СЛОВО ОБ УЧИТЕЛЕ. ПАМЯТИ ЗАМЕЧАТЕЛЬНОГО ПЕДАГОГА И УЧЕНОГО М.Р. САПИНА

M.R. Sapin (1925–2015) was a professor at I.M. Sechenov First Moscow State Medical University, honorary academician of Russian academy of medical sciences (1988), and an outstanding representative of the Moscow anatomical school of the middle of XX – early XXI century. From the very beginning of his medical training, Mikhail Romanovich got interested in anatomy, especially in angiology and lymphology, and later concentrated on its studying. The author of more than 30 text books and guidelines for schools, universities, and colleges, Mikhail Romanovich was the doctoral and thesis advisor of 51 Ph.D. and approximately 70 MD dissertations. M.R. Sapin made a significant contribution to the development of anatomical education providing the departments with a various range of dry and wet specimens. His stunning and effective work as a tutor was highly appreciated by his students and colleagues, Russian and foreign anatomists. M.R. Sapin was the leader of the Laboratory of Functional Anatomy since 1972, president of the International Association of Morphologists (1992–2006), chairman of the expert commission of Higher Attestation Commission (1959–1994), etc. A man of a great willpower, M.R. Sapin faced a lot of obstacles in his life and research work but overcame that all successfully. The article presents the most important facts of anatomist’s career and lifetime.Михаил Романович Сапин — профессор Первого Московского государственного медицинского университета им. И.М. Сеченова, почетный академик Российской академии медицинских наук с 1988 г., выдающийся представитель Московской анатомической школы середины ХХ – начала ХХI в. С самого начала обучения в медицинском институте Михаил Романович заинтересовался ангиологией и лимфологией, изучению которых посвятил свою работу. Профессор М.Р. Сапин — автор более 30 учебных пособий для школ, колледжей и университетов, под его началом выполнены более 50 докторских и более 70 кандидатских диссертаций. М.Р. Сапин внес огромный вклад в развитие анатомической школы, оснащая кафедры широким ассортиментом сухих и влажных анатомических препаратов. Его великолепный преподавательский талант всегда высоко ценился не только студентами, но и сотрудниками кафедры, анатомами России и зарубежья. Академик М.Р. Сапин как человек великой силы воли преодолевал все препятствия, встречающиеся ему на жизненном пути, сохраняя себя и двигаясь вперед. В данной статье рассмотрены наиболее важные вехи в жизни великого ученого и учителя

MONITORING OF SYSTEMIC HEMODYNAMICS INDICATORS DURING THE WORKING DAY ON THE EXAMPLE OF WOMEN OF CHILDBEARING AGE

It has been established that the state of the cardiovascular system in humans undergoes age-related changes, leading to an increase in the frequency of blood pressure disorders. Moreover, in the age category of 18-19 years, the proportion of cases with high blood pressure was 71.4%, and in other age categories from 28.5 to 71.4%. The upper pressure was in the range of 90 to 130 mmHg, and the lower pressure was from 60 to 80 mmHg. For the prevention of disorders, a set of five specially selected exercises aimed at improving cardiac rhythm and blood supply to the brain is recommended. The classes were aimed at the work of the muscles of the neck-shoulder girdle, back, legs, arms. The greatest effect after a course of exercises is achieved in reducing the waist circumference and increasing the vital volume of the lungs. In comparison with the initial measurements, the proportion of occurrence of blood pressure disorders decreased in group I – by 42.9%, in group II – by 23.8%. In group III as a whole, there was a decrease in blood pressure closer to the normal level, however, the number of violations did not decrease, and was in the range of 28.5-57.1%

Інтелектуальне моделювання E-готовності інформаційної економіки

Рассмотрены принципы когнитивного моделирования и когнитивная модель готовности страны к информационной экономике (E-готовности). Проведена экспертная формализация модели применительно к Украине, дана оценка начального вектора управляю-щего воздействия на E-готовность и интерпретированы результаты его приложения. Проведен мониторинг изменения базисных факторов когнитивной модели с появлением новых технологий и изменениями в социально-экономической жизни Украины

Інтелектуальне моделювання E-готовності інформаційної економіки

Рассмотрены принципы когнитивного моделирования и когнитивная модель готовности страны к информационной экономике (E-готовности). Проведена экспертная формализация модели применительно к Украине, дана оценка начального вектора управляю-щего воздействия на E-готовность и интерпретированы результаты его приложения. Проведен мониторинг изменения базисных факторов когнитивной модели с появлением новых технологий и изменениями в социально-экономической жизни Украины

Weight loss as the cornerstone in the therapy of metabolic syndrome in adolescents

Background. In the last decade, the relationship between metabolic syndrome (MS) and obesity is being actively discussed. An early detection of fat metabolism violations and treatment of healthy adolescents is an important component of primary prevention of metabolic syndrome. The aim of the study was to examine the clinical and epidemiological characteristics of obesity in adolescents and to estimate the effectiveness of primary prevention of metabolic syndrome. Materials and methods. The medical forms 026/o Medical record of a child (for pre-school and general educational institutions) of 656 adolescents aged 16–18 years, who study at HSEI of Ukraine Bukovinian State Medical University colleges within 2014–2016 years were analyzed. According to the result of the analysis, a study group was formed of 50 teenagers with overweight and obesity. The violation of fat metabolism was verified using percentile tables: BMI within 85–95 percentile was estimated as overweight, above 95 percentile — as obesity. In addition, there were analyzed of 67 medical records of inpatients adolescents who were treated for obesity in the Department of Endocrinology of the Chernivtsi Regional Children’s Hospital in the period from 2006 to 2016. There analyze such laboratory parameters as the levels of cholesterol, thyroid hormones, blood glucose fasting test and glucose tolerance test, levels of elastase-1 in feces, and the results of additional research tool. There was formed a clinical group of 20 adolescent parents who underwent a range of measures, including a complete exclusion of easily digestible refined carbohydrates from daily meals, a certain amount of physical activity, correction of day regimen. Results. The analysis of medical records of 656 teenagers data showed a violation of physical development in 50 (7.6 %) patients, including excess body weight in 28 (56 %), obesity in 22 (44 %) persons. Half of examined patients with overweight and obesity had clinical symptoms of hormonal imbalance (striae, hyperhidrosis, black acanthosis, hyperkeratosis, acne, hirsutism, gynecomastia, oily seborrhea). The increased blood pressure was observed in 72.6 % of adolescents. Different versions of carbohydrate metabolism impairment found in 42.7 % of cases. Nearly half of teens had changes in lipid profile, each seventh had deviations in hemocoagulation system, 17.1 % of adolescents had decreased pancreatic functional activity that manifested as a decrease of elastase-1 in feces. The vast majority of teens had a hereditary burden of obesity, diabetes type 2 and hypertension. 92.5 % of adolescents with obesity had some components of MS. The combination of obesity with one of the metabolic syndrome components was registered in 56.4 % cases, with two components in 32.2 %, with three components in 11.2 % of cases. Among 20 patients in the program in 12 (60 %) cases body weight became normal, in 8 (40 %) persons obesity remained. The effectiveness of the program was confirmed by a decrease in the prevalence of modified risk factors: poor nutrition by 13 %, smoking by 6.9 %, violation of physical activity by 25.2 %, increase of awareness by 54 %, decrease of metabolic syndrome components (body weight by 30 %, hypertension by 33.7 %, carbohydrate metabolism by 20 %, dyslipoproteinemia by 3.3 %). Conclusions. Violation of fat metabolism among adolescents occurred in 7.6 % cases, in particular excess body weight in 56 %, and obesity in 44 % persons. 92.5 % of obese adolescents had the components of metabolic syndrome. The combination of abdominal obesity with one of the components of metabolic syndrome is 56.4 %, with two components — 32.2 %, with three components — 11.2 %. The effectiveness of suggested program to reduce body weight is 60 % and it is confirmed by the decrease of the prevalence of modified risk factors for metabolic syndrome

Gilbert’s syndrome: clinical features, diagnostics, differential diagnosis and treatment (part 2)

We searched for published and unpublished research using PubMed as the search engine by the keywords: “Gilbert’s syndrome”, “clinical manifestation”, “diagnosis”, “treatment”, taking into consideration studies conducted in the last 10 years, citation review of relevant primary and review articles, conference abstracts, personal files, and contact with expert informants. The criterion for the selection of articles for the study was based on their close relevance to the topic, thus, out of 75 analyzed articles, the findings of the researches covered in 28 articles were crucial. Clinical manifestations of Gilbert’s syndrome (GS) are possible both in homozygous for UGT1A1, and in heterozygous status. A latent variant of the disease prevails in individuals with heterozygous status. Up to 30 % of homozygous for the defective gene of GS individuals have an asymptomatic course of the disease. Clinical types of GS: dyspeptic — 43.2 %, asthenovegetative — 15.9 %, icteric — 14.8 % and asymptomatic — 26.1 %. Dietary deviations, mental fatigue, stress, trauma, acute infections, including hepatitis, certain medications intake are the triggers for GS. In 86.4 % of children with GS, the pathology of the upper digestive tract was detected: duodenitis — in 58 % of cases, gastritis — in 56.8 %, esophagitis — in 12.5 %, duodenal ulcer — in 2.3 %, in 39.7 % of patients sphincter disorders were registered (duodenogastric and gastroesophageal bile reflux). The GS is characterized by reduced detoxification function of the liver, in particular in 2/3 of patients decreased hepatocyte metabolic activity was observed, the excretory function of liver cell suffers in another half of patients, the biliary tract disorders and increased risk of gallstones formation are described in 88 % of cases. Some patients with GS have certain psychological disorders, including anxiety. Diagnostic criteria for GS: 1. A peculiar pale yellowish discoloration of the skin (“teinte bilieuse”), especially on the face, hands, and feet without a distinct scleral icterus. Sometimes the development of repeatedly intermittent episodes of jaundice with high bilirubinemia (indirect bilirubin) without the evidence of hemolysis (differential diagnostic feature) is observed. 2. A tendency to development of pigmented and vascular nevi and xanthelasma of the eyelids, and hyperpigmentation around the eyes; to bradycardia, hypothermia, migraine, postural, intermittent albuminuria or to alimentary glycosuria. 3. An increased tendency to pigmentation under the influence of light, heat, and also chemical and mechanical stimuli. 4. A neuromuscular hyperexcitability. 5. Increased sensitivity to cold. 6. Dyspeptic complaints (pain, nausea, abdominal bloa­ting, diarrhea or constipation). 7. No signs of increased hemolysis (differential diagnostic feature) with increasing content in, bilirubin (differential diagnostic feature). 8. The majority of patients have normal liver function tests (differential diagnostic feature) also normal bromsulphalein test is also normal (differential diagnostic feature). 9. The biochemical abnormality is not detected by histological methods (differential diagnostic feature) .10. Frequently, a family disease of the liver is observed. The differential diagnosis of GS is conducted with all types of hyperbilirubinemias, hemolytic anemias, congenital hepatic cirrhosis, hepatitis, cholecystopathy, atresia of biliary ducts or the small intestine. Medications are used only in severe hyperbilirubinemias and as concomitant therapy in the presence of symptoms of vitamin deficiencies, violations of a motor-evacuation function of the upper digestive tract in the clinical picture and to prevent complications (cholelithiasis)