INVESTIGATION OF BONE MINERALIZATION IN PATIENTS WITH CORONARY HEART DISEASE COMPLICATED BY CHRONIC HEART FAILURE, STAGE II-A.

The majority of the studies have shown that individuals with cardiovascular diseases have a higher risk of experiencing bone loss and thus greater predisposition to risk of fracture. On the other hand there is growing evidence that individuals with low bone mass have higher mortality for cardiovascular events compared to patients with cardiovascular disease with normal bone mass. This research aims to investigate bone mineralization in patients with coronary heart disease complicated by stage II-A chronic heart failure. The study involved 33 men with coronary heart disease complicated by Stage II-A chronic heart failure. Bone mineral density was measured using dual energy x-ray densitometry of lumbar region of spine. Structural and functional changes of bone tissue of the lumbar spine have been found in 49,2% patients with coronary heart disease complicated by Stage II-A chronic heart failure, in particular, I stage of osteopenia - in 44,6%, II stage of osteopenia - in 27,7%, III stage of osteopenia - in 10,8% and osteoporosis - in 16,9%. It was established the same type of downward trend for BMD decreasing in L1 of patients with different stages of osteopenia, but in case of osteoporosis mineralization decreased equally in all vertebrae.

[The correction of metabolic disorders in severely burned patients by enteral hyperalimentation]. / Corrección de trastornos metabólicos en quemados graves mediante hiperalimentación enteral.

An investigation was carried out of the metabolic processes, and some procedures for standardizing them, for patients with severe burns receiving uniformly distributed dosified high-calorie catheter alimentation, i.e. enteral hyperalimentation, in addition to the hospital's daily diet. Fifteen types of mixtures of Combustal were used, made and preserved ad hoc, and two commercial probe alimentation liquid products--Biosorbin-MCT (Pfrimmer-Kabi) and Fresubin (Fresenius AG). The average period taken to normalize the nitrogen balance was sixteen days counted from commencement of hyperalimentation. While it shifted the nitrogen balance figures from negative to positive, it was also seen to reduce A and C phospholipase activities in serum, while the level of excretion of nitrogenated amino acids and creatine remained high. During this time, pseudocholinesterase activity dropped, with the concentration of fibronectine in serum, which indicates low levels of biosynthetic processes and insufficiency in the reticuloendothelial system. The average value for the determination of lipids in general remained normal throughout the catheter feeding period. To ensure complete normalization of the metabolic process in patients suffering severe burns, enteral hyperalimentation must be extended for at least one month.

Enteral hyperalimentation of burned patients: the possibility of correcting metabolic disorders by the early administration of prolonged high calorie evenly distributed tube feeds.

Metabolic processes and the ways they may be treated were investigated in severely burned patients receiving prolonged high calorie evenly distributed tube feedings. It was shown that in critically ill patients the absorption of nutrients in the upper regions of the intestine was slightly impaired but the ability to absorb was preserved, which made it possible to provide prolonged evenly distributed tube feeding. For these purposes we used the nutrient mixture 'Combustal'. Restoration of nitrogen balance could be reached within about 10 days after starting tube feeding. However, the creatine excretion remained high, a manifestation of increased dystrophy of muscle tissue. Pseudocholinesterase activity in serum was also decreased, suggesting subnormal biosynthetic processes. To provide the full correction to normal of the metabolic processes the tube feeding with 'Combustal' should be given for at least a month.

[Water-soluble phosphorus-containing forms of ionol in experimental treatment of thermal burns]. / Vodorastvorimye fosforsoderzhashchie formy ionola v éksperimental'noi terapii termicheskikh ozhogov.

The authors studied the membrane-stabilizing effect of two water-soluble preparations of antioxidants, analogues of ionol, in thermal burns. It was found that both preparations increase somewhat to a different degree the resistance of the red cell membranes to peroxide compounds and reduce hemolysis which is very characteristic of the first minutes and hours after the thermal trauma. The preparations alter the electrical properties of the red cells and affect the activity of phospholipases in blood plasma.

[Changes in several characteristics of the erythrocyte membrane and erythrocyte structure in severe burns in animal experiments]. / Izmenenie nekotorykh svoistv éritrotsitnoi membrany i struktury éritrotsitov pri tiazhelykh ozhogakh v éksperimente.

It is determined in experiments on rats that the IIIB degree thermal injuries of 20% of the total body surface significantly reduce the erythrocytic membrane's resistance and cause the production of peroxides in 15 minutes after trauma. Simultaneously the electrical properties begin to change. The structure of erythrocytes is also altered. In 30 minutes post injury these alterations are in progress, but in 60 minutes they are less expressed. The structure of the erythrocytes is significantly altered. The authors consider that the influence of membranotoxic factors--the products of free radicals' reactions and phospholipases--is accounted for all noticed alterations.

[Lipid metabolism in patients with burn disease during nasogastral tube hyperalimentation]. / Lipidnyi obmen u bol'nykh ozhogovoì bolezn'iu na fone nazogastral'noi zondovoi giperalimentatsii.

A study was made of lipid metabolism in burn disease patients who received prolonged nasogastral feeding. The main alterations were discovered in phospholipid fractions of blood plasma and red blood cell membranes. In patients receiving nasogastral feeding, the alterations returned to normal more rapidly than in those who did not receive such a feeding. It is recommended that such a type of intensive care should be introduced on a broader scale in the treatment of burn disease patients.

[Motor evacuatory function of the stomach and the absorptive capacity of the intestines in patients with extensive suppurative wounds receiving tube feeding]. / Motorno-évakuatornaia funktsiia zheludka i vsasyvatel'naia sposobnost' kishechnika u bol'nykh s obshirnymi gnoinymi ranami v usloviiakh zondovogo pitaniia.

Radionuclide gastroscopy conducted in patients with vast purulent wounds and sepsis disclosed reduced motor-evacuatory function of the stomach and the rate of its fractional emptying, that supports the necessity of continuous administration of nutrient mixtures by a drip method. A significant improvement of the motor evacuatory function and the rate of fractionated emptying of the stomach, 9-12 days after the commencement of the enteral (tube) nutrition, has shown the necessity of its use at the early stages of the course of severe purulent infection. The investigation of the absorptive capacity of the intestine with the use of the D-xylose test has revealed that it is insignificantly decreased in 82.6% of patients with severe purulent infection, and tube nutrition in such patients could be successfully conducted. Only in 17.4% of the patients the adsorptive capacity of the intestine was significantly decreased, and in these cases predominantly parenteral nutrition was recommended.

[The effect of tubal hyperalimentation on the metabolic processes in patients with severe burns]. / Vliianie zondovoi giperalimentatsii na metabolicheskie protsessy u tiazheloobozhzhennykh.

High caloric probe hyperalimentation used in 37 burned patients in addition to routine ration resulted in normalization of metabolic processes due to the inhibition of biopolymer degradation and stabilization of biological membranes followed by the activation of anabolic processes.

[Blood phospholipases in burn shock]. / Fosfolipazy plazmy krovi pri ozhogovom shoke.

The activity of blood plasma phospholipases A and C has been observed during burn shock periods in patients with severe burns affecting more than 20% of the body surface. It was experimentally demonstrated that the enzyme plasma activity increased 30 minutes after burning. Simultaneously, intensification of lipid peroxidation took place. Phospholipases are suggested to liberate from the damaged tissues with their following activation by free-radical products.

[Therapeutic plasmapheresis in acute burn toxemia]. / Lechebnyi plazmaferez pri ostroi ozhogovoi toksemii.

Curative plasmapheresis was used in 10 critically burned patients at the stage of acute burn toxemia with the delirious syndrome with the unfavourable prognosis. Good immediate results were obtained in all the patients: psychic disorders were arrested by the end of the procedure. Clinico-laboratory data have shown the curative plasmapheresis to be an effective detoxicating method resulting in the elimination of various toxic substances from the organism.