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Information × Registration Number 0220U001343, 0117U003023 , R & D reports Title Molecular genetic mechanisms of diffuse and nodular patology of thyroid gland. Prediction flow. New approaches to treatment strategy and surgical treatment popup.stage_title Head Bedenyuk Anatoly Dmitrievich, Registration Date 06-03-2020 Organization Horbachevsky Ternopil State Medical Academy popup.description2 GDR Report: 162 pp., 52 Tables, 379 sources Object of the study - nodular goiter, autoimmune thyroiditis, polymorphism of the studied genes, markers of apoptosis and proliferation, diagnostic methods and surgical treatment. Subject of study: Immunological and morphological changes in the thyroid gland and disorders of its function from the point of view of polymorphism and gene mutation, activity of peroxidation and antioxidant protection, parameters of apoptosis, proliferation and immunological reactivity, optimization of optimization, optimization nodal en-demic goiter against AIT background, long-term results of treatment, indications for surgical treatment and choice of its volume. Purpose - To optimize the diagnosis and surgical treatment of patients with nodal endemic goiter on the basis of autoimmune thyroiditis by introducing a comprehensive evaluation of clinical and pathogenetic, immunological, hormonal, cytological, histochemical and molecular-genetic features. Research methods are genetic, morphological, enzyme-linked immunosorbent, biochemical, statistical. For the first time, the role of genetic factors in the development and course of nodal endemic goiter against the background of autoimmune thyroiditis has been comprehensively established. The role of proliferative processes in the development of nodular goiter against the background of autoimmune thyroiditis, depending on the polymorphism of the genes CTLA-4 (rs 231775), BCL-2 (rs17759659) and APO-1 / Fas (rs2234767), was first established. The polymorphic variants of CTLA-4 (rs 231775), BCL-2 (rs17759659) and APO-1 / Fas (rs2234767) genes have been linked to immunologic, hormonal disorders in patients with nodular goiter against the background of autoimmune thyroiditis, which created a subunit pathogenetically substantiated new diagnostic criteria for this combined pathology, methods for predicting its course and indications for surgical treatment and choice of its volume. The results of the study of the dysregulation mechanisms of immunological and hormonal disorders, taking into account the personalized genetic approach, allowed to optimize the therapeutic and surgical tactics and prevention of postoperative complications in such patients. Using indicators of parenchyma functional capacity of the excess thyroid lobe, apoptosis and proliferation indices of the non-infected nodal part and CTLA-4 gene polymorphism, a new way of choosing the volume of surgery in patients with nodular goiter is developed. Algorithms for predicting long-term results of surgical treatment of patients with nodal endemic goiter on the background of autoimmune thyroiditis, which are associated with indicators of processes of peroxide oxidation, the ability of antioxidant systems, activity of apoptotic processes and non-specific inflammatory results. The developed and implemented method of antioxidant therapy leads to a decrease in the activity of autoimmune processes and improvement of lymphatic drainage function of the thyroid parenchyma allows to normalize the hormonal status of the thyroid balance and to reduce the percentage of recurrence of the disease after encephalitis. The method of prevention of postoperative hypothyroidism in patients with nodal forms of goiter on the background of autoimmune thyroiditis by the use of antioxidant therapy aimed at reducing the activity of processes of peroxide oxidation and stimulation of systems of antioxidant protection, allows to achieve a faster normalization of functional and functional function. the postoperative period. A new method of surgical access to the thyroid gland has been developed, which allows to increase the efficiency of surgical treatment of patients with nodal forms of goiter on the background of autoimmune thyroiditis, to reduce the percentage of relapses and to reduce the stay of patients in hospital. Product Description popup.authors Бідзіля Павло Васильович Беденюк Анатолій Дмитрович Боднар Петро Ярославович Боднар Тетяна Вікторівна Бурак Андрій Євгенович Війтович Любов Євгенівна Гриценко Степан Йосипович Гудак Петро Степанович Гусак Олег Михайлович Дзюбановський Олег Ігорович Доброродній Володимир Борисович Мальований Віталій Васильович Мисак Андрій Іванович Смачило Іван Ігорович Твердохліб Віктор Васильович Футуйма Юрій Михайлович Шідловський Віктор Олександрович Шідловський Олександр Вікторович Шеремет Михайло Іванович Якимчук Олена Анатоліївна popup.nrat_date 2020-07-03 Close