The Case of Myocardial Infarction in a Fifteen-Year-Old Adolescent Caused by Toxic Substances.

The article reveals about the clinical accident of myocardial infarction in an adolescent after visiting a night club, where he had been drinking tequila. A "sniper" test was performed at home and showed synthetic marihuana in urine. The uniqueness of this case is the adolescent's difficult premorbid condition (severe diabetes mellitus type 1 and sub-compensated hypothyreosis) and the clinical course of the disease had caused difficulty in diagnosis which led to a belated hospitalization on the third day. Considering pain syndrome, infarction-like findings in ECG (ST elevation), high levels of cardiospecific enzymes (troponin elevated 70 times, aspartate aminotransferase-two times, creatine phosphokinase-4 times, lactate dehydrogenase and alkaline phosphatase-two times) and their slow tendency to normalize-a non-Q myocardial infarction diagnosis was performed. After complex treatment, the general condition of the patient improved; he was discharged from the clinic in satisfactory general condition and was given recommendations for further rehabilitation. Given the potential for premature death and long-term disability with the development of negative individual and social consequences, the correct diagnostic assessment in such cases becomes particularly relevant.

PECULIARITIES OF MIR-146A AND MIR-155 EXPRESSION IN PATIENTS WITH ALLERGOPATHY IN COMBINATION WITH CHRONIC EPSTEIN-BARR VIRUS INFECTION IN LATENT AND ACTIVE PHASES.

Epstein-Barr virus (EBV) is referred to the viruses with lifelong persistence in the human body in active and latent phases. EBV initiates impairment of expression of cell microRNA, which participates in the regulation of immune system function and can be related to different pathological conditions, including allergopathy. Aim - to assess the levels of miR-146a and miR-155 expression in patients with allergopathy in combination with active and latent phases of EBV infection. Clinical, general laboratory, cytological, instrumental, specific allergological, molecular-genetic investigations were performed. Based on these investigations, patients were divided into two groups: 1st group (27 individuals) with allergopathy and active phase of chronic EBV-infection, 2nd group (19 individuals) with allergopathy and latent phase of EBV infection. Control group included 20 healthy individuals. Higher (р>0.05) levels of miR-146a expression were detected in patients of both groups compared with control group. Expression of miR-155 was higher (р>0.05) only in patients of the 1st group compared with control. No significant difference was noticed between investigated groups. In latent phase, EBV uses own mechanisms of latency to avoid immune surveillance, which are manifested by increase in miR-155 and miR-146а expression. In active phase, this vector of changes intensified and was associated with acute manifestations of allergopathy.

[FEATURES OF CEREBRAL BLOOD FLOW DYNAMICS IN PATIENTS WITH ARTERIAL HYPERTENSION DURING CARDIAC SURGERY].

Cognitive dysfunctions (CD) is the most common postoperative neurological complication in cardiac surgery, which is detected in 30%-65% of patients within 1 month after myocardial revascularization and 20%-40% of the examined, during the next five postoperative months. This problem is especially relevant for patients with arterial hypertension (AH). Goal - to study of the correlation relationship between the mean arterial pressure (MAP) and the velocity of blood flow in the middle cerebral artery (MCA) in patients with AH during coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). The study included 128 patients with coronary artery disease, which was performed by the CABG with CPB. The average age - 62.1±4.8 years. All subjects were divided into 2 groups: 1-st group - 83 patients with AH (II-III degree); 2-nd group - 45 patients without AH. Patients were operated under sevoflurane-based endotracheal anesthesia. Registration of cerebral blood flow was carried out by the method of transcranial doplerography. For neuropsychological testing MMSE-test, FAB-test, clock drawing test and SAGE-test were used. Reduced blood flow in the MCA in patients of both groups was observed at the following stages: induction into anesthesia (by 46.7 ± 2.5% relative to the initial value, p=0.0139), the onset of hypothermia during CPB (64.2±3, 9% of the initial value, p=0.0024). There was no significant difference in the levels of the average blood flow velocity in the MCA during the non-pulsative and pulsative CPB modes (p=0.758). Correlation analysis of the assoсiation between MAP and average velocity of cerebral blood flow in MCA in patients with AH revealed a significant correlation weak strength (r=0.099, p=0.004). According to the results of the neuropsychological tests, on the 6-th day after the operation, in patients of 1-st group, there was a significant decrease in the results of the MMSE test (p=0.046) and the SAGE test (p 0.041) compared to the baseline values. Patients in 2-nd group had no significant difference in the results of all four tests. Determination of the level of MAP does not allow to fully and properly evaluate the cerebral blood flow. In view of this, we recommend intraoperative monitoring of cerebral blood flow to prevent the development of CD for all patients with AH.

INVESTIGATION OF PROTECTIVE EFFECTS OF SYNBIOTICS ON ALLERGOPATHY FORMATION.

A strategic direction of modern medicine in combating allergy is the search for new methods of primary prophylaxis, among which a key role may belong to normalization of the human body microflora. The aim of the research was to study the influence of synbiotics on bacteriological and immune indices in premature infants evaluating their preventive role in allergopathy formation. During prospective cohort investigation, 88 babies from one to four months of age, born on the 27th to 37th week of gestation to healthy mothers and women with allergopathy, were examined. Routine laboratory, bacteriological and instrumental investigations were performed. Measuring total serum IgE, cytokines IL-5, IL-10 and TNF-alpha in coprofiltrates was performed by means of immunoenzymatic assay. The activity of histaminase was detected by means of "Histamine 50-Skin-Prick Test". All examined patients were divided into four groups, depend on parents's atopic disease and prescribing synbiotics. For month, children from the first and the third groups were administered a commercial synbiotic - nutritional supplement with probiotics and fructooligosaccharides in the dose: one billion viable microencapsulated bacteria Lactobacillus rhamnosus GG in combination with fructooligosaccharides. Children from the second and the fourth groups were not administered synbiotic. Control of indices was conducted after 4 weeks. On bacteriological analysis of feces, the number of lacto- and bifidobacteria increased by 30% in children from the first and the third groups. Indices of total serum IgE were within age norm both before intake of synbiotic (1-2 groups) and after treatment. A reliable (p≤0.01) reduction of TNF-alpha and increase in IL-10 was revealed in coprofiltrates of children, who received synbiotic Preema sachet. Inclusion of synbiotic, which contains one billion viable microencapsulated bacteria Lactobacillus rhamnosus GG in combination with fructooligosaccharides to complex therapy of premature children results in regulation of cytokine balance with the tendency to reduction of an inflammatory process and has a preventive effect concerning allergopathy formation.

[Regularity of psychophysiological adaptation to military-professional activity among staff of Northern Fleet].

There were examined regularities of psycho-physiological adaptation of different categories of military-navy specialists, were detected periods of maximum decrease of compensation abilities among sailor-men and staff reserve of Naval Fleet from students. Were educed psycho-physiological strategies of adaptation of military-navy specialists in dependence of reference level of adaptation capabilities. Was detected the influence on the process of psycho-physiological adaptation to service activity of young specialists of a complex of psychological and social factors. Was educed the influence of ulterior motive on success of psycho-physiological adaptation to new conditions of environment. Was elaborated a complex of measures on optimization of accompaniment of adaptation of military-navy specialists and was given financial evaluation of it's implementation.

[Psychophysiological factors of maintaining mental health in individuals with extreme professions].

The research aims to establish psychophysiological factors of maintaining health in individuals, in whose professional activities on the substantial level there is an extreme component. During the research it was established that the effective work of regulatory mechanisms contributes to the formation of the mental health, which stability is not a factor contributing to the restoration of psychophysiological resources.

[Peculiarities of psychophysiological status of flying staff of fighter aircraft of land basing].

It was investigated the influence of professional activity on psychophysiological peculiarities of fighter pilot of different types of aircraft of land basing and afloat aircraft. As a result of investigation, it was determined that on base of social parameters they are equal. Airmen of the aviation of land basing have a similar personality profile, but different types of interpersonal relations. Station of depletion among airmen of the aviation of land basing was absent. Among airmen of afloat aircraft every third had a forming stage of depletion, characterized by emotional deficit, personal suspension, psychosomatic and psychovegetative disorders.