Vol 23, No 8 (2012)

The paper gives survey data pertinent to the epidemiology of type 2 diabetes mellitus (T2DM), its diagnosis and treatment. It discusses the new diagnostic criterion glycated hemoglobin (HbA1c). Individual target HbA1c values are estimated for different categories of patients. Current drug therapy for T2DM, including the use of innovative agents from the group of incretins, such as dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 agonists, is considered in detail.

The widespread use of ionizing radiation sources in different industries and medicine, by violating their handling, storage, and transportation rules, may create conditions under which the population is exposed to them. In this regard, children who pick up unknown metallic objects and use them in games are most vulnerable. The paper describes 6 cases of radiation lesions resulting from their exposure to ionizing radiation sources in children. It gives basic information on the clinicalmanifestations of acute radiation lesions.

The paper gives data on the prevalence of insulin resistance (IR), non-alcoholic fatty liver disease (NAFL), hypertensive disease (HD) in patients with obesity. There is reliable evidence that there is a direct correlation between body mass index (BMI) and IR (correlation coefficient 0,24; p<0,001), hepatic steatosis, nonalcoholic steatohepatitis, and BMI (correlation coefficients 0,35 and 0,14,respectively; p<0,001), NAFL and IR (correlation coefficients 0,17; p<0,001), BMI and the prevalence of HD (correlation coefficient 0,21; p<0,001), HD and IR (correlation coefficient 0,11; p<0,001), BMI and systolic and diastolic blood pressures (DBP) (correlation coefficients 0,35 and 0,31, respectively; p < 0,001), and DBR and IR (correlation coefficient 0,22; p<0,001). It is advisable to use the hydrophilic angiotensin-converting enzyme inhibitor lisinopril for the treatment ofarterial hypertension in patients with IR.

The lecture is dedicated to the specific features of the etiology and pathogenesis of neonatal pneumonia and the principles of its diagnosis and therapy.

Unplanned or undesired pregnancy is one of the main problems of a contemporary woman and a factor that negatively influences her reproductive health and quality of life.

Among oral glucose-lowering drugs, glibenclamide (Maninil ®) continues to maintain its leading positions as the most effective hypoglycemic agent. The efficacy of the drug is due to its unique chemical structure that contains not only a sulfonylurea ring, but also a benzamide group in the side chain, which ensures the highest affinity for sulfonylurea (SU) receptor 1 (SUR1) on the β-cells of adenosine phosphate-dependent K + channels, on the one hand, and its ability to bind to SUR2A on the peripheral tissue cells, such as cardiomyocytes, vascular wall smooth muscle cells, and neurocytes, on the other hand. At the same time, this peculiarity can increase the risk of hypoglycemic states and have a negative impact on the cardiovascular system. The data of the clinical trials proving the efficacy and safety of the drug that received the 2010 G.G. Creutzfeldt Drug Prize due to the evidence-based long-term follow-ups demonstrating the reduced risk of vascular complications of diabetes mellitus, its capacity of combining with medicines of other groups, its use in elderly and multimorbid patients. Glibenclamide is the only SU agent entered into the WHO’s list of essential medicines.

The paper covers the role of the endogenous resident enteric microflora. It considers the factors that lead to impaired enteric microbiocenosis, its clinical symptomatology, and therapeutic correction options. A new probiotic complex (ProbioLog ®) that comprises Bifidobacterium lactis BB-12 ® and Lactobacillus acidophilus LA-5 ® and shows a high therapeutic activity is presented. The most important feature of ProbioLog ® is that it has an acid-resistant polysaccharide matrix included into the structure of a capsule; owing to which the high probiotic activity of the complex is retained after its presence in hydrochloric acid for an hour.

The impact of gender on arterial rigidity indices was studied in 134 apparently healthy public officers aged less than 60 years: in 74 men (mean age 48,96±8,53 years) and 60 women 53,95±5,61 years; p<0,05). 75% were in menopause. The groups were comparable in the prevalence of hypertensive disease, average heart rate, levels of cholesterol, low-density lipoproteins, and fasting glucose. The men had significantly higher office blood pressure levels and more frequently overweight and the women were more often recorded to have increased aortic augmentation index and higher aortic pulse wave velocity (APWV). The abnormal APWV rise (>12 m/sec) was observed in 29.58% of the women and in 12,7% of the men (p=0,02), which may be due to the specific features of remodeling of the vascular wall and its altered elastic properties in menopause.

The authors studied the time course of changes in the values of functional and transport stocks of iron metabolism in pregnant women with latent iron deficiency (LID) and chronic pyelonephritis in the presence and absence of treatment with the iron (III) preparation polymaltosate hydroxide. The efficiency of treatment for LID (selective prophylaxis) was ascertained to be significantly higher in pregnant women without renal inflammatory diseases (93,5%) than in those with LID and chronic pyelonephritis (70,9%). Selective prophylaxis in pregnant women with LID prevents manifest iron deficiency, causing a reduction in the incidence of placental insufficiency and fetal growth retardation.

The clinical efficacy and safety of the combined antitussive «Codelac Broncho with thymus» elixir were studied in 40 children aged 2 to 6 years who had acute bronchitis. The combined antitussive was shown to surpass the mono-drug ambroxol in its effect on the duration of harassing cough and cough accompanied by difficult sputum expectoration. Of clinical importance is the significant reduction induced by «Codelac Broncho with thymus» therapy in the duration of persistent symptoms of intoxication and severe rhinitis.

The paper gives the results of studying the reproductive health of adolescent females aged 15-17 years living in the rural area. It identifies the leading risk factors of reproductive losses and evaluates the impact of sex education of schoolchildren on their reproductive health.