[Enterovirus infection as a risk factor of acute coronary syndrome and its complications].

Antigens of enteroviruses were detected quantitatively in the modified complement-binding reaction in blood samples from 102 of the 208 (49%) patients with ACS, in coronary artery tissues from 23 of 24 and heart from 51 of 94 (54.3%) patients with MI who died from cardiogenic shock and/or cardiac rupture. The relative level of enterovirus antigen (RLEVA) in the blood of patients with MI complicated and uncomplicated by cardiogenic shock and/or cardiac rupture was 0.42 +/- 0.04 and 0.29 +/- 0.02 arbitrary units respectively (p = 0.032) compared with 0.21 +/- 0.07 in patients with unstable angina (UA) (p = 0.0001). RLEVA in patients with UA was significantly lower than in those with uncomplicated MI (p < 0.011). RLEVA in necrotized myocardial areas after death from cardiogenic shock (0.54 +/- 0.18) and/or cardiac rupture (0.46 +/- 0.15) was higher than outside MI zones (0.30 +/- 0.14 and 0.26 +/- 0.10 respectively) (p < 0.01). RLEVA in coronary vessels feeding the necrotic zones of patients with MI complicated by cardiogenic shock (0.44 +/- 0.18) was higher (p = 0.03) than in the vessel feeding tissues outside the MI zone (0.29 +/- 0.19). It is concluded that enterovirus infection is a factor of ACS; it is directly involved in its pathogenesis and promotes the development of cardiogenic shock and/or cardiac rupture.

[Changes in the interleukin-6 and interleukin-10 concentrations in the blood plasma of miners working in deep coal mines]. / Izmenenie kontsentratsii interleikina-6 i interleikina-10 v plazme krovi gornorabochikh glubokikh ugol'nykh shakht.

Blood plasma levels of interleukin-6 (IL-6) and interleukin-10 (IL-10) were measured in 45 miners working in a deep coal mine immediately after work shift using an immunoenzyme technique. The highest IL-6 level was recorded in those miners engaged in hard work under most adverse conditions of underground workings--it was found to exceed the control values. The same group of workers demonstrated the lowest level of IL-10 that differed from the control value. Miners aged between 41 to 50 years working in a coal mine, their underground service duration 16 to 20 years, displayed a decline in the level of IL-6. The coal mine miners with the 11- to 15-year service duration revealed an increase in the level of IL-10.

Significance of success rate of external cephalic versions and vaginal breech deliveries in counseling women with breech presentation at term.

OBJECTIVE: To appreciate the role of success rates of external cephalic versions and breech deliveries, in order to assess the risk reduction in women with breech presentation at term. STUDY DESIGN: We reviewed the patient files of all women with breech presentation whom had an attempt of external cephalic version (ECV) at term. Most of the ECVs were performed under intravenous ritodrine infusion. All women had a trial of labor (TOL) as long as they did not meet one or more of the exclusion criteria of vaginal delivery. Success rates of ECV and TOL were assessed, and statistical analysis was performed by using the student t-test for continuous data, and the Chi-square and Fisher's exact tests for categorical data. Statistically significant differences required a P value of <0.05. RESULTS: Of all women with breech presentation at term and not in labor, who had no contraindication for an ECV, 164 consented and were included in the study. The success rate of ECV was 30% (22/74) and 67% (60/90) for nulliparae and multiparae, respectively. Multiparity was the only significant positive predicting variable for ECV success (OR=4.73, 95% CI 4.19-5.27, P=0.00001). Of all the women that underwent a successful ECV, 18/22 primiparae (82%), and 52/60 multiparae (87%) had a vaginal delivery, compared to only 52% of the primiparae and 63% of the multiparae that reached labor with a breech presentation. There were no significant perinatal complications except for one case of mild placental abruption. In the primiparous women, ECV decreased the chance of cesarean delivery by only 9% (P=0.2), compared to a 16% decrease in the multiparae (P=0.019). CONCLUSIONS: When counseling women with breech presentation at term, complete information is needed for consent, and should take into account the success rate of ECVs and of vaginal breech deliveries in the specific center.

Indomethacin for preterm labor: a randomized comparison of vaginal and rectal-oral routes.

OBJECTIVE: To compare the efficacy of intravaginal and intrarectal plus oral indomethacin for the treatment of preterm labor. METHODS: Between December 1996 and November 1998, 46 eligible gravidas admitted with singleton pregnancies and idiopathic preterm labor before 33 gestational weeks were randomized to receive 200 mg of intravaginal or intrarectal plus oral indomethacin. RESULTS: Twenty-three subjects were allocated to each study group. The interval from initiation of treatment to delivery was significantly longer in the intravaginal indomethacin group (26.5 +/- 5.7 versus 12.6 +/- 3.7 days; P =.007). Delivery was delayed by more than 7 days in 18 of 23 subjects (78%) in the intravaginal indomethacin group compared with ten (43%) in the intrarectal plus oral indomethacin group (P =.03). Birth weights were significantly higher (2306 +/- 436 versus 1862 +/- 232 g; P =.002) and hospitalization in a neonatal intensive care unit (NICU) (3.1 +/- 0.8 versus 9.3 +/- 3. 7 days; P =.001) and mechanical ventilation (1.4 +/- 0.2 versus 5.3 +/- 1.6 days; P =.001) were significantly shorter in the intravaginal indomethacin group. CONCLUSION: Intravaginal indomethacin is more effective than intrarectal plus oral application in delaying preterm labor and is associated with higher birth weights, shorter NICU stays, and shorter intervals of mechanical ventilation.

[Blood plasma level of endothelin in miners of a deep coal mine]. / Vliianie raboty v usloviiakh glubokoi ugol'noi shakhty na uroven' éndotelina v plazme krovi gornorabochikh.

In 60 miners working in a deep coal mine the blood plasma level of endoteline-1 (E-1) was measured by the immunoenzyme technique immediately after working shift. Those in the mining where the working conditions are especially harsh were found to have the highest level of E-1 exceeding the control values. In studying the age-related content of E-1 in blood plasma of coal miners the highest levels of E-1 were recordable in workers 20 to 30 years old, declining and differing in age groups 20-30 and 41-50 years old. The level of E-1 was at its greatest in those workers with minimum length of service in the underground conditions, declining with the service more than 10 years in duration.

[The effect of acute and chronic overheating on morphological changes in the liver]. / Vliianie ostrogo i khronicheskogo peregrevaniia na morfologicheskie izmeneniia v pecheni.

Disturbances were disclosed in the functioning of the lysosomal and vacuolar apparatus in an electronic and histochemical investigation of 75 Wistar albino rats and 10 control animals exposed to acute and chronic overheating, with the numbers and structure of lysosomes undergoing changes, lysosomal membranes disrupting, which event was accompanied by an outgo of lysosomal contents into the cellular cytoplasm and beyond. There was no longer Golgi apparatus as a single whole; cellular cytoplasm stored lipid drops of low electron density with membrane inclusion and products of reaction to acid phosphatase in their matrix. Disruption of lysosomes and identification of acid phosphatase in cellular cytoplasm and Disse's space was presumably a cause of damage to the Golgi apparatus.

[Effects of age and length of service on the state of the renin-angiotensin-aldosterone system and prostaglandin synthesis in coal miners]. / Vliianie vozrasta i stazha raboty na sostoianie renin-angiotenzin-al'dosteronovoi sistemy i sintez prostaglandinov u gornorabochikh ugol'nykh shakht.

Radioimmune assay determined serum renin activity, serum aldosterone level and its excretion with urine, amounts of thromboxane A2 (TxA2), prostacyclins PgI2 and PgF2a in urine of 76 apparently healthy miners before and after the working shift. Conventional techniques were used for estimation of blood and urine electrolytes and creatinine. In this connection activity of renin-angiotensin-aldosterone system (RAAS) in the miners before and after the work appeared to depend on the age and the length of service, to reach the maximum at the age of 31-40 and at 11-15 years of the service. Afterwards the activity lowered. The miners older than 41 had RAAS response decreased or absent after the work. Ratio TxA2 PgI2 remained unchanged in the miners over age of 41, whereas in the younger miners the ratio considerably decreased during the work.

[Correction of bronchial hyperreactivity with Corinfar in patients with chronic renal insufficiency]. / Korrektsiia povyshennoi reaktivnosti bronkhov s pomoshchiu korinfara u bol'nykh s khronicheskoi pochechnoi nedostatochnost'iu.

As shown in the provocative tests in eighteen 24-42 year old chronics with renal insufficiency, corinfar pretreatment (20 mg sublingually) can protect against acetylcholine-induced bronchial hyperreactivity. This ability of the drug can be useful to reduce hyperreactivity of the bronchi of patients with chronic renal insufficiency.

[The role of pharmacological tests in detecting disorders in the bronchial patency and bronchial reactivity of patients with chronic glomerulonephritis]. / Rol' farmakologicheskikh testov v vyiavlenii narushenii bronkhial'noi prokhodimosti i reaktivnosti bronkhov u bol'nykh khronicheskim glomerulonefritom.

Data are reported of a study of the effect of atrovent, salbutamol and acetylcholine on bronchial patency and reactivity of the bronchi in 89 patients with glomerulonephritis (age: 17-49 years) with normal renal function and at the stage of chronic renal failure. The tests proved highly informative. Latent bronchospasm was found in 12.1% of patients with chronic glomerulonephritis. In 76.3% of patients at the stage of chronic renal failure hyperreactivity of the bronchi was found. The revealed changes require early diagnosis and treatment.

[Diseases of the kidneys and urinary tract and possibilities of their active detection in miners]. / Zabolevaniia pochek i mochevyvodiashchikh putei i vozmozhnosti aktivnogo vyiavleniia ikh u shakhterov.

The examination of 630 miners aged 18-64 working in the mines of the Lugansk region revealed urinary and renal diseases in 15.7% of them. They were affected with chronic prostatitis (34.3%), urolithiasis (27.2%), chronic pyelonephritis (14.2%), 162 miners (33%) out of 490 had urinary shifts (hematuria in 91, proteinuria in 52, both hematuria and proteinuria in 19 examinees) when examined upon ascending from the mine. 61 miners had urinary syndrome only after working shifts. It was unrelated to relevant diseases. The authors point out the necessity of active screening of renal and urinary diseases during routine medical check-ups in miners.

[Effect of a single overheating on kidney ultrastructure]. / Vliianie odnokratnogo peregreva na ul'trastrukturu pochki.

Large human populations have to live and work under conditions of heat in the arid zones or in industry. It is shown in the experiment, that a single overheating of animals of various duration results in a considerable damage of glomeruli and tubules the clinical manifestation of which is the development of acute renal failure.

[The determination of aldosterone, thromboxane A2 and prostacyclin in biological fluids]. / Opredelenie al'dosterona, tromboksana A2 i prostatsiklina v biologicheskikh zhidkostiakh.

The authors' findings have lead them to a conclusion that urinary prostacyclin may be measured directly without preliminary extraction. Double freezing-defrosting of the samples did not change urinary thromboxane A2 level. Prolonged (up to 8 months) storage did not tell on urinary thromboxane A2 and blood plasma aldosterone levels.

[Clinico-morphologic comparisons in mesangiocapillary glomerulonephritis]. / Kliniko-morfologicheskie sopostavleniia pri mezangiokapilliarnom glomerulonefrite.

Clinical, morphological and immunological examination was carried out in 146 patients with mesangiocapillary glomerulonephritis. The differences in the clinical manifestations of the disease were not significant. The lobular variant was more frequently distinguished by microhematuria, increased level of creatine and reduction of the blood serum complement. Morphological examination showed a significant increase of the mesangial matrix in the center of glomerular lobules.

[One of the possible mechanisms of development and progression of chronic glomerulonephritis]. / Odin iz vozmozhnykh mekhanizmov razvitiia i progressirovaniia khronicheskogo glomerulonefrita.

Proceeding from clinical examination of 430 patients with chronic glomerulonephritis (GN) and morphological, histochemical and biochemical studies on kidney biopsy specimens the author has proposed and substantiated a hypothesis, according to which prolonged raised protein reabsorption in cells of the proximal tubules (PT) of the kidney can cause breakage and distortion of the activity of transport systems responsible for the absorption and catabolism of macromolecules. These changes can result in PT cell breakage, escape of lysosomal enzymes into the lumen and basal membrane of PT cells and pericanalicular interstice with further development of cortical interstitial sclerosis. The combination of the above mentioned disturbances would lead to GN progression and development of renal insufficiency.

[Work experience of the Minsk City Epidemiological Health Station in organizing a system for the epidemiological health surveillance of infectious diseases]. / Opyt raboty Minskoi gorodskoi sanitarno-épidemiologicheskoi stantsii po organizatsii sistemy sanitarno-épidemiologicheskogo nadzora za infektsionnymi bolezniami.

The system of the sanitary and epidemiological surveillance of infectious diseases comprises three aspects: supply of information, epidemiological and sanitary-hygienic surveillance. The system ensures the reliable epidemiological diagnosis, close collaboration in the work of specialists of sanitary and epidemiological departments, the differentiated surveillance of epidemiologically important objects, and the effectiveness of measures aimed at decreasing the infectious diseases incidence rates.

[Nephrotic syndrome in primary glomerulonephritis]. / Nefroticheskii sindrom pri pervichnom glomerulonefrite.

The authors provide the clinico-morphological data obtained in 189 patients with primary glomerulonephritis (GN). The disease was manifested clinically by the nephrotic syndrome (NS). The NS was most commonly induced by membranous-proliferative GN (MPGN), membranous GN (MGN), diffuse mesangio-proliferative GN and focal segmental glomerulosclerosis (FSGS), accounting for 31, 25, 22.8 and 8.7% of cases, respectively. Hypertension together with edema was among the most common symptoms of the NS in adult patients. Functional disorders of the kidneys recorded in FSGS, MPGN and MGN patients were more significant as compared to those in other patients. The morphological findings alone, obtained with the aid of light, immunofluorescent and electron microscopy, play the key role in the diagnosis of different patterns of GN.