[Features of changes in volume-impedance hemodynamic indicators during the tilt test in young males with a history of vasovagal syncopes].

BACKGROUND: The direction of changes in hemodynamic parameters during the tilt test (TT) nin individuals with history of vasovagal syncope (VVS) is a subject of discussion. OBJECTIVE: to study changes of volume-impedance hemodynamic indicators in the process of tilt test in somatically healthy young men with history of VVS. MATERIALS AND METHODS: A total of 102 men aged 18-30 years were divided into 4 groups, taking into account the specific features of fainting history and response to TT. Persons of group 1 (n=14) had history of VVS and positive response to TT (syncope). Subjects of group 2 (n=14) had history of VVS and a pattern of postural tachycardia without fainting during TT. Persons of group 3 (n=42) had history of VVS and negative response to TT. Subjects of group 4 (n=32) had no history of VVS and negative response to TT. During TT, we studied dynamics of some indicators, including cardiac output (CO) and total peripheral vascular resistance (TPVR). RESULTS: In individuals of all groups in the initial horizontal phase of TT values of CO and TPVR corresponded to the norm. Subjects of group 1 had significantly lower CO compared with subjects of groups 2, 3, 4 (p<0.05, p<0.01, p<0.05, respectively). Values of TPVR in subjects of group 1 were significantly higher than in subjects of groups 2, 3, 4 (p<0.05; p<0.05; p<0.05, respectively). In response to orthostasis CO values increased in groups 1, 2, 4 (by 18%, 10%, 5%, respectively) and did not change in group 3; TPVR values decreased in groups 1, 2 (by 8%, 0.5%, respectively), and increased in groups 3, 4 (by 8%, 4% respectively). In the final horizontal phase of TT, CO values in group 1 were significantly lower than in groups 3, 4 (p<0.05), while TPVR values did not significantly differ between all groups (p>0.05). CONCLUSIONS: In tilt-positive and tilt-negative subjects with history of VVS, standardized postural stress leads to unidirectional changes in cardiac output, but to multidirectional changes in total peripheral vascular resistance.

[Use of spectral index of heart rate variability as a predictor of poor clinical outcome in patients with severe combined chest trauma].

Use of spectral index of heart rate variability as a predictor of poor clinical outcome in patients with severe combined chest trauma. The article provides information on results of research of connection between spectral index of heart rate variability, got during 5-minutes record of echocardiography in acute period of traumatic disease, and severity of trauma, severity of health condition and level of impairment of consciousness in patients with combined chest trauma. Defined correlating connections between separate indexes of spectral analysis of heart rate variability and scales, reflecting health status severity and severity of trauma when admission the patients. Defined accurate differences between indexes of a power of very low frequency, low frequency and high-frequency waves, indexes of a vagosympathetic balance in groups of patients with poor clinical outcome and lethal outcome. Proved the possibility of the use of definite, during 12 hours after getting injury, relative powers of low- frequency and high-frequency waves, expressed in normalized units, index of a vagosympathetic balance as physiological markers of poor clinical outcome in patients with severe combined chest trauma.

[CHARACTERISTIC OF ALTERATIONS OF ARTERIES IN PATIENTS WITH ISCHEMIC HEART DISEASE AND CHRONIC HEPATITIS C].

The article presents an assessment of degree and type of atherosclerosis of coronary and non-coronary vessels in old patients with ischemic heart disease associated with chronic viral hepatitis C (VHC), the incidence of myocardial infarction and the possibility of participation chronic VHC in atherogenesis. Patients with ischemic heart disease have correlation of atherosclerosis of arteries with age, hypercholesterinemia. Patients without chronic VHC more often give a higher risk of myocardial infarction, especially in early period (1-1,5 years) of onset of ischemic heart disease clinical implications. Patients with ischemic heart disease associated with chronic viral hepatitis C more often have generalized alterations in vessels, multifocal type of alteration. So, participation of VHC in atherogenesis is most probably connected with maintenance of chronic immune inflammation in vascular endothelium.

[Spiritual ties of the Military Medical (Medical and Surgical) Academy].

Before the revolution in its educational, research and clinical potential of Military Medicine (medical and surgical) Academy was on the head position among European institutions. Not less outstanding position among all secular institutions Russian Academy held by the number and wealth of churches, chapels and baptisteries. In the temples of the academy was concentrated a significant number of miracle-working icons and of the particles holy relics, there served some of faith and piety devotees and some of them were canonized. The article presents a brief historical overview of the major Academy shrines--spiritual ties of the different generations.

[Features of morbidity community-acquired pneumonia among young recruits].

Were examined 3338 military personnel of the combined training center. 183 of them diagnosed community-acquired pneumonia, in 3155 focal and infiltrative changes in lung tissue were not identified. The analisys of prevalence been made among young recruits of the acute respiratory illness before arriving in part and at the assembly point, foci of chronic infection, smoking, low body weight. 511 military personnel arrived at the training center in the disease state with symptoms of acute respiratory illness. Examined the relationship these risk factor to the development of community-acquired pneumonia in this category of servicemen.

[Therapeutic morbidity rate among female military personnel, with exposure to occupational hazards in the period of service in the Armed Forces its influence on the course of pregnancy and fetal development].

The study was made into therapeutic incidence among female military personnel who had contact with various kinds of occupational hazards in the period of military service, its impact on pregnancy and fetal development. Special attention was also paid to long-term consequences of obstetric and therapeutic pathological comorbidity on the development of the child. It has been established, that in the spectrum of therapeutic morbidity among female military personnel chronic gastritis, pyelonephritis and autoimmune thyroiditis prevail and often have a chronic stress as a background for their development. Children born to mothers, who in the period of pregnancy showed the combination of chronic pyelonephritis, autoimmune thyroiditis and late gestosis are a group of high risk for the development of the intracranial hypertension in children and/or infectious diseases.