Vestnik Rossiĭskoĭ akademii meditsinskikh nauk / Rossiĭskaia akademiia meditsinskikh nauk
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Vestn. Akad. Med. Nauk SSSR · Jan 2016
Review[Methods of Molecular Transfusion in the Intensive Therapy of Critical States].
Development of extracorporeal blood purification acquires greater significance in the intensive care of multiple organ failures (MOF) with all the pathophysiological aspects of its constituent parts. MOF are the main cause of mortality among critically ill patients and treatment of these patients require significant investment. The purpose of the implementation of extracorporeal blood correction techniques today is multiple organ support therapy (MOST). ⋯ MOST includes diffusion, convection, filtration, sorption, apheresis methodic. They affect the molecular and electrolyte composition of blood, allow to correct, repair, replace, and maintain homeostasis in severe multiorgan dysfunction. Extracorporeal new molecular technologies have been successfully applied in the intensive care of severe heart and respiratory failure, acute kidney injury and acute hepatic dysfunction, in the treatment of severe sepsis, metabolic disorders, the correction of immune imbalance.
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Vestn. Akad. Med. Nauk SSSR · Jan 2015
Review[Modern Views on Children's Interstitial Lung Disease].
Interstitial lung diseases (ILD, diffuse lung diseases) are a heterogeneous group of diseases in which a pathological process primarily involved alveoli and perialveolar interstitium, resulting in impaired gas exchange, restrictive changes of lung ventilation function and diffuse interstitial changes detectable by X-ray. Children's interstitial lung diseases is an topical problem ofpediatricpulmonoogy. The article presents current information about classification, epidemiology, clinical presentation, diagnostics, treatment and prognosis of these rare diseases. ⋯ The clinical semiotics of ILD, the possible results of objective research, the frequency of symptoms, the features of medical history, the changes detected on chest X-rays, CT semiotics described in detail. Particular attention was paid to interstitial lung diseases, occurring mainly in newborns and children during the first two years of life, such as congenital deficiencies of surfactant proteins, neuroendocrine cell hyperplasia of infancy, pulmonary interstitial glycogenosis. The diagnostic program for children's ILD, therapy options are presented in this article.
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The review is devoted to a relatively young direction in therapy of malignant gliomas, which is based on applying monoclonal antibodies against tumour-associated antigens. The current data on efficacy of main therapeutic agents in clinical practice or clinical trials concerning high-grade gliomas, especially glioblastoma multiforme, is summarized. Of particular interest is bevacizumab, a humanized monoclonal antibody against vascular endothelial growth factor (anti-VEGF), which is widely used in glioblastoma. ⋯ Significant part of the review is devoted to discussion of experimental and clinical data concerning efficacy of antibodies against VEGF receptor 2, platelet-derived growth factor receptor α, hepatocyte growth factor and its receptor c-Met. Unbiassed analysis of clinical trials on monoclonal antibodies does not allow us to conclude that passive immunotherapy directed against antigens listed above can significantly improve the overall survival of patients suffering from glioblastoma multiforme. This finding has encouraged us to mention several alternative approaches to passive immunotherapy and to list several prospective antigens for developing monoclonal antibodies.
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Vestn. Akad. Med. Nauk SSSR · Jan 2014
[Resuscitation of vital activity after cold arrest of respiration by physiological methods without rewarming the body].
The arrest of respiration during deep hypothermia means death, though at a low temperature the heart may rhythmically contract for 30-40 minutes more. The attempts of rewarming only shorten the time before the heart arrest. Calcium ions (Ca2+) are believed to accumulate in the nervous cells in cold. An excess of these ions inhibits the metabolism. Moreover it stimulates the cell proteases, which destroy the cell membranes. ⋯ A decrease in the surviving threshold by 1.5-1.8 degrees C is very important from the point of view of reanimation of an organism since to preserve life in the critical period of reanimation each 0.5 degrees C are important. Prolongation of minimal frequency of heart contractions and maintaining a minimal arterial blood pressure in an overcooled organism given the body temperature of 11-12.5 degrees C is a special problem of great interest associated with many physiological and biological parameters.