ARCHIVE

A complex investigation in the area of pediatric psychooncology including investigation of the psychoemotional state, personality and behavior peculiarities of cancer children and their parents, associated with reaction to cancer and family function, was performed. The factors of professional distress of medical staff and volunteers were determined. The obtained findings were used to work out a comprehensive system of medical psychological aid and to assess its efficacy.

The peculiarities of active psychological protection of the patients with chronic obstructive diseases of the lungs were investigated. Main correlations of coping strategies with personality and emotional features were determined.

The author features clinical situations prone to relapses in persons with alcohol addiction at danger of remission disruption. It was established that at danger of remission disruption of any duration by a generalized clinical factor, these patients form a uniform group. The obtained findings were used to formulate recommendations on target anti−relapse therapy in patients with alcohol addiction.

It is shown that an important role in the pathogenesis of ischemic stroke (IS) is played by endothelial dysfunction manifested by reduction of endothelial nitrous oxide and deficiency of cholinergic neuromeditation presented by reduction of the level of acetilcholine estarase in the blood serum in the most acute and acute periods of the disease especially against a background of arterial hypertension and heart pathology. A scheme of pathobiochemical cascade of IS allowing expanding the idea about the pathogenesis and neurochemical nature of IS and developing new directions in the diagnosis and effective treatment was suggested.

The principles of treatment of non−dementia cognitive and asthenic disorders in patients with dys−circulatory encephalopathy are featured. A positive influence of Memantin on a wide spectrum of neuropsychic functions including attention, verbal and visual memory, visual−spatial and regulatory functions was revealed. A marked antiasthenic effect with reduction of mental asthenia and decreased activity was revealed.

By the findings of large−scale clinical investigations, blockers of angiotensin II receptors and Aliskiren do not reduce the risk of cardiovascular complications and mortality at a wide spectrum of clinical states, besides they can aggravate renal outcomes. Inhibitors of angiotensin−converting enzyme, in particular Perindopril and its combination with Indapamide, considering their difference in influence on mortality, should be preferred to angiotensin II receptor blockers at treatment of patients with arterial hypertension.

The study involved 152 patients with coronary artery diseases (CAD). It was established that in patients with CAD low tolerance to physical load is connected with diffuse involvement of the coronary arteries, obesity, and presence of D−allele insertion−deletion polymorphism of ACE gene.

Structural functional changes of the myocardium and diastolic function revealed in patients with stable angina and obesity are described. Their correlation with fat tissue hormones is demonstrated.

Updated groups of hypolipidemic drugs used in drug correction of atherogenic dyslipidemia at me−ta−bolic syndrome are reviewed based on the analysis of the findings of clinical randomized trials. Prospective directions of combination of various groups of lipid reducing drugs are featured based on the findings of evidence−based medicine.

The state and dynamics of lipid peroxidation (LP) and general antioxidant protection (GAOP) were investigated in 123 patients, of them 99 (79,8 %) had combined chronic protozoal urogenital viral infection. The reserve capabilities of GAOP were determined at ozone therapy with individually adjusted ozone dose. The use of the original methods of ozone therapy significantly improved and normalized all LP and GAOP parameters, which promoted treatment of the organism from the infection agents and restoration of physicochemical properties of the cellular membranes.

The variants of delivery management after cesarean section were investigated. Possible complications are described, their diagnosis and treatment followed by rehabilitation are featured. Medical legal aspects of the physician's actions at unsuccessful attempt of vaginal delivery after cesarean section are discussed.

The analysis of clinical anatomical features of lethal cases with perinatal hypoxia vs. histological picture of adrenals of fetuses and newborns showed that dead fetuses and newborns had pathological changes of the structure reflecting development of functional insufficiency due to development of acute hypoxia (asphyxia) against a background of intrauterine chronic hypoxia or without it. The obtained findings allow conclusion about the necessity to control the functional state of the adrenals in mothers, fetuses and newborns at intrauterine hypoxia and postnatal asphyxia and development of the methods to prevent adrenal insufficiency.

The authors present the original tactics of restorative and reconstructive−restorative operations on the large intestine based on the use of absolute and relative contraindications to them. The use of this tactics, methods of prognosis and purposeful prevention of complications allowed to increase the number of restorative operations from 64,6 to 71,2 %, reconstructive−restorative from 16,8 to 25,7 % as well as to improve the functional results after reconstructive−restorative operations, reduce the incidence of complications of interintestinal anastomosis healing and anatomical functional constructions, reduce post−operative death rate.

The literature on the urgent questions of surgical removal of tumor thrombi of the inferior vena cava, i.e. approach to the right atrium through the diaphragm from the abdominal cavity, liver mobilization and causes of hemorrhage from the isolated segment of the inferior vena cava at thrombectomy, is reviewed. A considerable progress in surgical technique of venocavothrombectomy, primarily in development of extraction methods of high tumor thrombi without the use of artificial circulation, is emphasized.

Electron microscopy of the ultrastructure of leucocytes, erythrocytes and platelets was iperformed in the area of unstable blood flow at acute and chronic diseases of the veins of lower extremities. Their increased metabolic state was determined. Disorders of cytoplasmic membrane of the leucocytes promote their fixation on the endothelial surface of the venous wall. Some erythrocytes are destroyed by turbulent blood movement.

A method of cryonecrectomy of the wounds using cryoapplications resulting in adhesions, freezing on and fixation on the effective part of the cryoapplicator of the pathological structures, which together with it are detached or resected from the wound surface with the purpose to clean it from necrotic tissues, fibrin, purulent discharge, pathologically changed granulations or reduction of pain, was suggested. The experience of the application of this method using cryoapplicator with a cotton workpiece in 17 patients with long healing wounds and ulcers of the extremities is presented. Application of cryonecrotectomy of the wounds promoted removal of thin−layer (from 0,1 mm and more) pathologically changed tissues and foreign bodies without drug anesthesia. Positive results of preparation of the wounds to plastic reconstruction were obtained.

The findings of investigation of the role of pro−inflammatory cytokines in development of psychoneurological signs in cancer patients are generalized. Association of cytokine gene polymorphism and development of these signs is featured. The necessity of further investigation of mechanisms of cytokines influence on the behavior with the purpose of development of effective strategies for treatment of psychoneurological disorders in cancer patients is emphasized.

Morphological characteristics of gastric cancer complicated by perforation were investigated in 44 patients. It was revealed that chiefly nondifferentiated cancer, poorly differentiated carcinomas and cricoic cell cancer are prone to perforations.

The data about the capabilities of pre−operative diagnosis of tumor process generalization at cancer of the upper portion of the stomach using helical x−ray computed tomography are presented. The technique of the investigation as well as its advantages and disadvantages are described in detail.

Clinical efficacy of phytoselective therapy for nonspecific endocerviscitis was assessed in women of reproductive age based on the findings of clinical laboratory and ultrasound investigation.