Vol 24, No 3 (2018)

The actuality. The transitory ischemic attacks very often are considered as precursors of the stroke. The individual prognosis of risk of development of stroke after transitory ischemic attacks is unequal and is determined by differences in causes and risk factors of patients. The important place in establishing individual approach to treatment of patients with transitory ischemic attacks belongs to analysis of corresponding concomitant pathology. The analysis of morbidity is conditioned by necessity of differentiated analysis of characteristics of morbidity for development of personalized approach to treatment and restoration of health of this category of patients. The purpose of study is to investigate and analyze characteristics of morbidity of patients survived transitory ischemic attacks. Material and methods. The analysis was applied to morbidity of 351 patients survived transitory ischemic attacks, including 227 females (average age 59,6 ± 3,6 years) and 124 males (average age 57,6 ± 2,2 years). Results and discussion. It is demonstrated that level of morbidity increases with age from 233,9 до 605,9 cases of diseases per 100 examined. The analysis of rank distribution of diseases according classes of diseases demonstrated that teh first place belongs to diseases of blood circulation system (32.6%), the second place - to mental disorders (31.5%) and the third place - to diseases of endocrine system (15.5%). The positive correlation is established between availability of teo and more diseases of blood circulation system and development of recurrent transitory ischemic attacks (r = 0,688, p < 0,05). Conclusion. The availability of combined pathology in patients with transitory ischemic attacks dictates necessity of its registration at complex evaluation of health state of the given category of patients and development of multi-disciplinary approach to diagnostic and treatment of patients.

The purpose of study is to investigate pathogenesis of the first pre-clinical stage of retinopathy in premature children. Materials and methods. The sampling for examination included 642 premature born children. At the moment of birth, the gestation age was uз to 30 weeks, body mass up to 1500 g (very low body mass). The study included: indirect ophthalmoscopy; digital retinoscopy using wild-field retinal pediatric camera; calibermetry of retinal vessels. The intravital analysis of biochemical composition of vitreous body in 74 children with retinopathy and 45 animals (young rabbits chinchilla). The intra-vitreous injection of inhibitors VEGF was applied to more than 300 premature born children. The results. The retinopathy of premature born children is a leading cause of blindness. The article is devoted to mainly studying pathogenesis of only pre-clinical phase I of retinopathy of premature born children that is factually explored insufficiently. It is established that pathological angiogenesis of retina triggers an area of retina with vessels that stimulates functioning of system of struggle with hyper oxygenation and delays a normal development of angiogenesis. The immature auto-regulation of vessels of retina inadequately reacts to oxygen causing expressed angiospasm and developed circulatory disorders in vascularized retina aggravating total hypoxia. These processes delay angiogenesis almost for a month. The hypoxia-induced factors HIF1.2,3 began with significant delay both to be cumulated and to stimulate production of vascular endothelial growth factor. Conclusion. The study of pathogenesis phase I of retinopathy of premature born children open opportunity to effect pathogenic sections of disease and to prevent blindness and visual impairedness in premature born children.

The purpose of study is to evaluate the role of dynamic contrast intensification as a constituent of multi-parametric MR-therapy in diagnostic of clinical recurrence of prostate cancer and optimization of salutary X-ray therapy. Materials and method. The sampling consisted of 89 patients with marker (prostate specific antigen) prostate cancer recurrence after radical prostate ectomy. The preliminary examination established no distant metastases. The multi-parametric MR-imaging of pelvis minor was applied both before salutary X-ray therapy and 6 months later after with purpose of applied treatment control. In 44 patients’ analysis was applied to data of dynamic MR-imaging with contrast intensification constituent to multi-parametric MR-imaging with intravenous injection of various MR-mediums (1M Gadobutrol, ½M Gadodiamid and ½M Gadoversetamid). The results. The model of multiple linear regression was applied to demonstrate that square of substrate of clinical recurrence statistically reliably correlates with level of marker of prostate specific antigen (R = 0,74; p < 0,0008) independently of type of injected various MR-mediums. The sensitivity of multi-parametric MR-imaging in detection of clinical recurrence of prostate cancer was evaluated by comparison with levels of prostate specific antigen and amounted to 92%, specificity - to 82%, accuracy - to 88%. The application of technique of hypo-fractionating of radiation dose on area of clinical recurrence of prostate cancer detected by multi-parametric MR-imaging demonstrated more progressive decreasing of marker of prostate specific antigen as compared with standard scheme of salutary X-ray therapy (according McNemarre criterion p < 0,03). The statistically reliable dependence (Mann-Whitney criterion p < 0,018) of alteration of signal in case of dynamic MR-imaging with contrast intensification after intravenous injection of various MR-mediums from square of substrate of clinical recurrence of prostate cancer and initial concentration of injected various MR-mediums between 1M Gadobutrol and ½M Gadodiamid and ½M Gadoversetamid. Conclusion. The multi-parametric MR-imaging has high sensitivity, specificity and accuracy in detection of substrate of clinical recurrence of prostate cancer. The application of in initial concentration of 1M (Gadobutrol) reliably increase validity of detection of local clinical relapse of prostate cancer especially in case of detection of substrate of recurrence of enough little and extra-little sizes. The application of multi-parametric MR-imaging using various MR-mediums marker in initial concentration of 1M (Gadobutrol) prior to course of salutary X-ray therapy enables to plan a supposed zone of X-ray impact with the purpose of more personalized brining of of high tumorocide dose of radiation at the area of clinical recurrence of prostate cancer needed for full resorption of recurrent tumor.

The article presents the review of antitumoral medications for treatment registered in Russia nowadays and being at the final stage of their development - clinical studies in authorized testing centers for subsequent registration. The summarized information is presented by official sources - the State register of medications of the Ministry of Health of the Russian Federation, the Electronic Subject Heading List of Clinical Recommendations and Clinical Handbooks and prepared on their basis Orders on Standards of Medical Care. The place and role of chemotherapeutic remedies are demonstrated in relation to therapy of oncologic patients and typical schemes of application of anti-blastoma remedies in case of the most prevalent and most severe nosological forms of neoplastic diseases.

The article presents review of modern publications concerning studies of bipolar affective disorder type II. The materials are summing up concerning national and international studies of characteristics of clinical course of depressions and hypo-maniacal states within the framework of bipolar affective disorder type II, problems of differential diagnostic of bipolar affective disorder within spectrum of affective pathology. The significance of studying of pre-morbid background in case of bipolar affective disorder type II, co-morbid states for prognosis of course of disease is demonstrated. The screening, diagnostic and estimated scales and questionnaires are considered including principles of their application as an add-on to actual international diagnostic systems ICD-10, DSM-IV-TR, DSM-V.