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64 ISSNͲߠίȠ.2013.80..1..1 Difficult and controversial issue, according to the scientists, are congenital malformations. Statistical data of the Ministry of health of Ukraine show that in the post - Chernobyl period, the number of congenital malformations increased almost twice. Accordingly, the regions that suffered from radioactive contamination of people with the disease significantly more than in the relatively clean territories. It is proved that in the conditions of radiation accident with the environmental impact of radionuclides of iodine in the small doses of external irradiation also possible exposure of the fetus and the damage to his brain not only the most critical period of pregnancy (8-15 weeks), but in the later period. The most sensitive to irradiation of organs and systems of the human immune system, the suppression of which contributes to the increase of the risk of various diseases, as well as an increase in mortality from cardiovascular diseases and cancer.

Key words: Chernobyl disaster, health, disease, population, radioactive substances.

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I.V. Kochin, S.V. Gorpenko, D.O. Troshin, O.M. Akulova, P.I. Sidorenko, T.M.Gut, O.O. Gajvolya, V.M. Vasilenko, V.M. Ilina, I.F. Shilo THE METHODOLOGICAL BASIS FOR THE ORGANIZATION OF PHARMACEUTICAL CARE AFFECTEDIN EMERGENCY SITUATIONS 70 ISSNͲߠίȠ.2013.80..1..1 In the foci of emergency situations are formed extreme conditions that differ significantly from the daily activities of the State service of catastrophe medicine of Ukraine and bodies of drug supply. Furnished emergency situations is that, first, the specifics of the existing damaging factors, secondly, to mass health losses, and as a consequence, the disproportion between the demand for emergency medical aid, pharmaceutical assistance and the possibility of a timely manner in the optimal volume. Emergency situations require specific concerted action and the use of special forms and methods of management of Public service of catastrophe medicine of Ukraine and its pharmacological support. Experience the elimination of health consequences of emergency situations shows that medical personnel of the State service of catastrophe medicine of Ukraine and emergency medical care, involved in providing emergency medical care, in real emergencies sometimes discover confusion, lack of intelligence, allowing error organizational and medical. The reason for these shortcomings is the lack of clear management system of emergency medical care and pharmaceutical assistance in emergency situations. Development of science - based theoretical and methodological bases of medicinal maintenance in emergency situations, schemes of medicinal maintenance. Formula for the total need of medicines, as well as the total demand for medicines by all standards of medical emergencies.

Key words: pharmaceutical help, medical means, organization, emergency situation, Public service of medicine of accidents.

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I.V.Kochin, E.V.Khandoga, .. Gajvolya BIOLOGICAL DEFENCE AS CONSTITUENT OF BIOLOGICAL SAFETY OF UKRAINE IN COUNTERACTION BIOLOGICAL ASSASSINATIONS IN CONTROL SYSTEM BY GOVERNMENT SERVICE OF DISASTER MEDICINE OF UKRAINE In the last few years considerable political, social and economic changes took place in Ukraine, in the considerable scientific openings are the world done in industry of microbiology, biotechnology and molecular biology, the cases of terror took place with the use of biologically pathogenic agents, that is why questions, related to perfection of biodefence and biological safety, for control system Government service of disaster medicine of Ukraine are actual. In the article determination of concepts is given biosafety, biodefence and biothreat. Researches were conducted with the use of professional literary, historical, analytical methods and methods of theory of the systems. Grounded the modern state of the system of fight against biothreats in Ukraine and necessity of creation of the valuable system of defence, perfections of international cooperation, touching creation of the specially equipped central reviewer laboratories with the purpose of maintainance of collections pathogenic and especially pathogenic microorganisms. Biological agents are classified in relation to probability of their use as a biological weapon. The state of the special facilities of protecting is investigational from the most dangerous biological agents. A conclusion is done, that in Ukraine automatic facilities of exposure of biological agents absent in an environment, that stipulates impossibility reliably to protect society from the carefully planned biological attack. In conclusions the complex of measures is resulted on perfection of the system of medical counteraction bioterrorism in Ukraine.

Key words: biodefence, biothreat, biological safety, Government service of disaster medicine, control system, biological terrorism 616.12-008.331.1:618.173- .., .., .., .., .., .., .. 78 ISSNͲߠίȠ.2013.80..1..1 , . - , , .

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VI Koshlay, AS Kulbachuk, NT Ivachnenko, II Myronenko, N.Sosedkina, O.A. Marchenko, Y.A. Klitsunova ARTERIAL HYPERTENSIONIN POSTMENOPAUSAL WOMEN - A TACTIC FAMILY DOCTOR The estrogen deficit appears in the climacteric is one of the reasons of arterial hypertension. The nosotropic reasonable therapy of arterial hypertension contributes to reduction of cardiovascular risk from cardiovascular diseases among this contingent of women.

Control of hypertension in postmenopausal women - a key element to reduce cardiovascular risk. It is shown that achieving target blood pressure numbers such patients can reduce the risk of cardiovascular complications for more than 50%, which is significantly higher than in men of comparable age. In treating hypertension in postmenopausal women (including the metabolic syndrome, menopausal available) can be used all five basic classes of antihypertensive agents, but the most appropriate to select drugs with favorable effects on lipid and glycemic profile or at least metabolically neutral. Widespread use with ACE inhibitors are (quite possibly the use of quinapril - akkupro demonstrating sustained beneficial effects on endothelial function) and angiotensin receptor antagonists II. Also suitable calcium channel blockers (not causing reflex sympathetic hyperactivity: dihydropyridine drugs third generation, such as amlodipine - Norvasc very attractive fixed combination of amlodipine with atorvastatin - Caduet, as well as preparations of verapamil and diltiazem). Among the -adrenergic blockers (-AP) desired range of drugs with the highest cardioselective or the availability of additional 1-adrenoceptor blocking properties. The use of -AB is especially warranted in patients with coronary artery disease. Since -AB discussed in the category of patients to be used, as a rule, not as a single agent, but as a component of combination therapy, we must again emphasize the undesirability of a combination of verapamil and diltiazem (risk of conduction ISSNͲߠίȠ.2013.80..1..1 abnormalities). Among diuretics for long-term antihypertensive therapy in women with hypertension in postmenopausal women may be a viable option indapamide (especially his retard).

A special place in the combined antihypertensive therapy in postmenopausal women assigned to treatment with the central action of the new generation (MOX).

Along with distinct sympatholytic effects (favorable in terms of sympathetic hyperactivity inherent in postmenopausal women), the drug has a number of positive metabolic effects: it reduces insulin resistance and hyperinsulinemia, a positive effect on blood glucose profile.

Key words : postmenopause, arterial hypertension antihypertension preparations.


UDC: 616.12-008.331-1:612.141- V.I. Koshlia, O.O. Goloborodko Zaporizhzhya Medical Academy of Postgraduate Education, the Department of Family Medicine (the head Professor V.I. Koshlia), Zaporizhzhya.

CHANGES IN ENDOTHELIUM VASOMOTOR FUNCTION UNDER THE ACTION OF IVABRADINE AT IHD IN OPERATED ONCOLOGY WOMEN.

Key words: effort angina, Ivabradine.

Introduction. The problem in general and its connection with important scientific and practical tasks: the analysis of the literature suggests that the main cause of premature disability, disability and mortality of Ukrainian people is cardiovascular and oncological diseases [1,3]. IHD in operated oncology women specifies the necessity to find and improve treatment approaches. Endothelial dysfunction in IHD patients plays an important role in the regulation of procoagulant potential with a predisposition to thrombosis, vascular occlusion and atherosclerotic progression. The scientific research is closely connected with the planned research of the Department of Family Medicine of Zaporizhzhya Medical Academy of Postgraduate Education.

The analysis of recent researches.

Effort angina treatment in operated oncology women [4,7] is currently neglected [2], standard treatment regimens are prescribed, as a rule, without the consideration of changes in the endothelial function and blood flow indices in regional arteries.

The number of scientific works, aimed at active research of endothelium functional status in effort angina patients (EA) [8], defines the required permanent control not only over antianginal therapy effectiveness [5], but over vasoactive function as well [6].

86 ISSNͲߠίȠ.2013.80..1..1 However, today Ivabradine effect on endothelium vasomotor function is not enough studied resulting in the present study.

Study material and methods. The study of Ivabradine effect (Coraxan) was performed during the treatment of 28 operated oncology women with a stable effort angina (SEA) of (14 patients) and (14 patients) functional class. A group of healthy 20 women was examined for control purposes. Examination was performed prior to treatment and at the end of the treatment course. Ivabradine was for the patients of angina functional class in a daily dose of 5 mg 2 times a day, and for the patients of effort angina functional class in a daily dose 7.5 mg 2 times a day.

The treatment course lasted 3 months.

The study of brachial artery vasomotor function was carried out by scanning it with the definition of diameter and blood flow velocity before and after compression.

The material was processed by the analysis of variance on a personal computer in standard programs.

Study results and discussions. Studies have shown that prior to treatment, the brachial artery vasomotor function in healthy patients tended to reduce both brachial artery initial diameter (D) and the brachial artery diameter after a compression test (D1): control D - 3,90,1mm and D1 - 4,40,1mm;

SEA of functional class.: D - 3,70,1mm;

D1 - 4,20,1mm;

SEA of functional class.: D 3,50,1mm (0,01);

D1 - 3,90,1mm (0,001). The rate of blood flow in the brachial artery before its compression (V0) in healthy patients was 32,71,0 cm/sec, after compression (V1) - 91,34,1 cm/sec;

in patients with SEA of functional class: V0 30,82,0 cm/sec and V1 - 61,31,9 cm/sec (0,001), and in patients with SEA of functional class: V0 - 29,62,0 cm/sec and V1 - 43,22, cm/sec (0,001). The analysis of endothelium sensitivity factor to shear stress () shows its evident and progressive decrease with the increase of SEA functional class.

The treatment with Ivabradine at SEA and functional classes was accompanied by increase in Do and D1, that in patients with SEA of functional class made respectively 8,1% (4,00,1mm, 0,05) and 7,1% (4,50,1mm, 0,05), and in patients with SEA of functional class Do - 11,4% (3,90,1mm, 0,01), D1 - 7,7% (4,20,1mm, 0,05).

The study of changes in the blood flow rate of the brachial artery during the treatment have shown the increase in the specified indices in both groups of patients, namely in patients with SEA of functional class for V0 made 31,61,5 cm/sec and for V1 79,42,2 cm/sec (0,001), and in patients with SEA of functional class, respectively 30,11,8 cm/sec and 65,92,3 cm/sec (0,001). At the same time, the dynamic of endothelium sensitivity factor to shear stress explained the increased endothelium sensitivity (SEA of functional class - 0,0850,001, 0,001;

SEA of functional class 0,0760,002, 0,001).

The analysis also showed that in 28 cases of ischemic episodes ran with a predominance of sympathetic activity of the autonomic nervous system, in 12 cases, with a predominance of parasympathetic autonomic nervous system and in 25 cases without a clear predominance of one or another of the autonomic nervous system. In ISSNͲߠίȠ.2013.80..1..1 the process conducted by the treatment Ivabradine was noted a significant decrease in the total number of episodes of ischemic myocardium by 36,6% (p0,001) in patients with angina pectoris II functional students in the first group and 42,5% (p 0,001) in group 1-B. Patients with Other classes funktional of angina changes of these indicators, respectively, equaled 39,0% (p0,001) and 42,3% (p0,001).

Study of changes of end metabolites of nitrogen under the influence of treatment with ivabradine in cancer patients operated women testified normalization NOx in all groups, respectively: the first group 18,3% (p 0.01);

1-B group 39,9% (p 0.001), second group 31,7% (p 0.001), 2-B group 52,6% (p 0.001).

In analyzing the data, it should be noted that during the correlation analysis functional indicators vasoactive brachial artery function and systemic hemodynamics established direct high link between EF and Vcf and Vo (r = + 0,412;

r = + 0,479), as well as NOx - r = + 0,506 and r = + 0,375) and the inverse of ZPSO - r = - 0,386.

Episodes of ischemia study showed that in most cases with a predominance of sympathetic activity of the autonomic nervous system, in 12 cases, with a predominance of parasympathetic autonomic nervous system and in 25 cases without a clear predominance of one or another of the autonomic nervous system. In the process conducted by the treatment with Ivabradine noted a significant decrease in the total number of episodes of myocardial ischemia on 36,6% (p0,001) patients with angina pectoris II functional tional (p0,001) in group 1-B. students in the first group and 42,5% Patients with III funktsional class of angina changes of these indicators (p 0,001) and 42,3% respectively, equaled 39,0% (p 0,001).

In analyzing the impact of treatment on the prevalence of angina episodes sympathetic activity of the autonomic nervous system (LF component) was noted, which combined with Ivabradine number of episodes of ST segment depression for days in both groups as patients without additional surgery ovariectomy (p 0,001) and in patients who by 42,2% (p 0,001) and 39,3% (p 0,001) - respectively and conducted an additional operations ovariectomy 41,7% (p 0,001) and 40,6%, (p 0,001). However, as was noted that episodes of ischemia with a predominance of parasympathetic activity of the autonomic nervous system, also was marked influence of the applied treatment.

When analyzing changes in these indicators also was noted that in the context of treatment there was a significant reduction in the total duration of episodes of ST segment depression for days.

CONCLUSION The use of Ivabradine in treatment of operated oncology women with effort angina of and functional classes significantly improved endothelium vasomotor function in the brachial artery and explained the increased endothelium sensitivity to antianginal therapy.

Future research prospects. Future research prospects shall include the study of antianginal therapy effect on coronary angiogenesis factors.

88 ISSNͲߠίȠ.2013.80..1..1 REFERENCES 1. M.I. Lutay. Modern approaches of stable angina medical treatment /Ukrainian cardiology magazine.-2008.-3.-P. 32- 2. The attitude of primary care physicians to the problem of a secondary ischemic heart disease prevention (according to the results of a special survey)/ D. M. Aronov, N. M. Akhmedzhanov, O. Y. Sokolova et al. // Cardilology.-2006.-8.-P.14- 3. The results of an international study of life quality in patients with stable angine during the treatment with nitrates /Y.N. Belenkov, I.E. Chazova, L.G. Ratova et al.// Cardilology.-2003.-9.-P.18-24.

4. V.I. Tarutinov. Mammary gland: cancer and pre-malignant condition.-Kiev. 2006.-415p.

5. Anti-ischemic effects of ivabradin, a selective heart-rate reducing agent, in exercise-induced myocardial ischemia in pigs/Vilaine J.P., Bidouard J.P., Lesage L.

et al.//J. Cardiovascular Pharmacol.-2003.-V.42.-P.688-696.

6. Diaz A., Bourassa M.G., Guertin M-C. Long-term prognostic value of resting heart rate in patients with suspected of proven coronary artery disease.//Eur heart J. 2005.-V.26.-P.967-974.

7. Guidelines on the management of stable angina pectoris: executive summary:

The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology /Fox, K. et al.// Eur. Heart J. -2006.-V.27.-P.13411381.

8. Heart rate reduction during exercise-induced myocardial ischemia and stunning/Monnet X., Colin P., Ghaleh B. et al.//Eur Heart J. 2004.-V.25.-P.579-586.

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V.I.Koshlia, O..Goloborodko State Institution "Zaporozhye Medical Academy of Postgraduate Education Ministry of Health of Ukraine " CHANGE IN VASOMOTOR FUNCTIONS UNDER THE ACTION OF IVABRADINE AT IHD IN OPERATED NCOLOGY WOMEN Actual problems of modern oncology is optimized treatment of patients with stable angina II and III functional class that were who underwent surgery due to breast cancer, improving their quality of life and increase life expectancy.Breast cancer is the most common cancer in women taking in disease patterns.

Chemotherapy in addition to surgery and radiation therapy - one of the components to significantly reduce the mortality rate of patients. In the review the methods of diagnosis, current methods of treatment. On the basis of experimental and clinical studies discussed the possibility of using ivabradine in patients operated on oncological women with coronary artery disease.

Change in endothelial vasomotor function under the action of ivabradine in oncological patients operated on women with coronary artery disease.

Effect of ivabradine on endothelial vasomotor function was studied in 26 patients with stable angina, II and III, functional class which were who underwent surgery due to breast cancer. Studies have shown that treatment with ivabradine significantly improves endothelial vasomotor function of the brachial artery by increasing its diameter and increase the speed of blood flow. Learn the changes at the same level of end-metabolites of nitrogen under the influence of ivabradine in the treatment of cancer patients operated on women indicates the normalization of their levels in all groups. At the same time, and the correlation analysis confirmed the high accuracy of the data.

Key words: effort angina, Ivabradine.

UDC: 616.12-008.1:796.015-053. Alexandra ovalyova*, Olga Kovalyova ** Zaporozhian national university, Zaporozhye, Ukraine* Zaporozhian medical academy of postgraduate education, Zaporozhye, Ukraine** DISTINCTIONS IN ORIENTATION OF PULSE LOW-FREQUENCY ELECTRIC CURRENT INFLUENCE ON CARDIOVASCULAR SYSTEM FUNCTIONAL CONDITION AT TRAINED AND UNTRAINED PERSONS Key words: pulse low-frequency electric current, functional condition, trained young men, untrained young men, physical efficiency ISSNͲߠίȠ.2013.80..1..1 INTRODUCTION. The need for studying physiological mechanisms which underlie changes of human functional condition under the pulse low-frequency electric current (PLFEC) influence, estimation of an optimality of such changes and their specific orientation have been considered in a considerable number of studies [1-3]. Some studies attempted to study physiological mechanisms which define positive reactions of cardiovascular system, locomotor apparatus, external respiration system and other physiological characteristics of an organism to this exposure [4, 5].

The cumulated data enable their application in clinical practice and achieving positive medical effect [6-11].

However, studies of changes of organism functional condition following exposure to PLFEC are extremely insufficient. There are few data [4, 5], which were received in different conditions and on different tool base and which are not systematized. Absence of the unified approach to estimation of functional condition measurements in methodical and methodological maintenance of such studies restricts possibilities of the analysis and practical use of the practically obtained results. It particularly concerns the area of high level maintenance of general and special physical efficiency, and also estimation and correction of restoration stages after intensive physical activities in sportspeople at different stages of training process.

AIM. The aim of the study was to compare the characteristics of a pulse low frequency electric current influence on cardiovascular system functional condition in trained and untrained persons (17-24 years old) during the physical activity and restoration. The study included 56 healthy young men (23 trained and 33 untrained), who were divided into the main group (11 trained and 16 untrained persons) and control group (12 trained and 17 untrained persons).

MATERIALS AND METHODS. 56 healthy young men (17-24 years old) participated in research. The group of trained young men was presented by qualified sportsmen (n=23). Examined people have been divided into the main (n = 11 trained and 16 untrained persons) and control (n = 12 trained and 17 untrained persons) groups.

The study included two stages: the first stage the baseline functional condition was estimated in both groups;

the second the functional condition state reaction to repeated pulse low-frequency electric current during the physical activity was recorded.Indices of central blood circulation were defined by rheographic method.

The following measurements were taken: systolic arterial pressure (SAP, mm Hg), diastolic arterial pressure (DAP, mm Hg), heart rate (HR, bpm), systolic blood volume (SBV, ml), minute blood volume (MBV, ml/min), cardiac index (CI, l/m2), general peripheric vascular resistance (GPVR, dinscm-1). Reaction to physical activity was studied by PWC170 method through the use of bicycle ergometer. Also absolute (PWC170, kgm/min) and relative (rPWC170, kgm/min/kg) physical efficiency were assessed [12]. Diagnostics of heart rate variability included research of stress index (SI, s.u.), vegetative balance index (VBI, s.u.), index of centralization (IC, s.u.) [13]. The obtained results were processed statistically. Exposure to PLFEC was carried out by means of LEIT device according to a standard technique [14].

92 ISSNͲߠίȠ.2013.80..1..1 RESULTS AND DISCUSSION. The obtained data indicate uniformity of all studied groups according to initial anthropometrical and functional indices. Such uniformity, with high degree of a correctness, has allowed to estimate those changes which have been received as a result of the experiment.



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