THE COMBINATION OF CHRONIC RESPIRATORY DISEASES WITH OBSTRUCTIVE SLEEP APNOEA SYNDROME IN CLEAN-UP WORKERS OF CHORNOBYL NPP ACCIDENT. / ПОЄДНАННЯ ХРОНІЧНИХ ЗАХВОРЮВАНЬ ОРГАНІВ ДИХАННЯ ІЗ СИНДРОМОМ ОБСТРУКТИВНОГО АПНОЕ/ГІПОПНОЕ СНУ В ОСІБ, ЯКІ ПОСТРАЖДАЛИ ВНАСЛІДОК АВАРІЇ НА ЧОРНОБИЛЬСЬКІЙ АЕС.

The objective of the study was to establish the relationship between functional status of bronchopulmonary system and obstructive sleep apnea in clean-up workers of Chornobyl NPP accident in a remote post-accident period. MATERIALS AND METHODS: We included 58 COPD male patients clean-up workers of Chornobyl NPP accident: 21 with obstructive sleep apnea syndrome (OSA), 37 - without. A complex of functional tests and OSA screening was provided. RESULTS: In clean-up workers of Chornobyl NPP accident with COPD and obstructive sleep apnea in a remote post-accident period apnea-hypopnea index (AHI) negatively correlated with FVC, % of predicted (r = -0.36, p < 0.05), the intrathoracic gas volume (ITGV), % of predicted (r = -0.40, p < 0.05); AHI positively correlated with diffusion lung capacity (DLCO), % of predicted values (r = 0.57, p < 0.05), with the intrathoracic gas volume (ITGV), % of predicted (r = 0.53, p < 0.05), body mass index (r = 0.49, p < 0.05) and age (r = 0.62, p < 0.05). CONCLUSIONS: Obstructive sleep apnea was diagnosed in 36.3 % of patients with COPD clean up workers of Chornobyl NPP accident. Screening for OSA in patients with COPD, clean-up workers of Chornobyl NPP accident is a very important clinical task for prognosis and treatment.

[Organization and delivery of therapeutic care in modern local wars and armed conflicts].

The system of providing therapeutic care within a united system of staged treatment of wounded and sick and evacuation was established during the Great Patriotic War of 1941-1945 and helped to return 90,6% of casualties to duty. In terms of local wars and armed conflicts the most important task of military field therapy is to improve the provision of therapeutic support through regional and territorial principles, echeloning of forces and facilities, optimization of allocation of medical institutions in accordance with their capabilities, evacuation routes, etc. The organization of therapeutic assistance should be guided primarily by the size and structure of sanitary losses. In modern local wars cannot exclude the occurrence of massive sanitary losses with limited use of weapons of mass destruction, as a result of failure (with a conventional weapon or as a result of sabotage) of nuclear power plants, chemical plants, and transport containers containing toxic chemicals.

[Formation of therapeutic group of casualties in local wars and armed conflicts].

The necessity of improvement of the therapeutic care organization in the RF Armed Forces is dictated by the existing military threats. Conflicts between states or within a single country along with inefficiency of diplomatic, social and political efforts may lead to armed conflicts or local wars. Analysis of medical support results shows the consistent prevalence of therapeutic group of casualties in the overall structure of medical losses. 35-50% of all sanitary losses is accounted for by somatic diseases. Moreover, their structure is similar to the structure of the army's peacetime morbidity rate. Respiratory diseases head the list of somatic diseases in military personnel. Next--diseases of the digestive and circulatory systems. One of the most important tasks for physicians in wartime is early diagnosis and treatment of visceral pathology in the wounded. An additional point is that the use of tactical nuclear weapons during the armed conflict or local war cannot be completely excluded. There is also a real risk of nuclear and chemical facilities damage, with consequences that are comparable to the use of nuclear or chemical weapons. Thus, in the course of armed conflict or local war, military physicians can meet all possible therapeutic spectrum of pathology: from visceral pathology of peace and wartime to combat related therapeutic pathology.

Affinities of gidazepam and its analogs for mitochondrial benzodiazepine receptors.

Mitochondrial benzodiazepine receptors (MBRs) participate in many physiological processes, such as calcium flow regulation, proliferative and respiratory cell functions, mitochondrial steroidogenesis and adaptational reactions to stress. We have found that the selective anxiolytic gidazepam has a higher affinity for CNS MBRs as compared to central benzodiazepine receptors. The ability of gidazepam to bind to MBRs probably underlies a wide spectrum of its pharmacological effects. We have studied affinities of gidazepam analogs for CNS MBRs in search for the ligands possessing higher affinity and selectivity. The experiments were carried out with male Wistar rats weighing between 200-220 g. Affinities of the investigated compounds were assessed on their ability to displace radioligand Ro5-4864 from its specific binding sites on MBRs of rat brain. Within the series of tested compounds three substances comparable on affinity with Ro5-4864 were found. Experimental results have shown that the presence of chlorine atom in o-position of 5-phenyl substituent leads to a 10 to 15-fold increase in affinity for CNS MBRs. We have also found that the essential contribution in affinity of the investigated series is brought by lipophilicity of substituent in IN-position. Our data may be useful in design and synthesis of novel potent selectively acting ligands of CNS MBRs.