2012, volume 8

Objective: To evaluate the clinical and immunological features of the hemorrhagic fever with renal syndrome in women of different age groups. Materials and methods: Clinical and laboratory characteristics of hemorrhagic fever with renal syndrome in 148 women aged 17 to 65 years old have been investigated. Patients have been divided into two groups: group I included 101 patients with normal menstrual rhythm, group II included 47 female patients with menopause. In 57 women (36 from group I, 21 — from group II) the content of CD3+, CD4+, CD8+, CD16+, CD19+ — sub-populations of peripheral blood lymphocytes has been determined. Results: In compared groups significant differences in structure and frequency of complications of the disease have been revealed. Unidirectional tendency to increase significantly reduced absolute rates of investigated lymphocyte subpopulations in dynamics of the disease has been identified. It also has been stated that by the time of early convalescence in case of severe form of HFRS the indices did not reach the standard level. In an older group of women deeper damage and long-term recovery of immune system have been marked. Conclusion: According to the results of clinical and immunological studies the research work has revealed that in young women the response of the immune system to HFRS has developed faster and stronger than that in patients during the menopause period.

The review of literature is devoted to the comparative analysis of clinical researches of efficiency and frequency of complications after application of surgical and medicamentous methods of treatment of coronary heart disease.

The article stresses on the study of molecular markers of essential arterial hypertension providing insight into the pathological mechanisms underlying the disease and creation of «genetic passport» for every patient in the future. Objective: To study genetic markers of 5,10-methylenetetrahydrofolate reductase (MTHFR), involved in the metabolism of homocysteine, and N-acetyltransferase 2 (NAT2), ensuring the process of transformation of acetyl-CoAto acetoacetyl-coenzyme A. Methods: The study involved 160 patients with essential hypertension l-lll stages Caucasian (57.5% female.) aged 20-59 years. MTHFR gene polymorphisms and NAT2 in DNA of peripheral blood leukocytes were studied using a set of Wizard Genomic DNA Purification Kit (Promega, USA). Results: It was shown that «slow acetylators» (homozygous for a mutant version of the gene NAT2) were more frequently (p <0.05) determined among patients with hypertension stage 1. It was also revealed the dependence on the presence of hypertension stage mutant allele T (hetero-and homozygous variants) in 677 nucleotide gene MTHFR (r = 0,40, p <0.001). Conclusions: The regularities of the distribution of polymorphic variants of MTHFR and NAT2 gene were found out in hypertensive patients according to the stage of the disease.

The research objective: To find estimation tools of incidence of acute myocardial infarction at the regional level and to optimize organization of medical assistance to patients with acute coronary pathology. Materials. With the use of statistics of territorial distribution of acute myocardial infarction incidence in the region and GIS-TECHNOLOGIES the statistical analysis and mathematical modelling of the spatially-organizational data has been carried out. Results. On the basis of the received results the prognostic model of development of acute coronary pathology has been generated. Measures on optimization of organization of medical assistance to patients with an acute coronary pathology have been stated. Conclusion. Methods of intellectual support of the doctor may become effective in formation of organizational structure of the system of stage-by-stage qualified and specialized aid to patients with acute coronary syndrome.

The review presents modern definitions, classifications and criteria of severity of common viral-bacterial pneumonia. The study of literature about the role of metabolic functions of the lungs in the genesis of severe common viral-bacterial pneumonia has allowed the formulations of anew period in the intensive care based on the study of noradrenalin inactivating functions of the lungs.

Objective: to study the dynamics of individual indicators of free radical lipid peroxidation and antioxidant defense in acute and early periods of traumatic disease of the spinal cord during the development of infectious and inflammatory complications. Material and methods. An analysis of selected indicators of free radical lipid peroxidation and antioxidant protection in the development of infectious-inflammatory complications in the acute and early periods of traumatic disease of the spinal cord. In the state of the studied groups of lipid peroxydation was evaluated on the content of malon dialdehyde, antioxidant protection — at the level of ceruloplasmin and superoxidedismutase. Results. In patients with traumatic spinal cord disease in the absence of infectious and inflammatory complications revealed monophasic increase in the concentrations of the studied parameters in the 1-4th day after injury, followed by a gradual decrease in its 30th day. With the development of traumatic disease of the spinal cord is marked as a two-phase activation of the mechanisms of lipid peroxidation and antioxidant enzyme activities of systems occurring in the 1-4th and 14th day from the date of injury with a subsequent decrease in their 30th day. Conclusion. The findings suggest that differences in the metabolic response depending on the absence or presence of infectious-inflammatory process.

Research objective. The objective of this research is the study of venous blood flow parameters of lower uterus segment and cervix of uterus at the physiological course of preliminary period. Material and methods. The study was based on the investigation of the course of preliminary period of 90 patients with physiological delivery at term. Results. There is a growing rate of venous blood flow of lower uterus segment and cervix of uterus at rest as well as at peak of contractions. Conclusion. Veins are transformed into structures similar to lacunae at the physiological course of preliminary period. There is a growing rate of venous blood flow of lower uterus segment and cervix of uterus which results in blood storage and seems to be one of the mechanisms leading to cervical dilatation.

Objective: to study risk factors and options for clinical course of acute intestinal obstruction in pregnancy. Materials and methods. A detailed study of history, clinical course, diagnosis and treatment characteristics of acute intestinal obstruction in 79 pregnant women was undertaken. Results: It was determined that a combination of intestinal obstruction, and pregnancy is more common for II and III trimester of gestation (88,5%), with more likely to develop mechanical obstruction caused by the adhesive process (77,2%). Risk factors for intestinal obstruction in pregnancy are: chronic diseases of gastrointestinal tract, surgery of abdominal cavity and pelvis, burdened obstetric and gynecological history and long-term use of progestogens during pregnancy. Difficulties in diagnosis are associated with absence of classical symptoms of disease that is caused by changes in topographical relations of abdominal cavity, increasing size of uterus, as well as lack of immune response to the emergence of a pathological process. Conclusion. Formation of pregnant women at risk for development of intestinal obstruction and preventive measures to address violations of intestinal motor function can reduce the risk of disease. Algorithm of medical tactics for suspected acute intestinal obstruction in pregnancy, allowing to reduce time of diagnosis and provision of medical care.

Purpose: to study the dynamics of plasma hemostasis in women with uncomplicated pregnancies and with the manifestations of thrombophilia in the III trimester of pregnancy to the onset of delivery and the postpartum period. Materials and methods. Study of plasma parameters of hemostasis has been performed in 408 women. The surveyed patients have been divided into groups: A — Women with no abnormalities of hemostasis (n=152), В —Women with symptomatic thrombophilia (n=256). The women have been examined for the first time in the III trimester of pregnancy 38-39 weeks' gestation, 3 hours after birth and on the fifth day. Results. Women with thrombophilia have suffered significant changes in coagulation potential, characterized by hypercoagulability, thrombinemia and reduced reserve of natural anticoagulants, as well as decreased activity of fibrinolysis. The changes observed in the prenatal period, have intensified on the first days after birth. Conclusion. The indices can be used for control the risk of thrombogenic complications, rationale for therapy.

Analysis of literature review has presented authors' opinion about regularities of consistent change of haemopoietic cell differentiation steps in bone marrow. Particular attention has been paid to the role of numerous cytokines (stem cell factor, fit-3ligand, interleukine-3, interleukine-4, interleukine-6, interleukine-7, tumor necrosis factor, colony stimulating factors, erythropoietin, thrombopoietin) in mechanisms of myelo-, erythro- and thrombocytopoiesis in the normal conditions. Results of investigation have showed the important significance of blood cytokine profile disturbances in pathogenesis of tumor progression in chronic lymphocytic leukaemia.