All articles - General and Internal Medicine

The article presents data on the study of the activity and topography of enteral enzymes in rats of mixed, non- aggressive and aggressive groups under conditions of immobilization stress. The experiments were carried out on adult outbred rats. The experiment revealed that the topography of the enzymatic activities of the corresponding enzymes in the mucosal homogenate taken along the entire small intestine is more variable.

The “gut-brain axis” is a bi-directional system of interaction between the central nervous system and the gastrointestinal tract (GIT), which consists of closely related neural and humoral pathways. There is now evidence, mainly from animal studies using gnotobiological models and by irritating the microbiota with antibacterial drugs, that gut bacteria are important in the gut-brain axis, acting here as modulators, and signaling pathway intermediaries.

One of current problems of the modern neurophysiology is relationship of bark of larger hemispheres with subcortical structures of a brain. Among these structures a specific place is held by the hypothalamus differing in variety of the functional manifestations and playing an important role in a regulation of emotional and motivational, somatic and vegetative components of the composite reactions of adaptive behavior.

The incidence of hepatopathy in the world population has been continuously growing in recent years. Experts attribute this phenomenon to various factors: alcoholism, drugs, blood transfusions, iatrogenesis, infectious processes, and others. The search for new hepatotropic drugs is also relevant against the background of new viral infections. It has been established that the causative agent of a new coronavirus infection can lead to the development of virus-mediated hepatopathy [2, 5]. The pathogenesis of this liver lesion remains a subject of debate, but scientists consider the “cytokine storm” that develops during severe and very severe infectious process as a leading factor in this process [2].

Every year there is an increasing interest in combined expectorant drugs. In the context of a new coronavirus infection, accompanied by the development of pneumonia, mucolytic and antitussive drugs were prescribed to almost all patients, so interest in this group of drugs has grown significantly.

In order to maintain and strengthen the health of the population in a pandemic, the following preventive measures are being taken to prevent the spread of coronavirus infections: specific, non-specific, with the help of medicines, as well as at medical enterprises, preventive measures aimed at eliminating coronavirus infection are being considered. To prevent infection of the population with coronovirus, vaccination is mandatory.

Digestion as an external link of the functional nutrition system that links the external environment with the internal environment of the body and corrects homeostasis of biologically active substances, mineral composi­tion, therefore, our work reflects nutrition aspects based on literary analysis.

Preparation for the reception of food and, especially, feeding have a starting effect on the entire digestive system. This is manifested by an increase in the secretion of digestive juices, as well as a short-term relaxation of the stomach and a decrease in motility of the proximal small intestine.

The article analyzes the factors of students’ psychological readiness affecting the success of tr aining at the initial stage of studying at university. Psychological readiness for training is an integral formation, an important prognostic factor for rapid adaptation to the conditions of study at university and the success of mastering a curriculum. The results of the research showed that psychological readi ness could be viewed as a longterm forecast of the effectiveness of educational and professional activi ties in a medical school. During the initial period of training, the factor of psychological readiness is the psychological state reflecting the peculiarities of adaptation in students with varying degrees of ac ademic achievement at university. Adaptation of the «least successful» students is accompanied by o verstrain and exhaustion of personal psychological resources. Changing the subjective assessment of  the state of health, fixing on violations in the communicative and activity spheres allows for early det ection o a decrease in psychological readiness and timely correction aimed at increasing it.

Purpose of the study. Determination of the clinical and pathogenetic characteristics of COVID-19 in the early rehabilitation period according to retrospective analysis
Material and research methods. A retrospective analysis of the case histories of 128 patients who underwent COVID-19 and persistent symptoms of the disease was carried out. The number and frequency of underlying diseases and clinical manifestations of various pathological syndromes were determined.
The results of the analysis of case histories of patients showed that 44 patients suffered moderate severity of COVID 19, 45 patients - severe, 39 - extremely severe. 40 patients were diagnosed with a lesion of 25% of the lungs or less (CT 1), in 43 patients - more than 25 to 50% of the lung volume (CT-2), in 32 patients - more than 50 to 75% (CT-3) and in 13 patients - more than 75% (CT-4). On average, the number of background pathologies was 4.53 ± 2.20. The average number of background diseases was significantly higher in patients of the older age group (p <0.001). In patients with severe and extremely severe infections diabetes and obesity were more common (p <0.05 for both comparisons). In the group of patients with moderate severity of infection, chronic viral hepatitis was more common (p <0.05). Clinical syndromes pathogenetically associated with an autoimmune inflammatory reaction were observed in 99 patients (77.34%), cell dystrophy - in 123 patients (96.09%), coagulopathy - in 73 patients (57.03%), fibrosis - in 44 patients (34.38%). Conclusion. According to the data of retrospective analysis, the average number of background diseases was significantly higher in patients of the older age group. Diabetes and obesity were more common in patients with severe and extremely severe COVID-19. In patients with moderate severity of infection, chronic viral hepatitis was more common. The pathogenetic syndrome of an autoimmune inflammatory reaction was observed in 77.34% of patients, cell dystrophy syndromes in 96.09%, coagulopathic in 57.03% and fibrosis in 34.38% of patients.

Табакокурение является одним из факторов риска развития сердечно-сосудистых, дыхательных и онкологических заболеваний, и одним из весомых причин смертности в мире. Нужно отметить на фоне различных хронических заболеваний показатель смертности населения еще больше увеличиваться. В связи с этим, научное осмысление вопросов образа жизни человека и взаимосвязи с состоянием здоровья, является актуальной. В Узбекистане последовательно принимаются меры по предупреждению, лечению и контролю неинфекционных заболеваний и факторов их риска, снижению преждевременной смертности и заболеваемости населения. Об этом свидетельствует Постановление Президента Республики Узбекистан «О мерах по профилактике неинфекционных заболеваний, поддержке здорового образа жизни и повышению уровня физической активности населения» от 18 декабря 2018 года.

В настоящее время нарушения нормофлоры(дисбактериоз), состояние иммунного статуса и проявления болезни рассматриваются в единстве, причём роль пускового механизма в каждом конкретном случае может принадлежать любому из компонентов этой триады: дисбактериозу, иммунному статусу и патологическому процессу. [2,4]. Инфекционные факторы играют роль в возникновении многих ревматических болезней. Кишечные бактерии и продукты их жизнедеятельности могут стимулировать развитие артрита с поражением различных областей [1]. При этом значительно повышается проницаемость кишечной стенки для микробных антигенов и их токсинов, что рассматривается как важнейший фактор сенсибилизации организма к микробным антигенам и, возможно, развитию аутоиммунных заболеваний, в том числе артритов [5]. К возникновению артритов могут иметь отношение различные микроорганизмы, обладающие неспецифическим воздействием на иммунную систему, нарушения со стороны которой определяют дальнейшее течение болезни [3].

Purpose of the study. Evaluation of the effectiveness of early diagnosis and intensive care of surgical sepsis that developed against the background of bacterial destruction of the lungs in children based on a comprehensive analysis of clinical, laboratory, bacteriological criteria and the pSOFA scale. Materials and methods. The study period is 2019. - March 2021 The object of the study (n=24) were children with surgical pathology (bacterial destruction of the lungs). Results. The effectiveness of complex intensive therapy for surgical sepsis was noted in 91.6% of cases. In 2 cases, young children died as a result of delayed diagnosis and admission with BDL, pulmonary-pleural-mediastinal form, due to the development of refractory septic shock.

BACKGROUND: Sepsis is one of the leading causes of hospital mortality in children. a decisive role in improving the results of treatment of this group of patients belongs to early diagnosis and pathogenetic therapy. AIM: this study optimizes the diagnosis and intensive care of surgical sepsis in children based on clinical and laboratory criteria and bacteriological monitoring.
MATERIALS AND METHODS: the study period is 2018–2020. the study subjects were children (n = 73) with surgical pathology (diffuse purulent peritonitis, bacterial destruction of the lungs, post-traumatic brain hematomas, injuries of the abdominal organs, and others). clinical and laboratory parameters were analyzed, and microbiological monitoring was performed to determine antibiotic sensitivity.
RESULTS: Patients who developed sepsis had a pronounced hypermetabolic syndrome, which was manifested by tachycardia and tachypnea, hyperthermia, low levels of albumin, and total protein in the blood. Protein catabolism in patients was accompanied by a decrease in globulins (IgG) synthesis and the development of a secondary immunodeficiency state. Both gram-positive and gram-negative microorganisms were involved in developing surgical sepsis in children, increasing the proportion of the latter. Given the high proportion of multi-resistant flora, empirical combined de-escalation antibiotic therapy (aBt) with broad-spectrum antibiotics was prescribed. this was followed by its revision based on microbiological monitoring and clinical and laboratory data of the patient with sepsis. Studies have shown the effectiveness of complex intensive care in 86.3% of cases. Mortality occurred in 13.7% of cases. Patients with severe surgical pathology died: fecal, generalized peritonitis, severe traumatic brain injury + coma with irreversible neurological disorders, and urosepsis against the background of chronic renal failure after repeated surgical interventions.
CONCLUSIONS: early diagnosis of sepsis, rational aBt under the control of microbiological monitoring, non-aggressive infusion therapy, and active sanitation of the surgical infection focus contributed to a decrease in mortality in this category of patients.

Among the methods of instrumental diagnosis of respiratory diseases in pediatrics, bronchoscopic studies occupy one of the leading places. Perhaps this is due to the development of endoscopic equipment, low invasiveness and high information content. An urgent problem in the anesthetic management of FBS in children is ventilatory support and ensuring adequate gas exchange. Ensuring airway patency and adequate ventilation can be carried out by tracheal intubation or installation of a laryngeal mask (LM), which has certain advantages over an endotracheal tube in the form of less trauma, complications and severity of hemodynamic changes during installation

Parenteral nutrition (PN) is the most complex and technological variant of clinical nutrition, carried out by intravenous administration of nutrients into the body. It is intended for patients in whom it is impossible or insufficient to use other methods of nutrition and occupies the highest level in the hierarchy of clinical nutrition options, since it is considered the most difficult both in terms of technique and in terms of the variety of decision-making when prescribing it in clinical practice in the most difficult contingent of patients. . One of the main causes of death in patients with multiple organ failure is the development of an immune and inflammatory response. A number of studies have shown a decrease in the severity and incidence of septic complications in patients on enteral nutrition, after severe mechanical and thermal injuries, after major surgical interventions, it also allows you to maintain and maintain the barrier function of the intestine, which prevents the translocation of microflora. Based on the foregoing, it can be assumed that enteral nutrition will have a positive effect on the course of multiple organ failure.

In the treatment of patients with acute surgical diseases, even in the presence of multiple organ disorders and sepsis, prolonged artificial lung ventilation (ALV) through a tracheostomy is often required.

Parenteral nutrition (PN) is the most complex and technological variant of clinical nutrition, carried out by intravenous administration of nutrients into the body. It is intended for patients in whom it is impossible or insufficient to use other methods of nutrition and occupies the highest level in the hierarchy of clinical nutrition options, since it is considered the most difficult both in terms of technique and in terms of the variety of decision-making when prescribing it in clinical practice in the most difficult contingent of patients. . One of the main causes of death in patients with multiple organ failure is the development of an immune and inflammatory response. A number of studies have shown a decrease in the severity and incidence of septic complications in patients on enteral nutrition, after severe mechanical and thermal injuries, after major surgical interventions, it also allows you to maintain and maintain the barrier function of the intestine, which prevents the translocation of microflora. Based on the foregoing, it can be assumed that enteral nutrition will have a positive effect on the course of multiple organ failure.

Objective: to assess the prediction of ogres after cardiac surgery in children based on psychological characteristics and standardized ogre stimuli. Materials and Methods: We examined 42 children aged 2 to 6 years who underwent heart surgery for "OK" defects. Ogre sensations in the preoperative period with injections in 2 fingers and venipuncture; in the postoperative period was detected 4 times, i.e. immediately after waking up and after waking up 1 and 2 hours later. Results and conclusion. Prediction of the severity of postoperative acne syndrome can be determined based on the preoperative orange score at two time points and day 1 of the postoperative assessment.

In recent decades, the attention of doctors around the world has been attracted by non-specific lung diseases - acute bronchitis and pneumonia, chronic bronchitis, bronchial asthma, emphysema, chronic pneumonia, bronchiectasis and other rare forms of bronchopulmonary pathology. In patients with nonspecific lung diseases, acute lung failure can develop suddenly or as a result of exacerbation of a chronic condition.

Shock is one of the urgent problems of modern medicine. Patients with polytrauma are the most difficult and complex contingent of patients. The incidence of traumatic shock among polytraumatic injuries is 8-15%, and death is observed in 20-35% of the injured. The role of an anesthesiologist-nurse is important in conducting anti-shock therapy.

Any operation is a stressful situation, which causes the psychological state of patients to deteriorate. Psychological assistance to patients before and after surgery is considered the most necessary direction of a medical nurse. In inpatient treatment facilities, the patient is faced with unaccustomed situations, which causes a feeling of discomfort. The purpose of our study of the above issues is to study the psychological state and satisfaction of patients with treatment

Emotional stress syndrome is a chronic stress caused by emotional, mental and physical exhaustion. The development of this syndrome is primarily characteristic of the following professions: health workers, teachers, psychologists, social workers, rescuers, law enforcement officers, firefighters.

This article presents a brief review of sepsis/SS, reflecting the unresolved issues of pediatric sepsis and the results of our own study of surgical sepsis in children. Optimization of diagnostics and schemes of pathogenetic intensive therapy of surgical sepsis in children based on clinical and laboratory criteria and

bacteriological monitoring. Research period - 2018-2020. The subject of the study (n=73) was children with surgical pathology (widespread peritonitis, bacterial destruction of the lungs, post-traumatic brain hematomas, trauma to the abdominal organs, etc.). Studies have shown the effectiveness of complex intensive care in 86.3% of cases. Mortality was stated in 13.7% of cases. Patients with severe surgical pathology died: fecal, widespread peritonitis, severe TBI + coma with irreversible neurological disorders, urosepsis against the background of chronic renal failure, after repeated surgical interventions, due to the development of refractory SS.

The study involved 76 patients with children (46 boys and 30 girls) aged from 9 to 15 years, 34 of them - with allergic conjunctivitis and rhinosinusitis, 24 - with chronic recurrent obstructive bronchitis (preasthma), 18 - with asthma. Duration of illness ranged from a few months to 5 years examination. To clarify the rheological properties of blood there were determined electrical breakdown of the membrane, the electrophoretic mobility, the zeta potential of the membrane of erythrocytes and blood viscosity. The extent and intensity of the rheological proper­ties of blood disorders in association with other clinical and laboratory data has prognostic significance in the development of respiratory allergies in children.