№1, 2016, volume 12

The aim of the study was to evaluate the incidence of chronic kidney disease (CKD) in patients with chronic back pain and nonsteroidal anti-inflammatory drugs (NSAIDs) intake not less than a year, and to study the interrelation between CKD, peculiarities of pain and its treatment. Material and Methods. 91 patients with axial spondyloarthri-tis — ax-SpA(ankylosing spondylitis and non-radiographic ax-SpA) and 35 patients with degenerative diseases of the spine (DDS) with NSADs intake not less than 1 year were involved in the study. The control group included healthy volunteers who did not took NSAIDs during the last year (n=51). By age, gender, factors of cardiovascular risk, GFR
in patients with ax-SpA, DDS and controls were comparable. The activity of pain was evaluated according to the accepted recommendations. The index of NSAID intake as calculated for the preceding year. Results. GFR in patients with ax-SpAwas 87,0 [77,25; 102,0] ml/min/1,73 m2, 11 (18%) patients showed a reduction in GFR of less than 60 ml/ min/1,73m2. In patients with DDS GFR was 87,5 [65,5; 97,0] ml/min / 1,73 m 2 (p=0,27), decreased GFR of less than 60 ml/min / 1,73 m2 was detected in 3 (15%) patients. The ratio of albumin / creatinine urine in patients with ax-SpA was 35,8 [25,46; 43,4] mg/g, in patients DDS —207,1 [91,66; 244,59] mg/g (p<0,0001), in healthy individuals —25,45 [17,34; 33,65] mg/g. Conclusions. Patients with chronic back pain taking NSAIDs for a long time have revealed GFR, comparable with healthy people, and increased urine albumin. Patients with degenerative diseases of the spine have a greater index of albumin in urine than patients with ax-SpA.

The aim: to identify the frequency and clinical features of delirium in acute myocardial infarction (AMI) in the conditions of the intensive care unit. Material and Methods. The study involved 104 patients (43,3% women and 56,7% men) with AMI during the stay at the intensive care unit. The average age was 68,0 [59,0-76,7] years. Delirium was diagnosed using the criteria questionnaire Moss-ICU. For neurodevelopmental testing we used screening tests and rating scales. Results. The incidence of delirium in patients in this category was 28,8%. Most frequently delirium develops in patients aged 60-89 years: in the age group 60-74 years 25,0%, in the group of 75-89 years 44,7%. Delirium developed in the 1-2 day stay in the intensive care unit and intensive care. The average duration of delirium was 7,7 days. Hypoproductive form of delirium was detected in 64,3% of all cases, hyperproductive form in 21,4% of patients, mixed form in 14,2% of patients. The occurrence of delirium is associated with an increase of the duration of stay at the intensive care unit at 6 times compared with patients without delirium. Conclusion. The presence of delirium greatly increases the probability of death in the reanimation period of acute myocardial infarction. Moss questionnaire and training of doctors to work with rating scales should be accepted in all ICU intensive care units for early diagnosis of delirium and immediate correction of disorders of consciousness in patients in critical condition.

The article presents the review of contemporary concepts of tumor induction mechanisms applicable for neoplastic transformation, promotion and proliferation. The paper also contains an in-depth analysis of results of authors' own observations and study of immunological protection mechanisms of a significant number of patients diagnosed with oncopathologies of mammary and thyroid glands as well as adenocarcinoma of ascending colon. We have established common development patterns of T-cell and B-cell immunodeficiencies that are not influenced by location and proliferation of neoplastic tumors; the progress of such immunodeficincies, however, depends on regional metastasis development. Thus, we can conclude that insufficiency of immunological defense mechanisms leading to disruption of maligned cell elimination process is the primary pathogenic factor for metastatic tumor development.

Objective: the establishment changes in the structure of the causes of violent death in Saratov from 2011 till 2015. Material and Methods. The examination was based on analysis of the results of the forensic medical expert researches of corpses in the Saratov city office of forensic medical examination of corpses in the period from 2011 to 2015. Results. The structure of the causes of violent death was identical in Saratov in the last five years. The mechanical trauma was a leader, in second place — poisonings, then — mechanical asphyxia and external factors. There were two trends in the dynamics of components of each type of violent death: positive and negative. Positive trends were expressed as a decrease in the proportion of deaths from poisoning by ethanol and reducing the number of deaths from alcohol intoxication from other causes. Negative trends were expressed as the increase in the number of forensic medical expert examinations in the last two years, an increasing share of violent death of children in 2015, maintaining the leading position of automotive trauma among deaths from injuries by blunt objects. Conclusion. The number of forensic medical examinations of corpses was increased in Saratov for the studied period, but the proportion of fatal poisoning with ethanol was decreased. In 2015, the share of violent death of children aged under 14 was increased.

The interrelation of persistence of Helicobacter pylori in stomach with innate and adaptive immunity of human has been discussed. The analysis of the mechanisms of immunological recognition of the antigens of this microorganism and response to them has been performed. It has been considered, that the development and course of gastritis and ulcer in human with Helicobacter pylori stipulate for inadequate reactions of immune system and common reactivity by the individual organism in presence of Helicobacter pylori in mucus of stomach.

The information about anatomy of middle cerebral artery in adults has been summarized on the basis of data analysis of domestic and foreign scientific literature. Material concerning options for arteries discharge, area of blood supply, major anomalies and size characteristics (outer diameter, wall thickness, lumen diameter) has been represented in this work.

The aim is to identify the changes in the rat's thymus structure under immunosuppression induced injection of cyclophosphamide with the use of morpho-histochemical and morphometric methods. Material and methods. For immunosuppression of animals cyclophosphamide at 100mg/kg body weight 4-fold with a 24-hour interval was injected intraperitoneally. Thymus serial paraffin sections were stained with hematoxylin and eosin, azure ll-eosin, methyl green pyronin according to Brachet, and periodic acid-Schiff before and after treatment with amylase. Results. Significant morphological changes in the thymus at rats with injection of cyclophosphamide were established. Morpho-histochemical changes in the rat's thymus characterize the immunosuppressive state of the experimental animals' organisms. Conclusion. It was shown the necessity of complex morphological studies including macrophage activity and characteristics of the subpopulation of mononuclear leukocytes spleen, changes in the structure of hematopoietic and lymphoid organs under immunosuppression induced by cyclophosphamide.

Aim: to analyze the situation with injecting drug use in the Republic of Belarus during the period 2000-2014. Material and Methods. The analysis of the official data on the psychoactive substances' abusers, listed in the Narcological Register of the Ministry of Health in 2000-2014. Results. Over last 15 years the number of registered drug abusers increased three times, whereas the number of injecting drug users (IDUs) increased 2,2 times. The majority of recorded IDUs abused opium-based drugs and only 3% of them injected amphetamine-type stimulants. The increase in the number of recorded persons, who abuse synthetic opioids and analogues of well-known drugs, was noted during the last ten years. Conclusion. The data obtained indicate necessity of the studies on IDUs, and might be useful for working up preventive measures to restrain the spread of drug addiction.