[Fecal microbiome change in patients with ulcerative colitis after fecal microbiota transplantation]. / Изменение кишечного микробиома пациентов с язвенным колитом после трансплантации кишечной микробиоты.

Intestinal human microbiota is a dynamic system that is under the pressures of its host organism and external factors. Microbiota disruption caused by these factors can lead to severe diseases including inflammatory and oncological diseases of the gastrointestinal tract. One of the possible approaches in managing the intestinal microbiota is fecal microbiota transplantation (FT) - transfer of the microbiota from the stool of a healthy donor to the intestinal tract of a recipient patient. Currently, this procedure is recognized as an efficacious method to normalize the intestinal microbiota mainly in inflammatory diseases of the gastrointestinal tract. In Russia, pilot studies of the effectiveness of FT in patients with ulcerative colitis have been conducted for several years, and these studies were started in Novosibirsk. The aim of this study was to assess the change of intestinal microbiome in 20 patients with ulcerative colitis after a single FT procedure. The main method is a comparative analysis of 16S ribosomal RNA sequence libraries constructed using fecal samples obtained from patients with ulcerative colitis before and after FT and sequenced on the Illumina MiSeq platform. The obtained results showed that FT led to an increase in average biodiversity in samples after FT compared to samples before FT; however, the difference was not significant. In the samples studied, the proportion of Firmicutes sequences, the major gastrointestinal microbiota of healthy people, was decreased (~32 % vs. >70 %), while the proportion of Proteobacteria sequences was increased (>9 % vs. <5 %). In some samples collected before FT, sequences of pathogenic Firmicutes and Proteobacteria were detected, including Acinetobacter spp., Enterococcus spp., Klebsiella pneumoniae, Proteus mirabilis, Staphylococcus aureus, Stenotrophomonas maltophylia, Streptococcus spp. In most cases, the proportion of such sequences after FT substantially decreased in appropriate samples. The exception was the Clostridium difficile sequences, which accounted for <0.5 % of the sequences in samples from almost half of the patients and after FT, the share of such C. difficile sequences was significantly reduced only in samples from three patients. It should be noted that the proportion of Lactobacillus spp. increased ten-fold and their species composition significantly expanded. According to the obtained results, a preliminary conclusion can be made that even a single FT procedure can lead to an increase in the biodiversity of the gastrointestinal microbiota in patients and to the optimization of the taxonomic composition of the microbiota.

[Co-expression of glutamatergic and autism-related genes in the hippocampus of male mice with disturbances of social behavior]. / Коэкспрессия Ð³Ð»ÑƒÑ‚Ð°Ð¼Ð°Ñ‚ÐµÑ€Ð³Ð¸Ñ‡ÐµÑÐºÐ¸Ñ Ð³ÐµÐ½Ð¾Ð² и генов аутистического спектра в гиппокампе у самцов мышей с нарушением социального поведения.

There is a hypothesis of the involvement of the glutamatergic system in the development of autism. It has been shown that the chronic experience in daily intermale confrontations leads to disturbances in social behavior: a decrease in communicativeness, disturbances of socialization, emergence of stereotypical behaviors that can be considered as symptoms of the autistic spectrum disorders. So, the aim of this study was to investigate changes in the expression of glutamatergic (GG) and autism-related (GA) genes in the hippocampus of animals with impaired social behavior caused by repeated experience of social defeat or aggression in daily agonistic confrontations. To form groups of animals with contrasting behaviors, a model of sensory contact (chronic social stress) was used. The collected brain samples were sequenced at JSC Genoanalytica (http://genoanalytica.ru/ , Moscow, Russia). Transcriptomic analysis revealed a down-regulation of autism-related (Shank3, Auts2, Ctnnd2, Nrxn2) and glutamatergic (Grm4) genes in aggressive mice. At the same time, the expression of GA-related genes (Shank2, Nlgn2, Ptcdh10, Reln, Arx) and GG genes (Grik3, Grm2, Grm4, Slc17a7, Slc1a4, Slc25a22) excluding Grin2a was increased in defeated mice. Correlative analysis revealed a statistically significant association between GG and GA expression. These results can serve as a confirmation of the participation of the glutamatergic system in the pathophysiology of the autistic spectrum disorder.

[Incidence of adverse medical events in the neonatal intensive care unit with the help of a global trigger tool].

INTRODUCTION: Identification and monitoring of the frequency of adverse medical events are important in the organization of the patient's safety system in the intensive care units (ICU). The consistent and accurate identification of adverse events remains a problem for most medical institutions, even in developed countries of the world. AIM: To determine the frequency of adverse medical events in the NICU by using Global and Pediatric Trigger Instruments. MATERIALS AND METHODS: To achieve the goal, the cross-sectional study was conducted in which in retrospect analyzed 160 newborn development records which were treated in the ICU of the newborn in the perinatal center of the M.V. Sklifosovsky Poltava Regional Clinical Hospital in 2016 to identify in them certain neonatal triggers. RESULTS: In 21.3% of newborns, after detecting the triggers of the "Care" module, the hospital infection was confirmed, which we regarded as medical adverse event. The trigger "Infiltration / extravasation" of the same module was detected in 1.9% medical records. Triggers "Glucose less than 3.0 mmol / L after 48 hours from birth", "Increase in creatinine" and trigger "deviation of electrolytes" of the module "Laboratory" were accordingly found in 21.9%, 6.3% and 11.3% medical records of newborns. CONCLUSION: Trigger tool is an effective way to identify adverse events that cause to patient harm. Our results can form the basis for the development of a national neonatal trigger instrument that will effectively monitor the frequency of such events in the ICU of newborn.

[Morbidity rate of obesity in children in ukraine. Overweight as noncontagious disease risk factor].

INTRODUCTION: The upsurge of prevalence rate of obesity and overweight that in the majority of cases traces back to childhood is a risk factor of the most common noncontagious diseases in adults. THE AIM: The aim was to analyze prevalence of obesity in children in Ukraine and to conduct the pilot study of medical condition of overweight children. MATERIALS AND METHODS: Official state statistics of prevalence rate of obesity in kids and screening data of anthropometric characteristics, arterial tension levels, physical performance decrement and medical condition of children (boys - 50, girls - 90, average age - 15,1±0,1 years) was used in research. Data calculation performed by Statistica v. 6.0 software. RESULTS: Over the past few decades, the morbidity rate of obesity in children in Ukraine has greatly increased, especially in year class 15-17. Insufficient diagnosis of obesity in children is the consequence of the inadequacy of the existing system of preventive care and monitoring survey of decease risk factors. Children with body mass index (BMI) above normal have a risk of work decrement in 5,2 times (odds ratio, OR=5,2, CI95%: 1,7-10,6). Such children have higher risk of development of the diseases of the respiratory system (OR=8,1; CI95%: 3,9-13,6) and allergic dermatitis (OR=7,7; CI95%: 3,7-12,9). The odds ratio of arterial hypertension in such children is equal to 3,46±0,3 (95%CI: 2,0-5,9). CONCLUSIONS: According to prediction calculations, the situation with the increase of prevalence rate of obesity in children in Ukraine is unfavorable. The introduction of measures aimed at finding children with obesity, their registration and monitoring of patients' health with due regard to decease risk factors at the primary care level would conduce to improving prevention of obesity and prevention of alimentary diseases progression.

[Behavioral risk factors of chronic non-communicable diseases in medical doctors].

OBJECTIVE: Introdukcion: Group of chronic communicable disease is the main cause of mobility and mortality in industrially and development countries. The same behavioral risk factors are in the basis of these diseases. On the one side medical doctors are completely aware about risk factors management, from the other side, they are mainly unable to maintain healthy life style. The aim of the present study was to assess behavioral risk factors in medical doctors and awareness of need to maintain healthy life style. Fifty one medical doctors of different specialties were included in the study. Anthropometric parameters (high, weight, waist circumference, body mass index, body composition, smoking status, nutrition habits, sleep quality and physical activity were studied. The body composition was assessed with Omron Body Composition Monitor BF511. Physical activity was measurement by pedometer Omron Walking style III step counter HJ-203-EK. The status of smoking, nutrition habits and sleep quality were analyzed with standardized questionnaires. PATIENTS AND METHODS: Materials and Methods:Fifty one medical doctors of different specialties were included in the study. Anthropometric parameters (high, weight, waist circumference, body mass index, body composition, smoking status, nutrition habits, sleep quality and physical activity were studied. The body composition was assessed with Omron Body Composition Monitor BF511. Physical activity was measurement by pedometer Omron Walking style III step counter HJ-203-EK. The status of smoking, nutrition habits and sleep quality were analyzed with standardized questionnaires. RESULTS: Results: very low level of physical activity was found in medical doctors. Median of steps per day in male subjects was8462 [5742÷10430] and 7479 [5574÷10999] in female. Such physical activity was associated with overweight; low muscular and high fat tissue as well as with increased level of visceral fat. Different sleep disorders and associated day symptoms were detected in investigated medical doctors. Absence of continuous sleep and early awakenings dominated between diagnosed sleep disorders. Fifty three percent of women and 47 percent of men had early awakenings. CONCLUSION: Conclusions: the main part of medical doctors in present study had low physical activity, sleep disorders and unhealthy nutrition behavior. So, special programs designed for medical professionals are needed to correct risk of chronic non-communicable disease related to behavioral factors.

[Mechanisms of nitroxide-ergic dysregulation in tissues of parodontium in rats under combined excessive sodium nitrate and fluoride intake].

INTRODUCTION: intake of inorganic nitrates is typically accompanied by production of excessive amount of nitric oxide (NO), which level is maintained by the mechanism of autoregulation known as the NO cycle. Hypothetically, this process may be disrupted with fluorides that are able to suppress arginase pathway of L-arginine metabolism, which competes with NO-synthase pathway. AIM: to study mechanisms of disregulation of oxidative (NO-synthase) and non-oxidative (arginase) metabolic pathways of L-arginine in the tissues of periodontium under combined excessive sodium nitrate and fluoride intake. MATERIAL AND METHODS: these investigations were carried out on 90 white Wistar rats. Homogenates of parodontium soft tissues were used to assess spectrophotometrically the total activities of NO-synthase (NOS), arginase, ornithine decarboxylase as well as the peroxynitrite concentration. RESULTS: typical for the isolated sodium nitrate administration inhibition of total NOS activity varies under combined administration of nitrate and sodium fluoride and is usually manifested by its hyperactivation that is accompanied by an increase in peroxynitrite concentration. At this time arginase and ornithine decarboxylase activity is observed to be substantially reduced. The administration of aminoguanidine, an iNOS inhibitor, (20 mg/kg, twice a week during the experiment) increases arginase and ornithine decarboxylase activities, and the administration of L-arginine (500 mg/kg, twice a week) results in the increase of arginase activity. The administration of L-selenomethionine, a peroxynitrite scavenger (3 mg/kg, twice a week), and JSH-23 (4-methyl-N-(3-phenylpropyl) benzene-1,2-diamine, an inhibitor of NF-κB activation (1 mg/kg, twice a week) for modeling binary nitrate and fluoride intoxication reduces the total concentration of NOS activity and peroxynitrite concentration, and increases ornithine decarboxylase activity. CONCLUSIONS: the combined effect of nitrate and sodium fluoride for 30 days leads to disregulatory increased activity of NO-synthase enzymes and reduction of arginase pathway of L-arginine in the soft tissues of parodontium that is promoted by hyperactivation of iNOS and NF-κB, and increased peroxynitrite production.

[Alteration mechanisms of oxidative stress at periodontal tissues of rats in a simulated periodontitis and elaborate methods of their correction].

INTRODUCTION: one of the peroxidation stress mechanisms is inducible NO synthase (iNOS) expression involved in the pathogenesis of periodontitis. AIM: to access the influence of isoform NO synthase (NOS) on alteration mechanisms of oxidative stress at periodontal tissues of 50 mature rats in a simulated periodontitis (SP). MATERIALS AND METHODS: a SP at rats was induced by a high-carbohydrate, high-fat (HCHF) diet. Тreated SP rat groups were intragastrically administered with selective neuronal NOS (nNOS) inhibitor 7-nitroindazole, selective inducible NOS (iNOS) inhibitor aminoguanidine, and nitric oxide synthase substrate L-arginine. Oxidative stress level in the homogenated soft periodontal tissues was evaluated by TBARS (thiobarbituric acid reactive substances) level before and after 1,5 hours of incubation. Antioxidant response was evaluated by the increase in concentration of TBARS for incubation, аnd by antioxidant enzyme activity - superoxide dismutase and catalase. RESULTS: nNOS activity increase in a SP considerably limits oxidative stress activation at periodontal tissues, decreases antioxidant response, but heightens catalase activity. iNOS functional activity stimulates oxidative stress at periodontal tissues of rats, decreases antioxidant response. L-arginine in a MS effectively repaired antioxidant response at periodontal tissues that probably will give positive result at complex treatment of periodontitis and MS generally. CONCLUSIONS: in the near future, the appropriate regulation of NO activity by using NOS-active agents may provide a novel strategy for the periodontal disease prevention and correction in a MS.

[Harmful alcohol consumption: prevalence, trends, health burden, reduction strategy].

INTRODUCTION: Harmful alcohol consumption constitutes a significant cause of the global burden of disease, causing more than 200 different diseases, 5.9% of all deaths worldwide, causing substantial medical and social costs, major economic loss, slowing progress towards the strategic goals of human development. THE AIM: to substantiate approaches to the formation of a national strategy to combat the harmful use of alcohol in Ukraine based on the analysis of the prevalence of alcohol consumption and related health and social problems and international experience and recommendations of WHO. MATERIAL AND METHODS: The study was based on analysis of the extent and patterns of alcohol consumption in Ukraine, levels, structure and dynamics of morbidity and mortality from diseases associated with alcohol abuse; investigation of preventive activities in primary healthcare, the existing problems and doctors' needs for prevention alcohol abuse, national and international experience on this problem.This work usesbibliosemantic, medical, statistical, sociological, epidemiological methods. The information base are: European Health for All Database (HFA-DB)for 2000-2012,Center of Medical Statistics, Ministry of Health of Ukraine for 2000-2015, questionnaire survey of physicians in primary care, strategic and policy documents of WHO, WHO Regional Office for Europe. RESULTS: In Ukraine, as in most countries in the WHO European Region prevalence of alcohol is high. In the ranking of the WHO European Region Ukraine ranks fifth in alcohol consumption per capita. The structure of consumption of alcoholic drinks is dominated by strong spirits (48%). There has been a negative trend for this indicator from 5.4 liters in 2002 to 15.6 liters in 2012.The dominant pattern of alcohol consumption is characterized by early onset of alcohol consumption, significant frequency, large doses, mostly strong alcohol beverages, with significant share of low-quality alcohol. This factor contributes to high levels of morbidity. A total of546.3 thousandpeople with mental and behavioral disorders due to use of psychoactive substances wereregistered in health care facilities in 2014. Standardized mortality rate from causes related to alcohol in Ukraine (185.4 per 100 thousand.) is one of the largest in Europe, with only Kazakhstan (308.4) and Belarus (187.9) being behind. Regular work aiming at prevention of alcohol abuse is carried out by 49.4% of primary care professionals; 21.3% of physiciansinsist on reducing alcohol use on occasion. CONCLUSION: Alcohol abuse is a major factor of morbidity, epidemic of noncommunicable diseases in Ukraine, causing significant medical and social costs and economic losts.Ukraine ranks fifth in alcohol consumption per capita among WHO European Region countries. High level and unhealthy patterns of alcohol consumption in the population causes high morbidity and mortality from noncommunicable diseases, accidents, exceeding pan-European indices and indicators in the European Union. Primary health care facility staff has insufficient knowledge, skills and gaps in professional training regarding the prevention of harmful use of alcohol.There is a high need for effective strategies to reduce the prevalence of this risk factor in Ukraine. In developing the National Action Plan to reduce the harmful use of alcohol, a national context and WHO recommendationsshould be considered, including improving the efficiency of health services, high-quality prevention and effective treatment of disorders caused by alcohol, countermeasures on driving drunk, limiting the sale and availability of alcohol, prevention the spread of manufacturing and marketing of alcoholbeverages produced illegally, including falsification, the revitalization of local communities, weakening the impact of marketing of alcohol beverages.

[Modern look at pharmacotherapy of osteoarthritis accomplished with cardiovascular disease].

UNLABELLED: ABSTR ACTCT Introduction: At present, the main pathogenetic link in the development of OA as atherosclerosis is chronic inflammation, which is based on the activation of pro-inflammatory mediators and disorders of cholesterol metabolism. The aim of the research was to study the efficiency of the use of rosuvastatin in the treatment of patients with osteoarthritis in the combined arterial disease. MATERIAL AND METHODS: The study was conducted on the basis of the Poltava Regional Clinical Hospital. N.V. Sklifosovsky and Research Institute of Genetic and immunological bases of pathology and pharmacogenetics higher state educational institution of Ukraine "Ukrainian Medical Dental Academy" (HSEЕU «UMUMCA¼). Results of treatment of 30 patients with osteoarthritis and hypertension who received treatment with rosuvastatin. CONCLUSIONS: It was concluded that the use of rosuvastatin in these patients can reduce pain, improve joint function, reduce disease activity and improve quality of life for patients. Besides rosuvastatin does not affect the level of systolic and diastolic blood pressure and can be used with concomitant hypertension.

[Upgrading of complete removable prosthetic appliance of stomatological patients by the use of new base materials].

INTRODUCTION: The effectiveness of orthopedic treatment of edentulous patients depends on the properties of the basic materials. The main group of materials for manufacturing of such structures are acrylic plastics of thermal polymerization. However, many years of experience in the use of plastics has revealed a number of shortcomings. One of the main is insufficient functional durability of prostheses, and as a consequence - the fragility of acrylic constructions. At present, more and more dentists use nonacrylic thermoplastics, which can improve the functional quality of full removable dentures, as well as, avoid the above disadvantages of acrylic basic plastic. AIM: The work is devoted to the study of comparative clinical effectiveness of dental prosthetic in edentulous patients using a variety of basic materials for the production of removable dentures. MATERIAL AND METHODS: In this work we used the following materials - "Ftorax" - acrylic plastic of hot polymerization and «Vertex Thermosense¼ - nonacrylic thermoplastic plastic. RESULTS: As a result of the performed work it can be concluded that the use of the basic thermoplastic materials, namely «Vertex Thermosense¼, allows to get more rapid adaptation of the patient to full removable dentures due to better fixation and stabilization. CONCLUSION: Based on the results of our comparative clinical study it can be recommended using of base material «Vertex Thermosense¼ in the clinic of prosthetic dentistry in treatment of edentulous patients.

[Evaluation of therapy efficiency in patients with combined course of copd and osteoarthritis].

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is a disease that is characterized by chronic airflow limitation, a variety of pathological changes in the lungs, significant extrapulmonary manifestations, and severe comorbidities which may further aggravate the course of COPD [GOLD, 2013]. Intensity of systemic manifestations increases with the progression of obstruction, therefore the abovementioned symptoms are often overlooked and become apparent in the later stages of the disease. Systemic manifestations impair the quality of life, lead to early disability and significantly contribute to mortality in patients with COPD. Diseases of cardiovascular and musculoskeletal systems are the most serious and socially significant systemic manifestations of chronic obstructive pulmonary disease. Currently, there is no doubt that the activation of non-specific and specific immune responses in patients with COPD is associated with the influence of a number of universal mediators, among which a special place belongs to the cytokine network that controls implementation processes of the immune and inflammatory reactivity. The aim of our work was to increase the effectiveness of treatment in patients with chronic obstructive pulmonary disease in combination with osteoarthritis based on the study of clinical course, assessment of patient's life quality and substantiation of pharmacological correction. MATERIAL AND METHODS: The work was conducted on the basis of Poltava Regional Clinical Hospital named after N.V. Sklifosovskiy. The study was carried out at Research Institute for Genetics and Immunological Grounds of Pathology and Pharmacogenetics of Higher State Educational Establishment of Ukraine "Ukrainian Medical Stomatological Academy" (HSEEU "UMUMCA"). The study involved 40 patients with an average age of 54.4 ± 3.1 years with acute exacerbation of COPD (clinical group B-C - GOLD II-III), in combination with OA. The duration of COPD was 16.2 ± 2.1 years. Among patients there were 28 (70%) men and 12 (30%) women. All patients were smokers; the smoking period was 32.4 ± 2.9 pack-years. OA in the phase of unstable remission was verified in all patients, large joints were involved - knee, shoulder, and ankle. Depending on the chosen option of treatment, patients were divided into two representative groups - I and II. Patients of group I received only standard treatment for COPD in accordance with existing protocols, and in group II fenspiride hydrochloride 80 mg 2 times a day was added to the basic therapy for 12 days. Full examination of patients was carried out at admission and after 3 months from the date of admission. RESULTS: According to the study, on addition of fenspiride to basic therapy in patients with constellation of COPD and OA, the regression of disease (reduction in cough) was observed by 2.9 ± 0.4 days earlier, dyspnea by 2.3 ± 0.33 than in the comparison group (p < 0.05), quality of life improved, and exercise tolerance increased. FEV1 in patients of group I after 3 months amounted to 62.6 ± 4.2%, in group II - 68.1 ± 4.9%, recurrence of airflow obstruction in both groups increased: in group I - by 4.2 ± 1.1%, in group II - by 5.6 ± 1.5%. Adding fenspiride hydrochloride to the treatment significantly improved the life quality of patients with COPD combined with OA at all scales of SF-36 questionnaire, reflecting the patient's physical condition, namely, physical activity, the role of physical problems in vital functions, the intensity of pain, overall health status, vitality. After 3 months of follow-up, in patients with comorbidity influenced by fenspiride hydrochloride against the background of traditional pathogenic therapy, the indicators of VAS significantly decreased by 1.9 times (3.18 ± 0.24 cm versus 6.01 ± 0.59 cm, p <0, 05), Lequesne index - by 2.0 times (9.42 ± 1.81 points against 19.17 ± 4.15 points, p <0.05) and WOM AC by 1.6 times (38.7 ± 3.7 points against 63.8 ± 8.3 points, p <0.05), respectively. In patients of group II, a more pronounced positive dynamics of reducing inflammatory activity, confirmed by the decrease in TNF-α content by 1.9 times (61.8 ± 5.9 pg / ml versus 131.5 ± 6.9 pg / ml, p <0.001) was observed. The hospitalization period of patients in group I was 14.3 ± 0.4 days, in group II it was less and amounted to 12.9 ± 0.5 days. CONCLUSIONS: Supplementary application of fenspiride hydrochloride in the treatment of COPD patients in combination with OA improves the outcomes of patients' treatment, quality of life and prolongation of remission, indicating a decrease in the severity of systemic inflammation.

[Analysis of orthodontic treatment efficiency in children with dental crowding].

INTRODUCTION: Efficiency of dental treatment is necessary to provide optimal results with less outlay of clinical time and shorter duration of treatment and for stable and balanced occlusion. AIM: To compare duration of orthodontic treatment in children with dental crowding by authoring and traditional methods. MATERIAL AND METHODS: Orthodontic treatment of 37 patients with dental crowding of severe degree in period of mixed dentition was carried out. The first (1) (basic) group consisted of 27 patients (mean age 11,93±0,73 years) who were treated with removable orthodontic appliances of our own design and additional application of own theoretical and practical developments. Control group (2) consisted of 10 patients (mean age 12,6±1,28 years). They were treated by traditional removable appliances with screws. Student's t-test was applied to reveal significanсe deference of the obtained results for different groups. Before treatment comparative analysis has not showed significant difference between groups depending on age, gender, sagittal, vertical and lateral malocclusion as well as localization and severity degree of dental crowding (P >0,05). RESULTS: It was found that treatment duration of malocclusion with dental crowding of the maxillary teeth for groups 1 and 2 was 11,95±0,85 and 18,75±2,61 months respectively (P >0,05) . Duration of treatment for groups 1 and 2 of mandibular teeth crowding was 12,47±1,09 and 17,86±1,81 months respectively (P >0,05). CONCLUSIONS: It was proved that the application of own theoretical and practical developments which were introduced in orthodontic treatment of malocclusion complicated by dental crowding, makes it possible to reduce period of treatment on the average in 1,45 times in comparison with conventional.

[Clinical and morphological observation of purulent iliopsoitis].

The article describes the modern literary data on classification, etiology, pathogenesis and predisposing factors in the development of purulent iliopsoitis. Where are clinical and morphological analysis of five deaths cases of purulent ileopsoitis. On the basis of these studies found that purulent ileopsoitis that occur in middle and old age, are more common in women, can be either unilateral or bilateral localization. Purulent ileopsoitis arises by forming abscess in the iliopsoas muscle. Primary ileopsoitis arises in connection with injuries gluteal and lumbar region. Secondary ileopsoit developed as a complication of inflammatory and neoplastic processes, with an initial mechanism for the development of the pathological process were necrotic changes in the external iliac lymph nodes. In vivo it is difficult to diagnose, that`s why is necessary to apply a comprehensive study, including clinical data, anamnesis, general clinical and laboratory parameters, instrumental methods.

[Antithrombotic therapy in patients with atrial flutter before planned cardioversion].

INTRODUCTION: atrium flutter and fibrillation are the heart rhythm disorders that increase the risk of life-dangerous complications, e.g. cardioembolic stroke, pulmonary embolism. Recommendations for managing patients with atrial fibrillation - atrial flutter, with paroxysm duration over 48 hours, demand anticoagulant therapy. Oral anticoagulants, which are the antagonists of K vitamin (Varpharin) and the new oral anticoagulants (Rivaroxaban), are used during the per-manipulative procedure of patients with atrial flutter before restoring the sinus rhythm with transesophageal cardiac pacing. AIM: the present investigation aims to compare efficiency and safety of Varpharin and Rivaaroxaban in treatment patients with atrial flutter before planned cardioversion with transesophageal heart pacing. MATERIALS AND METHODS: Varpharin (control group) - in doses equivalent for reaching the target МНВ - or Rivaroxaban (research group), 20 mg., were prescribed to 42 patients with coronary heart disease, concomitant arterial hypertension, and non-valvular paroxysm of atrial flutter with more than 48-hour duration, divided into two groups. There was held the general clinical, echocardioscopy examination. Thrombotic Risk Factor Assessment was made according to the CHA2DS2-VASc scale, Hemorrhagic Risk Factor Assessment was performed according to the HAS-BLED scale, and clinical symptoms assessment was made according to the EHRA scale. The heart rhythm was restored with the transesophageal heart pacing. RESULTS: the per-manipulative procedure of the patients of research group (21 days were suggested according to the guidelines) shortened, unlike the patients of control group (the period of target МНВ selection had made 30,76±0,62days), the reduction of the symptoms severity by EHRA was considered in dynamics. According to the results of transesophageal heart pacing, the heart rhythm of 15 research group patients restored, and 6 research group patients had atrial fibrillation. Among the patients of the control group, 6 had their heart rhythm restored, as 10 patients had the atrial fibrillation. CONCLUSIONS: the use of Rivaroxaban during the per-manipulative procedure before planned cardioversion with transesophageal heart pacing causes shortening of the permanipulative period, reduces the risk of development of symptoms of heart failure, helps to restore the heart rhythm of the patients with atrium flutter.

[Mechanisms of nitroxide-ergic dysregulation in tissues of parodontium in rats under combined excessive sodium nitrate and fluoride intake].

INTRODUCTION: intake of inorganic nitrates is typically accompanied by production of excessive amount of nitric oxide (NO), which level is maintained by the mechanism of autoregulation known as the NO cycle. Hypothetically, this process may be disrupted with fluorides that are able to suppress arginase pathway of L-arginine metabolism, which competes with NO-synthase pathway. AIM: to study mechanisms of disregulation of oxidative (NO-synthase) and non-oxidative (arginase) metabolic pathways of L-arginine in the tissues of periodontium under combined excessive sodium nitrate and fluoride intake. MATERIAL AND METHODS: these investigations were carried out on 90 white Wistar rats. Homogenates of parodontium soft tissues were used to assess spectrophotometrically the total activities of NO-synthase (NOS), arginase, ornithine decarboxylase as well as the peroxynitrite concentration. RESULTS: typical for the isolated sodium nitrate administration inhibition of total NOS activity varies under combined administration of nitrate and sodium fluoride and is usually manifested by its hyperactivation that is accompanied by an increase in peroxynitrite concentration. At this time arginase and ornithine decarboxylase activity is observed to be substantially reduced. The administration of aminoguanidine, an iNOS inhibitor, (20 mg/kg, twice a week during the experiment) increases arginase and ornithine decarboxylase activities, and the administration of L-arginine (500 mg/kg, twice a week) results in the increase of arginase activity. The administration of L-selenomethionine, a peroxynitrite scavenger (3 mg/kg, twice a week), and JSH-23 (4-methyl-N-(3-phenylpropyl) benzene-1,2-diamine, an inhibitor of NF-κB activation (1 mg/kg, twice a week) for modeling binary nitrate and fluoride intoxication reduces the total concentration of NOS activity and peroxynitrite concentration, and increases ornithine decarboxylase activity. CONCLUSIONS: the combined effect of nitrate and sodium fluoride for 30 days leads to disregulatory increased activity of NO-synthase enzymes and reduction of arginase pathway of L-arginine in the soft tissues of parodontium that is promoted by hyperactivation of iNOS and NF-κB, and increased peroxynitrite production.

[Alteration mechanisms of oxidative stress at periodontal tissues of rats in a simulated periodontitis and elaborate methods of their correction].

INTRODUCTION: one of the peroxidation stress mechanisms is inducible NO synthase (iNOS) expression involved in the pathogenesis of periodontitis. AIM: to access the influence of isoform NO synthase (NOS) on alteration mechanisms of oxidative stress at periodontal tissues of 50 mature rats in a simulated periodontitis (SP). MATERIALS AND METHODS: a SP at rats was induced by a high-carbohydrate, high-fat (HCHF) diet. Тreated SP rat groups were intragastrically administered with selective neuronal NOS (nNOS) inhibitor 7-nitroindazole, selective inducible NOS (iNOS) inhibitor aminoguanidine, and nitric oxide synthase substrate L-arginine. Oxidative stress level in the homogenated soft periodontal tissues was evaluated by TBARS (thiobarbituric acid reactive substances) level before and after 1,5 hours of incubation. Antioxidant response was evaluated by the increase in concentration of TBARS for incubation, аnd by antioxidant enzyme activity - superoxide dismutase and catalase. RESULTS: nNOS activity increase in a SP considerably limits oxidative stress activation at periodontal tissues, decreases antioxidant response, but heightens catalase activity. iNOS functional activity stimulates oxidative stress at periodontal tissues of rats, decreases antioxidant response. L-arginine in a MS effectively repaired antioxidant response at periodontal tissues that probably will give positive result at complex treatment of periodontitis and MS generally. CONCLUSIONS: in the near future, the appropriate regulation of NO activity by using NOS-active agents may provide a novel strategy for the periodontal disease prevention and correction in a MS.

Benign Fibro-Osseous Lesions of the Craniofacial Area in Children and Adolescents: A Review.

Benign fibro-osseous lesions (BFOL) of the craniofacial area are represented by a variety of morphologic processes that are characterized by pathologic ossifications and calcifications in association with a hypercellular fibroblastic marrow element. The current classification includes neoplasms, developmental dysplastic lesions and inflammatory/reactive processes [5]. The final diagnosis depends on-clinical, radiological and pathological features. The clinico-pathologic features of this heterogeneous group of diseases are presented in this article.

[Features of autonomic dysfunction in myofascial pain syndromes cervicobrachial localization].

INTRODUCTION: The relevance of this study is due to the prevalence of autonomic disorders and musculoskeletal pain, especially among the young people of working age. In recent years, many authors in scientific works have been highlighted aspects of mutual development myofascial and autonomic dysfunction, which is caused by neurophysiological preconditions and anatomical and topographical relationships that need to be considered in the diagnostic and therapeutic approaches. OBJECTIVE: To study the characteristics of the formation and flow of autonomic dysfunction syndrome with paroxysmal and permanent types of flow in patients with myofascial pain syndromes cervicobrachial localization. MATERIAL AND METHODS: Using clinical neurological, vertebral neurological, neuropsychological methods of studying the severity of pain (visual analogue scale and Pain questionnaire of Mac Gill) examined 84 patients suffering from autonomic dysfunction on the background of myofascial pain syndromes cervicobrachial localization. To identify the features of vegetative regulation of patients were divided into two groups: group 1 (51 people) - with a permanent type of course; group 2 (33 patients) - a type of paroxysmal of course of autonomic dysfunction. RESULTS: It was found more pronounced disturbances in patients with paroxysmal type of course of autonomic dysfunction. The frequency and severity of autonomic paroxysms associated with the severity of musculo-tonic syndrome and location of active trigger points in the muscles of the neck and shoulder girdle, due to anatomic and topographic features of these muscles, namely the proximity of their location to the sympathetic formations neck. The formation and development of emotional and affective disorders in both groups played a significant role of pain and musculo-tonic syndrome. The syndrome of autonomic dysfunction, in particular its paroxysmal type of flow, on the one hand is a response to the development of myofascial pain syndromes cervicobrachial localization, with another - a factor that facilitates the development of pain and muscular-tonic syndromes, burdening the disease. CONCLUSION: In the diagnosis and treatment of myofascial and autonomic dysfunction should take into account comorbidity data of pathological conditions, which is important for developing individual therapeutic regimens.