Purpose: to develop an effective and affordable method for a practical doctor to predict the development of bacterial pneumonia in patients with influenza and other acute respiratory viral infections. Materials and methods: to develop a method for predicting bacterial pneumonia in patients with influenza and other acute respiratory viral infections, a continuous group of 247 patients was formed: 63 of them were diagnosed with bacterial pneumonia for 5-7 days of illness, and the remaining 184 had verified infectious diseases in uncomplicated form. Evaluation of the effectiveness of the proposed forecast method was performed on 150 patients with influenza and other acute respiratory viral infections. The technical basis of this study was the Extech 110 pH meter, with which the observed acidity of the skin of the lower third of the palmar surface of the forearm was studied on the 1-2, 3-4, 7-10 days of the disease. Results: the developed method for predicting bacterial pneumonia in patients with influenza and other acute respiratory viral infections is characterized by prostate use, as well as high rates of sensitivity, specificity and accuracy.Conclusions: the pH level of the skin of the palmar surface of the lower third of the forearm in patients with influenza and other acute respiratory viral infections of less than 4.80 is a statistically significant prognostic criterion for the development of this category of patients in the next 2-3 days of bacterial pneumonia.

The aim of the present study was to assess the effectiveness of standard medical therapy in lowering the risk of cardiovascular death in the remote period after myocardial revascularization (MR), taking into account the presence of renal dysfunction. Material and Methods: The study included 90 patients with coronary heart disease (CHD) and indications for revascularization. We evaluated a drug therapy obtained at different stages of revascularization, as well as the severity of patients' condition and the prevalence of renal dysfunction. Results: In the remote period after MR (5.8±0.05 years), 71/78.9% patients participated in the study; death occurred in 10/12.3% patients. The duration of therapy for chronic myocardial ischemia before MR (P=0.005), as well as compliance with prescribed therapy during 6 months (P=0.008) after this procedure, affected cardiovascular death in the remote period after MR. Using statins before MR reduced the risk of cardiovascular death by 17.2% (P=0.01), beta-blockers-14.95% (P=0.04), and ACE inhibitors (ACEIs)-15.75% (P=0.03). The lack of regular use of acetylsalicylic acid (ASA) for 6 months after RM was associated with an increase in the risk of cardiovascular death up to 36.2% (P=0.005). Statins and ACEIs are drugs that reduce the risk of cardiovascular death in the presence of renal dysfunction (P<0.05). Conclusion: An efficient drug regimen for patients after MR is important in reducing a long-term prognosis of cardiovascular death and for an efficient correction of coronary artery patency.

Aim. To assess the role of remodeling of small diameter kidney arteries in the prognosis of progression of tubulointerstitial fibrosis in patients with chronic glomerulonephritis.Material and methods. The study involved 97 patients with primary glomerulonephritis. The average age of patients was 37,27±1,2 years. The inclusion criterion was the presence of indications for renal biopsy. Renal biopsy was used to analyze renal tissue, in particular, for determining of tubulointerstitial fibrosis (TIF). Based on TIF sign, the patients were divided in 2 groups. The first group includes patients with TIF, the second — without TIF. Vasometry, a measurement of the renal arteries structures, was performed as part of renal biopsy. Parameters of internal and external diameters, wall thickness, intima, media, intima-media complex, vascular mass were analyzed.Results. The influence of the size of the inner and outer diameters of the interlobular artery (MA) on the studied risk was established. Probability of TIF developing increases with decreasing of MA inner diameter (χ2-criterion =5,34, p=0,02) and increasing of MA outer diameter (χ2-criterion =7,77, p=0,005). Intimal thickness does not have a statistically significant effect on the risk of TIF developing (p=0,29), whereas media thickness has a high statistical significance in renal tissue remodeling (χ2-criterion =13,71, p=0,0002). A statistically significant effect of an increase in the vascular mass on the risk of TIF was determined (χ2-criterion =6,55, p=0,01).Conclusion. We established that changes in the structure of small diameter kidney arteries in chronic glomerulonephritis occurs according to a hypertrophic type. Remodeling of small diameter kidney arteries plays significant role on the risk of TIF.

The aim of the present study was the integrated assessment of the role of non-traditional factors (inflammation, malnutrition, calcium-phosphorus disorder and imbalance in the concentration of inducers and inhibitors of calcification) in forming cardiovascular calcification (CVC) and the structural-functional rearrangement of LV myocardium in patients with chronic kidney disease (CKD) receiving hemodialysis (HD). Materials and Methods:The present study included 84 HD patients with CKD 5D stage. We evaluated 3 components of the Dialysis Malnutrition Score (DMS), according to which body mass index (BMI), the level of serum albumin, and the percent saturation of transferrin with iron were determined. We also analyzed CRP, fibrinogen, and beta-2 microglobulin, and calculated the number of points (from zero to 2) according to the Glasgow Prognostic Score (GPS), which allowed us to combine indicators of inflammation and make a common prognostic assessment.The serum levels of protein alpha-Klotho и FGF-23 were determined by enzyme immunoassay. Echocardiographic measurements were performed using B-mode, M-mode and Doppler-mode. Different patterns of LV geometry were identified according to Ganau et al. (1992). The severity of calcification was estimated by a semi-quantitative scale for assessing the degree of calcification of heart structures according to the National recommendations for CKD-MBD (2010).Results: The increased risk for development of CVC, LVH, and diastolic dysfunction was associated with markers of malnutrition, anemia, and inflammation in HD patients. Reduced serum alpha-Klotho level, hypoalbuminemia and a high level of FGF-23 had a prognostic value in CVC formation. (Int J Biomed. 2016;6(1):22-26.). Abbreviations CVD, cardiovascular disease; CKD, chronic kidney disease; LVH, left ventricular hypertrophy; IVST, interventricular septal thickness; LVPWT, left ventricular posterior wall thickness; LVMI, left ventricular mass index; CRP, C-reactive protein.

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