A pre-clinical study of the general toxicity of the medication “Fitin-S” has shown that it is referred to class IV of low toxic compounds. The medication “Fitin-S” does not have aaccumulative and local irritant action. At multiple intramuscular administration to rats and rabbits it does not influence the behavior and the dynamics of animals growth, does not cause a toxic effect on the composition of peripheral blood, kidneys’ and liver’s function as well as on the pathomorphology of animals organs and tissues. There is a slowdown in the process of blood coagulation in rabbits at doses of 16 and 32 mg/kg during the whole study period. In 1 month of a recovery period all the indicators have been changing within physiological norm. All the aforementioned data allows us to make a conclusion that the medication does not cause a toxic effect on the organism of animals.
To study the anti-inflammatory and some other pharmaco- logical properties, toxicity of the new thiocarbamate and thiourea derivatives (codes UB-421 and BIK-15, respectively), selected after the scrinning reseaches among the compounds of this group and to ground the possibility of their using in clinic
To assess the safety of the new carbon hemosorbent, the authors carried out experimental studies on 138 white laboratory rats of the nature "Wistar" and 16 mongrel dogs with toxicological, biochemical and physiological studies. The simulation of the mechanical block was carried out according to the author's methodology. The authors studied the acute and chronic toxicity of carbon hemosorbent with intragastric, intraperitoneal administration of the drug, and also evaluated the local irritant, skin-resorptive effect. The research carried out by the authors showed that carbon hemosorbent can be recommended in the complex treatment of liver failure.
Ўткир ичак тутилиши (ЎИТ) билан касалланган беморлар сонининг ортиши ва операциядан кейинги ўлим кўрсаткичининг юқорилиги туфайли, бу синдромнинг диагностикаси ва давоси шошилинч абдоминал жарроҳликда долзарб аҳамиятга эга. ЎИТ қорин аъзолари билан боғлиқ шошилинч ҳолатларнинг 10% ни ташкил этади, шундан энг кўп учрайдигани - ўткир ингичка ичак тутилиши (ЎИИТ) - 60-70%, ўткир йўғон ичак тутилиши эса (ЎЙИТ) - 30-40% ҳолатларда. ЎЙИТ сабаблари - ўсма билан боғлик тутилиш (93%), йўғон ичак буралиб қолиши (4%) ва бошқалар (2%). Бу шошилинч ҳолатда ўлим кўрсаткичи юқорилигича қолмоқда - 15-40%.
Guillain-Barre syndrome (GBS) is a very rare autoimmune disease that is associated with demyelination of the peripheral nervous system and progressive muscle weakness that occurs mainly in previously healthy people. The incidence of GBS is 1.1-1.8 cases per 100,000 per year, and the incidence increases with age. The clinical spectrum of GBS is heterogeneous and includes acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN), acute motor and sensory axonal neuropathy (AMSAN), and Miller Fisher Syndrome (MFS). The disease is usually characterized by a rapid onset of symmetrical limb weakness, which progresses within a few days to 4 weeks and occurs in patients of any age. In developed countries, GBS has become the most common cause of acute flaccid paralysis. Despite improved recognition and treatment, GBS continues to be a serious disease.
Relevance of the problem.Despite the great successes of angiosurgery, the problem of surgical treatment of abdominal aortic aneurysms does not lose its relevance. World health statistics records a steady increase in the incidence of abdominal aortic aneurysm (ABA). According to L.J. Melton et al. (1984) and L.K. Bickerstaff et al. (1984) in the USA the number of patients with abdominal aortic aneurysm has increased 7 times in 30 years since 1951. In England and Wales, according to F.G. Fowkers et al. (1989) for the same period revealed a 20-fold increase in abdominal aortic aneurysms in men and 11-fold in women. According to the results of multicentre screening studies ABA was detected in 8% of the examined (E.S. Vourvouri, 2001), and in the age group of 64-69 years ABA was detected in 5.7% of the examined, and in the age group of 75-81 years - in 8.9% (R.A.P. Skott et al., 2001). A similar trend is observed in other countries. Accordingly, mortality from ABA is also increasing - aneurysm rupture in a number of countries is one of the ten most frequent causes of death among elderly and senile people (F.A. Lederle et al., 1990)
Currently, planned aneurysm resection has become a recognised standard of radical treatment of ABA patients and the number of these operations is steadily increasing. For example, about 40,000 ABA resections are performed annually in the USA (J.J. Grange et al., 1997). In Sweden during the period from 1987-89 to 1993-95 the number of ABA operations increased 5 times and currently 10 operations per 100,000 population are performed (A.Hallin et al., 2001), although this is 1.5 - 2 times less than the required number. However, postoperative lethality is still quite high and makes 5-7% (A.V.Pokrovskiy et al., 1992; Y.V.Belov et al., 1992; V.V.Vakhidov et al., 1992; A.W. Bradbury et al. Bradbury et al., 1997; A.Hallin et al., 2001).
E.W. Steyeberg et al. (1995) summarised the data of literature on 17238 ABA resection operations and gave an average mortality of 6.8%.
Multicentre studies in five major hospitals in the Netherlands found that only 74% of patients underwent ABA resection without complications; 26% had some complications, 9% of which were severe and 4.1% of which were fatal (G.J. Akkersdijk et al., 1998). Similar results were obtained in the Canadian Cooperative Study (K.W. Johnston et al., 1990). It was established that the peculiarity of complications in the majority of patients was their systemic character (L.L. Lau et al, 2001) The course of the postoperative period is most often complicated by cardiac, respiratory, renal, cerebrovascular, as well as complications associated with thrombosis and bleeding (W.E. Lloyd et al., 1996; R.D. Sayers et al., 1997; J.D. Blankenstein et al., 1998; R. Ayari et al., 1998). Ayari et al., 2001)
The undisputed leadership, without doubt, belongs to cardiac complications, the incidence of which varies from 10% to 20%. Moreover, cardiac complications account for 50-70% of total mortality. Cerebrovascular complications, although not uncommon, account for no more than 1-1.5%, but their mortality reaches 40%. Complications associated with thromboses and haemorrhages in the perioperative period reach 2-5% (M.M.Reigel et al., 1987; K.W.Johnson et al., 1990; N.Franklin et al., 1993; A.A.Milne et al., 1994).
Certainly, a large number of complications after resection of abdominal aortic aneurysms is caused by the initial severity of patients' condition, however, many unresolved tactical and technical issues of patients' preparation for the operation, stage of performance in case of combined lesions of several vascular basins play a practically significant role. Adequate management of the operation itself and the immediate postoperative period is no less important, taking into account the possibility of such dreadful complications as thrombosis and embolism, cerebral and cardiac death. Until now there is no unified complex analysis of the results of treatment of uncomplicated abdominal aortic aneurysms and, accordingly, recommendations for the prevention of possible complications.
All this determined our aim and objectives of the study.
The aim of the study is to improve the results of surgical treatment of ABA by developing an effective system for determining the main risk factors of surgical treatment and optimal surgical tactics to prevent possible complications.
Scientific novelty.For the first time a complex analysis of indications and contraindications to surgical treatment of abdominal aortic aneurysms was carried out
The most significant concomitant pathology capable to lead to formidable complications and lethality during the intervention and in the nearest postoperative period was revealed. Adequate measures of their prevention and treatment were proposed.
The algorithm of surgical treatment tactics for patients with combined pathology of coronary arteries and aortic arch branch lesions was developed
The state of haemostasis system at all stages of reconstructive surgery on abdominal aorta, starting from skin incision to wound closure, was studied for the first time.
Conclusions:
1. The proposed original classification of ABA, based on mutual dependence on the etiology of the disease, localisation, concomitant diseases, clinic and its course, allows to determine the strategy of early diagnosis, to estimate the most significant risk factors, the stage of intervention in combined lesions of adjacent and distant vascular basins and, ultimately, to determine the ways to reduce complications and mortality in patients with ABA.
2. The most informative methods of ABA diagnostics are duplex scanning and computed tomography. Non-invasive diagnostics capabilities are enough to determine the aneurysm size, its relation to the renal arteries, as well as to find out the state of visceral branches and aortic bifurcation. Abdominal aortography is indicated in patients with concomitant arterial hypertension to identify the state of the renal arteries.
3. Significant risk factors in these patients are ischaemic heart disease (44.1%), arterial hypertension (49%), haemostasis disorders (almost 100%).
4. The leading concomitant disease in the development of postoperative complications is ischaemic heart disease. Its share in abdominal aortic aneurysms is 40%. Postoperative cardiac complications reach 14.9%. Diagnostics of ischaemic heart disease should be based on the stage-by-stage detection of coronary lesions and its functional-compensatory abilities.
5. The main complications of the postoperative period after ABA resections are acute heart failure (14,9%), cerebral circulatory disorders (1,5%), acute renal failure (3,33%).
6. When significant coronary vascular channel lesions are detected in patients with ABA, it is fundamental to solve the issue of intervention staging. At 3-4 functional classes of circulatory insufficiency, appearance of new zones of hypo- or akinesia, decrease of ejection fraction below 40%, the first stage should be myocardial revascularisation surgery
7. In patients with combined lesions of brachiocephalic vessels in patients with ABA it is reasonable to assess the cerebral blood flow. In the presence of 70% or more stenosis of VCA, presence of embologenic plaque, bilateral haemodynamically significant stenosis it is necessary to perform carotid artery intervention as the first stage.
8. One of the most difficult problems of reconstructive operations in ABA is the contiguous lesion of renal and visceral branches of the abdominal aorta. The principle is their one-stage reconstruction. The types of reconstruction of these branches should be variable depending on the volume and extent of the pathological process.
9. Patients with aneurysmal lesion of abdominal aorta initially always have significant disorders of haemostasis system. In 30% of patients with occlusive diseases of aorta and its branches in the preoperative period the activity of thrombocytic-vascular link of hemostasis is increased, antithrombotic ability of vascular wall endothelium is decreased and blood rheological properties are disturbed. Activation of fibrinolysis was noted in patients with aneurysmal lesion of abdominal aorta.
10. During the operation for abdominal aortic aneurysmal lesion, after starting the blood flow the level of plasminogen increases additionally by 30%, which is a risk factor for haemorrhagic complications in the perioperative period. On the 1-3 day after the operation there is a significant decrease of blood anticoagulant potential - antithrombin-Sh by 25-27%, protein C by 23-25%. This period is the most dangerous in terms of thrombohemorrhagic complications development.
11. When using standard heparin during the operation there is a consumption of antithrombin-Sh by 30-45% and increase of platelet aggregation by 10%, which is a threatening condition for the occurrence of thrombosis of deep veins of the lower extremities with subsequent TELA. When using fraxiparin during reconstructive vascular surgeries the consumption of antithrombin-Sh and increase in platelet aggregation do not occur, prothrombin time, activated partial thromboplastin time, thrombin time are lengthened insignificantly that testifies to expediency of its use for prevention of thrombohemorrhagic complications.
12. Application of the diagnostic methods proposed by us to detect the main risk factors during the operation and in the nearest postoperative period, use of the algorithm of stage and volume of intervention allowed to reduce significantly the number of threatening complications, thus the lethality decreased 4 times, and the number of non-fatal complications - 4 times non-fatal complications - 1.5 times.
На протяжении многих лет одной из главных проблем человечества остается проблема пищевых продуктов, а именно их безопасность. По данным ВОЗ ежегодно небезопасные пищевые продукты связаны со смертью приблизительно 2 миллионов человек, а именно этой опасности подвергаются дети. Патогенные бактерии, вирусы, паразиты или химические вещества, содержащиеся в пище, являются причиной более 200 заболеваний, начиная от диареи и заканчивая раком. В 2015 году 7 апреля был отмечен Всемирный день здоровья под девизом "От фермы до тарелки — сделать продукты питания безопасными!", подчеркивая важность и актуальность данной проблемы.
The search for new sources of highiy active drugs based on iocai raw materials is an urgent task of modern science, it is known that iicorice root is widely used in various sectors of the economy, the main component of it is glycyrrhizic acid. The presence of anti-inflammatory activity, iow toxicity and iack serious side effects make new synthetic derivative of glycyrrhizic acid promising for medicine compounds.
The purpose of the study. To study the antiulcer activity glycerinate on an experimental model of neurogenic uicers caused by 24-hour immobilization of animals and to identity the mechanism of antiulcer activity.
The article is devoted to the problems of the development of Currently used antiretroviral therapy has made HIV infection a chronic controlled infection and has prolonged life and quality of life. However, any antiretroviral drug has side effects, although not on every patient and not always the same.
To assess the current state of the side effects problem of antiretroviral therapy in HIV - infected patients based on the analysis of literature data.
The following are data on the side effects of various groups of antiretroviral drugs used in the past and now, as well as some of their representatives. Antiretroviral drugs exhibit various side effects, in particular mitochondrial toxicity caused by nucleoside reverse transcriptase inhibitors (NRTIs), causing a wide range of side effects such as lactic acidosis, hepatic steatosis, myopathy, cardiomyopathy, peripheral neuropathy, pancreatitis, and possibly lipodystrophy syndrome. In general, integrase inhibitors are well tolerated and cause minimal drug interactions
The use of older antiretroviral drugs has been associated with a variety of side effects, which include lactic acidosis, hepatic steatosis, allergic reactions, myopathy, cardiomyopathy, peripheral neuropathy, pancreatitis and lipoatrophy.These side effects are less common with newer recommended ARVs. drugs. When treating, it is necessary to consider the likelihood of side effects and the possibility of their prevention.
Subject of the inquiry: rabbits, visceral-ischemic shock, metabolism, mitochondria, suktsinasol, suktsivil.
Aim of the inquiry: to study effect of new hemocorrectors such as suktsinasol and suktsivil on the basic pathogenetic mechanisms of visceral-ischemic shock.
Methods of inquiry: physiological, biochemical, biophysical, statistical.
The results achieved and their novelty: A complete evaluation of indices in hemodynamics is given in VIS including AAB and toxemia, functional changes in liver, indices of carbohydrate-phosphoric metabolism. A number of research methods have been studied which gave the opportunity to have a distinct understanding about metabolic status of the organism. Efficiency of a new polyfunctional hemocorrection - suktsinasol on hemodynamic and metabolic indices of VIS have been studied for the first time. The effect of a new polyfunctional hemocorrector Suktsivil on the hemodynamical and metabolic indices of VIS have been studied. A comparative analysis of effective blood substitutes during infusion for VIS in experiment has been carried out.
Practical value: We have determined hypothesis about disorder of energetic metabolism in liver cells in VIS. We have proved efficiency of using new complex blood substitutes sulktsinasol and suktsivil as supply of rich energetic compounds (sulktsinasol) and corrector of electronic and transport function of mitochondria in liver in emergency complicated by hypoxia and toxemia.
Degree of embed and economical efficiency: Obtained results concerning effective new substitutes suktsinasol and sukrsivil for VIS can be recommended for combined treatment of VIS in medicine new blood substitutes can restore hemodynamics, acid-alkaline balance, metabolism, reduce toxemia.
Sphere of usage: medicine.
Subject of the inquiry: diets for nutrition in the families and kindergardens, biological active addition to the food, animals, children.
Aim of the inquiry: elaboration of effective methods of rationalization of diet for nutrition of studying-educational institutions with usage of biological active additions for food.
Methods of inquiry: hygienic, medical- biological, toxicological, biochemical, chemical and statistical.
The results achieved and their novelty: According to the results of hygienic and toxicological explorations of biological active addition “ Biovit” was selected as the most successful, which made compensation of the deficit of vitamin C, A, B6, B12; folium acid, calcium, magnesium; irreplaceable aminoacids in daily diet of children, who attends kindergardens. It was estimated the increase of biological value of nutritional diet, increase of nitrogen’s balance, secretion of nitrogen, assimilation of the protein and improvement of biochemical index of nitrogenical components of the urine and sufficiency in vitamin C among children. The methodological approach was established to the basis of using biological active additions and estimation their effect in kindergardens.
Practical value: The results of research, which was appvouba by Sanitary rules and norms Republik of Uzbekistan, 2 methodical recommendations, method of avaluation of nutrition’s condition was elaborated and approved for practical health care according to research works;
Degree of embed and economic effectivity: the introduction on the Republic level has public cultural, general prophylactic, social and ecological hygienic role in the safety of the health of population.
Sphere of usage: in prophylactic medicine and hygienic practice, in study of medical Universities.