Search

Research objective: to study the clinical and biochemical risk factors and markers for the formation of tubulointerstitial nephritis in children with oxalate-calcium crystalluria. Methods: 30 children with tubulointerstitial nephritis were examined on a background of oxalate-calcium crystalluria. Special clinical and laboratory methods of research were used: stable metabolites of nitric oxide-nitrites and activity of superoxide dismutase, albumin in urine were determined in erythrocytes and urine. To determine the clinical features of the course and identify risk factors for the development of tubulointerstitial nephritis, we analyzed: perinatal and genealogical anamnesis, the age of debut of oxalate-calcium crystalluria and tubulointerstitial nephritis, and ultrasound data from the organs of the urinary system. Results: In children with tubulointerstitial nephritis, in 22% of cases the signs of oxalate-calcium crystal-luria preceded the underlying disease. For tubulointerstitial nephritis, which occurred against the background of metabolic disturbances, whose debut occurred at an early age, a latent course is typical, and minimal tubular kidney dysfunction, formed at the age of 4–11 years. The following clinical and anamnestic factors had the greatest impact on the formation of tubulointerstitial nephritis from a single-factor analysis: a family history with family history and the presence of 2 degrees of kinship of urolithiasis, a threat of termination of pregnancy and gestosis of the first half of pregnancy, hyperechoic inclusions in the renal parenchyma by ultrasound examination of child. In parallel with the processes of antioxidant protection against the background of oxidative stress, there is an increase in the level of metabolites of nitric oxide in the urine, and in combination with albuminuria, an increase in endothelial dysfunction. Conclusion: the leading factors in the formation of tubulointerstitial nephritis in children with oxalate-calcium crystalluria are an aggravated genealogical anamnesis due to the presence of urolithiasis in relatives of the first and second degree of kinship. According to the results of special research methods, albuminuria, low activity of superoxide dismutase in the urine, higher levels of nitric oxide in erythrocytes and urine indicate the progression of tubulointerstitial nephritis and are markers of the inflammatory process.

The impact of gynecological operations on the rate of lipid peroxidation (LPO) and erythrocytic antioxidant defense (EAOD) was studied in women with uterine myoma. The higher rate of LPO and the decreased level of vitamin E were preoperatively found. A further increase in LPO activity and a reduction in vitamin E concentrations were observed 1-4 days after surgery. Recovery of the study parameters was seen on days 5-7 postoperatively. The enzyme glutathione-S-transferase was ascertained to play a pivotal role in the EAOD system.

The results of clinical and biochemical studies of 93 full-term neonatal infants with perinatal hypoxia-induced ischemic nervous system lesion are presented. Perinatal ischemia in the newborns has been found to cause an increase in the serum content of nitric oxide, more significant and stable in severe encephalopathy. The level of nitric oxide remained significantly elevated in the natural development of the disease in children with persistent neurological symptoms; its normalization was observed by the third month of life when the clinical syndromes regressed. The authors proposed to use the blood level of nitric oxide as a marker of acute cerebral ischemia and as an additional criterion for predicting the nervous and mental development of children with prior neonatal ischemia.

Aim of the study was to assess significance of deviations of activated partial thromboplastin time (APTT) from optimal level (50-75 sec) after 48 hours of intravenous infusion of unfractionated heparin (UFH) in streptokinase treated patients with myocardial infarction (MI) for prognosis of nonfatal reinfarction and cumulative criterion comprising cardiac death, nonfatal MI and early postinfarction angina. Infusion of streptokinase (1,500,000 U in 30-60 min) was carried out after loading dose of aspirin (250 mg) and intravenous bolus (5,000 U) of UFH in 75 patients (age 34-76 years) admitted within 6 hours after onset of acute ST-elevation MI. UFH infusion was started prior to termination of administration of streptokinase and continued for 48 hours. During first 12 hours infusion rate was 1,000 or 800 U/hour in patients with body massor = 80 and80 kg, respectively. During initial 12 hours infusion rate was corrected if at 6 hours APTT was less than 40 or exceeded 150 sec. After 12 hours a nomogram was used for UFH dose adjustment according to APTT. Maximal number of optimal APTT values during UFH infusion just reached 50%. During first 12 hours prevailed values above 75 sec, after 24 and 36 hours -- values below 50 sec. Deviation of APTT from optimal level in 12 hours after onset of UFH infusion was the only independent predictor of nonfatal recurrent MI during following 30 days (relative risk [RR] 9.01, 95% confidence interval [CI]1.1 to 77.2; p=0.043). Independent predictors of cumulative criterion were level of risk of death according to TIMI scale (RR 1.47, 95% CI 1.-3 to 2.11; p=0.036) and deviation of APTT from optimal level in 12 hours after onset of UFH infusion (RR 3.24, 95%CI 1.05 to 10.5; p=0.046). It should be noted that rather than suboptimal excessive hypocoagulation by 12th hour of UFH infusion was associated with worse prognosis. APTT levels in 6, 24, and 36 hours of UFH infusion had no prognostic significance in relation to events assessed in the study.

To evaluate levels of total cholesterol (TC), HDLP cholesterol, triglycerides (TG), occurrence of hypercholesterolemia (HCE), hypertriglyceridemia (HTG) and low HDLP cholesterol in the Tyumen population.866 men and women aged 25-64 years have been examined in one-stage cardiological screening within a two-stage epidemiological study of serum lipoproteins by WHO criteria.HCE was registered in 15.6% males and 18.8% females, a low HDLP cholesterol--in 5.3 and 4.2%, HTG--in 5.8 and 4.3% males and females, respectively. A high TC level and HCE occurred more frequently in women over 54 years of age; a low HDLP cholesterol level in insignificant fall in HDLP cholesterol and no age-related changes of this index were found both in males and females; TG were elevated in older males in moderate prevalence of HTG in the population.It is shown that Tyumen population is at high risk of cardiovascular diseases. Further studies are needed to specify targeted preventive programs.

To study specific features of lipid plasm profile in patients with metabolic syndrome (MS) and manifest disorder of carbohydrate metabolism (CM) as well as their relationships with clinical symptoms of MS.Contents of lipids and apolipoproteins of plasm was measured on an empty stomach in 30 patients (18 females and 12 males) with MS and manifest disorder of CM (diabetes mellitus type 2 at the stage of good and satisfactory compensation of CM without terminal complications).The patients were found to have a subnormal level of HDLP cholesterol, high levels of total cholesterol, LDLP cholesterol and LP alpha. Hypertriglyceridemia occurred only in 31.4% patients (TG200 mg/dl). Mean TG level was 173.69 +/- 21.52 mg/dl. TG and diastolic arterial pressure, fasting glycemia and waist circumference significantly correlated. If the WC/TC was 1.0 and higher, the antiatherogenic plasm factor--HDLP cholesterol--significantly lowered. Positive correlation existed between TG and total cholesterol, LDLP cholesterol, apoB, LDLP cholesterol/HDLP cholesterol, apoB/apoA1, while negative correlation was seen between TG and HDLP cholesterol levels. Patients with hypertriglyceridemia had significantly higher levels of total cholesterol, LDLP cholesterol, apoB, apoB/apoA1.Plasm levels of TG most significantly reflect severity of basic clinical manifestations of MS: abdominal obesity, arterial hypertension, CM compensation. The presence of hypertriglyceridemia in MS patients can be considered as an indicator of high atherogenic potential of plasm.

To evaluate changes in oxidative lipid metabolism in platelet membranes by content of lipid peroxidation (LPO) products and antioxidant defense (AOD) activity in patients with stable chronic ischemic heart disease (IHD) after single intake of animal fat or vegetable oil.30 IHD patients with stable angina of effort functional class II-III and 30 healthy controls had a single meal with animal fat or vegetable oil. Before the meal and 6 hours after it tests were performed for LPO activity and AOD in platelet membranes.Patients with stable chronic IHD showed LPO activation and suppressed enzymatic and non-enzymatic AOD. Single animal fat or vegetable oil intake cause insignificant shifts in oxidative platelet metabolism in healthy controls while animal fat in IHD patients activates LPO and promotes accumulation of initial and end peroxidation products in platelet membranes. Vegetable fat in IHD patients suppresses enzyme AOD.Animal fat and vegetable oil as a single diet load have a prooxidant effect at the levels of platelet membranes in IHD patients but not in healthy persons.

Special membranological studies of the role of antioxidant emoxipine in combined pharmacological support of stable function of the transplanted kidney in 30 patients have shown that this drug restores phospholipid pool of red cell membranes and improves their physical properties. No significant fluctuations of cyclosporin A blood concentrations were registered. Emoxipine addition to combined therapy of patients with transplanted kidney is recommended.

Intracellular homeostasis of calcium was studied in patients with essential hypertension by two methods: calcium measurements using Lachema kits and study of the kinetics of interaction between chlortetracycline fluorescent probe and cellular membranes. Both the methods are highly sensitive, but they reflect different aspects of calcium homeostasis of the cells and supplement each other, and therefore should be used together to assess the severity of essential hypertension and monitor the therapy administered. The method of interaction of chlortetracycline with cellular membranes should be preferred as a more up-to-date and informative.

A study was made of transmembranous ionic transport enzymes (Na(+)-K(+)-, Mg2(+)- and Ca2(+)-ATPases) in 95 patients with essential hypertension (EH) and 39 healthy persons. The activity of Na(+)-K(+)-ATPase was decreased for the most part at the early stages of EH. Measurements of the content of natriuretic hormone in the plasma did not reveal any significant differences between EH patients and healthy persons. However, the daily excretion of natriuretic hormone was significantly increased at the early stages of EH, which correlated with the changes in the activity of Na(+)-K(+)-ATPase in red blood cell membranes. This may lead to the derangement of homeostasis of intracellular electrolytes, attesting to an important role played by these factors in the pathogenesis of EH. As EH progressed, the cholesterol/phospholipid ratio increased which may also influence the activity of Na(+)-K(+)-ATPase. After enlargement of the intravascular liquid volume (drinking load 22 ml/kg) the EH patients manifested the loss of an adequate reaction of Na(+)-K(+)-ATPase towards elevated production of natriuretic hormone.

The liver glycogen and sugar levels in intact rats are shown to experience diuranal variations with a maximum at 3-9 and minimum at 15-21 hours. Intragastric administration of ethanol in a dose of 1.5 ml/100 g produced an abrupt fall of the glycogen content in the liver of rats in 3.12 and maximally after a lapse of 6 hours, this being followed by a drop in the amount of sugar in 12 hours. The decline in the level of metabolites at different periods of the day (3, 9, 15 and 21 hr) was dissimilar. The lethality among the animals and concentration of the alcohol in the liver 3 and 6 hours following the action of alcohol at the hours of the day under study correlated and were inversely proportional to the sugar and glycogen content of the same hours of the day.