[THE ROLE OF THE COMBINATION OF INFLAMMATORY PROCESSES IN THE JOINTS AND ALTERED REGIONAL MICROCIRCULATION IN THE DEVELOPMENT OF HEMOPHILIC ARTHROPATHY].

AIM: To study the role of the combination of inflammatory processes in the joints and altered regional microcirculation as well as factors influencing them in the development of hemophilic arthropathy in 82 patients with recurrent hemarthrosis of the knee and ankle joints by computed IR thermography, laser Doppler flowmetry, and bioimpedancometry for determining fatty and muscle tissue mass. It was shown that deviation of body mass from the normal value were pathogenetically associated with different variants of hemophilic arthropathy. Its risk factors in the patients with continuously recurrent hemarthrosis include epiarticular perfusion, elevated body temperature, low BMI, and muscle mass deficit in excess of 2 kg. 12% of the patients with the history of hemarthrosis-free joints experienced a rise in epiarticular temperature and 6% suffered enhanced perfusion due to latent post-hemorrhagic inflammation.

[Computer morphometry of peripheral blood cells in patients of different age with pneumonia].

The aim of the research was to study blood responses to pneumonia in patients of different age and sex. The subjects of the study were 116 patients with extrahospital bacterial pneumonia (80 men and 36 women). The patients were divided into three age groups: 18 to 44 years, 45 to 59 years, and 60 to 74 years. Almost healthy 16 men and almost healthy 14 women have made the control groups. Computer morphometry of leukocytes of peripheral blood was made to all patients. Various reaction of lymphocytes on a pneumonia in men and women of young and middle age was revealed. Indirect evidences of decrease in level of lymphocytes activation in women of young and middle age at pneumonia development were received. The sizes of lymphocytes in elderly patients with pneumonia do not change comparing with the control groups. Sexual differences in reaction of monocytes to pneumonia are not present. The sizes of monocytes in patients with pneumonia of all age groups decrease at the expense of kernels, which indicate to their accelerated manufacture in a marrow. Absence of increase in cytoplasm to nucleus ratio index in elderly patients testifies a smaller degree of monocytes activation in this group of patients. The trend to reduction of the sizes of neutrophiles speaks of the accelerated division of predecessors' of mature neutrophiles. The increase in cytoplasm to nucleus ratio index of neutrophiles in women with pneumonia of young and middle age comparing with the control group specifies to the big degree of activation of neutrophiles link in these groups.

[Acute secondary iatrogenic thrombocytopenia in middle-aged patients].

Iatrogenic blood diseases are a primary concern for both patients and physicians. Pathology of blood coagulation system associated with pharmacotherapy has been studied in Samara regional Hemostasiological Centre during the last 30 years. A clinical case of secondary iatrogenic thrombopenic purpura is reported in a patient with a history of uncomplicated allergologic disorder. The disease developed after intake of several drugs at non-toxic doses.

[Immune status of patients with idiopathic thrombocytopenic purpura in the delayed post-spelenectomy period].

The aim of the work was to evaluate results of the treatment of idiopathic thrombocytopenic purpura (ITP) in terms of relationship between immunity and clinical compensation of the disease, changes in the immune status of patients with its long duration, causes of long-term success or failure of splenectomy (SE) compared with cases treated by glucocorticoids alone. The study included 76 patients with chronic ITP of less than 1 year duration divided into 2 groups. 36 of them underwent SE and 40 were given prednisolone therapy. Examination included identification of lymphocyte subpopulations by flow cytometry, besides IgA, IgM, and IgG during exacerbation and remission (absence of hemorrhagic syndrome). It was shown that the major factors exerting negative effect after SE were elevated levels of total T-lymphocytes and their subpopulations (CD4+ and CD8+, especially T-helpers), B-lymphocytes, and IgM. Lower efficiency of conservative therapy with prednisolone was due to the absence of decrease in the absolute number of T-lymphocytes and changes in IgM.

[Peripheral blood responses in elderly patients with some prevalent diseases].

The aim of the research was to study blood responses to inflammatory processes in patients of different ages. The subjects of the study were 31 healthy persons and 198 patients, 116 of whom had pneumonia and 82 had chronic pyelonephritis. The patients were divided into three age groups: 16 to 39 years, 40 to 59 years, and older than 60 years. The following parameters were calculated on the basis of peripheral blood leukocyte composition and ESR: leukocyte intoxication index (LII), lymphocyte index (LymI), leukocyte shift index (LSI), leukocyte index (LI), leukocyte to ESR ratio index (LESRRI), lymphocyte-granulocyte index (LGI), total index (TI), neutrophile to lymphocyte ratio index (NLymRI), neutrophile to monocyte ratio index (NMRI), and lymphocyte to monocyte ratio index (LMRI). The majority of the indexes (LII, LymI, LSI, LI, LESRRI, LGI, and LMRI) in acute inflammation processes and some of them (LESRRI, NLymRI, and LMRI) in chronic inflammation altered significantly in all the age groups, which demonstrated that compensatory and adaptive mechanisms remained preserved in the elderly. The were age-dependent differences in blood responses to inflammation: LymI, LI, and LGI were significantly lower in the elderly with chronic pyelonephritis, whereas in Groups 1 and 2 there were no changes; NMRI was decreased in Groups 1 and 2 in chronic pyelonephritis and did not differ from the elderly controls. In acute inflammation, there were no significant differences from the controls in NlymRI in Group 3, while this parameter in Groups 1 and 2 differ from that in the controls. Thus, hematological indices make it possible to assess the work of effectory mechanisms of the immune system, the degree of their compensation in patients belonging to different age groups.

[Optimization of treatment of outpatients and inpatients with bronchial asthma in the Samara region].

AIM: To identify factors influencing hospitalization rate of bronchial asthma (BA) patients for optimization of medical care for BA patients, improvement of hospital-outpatient clinic succession. MATERIAL AND METHODS: Personal benefit drug data base of the Samaia region was used for monitoring of pharmacotherapy quality in 19,697 BA patients aged 17 years and older. The list of the prescribed anti-asthmatic drugs was compared to some indices of medical care quality. The data were analysed with the multifactorial analysis. RESULTS: The multifactorial analysis has shown that BA patients' hospitalization rate depends on the structure of pharmacotherapy, especially optimal administration of basic drugs. A model of effective pharmacotherapy of BA patients on the out- and inpatient stages of medical care is proposed. CONCLUSION: Regional standards allowed general practitioners to give effective therapy in BA, hospital physicians to formulate recommendations for patients after hospital treatment.

[Additional diagnostical ECG parameters in particular cardial pathology].

The authors offer additional diagnostic ECG parameters including temporal dependences of the angular (phase) rotation speed of the integral electric heart vector relative to the pinning point of the vector origin, the linear speed of the transference of the terminus along the loop trajectory, as well as a new parameter, the product of vector angular speed magnitude and the magnitude of its value at each moment of time. Reference values are adduced; their changes in post-infarction patients and in Wolff Parkinson White syndrome and their sensitivity to these diseases have been analyzed.

[Evaluation of the vascular wall by the spectra of Korotkov's tones]. / Otsenka sostoianiia sosudistoi stenki po spektram tonov Korotkova.

A method has been proposed for the registration and frequency analysis of Korotkov's tones. For interpretation of spectra, the authors accept the theory which interprets the tones as an acoustic result of hydrodynamic flutter in the partially ligated arterial portion. A unit based on a multifunctional recorder with variable frequency characteristics, an analog-to-digital converter, and a computer is used to record the tones. Computer-assisted Fourier analysis of tones is made. Three basic types of frequency spectra for brachial artery have been obtained in patients of different age. The signs used to evaluate the vascular wall at different stages of development of vascular pathology have been established.

[Methods for detection and characterization of mechanical resistance of erythrocytes in healthy men (review of literature)]. / Metody opredeleniia mekhanicheskoi rezistentnosti éritrotsitov i kharakterizuiushchie ee pokazateli u zdorovykh liudei (obzor literatury).

Published reports on methods for evaluation of erythrocyte rheology and mechanical resistance are reviewed. The processes running in red blood cells under the effect of mechanical factors are described. An original method for studies of vibration resistance of erythrocytes is proposed. It allows evaluation of the erythrocyte hemolysis, aggregation, and fragmentation. The method consists in combined vibroexposure of whole capillary blood in vitro (including blood collected under conditions of redistribution of erythropoiesis after exercise) and differentiated cytometry by conductometric hematological scintillators with plotting a histogram of erythrocyte distribution by volume. The method was used by many scientists who obtained different results in examinations of normal subjects. This disagreement of results of different studies is explained by numerous causes, some of which can hardly be taken into consideration. The authors attempted to standardize the method and normal (reference) values. The method is sensitive to various factors (even low intensive) affecting the erythrocyte population and allows the detection of diseases at the preclinical stage and evaluation of the degree of subject's training.

[Integral parameters of electrocardiogram: perfection of assessment]. / Sovershenstvovanie otsenki integral'nykh parametrov élektrokardiogrammy.

The role of such parameter as electric quality of the heart (EQH) is assessed by a biophysical analysis of a new model of dipolic equivalent electric generator of the heart taking account of myocardial inductivity in the course of excitation. How to estimate EQH by standard ECG parameters using calculated nomogram is shown. Results of EQH estimation in the course of treatment are provided.