Bacterial overgrowth syndrome in the small intestine: pathogenesis, clinical significance and therapy tactics]

The redundant bacterial growth syndrome in the small intestine is associated with the increased total semination of over 10(5) CFU/ml presented by enterobacteria, bacteroids, clostridia, fusobacteria, etc. It is developed at the dysfunction of the gastrointestinal tract, insufficient bacteria inhibition at the time when they come from the large intestine (atony, stasis, bypasses) and is accompanied by the enhanced intestinal barrier permeability along with chronic diarrhea and intoxication. Intestinal absorption disorders cause B12-deficiency anemia, hypovitaminosis and protein deficiency. The redundant growth is diagnosed based on the hydrogen concentration in the expired air or bacterial inoculation of the small intestine aspirate. Tetracycline, Vancomycin, Metronidazole and aminoglycoside are used for the therapy; Amoxicillin/clavunate and cephalosporins of the second generation are also applied with success. Decontamination of the small intestine is more successful when probiotics are prescribed (both after antibiotics and independently), which suppress the opportunistic flora, protect the mucous coat, improve digestion and arrest diarrhea. Probifor or Bifidumbacterin forte in the complex with probiotics comprising lactobacteria can also have a therapeutic effect.     

Tumor necrosis factor in medicinal interferon preparations]

In response to virus induction a culture of donor leukocytes alongside with interferon (IF-alpha) produced a factor of tumor necrosis (TNF). The kinetics of TNF and IF-alpha biosynthesis did not depend on the kind of IF used for priming, was rapid, with maximum production within 7-8 hours. Antibodies to IF-alpha and IF-alpha had no effect on TNF production, while antibody to TNF did not reduce IF-alpha yields. TNF in detectable titres was present in medical preparations of native IF-alpha but was absent in preparations of recombinant IF-alpha and IF-alpha as well as in an injection preparation of IF purified by chemical methods.     

Cognitive and Emotional Disorders in Patients with Migraine and Signs of Leukoencephalopathy

Neuroscience and Behavioral Physiology - Objective. To identify cognitive and/or emotional impairments and their relationships with neuroimaging features in chronic migraine. Materials and methods....     

Relation between disorders of the rheological properties of the blood and the system of hemostasis in patients with ischemic heart disease

The paper gives evidence for relationship between blood rheologic parameters (erythrocyte aggregation, plasma and whole blood viscosity, hematocrit) and the hemostatic system. A correlation was found between the presence of high molecular fibrinogen and fibrin derivatives and the function of erythrocytes and platelets in patients with coronary heart disease.     

Review article: A primer for clinical researchers in the emergency department: Part VI. Measuring what matters: Core outcome sets in emergency medicine research

In this series we address important topics for clinicians who participate in research as part of their work in the ED. The overarching goal of clinical research is to improve care and determine which treatment is best. Yet, defining and measuring outcomes – what is ‘best’ – can be one of the most difficult steps in the design of a study, in particular when answers to research questions cannot be captured in simple binary results. This article addresses how to choose outcome measures and highlights the increasingly important concept of core outcome sets.     

Cerebral circulatory disorders in varying brain injury, as evidenced by transcranial Doppler study

The investigation was undertaken to elucidate the specific features of cerebral blood flow in acute brain injury (BI) in relation to its severity. Cerebral circulation (CC) was studied in 83 patients aged 5 to 64 years in the acute period of BI. The authors estimated the consciousness by the Glasgow coma scale and CC from the mean linear blood flow velocity (LBFV) in both middle cerebral arteries (MCA). To calculate the hemispheric index (HI), blood flow was examined in the extracranial portion of the ipsilateral internal carotid artery. The traumatic lesion substrate was verified by computed tomography and magnetic resonance imaging. Intracranial and cerebral perfusion pressures were continuously monitored in 39 patients. The outcomes of BI were assessed by means of the Glasgow outcome scale. In accordance with the values of LBFV, all the patients were divided into 3 groups: 1) patients in whom MCA LBFV throughout the acute period of BI remained within the range of normal or low values (30-70 cm/sec); 2) those in whom MCA LBFV ranged from 80 to 120 cm/sec at a HI of less than 3.0; 3) those with vasospasm in whom MCA LBFV was more than 120 cm/sec at a HI of more than 3.0. Analysis of the studies revealed that despite the same consciousness impairments, the magnitude of CC disorders was appropriate to the severity of brain lesions in all three groups. At the same time severe and mixed brain lesions as intracranial hematomas, type 3 contusion foci, and profuse subarachnoidal hemorrhages were attended by the development of unilateral or bilateral vasospasm of MCA. In addition, the low CC values mainly associated with prehospital overall cerebral hypoxia were ascertained to be a poor factor of the outcome of BI. The best results of treatment for BI are achieved in moderate CC disorders as a moderate LBFV increase.