The purpose of the study. To determine whether it is possible to use passive acoustic thermometry to measure the core temperature of human body regions. Materials and methods. Thermal acoustic radiation was measured by a multichannel acoustic thermograph with a threshold sensitivity of 0.3°С at an integration time of 10 s. A portable computer infrared thermograph with a sensitivity of 0.1°С was used to measure the superficial temperature. Results. Measurements of thermal acoustic radiation of the right hypochondrium of the study subject were carried out to obtain an integral temperature of the liver after intake of sugar. At the same time, blood glucose concentrations were measured. The glucose level increased from 4 to 8 mmol/l within an hour and a half; then it began to decline. The acoustic radiation temperature increased by 2°С with a half an hour delay after the increase in the glucose level. Model calculation showed that the liver temperature increased from 37 to 38°С. Conclusion. It was shown that passive acoustic thermometry can be used to measure the core temperature of different regions of the human body. The proposed method may be useful in the emergency medicine.

The purpose of the study: to identify significant changes in the electrochemical properties of quarantine-stored blood plasma and of donor blood plasma during its in vitro mixing with quarantined plasma in order to assess the effect of transfusion of quarantine-stored plasma on recipient plasma in a model experiment. Materials and methods. Blood plasma of 20 clinically healthy volunteer donors was quarantined for 6 months at -40°C. Monitoring of the redox potential (RP) of the quarantined plasma was carried out directly on the day of sampling without freezing the sample, and then on days 1, 3, 7 and 14, as well as after 1, 1.5, 2, 3, 4, 5 and 6 months of storage of frozen samples. Each of 15 blood plasma samples donated by clinically healthy volunteers was mixed in vitro with blood plasma quarantined for 6 months at a ratio 1:1, and the RP of the mixture was measured by a platinum microelectrode technique. Results. It was found that during the storage of quarantined samples at a temperature of -40°C, the blood RP shifted to more positive values in 70% of cases. Addition of the quarantined plasma to the plasma of practically healthy volunteer donors also led to a shift in the final mixture RP to positive values in 13 of 15 cases (87%). Conclusion. Significant changes in RP values have been found when measuring the RP of the quarantined blood plasma, demonstrating predominantly oxidative processes in the plasma. Since significant shift of RP in blood plasma to the positive values has been associated with the deterioration of the patient's state, we concluded that further clinical studies on the use of quarantined plasma with high positive RP values are warranted.

The purpose is to study antibacterial and antimycotic properties of produced granular carbon sorbents. Material and methods. A VNIITU-1 carbon sorbent was used as a starting material, which was modified with polyvinylpyrrolidone and lactic and glycolic acids oligomers. Microbiological bench tests were carried out to determine the antibacterial and antimycotic activity of these granulated carbon hemosorbents. Antibacterial properties of sorbents were studied in relation to pathogenic and conditionally pathogenic microorganisms: Staphylococcus aureus, Pseudomonas aeroginosa, Klebsiella pneumonia, Escherichia coli, Streptococcus agalactiae as well as their mixtures: mixture No. 1 — S. aureus and E. coli; mixture No. 2 — S. aureus and P. aeruginosa. Results. Presented data demonstrate that the modified VNIITU-1 exhibits significant antibacterial and antimycotic activity against most of the studied microorganisms compared to original sorbent.  Conclusion. Modified sorbents as antimicrobial and detoxifying drugs may further be employed in treatment of obstetrical-gynecological and surgical diseases. The carbon sorbents are promising materials for medicine, as they expand the potential of sorption therapy in clinical practice.

Neurotrophins are proteins that play an important role in the nervous system functioning by regulating cell proliferation, differentiation, processes of neuronal survival and death, and by participating in the mechanisms of neuronal plasticity. The brain-derived neurotrophic factor (BDNF) is one of the most well-described representatives of the neurotrophin family, which has received close attention over recent years. It is considered one of the key mediators of neuronal survival and recovery, and a drop of the BDNF level is considered a common mechanism underlying the development of various neurodegenerative diseases. The review discusses changes in BDNF levels in ischemic and traumatic brain damage, the prospects of its use in the clinical practice as a marker of brain dysfunction, as well as the possibility of its use for the treatment of post-ischemic encephalopathies.

Purpose. To assess changes in nucleic acid (NA) metabolism in severe burn injury and to develop recommendations for correction of the alimentary status taking into account changes in the NA metabolism. Materials and methods. All patients (37 patients with II–III degree thermal burns and a burn area of more than 40%) were divided into 2 groups: Group I included survivors (23 patients), group II consisted of the deceased. The intensity of the NA metabolism was assessed based on the dynamics of the of uric acid (UA) and oligonucleotides serum concentrations. Results. In the acute period of burn injury, marked decrease in UA levels (less than 100 μmol/l), with gradual stabilization in survivors is typical. In addition, a 2–3-fold increase in the concentration of serum oligonucleotides compared to the normal limit is typical for survivors in the acute period, and these changes were significantly different from the group of deceased patients starting from day 5. Taking into account the data obtained, the level of serum UA can be recommended in clinical practice for the assessment of alimentary status in burn disease, as well as a criterion for f the prescription of glutamine administration in critically ill patients. In patients with burn disease a decrease in the UA level to less than 100 μmol/l was regarded as an absolute indication for the use of L-glutamine products. The use of glutamine in patients with significant decrease in UA levels was accompanied by a significant increase in the intensity of NA metabolism, which was demonstrated by both an increase in uric acid levels (by 85% by day 10 after the start of glutamine administration, P<0.01) and restoration of repair processes. Conclusion. Therefore, there was a marked alteration of NA metabolism in both groups of patients with severe burn injury. At the same time, surviving patients are characterized by rapid recovery of NA metabolism. Glutamine was employed as a pharmacological agent that effectively abrogates the depression of NA metabolism.

 

 

Infusion therapy is the main element of treatment of critical illness; at that, it is critical not only to eliminate hypovolemia, but also to prevent fluid overload. The purpose of the study was to identify predictors of a lethal outcome due to the peculiarities of infusion therapy and fluid balance in critically-ill children. Materials and methods. The study included 96 children admitted to the pediatric ICU. The average age of the children was 0.7 (0.2–2) years. Depending on the outcome, all patients were divided into two groups: I — «Recovery», II — «Lethal outcome». The daily volume of administered fluid, the volume of infusion therapy, the volume of pathological losses and fluid balance were estimated. Results. On the first day of therapy, parameters related to the volume of administered fluid were main factors that increased the probability of a lethal outcome; then mortality was associated with parameters related to the volume of discharged fluid. The volume of discharged fluid less than 20% of the administered volume increased the risk of a lethal outcome by 12-fold; the increase in the volume of fluid loss to 80% of the administered one contributed to a significant reduction in the risk of children's death. Conclusion. Positive fluid balance due to reduced volume of the discharged liquid is a major risk factor of a lethal outcome in children.

The purpose of the study was to compare the possibility of rapid activation of elderly patients after carotid endarterectomy performed under sevoflurane- or desflurane-based anesthesia. Materials and methods. 67 patients aged 75 to 89 years divided into two groups were examined. To maintain anesthesia, desflurane was used in the 1st group and sevoflurane was employed in the 2nd group. Results. Patients from the group receiving desflurane, experienced decreased ability to take a sip of water and to hold oneself in a sitting position, and were characterized by decreased time before the tracheal extubation. Conclusion. Desflurane-based anesthesia provided faster awakening and activation of elderly patients after carotid endarterectomy than the anesthesia with sevoflurane, which allowed to implement the fast-track recovery protocol. In addition, the desflurane-based anesthesia provided excellent manageability and less negative impact on the hemodynamics (within the drug concentration range of up to 1.3 MAC).