[Succinate salts in solving the «oxygen paradox¼ of reperfusion]. / Suktsinaty v reshenii «kislorodnogo paradoksa¼ reperfuzii.

Reperfusion damage to the cellular structures of tissues in the early post-ischemic period is a consequence of the restoration of blood flow and reoxygenation. Currently, there is no effective treatment for reperfusion metabolic disorders in clinical practice. Over the past decades, biological studies of hypoxia and the role of hypoxia-inducible factor-1α (HIF-1), potentiating succinatoxidase oxidation by signal from the succinate-dependent receptor (GPR91), have significantly improved the understanding of oxygen homeostasis during the period of recovery of blood flow. HIF-1 plays a key role in postischemic damage and is an oxygen-sensitive transcription factor that mediates adaptive metabolic responses to hypoxia and hyperoxia during reperfusion and reoxygenation. Activation of HIF-1 by succinate improves cell survival in hypoxic and posthypoxic (hyperoxygenated) environment, altering energy metabolism, proliferation, angiogenesis and vascular remodeling. The role of succinate oxidation in the period of ischemia / reperfusion and reoxygenation suggests the widespread use of infusion succinate as a protector that reduces the degree of tissue damage by reactive oxygen species (ROS) and restores the usual oxygen homeostasis.

[A critical incident during marathon competition as a result of metabolic decompensation].

A case of polyorganic insufficiency syndrome associated with coma, convulsive disorder, acute hepato-renal and respiratory dysfunction, hypovolemic shock, and hyperthermal syndrome in a 46 year-old participant ofa marathon competition is reported. The clinical picture was dominated by acute hepatic insufficiency treated with remaxol to activate substrate phosphorylation under effect of exogenous succinate for slowing down the development of energy deficit in mitochondria under condition of oxygen deficit. This case can be regarded as a variant of correction of mitochondrial dysfunction with the use of a mitochondria-targeted medication such as succinate-containing remaxol. This medication reduced AST and ALT activities and utilization of endogenous enzymes for succinate synthesis from alanine and aspartate under hypoxic conditions. Prescription of remaxol as a form of direct substitution therapy was dictated by pathogenetic considerations.

PREECLAMPSIA AND IRON EXCHANGE. ARE THERE ANY COMMON PATTERNS?

THE AIM: Detarmination of correlation between the level ofserm iron and hemoglobin with clinical symptoms ofpreeclampsia. MATERIALS AND METHODS: A prospective randomized controlled investigation of 62 women in the gestation of 30 to 39 weeks. Women were divided into 2 main groups. The first group included 38 nulliparous women with preeclampsia moderate degree (Io group) gestational age from 30 to 39 weeks, at the age of 26,8±2,7 years. The second main group included 24 nulliparous women with preeclampsia severe degree (II group) in gestational age from 30 to 39 weeks of similar age. The conditionfor inclusion in the main groups was iron supplementation in the period of total hemoglobin reducing < 115 g/l. The first control group (I) included 26 nulliparous women average 26,2±1,6 years, which admitted to a maternity hospital for planned Cesarean section. The second group (IQ included 22 healthy non-pregnant women at the age of 25,8±4,4 years. During hospitalization, before delivery and at 2 hours after delivery was investigated the concentration of total hemoglobin, serum iron, total bilirubin, creatinine, urea, endothelin-1 (immediately before delivery and after delivery). The total analyses of urine examined the number of red blood cells and white blood cells and protein concentration. RESULTS: It''s revealed that the serum iron level has a direct correlation with the level of blood preasure (r = 0,5412 and r = 0,6229) and concentration of endothelin- with total hemoglobin (r = 0,6446 in p < 0,03) and with serum iron concentration (r = 0,7841 in p < 0,02). Conclusuion. The analysis of conducted investigation allows to approve about the pathogenetic importance of iron in the development ofpreeclampsia and post-partum complications, that require new approaches of iron during gestation.

[PLACE REMAXOL AS A HEPATOPROTECTOR IN INTENSIVE THERAPY OF PERVASIVE PERITONITIS].

UNLABELLED: PERPOSE OF RESEARCH: to evaluate the effectiveness of Remaxol in patients with pervasive peritonitis. MATERIALS AND METHODS: assessed the effectiveness of a balanced infusion of the drug (Remaxol) in the treatment of 44 patients agedfrom 18 to 50 years. Patients were devided into 2 groups by the method of envelopes. All patients received a comprehensive differential therapy: 21 patient 1 group consisting of infusion therapy in the postoperative period received Remaxol at a dose of 800 mg/day for 7 days. RESULTS: the comporative assessment of indicators of systemic hemodinamics, oxygen transport, asid base status, glucose, lactose and free radical oxydation. Patients on the first background was used Remaxol have experiensed a more rapid relief of metabolic disorders, endotoxemia and hepatic dysfunction compared with the indices of the 2 group patients. Noted earlier stabilization of rudicators of systemic hemodynamics and oxygen transport. This has reduced the duration of respiratory and vasopressor suppot, early start ofparenteral intreduction in case the power (p < 0.05). CONCLUSIONS: this study shows that use of the drug for the purpose of relief Remaxol hepatic dysfunction and prevention of drug liver toxicity in conditions ofperitonitis, after 48 hours of operation, provides a positive dynamics and stabilization ofparameters of central hemodynamics, contributing to the abolition of vasopressor support, and contributes to the effective utilization of oxygen, while providing antioxidant effect.

[Correction of endotoxemia in patients with pancreatic necrosis]. / Korrektsiya svobodnoradikal'nykh protsessov i endotoksemii u bol'nykh pankreonekrozom.

AIM: To study the results of deferoxamine (Deferal) administration in intensive therapy program of 63 patients with severe acute pancreatitis to decrease effect of oxidative stress and endotoxemia. MATERIAL AND METHODS: In deferoxamine group (31 patients) there were decrease of serum iron's level and inhibition of free radical oxidation that led to early relief of endotoxemia, reducing periods of organs' dysfunction. It was not observed in comparison group (32 patients). RESULTS: Deferoxamine decrease risk of pancreatic necrosis and pancreatogenic sepsis. It allows reducing ICU- and hospital-stay and number of extended surgical procedures.