This study was aimed at measuring concentrations and investigation of relationships between macro- and microelements in mediastinal lymph nodes of patients with sarcoidosis. Methods. The study involved 28 patients (50% were males; median age, 42.5 (23; 53) years) with confirmed diagnosis of sarcoidosis. Autopsy samples from 13 individuals died from occasional causes (41.2% were males; median age, 43 (38.7; 61.3) years) were used for comparison. The groups did not differ in age and gender. Neutron activation analysis was used to investigate chemical elements in mediastinal lymph node tissue samples. Results. Concentrations of Ca, Cr, Fe, Co, Zn, Rb, Sb, Cs, Ba, Eu, Lu, Yb, Hf, Th, and U in the lymph node tissue of patients with sarcoidosis were increased, and concentration of zinc was decreased compared to control samples. Concentrations of Sm, Au, Sr, Nd, As, Br, Ag, Tb, Sc, Ta, Na, and La did not differ between the groups. Direct relationships were found in element groups Fe-Cr-Sb-Ca, Fe-U-Th, Co-U-Th, U-Cr, Th-Br, Sc-Zn, Eu-La, and Ce-Lu.

In a prospective non-randomized comparative open, parallel-group study evaluated the clinical efficacy of succinic acid on the impact on symptoms of anxiety and depression in patients with acute exacerbation of COPD and severe. A total of 134 patients. All subjects men 5168 years. The survey was conducted according to the criteria GOLD 2011. To assess the level of anxiety and depression questionnaire used HADS depression and samooprosnik CES-D. Patients in group 1 (n=61) standard therapy exacerbation. Patients in Group 2 (n=72), the standard therapy was supplemented with acute drug Amber-antitoks within 14 days, 1 tablet (0.5 g) 3 times daily after meals. Between groups were compared indicators characterizing COPD before and after treatment. The positive effect would be achieved in both groups. Patients whose treatment included succinic acid reached higher levels in relation to the comparison group: FEV 1p=0.01; FVCp=0.01; distance traversed in the test with the 6-min walk p=0.003; oxygen saturation after the 6-minute walk test p=0.0001; expiratory pressure at the mouth p=0.01; decreased symptoms of anxiety p=0.003; manifestations of depression decreased p=0.0001. It is concluded that succinic acid is included in the standard treatment of exacerbations of COPD, severe effective for relief of elevated levels of anxiety and depression. This effect is largely associated with improved somatic condition of patients after treatment. This is evidenced by the correlation between the level of anxiety and depression prior to treatment with the clinical manifestations of COPD exacerbations. In particular, the FEV1 (r=-0,72; p=0,01), with the distance traveled by a 6-minute walk test (r=-0,61; p=0,001); with oxygen saturation after 6 minutes walk test (r=-0,77; p=0,001); with expiratory pressure in the oral cavity (r=-0,53; p=0,01), with the oxygen saturation (r=-0,69; p=0,01).

A case of thoracic actinomycosis manifest as round shadow in the lung is described. Diagnosis was based on the presence of actinomycetes in a transthoracic lung biopsy sample. Treatment for 3 months resulted in recovery. No relapse was documented during 1 year follow-up period.

Проведено 3-летнее обсервационное проспективное исследование по оценке прогностической значимости показателей алкогольного анамнеза у 203 больных циррозом печени алкогольной этиологии. Группы умерших и выживших больных за одинаковые периоды наблюдения сравнивались по суточной дозе алкоголя, суммарной (за все годы) дозы принятого алкоголя и частотам (режимам) приема алкоголя. Статистически значимые отличия в сравниваемых группах получены только по показателям частоты приема алкоголя. Более частый режим приема алкоголя связан с повышенной летальностью цирроза печени. Это обусловлено трудностью определения суточной дозы алкоголя больными, которым легче вспомнить частоту употребления алкоголя, чем его количество. Наличие энцефалопатии (печеночной и алкогольной) у данной категории больных осложняет процесс определения суточной дозы употребляемого алкоголя и является основной причиной ограничения использования данного показателя при прогнозировании выживаемости больных алкогольным циррозом печени. По нашим данным, в клинической практике наиболее высокую значимость в прогнозе выживания больных алкогольным циррозом печени с признаками энцефалопатии (печеночной и алкогольной) имеет анамнестическое определение частоты приема алкоголя.

He results of the study of chemical elements (Ca, Sc, Cr, Fe, Co, Zn, Br, Rb, Ag, Ba, Sr, Nd, As, Au, La, Th, U, Hf, Cs, Tb, Ta, Sm, Eu, Yb, Lu) by instrumental neutron activation analysis of the blood of 109 patients with onset of sarcoidosis versus control (28 people) are presented in the article. In blood of patients with sarcoidosis was found low content of Sc, Fe, Co, Zn, Rb (p

Objective: to study influence of age and sex on the survival of patients with cirrhosis of viral and alcoholic etiology. For realization of the objective conducted cohort study with the inclusion of 249 patients with cirrhosis of viral (B, C, B+C), alcohol and mixed (alcohol+virus) etiology with the assessment of the ultimate solid point occurrence of death from cirrhosis or its complications. Age of patients from 17 to 75 years (Me=50 years), 114 men and 135 women. Observation period amounted to 47 months. For all the time of observation died 119 patients. It is established that the chances of dying in men with cirrhosis class C of Child-Pugh are 2.2 times higher than in women. Statistically significant differences began to be defined about 3 months of observation. This may be due to the best compensatory abilities of the female body. Because patients were at different stages of the disease for a correct estimation of the influence of age on survival was held stratification of patients according to the classes of Child-Pugh of cirrhosis and a correlation of age and the time prior to death studied within each class of cirrhosis. Not statistically significant effect of age of the patients with cirrhosis on survival.

Nowadays the problem of comorbidity of cardiac artery disease (CAD) and chronic obstructive pulmonary disease (COPD) is a complex, diverse and still poorly studied. Comparative analysis of the clinical features of acute myocardial infarction (AMI) in patients with COPD and without COPD has been performed in the study. It has shown that in patients with AMI diagnosis of COPD is exposed on the basis of the medical history, clinical course that is a complex of syndromes: bronchitic, bronchoobstructive and lung emphysema. It has been found that patients with COPD are more likely to have a history of attacks of angina pectoris, congestive heart failure and ischemic stroke; often the duration of the AMI complicated by cardiac arrhythmias, recurrent myocardial infarction, hospital and high annual mortality in comparison with the patients without COPD. On admission respiratory symptoms have been recorded not only in patients with COPD, but also in long-term smokers with AMI without COPD. In the treatment of acute myocardial infarction in patients with COPD β-blockers have been used in 74%, they have been canceled in 22% in the first 5 days of treatment of the main disease and in 17.4% due to the increase of bronchoobstructive syndrome. Major bronchodilator drugs for the treatment of COPD patients in acute myocardial infarction period were M-cholinolitics and combination (β2-agonist and glucocorticosteroid) drugs, the use of which has shown no adverse effect on the cardio vascular system.

In comparative, prospective, non-randomized cohort study the frequency of hospital relapse of infectious COPD exacerbation was evaluated in patients hospitalized with non-infectious exacerbation of the disease; typical spec-trum of sputum microflora for hospital exacerbations of COPD was defined. It was found that 57 % of patients hospitalized with non-infectious type of COPD exacerbations demonstrated relapse of infectious type exacerbation by 10–16 day of hospitalization in which initiation involved nosocomial microorganisms: Pseudomonas ae-ruginosa, Klebsiellapneumoniae (ESBl), Acinobacterboumonii, St. aureus (MRSA), Klebsiellaoxytoca (ESBL), E.coli (ESBL), Citrobactercoseri, Stenotrophomonasmaltophilia, Morganellamorganii. Multidrug-resistant mi-croorganisms in patients with hospital exacerbation of COPD were more common than in patients with commu-nity-acquired COPD exacerbation (45 % and 18 % respectively). The assigned antibiotic therapy for hospitalized patients with non-infectious exacerbation did not prevent the aggravation of hospital infection.

The article presents analysis of diagnostic problems in determining causes of shortness of breath associated with anxiety. By example of two clinical cases, authors elucidated typical diagnostic mistakes such as the effect of inappropriate early diagnostic focus and the negative effect of narrow specialization. The authors discussed possible origination of diagnostic problems in context of close neurophysiological links between cerebral structures involved in perception of shortness of breath and anxiety based on results of state of art brain imaging studies.

С целью изучения прогностической значимости уровня альфа-фетопротеина крови при циррозе печени проведено 3-летнее проспективное, когортное исследование с включением 107 больных циррозом печени вирусной (В, С, В + С), алкогольной и смешанной этиологии. За время наблюдения умерли 43 больных. Получено отсутствие статистически значимых различий уровня альфа-фетопротеина крови в группах умерших и выживших больных циррозом печени в периоды наблюдения от 1 до 36 месяцев. Также не получено статистически значимых различий уровня альфа-фетопротеина крови между группами больных циррозом печени различных этиологических вариантов, но одного класса по Чайлду-Пью. Методом анализа 95 % доверительных интервалов уровня альфа-фетопротеина между классами цирроза печени по Чайлду‒Пью определен пороговый уровень АФП (5,96 МЕ/л), превышение которого ассоциируется с развитием декомпенсации цирроза печени (чувствительность 0,58; специфичность 0,81). Не получено статистически значимых корреляций уровня альфа-фетопротеина с активностью индикаторных ферментов цитолиза − АсАТ и АлАТ, что позволяет сделать вывод о том, что повышение уровня альфа-фетопротеина в основном обусловлено стадией цирроза печени, а не его активностью.