[Peculiarities of metabolic syndrome and nonalcogolic fatty liver disease in menopausal women].

Correlation between menopause metabolic syndrome and nonalcogolic fatty liver disease (NAFLD) is reviewed. NAFLD refers to a wide spectrum of liver disease ranging from simple fatty liver (steatosis), to nonalcoholic steatohepatitis, to cirrhosis. The causes and pathogenetic factors of the disease are still under investigation. The risk of development of NAFLD during menopause is twice higher in comparison with fertile age and abdominal obesity and insulin resistances is more apparent. This feature is associated with deficit of estrogens during menopause, as risk of development of NAFLD is diminished with substitutive hormonotherapy. The obesity, particularly in the period of menopause, is discussed as additive, independent risk factor of metabolic syndrome and of diseases of hepatobiliare and cardiovascular systems.

[Treatment of nonalcogolic fatty disease of liver].

The experimental and clinical data concerning of treatment of nonalcogolic fatty liver disease (NAFLD) are summarized and analyzed in the review. Some aspects of pathogenetic pharmacotherapy of NAFLD have been discussed (correction of insulin resistance, obesity, dislipidemia, oxidative stress, hepatoprotectors, restoration of intestine microbiosis, replacement hormonal, syndrome and antihypertensive drugs). Medical and non - medical methods of treatment is compared. It is concluded that further study to improve methods of prevention and treatment of NAFLD are required.

[Antidiabetic activity of berberin and extract, obtained from the bark of Phellodendron lavalei, introduced in subtropic regions of Georgia, in streptozotocin induced diabetic rats].

The goal of the study was to identify antidiabetic impact of berberin and extract, obtained from the bark of Рhеllodendron lavalei, introduced in subtropic regions of Georgia. The study was conducted on Streptozotocin induced diabetic rats. Diabetes in animals was induced by single intraperitoneal injection of streptozotocin in 1M citrate buffer, pH 4.5, dose 40 mg/kg per body weight, 1 ml volume. Treatment was conducted using berberin hydrochloride dose 150 mg/kg and extract of the bark of Рhеllodendron lavalei dose 400 mg/kg per orally, on an everyday basis, once a day during 3 weeks. The following indicators were measured: weight gain during the observation period, amount of food intake g/day, food efficiency ratio (%), relative mass of internal organs and blood glucose level. Blood glucose level was measured after 3 weeks from the day experiment started, after fasting all night. It was determined that per oral administration of berberin hydrochloride dose 150 mg/kg and extract of the bark of Рhеllodendron lavalei dose 400 mg/kg, during 3 weeks caused decrease in blood glucose level in streptozotocin induced diabetic rats. The marker of this efficacy was improvement of symptoms: decrease in hyperglycemic values, decrease in polyuria and polyphagia and relative weight of kidneys and heart, improvement of food efficiency ratio and mark decrease of weight loss. It should be noted that berberins antidiabetic activity was more marked. It is suggested that medicinal plants containing studied active components can be used as a crude drug for obtaining medicinal agent of promising antidiabetic phytotherapy and along with standard treatment can be used against metabolic syndrome and prevention of diabetes type 2.

[Pharmacotherapy and prevention of osteoporosis].

In the article data regarding pharmacological prevention of primary osteoporosis is reviewed. Some main aspects of the disease are underlined. The primary prevention of osteoporosis is targeted on building up and sustaining the strength of the skeleton during different periods of human life. The secondary prevention is aimed to avert the fractures in the case of developed osteoporosis. The main mechanism of fracture risk lowering is prevention of bone mineral density (BMD) reduction. The prevention is based on risk-factor modification. It is important, that success during prevention of osteoporosis may be reached, if the group with high risk of disease development will be identified in time. In the article the risk-groups for BMD determination, the WHO criteria of disease diagnostics, as well the prevention approaches--healthy life style promotion and pharmacological prevention were presented. The main group of agents acting against bone resorption: bisphosphonates (BP), calcitonin, hormone replacement therapy, selective modulators of estrogen receptors, as well as fluorides stimulating bone production and recombinant agent of parathyroid hormone--teriparatide were discussed. Bisphosphonates are most powerful inhibitors of bone resorption and are discussed as first line agents for prevention and care of osteoporosis. At present, there are a large number of antiresorptive agents, with different pharmacodynamics and pharmacokinetics and the task for physician is to define the correct treatment in each case.

[Comparative characteristic of angiotensin-converting enzyme inhibitor--captopril and the angiotensin II receptor blokers--losartan action on the oxidative metabolism in experimental hyperlipidemia in rabbits].

The aim of present study--comparative characteristic of captopril and of losartan action on the oxidative metabolism in experimental hyperlipidemia. Experiments carried out on rabbits,which were divided into three groups(ten animal in each group) and orally receiving during 45 days: I control group (cholesterol 500mg/kg + methylthiouracil 100mg/kg, II group-captopril 5 mg/kg + cholesterol 500mg/kg + methylthiouracil 100mg/kg, III group-losartan 8mg/kg + cholesterol-500mg/kg + methylthiouracil 100mg/kg. Activity of superoxide dismutase, catalase, level of malonic dialdehyde, osmotic resistance of erythrocytes and resistanse of LDL to oxidation and concentration of nitric oxide in the blood have been evaluated . The administration of captopril and losartan in experimental hyperlipidemia eqivalently increased activity of SOD and catalase, osmotic resistance of erythrocytes and resistanse of LDL to oxidation, whereas decreased content of malonic dialdehyde compared to the control group . Captopril was more effective than losartan in preserving of nitric oxide. We conclude that captopril and losartan inhibited oxidative stress, which are probably associated with the inhibition of angiotensin 11. Captopril and losartan are safely used in patients during cardio-vascular disease with dyslipidemia.

[Antimicrobial prophylaxis in urological surgery].

The present review is dedicated to the problem of perioperative antimicrobial prophylaxis in urological surgery. There are considered modern guidelines for perioperative antimicrobial prophylaxis in urology. There are discussed; aims, timing, and duration of perioperative antimicrobial prophylaxis, risk factors of postoperative infections in urological surgery, pharmacological properties of major antimicrobial drugs, selection and route of administration of antibacterial agents. There are presented the recommendations of perioperative antimicrobial prophylaxis for the varies types of urological surgery, as well as, are given in detail the recommendations about clinical uses of antibiotics for the different types of urological interventions. There are concluded, that perioperative antimicrobial prophylaxis reduces risk of postoperative infections in urological surgery, but sometimes this prophylaxis is not effective and the problem of perioperative antimicrobial prophylaxis in urology is debatable at present. It is necessary continues search of optimal methods of of perioperative antimicrobial prophylaxis in urology. These review are designed for urologists and clinical pharmacologists.

[Oxidative stress during thyrotoxicosis and its correction].

Oligocrine is a preparation of vegetable origin characterized by anti-inflammatory, antioxidant, immunomodulating properties. Our study shows that administration of L-thyroxine injections (irrespective of the duration) results in elevated synthesis of thyroid hormones and intensification of oxidative stress in experimental animals. These changes are evidenced by accumulation of membrane phospholipide peroxidation products - lipid peroxides in the blood. At that we should point that while dependence of FT3 and FT4 levels on the duration of L-thyroxine administration was insignificant in the experimental model of thyrotoxicosis, intensity of lipid peroxidation increased along with prolongation of injections. Blood levels of free nitric oxide were decreased likely due to the transformation of nitric oxide into peroxinitrite. Oligocrine facilitates to the stabilization of thyroid status and restriction of NO hyperproduction, hypermetabolism and oxidative stress in the body.

[Major pathogenic links of atherosclerosis].

The experimental and clinical data concerning pathogenesis of the atherosclerosis are summarized and analyzed in this article. Major concepts that explain initiation and progressive growth of atherosclerosis such as lipid infiltrations, response to disturbing factors, "response on the keeping of particles" and inflammatory processes are discussed. These concepts are considered as base for integral theory of atherosclerosis according which the inflammatory process in atherosclerosis are the result of the universal response reaction of endothelium to the various disturbing risk factors. Chronic inflammation leads to complex cellular and molecular interactions among cells derived from the endothelium, smooth muscle and several blood cell components and causes oxidative stress, proliferation of smooth muscle cells, oxidative modification of LDL, uptake and macrophage foam cell formation, endothelium dysfunction. Major pathogenic links of atherosclerosis, such as inflammation, oxidative stress, oxidative modification of LDL, lipid infiltration, endothelial dysfunction closely interact, forming close vicious circles which leads to metabolic and morphological disturbances, re-modulation of blood vessels, cardiovascular diseases and such complication as cardiac infarction and stroke. Pathogenic peculiarities of atherosclerosis are the theoretic base to the elaboration of therapeutic strategy. Endothelium may be discussed as a new therapeutic target in atherosclerosis. So far as the leukotrienes play an important role in inflammatory processes, it is suggested that the leukotrienes may be as a potential therapeutic target in cardiovascular diseases.

[Pharmacological correction of hyperactivity of renin-angiotensin-aldosterone system].

Reference data on the function of renin-angiotensin-aldosterone system (RAAS) and pharmacological correction of its hyperactivity are summarized and analyzed in the paper. RAAS plays important role in the development and worsening of hypertension, facilitates proliferation of smooth muscle and heart cells. The hyperactivity of RAAS promotes the development of cardiovascular complications, such as myocardial infarction, stroke, increases cardiovascular mortality and morbidity. Pharmacological correction of RAAS hyperactivity decreases hypertension, prevents occlusion of heart and blood vessels, provides anti-ischemic action, vascular and cardiac protection, improves life style, prevents cardiovascular mortality, such as fatal stroke, myocardial infarction and sudden death. b-blocker inhibitors, angiotensin converting enzyme (ACE) inhibitors, angiotensin AT1-receptors blockers are reviewed as first line therapy of essential hypertension and congestive heart failure. ACT inhibitors, AT1- receptor blockers decrease total cholesterol, LDL, but increase HDL, beta-blockers decrease HDL. AT1-blockers are alternative drugs for treatment of cardiovascular diseases in those cases where ACE inhibitors are contraindicated or intolerance exists.