[Prevention and correction of cognitive dysfunction after general anesthesia]. / Profilaktika i korrektsiia kognitivnykh narushenii posle obshchei anestezii.

AIM: To evaluate clinical efficacy of intraoperative use of cytoflavin in the prevention and correction of cognitive functions in surgical patients with no history of neurological and psychosomatic disorders. MATERIAL AND METHODS: The study included 60 female patients who underwent surgery on the thyroid gland. Patients were stratified into two equal groups matched for main indices. Patients of the main group received infusions of cytoflavin (20 ml in 200 ml of 5% glucose solution). Patients underwent thyroidectomy with general inhalation anesthesia using desflurane. Cognitive testing was performed one day before operation and 6, 24 and 48 h after. Waking time after stopping desflurane administration and time prior tracheal extubation were recorded. RESULTS AND CONCLUSION: The use of cytoflavin promoted the early post anesthesia adaptation and more rapid recovery of initial cognitive status of the patients.

First cage-like pentanuclear Co(ii)-silsesquioxane.

A new pentanuclear "cylinder"-like cobalt(ii) phenylsilsesquioxane [(PhSiO1.5)10(CoO)5(NaOH)] exhibits a slow relaxation of the magnetization and a high catalytic activity and stereoselectivity in the oxidation of alkanes and alcohols.

Two pathways of proton transfer reaction to (triphos)Cu(η(1)-BH4) via a dihydrogen bond [triphos = 1,1,1-tris(diphenylphosphinomethyl)ethane].

The interaction of the η(1)-tetrahydroborate copper(i) complex (triphos)Cu(η(1)-BH4) () with proton donors [CF3CH2OH (TFE), (CF3)2CHOH (HFIP), (CF3)3COH (PFTB), PhOH, p-NO2C6H4OH (PNP), p-NO2C6H4N[double bond, length as m-dash]NC6H4OH (PNAP), CF3OH] was a subject of a combined IR spectroscopic and theoretical investigation. Spectral (Δν) and thermodynamic (ΔH) parameters of dihydrogen bond (DHB) formation were determined experimentally. The terminal hydride ligand (characterized by the basicity factor Ej(BH) = 0.87 ± 0.01) is found to be a site of proton transfer which begins with nucleophilic substitution of BH4(-) by the alcohol oxygen atom on the copper center (BH pathway). The activation barrier computed for (CF3)2CHOH in CH2Cl2 - ΔG = 20.6 kcal mol(-1) - is in good agreement with the experimental value (ΔG = 20.0 kcal mol(-1)). An abnormal dependence of the reaction rate on the proton donor strength found experimentally in dichloromethane is explained computationally on the basis of the variation of the structural and energetic details of this process with the proton donor strength. In the second reaction mechanism found (CuH pathway), DHB complexes with the initial ROH coordination to the bridging hydride lead to B-Hbr bond cleavage with BH3 elimination. "Copper assistance" via the CuO interaction is not involved. This mechanism can be evoked to explain the occurrence of proton transfer in coordinating solvents.

[TREATMENT OF SEVERE INTRAPATUM ASPHYXIA.]

THE AIM: Estimate of efficiency of newborns with severe birth asphyxia treatment using systemic therapeutic hypothermia. MATERIALS AND METHODS: a retrospective open-controlled clinical research with a resolution of the Ethics;Committee performed in 33 neonates born in asphyxia and treated at the NICU All newborns due to the presence of indications, overall controlled hypothermia was conducted according to the approved protocol, using the apparatus Allon 2001". RESULTS: The neurological status at admission: Sarnat II was detected in 60.6% (20) children; Sarnat III was detected in 39.4% (13) children. The correlation ofApgar scores with the most severe hypoxic ischemic encephalopathy. Pupillary reflexes admission absent in 48.5% (16) newborns. Convulsions within first hours of lfe were observed in 57.6% (19) newborns. Convulsions within I day of life were observed in 81.8 % (27) newborns. The correlation of the amniotic infection (AI) and meconium aspiration syndrome (MAS) treatment using high-frequency mechanical ventilation (p<0,05) and prolongation of mechanical ventilation for more than 5 days (p<0,01). At the beginning of systemic hypothermia fraction of inspired oxygen (FiO2), mean airway pressure (MAP), respiratory rate (RR) were down to the 12th hour of life and reaches a minimum at the end of the third day. These trends have been observed in children with MAS. The correlation of the use of high-frequency mechanical ventilation using high doses ofcardiotonics and the transition to the infusion of epinephrine or norepinephrine (p <0.01).There were no deaths in the studying group. CONCLUSIONS: 1. Reliable predictor of the clinical outcomes severity of hypoxic-ischemic encephalopathy (HIE) by the end of the first month lf is the presence of convulsions within the first hour of lf (p<0. 03). 2. When comparing the evaluation on Apgar scale with the data of acid-base balance and severity of HIE a significant correlation between the estimation at the first minute is I point and at the fifth minute 3 point and more severe pH shift, base deficiency, hyperlactatacidosis and severe HIE. 3. MAS and AI are the most frequent accompanying diseases that complicates the severity of newborn status causing prolonged artificial ventilation and the infusion ofcardiotonics. 4. There is a decrease in all parameters of artficial lung ventilation to the twelfth hour life in early systemic hypothermia and reached minimum by the end of the third day.

[Prevention of cognitive dysfunction in patients operated on thyroid gland].

The cognitive functions assessment in 68 patients operated on thyroid gland is presented. It is elicited that attention decrease, short-term memory upset, depressed work-capacity develop after intervention. It is shown that cytoflavin use within the intervention and early postoperative period permit to decrease cognitive dysfunction signs.

[Multimodal antinociceptive management of patients with ileus in surgery]. / Multimodalnaia antinotsitseptivnaia zashchita u bol'nykh s ostroi kishechnoi neprokhodimost'iu.

Acute ileus has been for years a topical problem in abdominal surgery. Successful surgical treatment with the pathology depends not only on a surgical scheme but also on the efficiency of anesthetic management. The purpose of the present case study was to investigate issues related with appropriate anesthesia for elderly and senile patients in ileus surgery. General analgesia with sodium oxibutiratis, ketamine and phentanil, when combined with epidural anesthesia with ropivaciane, provides for an adequate anesthetic management of elderly and senile patients in ileus surgery.

[Effects of different types of general anesthesia on metabolic activity of erythrocytes]. / Vliianie razlichnykh vidov obshchei anestezii na metabolicheskuiu aktivnost' éritrotsitov.

The effect of general anesthesia with ether, azeotropic mixture and drugs for neuroleptanalgesia on the activity of glycolytic enzymes and the content of glycolysis metabolites in erythrocytes has been studied in 212 patients with II to IV stage gastric cancer. It has been shown that ether anesthesia and anesthesia with azeotropic mixture aggravate metabolic disturbances, while neuroleptanalgesia has no negative effect on cellular metabolism. The absence of correlation between the severity of surgical intervention and the degree of disturbances in erythrocyte metabolism indicates a sufficient anesthesiological protection when drugs for neuroleptanalgesia are used.