Our studies have shown that physical activity (bicycle ergometry) alters the biochemical status of male volunteers. We observed a significant decrease of glucose level and an increase in concentration of magnesium, phosphorus and especially of lactic acid in capillary blood after 5 min of bicycle ergometry start. Creatine phosphokinase activity and the concentration of triglycerides did not differ significantly from the original values. The tendency of changes in the examined parameters was the same in the supine and in the sitting positions. Therefore, biochemical investigations may complement essentially the physiological and neurophysiological tests of human adaptability to physical loads. The method of dry chemistry described in this study can be effectively used in a space flight as the rapid method for evaluation of biochemical parameters of the body.

Parameters reflecting oxidative stress (OS) have been studied in 37 patients with alcoholic liver disease (ALD) during admission to the hospital and 2 weeks after the beginning of therapy. The patients were divided into 3 groups: alcoholic hepatitis (AH), alcoholic cirrhosis with hepatic insufficiency (the group C by the Child-Paquet scale) and terminal stage patients (subsequently died). All patients were characterized by a significant increase in plasma products of lipid peroxidation (conjugated diene and malondialdehyde) and a decrease of the ceruloplasmin level. The coefficient C OS significantly exceeded normal values both on admission and after the 2-week course of traditional therapy. This suggests an important role of the OS with ALD.

The time course of changes in the serum levels of average mass molecules and malondialdehyde in patients with pelvic peritonitis was studied within two weeks after surgery. The values of the above indices of endogenous intoxication (EI) were found to be 1.3-2.9 times higher than the normal values almost throughout the follow-up (p < 0.05). An integral EI coefficient (EIC) including relative (as compared with the normal values) EI indices was proposed to evaluate the magnitude of EI. In patients with pelvic peritonitis, EIC was established to be 2.9-4.8 times greater than the normal values (p < 0.05) in all follow-up periods. Thus, the application of EIC enhances the sensitivity of EI diagnosis in patients with pelvic peritonitis as compared with that in the determination of individual EI indices.

The parameters of endogenous intoxication (EI) were studied in patients with purulent mediastinitis (PM). The integral index of E1--the coefficient C(EI) that included the relative indices (as to the normal values) of the total and effective concentrations of albumin, medium molecular-weight peptides, leukocytic intoxication index, and malonic dialdehyde, was developed. The values multiplied together are C(EI) and reflect the manifestation of EI. The level of EI in patients with PM was ascertained to be much increased on postoperative days 1 and 3. Extracorporeal hemocorrection (plasmapheresis, prolonged venovenous hemofiltration) used in complex therapy diminishes the degree of EI by several times, on day 10 after surgery in particular. The use of C(EI) is shown to considerably increase the diagnostic sensitivity of the early stage of EI, to prescribe adequate detoxifying therapy in time, and to evaluate its efficiency.

The paper deals with the determination of infusion therapy tactics in critically ill patients with intracranial hemorrhages on the basis of invasive measurements of systemic hemodynamics. The routine hemodynamic parameters (blood and central venous pressures, heart rate) are noted to fail to assess the volemic status of the patients in full. Unlike the use of colloidal solutions, infusion therapy with physiological sodium chloride is not shown to correct systemic hemodynamics. It has been ascertained that in acute intracranial hemorrhages, infusion therapy with crystalloidal solutions leads to impaired pulmonary gas exchange and increased pulmonary extravascular fluid and the use of a combination of crystalloidal solutions and a colloidal agent in a 1:1 ratio can correct the volemic status of the patients and is not followed by lung dysfunctions.

Acute purulent mediastinitis (APM) is one of the most difficult forms of surgical infection with severe clinical course and lethality from 17 to 80%. Overall 80 patients with APM were treated; plasmapheresis in postoperative period was used at 66 of them. The main criteria of negative prognosis at the patients with APM were elderly age, high score on APACHE-2, SAPS-2 and SOFA scales, higher level of creatinine and urea serum concentration, hyperglycemia, leucopenia. Early application of plasmapheresis was associated with lower lethality (12.5% at the group with early beginning of plasmapheresis, 35.3% at the group with late beginning, 36.2% at the control group). Plasmapheresis promotes normalization of hemostasis, microcirculation and immune parameters, reduction of intoxication and systemic inflammation syndrome.

The study included 44 patients who were divided into 3 groups according to the type of anesthesia. In group 1 patients (n = 15), initial anesthesia was accomplished by inhaled sevoflurane and intravenous fentanyl (2.5-3.5 microg/kg); basal anesthesia was performed with sevoflurane. In Group 2, midazolam, 0.1-0.15 mg/kg, fentanyl, 5.2 +/- 0.01 vg/kg, and ketamine, 0.85 +/- 0.13 mg/kg were given for induction. Basic anesthesia was carried out, by administering fentanyl in a dose of 4.71 +/- 0.4 microg/kg/hour, halothane, 0.5-1.5 ob %. In Group 3, midazolam, 1.2 +/- 0.01 mg/kg) and fentanyl, 7.8 +/- 0.6 microg/kg) were used to induce anesthesia. Basic anesthesia was effected with fentanyl, 5.31 +/- 0.5 microg/kg/hour, ketamine, and diprivan. Anesthetic management using halogen-containing inhalational anesthetics at coronary bypass surgery in patients at high anesthetic risk was ascertained to cause a significant reduction in the degree of manifestations of oxidative stress and facilitated a better intraoperative period. Sevorane was found to have the most significant effect on oxidative stress.

Objective: to study the effect of the antioxidant and cardioprotector mexicor on oxidative stress in patients with acute coronary circulatory disorders (ACCD) during perioperative direct myocardial revascularization. Subjects and methods. The study included 33 patients with ACCD who had undergone coronary bypass surgery. Two groups (a study group and a control one) were formed. Prior to surgery, all the patients received the maximum doses of antianginal and antihypertensive drugs. The study group patients additionally took mexicor. All patients were operated on under extracorporeal circulation and moderate hypothermia. Lipid peroxidation (LPO) indices were estimated via measurements of the serum levels of dienic conjugates, malonic dialdehyde, and the degree of serum lipid oxidability. The serum antioxidative system (AOS) was judged from the concentration of а-tocopherol and cerulo-plasmin. The oxidative stress coefficient K, an integral index, was calculated to evaluate LPO-AOS imbalance. Results. High oxidative stress was found to be detectable in patients with ACCD. Mexicor lowers oxidative stress, diminishes LPO-AOS imbalance, improves oxygen balance and cardiac contractility, and reduces the number of life-threatening cardiac arrhythmias. Conclusion. Mexicor diminishes oxidative stress in patients with ACCD in the perioperative period of coronary bypass surgery. Mexicor-induced stabilization of LPO positively affects better oxygen balance and cardiac contractility, thus reducing the number of perioperative complications. Key words: oxidative stress, dienic conjugates, malonic dialdehyde, а-tocopherol, ceruloplasmin, coronary bypass, acute coronary circulatory disorder, hemodynamics.

Objective: to determine the impact of the degree of oxidative stress on homeostatic parameters in critically ill patients with acute poisoning by psychotropic agents (PTA).Materials and methods. The components of lipid peroxidation (LPO) and the antioxidative system (AOS), blood rheological and immunological parameters, and the markers of endogenous intoxication were studied in 43 patients with severe acute PTA intoxication before and during intensive detoxification therapy.Results. The first hours of poisoning were marked by LPO-AOS imbalance with a significant preponderance of peroxidation processes, by impaired blood viscous properties, the manifestations of secondary immunodeficiency and endogenous intoxication. There were changes in the study parameters during detoxification therapy and at the early somatogenic stage of the disease.Conclusion. In patients with acute poisoning-induced critical conditions, the degree of oxidative stress affects the time course of homeostatic changes and determines the severity of endotoxicosis at all stages of the disease.

The study evaluates the efficacy of the body enteral detoxication method that is the gut lavage with enteral saline solution isotonic to the chyme as in the initial small intestine. The method was used in a complex therapy with destructive pancreatitis. The study has demonstrated that a procedure of the gut lavage included in a complex treatment of the patients with destructive pancreatitis is an effective option of the body detoxication providing the reduction of endotoxin release from the gut into the blood, eliminating the signs of bowel insufficiency, reducing the patients' length of stay in the Intensive Care Unit.

The parameters of endogenous intoxication (EI) were studied in patients with inflammatory small pelvic organs diseases complicated by organs pelviperitonitis and generalized peritonitis. The integral index of EI--endogenous intoxication coefficient (EIC) was developed, which included relative values (as to the normal values) of the total and effective concentration of albumin, medium molecular peptides and leukocytic intoxication index. The values multiplied together are EIC. In patients with inflammatory small pelvic organs diseases, the level of EI was shown to considerably increase. The use of EIC was ascertained to significantly increase the accuracy of diagnosis of early-stage EI, to perform detoxifying therapy, and monitor its efficiency, as confirmed by the use of sodium hypochlorite in the combined treatment of patients with inflammatory small pelvic organs diseases.

Mexicor (5% solution and capsules) was used in 40 of 80 conventionally treated patients with acute myocardial infarction. The drug was given intravenously for 5 days, than intramuscularly (6-9 mg/kg) for 9 days and orally (0.1 mg t.i.d.) thereafter until discharge. Severity of oxidative stress was evaluated by K coefficient. Calculation of this coefficient required data on degree of oxidation of lipids in blood serum, serum levels of diene conjugates, malonic dialdehyde, alpha-tocopherol and ceruloplasmin. These parameters as well as activity of superoxide dismutase, glutathione peroxidase and catalase in erythrocytes were measured at admission, on days 2, 3, 7, 14 and at discharge. Mexicor treated compared with untreated (n=40) patients were characterized by diminished severity of oxidative stress at the account of lower levels of lipid peroxidation products and augmented compensatory potential of the endogenous antioxidant system.

Aim . To study clinical efficacy of hypertensive crise (HC) complex therapy and prevention in patients with combination of essential arterial hypertension (EAH) and coronary heart disease (CHD), at hospital and posthospital levels. Complex management program included treatment with antioxidant-cytoprotector, Mexicor®, as well as 24-hour blood pressure monitoring (BPM), ECG monitoring, and various BP self-monitoring variants. Material and methods . In total, 157 patients with HC, EAH, and CHD, were examined. The participants were randomized into three groups: standard post-hospital follow-up (Group A, n=45); BP self-monitoring, without (Group B, n=54) or with (Group C, n=58) weekly telephone control by a doctor, and correction of therapy regimen, if necessary. At hospital and post-hospital levels, 20 patients from group B (sub-group B1), and 20 patients from group C (sub-group C1), were additionally administered antioxidant-cytoprotector. Post-hospital follow-up time varied from 1 month (uncomplicated HC) to 2-3 months (HC with cardiac complications). Treatment efficacy assessment included bi-functional 24-hour BPM and ECG monitoring at Day 1, Day 7-10, and Day 40-50 of the follow-up. Results . Among patients with HC and CHD, BP self-monitoring and dynamic medical control facilitated BP normalization (83.1%), and decrease in post-hospital incidence of pre-crise states or recurrent HC (5.2% and 1.7%), compared to standard post-hospital follow-up – 68.9%, 20.0%, and 11.1%, respectively. Adding to complex hospital and post-hospital management was associated with BP normalization, decrease in total cardiovascular event risk, and reduction in pre-crise state or recurrent HC incidence. Conclusion . Efficacy of HC treatment and prevention in patients with EAH and CHD was improved by posthospital BP self-monitoring and additional administration of antioxidant-cytoprotector.

Examinations of patients with acute oral poisoning by psychotropic agents have indicated that toxicohypoxic encephalopathy develops, when the high concentrations of toxicants and their active metabolites specifically affect brain structures, resulting in oxidative stress and impaired natural detoxification mechanisms.

Aim. To study clinical efficacy of hypertensive crise (HC) complex therapy and prevention in patients with combination of essential arterial hypertension (EAH) and coronary heart disease (CHD), at hospital and posthospital levels. Complex management program included treatment with antioxidant-cytoprotector, Mexicor®, as well as 24-hour blood pressure monitoring (BPM), ECG monitoring, and various BP self-monitoring variants. Material and methods. In total, 157 patients with HC, EAH, and CHD, were examined. The participants were randomized into three groups: standard post-hospital follow-up (Group A, n=45); BP self-monitoring, without (Group B, n=54) or with (Group C, n=58) weekly telephone control by a doctor, and correction of therapy regimen, if necessary. At hospital and post-hospital levels, 20 patients from group B (sub-group B1), and 20 patients from group C (sub-group C1), were additionally administered antioxidant-cytoprotector. Post-hospital follow-up time varied from 1 month (uncomplicated HC) to 2-3 months (HC with cardiac complications). Treatment efficacy assessment included bi-functional 24-hour BPM and ECG monitoring at Day 1, Day 7-10, and Day 40-50 of the follow-up. Results. Among patients with HC and CHD, BP self-monitoring and dynamic medical control facilitated BP normalization (83.1%), and decrease in post-hospital incidence of pre-crise states or recurrent HC (5.2% and 1.7%), compared to standard post-hospital follow-up – 68.9%, 20.0%, and 11.1%, respectively. Adding to complex hospital and post-hospital management was associated with BP normalization, decrease in total cardiovascular event risk, and reduction in pre-crise state or recurrent HC incidence. Conclusion. Efficacy of HC treatment and prevention in patients with EAH and CHD was improved by posthospital BP self-monitoring and additional administration of antioxidant-cytoprotector.

We have studied NO production, ACE activity and their correlation in pleural fluid of patients with and without lung wound, in the blood serum of the wounded and blood donors. Chest wound was associated with a significant elevation of NO levels in all study groups versus controls. The greatest increase of ACE activity was observed in pleural fluid of patients with a lung wound. There was a negative correlation between NO and ACE in pleural fluid of patients with a lung wound. In all the other groups, a positive correlation between NO and ACE was revealed. ACE overactivity in the pleural fluid may be one of the factors of impaired relationship between NO and ACE in lung wound. Determination of ACE activity in the pleural fluid may serve as a diagnostic criterion of the lung injury.