ПЕРФУЗІЙНА ДИСФУНКЦІЯ ПРИ ГОСТРОМУ ПАНКРЕАТИТІ: ПЕРСПЕКТИВНІ НАПРЯМКИ УДОСКОНАЛЕННЯ ДІАГНОСТИКИ ТА СТРАТИФІКАЦІЇ ЗАХВОРЮВАННЯ

Introduction. Acute pancreatitis (AP) is one of the most common diseases of the digestive system that require hospitalization. To date, the problem of stratification and differential diagnosis of AP in the early stages remains unresolved, which encourages the search for new methods of diagnosis and prediction of the severity of AP. Aim. To evaluate the possibility of creating a clinically oriented system of stratification and prognosis of AP on the basis of dynamic changes in microcirculation depending on the duration of the disease and severity of AP. Materials and methods. Assessment of the state of microcirculation (MC) of patients by laser Doppler flowmetry (LDF) was performed with the “LAKK-02” device. Kruskal-Wallis non-parametric analysis of variance and the median test were used to test statistical hypotheses when comparing independent samples. Pairwise comparison of independent samples was performed using the Mann-Whitney U test. Results. The study determined the indicators of MC in patients with different AP severity degrees on the first day of the disease. The microcirculation parameter (MP) in patients with mild, moderate, and severe AP was 3.9; 3.8 and 6.8 perfusion units (p.u.), respectively. The blood flow modulation rate (ơ) was 0.52; 0.54 and 0.69 p.u. in mild, moderate, and severe AP. In our study, the coefficient of variation (Kv) averaged 17.3%; 20.0% and 11.7% in patients with mild, moderate, and severe AP, respectively. Conclusions. LDF in AP is an informative method of diagnosing the state of MC, which is a universal link in all pathophysiological reactions of the organism. Changes of MC in AP depend on the severity of AP and the period of the disease. The pathophysiological microcirculatory phenomena, revealed on the first day of the disease, provide us with the perspectives of early clinical distinguishing the moderate and severe forms of AP from the so-called group of “destructive forms”.

Age peculiarities of the cardiovascular system and blood microcirculation in students under the influence of dosed physical training

We investigated the adaptive capabilities of the cardiovascular system and blood microcirculation in 18–21-year-old students under the influence of dosed physical training. It was shown that there are significant age-related differences in the indicators of the cardiovascular system function at rest. By the 21-th year the majority of the studied parameters have reached the level characteristic of adult young men. After dosed physical training the indices of the cardiovascular system function increased to a greater or lesser extent, and the greatest increase was observed in 21-year-old students. In younger age groups the changes were less effective, which characterizes the adaptive capabilities of the cardiovascular system depending on age. A marker indicator of the blood microcirculation system functioning — a microcirculation parameter that determines the direction of the microcirculation response to a dosed physical training — has been identified. It was found that among students of the 1st subgroup (low level of the microcirculation parameter) after physical activity it increased, and among students of the 2nd subgroup (high level of the microcirculation parameter) it mainly decreased, which characterizes the inclusion of various regulatory mechanisms in the blood microcirculation system. A decrease in the index of microcirculation efficiency under the influence of physical training was shown (the most significant in younger students). Such features can be explained by the lack of development of compensatory reactions in the microcirculation system.

Features of blood`s microcirculation at physical loads

This research deals with the study of blood microcirculation peculiarities.Materials and methods. 72 students of Bogdan Khmelnytsky Melitopol State Pedagogical University, aged 18–19, were examined. The experimental research consisted of the study of blood microcirculation functional state by means of Laser Doppler flowmetry (LDF) method. It helped to evaluate the state of tissue blood-circulation and to detect individual-typological peculiarities of blood microcirculation under the influence of physical activity (before and after exercise).Results. Three types of blood microcirculation were identified by using LDF-metry. The normoemic type of blood microcirculation, characterized by the superposition of oscillatory rhythms and reflected the balance of the mechanisms of regulation of microcirculation. The hyperemic type, characterized by a «monotonous» LDF-gram with a high parameter of microcirculation, which reflects the relative predominance of metabolic mechanisms in the regulation of microcirculation. The hypoemic type, characterized by a «monotonous» LDF-gram with a low parameter of the microcirculation parameter, which reflects the decrease of vasomotor mechanisms in the regulation of microcirculation. According to the LDF-metric data, the examined students under intensive physical activity have a significant increase in microcirculatory status: by 6 % of the microcirculation parameter, by 28 % of the mean square deviation and by 45 % of the initial value of the coefficient of variation.Conclusions. This dynamics of microcirculation shows that under the influence of physical exertion, a person creates significant functional reserves for the redistribution of blood flow and for more perfect intraorgan capillary blood flow. It was found, that in the process of physical activity, morpho-functional rearrangements of the human cardiovascular system occur. This reaction is formed by several components of blood microcirculation: blood flow in the transport direction, regulating blood supply in accordance with the needs of tissues and the exchange component of the histochemical barrier

Assessment of the effectiveness of physiotherapeutic methods for management of early menopause disorders

Objective. Assessment of the effectiveness of pelotherapy in combination with phytoaromatic baths in women during menopause transition. Patients and methods. We examined 26 women aged 52 ± 2.4 years. All women with vegetative-vascular manifestations of the climacteric syndrome were randomly assigned to 2 groups for comparison: group 1 – 12 patients, who received full-body “rapa” baths, inhalation phytoaromatherapy with a complex composition including phytoestrogens; group 2 – 14 patients, who received pelotherapy with applications of Saki lake mud on the «panty» zone and hydrodynamic phytoaromatic baths with a complex composition including phytoestrogens. Results. After therapy, a significant improvement of the parameters of climacteric disorders was noted in group 2. Severe disorders were practically absent in the second group – 2% (65 ± 6.1 scores), whereas mild changes prevailed – 64% (18 ± 5.3 scores). Changes in the microcirculation parameter were found, which increased by 19%, an increased contribution of endothelial oscillations to the total flux motion level, an increase of the amplitude of neurogenic and myogenic oscillations, a decrease of respiratory rates on average from 9.2 to 5.51 perf. units. In the first group, no significant changes were recorded. Conclusion. The use of pelotherapy in combination with hydrodynamic phytoaromatic baths permits to improve the parameters of microcirculation, venous and lymph output, trophism and oxygenation of tissues, and also ensures an adaptogenic effect. Key words: balneothaerpy, menopause transition, pelotherapy, rehabilitation

Changes of microcirculation in rats detected by laser Doppler flowmetry at physical load accompanied by the development of thrombotic readiness

Introduction. A considerable physical load can lead to the damage of various organs and systems including the system of the microcirculatory bloodstream. Materials and methods. The experimental groups of animals were exposed to 4-hour and 8-hour physical load. The state of the microcirculatory bloodstream was examined by means of laser Doppler flowmetry. Results. 4-hour physical load did not cause any reduction of the microcirculation parameter in rats. 8-hour physical load led to a decrease of the microcirculation parameter and further reduction of flux parameter. Conclusions. Such changes of microcirculation parameters can be one of the symptoms of development of the state of thrombotic readiness and high risk of thrombosis in rats after 8-hour physical load.

Features of the Dynamics of Infected and Septic Wounds Microcirculation in Children

Treatment of infected and septic wounds remains one of the most important problems of pediatric surgery. According to the authors, the wound process monitoring affects the treatment outcome not less than operative technique.The objective of the research was to examine the dynamics of microcirculation of the infected and septic wounds in children.Materials and methods. The analysis of the study of infected and septic wounds microcirculation in 178 children was performed. Blood flow laser analyzer (“LAKК-02” RPE “Lazma”, Russia) was used to study the blood flow in the wound area. Monitoring of wound healing process dynamics was conducted by studying the wound healing cytogram.Results. On the first day the average parameter of microcirculation was markedly increased in the area of wound edges in comparison with the contralateral area. The subsequent study of a blood flow during 5 days showed that average value of microcirculation parameter in the wound area decreased by more than 2 times in comparison with the figures on the first day. Microcirculation parameters of in the wound area further decreased.Conclusions. Dynamics of microcirculation changes in wound healing process significantly corresponds to cytogram of impression smears obtained from infected and septic wounds in children. Laser Doppler flowmetry is an effective method microcirculation control and minimally invasive diagnostic method of wound healing process.