Mudra U. Clinical, biochemical and thermographic criteria for assessing the course of gout in combination with non-alcoholic steatohepatitis and improving treatment

The thesis presents a theoretical generalization and a new practical solution to the current scientific and practical problem of internal medicine – increasing the effectiveness of diagnosis and treatment of patients with gout and its combination with nonalcoholic steatohepatitis by including in complex therapy enterosorbent based on the detection of thermographic criteria treatment for the dynamics of clinical and laboratory manifestations of this pathology. A study of the effect of nonalcoholic steatohepatitis on the clinical manifestations and course of gout found that the presence of concomitant pathology causes a severe course of the underlying disease and is accompanied by a significant increase in the intensity of the joint syndrome and reduced functional activity of patients. The aggravating effect of concomitant nonalcoholic steatohepatitis on the clinical picture and gout course was manifested by metabolic disorders, changes in purine metabolism, markers of systemic inflammation, endotoxicosis and cytokines, which in this combination significantly exceeded those of patients with gout without clinically significant comorbidities. We can see imbalance between lipid peroxidation and antioxidant system. Thermographic semiotics of gout in the acute phase and its combination with non-alcoholic steatohepatitis was established, taking into account the peculiarities of the inflammatory process. Determination of the content of endogenous intoxication indicators, namely average weight molecules 254, average weight molecules 280, leukocyte intoxication index, malondialdehyde, superoxide dismutase, ceruloplasmin, catalase, interleukin 1β, tumor necrosis factor- α, interleukin 10 in the examination of patients with gout without and in combination with nonalcoholic steatohepatitis allows to increase objective assessment of the condition of a particular patient and supplement the generally accepted comprehensive treatment with appropriate pathogenetic agents. The possibility of effective use of the thermography method in the examination of patients with gout (Patent of Ukraine No. 138317 for a utility model), as well as to assess the completeness of recovery and predict exacerbations. It is proposed to use the carbonic enterosorbent carboline in the form of small granules 1 teaspoon 3 times a day for 10 days to improve the effectiveness of complex therapy of patients with gout in the acute phase, which allows to reduce the level of endogenous intoxication, activity of lipid peroxidation-antioxidant system (Patent of Ukraine No. 143644 for utility model), to regulate the cytokine system (Patent of Ukraine No. 143649 for utility model).