Научная статья на тему 'Frequency and nature of family aggregation at probands with the burdened inheritance of the inactive adenoma of hypophysis(the genealogic status in panmixia with inheritance of inactive adenoma of hypophysis)'

Frequency and nature of family aggregation at probands with the burdened inheritance of the inactive adenoma of hypophysis(the genealogic status in panmixia with inheritance of inactive adenoma of hypophysis) Текст научной статьи по специальности «Клиническая медицина»

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INACTIVE ADENOMAS OF HYPOPHYSIS / TUMOR / FAMILY / DIFFERENTIAL DIAGNOSTICS / PROBANDS / GENEALOGICAL STATUS / SYMPTOMS

Аннотация научной статьи по клинической медицине, автор научной работы — Khamedova Firuza Saidovna

Study of frequency of inactive adenoma of hypophysis (IAH) cases among relatives is of great importance for a choice of strategy and tactics of treatment of these patients, development of methods of forecasting in population families with genetic predisposition to this disease. In this regard the purpose of our research in which 104 patients with IAH were included there was studied nature of family aggregation at probands with the burdened family anamnesis.

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Текст научной работы на тему «Frequency and nature of family aggregation at probands with the burdened inheritance of the inactive adenoma of hypophysis(the genealogic status in panmixia with inheritance of inactive adenoma of hypophysis)»

Frequency and nature of family aggregation at probands with the burdened inheritance

keratinization of the mucosal epithelial of the oral cavity as the manifestations of such diseases as leukoplakia (17.8 %) and exfoliate cheilitis (8.6 %), and the interrelation between a level of keratinization, duration and degree of the contact of the workers with manufacture pro-cess has been revealed. So, the most high level of keratinization was observed in workers manu-factured washing and cleaning agents 5.2 times higher (p < 0.001), than in the persons of control group.

Thus, on the basis of results obtained from the studies performed, it is possible to conc-lude, that among working engaged in

the manufacture of the washing and cleaning agents the al-lergic diseases and diseases of mucosa of the oral cavity and lips with tendency to development of hyperkeratosis including exfoliate cheilitis and leukoplakia of the red edges and cheek mucosa are widely distributed. It indicates that the unfavourable factors of the manufacture of the synthetic washing and cleaning agent have negative effects on frequency and character of patho-logical processes in the oral cavity mucosa and lips of the workers participating in this process.

References:

1. Artamonova V. G., Barsukov A. F., Gadjiev A. S. The state of the upper respiratory ways at workers manufacturing synthetic deter-gents//Medicina truda I promishlennaya ecologia (in Russian). - 1997. - № 12. - P. 14-16.

2. Potemkina O. L. Toxicological-hygienic estimation of the modern means of household chemi-stry (the example of synthetic cleaning agents, and glues): The Abstract ... diss. cand. med. sciences. - St. Petersburg, 2005. - 24 p.

3. Frolova A. D., Sidorin G. I., Lukovnikova L. V. To a problem of a hygienic regulation synthetic cleaning agents//Medicina truda I promishlennaya ecologia (in Russian). - 1999. - № 11. - P. 8-12.

4. Masagutova L. M., Bakirov A. B., Fisherman I. D. Specific sensibilization and local immunity of the oral cavity under the conditions of airogenic loading//Clinical laboratory diagnostics. - 2013. - № 4. - P. 27-29.

5. Briggs E. C., Nguyen T., Wall M. A. et al. Oral antimicrobial use in outpatient cystic fibrosis pulmonary exacerbation management; a single - center experience//Clin Respir J. - 2012. - Vol. 6, № 1. - P. 56-64.

6. Lin G. H. Y., Hemming M. Ocular and dermal irritation studies of some quaternary ammonium compounds//Food-Chem-Toxical. -1996. - Vol. 34, № 2. - P. 177-182.

Khamedova Firuza Saidovna, Independent scientific the applicant, Bukhara State Medical Institute, Bukhara, Uzbekistan

E-mail: [email protected]

Frequency and nature of family aggregation at probands with the burdened inheritance of the inactive adenoma of hypophysis (The genealogic status in panmixia with inheritance of inactive adenoma of hypophysis)

Abstract: Study of frequency of inactive adenoma of hypophysis (IAH) cases among relatives is of great importance for a choice of strategy and tactics of treatment of these patients, development of methods of forecasting in population families with genetic predisposition to this disease. In this regard the purpose of our research in which 104 patients with IAH were included there was studied nature of family aggregation at probands with the burdened family anamnesis.

Keywords: inactive adenomas of hypophysis, tumor, family, differential diagnostics, probands, genealogical status, symptoms.

Hormonal-inactive or the nonfunctioning adenoma of a hypophysis (IAH) — one of the most frequent (25-48 %) among all tumors of a hypophysis, proceeding without any manifes-tations of the raised production of hypophyseal hormones. Frequency of IAH in the general population makes about 10 new cases a year on one million population [1-3].

Problem of diagnosis of hormonal and inactive adenomas of a hypophysis (IAH) remains extremely actual that is directly connected with that now there are no the sensitive and reliable laboratory techniques allowing to define at a presurgical stage existence of pathological hormo-nal secretion among IAH [4].

In recent years efforts of researchers on studying of etiopato-genesis of IAH are directed on clarifications of molecular and genetic factors [5]. Family forms of adenomas of a hypophysis are renowned for many years and now, according to literature make from 1-2 % to 5 % of all cases [6].

Identification of a role of heredity in origin of IAH is one of actual problems of modern neuroendocrinology. Aspects of identification of frequency of IAH cases among relatives of probands

are also essential. It is of great importance for a choice of tactics of treatment of these patients, development of methods ofprevention and forecasting in population families with genetic predisposition to this disease.

Materials and methods

104 patients with IAH are examined. In the anamnesis of 83 (79.8 %) surveyed (1st group) was absent the presence of incidence of IAH among close and dis-tant relatives — grandfathers, grandmothers, fathers, mothers, brothers and sisters, etc. At 21 (20.2 %) of patients (the 2nd group) the disease was connected with heredofamilial predispo-sition. These were representatives of 6 families with the presence of two and more relatives with adenomas of a hypophysis of various types of secretion.

The analysis of the surveyed showed that both in the first and in the second group women met more often. Average age of patients of the 1st group made — 36.1 ± 11.6 years old, the 2nd — 44.5 ± 13.2 years old.

Most patients with IAH without the burdened family anamnesis were aged from 18 till 50 years (84.3 %), and more than a third

Section 5. Medical science

of patients of this group were aged from 18 till 30 years (34.9 %), to a lesser extent persons of 50 and more (15.7 %) are met. As for patients with heredi-tary predisposition, persons from 18 to 30, it appeared much less (9.5 %), more than a third of pa-tients of this group were in the age range from 30 to 40 years (38.2 %) and a third of the persons of 50 and more (33.3 %). At considerable part of patients with IAH of both groups disease duration is from 1 year to 10 years.

For clinic and diagnostics of IAH the tumor size has significance [7]. The diagnosis of IAH, as a rule, is established already when the tumor reaches the considerable sizes, causing sight violations, the headache, vegetative frustration connected with pressure of structures of a forward part of a hypophysis [8; 9].

According to Computer Tomography (CT) /Magnetic Resonant Tomography (MRT) at most of patients (65-62.5 %)

macroadenomas are revealed, at 38 (36.5 %) — microadenomas and only one patient has had huge adenoma.

In the analysis of clinical records it is established that 6 (12 %) patients have diseases of stomach and intestines (chronic gastroduo-denitis — 3 cases, a chronic ulcer — 2 cases and chronic nonspecific ulcer colitis — 1 case), liver diseases at 7 (14 %) including chronic hepatitis B — 3 cases, C — 2 cases, hepatocholecystitis — 2 cases. At 9 (18.0 %) patients it is revealed earlier postpo-ned craniocerebral traumas (brain concussion — 7 cases, a fracture of an occipital bone combined with fractured wrist — 1 case, the combined injury of a brain with a spine injury — 1 case), at 14 (28 %) is revealed the chronic stress caused by continuous quarrels in a family (financial problems, unsatisfied with work not by profession, loss of profession).

At an assessment of the genealogical status six families which had sibs from parents of patients are allocated (fig. 1 and fig. 2).

Fig. 1. The genealogical status in 4 families in which at probands fathers are with IAH

Fig. 2. The geneological status in 2 families

Conclusions:

1. The carried-out analysis consisting in an individual assessment of sibs linked to sex in posterity from sick parents showed that in group with a panmixia a ratio of men and women on the line when mother is sick with IAH occurs 2: 3, on the line of the father 4: 12 and in a case when the father and mother are healthy, 2: 1 thus female sibs occurs 2.8 times more often than man's.

2. Contributing factors (a disease of bodies of a gastrointestinal tract, a chronic stress, craniocerebral injuries, smoking, alcoholism, frequent intake of strong medicines, ecological pol-lution),

in which at probands mothers are with IAH

serve as the progressive reason of acceleration of growth of a tumor of a hypophysis, expressiveness of clinical symptomatology as in population among patients with the sporadic, and family anamnesis with IAH.

3. Adverse factors of internal and environment provoke increase in frequency of second-dary cases at patients with IAH with the burdened family anamnesis that is explained by total action of these factors and early identification of clinical symptoms of disease and frequency of cases of detection of macroadenomas in population among groups with a panmixia and inbree-ding.

Features of formation and clinics depressive disorders in patients after myocardial infarction

References:

1. Al-Shraim M., Asa S. L. The World Health Organization classification of pituitary tumors: what is new?//Acta Neuropathol. - 2006. -Vol. 111. - P. 1-7.

2. Greenman Y., Stern N. Non-functioning pituitary adenomas//Best Pract Res Clin Endocrinol Metab. - 2009. - Vol. 23, № 5. - P. 625-638.

3. Magagna-Poveda A., Frontzek K., Bode-Lesniewska B., Rushing E. J. A 59-Year-Old Woman with a Retroauricular Tumor//Brain Pathol. - 2013. - Vol. 23, № 5. - P. 603-604.

4. Lipatenkova A. K., Dzeranova L. K., Pigarova E. A. et. al. The immunohistochemical and radio-logical features of nonfunctioning pituitary adenomas//Probl. Endocr. - 2015//[Electronic resource]. - Available from: http://endo-jour-nals.ru/index.php/probl/ar-ticle/view/7677

5. Kalinichenko S. G., Dudina Y. V., Dyuzen I. V., Motavkin P. A. Induction of NO synthase and glial acidic fibrillary protein in astrocytes in the temporal cortex of the rat with audiogenic epi-leptiform reactions//Neuroscience and Behavioral Physiology. - 2005. - Vol. 35, № 6. - P. 629-634.

6. Beckers A., Daly A. F. The clinical, pathological, and genetic features of familial isolated pituitary adenomas//J Clin Endocrinol Metab. - 2007. - Vol. 92, № 5. - P. 1948-1951.

7. Vanommeslaeghe K., Hatcher E., Acharya C. at al. ARMM general force field: A force field for drug-like molecules compatible with the CHARMM all-atom additive biological force fields//J Comput Chem. - 2010. - Vol. 31, № 4. - P. 671-690.

8. Misra R., Acharya S., Sahoo S. K. Cancer nanotechnology: application of nanotechnology in cancer therapy//Drug Discov Today. -2010. - Vol. 15. - P. 842-850.

9. Pimentel A., Nunes D., Duarte P. at al. Synthesis of long ZnO nanorods under microwave irra-diation or conventional heating//The Journal of Physical Chemistry C. - 2011. - Vol. 118, № 26. - P. 14 629-14 639.

Muxamadiyeva Nigina Bakhodirovna, Assistant of the Department of Psychiatry and Narcology, Bukhara State Medical Institute, Bukhara, Uzbekistan

E-mail: [email protected]

Features of formation and clinics depressive disorders in patients after myocardial infarction

Abstract: Now the problem of depression and somatic diseases, in particular, a cardiovascular profile is extremely actual. In the given research the factors contributing to formation of post infract depression are considered, the characteristic actually post infract is given to depression.

Keywords: acute myocardial infarction, depressive disorders, post infract depression, risk factors.

Depression is very often connected to one another, somatic, to diseases, and in such cases of disease of two different spheres — mental and somatic — aggravate each other, at times leading to serious consequences. In special degree it concerns diseases of cardiovascular system [1]. Among patients with cardiovascular diseases (CVD) frequency of accompanying depression makes 22-33 % [2]. At 17-27 % of patients with the ischemic heart trouble, undergoing procedure coronary angiography depressions [3; 4] come to light, and in patients in post infarct the depression (PID) period are found out in 16-45 % of cases [5; 6]. Presence of depression at patients of CVD not only complicates a current and therapy of these disorders, but also reduces life expectancy of patients. Connected to a heart attack depression predetermines three-quadruple increase in cardiovascular death rate. Though the quantity of the researches devoted to depression at patients of post infract, is rather insignificant, there is a number of proofs of that without treatment it within a year after the transferred myocardial infarction (MI) gets chronic character [7-9].

All of the above, and especially poorly known immediately PMI depression in patients late after suffering a MI, and in the first days after an acute attack has defined the purpose of this study, which is a part of a larger research work.

The aim of the research — studying of the factors promoting occurrence of depressive disorders (DD) at patients with acute myocardial infarction (AMI).

Materials and methods

The given research was spent on the basis of cardiological department of Bukhara branch of the Republican Scientific Center of Emergency Medical Care and a Regional Cardiological Dispensary to the period from 2010 to 2014. 121 patient has been included in research with the established diagnosis of a AMI by criteria MCB-10, given the informed consent and not finding out the expressed changes of the person interfering inspection.

Patients have been divided into 2 groups. In the 1st, the basic, 88 patients with AMI which in the subsequent the DD confirmed clinically and by means of diagnostic scales have developed have entered; the 2nd group have made 33 patients who also have transferred AMI, but not suffering in the subsequent the depression symptoms. Clinic dynamic supervision over patients in the period of PMI has been carried out.

Patients have been included in research as man's (52 persons (59.1 %) in the basic group and 27 persons (81.8 %) in comparison group), and female (36 (40.9 %) and 6 (12.2 %) the person accordingly). At the analysis of distribution ofpatients on age at the moment of the beginning of carrying out of research it has been revealed that the most part of patients both in the basic group, and in comparison group is made by patients at the age from 61 years and is more senior (50 % ofpatients of the basic group and 45.4 % ofpatients ofgroup of comparison). At all investigated patients DD were a consequence of the PMI, that is the fact of a AMI became the psychologic traumatic

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