CRITERIA OF THE CLINICAL OUTCOME OF THE ACUTE CORONARY SYNDROME INTO THE PROGRESSIVE STENOCARDIA AT THE HOSPITAL STAGE

Aim. The aim of this study is to develop a prognostic flowchart for the clinical outcome of acute coronary syndrome into progressive stenocardia at the hospital stage.Materials and methods. The studies were carried out basing on the results of the survey of 68 patients admitted to the infarction department of the Republican Clinical Hospital of the Center for Special Emergency Medical Care in Makhachkala in 2015 which correspond to the basic principles of the Declaration of Helsinki - Ethical Principles for Medical Research Involving Human Subjects as amended in 2000. The severity of acute heart failure by Killip, electrocardiography (ECG) and EchoCG studies were conducted according to generally accepted standards.Findings. The research allowed developing the model of the prognostic block diagram. All indicators of relative risk (RR) for the studied indicators were reliable. Calculations of the values of RR were carried out according to the most frequent ranges of concentration of indicators of the number of patients. The greatest statistical power was possessed by concentration ranges for cardiac markers - TP-I from 0.6 to 1.1 ng / ml and BNP-32 from 60 to 110 pg / ml; For inflammation markers - IL-1β from 1.4 to 2.4 pg / ml and TNF-α from 2.6 to 3.6 pg / ml; For endothelial dysfunction markers - NO from 10 to 15 μmol / l and ET from 3.3 to 4.3 fmol / ml; For immunomarkers, cardiolipin antibodies (CA) from 1 to 3 U / ml and NP from 17 to 26 nmol / l. Measurement of these parameters at the initial stage of admission of patients with acute coronary syndrome (ACS) to the hospital (the starting point of reference) and the statement of positive results (the point of separation) made it possible to predict the outcome of ACS into the progressive stenocardia (end point) with high probability.Conclusion. In the calculation of relative risk, were taken into account the concentration ranges that were most frequently encountered among the number of patients. This methodological approach allowed to significantly increase the reliability of the prognosis, thus we reasonably recommend the use of the proposed flowchart in the clinical practice

Cytogenetic aspects of occupational carcinogenic hazard

© 2016,International Journal of Pharmacy and Technology. All rights reserved.The effect of chemical factors of the production environment is studied with a wide range of test systems,among which the short-term tests with high sensitivity are in the foreground. We conducted a study to assess the cytogenetic status of servicemen. Micronucleus test was a convenient method of substance screening that can quickly determine the presence or absence of various compounds of cytogenetic nature. We have identified a relationship between exposure of occupational hazards and the level of micronuclei in human peripheral blood. Excess in number of micronuclei occurs at almost three times the rate in the retired servicemen. Indicator in this contingent group was 92.7%. Subject to the age,the risk group of the high chance of malignancy development is the people over age 70. 3N micronuclei level in this age group was found in 96.3%. 3N micronuclei level is found in 71.4% of representatives of the employment group of 3-9 years,while in the employment group of 30-39 years - only in 68.7%. Subject to the military force,the risk group of the high chance of malignancy development are missile,ground,and motorized rifle troops

Prenosological diagnosis as an improving element of the health care of working-age population

Studying red blood cells in the pathogenesis of tumor growth increasingly attracts attention due to the high biological activity. There is evidence of changes in red blood cells under the influence of negative production factors. The study applied screening tests for the presence of inter-erythrocyte lagoons and luminescent red blood cells. The object of the study were military servicemen engaged in the chemical weapons storage and destruction facilities. The objective of the study was to conduct analysis of the peripheral blood with the further development of preventive measures to reduce the risk of malignancies. The results of the study revealed the following trends: a risk group for the emergence of malignant tumors includes the retired and former military servicemen. The highest percentages of positive tests for the presence of inter-erythrocyte lagoons and luminescent red blood cells were observed in the contingent group (95.1% for each indicator). Analysis of the results by age and employment structure revealed a direct correlation - the older the age and the greater the working experience is, the higher the risk of cancer development is. The risk group includes persons over 70 years old (100% of positive results for the presence of lagoons and luminescent red blood cells). High percentages of positive tests are in working intervals of 30-39 years (71.6% for lagoons and 70.1% for luminescent red blood cells), 10-19 years (58.8% for lagoons and 70.6% for luminescent red blood cells), and 20-29 years (58.6% for lagoons and 69% for luminescent red blood cells)

Comprehensive approach in treatment of locally disseminated oropharyngeal cancer

The article contains information about current trends of treatment of the locally advanced oropharynx cancer. We analyzed the results of chemoradiation treatment, and surgery treatment of patients with rudimentary tumors after the chemoradiation therapy, taking into account the tumor margin, which gives capacity to perform an adequate operation with good oncological results

Indicators of hormonal status of the military servicemen in the modern type of military technogenesis

© 2016, International Journal of Pharmacy and Technology. All rights reserved.The paper presents the results of the evaluation of the testosterone level in the military servicemen. The work at the military enterprises is characterized by storage and disposal of chemical weapons and the presence of a number of harmful factors. The effect of carcinogens and reproductive hazards in the operation environment on the hormonal system changes the levels of hormones responsible for the reproductive function of the body. It is known that the reduction in the concentration of testosterone leads to male infertility, and its increase with age can trigger the development of prostate cancer. Testosterone indicators in our study were distributed subject to the contingent, age, length of service and a type of troops. Determination of hormone was conducted by enzyme-linked immunosorbent assay (ELISA) of blood. The study revealed hormonal disorders in all contingents examined. A high-risk group involves retired and former military servicemen (high levels of testosterone were found in 52.1% of the surveyed of this contingent), persons over 70 years old (high levels of testosterone were found in 61.5% of the surveyed in this age group), the workers with length of service of 30-39 years (high levels of testosterone were found in 55.2% of the surveyed with this length of service). Low levels of testosterone were found in private soldiers (3.6% of the surveyed of this contingent), in persons aged 18-29 years (3.3% of the surveyed in this age group), and in those with length of service of 1-2 years (3.6% of the surveyed with this length of service)

Сочетание криогенного и лучевого воздействий в лечении больных распространенными и рецидивными формами рака кожи головы и шеи

Grupul de autori a elaborat o metodă de tratament al pacienţilor cu cancer cutanat infi ltrativ, ce constă din radioterapie şi criochirurgie în diferite variante de asociere.Сочетание криогенного и лучевого воздействий в лечении больных распространенными и рецидивными формами рака кожи головы и ше

Interplay of unsteady aerodynamics and flight dynamics of transport aircraft in icing conditions

Airframe icing causes significant degradation of aerodynamic characteristics and influences the flight safety. Wind tunnel study of longitudinal steady and unsteady aerodynamic characteristics of a transport aircraft in icing conditions is carried out in order to develop mathematical model of aerodynamics in the extended flight envelope. The wind tunnel results are validated through flight tests conducted for the real aircraft. Large, glaze-horn ice shapes, corresponding to holding flight phase, are considered. Influence of an ice protection system as well as its failure is examined. Effect of icing on the unsteady aerodynamics characteristics is studied not only through wind tunnel tests but also via analysis of subsequent influence on the flight dynamics of the aircraft. The conducted study shows that the ice shapes of the holding phase leads to reduced stall angle of attack (AoA), maximum lift, and longitudinal damping. Flight dynamics analysis demonstrates that dangerous aircraft behaviour in the form of high AoA departure and limit cycle oscillations (LCO) can be observed at smaller elevator deflections for the iced aircraft. Taking into account icing influence on the unsteady aerodynamics in the flight dynamics simulations revealed degradation of the dynamic response and deterioration of phase portraits of the system. Even for small AoA and elevator deflection the aircraft might be trapped into the basin of attraction of high-AoA LCO. In addition, incorporating icing effects in unsteady aerodynamics manifest larger amplitude of LCO

The efficiency of tear substitute therapy at dysfunction tear basic secretion

Purpose: to evaluate the efficiency and tolerance of drops replacing tear with hyaluronic acid 0.15% (Hylabak, thea, France) for the treatment of tear film diseases, in particular blepharoconjunctival form of dry eye syndrome.Methods: 32 patients (range 38 to 72 years) with blepharoconjunctival form of dry eye syndrome were treated lubricant Hylabak 2-4 times a day during 7-30 days.Results: After treatment was detected the elimination of complaints in 30 of 32 people, increasing the stability of the tear film (increasing values of the samples Norn test from 7.3 ±0.5 to 10.1±0.6 seconds), as well as normalization of Schirmer test (from 8.8±0.4 to 15.2±0.5 mm).Conclusion: the study was showed high efficacy of lubricant Hylabak and subjective tolerability at blepharoconjunctival form of dry eye syndrome

Renalase – a new instrument in multicomponent heart failure assessment

Heart failure (HF) remains a serious problem in Russian and world health care due to the growing morbidity and mortality from complications of heart failure, despite the development and implementation of programs for the early detection and treatment of heart failure in asymptomatic patients. Currently, a large number of new biological markers have been studied that could serve as a laboratory tool for diagnosing and predicting the course of heart failure, but only brain natriuretic peptides have found application in real clinical practice. Renalase is a recently discovered cytokine that is synthesized by the kidneys and released into the blood. To date, seven subtypes of renalase have been found, each of which plays a different physiological role in the human body. Renalase is usually positioned as a signaling molecule that activates cytoprotective intracellular signals, leading to a decrease in blood pressure and protection of the heart muscle. The concentration of renalase freely circulating in the bloodstream of an adult is approximately 3–5 ng / ml. Currently, the level of renalase is determined by the enzyme immunoassay with a detection range of 3.12 to 200 ng / ml, while the minimum detectable concentration of the marker is less than 1.38 ng / ml. The presence of missense polymorphism of renalase is associated with myocardial dysfunction. Data from animal and human studies have shown that renalase plays a key role in the metabolism of catecholamines and in cardioprotective processes. Studies have shown the contribution of renalase to the occurrence of cardiovascular diseases: ischemic heart disease, arterial hypertension, diabetes mellitus, and aortic stenosis. Moreover, detailed protocols of multicenter prospective studies have demonstrated that functional polymorphism of the renalase gene was associated with myocardial hypertrophy in patients with aortic stenosis, hypertension, metabolic syndrome, unstable angina pectoris and stable forms of coronary artery disease, as well as in patients receiving renal replacement therapy. Based on these data and further studies, renalase has been proposed as a predictive biomarker of ischemia in patients with coronary microvascular dysfunction, as well as a predictor of clinically significant progression of chronic kidney disease in patients with cardiovascular diseases.Our review presents data on the role of renalase in heart failure. Further study of the structure and function of renalase, as well as future clinical studies, will allow determining the diagnostic, prognostic and, possibly, therapeutic significance of this biological marker in HF and other cardiovascular diseases

Integrated solution for very high cardiovascular risk patients. Rationale and design of a pilot study

Coronary artery disease (CAD) is the most common cardiovascular disease and the leading cause of morbidity and mortality. Acute coronary syndrome (ACS) as an abrupt destabilization of CAD, multiplies the risk of cardiovascular events. To reduce the incidence of recurrent cardiovascular events, timely tackling potentially reversible risk factors such as hypertension and/or hyperglycemia is imperative. However, a solid basis for a secondary prevention lies in the treatment of dyslipidemia and begins in the first hours of hospital admission. Despite considerable evidence regarding the efficacy and safety of lipid-lowering therapy, averagely only one third of patients maintain control of lipids. The main challenges are low adherence, poor continuity of medical care, and the lack of an ambulatory routine follow-up. Telehealth solutions are believed to address these barriers and may be considered as an add-on to in-person patient care. Telemonitoring of vital and laboratory parameters, remote patient counseling can be introduced into routine care delivery. Telemedicine shows promise for fostering better clinical effect, and provides health-related quality of life improvement.It is planned to conduct a pilot observational study aimed to create and to test an integrated solution, i.e. telemonitoring and remote counseling in patients of very high cardiovascular risk with ACS followed by myocardial revascularization. The goal is to determine the clinical effectiveness, i.e achievement of target values of blood pressure, lipid profile and glycemia, and patient-centeredness of this approach