Medicni perspektivi, 2017;22(3).
2017 Vol. XXII N 3
Key words: gold nanoparticles, cerium dioxide nanoparticles, reproductive system, aging, prostate cancer
Abstract. Experimental evaluation of the influence of gold nanoparticles and cerium dioxide on normal and malignant cells and tissues. Reznikov A.G., Falyush O.A., Nosenko N.D., Sachynska O.V., Polyakova L.I., Limareva A.A., Perchyk I.G. The results of experimental studies of the effect of gold nanoparticles (AuNPs) on the organs of the reproductive system of male rats, cells and tissues of androgen-dependent prostate cancer (PCa) are presented, as well as the effect of cerium dioxide nanoparticles (CeO2NPs) on the testes and fertility of aging male rats. Addition of polydisperse colloidal solution of AuNPs (10-50 nm) to the culture medium in a final concentration of 10 μg/ml inhibited the growth of the LNCaP culture, PCa cells, while monodisperse solution of AuNPs (20 nm) caused no effect. The polydisperse colloidal solution of AuNPs arrested the growth of PCa xenografts in mice, when administered parenterally at a dose range of 0.64-6.4 μg/kg body weight. The selectivity of the drug effect on the malignant epithelium is confirmed by signs of its destruction and decrease in the epithelial stromal ratio on histological preparations of xenografts. There was no significant damaging effect of poly- and monodisperse AuNPs solutions on the organs of the reproductive system of male rats when administered for up to two weeks. The stimulating effect of a low dose of CeO2NPs (1 mg/kg b.w.) administered orally on hormonal function of testes and spermatogenesis, proliferative and secretory processes in the prostate of aging male rats was established. However, fertility of animals was reduced in comparison with the control group due to immaturity of the part of spermatozoa. Thus, metal nanoparticles and their salts can have both a stimulating and destructive effect on organs and tissues, which should be taken into consideration when studying their therapeutic potential and in toxicology.
Key words: Parkinson's syndrome, catalepsy, tremor, amantadine, glycine
Abstract. The comparative analysis of antiparkinsonian activity of glycine combined with amantadine in conditions of changing neurosynaptic transmission. Mamchur V.I., Kryvoruchko T.N., Makarenko O.V. Parkinson's disease is traditionally viewed as a disease which affects the human motor sphere. Besides motor manifestations in the clinical picture of the disease, non-motor manifestations with dementia as the most common are present. The purpose of the work – experimental evaluation of the possible antiparkinsonian action of glycine in terms of experimental models of Parkinson's disease equivalents (akinetic-rigid and tremor forms) on the background of antiparkinsonian correction by amantadine. Methods: catalepsy model (inhibition of dopaminergic transmission, equivalents of hypokinesia and rigidity states) and model of arekolyn tremor (activation of cholinergic transmission that corresponds to parkinsonian tremor) on the background of amantadine administration (50 mg/kg), glycine (100 mg/kg and 200 mg/kg) and their combined introduction. The research results show a positive dynamic in combined using of amantadine with glycine at a dose of 100 mg/kg and 200 mg/kg, which was is determined by the low percentage of animals with symptoms of catalepsy (50-70%) with evaluation criteria of 0.5-1.8 points with maximum possible 6 points. Similar results were obtained in terms of activation of the cholinergic system (arekolyn tremor). Glycine at a dose of 100 mg/kg and 200 mg/kg facilitated to optimization of antitremor action of amantadine, that is registered in increased latent period of tremor, reduction of its duration and intensity attenuation almost by 2,1 times in comparison with indicators of the control group. Thus, studied combinations of amantadine with glycine at a dose of 100 mg/kg and 200 mg/kg are promising in studying of their influence on dementia in Parkinson's syndrome, and this study will be continued.
Key words: community acquired pneumonia, complications, thrombosis
Abstract. Clinical, general, hemocoagulation and pathologicanatomical features of patients with moderate and severe community acquired pneumonia by the data of retrospective analysis. Pertseva T.A., Kireyeva T.V., Bielosludtseva K.O., Kryhtіna M.A. According to literature data, patients with community acquired pneumonia (CAP) fall into several groups of unfavorable prognostic factors. Development of thrombotic complications is one of causes of mortality of hospitalized patients. In this case systemic inflammation, which is always present in moderate and severe CAP, is the starting mechanism of formation of disorders in the hemostasis system. The aim of our work was to determine anamnestic, clinical, laboratory and pathologic anatomical features in patients with CAP, taking into account markers of systemic inflammation and coagulogram indices, as well as predicting the occurrence of complications. In the course of the work, a retrospective analysis of 151 medical histories of hospitalized patients with CAP was made. We analyzed anthropometric indicators, complaints at the time of hospitalization, results of physical examination, results of the chest X-ray, clinical and laboratory indicators, microbiological sputum analysis and to assess the possibility of thrombotic complications a RAM scale was used. It was found that late asking for medical help, the presence of mixed infection, underestimation of the severity of condition and severe systemic inflammation increase the risk of lethal outcome in patients with CAP. Considering a high risk of thrombosis in patients with CAP, it is necessary to assess the risk of thrombotic complications with the help of special scales, as well as timely detection and correction of disorders from the hemostasis system.
Key words: chronic heart failure, myocardial infarction, cardiohemodynamics, dyslipidemia, cardiorenal syndrome
Abstract. Risk factors, cardiohemodynamics and renal function state in patients with chronic heart failure and myocardial infarction in anamnesis. Kuryata O.V., Zabida A.A., Chvora D.L. The importance of the problem of heart failure for modern medicine is due to its growing prevalence and poor prognosis, despite a tendency to decrease of deaths from major cardiovascular diseases: coronary heart disease (CHD) and arterial hypertension (AH). Objective: to evaluate the risk factors, the state of cardiac hemodynamics and kidney function in patients with chronic heart failure (CHF) and acute myocardial infarction (AMI) in history. A retrospective analysis of 144 case histories of patients with CHF with preserved systolic function, aged 40 to 80 years and with disease duration from 1 year to 10 years was made. The patients were divided into 2 groups depending on the presence of anamnestic data in favor of past AMI: group 1 – 35 patients (24%) with CHF and AMI in anamnesis, 2 group, 109 patients (75,7%) with CHF without AMI in anamnesis. It was found that prevalence and severity of hypertension as well as arrhythmia were not significantly different in patients of both age groups. Among patients with stable angina and CHF with preserved ejection fraction there was established a high prevalence of hypertension, diabetes and obesity. The presence of AMI in anamnesis was associated with worse control of hypertension on the background of normal indicators of lipidogram, compared to patients with CHF without AMI in anamnesis. There was established a higher incidence of revealing patients with impaired renal function among patients with CHF with a trend to increase of manifestations of chronic renal failure and hyperuricemia among patients with postinfarction cardiosclerosis, regardless of patients’ age.
Key words: carotid intima media thickness, atherosclerosis, arterial hypertension, circadian rhythm of blood pressure, elderly age
Abstract. Features of interrelation of the structural state of brachiocephalic arteries in middle-aged and elderly patients with characteristics of the daily profile of blood pressure in patients with essential arterial hypertension stage II. Kolesnyk T.V., Kosova H.A. The aim of our study was to evaluate the interrelation of the structural state of brachiocephalic arteries with the characteristics of the daily profile of blood pressure (BP) in middle-aged and elderly patients with essential arterial hypertension stage II. The study included 74 untreated middle-aged (n=46) and elderly (n=28) patients with essential uncomplicated hypertension, which were divided into two groups depending on age. By risk factors, degree of arterial hypertension patients did not differ significantly. In group I, a significantly higher prevalence of stenotic atherosclerosis of the carotid arteries was found in comparison with the patients of group II. In elderly patients with stenotic carotid artery atherosclerosis, a significantly higher level of systolic blood pressure (BP) was established at night time. The increase of carotid intima media thickness in patients with impaired circadian BP rhythm was associated with the insufficient degree of nocturnal decrease in systolic BP. The degree of carotid arteries stenosis in patients with preserved daily BP rhythm was associated with the increasing of systolic BP level at night time, of pulse BP level within 24 hours, and an insufficient decrease in diastolic BP at night time.
Key words: сholedocholithiasis, diagnosis, surgical treatment
Abstract. Minimally-invasive and endovideosurgical technologies in diagnosis and treatment of choledocholithiasis. Kutovoy A., Rodinskaya G., Balyk D. The paper presents the results of the use of minimally-invasive methods in the diagnosis and treatment of choledocholithiasis. The results of treatment of 595 patients aged from 24 to 92 years with the diagnosis of choledocholithiasis were evaluated. In 552 (93,0%) patients, clinical manifestations of mechanical icterus were noted. In 508 (85,3%) patients, choledocholithiasis was combined with the presence of gallstones, in 15 (2,5%) cases – with calculous cholecystitis, in 69 (11,6%) cases - choledocholithiasis was residual. For the diagnosis of choledocholithiasis, ultrasound of the abdominal cavity, computed tomography, endoscopic retrograde cholangiopancreatogy, percutaneous fistulocholangiography, intraoperative cholangiography or cholangiography were used. Surgical treatment included both mini-invasive interventions and traditional operations. 227 (38,1%) patients underwent endoscopic papillosphincterotomy, which was effective in a size of concrement up to 7 mm in 83,7%. The percutaneous drainage of the bille ducts was performed in 88 (14,7%) patients, the efficacy was achieved in 82,9%. 313 (52,6%) patients subsequently underwent the second stage of surgical treatment of choledocholithiasis by laparoscopy – 263 (84,0%) and laparotomy – 50 (16,0%) with cholecystectomy with choledocholithoextraction and subsequent external or internal drainage of choledochus. Comparison of different methods of investigation showed that none of the diagnostic techniques had 100% of accuracy and informative value. The efficacy of transpapillary manipulation directly depended on the size of the stones.
Key words: incidentaloma diagnosis, computed tomography, ultrasound examination of the adrenal glands
Abstract. Diagnosis of adrenal glands incidentaloma. Kutovoy O.B., Zhmurenko E.V., Kunyk L.V. In this study the results of examination and treatment of 91 patients with adrenal glands incidentaloma were analyzed. According to the results of the morphological study, adenomas were the most common (n=60). Among malignant tumors, ACC was detected in 7 patients, low and undifferentiated cancer – in 3 patients, sarcoma – in 2 patients and metastasis of cancer – in 4 patients. To assess the nature of the tumor, the following criteria were used: size and density according to CT. In 43 patients with neoplasms less than 4 cm in 9,3% of cases malignant adrenalomas occurred, at 4-6 cm (n=29) - in 17,2% of cases, more than 6 cm (n=19) - in 31,6%. In patients with ACC, 71,4% of tumors exceeded 6 cm, 28,5% - were within 4-6 cm, 14,1% - less than 4 cm. The frequency of detection of malignant incidentalomas increases in proportion to the growth of tumor size, and with a diameter of more than 4 cm it was 27,1%. Adrenal adenomas in 31.6% of cases were from 4 to 6 cm, and in 10% - more than 6 cm. Thus, the orientation only on the size of tumors did not provide enough convincing grounds for determining its malignant potential. High native density was noted in ACC (33.4±2.8 HU), ganglioneuroma (36.6 НU) and metastases of cancer (43.6±9.0 HU). Low density was found in adenomas (0.4±10.7 HU) and adrenal cysts (6.0±8.2 HU), p<0.05. The most informative method of investigation in adrenal incidentalomas was CT, with sensitivity in adenomas and cancers – 98,3% and 94,4% respectively, specificity – 82,4% and 84,6%.
Key words: low-grade gliomas, anaplastic astrocytoma, glioblastoma, surgery, gross-total resection, adjuvant therapy, survival, Kaplan-Meier
Abstract. Prediction of treatment results of low-grade gliomas of the cerebral hemispheres. Sirko A.G., Dzyak L.A., Balashova O.I., Berdova T.L., Donchenko G.N., Skljar N.V., Shestakova N.N., Romanukha D.N. Glial tumors are the most common primary neoplasms of the central nervous system. Their proportion in the total structure of primary brain tumors is 50-65%. In Ukraine, according to the statistical data of the cancer-registry of the year 2014, 49,3% of patients with primary diagnosed malignant neoplasms of the brain did not live for one year. The aim of the study was to improve the survival rates of patients with low-grade glial tumors (LGT) (grade III-IV) by determining optimal treatment strategy and main prognostic survival factors. A prospective study of the results of treatment of patients with LGT from 2009 to 2014 was conducted. The study consistently included 100 operated patients with LGT (anaplastic astrocytoma (AA) and glioblastoma (GLB)). The median survival in the total group of patients (n=100) was 363.5 days (12 months). The main statistically significant prognostic factors of survival were: the completeness of tumor removal (p=0.00000000007) and the character of adjuvant therapy (p=0.000012). With the removal of LGT III-IV grade aplasias, which do not spread to functionally important areas and deep areas of the brain, one should try to perform Gross-total resection (GTR), which ensures long-term survival. The median survival of patients after GTR was 22.3 months. An integrated approach to the treatment which includes surgery, adjuvant radiotherapy and monochemotherapy with temozolamide showed the best survival rates – 20.5 months.
Key words: cognitive disorders, polytrauma, posttraumatic stress disorder, thiocetam
Abstract. Cognitive functions in the acute period of polytrauma and correction of their disorders with thiocetam. Krishtafor A.A. Aim of the work – to evaluate the effectiveness of thiocetam as a medicine that prevents cognitive impairments in patients with polytrauma, as well as to compare the scales of cognitive function assessment - MoCA and MMSE. We examined 50 victims with polytrauma without severe intracranial lesions, randomly divided into a control group (26 patients) and a main (24 patients) group. Patients of the control group received conventional intensive therapy for traumatic illness, patients of the main group in addition to this therapy received thiocetam. The somatic status was assessed according to the generally accepted clinical and laboratory indicators. The level of cognitive functions before the injury was assessed by the CFQ questionnaire for 2-3 days after the injury; The MoCA and MMSE scales were used on the 2nd day, when patients were transferred from the intensive care unit and before the discharge. The severity of injury was assessed by the ISS scale. The severity of the response to traumatic stress was assessed by the IES-R scale. In both groups, the baseline level of cognitive function was within the age range. On the second day after the trauma, significant inhibition of cognitive functions in both groups was noted, but in the main group this decrease was unreliably less. At subsequent stages a gradual increase in both groups was noted, however, in the main group recovery of cognitive functions occurred more rapidly. After 3 months, decrease in cognitive functions preserved at a level when patients were discharged from the hospital. In the main group there were significantly fewer patients whose posttraumatic stress after 3 months increased from minimal to low. When using the MoCA scale, there was a more pronounced decrease in cognitive functions than with the MMSE scale, but it in the less degree consider peculiarities of thinking. Thiocetam prevents the decrease of cognitive functions in patients with polytrauma and, due to that, also reduces the severity of posttraumatic stress reaction. For practical using in intensive care units it is preferable to use the MMSE scale.
Key words: Endonasal dacryocystorhinostomy, chronic dacryocystitis
Abstract: Investigation of effectiveness of surgical treatment of chronic dacryocystitis - endonasal dacryocystorhinostomy. Borodulya V.L., Grechka E.M., Stepakhina M.E., Derbina E.A. Prolonged and continuous lacrimation (symptom of epiphora) causes discomfort, inclination to conjunctiva infect, reduces visual acuity and ultimately the quality of life of the patient. Despite the fact that there is a large number of various surgical interventions to restore tearing in patients with chronic dacryocystitis, the problem of lacrimation remains relevant. We have studied the operation of endonasal dacryocystorhinostomy and its long-term consequences. Surgical intervention in endonasal dacryocystorhinostomy is aimed at eliminating lacrimation by eliminating stenosis and forming a new combination of the cavity of the laryngeal canal with the nasal cavity, as well as the sanation of purulent foci of infection in the throat. There were 8 surgical interventions. Period of observation of patients in the postoperative period by ophthalmologist and ENT-doctor is from 1.5 to 2 years. The evaluation of the result was carried out in 6 months or more after the operation. A complete recovery with the recovery of the tear excretion in the nasal cavity has been achieved in all patients. The formed rhinostoma was wide, well functioning. Thus, endonasal dacryocystorhinostomy is a highly effective and should be a method of choice for inflammation of the lacrimal sac at any stage of development.
Key words: asthma, COPD, asthma-COPD overlap, airway resistance
Abstract. Assessment of functional tests on determining resistance of respiratory tract in patients with bronchial asthma, COPD and their combination. Nazarenko K.V., Opimakh S.G., Polianskaja M.O. The mechanical properties of the respiratory tract (including airway resistance) is an important indicator of pulmonary function, and definition of resistance is used to diagnose and monitor obstructive lung diseases. This study was performed in order to evaluate and compare functional results of tests to determine the resistance of the airways in patients with asthma, chronic obstructive pulmonary disease and their combination. The study involved 191 patients: with asthma (n=34), with COPD (n=17) and their combination (n=140). Patients underwent bodyplethysmography and impulse oscillometry. A statistically significant correlation of medium strength between parameters of the total resistance, determined with the help of bodyplethysmography and impulse oscillometry, r=0.57, p<0.001. According to ROC-analysis, the best point of distribution of normal and pathological parameters of impulse oscillometry (R5Hz) as a diagnosis of increased respiratory resistance is 130% and higher from the proper values. The area under the ROC curve is 0.807. When interpreting the results of impulse oscillometry in patients with asthma, COPD and their combination, R5Hz level equal to or exceeding 130% of the proper values is proposed to be regarded as a sign of an increased respiratory resistance with sensitivity of technique – 64.0%, specificity – 87.5% and prognostic value of the positive result - 98.2%.
Key words: HLA DRB1 gene polymorphism, HIV-infected patients, co-infection HIV/tuberculosis
Abstract. HLA DRB1 polymorphism and risk of HIV/tuberculosis co-infection. Shostakovych-Koretskaya L.R., Volikova O.O., Lytvyn K.Y., Gubar I.O., Kushnerova O.A., Sheveleva O.V. In the research data on the study of interconnection between polymorphism of HLA DRB1 genes and the risk of HIV infection and co-infection and HIV/tuberculosis are presented. The cohort of observation was HIV-infected individuals with different clinical stages aged from 24 to 58 years, average age being 38 years. 90 patients (89.2%) received HAART. There were 32 (31.4%) HIV-infected patients with manifestations of tuberculosis, 70 (68.6%) HIV patients without manifestations of tuberculosis. Among the cohort of HIV-infected patients with manifestations of tuberculosis, pulmonary forms of tuberculosis was in 32 (100%), of which extrapulmonary forms of tuberculosis were in 12 (37.5%) patients. The majority of cases of tuberculosis occurred in HIV-infected patients in the IV clinical stage. Among HIV-infected patients, the following alleles of the HLA gene DRB1 *01 (10%) *04 (10%) *07 (13%), *11 (15%), *13 (13%), *15 (10%) occurred more often, HLA DRB1 *03 *08 *09 *10, *12, *14, *16, * 17, *18 were rarely found (1-7%). Similar distributions of DRB1 genes were noted among residents of the region with the dominance of HLA DRB1 *01 *04 *07 *11 *13 and *15. With the presence of alleles of the locus DRB1 *13, DRB1 *03 and DRB1 *08, the greatest probability of co-infection of tuberculosis was observed in HIV-infected patients. The risk of tuberculosis is by 2 times higher with a significant difference in HIV-infected patients with DRB1 *13 locus alleles, DRB1 *03 – by 4.4 times and DRB1 *08 – by 5.4 times. Significant chances of tuberculosis occurrence are higher – by 2.6 times in HIV-infected patients with DRB1 *13 locus alleles, DRB1 *03 – by 5.1 times and DRB1 *08 – by 6.4 times. Thus, the variability of the HLA DRB1 locus alleles may play a predisposing or protective role in the occurrence of tuberculosis in HIV-infected patients.
Key words: brain tumor, immunohistochemistry, diagnostics, vimentin, GFAP
Absract. Immunohistochemical expression of intermediate filaments in diagnostics of diffuse gliomas. Shynkarenko T.V. Intermediate filament proteins play an important role in maintaining a stable shape, as well as the possible movement of cells, including neoplastic cells. However there, are few works dedicated to the investigation of these proteins expression in diffuse gliomas and they are quite contradictory. The authors studied the expression of intermediate filaments (glial fibrillar acid protein GFAP, vimentin) in diffuse gliomas of the brain. 52 postoperative samples with the diagnosis of astrocytic and oligodendroglial brain tumors were examined. Primary antibodies against GFAP, vimentin, Ki-67 were used. The proliferative index and the expression area were calculated using the tools ImageJ 1.47v. The statistical Fisher test was included. Most samples with moderate expression of GFAP (62.5%) are rated to oligodendroglial tumors. Part of oligodendroglial tumors (58.3%) showed no expression of vimentin by tumor cells, this was not observed in astrocytomas. Meanwhile, a high level of expression of intermediate filament proteins - GFAP (100%) and vimentin (87%) is characteristic for diffuse gliomas. The expression level of GFAP and vimentin is higher in astrocytic tumors than in oligodendroglial (p<0.05). Levels of GFAP and vimentin expression are differential feature of astrocytic and oligodendroglial tumors.
Key words: physical condition, girls, weakening of vision, aerobic exercises, physical rehabilitation
Abstract. Dynamics of morphological and functional parameters of the physical condition of secondary-school age girls with impaired vision under the influence of aerobic exercises in a complex physical rehabilitation. Maryukhnich N.V., Klapchuk V.V. To assess the impact of the rehabilitation complex on the physical condition of schoolchildren, 90 girls of secondary school age with impaired vision were examined. The evaluation of the physical condition was carried out by the express method of G.L.Apanasenko. The results of the initial survey showed that average indicators of physical condition of girls with impaired vision are low. Under the influence of the rehabilitation complex, there were statistically significant positive changes in the indices of the main groups of girls, in addition to this, the total score in all investigated criteria increased. In adolescence, the variability of anthropometric characteristics of the organism changes in close connection with individual motor activities. On this basis aerobic exercises can be recommended in the complex physical rehabilitation of secondary-school age girls with poor vision.
Key words: methods of actual food consumption study, questionnaire, expert assessment, student youth
Abstract. Substantiation of ways for improvement of questionnaire-survey method of asssessment of population’s actual nutrition. Ieltsova L.B., Omelchuk S.T. Actual nutrition state indicates a significant prevalence of polynutrient deficits in Ukraine. One of the key issues in the fight against alimentary-dependent diseases is monitoring of population’s nutrition status. Only reliable methods for assessing actual nutrition can provide reliable information about the nature of nutrition and establish a relationship with health state. Taking into account the abovementioned, the aim of our study was to compare the existing methods of studying nutrition and nutrition status of individuals or population groups to substantiate and develop a new universal, effective method for assessing nutrition and its subsequent approval. It has been found that existing methods for assessing human food consumption have its disadvantages and advantages and provide the opportunity to receive certain types of nutrition information. There is no single universal method that would allow to make comprehensive assessment of population’s nutrition, including student youth. To solve this issue, we have substantiated and developed a questionnaire for assessing the nutrition of different population groups, including student youth, which has been evaluated and approved by specialists from leading institutions in the field of nutrition hygiene, gastroenterology and dietetics. Created survey questionnaire is a universal tool for collecting primary information and providing an opportunity to assess the social and welfare standards of respondents, working conditions and living conditions, the presence of hazard factors and bad habits, involvement in sports, anthropometric indicators, as well as it allows to assess the diet, drinking regime, main food product groups consumption, weight of portions, food handling methods, priority and benefits when choosing food, food intake places, which will be taken into account in the future to develop effective measures for the prevention of alimentary and alimentary-dependent diseases.
Key words: difenoconazole, combined formulations, acute poisoning, risk, action selectivity
Abstract. Forecasting of development of acute poisonings in agricultural workers while using combined formulations based on difenoconazole. Stavnichenko P.V., Antonenko A.M., Bardov V.G. In the general structure of occupational diseases, a large proportion belongs to acute poisoning with pesticides (mainly group cases). However, today it is impossible to drop the use of pesticides in agriculture. Their application ensures high biological and economic efficiency of the latter, reduces losses of the yield. The purpose of the work was to predict the possibility of acute toxic effects in agricultural workers when working with combined formulations based on difenoconazole. Materials and methods. To assess the influence on the organism of the workers of the above-mentioned substances and formulations on their basis, the coefficient of inhalation poisoning possibility (CIPP), the coefficient of selective action of the pesticide in inhalation effect (CSAing) and the selective action of the pesticide in the dermal effect (CSAderm) were calculated. Results. Calculated values of CSAing (103.4-4701.2) and CSAderm (237.4-12345.7) for all investigated active substances were more than 100, this indicates to a rather high selectivity of their action. By the CSAing value formulations Celeste Top, Celeste Trio, Dinali, Cydeli Top belong to pesticides with a relatively low selectivity of action when they are inhaled by workers in the process of crops treating, the remaining formulations have a sufficient selectivity of action in inhalation intake. In addition, it should be noted that in general, for all combined preparations CSA values are significantly lower than for separate active ingredients, in addition to the above assumption, can be explained by the presence of other formulants in the preparation that may have not significant but toxic effect on the body of workers. All investigated substances in the probability of occurrence of acute poisoning with the use of combined preparations on their basis are related to the 4th grade of danger according to State Standards 8.8.1.002-98. There was proved relative safety in case of penetration into the organism of agricultural workers by percutaneous and inhalational way of all studied active ingredients and most of the formulations on their basis.
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