Endogenous Intoxication Syndrome Research Articles

Effects of flavonol quercetin on syndrome of endogenous intoxication in experimental periodontitis

The article presents the results of study effect of quercetin on the indicators of endogenous intoxication syndrome under conditions of experimental periodontitis. One of the key links in the pathogenesis of any inflammatory disease, including maxillofacial area, is endogenous intoxication, an important pathophysiological mechanism of which is the activation of lipid peroxidation. The experimental animals were treated by intramuscular injections with water-soluble quercetin for 7 days. For further research the blood serum was selected in which was determined the content of middle molecular weight molecules and erythrocyte intoxication index. Excessive lipoperoxidation was accompanied by accumulation of peroxidation products and depletion of antioxidant reserves, which led to accumulation of toxic substances. That is why the study of the level of middle molecular weight molecules and erythrocyte intoxication index in simulated bacterial-immune periodontitis is a reliable criterion. Quercetin was able to reduce the expression of endogenous intoxication syndrome in experimental bacterial-immune periodontitis.

ЗНАЧЕНИЕ СОДЕРЖАНИЯ ВЕЩЕСТВ НИЗКОЙ И СРЕДНЕЙ МОЛЕКУЛЯРНОЙ МАССЫ И ОЛИГОПЕПТИДОВ В ПАТОГЕНЕЗЕ ВЕТРЯНОЙ ОСПЫ

Endogenous intoxication syndrome is an important link in the pathogenesis of many infectious diseases. The role of low and medium molecular weight substances and oligopeptides acting as indicators of endogenous intoxication syndrome in the pathogenesis of varicella was studied, depending on the period of the disease, the severity of the course and the presence of complications. Based on this goal, 125 patients with varicella aged 18 to 49 years were examined. Determination of the content of substances of low and medium molecular weight in biological body fluids (blood plasma, red blood cells and urine) was carried out by the method of M. Ya.Malakhova (1995) on a spectrophotometer SF-46. The Lowru (1951) method was used to determine the level of oligopeptides in body fluids. The maximum level of substances of low and medium molecular weight was observed in patients with a complicated course of varicella during the height of the disease, as well as in patients with a severe course of the disease during the height. When determining the oligopeptides, the highest values were also obtained at the height of the disease in the severe course, as well as in the complicated course at admission. During the examination, the dependence of the studied indicators on the period of the disease, the severity, as well as the presence of complications was revealed. Thus, the most pronounced changes in the level of low and medium molecular weight substances and oligopeptides were observed in severe, and the least – in the mild course of varicella in all the studied media. In patients with developed complications, the disease was more severe, while the changes in the studied parameters were more pronounced.

Electrochemical detoxification in cancer patients after multiorgan surgery with severe endogenous intoxication

Background. Enteral insufficiency syndrome accompanies the development of many acute diseases of the abdominal cavity. According to the statistics, advanced and multi-organ surgical intervention in oncosurgery within the period from 2019 to 2020 resulted in enteral insufficiency being a complication in 39% of all cases, regardless of anatomical and physiological area, while complications in the form of endogenous intoxication syndrome made up 68% of cases.
 Purpose – studying the effectiveness of treatment of enteral insufficiency syndrome in cancer patients after multiorgan surgery with severe endogenous intoxication by means of indirect electrochemical detoxification with sodium hypochlorite solution.
 Materials and methods. The study involved 71 cancer patients who underwent multi-organ surgery on different anatomical and physiological areas. The patients were divided into 2 groups: treatment group (n=36) provided with indirect electrochemical detoxification by means of sodium hypochlorite solution at a concentration of 0.06%, comparison group (n=35) undergoing treatment according to standard schemes. The groups were comparable in age and anatomical and physiological areas that were operated on (surgery was performed on the chest and mediastinum as well as abdominal organs).
 Results. The method of electrochemical detoxification with sodium hypochlorite reducing the indicators that reflect blood toxicity and intoxication level was used for treating patients with enteral insufficiency. This was evidenced by decreased concentration of bilirubin by 23.1%, urea by 91.6%, creatinine by 99.4%, LII (leukocytal intoxication index) by 47.2% and procalcitonin by 68.2%. Being applied this method has made it possible to achieve a detoxifying effect early on day one.
 Conclusions. The findings of complete physical examination of cancer patients after multiorgan surgery with severe endogenous intoxication have shown a practical significance of sodium hypochlorite being included in comprehensive post-surgery treatment in enteral insufficiency syndrome cases. Infusions of 0.06% NaClO solution within 24 hours have been proved to provide a detoxifying effect: they significantly reduce elevated concentrations of bilirubin, creatinine, urea, LII and improve blood rheology.
 Administering sodium hypochlorite in the suppre-ssion of antioxidant defense mechanisms leads to the activation of oxidative processes.
 Including sodium hypochlorite in comprehensive post-surgery treatment in enteric insufficiency syndrome has shown a high efficiency.

Antioxidant status of the organisms of young bulls in the conditions of lead-cadmium load and effect of correcting factors

Prolonged ingress of heavy metals into the organisms of animals, even in low concentrations, causes a number of toxic impacts, affecting various organs and systems. The objective of this study was to research parameters of enzymatic and non-enzymatic links of the system of antioxidant protection of the organism of young cattle in the condition of lead-cadmium load and the effect of Metisevit Plus feed additive. Studies were conducted on the basis of the Private Agricultural Company “Ukraina”, located in Dubrovytsia district of Rivne Oblast, using 12 six-month old bulls of Ukrainian Black Pied Dairy breed divided into two groups, each consisting of 6 animals. Bulls of the control group received the standard diet. The bulls of the experimental group were fed with Metisevit Plus feed additive in the dose of 0.5 g/kg of feed. The contents of lead and cadmium in feed at the enterprise were determined to be high. According to the conducted studies, it was determined that in conditions of cadmium and lead load, there is a decrease in activity of glutathione link of the system of antioxidant protection of the organism of bulls. Feeding the bulls of the experimental group with Metisevit Plus feed additive for 30 days led to increase in the levels of non-enzymatic and enzymatic activities of the glutathione system. Significant increase in the level of reduced glutathione was recorded on days 30 and 40 of the experiment. Consumption of Metisevit Plus by the animals of the experimental group promoted increase in the activity of catalase and superoxide dismutase starting on the 20th day of the experiment. On days 30 and 40 of the experiment, the activity of the studied enzymes ranged within the physiological values. Therefore, the studies conducted on the bulls indicate that in the conditions of cadmium and lead load the feed additive Metisevit Plus fed to the bulls activated the system of antioxidant protection by increasing the levels of enzymatic and non-enzymatic links. When feeding bulls of the experimental group with Metisevit Plus feed additive, we determined significant decreases in diene conjugates and TBA-active products in their blood starting already on the 10th day of the experiment. On days 20 and 30 of the experiment, the level of diene conjugates in the blood of animals of the experimental group decreased by 14.5% and 24.0%. Efficiency of the feed additive may be explained by the effect of its constituents on the main pathogenic links of the pathological process caused by cadmium and lead. As indicated in the studies, liquidation of the syndrome of endogenous intoxication restores the functional condition of cellular membranes of the liver, protein-synthesizing function of the liver, increases the antioxidant status of the organisms of bulls. The studies we conducted confirm the expedience of using feed additive Metisevit Plus to prevent lead-cadmium toxicosis.

Endogenous intoxication syndrome in pyelonephritis and methods of its therapy with the use of nutrient support

Endogenous intoxication syndrome in pyelonephritis and methods of its therapy using nutritional support G.M. Letifov FSBEI HE «Rostov State Medical University Ministry of Health of Russia Rostov-on-Don Summary The aim of the study was to scientifically substantiate and determine the prospects for the use of nutritional support in the form of the use of dietary supplements containing a complex of natural dietary fibers, inulin (from artichoke), effective probiotics-short-chain fructooligosaccharides, maltodextrin 1.5 teaspoon 2 times a day. The course of treatment is 3 weeks. The appointment of a prebiotic complex, prevention of dysbiosis and restoration of the intestinal barrier function significantly reduced the risk of re-entry of opportunistic intestinal flora into the urinary system, thereby reducing the need for antibacterial prophylaxis of recurrent pyelonephritis.

Surgical strategy for suppurative complications of pancreatic necrosis

Improving the results of treatment of patients with infected pancreatic necrosis by applying a step by step surgical approach and comprehensive correction of endotoxicosis. The study was retrospectively prospective. All patients were divided into two clinical groups. The control group for the period from 2018 to 2019 included 31 patients for whom the standard surgical tactics of treating pancreatic necrosis were used: laparotomy, necrsecestrectomy and drainage of parapancreatic fluid accumulations, and, if necessary, repeated sanation. The main group included 26 patients, treated from 2019 to 2020. According to the developed step-by-step approach with the application of the correction of endogenous intoxication and enteral insufficiency syndrome. The choice of surgery for the patients of the main group depended on the type of parapancreatic fluid accumulation and included minimally invasive interventions in the first stage and, if necessary, the expansion of the amount of interventions (puncture and drainage under ultrasound control + video assisted retroperitoneal debridement, or ultrasound-controlled puncture and drainage + laparotomy). The effectiveness of the treatment in both groups was determined by changes in blood leukocyte and C-reactive protein values on the day of the operation, as well as on the 2nd, 4th, 6th day of the post-operative period. By the fourth day after the surgery, the main group patients' white blood cell and CRP blood levels were positively lower than in the control group: p=0.0001, t=9.65 and p=0.0001, t=9.02, respectively. Forty-eight hours after the operation, the dynamics of the EIS were determined. In the control group, where standard methods of treating enteral insufficiency were used, there was an increase in the number of patients with II and III degrees of severity, in comparison with patients of the main group (p<0.05). The number of complications of pancreonecrosis of IIIb and IVb of degrees on the Clavien-Dindo scale in patients of the major group was lower than in the control group: χ2=0.00021, p<0.05 and χ2=0.01553, p<0.05, respectively. 10 (32.3%) died in the control group, 2 (7.7%), χ2=0.04739, p<0.05. The choice of surgical intervention for pancreonecrosis should be determined taking into account the development phase of the disease, the type of location of the purulent-necrotic sinuses, and its delimitation from surrounding tissues. Phased surgical treatment with the initial application of minimally invasive technologies affects the number and severity of post-operative complications as well as the early start of correction of enteric insufficiency syndrome - the early relief of endogenous intoxication.

The role of endogenous intoxication in pathogenetic mechanisms of heat stress in cattle

The article presents the results of studies to identify the role of endogenous intoxication in the pathogenetic mechanisms of heat stress in cows in a comparative aspect between healthy animals and animals with hepatopathology. The obtained data indicate that in summer period in a farm located on the flat territory of the Krasnodar region the cattle are influenced by the heat stress. The relationship between the state of moderate heat stress in dairy cattle and the dynamics of a number of indicators characterizing the syndrome of endogenous intoxication of their body was revealed. The increase in the concentration of medium mass molecules (MMM) in healthy livestock was almost two times lower than in animals with fatty hepatosis. The obtained results can serve as a rationale for the development of an effective strategy for pharmacological correction of heat stress in cattle.

ENDOGENOUS INTOXICATION SYNDROME ACTIVITY IN BILIARY AUTONOMIC VISCERO-VISCERAL CARDIONEUROPATHY

Toxic excess of biologically active substances named middle molecules (MM), which include byproducts of normal and altered metabolism, products of inflammation and oxidation, bacterial remnants, antibodies and immunoactive substances, plays an important role in pathogenesis of gallbladder diseases and biliary autonomous viscero-visceral cardioneuropathy (BAVVCNP). In order to assess activity of the endogenous intoxication syndrome secondary to BAVVCNP, we examined 20 patients with coronary heart disease to determine the levels of MM in the blood (total and at 238, 254, 266, and 280 nm waves); the levels of MM in urine (at 238, 254, 266, 282, 288, and 310 nm waves) with calculation of aromaticity index (MM 238/280), peptide-nucleotide index (MM 238/266), distribution index (MM 280/254), and L-arginine, and nitrites of the urine. The results were statistically processed. It was revealed that in case of BAVVCNP the severity of the endogenous intoxication syndrome was higher for all specific parameters of endotoxicosis, and especially for the total level of MM in blood (0.77 ± 0.13 units vs. 0.46 ± 0.13 units, p = 0.08), the MM level at 238 nm wave (1.53 ± 0.55 vs. 0.49 ± 0.06, p = 0.08) and hydrophilic MM level in the urine at 288 nm long waves (0.72 ± 0.12 vs. 0.40 ± 0.11, p = 0.05) and 310 nm (0.27 ± 0.08 vs. 0.10 ± 0.03, p &lt;0.05). According to the literature, this may indicate an increase in levels of cholecystokinin, leptin, endothelin, proinflammatory interleukins and tumor necrosis factor α. According to the correlation analysis, activation of endogenous intoxication syndrome was associated with lipid distress syndrome, increased leptin content and accelerated renal filtration.

Dynamics of endogenous intoxication indicators in condition of acute blood loss complicated by ischemia-reperfusion of the limb, and their correction by carbacetam

Introduction. In the structure of injuries from gunshot wounds dominate the limb injuries that are often complicated by massive bleeding from the main vessels. The only means of rescue on the battlefield is a timely application of a tourniquet. This ensures complete exsanguination of the limb. The duration of exsanguination should not exceed 2 hours. It is proved that in conditions of acute blood loss complicated by ischemia-reperfusion of the limb, there are prerequisites for the development of dysfunction of internal organs, which in turn exacerbates dysmetabolic and functional disorders, stimulates endotoxicosis and may be complicated by multiple organ failure. However, the patterns of formation of the syndrome of endogenous intoxication in the conditions of ischemia-reperfusion of the limb, acute blood loss and their combinations have not been studied. There are no data on the effect of Carbacetam on these processes. It is known that Carbacetam has proven itself to reduce the manifestations of dysfunction of internal organs in the conditions of ischemic-reperfusion syndrome of the limb.The objective of research: To establish the dynamics of endogenous intoxication in the conditions of ischemia-reperfusion of the limb, acute blood loss and their combination. To evaluate the effectiveness of Carbacetam in the correction of identified abnormalities.Materials and methods. The experimental studies were conducted on 108 white nonlinear male rats weighing 200-220 g, which were housed in standard vivarium conditions. All animals were divided into five groups: control and four experimental. Under thiopental-sodium anesthesia in the first experimental group was simulated ischemia-reperfusion of the limb, in the second – acute blood loss, and in the third – these injuries were combined. In the fourth experimental group, animals with acute blood loss and ischemia-reperfusion of the limb were intraperitoneally administered Carbacetam at a dose of 5 mg per kilogram of animal weight. After 1 and 2 hours, as well as after 1, 7 and 14 days in the blood serum was determined the content of middle-mass molecules (MMM254, MMM280).The results and discussion. It was found that ischemia-reperfusion of the limb in comparison with the control group is accompanied by a significant increase of the MMM254 fraction in the blood serum content. From the first hour of the experiment with a maximum after 1 day and normalization of the index up to 14 days. The content in the blood serum of the MMM280 fraction became significantly higher, from the control only after 1 day with subsequent normalization in the following terms of the experiment. After simulation of acute blood loss, both studied fractions of MMM increased from 1 hour of the experiment, reached a maximum after 1 day and did not return to the control level after 14 days. For the first time it was found that two-hour ischemia-reperfusion of the limb significantly aggravates the course of acute blood loss, which revealed a significantly higher content in the serum of fractions MMM254 and MMM280 compared to other experimental groups in almost all periods of the experiment. Due to the use of Carbacetam, the content of both studied fractions of MMM in the serum compared with animals without correction was significantly reduced after 7 and 14 days of the experiment. Although the studied parameters did not return to the level of the Carbacetam control group, it can be considered a pathogenetically justified means of reducing the level of endotoxicosis in the conditions of ischemia-reperfusion of the limb and acute blood loss.Conclusions. Simulation of limb ischemia-reperfusion is accompanied by accumulation of MMM254-280 fractions with a maximum after 1 day of the experiment and normalization up to 14 days. Acute blood loss causes an increase in the serum content of fractions MMM254-280 from 1 hour of the experiment, which up to 14 days do not reach the level of control. The detected disorders are significantly exacerbated after a combination of acute blood loss and ischemia-reperfusion of the limb. The use of Carbacetam in comparison with animals without correction is accompanied by a significant decrease in the content of MMM254-280 fractions in the serum after 7 and 14 days of the experiment.

Specialized dietary food products in oncological practice

This review presents current data on the role of nutritional support in patients with cancer. The main reasons for the decrease in body weight, protein-energy deficiency in the development of malignant neoplasms are described. The data substantiating the appointment of dietary food products in various phases of the disease to patients receiving systemic anticancer therapy (chemotherapy, targeted therapy, immunotherapy) for a long time, and to cancer patients who underwent volumetric abdominal surgery are presented. The mechanisms of intoxication arising as a result of the disease itself, as well as a result of prolonged polychemoor irradiation therapy, are described in detail. The concept and mechanisms of endogenous intoxication syndrome are given. Special attention is paid to the role of the cytochrome system of the liver in detoxification processes. It has been shown that the accumulation of toxic metabolites in cancer disrupts the activity of the organs of detoxification and excretion, metabolites accumulate in tissues, which leads to difficulty in regulating the functions of the body and its protection from intoxication factors. The results of clinical studies of the data are presented and their effectiveness of the use of specialized dietary products of domestic production for cancer patients is presented. Detoxification protein cocktail for cancer patients (based on animal protein), Lactose-free detoxification protein cocktail for cancer patients (based on plant protein) and Drink detoxification for cancer patients (fruit-based). These specialized products have promote tonic, antioxidant, anti-inflammatory, analgesic, anti-toxic, detoxifying properties. It has been shown that dietary products contribute to the restoration of the concentration in the blood of the most important enzymes of antitoxic liver defense – ALT and AST, gamma-HT, total and direct bilirubin, and urea.

Extracorporeal detoxification techniques in septic complications in children at the acute stage of severe combined injury

Relevance. The given literature review analyzes current approaches to the extracorporeal detoxification (ECD) in ICU in patients with sepsis. In case of severe polytrauma in a child, anatomical and physiological features of his/her organism, marked severity and rapid progression of multiple organ failure as well problems in taking anamnesis put specialists into a challenging situation. A pathogenetically differentiated approach to the choice of extracorporeal detoxification technique in the complex treatment of sepsis – with respect to the syndrome of endogenous intoxication - will increase the effectiveness of therapeutic measures of intensive care in children at their acute stage after severe combined injuryObjective. To improve outcomes in children at the acute stage of severe combined injury by applying differentiated techniques for extracorporeal detoxification in septic complications .Material and methods. The most common techniques were analyzed: hemosorption, plasmapheresis, prolonged veno-venous hemofiltration and hemodiafiltration.Results. A large number of works have been published which confirm ECD effectiveness in adult patients with severe sepsis and septic shock. However, in the available literary sources, there are almost no information on the differentiated approach to various ECD techniques in children with severe combined injury who have traumatic endotoxicosis and multiple organ failure. Conclusion. Clinical trials and prospective researches on practical aspects of extracorporeal treatment in pediatrics are priority and compulsory because of the gained world experience of its application in patients with septic endotoxicosis. This impels towards further clinical researches in this direction.

Intoxication syndrome in the practice of internist

Background. Intoxication syndrome (IS) is one of the most common syndromes in the medical practice, but its exact scientific outline has not yet been established. This is due to a variety of toxic factors, a large polymorphism of symptoms, and complex interactions between the processes of toxin production and detoxification.&#x0D; Objective. To describe the main features of IS and its treatment.&#x0D; Materials and methods. Analysis of literature sources on this issue.&#x0D; Results and discussion. The morphological basis of IS is the subcellular interaction between the toxin and the receptor. IS develops if the toxins’ entry or formation outweigh their elimination. Intoxications are divided into exogenous and endogenous. The diagnostic criteria for exogenous intoxications are the contact of the patient with the substance that caused the intoxication and the corresponding damage to the organs. Exogenous intoxications have a clear clinical picture, and the introduction of specific antidotes or antitoxins is the best treatment. In turn, endogenous IS is mediated by the accumulation of bacterial endotoxins, excess amounts of physiological metabolic products, biologically active substances and mediators. Natural ways of detoxification include metabolism, excretion and immune mechanisms. Infusion detoxification (IDT) with a significant load by crystalloids and multicomponent drugs is a mandatory treatment for both exogenous and endogenous IP. In most cases, the volume of infusion should be 25-35 ml/kg body weight. Requirements for the ideal drug for detoxification include hypervolemia, improving microcirculation and rheological properties of blood, correction of electrolyte disorders and disorders of acid-base balance, increase of diuresis and peristalsis. All these effects are typical for Reosorbilact (“Yuria-Pharm”). In general, the IDT program may include classical and balanced crystalloids (800-1500 ml), Reosorbilact (600-800 ml), specialized solutions (100-200 ml), and symptomatic drugs. The optimal duration of treatment with Reosorbilact is 7 days.&#x0D; Conclusions. 1. Exact scientific characteristics of IS are still missing. 2. IDT is the mandatory method of treatment of exogenous and endogenous IS. 3. Reosorbilact is the main component of IDT in any IP, as it affects the main links of the pathogenesis of the latter.

Fluid resuscitation patients with burn sepsis

Objective. The purpose the of the study is to improve the fluid therapy regimens for burn sepsis patient.&#x0D; Materials and methods. The study is based on the observation 52 patients with burn sepsis aged 23 to 65 years, with a total body surface area more than 35 % at the Kyiv City Clinical Hospital № 2 during 2016-2019. Patients were divided into two groups: the main group – 30 patients were treated with crystalloids, plasma, albumin and Rheosorbilact (RSL); control group – 16 patients received treatment without using of RSL. Clinical and biochemical parameters of endogenous intoxication (tissue destruction products, medium weight molecules (MWM), concentrations of lipid oxidation products (LOP) – by diene conjugate content and oxidatively modified proteins (OMP) – by carbonyl groups) were studied.&#x0D; Results and discussion. Syndrome of endogenous intoxication was an increase in burn sepsis patients, which correlated with an increase in the number of LOP, OMP, MWM, namely an increase in the hydrophobic (most toxic) fraction of MWM, which is 2-3 times higher than in healthy, sick and both groups. MWM and hydrophobic fraction remained high during the observation period in patients of the comparison group. MWM decreased by 1.35 times in patients of the main group relative to the group of crystalloids. The level of carbonyl groups of serum OMP in patients of the comparison group was 50 % higher than in the main group. The indicators of LOP exceeded 1.45 times in the comparison group, which testified to the continuation of oxidative stress and the continuation of systemic inflammation. Acute respiratory distress syndrome (ARDS) was characterized by the appearance of bilateral infiltrates in the lungs, according to radiography. This common organ dysfunction was detected in 75 % of patients in the comparison group and in 63 % of patients in the RSL-group. The duration of mechanical ventilation in the main group decreased by 1,6 days.&#x0D; Conclusions. The use of Rheosorbylact for patients with burn sepsis at a dose of 15 ml/kg has led to a decrease in the manifestations of intoxication syndrome, reduction of MWM, LOP, OMP, clinical manifestations of systemic inflammatory response, septic complications by 1.3 times, septic shock from 16 to 12 %, and the incidence of ARDS from 75 to 63 %.

Оценка выраженности эндогенной интоксикации при болезни Альцгеймера

The development of neurodegenerative pathologies, among which the leading positions worldwide belong to Alzheimer's disease, is accompanied by the activation of free radical processes in the tissues of the brain and in the patient's body as a whole, which leads to the accumulation of products of oxidative modification of proteins, lipids, nucleic acids, and the formation of a syndrome of endogenous intoxication. An integral indicator reflecting the severity of this syndrome is the level of substances of low and medium molecular weight in various biological media. It is known that changes at the molecular level in Alzheimer's disease occur 5-10 years before the clinical manifestation of pathology. The development of polymodal panels for biochemical screening, diagnostics, monitoring of the course of pathology is underway. The aim of this study was to determine the severity of endogenous intoxication in patients with Alzheimer's disease and vascular dementia. The object of the study was the blood plasma of patients, as well as fractionated leukocytes - mononuclear and polymorphonuclear. The choice of biological material for the study is dictated by the need to search for a prognostic marker of the disease available for diagnosis, as well as by the accumulated theoretical material on various metabolic changes in peripheral blood cells in neurodegenerative diseases. According to the results of the study, it was found that in patients with Alzheimer's disease in mononuclear leukocytes of peripheral blood, the level of substances of low and medium molecular weight is higher than in patients with vascular dementia and patients without signs of neurodegeneration. In addition, in this fraction of leukocytes, the concentration of hypoxanthine, inosine, xanthosine and their derivatives is high, which may be a consequence of the oxidative modification of nucleic acids in the cells under study.

The influence of xylate on the volumo- and osmoregulatory function of the kidneys in diabetes complicated by the syndrome of endogenous intoxication of purulent-septic origin.

The combination of insulin-independent diabetes mellitus with endogenous purulent-septic genesis syndrome is a fairly common nosology. The search for ways to optimize the results of its treatment, after screening observations, led to the expediency to consider the pharmacodynamic aspects of the action of polyhydric alcohols through the prism of homeostatic support functions. Detailing this direction was focused on the consideration of the action of xylate mediated through the volumetric and osmoregulatory function of the kidneys. The effect of xylate on the volumo-and osmoregulatory function of the kidneys in insulin-independent diabetes mellitus complicated by the syndrome of endogenous intoxication of purulent-septic origin was investigated. The study group consisted of 53 patients with insulin-independent diabetes mellitus complicated by the syndrome of endogenous intoxication of purulent-septic origin (IDCSEI). Under the condition of infusion loading (3 ml/kg/h for three hours) with Ringer's solution or xylate within the fragments of planned intensive care, indicators characterizing the state of the volumo- and osmoregulatory function of the kidneys were investigated. The loading with Ringer's solution in patients with IDCSEI increases sodium clearance by 260±47.8% (Δ, p=0.020), without changing the concentration of sodium ions in the blood plasma and filtration fraction and purifying the blood plasma from osmotically active substances 147±46.9% ( Δ, p=0.011). Extension of the extracellular space by infusion solutions by 3 ml/kg/h for three hours in patients with insulin-dependent diabetes mellitus, complicated by the syndrome of endogenous intoxication by purulent-septic genesis, activates volumetric and osmoregulatory function. Extension of extracellular space with infusion solu­tion by 3 ml/kg/h for three hours in patients with insulin-independent diabetes mellitus activates volumo- and osmo­regulatory function. Activation of volumetric function occurs by reducing the reabsorption of sodium and water in the proximal nephron, without increase of glomerular filtration rate, increasing the distal transport of sodium and water.

КЛИНИКО-ЛАБОРАТОРНЫЕ ОСОБЕННОСТИ СИНДРОМА ЭНДОГЕННОЙ ИНТОКСИКАЦИИ У ДЕТЕЙ РАННЕГО ВОЗРАСТА С ПНЕВМОНИЕЙ

Objective: To study the clinical features of the course and the dynamics of some haematological indices in endogenous intoxication syndrome in children under 3 years of age suffering from pneumonia. Methods: There were 80 children under surveillance, of which 60 were pneumonia patients (main group), and 20 healthy children (control group). Laboratory survey included determining levels of leukocyte index of intoxication (LII), lactic and uric acids. The respiratory failure (RF) I is noted in 51.6%, RF II in 34.2% and RF III in 14.2% of cases. Results: Clinically and radiologically, 60.5% of children were diagnosed with bilateral processes in lungs, and in 39.5% the unilateral process. Signs of endogenous intoxication were: hyperhidrosis (59.4%), acrocyanosis (46.6%), perioral cyanosis (55.5%), mottled skin integument (49.2%), pronounced subcutaneous venous network (48.2%). The LII rate in the acute period had a strong tendency towards an increase of up to 5 days, with a gradual reduction to normal reference values by the end of the first week. It was found that high levels of lactic and uric acids were closely correlated with hypoxia. For example, in RF I, II and III levels of lactic acid were 1.3±0.1, 1.9±0.2 and 2.61±0.25 respectively. Children with RF III have degrees of lactic acid concentration that was statistically significant (p&lt;0.001) higher than in the control group. Conclusions: Lactic and uric acid levels depend on the degree of RF and can indicate the severity of endogenous intoxication syndrome. The reduction of LII indices below 3.0 by the end of the first week of the disease, maybe a sign of a favorable outcome. Keywords: Pneumonia, respiratory failure, endogenous intoxication, leukocyte index of intoxication, lactic acid, uric acid.

The marker level of endogenous intoxication in the midst of bronchopneumonia and during the convalescence of calves

The research on the level of markers of endogenous intoxication in the midst of bronchopneumonia and during convalescence in calves was conducted in conditions of a complex for feeding young cattle. The experiment involved calves aged 4–5 months, group 1 – clinically healthy (n = 30), group 2 – animals with bronchopneumonia with moderate severity of the disease (n = 72) subjected to full treatment. Blood sampling was carried out the day the groups were formed (in calves from group 2, this is the period of “high disease”), as well as on days corresponding to days 1, 3, 6, 10, 13, 18, and 25 after the disappearance of specific symptoms of bronchopneumonia. From the markers of endogenous intoxication syndrome in the blood, the content of medium-weight molecules (AWM), the sorption capacity of erythrocytes, non-erythrocyte hemoglobin by the hemoglobin cyanide method, and malondialdehyde were determined. Studies have shown that in 37.5 % of those who have suffered, intoxication markers disappear within 10–13 days after completing the course of treatment, and in 41.7 % of calves after positive dynamics, the AWM level increases at 10–13 days at a wavelength of 237 nm, which indicates activation of the resorptive mechanism of autointoxication and the risk of relapse. At the same time, the dynamics of recovery processes in 20.8 % of patients who were ill was characterized by normalization of most of the studied parameters, but by maintaining an increased level of lipid peroxidation products and transmembrane hemoglobin loss, which can cause secondary anemia and re-illness.

THE CONDITION OF VOLUMETRIC AND OSMOREGULATORY FUNCTION OF THE KIDNEYS IN TOXICEMIA OF PURULENT-SEPTIC GENESIS IN PATIENTS WITH DIABETES MELLITUS

The aim of the study is to investigate the state of volumetric and osmoregulatory function of the kidneys in diabetes complicated by the syndrome of the endogenous intoxication of purulent-septic genesis. Materials and methods: The study group was consisted of patients with insulin-dependent diabetes mellitus with complicated syndrome of the endogenous intoxication of purulent-septic genesis (CSDI). Results: The starting indices of volumetric and osmoregulatory function of the kidneys in patients with INCs complicated by the endogenous intoxication of purulent-septic genesis (CEI GHG) syndrome are characterized by the values of the inhibition of the volumorregulatory (by the clearance of sodium by 11%, p <0.05) and the activation of the osmoregulatory osmotically active substances by 23%, p <0.05) renal function. The volume increasing of the extracellular space by the Ringer solution activates the volumetric and osmoregulatory function of the kidneys, respectively, in patients with NSCL at 162 ± 27.1% (Δ, p <0.05) and 138 ± 48.3% (Δ, p <0.05), and at INCS complicated CEE GHS by 260 ± 47.8% (Δ, p <0.05) and 147 ± 46.9% (Δ, p <0.05). Conclusions: The low-level isotonic loads with Ringer's solution initiate the same direction of change in indices of volumetric and osmoregulatory function of the kidneys in patients with systemic inflammatory response syndrome and diabetes mellitus with complicated endogenous intoxication syndrome of purulent-septic genesis and show dissociative hyper reactivity of the volumorregulatory function in relation to the osmoregulatory one.

Endogenous Intoxication in Patients with Coronary Heart Disease on the Background of Different Gallbladder Condition

The endogenous intoxication syndrome (EIS) is one of the leading syndromes of many pathological processes. EIS is a result of the accumulation of harmful substances. This accumulation depends on formation and excretion of bile, and gallbladder (GB) condition, because intrahepatic and intraductal bile stasis, provoked by cholelithiasis, strictures and deformations of bile ducts, cellular and enzymatic dysfunctions, worsens the detoxifying function of bile system. Together with this, persistent inflammation increases the amount of proinflammatory mediators.The objective: was to estimate EIS activity according to hematological indexes in patients with coronary heart disease (CHD), namely, non-stable angina pectoris, with various GB condition.Material and methods. We analyzed the data of 116 patients, which were divided into groups according to GB condition: intact GB; sludge, cholesterosis and GB polyps; GB body deformations; GB neck deformations and cholecystitis in anamnesis; cholelithiasis; cholecystectomy in anamnesis. According to blood analysis, we counted the cellular indexes of EIS: index of neutrophils’ reactive answer, leucocytic index of intoxication in modification of B.A. Reys, hematologic index of intoxication, intoxication marker. Results were processed by variation statistics methods. Data were considered significant if р&lt;0,05.Results. Groups with different GB conditions were significantly different according to absolute levels of index of neutrophils’ reactive answer and both leucocytic indexes of intoxication. GB neck deformations, cholecystitis and cholelithiasis (both at the moment or in anamnesis) in patients with CHD were accompanied by activation of EIS. This tendency continued after cholecystectomy.Conclusion. Hematologic markers of intoxication directly correlated with biochemical parameters of inflammation, intoxication, lipid metabolism, and cytolysis. Increase of the former was associated with distension of mitral and aortic valves, and systolic dysfunction. In case of minimal EIS its markers did not correlate with inflammatory parameters. The biggest amount of correlations was revealed in case of present of past cholecystitis.

CORRECTION OF ANTIOXIDANT SYSTEM STATE IN PATIENTS WITH MICROBIAL ECZEMA

Antioxidant system dysfunction is a significant factor in the pathogenesis of inflammatory dermatosis. Despite an impressive number of studies on the causes and chronization of microbial eczema, the development of a comprehensive approach to therapy taking into account metabolic disorders remains a pressing task. Material and metods. In the course of this study, the effectiveness and expediency of including in microbial eczema therapy a preparation of antioxidant action of dimethyloxobutylphosphonyldimethylate (DFD) was evaluated based on the dynamics of antioxidant system dysfunction indices, markers of syndrome of endogenous intoxication and clinical manifestations. The material for the study was the blood of patients with microbial eczema taken before and after treatment. Dynamics of parameters of enzymatic and non-enzymatic units of antioxidant system dysfunction, level middle mass molecules were analyzed against the background of standard therapy and with inclusion of DFD. Results. Inhibition of antioxidant system dysfunction activity compared to the control group was detected in the blood of all microbial eczema patients prior to treatment. No antioxidant status was observed after the standard therapy course despite achieving clinical improvement. The inclusion of DFD in complex microbial eczema therapy had a positive effect on the state of antioxidant system dysfunction and the dynamics of the skin pathological process.