Urgent Problem Of Modern Medicine Research Articles

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.
 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.
 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.
 Discussion: Possibly, ademethionine and taurine have an endothelioprotective effect because of their ability to decrease hyperhomocysteinemia.
 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.

Evaluation of pharmacological correction of L-name-induced endothelial dysfunction, platelet aggregation and venous tone with diosmin Detralex 1000 mg

Introduction. Chronic venous diseases are one of the urgent problems of modern medicine. Recent studies have shown high significance of endothelial dysfunction (ED) and oxidative stress in their pathogenesis. For the correction of the occurring changes, drugs of the flavonoid group, particularly diosmin and hesperidin, are currently used. Numerous studies have confirmed a vast range of biological effects of diosmin; however, there are only sporadic data on its endothelium protective effects.
 Materials and methods. The study was performed in 70 white mature male rats of Wistar line, weighing 180-220 g. ED simulation was performed using non-selective blocker of NO-synthase N-nitro-L-arginine methyl ester (L-NAME). Functional vascular tests and biochemical markers were used to determine a degree of correction of functional disorders. An anti-inflammatory effect of Detralex 1000 mg was estimated in 10 mature albino rabbits weighing 2800 - 3200 g by using o-xylene. The study of the venotonic property of the drug was carried out in the experiment in an isolated segment of the rats’ portal vein with Ca2+ solutions at a concentration of 0.08-1.75 mcM. The histologic specimens were prepared in accordance with the generally accepted methods.
 Results and discussion. The administration of the test drug did not lead to a statistically significant decrease in blood pressure in the conditions of L-NAME-induced ED. However, there was a dose-dependent statistically significant decrease in the coefficient of ED (CED), which indicates a positive endothelium protective effect. Course administration of Detralex 1000 mg leads to a significant dose-dependent correction of platelet aggregation disorders, which is manifested in the extended aggregation time. The results of studying an anti-inflammatory activity of the drug showed a decrease in the size of spots caused by the application of o-xylene, and the extention of the time interval before their onset. Studying a Ca2+-mediated smooth muscle response showed that the vein contractile force reaches its maximum at a higher dosage of the drug with a lower concentration of Ca2+. In the morphological study of the stomach wall, small and large intestine of the intact rats and rats receiving a course of Detralex 1000 mg, there were no inflammatory changes in the mucosa of the comparison group.
 Conclusions. The study found that Detralex 1000 mg significantly reduces the ED coefficient and slows platelet aggregation against the background of L-NAME-induced ED; the efficacy is dose-dependent. Detralex 1000 mg dose-dependently reduces vascular permeability disorders caused by the application of o-xylene. The test drug has a Ca2+-mediated mechanism of increasing the contractile activity of the venous wall. It was found that the course administration of the drug per os has no local irritative effect.

THE MEDIC-STATISTICAL CHARACTERISTIC INCIDENCE OF PNEUMONIA IN THE UDMURT REPUBLIC

The Community-acquired Pneumonia (CAP) is an urgent problem of modern medicine owing to its high prevalence, gravity of a current, the increasing resistance of a microflora to antibacterial therapy, a large number of complications and a high lethality. Udmurt republic is one of leaders among the regions of Russian Federation on morbidity by diseases of the respiratory system, include CAP. It is therefore necessary to take analysis and prognosis incidence for the future improving quality administer. Research objective. The analysis of incidence and mortality from diseases of respiratory organs in the Udmurt Republic for 2009-2016. Materials and methods. The retrospective and prospection clinical-epidemiological research of prevalence and primary incidence of diseases of respiratory organs among the adult population of the Udmurt Republic living in 4 cities is conducted (Izhevsk, Sarapul, Glazov, Votkinsk) and 25 rural areas for the 8-summer period (2009-2016). The analysis is carried out on the basis of data of the state statistical registration and reporting documentation of Budgetary institution of health care of the Udmurt Republic «Republican medical information and analysis center of the Ministry of Health of the Udmurt Republic». Results of a research. The prevalence of diseases of respiratory organs in the Udmurt Republic was 49871,39±1,33 on 100 thousand population. The average growth rate was 2,3%, and the average rate o f a gain was — 0,25%. In comparison with data for the same period to the Russian Federation, average growth rate the average rate of a gain — 5,48% was 1,7%, and that demonstrates some decrease in incidence. In the analysis of structure of incidence of diseases of respiratory organs of the population of the Udmurt Republic it is established that she throughout the entire period of observation significantly hasn’t changed. At the same time annually, leading places are taken by pneumonia and the chronic obstructive pulmonary disease (COPD). Estimating the level of primary incidence of diseases of respiratory organs, it is noted that on UR the average growth rate is 105,42%, the average rate of a gain of 5,42%, in comparison across the Russian Federation average growth rate of 87,07%, and the average rate of a gain — 12,93%. Conclusion. Thus, to UR, as well as in general across the Russian Federation steadily high incidence of pneumonia is noted. At the same time the tendency to increase in incidence and this pathology mortality is noted. This circumstance demands further studying of a problem of pneumonia, including improvement of methods of medical correction.

INFLAMMATION ROLE IN FORMATION OF EARLY DISTURBANCES OF A FUNCTIONAL CONDITION OF A LIVER AT COMMUNITY — ACQUIRED PNEUMONIA (LITERATURE REVIEW)

The Community-acquired Pneumonia (CAP) is an urgent problem of modern medicine due to its high incidence, morbidity, the increasing resistance of a microflora to antibacterial therapy, a large number of complications and a high lethality. Now in a pathogenesis of pneumonia the leading value belongs to various changes of metabolism, including an induction of peroxide oxidation of lipids and formation of an oxidizing stress. The importance is attached to violations of a functional condition of a liver at pneumonia which pathogenetic mechanisms of damage are diverse, including with participation of a vascular endothelium. At the same time in realization of therapeutic approaches on a normalization of metabolism of cages of an organism the priority part is assigned to oxidation substrata. It is shown that the succinatecontaining medicines realize various pharmacological effects, providing in general cytoprotective action that allows to consider them as perspective the compositions having hepatoprotective activity which are necessary in complex therapy of the community-acquired Pneumonia (CAP).

The Effect of Laser Irradiation on Reparative Osteogenesis

Introduction: The use of non-medicinal facilities for correcting processes in various pathological conditions is one of the most urgent problems of modern medicine. Purpose of the Work: To study the effect of low-intensity infrared laser radiation on reparative bone formation and angiogenesis in bone regeneration which is formed in treatment of fractures under conditions of transosseous osteosynthesis. Material and Methods: A tibia fracture was modeled experimentally in rats in the control and experimental groups. Reposition and fixation of fragments were performed. The fracture zone in the experimental group animals was exposed to the impact of pulsed infrared laser irradiation of low intensity. Animals from the control group underwent the impact simulation. The operated bones were investigated using the methods of X-ray, light and electron microscopy, X-ray electron probe microanalysis. Results: It was established that laser radiation exposure sessions activated fibrillogenesis and angiogenesis, accelerated compacting of newly formed bone tissue and increased its maturity while primary fracture healing occurred. Prolonged capillary dilatation and endothelium-dependent vasodilation, intensive capillarogenesis were noted after sessions of laser therapy in bone regeneration. Endothelial outgrowth was formed in the lumen of the vessels forming capillary buds that propagate along the “mother” vessels (endovascular capillarogenesis). Conclusion: The data obtained revealed a possible mechanism of laser radiation exposure at the level of a whole organism and proved the effectiveness of its application in clinical practice at the early stages of patient rehabilitation under conditions of transosseous osteosynthesis.

A modern view of the pathogenesis of osteoarthritis and the choice of effective symptomatic slow action anti-inflammatory drugs in terms of recent recommendations

Osteoarthritis is the most common joint disease in many populations, which is usually manifested in persons over 40 years. This disease has become one of the main causes of disability and quality of life of patients, including young and middle-aged, of great socioeconomic significance and an urgent problem of modern medicine. Today, we have a fairly significant list of symptomatic slow-acting anti-inflammatory drugs, which have not only a symptomatic effect, but also structural-modifying, that is, the effect of slowing the destruction of cartilage tissue. These drugs include chondroitin sulfate, glucosamine sulfate, diacerein, ginger root extract, unformed soy and avocado compounds. That is, the doctor has the opportunity to choose the drug in the treatment of osteoarthritis. For example, with hyperuricemia, diacerein reliably reduces uric acid levels, as well as glucose levels. And preparations which includes chondroitin sulfate and glucosamine can reduce the pain syndrome with lower back pain. Glucosamine sulfate reduces cholesterol levels.

Особенности клинических данных у женщин в ранней хирургической постменопаузе

Surgical deactivation of ovarian function in women of reproductive age remains one of the urgent problems of modern medicine. This analysis was performed in 60 women of the main group aged 40-55 years in early surgical postmenopausal women who underwent abdominal gynecological operations with ovarian excision. Indications for surgical interventions on the organs of the reproductive system in women are ovarian tumors, combined pathology of the reproductive system, severe purulent processes of the genitals and others, the volume of which includes removal of the ovaries.

OSTEOPOROSIS IN CHILDREN AND ITS RELEVANCE FOR PEDIATRIC SPORTS MEDICINE

The article is dedicated to one of the urgent problems of modern medicine – osteoporosis. Modern trends in the national epidemiology, risk factors, and diagnostic approaches are discussed. Particular attention is paid to the ambiguity and inconsistency of information on osteoporosis in childhood and adolescence, as well as the lack of convincing studies of this issue in children’s sports medicine. The authors conduct an analysis of the generally accepted approaches to the identification of risk groups for the development of osteoporosis in children, the predisposing factors and complex issues of diagnosing this condition are discussed in detail. The publication presents the results of our own observations of the most complex clinical cases in a group of children and adolescents involved in sports, including elite sports. A separate section is devoted to the analysis of pharmacological agents for the prevention and treatment of osteoporosis in children and young athletes. All presented data are in accordance with the legislation and rules of the World Anti-Doping Agency (WADA, 2017).

THE EFFICIENCY OF PREVENTION OF VIOLATIONS IN THE SYSTEM MOTHERPLACENTA-FETUS

Given that over the last decade in Ukraine has considerably worsened the demographic situation and at the same time retain high rates of perinatal complications, it is extremely relevant for practical obstetrics is the study of various risk factors of human in the system mother-placentafetus. Prevention of perinatal pathology and preservation of health of a pregnant is one of the most urgent problems of modern medicine. The results of the effectiveness of the prevention of placental dysfunction in women at risk, which were evaluated through clinical, laboratory, instrumental, histological and immunohistochemical methods. The main group consisted of pregnant women with symptoms of placental dysfunction without specific prevention of placental dysfunction, and pregnant with our proposed method of prevention of placental dysfunction. The control group consisted of healthy pregnant women. The proposed method of prevention of placental disorders of the complex allows to achieve the best results for most indicators, and in relation to individual processes in the placenta allows you to bring them to the level of physiological pregnancy.

Influence of Laser Irradiation Low Intensity on Reparative Osteogenesis and Angiogenesis Under Transosseous Osteosynthesis.

Introduction: The use of non-medicinal facilities of correcting processes for various pathological conditions is one of the most urgent problems of modern medicine. The purpose of the work is to study the efficiency of low-intensive of infrared laser irradiation in promoting reparative osteogenesis and angiogenesis during fracture treatment under transosseous osteosynthesis with a qualitative and quantitative morphological analysis. Methods: A tibial fracture was modeled experimentally in rats from control and experimental groups, then repositioning and fixation of fragments performed. The fracture zone of the experimental group animals was exposed to pulsed infrared laser irradiation of low intensity. The animals from control group underwent irradiation simulation. The operated bones were investigated using x-ray, light and electron microscopy, x-ray electron probe microanalysis. Results: The sessions of laser irradiation decreased inflammatory process severity, activated fibrillogenesis and angiogenesis, accelerated the compactization of newly formed bone tissue, and enhanced its maturity degree while primary healing occurred in the fracture. Conclusion: Laser therapy of fracture zone ensures the formation of regenerated bone and fragment union within earlier periods.

Treatment for low back pain, use of meloxicam

To manage patients with low back pain is an urgent problem of modern medicine. The paper considers the main causes of chronic nonspecific lumbago and the principles of its diagnosis and treatment in the context of evidence-based medicine. Medical treatment using analgesics (nonsteroidal anti-inflammatory drugs (NSAIDs), weak opioids), antidepressants, therapeutic exercises, and cognitive-behavioral therapy as components of a multidisciplinary treatment is noted to be highly effective. The efficacy and side effects of NSAIDs, the high efficiency and safety of using meloxicam in different dosage forms are outlined. The authors set forth their experience in treating 85 patients with chronic low back pain and an observation of a female patient who has concurrent chronic migraine and abuses analgesics.

Management of patients with headache and cervicalgia in outpatient practice

The management of patients with headache (cephalgia) concurrent with neck pain (cervicalgia) remains an urgent problem of modern medicine. Concurrent cervicalgia in cephalgia substantially lowers quality of life in these patients and is encountered in more than half the patients. Cervicalgia is considered as a risk factor of migraine and tension headache attacks. Cervicogenic headache is assigned to one of the most common forms of secondary cephalgias. It is shown that patients with daily headache have functional insufficiency of the antinociceptive system that plays an important role in the maintenance and chronization of neck pain. The diagnosis of different cephalgic syndromes and the identification of causes of cervicalgia commonly raise problems in a physician; the rate of misdiagnoses and hence inadequate treatment has been high so far. The detection of various comorbid conditions, including cervicalgia, in a patient with cephalgia makes it possible to use effective treatment and to achieve good results.

THE EFFECT OF MINERALIZED BONE MATRIX ON REPARATIVE OSTEOGENESIS

Background: The development and experimental-and-clinical evaluation of osteoplastic implantation materials one of the most urgent problems of modern medicine. Material and Methods: The special features of reparative osteogenesis for implantation of granulated mineralized bone matrix (MBM) obtained without thermal and demineralizing treatment into a tibial defect have been studied experimentally in 50 Wistar rats using scanning electron microscopy, x-ray electron-probe microanalysis and histological techniques. Results: MBM has been established to possess marked osteoinductive and osteoconductive properties, the prolonged activation of reparative osteogenesis is observed during implantation, as well as deep bone tissue sprouting into the implant, acceleration of organotypic remodeling of regenerated bone, intense angiogenesis and early restoration of the bone involved. Conclusion: The use of the implant from the МВМ appears theoretically sound and promising, particularly in the surgical treatment of bone defects, osteomyelitic seizures, bone cysts and foci of osteonecrosis.

Current principles in the management of patients with chronic nonspecific lumbago

To manage patients with low back pain is an urgent problem of modern medicine. The paper covers the main causes of chronic nonspecific lumbago and the principles of its diagnosis and treatment in the context of evidence-based medicine. A multidisciplinary treatment approach involving drug therapy with analgesics (nonsteroidal anti-inflammatory drugs), antidepressants, myorelaxants, therapeutic exercises, and cognitive-behavioral therapy is noted to be highly effective.

Th e eff ect of mineralized bone matrix on reparative osteogenesis

Background: The development and experimental-and-clinical evaluation of osteoplastic implantation materials one of the most urgent problems of modern medicine. The purpose of the present work consists in studying the characteristics of reparative osteogenesis for filling bone defect under implantation of the allogenic mineralized bone matrix (MBM). Materials and Methods: The special features of reparative osteogenesis for implantation of granulated MBM obtained without thermal and demineralizing treatment into a tibial defect have been studied experimentally in 50 Wistar rats using scanning electron microscopy, X-ray electron-probe microanalysis, and histological techniques

Selective Hemosorption of Endotoxin in the Treatment of Abdominal Sepsis

Sepsis remains to be one of the most urgent problems of modern medicine, which are associated with a steadily high mortality (as high as 70%). The central point of the pathogenesis of abdominal pathogenesis is the translocation of the gram-negative flora and the elevated blood concentrations of lipopolysaccharide in the bacterial cell wall (endotoxin), which induces a systemic inflammatory reaction and has direct and indirect cell damaging actions. The technologies that have recently emerged in the clinic for the selective hemosorption of endotoxin in combination with dynamic monitoring of its blood level (LAL test) open up wide prospects for the treatment of abdominal sepsis. The paper gives a clinical example of successful therapy for septic shock, by using the sorbent LPS adsorber (Alteco, Switzerland) in a patient with abdominal sepsis in the presence of blood cancer. Selective hemosorption of endotoxin could substantially reduce its blood concentration, which attenuated a systemic inflammatory reaction, stabilized hemodynamics, and improved lung microcirculation with resolution of respiratory failure. Key words: abdominal sepsis, endotoxin, selective hemosorption.

THE EPIDEMIOLOGICAL AND CLINICOPSYCHOLOGICAL CHARACTERISTICS OF HEADACHE IN PARTICIPANTS OF LOCALMILITARY CONFLICTS

Headache is an urgent problem of modern medicine. The purpose of the investigation was to study the pattern and clinicopsychological aspects of headache in participants of local military conflicts (LMC). Among the examined participants of LMC (n = 162), 69.8% complained of headache. The clinicopsychological characteristics of posttraumatic and exertion-induced headache are presented depending on the type of LMC.