[Primary (idiopathic) pulmonary hypertension (Ayerza-Arrillaga syndrome) and pregnancy - intensive care and anesthesia management].

The lecture deals with detailed information about the etiology, pathogenesis and clinical manifestations of primary (idiopathic) pulmonaiy hypertension, intensive treatment and anesthesia in pregnancy.

[Heparin-induced thrombocytopenia: theory and practice].

The article deals with detailed information about etiology, pathogenesis, clinical signs, prophylactics and treatment of a heparin-induced thrombocytopenia.

[Comparative assessment of prolonged femoral nerve blockade and epidural analgesia for postoperative pain in total knee joint arthroplasty].

The study deals with two mostly discussed techniques of postoperative analgesia for total knee joint arthroplasty. Surgeries were performed under subarachnoid anaesthesia with intravenous sedation. 9 patients of first group in received prolonged femoral nerve blockade as a component of multimodal analgesia.

[Dexmedetomidine use for postoperative adrenergic analgesia and sedation in abdominal surgery].

Comparative study of postoperative analgesia and sedation with trimeperidine and dexmedetomidine and their effects on haemodynamics and vegetative nervous system was performed. Assessment of analgesia and sedation during vagotonia (first part of the study) and hypokinetic type of haemodynamics (second part of the study) was carried out with visual analogue scale (VAS) and Richmond scale. Results of the study showed that dexmedetomidine is more effective and safer than trimeperidine for analgesia and sedation in patients with spontaneous breathing after abdominal surgery.

[Neuro-autonomic inhibition and haemodynamics management optimization during cesarean section under spinal anaesthesia in pregnant women with gestosis].

Results showed that autonomic nervous system (ANS) and blood circulation system (BCS) dysfunction in 3rd trimester pregnant women with gestosis are more pronounced, than in healthy pregnant women, despite the prescribed treatment. The most significant disturbances were vagotonia and hypokinetic haemodynamics type (often iatrogenic). Spinal anaesthesia (SA) during Cesarean section in pregnant women is accompanied by blood pressure decrease to the level demanding on vasopressors use.

[The autonomous nervous system and blood circulation system--homeostasis and homeokinesis during spine surgery].

In 30-surgical patients, operated for degenerative-dystrophic changes of the spine (microdiscectomy), with due regard for initial condition of the ANS (differentiated by Kerdo index), homeokinesis state has been studied. The circulatory system function was controlled with the use of a standard monitoring and central hemodynamics indices, that has allowed to mark out Hyper-and Hypo - eukinetic circulation types. Microdiscectomy performed under combined anesthesia (N2O/ O2 - 0.

[Anaesthesia in abdominal delivery in pregnant patients with hypertension].

A differentiated administration of calcium antagonists in preoperative preparation of pregnant patients with hypertension enabled the conversion of circulatory system state to "normal pregnancy range": a conversion of hypokinetic (including the HES solution infusion) and hyperkinetic types of haemodynamics to eukinetic one, with the decrease of total peripheral resistance and myocardium need for oxygen, autonomous nervous system state to physiological sympathicotonia. Evidence shows that continued intra-operative treatment including tranexamic acid enables to maintain those results during the surgery. In postoperational period, the clinical manifestations of SIRS in patients who has received the mentioned therapy were marked less then in control group, and the newborns have a higher Apgar score.

[Optimization of the neuroautonomic inhibition and regulation of hemodynamics during subarachnoid anesthesia in abdominal delivery].

Pregnancy is considered in the spotlight of creation of general adaptation syndrome. It was revealed that 85% and 58% of healthy non-pregnant women had an inadequate autonomous nervous system (ANS) and circulatory system response respectively. This favoured the labour activity malfunction in 20% of women in childbirth when an abdominal delivery was needed.

[Preoperative preparation of pregnant with hypertension according to state of the autonomic nervous system and circulatory system].

Pregnancy in patients with hypertension is considered in the spotlight of creation of general adaptation syndrome. According to evidence, when a stable hypertension in pregnant patients with hyper- and eukinetic types of haemodynamics is observed, the response of circulatory system and body fluid compartments has a moderate difference with normal. In pregnant patients with hypertension and a hypokinetic type of haemodynamics and pregnant patients with gestosis developed against the background of eukinetic type of hypertension, a physiological decrease of total peripheral resistance (TPR) is absent, which contributes into interstitial hyperhydration.

[Difficult tracheal intubation: comparative assessment of the value of prognostic indices in using Macintosh and Truview laryngoscopes].

The paper describes the experience in using three predictive criteria, such as Mallampati test, Patila test, and ULBT test, to evaluate tracheal intubation and compares their predictive validity. The experience in applying Macintosh and Truview laryngoscopes to patients with predicted difficult tracheal intubation (DTI) is also depicted. A combination of three above predictive procedures is a reliable predictor of DTI (r = 0.

[Mathematical modeling of kinetics of the tegumental-socket gastric epithelium].

With the aim of formalization of gastric epithelium kinetics estimation the morphometric analysis of gastric mucosa bioptates was performed in 26 patients without endoscopic signs of stomach pathology. During step estimation of gastric pits at different depth authors analyzed changes of cells size, nucleocytoplasmic ratio, coefficient of nucleus elongation in immature cells of pit bottom (11 zone), differentiating cells in pit intermediate zone (L2), and on mucosa surface (L3 zone). Authors used claster and neuronet analysis (by Statistica and MedStat) to make the mathematical model which permit to determine the proportion of functional zones in normal pit (L--33 +/- 3%; L2--27 +/- 3%; L1--40 +/- 3% of gastric pit depth) and to develop the system of cell standards for each zone.

Correlation between the prevalence of type 1 diabetes with the daily insulin dose and the autoimmune process against glutamic acid decarboxylase in adults.

In this study, we compared the rate of insulin requirement among adults with type 1 diabetes (T1D) in 24 Ukrainian regions. The glutamic acid decaroxylase 65 antibody (GADA), insulin antibody (IA), and plasma c-peptide levels were investigated. The data included the prevalent cases of T1D in Ukraine at the end of 2006.

[Calcium antagonists in the preoperative preparation of pregnant women with gestosis].

Differential preoperative preparation of pregnant women with gestosis, which is aimed at eliminating dysfunction of the universal secondary calcium messenger and preventing further disorders caused by calcium antagonists, is accompanied by positive changes in the basic links of development of the general adaptation syndrome--the autonomic nervous and cardiovascular systems. A physiologically required reduction in total peripheral vascular resistance (TPVE) is achieved in pregnant women with hyper- and eukinetic hemodynamics. In pregnant women with hypokinetic type, who receive hydroxyethyl starch-130/04 solution in the infusion therapy protocol, there is elimination of its pathological increase and there is a tendency for its physiological reduction.

[Pregnancy in the context of general adaptation syndrome].

Based on their own findings and the data available in the literature on pregnancy including that complicated by gestosis, the authors consider these conditions in the context of Selye's general adaptation syndrome. They identify its basic links (the autonomic nervous and cardiovascular systems) the function of which is affected by all the physiological and pathophysiological processes involved in its development. There is a high likelihood of baseline impaired adaption processes in these links, which may lead to an inability to accommodate (dysadaptation) by the moment of delivery.

[Optimization of anesthetic service during abdominal delivery of pregnant women with gestosis].

Differential preoperative preparation of pregnant women with gestosis, by using calcium antagonists is an effective preventive measure against a circulatory hyperdynamic response to transportation to the operating suite. In pregnant women who had all hemodynamic types at baseline, the eukinetic type achieved during the preparation is retained. The patients with gestosis who did not receive calcium antagonists were found to have a circulatory hyperdynamic response with increased myocardial oxygen uptake (during surgery in particular).

[Hemodynamics, the autonomic nervous system and water metabolism as criteria for developing the general adaptation syndrome in pregnant women].

By taking into account the fact that the autonomic nervous and cardiovascular systems (ANS and CVS) are the major links of development of the general adaptation syndrome in pregnancy, which are affected by all the processes involved in the development of the syndrome, the author analyzed the state of these systems in healthy non-pregnant and pregnant women (HNPW and HPW) and in pregnant women with gestosis. HNPW were found to have already a prerequisite for impairing pregnancy adaptive processes as ANS and CVS dysfunction. In HPW, these impairments were more pronounced.

[Experimental investigations of the analgesic activity of fentanyl and the non-opiodal agents -clonidine and isradipine, and protease inhibitors].

The analgesic activity of clonidine, isradipine, antagosane (aprotinine), transamine, and their combinations with fentanyl in subanalgesic doses was experimentally studied on mice, by using the tail-flick test. Analgesic activity was found in clonidine, antagosane, and transamine. A combination of fentanyl used in subanalgesic doses and clonidine, isradipine, antagosane, or transamine had supertotal analgesic activity.

[Role of seasonal factors in pre- and postnatal ontogenesis for etiology of type 1 diabetes mellitus].

Type 1 diabetes mellitus is a chronic disease characterized by autoimmune degradation of insulin-producing beta-cells. It was shown in a number of epidemiological studies of seasonality of birth in children with type 1 diabetes that the autoimmune process began during fetal and postnatal development. No such studies were carried out in the former Soviet Union countries.

[General anesthesia components during abdominal surgeries in patients with abdominal sepsis].

Results of optimization of general anesthesia during abdominal surgeries in patients with abdominal sepsis are analyzed. Inhibitors of proteases (transamin and antagozan) were used as non-opiate component in transduction stage. Central hemodynamics, gaseous metabolism and heart rate were analyzed in two groups of patients: group 1 -- anesthesia was carried out with inhibitors of proteases (32 patients), group 2 -- without it (30 patients).

[Incidence of proliferative retinopathy and sex-related differences in death rate among patients with diabetes mellitus and sight impairment treated with insulin (according to the data from national diabetic registry)].

The article presents the analysis of the occurrence of diabetes mellitus-linked sight impairment and proliferative retinopathy after data of National Diabetes Population Register among patients receiving insulin therapy. The number of women with above mentioned impairments has been found to prevail significantly over that of men. This tendency is also observed among the patients aged to 50 y.