[The integral evaluation of oxidative anti-oxidative status in patients of neuroreanimation department].

The article presents comparative evaluation of serum total oxidizing and total anti-oxidizing activity in reanimation patients with severe cranio-cerebral injury and ischemic and hemorrhagic strokes. Due to irregularity of experimental groups in a number of demographic and clinical indicators the new estimated indicator was proposed. The normalized coefficient of oxidation made it possible to apply comparative evaluation of expression of oxidative anti-oxidative imbalance in these groups. The characteristics are presented concerning the oxidative derangements in the studied groups during acute period of disease.

[Homocysteine and von Willebrand factor in chronic alcoholism].

The levels of homocysteine (HC) and von Willebrand factor (VWF) as cardiovascular risk factors were studied in patients with Stage II chronic alcoholism. Forty-one men with Stage II chronic alcoholism without clinical signs of somatic and infectious diseases were examined. Their median age was 37 (range 32-40) years; the alcoholization period was 12 (range 8-17) years. Plasma HC and VWF (amount and activity) levels were determined. In 63.4% of chronic alcoholic patients, HC levels was twice as high as in the controls; in 80.6%, both the content and activity of VWF were increased. There was no correlation between the levels of HC and VWF. Vascular endothelial damage concurrent with hyperhomocysteinemia increases a cardiovascular risk in patients with Stage II chronic alcoholism.

[Hemostasis disorders in coal miners].

Findings are that coal miners having long contact with vibration instruments and coal dust develop endothelial dysfunction, increased platelets aggregation, hypercoagulation and lower anticoagulation activity. The hemostasis disorders revealed could result in earlier coronary atherosclerosis development in workers exposed to vibration.

[The specific features of immune disorders in acute severe brain injury].

Fifty-three patients aged 17-65 years who had severe brain injury (SBI) were examined and randomized to 2 groups: 1) 16 patients without complications; 2) 37 patients developed pneumonia (35.2%), bronchitis (32.4%), meningitis (10.8%), meningitis concurrent with pneumonia (8.1%), bedsores concurrent with bronchitis (13.5%) on days 4-7. The authors studied the immune status: the subpopulation composition of lymphocytes (CD+, a marker of adult lymphocytes; CD+, a marker of T helper/inductor cells, CD8+, a marker of cytotoxic lymphocytes, CD16+, a marker of natural killer cells, CD20+, a marker of B lymphocytes) by the indirect immunofluorescence technique using monoclonal antibodies; the functional activity of lymphocytes from the expression of activation antigens, such as CD71+, CD25+, HLA-DR; serum immunoglobulins (IgG, IgA, and IgM) by the immunoturbidimetric technique using the test systems (Spinreakt, Spain). A control group included 23 apparently healthy individuals. Immunosuppression developing as significant T lymphopenia due to lower CD4+ and CD8+ lymphocytes, as well as impaired humoral immunity with inadequate IgG generation was detected in the acute phase of SBI. The indicators reflecting the development of secondary pyoseptic complications were elevated CD3+, CD4+, and CD8+ lymphocytes on day 7 and the higher lymphocytic expression of the activation antigens CD25+ and CD71+. The findings show that the diagnostic markers, such as CD3+, CD4+, CD8+, CD25+, and CD71+ lymphocytes, should be included into a comprehensive examination of patients with SBI.

[Serum biochemistry data in association of atherosclerosis with pulmonary dust diseases].

The authors studied prevalence of atherosclerosis, serum levels of lipids and homocysteine in coal miners suffering from pulmonary dust diseases. More marked hyperlipidemia and hyperhomocysteinemia are associated with combination of atherosclerosis and pulmonary dust diseases. Respiratory failure as a complication of pulmonary dust diseases promotes hyperlipidemia.

[Hemostasis disorders in patients with occupational fluorosis are risk factors for IHD].

The studies covered hemostasis changes in workers with occupational fluorosis. The disorders diagnosed could be a risk factor for IHD in aluminium production workers

[Antithrombotic mechanisms in the acute period of severe brain injury]. / Antitromboticheskie mekhanizmy v ostrom periode tiazheloi cherepno-mozgovoi travmy.

Antithrombotic mechanisms were studied in 156 patients with severe brain injury (SBI) on days 1, 3, 5, 7, and 9 after injury. It was found that the acute period of SBI was marked by a reduction in the athrombogenic potential through both the consumption of physiological anticoagulants, antiaggregants, the components of the plasmin system and the elevated levels of fibrinolytic inhibitors. The inhibitory mechanism responsible for impaired fibrinolysis predominated when infectious complications of SBI developed.

[Effects of local vibration on development of ischemic heart disease in miners of South Kuzbas]. / Vliianie lokal'noi vibratsii na razvitie ishemicheskoi bolezni serdtsa u shakhterov iuga Kuzbasa.

The incidence of ischemic heart disease (IHD) and risk factors of its genesis have been studied in 380 miners of a control group non-exposed to industrial vibration. Constitution type and a number of phenotypic signs have been determined for all examined workers with hemostatic indices defined in 60 miners before and after the performance of vibrational load test. High incidence of IHD, arterial hypertension and hyperholesterolemia have been detected in the miners working with vibration instruments and hemostatic disorders predisposing to ischemic heart disease have been revealed. In the miners of vibrodangerous occupations suffering from ischemic heart disease, hypersthenic constitution type determined by Rees-Eysenc index less than 92.2 and the height below 170 cm was found to occur more frequently.

[Treatment of DIC syndrome in patients with severe craniocerebral trauma]. / Lecheni DVS-sindroma u bol'nykh s tiazheloi cherpno-mozgovoi travmoi.

Transfusion of fresh-frozen plasma with fraxiparin is the most rational basic therapy for the first and third clinical pathogenetic variants of subacute disseminated intravascular coagulation in multiple-modality treatment of severe craniocerebral injury. In the second variant of this condition, high doses of proteinase inhibitors in combination with minimum heparin doses are the most rational.

[Clinico-pathogenetic variants of DIC syndrome in patients with severe craniocerebral trauma]. / Kliniko-patogeneticheskie varianty DVS-sindroma u bol'nykh s tiazheloi cherepno-mozgovoi travmoi.

Detection of clinical and pathogenetic variants of the DIC syndrome for development of its differentiated therapy in multiple-modality treatment of severe craniocerebral injury was the purpose of this study. A total of 170 patients with grave craniocerebral injury were examined. The hemostasis system was studied by the following methods: analysis of platelet hemostasis, general coagulation tests, fibrinolysis evaluation, detection of physiological anticoagulants and markers of intravascular blood coagulation and fibrinolysis. Based on the clinical (intra- and extracranial) symptoms and results of studies of the hemostasis system, 3 clinical pathogenetic variants of the DIC syndrome were distinguished, which should be borne in mine when treating patients with severe craniocerebral injury developing the DIC syndrome.

[Platelet hemostatic changes in patients with chronic alcoholism stage II in rest and exercise]. / Izmenenie trombotsitarnogo zvena gemostaza u bol'nykh khronicheskim alkogolizmom II stadii v pokoe i pri fizicheskoi nagruzke.

Platelet hemostasis was studied in 23 patients with chronic alcoholism (CA) stage II at rest and under muscular exercise. At rest, the patients had elevated spontaneous aggregation of platelets and more active start of adrenaline and ristomycin aggregation. Exercise stimulated spontaneous platelet aggregation, enhances adrenaline and ristomycin aggregation. According to adrenalin test 32% of the examinees had platelet dysfunction. According to ristomycin aggregation, vascular endothelium was impaired in 95.7%of the patients. Thus, it is evident that CA stage II patients develop disorder of platelet hemostasis and vascular endothelium. Such patients are at high risk of thrombogenesis.

[Thrombocytic hemostasis in patients with severe craniocerebral trauma]. / Trombotsitarnyi gemostaz u bol'nykh s tiazheloi cherepno-mozgovoi travmoi.

Platelet vascular hemostasis was assessed in 32 patients with slight craniocerebral injuries (SCCI) (Glasgow coma score 14-15) (group 1) on days 1, 3, 5, and 7 and in 84 patients (score 3-8) (group 2) in the same terms and on days 9, 14, and 21 after the injury. Under study were platelet count, spontaneous platelet aggregation and that induced by ADP, adrenalin, and ristomicin. Moderate disorders of platelet vascular hemostasis were revealed in all the patients; they were most of all expressed on day 5 and were mainly due to moderate disorders of the athrombogenicity of the vascular endothelium. The injury caused a manifest dysfunction of platelets connected with the developing disseminated intravascular blood coagulation and, specifically, with injury to the vascular endothelium. Spontaneous aggregation of platelets was the maximum on day 5 and coincided in time with an increase in Willebrand factor-dependent ristomicin-induced platelet aggregation (Willebrand factor is a marker of injury to the vascular endothelium). An increase of ristomicin-induced platelet aggregation was more often observed in the patients who died than in the survivors, and in those developing the respiratory distress syndrome (stages II-IV) and that combined with pneumonia.

[The possible mechanisms of a fibrinolytic disorder in patients with severe craniocerebral trauma]. / O vozmozhnykh mekhanizmakh narusheniia fibrinoliza u bol'nykh s tiazheloi cherepno-mozgovoi travmoi.

Fibrinolysis components were studied in 32 patients with slight and 38 ones with grave craniocerebral injuries on days 1, 3, 5, and 7 after the injury. No expressed disorders of blood fibrinolytic activity were revealed in patients with slight injuries. Grave craniocerebral injuries were associated with disorders of the plasmin system. Depression of the external and internal mechanisms of fibrinolysis were the most manifest starting from day 3 and caused by a number of factors characteristic of the developing disseminated intravascular blood coagulation syndrome and, possibly, by impaired regulation of the plasmin system by the central nervous system.

[A case of the successful treatment of a patient with severe craniocerebral trauma combined with hemophilia]. / Sluchai uspeshnogo lecheniia bol'nogo s tiazheloi cherepno-mozgovoi travmoi v sochetanii s gemofiliei.

The described case with a severe craniocerebral injury in a patient with hemophilia A demonstrated that the initial hypocoagulation does not preclude the development of intravascular blood coagulation. Therefore, in patients with severe brain injury, a more rapid reduction of antihemophilic globulin A is possible, in comparison with that occurring during planned surgery, and, hence, higher doses of cryoprecipitate and longer duration of its infusion are needed. Moreover, this case demonstrated that even in patients with a slight form of hemophilia A the treatment with cryoprecipitate should be continued till the levels of thrombinemia markers are reduced and the concentration of antihemophilic globulin A in the blood stabilized at a level of at least 10%; the dose of infused cryoprecipitate should be reduced gradually.

[Diagnosis and treatment of DIC syndrome in patients with severe craniocerebral trauma]. / Diagnostika i lechenie DVS-sindroma u bol'nykh s tiazheloi cherepno-mozgovoi travmoi.

The hemostasis parameters are compared in 32 patients with slight (14-15 Glasgow score) and 114 with grave craniocerebral injury (3 to 7 Glasgow score) on days 1, 3, 5, and 7 after the injury. Assessment of hemostasiograms revealed a regular development of disseminated intravascular blood coagulation (DIC) in patients with grave craniocerebral injury, whereas in patients with slight injury the changes in the hemostasis system were compensatory. Early (starting from day 1) addition of anticoagulants, disaggregants, and fresh-frozen plasma to treatment protocols are advisable for patients with grave craniocerebral injuries.

[The effect of finoptin on platelet aggregation, blood coagulability and fibrinolysis in patients with ischemic heart disease during physical exercise]. / Vliianie finoptina na agregatsiiu trombotsitov, svertyvaemoct' krovi i fibrinoliz u bol'nykh ishimicheskoi bolezn'iu serdtsa pri fizicheskoi nagruzke.

Exercise platelet aggregation, blood coagulability, and fibrinolysis were examined in patients prior myocardial infarction 2-3 months following the disease. Seventy patients of whom 35 had received placebo and 35 finoptin prior to exercise were studied. The platelet aggregation, blood coagulability, and fibrinolysis were explored before and after bicycle ergometric test. Following exercise, the patients on placebo showed higher platelet aggregation, blood coagulability and lower fibrinolysis, whereas those on finoption exhibited a lower increase in platelet aggregation and blood coagulability and activated fibrinolysis.

[The coagulating and anticoagulating blood systems and thrombocyte aggregation in healthy subjects and patients with ischemic heart disease at rest and under physical loading]. / Svertyvaiushchaia, protivosvertyvaiushchaia sistemy krovi i agregatsiia trombotsitov u zdorovykh lits i bol'nykh ishemicheskoi bolezn'iu serdtsa v pokoe i pri fizicheskoi nagruzke.

A study was made of hemostasis, fibrinolysis and platelet aggregation at rest and exercise in 32 healthy persons and 35 patients suffering from coronary heart disease (CHD) with a history of myocardial infarction that had occurred 2-3 months before. It has been discovered as a result that in healthy persons at exercise, the blood coagulation system and fibrinolysis are activated, the level of antithrombin-III rises and initial platelet aggregation decreases. In patients with CHD at exercise, hypercoagulation, deceleration of fibrinolysis, and the decline of the level of AT-III are detectable, with platelet aggregation being enhanced.