METABOLIC AND FUNCTIONAL DISTURBANCES IN THE LIVER OF RATS WITH INTOXICATION BY PARACETAMOL: HEPATOPROTECTIVE ACTION OF TAUCIN
Radkovets A.U., Bartosh A.N., Krotkov K.O., Bushma M.I.
UDC: 615.276:616.36-008.6-06]-085.272
Abstract: The purpose of the study was to investigate the hepatoprotective action of combination of taurine with zinc diaspartate (Taucin) in rats with liver damage caused by paracetamol. In experiments on 40 outbred male rats by histochemical studies of the liver and blood biochemical studies it was shown that inserted into the stomach paracetamol (2.5 g/kg - 5 doses) causes liver damage. It is accompanied by inhibition of activity of SDH (succinate dehydrogenase), LDH (lactate dehydrogenase), NADP (nicotinamide-adenine dinucleotide phosphate), and ACP (acid phosphatase) in hepatocytes; increase in activity of ALAT (alanine aminotransferase), AST (aspartate aminotransferase), ALP (alkaline phosphatase) and the content of total bilirubin and its conjugated fraction, cholesterol in the plasma. Сombination of taurine (50 g/mol; 6.25 g) with zinc diaspartate (1 g/mol; 0.35 g) - "Taucin" (inserted into the stomach 0.5 g/kg/day - 10 doses) has a hepatoprotective effect. Hepatoprotective action of "Taucin-20" (0.5 g/kg/day - 10 doses) is less than that of "Taucin-50".
Key words: крысы, поражение печени парацетамолом, комбинация таурина с цинка диаспартатом, гепатозащитное действие, rats, paracetamol liver disease, combination of taurine with zinc diaspartate, hepatoprotective action
ALCOHOL CONSUMPTION AS A RISK FACTOR FOR TRAUMATISM AND LONG-TERM IMPAIRMENT OF COGNITIVE FUNCTIONS: GENDER PECULIARITIES
Pereverzev V.A., Pereverzeva E.V., Welcome M.O., Razvodovsky Y.E., Sikorsky A.V.
UDC: 612.821.44:616-001:616.8
Abstract: The aim of the study was to compare the performance of cognitive functions (memory, attention and academic performance (AP)) and the prevalence of alcohol related injuries in non-drinkers and sober (from the third and more days of abstinence) young people of different sexes, and to analyze the relationship between indicators of these functions with the volume of recognized amounts of alcohol consumption. The "AUDIT" test profiles of 1764 students (1188 girls and 576 boys) revealed significant gender differences in alcohol consumption by the youths. The prevalence of alcohol consumption was 6.1% (χ=12.470, P<0.001) higher among females (88.7%) compared to male students (82.6%). Average scores of the “AUDIT” showed that the proportion of young people who consumed alcohol, reported recognized single and monthly dose of ethanol consumption significantly higher among boys compared with girls. Alcohol consumption in any (small/moderate and heavy) quantity leads to a significant increase of the proportion of injured persons among the youth and students with complaints of memory function impairment. The number of alcohol users among the girls had a more pronounced decline in the AP, and higher rates of injury and relative risk of memory disorders compared with the boys who consume alcohol. This indicates a greater toxicity of ethanol to the female body. It was found that the number of errors committed by the sober (from 3 to 21 days of abstinence) respondents in the test "CP" was 3 times higher compared with the total abstainers. The rank correlation analysis showed a significant weak positive relationship between the volume of alcohol consumption and number of errors (ρ=0.274, P˂0.001). These findings indicate long-term impairment of the function of attention in sober people who abstained from alcohol for at least 72 hours.
Key words: трезвенник, употребление алкоголя, фактор риска, девушка, юноша, травматизм, когнитивные функции, alcohol consumption, risk factor, girls, boys, traumatism, cognitive functions
GENETIC POLYMORPHISMS OF GENES OF VITAMIN D SYSTEM INFLUENCE ON 25(OH)D SERUM LEVEL (REVIEW)
Maylyan E.A.
UDC: 615.356:575
Abstract: The major factors having significant effect on vitamin D saturation indicators are ultra-violet radiation intensity and level of its consumption with foodstuff or nutritional supplements and medicinal preparations. But genetic factors are also important. The genotype contribution to 25(OH)D serum indicators fluctuations makes from 23-43% to 77-80%. As the main genes that cause influence to the 25(OH)D concentration through the their mutations are GC (DBP), CYP24A1, CYP2R1, CYP27B1, VDR, NADSYN1/DHCR7. The knowledge of genetic factors which influence 25(OH)D levels can have important practical value for identification of the persons with vitamin D deficiency risk, and treatment-and-prophylactic actions individualization.
Key words: ген, полиморфизмы, витамин D, gene, polymorphisms, vitamin D
ASSESSMENT OF DIASTOLIC RESERVE IN ADOLESCENTS WITH ARTERIAL HYPERTENSION AT STRESS TESTS
Klimenko T.M., Yailenko A.A., Otrohova E.V.
UDC: 616.12-008.331.1
Abstract: Diastolic reserve (DR) calculated by transmittal Doppler flow using functional stress tests describes the compensatory potential of the heart. In order to detect initial signs of hemodynamic disturbances in adolescents with arterial hypertension (AH) and cardiovascular risk for early diagnosis and timely prevention of cardiovascular complications we conducted a complete clinical and instrumental examination of 140 adolescents. 60 adolescents with hypertension were included in group I, 40 healthy adolescents with cardiovascular risk - in group II, 40 healthy adolescents without any cardiovascular risk - in control group III. Changes in diastolic parameters were studied using stress tests (isometric and Valsalva) by the Doppler method with the calculation of the DR. The decrease in DR shows that at the pre-clinical stage of AH development (in the presence of the cardiovascular risk and normal AH) inadequate response to the load, which represents a decline in the compensatory mechanisms of the left ventricle can be determined in adolescents.
Key words: артериальная гипертензия, подростки, диастолический резерв, нагрузочные пробы, ремоделирование, левый желудочек, arterial hypertension, adolescents, diastolic reserve, stress test, cardiac remodeling, left ventricle
POSTOPERATIVE ANALGESIA AND GAS EXCHANGE IN THE LUNGS IN GERIATRIC PATIENTS WITH DIFFUSE PERITONITIS
Petrova M.M., Petrov V.S., Bobrinskaya I.G., Minchenkova V.N., Nikolaev S.V.
UDC: 616.94-008.8-085.37
Abstract: The aim of this work was to study the influence of the methods of postoperative analgesia on gas exchange in the lungs in geriatric patients with diffuse peritonitis. The study included 82 patients with diffuse peritonitis at the age from 60 to 88 years. Lung volumes and bronchial obstruction was investigated by a conventional method of spirography. To determine the volumetric rate of inhalation and exhalation pneumotachometry was used. The degree of impairment of respiratory function was determined by N.N. Kanaeva method. Arterial blood gases were measured by Roshe OmniC gas analyzer. The CO content in the exhaled air was determined by the method of capnography with Phillips Intelli Vue MP-5 monitor. On the basis of the obtained data we calculated alveolo-arterial O difference (A-aDO), veno-arterial CO difference (v-aDCO), dead space according to Bohr, alveolar ventilation (V) and ventilation-perfusion ratio (V/Q). Diffusion capacity of the lungs was determined by the steady state technique with carbon monoxide. In response to the introduction of narcotic analgesics the majority of patients noted a subjective feeling of breath «relief». This marked a decline in total and alveolar ventilation. Pulmonary ventilation in 85% of patients was accompanied by an increase of hypoxemia and a tendency to hypercapnia. The impact of epidural analgesia on the function of pulmonary respiration is to improve oxygen exchange in the lungs with simultaneous influence of analgesia on ventilation and pulmonary blood flow. When using acupuncture of igloreflexoanalgesia we observed an increase in total and alveolar ventilation marked by moderate bronhodilatation. The volume of pulmonary blood flow does not change significantly, but РаО increases reducing the overall venous admixture. Conclusions: Postoperative analgesia with narcotic analgesics in geriatric patients with diffuse peritonitis in pite of the low cost of this method of postoperative analgesia impairs blood oxygenation in the lungs by increasing alveolar shunt and distribution of violations of ventilation and blood flow. The benefits of its use in of elderly and senile patients should be considered questionable. Given a sufficient analgesic effect of epidural analgesia and its impact on various components of total venous admixture, the method of postoperative analgesia must be considered the most indicated in geriatric patients. Acupuncture in combination with the introduction of NSAIDs in patients older than 60 years along with the elimination of pain syndrome, improves gas exchange in the lungs and is a component of intensive therapy of acute respiratory failure in patients of older age groups.
Key words: распространенный перитонит, газообмен в легких, острая дыхательная недостаточность, diffuse peritonitis, gas exchange in the lungs, acute respiratory failure
ASSESSMENT OF THE STATUS OF THE AUTONOMIC NERVOUS AND CARDIOVASCULAR SYSTEMS IN NEONATES HAVING SUFFERED FROM HYPOGLYCEMIA
Kozlova L.V., Ivanov D.O., Derevtsov V.V., Priyma N.F.
UDC: 616-053.34-35:611.127.839
Abstract: Оn the basis of clinic-anamnestic, physical, laboratorial, electrophysiological, ultrasound and statistical methods we studied the status of neonates’ autonomic nervous system and cardio-vascular system. It was found that in two- and three-day-old infants a significant increase in sympathetic activity and strain on depleted adaptive reserves, higher frequency of myocardial repolarization defect and intraventricular conduction defect, changes similar to hypertrophic cardiomyopathy with a more intense myocardial relaxation defect and myocardial hypocontractility were related to neonatal hypoglycemia. In one-month-old infants an increase and higher intensity of clinical implications of autonomic dysfunction (excessive sympathetic activity and ahigher frequency of asympathicotonic autonomic responsiveness), more intense strain on depleted adaptive reserves, higher frequency of nomotopic cardiac dysrhythmias, myocardial repolarization defect and intraventricular conduction defect result from the earlier neonatal hypoglycemia.
Key words: неонатальная гипогликемия, новорожденные, вегетативная дисфункция, сердце, neonatal hypoglycemia, newborns, vegetative dysfunction, heart
CORRECTION OF MAINTENANCE AND CORRELATION DISORDERS OF PROTEINS AND LIPIDS IN ERYTHROCYTE’S MEMBRANE DURING DYSCIRCULATORY ENCEPHALOPATHY ON DIFFERENT STAGES OF DISEASE
Sunyakina O.A., Shulginova A.A., Bystrova N.A., Horlyakova O.V.
UDC: 612.111.6:616.831-005-08
Abstract: The aim of the study was to establishe clinical and laboratory effectiveness of Glutoxim in the correction of protein-lipid maintenance disorders of erythrocytes on I and II stages of dyscirculatory encephalopathy on the background of II stage hypertonic disease. During a checkup of 48 patients, equally separated into 4 groups, were studied the parameters of structural-functional properties of erythrocytes before and after basic pharmacotherapy, what included Enalapril, Cavintonum, Actovegin and Cereton. Patients from 2 and 4 groups were additionally administered immunomodulator Glutoxim. Significant changes of maintenance and correlation of proteins and lipids in erythrocyte membrane, responsible for structure formation, architectonics, stabilization, shaping and flexibility of membrane, intercellular metabolism were established that leaded to disorders of functional properties of erythrocytes on early stage of the disease. Glutoxim proved to be more effective in comparison with basic pharmacological therapy. In patients with I and II stages of dyscirculatory encephalopathy before beginning of treatment we established disorders of accordingly 84.1% and 92.1% laboratory structural and functional parameters of erythrocyte properties, from which 65.9% of indices were identical in the quantity and direction of changes in the patients with both stages of the disease and in 19.5% of patients they were dentical in direction. The use of basic pharmacotherapy in the treatment of I and II stages of dyscirculatory encephalopathy normalizes and correlates accordingly 83.8% and 65.9% of changed indices of structural and functional properties of erythrocytes before treatment. Inclusion of Glutoxim is more effective, because it increases these parameters up to 91.9% and 92.7%
Key words: дисциркуляторная энцефалопатия, коррекция нарушений структурно-функциональных свойств эритроцитов, dyscirculatory encephalopathy, correction of erythrocyte’s structural-functional disorders
MICROBIOLOGICAL FEATURES OF FATAL PNEUMONIA IN SMOLENSK
Asovskova O.V., Fedosov E.A.
UDC: 616.24-002-074
Abstract: The article represents the analysis of the etiological structure of pneumonia with a fatal outcome according to the results of microbiological examinations of autopsy material from hospitals in the city of Smolensk in recent years. In total, we analyzed 195 cases of lethal pneumonia. Cultivation and identification of isolated microorganisms was performed using standard techniques. To test the hypothesis about uniform distribution of sex of patients in all cases we used the exact binomial criterion for the comparison of frequencies and Fisher's exact test. It was established that the leading role in the development of lethal pneumonia as community-acquired and nosocomial, is given to the members of the Enterobacteriaceae family and non-fermenting microorganisms. Microbiological features of fatal pneumonia in individuals with comorbid background and the dead with the diagnosis of "flu" were revealed.
Key words: аутопсийный материал, пневмония, этиология, etiology, pneumonia, post-mortem specimens
UPDATED RECOMMENDATIONS OF THE EUROPEAN SOCIETY OF CARDIOLOGY FOR THE MANAGEMENT OF PATIENTS WITH INFECTIVE ENDOCARDITIS
Danilov A.I., Kozlov S.N., Evseev A.V.
UDC: 616.126-002-08
Abstract: The problem of acute infective endocarditis is acute in many countries around the world. The incidence of infective endocarditis is 3-10 cases per 100 thousand a year and is due to the prevalence of intravenous drug use, cardiac surgery, invasive medical procedures (prolonged catheterization of veins, hemodialysis, etc) and organic lesions of heart valves. The article deals with the prevention, diagnosis, antibiotic therapy and surgical treatment of infective endocarditis presented in the updated recommendations of the European Society of Cardiology (ESC) 2015 for management of patients with infective endocarditis.
Key words: инфекционный эндокардит, специализированные центры, диагностика, антибактериальная терапия, nfective endocarditis, specialized centers, diagnosis, antibacterial therapy
RHEUMATOLOGICAL MANIFESTATIONS OF ACUTE NONLYMPHOBLASTIC LEUKEMIA: CASE IN CLINICAL PRACTICE
Molotkova S.A., Molotkov A.O., Litvinowa I.A., Bazina I.B., Khokhlova U.A.
UDC: 616.155.392:616.72-002.77
Abstract: Acute myeloid leukemia (AML) is characterized by many different symptoms and different patients may manifest differently. It was established that in this category of patients at all stages of the disease immune status lesions were detected, most pronounced at the stages of remission and relapse. The emergence of these disorders in remission is determined by the effects of cytostatic therapy, which leads to a significant deterioration of the parameters of cellular immunity and may cause the development of autoimmune diseases, including rheumatological. Their clinical picture may be uncertain under the guise of acute leukemia and impede timely diagnosis. One of such diseases is chronic relapsing polychondritis (CRP), which is a generalized progressive inflammation of cartilages. The disease is very rare in clinical practice; therefore, any case of CRP is important from the point of view of diagnosis and further tactics of patient management. The aim of the publication was to describe clinical cases of acute myeloid leukemia in combination with CRP. It will enhance the understanding of the disease and help to optimize the tactics of management of such patients.
Key words: острый миелобластный лейкоз, хронический рецидивирующий полихондрит, хрящевая ткань, acute myeloblastic leukemia, chronic relapsing polychondritis, cartilaginous tissue
THE POSSIBILITIES OF SURGICAL CORRECTION OF CICATRICIAL-DEFORMED CERVIX UTERI IN PREGNANT WOMEN
Sergeeva I.A., Ivanyan A.N., Gustovarova T.A., Krucovsky S.B., Kiracosyan L.S., Belskaya G.D., Kuzminyh V.V.
UDC: 618.3-06
Abstract: On the basis of Smolensk Cinical hospital №1 an assessment of the results of surgical correction of cicatricially deformed in labor cervix was carried out. Cicatricially deformed cervix was established to be an indication for cesarian section in 2 % of all cases. Also according to medical records, peculiarities of previous and present gestation course were studied. On the fourth stage of labor hysterotracheloplasty was carried out. In patients with deep lacerations of cervix to the vaginal vaults delivery was carried out by Caesarian section. If the circular fibers were preserved, the labor was performed through maternal passages. A significant risk factor of cicatricially deformed cervix was found out to be genital inflammations and intrauterine interventions. The course of the postoperative period was analyzed. In 6 months after delivery more than 94% of women with hysterotracheloplasty did not have any abnormalities. Normal anatomic and functional cervix indicators are the prophylaxis of background and pre-malignant diseases. They also contribute to the restoration of normal vaginal biocenosis and reduce the risk of miscarriage and premature delivery in subsequent pregnancies.
Key words: рубцовая деформация шейки матки, кесарево сечение, пластика шейки матки, cicatricial-deformed cervix uteri, cesarean section, tracheloplasty
ENDOTHELIAL DYSFUNCTION IN THE MICROCIRCULATION SYSTEM AMONG WOMEN WITH PREMATURE OVARIAN FAILURE
Ignatieva R.E., Gustovarova T.A., Ivanyan A.N., Kryukovsky S.B., Dmitrieva E.V.
UDC: 618.11-008.6:616.1-073.173:611-018.7
Abstract: The aim of the study was to determine the functional state of the endothelium in the microcirculation system of women with premature ovarian failure (POF). POF - is a syndrome, including secondary hypergonadotrophic amenorrhea, infertility and symptoms of estrogen deficiency in patients under the age of 40 years. The endothelial function in patients with POF was assessed using the method of photoplethysmography by the non-invasive diagnostic complex «AngioScan-01». It was found that women with POF compared with women with preserved ovarian function, suffered from endothelial dysfunction in their microcirculation system, which is a leading pathogenetic factor of many heart and blood vessels disorders. Due to the above mentioned facts, the determination of endothelial function in patients with premature ovarian failure is effective in the prevention of cardiovascular diseases, and the advantages of the photoplethysmography method allow to use widely the diagnostic complex «AngioScan-01» in the clinical practice of an obstetrician-gynecologist.
Key words: преждевременная недостаточность яичников, эндотелиальная дисфункция, микроциркуляция, сердечно-сосудистые заболевания, метод фотоплетизмографии, premature ovarian failure, endothelial dysfunction, microcirculation, cardiovascular diseases, photoplethysmography method
PSYCHOLOGICAL CHARACTERISTICS OF SELF-DESTRUCTIVE BEHAVIOR IN YOUNG MEN OF MILITARY AGE
Severova E.A., Federova E.A., Morozova E.A., Okhapkin A.S., Dautova M.A.
UDC: 616.89-008.441-053.7
Abstract: Self-destructive behavior among young men of military age has no tendency to decrease, which causes their direction to the military examination, exemption from military service and the violation of further professional adaptation. The aim of the study was to investigate the psychological characteristics of young men of military age with self-destructive behavior in history to establish potential risk factors for repeated acts of self-destructive behavior. The article presents the results of a study of the psychological and mental factors of self-destructive behavior of young men of military age with a history of self-destructive behavior. Discovered significant differences in range psychologies factors in groups of young men with personality disorders and accentuations of character.
Key words: юноши, аутодеструктивное поведение, призывной возраст, расстройство личности, акцентуация характера, youth, self-injurious and suicidal behavior, age range, personality disorder, accentuation of character
INPATIENTS SUICIDAL ATTEMPTS AND SUICIDES IN PSYCHIATRIC CLINIC, DURING THE SICK-LEAVE AND IN EARLY TERMS AFTER DISCHARGE FROM THE HOSPITAL
Vaulin S.V., Alekseeva M.V., Morenets T.V.
UDC: 616.89-008.441.44
Abstract: The aim of the study was improvement of the suicidological help in a psychiatric hospital and in early terms after discharge from the hospital. In the presented article the issues of suicidal behavior in psychiatric hospital are illustrated. 50 causes of suicidal acts have been analyzed during the treatment in the psychiatric clinic, during the leave and in early terms after discharge from the hospital. Except for the data of clinical patent examination, the results of psychological research using psychometric scales are presented in the article. Beck's suicidal ideation scale (SSI) and Montgomery-Asberg depression rating scale (MADRS) were used. Clinical and social characteristic of suicides were studied, as the factors of suicidal disadaptation. The methods of suicidal attempts in the psychiatric hospital, during the leave and in early terms after discharge from the hospital were described. The influence of psychopathological symptoms on suicidal behavior and on the degree of the suicidal risk was determined. The developed medical and rehabilitation programs taking into account the revealed factors will allow to increase the quality of the suicidological help by decreasing level of suicide actions and to prevent hospital suicides.
Key words: суицид, самоубийство, суицидальная попытка, суицидальный риск, предупреждение самоубийств, госпитализация, suicide, suicidal attempts, suicidal risk, inpatients, suicide prevention, hospitalization
SEROEPIDEMIOLOGICAL SCREENING FOR HIV INFECTION
Tursunov R.A., Odinaev F.I., Karimov S.S. , Sayburhonov D.S.
UDC: 616.9-036.2; 616-097; 616.98
Abstract: The article presents an assessment of serological screening for HIV infection among different population social groups of the Republic of Tajikistan (RT) according to 2008-2015. During the analyzed period, there was a tendency of growth of the total population coverage of voluntary counseling and testing (VCT). So, if in 2008 VCT covered 148,255 (2.0% of the population) people, in 2015 - 597 426 (7.0% of the population), that is, the coverage examined for antibodies to HIV increased by 3.5 times. From the total number of the examinees who were tested for HIV [n=597 426] in 2015 we found 1151 new cases, the detection rate being 0.2. Depending on the scope of the study, the highest detection rate of HIV infections occurs among people as clinically indicated (22.1%), pregnant women (16.7%), sex workers (CSW) and their sexual partners (14.9%), injecting drug users (IDUs, 12.9%), migrant workers (10.1%) and prisoners (4.6%). These serological monitoring in Tajikistan suggests that HIV epidemic is growing in the country, mainly due to population groups with risky behavior in relation to HIV. In addition, there is a tendency of transition spread of the disease among general population, which, in turn, requires the expansion of blood tests for antibodies to HIV among vulnerable groups and general population. The findings of the study confirm the importance of serological monitoring in terms of oversight of the development of HIV epidemic with a view to early detection of persons infected with HIV.
Key words: ВИЧ, ВИЧ-инфекция, сероэпидемиологический скрининг, серологическое обследование, тестирование на антитела к ВИЧ, HIV, HIV infection, seroepidemiological screening, serological survey, testing for antibodies to HIV
ROLE OF COL1A1 GENE -1997 C>A POLYMORPHISM IN OSTEOPOROSIS DEVELOPMENT IN SKELETON VARIOUS SITES IN POSTMENOPAUSAL WOMEN
Maylyan E.A.
UDC: 618.173:616.71-007.234]+615.356:575
Abstract: The aim of the study was to assess the role of COL1A1 gene -1997 C>A polymorphism in osteoporosis development in skeleton various sites in postmenopausal women. Examination of 483 postmenopausal women included densitometry by dual-energy X-ray absorptiometry method and COL1A1 gene -1997 C>A polymorphism detection by PCR method. It was established that A allele was a predictor of postmenopausal osteoporosis in the zone of both femoral proximal departments and also both femoral necks (p<0.05), but C allele and CC genotype had a protective effect (p<0.05). The role of -1997 C>A polymorphism of COL1A1 gene in the development of osteoporosis in L1-L4 lumbar vertebrae and forearm distal department was not established (p>0.05). The obtained data can be useful for the detection of predisposition to osteoporosis and treatment-and-prophylactic activities individualization.
Key words: ген COL1A1, полиморфизм, остеопороз, женщины, постменопауза, COL1A1 gene, polymorphism, osteoporosis, women, postmenopause
ABNORMAL GESTATIONAL WEIGHT GAIN, NEONATAL ANTHROPOMETRIC STATUS AND DURING THE EARLY PERIOD OF ADAPTATION
Shalkina L.A., Alimova I.L., Pokusaeva V.N., Krivenko A.S., Kalandia M.R.
UDC: 616-053.31-003.96
Abstract: The aim of the study was to analyze the effect of abnormal gestational weight gain on neonatal anthropometric indicators, and the course of the early period of adaptation. Length, weight and body mass index in newborns were studied according to WHO recommendations. It was found that excessive gestational weight gain results (p <0.05) in the increase of length and weight of newborn infants, birth of children with high levels of physical development (z-score> +2) and body weight> 4000 g (14%). Excessive gestational weight gain increases the risk of neonatal birth trauma, and insufficient weight gain leads to the birth of children with morphological and functional immaturity. The leading role for the prevention of birth of children with high anthropometric indicators and violations of early adaptation period is health education among women of on healthy diet and regular prenatal care.
Key words: новорожденные, антропометрические показатели, патологическая гестационная прибавка массы тела, период ранней адаптации, newborn, anthropometric indicators, abnormal gestational weight gain, early period of adaptation
VEGETATIVE AND ENDOTHELIAL FUNCTIONS IN CHILDREN WITH PRIMARY ARTERIAL HYPOTENSION
Sukalo A.V., Sikorski A.V., Pereverzev V.A.
UDC: 616.12-008.331.4-021.3-008
Abstract: The aim of the study was to investigate the role of the autonomic nervous system and endothelial vasoregulators in the development of arterial hypotension in school-age children. The results of cardiointervalography of 113 children with primary arterial hypotension in the initial position prove high activity of the sympathetic (AMO=17.2%; p<0.001) and parasympathetic (X=0.54 s; p<0.001) divisions of the autonomic nervous system with the formation of rigid correlations between higher regulation divisions and the cardiac pacemaker. The change of a patient’s position from horizontal into vertical is accompanied by a rise in AMO rates (p<0.001), preservation of Mo, X, VIR, TI, IVB and shows inadequate response of the autonomic nervous system in children with PAH to the active clinoorthostatic test. The central contour in this category of pediatric patients, on the one hand, loses interaction with the humoral contour, and, on the other hand, reduces the strength of correlations with the neural regulation channel. The parasympathetic division of the autonomic nervous system produces the maximum effect on the heart rate. A decline of AMO (p<0.001) to the indices of the initial position is registered on the tenth minute of the vertical position in the patients of the main group, which indicates the exhaustion of adaptational and compensatory possibilities of the sympathetic nervous system and may be a cause of syncope in sick children. Repeated horizontal position preserves high values of mode amplitude (p<0.001, p<0.001) and the variation range (p<0.001, p<0.001). The established disorders of heart rate variability indicate a high activity of the parasympathetic division of the vegetative nervous system in children with primary arterial hypotension in all positions of the clinoorthostatic test. Increased impact of the sympathetic VNS in this category of patients may be considered compensatory and insufficient in case of a prolonged vertical position. High vagal activity of patients is associated with more intensive synthesis and accumulation of nitric oxide in blood, which results in vasodilatation and is involved in the pathogenesis of primary arterial hypotension in school-age children.
Key words: первичная артериальная гипотензия, вегетативная нервная система, кардиоинтервалография, клиноортостатическая проба, оксид азота, эндотелеин, primary hypotension, autonomic nervous system, cardiointervalography, clinoorthostatic test, nitrogen oxide, endothelin
FUNCTIONAL BLOCKADE OF CELLS SYNDROME IN ACUTE PANCREATITIS
Karman A.D., Kazuschik V.L.
UDC: 616.37-002.1-008.6
Abstract: Parameters of microcirculation in 16 patients with severe forms of acute pancreatitis were defined by enemometry. In this disease severe injuries were revealed. They were manifested by a significant increase in the maximum pressure drop (MPD), increases in the hyperhydration index (IH) inflow-outflow index (IIO) demonstrating significant violations of the vascular component of microcirculation (MPD, IH, IIO). This was accompanied by profound alterations of the cellular component of the microcirculatory environment: reduction of the integral microcirculation pressure (IMCP) and tissue pressure (TP). Changes in the cellular component of the microcirculation were accompanied by reduction of IMCD and TP coefficients. These findings reflected the microcirculatory code of severe acute pancreatitis: hyperhydration tissue, reducing the integral of the microcirculation and tissue pressure. The method of edemometry identified another syndrome - functional blockage of the cells of the microcirculatory environment. When injected into the vein of 1.0-1.5 liters of glucose and electrolytes in patients with severe clinical forms of acute cholecystitis, the cells of the microcirculatory environment actively respond to the infusion, which was accompanied by a decrease in MPD, increasing IMCP and TP. After the introduction into the vein of the same amount of glucose and electrolytes in patients with severe forms of acute pancreatitis all the original parameters of microcirculation remained unchanged. Such inertness of the microcirculatory system is due to the functional blockade of cell of this environment in this disease.
Key words: эдемометр, эдемометрия, МСД, ИГ, ИПО, ИМЦД, ТД, функциональная блокада клеток, гипергидратация тканей, edemometer, edemometry, MPD, IH, IIO, IMCP, TP, functional blockade of cells, hyperhydration of tissues
ULTRASOUND IN THE DIAGNOSIS OF HYPERTROPHIC PYLORIC STENOSIS
Labuzov D.S., Savchenkov A.L., Salopenkova A.B.
UDC: 616.334-007.271-053.1-073.432.1
Abstract: Hypertrophic pyloric stenosis is a frequent surgical pathology. Additional diagnostic methods are X-ray examination of the stomach with barium, fibrogastroscopy, and ultrasound. The aim of the study was to show the possibilities and privilege of the method of ultrasound diagnostics for congenital pyloric stenosis in children. 37 children with pyloric stenosis were included in the study. In 25 children (main group) only sonography was performed. The control group was 28 children without clinical signs of vomiting syndrome. Echo signs of pyloric stenosis were revealed. In the main group the muscular wall thickness of the pylorus was 5.2±1.2 mm, the length of the pyloric stomach 20.4±1.7 mm, lumen 1.3±0.2 mm. Evidence of pyloric stenosis was confirmed intraoperatively. In the control group, the thickness of the muscle wall of the pylorus was 2.7±0.4 mm, the length - 17.8±1.2 mm and the width of the lumen 2.4±0.5 mm. Ultrasonography, as the primary method of diagnosis is sufficient for diagnosis, being an accurate and fast method. The method has no contraindications, and does not emit radiation.
Key words: врожденный гипертрофический пилоростеноз, желудок, ультразвуковое исследование, infantile hypertrophic pyloric stenosis, stomach, ultrasound examination
PAROVARIAN CYST OF LARGE SIZE
Labuzov D.S., Savchenkov A.L., Salopenkova A.B.
UDC: 618.11-006-055.25-089
Abstract: Paraovarian cyst is a retention growth, developing from parovarium, embryonic remnant of the Wolffian duct. The size of the cyst varies from small to giant. Paraovarian cyst has no specific clinical manifestations. The aim of the study was to describe a rare observation of a large size paraovarian cyst in a 14-year-old girl. То clarify the diagnosis we performed ultrasound examination and multislice computer tomography of the abdominal cavity and retro peritoneal space. A cystic formation with clear contours, thin walls with the size of 240×194×80 мм, occupying more than 2/3 of the volume of the abdominal cavity was revealed. Laparotomy, with cyst resection was carried out. Microscopic research revealed the cyst wall represented by connective tissue fibers with smooth sclerosed fibers lined with single-layer cubic epithelium with areas of atrophy. The findings prove tha diagnosis of a large paraovarian cyst.
Key words: параовариальная киста, девочки, parovarian cyst, girls
STEREOTACTIC LESION AND CHRONIC STIMULATION OF ANTERIOR THALAMIC NUCLEI FOR TREATMENT OF PHARMACORESISTANT EPILEPSY
Sitnikov A.R., Maslova N.N., Grigoryan Yu.A., Mishnyakova L.P., Grigoryan G.Yu.
UDC: 616.853-089
Abstract: The aim of this study was to compare the results of chronic stimulation and bilateral radiofrequency lesions of anterior thalamic nuclei in patients with pharmacoresistant epilepsy. The selection of the anterior nucleus of thalamus (ANT) as a potential target for treatment of pharmacoresistant epilepsy was based on data suggesting its crucial role in seizure propagation. This article describes the results of bilateral ANT lesions and chronic stimulation in 31 patients with refractory epilepsy. 19 patients underwent the stereotactic radiofrequency lesions of ANT (I group) and 12 have the ANT-DBS (II group). Targeting was based on stereotactic atlas information with correction of the final coordinates according to location of clearly visible structures and microelectrode recording. Both groups were quite similar in age, gender, seizures frequency and duration of disease. The median x, y, and z coordinates of ANT were found to be 2.9, 5, and 11 mm anterior, lateral, and superior to the midcommissural point, respectively. Mean seizures reduction reached 80,3% in I group with 2 non-responders and 91,2% in II group. 3 patients form I group and 4 patients from II group are seizure-free now. The morbidity rate was low in both groups. The stereotactic lesion and chronic stimulation of ANT both effective for seizure control in epilepsy originated from frontal and temporal lobes. Secondary generalized seizures more demonstrated more sensitivity to ANT lesions and stimulation comparatively to simple partial seizures. Microelectrode recording allows to identify the physiological borders of ANT and improves the surgical outcomes.
Key words: эпилепсия, приступы, переднее таламическое ядро, стереотаксическая деструкция, глубинная стимуляция мозга, микроэлектродный анализ, epilepsy, seizure, anterior thalamic nucleus, stereotactic lesion, deep brain stimulation, microelectrode recording
EXPRESSION OF CD-LYMPHOCYTE MARKERS IN PATIENTS WITH COLD URTICARIA AND CHRONIC SPONTANEOUS URTICARIA
Meshkova R.Y., Kovrigina N.V., Vitchuk A.V., Aksenova S.A., Maksakova T.S., Bityutskaya V.V., Slabkay E.V., Volkova E.V.
UDC: 616.514:577.1
Abstract: The expression of CD-lymphocyte markers in patients with cold urticaria with depending on the varying degrees of sensitivity to cold and in patients with chronic spontaneous urticarial were studied for the first time. The study revealed that the contents of the total number of T lymphocytes (CD3), T-helper (CD4), cytotoxic T-lymphocytes (CD8 ), B-lymphocytes (CD19), NK cells (CD16 CD56), activated T-lymphocytes (CD3 CD25) cells in the examined patients with all type of urticaria does not differ in comparison with the control group. A significant reduction of T-helper and cytotoxic T lymphocytes expressing CD95+ marker of apoptosis in patients with cold urticaria and chronic spontaneous urticarial was observed. In the patients with an average degree of sensitivity to cold, an increase of B-lymphocytes and TNK- lymphocytes (CD3 CD16 CD56) was registered, compared to the patients with high sensitivity to cold. In the patients with chronic spontaneous urticaria, there was a decrease of the quantity of regulatory T cells (CD4 CD25 bright) and activated T lymphocytes expressing HLA-DR (CD3HLA-DR). Thus, we identified similar quantitative indicators of basic lymphocyte subpopulations in the patients with two different forms of chronic urticaria. This may indicate a common immune mechanism of these diseases.
Key words: холодовая крапивница, хроническая спонтанная крапивница, CD-маркеры лимфоцитов, cold urticaria, chronic spontaneous urticaria, CD- lymphocyte markers
EFFICIENCY OF SCREENING FOR TUBERCULOSIS INFECTION IN CHILDREN POPULATION
Frolova J.V., Myakisheva T.V.
UDC: 616-002.5-022.7-053.2
Abstract: The aim of this work was to carry out a two-step analysis of the role of the Mantoux test and Diaskintest in schoolchildren and adolescents. Stage I included screening for tuberculosis infection in 95 659 children of Smolensk. We evaluated the results of the screening in one of the secondary schools through a continuous analysis of 1 464 medical f.026/y students’ cards. Stage II included examination of 150 children at risk for tuberculosis in the TB dispensary. It was founded that the TB detection rate for 1 000 examined pupils by the Mantoux test was 0,006, but by Diaskintest it was by 6 times higher - 0,024. As a result of Diaskintest, the number of children in need of counseling phthisiatrician was by 2.4 times lower, and the number of children to be monitored in a TB clinic is by 2 times higher. This proves a high specificity of Diaskintest. On the second stage, it was found that samples from hyperergic Diaskintest allow selecting a group of children with the highest risk of tuberculosis. These children should be evaluatied by CT-scan of the chest. Latent TB infection in the presence of a contact or a local form of tuberculosis was established in this group.
Key words: туберкулинодиагностика, проба Манту, Диаскинтест, латентная туберкулезная инфекция, tuberculin diagnostics, Mantoux test, Diaskintest, latent tuberculosis infection
QUALITY OF MEDICAL CARE IN A LARGE DENTAL POLYCLINIC (RESULTS OF THE PATIENTS SURVEY)
Tsepov L.M., Nikolaev A.I., Scherbakova T.Ye., Nesterova M.M., Rusakova P.Yu.
UDC: 616.31(075.8)
Abstract: The article discusses the results of the patients’ interview on the quality of dental care in the dental clinic of Smolensk and the authors’ opinions on the role of this factor in the diagnostics and treatment of dental diseases. The ways to improve the results of treatment of patients with caries, gingivitis and periodontitis is an acute problem of dental care. The authors note that providing diagnostic and curative measures of separate patients by dentists alone is not enough in solving this problem. Further analysis is important. Effective treatment of caries, chronic inflammatory generalized periodontal diseases may be important to reduce the systemic disease process and to improve the general health status irrespective of the presence or absence of evident links between them. Evident pathogenetic relationship between some internal diseases and periodontitis requires a multidisciplinary approach to the management of patients with comorbidities.
Key words: кариес, хронические воспалительные заболевания пародонта, диагностика, лечение, качество стоматологической помощи, медицинская организация, caries, chronic inflammatory generalized periodontal diseases, diagnostics, treatment, quality of the dental care, healthcare organization
METABOLIC SYNDROME AS AN UNSOLVED PROBLEM OF MEDICINE AND MODERN SOCIETY
Uryasev O.M., Gorbunova D.Y., Sherbakova O.N., Pyko A.A.
UDC: 616-008.9-056.52-036.21-071.3-073.175
Abstract: Metabolic Syndrome (MS) is a syndrome including abdominal obesity, reduction of peripheral insulin sensitivity, hyperinsulinemia, dyslipidemia, which leads to matabolic impairment, Type 2 diabetes and the development of hypertension. Currently, the issue of the metabolic syndrome is considered one of the main in the medical, social and economic orientation of the modern society, leading to reduced life expectancy and poor quality. This review deals with modern views on the problem. We assessed the chronology of the study and presentation of the components of metabolic syndrome. Studies on the prevalence of the etiopathogenesis «X» syndrome and modern criteria for its diagnosis were observed as well. Attention is given to contemporary factors affecting the development of the disease, that are, as a rule, genetic factors, consumption of large quantities of high-calorie food and low physical activity. Genetic risk factors may be due to constitutional features of the composition of muscle fibers, fat distribution, activity and insulin sensitivity key enzymes in carbohydrate and fat metabolism. The development of the MS is due to genetic predisposition to several groups of candidate genes. Eating disorders that often accompany the metabolic syndrome, the most frequent hyperphagia reaction to stress, compulsive hyperphagia, premenstrual carbohydrate craving and hyperphagia were analysed as well. The issue of «versatility" of the disease as an epidemic of the XXI century, its influence on the development of disorders of the internal organs is discribed in the article.
Key words: метаболический синдром, критерии диагностики, инсулинорезистентность, metabolic syndrome, diagnostic criteria, insulin resistance
INTEGRATED QUALITY ASSESSMENT OF DRINKING WATER IN CENTRALIZED WATER SUPPLY OF THE SMOLENSK REGION
Sidorenkova L.M., Mayorova E.G., Barsukov V.A., Avchinnikov A.V.
UDC: 613.31-074
Abstract: An integral quality assessment of drinking water in the centralized systems of the drinking water supply in different areas of the Smolensk region was carried out. The aim of the study was physical and chemical quality indices of the water from the network of the centralized systems of the drinking water supply in the region. The study used the results of the socio-hygienic monitoring of drinking water quality in the network of the centralized systems of the drinking water supply for 2005-2015 period. The features of the drinking water quality and human health risk factors due to this quality were determined. The risks of reflex-olfactory effects, non-carcinogenic and carcinogenic risks to the health of the population of the region due to the oral drinking water consumption were estimated on the basis of the application of risk assessment techniques. It was proved that it was necessary to take into account a number of drinking water quality indices while grounding the measures to optimize Smolensk region water systems.
Key words: качество питьевой воды, централизованные системы водоснабжения, риск для здоровья, интегральная оценка, drinking water quality, centralized water supply systems, health risks, integrated assessment
PREVENTION OF DENTAL DISEAS AMONG ADSOLESCENTS IN A SCHOOL DENTAL STUDY (REVIEW)
Shahmurina V.R., Kargina A.S., Mishutina O.L.
UDC: 616.31-053.71-084
Abstract: The study of the program of prevention of dental diseases in school dental office assesses the effectiveness of methods of prevention of dental diseases. The most common methods are the following: hygiene education, occupational hygiene, fissure sealing, and preparation of teeth with fluoride. The lack of measures for dental examination and preventive work with children and adolescents is a serious negative factor, which leads to a sharp increase in the incidence of all types of dental disease, primarily dental caries and its complications. Low level of hygienic knowledge and skills, lack of motivation to participate in prevention programs, determine the growth of prevalence and intensity of dental diseases, primarily in children and adolescents. Implemented programs of prevention of dental diseases in school dental offices was effective and improved the quality of dental care for children. Currently there are only a few data on the characteristics of prevention programs and their effectiveness in adolescents.
Key words: профилактика стоматологических заболеваний, школьный стоматологический кабинет, герметизация фиссур, обучение гигиене рта, профессиональная гигиена, prevention of dental diseases, school dental office, fissure sealing, teaching dental hygiene. professional hygiene, adolescents
DETERMINATION OF THE QUANTITY OF OPERATING FLUID IN TISSUES BY THE METHOD OF EDEMOMETRY
Kazushchik V.L., Karman A.D.
UDC: 617-089:616-073
Abstract: The aim of the study was to develop a method for determining the number of functional fluid in the tissues by the method of edemometry. To do this, carrying out edemometry the doctor should determine the original tissue volume, muffled with the jaws of edemometer. At the end of the study the tissue volume between the jaws of edemometer is assessed again. The difference of tissue volume will document the amount of squeezed fluid. This allows you to quickly, noninvasively and accurately determine the amount of fluid in a certain volume of tissue, to compare it with the total mass of the investigated tissues that is an important indicator of the content of fluid in the tissues. Results: a simple, affordable, non-invasive and accurate method of determining the content of fluid in the tissues was developed. Conclusions: edemometry allows you to define the number of functioning fluid in a specific volume of tissue, to assess the degree of hydration of the tissues and on the basis of these data to optimize the diagnosis and correction of therapeutic measures.
Key words: эдемометр, эдемометрия, количество жидкости в тканях, выдавливание жидкости, edemometer, edemometry, the amount of fluid in the tissues, squeezing fluid
PROFESSOR JAROSLAV KULIK - A PIONEER OF CARDIAC SURGERY IN SMOLENSK REGION: BECOMING A SURGEON AND A SCIENTIST
Pchelina I.V., Glyantsev S.P.
UDC: 616.1-089:614.253.1(470.332-25)61928/19679(092)
Abstract: In the article involving archive, printed, visual and verbal sources the scientific biography was studied, the facts and events of the initial period of the life and work (from 1928 to 1967) of a graduate of the Smolensk State Medical Institute (SSMI), Professor J.P. Kulik (1928 -2007) were reconstructed. Studying in 1954-1957 in clinical internship at the Department of General Surgery at the SSMI he participated in the first closed heart surgery in Smolensk. Heading from 1959 the Department of the Thoracic Surgery at the Regional Hospital, and in 1964 - the Department of Cardiovascular Surgery in 1 City Hospital of Smolensk, J.P. Kulik was the first in the region who began to perform heart surgery under direct vision. During 10 years of intensive scientific and practical activities after defending his thesis for the degree of a Candidate of Medical Sciences in 1965, J.P. Kulik was formed as a surgeon and scientist. After moving in 1967 to the Far East, he became a major heart surgeon, the founder of the clinical school, but the beginning of this path originated in the Smolensk region.
Key words: история кардиохирургии в России, Смоленск, Я.П. Кулик, history of cardiac surgery in Russia, Smolensk, J.P. Kulik