THE EFFECT OF APPLICATION OF ANTIOXIDANT THERAPY IN THE TREATMENT OF NON-ALKOHOLIC STEATOHEPATATIS IN CHORNOBYL NPP ACCIDENT SUFFERERS IN THE REMOTE PERIOD AFTER IRRADIATION. / ZASTOSUVANNIa ANTYOKSYDANTNOÏ TERAPIÏ V LIKUVANNI NEALKOGOL'NOGO STEATOGEPATYTU U POSTRAZhDALYKh VNASLIDOK AVARIÏ NA ChAES U VIDDALENYI PERIOD PISLIa OPROMINENNIa.

OBJECTIVE: to determine the effectiveness of combined treatment with hepatoprotectors and antioxidant a complexpreparation of vitamins A and E (I) in patients with non-alcoholic steatohepatitis (NASH) who suffered from theChornobyl NPP accident based on the results of evaluation of metabolic changes. MATERIALS AND METHODS: The state of the hepatobiliary system of 72 patients with NASH suffered as a result of theChornobyl accident was studied based on the results of the biochemical analysis of blood, indicators characterizingthe processes of oxidative modification of macromolecules and the state of the antioxidant system (AOS), as well asstructural changes in the liver according to ultrasound investigations in the course of the examination before andafter treatment. RESULTS: The treatment of NASH with hepatoprotectors and antioxidant I in the sufferers of the Chornobyl accidentincreased the level of antioxidant defense products (catalase and superoxide dismutase) with the normalization ofthe integral index of the AOS, and a significant decrease in the number of patients with reduced AOS status (from42.6% to 24, 2%, p <0.05), positive dynamics of biochemical parameters of blood with decreasing frequency ofdetection of cholestasis syndrome, hypercholesterolemia and hyperglycemia were established as well as the positivedynamics of structural changes in the liver according to ultrasound data. CONCLUSION: Combined therapy of NASH with hepatoprotectors and antioxidant I in patients who suffered from theChornobyl NPP accident contributes to the restoration of the prooxidant-antioxidant balance, decreases cholestasis,hypercholesterolemia and hyperglycemia, and promotes positive dynamics of structural changes in the liver.

Clinical importance of the nonalcoholic fatty liver disease: a review.

Literature data analysis summarizing features and peculiarities of clinical presentation, pathways and complications of the nonalcoholic fatty liver disease is presented. The key role of insulin resistance, lipid and carbohydrate metabolic disorders, lipid peroxidation and abnormal antioxidant defense system is described. Clinical importance of non-alcoholic fatty liver disease is essential because of a widespread comorbidity and imbalance in the key regulatory body systems.

Radiation protection and health of personnel of contracting enterprises participating in works for transformation of the object "shelter" of SSE Chornobyl NPP into an ecologically safe system.

UNLABELLED: Transformation of the object "Shelter" (OS) of SSE Chornobyl NPP into an ecologically safe system is one of the most important state programs in Ukraine. Both medical and dosimetric measures on healthcare of personnel participating in these works ranks the main place among most actual problems of contemporary clinical radiobiology, radiation hygiene, and radiation protection. The study objective was to work out and implement the medical and biophysical checking of the health status and workability both with radiation protection of personnel executing works on transformation of OS into an ecologically safe system. MATERIALS AND METHODS. The interdependent complex program of medical and biophysical (for internal and external irradiation) control of personnel executing the production tasks under conditions of ionizing radiation impact and open sources of ionizing radiation. Realization of medical examination envisages the estimation of the status of haemopoietic, immune, endocrine, respiratory systems, organ of vision, nervous system, psychics status and psychophysiological adaptation, ear, both with circulatory, digestive, urogenital, and bone-muscular system. There were 19434 cases of medical control of personnel in total. RESULTS: Results of the input medical control testify to the following: 4698 (48.90%) were admitted to work, 4909 (51.10%) were rejected. Individual annual effective doses of irradiation in the major part of cases did not exceed 12 mSv. There were 1845 cases of 239+240Pu content in excrements exceeding the level of 1.5 mBq/sample at a current biophysical control. Individual doses of internal irradiation at that did not exceed 1 mSv. CONCLUSIONS: The program of medical and biophysical service for reconstruction works on the OS proved its necessity and efficiency as its results showed that under the unique radiation-hygienical conditions not engineering challenges and technical problems but issues of how to save the health and workability of people and prevent the overdose of personnel including due to an internal irradiation are most critical.

[The effects of beta-adrenoblocker therapy on the physical working capacity of patients with chronic heart failure of various origin].

The purpose of the study was to evaluate the influence of metoprolol succinate and carvedilol on the physical ability (FA) of patients with chronic heart failure (CHF) of different etiologies. The subjects of the study were 108 patients with postinfarction cardiosclerosis and 39 patients with dilated cardiomyopathy with I to V functional class (FC) CHF and left ventricular ejection fraction of less than 45%. The dynamics of functional parameters were assessed after 6 to 12 months of carvedilol therapy (57 patients) or metoprolol (81 patients) therapy. Therapy with beta-adrenoblockers resulted in a significant decrease in CHF FC (by 0.80 +/- 0.57; p < 0.05), an increase in the distance of six-minute walking test (by 110.7 +/- 86.5 m; p < 0.001) and everyday activity according to DASI questionnaire. The improvement was more substantial in patients with non-ischemic CHF. Peak oxygen consumption during treadmill test did not change, but CO2 ventilatory equivalent increased. The results demonstrate that carvedilol and metoprolol improve subjective and submaximum parameters of the functional status of patients with CHF without changing maximal FA.

[Chronic dyspnea in cardiological patients: prevalence and etiology].

The authors analyzed the medical records of 1414 patients aged 60 +/- 14 years, who were examined in a specialized cardiological clinic within a one-year period. Among the patients, 41.2% complained of dyspnea; the number of women with dyspnea prevailed over the number of men. Dyspnea was caused by chronic heart failure in 42.2% of patients, by transient myocardial ischemia in 12.3% of patients, and by paroxysmal tachyarrhythmia in 6.3% of patients. In 45.6% of the patients, mostly in women, significant non-cardial factors were revealed: obstructive or restrictive respiratory failure (20.6%), obesity (14.7%), thyroid gland dysfunction (3.9%), pulmonary arterial thromboembolism, anemia etc. A combination of two or more etiological factors took place in 22.6% of cases. The reason for respiratory discomfort remained unclear in 21.3% of the patients, mostly women. Symptom-limited load test with gas analysis (ergospirometry) was performed in 70 patients with dyspnea of unclear origin. According to its results, in 75% of elderly patients with essential hypertension and postinfarction cardiosclerosis, who did not have significant systolic dysfunction, restrictive diastolic dysfunction, valvular disorder, or atrial fibrillation, dyspnea was caused by hyperventilation, obesity, and respiratory pathology.

[Measurement of output sound pressure in a real ear to raise efficacy of electroacoustic hearing correction]. / Ispol'zovanie metoda izmereniia vykhodnogo urovnia zvukovogo davleniia v real'nom ukhe dlia povysheniia éffektivnosti élektroakusticheskoi korrektsii slukha.

Fifty adult patients with neurosensory hypoacusis of different severity participated in the study of feasibility of using analytic computer systems in selection of optimal regimes of acoustic aid function with use of pressure measurement in the real ear. The results have shown that measurement of the frequency response in the camera of 2 sm(3) in volume is unable to predict the function of the acoustic aid in each individual case. Most of the acoustic aid users need correction of the program adjustment. The efficacy of electroacoustic correction should be evaluated on the basis of measurements of output sound pressure in a real ear as most reliable and significant. The results of the study are useful in conduction of hearing prosthetic correction.

[The use of capoten in the treatment of chronic cor pulmonale in elderly patients]. / Ispol'zovanie kapotena v lechenii khronicheskogo legochnaia serdtsa u bol'nykh starshego vozrasta.

Forty patients of elderly and senile ages with chronic obstructive bronchitis, complicated with degrees II-III respiratory insufficiency, and chronic cor pulmonale with stage IIA circulatory failure have been examined. The examination revealed impairment of the external respiration and tissue oxygen exchange, changes in the cardio- and hemodynamics the most typical of which was a significant rise of the diastolic volume of the left ventricle, activation of the renin-angiotensin-aldosterone system, and an increase of the extracellular volume of fluid. To explore the ways to correct these changes, nine patients were given a single dose of capoten, an inhibitor of the converting enzyme angiotensin (12.5 mg orally), after which a 20-day course was administered (12.5 mg three times daily). The agent proved to be highly effective, which suggested the expediency of its use in the complex management of old-age patients with decompensated cor pulmonale.