Effect of an endotoxicosis on the vegetative status of patients with chronic pancreatitis

Background. One of the defining typical clinical and pathogenetic syndromes of the formation and severity of chronic pancreatitis (CP) are the syndromes of endogenous intoxication (SEI) and autonomic (vegetative) dysfunction (VD). We did not find any studies of hematological indices of inflammation and intoxication, and especially in comparison with the parameters of vegetative status in CP, which motivated us to conduct this research work. The purpose of the study was to establish the relationship between hematological indices of inflammation and intoxication and the parameters of the autonomic status of patients with chronic pancreatitis. Materials and methods. We examined 69 patients diagnosed with CP who were treated as out-patient. The following hematological indices were determined: leukocyte intoxication index (LII), adaptation index (IA) with subsequent determination of the type of nonspecific adaptive response, lymphocyte-granulocyte index (ILG). The correlations of LII with the parameters of psycho-emotional state (neuroticism, reactive (RA) and personal (PA) anxiety according to the Eisenk, Spielberger-Khanin questionnaires), VD according to the Wayne questionnaire, and the duration of the disease were studied. Results. 63% of patients with chronic pancreatitis were diagnosed with endogenous intoxication of mild and moderate severity according to the Kalf-Khalif index, which makes it necessary to use drugs aimed at its correction. Significant correlations were established between LII and personal anxiety (direct weak r = 0.23, p <0.05), neuroticism (direct moderate force r = 0.41, p <0.05), autonomic dysfunction (direct weak r = 0,1, p <0,05), duration of the disease (direct weak r = 0,15, p <0,05), structural condition of the pancreas by ultrasound manifestations in points (direct weak r = 0.29, p <0.05), the level of α-amylase of the pancreas (direct medium strength r = 0.30, p <0.05). The obtained results proved the presence of significant interactions between the parameters of inflammation and endotoxicosis with indicators of autonomic status and the state of the pancreas. This makes it necessary to prescribe anti-inflammatory and vegetotropic drugs to patients with CP to enhance protocol treatment. Conclusions. Among patients with CP, favorable adaptive reactions were observed in only 36% of subjects, adverse - in 25%, intermediate - in 39%, and the average value of the adaptation index was - 0.48 ± 0.18, which corresponds to the upper limit of the orientation reaction. This motivates additional prescription of vegetotropic and adaptogenic drugs to such patients with CP. Only in 10% of patients with chronic pancreatitis the general immune response has no deviations from the adequate immune response, in 48% of subjects there is an inability of the immune system to complete inflammation, in 42% - the predominance of autoimmune intoxication, which requires enhanced anti-inflammatory therapy.

Potentials of intravenous laser blood irradiation to correct peroxidation and antioxidant activity as a result of surgical distress

Purpose: to reveal protective effects of intravenous low-level laser blood irradiation (ILBI) during surgical interventions at the gallbladder as well as to study the state of antioxidant activity, lipid peroxidation and endogenous intoxication.Material and methods. In the perioperative period, 40 patients from the main group (I) had traditional treatment which included pharmacological preparations and sessions of intravenous laser blood irradiation. 45 patients from the control group (II) had only traditional (pharmacotherapeutic) treatment. In both groups during surgery, the anesthetic protection consisted of classical neuroleptanalgesia. The age of patients in both groups did not differ significantly. Intravenous laser blood irradiation was done with helium-neon laser “Atoll” 632 nm (Fokon Ltd, St-Petersburg, Russia). During surgery, three irradiation sessions were performed at radiation power of 20 mW and exposure 15 minutes at various stages of surgery: 30 minutes before induction of anesthesia, at the traumatic stage and 30 minutes before the expected finish of the surgery. Ceruloplasmin and transferrin levels in the blood plasma were assessed with the electron paramagnetic resonance technique. The ratio of ceruloplasmin/transferrin which characterizes the level of antioxidant activity was also established. The level of endogenous intoxication was assessed using the previously published technique. The quantitative characteristics of endogenous intoxication by this technique is the value of optical density (D280) and total optical density of components related to high molecular weight and low molecular weight fractions.Results. ILBI sessions in patients neutralize changes in the level of ceruloplasmin and transferrin in blood. The data obtained also confirm ILBI protective effects at protein SH-groups or activation of the restoration of protein SH-groups that were damaged by oxidation as a result of surgical aggression and trauma.Conclusion. The protective effect of intravenous laser blood irradiation in addition to the standard preoperative therapy optimizes pharmacological anesthetic protection during surgery under the existing traditional schemes of combined general anesthesia.

Evaluation of endogenous intoxication indicators in the dynamics of experimental periodontitis and immobilization stress

The aim of our work was to investigate the peculiarities of changes in endogenous intoxication rates: medium mass molecules (MMM) and erythrocyte intoxication index (EII) in the blood of guinea pigs in the formation of combined pathology - experimental periodontitis (EP) and immobilization stress (IS).The results of biochemical studies showed that at all stages of development of combined pathology - experimental periodontitis and immobilization stress there is a consistent increase in the degree of endogenous intoxication, which dominated on the 15th day of the experiment, namely increased content of medium mass molecules (МMМ254 , MMM280) and EII in the blood by 58.5% (p≤0.05), 80.3% (p≤0.05) and 95.7% (p≤0.05), respectively, compared with the first group of animals is a clear manifestation of the formation of endogenous intoxication. These changes are obviously the result of insufficient elimination of toxic products on the background of the inflammatory process in periodontal tissues and stress.

Rat Endogenous Intoxication Level under Experimental Nephropathy and Reduced Glutathione Application

The purpose of the study, therefore, was to investigate the content of substances of low and medium molecular weight, total and tyrosine-containing peptides and to assess the level of endogenous intoxication of the rat organism under conditions of experimental nephropathy and the use of reduced glutathione. Materials and methods. The experiment was performed on nonlinear white rats weighing 160-180 g. The animals were in a vivarium with a constant temperature (18-22°C), relative humidity (50-55%) in individual exchange cells in the formed groups, on a constant balanced mode of a diet with free access to water and food. Nephropathy was modeled by a single intraperitoneal injection of folic acid at a dose of 250 mg/kg. Glutathione was administered intragastrically (100 mg/kg) for 7 days after folic acid intoxication. Results and discussion. Under conditions of nephropathy in the blood serum of rats, an increase in the level of molecules of average weight was observed by 2 times, as well as low-molecular substances by 1.6 times compared with the control. Daily administration of reduced glutathione to animals with nephropathy for 7 days led to a decrease in the level of substances of medium and low molecular weight by 21% and 27% in comparison with the indicators of animals with nephropathy, but still significantly differed from the control indicators. Against the background of an increase in the content of total oligopeptides by 2.2 times in the blood serum of experimental rats, the level of tyrosine-containing peptides increased by 1.8 times in comparison with the control. The introduction of glutathione to rats with nephropathy led to a decrease in these parameters by 40 and 35%, respectively, compared with the experimental control. As a result of the established changes in the level of albumin and average weight molecules in the blood serum of animals, under conditions of nephropathy, an increase in the coefficient of endogenous intoxication was observed by 2.3 times. This imbalance indicates a violation of the processes of detoxification of endogenous metabolites in the liver of animals under conditions of nephropathy. In the groups of animals with nephropathy, which were injected with an antioxidant, the coefficient of endogenous intoxication decreased by 41% compared with animals that did not receive glutathione, but this indicator did not return to the level of control values. Conclusion. Thus, under the conditions of experimental nephropathy in the blood serum of rats, an increase in the content of total and tyrosine-containing peptides, substances of low and medium molecular weight, as well as an increase in the values of the intoxication coefficient was observed, which indirectly indicates a violation of the processes of detoxification of endogenous metabolites in the liver of experimental animals with kidney pathology. In the group of animals with nephropathy that received reduced glutathione for 7 days, only a tendency towards normalization of the studied parameters characterizing the level of endogenous intoxication under conditions of nephropathy was noted

CHANGES OF THE CYTOKINE PROFILE DEPENDING ON THE SEVERITY OF ENDOGENOUS INTOXICATION IN MECHANICAL JAUNDICE

Aim. Study of the reaction of the cytokine pofil to the severity of the course of endogenous intoxication in patients with obstructive jaundice.Material and methods. The study involved 84 patients with obstructive jaundice (MJ) caused by malignant tumors of the biliopancreatoduodenal zone (BPDZ). There were 55 men (65.5%), women - 29 (34.5%). The average age of the patients was 59.1 ± 2.3 years. The severity of endogenous intoxication and the cytokine profile of patients with breast cancer were assessed by determining the concentration of medium molecular peptides (MMP) and proinflammatory cytokines TNF-α and IL-6 in blood plasma and bile.Conclusion. In patients with breast cancer of tumor genesis, there is a multiple increase in the concentration of proinflammatory cytokines in blood serum and bile. There is also a manifold increase in apoptosis indices of blood lymphocytes and the content of MMP. Adequate and timely decompression of the biliary tract in breast cancer ensures the elimination of factors that cause endogenous intoxication and an increase in the inflammatory process, which makes it possible to prepare the patient for the second stage of radical surgical treatment after of the aplication of a percutaneous-transhepatic cholangiostomy.

Clinical and Pathophysiological Phenotyping of Chronic Obstructive Pulmonary Disease

The purpose of the study was to determine the clinical and laboratory features of inflammatory phenotypes among patients with chronic obstructive pulmonary disease, moderate respiratory failure and anemia of chronic disease. Materials and methods. The study included 150 patients with exacerbation of chronic obstructive pulmonary disease and chronic anemia, in which inflammatory phenotypes were identified, among which the largest share was neutrophilic (66/44.0±4.0%), less lymphocytic (35/23.3±3.4%) and eosinophilic (16/10.7±2.5%). In 33/22.0% of patients, the inflammatory phenotype was mixed and patients were excluded from the study. Among 117 patients included in the study, 67.5% were men and 32.5% were middle-aged (25.6%), elderly (42.7%) and senile (24.8%). The results were processed by the methods of variation statistics, the materiality threshold p <0.05. Results and discussion. It was established, that peripheral blood analysis and biochemical parameters, regardless of the pathophysiological nature of inflammation in all groups showed moderate dysfunction of external respiration, normochromic normocytic nature of mild chronic anemia with activation of all components of the external coagulation mechanism and increased prothrombin time and inflammation activation (by C-reactive protein and seromucoids). The neutrophilic phenotype of inflammation, in comparison with lymphocytic and eosinophilic, was the most common and was accompanied by the most pronounced anemic syndrome, the highest activity of systemic inflammation and the most pronounced syndrome of endogenous intoxication with deterioration of liver function. The lymphocytic phenotype of inflammation was the second widespread and was characterized by the most pronounced normochromic anemic syndrome with the most pronounced predisposition to hypercoagulation (the highest prothrombin index) with high activity of the inflammatory syndrome. The eosinophilic phenotype of inflammation was significantly less common than the neutrophilic and lymphocytic with the favorable characteristics of the anemic syndrome and with low inflammatory activity and the small activity of endogenous intoxication but the highest fasting blood glucose level as normo-hyperglycemia. Conclusion. Clinical and pathophysiological phenotyping of chronic obstructive pulmonary disease makes it possible to determine not only the activity of inflammation, but also the severity of anemic syndrome, endogenous intoxication, liver status and carbohydrate metabolism, which is of practical importance for both physicians and scientists

The intensity of endogenous intoxication syndrome and methods of its therapy for the urinary system infection in children

Endogenous intoxication syndrome is one of the leading syndromes in high urinary system infection activity in children. The study of clinical and laboratory manifestations of endogenous intoxication syndrome with the aim of optimizing its methods of therapy is topical. The examination was conducted in 52 children aged 3–7 years, including 22 children with active forms of pyelonephritis and 30 almost healthy children (control group). Endogenous intoxication syndrome was determined by clinical signs and by the level of leukocyte index of intoxication and medium-sized molecular peptides in blood plasma. Statistical analysis was carried out on the basis of Student’s t-test (p<0.05), the frequency of symptom occurrence (q) in relation to the totality in the group taken for 1 and the coefficients (Q) of the ratio of the comparable indicators in groups. In the control group, the leukocyte intoxication index did not exceed 1.0, the average molecular peptides— 0.24 conditional units. Most patients (q-0.73) had a moderately severe course, expressed symptoms of intoxication, pain abdominal syndrome (q-0.73), dysuria (q-0.73), high temperature (q-0.73). In complex therapy, prebiotic (complex fructoolygosaccharides, inulin and maltodextrin) was prescribed in age dosage for three weeks. Detoxification therapy contributed, first of all, to the positive dynamics of clinical manifestations of the intoxication syndrome. During the first two days, the temperature reaction decreased; on the 4-5th day, the general condition improved, other symptoms of intoxication disappeared; highly reliable (p<0.001) positive changes in the studied indicators were found within 3 weeks. They were characterized by the normalization of the level of leukocyte index of intoxication and medium-sized molecular peptides, which justifies the use of prebiotic products in the complex therapy of urinary system infection in children.

Effects of flavonol quercetin on syndrome of endogenous intoxication in experimental periodontitis

The article presents the results of study effect of quercetin on the indicators of endogenous intoxication syndrome under conditions of experimental periodontitis. One of the key links in the pathogenesis of any inflammatory disease, including maxillofacial area, is endogenous intoxication, an important pathophysiological mechanism of which is the activation of lipid peroxidation. The experimental animals were treated by intramuscular injections with water-soluble quercetin for 7 days. For further research the blood serum was selected in which was determined the content of middle molecular weight molecules and erythrocyte intoxication index. Excessive lipoperoxidation was accompanied by accumulation of peroxidation products and depletion of antioxidant reserves, which led to accumulation of toxic substances. That is why the study of the level of middle molecular weight molecules and erythrocyte intoxication index in simulated bacterial-immune periodontitis is a reliable criterion. Quercetin was able to reduce the expression of endogenous intoxication syndrome in experimental bacterial-immune periodontitis.