Vol 21, No 1 (2015)

The article presents intermediate results of analysis of effectiveness and tolerance of Ipilimumab applied within the framework of program of broadened access CA184-089 EAP. Ipilimumab is a new immune stimulator blocking receptors of CTLA4 om lymphocytes and regenerating anti-tumor immune response. The analysis covered 52 patients receiving treatment from October 2011 to August 2012 in the N.N. Blokhin Russian oncologic national center. The effectiveness of pharmaceutical corresponded to previously published data. The median of total survival in all population of patients made up to 13.7 months (confidence range 95% from 8.0 to 19.5 months). The six-moths total survival made up to 77.5±5.9%, one-year survival made up to 45.9±7.9%. No new undesirable occurrences were detected. Altogether, 9 severe undesirable occurrences were registered (from third to fifth degrees of severity according CTCAE V4.0) in seven patients (13.5%), one with lethal outcome (1.9%).

The article presents analysis of results of treatment of 698 patients with successfully implemented primary endoscopic hemostasis with purpose to stop or to prevent bleeding. The comparative analysis of results of prevention of relapse of ulcerous bleeding depending on specific technique of endo-hemostasis (electrical coagulation, radio-wave coagulation, orgonoplasm coagulation) revealed no statistically reliable advantage of any mode. All methods are equal alternatives.

The article deals with studying indicators of lipoprotein metabolism in relationship with psycho-emotional factors in healthy individuals. The sampling included 107 healthy individuals of able-bodied age from organized population (46 males and 61 females) with mean age made up to 43.4±10.8 years. All examined individuals were applied clinical psychological study using such questionnaires as Spielberger-Khanin test, Center for Epidemiological Studies Depression cale (USA), visual analogue scale-modified version of Dembo-Rubinstein technique, social frustration scale, Holmes-Rahe social adaptation test. To analyze indicators of lipidogram venous blood was taken. The most of lipid indicators were higher in individuals with clinically significant levels of depression, personal anxiety and accumulated stress independently of gender. In female group statistical reliability was reached by mean indicators of total cholesterol, cholesterol lipoproteins of low density, cholesterol not bounded with lipoproteins of high density. In male group statistical reliability was reached by ratio apoB/apoA. The most prevalence of dislipoproteinemia was established in male group and at that reliable differences were reached by rate of hypertriglyceridemia and higher level of apoB100. The rate of personal anxiety and clinically significant stress measured by Holmes-Rahe scale was reliably higher in group of examined females and made it up to 75% and 36% correspondingly. In both groups association of psycho-emotional factors with indicators of lipid profile was established. At that, in males the study detected an independent relationship between both of level of personal anxiety and social frustration and apoproteins and between cumulated stress and level of cholesterol not bound with lipoproteins of high density as well. In females association of accumulated stress according Holmes-Rahe scale with level of total cholesterol and atherogenity index was established. The study data indicate at necessity to determine means of development of complex primary prevention of stress-induced disorders of lipoprotein metabolism with consideration for psycho-emotional factors and gender characteristics of their effect.

The article considers application of complex immunoglobulin preparation in comprehensive treatment of acute obstructive bronchitis in children of infancy age with purpose to develop intestinal local immunity. The complex immunoglobulin preparation is a pharmaceutical for enteric application derived from donor blood. In contrast, with normal human immunoglobulin, the preparation includes immunoglobulines of three classes (50% IgG, 25% IgM, 25% IgA) and is characterized by increased content of antibodies to different pathogenic and opportunistic agents.

The venous thromboembolism comprising thrombosis of deep veins and thromboembolism of pulmonary artery remains one of main problems of modern medicine. The multi-detector computer tomography - angiopulmonography is the most effective technique of diagnostic of thromboembolism of pulmonary artery and as appropriate it can be amplified with indirect multi-detector computer tomography - venography of pelvic and abdominal veins which visualization can be complicated under ultrasound examination. The article considers characteristics of application of mentioned above techniques of radiodiagnostics on suspicion on venous thromboembolism. The advantages, limitations and technical difficulties of these techniques are considered too.

The article discusses technique of measurement of arterial pressure as issue of large value in examination of every patient. The historical prerequisites of development of method applied nowadays are presented. The pathophysiological mechanisms of regulation of arterial pressure, external and internal factors impacting arterial pressure, characteristics of technique of measurement of arterial pressure and modes of interpretation of obtained results are discussed.