№1, 2017, volume 13

Purpose of the study: to evaluate the prognostic value of brain natriuretic peptide (BNP) as a predictor of cardiovascular events in patients with acute coronary syndrome (ACS) within one year after hospitalization. Material and Methods. The study included 201 patients, including 150 men and 51 women, who were treated in the emergency department of cardiology with ACS including 96 patients without symptoms of CHF and/or AHF. Results. All patients were divided into groups depending on the presence signs of heart failure of CHF and/or AHF at the time of admission: patients with no signs of heart failure were divided into 2 groups: those with BNP levels >101 pg/mL (group 1; n=37) and <100 pg/mL (group 2; n=59); the third group consisted of patients with symptomatic HF (n=105). In patients without clinical signs of CHF and/or AHF with elevated level of the BNP at the time of hospitalization was observed significantly increased risk of unstable angina during the year compared to patients with normal levels (OR 2.83 [95% Cl: 1.1—7.24], p=0.04). In patients without clinical signs of CHF and/or AHF with elevated BNP levels at the time of hospitalization compared to patients with AHF and/or CHF, had no statistically significant differences in the long-term prognosis. Conclusion. Patients with ACS in the absence of CHF and/or AHF but with elevated levels of BNP at admission should be attributed to the group of high risk for cardiovascular complications. Increasing the level of BNP in ACS patients at admission has an adverse value for long-term outcome and can be used as an additional risk marker.

Measurement of the central aortic pressure and the augmentation may have additional benefits for characterizing the state of the cardiovascular system than the only stiffness of the vascular wall. The purpose of the study is to assess the changes of indicators of central aortic pressure and arterial stiffness in women of early postmenopausal period, against the background of the prolonged use of menopausal hormone therapy 1 mg E2 / 2mg DRSP. Material and Methods. The study included 162 women in early postmenopause. The subjects were divided into 2 groups: primary — 84 patients, which was appointed menopausal hormone therapy 1 mg E2 / 2mg of DRSP (drug "Angelique", Bayer), control group — 78 women who did not receive menopausal hormone therapy. The duration of observation is 5.2 years. ABPM was performed with the evaluation indicators of arterial stiffness (RWTT, Alx, ASI, AASI, (dP/dt) max.), central aortic pressure, aoPW. Results. Initial aoPW increase was detected in 15 (21.4%) women of the main group and in 19 (24.3%) control group patients (p=0,4). The women in both groups showed an increase to the end of the study aoPW more pronounced in women of control group. Increasing falls detected in 25 (29.7%) women of the main group and in 25 (32%) women of control group (p=0.84). It was noted that in women in both groups a significant decrease of central aortic pressure has been matched. In women of the main group to the end of the study there was a reduction in pulse pressure from 38,4±6,2 to 35,3±4,19mm Hg (p<0,001) and the absence of changes in women drops the control group. It is noted a significant increase of Alxao in patients of control group and no change in women of the main group. ASI revealed a decrease in women of the main group with 132.0 (121.0; 142.0) to 127.0 (115.5; 137.0) to the end of the study, and an increase from 133.0 (111.0; 155.0) to 148.0 (134.2; 171.0) in women in the control group (p<0.01). Decrease of AASI in women of the main group to 0.379 (0.320; 0.463) to 0.264 (0.203; 0.329), (p<0.001)and no change in the control group of women has been detected. Conclusion. The measurement of the central aortic pressure and the augmentation may have additional benefits for characterizing the state of the cardiovascular system. The positive changes in arterial stiffness and reflected waves, determining the value of central aortic pressure, on the background of long-term menopausal hormone therapy combined 1 mg E2 / 2 mg DRSP.

The literature review is devoted to the universal molecular markers and predictors of forming non-alcoholic fatty liver disease and pathology of the colon, the role of insulin resistance as one of the factors of the pathogenesis of non-alcoholic fatty liver disease in the development of colorectal cancer. The mechanisms of diseases of the colon (colorectal cancer) are found out to be due to non-alcoholic fatty liver disease.

The aim of the article is a comparison of resolution of the acousto-optical method for blood typing for two types of reagents: monoclonal antibodies and standard hemagglutinating sera. Materials and Methods: The influence of the concentrations of reagents (monoclonal antibodies and standard hemagglutinating sera), of blood sample, which is to be tested, as well as of the duration of the ultrasonic action on the biological object upon the resolution of acousto-optical method were investigated. The peculiarity of this work is the application of digital photo images processing by pixel analysis previously proposed by the authors. Results: The optimal experimental conditions to obtain maximum of the resolution of the acousto-optical method were found, it creates the prerequisites for a reliable blood typing. Conclusions: The present paper is a further step in the development of acousto-optical method for determining human blood groups.

Steroid compounds of phytogenic origin are important in clinical medicine rendering anti-inflammatory, anti-prolifer-ative and antithrombotic actions. However, steroid compounds of phytogenic origin, in particular, steroid saponins are insufficiently studied from an identification position in tissues of vegetable organisms and methods of their physical and chemical analysis. The scientometric analysis of research data (abstract documents) containing an analytical array of scientific publications concerning isolation, selection, cleaning, identification and the quantitative definition of steroid saponins in tissues of the higher vascular plants in the abstract bibliographic database SciVerse Scopus (Elsevier publishing house) with use of criteria "key word" and "the key phrase" is provided in the article.

Objective: to determine the characteristics of the outcome of the improper care for children, established during the commission of forensic examinations. Material and Methods. The material of this study was commission a forensic medical examination of the archives department of complex expertise of the Bureaus of Forensic Medicine of Moscow; the Moscow, Penza, Samara and Ulyanovsk regions, and the Republic of Mordovia, conducted from 1996 to 2006. The method of this study was a statistical database processing using Excel software application package. Results. The article presents the results of the analysis of 279 forensic medical examinations conducted by committees in the Bureaus of Forensic Medical Examination of Moscow; the Moscow, Penza, Samara and Ulyanovsk regions, and the Republic of Mordovia from 1996 to 2006. The examinations were conducted in connection with poor outcomes of rendering medical care to children. Conclusion. The number of conducted examinations correlates with the population of the region. The parents of the children affected by poor treatment mostly demand the medical staff to be prosecuted and more often make legal claims to the quality of emergency medical care; dissatisfaction with the quality of medical care is more often expressed by the parents of children under 3 years old. Legal claims are more often made against obstetricians-gynecologists, pediatricians, surgeons, infectious disease specialists and anesthesiologists-resuscitators. If the conclusion of the forensic medical examination committee on the nature of the pathological process coincides with the final clinical diagnosis, the provided medical care often turns out to be adequate; in cases of inadequate medical care the risks of moderate and grievous bodily harm as well as the patient's death are high.

Aim: to justify the ways of optimization of availability of primary health care for working-age patients with arterial hypertension. Material and Methods. The study of the availability of drug treatment of working-age patients with arterial hypertension was based on a survey of 409 patients and calculated the average cost of treatment of this group of patients for 1 month in accordance with the care standards. Results. On 01.06.2016, the cost of treatment for a patient with stage 1 hypertension amounted to 316.89 rubles per month, with 2 stage 652.68 rubles per month. 67% of patients of working age are unable to follow the doctor's recommendations and take the prescribed medicines. Conclusion. Provision of free medicines to patients with arterial hypertension of stages 1 and 2 and the formation of their commitment to preventive treatment causes a direct economic effect, which will be 7915979 rubles per year, and indirect economic effect of the decreased mortality from cardiovascular diseases, disability, reduce in disability days and increase of the gross domestic product.