Nº 3 (2021)

Introduction. Carbon monoxide (CO) remains one of the most common causes of acute poisoning and death, both in everyday life and in emergency situations, especially in fires.

Material and methods. The paper summarizes information about the regulatory effects, mechanisms of toxic action, pathogenesis and clinical picture of intoxication, as well as predictors of the severity of CO poisoning.

Results. The main mechanism of the toxic effect of CO is due to its ability to bind to the protohemal iron of hemoglobin (Hb) to form carboxyhemoglobin (HbCO). The toxicity of CO may also be enhanced by impaired functions of the myoglobin of the myocardium and skeletal muscles, mitochondrial cytochrome oxidase, and iron-containing enzymes of the antioxidant system. The leading link in the pathogenesis of acute CO intoxication is a violation of the oxygen transport function of hemoglobin and the associated development of hemic and tissue hypoxia. CO-induced cell and tissue damage due to the induction of mitochondrial dysfunction, oxidative stress, free radical hyperproduction, lipid peroxidation, inflammation, and apoptosis also play a role in the pathogenesis of intoxication.

Conclusion. The mechanism of toxic action of CO, associated primarily with the formation of carboxyhemoglobin and the development of hypoxia, determines the clinical manifestations of acute intoxication, which depend on the concentration of CO and the duration of exposure, but are almost always associated with the central nervous system and cardiovascular system.

The article summarizes the authors' long-term experience in the diagnosis and treatment of acute poisoning with phenothiazine derivatives and presents data on the epidemiology of the effects of phenothiazines on the central nervous system. The original classification of acute phenothiazine intoxication confirmed by electrophysiological studies of the brain is given. The involvement of deep brain structures in the pathogenesis of acute phenothiazine coma has been confirmed. Based on studies of visual evoked potentials, the absence of inhibition of deep brain structures despite a pronounced comatose state is shown. In some cases, repeated light stimulation provoked hypersynchronization of evoked potentials and the appearance of convulsive manifestations in the clinic, which was regarded as a state of parabiosis (according to N.E. Vvedensky). Emergency treatment measures for phenothiazine poisoning associated with accelerated detoxification of the body mainly using active methods such as peritoneal dialysis, intestinal lavage with constant monitoring of respiratory function and the cardiovascular system, are presented. The materials of the article will help doctors of intensive care and toxicology departments to improve the quality of diagnosis and treatment of these pathologies.

The aim of the stady wos to investigate the mechanisms of suppression of cerebral bioelectrical activity under adverse effects caused by neurotoxicants using inhalation anesthesia with sevoflurane. The research included 19 cases (male/female 12/7, aged 19—55, BMIs under 35) with intracerebral tumors. Patients were under medical observation and neurosurgical treatment. Invasive procedures were carried out under sevoflurane-based general anesthesia with a dose of anesthetic varying from 0,8 to 1,3 MAC (minimum alveolar concentration). Technologically advanced neurosurgical procedures involved neurophysiological polymodal monitoring, which included EEG and ECoG testing. Probit analysis results showed that, with cerebral cortex bioelectrical activity suppression index equal to 32±8%, nearly half the cases displayed a formation of an «outburst-suppression» type of pattern on the scalp EEG. The condition for half the cases displaying a formation of this type of periodic pattern is the suppression index equaling 58±7% on ECoG. Space-and-time evolution of suppression patterns, formed on the cerebral cortex, is the main reason for persistence of uninterrupted activity on EEG. The obtained results allow to further define principles of neurodynamics, which apply to acute intoxication with neurotoxicants. With regard to relative similarity of intoxication-induced coma cases, registration of periodic EEG patterns even with a low suppression index indicates a more severe form of cerebral insufficiency.

A biotesting technique is described that provides for periodic (every 2 hours) recording of changes in pH, redox potential, and electrical conductivity of a liquid culture medium incubated in the presence and in the absence of viable test microorganisms (TM) and test samples (TS). The results of a comparative analysis using this technique of antibiotic activity against Staphylococcus aureus of different concentrations of «essential oils» obtained from 10 types of plant raw materials are presented. Based on this, we can conclude the following. Using the presented methodology, it is possible to assess the effect on the dynamics of the vital activity of TM of samples of various pharmaceutical, cosmetic, food, feed and other products, much more quickly, objectively and informatively than using standard visual methods of microbiological testing. The initial antibiotic activity of TS in most cases was greater than their prolonged antibiotic activity. At the same time, the mid-term (in terms of the time of interaction of TS with TM) antibiotic activity of TS was usually intermediate in value between their initial and prolonged biological activity.

The oil industry is a leader in the negative impact on all areas of the natural environment. Polluting the atmospheric air, soil, surface and underground waters, oil production processes expose the population living in the adjacent territory to the dangerous effects of xenobiotics. The reproductive system is the most sensitive to environmental problems.

The aim of the study was to identify the features of the intrauterine development of fetuses of women living in the territory of oil technogenesis in comparison with the fetuses of women living in a territory without it. A comparative assessment of the frequency of blastogenesis defects in the studied groups was carried out as a result of the analysis of embryological protocols of women who received infertility treatment using methods of assisted reproductive technologies. In order to assess the frequency and structure of defects in embryogenesis and fetogenesis, an analysis of cases of congenital malformations was carried out according to the data of the primary medical documentation of the Medical Genetic Consultation.

The identification of differences in the development of embryos was determined by the Pearson agreement criterion. Assessment of statistically significant differences in indicators in the study of the frequency and structure of congenital anomalies in fetuses identified by ultrasound and in newborns, the structure of factors that influenced the mother during pregnancy, which could lead to the development of congenital anomalies and complications of the course of pregnancy, was carried out using t-Student's criterion. Defects of cleavage and blastulation of embryos of women in the observation group were revealed. It was found that the frequency of birth of children with congenital anomalies in the territories of oil technogenesis is statistically significantly higher than in the territories without it. In the observation group, congenital anomalies of the respiratory system detected by ultrasound examination of the fetus, congenital anomalies of the genitals, urinary organs, musculoskeletal systems, multiple malformations revealed antenatally are statistically significantly more common.