Vol 15, No 2 (2018)

In this article innovative issues of rheumatoid arthritis (RA) treatment with disease-modifying anti-rheumatic drugs (DMARD) have been discussed. Updated national and international (EULAR 2016) recommendations for management of RA have been analyzed. It was pointed out that current approach rests on treat-to-target strategy and on early aggressive therapy with conventional synthetic drugs and/or biological agents. The brief review of available biologics approved for RA treatment has been presented. The novel class of target synthetic disease modifying drugs (ts-DMARD) was highlighted. Authors have presented theirs clinical experience data demonstrating efficacy and safety of novel ts-DMARD Tofacitinib, a Janus kinase inhibitor in RA treatment.

One of the many causes of male infertility are traumatic damages of the scrotum organs, which in 80 % of cases are accompanied by rupture of the testicle and epididymis. With traumatic tearing of the testicles, the optimal method is an organ-preserving operation. For reliable recovery of the spermatogenesis process, an effective method is the implantation of a 30 % solution of hyaluronic acid, which helps protect the hematotestick barrier and restore spermatogenesis.

Aim. To evaluate the background which antihypertensive therapy the most frequently achieved target blood pressure (BP) level in patients with hypertension and type 2 diabetes mellitus without manifested micro- and macrovascular complications in outpatient practice. Materials and methods. An open nonrandomized observational study wits analysis of primary medical records of patients was performed. Results. The data of 170 patients meeting the inclusion criteria were analyzed. Only 60 of patients reached the target BP level. In this case, slow calcium channel blockers (SCCB) and beta-blockers (BB) were most often prescribed - in 25,8 and 23,4 %, respectively. Angiotensin converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARBs) were prescribed in 14,5 and 15,3 %, respectively Fixed combinations (FC) prescribed in 15,4 % cases, most often this were diuretics combined with ACEI or ARBs. Conclusion. In the study group the target level of BP was reached in 35,3 % cases. Most often it was achieved against the background of two- and three-component therapy (31,7 and 45 %, respectively). FC were appointed only in 15,4 % cases. Low frequency of ACEI and ARBs prescriptions, which should be first-line drugs in these patients, was revealed.

Currently there are several biological therapy drugs used in the treatment of rheumatoid arthritis (RA), in connection with which there was a problem of choosing a drug. Materials and methods. 18 patients with rheumatoid arthritis, who received combination therapy with methotrexate and infliximab were examined. All patients before the start of treatment with infliximab and after 30 weeks were determined in the blood serum of TNF-α, IL-1, IL-2, IL-6. Results and conclusions. Hyperproduction of proinflammatory cytokines again confirms their participation in the development and progression of the RA. Increased levels of TNF-α, IL-1, IL-2 are more likely associated with a moderate effect of the conducted gene therapy at minimal and medium therapeutic dosages.

The analysis of heart rate variability parameters, got by using a 5-minute ECG record, allows to obtain a complex data about functional state of organism. In this regard, this method was used in assessment of hospital and post-hospital rehabilitation of patients with acute coronary pathology In the course of the study 197 patients (137 men and 60 women) aged 40-65 years (56,9 ± 6,2), who entered the department of emergency cardiology with a diagnosis of acute coronary syndrome, were included. The registration of heart rate variability was carried out on the 3rd, 8th, 14th days and on 6th and 12th months afterwards. The results of the study revealed unidirectional disturbances of the regulation mechanisms of cardiac rhythm at all levels, the predominance of sympathicotonia from 3th day to 12th month in patients with acute coronary pathology. Differences between groups of unstable angina and acute myocardial infarction were revealed from 3 days to 6 months for a number of indicators.

This paper describes the new approach of process of optimization and comprehended analysis of results for copper-induced ascorbate autoxidation method. This is a metod of chelating activity detection. Real-time technique in data registration was used and integrative analysis in comparison of the results was applied. It gived a possible to evaluate the chelation properties of pioglitazone without calculation of IC50. This variant is most acual for spread screening of chelating activity.

The article presents the results the study of dental patients compliance to the treatment provided, who suffer from somatic disorders and that are in need of surgical treatment. It is established that among the other socio-demographic factors the largest influence portion on the compliance of dental patients with surgical pathologies of internal organs has their education F (2, 122) = 9,84, p = 0,0001, ŋ2 = 0,14, the field of patients activity has the contribution of F (3, 121) = 3,5, p = 0,016, ŋ2 = 0,08, income level has the influence rate on the compliance on the studied group of patients as F (3, 121) = 3,9, p = 0,01, ŋ2 = 0,09, and the diversity of free time passing equaled F (2, 122) = 6,3, p = 0,0024, ŋ2 = 0,09.

The incidence and localization of hyperplastic jawbone formations in men and women in the city of Volgograd was determined according to the data of X-ray studies. An algorithm for managing patients with hyperplane jawbones in an orthodontic treatment is proposed.

The article reflects the results of the use of platelet-enriched autoplasm in prosthetics of the anterior abdominal wall with an ultralight polypropylene-polyvinylidene fluoride endoprosthesis. The aim of the study was to study the morphological changes in the connective tissue surrounding the ultralight polypropylene-polyvinylidene fluoride endoprosthesis at different implantation times using platelet-enriched autoplasm. As a result, it was found that after the introduction of autoplasm, the inflammatory response to implantation of the endoprosthesis was lower by the 7th day at 1,5, and on the 14th day by 1,2 times. The thickness of the periprosthetic connective tissue capsule was statistically significant (p < 0,05) more by 7th in 1,3, by 14th in 2,6 times. Thus, the introduction of autoplasma, enriched with platelets, allows to accelerate the formation of a mature connective tissue capsule with ultralight abdominal endoprosthetics and provides a faster survival of the prosthesis.

Preservation and maintenance of the energy function of the heart is one of the central tasks of modern cardiology. The study was carried out on 25 mature male Wistar rats weighing 220-310 g. To obtain a toxic solution, the salt of cobalt chloride was dissolved in sterile distilled water in such a way that 0,8 mg of cobalt was concentrated in 0,2 ml of solution. The study showed that changes in the myocardium of experimental rats developed which could be attributed to varieties of toxic cardiomyopathy according to morpho-functional manifestations. Typical changes in the myocardium after the introduction of cobalt chloride were manifested in the following: a) a progressive decrease in the proportion of intact cardiomyocytes; b) lysis of mitochondrial cristae and contractural changes in the contractile apparatus; c) the growth of stromal proliferation and lymphocytic infiltration, affecting the muscle fibers with subsequent collagenogenesis.

The only helminthes transmitting by mosquitoes to humans in Europe are nematodes of the genus Dirofilaria. Dirofilariasis is an emerging zoonotic infection in which the human serves as an accidental host. Russia has been one of the most important endemic regions worldwide for dirofilariasis. Globally, the majority of cases in humans and animals are caused by the two Dirofilaria species, D. repens and D. immitis. In European countries, D. repens is the main causative agent of human dirofilariasis. The Volgograd region may be characterized as one of the new endemic regions of Russia for dirofilariasis. Materials and methods. The aim of this study was to describe the current epidemiology of dirofilariasis in the Russian Federation and in the Volgograd region based on data published since the first case described, together with the data of the veterinary clinic «Help to a friend (medical care for pets)». Results. The current epidemiological trends are derived especially for the Volgograd region when compared with previous data.

The rate of mistakes during eye-drop instillation and the most frequent mistakes done by 77 patients in age of 35-50 years is analyzed. The study revealed that 20,7 % of patients done the instillation not into the conjunctival bag, 33,4 % had closed eyes tight, 37,7 % had rapidly moved their heads down, 45,5 % had forgotten about the interval between the different eyedrops instillation. These mistakes could reduce the efficacy of the local therapy and lead to the systemic effects. Thus, ophthalmologists must make efforts to be sure that patient uses the prescribed eye-drops correctly.

Currently there is no clear guidance on the management of patients with concomitant chronic diseases of the veins (CVD), such as varicose and postthrombotic disease of the lower limbs, with endoprosthetics of the knee or hip joint. To reduce the risk of thromboembolic complications in patients of this group, the authors developed individual algorithms of reference.

This article presents the results of investigations of qualitative composition and quantitative content of amino acids of the studied species of Аrtemisia scoparia. In the raw has 16 amino acids, 9 of them being essential. Total amino acid content in the herb is 7,27 %.

The article presents the results of the study assessing the role of thyroid dysfunction and cytokine imbalance in the pathogenesis and manifestations of functional dyspepsia. We found that 31 % of the patients with functional dyspepsia had low serum triiodothyronine (T3) and/or free serum thyroxine (T4) levels as well as normal or mildly reduced serum TSH levels, thus confirming the presence of euthyroid sick syndrome in such patients. These changes in thyroid hormone levels were more frequent in postprandial functional dyspepsia than in epigastric pain syndrome. Moreover, the functional dyspepsia group was found to have elevated mean anti-TPO levels as compared with the controls. Thyroid imbalances were associated with mildly elevated pro-inflammatory (TNF-α, IL-1 ß, IL-6, IL-8) cytokine levels and low levels of serum anti-inflammatory IL-10 cytokine as compared with the healthy subjects. Along with this, hypercytokinemia was less pronounced in functional dyspepsia than in peptic ulcer. We obtained evidence of a strong correlation between clinical manifestations of functional dyspepsia and the severity of thyroid dysfunction. Positive correlation was found between T3, free T4, TNF-α, IL-1 ß, IL-6 and IL-8, while pro-inflammatory IL-10 cytokines were negatively correlated with free T4 leväs. Our findings suggest that thyroid dysfunction and regulatory cytokines play a significant role in the pathogenesis and manifestations of functional dyspepsia and represent objective markers of disease severity.