The purpose of the study is to determine the significance of genetic factors in the development of chronic nephritic syndrome in children and to clarify the features of the clinical course
The оbject of research were 129 children aged 4-15 years who were treated for chronic nephritis in the nephrology department of the Samarkand Regional Multidisciplinary Paediatric Medical Centre.
The scientific novelty of the study is as follows:it has been established that the severity of chronic nephritic syndrome in children is associated with clinical manifestations (gradual development, dyspepsia, abdominal pain) and an increase in the amount of Cystatin C in the blood;for the first time, it was revealed that the development of sclerotic lesions due to increased proliferation in patients with the presence of the MMP-9 (A-8202G) rs 11697325 genotypes in chronic nephritic syndrome leads to a worsening of the clinical course of the disease; established early diagnostic marker MMP-9 (A-8202G) rs 11697325 and its tissue inhibitor TIMP-2 (C536T) rs 11551797 in chronic nephritic syndrome in children in the diagnosis of the disease; for the first time, the prognostic value of the alleles of the MMP-9 (A-8202G) rs 11697325 genes and the homozygous G/G genotype in determining the risk of developing the disease in children with chronic nephritic syndrome has been proven.
Implementation of the research results. Based on scientific results of evaluation of the role of polymorphic genes of matrix metalloproteinase and its tissue inhibitors in chronic nephritic syndrome in children: methodological recommendation “The role of polymorphic genes of matrix metalloproteinase and its genetic inhibitors in the development of chronic nephritic syndrome in children” was developed and approved (reference of the Ministry of Health of the Republic of Uzbekistan No. 8n-r / 554 of 30.02.2022).
This methodological recommendation made it possible to predict the development of chronic nephritic syndrome in children and improve preventive measures; approved and developed on the basis of scientific results of research on early diagnosis and prognosis of chronic nephritic syndrome “Dynamics of clinical and laboratory parameters in nephritic syndrome in children”, (reference of the Ministry of Health of the Republic of Uzbekistan No. 8n-r / 555 of 30.02.2022).
This methodological recommendation made it possible to optimize the diagnosis and treatment tactics for various forms of nephritic syndrome in children;
The results obtained were implemented in the practice of health care, in particular, in the Republican Children's National Medical Center, in the 1st clinic of the Samarkand State Medical University, in the Samarkand Regional Children's Multidisciplinary Medical Center (conclusion No. 8 n-r/324 of 21.06.2022 of the Ministry of Health of Uzbekistan).
The application of the obtained results to practice has made it possible to reduce the frequency of recurrence of the disease in children, prevent complications of the disease, improve the quality of life of patients, diagnose and prevent the disease.
The structure and scope of the dissertation. The dissertation consists of an introduction, 4 chapters, conclusions, practical recommendations. The volume of the dissertation is 120 pages.
In the course of the study, the need and degree of participation of narrow-profile specialists in the treatment ofparadontal diseases was determined for the timely detection of comorbid pathology and the appointment of adequate therapy.
We studied 225 patients with generalized parodontitis of varying severity. 40 patients without generalized parodontitis (GP) and pathology of the oral mucosa (POM) formed a control group.
Statistically significant differences in the frequency of registered pathology in patients of the compared groups with control indicators, as well as correlations between the frequency of detected diseases and the severity ofparadontal pathology, were established. Thus, the total incidence of previously existing diseases increased in the series of mild generalized parodontitis (MGP), moderate generalized parodontitis (MODERGP) and severe generalized parodontitis (SGP) from 32.47 ± 5.34% with MGP; up to 51.25 ± 3.83% with MODERGP up to 86.96 ± 3.14% in patients with SGP (linear correlation coefficient χ² = 96.167; P ≤ 0.001); the corresponding dynamics of the newly discovered pathology was 42.86 ± 5.63%; 47.65 ± 3.83% and 13.04 ± 3.14% (χ² = 65.087; P ≤ 0.001); and the corresponding frequency of all somatic pathology requiring systematic drug correction was 75.32 ± 4.93%; 99.41 ± 0.52% and 100.00 ± 0.00% (χ² = 235.351; P ≤ 0.001).
Based on the studies performed, local therapy tactics should be determined for the following pathogenetic mechanisms of the development of parodontitis: microcirculation disorders, the prevalence of lipid peroxidation processes, an increase in cytokine aggression and an increase in bone resorption.
When making a diagnosis, the scope and methods of therapy should be maximally individualized based on an assessment of the patient's individual clinical and laboratory parameters, by identifying markers that determine the priority mechanisms of the development of the disease.
В настоящее время нет оптимальных методов воздействия на механизмы патогенеза воспалительных заболеваний пародонта, но несмотря на существующее большое количество лекарственных средств, проблема лечения активных воспалительно-деструктивных процессов в пародонте продолжает оставаться актуальной. Учитывая многофакторность патологии, лечение хронического генерализованного пародонтита должно быть комплексным и дифференцированным, осуществляемым с участием пародонтологов, стоматологов-терапевтов, хирургов, ортопедов. Важную роль играет обучение пациента правилам гигиены, профессиональная помощь в подборе средств ухода за полостью рта.
Изучить клинические особенности хронического генерализованного пародонтита и предложить медикаментозную коррекцию у пациентов сердечно - сосудистой недостаточностью
По данным последних эпидемиологических исследований в Узбекистане, среди населения в возрасте 35-44 лет в комплексном лечении генерализованного пародонтита нуждаются 64,3 ± 1,6%. К сожалению, некоторые врачи до сих пор считают это заболевание неизлечимым. Поэтому проблема эффективного этиопатогенетического лечения болезней пародонта остается по-прежнему актуальной.
Болезни пародонта представляют собой в настоящее время одну из наиболее важных проблем в стоматологии. Целью нашей работы явилось клиническое исследование эффективности применения остеопластического материала Био-Ген при лечении хронического пародонтита и воздействие его на микроциркуляцию тканей пародонта.
The first set of frequency of occurrence and identified the need for treatment of periodontal diseases among participants of elimination of consequences of the Chernobyl accident residing in the city of Tashkent; researched content in gingival fluid cytokines and anti-inflammatory medium molecular peptides in periodontitis among clean up workers at Chernobyl, living in Tashkent, and studied the extent and nature of microcirculatory disorders of the periodontium; designed for optimal treatment of periodontitis have a designated group of patients. A set of measures aimed at restoring hemostasis of periodontal tissues, enhancing regeneration, helping to prevent relapses of the lesion and prolonging the remission period has been developed. In this regard, the optimal mode of local application of Enterosgel for the treatment of periodontitis in ULP at the Chernobyl nuclear power plant has been developed. In addition to General clinical dental examination, all patients will be provided with special research methods: laser Doppler flowmetry; study of.
Повышение эффективности хирургического лечения хронического генерализованного пародонтита с применением комбинированного трансплантата, включающего «Гемогубка коллагеновая» и насыщенная витамином С.