[End products of glycation (AGEs) and inflammation in the clinic of cardiovascular complications and vascular calcification at different stages of chronic kidney disease (G1-G5D)].

AIM: To clarify the role of advanced glycation end products (AGEs) and inflammation in the development of vascular calcification and cardiovascular complications at different stages of chronic kidney disease (CKD) G1-G5D. MATERIALS AND METHODS: We examined 105 patients aged 19 to 75 years with stage C1-C5D CKD, 77 (74%) of whom were patients with diabetic nephropathy. The concentration of AGEs, interleukin (IL)-1, IL-6 and tumor necrosis factor α (TNF-α), troponin I, parathyroid hormone was determined by enzyme-linked immunosorbent assay (ELISA) using kits from BluGene biotech (Shanghai, China), Cloud-Clone Corp. (USA), ELISA Kit (Biomedica, Austria). RESULTS: A high content of AGEs, IL-1, IL-6, TNF-α was established, which directly correlated with the increase in renal failure and changes in the morpho-functional parameters of the left ventricle and aorta. CONCLUSION: An increase in serum concentrations of AGEs and inflammatory mediators, correlating with a decrease in renal function and changes in the morpho- functional parameters of the left ventricle and aorta, indicate their significant role in the processes of damage to the cardiovascular system in CKD.

[Clinical significance of uremic toxin indoxyl sulfate and inflammation in the development of vascular calcification and cardiovascular complications in stage C3-C5D chronic kidney disease].

AIM: To clarify the role of the uremic toxin indoxyl sulfate (IS) and inflammation in the development of vascular calcification and cardiovascular complications in chronic kidney disease (CKD). MATERIALS AND METHODS: One hundred fifteen patients aged 25 to 68 years with CKD stage C3-C5D were examined. Serum concentrations of IS, interleukin 6 (IL-6), tumor necrosis factor (TNF-α), troponin I, parathyroid hormone were determined by enzyme immunoassay using kits from BluGene biotech (Shanghai, China), Cloud-Clone Corp. (USA), ELISA Kit (Biomedica, Austria). RESULTS: An increase in the serum concentration of IS, IL-6, TNF-α was revealed, which was significantly associated with a deterioration in renal function and changes in the morphological and functional parameters of the heart and aorta. CONCLUSION: High concentrations of IS, IL-6, TNF-α, which are closely associated with an increase in renal failure and cardiovascular complications, indicate their significant role in vascular calcification, which underlies the damage to the cardiovascular system in CKD.

[Small bowel volvulus due to a giant mesenteric lipoma]. / Zavorot tonkoi kishki, obuslovlennyi gigantskoi lipomoi bryzheiki.

Mesenteric lipomas are very rare. They are asymptomatic in most cases, but some patients can develop certain complications such as small bowel volvulus and acute small bowel obstruction. We report a 78-year-old patient with giant mesenteric lipoma complicated by jejunum volvulus and acute small bowel obstruction. The patient underwent laparotomy, en-bloc resection of small bowel, mesentery and lipoma followed by side-to-side anastomosis.

[The ecological determinancy of development of bronchial asthma in adult population (as exemplified by the Republic of the North Ossetia-Alania].

The intensive impact of anthropogenic factors on health causes more than 40% of all human diseases. First of all, it has to do with respiratory organs and comes out as the main determinant of development of chronic respiratory pathology. The article presents an assessment of negative impact of environmental factors on dynamics of increasing of incidence of bronchial asthma morbidity in the Republic of North Ossetia-Alania. The indicators of the general morbidity that increased up to 75.6% and for the first time detected up to 97.5% over six-year period. The results of present study correspond with the results of similar studies implemented in various territories of Russia indicating at mediation of increasing of bronchial asthma morbidity by negative impact of environment risk factors. In the Republic, over a period of many decades, contribution of the metallurgical plant producing zinc, cadmium, sulfuric acid and zinc-aluminum alloys, to atmospheric air pollution made up not less than 40%. Only two out of eight rural municipal districts are relatively environmentally problem-free today. In rural areas, more than 50% of atmospheric air pollutants is related to carbon oxide. Nowadays, along with industrial emissions into atmospheric air and their accumulation, increases importance of motor transport in environmental pollution. The cars account for 50-70% of all harmful emissions. The presence of harmful substances contained in exhaust gases exceeds permissible standards by 2-3 times. According to the data of systematic analysis of urban air quality, most of the year citizens breathe atmospheric air not meeting normative requirements. The actual situation favors development of bronchial asthma. In the Republic, its morbidity has not decreased for many decades. To improve indicators of bronchial asthma morbidity can be achieved by leveling harmful effects of environment through identification of main sources of environmental troubles. The priority is both to decrease industrial emissions that pollute atmosphere and to transit to more ecologically safe modern power supplies of motor transport facilities.

[Clinical significance of serum levels of osteoproteherin and sclerostin in assessment of vascular calcification in chronic kidney disease stage 3-5].

AIM: To clarify the mechanisms of the effect of osteoprotegerin (OPG) and sclerostin on vascular calcification and the state of the cardiovascular system in chronic kidney disease (CKD). MATERIALS AND METHODS: A total of 110 patients aged 18 to 65 years with CKD stages 35D were examined. OPG, sclerostin, intact parathyroid hormone, and serum troponin I were determined using the commercial "Enzyme-linked Immunosorbent Assay Kit for Sclerostin" from Cloude-Clone Corp. (USA) by enzyme-linked immunosorbent assay. RESULTS: An increase in sclerostin and OPG levels was revealed, which significantly correlated with a decrease in glomerular filtration rate, as well as an increase in left ventricle myocardial mass index and peak systolic blood flow in the aortic arch. CONCLUSION: Changes in the regulation of bone-mineral metabolism, in which the proteins inhibitors of bone metabolism, OPG and sclerostin, as well as the interactive interaction between the vascular and skeletal systems, play a decisive role in the development of lesions of the cardiovascular system caused by vascular calcification in CKD.

[Isolated splenic metastasis from colorectal cancer]. / Izolirovannyi metastaz kolorektal'nogo raka v selezenku: klinicheskii sluchai.

Splenic metastases are a rare finding and usually associated with advanced cancer. At the same time, isolated splenic metastases are an exception. The authors report a 62-year-old woman with isolated splenic metastasis from colon carcinoma in 28 months after surgery. Splenectomy was successfully performed.

The estimation of quality of life of children with diseases of musculoskeletal system.

The study of life quality was carried out covering 432 children aged 6-17 years with diseases of musculoskeletal system on the basis of the cardio-rheumatological department of the Republican Children Clinical Hospital and children polyclinics of the Republic of North Ossetia-Alania. The Russian version of the SF-36 questionnaire was applied which included 11 questions. The physical and emotional state was studied in 4 age groups: 6-8 years old (8.56%), 9-11 years old (20.14%), 12-14 years old (35.65%), 15-17 years old (35. 65%). The average age of children was 13.06±3.9 years. The significant influence of rheumatic diseases on parameters of life-quality of patients was established: physical and psychological state of children suffers, social adaptation is disturbed. According to the study results, the most problematic age group are children aged 15-17 years, who characterize their condition as mediocre (35.1%). Particular attention should be paid to the fact that there was no improvement in health state during a year among significant proportion of patients (65.3%). The obtained results testify limitation of physical state of health in 78.5% of cases, the most noticeable in age group of 15-17 years. The direct correlation between increase in pain syndrome and age of patient is established. In all age groups, there is decrease in emotional state, which increases with age. The indices of physical component of health in all age groups are significantly lower than the mental one. There are no significant gender differences in respondents assessment of life quality. The indices of life quality of children are generally characterized as low and do not reach 50 points on 100-point scale.The identified problematic age groups require increased attention from pediatric service of the Republic. The anxiety is caused by increase of negative symptoms in older age groups. The study results indicates both low efficiency of specialized rheumatological care of children and need for increased attention to dispensary work with this group of patients at early stages of disease.

[Reality and prospects of sepsis epidemiology research]. / Real'nost' i perspektivy izucheniia épidemiologii sepsisa.

Current foreign and Russian literature for sepsis epidemiology is reviewed. There is advanced incidence of sepsis in developing countries among young people as a rule. Absent high-quality epidemiological studies lead to overdiagnosis of sepsis and increased morbidity. National and territorial screening and diagnostic programs for sepsis became possible with introduction of new recommendations 'Sepsis-3'. Thus, there is a possibility to systematize regular epidemiological studies devoted to sepsis.

[The definition of sepsis. 25-year experience of concept development]. / Chto takoe sepsis: 25-letnii opyt razvitiia kontseptsii.

The review, presented in chronological order the stages of formation of the modern definition of sepsis syndrome, since the recommendations of the conciliation conference ACCP/SCCM (1991), the experience of the practical use of which has been extensively critically assessed in future studies. As a result, it formed a strong opinion that the global challenge of early diagnosis of sepsis, under the previously proposed definitive categories have not been solved, moreover, in the scientific community formed a firm belief in the need to make fundamental changes in the definition of the term 'sepsis'. As a result, in 2016 the scientific community were presented the recommendations of the working group 'Sepsis-3', in which sepsis is defined as life-threatening organ dysfunction due to dysregulated response to infection, and fundamentally distinguish them from the former, is a laconic definitions and availability of diagnostic criteria. National expert community to analyze, discuss and define the field of clinical testing 'Sepsis-3' in the Russian Federation.

[Bronchopulmonary ACTH-producing tumors].

Neuroendocrine tumors have the ability to produce the hormones and vasoactive peptides. Excess of these hormones leads to different symptoms and syndromes because of organs' injuries. Detection of ACTH origin by using of modern diagnostic methods is not always possible. Lungs and bronchi are one of the most frequent localization of ACTH-producing tumors. It is considered that carcinoids with bronchopulmonary localization like a benign tumors in the clinical course. But at the same time carcinoid tends to metastasize, so timely diagnostics and treatment improve quality of life significant and increase the life expectancy of patients. The modern state of diagnostics and surgical treatment problem of ACTH-producing tumors with bronchopulmonary localization is presented in the article. It was described the brief historical background, clinical symptoms, instrumental and biochemical methods of diagnosis. The principles of surgical treatment are presented in the article.