Vol 28, No 1 (2017)

Today chronic kidney disease (CKD) can be found in 10% of the adult population in the different countries. The management of patients with CKD depends on the glomerular filtration rate (GFR). So there is renal protection therapy including in low-protein diet, the fight against hypertension, atherosclerosis, chronic infections to patients on non-dialysis stages. The patients on the end-stage CKD need to carry out the renal replacement therapy (RRT) - dialysis and/or kidney transplantation. Whereas the qualitative and quantitative changes of gut microbiota in a varying degree are detected at all (majority)patients with CKD so the one of the perspective directions of renal protectiontherapy at all stages of CKD must be the use of the medicines modulating gut microbiota, allowing to slow the progression of CKD and to stabilize the residual renal function.

The paper considers the use of the ankle-brachial index in the diagnosis of primary arterial hypertension (AH). It shows the role of the index as an indicator of the proper functioning of the arterial neuroreflex regulation system. It is noted that primary AH may be both ontogenetic and pathological. Symptomatic antihypertensive therapy is mainly indicated to manage ontogenetic primary AH.

Premature birth is not only a medical but also socioeconomic problem. Therefore, a search for effective drugs to prevent preterm labor is relevant. According to Russian and foreign publications, the rate of premature birth after in vitro fertilization is quite high. Atosiban as an oxytocin receptor antagonist and a drug that binds to vasopressin and decreases its effect is the only tocolytic agent used to prevent preterm delivery in pregnant women with IVF.

The babies of singleton in vitro fertilization pregnancy differ from those conceived naturally in the higher incidence of somatic diseases. There were no differences between these groups of babies in their physical and neuropsychic development and the degree of resistance; they are followed up in accordance with the follow-up groups.

A survey of 178 infants with spastic infantile cerebral palsy has established that they have a high incidence of somatic diseases, especially acute respiratory infections; deficiency anemias; hypotrophy; reduced emotional status; autonomic dysregulation with increased activity of the parasympathetic nervous system and decreased autonomic reactivity; tissue hypoxia; the increased intensity of free radical lipid oxidation and antioxidant activity.

The use of antisecretory drugs, particularly proton pump inhibitors in combination with 2 antibacterial drugs, reduces the recurrences of bleeding gastroduodenal ulcers (BGDU). It is expedient to incorporate sedative therapy into the combination treatment for BGDU.

Knee replacement has become a routine surgical intervention for osteoarthritis. The paper describes a clinical case with surgical planning stages and postoperative control of the position of components using the topograms obtained by a current multi-slice CT scanner.

The paper presents the experience in using lisinopril and rosuvastatin that affect left ventricular structural and geometric changes, peripheral arterial endothelium-dependent vasodilation, blood pressure levels, and clinical manifestations in hypertensive women with hypoestrogenemia and dyslipidemia in the late fertile period.

The study of the immunological profile (a cellular component and the cytokine profile) in vibration disease opens up opportunities for the rehabilitation and treatment of patients with this pathology and augments our knowledge of the pathogenesis of this disease

The paper gives an example of clinical and immunological monitoring in a young participant of liquidation of the consequences of the Chernobyl accident.

There are a number of approaches to the isolation of adipose-derived stromal vascular fraction (SVF) for the applications in regenerative medicine. Despite all advantages, existing approaches are expensive and therefore hardly available for the clinical use. Here we present a new automated system for the isolation of adipose-derived SVF which combines an acceptable quality with high speed and acceptable cost. We describe the requirements for liposuction, infiltration anesthesia, and preservation of lipoaspirate, an original protocol of SVF isolation, and a quality control experiment. According to the flow cytometry data, SVF isolated by system contained 66,000 cells (>98% alive, >92% nuclear) per 100 μL. The proportion of lymphocytes/monocytes and target cell fraction amongst the nuclear cells was 91.8% and 7.5%, respectively. The proportion of adipose-derived stem cells in SVF was >0.5%. Therefore, system is efficient for the rapid isolation of adipose-derived SVF.

In recent years, by attracting secret visitors, the work quality assessment system in different service areas has become not only normal but also necessary: this assists an enterprise to adequately evaluate its weaknesses and strengths and, by consider the opinion of service users, to be improved. The analogue to this technique (the secret patient) has been also actively used in the field of medical services. Budgetary organizations should involve voluntary group activists or public organizations in these inspections. The latter are carried out unexpectedly; a check-list, on the basis of which conclusions of work quality may be made, is filled in and appropriate organizational decisions are made.

Introducing the therapeutic drug monitoring of valproic acids can reduce the economic burden of epilepsy; thus this is a clinically justified and pharmacoeconomic aspect of therapeutic management of the above disease.