation in 3.75% ethylene glycol with followed photometry. Results: The presence of active endotoxicosis and lipid peroxidation in CP was established, which was significantly more significant in the comorbidity of CP with type 2 diabetes: erythrocyte intoxication index was higher by 19.2%, the content of medium molecules MMP1 – by 29.5%, MMP2 – by 35.4%, malonic aldehyde – 10.9%, circulating immune complexes – 23.9%, ceruloplasmin – by 11.9% (p <0.05) Conclusions: A deeper level of excretory and incretory insufficiency of the pancreas in concomitant diabetes mellitus 2, which deepened with increasing endotoxicosis by the level of erythrocyte intoxication index based on an increase in the strength of significant moderate and moderate inverse correlations between it and fecal α-elastase such in isolated CP (respectively r=-0.517 and r=-0.471, p<0.05) and significant direct moderate and medium strength correlations between levels of HbA1c and erythrocyte intoxication index – respectively r=0.552 and r=0.337, p<0.05.