Journal «MEDICINA» 3/2020

Heterotopic ossification (HO) is a common complication after injuries and orthopedic interventions. The aim of the study is to assess the feasibility of using laboratory tests to predict and determine the degree of risk of developing heterotopic ossification in patients after surgical treatment of bone fractures. Materials and methods. The results of surgical treatment of the effects of a humeral fracture in 25 patients were analyzed. In retrospect, all patients were divided into two groups: the main group included patients (n=9), who after surgery of the elbow fractures developed complications in the form of HO elbow para-articular tissues. The control group (n=16) consisted of patients who in the year after elbow fractures surgery developed no complications in the form of HO. Blood tests were performed in all patients prior to treatment, 7 days after surgery and at discharge from the hospital. The two groups of comparison (main and control) were comparable in age, time elapsed from the injury, the type of surgery performed, and length of hospital stay. Results. As a result of the study three potential predictors of HO were distinguished by laboratory tests in patients of the main group at the time of discharge: 1) high values of lactate (cut point with 100% sensitivity of the test – 2.32 mmol/l); 2) high values of hemoglobin (cut point with 100% sensitivity of the test – 130 g/l); 3) decreased activity of bone isoenzyme of acid phosphatase (cut point with 100% sensitivity of the test – 4.4 U/l). The odds ratio for a positive result of all three tests for predicting heterotopic ossification is 15.0. Conclusion. The identified laboratory tests allow to predict and determine the degree of risk of heterotopic ossification in patients after treatment of the effects of bone fractures.

Key words: heterotopic ossification, blood biochemistry, complete blood count, orthopedics

A clinical case of a patient with floppy eyelid syndrome who underwent a resection of the lower eyelid for a neoplasm is presented. Despite of the large volume of tissue removed and given his current state, it was possible to close the defect by direct tissue matching. Thus, patients with floppy eyelid syndrome have an advantage in case of removal of large volume neoplasms, which in the future do not require the use of complex plastics.

Key words: floppy eyelid syndrome, basal cell carcinoma, compound nevus, eyelid plastic

For decades, portion sizes in packaged and unpackaged foods have been growing steadily. This not only affects amount of calories consumed, but also shifts our perception of «normal» serving sizes. Reducing the size of the package can make a significant contribution to the reduction of energy consumption and, hence, in fight against excess weight. This is especially true for sugary soft drinks containing about 10% sugar, so a 500 ml serving contains about 50 g of sugar, which makes up 200% of the WHO recommended 25 g daily serving.

Key words: serving, calory, overweight, obesity

According to the results of several short-term randomized controlled trials (RCTs), nicorandil is not inferior in its antianginal efficacy to beta-blockers (BB), calcium channel blockers (CCB) and long-acting nitrates (LAN). At the same time, in some short-term RCTs, as well as in the long-term RCT IONA (2002), it was shown that antianginal efficacy of nicorandil as monotherapy or in combination with other antianginal drugs did not differ from placebo. Ability of nicorandil to reduce the risk of adverse cardiovascular events, demonstrated in the RCT IONA, requires confirmation in a long-term trial with a stronger primary endpoint and concomitant treatment that would meet the current guidelines for the management of patients with chronic coronary syndromes. In this regard, and also taking into account the proven ability of nicorandil to cause gastrointestinal ulcerations, European experts currently consider nicorandil as a drug that is inferior in priority of choice to the first-line antianginal drugs (BB, CCB) and, in some cases, to the second-line drugs (LAN, ivabradine, ranolazine, trimetazidine).

Key words: nicorandil, stable angina, efficacy, safety

The hypothesis of British physiologist Starling explaining the mechanism of venous rise is considered. The theoretical arguments demonstrating its insolvency are presented. The principal one is, that Sterling’s hypothesis contradicts basic laws of physics. It is offered, for discussion, the hypothesis explaining venous rise not contradicting with physical laws. The hypothesis is based on the idea, that the common view of physiologists and doctors on the locked anatomy of blood circulation system is false. Examples of «open end» circulation in muscle and lung based on capillary effect and not on diffusion are presented.

Key words: post-capillary, law of hydraulics, hypothesis of «open ends», capillary rise

Pharmacophoric analysis of the structure of valprazolamide, a 1,3,4-thiadiazolylamide derivative of valproic acid, was carried out. It was shown that the new valproate contains a substituted amide group, hydrophobic and electron-donor domеns – pharmacophores, determining its antiepileptic activity. Valproic acid has only a hydrophobic moiety. Modification of valproic acid by introducing an additional pharmacophore, 1,3,4-thiadiazole, into its structure leads to a decrease in toxicity and an increase in antiepileptic activity.

Key words: pharmacophoric analysis, valproic acid, 1,3,4-thiadiazole, antiepileptic activity

Purpose: Analysis and prognostic outcomes of retinopathy of prematurity (ROP) depending on the solar activity at birth time and gestational age. Material and methods. 229 case histories of premature babies born within 2017-2019 were randomly selected. They were split into two groups: group I – children with ROP (1, 2 and 3 degree) and group II – without any ROP (pre retinopathy). The disease outcome was taken into account in the children with ROP: laser coagulation (LC) and spontaneous regression. Also, all children were split according to the seasons of birth: winter, spring, summer and autumn. Results. The seasonal differences in retinopathy outcomes were observed: in children born in spring and summer, the percentage of spontaneous regression was much lower and was 15% in spring, 13.2% in summer, 29% in autumn and 29.6% in winter. The percentage of performed LC on the contrary was 21.7%-28.3% in spring and summer period and 9.7%-14.8% in autumn and winter. Conclusion. A mathematical model is constructed for predicting the outcome of retinopathy of prematurity, determining the probability of spontaneous regression of the disease based on such independent variables as the level of insolation and the gestational age of the child. According to the obtained formula, the probability of spontaneous regression of retinopathy increases with an increase in gestational age and a decrease in solar activity at birth time. On the contrary, the probability of need for laser coagulation increases with a decrease in gestational age and an increase in the insolation intensity.

Key words: retinopathy of prematurity, solar activity, gestational age, preventive measure, prediction

The article presents results of the study of the biological activity of newly synthesized 1-benzoyl-substituted-6- (methylthio) -4-chloro-1H-pyrazolo [3,4-d] pyrimidines. The acute toxicity of 2-aryl-6- (methylthio) -4-chloro-2H-pyrazolo [3,4-d] pyrimidines was determined experimentally on non-linear white male mice with a total weight of 16-20 g. A generation model was used to experimentally evaluate the analgesic activity acetic «writhing» in mice. It was experimentally confirmed that the synthesized new 2-aryl-6- (methylthio) -4-chloro-2H-pyrazolo [3,4-d] pyrimidines are non-toxic and have pronounced analgesic activity.

Key words: 1-Benzoyl-Subctituted 6-(Methylthio)-4-Chloro-1h-Pyrazolo[3,4-D]Pyrimidines, biologic activity, PASS program, acute toxicity, analgesic activity

By the beginning of the reproductive period, myopia accounts for 25-30% of the female population in Russia. For a long time, it has been believed that pregnancy and childbirth can provoke the development of peripheral dystrophies and, as a result, retinal detachment, which is an absolute indication for surgical delivery. However, there is literature evidence about the possibility of natural delivery for patients with retinal detachment. Detection of peripheral dystrophies during examination in pregnant women is an indication for preventive laser treatment. The modern approach to choosing the method of delivery of pregnant women, taking into account the state of the visual organ, based not on the presence of the degree of myopic refraction, but on the retinal status (the presence of PVCRD and retinal detachment), can significantly reduce the frequency of operative delivery for ophthalmological indications.

Key words: myopia, peripheral vitreochorioretinal dystrophy, regmatogenous retinal detachment

The article provides data on such a well-known fungus as Ganoderma lucidum. It is noted that after exposure to oxidative stress, physiological parameters are normalized, the superoxidation radical, glutathione is restored, which is proven by histological, electron microscopic and biochemical research methods. The results are discussed, and the corresponding conclusions are drawn.

Key words: superoxide radical anion, glutathione, Ganoderma lucidum