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

Pulmonary embolism and atrial fibrillation: analysis of data from the SIRENA Russian registry

Aim. To present the clinical characteristics and in-hospital prognosis in patients with pulmonary embolism (PE) and atrial fibrillation (AF).Material and methods. On the initiative of a working group of physicians, the basic principles of an observational prospective study (SIRENA registry) have been developed.Results. Among the 660 patients included in the registry, AF was diagnosed in almost every fourth patient — in 22,9% of cases (n=151), which reflects its high incidence in relation to PE. The prevalence of AF corresponded to such conditions as heart failure (HF) (23,2%; n=153), diabetes (15,6%; n=103), and hypertension (HTN) (65,7% n=400). The diagnosis of AF in most patients is based on the history data (n=144; 95,4%), while the first registered AF episode was verified in 7 patients (4,6%). Patients with AF were characterized by older age, significantly higher prevalence of HF (51,2%), HTN (80,8%), chronic kidney disease (18,5%), stroke or transient ischemic attack (23,2%). It is important to note the low prevalence of anticoagulant therapy (15,3%) in the group of patients with previously diagnosed AF (n=144). The prevalence of thrombolytic therapy in patients with AF was significantly lower than among patients without AF (13,9 vs 25,8% (p=0,026)), which is due to contraindications and underdiagnosis of PE. Given the predominantly senile age, high comorbidity rate in patients with AF, as well as the absence of outpatient anticoagulant therapy, in-hospital mortality in patients with PE and AF was 31,1%, and significantly differed from that in those without AF 12,6% (p=0,001). In the general group, post-mortem diagnosis of PE was noted in 7,7% of cases (n=51), of which the proportion of patients with AF was 54,9% (n=28). A possible explanation for the underestimation of PE in AF patients was an erroneous explanation of its manifestations (tachypnea, tachycardia, lower limb edema) due to concomitant HF.Conclusion. Suspicion for PE in elderly patients with AF and manifestations of HF decompensation, as well as the timely administration of anticoagulant therapy, will prevent both arterial and venous embolism

Взаимосвязь маркеров эндотелиальной дисфункции при гнойном холангите у больных с хроническим гепатитом и без хронического гепатита на фоне обтурационной желтухи

Цель. Изучение взаимосвязи маркеров эндотелиальной дисфункции при гнойном холангите у больных с хроническим гепатитом и без хронического гепатита на фоне обтурационной желтухи, выявление его раннего перехода в цирроз печени и оптимизация тактики лечения в до- и послеоперационном периоде с оценкой показателей исследуемых лабораторных тестов. Материалы и методы. Исследование проведено в отношении 15 больных с гнойным холангитом, из них у 9 больных был хронический гепатит, у 6 больных хронического гепатита не было. Из 9 больных с хроническим гепатитом 4 больным противовирусную терапию не проводили, 5 - проводили. Результаты. Непосредственные результаты проведенного лечебно-диагностического исследования свидетельствуют о сходных проявлениях эндотелиальной дисфункции при гнойном холангите у больных с хроническим гепатитом и без хронического гепатита. Всем больным с гнойным холангитом выполняли декомпрессию желчных протоков, устраняли причины обтурации, проводили дезинтоксикационную терапию. По данным корреляционного анализа показателей функционального состояния эндотелия у больных с хроническим гепатитом, получавших противовирусную терапию, улучшение отметили на 10-е сут, через 1 мес оно было более выраженным, чем у больных, не получавших противовирусную терапию. У 6 больных с гнойным холангитом без хронического гепатита своевременное хирургическое, дезинтоксикационное лечение совместно с озонотерапией привело к улучшению показателей функционального состояния эндотелия на 10-е сут, через 1 мес они приблизились к норме. Выводы. Своевременное выявление эндотелиальной дисфункции при гнойном холангите у больных с хроническим гепатитом и без хронического гепатита способствует раннему прогнозированию его перехода в стадию цирроза печени и правильному выбору тактики лечения в до- и послеоперационном периоде. Подытожив полученные данные, можно сделать вывод о том, что при гнойном холангите у больных с хроническим гепатитом целесообразно проведение противовирусной терапии до и после операции

Obesity in the elderly: peculiarities of treatment in outpatient practice

Today there is a worldwide trend of population aging, in addition, the proportion of older people with obesity is increasing. In order to adequately manage these patients in the outpatient setting, it is critical to understand the dynamic relationship between body weight, chronic disease prevalence, development of functional disability, life expectancy, and health care costs. While the obesity epidemic has affected people of all age groups, empirical knowledge about the management of obese older people remains largely scarce. Currently, there is no single therapeutic approach to this problem. Weight loss should be treated with caution in people over 60 years of age. The risk of sarcopenia, malnutrition, bone loss, increased risk of falls and injury must be considered, which can lead to an increase in the number of people with disabilities and the associated costs of medical and social care. The analytical review focuses on the relationship between two of the greatest epidemiological trends: aging and obesity. This paper highlights the features of the pathophysiology of obesity in the elderly, the phenomenon of the «obesity paradox». Also from the perspective of evidence-based medicine approaches to the treatment of obesity in the elderly, including surgical interventions aimed at reducing body weight, are analyzed

Pulmonary placental transmogrification.

The article is devoted to the phenomenon of lung placentation, this problem is poorly studied and requires further research. The article summarizes the material of domestic and foreign scientific publications on the topic over the past five years. Comparison was literature data with own research data. In the article was analyzed the various views of researches on placental changes of the lung tissue, and also considers the real clinical cases of «placental transmogrification» from various lung diseases in different age groups of patients.Статья посвящена феномену плацентоподобной трансформации легкого, данная проблема мало изучена и требует дальнейших исследований. Обобщен материал отечественных и зарубежных научных изданий по исследуемой теме за последние пять лет. Произведено сравнение литературных данных с данными собственного исследования. В статье проанализированы различные взгляды исследователей на плацентоподобные изменения легочной ткани, а также рассмотрены реальные клинические случаи «плацентоподобной трансформации» ассоциированные с различными заболеваниями легких у разных возрастных групп пациентов

Impact of COVID-19 infection on the development of type 1 diabetes mellitus in children and adolescents

Children did not escape the COVID-19 pandemic. Although, in general, the course of viral infection in children is mild, the question of the long-term effects of COVID-19 on a child and adolescent, in particular, on pancreatic beta cells, remains unclear.Аim: Тo study the characteristics of children with diabetes mellitus identified after COVID-19 infection.Materials and methods: This article presents the preliminary results obtained from children and adolescents hospitalized at the RSSPMCE clinic with the newly diagnosed diabetes mellitus after COVID infection, as well as a systematic review of 61 clinical cases (case series study).Results: Of the 120 children hospitalized at the RSSPMCE clinic with newly diagnosed diabetes, 15 were diagnosed with diabetes after COVID-19 infection, all in a state of diabetic ketoacidosis. Only 20% of children knew about the previous COVID-19 infection, the course of the disease was mild, in 80% of children the infection was asymptomatic. At the time of diabetes onset, all children had a high level of HbA1c - above 10%, a low level of vitamin D, high levels of antibodies to SARS-CoV-2 (IgG), and the need for insulin was above the average.Conclusion: The SARS CoV-2 virus could be the direct cause of the development of diabetes mellitus in children, even with the asymptomatic course of the viral infection. However, the question remains about the exact classification of diabetes after COVID-19 in children. It is necessary to inform the population about the first signs and symptoms of diabetes mellitus in order to timely consult a doctor for the diagnosis of diabetes mellitus

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

The impact of micronutrients on athletes’ vision: a retrospective analysis of revalent articles

The eyes, like other human organs, are deficient in nutrients during over-training, which can affect visual acuity and, accordingly, the quality of training.This article defines the importance of the organ of vision for sports results. It also provides an overview of the latest scientific research on the impact of biologically significant micronutrients on the functions of the visual analyzer with examples of products that help improve visual functions

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

Prevention of Cardioembolic Complications in Patients with Atrial Fibrillation: Efficacy and Safety of Left Atrial Appendage Isolation and Oral Anticoagulants

Aim. To study the outcomes frequency and structure in patients with atrial fibrillation (AF) depending on the cardioembolic events preventing method: left atrial appendage (LAA) isolation, direct oral anticoagulants (DOACs) or warfarin.Material and methods. A prospective observational study included patients with AF and high risk of cardioembolic complications and without contraindications to anticoagulants. Patients who refused long-term oral anticoagulants taking underwent LAA isolation, the rest of the patients received DOACs or warfarin. The observation period was 3 years. Mortality, cardioembolic complications and major bleeding (according to GARFIELD criteria) cumulative incidence was assessed.Results. We included 245 patients: 46 patients were treated with LAA isolation, 100 with warfarin, and 99 with DOACs. Multivariate regression analysis demonstrated a statistically significant advantage of LAA occluder in terms of combined endpoint achieving frequency compared to warfarin (hazard ratio [HR] 3.10; 95% confidence interval [CI] 1.01-9.54; p=0.049), and to DOACs (HR 3.44, 95% CI 1.15-10.29; p=0.027). A similar result was obtained for all-cause mortality (HR 5.24; 95% CI 1.12-24.55; p=0.036 and HR 5.58; 95% CI 1.22-25.49; p=0.027, respectively). There were no significant differences in bleeding rates between the groups.Conclusion. This observational study demonstrates the superiority of LAA isolation as a first-line therapy over DOACs and warfarin in patients with AF and high risk of cardioembolic complications. Randomized trials are required to confirm these observations