Vol 22, No 3 (2016)

The article considers evaluation of indicators of inflammation, antioxidant defense and myocardium ischemia in patients with ischemic heart disease exposed to coronary bypass surgery using artificial blood circulation or on functioning heart. The sampling included 96 patients distributed to two groups. The first group included 84 patients (81% of males, average age 62,2±7,7 years) exposed to coronary bypass surgery in conditions of artificial blood circulation. The second group included 12 patients (91,7% of males, average age 59,8±8,0 years) exposed to coronary bypass surgery on functioning heart without artificial blood circulation. The study demonstrated significant increasing of level of interleukin-6 in patients with ischemic heart disease after application of coronary bypass surgery with extra-corporal blood circulation that confirms high activity of inflammation factors at the given disease. The reconstructing operations on hearts in conditions of artificial blood circulation are accompanied by decreasing of concentration of superoxiddismutase. At that, the level of analyzed bio-marker remains as compared with operation on functioning heart. This occurrence testifies activation of oxidative process and intensified consumption of as factor of antioxidant defense in the course of direct re-vascularization of myocardium. The concentration of troponin increases in post-operational period of reconstructing operation but differences are unreliable when analyzed groups are compared.

Over the time of recent years, in surgical treatment of inguinal hernia such revolutionary changes occurred as implementation of Lichtenstein's nonstrain prosthetic inguinal hernioplasty (1986) into surgical practice and application of laparoscopic hernioplasty (Arregui M.E., 1992; McKernan and Ferzli, 1993). The study was carried out to evaluate reliability and effectiveness of application of trans-peritoneal and total extra-peritoneal hernioplasty in case of inguinal hernia. During 2012-2015, in the municipal clinical hospital №4 and the Russian gerontological research clinical center (Moscow) 12 patients underwent 12 hernioplasties using technique of total extra-peritoneal hernioplasty and 65 patients underwent 73 hernioplasties using technique of trans-peritoneal hernioplasty (in 8 cases herniae were bilateral). The technical intra-operational characteristics of procedures were analyzed. The evaluation of intra-operational and post-operational complications during earlier post-operational period and in a year after operation was carried out. The single patient in the group of total extra-peritoneal hernioplasty inguinal hernia was relapsing after herniotomy with plasty with local tissues. All herniae were one-sided. The average duration of operation made up to 62.5 minutes. The conversion was never required. In the group of trans-peritoneal hernioplasty average duration of operation made up to 58.5 minutes. The conversion was never required too. The rate of intra-operational complications in both groups was low. The most of the patients in main group (total extra-peritoneal hernioplasty) were ready to be discharged from the hospital at second day after operation. The total rate of post-operative complications made up to 20.6%. Only in the group of trans-peritoneal hernioplasty single relapse was observed after three months after operation. According to results of study, the laparoscopic inguinal hernioplasty is the most preferable and rational treatment of most of the types of inguinal herniae. The total extra-peritoneal hernioplasty is more preferable than trans-peritoneal hernioplasty because of number of reasons i.e. the post-operative pain is less expressed; operation is performed in retroperitoneal way; the risk of damaging of internal organs and development of peritoneal commissures is minimized.

The endothelium keratoplasty of various modifications (DSEKTDMEK) is the first operation of choice under endothelium pathology of cornea of different genesis. The endothelium transplantation is most often implemented against the background of pseudophakia or at the same time instant with extraction of cataract and implantation of artificial crystalline lens. The clinical cases of damage of transparency of artificial crystalline lens after a routine extraction of cataract are known for a long time while dimness after endothelium transplantation is a new occurrence and related publications are singular. The study was carried out to present cases of damage of transparency of artificial crystalline lens after endothelium transplantation. During 2006-2015 more than 500 patients underwent endothelium transplantations in modifications of DLEK, DS(A)EK, FS-DSEK, invFS-DSEK and DMEK. The most of them (n=291) continue to be under regular or periodic observation. During average period of observation (78±16.8 months) four cases of dimness of artificial crystalline lens after endothelium keratoplasty were established. The biomicroscopy, visiometry and photoregistration were the main analysis techniques of establishing and studying of dynamics of dimness of crystalline lens. It is extremely difficult to establish the nature of dimness of intraocular lens after endothelium keratoplasty because explantation of intraocular lens is required. The surgical inflammatory reaction and presence of air in front camera are common for all cases of dimness of intraocular lens. The damage of transparency of intraocular lens is a complication of remote period after endothelium transplantation. The application of original technique of pneumocorneopexia promotes significant reduction of recurrent injections of air and possibly decreasing of probability of damage of transparency of intraocular lens.

The article considers eponymic names of predominantly diseases of central nervous system (Hallervorden-Spatz disease, etc.) which origin is related to physicians actively cooperated with Nazis during the Second world War. The participation of these physicians in euthanasia program and also in inhuman experiments on people implemented by Nazis in concentration camps is emphasized. The conclusion is made that the reason of all this is lacking of moral standards. It is proposed to exclude a number of eponymic names related to physicians actively cooperated with Nazis.

The pancreatic encephalopathy is characterized by various focal neurological symptomatic and sporadic fast development of dementia is considered as a rare complication of acute pancreatitis developing in 9-35% of patients with diseases of pancreas. Factually every patient with acute pancreatitis has a risk of development of pancreatic encephalopathy that significantly makes severer course of disease and increases lethality. The review article considers particular aspects of clinical manifestations and probable diagnostic algorithm of neurological disorders observed in patients with acute pancreatitis. The actuality of development of diagnostic algorithm of pancreatic encephalopathy is emphasized. This algorithm will permit ultimately early, probably at pre-clinical stage, discover the mentioned complication of acute pancreatitis with the purpose of not only ultimate early detection of pancreatic encephalopathy but also development of pathogenically conditioned therapeutic algorithm considering all chains of pathogenesis.

The modern technologies provide broad possibilities for acquiring information about pharmaceuticals. However, reliability of this data has no guarantee. The document about pharmaceutical developed by manufacturer and regulatory authorities is taken very often for the source of official information. The quality of content of these documents is criticized by professional community. In the European Union it is taken for trusting the short characteristic of product (SmPC) that is an official source of information about pharmaceutical. The review presents sections of SmPC criticized more often.