Urgent Problem Of Modern Medicine Research Articles

Substitutional urethroplasty with tissue-engineered structures in an experiment

Introduction. In order to exclude the difficulties arising in the course of traditional surgical interventions in the scope of substitutional urethroplasty, in recent years, alternative materials have been developed using tissue engineering. This study is devoted to the development of new tissue-engineered constructions for urethroplasty using cells of different tissue origins and biopolymers, which is an urgent problem of modern medicine.
 Aim. Experimental provision of a rationale for the possibility of using tissue-engineered constructions to replace urethral defects.
 Methods and materials. Two-staged, experimental, controlled study. Dedicated to the development of tissue-engineered constructions (TEC) based on biopolymers seeded with mesenchymal stem cells or buccal epithelial cells. The prepared TECs were implanted into the rabbits urethra wall in a acute trauma model. Comparison of the results of the TECs usage with the gold standard buccal urethraplasty was carried out.
 Results. Urethrography showed similar results in all groups of animals, regardless the type of implanted material. No urethral patency was found, and confocal microscopy of urethral cryosections revealed the presence of nanoparticle-labeled mesenchymal stem cells / buccal epithelium cells with signs of their differentiation in the urothelial direction in the mucous layer.
 Conclusion. The possibility of using tissue-engineered constructions based on biopolymers containing autologous mesenchymal stem cells or buccal epithelium cells for experimental substitutional urethroplasty was shown. The developed TECs can be used as an alternative to buccal urethroplasty in an experiment.

Morphofunctional features of the cardiovascular system in extreme specialists of the navy (depending on the polymorphism of the genes of the matrix metalloprotheinase 1 (MMP-1) and collagen 1 (COL1A1)

Background. Diving experience and the influence of factors of professional activity lead to the development of cardiovascular pathology and the study of the state of the cardiovascular system of divers is one of the urgent problems of modern medicine. Objective. The aim of the study was to determine hereditarily structural and functional features of the cardiovascular system representatives of extreme professions of the Navy and differentiate them from the influence of some factors. Design and methods. Surveyed 81 military personnel at the age of 21-44 years. The surveyed were represented by three groups, which did not differ significantly in age. In the first group (n = 31) included the deep-sea divers, the second group (n = 28) was introduced by the technical operators of deep-sea vehicles and third (n = 22) group consisted of officers of the Navy, which were not factors of diving work and the specific factors of deep-sea resources. Used regulated and special methods for the study of the cardiovascular system, which was estimated depending on the polymorphic gene variants of matrix metalloproteinase 1 (MMP-1) gene and collagen type 1 (COL1A1) gene. Results. Statistically significant differences in the distribution of polymorphic variants of the MMP-1 and COL1A1 genes from the specialists of the Navy of the surveyed groups, the distribution of genotypes and analysis in the future was conducted on the combined group. Fifteen groups of indicators (clusters) were identified that change unidirectionally depending on the polymorphic variants of the MMP-1 gene and the COL1A1 gene. Identified favorable and unfavorable combination of polymorphic gene variants of the gene MMP-1 and the gene COL1A1. Conclusion. The resistive characteristics of the cardiovascular system respond to the conditions of professional activity, including those of specialists in extreme specialties of the Navy. Basic resiliently-elastic properties of the cardiovascular system are associated with polymorphic variants of the MMP-1 and COL1A1 genes involved in the synthesis and degradation of collagen; however, to determine the specific role of each under the influence of extreme occupational factors, larger studies are required.

Insomnia and cognitive behavioral therapy for chronic back pain

To manage patients with chronic back pain (CBP) is one of the urgent problems of modern medicine, as CBP is associated with high disability, considerable socioeconomic costs, and low quality of life. Concurrent disorders, such as insomnia, depression, and anxiety, which make a significant contribution to the severity of CBP and related disability, are frequently disregarded when managing patients with CBP. Insomnia is observed in the majority of patients with CBP, but it is relatively rarely diagnosed, therefore the bulk of patients do not receive appropriate treatment. Cognitive behavioral therapy (CBT) combined with therapeutic exercises is one of the most effective treatments in patients with CBP; moreover, of great importance is the identification of concomitant insomnia, whose treatment with CBT is able not only to improve sleep, but also to reduce pain and to increase the physical and social activities of patients. A positive combination treatment effect is achieved due to a change in the patients’ ideas about the prognosis and causes of the disease, as well as to the increased intensity of physical activity and to the prevention of strenuous exercise and static stresses.

Neurorehabilitation in cognitive disorders in patients with neurosurgical brain pathology

Background.Neurosurgical pathology of the brain is an urgent problem of modern medicine. Existing models of cognitive rehabilitation are based on neuropsychological correction. The literature does not contain enough information about the effect of medical and physiotherapeutic techniques on higher nervous activity.Objective.To assess the effect of neurorehabilitation in cognitive impairment in patients with neurosurgical brain pathology.Design and methods.The dynamics of cognitive impairment was studied in 165 neurosurgical patients (72 men, 93 women, average age 52.82 ± 14.79 years) at the second stage of rehabilitation. The severity of the deficit of higher cortical functions was assessed upon admission and after 30 days in the rehabilitation department. Roschina test, MMSE, FAB, HDRS were used to detect depression.Results.When analyzing the dynamics of indicators for scoring higher cortical functions, it was found that in all groups of patients, cognitive rehabilitation led to positive results.Conclusion. The combined use of neuropsychological, medical and physiotherapeutic techniques can significantly improve the results of rehabilitation treatment.

Stomach wall changes after gastroplication in patients with morbid obesity

Morbid obesity is a distinct disorder which leads to metabolic disorders and to the development of many severe chronic diseases, therefore, the effective treatment of the disorder is an urgent problem of modern medicine. Currently, morbid obesity and the corresponding disorders are a growing problem associated with a significant risk of morbidity and mortality. The study was aimed to assess the morphological and functional changes in the stomach wall after gastroplication performed by the new method worked out in the Clinic of the Department of Surgical Diseases and New Technologies of the Bashkir State Medical University. Gastroplication was performed in 15 male rabbits of the Gray Giant breed aged 12–16 months weighting 3050–5380 g. The animals were withdrawn from the experiment 3, 6 and 12 months after surgery, followed by histological examination of the stomach wall plicated section. Changes in the mucous membrane and the muscle layer of the stomach wall after gastroplication were adaptive and associated with no severe morphological impairment. That made it possible to use the method in clinical practice in 15 patients with morbid obesity, 9 women and 6 men aged 42 ± 2.1. In most patients (13 people, 86.7%), a steady decrease in the body weight was achieved during the first 2–12 months. Long-term treatment results had been tracked during two years. It has been confirmed, that the new laparoscopic gastroplication technique does not lead to pathological changes in the stomach wall plicated section, therefore, the simple and cost-effective method may be used in clinical practice for treatment of patients with morbid obesity.

Selection of excipients for the purpose of creating an intranasal gel of interleukin-1 receptor antagonist β (IL-1ra)

There is a negative dynamic of the spread of cerebrovascular diseases, which often lead to disability or death in patients in the world, today. Such diseases are characterized by acute disorders of cerebral metabolism and blood circulation, against the background of other chronic pathologies. More than one hundred thousand cases of stroke are registered in Ukraine every year, with more than thirty percent of patients dying within the first month of the disease according to the Center for Medical Statistics of the Ministry of Health of Ukraine. The nasal route of administration is a promising method of transporting active substances for systemic action, various pharmacotherapeutic groups, both small and large molecules. The created nasal preparations of hormones, antibiotics, analgesics, exhibit a quick therapeutic effect due to the branched capillary system in the nasal cavity. In addition, the nasal route of administration is the most promising non-invasive method for delivering active substances to the brain for cerebroprotective drugs, due to the anatomical features of the location of the nerves. According to published data, the researchers found that the receptor antagonist of interleukin-1 (IL-1ra) exhibits neuroprotective properties in brain ischemia by blocking excess IL-1 and activating the anti-inflammatory cytokine cascade, in order to reduce local inflammation and neuronal loss. Therefore, in order to expand the range of pharmacotherapeutic drugs – neuroprotectors, the development of a new intranasal form with the active pharmaceutical ingredient - receptor antagonist interleukin-1 (IL-1ra) is an urgent problem of modern medicine and pharmacy. The aim of work was to substantiate the choice of excipients for the new intranasal gel of the receptor antagonist of interleukin-1 (IL-1ra). Materials and methods. The studies were carried out according to the plan of two-way analysis of variance with repeated observations. Factors that were investigated: factor A (type of polymer) – A1 – chitosan 3 %, A2 – sodium carboxymethyl cellulose 0.3 %, A3 – sodium hyaluronate 0.7 %, A4 – sodium alginate 0.5 %; factor B (type of alcohol): B1 – without alcohol, B2 – sorbitol, B3 – glycerin, B4 – D-panthenol. A prefabricated solution of the receptor antagonist of interleukin-1 (IL-1ra) was used as an active substance. A portion of the active substance was taken considering the calculations, to ensure a concentration of 0.5 % IL-1ra in each composition. The release of the active pharmaceutical ingredient was determined by equilibrium dialysis according to Kruvchinsky at 37.0 ± 0.5 °C through a semi-permeable membrane – “Cuprofan” for all compositions. Dialysis was performed in Franz cells at a nine-position station (PermeGear, Inc., USA). The concentration of IL-1ra, after 30 minutes, was determined by UV spectrophotometry at a wavelength of 280 nm on a UV-2600 spectrophotometer (Shimadzu Corporation, Japan). Results. We studied the effect of pharmaceutical factors (polymers and alcohols) on the intensity of the release of IL-1ra from the nasal form to justify the choice of excipients for the nasal gel of the receptor antagonist interleukin-1 β. The results of the analysis of variance of pharmaceutical factors (polymers and alcohols) showed that hydrophilic polymers and humectants had a significant effect on the release of the active substance from the experimental compositions. It is advisable to use a mucoadhesive polymer – sodium salt of carboxymethylcellulose, as well as alcohol-moisturizer D-panthenol for the new nasal form of IL-1ra, as excipients. Conclusions . Excipients were selected for a liquid intranasal gel with the receptor antagonist interleukin-1 (IL-1ra). It was found that the type of mucoadhesive polymers and alcohols, to moisten the mucous membrane, had a significant effect on the release of the active pharmaceutical ingredient from nasal dosage forms. As a result of research, it was found that the optimal release of IL-1ra from nasal compositions was provided by excipients - hydrophilic mucoadhesive component - sodium carboxymethylcellulose with the addition of humectant alcohol – D-panthenol.

Reflection of modern concepts of therapy in the treatment of allergic diseases of the nose and paranasal sinuses

The article highlights the urgent problem of modern medicine - allergic diseases. Over the past decades, there has been a significant increase in the prevalence of this pathology, the share of which in the general structure of the incidence of the population remains high to this day. The statistics are staggering. According to various sources, various manifestations of allergies affect from 10% to 40% of the world’s population. According to conservative estimates, more than 500 million people in the world. According to epidemiological studies, the amount of atopy is growing by 5-6% every year. The disease has a huge impact on the quality of life of the patient. Needless to say, an allergic disease can be accompanied by complications, including life-threatening. The big financial burden on the budget of our country is the economic costs of combating allergies and its complications. Therefore, the treatment of this nasology is one of the key issues both in the global and in Russian healthcare.Intranasal (topical) corticosteroids (IKS) are the drug of choice in the treatment of patients diagnosed with allergic rhinitis (AR). However, ICS are widely used in clinical practice and in the treatment of other diseases of the nose and paranasal sinuses. Depending on the nature of the pathological process, the duration of the drug can vary widely: from two weeks to several months or years. The purpose of this work is to systematize relevant publications and analyze possible uses for this group of drugs. The article reflects the issues of epidemiology, etiopathogenesis of allergic rhinitis. Consistently considered modern methods of treatment, in particular the use of (ICS) in therapy regimens. The results of international multicenter randomized controlled clinical trials are presented, the purpose of which was to determine and evaluate the efficacy and tolerability of ICS, in particular fluticasone propionate. It is concluded that fluticasone propionate is a modern and effective agent for the pathogenetic treatment of patients with not only allergic but also non-allergic rhinitis and can be recommended in the modern treatment regimen for both allergic and non-allergic rhinitis.

The role of matrix metalloproteinase-9 in the genesis of chronic bronchi inflammation in children with bronchial asthma

Bronchial asthma as the most common respiratory tract disease is an urgent problem of modern medicine. Matrix metalloproteinases (MMР) play a significant role in the processes of inflammation maintaining and bronchi remodeling in children with bronchial asthma.Objective:To study the role and inheritance of MMR9 in the bronchial asthma pathogenesis in children.Characteristics of children and research methods.The authors carried out the prospective study of 54 children with bronchial asthma and 56 healthy children with the determination of the MMP-9 level in blood serum, as well as the polymorphic variant 8202A>G ofMMP9gene.Results.Children with bronchial asthma had significantly higher content of MMP9 in the blood serum (431.76 [306.15; 612.93] ng/ml), as compared to the control group (276.05 [160.33; 397.02] ng/ml). When studying polymorphism 8202A>G ofMMP9gene in the examined patients it was found that the children with bronchial asthma had the G allele a little more often (57.5%) than A allele (42.5%). Heterozygous carriers of the MMP9 gene polymorphic variant predominate both among the patients with bronchial asthma and in the control group. When comparing the frequency of genotypes and alleles in the group of children with bronchial asthma and control group the authors revealed no statistically significant differences.Conclusion.The disease mechanism significantly depends upon the MMR9 concentration in the serum of patients with bronchial asthma and the peculiarities of this enzyme inheritance.

SURGICAL TREATMENT OF NECROTIZING INFECTION OF THE SOFT TISSUES OF THE NECK

Summary. Early diagnosis and timely surgical treatment of necrotizing soft tissue infection of the neck is an urgent problem of modern medicine, far from a definitive solution.
 The purpose of the work is to optimize the surgical treatment of patients with necrotizing infection of the soft tissues of the neck.
 Materials and methods. The results of surgical interventions of 76 patients with odontogenic phlegmon of the neck that were treated at the surgical ward were analyzed.
 Results and discussion. The essential condition for successful treatment of phlegmon neck is immediate surgery. Indications for surgery in the mediastinum should be considered in the total involvement in the necrotic process of the deep and superficial cell spaces of the neck. Preventive antibiotic therapy in patients after surgery on the neck helps to reduce the incidence of postoperative inflammatory complications and improve the quality of life of patients.
 Conclusions. Mortality in acute purulent odontogenic mediastinitis depends on timely hospitalization, diagnosis and early surgical treatment using extracorporeal detoxification methods.

Comparative Experimental Biomodelling of NSAID-induced Enterocolitis

Use of non-steroidal anti-inflammatory drugs (NSAIDs) is considered to be a factor in the development of gastrointestinal tract (GIT) diseases. Thus, enterocolitis is a frequent complication of NSAIDs. Experimental modelling of GIT diseases in laboratory animals, which describes the origin and mechanism of the corresponding disease in humans with maximal precision, is an urgent problem of modern medicine. This paper presents the results of comparative experimental biomodelling of NSAID-induced enterocolitis in laboratory rats. It was found that the intragastric administration of acetylsalicylic acid resulted mainly in stomach damage. The introduction of dexketoprofen — both orally and intramuscularly — causes erosive and ulcerative lesions of the stomach and intestines. The type of damage showed no correlation with the type of administration. For the first time, the results of enterocolitis biomodelling using dexketoprofen are presented.

Современные подходы к курации больных с ожирением

Obesity and its concomitant diseases preserve to be an urgent problem of modern medicine, as they are widespread worldwide and lead to negative medical, social and economic consequences that damage both patients and the state. The article presents statistical data reflecting the situation of obesity in Russia, describes the risk factors of obesity, highlights modern methods to follow-up of patients with obesity (e.g., correction of lifestyle and nutrition with the calorie control, change in physical activity, the use of pharmacological drugs and conducting various types of bariatric interventions). It is noted that the key factors that prevent the obesity development and control the body weight are rational nutrition (taking into account individual health problem), compliance with the principles of moderation, diversity, and dietary intake. Besides, it may be useful to practice wellness techniques (e.g., callanetics), which help to reduce and normalize body weight and develop concentration and stress tolerance. Special attention is paid to the obesity effect on the course of COVID-19 infection, which causes higher susceptibility and the development of severe complications. KEYWORDS: obesity, overweight, risk factor, rational nutrition, diet, physical activity. FOR CITATION: Akhmedov V.A., Gudim A.S. Modern methods to follow-up of obese patient. Russian Medical Inquiry. 2020;4(5):308–313. DOI: 10.32364/2587-6821-2020-4-5-308-313.

Theoretical Aspects of Spinal Osteochondrosis Patient Psychological Characteristic Study

Spinal osteochondrosis is an urgent problem of modern medicine, sociology, psychology, and a number of other disciplines. The interdisciplinary status of degenerative-dystrophic diseases of the spine is indicated by the fact that they are a manifestation of both a number of somatic and neurological diseases. Every year the number of patients with this pathology rapidly grows. According to studies, they affect up to 90-97% of the adult population and represent an economic burden, since rehabilitation treatment of patients involves significant financial costs. The article provides a theoretical analysis of existing studies related to the study of the influence of individual psychological characteristics of patients with spinal osteochondrosis.

REGULARITIES OF THE ANATOMICAL VARIABILITY OF THE SHAPE OF THE THYROID GLAND

According to the literature, the study of the typical anatomy of the thyroid gland is an urgent problem of modern medicine. Performing surgical interventions on the thyroid gland, as a rule, is associated with significant technical difficulties due to the exceptional variability of the organs form. Objective of this research was studying the patterns of anatomical variability of the shape of the thyroid gland in individuals with various forms of the neck and body type. Work is performed with using autopsy material of 120 bodies (67 men and 52 women) long lived in the territory of the Rostov region and died of the diseases which are not connected with pathology of organs of a neck. In the course of work, the sizes of the right and left thyroid lobes and the size of the isthmus were determined. For identification of a shape of a thyroid gland used Y.V. Maleevs recommendations (2016). The shape of a neck was defined according to coefficient of proportionality of width of a neck of T.P. Tikhonova and E.V. Zakhvatova (2006), the constitutional type of the person by means of a technique of L. Rees - H.J. Eisenck (1945). The checked measurements allowed to differentiate a form of a butterfly (50,5%), a form of letter «Н» (18,3%), boat shaped (20,1%) and semilunar (11,1%) forms. Significant differences in the morphometric parameters of various forms of the thyroid gland were established (р<0,05). The correlations between the shape of the thyroid gland and the shape of the neck (r=0.51), between the shape of the thyroid gland and the somatic type of a person (r=0.63) were determined. In the course of work are formulated as patterns of anatomical variability of the shape of thyroid gland: The thyroid gland in the form of a butterfly is characteristic of normostenic (58,7%) and astenic (36,5%) types from normal (35,5%) and thin (53,2%) shapes of a neck; thyroid gland in the form of letter «Н» - for persons pyknic (54,5%) and normostenic (27,3%) types with a wide shape of a neck (45,5%); thyroid glands boat shaped and semilunar forms - for persons of pyknic type (85,5% and 90,9% respectively) with a wide shape of a neck (69,6% and 72,7% respectively).

Gram-negative hospital pathogens at risk of severe bacterial infection

Background. Nosocomial infections remain an urgent problem of modern medicine. Along with bacterial infection of the bloodstream a special danger is posed by ventilation-dependent lung infection (VDLI), the main source which are still at the intensive care unit (ICU).Objectives. Assessment of the spread of bacterial infections in ICU over a five-year period. Analysis of the severity of postoperative complications depending on the infection location.Methods. A retrospective analysis of the frequency and form of blood flow and ventilation-dependent lung infection in patients, operated under cardiopulmonary bypass in the years 2013–2017.Results. The rate of blood contamination in the departments ranged from 8.0 to 9.8 %; against the ICU — from 17 to 24 % (p &lt; 0,01). Gram-negative associated mortality was significantly higher than gram-positive (p &lt; 0.001). Acinetobacter spp. and Klebsiella spp. are the most common agents. Analysis of the primary detection of the pathogen showed that in 73.6 % of cases, the trachea is the area of the initial localization of combined-form infection.Conclusions. The risk of bacterial complications in the early postoperative period is associated with gram-negative pathogen s (Acinetobacter spp. and Klebsiella spp.). Constant bacteriological monitoring in ICU is an effective prognostic tool of blood flow and ventilation-dependent lung infection.

Genetic predictors of chronic heart failure in obese patients

BACKGROUND: the study of molecular genetic markers and pathogenetic mechanisms of neurohormonal activation, as well as their importance in the formation of heart failure in obesity, is an urgent problem of modern medicine, the solution of which will allow effective prevention of cardiovascular complications, optimize treatment and improve the prognosis of obese patients.&#x0D; AIMS: search for genetic markers presumably involved in the pathogenesis of secondary diastolic heart failure in patients with obesity.&#x0D; MATERIALS AND METHODS: PCR-diagnostics of whole blood of 104 patients with obesity was carried out, which were divided into 2 groups, depending on the presence of diastolic heart failure. The following candidate genes were analyzed: angiotensinogen AGT gene (C521T and T704C), angiotensin II receptor gene of the first type AGTR1 (A1166C), angiotensin II receptor gene of the second type AGTR2 (G1675A), aldosterone synthase gene CYP11B2 (C (-344) T).&#x0D; RESULTS: It is shown that the development of secondary diastolic heart failure in obese individuals of both sexes is associated with the mutation of the aldosterone synthase gene CYP11B2, namely, with the replacement of the C allele at the -344 position by the T allele and the presence of the T / T genotype. The relative risk of developing the disease with the T / T genotype was 5.93 times higher in men (p = 0.008) and 4.57 times in women (p = 0.014). For men, the mutation of the angiotensinogen AGT gene, namely the replacement of the allele C at position 521 by the T allele, is important. At the same time, the relative risk of development of SDS in the T / T genotype is increased by 4.26 times (p = 0.039). Mutations of the genes of the angiotensin II receptor of the first type AGTR1 (A1166C) and the angiotensin II receptor of the second type AGTR2 (G1675A) are not associated with the development of diastolic heart failure in obese patients.&#x0D; CONCLUSIONS: The data presented can be used to stratify the risk of secondary heart failure in obese individuals.

Calliphoridae Flies in Medical Biotechnology

Blow flies (Diptera, Calliphoridae) and their medical applications have attracted the attention of biologists and doctors for more than a century. The best known is the use of “surgical maggots” in the treatment of infected wounds and ulcers. Another promising direction is the use of Calliphoridae as producers of pharmacologically active substances. Compounds with antiviral and antitumor activity isolated from blow fly maggots have found application in the treatment of viral infections. The maggot enzymes and antimicrobial peptides are another group of drug candidates that have received much attention. This review summarizes information on Calliphoridae as a source of new drugs and the prospects for their use in solving the urgent problems of modern medicine, such as the growing antibiotic resistance of pathogens, the treatment of viral infections and cancerous diseases.

The study of the pharmacological action of the dry extract from Prunus domestica fruits on the model of comorbid functional constipation in the combined alcoholic liver damage in rats

The search for the most effective hepatoprotective agents is an urgent problem of modern medicine. As a rule, crude plant is promising object for the study of medicinal properties. Based on the literature data, we are interested in the horticultural crops Prunus domestica , the family Rosaceae , which is quite cultivated and attracts attention to its pharmacoeconomic component. The purpose of the study. In previous experimental studies, the Prunus domestica extract, containing fibers, was found to have laxative, hepatoprojector and probiotic effects. The foregoing provided an opportunity to study the Prunus domestica extract, containing fibers for activity in the comorbidization of several relevant pathologies and to experimentally substantiate the prospect of its application as a means of choice for constipation in patients with pathologies of the digestive system. Materials and methods. The object of research was a dry extract from Prunus domestica fruits, containing fibers. The experiment was carried out in stages. At the first stage, the animals caused experimental subacute alcoholic liver damage. In the second stage of the experiment, the animals were modeled with functional constipation. During the course of subacute hepatosis and during the second phase of the experiment, the test extract was injected into the animal at a dose of 200 mg/kg and the reference drug was hepatoprotector Silybor at a dose of 25 mg/kg. In the second phase of the study, the laxative agent Senadexin at a dose of 14 mg/kg was added to the therapy. All substances were injected into the body of the experimental animals orally. To evaluate the motor activity of the intestine, Sagar et al, modified by Choi et al., was used. Motor activity of the small intestine was determined according to the corresponding calculation formula. The functional state of the liver was evaluated according to the biochemical parameters in the blood serum: the total protein, urea and ALT activity. Results. An analysis of experimental data showed that the test extract exhibits a moderate laxative effect. In animals of the intact group, the relevant signs (pronounced laxative effect) indicate the development of diarrhea, which is not an adequate solution to the development of constipation. With the use of the extract from Prunus domestica fruits during the whole period of the experiment, normalization of all indicators that characterize the intestinal motility was observed. Analysis of experimental data showed that the investigated phytoobject has a soft laxative effect, mainly through the improvement of intestinal motility. In the study of the functional state of the liver on the introduction of the investigated extract, positive changes in the content of markers of liver damage (decrease in urea concentration and decrease in the activity of ALT in animal serum) were detected in comparison with the control group of animals. Conclusions. The obtained experimental data on the study of the correlation mechanisms of hepatoprotective and laxative activity of the extract from Prunus domestica fruits containing fibers indicate that there is a soft laxative effect that is realized with the help of intensifying intestinal motility, as well as the presence of pronounced hepatoprotective action. The indicated effects of the investigated extract were revealed when used in the treatment of constipation on experimental subacute liver damage, while not losing out to the studied effects in the complex application of hepatoprotective and laxative comparisons. The key conclusion is that the test extract, as opposed to the reference drug, does not cause signs of diarrhea in its laxative effect, which can be a distinctive, positive feature in further clinical studies. This herbal object can be promising and rational in application with single-stage complex therapy, such as hepatoprotective and laxative agent in the treatment of comorbid conditions in gastroenterology associated with diseases of the liver and congestive intestinal phenomena.

Pharmacological correction of endothelial dysfunction using ademethionin and taurine

Introduction: Рharmacological correction of endothelial dysfunction is a urgent problem of modern medicine.&#x0D; Materials and methods: Endothelial dysfunction was simulated in male rats using the e-NOS inhibitor L-NAME (25 mg/kg/day intraperitoneally, for 7 days). Simulation of ADMA-like preeclampsia was performed by intraperitoneal injection of L-NAME to females in the same doses for 7 days (14-20th days of pregnancy). These pathologies were corrected by administering ademethionine in dose 150 mg/kg and taurine at a dose of 260 mg/kg, as well as their com­bination at the same doses, intragastrically, through an atraumatic probe, once a day.&#x0D; Results: In the group with use of taurine at a dose of 260 mg/kg the coefficient of endothelial dysfunction decreased to the level of intact animals. Use of ademethionine at a dose of 150 mg/kg and taurine at a dose of 260 mg/kg combined resulted in the most pronounced endothelioprotective effect on the ADMA-like preeclampsia model. The coefficient of endothelial dysfunction decreased more than when using monotherapy of these drugs. Morphological studies of myo­cardiocytes showed that the combination of ademethionine at a dose of 150 mg/kg and taurine at a dose of 260 mg/kg prevented an increase in the cross-section of cardiomyocytes.&#x0D; Discussion: Possibly, ademethionine and taurine have an endothelioprotective effect because of their ability to decrease hyperhomocysteinemia.&#x0D; Conclusion: The investigated drugs showed pronounced endothelioprotective activity and can be recommended for further pre-clinical studies.

MINOR CARDIAC ABNORMALITIES IN CHILDREN OF KHARKIV: PECULIARITIES OF STRUCTURE AND DISTRIBUTION

Cardiovascular pathology is one of the urgent problems of modern medicine, including children. The peculiarity of most cardiovascular diseases in children lies in their prolonged formation, tendency to chronic course, less apparent clinical manifestations in the first stages of the disease. Objective. In childhood, large-scale clinical epidemiological studies have not yet become widespread. But the available statistics allows analyzing trends and patterns that reflect the features of cardiovascular pathology in childhood, its role in health of the child population, which was the objective of this paper. Materials and methods. The analysis of medical and statistical documents of 1825 children aged 0–18 years followed up for cardiomyopathies of dysplastic genesis (DGC) in healthcare facilities of Kharkiv. The indications for following up were clinical symptoms and cardiac ultrasound findings during outpatient or inpatient examination in the absence of organic cardiovascular diseases. Results. Most often, clinical manifestation and, accordingly, diagnosis were observed from 4 to 11 years. Most minor cardiac abnormalities persist over the lifetime, and clinical significance may increase with age, contributing to the development of pathology or becoming a risk factor for cardiac pathology. Conclusions. The structure of minor cardiac abnormalities among the children of the dispensary group is heterogeneous: prolapse of the mitral valve (mostly isolated), abnormal chords of the left ventricle and open foramen ovale are most frequently recorded; prolapse of other valves and aneurysms of the atrial septum are very rare. Primary diagnosis of minor cardiac abnormalities mainly takes place at age 4 to 11 years. Summarizing the findings, it can be noted that minor cardiac abnormalities have a relatively high detection rate and constitute a large and heterogeneous dispensary monitoring group.

The influence of metabolic syndrome on the development and clinical manifestations of benign prostatic hyperplasia

Benign prostatic hyperplasia (BPH) — one of the most common urological diseases that lead to the development of symptoms of the lower urinary tract (SLUT). BPH-multifactorial disease, in which a significant role is given to increase the activity of the enzyme 5a-reductase and hormonal imbalance associated with the exchange of testosterone and dihydrotestosterone. However, to date, not all aspects of the etiology and pathogenesis of this condition have been studied. The results of numerous studies indicate a significant role of complex metabolic disorders included in the modern concept of "metabolic syndrome" (MS), the development and progression of BPH/SLUT. The main pathogenetic factors leading to the formation of BPH and concomitant urination disorders are considered to be a violation of the balance of sex hormones, the development of chronic ischemia of the pelvic organs, a violation of carbohydrate and lipid metabolism. The relationship between BPH and MS is one of the most urgent problems of modern medicine. Different components of MS independently from each other can influence more pronounced progression of BPH/SLUT in comparison with development of this disease in men without metabolic disorders that is the reason of lower efficiency of surgical and medical treatment of this group of patients.