Vol 34, No 1 (2017)

Aim. To study the influence of muscular bridges on the stent thromboses in the anterior descending artery. Materials and methods. The study included 209 patients, who underwent interventional coronary interference in the anterior descending artery. Group 1 (main) engaged 87 patients with “muscular bridges” confirmed by coronarography data. Group 2 (control) included 122 patients without the above mentioned anatomic anomaly (all patients of the control group were randomly chosen). The results, obtained since 2007, when the primary transcutaneous coronary intervention (TCCI) was carried out, were assessed. Results. While studying the indices, it was established that the repeated restenoses in the arterial stents did not differ in the main and the control groups. However, 6 patients of the main group after TCCI had repeated thromboses in the inserted stents. In the control group, 2 cases of acute thromboses prior to and after TCCI were fixed. When using nonparametric statistical criteria (chi-square criterion), differences in both groups were found to be significant ( p < 0,05). Conclusions. The number of thromboses in the arterial stents with muscular bridges tended to increase - 6 clinical cases in the main group versus 2 cases in the control. So, a new and deeper investigation of this problem with respect to anatomic variants of intramyocardial location of the coronary arteries is to be performed.

Aim. To assess the medium-term results of the left-atrial modification of the surgery “labyrinth-3” in 100 patients with associated pathology of the mitral valve (MV). Materials and methods. One hundred patients (mean age 62,7 ± 4,5 years) with MV pathology, protractedly persisting form of atrial fibrillation (AF) (during 18±5,1 months) ( n = 81), persisting form of AF ( n = 15) and paroxysmal form of AF ( n = 4) were examined. All patients were operated for associated MV pathology over the period from 2010 to 2012. Etiology of mitral valve damage was estimated: degenerative damages - in 62 patients, ischemic mitral insufficiency - in 30 patients, rheumatic heart disease - in 4 patients, idiopathic annulectasia and mitral insufficiency - in 4 patients. During the pre-and postoperative periods, the general clinical and echocardiographic data, the results of Holter monitoring and coronography were assessed. Results. All patients underwent the left-atrial modification of the surgery “labyrinth-3” with correction of mitral valve pathology. Thirty one patients underwent intervention associated with coronary artery bypass grafting, 33 patients - tricuspidal insufficiency correction. Hospital lethality was 3 % - 3 patients died from multiple organ failure. During the first month ( n = 96), sinus rhythm was observed in 85 (89 %) patients including mechanical systole of the left atrium - in 18 %. Eight patients (8,2 %) had atrial fibrillation, 3 (2,8 %) patients needed introduction of electrical stimulator in connection with weakness of sinus node. Six months after the surgery ( n = 71), sinus rhythm was registered in 59 (83 %) patients, mechanical systole of LA - in 55 % of them; one year after the surgery ( n = 39), sinus rhythm was detected in 31 (81 %) patients, mechanical systole of LA - in 48 %. During one year, a two-chamber electrical stimulator was introduced to 4 patients more, in connection with atrioventricular blockade. During 12 months, 80 % of patients were free from atrial fibrillation, 98,7 % were free from acute stroke. Conclusions. The procedure of the left-atrial “labyrinth” associated with correction of MV pathology does not elevate lethality and is efficient in 80 % of patients. Mechanical function frequency of LA in patients with sinus rhythm is being increased during a year in half of patients. Cumulative freedom from stroke is 98,7 % a year.

Aim. To characterize the response of the abdominal vessels to food load in healthy children and to determine the referent values of postprandial changes in the regional blood flow. Materials and methods. The Doppler investigation of the abdominal vessels before and 30 minutes after the standard breakfast with determination of their diameters, linear and volumetric rate indices, resistance index was performed in 44 healthy children aged 3-15 years. Results. During the postprandial phase, the dilatation of the superior mesenteric artery, celiac trunk, hepatic and splenic arteries, portal vein and splenic veins was observed in healthy children. Increase in volumetric blood flow rate is revealed in all these vessels that reflects intensification of blood circulation in the abdominal organs. Conclusions. The character and degree of changes in hemodynamic parameters after food intake have no age differences in healthy children. Reference values of the postprandial blood flow changes in the abdominal vessels for children aged 3-15 years were obtained.

Aim. To carry out the hygienic and clinical studies of the possibility of using sylvinite physiotherapeutic room in complex treatment of chronic catarrhal pharyngitis. Materials and methods. The objects for studying: sylvinite physiotherapeutic room, 52 patients, diagnosed chronic catarrhal pharyngitis (age: 20-25 years). Hygienic methods were used to study the aeroionization and aerosol environment, microclimate. According to the results of pharyngoscopy, 5-score sensoanalogous and visual-analogous scales were filled in. The local immunity indices of pharyngeal mucosa (SIgA, IL4, IL8) were assessed. Results. Physiotherapeutic factors contributed to decrease in the degree of manifestation of clinical signs of this disease as well as to elevation of the local immunity of pharyngeal mucosa. Conclusions. The results of the study proved good prospects for using sylvinitotherapy in complex treatment of patients with chronic catarrhal pharyngitis.

Aim. To develop the modern predictors of clinico-epidemiological diagnosis of whooping cough in children. Materials and methods. The retrospective study included 56 children aged 2 months to 6 years, who were hospitalized for whooping cough infection. Diagnostic verification was carried out by means of a double bacteriological study of fauces mucosa as well as serological study of blood serum in dynamics of the disease. Standard study included general blood and urine analyses, biochemical blood analysis, epidemiological anamnesis and clinical examination. To assess the significance of diagnostic predictors, analytical (optimal quantization) and statistical (Pirson criterion) methods were used. Results. Diagnosis of whooping cough was found to be verified using laboratory methods in 59,0 % (33/56) of children: bacteriological method - in 12,1 %, serological - in 87,9 %. Statistically significant clinico-epidemiological predictors of whooping cough infection were determined without laboratory confirmation of diagnosis in 23 (41 %) children. Conclusions. In case of typical clinical picture of whooping cough and negative results of bacteriological/serological study, it was suggested to use the following predictors as additional diagnostic criteria: absence of whooping cough vaccination, age - under 1 year, marked leucosis (Le > 15·109) of lymphocytic character with normal ESR and contact with protractedly coughing persons.

Aim. To determine the peculiarities of revealing and clinical manifestations of spondylitis in HIV-infected patients. Materials and methods. The case history data of 116 patients, hospitalized to the unit of surgical tuberculosis of the institute hospital, were analyzed. Results. In the group of HIV-infected patients with spondylitis there prevailed parenteral narcomania, hepatitis C, staying at institutions of confinement in anamnesis, acute onset of disease, generalization of tuberculous process with specific etiology of spondylitis, not so often - developing congestive abscess and neurological deficit in the form of paresis and plegia. Tuberculous etiology of spondylitis associated with HIV-infection is more often confirmed by molecular-genetic method of study. Conclusions. The obtained data can be used by physicians for a timely detection of tuberculous spondylitis at the earlier stage, chemotherapy and surgical treatment of patients.

Aim. To develop and ground a new hygienic method for complex assessment of functioning efficiency of sylvinite devices. Materials and methods. The studies were carried out in the sylvinite devices of 3 types: saline microclimatic ward, sylvinite physiotherapeutic room and saline sylvinite device. The overall number of measurements was 108. Mann-Whitney criterion was used for statistical processing of the data. Results. The hygienic method for assessment of the efficiency of sylvinite devices functioning, based on registration of antimicrobial effect of their internal environment on the growth characteristics of museum strain S.aureus (strain number 201188, № 906) was developed. When using this method in different types of sylvinite rooms, a bacteriostatic effect, which confirms formation of special biopositive environment rendering a complex influence on the microorganisms S.aureus , was established. Conclusions. The suggested method for assessment of the efficiency of functioning of physiotherapeutic potassium salt devices permits to take into account a complex of environmental factors, it simplifies and reduces the price of the process of determining the quality of functioning and can be successfully used for control of device exploitation.

Aim. To study the fatty and organic acids in Astragalus glycyphyllus L . Materials and methods. The object of this study was a dry-grinded grass of Astragalus glycyphyllus L. , prepared in 2016 in Kursk region during the period of mass plant blossoming. The method of gas-liquid chromato-mass-spectrometry was used to study the qualitative composition and quantitative content of fatty and organic acids of the plant. Results. Astragalus glycyphyllus L. contains 19 fatty and 10 organic acids. Fatty-acid composition of Astragalus glycyphyllus L. , presented by saturated, monounsaturated and polyunsaturated acids, is characterized by a low coefficient of polyunsaturated acids. Conclusions. The obtained results prove the possibility of using Astragalus glycyphyllus L. in medical and pharmaceutical practice as a source of organic and fatty acids including omega-3 and omega-3-based drugs.

Theoretical review of data regarding the association of cardiac pathology with comorbid course of gastroesophageal reflux disease and nonalcoholic amyloid liver disease is presented in the paper. Pathogenesis of these diseases is considered. The associated influence of these diseases was proved to elevate risk for the development of cardiac pathology by several times.

Aim – to develop and to prove new hygienic way of complex sylvinite chambers efficiency assessment.

Materials and methods. Researches were conducted in sylvinite constructions of 3 types: saline microclimatic chamber, sylvinite physiotherapeutic room and saline sylvinite device. Total of researches was 108. Mann-Whitney U-test was used for statistic data processing.

Results. The way of sylvinite chambers efficiency assessment was developed. It was based on registration of their antimicrobial influence on growth indicators of S.aureus.

In all explored rooms the bacteriostatic effect was established that proved formation of special biopositive inner environment, which exerted complex influence on microorganisms S.aureus.

Conclusions. The offered method of physiotherapeutic potash salts constructions efficiency definition allows to consider complex of inner environment factors, simplifies and reduces the price of quality assessment process and it can be applied to holding control actions for exploit sylvinite chambers.