Objective. To summarize the experience of the exogenous surfactant therapy for the treatment of postoperative ARDS in the cardiac surgery clinics in St. Petersburg. Methods. Analysis of 56 cases of exogenous surfactant (Surfactant-BL, «Biosurf», Russia) administration for therapy of postoperative ARDS was performed. All the cases were observed from 1998 to 2012 in the cardiac surgery clinics in St. Petersburg. Results. We have divided fifteen-year interval into three periods. First period: 1998-2001 years. Technology of surfactant therapy was developed. When exogenous surfactant was used for ARDS treatment, mortality dropped to 42.1 %. Second period: 2002-2007 years. The surfactant therapy of ARDS was used within the concept of «protective mechanical ventilation». ARDS mortality was 33,3 % in patients treated with surfactant, in the retrospective control group - 50 %. Third period: 2008-2012. This period was characterized by active introduction of a combination of alveolar recruitment maneuver and surfactant therapy for ARDS treatment. In the cases of combination of alveolar recruitment and surfactant therapy mortality dropped to 23.1 %. Discussion. In our study it was found that the surfactant therapy was not effective only in 16 % patients with ARDS after cardiac surgery procedures. Probably, in the future exogenous surfactant administration will reduce mortality in ARDS up to this boundary of its clinical effectiveness.

Translational medicine is a new concept which aims reduction of the distance between basic science discoveries and routine medical practice. This review focuses on the history of the concept of translational research in medicine and summarizes the current state of translational biomedical studies in USA and Europe. In addition, the phases and models of translational process are described, as well as the major translational barriers. Special attention is paid to the estimation of translation potential of new technologies which guarantees the success of translation. The problem of improved translation of new knowledge to clinical realm requires complex approach, including three basic principles: highest possible quality of research, perfect management of translational projects, and setting up an efficient dialogue between the representatives of different professional teams.

Metabolic syndrome (MS) is associated with the current diseases: obesity and diabetes, which are accompanied by changes of intestinal microbiota and of immune and neurohumoral systems. The aim of the work was to analyze the data obtained in the study of the role of the intestinal microbiota in case of MS and its correction. Discussed issues: features of the microbiota in MS metabolic endotoxemia and bacteremia, the role of surface structures and metabolites of bacteria, the ability to diagnostics and treatment of MS using microbiological approaches.

Treatment of lymphomas has considerably improved survival rates for young women. As a result women’s reproductive function will be damaged due to the gonadotoxicity of chemo- and radiotherapy regimens. Fertility preservation using cryopreservation of ovarian tissue is appropriate for women receiving chemotherapy and radiotherapy for treatment of lymphomas. Progress in assisted reproduction techniques and ongoing rapidly developing research protocols during last years have made possible to offer not only established but also experimental fertility preservation options to young women with Hodgkin’s and Non-Hodgkin’s lymphomas facing gonadal failure. Before patients will be submitted to oncological treatment, the right ovarian cortex is extracted by robotic surgery and then cryopreserved according to standard procedure. As soon as the patient is free of disease, the right ovarian cortex will be thawed and implanted onto the left ovarian medulla using robotic surgery. Ovarian tissue autotransplantation is feasible option to preserve ovarian function and further fertility in young women at risk of developing premature ovarian failure due to chemotherapy and/or radiotherapy. Gynecologists, oncologists and reproductive professionals should be aware that ovarian tissue autotransplantation may be considered and reproductive function can be preserved in any case when fertility might be threatened.

Work is based on the follow-up analysis of the status of newborn children’s health undergoing critical condition. The impact of perinatal pathology detects the quality of life of the child in the future. Reflected action ante and intranatal factors on the health of the newborn and children.

214 newborn with serious perinatal pathology (posthipoxic syndrome, sepsis, surgical intervention and etc.) were examined in progress, according to 27 parameters wich were including coagulative, trombocitic, anticoagulative and fibrinolitic parts of hemostasis system. It was proved, that neonatal DIC-syndrom had different hemostasiological patterens, which were connected with the genesis: sepsis, surgical intervention or posthipoxic syndrome. Clear periods of DIC-syndrom are often absent with newborns. DIC-syndrom with neonatal sepsis has 2 different patterns (supercompensated and decompensated). The manifestation of trombo-hemorrahagic disoders and their character depend on the genesis of DIC-syndrom (an infections process and hyperbilirubinemia are provide the appearance of hemorrahagic syndrom).

The lab-clinical servey of 94 newborns infants of their first week of life was made. The «A» group was of newborns had hypoergic variant of sepsis (17 preterm with the gestation > 32 weeks and 11 term newborns). The «В» group was of newborns had hyperergic sepsis (16 preterm with the gestation > 32 weeks and 27 term newborns). 23 newborns with acute pneumonia comprised the group a comparison. Following lab-tests were made: definement of the level of 12 acute-phasic proteins, circulating immune complexes, IgG, IgM, IgA; STG, TTG, T3, the analyses of leukocytic formulas, four leukocytic indexes of reactivity. On the bases of the obtained results patterns of 2 lab-clinical variants of the SIRS have been suggested. Pattern SIRS in hypoergic variant of sepsis - deficient condition with prevalance of proteases in the spectrum of mediators against the background of hypothyrosis of septic genesis. Pattern SIRS in hyperergic variant of sepsis - «cytocine storm» with preserved hormonal provision of protein-synthetic processes and immunity.

Authors represent a clinical case of endocrine disruptions: syndrome of hyperandrogenism accompanied disorder of a menstrual cycle in a 15 year-old-girl with proven cytogenetically rare chromosome mutation: deletion of a long arm 11 chromosome (karyotype 46, XX, del(11)(q23)) called Jacobsen syndrome. These endocrinologycal disorders were not described early in scientific literature.

This research presents an analysis of the results of psychodiagnostic screening of patients with coronary heart disease before and after coronary bypass surgery. Evaluated the incidence of anxiety and depression in patients with coronary heart disease (CHD) before and after coronary artery bypass surgery (CABG). The issues, concerning the feasibility of implementing a psychological screening - testing into everyday practice of cardiological hospital, were discussed in our research.

Objective. Analysis based on RUssian hoSpital Heart Failure Registry (RUS-HFR) etiology of systolic CHF, cause of hospitalization of these patients and compliance their therapy with international recommendations in 3 subjects of the RF. Design and methods. The RUS-HFR is a prospective, multicentre, observational study conducted in 3 Cardiology Centers (St. Petersburg - the central coordinator of the project, Samara, Orenburg). Inclusion criteria were CHF NYHA I-IV functional classes, LVEF<40 %, age 18-75 years, the absence of current myocardial infarction and pulmonary embolism. Results. From October 2012 to Jun 2013, 251 patients were enrolled, the mean age of the patients was 60 years and 79 % were men. Main etiologies were ischemic heart disease and hypertension. Ratio causes of hospitalization, its duration varied depending on the profile and capabilities of hospitals. conclusion. Compared with 10 years ago in Russia, in general a «portrait» of a patient with systolic heart failure has not changed, however, increased the proportion of patients undergoing cardiac surgery, and the percentage of patients receiving RAS blockers, P-AB, MRAs today compares with European registers. The greatest number of inconsistencies recommendations for mandatory drug therapy is detected in patients with CHF functional class II. Diuretic therapy is not prescribed for clinically expressed HF in 20-35 % of cases. High-tech methods of treatment in CHF patients (NYHA II-IV) in hospitals participating RUS-HFR recommend not often enough. «Planned» hospitalization (requiring correction of drug therapy) is 12-36 % of cases, and their duration was significantly higher than in the EU and USA.

Objective. Difference in cardiovascular diseases (CVD) prevalence between Russia and European Union may be caused by life style risk factors. Long period of common history and close geographic position allows to compare the nutrition behavior in North-West region of Russia and Estonia. Design and methods. As a part of collaborative study between Almazov FMRC and DIfE (IDAMES project), 131 inhabitants from St. Petersburg and 70 from Estonia randomly selected 18-65 y/o were interviewed by European food propensity questionnaire (EPFQ), translated and adapted to Russian and Estonian languages. It contained questions about frequency of main food groups consumption during last year. Informed consent and data regarding smoking status and anthropometry (height, weight with body mass index (BMI) calculation) were obtained from all participants. Results. Between Russia and Estonia no difference in smoking status and BMI were revealed (28,57 % and 24,81 % of current smokers; 26,32 kg/m² and 26,28 kg/m² for BMI respectively). Estonians take meat 2 times more frequent compared to Russian inhabitants. Estonian women consume 1,5 times more bread and fish than Russian, drink 2 to 5 times more alcohol. Russian men take more fruits and vegetables, 5 times more strong drinks, but 2 time less beer compared to Estonian men. Consumption levels of milk, semi-processed products, eggs, rice, pasta and sweets were comparable between groups. conclusion. Obtained data show differs in Estonia and in St. Petersburg eating behavior in spite of close geographical position and common history as well as comparable prevalence of smoking and obesity. Estonians have higher meat intake. Gender analysis surprisingly showed that Estonian females take more alcohol than Russian females. Russian males keep superiority in strong drinks consumption but have better level of fruits/vegetable intake and drink less beer.

Background. There are no obvious data concerning the mechanisms of the active reactions of the pulmonary vessels following myocardial ischemia, which are important for fundamental and clinical medicine. Objective. The investigations of the neurogenic mechanisms in the pulmonary hemodynamics changes following experimental myocardial ischemia. Design and methods. In acute experiments in anesthetized rabbits the changes of the pulmonary hemodynamics and cardiac output were studied following 60 s myocardial ischemia in the region of the descendent left coronary artery in control animals and after the blockade of α-adrenoreceptors by phentolamine or M-cholinoreceptors by atropine. Results. Following myocardial ischemia: 1) in control animals the pulmonary artery pressure decreased, the cardiac output diminished more, than the pulmonary artery flow; 2) after the blockade of α-adrenoreceptors the pulmonary artery flow and cardiac output decreased in the same level; 3) after the blockade of M-cholinoreceptors the pulmonary hemodynamics changes were the same as in the control rabbits, the cardiac output decreased twice more than the pulmonary artery flow. Conclusion. The neurogenic adrenergic mechanisms are involved in active pulmonary vessel reactions which led to the disbalance of the cardiac output and pulmonary artery flow changes in the case of the left ventricular myocardial ischemia.

A historical and biographical article about scientists and physicians who have made a decisive contribution to the development of the basic ideas in Thyroidology. It covers the circumstances and significance of basic discoveries and descriptions in the field of Physiology and Pathology of the thyroid gland during Antiquity, Middle Ages and Renaissance. (7 figs., bibl.: 19 refs).