The Journal of V. N. Karazin Kharkiv National University. Series «Medicine»

8-12

Authors: J. Akermi, Y. A. Andreeva

The article presents the results of investigation of gastric mucosal microcirculation with the help of laser-Doppler flowmetry in acute phase of duodenal ulcer during 7 and 14-day eradication therapy. The study enabled to obtain some data on effectiveness of the two therapeutic eradication regimens as well as their im-pact on gastric mucosal microcirculation in the process of ulcer defects healing.

17-21

Authors: P. А. Garkaviy

Age and gender difference of SBP orthostatic reaction types and HR in healthy subjects and AH patients were found. Rate of SBP hyper- and hypotensive reaction types decrease with age. Frequency of hypertensive type in AH is increased. HR increases in orthostasis disregarding SBP reaction type, the extent of growth increases from hyper- to hypotensive reaction. HR reactivity is higher in males.

29-36

Authors: M. S. Maltseva, D. E. Volkov, D. A. Lopin, I. V. Soldatenko

Implantation of the pacemaker (ECS) in the various classes of corrected QTc interval duration of stimulated complexes were investigated. Evaluation was made by sex and age of the patients, chronic forms of ischemic heart disease (CIHD): postinfarction cardiosclerosis, stable angina (I-IV functional classes (FC)); stable angi-na (I-IV FC), arterial hypertension (AH) – 1-3 degrees and stages (1-4), type of diabetes mellitus (DM), atrial fibrillation (AF) (paroxysmal and persistent, permanent), chronic heart failure (CHF) – stages I-III, I-IV FC; functional indicators before pacemaker implantation and in the acute postoperative period (3-5 days after surgery): QTc interval duration, heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP); ejection fraction (EF) of the left ventricle (LV), anterior-posterior size of the left atrium (LA), end-systolic volume (ESV) and end-diastolic volume (EDV), the thickness of the back wall of the left ventricle (AP LV), the thickness of the interventricular septum (IVS), left ventricular mass (LVM). The patients were divided into 3 classes: class 1 – normal QTc (320-440 ms) – 27 (22 %) patients, class 2 – elongated QTс (> 440 ms) – 97 (78 %) patients. Standard statistical procedures using Microsoft Excel were applied for data processing. The results showed that QTc interval duration of stimulated complexes in the acute postoperative period after pacemaker implantation can be established in a physiological range in 22 % of patients, and in 78 % – it remains longer or even elongated. Elongation associated with a higher incidence and the increase of FC and stages of heart failure, high values of ESV and EDV, mostly in the pacing mode VVI/VVIR and DDD/DDDR. Patients with a pacemaker require more careful monitoring the stimulation parameters as well as ongoing drug therapy.

42-46

Authors: I. V. Shanina, D. E. Volkov, D. A. Lopin, N. I. Yabluchansky

125 patients (57 – women, 68 – males) with permanent pacing were examined. Among the indications for pacemaker installation there were atrio-ventricular block (AV-block) – 77 people (62 ± 4 %), sick sinus node syndrome (SSNS) – 32 patients (26 ± 4 %), bradysystolic AF – 8 patients (6 ± 2 %). 8 patients with cardioresynchronization therapy (6 ± 2 %) were also included. Average age was 69 ± 7 years. The patients were divided into two groups: first – patients with QRS complex duration under 120 mc, second – QRS duration complex with more than 120 mc. It was found that QRS complex duration with more than 120 mc is associated with males and patients with postinfarction cardiosclerosis, heavier functional class of heart failure and atrial fibrillation. Given the trend towards more clinically significant cardiovascular disease in patients with a QRS complex duration with more than 120 mc, this group of patients needs optimal therapeutic management. The results show the feasibility of and prospects for further study of this group of patients.

54-63

Authors: V. P. Starenkiy

The possibilities of use of modern multimodal imaging technologies during the distant radiation therapy treatment planning are analyzed. The conditions for carrying out of different modality tomography research for needs of treatment planning are determined. The issues of informativity of the hybrid images for target volume finding are considered.

72-76

Authors: I. V. Shanina, D. E. Volkov, D. A. Lopin

The case of cardiac biventricular resynchronization without destruction of the atrio-ventricular node in patients with chronic heart failure (CHF) and permanent atrial fibrillation (AF) is described. The observation period was 14 months. The case demonstrates that biventricular resynchronization for severe heart failure with atrial fibrillation and significant atria size with theoretical and practical impossibility of its’ transforming into the long-term persistent atrial fibrillation is a reasonable alternative of atrio-ventricular pacing. Though the destruction of the atrio-ventricular node can be delayed for a significant period of time, it should be done at the earliest opportunity. Pacemaker implantation does not cancel medical therapy, with the necessity for the latter to be according to the conducted biventricular pacing.

13-17

Authors: S. А. S. Belal, A. L. Kulik, A. V. Martynenko, M. I. Yabluchanskiy

On 14 healthy volunteers (6 men and 8 women) aged from 21 to 27 years the effectiveness of biofeedback in the loop of paced breathing and heart rate variability (HRV) parameters in different race groups was examined. All volunteers were divided into 2 groups comparable in age and sex: 1 — representatives of the South Europeoid race, 2 — representatives of the Medium Europeoid race. Each volunteer underwent 7 bio¬feedback sessions in the studied loop. It was found that in the beginning in representatives of the South Europeoid race biofeedback quality index was lower than that in representatives of the Medium Europeoid race, but both of them was located in the suboptimal zone. Biofeedback in the loop of paced breathing and HRV parameters has the same positive effect on the representatives of both races, that allows to recommend it for correction of regulation balance in each of them.

23-31

Authors: M. P. Kopytsya, N. V. Tytarenko, N. V. Bila, O. L. Oparin

The aim of this study was to define the utility of the measurement N-terminal pro-brain natriuretic peptide (NTproBNP) and other clinical and biochemical markers to predict adverse events (death, stroke, unstable angina, re-infarction, or necessity of revascularization at 1 year in patients with acute coronary syndrome (ACS). Parameters with significant differences in patients with and without complications were taken for ana-ly¬sis: age, heart rate (HR) at admission, levels of hemoglobin and NTproBNP. Curves of sensitivity and spe¬ci-fi¬city were used based on the method of ROC analysis and cut-off values were chosen for each variable. Ball scoring was performed for each parameter regard to the cut-off value and a scale for calculating the summarized diagnostic coefficient (DC) by the method of Gubler was offered. A multimarker approach includ¬ed on NTproBNP, hemoglobin, HR at admission and age and the summation of balls based on offered sca¬le and calculating DC provides in¬formation in terms of ACS prognosis at 1 year, with a worse outcome for those with diagnostic coefficient has negative value (sensitivity 87,5 % and specificity 75,6 %).

38-41

Authors: T. М. Pasieshvili

In patients with asthma and obesity studied the performance of proinflammatory cytokines ТNF-α and IL-6 and lipid profile. It is shown that the active inflammatory process in the broncho-pulmonary system leads to a significant increase of the TNF-α and IL-6, which is due not only inflammation, but also the additional generation of adipose tissue. Lipid profile of these patients is characterized by the formation of the most atherogenic lipoproteins voices, which is considered as an adverse factor in the formation of metabolic disorders.

52-62

Authors: О. E. Tominа, O. Yu. Bichkova, G. M. Fomych, O. O. Ivleva, О. O. Ohriamkina, N. Yu. Usan

In out-patient conditions patients with hypertension were investigated (n = 141): of which the core group consisted of 41 patients with hypertension (H) comorbid with peptic ulcer (PU); the comparison group 1 con-sisted of 58 patients with isolated H and comparison group 2 consisted of 42 patients with isolated РU. The frequency of circadian rhythm (CR) of systolic blood pressure (SBP) and heart rate variability (HRV) were studied, including taking into account the different types of CR SBP. Three types of CR SBP (dipper, non-dipper, knight-peacker) with a prevalence of pathological (45 % of non-dipper, 15 % of knight-peacker) CR SBP are characterized. Low Total Power (TP HRV) (1203 ms2 ± 852) with the lowest values in the group with knight-peacker CR SBP (839 ± 462 ms2), and there is a significant removal of simpatovagalnogo balance (LF/HF) in the sympathic direction (3,3 ± 2,6) due to the non-dipper CR SBP (5,3 ± 2,6). Violation of or-thostatic reactions is observed from the side of TP HRV (increase on 44,8 %) in the dipper CR SBP, and the test with modulated breath (decrease on 47,2 %) from the side of the LF/HF in the non-dipper CR SBP.

69-73

Authors: M. І. Shevchuk, N. І. Yabluchansky

This article was to examine the relationship between of the QRS complex duration and clinical manifesta-tions of arterial hypertension (AH). Relationship between the QRS complex duration (QRSD) and clinical manifestation of disease was studied in 130 patients (53 males and 77 females) mean age 65 ± 10 years with AH 1–3 degrees, and I–III stages. Estimated age, sex, prescription of hypertension, blood pressure (BP), heart rate class, the severity of heart failure, left ventricular ejection fraction (LVEF), acute myocardial infarction in the anamnesis (AMI), stroke in the anamnesis. Registration of the QRS complex was carried out on a com-puter electrocardiograph «Cardiolab+». In study population the range of QRSD was on five groups: 60–99 ms, 100–119 ms, 120–139 ms, 140–159 ms, > 160 ms. Evaluation of results by methods of parametric sta¬tis¬tics. Of these patients, 54 % had QRS complexes > 120 ms, shortened QRS complexes were absent. Distri¬bu¬tion of QRSD was asymmetric with a shift toward smaller values. Relationship QRSD in patients with AH was with its remoteness, the level of blood pressure, heart rate class, the severity of heart failure, reducing the degree of LVEF. Established the important role of the QRSD in clinical manifestations of hypertension. The degree of change in the QRSD should be used as a marker of the effectiveness of antihypertensive therapy.

81-90

Authors: N. V. Lysenko, A. Y. Kartvelishvili

Presented clinical pharmacology of biological products under the ATC classification system. The classifi-cation, characteristics of pharmacodynamics of drugs. An algorithm for the use of biological agents in thera-peutic practice: rheumatology, gastroenterology, neurology. Examined in detail the absolute and relative con-traindications and side effects of biological agents, as well as control measures in their long-term use.

99-104

Authors: N. V. Chuchula, E. N. Chuchula

Local anesthesia for the patient’s general condition is the most important dental procedures. This article pre¬sents the classification and overview of integral components of modern local anesthetic drug. Represented the classification of local anesthetics, the absolute and relative contraindications and characteristics of use according to concomitant somatic pathology of the patient. Characteristics, the use in risk groups and contraindications of complex corpular components of modern local anaesthetic preparations are presented.

109-112

Authors: N. N. Popov, A. N. Savvo, O. V. Piontkovsky, N. I. Timokhina, E. A. Dyachenko

Children are often treated in non-core healthcare establishments and receive consultation of a pediatric immunologist too late when they already suffer from irreversible changes in various organs and body systems. For the main purpose to expand practical doctors’ knowledge about humoral immunity primary immunodefi¬ciencies (PID) description of two cases of hypogammaglobulinemia in children (boys) aged 10 years is provided though clinical manifestation of the disease began in the early childhood. It was shown that proper diagnostics of PID allows providing adequate substitutive therapy and preventing children disability.

121-126

Authors: K. I. Reminskaya, L. O. Martymianova

The clinical pharmacology of thyroid hormons in the classification system of ATS is described. Clinical classification, pharmacokinetics and peculiarities of drugs of this groupare submitted. Indications for use and features of use of thyroid hormons in a therapeutic clinic are considered.The article points out the urgency of use of these drugs curing hypothyroidism (any genesis), preventing the recidivation of nodular goiter. The primary contraindications, emphases of interaction with other drugs, side effects and symptoms of over-doseare given.

10-21

Authors: A. N. Yabluchanskiy

Hemorrhagic stroke in response to intracerebral hemorrhage is considered an aseptic form of inflammation. With this in mind the dynamics of leukocytes changes in blood and in the hemorrhagic stroke zone as main factors of inflammation are examined. Sprague-Dawley rats (N = 24) underwent surgical procedures and were divided into two groups — control group and a hemorrhagic stroke group — an injection of 2 µL of sterile saline and 2 µL of 0,2U of Collagenase-IV (S) respectively. White blood cells count analysis, combined histological and immunohistological examination with further densitometric and statistical analysis of blood and hemorrhagic stroke zone leukocytes were performed. A synchronized increase in blood and hemorrhagic stroke zone levels of both polymorphonuclear and mononuclear leukocytes was observed, highlighting the inflammatory nature of hemorrhagic stroke. A delay of 48 hours between peak levels of polymorphonuclear and mononuclear leuokocytosis both in blood and the hemorrhagic stroke zone was established. Therefore, understanding hemorrhagic stroke as one of the forms of aseptic inflammation suggests alternate perspectives in the development of new approaches to diagnosis and treatment including interventions into kinetics of blood and hemorrhagic stroke zone leukocytes.

29-33

Authors: N. M. Zheleznyakova

The article deals with aspects of quality of life of patients with isolated COPD and combined with chronic pancreatitis (CP). Quality of life was assessed with general medical (SF-36 questionnaire) and specialized respiratory (St. George’s Hospital Questionnaire — SGRQ) questionnaires quality of life. It was found that the accompanying CP has a negative effect on quality of life of patients with COPD.

39-45

Authors: O. O. Lutsak, L. P. Parashchenyuk, P. M. Babych, L. G. Voronkov

Total score of standardized CHF-specific QOL survey MLHFQ, as well as it changes during treatment allow to foresee in approximation chances for survival in the patients with CHF of III–IV NYHA functional over the following 6 and 12 months of treatment. Total MLHQL score exceeding 72 (HR = 2,64) is an infor-mative predictor of patients’ with manifested CHF non-survival over the following 6 months. Total MLHQL score exceeding 69 (HR=2,34) is an informative predictor of patients’ with manifested CHF non-survival over the following 12 months. Increase in the total score in > 2,5 is a predictor of patients’ with clinically mani¬fested CHF over the following 6 months (HR = 4,97) and 12 months (HR = 3,50).

50-56

Authors: A. V. Muzhichuk

On base of a comprehensive survey of 248 patients with different thyroid pathology, artificial neural network has been created. Its task was to predict the possibility of cancer risk in patients with thyroid benign pathology. Neural network training based on the data of surveys carried out 120 patients, testing according to 128. Trained artificial neural network is highly flexible with regard to the different variants of the background benign pathology and capable with high sensitivity (89,5 %) and specificity (80,3 %) forecast the existence of hidden currents or probability of occurrence in future thyroid cancer in patients with benign pathology.

65-71

Authors: N. P. Kopitsa, Ya. V. Gileva, N. V. Belaya

Vascular inflammation plays a key role in atherogenesis. In this regard, in cardiology for clinical evaluation of patients are widely being used biomarkers reflecting inflammation in the organism, as their increasing is associated with an increased risk of cardiovascular disease development. Determining of the level of one of these biomarkers — lipoprotein-associated phospholipase A2 (Lp-FLA2) along with the already widely used C-reactive protein promises to significantly improve the detection of high-risk patients especially in acute coronary syndrome, as well as to assess the adequacy of therapeutic strategy.

88-101

Authors: M. I. Shevchyk, L. A. Martimyanova, N. I. Iabluchanskyi

This review discusses the importance of the QRS complex duration in patients with hypertension. QRS complex of ECG reflects the functional state of the myocardium — isovolumetric contraction and systole de-fining the entire follow-up of the heart. The change in QRS complex duration of hypertension is an important marker for early detection of ECG myocardial hypertrophy, the risk of arrhythmias, ECG changes the picture when combined with concomitant diseases and conditions, the effectiveness of antihypertensive therapy.

105-111

Authors: V. A. Strikhar, A. N. Fomich, N. I. Yabluchansky

An example of the clinical case demonstrates a significance of the correct diagnosis and treatment of is-olated diastolic arterial hyper-and hypotension in patient with sympathetic distress and atherosclerosis. Research methods comprised lipid profile, heart rate variability, blood pressure monitoring and Holter ECG. The crucial role in the treatment of the patient belonged to biofeedback and medical therapy with atorvasta-tin and cinnarizine.

17-21

Authors: N. P. Kopitsa, I. R. Vishnevskaya

For mechanical reperfusion using as primary percutaneous coronary intervention (PPCI) and at pharma-coinvasive strategy requires a clear compliance with the time intervals that is an important moment in the treatment of myocardial infarction-segment elevation ST (MI ST). However, it should be noted that a large proportion of patients who in the time frame set was performed reperfusion therapy with thrombolytic or PCI restoring blood flow is achieved only at the epicardial vessels, i.e. developed the so-called phenomenon of «no-reflow» or the phenomenon of «no blood flow recovery». Proved that in the development of the state play a role once 4 pathogenetic factors that complicates diagnosis and treatment of the phenomenon of «no-ref¬low». Largest proven positive effect for preventing the development of the phenomenon of «no-reflow» have blockers GP IIb/IIIa receptor.

28-32

Authors: N. M. Zhelezniakova

In 67 patients with chronic obstructive bronchitis (COB), which in 46 cases, proceeded in combination with chronic pancreatitis (CP), studied the state of pro-and anti-inflammatory immunity link and levels of antibodies to the liver and lungs tissue. It was shown that COB exacerbation leads to increased levels of IL-1 and TNF-α against the oppression of IL-4 production and inadequate response of IL-6. In case of combining course of COB and CP changes in cytokine state were reliable. Increasing of IL-6 level indicate a significant ac¬tivation of nonspecific humoral immunity. At the same time shows an increase of antibodies to the lungs and liver tissues number, which was more pronounced in case of diseases combination, which is regarded as the possibility of disease progression and complications.

38-43

Authors: I. V. Lakhno, E. A. Barannik, A. E. Tkachov

It was performed the investigation of the umbilical vein blood flow Doppler spectrograms of 85 patients in the term 37–41 week of gestation and 22 persons of them had normal fetal condition. Intrauterine fetal growth restriction was diagnosed in 63 pregnant women. The spectral components of maximum blood flow velocity were defined. In case of physiological pregnancy umbilical vein blood flow was provided with proper myo¬genic contractile activity with the frequency of 7 Hz. It was also depended on the arterial component asso¬ciated with fetal heart rate in the range of 2 Hz. It was determined that fetal compromise was associated with an increase of the slow-wave maternal origin processes with a frequency of 0,5 Hz in the umbilical venous hemodynamics regulation and depletion of the proper myogenic activity. The applied approach could improve current concepts of ergo-trophotropic mechanisms of fetal well-being.

48-53

Authors: A. V. Letjago, I. S. Lebets, I. N. Nelina, O. L. Govalenkova

There has been carried a study of connections between cytokine status (IL-1β, IL-6, PNP-α) and microcir-culation system (MCS) in adolescents at the age of 15–18, with knee joint osteoarthrosis (OA). MCS para-meters have been estimated by nail bed capillaroscopy; cytokine level has been measured by immunoassay method applying test system produced by «Proteinovyj Kontur», Saint-Petersburg, Russia. It has been estab-lished that inflammatory reaction in affected joints took place in ⅓ of patients and has been characterized by swelling, pain on palpation and movement, morning stiffness, local rise of temperature over knee joints. Anti-inflammatory cytokines level manifested a significant increase even without objective signs of synovitis. MCS parameters manifested some changes in perivascular background which has been characterized by blur¬riness and paleness. Correlations between microcirculatory abnormalities and anti-inflammatory cytokine levels have been discovered. It has been established that an increase in cytokine level positively correlated with a decrease in blood circulation velocity and a decrease in quantity of capillaries in function.

59-63

Authors: G. M. Fomych, O. E. Tomina

Prognostic significance of orthostatic reactions of ventricular rate (OR VR) among other clinical and hemo-dynamic characteristics in patients with permanent atrial fibrillation (AF below) in 123 patients (62 men and 61 women) aged 55 ± 15 years with a prescription AF 6 ± 5 years has been studied. Prognostic signi¬ficance of clinical signs and hemodynamic parameters in assessment of the effectiveness of permanent AF control was determined retrospectively on the medical therapy results via step discriminant analysis. It is established that the type of OR VR together with other clinical and hemodynamic characteristics (body mass index, QRS duration, prescription of AF, the total power spectrum, the sympathetic and vagal balance) has prognostic significance in the effectiveness of control ventricular rate in atrial fibrillation, it is necessary con¬si-der when choosing a treatment strategy for these patients.

68-74

Authors: Vatutin N. T., Kalinkina N. V., Bakhteeva T. D., Kolesnikov V. S.

Nowadays theraputical strategy of acute myocardial infarction includes both repefusion methods and treatment of consequences of blood flow restoring. This review presents recent data of literature on one of endogenous cardioprotection mechanisms, that preserves myocardium from ischemic and reperfusion dama-ge ― ischemic postconditioning. Separately we marked at the history of investigation of this question. We examined processes, underlying this mechanism, triggers, that initiate it’s launch and its clinical perspectives.

82-93

Authors: A. L. Kulik, N. I. Yabluchansky

In the review the technology of biofeedback is examined ― promising direction in modern clinical medi-cine. The history of the method and variants of the technical implementation of the contours of biofeedback is described. The efficiency of the method in clinical practice on the example of chronic heart failure is discussed.

100-105

Authors: A. Volkovа

The article deals with topical issues of international legal regulation of transplantation, as well as the practice of the international community and Ukraine, in particular the implementation of health activities in the field of transplantation.

9-15

Authors: L. A. Yurchenko

Determinated haemolitics and lecithinase activity 80 cultures of Proteus, abstracted from the different hearts of infection; the cultures from pathological material had greater haemolitics activity as compared rela-tively transmitters. A hard defined medium with properties swarming inhibition, which didn’t inhibition acti-vity Proteus for haemolitics of erythrocytes, is developed. Dependences of haemolytic or lecithinase activity of Proteus from its finding in O- or the H-form not revealed.

22-29

Authors: A. N. Boiko

The content of proinflammatory cytokine is increased in blood of the patients with helicobacter pylori – negative gastropathies and with chronic heart failure (CHF) of an ischemic genesis. This confirms the theory of existence of the system inflammatory answer at this category of patients. 105 patients with essential arterial hypertension and CHF of II and III functional classes with helicobacter pylori – negative gastropathies with the mediana of age 54 years were examined. It was established that degree of rising blood concentration of such cytokines as IL-1 and the TNF-1 has direct dependence with stages of CHF. The analysis of the re¬ceived results gave us the evidence that patients with CHF and helicobacter pylori – negative gastropathies have significantly higher levels of proinflammatory cytokines and ET-1 in comparison with patients without gastropathy. Also the blood level of PGF1 was significantly smaller at this group. Thus, the development of gastropathy at the patients with arterial hypertension of 2 degree and with CHF is associated with activation of an immune inflammation and increasing disturbance of an endothelium functional condition. Significant differences at the patients with various level of cardiovascular risk were revealed only for the blood TNF-1 content. This fact confirms the strong connection between this indicator and the forecast for the given category of patients.

37-42

Authors: N. G. Gravirovska, О. I. Zalyubovskа

During examination of the regional indexes of prevalence and morbidity of duodenum peptic ulcer (PU) in Kharkov and Dnepropetrovsk regions and tendency of their development, the high growth rates of PU prevalence in Ukraine as well as in indicated above regions has been determined. Regional domination of PU morbidity growth rate in Khakov region has been established. It exceeds the similar index in Ukraine by 87 % with maximum increasing in 2004 by 63, 6 %. Reducing of the number of first time diagnosed PU cases in subsequent years can be explained not only by more effective medical technologies but also by the lack of diagnostic capabilities of medical service, imperfect management of the patients at the dispensary observation stage that leads to an increase of severe complications and necessity of surgical intervention.

46-49

Authors: A. А. Zazdravnov

In this article author analysed the corellation of anemia and gastroesophageal refluxe disease (GERD) by patients with rheumatoid arthritis (RA). Author offers personal experiences (110 cases). The main patho-genetic links of anemias and heterogeneity of anemia in patients with rheumatoid arthritis have been elucidated. The frequency of occurrence of GERD and pathogenetic mechanisms of GERD in these patients were studied. Relationship between anemia and GERD in patients with RA has been established.

52-60

Authors: M. P. Kopytsya, N. V. Tytarenko, N. V. Bila, O. L. Oparin

The aim of this study was to define the utility of the measurement N-terminal pro-brain natriuretic peptide (NTproBNP) and other clinical and biochemical markers to predict adverse events at 1 year in patients with ACS. Parameters with significant differences in died and surviving patients were taken for analysis: age, heart rate (HR) at admission, levels of hemoglobin and NTproBNP. Curves of sensitivity and specificity were used based on the method of ROC analysis and cut-off values were chosen for each variable. Ball scoring was per-formed for each parameter regard to the cut-off value and a scale for calculating the summarized diagnostic coefficient (DC) by the method of Gubler was offered. A multimarker approach included on NTproBNP, hemoglobin, HR at admission and age and the summation of balls based on offered scale and calculating DC provides information in terms of ACS prognosis at 1 year, with a worse outcome for those with diagnostic coefficient has positive value (sensitivity 88,9 % and specificity 93,8 %).

66-71

Authors: T. V. Lukyanenko

The article presents the research results of the antistreptolysin O, antihyaluronidase, complement, and lysozyme levels in patients with alcoholic delirium complicated and not complicated by community-acquired pneumonia. Antistreptolysin O and antihyaluronidase levels in patients with pneumonia are above the norm and correlated with the severity of community-acquired pneumonia course. The complement and lysozyme titers are below the norm. We consider this to arise from the prolonged course of alcoholism, frequent bacte-rial complications caused by associations of mircroorganisms, including Streptococcus sp. The bacterial complications for this category of patients are caused by the microflora with a considerable level of antilysozyme and anticomplementary activity. The data we obtained may be used for prognosticating the infectious complications in patients with alcoholic delirium.

76-83

Authors: G. M. Fomych, N. I. Yabluchanskiy, L. A. Martimyanova

A relationship between different types of orthostatic reactions (OR) of ventricular rate (VR) and clinical ma¬nifestation of permanent atrial fibrillation (AF) in 73 patients (32 men and 41 women) aged (55 ± 15) years with a prescription AF (6 ± 5) years has been studied. All types of OR have been noticed in studied popu-lation. Positive OR of VR have been dominated (41 %), negative and absent OR of VR have been occurred more rarely (34 % and 25 % respectively). Qualified positive OR of VR have been occurred in 27 %, and negative – 40 % of patients. High incidence of prognostically less favorable qualified negative, positive and absent OR of VR in elderly and senile patients with AF requires closer attention with more precise exami¬na-tion, drug therapy and lifestyle modification of patients.

88-104

Authors: A. М. Yabluchanskiy

Intracerebral hemorrhage remains one of the less studied problems in modern neurology. Later pub-lications suggest that inflammatory processes play a significant role in hemorrhagic stroke; however, most of these reports represent fragmentary information on the local and less system levels of inflammation, and do not show the correlation between these levels. In this review the attention is focused on the compensatory, adap¬tive and restorative nature of the inflammation in the post-intracerebral hemorrhage damage. Non-complicated and complicated forms of inflammation are discussed regarding their influence on the course and outcomes of hemorrhagic stroke. Optimization of complicated inflammation could be one of the approaches for improving the outcomes of hemorrhagic stroke.