No abstract

Perfusion scintigraphy of the myocardium was carried out with the help of the Millennium MG gamma camera (USA) in synchronization with the ECG in 141 patients aged of from 5 to 15 years. Patients were divided into four groups: 30 chronic myocarditis (CM) patients, 30 hypertrophic cardiomyopathy (HCMP) patients, 30 dilated cardiomyopathy (DCMP) cases and 21noncompact cardiomyopathy (NCMP) patients. The left ventricular (LV) ejection fraction was established to be preserved in CM and HCMC patients (in cases without signs of obstruction), a significant reduction in the ejection fraction was found in NKMP and DCMP patients. The thickness of the myocardium of the LV significantly increased only in HCM patients. The expansion of the LV cavity was detected in all patients, but its decrease was present only in HCM cases. The contractility of the myocardium was impaired in all the patients examined. Disturbances of the myocardial perfusion were the most pronounced in NKMP and DCMP patients. Signs of fibrosis were detected in most patients, but HCM patients. In 40% of CM patients, scintigraphic signs of inflammation were determined. In 17% of all examinations there was noted hyperperfusion of the right ventricular myocardium. The authors believe myocardial tomoscintigraphy to be the unique method for analyzing myocardial viability in various forms of cardiac pathology that can be used for the evaluation of the effectiveness of the treatment.

Possibilities of legal regulation of cyber bullying are considered in modern conditions. Aggressive behavior in the Internet space is gaining momentum in its distribution among adolescents not only in Russia but throughout the world. Cyber bullying is one of the newest, most dangerous, and also depressing emotional states of a teenager in terms of the consequences of the risk they face. The concept of “cyber bullying” is considered; its forms are specified; proposals aimed at neutralizing the bullying that occurs among adolescents in the Internet space are formulated.

Summary. Goal. Investigation of the interactions of coagulation, anticoagulant and fibrinolytic systems with factors of immunoresistance in hepatosplenomegaly syndrome (SHSM). Materials and methods. Materials — сells and blood serum of 58 patients with SHSM against the background of liver cirrhosis complicated by portal hypertension, with the etiological factor — HCV / HBV virus infection (group I, 22 people) and the etiological factor — CMV / VEB virus infection (group II, 36 people), who were admitted to the hospital for bleeding from esophageal varicose veins. Methods - photometric on a biochemical analyzer Stat Fax 1904 Plus (USA). (C3 and C4 components of complement, antithrombin III and plasminogen, concentration of circulating immune complexes (CIC), determination of the coagulation time of venous blood Lee-White, calculation of the prothrombin index, fibrinogen content by the Rutberg gravimetric method. Protein C activity (PrS) by the clotting method on a coagulometer K 3002 Spectramed (Poland). Peripheral blood platelet counts were performed using immersion microscopy according to the Fonio method. Results. Multidirectional changes in the functions of the hemostasis system were revealed: a decrease in antithrombin III activity, protein C content, fibrinogen concentration, a decrease in plasminogen activity, a decrease in platelet counts, an increase in platelet antibodies, an increase in the concentration of the C3 component and a decrease in the C4 component of complement. Conclusions. Hemorrhagic and thrombotic complications of HCV, life-threatening and affecting the tactics and results of surgical and minimally invasive treatment, can occur both in the HCV group on the background of HBV/HCV viral hepatitis, and in the HCV group on the background of herpes virus CMV/VEB infection, but in group I both hemorrhagic and thrombotic complications were dominated by plasma risk factors for and in group II - platelet and immunological (complement component C3) risk factors for hemorrhagic complications, plasma factors of thrombotic complications.

Summary. Purpose: to identify the features of lipid metabolism in patients with hepatosplenomegaly syndrome (HSS) of various origins to develop an individualized approach to the treatment of patients with this pathology. Materials and methods: blood serum of 73 patients with HSS on the background of liver cirrhosis complicated by portal hypertension, divided into 3 groups 1) with the etiological factor of hepatitis viruses HCV / HBV, 2) with autoimmune hepatitis with the etiological factor of the herpes group viruses CMV / VEB, 3) against the background of liver hepatosis and fermentopathies. Results and its discussion. In patients with HSS, multidirectional changes in the synthesis of lipid fractions were observed, also associated with impaired protein metabolism, namely: - with HSS against the background of viral hepatitis B and C, hypocholesterolemia and hypobetacholesterolemia were observed due to a decrease in cholesterol synthesis in hepatocytes; a decrease in the concentration of HDL is also associated with a violation of the process of cholesterol esterification due to a deficiency of the enzyme lecithin cholesterol acyltransferase, and an increase in the concentration of LDL is associated with a deficiency of the enzyme lipoprotein lipase in viral damage to hepatocytes. - with HSS against the background of autoimmune hepatitis, no significant changes were observed in the synthesis of lipid fractions; - in hepatosis (fermentopathies), type 5 hyperlipidemia with hypercholesterolemia and hypotriglyceridemia was found, which are a consequence of impaired formation and excretion of lipids from the liver, probably as a result of a decrease in the synthesis of apoproteins and indicate the accumulation of fat in hepatocytes and the formation of hepatosis. Conclusion: Surgical or endovascular treatment of HSS against the background of liver cirrhosis or hepatosis needs to be supplemented with individualized metabolic drug therapy, including lipid-lowering therapy. When detecting hypocholesterolemia and hypobetacholesterolemia in the first group, lipid-lowering therapy is not indicated, whereas if type 5 hyperlipidemia with hypercholesterolemia and hypotriglyceridemia is detected in the group of patients with fatty hepatosis, lipid-lowering therapy is necessary.