Authors: Gunina L. M.
Introduction. The enhancement of the general and special physical workabilities of sportsmen under the influence of significant physical loads and under conditions of the fast course of the processes of rehabilitation and the prevention of the state of overtraining are the important components for the realization of the sportsman as a professional and for the support of his/her health and life quality. One of the very weighty factors in the appearance of an overstrain and in a decrease of the physical workability is the activation of the lipid peroxidation at the simultaneous damping of the activity of the endogenous antioxidant system, which accompanies permanently the physical loads and causes the development of such pathobiochemical and pathophysiological phenomenon as the oxidative stress. On the level of a holistic organism, the damping of the activity of enzymatic systems (first of all, antioxidative ones) under the action of physical loads prolongs the period of rehabilitation after trainings and complicates the formation of a necessary level of adaptation mechanisms inherent in sportsmen. It is clear that, at high-intensity physical loads, there is a necessity to use antioxidant pharmacological preparations that are not forbidden. A large number of such preparations available at the modern sport-pharmaceutical market do not allow a physician to independently clarify the mechanisms of action of certain preparations or dietary additives on the physical workability. This leads to the groundless use of several preparations together and can be accompanied by the appearance of their cross interaction and by secondary effects. One of the ways to solve this complicated task is the application of antioxidant preparations of the metabolitotropic character.
Purpose – to determine the fine mechanisms of effect of pharmacological preparations with antioxidant directivity on the physical workability.
Materials and Methods. Analysis and generalization of data of the modern scientific literature, the Internet, and author’s own results of studies.
Discussion. The study showed that presented survey of the literature generalizes the ways of participation of natural antioxidants in the formation of a metabolic basis of the physical workability of sportsmen. It is shown that one of the main system-forming factors that hamper an increase in the physical workability is the oxidative stress mediated by loads of the training. This is related to the fact that the distortion of a structural-functional state of cell membranes, particularly the membranes of erythrocytes, due to the oxidative stress causes the changes in their shape and volume, which affects mediately the process of oxygen transport to the muscular tissue of sportsmen and, thus, decreases the physical workability. The antioxidant properties of the studied pharma-cological preparations of the natural origin and the metabolitotropic character are related to the presence of a membranotropic action, which allows one to refer the preparations with such biological effects to ergogenic ones. The executed analysis has clarified the mechanisms of influence of the pharmacological preparations with antioxidant properties such as ceruloplasmin, omega-3-polyunsaturated fatty acids, and probiotic products on components of the process of stimulation of the physical workability. It is shown that, along with the direct antioxidant action, the presence of membranotropic (membranoprotective), detoxifying, immuno- and cardioprotective actions, etc. is of great importance for the manifestation of ergogenic properties of a pharmacological preparation. It is proved that the influence of the indicated factors, which participate in the formation of metabolic foundations of the physical workability and are related to the presence of the antioxidant effect for organism, can be associated with other various complex changes in the homeostasis of organism, by starting from the exhaustion of the stores of ATP in cells and the accumulation of catecholamines to the expression of genetic markers of the mitochondrial biogenesis and the apoptosis of cells. Based on the results of the executed analysis, we may consider that the various mechanisms inherent in pharmacological antioxidant preparations of the mainly metabolitotropic character must be taken into account at their prescription to sportsmen on various stages of the training process.
Keywords: exercise, oxidative stress, antioxidant agents, structural and functional state of cell membranes, detoxic properties, cardiotropic effect.
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Authors: Hovbaкh I.A.
Introduction. The epidemiological, clinical-genetic aspects of hereditary motor-sensory neuropathy (HMSN) have been considered in the article. HMSN are the heterogeneous group of hereditary diseases characterized by the injury of the axon and myelin sheath of peripheral nerves; HMSN manifest a marked significant clinical polymorphism with a broad distinction of phenotype; different type of inheritance; features of the clinical course, electroneuromyographic and morfohistochemical changes; chronic slowly progressive course.
NMSN epidemiologyis characterized by a broad prevalence in all world populations and makes up ranging from 10 to 40 morbid events by 100 000 people with significant differences in distinct populations. The basic NMSN clinical manifestations are muscle weakness and atrophy, predominantly in the distal lower extremities, extending as far as disease development in the distal upper extremities; moderate decrease in sensitivity; changing of the foot shape; gradual onset and slow progress with the development of significant defect within 1-2 decades. At the present more than 29 genes in which mutations lead to HMSN development have been identified. According to the classification by Dyck PJ and Lambert EH 7 types of NMSN are specified. Taking in account conduction velocity (СV) in motor fibers of the median nerve in accordance with Harding and Thomas NMSN types are distinguished: 1) demyelinating (SV <38 m/s); 2) axonal (SV > 38 m/s) 3) intermediate (SV 25-45 m/s).
Discussion. In consideration of that at the present NMSN pathogenetic therapy methods have not been developed early diagnosis and disease prevention in following generations have great important in disease prevention that causes the necessity of their further study and refinement of an integrated clinical and genetic testing of this disease.
Keywords: hereditary motor-sensory neuropathy, epidemiology, clinical manifestations, genetic polymorphism, inheritance patterns.
Authors: Vilkhova I.V., Paltov E.V., Kryvko Y.Y., Kyryk K.A., Demikhova N.V.
The aim of conducted study was to identify the morphological changes of renal corpuscle as a result of chronic effect of low opioid doses. The research subjects consisted of 32 mature male albino (Wistar) rats, weighting 160 to 170 gm and 4.5 to 5.5 months of age. The chronic opioid effect model was created. Intramuscular injection of nalbuphine was made once daily between 10am and 11am for a period of 98 days with a 0.212 mg/kg of primary dose and its gradual increase within acceptable therapeutic range. Histological preparations were made by a universal method. All animals were kept in vivarium conditions and the work was done according to “Guide for the Use of Laboratory Animals”. Structural changes of renal corpuscle were identified on eighth, tenth, twelfth and fourteenth week of chronic opioid use. As a result of long-termed exposure to low doses of nalbuphine intense alteration of renal corpuscles was discovered, such as segmental glomerulosclerosis and mesengial glomerular inflammation. The most intense changes were observed in renal corpuscles of subcapsular zone, where sclerosis of the majority of renal corpuscles, focal lymphohistiocytic infiltration and replacement of the necrotic area with the connective tissue were revealed.
Isolated sclerosed glomeruli, increased number of mesangial cells and proliferation of endotheliocytes were discovered in intercortical and juxtamedullary renal corpuscles. In some renal corpuscles, capillary loops were fused with outer capsular leaf, connective tissue fibers of Bowman’s capsule outer leaf were proliferated, and swollen cubic epitheliocytes were observed. The most intense changes of animal renal corpuscles were revealed in the end of fourteenth week of the study.
Keywords: renal corpuscle, opioid analgesic, rat, morphology, histological research, segmental glomerulosclerosis.
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Authors: Pikalyuk V.S., Makalish T.P.
The spleen is the largest organ of the peripheral immune system in the human body that makes the significant contribution to the immune response, the quantitative and qualitative composition of the immune cells of blood, lymph and other lymphoid organs [3-5]. The influence of various chemical and biological substances on spleen was investigated . Of particular interest among them is xenogenic cerebrospinal fluid (XCSF). The influence of XCSF on the morpho-functional features of ovaries, adrenal glands, bone marrow, mesenteric lymph nodes  were revealed, but the structural changes of the spleen after injections of XCSF was not studied. In the early postnatal period there is a rapid development of the lymphoid organs, including spleen, and therefore the response to various factors is expressed. Therefore, the aim of our work was to investigate the histomorphological features of neonatal rat spleen after three and ten times injection of xenogenic cerebrospinal fluid.
The experiment was conducted on Wistar rats of both sexes weighing 10 to 45 g, depending on the time of sampling of the material. All exposures were carried out in accordance with "The international guidelines for biomedical research using laboratory animals." All animals were divided into 2 groups: control and experimental. Each group had two subgroups of six animals, the first of which was administered parenterally saline or XCSF three times, the second one 10 times exposure, every third day, in a dose of 2 ml/kg of body weight. For histological examinations thin slices 3-5 mm thick were made, followed by staining with hematoxylin-eosin.
Based on the data the conclusion was made that triple parenteral administration of XCSF for newborn rats promoted more rapid development of the white pulp of the spleen. Its relative area increased by 60%. By the thirtieth day of life the majority of nodules of white pulp of the spleen already had separate zones. There were secondary nodules containing lymphocytes productive centers. Repeated administration of XCSF for newborn rats caused an increase in the relative area of the white pulp by 18%, while the average square of lymph nodules increased by 44.89% compared to the control group.
Key words: xenogenic cerebrospinal fluid, spleen, white pulp, newborn.
Authors: Romaniuk A., Lуndіn M., Karpenko L., Budko A., Lyndina Yu., Logvinova O.
The passing of breast cancer (BC) is dependent on many factors. Presence of inflammatory infiltration in the stroma and its qualitative composition play one of the key roles. Information about its influence is contradictory. On the one hand the reduction of leukocyte infiltration increases the incidence of damage lymph nodes; on the other hand immune microenvironment of tumor determines the proliferative activity, migration and metastasis of cells. Heat shock proteins or chaperones are a family of highly conserved intracellular proteins. They are constantly synthesized in normal conditions, but under the stress the synthesis significantly is increased. The influence of inflammation and oxidase stress leads to the synthesis of HSP. Hsp90 is responsible for the conformational maturation and repair of more than 300 intracellular proteins that play an important role in the growth, differentiation and maturation of cells. It is known the influence of chaperone 90 on the stability steroid receptors.
Objective of the investigation was the study of Hsp90 synthesis in the presence of inflammatory infiltration in the intercellular neoplastic space and the possibility of its influence on the malignant process.
We selected 43 cases of infiltrative ductal carcinoma of different degree of malignancy by Scarff-Bloom-Richardson. The material was divided into two groups. The first group included 24 cases of breast cancer with the presence of leukocyte infiltration in tumor stromal component, the second - 19 cases without inflammatory infiltration in the stroma. Immunohistochemical reaction took place in 2 stages: I – incubated with primary rabbit antibody at a dilution of 1:200; II - incubation with secondary antibodies (UltraVision ONE HRP Polymer). Mathematical calculations were done using Microsoft Excel 2010 with AtteStat 12.0.5 option.
The presence of inflammatory infiltration in the stromal component of the tumor tissue does not depend on the degree of malignancy of tumor (p>0.05). It was established a correlation between the level of expression chaperones in the epitheliocytes and infiltration of stromal breast cancer tissue (p<0.05). Immune microenvironment stimulates the synthesis in epithelial cells Hsp90α, which may increase their protective properties against the action pharmaceutical preparations and the influence of the macroorganism.
Key words: chaperones, breast cancer, inflammatory infiltration.
Authors: Rezunenko U., Kucheriavchenko M., Zhukov V., Nikolaeva O.
Introduction. Laproxides are classified as simple poly-ethers and are widely used in various fields of national economy as ingredients for manufacturing epoxide resin, varnishes, enamels, plastics, glues, photo-reagents, emulsifiers et cetera. Literature data show that in spite of slight toxicity, poly-ethers are capable of exerting negative impact on the body. This conditions critical need in assessment of their potential safety prognosis for homoithermic animals and humans basing on the evaluation of mechanisms resulting in the development of structural metabolic disorders and determination of integrative systems state necessary for the control of homeostatic function of the body, in which nervous, endocrine and immune systems play a key role.
The objective of the study was to investigate some hormonal exchange indices in subtoxic prolonged exposure of the body to epoxide-containing simple poly-ether L-303 and assessment of potential safety prognosis for homoithermic animals.
Materials and Methods. The trial was performed on mature white Wistar rats of both sexes weighing 180 - 200 g, which for 45 days were perorally administered Laproxide L-303 in doses of 1/100 and 1/1000 DL50. The substance was inserted as water solution with the employment of metallic tube in the morning on an empty stomach. The state of hormonal exchange in control and experiment group was assessed following the completion of acute trial. Radioimmunoassay technique with corresponding reagent sets was employed to evaluate the amount of progesterone, thyroxine, triiodothyronine, insulin, glucagon, prolactin, adrenocorticotropic hormone, luteinizing and follicle-stimulating hormone, estradiole, testosterone, thyrotrophic, somatotropic hormone, calcitonin and parathyrin. The study also involved evaluation of group E prostaglandins – PGE1, PGE2, PGE and group F prostaglandins – PGF2α, 6-keto- PGF1α and leukotriene В4 and С4 contents. Statistical processing of the study outcomes was carried out with the employment of Student-Fischer test.
Discussion. Evaluation of the obtained results is indicative of the fact that Laproxide L-303 in 1/100 DL50 triggers profound impairment of structural metabolic processes in endocrine system on all the levels of its structural functional organization: hypothalamus – hypophysis – adrenal and other glands of internal secretion, which can manifest in dysfunction of all kinds of metabolic exchange and energy. The dose of 1/100 DL50 results in significant stress of protection-adaptation mechanisms, which function is to maintain homeostatic function of the body. In this dose Laproxide L-303 stimulates both catabolic and anabolic processes with predominance of catabolism. Evaluation of hormone dynamics, as well as histohormones contents pro vides evidence of polytropic character of Laproxide L-303 action, which is closely related to the development of membrane pathology. Investigations show that biological action of Laproxide L-303 is characterized by numerous structural metabolic disorders, as well as possibility to condition remote consequences, such as acceleration of body aging, immune deficiency, inhibition of generative function, atherogenesis, mutagenesis and so on.
Keywords: xenobiotics, laproxid, hormones contents, histohormones.
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Authors: Sukhodub L.B., Yudin I.P., Gushilik B.I., Pokhil S.V., Kazmirchuk V.V.
Under the influence of the environment pathogenic bacteria may become viable, but nonculturable characterized by the inability of microorganisms to grow in vitro. Indicator assessing the viability of microorganisms enough depends on the characteristics of the method used and the subjective factor, so it becomes more urgent precise quantitative analysis of viable bacteria in the material. The objective of this study was to develop methods for determining the status nonculturable bacteria E. coli, S. sonnei, S. flexneri, S. enteritidis, caused by the action of a biocide - sodium hypochlorite by fluorescence microscopy on membrane filters using fluorochromes rhodamine 123 to identify viable cells and propidium iodide, as an indicator of non-living cells. Research has shown that even after 300 seconds in the biocide action of 1 mg/l of active chlorine still possible to identify viable microorganisms, while under the standard method for seeding onto solid medium the culturability E. coli and S. enteritidis was observed only after 10 second action said biocide concentration, S. sonnei and S. flexneri under these conditions did not show the growth. All tested microorganisms cultured at 20°C, proved to be more resistant to biocide than cultured at 37 °C.
Keywords: enterobacteria, nonculturable state, method of fluorescence microscopy on membrane filters.
Authors: Shkrioba A.O.
Introduction. There have been a few studies on neuroendocrine system of a prostate in comparison with the studies on NE-cells in other organs until recently. The quantity of published works has increased substantially within the recent years due to the development of immunocytochemical methods, though studies on prostate neuroendocrine system are still at the very beginning .The paper focuses on morphological peculiarities of neuroendocrine cells of the prostate gland under conditions of exposure to heavy metal salts.
Purpose. The purpose of the present work lied in the study of neuroendocrine cells, that secreted chromogranin A, of a prostate of rats under conditions of the influence of heavy metal salts.
Materials and Methods. The experiment was performed in 48 pedigreeless sexually mature (6 months) rats. Morphological peculiarities of neuroendocrine cells, immunoreactive to chromogranin A, of the prostate gland have been studied using immunohistochemical methods.
Discussion. In the result of the held immunohistochemical research it has been demonstrated that under the impact of heavy metal salts the increase of the number of a population of neuroendocrine cells that secreted chromogranin, was observed in the tissue of the prostate gland of experimental rats. The area of expression of chromogranin A increased in the tissue of the prostate in all animals during the whole experiment, and it was significantly higher compared to a control group. This research confirms the protective, adaptive and compensatory nature of the adjustment of neuroendocrine system of a prostate of rats and its role in the pathogenesis of morphofunctional disorders that occur under the influence of heavy metal salts.
Key words: prostate, neuroendocrine system, chromogranin A, heavy metal salts.
Authors: Avramenko I.
Congenital development defects (CDD) are a difficult medical and much more social problem. They are observed in 3-5% of newborns and are a cause of 20% infant deaths. The opportunity of modern ex-amination methods as well as improvement in operative technique and perioperative care and rehabilitation gave a chance to improve considerably the results of CDD patient treatment. However, CDD is further one of main lethality causes of newborns, infants and children of early years as well as one of key causes of children’s disability. It is not always able to make a full correction of congenital multiple development defects. Alternate surgical treatment depends mainly on defect constituents and hospital potentials. Therefore, treatment algorithm of different combined development defects is not finally developed and under discussion.
The aim of our research is to analyse the results of treatment and priority of helping children with congenital multiple development defects, among of which there is a heart defect.
It is done a retrospective analysis of medical documents on children with congenital multiple development defects and congenital heart defects at the age of less than one year. All results were statistically worked out by means of an original computer program Microsoft Ex-cel.
Most of all congenital heart defects are combined with anomalies of the urinary system and the gastrointestinal tract, rarely they are combined with development defects of the nervous system, a skeleton and respiratory organs. The anomaly of a skeleton and the urinary sys-tem influences rarely on a patient status, but does not need emergency surgical treatment. Critical congenital heart defects at CDD require surgical treatment first of all. Noncritical congenital heart defects influence on the course of postsurgical period and are to be taken into consideration while children with CCD undergo the treatment. The anomaly of the gastrointestinal tract is crucial in the destabilization of a patient clinical state and needs surgical treatment in the very period of newbornness. Considerably higher mortality after surgical treatment is connected with doing palliative operations, but not with completed correction of development defects.
Carrying out a research of multiple organ congenital anomalies makes it able to understand better aetiology and pathogenesis of their occurrence; moreover the profound analysis of the treatment provided makes it able to set priorities of helping such patients.
Key words: congenital multiple development defects, congenital heart defects, children.
Authors: Bielogortceva O.I., Dotcenko Ya.I., Rekalova O.M., Pobedionna G.P., Sivachenko O.E.
Introduction. The epidemiological situation of tuberculosis (TB) in Ukraine remains tense, including among children and adolescents. The immune system can identify children likely to develop TB, characteristics of the disease and its prognosis.
The aim was to study the features of cell-mediated immunity of children with local forms of TB.
Materials and methods. Were examined 44 patients aged 5 to 16 years who have had a positive Mantoux test with 2TO with newly diagnosed TB (NDTB). Children were divided into two age groups - 5-9 and 10-16 years. The control group comprised 44 healthy BCG vaccinated children aged 5 to 16 years, not M. tuberculosis infection who have been treated in NIFP NAMS for 2012-2014 about further diagnosis. In the age group 5-9 years were 20 children in the respective control group - 26 healthy, vaccinated with BCG, children of the appropriate age and gender of children with local forms VDTB aged 10-16 years - 24 children in the control group - 18 children same age and sex. In children studied content CD3 + -, CD4 + -, CD8 + -, CD4 + -, CD16 + -, CD19 + lymphocytes with sets of monoclonal antibodies BD Simultest CD3 / CD16 + CD56, CD3 / CD19, CD4 / CD8 (USA).
Results. Children in age group 5-9 years with a local TB showed a decrease CD4/CD8 ratio with a decrease of absolute and relative content of B-cells. Children 10-16 years old was diagnosed secondary immunodeficiency due to inhibition of T- and B-cell immunity, decreased absolute number of T-lymphocytes, absolute and relative content of CD4 +-, CD16+-, CD19+-lymphocytes with decreasing absolute number of CD8+-cells with not changed CD4/CD8 ratio. These changes can help determine the direction and volume of immunocorrection.
Key words: children, tuberculosis, indicators of cellular immunity.
Authors: Boyko V.I., Sukharev A.B., Nikitina I.N.
The aim of this study was to investigate the hemodynamic features in the "mother-placenta-fetus", the functional state of the fetus in pregnant women with ekstrosistoly and paroxysmal tachycardia.
In order to clarify the diagnosis to all pregnant women during their stay in the maternity hospital performed tests: ECG, echocardiography, consultation of a cardiologist.
In the study used the following methods: cardiotocography fetal echographic study of the fetus, placenta, doplerometrii fetoplacental complex.
The survey showed that in pregnant women with heart rhythm disorders as ekstrosistoly hemodynamics in the "mother-placenta-fetus", fetal biophysical profile parameters were not significantly different from healthy pregnant.U women with paroxysmal tachycardia have been certain circulatory disorders in the uterine arteries, umbilical artery ., which do not significantly affect the performance of fetal biophysical profile.
Results of the study confirmed: the state of the fetus in pregnant women with these cardiac arrhythmias is not distress.
Based on the findings it can be concluded that the alleged tactics of birth in pregnant women with ekstrosistoly and paroxysmal tachycardia is defined obstetric situation.
Recommendations made as a result of the study were implemented in obstetric clinic.
Requires further study of the fetus in the latent and active phase of labor.
Keywords: pregnant, cardiac arrhythmia, fetal biophysical profile, cardiotocography.
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Authors: Vynnychenko L.B., Demikhova N.V., Vynnychenko K.A.
The aim of the study was to examine the peculiarities of cardiorenal relations in patients with mixed pathology - chronic heart insufficiency (CHI) on the background of ischemic heart disease (IHD) in combination with chronic obstructive pulmonary disease (COPD). A total of 134 patients aged from 45 to 78 years, comparable by age and sex, with CHI II of functional class (FC) III of ischemic origin. The main group consisted of patients with CHI II, FC III with concomitant COPD II, stage III (n = 74). The control group (group II) represented patients with CHI II, FC III without disrupting of respiratory function (RF) (n = 60). The study of morphofunctional state of the myocardium showed that for the same functional class of CHI in patients with concomitant COPD, compared with patients with CHI without COPD we observe a significant increase in the size of the right atrium (RA), right ventricular (RV), the average diameter of the pulmonary artery (ADPA); significantly more often we observe arterial hypertension, left ventricular hypertrophy (LVH), prognostically unfavourable types of LV remodeling (concentric and eccentric), the number of people with "delayed" type of diastolic dysfunction of the left ventricle (DD LV) is decreased due to increasing the proportion of patients with an intermediate "pseudonormal" violation of DD LS.
In patients with mixed pathology - CHI on the background of IHD with COPD compared with those without CORD more frequently we observed clinically significant: increase in serum creatinine (35,1% vs 10%, respectively, p <0.05), reduced glomerular filtration rate (GFR) (<60 ml / min / 1,73m2) (47,3% vs 25,0%, respectively, p <0.05), exhausted funktsionalnіy renal reserve (FRR) (47,3% vs 15%, respectively, p <0.05) microalbuminuria (MAU) (89,2% vs 61,7%, respectively, p <0.05). It is discovered that increasing the MAU is associated with dilation of the right parts of the heart, reduction of tolerance to physical exercise and an increase in the severity of CHF. The increase of Urine Specific Gravity (USG) is due to decrease in RV dilatation. It is proved that the maximum percentage of patients with MAU and exhausted FRR, clinically significant reductions in GFR, increased КК and decrease of the relative density of urine was observed among patients with stage III COPD, as well as in patients with FC III CHI. It is determined that eccentric hypertrophy and concentric hypertrophy of the LV are accompanied by a more symptomatic deterioration in glomerular and tubular nephron function.
Keywords: chronic heart insufficiency, coronary heart disease, chronic obstructive pulmonary disease, cardiorenal syndrome.
Authors: Duzhiy I.D., Aleksandrenko A.V., Bratushka V.O., Bilous G.V., Kharchenko S.V.
Introduction. The prehospital phase is a responsible component of conservative and surgical treatment for patients with any pathological process, particularly a gastroduodenal bleeding of ulcer or erosion origin, because a bleeding is often premortal condition where clinical success depends in the main from care giving time. The aim is to study motivational causes of calls in emergency rota for patients with erosion and bleedings, diagnostic difficulties and traits of patient transportation during the prehospital phase.
Methods and materials. Thirty one patients with ulcer and erosion bleedings of the stomach and the duodenum, and patient documentation were analyzed.
Results. During the prehospital phase the major cause of calls in emergency rota was specific as for bleeding: the melaena in 15 patients(48,4%), the hematomesis in 2 (6,4%); the nonspecific causes gave the minority (45,2%). The number of the said causes during hospitalization rose remarkably: the melaena in 1.7-fold (80,6%), the hematomesis in 5-fold (32,3%). Meanwhile the principal symptom on hospitalization was nonspecific as a general weakness.
Conclusions. The principal cause of calls in emergency rota remains reliable signs of the bleeding (melaena, hematomesis). On hospitalization the number of such manifestation of the bleeding rises 1.7–5-fold. In a case of gastrointestinal bleeding suspicion it is recommended a diagnostic algorithm and a transportation in the supine with infusion support from the start. This may prevent or minimize bleeding prolongation.
Key words: ulcer bleeding, diagnostics, prehospital treatment.
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5. Nikonov VV, Belebezev GG [editors in chief]. Ekstrennaja medciinskaja pomoshhj na doghospytaljnom эtape. Praktycheskoe rukovodstvo.[Emergency medical aid on the prehospital stage. A practical manual]. Luhansk, 3rd edition, revised and supplemented. 2006, 224 p. [In Russian]
6. Nakaz Ministerstva okhorony zdorov'ja 02.04.2010 # 297. "Pro zatverdzhennja standartiv ta klinichnykh protokoliv nadannja medychnoji dopomoghy zi specialjnosti «Khirurghija»". [Order by the Ministry of Healthcare of Ukraine № 297 from 02.04.2010"About establishment of standards and clinical protocols for medical treatment in the speciality«Surgery»"]. [InUkrainian]
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Authors: Loboda A.N., Markevich V.E.
The study of the concentration of main electrolytes in serum of blood and erythrocytes in neonates with impaired renal function due to asphyxia is important, because it allows to determine violations of their content and balance, tactics of infusion and diuretic therapy. The purpose of the work is explore the features of the content and balance of electrolytes (sodium, potassium, calcium, magnesium) in serum and red blood cells of newborns with disturbance kidney function due to asphyxia.
The study involved 200 term infants with signs of disturbance kidney function: 100 children who have suffered severe asphyxia, 100 children – with moderate asphyxia. Comparison group consisted of 20 infants without asphyxia at birth. The content of electrolytes determined by emission photometry, also expected ratios in pairs Na/K and Ca/Mg and transmembrane ratio of trace elements.
The critical period of formation electrolyte imbalances in neonates with impaired renal function due to moderate asphyxia is the early neonatal period, in case of severe asphyxia – all neonatal period. The feature of ischemic renal impairment in newborns is the development of serum hypernatremia and hyperkalemia, hypocalcemia and hypomagnesemia, decrease the ratio of Na/K and increase Ca/Mg. Red blood cell pool of macroelements in case of neonatorum ischemic nephropathy is characterized by the growth of sodium level and deficiency of potassium, calcium and magnesium, as well as growth transmineralisation Na/K ratio and decrease Ca/Mg. Growth transmembrane ratios relative to sodium and magnesium reflects their transport into the cell, and reducing ratios relative potassium and calcium indicates the predominance of these electrolyte transport in the extracellular fluid. Changes in serum and intracellular electrolyte content and balance must be considered during infusion therapy in infants with impaired renal function due to asphyxia.
Keywords: kidney, electrolyte, balance, relationship, blood.
Authors: Melekhovets Y.V., Leonov V.V., Melekhovets О.К., Marchenko E.E.
Introduction. Endovenous laser coagulation (EVLC) of varicose veins was proposed as a minimally invasive alternative to conventional surgery for varicose disease of the lower limbs. Various strategies were proposed for optimal management. But until now, the safety and effectiveness of different endovenous laser ablation regiments for varicose disease has not been fully evaluated.
Purpose. The objective of this study was to compare efficacy and side effects of endovenous laser coagulation (EVLC) in early postoperative period using an 940-nm, 1470-nm и 445-nm diode lasers.
Materials and Methods. 142 patients, diagnosed with varicose disease of the lower limbs with CEAP classification 2 to 6, were enrolled in this study. We compared three groups of the patients: 1 group – 48 patients, who was treated with an endovenous diode 940-nm laser by pulse regime 50:10 emission at 15 – 18 W, 2 group – 53 patients with an 1470-nm diode laser by continuous emission at 7 to 9 W, 3 group – 41 patients with an 445-nm diode laser by continuous emission at 1,5 to 2 W. Intravascular laser ablation was performed with variable retraction speed. Spinal or local, but not tumescent, anesthesia was used.
A duplex ultrasound examination (combination of the traditional ultrasound with color and spectral Doppler) was performed to evaluate degree of reflux in junction of the common femoral vein with the great saphenous vein, make an assessment of the local haemodynamics, vein wall characteristic ets.
Discussion. Patients were scheduled for duplex sonography follow-up at Day 1 and also at 1, 2, 3 and 4 weeks, postoperatively.
Objective examination was performed at 1 day, 1, 2, 3 and 4 weeks after the procedure. Clinical characteristics include: pain sing, sensitivity disturbances and local postablation inflammation sings (infiltration, hyperaemia, oedema, pain along treated vein). Measurement of pain in the patients in early postoperative period was evaluation with Verbal Descriptor Scale (Gaston - Johansson F., Albert М., Fagan E. et al., 1990).
It was found minimum tissues injury in patients, who was treated by intravascular laser ablation lengthwise 1470 nm и 445 nm, compared an endovenous diode 940-nm laser, that provides with favourable effect on postoperative period.
Key words: Varicose Disease, Endovenous Laser Coagulation, Varicose Veins, Laser Ablation, Postoperative Period, Duplex Ultrasound Examination.
Authors: Orlovkskiy V.F., Kmyta V.V.
It is known that reduced responsiveness to asthma treatment in about half of patients is due to genetic peculiarities.
Taking into account proved role of Bcl1 gene polymorphisms of glucocorticoid receptor (GR) in the occurrence of bronchial asthma (BA) and changes in response to glucocorticoids (GCS), the aim of our study was to evaluate effectiveness of bronchial asthma basic therapy, depending on genotype of BCL1 polymorphism of glucocorticoid receptor gene.
Materials and methods. 188 patients with BA have been examined. The control group consisted of 95 apparently healthy adult individuals. Effectiveness of treatment was assessed with the help of ACQ questionnaire and forced expiratory volume in 1 second (FEV1) after 4 and 16 weeks of treatment. During 4 weeks of treatment all patients received low-dose inhaled glucocorticoids (IGCS) with prolonged β2-agonists, and the next 12 weeks, patients with partially controlled, uncontrolled - middle doses of IGCS. The determination of allelic polymorphism in the second exon of the GR gene, Bcl1 (C647G) - rs41423247, was performed by polymerase chain reaction (by Fleury I. еt al.) with modifications. Statistical analysis of the results was performed using SPSS-17 program.
Results. BA control analysis excluding genetic factors have been demonstrated that 8.5% of patients had complete control, 68.6% - partially controlled, and in 22.9% - uncontrolled. Investigation of BA control depending on the genotype of Bcl1 polymorphism of the GR gene showed the presence of a statistically significant difference in the distribution of allelic variants of the gene by χ2 Pearson criterion (p = 0.001).
C/C genotype was associated with controlled and G/G genotype - with uncontrolled BA. Analysis of BA control depending on the genotype of Bcl1 polymorphism of the GR gene showed that its level increased after 4 weeks of treatment (p <0.001) in patients with C/C, C/G and G/G genotypes and was accompanied with significant increase in FEV1.
On the next stage patients without enough BA control have been selected: 92 partially controlled (group I) and 23 uncontrolled (group II), and dosage of IGCS have been increased. The level of control in the group I depending on the genotype of Bcl1 polymorphism of GR gene after 12 weeks increased in patients with C/G genotype and was significantly higher compared with patients with G/G genotype. FEV1 before and after basic treatment was lower in patients with G/G genotype compared to C/C and C/G genotypes (p = 0.001).
Analysis of BA control and FEV1 in patients with uncontrolled course depending on the genotype of Bcl1 polymorphism of the
GR gene showed that treatment with medium doses of IGCS has contributed to the control, but in patients with G/G genotype was significantly lower compared with the same in patients with C/C genotype . FEV1 at the end of treatment in the presence of C/C genotype was higher compared with the same in patients with C/G and G/G genotypes.
Conclusions. Uncontrolled course of BA twice more common in the presence of G/G genotype compared to C/G genotype and tripled compared to the C/C genotype. Increasing doses of IGCS contributes to significant strengthening of clinical efficacy in the treatment of BA patients with C/C and C/G genotypes compared with G/G genotype. Thus, G/G genotype is associated with lower response to inhaled corticosteroids.
Key words: bronchial asthma, Bcl1 polymorphism, control, treatment.
Authors: Roschupkin А.А.
Introduction. The one of problem of modern pharmacotherapy - not accurate or improperly execution of doctor's recommendations was described in this article. It is very important in the treatment of older patients because their drug therapy have a some differences (multiple medical appointments, problems with memory, lack of positive motivation to improve, more frequently side effects etc.). Practical doctor must considered certain objective moments affecting regular and prolonged use of prescription drugs also. That's why the understanding of the problems with the correct execution of prescribing and to identifying ways of their correction will enhance the effectiveness of existing treatments in geriatrics.
Materials and methods. This study was conducted in hospital of World War II invalids, by distributing a questionnaire between hospitalized patients with a wide range of age-related pathology. Based on analysis of the survey questionnaire of 124 elderly patients (72-91 years old) to draw conclusions about the level of compliance in geriatric patients.
Discussion. The results of the study show than in about 90 % of cases the compliance was not be satisfactory. But not in all cases it depends from the patients only. There are many difficulties in the patient-doctors cooperation. A few patients have problem with drugs logistics. The causes of deviations from the strict implementation of medical recommendations received by elderly patients at hospital discharge. Based on the findings the recommendations to improve the relationship doctor - an elderly patient in order to increase the effectiveness of pharmacotherapy was given. All geriatricians must find possibilities and time to explain the need for adherence to medical recommendations during the treatment of oldest and elderly patients.
Keywords: Compliance, pharmacotherapy, elderly patients.
Authors: Sychov R.О.
The aim of the present study was to establish clinical, diagnostic and predicted significance of beta-2-microglobulinuria as a marker of renal damage at essential hypertension and to determine the prevalence of increased urinary beta-2-microglobulin excretion in essential hypertension. The level of beta-2-microglobulinuria was measured in a group of 46 patients with essential hypertension (21 women, 25 men) and in 17 healthy subjects (as control group). Subjects with clinically significant accompanying pathology were carefully excluded during the patient’s selection. The urinary albumin and beta-2-microglobulin excretion were determined by immune-enzyme assay. According to protocol of the study, all patients have undergone examination: clinical, laboratory and instrumental studies, including echocardiography, 24-h ambulatory blood pressure monitoring, investigation of renal hemodynamic by ultrasound Doppler and evaluation renal functional reserve, estimate of glomerular filtration rate according to Cockroft-Gault formula. The beta-2-microglobulinuria value in hypertensive patients was statistically increase from that observed in normal controls. All patients with essential hypertension were distributed into two groups: with normal value (<400 µg/l) and hyperbeta-2-microglobulinuria. In the second group were registered significantly more often violation of intrarenal hemodynamic, left ventricular hypertrophy, proteinuria, decrease of glomerular filtration rate. The method of beta-2-microglobulin evaluation has enough high specificity, sensitivity in diagnostic hypertensive nephropathy. We conclude that the increased urinary beta-2-microglobulin excretion in patients with essential hypertension is a significant marker of the hypertensive nephropathy.
Keywords: beta-2-microglobulinuria, renal reserve, hypertension, myocardial remodeling, microalbuminuria.
Authors: Smiyan O.I., Kurganska V.A., Romaniuk O.K., Sichnenko P.I., Bynda T.P., Gorbas V.A., Vasylieva E.G.
Introduction. Dysbiotic violation of intestinal microflora lead not only to changes in metabolism, but also can be a direct cause of a number of pathologies, including allergic, increase the risk of disease, including bronchial asthma.
The purpose of our study is to determine the effect of probiotic medicine on the condition of the intestinal microflora of children with asthma and indirect - on the immune system and trace element metabolism.
Materials and Methods. The study involved 43 children with moderate persistent form of bronchial asthma between the ages of 12 and 18 to identify the influence of probiotic medicine on the state of the biocenosis of the intestine, the immune system and the trace element composition. To determine the condition of the intestinal microbiota performed microbiological examination of excrement for determining species composition and population of microorganisms by the method of Epstein-Litvak RB and Vilshanska FL. The study of the immunological status of children was conducted by determining the level of indicators of cellular and humoral immune system (CD3 +, CD4 +, CD8 +, CD16 +, CD22 +, FI, IgG, IgA, IgM, IgE), and the profile of cytokines (proinflammatory IL-1 and anti-inflammatory IL- 4) in immunological laboratory "Plus Diagnostics" on immunoferment analyzer "ImmunoChem - 2100 MicroplateReader" firm "HighTechnology, Inc." (USA), 2009 model year. The explore of trace-element composition of blood serum was based on the determination of concentrations of Zn, Cu, Mg and Ca by atomic absorption spectrophotometry. Statistical analysis of the results was performed according to the method of variation statistics using licensing program Microsoft Excel 7.0. To estimate the density of communication among the variables have used the correlation coefficient, the significance of which tested for appropriate formula and compared with tabulated (t Student”s test ).
Discussion. The dependence of the normalization of intestinal microbial spectrum not only on the nature of the treatment, in particular the inclusion of complex treatment probiotic preparation " Laktofit " that contains a combination of lactic acid bacteria (Lactobacillus Sporogenes and Bacillus coagulans), Folic acid (vitamin B9 ), and Cyanocobalamin (vitamin B12 ), but also depends on the dose. Administration of a double dose also gave a more pronounced effect on the impact of cellular and humoral immunity, revealed a decrease in the production of proinflammatory cytokines and normalization of the mineral balance in this group of children.
The obtained results gives reason to recommend the inclusion of probiotic preparation in complex therapy of moderate persistent forms of asthma in older children from the first days after hospitalization for acute illness according to this scheme :- 2 capsules 2 times daily with meals for 14 days.
Keywords: children , asthma, probiotic , microbiocenosis intestine, immune system, microelements.
Authors: Shuper S.V.
Introduction. Comorbidity of Chronic Obstructive Pulmonary Disease (COPD) with Ischemic Heart Disease (IHD) is one of the important problems of the modern pulmonology. Microcirculatory disorders are the common pathogenic links of both diseases.
The aim of this work was to study the state of aggregation capacity of platelets in patients with a combination of COPD with IHD and to identify possible ways of its correction.
Materials and methods. 32 patients in average age (54,4 ± 3,1) years with a combination of exacerbation of COPD (clinical group B, GOLD II), combined with ischemic heart disease (stable angina pectoris, II functional class) - main group - were studied. 25 patients with exacerbation of COPD (comparison group I) and 27 with ischemic heart disease, stable angina pectoris, II functional class (comparison group II) were included in the comparison groups. Diagnoses of COPD and IHD, the volume of their treatment was determined in accordance with existing protocols. The state of spontaneous and ADP-induced platelet aggregation was studied in those patients.
The results of the study. All indicators of spontaneous and ADP-induced aggregating ability of platelets in patients of the main group were increased in comparing to the norm and parameters of the patients from the comparison group I. Indicators of the aggregating ability of platelets of patients from the comparison group I were multidirectional. Aggregation capacity of platelets in patients of comparison group II was high, but lower than in the main group. Increasing of the aggregation capacity of platelets in patients with a combination of COPD and IHD indicates an increased risk of complications due to the formation of the syndrome of hypercoagulability and requires selection of rational correction.
Keywords: COPD, ischemic heart disease, platelet aggregation.
Authors: Smiyan O.I., Plakhuta V.A., Vasileva E.G., Emets A.М.
The article is devoted to the questions of development and functioning of the thymus, its importance in normal and pathological conditions. The data of embryogenesis and pathomorphology of thymus in infants according to domestic and foreign literature were covering in the article. Analysis of worldwide research over the past decade about the relevance of the study of the pathology of the thymus in children pre-preschool age, its prevalence, the value for the normal development of the child's body and the ability to adequate immune response in pathological conditions was conducted. Main stages of development of the thymus are defined in the article. It were presented different views on its formation and structure. The formation of the thymus as neuroendocrine and immune organ is described in detail. Information about the dimensions and the further formation of the thymus in infants and older children analyzed. The main stages of age and accidental involution of the glands and their significance for the organism were described in the article. Later in the article deals about the importance of the thymus in the development and adequate functioning of the immune system, the implementation of the endocrine function of the gland and its ability to produce a variety of biologically active substances that play a key role not only in immunological, but also in other physiological processes in the body.
Key words: thymus, children, immunity, thymomegaly.
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