The aim: Is to determine the tactics and methods of treatment of bezoars of the gastrointestinal tract. Materials and methods: From 2001 to 2019, 17 patients were diagnosed with “bezoar”. Results: Due to the “weariness” of the clinic, the diagnosis was made in the first 3 days only for 3 (17,6 %) patients. On the basis of the obtained average pH values for 4 (23,5 %) patients established moderate hypoacid, for 4 (23,5 %) - pronounced hypoacid, for 6 (35,3 %) - anacid. For 5 (29,4 %) patients, the bezoars were withdrawn on the first attempt, while the other 5 (29,4 %) were “lumped”. In the course of fibrogastroscopic examination, all patients were diagnosed with impaired motor-evacuation function of the stomach: gastroesophageal and duodenogastric refluxes, presence of passive discharge of the contents of the stomach into the esophagus. Conclusions: Therefore, the preconditions for the development of bezoars may be: hypo- and anacid, impaired motor-evacuation function of the stomach, chronic gastric ulcer,cognitive impairment. Endoscopic method should be preferred in the treatment, on condition of its failure - laparoscopic gastrotomy with bezoar extraction.

Introduction: Cardiac arrhythmia often occurs in the gestational period of pregnant women, contributing to the development of complications of pregnancy, childbirth and perinatal pathology, which requires a more thorough examination of pregnant women and antiarrhythmic treatment, which in turn increases the risk of complications pregnancy and childbirth. Many types of arrhythmias occur in women without structural damage to the cardiovascular system. The aim is to study the occurrence of cardiac rhythm disturbances in healthy pregnant women, depending on the gestational age, the number of previous pregnancies, infectious diseases during pregnancy, and arrhythmia analysis, which required antiarrhythmic treatment. Materials and methods: Retrospectively 60 individual cards of pregnant women were studied. An ECG monitoring was performed to identify the arrhythmia. Results: Among the arrhythmia were: supraventricular and ventricular extrasystoles, unstable paroxysmal tachycardia. All cases of arrhythmia were without lengthening QT interval. Sinus tachycardia was significantly more common in combination with anemia. Heart rhythm disorders are associated with emotional excitement. Conclusions: Most violations of the heart rate occurred in the second trimester of pregnancy. With concomitant anemia, sinus tachycardia is significantly more common, and sinus bradycardia is associated with an enlarged uterus in compression of the inferior vena cava. With the increase in the number of pregnancies, the risk of heart rhythm disturbances increases. However, the past infectious diseases of the bronchopulmonary system during pregnancy did not significantly affect the occurrence of rhythm disturbances. The appointment of antiarrhythmic drugs was observed in all pregnant women whose cards were included in the study.

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The purpose of the study is to study the possible role of vasodilation factors in the pathogenesis of chronic heart failure (CHF) in persistent atrial fibrillation (AF) in patients with stable coronary heart disease. Materials and methods. A survey of 86 patients with stable coronary heart disease complicated by CHF II-III FC according to the NYHA classification. There was 1 group - 22 patients with CHF with reduced LV EF ≤ 40.0% and AF; I (comparative group) - 20 patients with CHF with reduced LV EF without AF; 2-nd group - 24 patients with preserved LV EF ≥ 40.1% and AF and II (comparative group) - 20 patients with CHF with preserved LV EF without AF. The content of endothelial nitric oxide synthase (eNOS), nitrites (NO2-) and nitrates (NO3-) was determined. All patients underwent electrocardiographic examination (ECG) for the initial screening of arrhythmias and conduction, diagnosis of focal changes in the ventricular myocardium. Structural and hemodynamic characteristics of the heart muscle were determined by echocardiography.Results. In the examined patients of the 1st group with CHF of ischemic origin and reduced LV EF ≤ 40.0% and AF in comparison with the 2nd group of patients with CHF with preserved LV EF and AF, a significant increase in the values of ICO, ICD, IMML, the size of LA and a decrease in LV EF (p <0.01), indicating the development of LVH (remodeling) and a decrease in isotropic heart function. When comparing the levels of vasodilation factors in patients with CHF with low LV EF and AF and data from the CHF comparison group without AF, a significant decrease in eNOS by 96.8% (almost twice) and a significant decrease in serum nitrite and nitrate levels (p < 0.01), indicating the development of endothelial dysfunction. Conclusions. In patients with CHF of ischemic origin in the development of persistent forms of AF pathogenetic role is played by a significant decrease in vasodilating factors (content of eNOS, nitrites and nitrates). At decrease in EF of LV ≤ 40,0% there is a significant decrease in vasodilating factors, as a result of disturbance of endothelial function that testifies to need of correction of the revealed changes directed on slowing down of disease progression.

Цель работы -на основании данных научной литературы проанализировать последние научные исследования для возможности прогнозирования развития электрической нестабильности миокарда.