[Comparative efficacy of pharmacoinvasive strategy of myocardial reperfusion and primary angioplasty in patients with acute ST elevation myocardial infarction].

In order to assess comparative efficacy of pharmacoinvasive strategy of myocardial reperfusion and primary angioplasty in ST elevation acute myocardial infarction 289 patients were randomized at prehospital stage within first 6 hours of the disease into 2 groups: primary angioplasty (group 1), and prehospital thrombolysis with subsequent rescue or delayed angioplasty depending on efficacy of thrombolysis. We analyzed clinical and anamnestic characteristics of patients, efficacy of reperfusion measures, dimensions of myocardial necrosis, and clinical course of the disease. Pharmacoinvasive myocardial reperfusion with prehospital thrombolysis compared with primary coronary angioplasty decreased time of myocardial ischemia (224.65 +/- 71 vs. 278 +/- 184 min, p < 0.03), increased rate of achievement of TIMI grade 3 flow after percutaneous coronary intervention (80.5% vs. 71.4%, p = 0.002) and more effectively preserved left ventricular ejection fraction (60.0 +/- 14.9% vs. 54.9 +/- 12.3%, p < 0.01). Prehospital thrombolysis before coronary angioplasty compared with primary angioplasty was associated with lower rate of development of no-reflow syndrome (1.4% vs. 11.6%, p < 0.003).

Autoimmune thyroiditis and exposure to iodine 131 in the Ukrainian cohort study of thyroid cancer and other thyroid diseases after the Chornobyl accident: results from the first screening cycle (1998-2000).

CONTEXT: Due to the Chornobyl accident, millions were exposed to radioactive isotopes of iodine and some received appreciable iodine 131 (131I) doses. A subsequent increase in thyroid cancer has been largely attributed to this exposure, but evidence concerning autoimmune thyroiditis (AIT) remains inconclusive. OBJECTIVE: The objective of the study was to quantify risk of AIT after 131I exposure. DESIGN/SETTING/PARTICIPANTS: Baseline data were collected from the first screening cycle (1998-2000) of a large cohort of radiation-exposed individuals (n = 12,240), residents of contaminated, iodine-deficient territories of Ukraine. Study individuals were under the age of 18 yr on April 26, 1986, and had thyroid radioactivity measurements made shortly after the accident. OUTCOMES: AIT was defined a priori based on various combinations of elevated antibodies to thyroid peroxidase (ATPO), TSH, and clinical findings; elevated ATPO were considered to be an indicator of thyroid autoimmunity. RESULTS: No significant association was found between 131I thyroid dose estimates and AIT, but prevalence of elevated ATPO demonstrated a modest, significant association with 131I that was well described by several concave models. This relationship was apparent in individuals with moderately elevated ATPO and euthyroid, thyroid disease-free individuals. CONCLUSIONS: Twelve to 14 yr after the Chornobyl accident, no radiation-related increase in prevalence of AIT was found in a large cohort study, the first in which 131I thyroid doses were estimated using individual radioactivity measurements. However, a dose-response relationship with ATPO prevalence raises the possibility that clinically important changes may occur over time. Thus, further follow-up and analysis of prospective data in this cohort are necessary.

[Tumor markers in the diagnosis of thyroid cancer]. / Opukholevye markery v diagnostike raka shchitovidnoi zhelezy.

Informational value was studied of radioimmunologic analysis of tumor markers, such as thyroglobulin, carcinoembryonic antigen, ferritin, beta 2-microglobulin, CA 19-9, thyrotrophin and free thyroxin in diagnosis of carcinoma of the thyroid gland. Forty-eight patients with carcinoma of the thyroid gland and benign tumors were examined together with 12 essentially healthy subjects. Sensitivity, specificity and accuracy of the methods employed were evaluated along with whole number of false-positive and false-negative results. Tumors of the thyroid gland were verified by histologic studies after surgical excision thereof. Of all the tumors markers approved of, thyroglobulin was found out to have the highest diagnostic sensitivity. Radioimmunologic determination of thyroglobulin in blood can be recommended for use in preoperational diagnosis of carcinoma of the thyroid gland and formation of groups of high risk for development of carcinoma.

[The use of dynamic renal scintigraphy for studying kidney functional disorders in patients with different forms of hypercorticism]. / Ispol'zovanie dinamicheskoi renostsintigrafii dlia izucheniia narushenii funktsii pochek u bol'nykh s razlichnymi formami giperkortitsizma.

Results are submitted of studying the function of the kidneys in 34 patients with Itsenko [correction of Icenko]-Cushing disease and syndrome, who were evaluated by dynamic renoscintigraphy besides routine clinical procedures. Dynamic renoscintigraphy was found to be an important diagnostic acid enabling one to disclose function disorders of the kidneys in the preclinical stage under normal routine investigations. In this setting, there have been revealed disturbances both in secretory-filtrational and excretory and aggregate functions of the kidneys practically in all the patients irrespective of the type of hypercorticoidism. Surgical treatment of hypercorticoidism does not lead to normalization of the function of the kidneys. And what is more, function disorders of the kidney on the side of the surgical intervention appear to be even more serious.

[Peripheral circulation regulation in patients with the neuroendocrine metabolic form of hypothalamic syndrome]. / Reguliatsiia perifericheskogo krovoobrashcheniia u bol'nykh s neiroéndokrinno-obmennoi formoi gipotalamicheskogo sindroma.

Peripheral circulation and regulating hormonal (renin-angiotensin-aldosterone system) and electrolytic (plasma sodium and potassium) factors were studied in 102 patients with the hypothalamic syndrome neuroendocrine metabolic form administered pathogenetic therapy with antiserotonin and dopaminergic drugs as well as routine therapy. Blood plasma sodium vasopressin and aldosterone levels were found increased, arterial vessel reactivity in the forearm reduced, and venous circulation disordered in these patients. Routine therapy failed to normalize electrolytes and hormonal parameters and was conducive to a still more marked reduction of arterial vessel reactivity. Peritol therapy resulted in a reduction of vasopressin concentration and normalization of blood plasma sodium and aldosterone, as well as in improvement of the myogenic mechanisms of vascular tone regulation and normalization of venous circulation parameters. A course of parlodel therapy lead to normalization of blood plasma levels of vasopressin, aldosterone, and sodium but no changes in the regional vessels were observed.

[The effect of the one-time and long-term administration of preparations acting on biogenic amine metabolism on the blood level of pressor peptide hormones]. / Vliianie odnokratnogo i dlitel'nogo priema preparatov, deistvuiushchikh na obmen biogennykh sminov, na so9derzhanie v krovi pressornykh peptidnykh gornonov.

Blood contents of pressor peptide hormones vasopressin and angiotonin II were studied in patients with neuro-endocrine syndrome before and after single intake and prolonged treatment with anti-serotonin drug peritol and cholinergic agent parlodel which affect biogenic amine metabolism and, consequently, influence blood pressure. Single doses of the drugs were established to cause different blood dynamics of vasopressin and angiotonin II which classified as marked and paradoxic reactions on peritol and parlodel used separately and associatively. Fall of blood vasopressin content induced by single dose of parlodel was accompanied by blood pressure decrease. Tree-week treatment with peritol and parlodel exerted hypotensive effect and significantly reduced vasopressin blood content.

[Status of the renin-angiotensin-aldosterone system in patients with a neuroendocrine-metabolic type of the hypothalamic syndrome]. / O sostoianii renin-angiotenzin-al'dosteronovoi sistemy y bol'nykh neiroéndokrinno-obmennoi formoi gipotalamicheskogo sindroma.

The paper is concerned with the results of a radioimmunoassay of the state of the renin-angiotensin-aldosterone system in patients with a neuroendocrine-metabolic type of the hypothalamic syndrome. They received pathogenetic therapy with peritol (an antiserotonin drug) or parlodel (a dopaminergic drug) during three months and routine therapy. The latter was not enough to return to normal the basal blood levels of aldosterone, reaction of the glomerular zone of the adrenocortical substance and the juxtaglomerular apparatus of the kidneys. Peritol therapy normalized the blood concentration of aldosterone; reactions of the glomerular zone of the adrenocortical substance and the juxtaglomerular apparatus to insulin hypoglycemia and furosemide acute testing improved considerably. After a course of parlodel therapy blood concentration of aldosterone got to normal, and reaction of the glomerular zone of the adrenocortical substance and the juxtaglomerular apparatus to insulin hypoglycemia was unchanged whereas it improved after furosemide testing.

[The results of a mass examination of the children of Ripkyns'kyi District, Chernigov Province, for thyroid status]. / Deiaki rezul'taty masovoho obstezhennia ditei Ripkyns'kogo raionu Chernihivs'koï oblasti na stan shchytovydnoï zalozy.

Mass screening of children revealed that the locality of Ripky, Chernigiv region showed to be a low-endemic goiter region. It was found that team screenings are effective.

[Radioimmunological analysis in assessing the function of the hypothalamo-neurohypophyseal system in patients with hypothalamic syndromes]. / Radioimmunologicheskii analiz v otsenke funktsii gipotalamo-neirogipofizarnoi sistemy u bol'nykh s gipotalamicheskimi sindromami.

Assessment of vasopressin by radioimmunoassay has shown an increase in its blood concentration and a disturbed reaction of the vasopressinergic structures of the hypothalamus to metoclopramide, furosemide, insulin hypoglycemia, and exercise. Functional tests with the dopaminergic drug bromocriptine and antiserotoninergic drug cyproheptadine help to make an individual choice of the most effective drug for therapy of the hypothalamic syndrome of neuroendocrine-metabolic type. The patients can be divided into sensitive to either the first or the second drug of both which is important for adequate pathogenetic therapy.