[Peculiarities of pregnancy management after multiple stenting of coronary arteries].

This paper describes the strategy for pregnancy and labour management in women with the history of myocardial infarction after multiple stenting of coronary arteries using stents with cytostatic coating. The authors discuss a broad range of diseases underlying coronary lesions in young pregnant women receiving antiaggregation therapy. Neither multiple stenting nor intake of aspirin and ticlopid provoked teratogenic effect.

[Lipolysis in fatty tissue of patients with adrenohypercorticism]. / Lipoliz v zhirovoi tkani u bol'nykh s adrenogiperkortitsizmom.

Lipolytic activity was studied in subcutaneous and peripheric adipose tissue of patients with adrenohypercorticism (25 patients with Itsenko-Cushing disease and 4 patients with Cushing syndrome caused by corticosteroma of adrenal gland) and in 11 persons without this pathology. The lipolytic activity of the both adipose tissues in the patients with Itsenko-Cushing disease was similar to that of healthy persons and decreased in the patients with Cushing syndrome. The receptor-enzymatic system, responsible for lipolysis in adipose tissue, was not impaired in Itsenko-Cushing disease; differences found in lipolytic effects of corticotropin and somatotropin were caused by deteriorations in secretion of endogenous hormones in the disease. This system was inhibited in Cushing syndrome. Antilipolytic effect of insulin (especially in presence of glucose) was more distinct in subcutaneous adipose tissue of patients with Itsenko-Cushing disease as compared with controls.

[Level of substances reacting with 2-thiobarbituric acid in the plasma of healthy people and patients with various endocrine diseases]. / Soderzhanie soedinenii, reagiruiushchikh s 2-tiobarbiturovoi kislotoi, v plazme krovi zdorovykh liudei i bol'nykh nekotorymi éndokrinopatiiami.

After estimation of the substances reacting with 2-thiobarbituric acid (malonic dialdehyde, MDA) in human blood plasma using a long-term intralaboratory control of the procedure, increase in content of MDA was observed in blood plasma of patients with endocrinopathies, accompanied by obesity, particularly in the patients with Itsenko--Cushing disease (52 patients before treatment and III patients during various steps of complex treatment). The increase in MDA content in blood of these patients appears to occur due to activation of lipid free radical oxidation.

[The extratumor mechanisms of osteolysis in multiple myeloma and the means for their correction]. / Vneopukholevye mekhanizmy osteoliza pri mnozhestvennoi mielome i puti ikh korrektsii.

In 70 patients with stage III multiple myeloma (MM) the authors studied spontaneous and lipopolysaccharide-induced production of interleukin-1 (IL-1) and interleukin-6 (IL-6) by blood and bone marrow mononuclear cells, concentration of parathyroid hormone and vitamin D3 in the serum. Bone marrow density was measured at photon absorption (Gambro), in patients treated with osteoprotectors bonefos and oxidevit before and after therapy (3.5-6 month course). It is shown that in MM there is a pathogenetic association between production of osteotropic IL-1, IL-6 and bone demineralization. The cases with reduced concentration of Ca and P ions in the serum (4 and 5.7% of patients, respectively) and increased PTH concentration (7%) suggest the existence of new, extratumor mechanisms of osteolysis. It is found that biphosphonates are optimal osteoprotectors. Bonefos (chlodronat, Lieras, Finland) arrests osteolysis proved by a significant increase of bone marrow density and clinical effect.

[Individual patient sensitivity to glucocorticoids and hormone resistance in bronchial asthma]. / Individual'naia chuvstvitel'nost' bol'nykh k gliukokortikoidam i gormonorezistentnost' pri bronkhial'noi astme.

The paper reports glucocorticoid actions in bronchial asthma, covers problems of individual sensitivity to glucocorticoids and resistance to hormones, illustrates the dependence of beclometasone dipropionate efficacy on condition of glucocorticoid receptors in alveolar macrophages and clinical appearance of the disease, describes physiological features of patients with hormone-resistant bronchial asthma and its new treatment (extracorporeal photohemotherapy) allowing reduction of prednisolone dose in 14 of 15 patients from 29.6 to 11.4 mg/day, on the average.

[Clinico-biochemical parallels in diverse forms of primary hyperparathyroidism]. / Kliniko-biokhimicheskie paralleli pri razlichnykh formakh pervichnogo giperparatireoza.

Altogether 184 patients with bone, renal or mixed hyperparathyroidism (HPT) presenting primarily were examined for blood levels of parathyroid hormone and indirect indicators of parathyroid function. None of the indices (calcium concentration, phosphorus level, serum activity of acid and alkaline phosphatase, oxyproline excretion with urine, etc.) was changed. The commonest biochemical signs of primary HPT were hypercalcemia, hypersecretion of parathyroid hormone, hyperoxyprolinuria. Biochemical indices deviations occurred more often and were more profound in bone primary HPT and parathyroid adenomas.

[Glucocorticoid adrenal function and clinical implications of hydrocortisone metabolism tests in patients with bronchial asthma]. / Gliukokortikoidnaia funktsiia nadpochechnikov i klinicheskoe znachenie opredeleniia metabolizma kortizola u bol'nykh bronkhial'noi astmoi.

A glucocorticoid adrenal function was studied in 42 perimenopausal women with bronchial asthma (BA) by radioimmunoassay estimation of blood hydrocortisone levels, free and conjugated fractions of urinary hydrocortisole, 24-h excretion of overall 17-OCS and hydrocortisone metabolism index. Replacement estrogens inhibit processes of microsomal hydroxylation and reduce clearance of the introduced steroids. Replacement therapy with sex hormones conducted to correct menopause had no negative influence on hydrocortisone blood levels and its metabolism.

[Metabolic function characteristics and respiratory pathology of premature infants]. / Nekotorye osobennosti obmennykh funktsii i respiratornaia patologiia u nedonoshennykh detei.

A total of 143 premature children of the first 3 months of life (the body weight upon birth 1200-2500 g) staying at a specialized hospital, and 28 children (the body weight upon birth 1100-2500 g) under 3 years staying at a pulmonological sanatorium were examined. Studies on enzymatic functions (uropepsin, glutathione, protease and lipase activity in the blood serum) revealed a decrease in adaptation processes in premature children with acute pneumonia, and during reconvalescence in children with hypotrophy. In premature neonates on formula feeding with a mixture of "Malyutka", the content of total lipids, cholesterol and phospholipids was lower than in children on natural feeding. The content of free fatty acids and acetone tended towards an increase during formula feeding. Pneumonia incidence in premature children was 4 times higher in the first year of life and 2 1/2-2 times higher in the second and third years of life, as compared to full-term babies. The respiratory diseases in premature children were followed by the asthmatic syndrome. The results obtained may be used for the development of dietetic management of premature children with pneumonia and hypotrophy.

[Effects of hemofiltration on lipid peroxidation and lipidograms in multiple organ failure syndrome in patients with peritonitis]. / Vliianie gemofil'tratsii na pokazateli perekisnogo okisleniia lipidov i lipidogrammy pri sindrome poliorgannoi nedostatochnosti u bol'nykh peritonitom.

Hemofiltration was used in multiple-modality treatment of 45 patients with peritonitis who developed polyorgan failure. Lipid peroxidation parameters and lipidograms were under study. Lipid peroxidation was activated and supply with alpha-tocopherol drastically decreased. Hemofiltration helped improve the antioxidant defense.

[Low-flow membrane oxygenation of blood in patients with diffuse purulent peritonitis]. / Malopotochnaiua membrannaia oksigenatsiia krovi pri razlitom gnoinom peritonite.

Small-flow membranous oxygenation of the blood was used in 45 patients with peritonitis in the multiple organ failure phase. In ten cases blood oxygenation was combined with hemofiltration. MOCT 19-03 (Kvant Research and Production Unit) and Gambro FH hemofilters (Sweden) were employed. Combination of small-flow membranous oxygenation of the blood combined with hemofiltration appreciably improved the oxygen-transporting function of the blood in adult patients with the respiratory distress syndrome, which was due to mutual potentiation of the two methods' effects. Small-flow membraneous oxygenation alone improved cellular immunity and decreased the laboratory manifestations of endogenous intoxication due to biotransformation of toxic products.

Prevalence of diabetes mellitus in patients with acromegaly.

Early carbohydrate metabolism disorders (ECMDs) and diabetes mellitus (DM) are frequently associated with acromegaly. We aimed to assess the prevalence of ECMDs in patients with acromegaly and to compare the results with those in adults without acromegaly using two population-based epidemiologic surveys. We evaluated 97 patients with acromegaly in several phases of their disease (mean age, 56 years and estimated duration of acromegaly, 12.5 years). An oral glucose tolerance test was done in those not yet diagnosed with DM to reveal asymptomatic DM or ECMDs (impaired glucose tolerance+impaired fasting glucose). Comparisons were made between patients with acromegaly and participants from the general adult population (n=435) and an adult population with multiple type 2 diabetes risk factors (n=314), matched for gender, age and BMI. DM was diagnosed in 51 patients with acromegaly (52.5%) and 14.3% of the general population (P<0.001). The prevalence of ECMDs was also higher in patients with acromegaly than in the general population and in the high-risk group; only 22% of patients with acromegaly were normoglycaemic. The prevalence of newly diagnosed ECMDs or DM was 1.3-1.5 times higher in patients with acromegaly compared with the high-risk group. Patients with acromegaly having ECMDs or DM were older, more obese and had longer disease duration and higher IGF1 levels (Z-score). Logistic regression showed that the severity of glucose derangement was predicted by age, BMI and IGF1 levels. In patients with acromegaly, the prevalence of DM and ECMDs considerably exceeds that of the general population and of a high-risk group, and development of DM depends on age, BMI and IGF1 levels.