2013, volume 9

Postural violations (PV) compose the topical issue for elderly people. The research objective is to study features of postural control at elderly people by means of the computer stabilometry (CS). This technique can also serve as control of efficiency of the carried out therapy of PN. In literature there are only single researches devoted to the change of the main rack for persons over 60 years. Material and Methods: 138 patients aged from 61 to 102 years have been investigated and averaged 77,8+2,3 years. Three age groups of the persons under the study by 46 years have been determined: elderly, old men and long-livers. Results proved the expressed decrease in compensatory opportunities of maintenance of balance at people after 60 years, growth of postural instability according to the increase in age. Prior to therapy at all patients significant increase in the area and length of statokineziograms, speed of movement of the center of pressure has been revealed; average value of the «average position of the center of pressure» parameter in the frontal and sagittal planes considerably differed from normal indicators. After carrying out a standard course of treatment average values of the Deviation, Way and Speed parameters decreased in comparison with similar values before the treatment. Average value of the area parameter appeared to be the most sensitive to medical influences. Conclusion: The CS method allows to carry out rather objectively early diagnostics of PN at elderly people and to estimate their condition in dynamics.

The purpose of the article is to evaluate the state of metabolic status of patients with distal onycholysis of hands. Materials and methods: Evaluation of hemoglobin, red blood cells, neutrophil granulocytes, the level of glycolytic processes of lactate and pyruvate, the activity of superoxide dismutase, catalase, myeloperoxidase, neutrophil elastase, serum alkaline phosphatase activity, as well as degradation products content of collagen structures to relative fractions of the blood free and peptide bound oxyproline. Results: It has been shown that free fraction oxyproline in 18 women with distal onycholysis of hands and hemoglobinemia prevails over peptide bound oxyproline fraction in blood, activated glycolytic processes on the modulation mechanism of adaptation with a slight increase of the lactate and pyruvate, the inhibition of activity of antioxidant enzymes, alkaline phosphatase and serum first phase elongation of blood coagulation as a result of the activated plasma recalcification time. Conclusion: The functional state of red blood cells, neutrophil granulocytes in the oppression of the first line of antioxidant enzyme defense and extension in patients with distal onycholysis of hands points to the formation of a mixed type of chronic hypoxia.

The purpose of the study is to examine the feasibility of a self-learning neural network to predict the risk of hemo-static disorders in newborns and their mothers. Material: To solve the problems 214 patients have been under the study, of which — 107 women on a day of labor and 107 of their infants. Morphofunctional state of platelets was assessed by automatic hematological analysis, computer cytomorphometry and platelet aggregation. These laboratory studies of patients were used as a training set for a neural network. This study used a neural network with classical structure «layer perceptron.» Results: Testing of the neural network was carried out on two female patients with physiological pregnancy and signs of imbalance of the hemostatic system. At the output of neural network based on laboratory confirmed the presence or absence of pathology of the hemostatic system in two specific patients and their newborns. Conclusion: The introduction of practical obstetric program being developed based on the neural network will reduce and prevent the development of thrombohemorrhagic complications, the protocol will optimize diagnostic and treatment activities, and an opportunity for the state of hemostasis monitor on a background of pathogenetic therapy for women and their newborns during childbirth and neonatal period.

The purpose: To study possible interconnection between programmed cell death and the processes of lipid peroxidation in the patients with metabolic syndrome. Material and Methods: 270 patients with metabolic syndrome at the age of 30 till 60 (162 men and 108 women) have been examined. MC diagnostic was based on the criteria recommended by experts of society of cardiologists of Russia (2009). Lipid peroxidation was estimated according to the content of hydroperoxide (mkM), the programmed cell death process was studied with protein p53 concentration determination; high sensitivity C-reactive protein content in blood serum was studied by enzyme multiplied immunoassay method (ELISA). Results: In the patients with metabolic syndrome the programmed cell death processes and lipid peroxidation are intensified. High level of lipid hydroperoxide indicates it — 2,89(1,94; 4,1) mkM and protein p53-1,59 (1,361,91) U/ ml in blood serum. Strict direct correlation between lipid peroxidation level and body weight index was defined (r+0,77, p<0,05). Conclusion: Researched processes are interconnected. Strict positive correlation between hydroperoxide level and protein p53 (r+0,71, p<0,05) concentration was defined, their intensity grows parallel to body weight index.55,2% of patients with metabolic syndrome have high risk of development of cardiovascular complications because high sensitivity C-reactive protein content is more than 3mg/l.

Modern pathophysiological mechanisms, which lead to the damage of cardiovascular system in perimenopausal women are represented in review. The most significant of them are hormonal imbalances, inflammation, and psycho-emotional disorders, as well as disturbances of energy metabolism, endothelial dysfunction, electrolyte and vegetative disorders, apoptosis, acceleration of atherosclerosis, obesity and insulin resistance. We conducted random search of the literature on the subject in scientific journals, electronic libraries. The selection of material for the review has been carried out concerning the clinical relevance.

The main purpose of the article is to identify the peculiarities of a doctor personality, affecting long-term therapy in patients with cardiovascular diseases. Materials and methods: To determine the type of temperament, the presence and intensity of the syndrome of emotional burnout and capacity for empathy therapists and cardiologists were asked to fill in a number of questionnaires. Each doctor had a group of patients contacting by telephone for a year after the discharge from the hospital. During the telephone contact, the patients were asked about the continuation of their therapy recommended in the hospital, the regularity of therapy, the frequency of absence, and the assessment of a physician by the patients. Results: 35 questionnaires were suitable for interpretation. Through one year after the discharge from the hospital it was able to contact with 147 patients, 18.4% (27) of patients completely stopped the treatment by recommended drugs. Positive assessment of physicians was associated with the continuation of the therapy by recommended drugs and regularity of drug taking (p=0,03). Patients assessed physicians positively more often in cases of low level of emotional state, high level of depersonalization (cynicism) and the reduction of personal accomplishment (feeling of professional inefficiency) in a doctor. Conclusion: Assessment of physicians by patients is reliably and significantly influenced by continuation of long-term therapy and regularity of drug taking.

Aim: to assess the levels of lipid peroxidation (LPO) products of malondialdehyde (MDA) and glutathione system in patients with the exacerbation of chronic pancreatitis (CP). Material and Methods: 80 patients with exacerbation of CP and 23 controls have been investigated. The level of reduced glutathione (GSH) and activity of enzymes of glutathione reductase (GR), glutathione transferase (GT), glutathione peroxidase (GP) have been determined in plasma and erythrocytes, while the MDA has been studied in plasma. Results: The MDA levels in plasma were higher in CP patients as against the values of the controls. The MDA level correlated positively with intensity of pain. Increased GSH concentration and activity of GT were revealed in plasma. In the erythrocytes reduction in GP activity and GSH concentration were determined. Conclusion: In the exacerbation of chronic pancreatitis lipid peroxidation and reduced antioxidant protection have been activated.

Article focuses on the intestinal polyps. Intestinal polyps are considered to be obligatory precancerous diseases of the colon. Risk factors, epidemiology, clinical manifestations and diagnostic methods of polyps have been analyzed. The courses of treatment of colon polyps have been revealed.

The aim of the study was to determine correlation between arterial blood pressure daily rhythm and daily profile of arterial stiffness in male patients with chronic obstructive pulmonary disease (COPD) and arterial hypertension. Materials et methods: Prospective investigation comprised 45 male patients with COPD and arterial hypertension. Individuals of 40 years younger and 80 years elder, patients with diabetes, stroke, angina pectoris, or heart infarction, vascular diseases, and exacerbation of chronic disease, bronchial and pulmonary diseases of other etiology were excluded from the analyses. Comparison group included 47 patients with essential arterial hypertension and without chronic respiratory diseases closely similar on general parameters with patients from main clinical series. Twenty-four-hour arterial blood pressure monitoring (ABPM) and daily arterial stiffness monitoring were performed using BPLab® MnSDP-2 apparatus (Petr Telegin, Russian Federation). Results: Patients with COPD combined with arterial hypertension with raised arterial stiffness measures prevail over individuals in essential hypertension group. There is pathological alteration of the ABPM circadian rhythm and raised «Pressure load» values in raised arterial stiffness group. Conclusion: We found ABPM raised parameters in patients with COPD and arterial hypertension. It confirms necessity of ABPM in daily arterial stiffness assessment in patients with COPD.

Purpose: To improve the quality of anesthetic protection in prosthetics of large joints based on a steady state energy balance. Materials and methods: Prospective, randomized study on the basis of a controlled hemodilution (CM) double mask has been performed. In the first group of patients (32-19 women) hemodilution (HS) has not been done. The second group of patients (31-17) consisted of patients with HS. Three phases of the survey have been selected — before surgery, traumatic phase of the operation, after the operation. Analyzed the parameters of central hemodynamics (Cl (I/ min/m2) and total peripheral vascular resistance TPVR (dyn * sec1 * cm5), gas exchange (DO (ml / min) and V02 (ml / min), energy metabolism (kcal / min; kcal / day). For data processing statistical package STATISTICA6,0 was used. Results: Central hemodynamic parameters in both groups did not significantly change, and did not differ between the groups. A significant reduction in D02. DO differences between groups of patients at all stages of the studies found has been determined in both groups of patients. Oxygen consumption in the first group of patients decreased significantly to traumatic phase of the operation, and the next stage rose to baseline. Oxygen consumption in the group with CM increased by traumatic phase of the operation, but then returned to baseline. In patients with CM oxygen consumption was significantly higher than in patients without CM at all time points. It is found that there is a significant drop in energy metabolism in the first group of patients in traumatic phase of the operation, followed by reduction of the energy poten-
tial. It is noted that insignificant increase of energy on stage traumatic operation in the second group of patients, with a subsequent decrease to the original level. Energy exchange at all stages of the study was significantly higher in the second group of patients. Logistic regression analysis found that controlled hemodilution is associated with increased energy metabolism at the stage prior to surgery for traumatic stage and after the intervention. Conclusion: It has been established a connection with the growth of energy controlled hemodilution with radical intervention on the hip joint. Substantial energy deficit in patients without HS on traumatic phase of the operation reveals that the high probability of occurrence of cardiovascular complications.