Capillaroscopy and ECG parameters in children and adolescents with diabetes mellitus type I.

AIM OF THE RESEARCH: Evaluate ECG parameters and detect changes in capillaroscopy parameters in children and adolescents with Diabetes mellitus type 1 (DMT1). ECG and capillaroscopy were performed in 32 children and adolescents (6-15 years old, 17 boys,15 girls) with DMT1. Disease duration - less than 2 years -13, 2-4 years - 10, 5-10 years - 9 cases. The patients were divided into two groups: I group - 12 patients with no complications of DMT1 (in all them duration of disease was less than 2 years), II group - 20 patients with diagnosed cardiac complications of DMT1 (diabetic cardiomyopathy, angiopathy). Additionally 6 of them had diabetic encephalopathy , 4 - diabetic encephalopathy and peripheral neuropathy, 4 - nephropathy and retinal antipathy. Level of glycosides hemoglobin was 8-11%, level of glucose 4 to 15 mmole/L. Control group included 20 healthy children of the same age. In group I ECG is less informative. Hypertrophies of left ventricle and atrium and disorders of repolarization were mainly found in group II. In 62.5% of cases rhythm and conduction disorders were revealed, which were more often in group II. Capillaroscopy changes (pale and cyanotic background, decreasing of the number of capillaries in sight, dilated and contracted diameter, pathological shape and order of capillaries, slow blood flow) were seen both in I and II groups with more prevalence and intensity in the latter one. In children and adolescents with Diabetes mellitus type 1 ECG and capillaroscopy should be performed on the regular basis in order to reveal early changes and start the appropriate treatment in time.

Assessment of anthropological, physical and functional indices in sportsmen (basketball players) against the background of high physical loading.

The goal of the investigation was the estimation of functional condition of anthropometrical, physical and cardiovascular system of sportsmen-basketball players against the background of high physical loading. 100 basketball players at the age from 12 till 18 years underlay the study. Randomized and open controllable research was carried out during 6 months. The following characteristics have been studied: how many days the sportsman is training in a week, how many hours the sportsman is training per day, his mood after training, over fatigue and overtension, frequency of heartbeat, time of breath holding, the general condition, the height in sitting and standing position; circumference of lumbus, chest, arm and limbs, the pulse, pulse, systolic and diastolic arterial pressure before and after physical loading. According to these factors the following sport indices are calculated: Index of Rufe (physical work capacity), the coefficient of endurance (Kvas formula), Shtange test (breath holding at sighing), Genchi test (breath holding at exhalation), average arterial pressure, systolic and cardiac output of blood circulation (the formula of Lilienstrad and Tsander), the coefficient of blood circulation effectiveness, Ketle index (the ratio of height and weight), Minuvre index (the ratio of body and feet length), Pinie index (power of body-build). Statistically authentic increase of breath and pulse in frequency was observed in sportsmen-basketball players after physical loading. The study of amplitude parameters of cardiac cycle among sportsmen-basketball players before and after physical loading has revealed the ability of rather low adaptation of cardiovascular system to physical loading.

[Treating bronchoscopy at ventilator-associated pneumonia in critically ill patients].

On the material, based on the experimental treatment of broncho-pulmonary derangements, including ventilator-associated pneumonias, at 105 critically ill patients, the authors recommend methods of prophylaxis and treatment of these types of pathologies, which are based on the suction fibrobronchoscopy with the use of different suction mixtures. The more satisfying evolvement of pathological processes, decrease of the expressing of the degree of clinical appearance and intoxication, the indisputable improvement of dynamics of the condition of the patient and subsidence of the average continuation of treatment prove the advantage of this method. The important economical effect is also achieved with the subsidence of the price of daybeds, decrease of the expenses of the diagnostics and cures. The achieved results give us the permission to recommend the widespread use of the treating suction fibrobronchoscopy when treating patients with acute diseases of lungs, advantages at VAP. The expressed efficiency, reliability and the important economical effect are the base priorities of this method.

[Endoscopic treatment in critically ill patients with upper gastrointestinal bleeding].

The goal of the current research was to ascertain the optimal methods of an endoscopic haemostasis in critical care patients with GDB. The research was conducted on critically ill patients. The different endoscopic methods of treatment: injectional hemostasis, irrigation with local hemostatics, thermo coagulation, and combined method were used. Treatment with injectional hemostasis resulted in hemostasis in 75% of patients. Irrigation with local hemostatics was conducted using the local hemostatic agent caprofer and (or) 10% solution of epsylonaminocapronal acid. The final hemostasis was achieved in the 90% of the cases; bleeding was stopped in 85% of the cases when the hemorrhages occurred from chronic ulcers. The effect of thermo coagulation method was 80-85%. Combined method of treatment (combination of the irrigation with caprofer and thermo coagulation) helped to achieve 95% of the final hemostasis in critically ill patients. The achieved results certify that the combined use of caprofer and method of electro coagulation in critical care patients with GDB is very perspective. Simultaneously with this, it is also recommended to use anti-segregation therapy with blockers of proton pomp and boosting the defense of the mucous tissue with high doses of mucogen.

[Clinical value of changes in red blood cell ultrastructure and energy metabolism in children with cystic fibrosis of the pancreas].

In 42 patients of various age (from 1 month to 14 years) with cystic fibrosis were analyzed ultra structure, level of adenylnukleotides and activity of ATP-ase of erythrocytes, in order to characterize their membrane and energy metabolism . Our recent studies revealed increase of ATP-ase and decrease of ATP of erythrocytes, in children both with bronchopulmonary and mixed form of cystic fibrosis. In patients with lethal outcome were detected more significant decrease of the ATP combined with increase of ATP-ase in erythrocytes then in other cases, which is resulted not only by suppressed glycolic processes but also by exhausted compensative-adaptive abilities of the human organism in whole. In patients with cystic fibrosis were detected changes both in quantity and quality of erythrocytes' stereoultrastructure: the level of the discocytes was significantly decreased, while the level of all other 12 types of erythrocytes were increased, also there were detected appearance of erythrocytes with pathogenic forms. The changes mentioned above were more apparent in patients with mixed form of cystic fibrosis and lethal outcome. The results of our study have a great value for medical practice providing more precise diagnosis, in time correction of disorders and a comprehensive assessment of multiple-modality treatment of cystic fibrosis.

[Interferon system in children with cystic fibrosis].

Parameters of interferon-producing leukocyte function were studied in vitro, in 32 patients of different age (from 1 month to 14 years) with cystic fibrosis and 30 normal children. Mixed form of cystic fibrosis were detected in 20 patients, while bronchopulmonary form were found in 12 patients. According to Shvaxman scale 16 patients had 40 point (severe), 13 patient had 41-45 point (moderate) and 3 patient had 56-70 point (mild). The interferon was studied using the Soloviov-Bektemirov technique in the A. Natishvili Institute of Experimental Morphology of Georgian Academy of Sciences. Interferon level varied between 0 and 2 U/ml both during the acute phase and remission, while the normal level would be at 4-24 U/ml. Therefore, interferon therapy can be recommended as part of combined treatment, particularly at an early stage of acute respiratory viral infection, during epidemic outbreaks and in hospital where patient should only be admitted (and kept in individual cubicles) after outpatient treatment for aggravations of the disease proved ineffective.

[Structural indices of blood cells in young athletes after one month of training taking into account different types of sport].

Blood cells of young sportsmen have been studied taking into account different types of sport (classical wrestling, judo, free-style wrestling). Our observations have shown that the most important shifts in blood cells take place during classical wrestling and judo. The most intensive changes were noted in erythrocytes and thrombocytes. The immune response shows different patterns in classical wrestling and judo. Data obtained using light microscope method are further supported by morphometric study of our clinical material. Thus, physical training plays an important role in the activation of functions of the organism, particularly in the activation of blood cells. Increase of euchromatin indicates to the activation of the nucleus, while the decrease, particularly in the cases of classical wrestling and judo, to the activation of perinuclear space and increase of interaction between the nucleus and cytoplasm.