Endogenous Intoxication Syndrome Research Articles

MANIFESTATIONS OF ENDOGENOUS INTOXICATION SYNDROME DEPENDING ON ITS ACTIVITY ACCORDING THE LEVEL OF MEDIUM-MASS MOLECULES

Substances of endogenous intoxication syndrome (EIS), which belong to medium-mass molecules (MMM), have cardiovascular toxicity; their content is increased in conditions of chronic heart failure. However, the influence of EIS activity has been studied not enough, which determined the relevance and expediency of our study.Aim. In order to compare the laboratory-instrumental features of the course of metabolically associated liver steatosis (LS) under the conditions of pronounced and insignificant activity of EIS, 19 patients (10 men, 9 women; average age 61,8 years) with coronary artery disease (CAD), atherosclerotic cardiosclerosis, HF of I-II FC and sonographically diagnosed LS were examined. Depending on the level of MMM, patients were divided into two groups with pronounced EIS (MMM >0,6 units) and moderate activity (MMM <0,6 units), which were identical in gender and age composition, hemodynamic indicators, body mass index and area body surface. Photometric determination of MMM total and at wave lengths of 238, 254, 266, 282 nm in blood and urine was carried out; determination of blood L-arginine and urine nitrites, leptin were provided; aromaticity coefficient 238/282, hepato-steatosis index, AST/platelet ratio, nuclear intoxication index (NII), the ratio of lymphocytes and neutrophils to monocytes were calculated. All results were calculated statistically, the level of significance was taken as p<0.05.The results. Among the examined patients, 36.8% had high EIS activity (grades 2-3), and in 63.2% it was moderate (grade 1). Patients with pronounced EIS activity were characterized by hypoalbuminemia, dyslipidemia, low leptin content and higher arginine level, peripheral blood lymphopenia, and relative thinning of the heart walls. The content of MMM254,266,282 in blood was correlated with the size of the left ventricle in diastole, MMM266,282 in urine - with total cholesterol, low and very low density its particles and triglycerides, the aromaticity coefficient - with urinary nitrites. Integral hematological NII was directly proportional to diastolic pressure, and the lymphocyte/monocyte ratio - to systolic pressure. The ratio of neutrophils to monocytes and AST/platelets were correlated with the content of total bilirubin; and the hepato-steatosis index - with high-density lipoproteins and the coefficient of atherogenicity.Conclusion. Patients with concomitant metabolic-associated steatosis of the liver and a high level of EIS were characterized by metabolic disorders. Specific indicators of EIS correlated with parameters of lipid metabolism and hemodynamics.

Dishomeostatic phenomena in acute pancreatitis of variable severity

Acute pancreatitis remains one of the most dangerous pathologies in the structure of emergency abdominal surgery. This is due to many reasons, including an increase in the frequency of destructive forms of the disease, high mortality, and frequent unfavorable outcomes. The aim of this study was to investigate a number of leading components of homeostasis in patients with acute pancreatitis of varying severity. A retrospective study was conducted on 50 patients with acute pancreatitis of diff erent severity levels who were hospitalized at the Republican Clinical Hospital named after S.V. Katkovа (Saransk, Russia). The patients were divided into groups: the fi rst group (control, n = 30) consisted of patients with mild acute pancreatitis, and the second group (main, n = 20) consisted of patients with severe acute pancreatitis. The study evaluated the endogenous intoxication syndrome, the activity of lipid peroxidation and phospholipase systems, microcirculation status, liver function, and the activity of the coagulation-lytic blood system. The results showed that in the early stages of acute pancreatitis, several pathological processes were observed: the development of endotoxemia syndrome, activation of lipid peroxidation and phospholipase systems, microcirculation disorders, changes in the coagulation and fibrinolytic links of the hemostasis system, and liver function suppression. The severity of these disorders was associated with the severity of the pathology. In cases of mild severity, the changes in the parameters studied were reversible, while in severe cases they were stable and oftenirreversible. The presence of toxemia, oxidative stress, dysmicrocirculation, and hemostatic disorders should be considered as risk factors for disease progression and complications.

Endogenous intoxication syndrome in rats consuming drinking water with different phosphate contents

Abstract. Endogenous intoxication plays a significant role in the pathogenesis of many diseases. The erythrocyte intoxication index and molecular weight medium are informative indicators for its research. The goal is to establish the degree of expression of endogenous intoxication syndrome in white rats against the background of drinking water with different phosphate content for 30 days. Materials and methods. The study was conducted on 36 white purebred male rats weighing 180-200 g, divided into six groups, which for 30 days consumed: the control group – settled water from the city waterworks, the animals of five experimental groups - water with the addition of sodium monophosphate in doses of 100.0; 10.0; 1.0; 0.1; 0.01; mg/dm3 in terms of elemental phosphorus. The level of endogenous intoxication was estimated by the content of molecular weight medium in blood serum at wavelengths λ = 254 and 280 nm and the level of erythrocyte intoxication index, which was determined using the method of A. A. Togaibaev, et al., which is based on the ability of the erythrocyte membrane to absorb methylene blue. Results. It was established that the content of molecular weight medium 254 in the blood serum of experimental animals significantly increased in the 1st group by 65 % (p < 0.05), the content of molecular weight medium 280 in the 1st group by 154 % (p < 0.05), in the 2nd – by 138 % (p < 0.05) and the 3rd – by 64 % (p < 0.05). Consumption of drinking water with added phosphates leads to a significant increase of erythrocyte intoxication index in the 1st group – by 186 % (p < 0.05), in the 2nd – by 142 % (p < 0.05) compared to the control. Conclusions. Consumption of drinking water with different phosphate content for 30 days causes an increase in the level of endogenous intoxication in the body of experimental rats, as indicated by an increase in the permeability of erythrocyte membranes and an increase in the erythrocyte intoxication index and molecular weight medium content, most pronounced at a concentration of 100.0 mg/dm3.

Влияние гепатопротекторного фитокомплекса на выраженность эндогенной интоксикации у лабораторных крыс при экспериментальной патологии печени, вызванной гидразином

Abstract. The purpose is to study the influence of the hepatoprotective phytocomplex on the severity of endogenous intoxication in laboratory rats with experimental liver pathology caused by hydrazine. Methods. The studies were carried out on non-linear rats, formed into 3 groups (n = 10). Toxic damage to the liver in rats of groups 1 and 2 was modeled by a single intragastric administration of hydrazine at a dose of 200 mg/kg of body weight. Immediately after intoxication and for the next three weeks in 1st group, the drug fitosomin was used – daily orally in the form of boluses at a dose of 0.5 g/kg of body weight, 2nd group after intoxication received empty cereal boluses, 3rd group was intact. In dynamics, the degree of endogenous intoxication was studied by the concentration of medium mass molecules (MMM) in the blood of animals at λ = 254 and 280 nm. Scientific novelty. Experimentally new data on the pharmacological effects of the hepatoprotective phytocomplex was obtained, which includes lecithin, dihydroquercetin, extracts of milk thistle, agrimony and golden boletus. For the first time, the effectiveness of the drug fitosomin was determined to reduce the severity of the endogenous intoxication syndrome in laboratory rats with experimental liver pathology caused by hydrazine. Results. It has been determined that hydrazine-induced liver pathology in laboratory rats is accompanied by the development of endogenous intoxication syndrome with a more pronounced increase in the blood fraction of MMM 254 relative to MMM 280. The use of fitosomin leads to a weakening of the toxic effect of hydrazine both on the liver and on the body of animals as a whole. The course application of the hepatoprotective phytocomplex increases the survival rate of rats, improves their clinical condition and leads to a decrease in the concentration of MMM in the blood. The obtained results outlined the prospects for the use of the drug fitosomin in veterinary practice in case of liver damage, as well as intoxication of animals.

Risk factors for life-threatening ischemic events and death in patients with myocardial infarction

The development and implementation of effective measures of secondary prevention of recurrent ischemic events and post-hospital mortality in patients with myocardial infarction remains relevant. A total of 130 patients (89 men and 41 women) with myocardial infarction of type I were examined. At the in-patient stage of treatment, a set of laboratory data characterizing endogenous intoxication syndrome was subjected to clustering. As a result, four clusters were formed: polymarker-retentive, necrotic-inflammatory, hypoxic-inflammatory and a cluster with no endogenous intoxication syndrome. Recurrent heart attack, stroke, and mortality from cardiac causes constituted the combined end point. The probability of its occurrence within 1 year after myocardial infarction development was 18.6 %. We proposed a model for predicting the development of the combined endpoint, taking into account the type of endogenous intoxication syndrome.

Microbiological aspects of acute odontogenic osteomyelitis in children

Objective: to determine the species composition of pathogens of acute odontogenic inflammatory processes of the jaws in children, to determine the sensitivity and resistance of the isolated microflora to antibiotics of various groups, as well as to determine the dependence of the characteristics of the clinical course of the disease on the type of dominant pathogen. Material and methods. The analysis of the results of microbiological methods for the study of exudate from purulent odontogenic foci of 900 children, due to periostitis and osteomyelitis of the jaws, was carried out. Results. In 65.6% of cases, the causative agent was Pyogenic streptococcus or group A beta-hemolytic streptococcus (BHSA) ith a high level of sensitivity to vancomycin (99%), fluoroquinolones (98%), beta-lactams (91 %) and the highest percentage of resistance to macrolides (41%). Streptococcus viridans (6.1%), Streptococcus pneumoniae (4.3%) and others were also isolated; mixed microflora (14.3%). The syndrome of endogenous intoxication of the body was manifested in 56% of cases by fever, in 38% by leukocytosis, in 57.4% by accelerated ESR. There was no statistically significant difference in the degree of endogenous intoxication in groups with different types of streptococcus. Conclusions. The cause of the inflammatory process of the jaws in 65.6% of cases was BHSA with a high level of sensitivity to vancomycin (99%), fluoroquinolones (98%), beta-lactams (91 %).

Pathogenetic development patterns of respiratory and gastrointestinal pathologies in calves with proventriculus dysfunction history

An experiment was conducted in the conditions of an industrial complex specializing in the intensive fattening of young cattle, to study the development patterns of respiratory and gastrointestinal pathologies in calves with a history of previous proventriculus dysfunction. The object of the research were calves aged 120 days, which were divided into three groups: control, and two experimental groups - with a difference in using or the absence of phytosorbent. The diet included cereal hay and compound feed (CP 21.5%) according to the norms and regimen of feeding, for animals of this age. It appeared that for calves shortening of the adaptation period to the consumption of a large amount of compound feed had a negative impact on the rumen contractile function and the processes of digestion in it with the formation of a complex of symptoms of frothy tympany and rumen acidosis. After a course of appropriate treatment, the specific symptoms of these pathologies of the rumen disappeared, but the imbalance between the depression of symbiotic and activation of abdominal digestion remained, with the formation of a constant pre-threshold level of local autointoxication. The transfer of animals to the technological diet activated the processes of rumen metabolism and increased biochemical imbalance, which caused the progression of the endogenous intoxication syndrome and vegetative dystonia with a corresponding increase in the risk of developing respiratory and gastrointestinal pathologies. The use of a combined native premix based on the enterosorbent Rigatirin against the background of residual pathological phenomena after proventriculus dysfunctions reduced the level of toxic substances in the rumen, which excluded the generalization of autointoxication with an increase in the functional load on the digestive organs. As a result, the mechanism of pathogenetic integration (predisposition) formation in the body was leveled with a corresponding decrease in the incidence of the lungs, rumen and intestines. As a result, the mechanism of pathogenetic integration (predisposition) formation in the body was leveled, which caused a 6.7-fold decrease in the level of morbidity in animals and a 22.9 % increase in their growth.

Specific indicators of endogenous intoxication syndrome under the conditions of concomitant steatosis of the liver

The basic aspects of the endogenous intoxication syndrome (EIS) in the pathogenesis of many diseases are still poorly understood - an increase in the content of a wide variety of compounds, most of which belong to middle mass molecules (MMM) with a mass of 500-2000 D, the content of which under the conditions of metabolically associated steatosis of the liver (MASL) as the initial stage of the fatty disease has not been yet established.
 In order to determine the content of molecules of average mass of total and their fractions in the blood and urine in patients with MASL, 25 patients were examined (14 men, 11 women; average age 63,8 years) with coronary artery disease (CAD), atherosclerotic cardiosclerosis, heart failure of I-II FC and sonographically diagnosed fatty liver disease (19 with MACL and 6 with steatohepatitis (SH)), in which MMMs were additionally determined at 238, 254, 266 and 282 nm in blood and urine at 238, 254, 266, 280, 288, 310 nm; coefficients of aromaticity were calculated, peptide-nucleotide, distributive; de Ritis indices and hepato-steatosis, AST/platelet ratio. The results were calculated statistically. The level of significance is p<0,05.
 The results. In patients with chronic forms of coronary artery disease, under the conditions of concomitant MASL, the content of total MMM was significantly higher (0,63±0,06 vs 0,34±0,02; p<0,05), which correlated with the level of high-sensitivity C-reactive protein (r=0,86; p<0,05). It was accompanied by the elevation of MMM at all wavelengths in the blood (238, 254, 266, and 280 nm) and hydrophilic chain MMM238 in urine and was associated by significantly higher values of aromaticity coefficients (2,14±0,23 vs 1,60±0,05) and peptide-nucleotide (2,65±0,37 vs 1,38±0,05), all p<0,05. The group with concomitant MASL differed from patients with comorbid SH significantly only in the lower content of hydrophilic MMM238 in urine (1,92±0,18 vs 2,30±0,03; p<0,05).
 Conclusion. Metabolic-associated steatosis of the liver is accompanied by the activation of the endogenous intoxication syndrome with an increase of the content of MMM in the blood and urine, which occurs in parallel with the syndrome of systemic inflammation.

MORPHOLOGICAL CHANGES OF RATS’ CEREBRAL CORTEX UNDER CONDITIONS OF DMH-INDUCED EXPERIMENTAL CARCINOGENESIS

Abstract. The progression of the endogenous intoxication syndrome accompanies the development of any neoplasm. The infl uence of toxic products leads to signifi cant disruptions in homeostasis, which seriously aff ects the central nervous system, specifi cally the cortex of the large hemispheres. Therefore, the purpose of our study was to establish changes in the morphological reorganization of the cortex of the large hemispheres of rats with DMG-induced adenocarcinoma in situ. The study used 85 mature white male rats. All animals were divided into 2 groups: I – 35 intact animals and II – 50 animals with DMG-induced colon adenocarcinoma.Histological slides of the brain were prepared by the generally accepted methodology. The drugs were studied using a MICROmed SEO SCAN light microscope and photo- documented using a Vision CCD Camera. The histological organization of the cerebral cortex of intact animals had typical histoarchitectonics. In the fi rst three stages of the experiment, moderate changes in the morphological organization of the cortex were detected compared to the control group. The fourth stage of DMG-induced carcinogenesis modeling was characterized by the manifestation of morphological changes, a decrease in the number of normochromic, an increase in hypo- and hyperchromic neurocytes, and the appearance of cell alteration signs. Typical for this period also was the progression of hemodynamic disorders: venous hyperemia, stasis, aggregation of erythrocytes («sludge»), and an increase in perivascular and pericellular edema. At the 5th and 6th stages of the experiment, a violation of the cytoarchitectonics of the cortex was revealed. Destructive changes in neurocytes increased. Betz cells were in a state of tigrolysis, sometimes in total one. A decrease in the Nissl substance in neurons confi rmed their impaired functional capacity. Increased permeability of capillary walls led to severe pericellular edema of neurocytes. Intracellular edema was also detected in most neurocytes. The 7th stage of the induced carcinogenesis was characterized by the presence of severe destructive changes in neurons: an increase in the number of hypo-, hyperchromic, sharply hypo-, and sharply hyperchromic neurocytes, a fragmentation of neurocyte neuroplasm, most of Betz cells in a state of total tigrolysis, a decrease in the content of Nissl substance in them, up to its complete absence. Blood capillaries had a deformed wall and signifi cantly enlarged perivascular spaces. Consequently, the study established the development and dynamics of alterative changes in the neurocytes of the cerebral cortex caused by DMG-induced carcinogenesis. These disorders were characterized by alteration of neurocytes and progressive microcirculation disorders. All identifi ed morphological changes in the brains of aff ected animals prove their dependence on the duration of carcinogen exposure.

Pathogenetic mechanisms of mental disorders: endogenous intoxication

There is described the existence of the syndrome of endogenous intoxication in patients with mental disorders. Oxidative stress, middle-mass endotoxic molecules, disorders in functional properties of the blood albumin and the thiols of the albumin, disturbances in the state of the neurotrophic factors and in the activity of several enzymes, including monoamine oxidase and semicarbazide-sensitive amine oxidase, contribute to the development of the endogenous intoxication. We introduce the scheme of the possible pathogenetic mechanisms of the development of the endogenous intoxication and the ways of its overcoming.

Treatment of pets with the active substance dexpanthenol in wound processes

Animal skin is a complex organ that directly perceives the influence of the external environment and performs a barrier-protective function, helps maintain the balance of the internal environment of the body. Disruption of each of the levels of the protective system leads to the development of inflammatory skin diseases. Treatment of wounds remains one of the most pressing scientific and practical problems of modern veterinary medicine. A number of researchers are searching for and developing new veterinary drugs for the treatment of wounds of various etiologies in small pets, but the use of drugs often causes adverse skin reactions. The purpose of this study was to evaluate the effectiveness of using a veterinary drug (ointment) in the treatment of wounds in domestic animals (dogs, cats, rabbits). The paper uses standard clinical, haematological, and biochemical research methods. The studies used a drug with the active substance dexpanthenol and excipients decamethoxine, Vaseline oil, emulsifier, glycerin, methylparaben, propylparaben, and purified water. The drug under study effectively reduced the wound surface area at all observation periods. It is proved that when using dexpanthenol-based ointment (10%), a complete wound-healing effect was observed in experimental animals on the 14th day of treatment: the area of wound surfaces decreased by 93.1±1.51%. The examined indicators were statistically substantially different from those in the group of untreated animals with skin wounds. The general clinical condition of domestic animals was examined, haematological and biochemical studies of animal blood were conducted under the conditions of applying an experimental drug to damaged skin areas. In animals with skin damage without treatment, the dynamic development of an acute inflammatory process in the body, the development of endogenous intoxication syndrome, signs of wound infection, pronounced exudation and slowing of contraction were observed. The developed veterinary drug with the active substance dexpanthenol simultaneously shows a pronounced antiinflammatory and wound-healing effect and provides a rapid therapeutic effect in wound processes in small pets

ПРОГНОЗ НАСТУПЛЕНИЯ ЗНАЧИМЫХ ИШЕМИЧЕСКИХ СОБЫТИЙ И ЛЕТАЛЬНОГО ИСХОДА У БОЛЬНЫХ ИНФАРКТОМ МИОКАРДА НА ФОНЕ ХРОНИЧЕСКОЙ ОБСТРУКТИВНОЙ БОЛЕЗНИ ЛЕГКИХ

Introduction. Myocardial infarction remains significant due to its high prevalence and disability. Of particular importance is the prediction of the risk of adverse events in myocardial infarction patients with cardiorespiratory comorbidity, in particular with chronic obstructive pulmonary disease. It can be assumed that endogenous intoxication syndrome can be considered as a predictor of life-threatening events (repeated myocardial infarction, stroke) and lethal outcome in patients with myocardial infarction against chronic obstructive pulmonary disease. Aim. The aim is to determine the probability of combined endpoint development (repeated myocardial infarction, stroke, lethal outcome) in patients with myocardial infarction against chronic obstructive pulmonary disease during 12-month follow-up depending on gender-anamnestic and clinical-functional characteristics. Material and methods. We examined 325 patients with myocardial infarction - 195 patients with myocardial infarction against chronic obstructive pulmonary disease and 130 patients with myocardial infarction without chronic obstructive pulmonary disease (comparison group). As markers of endogenous intoxication syndrome, we studied middle weight molecules, hematological intoxication indices, blood gas indices, apoptosis, protein and lipid peroxidation and antioxidant protection, inflammation and renal function. Statistical data processing was performed using SPSS 26.0 software package. Results and discussion. Two-stage cluster analysis resulted in four clusters characterizing the type of endogenous intoxication syndrome: «polymarker-retentive», «necrotic- inflammatory», «hypoxic-inflammatory» and a cluster with no endogenous intoxication syndrome. The polymarker- retentive type of endogenous intoxication syndrome prevailed among patients with myocardial infarction against chronic obstructive pulmonary disease. Recurrent myocardial infarction, stroke and mortality constituted the combined endpoint. A decision tree was constructed to determine the probability of developing the combined endpoint in patients with myocardial infarction against the background of chronic obstructive pulmonary disease during the 12-month follow-up. It was found that the most significant predictors of combined endpoint occurrence are polymarker-retentive type of endogenous intoxication syndrome, the presence of acute infarction period complications and pronounced bronchoobstruction (degree 3-4). Conclusion. The constructed decision tree allows to stratify patients with high risk of repeated infarction, stroke and lethal outcome during the first year of follow-up after myocardial infarction against chronic obstructive pulmonary disease without increasing economic costs, which promotes optimization of treatment and secondary prevention in this category of patients.

Endogenous intoxication, oxidative stress and antioxidant system in acute lower limb ischemia

Aim. To study features of endogenous intoxication syndrome (EI), oxidative stress (LPO) and antioxidant defence (AOS) in patients with acute lower limb ischemia (LLI).Materials and methods. Some parameters of EI, LPO and AOS were studied. EI syndrome was studied in 86 patients with LLI who underwent complex examination and treatment in 2020-2021 in the Department of Vascular Surgery of the RNCfCS. POL and AOS parameters were studied in 14 patients out of 86. There were 51 (59.3%) men and 35 (40.7%) women, mean age was 56.0±5.8 years. Acute occlusion of the iliofemoral segments was noted in 33 (38.4%) patients, in 32 (37.2%) - the femoral segment, and in 21 (24.4%) - the popliteal and femoral vessels. In all cases, ischemia had a unilateral localization - on the right in 59 (68.6%) cases and on the left in 27 (31.4%) cases. In 52 (58.1%) cases, there were clinical signs of grade II b ischemia, and in 36 (41.9%) cases - grade III A (according to V.S. Saveliev, 1987). The average duration of ischemia was 77.9±28.3 hours.Results and discussion. In all cases of LLI before revascularization, there were signs of acute inflammatory reaction and EI syndrome in the form of increased ESR (42.3±7.1 mm/h), CRP concentration (16.1±4.2 mg/L), fibrinogen (8.5±0.9 g/L) and leukocytosis (12.7±1.5×109/L). Also, all patients had a slight elevation of blood glucose against the background of EI (7.5±1.8 mmol/L), a significant increase of creatinine concentration (128.9±6.1 µmol/L), urea (9.2±0.6 mmol/L) and aminotransferases as compared to normal indices. Results of LPO and AOS indices study in 14 patients showed that in LLI, malondialdehyde (MDA) increases 2.6-fold (3.9±0.1 μmol/L), diene conjugate increases 3.7-fold (0.77±0.04 units a/mL). However, after the elimination of ischemia, there was no significant decrease for 12.2±2.4 days, which confirms the presence of reperfusion syndrome. AOS indices - superoxide dismutase (20,8±1,0 u/l) and catalase (128,9±11,2 μl/l) increased 1,2 and 1,1 times in the examined patients cohort, respectively. Statistically significant associations were established between the following indices: Ischemia level and urea (r=0.89), Ischemia level and white blood cell count (r=-0.82), Hb and Er (r=0.99), Hb and creatinine (r=0.79), Hb and urea (r=0.79), Er and urea (r=0.79), creatinine and Er (r=0.90), ACTV and creatinine (r=-0.77), creatinine and urea (r=0.90).Conclusion. Acute lower limb ischemia is accompanied by ischemia-reperfusion damage manifested by endogenous intoxication syndrome, impaired glucose metabolism and activation of lipoperoxidation processes and antioxidant system. After the elimination of acute ischemia, there is not always a significant decrease in lipid peroxidation and some inflammation parameters. Therefore, prolonged use of antioxidants in the reperfusion period is recommended.

New approaches to laboratory diagnosis of liver condition in cattle

Relevance . Today the scientific community all around the world is showing significant interest to the study of endogenous intoxication syndrome in the body. The article presents the results of assessing the level of endogenous intoxication in diseases of the liver of cattle by the concentration of molecules of medium mass in the blood serum. Methods . Two groups of cows were formed, 50 animals each: 1 — healthy livestock; 2 — with liver pathology. The state of the liver in cows was assessed by the clinical status, the boundaries of the liver and its sensitivity, biochemical blood tests and ultrasound diagnostics of the hepatobiliary system. The level of endogenous intoxication in cows was studied using two MMM fractions at wavelengths = 254 nm (MMM 254) and = 280 nm (MMM 280). Results . The highest values of markers of endotoxicosis in the blood were observed in cows with hepatitis. Thus, a significant difference in MMM 254 (toxic fraction) with healthy animals in this subgroup was 1.8 times, changes in the MMM 280 fraction (fraction containing aromatic amino acids) were less pronounced — there wasan increase of 25.4%. The level of MMM 280 in the blood of cows with hepatosis did not significantly change in relation to the data of healthy livestock, at the trend level, an increase of 10.1% was observed. The level of MMM 254 at the same time significantly increased by 1.5 times. The calculation of IR 280/254 in cows with hepatopathology revealed a decrease in the index with maximum changes in animals with hepatitis; relative to healthy livestock, there was a difference of 30.4% (hepatitis) and 25.3% (hepatosis).

CHARACTERISTICS OF CYTOPROTECTIVE EFFECT ON THE GASTRIC MUCOSA OF CRYOPRESERVED PLACENTA EXTRACT UNDER WATER-IMMOBILIZATION STRESS

Various stressors are currently considered to play a significant role among the etiological factors for development of peptic ulcer disease. Along with psycho-emotional stressing experiences, the causes of formation of stress ulcers include major surgical interventions, thermal or mechanical injuries, severe blood loss, progressive syndrome of endogenous intoxication and more. Among patients in intensive care units, the incidence of stress ulcers is 5.0%, and in 30.0-50.0% of cases stress ulcers are complicated by bleeding and perforation.
 Aim. The research aims at characterizing the gastrocytoprotective effect of cryopreserved placenta extract (CEP) on the model of water-immobilization stress in rats according to macroscopic data and the results of biochemical study of homogenates of the gastric mucosa (GM).
 Materials and Methods. In vivo experimental studies were performed on 28 nonlinear laboratory male rats weighing 200-220 g. Stress-induced gastric ulcer was simulated under water-immobilization stress (WIS) in rats. WIS simulation according to the method of Takagi K.Y. et al. The activity of NO synthases (NOS) in GM was determined spectrophotometrically by the amount of oxidized NADPH+H+.
 Results and Discussion. The use of CEP, as well as esomeprazole, led to a weakening of GM ulcers. This was indicated by a statistically significant (p<0.05) decrease in ulcer index (UI) relative to the indicators of control rats by 9.8 and 3.3 times, respectively. At the same time, this indicator was three times lower on the background of preventive use of CEP than in rats treated with esomeprazole, respectively, antiulcer activity (AUA) was 96.4% and 69.2%. The study of the activity of constitutive (cNOS) and inducible (iNOS) isoforms of NOS showed that at the pathobiochemical level against the background of stress-induced ulcerogenesis in the tissues of the central nervous system there is a statistically significant (p<0.001) increase in iNOS activity in 5.2 times was 0.89±0.01 NADPH2/min´g protein. According to the degree of modulation of the activity of both total NOS and its individual isoforms, the study showed that preventive five-day administration of esomeprazole is inferior to the effectiveness of CEP. Thus, the activity of total NOS in rats administered esomeprazole was statistically significantly (p<0.001) decreased by only 17.1%, while the activity of this enzyme decreased (p<0.001) by 35.8% due to the use of CEP.
 Conclusions. Prophylactic five-day administration of CEP modulated the activity of the NOS system in the central nervous system, which in a macroscopic study appeared statistically significant (p<0.05) reduction in UI relative to rats in the control group by 9.8 times. Thus, NOS activity statistically significantly (p<0.001) decreased by 35.8%, and iNOS activity statistically significantly (p<0.001) decreased by 58.4% relative to the control animals. CEP under the prophylactic regimen showed more pronounced anti-ulcer activity than esomeprazole, which was 96.4% and 69.2%, respectively.

Efficiency of Complex Correction of Endotoxicosis in Chronic Pancreatitis During Renewal Treatment

Clinical manifestations and features of endogenous intoxication syndrome (EIS) in severe and critical conditions are described in the literature. EIS is one of the defining typical clinical and pathogenetic syndromes of the formation and severity of chronic pancreatitis (CP). The objective: to analyze the EIS parameters by CP in patients outside of exacerbation and their impact on the quality of patient’s life and the dynamics under the influence of the proposed treatment programs with the inclusion of ginkgo biloba drugs and bioregulatory therapy. Materials and methods. 100 patients with diagnosis of CP who had outpatient treatment took part in the study. The age of the patients ranged from 25 to 73 years old, the average age was 51.0±1.1 years. EIS was determined based on the concentration of medium molecular weight peptides with maximum absorption at the wavelength 254 nm and 280 nm and circulating immune complexes. Patients’ quality of life was assessed using the SF-36 questionnaire. The patients were divided into three 3 groups. The persons in the 1st group (n=34) received generally accepted treatment (GAT) in accordance with the clinical diagnosis and the protocol proposed by the Ministry of Health of Ukraine (Order No. 638 of 09/10/2014), the patients in the 2nd group (n=33) received GAT together with a course of ginkgo biloba (memoplant), the individuals in the 3rd group (n=33) received the GAT with a course of memoplant and bioregulatory therapy (BRT). Results. In the examined patients with CP a decrease in all indicators of the quality of life according to the SF-36 was found, the parameters of the role (33.7±3.4) and emotional (37.0±3.9) functioning scales decreased mostly, the average value of physical health was 51,1±7.2, psychological one – 45.1±3.9. An increase in EIS indicators was determined, which were reliably correlated with indicators of quality of life. In the patients who received GAT and ginkgo biloba the more significant dynamics of EIS regression were established at the levels of the studied indicators, however, their normalization to the control level was observed only in the 3rd group of patients who received an additional course of BRT (p<0.001). Conclusions. The results of the study determined a negative impact of EIS on parameters of quality of life according to the SF-36 in patients with CP, which justifies the necessity for the correction. A more severe EIS according to the levels of the studied indicators was found among people with excessive and reduced body weight (p<0.05), which indicates a more severe course of the inflammatory process. According to the dynamics of EIS the indicators in patients with CP it is possible to claim a higher efficiency of therapy with additional prescription to the generally accepted treatment of ginkgo biloba and a course of bioregulatory therapy.

ОСОБЕННОСТИ ЭКСПРЕССИИ ФАКТОРОВ ПРОЛИФЕРАЦИИТИРОЦИТОВ ПРИ ХРОНИЧЕСКОЙ ЭНДОГЕННОЙ ИНТОКСИКАЦИИ

Currently, thyroid diseases are one of the key problems of modern endocrinology, where the restoration of the thyroid parenchyma after exposure to negative factors and the direction of proliferative processes remain relevant. We conducted a study of the material obtained from deceased individuals as part of a standard pathoanatomical study, followed by animmunohistochemical staining of the expression of nonspecific markers of proliferative activity.It was found that the proliferative activity of thyrocytes increases from the upper to the lower part of the thyroid lobe. Also, in a comparative analysis of the central and peripheral zones, it was found that in normal conditions, the source of neoplasm of thyrocytes is located in the central zone, while when the tissue is involved in the pathological process, an increase in the expression of Ki-67 and PHH3 occursin the peripheral zone.The mitotic activity of cells can lead to the development of thyropathy and disruption of thyroid homeostasis,which serves as the basis for screening the thyroid gland in patients with chronic endogenous intoxication syndrome.

Фармакоекономічний аналіз інфузійної терапії N-хлортаурином в лікуванні пацієнтів з перитонітом

Peritonitis is the main cause of death in patients with acute surgical diseases of the abdominal cavity. The average mortality rate from disseminated forms is currently 30%. In complications of multiple organ failure and infectious-toxic shock, as well as in postoperative peritonitis in elderly patients, the lethality rate can reach 40%–70%. Thus, this disease is one of the most pressing medical, biological and economic problems of our time. The purpose of the study was to perform pharmacoeconomic analysis of peritonitis treatment by medical technology using N-chlorotaurine in comparison with infusion detoxifying solutions. Materials and methods. The source of data on the effectiveness of N-chlorotaurine is the results of the clinical effectiveness of the use of N-chlorotaurine in patients with peritonitis. As part of the study, there was a pharmacoeconomic evaluation of the use of the infusion solution of N-chlorotaurine (52 patients) in comparison with the use of Ringer's solutions (50 patients) and Rheopolyglucin solution (45 patients). Results and discussion. Costs were calculated based on Peritonitis Treatment Guidelines. The cost of a course of infusion therapy using N-chlorotaurine, Ringer's solution, and Rheopolyglucin was added to the standard therapy specified in this regulatory document. The daily composition of complex infusion therapy included 1000 ml of sodium hypochlorite solution or 1000 ml of glucose solution, as well as a daily dose of comparative infusion detoxifiers, namely, Ringer's solution and Rheopolyglucin, in the proven volume of total infusion therapy up to 4000 ml. Thus, treatment efficacy in patients treated with the drug was 94.2%, which is statistically significantly higher than the corresponding indicator in the control group – 52.0%, and confirms the hypothesis about the predominant efficiency of therapy in the main group of subjects compared to the control group. Taking into account the treatment regimens used in the study and the cost of drugs, we calculated the cost of each at the inpatient phase, taking into account the equivalent course dose and taking into account the data on the equivalent course dose. So, the amount of costs is 93,834 UAH for N-chlorotaurine, 110,650 UAH for Ringer, and 98,252 UAH for Rheopolyglucin. The economic component of the calculations showed that according to the "cost-effectiveness" methodology, the results of the efficiency and cost and effectiveness analyses performed earlier showed the advantages of using N-chlorotaurine in patients with acute peritonitis in the complex treatment. Conclusion. The above data indicate the relevance of the development and clinical and economic substantiation of the use of a fixed combination of a low-concentration solution of sodium hypochlorite with N-chlorotaurine in the treatment of peritonitis with endogenous intoxication syndrome

The effect of L-arginine and L-carnitine preparations on the dynamics of indicators of endogenous intoxication and systemic capillary leakage in patients with a complicated course of diabetes

ABSTRACT. In order to study the effect of drugs containing L-arginine and L-carnitine on the indicators of endogenous intoxication and systemic capillary leakage in patients with complicated diabetes mellitus, 30 patients with diabetic ketoacidosis, representative by age, sex, comorbidity were examined. Among the patients were 13 men and 17 women, with a mean age of 52.36±2.87 years. It is shown that the use of the drug Tivorel in the treatment of such patients reduces the severity of systemic capillary leakage syndrome and manifestations of endogenous intoxication.

Assessment of endogenous intoxication based on the study of medium and low molecular weight substances in patients with myocardial infarction against a background of chronic obstructive pulmonary disease

Introduction. Frequent comorbidity of chronic obstructive pulmonary disease and myocardial infarction is due to the commonality of a number of etiopathogenetic links and the development of endogenous intoxication syndrome. The convincing markers of endogenous intoxication syndrome are medium and low molecular weight molecules including medium and low molecular weight substances and oligopeptides.Aim. To study the levels of medium and low molecular weight substances in patients with myocardial infarction against the background of chronic obstructive pulmonary disease.Materials and methods. 225 patients with myocardial infarction were examined. In 195 patients the infarction developed against the background of COPD, in 130 patients – without COPD. The comparison group consisted of 110 somatically healthy individuals. Substances of medium and low molecular weight (MLMWS) and oligopeptides (OP) were determined by direct spectrometry (according to M.Y. Malakhova, 1995) in plasma, erythrocytes and urine. Endogenous intoxication indices and intoxication coefficient were calculated on the basis of these indices. Statistical processing of the data was performed using SPSS 26.0 software package.Results. In blood plasma and erythrocytes, the levels of average molecules in both studied groups were statistically significantly higher compared to controls. The highest levels were detected in comorbid patients. In the group of patients with myocardial infarction without chronic obstructive pulmonary disease 60% of the examined patients had phase I endogenous intoxication. Phase III intoxication prevailed among comorbid patients with myocardial infarction against chronic obstructive pulmonary disease – 62,6%.Conclusions. Molecules of average mass have proven to be informative indices of endogenous intoxication syndrome in patients with myocardial infarction accompanied by chronic obstructive pulmonary disease. This opens the prospect of using these indices in the development of assessment scales and the creation of prognostic algorithms in patients with cardiorespiratory comorbidity.