DRINKING WATER IN THE SMOLENSK REGION
Avchinnikov A.V., Egoricheva S.D., Rodyukova O.A., Punina M.A.,
UDC: 613.31
Abstract: The article involves comprehensive assessment of current situation and prospects of the Smolensk Region concerning drinking water supply, Specific character of the man-made pollution and hydro and chemical features of the regional water supply sources have been taken into consideration. Poor quality of drinking water dramatically reduces the level of living conditions increasing risks of infectious and somatic pathologies. The study involved various characteristics and sources of drinking water. Physicochemical, microbiological and radiological characteristics of the water sources and the drinking water supply system in the region are discussed. Results of social and hygienic monitoring of the regional water sources and drinking water from a distribution network during the period 2007-2013 are provided in the paper. Long-term study of water quality became the basis for the forecasting investigations up to 2020. Characteristics of soil waters wеrе rеvealеd and correlation of the characteristics with health risk factors wеrе identified. Significance of various drinking water quality indicators in optimization of water supply systems was clearly demonstrated.
Key words: drinking water supply assessment, drinking water, population health, оценка состояния водоснабжения, питьевая вода, здоровье населения
ASSESSMENT OF BELARUSIAN STATE MEDICAL UNIVERSITY STUDENTS’ BODY HEALTH
Romanov K.U., Trofimenko A.M., Pereverzev V.A.,
UDC: 613.71-057.875(476)
Abstract: We have studied first-year students’ body health at the beginning and the end of their academic year. Investigated parameters involved body height, weight, spirometer data, and hand dynamometry as well as heart rate at rest and after physical exertion. Life, power and weight-height indices as well as a Rufe-Dixon test were also included into the study. Integral estimation of students’ physical health was assessed on the basis of these indicators. The data obtained were mathematically and statistically analyzed. The study of the 1st year students’ physical health discloses negative deviations in the mean values characterizing functional state of the cardiovascular, respiratory and muscular systems. Integral indicator of physical health in this group is low. During an academic year positive changes in the majority of investigated indicators did not occur. The study clearly demonstrated urgency of health-improving thinking and interests in physical education in students (in girls, in particular) with a focus on health techniques to optimize functional body state.
Key words: студенты, физическое здоровье, рос, вес, спирометрия, динамометрия кисти, частота сердечных сокращений, эксперимент, students, physical health, growing up, weight, spirometer data, hand dynamometry, heart rate, experiment
ADAPTATION TO HYPOXIA IN TUMOUR GROWTH
Pozhilova E.V., Novikov V.E.,
UDC: 615.015:616-001.8
Abstract: Protein regulatory factor HIF-1α (hypoxia-inducible factor-1alfa) plays a crucial part in adaptation of body tissue to hypoxia, including tumor hypoxia. HIF-1α is a potent inducer of angiogenesis in tumor growth. Importance of HIF-1α and the related growth factors in development of tumors is discussed in the article. Clarification of pathogenetic role of HIF-1α in the development of tumors contributes to success of target therapy in malignant new growths being a perspective method in pharmacotherapy of cancer diseases in pathogenesis of which intratumoral hypoxia plays an inducing part.
Key words: гипоксией индуцированный фактор (HIF-1α), сосудистый эндотелиальный фактор роста (VEGF), гипоксия опухолевых клеток, онкологические заболевания, hypoxia-inducible factor (HIF-1α), vascular endothelial growth factor (VEGF), tumor hypoxia, oncological diseases
PROSPECTS OF INHIBITORS OF ADAPTATION TO HYPOXIA IN CANCER MEDICINE
Novikov V.E., Levchenkova O.S.,
UDC: 615.015:616-001.8
Abstract: Protein regulatory factor HIF-1α (hypoxia-inducible factor-1alfa) plays the most significant part in adaptation of tumor cells to hypoxia. Increase of expression of HIF-1α is registered in various cancer diseases. HIF-1α is a powerful inducer of angiogenesis in tumor development. Pharmacological regulation of HIF-1α level and the related growth factors with a targeted action of HIF-1α inhibitors is discussed in the article. Such approach is considered to be a perspective study in pathogenetic pharmacotherapy in cancer diseases in which pathogenesis of hypoxia acts like an inducer. Experimental and clinical data involving HIF-1α inhibitors and growth factors in treatment of tumors are analyzed and discussed in the paper.
Key words: гипоксией индуцированный фактор (HIF-1α), гипоксия опухолевых клеток, ингибиторы HIF-1α, фармакотерапия опухолей, hypoxia-inducible factor (HIF-1α), tumor hypoxia, HIF-1α inhibitors, pharmacotherapy of tumors
CLINICAL AND IMMUNOLOGICAL FEATURES OF SELECTIVE IGA DEFICIENCY IN YOUNG CHILDREN
Slabkaja E.V., Sazonenkova L.V., Andreenkova J.S., Meshkova R.J.,
UDC: 616-097-053.4
Abstract: Early diagnosis of primary immune deficiency is of great significance. We have examined 859 children with a high incidence of various illnesses. Their serum immunoglobulin level was assessed with ELISA method. In 46 children aged up to 4 years the diagnosis of IgA selective deficiency was verified. Depending on a dominant clinical type, 3 groups of children were identified: atopic syndrome - 13 children, infective syndrome - 13 children, mixed clinical type - 20 children. We studied the following clinical data and medical history: age at first manifestation of immunodeficiency, family and obstetric anamnesis, features of infectious and allergic reactions. The first clinical symptoms in children with atopy were registered at their earlier age. Family history was had atopy in 25-30% children of all groups, even in the lack of allergic manifestations. Family anamnesis weighed down by non-atopic pathology was detected in 2 times more often and more severe in the mixed variant. Histories of obstetric and gynecological malfunctions were identified with equal frequency in all groups of children. In the clinical picture with infectious and mixed clinical form ENT-organs infections dominated, with mixed clinical types - allergic rhinitis took the 2-nd rank, with an atopic form - acute urticaria. Malformations and development abnormalities are diagnosed in every third child with infectious and mixed variants of immunodeficiency. The study confirmed lack pathognomonic symptoms of this pathology. It also demonstrated importance of atopy, along with an infectious syndrome, particularly in the form of ENT-organs infections and more frequent incidences of malformations and development abnormalities.
Key words: первичный иммунодефицит, селективная недостаточность IgA, primary immunodeficiency, selective IgA deficiency
MORBIDITY AND MORTALITY RATES IN MALIGNANT NEWGROWTHS IN THE SMOLENSK REGION
Chernoshvec E.N., Kisiljova A.N., Gulo S.A., Semkina E.N., Solovjev V.I., Lopashinov P.M.,
UDC: 615.45:616-006
Abstract: Statistics involving population of the Smolensk region suffering from malignant new growths in 2010-2014 shows progressive increase in morbidity and mortality rates. In 2014 in Russia (summary data are presented with involvement of the Crimean FD) there were 566 970 primarily revealed cases of malignant tumors that is 8.8% higher than in 2010. According to the World Health Organization (WHO) totally 2 102 000 deaths because of malignances were registered in Russia in 2014. The Smolensk region for the many years is a region with high cancer morbidity. The number of cancer patients in the Smolensk region has increased by 2 490 people in 2014 compared to 2010 and with total number 22 017 patients with various malignant growths. Morbidity index (per 100 thousand) was 2021.4 in 2010. In 2014 it increased up to 2274.7 (11 %.) The index of the primary cancer morbidity (per 100 thousand) during the same period increased from 338.7 to 400.7 (15%). Cancer death rate (per 100 thousand) from 161.6 in 2010 increased up to 192.8 in 2014, representing 16% population. Prevention as well as early diagnostics is of prime significance to improve the situation.
Key words: злокачественные новообразования, онкологические больные, первичная заболеваемость, общая заболеваемость, смертность, malignant growths, oncological patients, primary incidence, general incidence, mortality
BREAST CANCER IN THE SMOLENSK REGION
Chernoshvec E.N., Kisiljova A.N., Gulo S.A., Semkina E.N., Solovjev V.I., Lopashinov P.M.,
UDC: 615.45:616-006
Abstract: The article presents data on breast cancer in women of the Smolensk region in 2010-2014. Breast cancer accounts for 16% of all cancers in women. In Russia breast cancers is diagnosed in 102 women every day. By the end 2014 in Russia there were 3,291,035 breast cancer patients, which is 2.25% population. In 2014, malignant tumors of the breast were diagnosed in 18.2%, uterine body (7.1%) and colon (5.7%) female population. Breast (20.7%) demonstrated the highest rate in patients followed up for 5 years or more. The proportion of patients with morphologically confirmed diagnosis of breast cancer was 88.8% in 2014, compared to 2013 (87.7%). The WHO significantly contributes the fight against breast cancer with various national programs combined with programs for non-communicable disease prevention and control. The Ministry of Health of the Russian Federation has developed some regulations to be implemented by 2018. In accordance with the regulations, cancer mortality rate is planned to be decreased from 199.2 per 100 000 population in 2013 to 192.8 in 2018. To achieve this goal it is necessary to reduce consumption of alcohol, tobacco smoking and promote healthy lifestyle. Regular free check-ups each three years are also of great significance.
Key words: злокачественные новообразования, рак молочной железы, заболеваемость, смертность, malignant growths, breast cancer, incidence, mortality
SOME ISSUES OF DIFFERENTIAL DIAGNOSIS OF PLEURAL EFFUSION IN ISCHEMIC HEART DISEASE AND ISCHEMIC NEPHROPATHY (CLINICAL OBSERVATION)
Litvinova I.A., Kurilenko T.S., Litvinov A.V.,
UDC: 616.61:616.12-009.72-003.2
Abstract: Pleural effusion is usually considered to be an excess of fluid accumulated in the pleural cavity as a result of an inflammatory process or imbalance of blood colloid osmotic pressure and hydrostatic pressure in haemocapillaries. Differential diagnostics of such cases can be a challenge. Clinical case of right-sided chronic recurrent pleural effusion in a patient with ischemic heart disease and chronic renal ischemia of atherosclerotic origin following coronary artery bypass graft surgery and mammary coronary bypass surgery is described in the article. Before cardiac surgery creatinine blood level was 220 μMol/L, urea level - 11.6 mMol/L, glomerular filtration rate - 29 mL/min. Small quantities of proteins were detected in urine. Recurrent right-sided pleural effusion had been persisting for 11 month following surgery with no trend to involution and required evacuation of total 70 L pleural fluid. When renal-artery stenting was performed, the patient’s condition improved, dyspnea became less prominent, blood pressure was normalized, left ventricular output increased from 36% to 64%, and systolic blood pressure in the pulmonary artery decreased from 42 to 28 mmHg. No fluid was revealed in pleural cavity. The patient was followed-up for 8 years. No pleural effusion was identified; urea level in blood as well as renal function being stable. The article provides discussion on potential causes and mechanisms of liquid accumulation in the pleural cavity of such cases. At the same time internal mechanisms of one-sided pleural effusion development in patients with severe impairment of renal hemodynamics of primary origin remain unclear.
Key words: ишемическая болезнь сердца, аортокоронарное шунтирование, маммарокоронарное шунтирование, ишемия почек, плевральный выпот, дифференциальная диагностика, ischemic heart disease, coronary artery bypass graft surgery, mammary coronary bypass surgery, renal ischemia, pleural effusion, differential diagnostics
FEATURES OF ATTENTION AND MEMORY IN CHILDREN WITH EPILEPSY
Kasaminskaya E.S., Maslova N.N., Pugach L.I.,
UDC: 616.853-009.24
Abstract: Attention and memory were investigated in children with epilepsy and compared with those with vegetative disorders as well as healthy children. All children with epilepsy had normal level of intellect and remission of seizures for more than 3 months. To assess cognitive features, tests of 10 words by Luria and Shulte’s tables were performed. Average indexes of memory and attention did not have any significant differences in both tests between all groups investigated, though some indices were lower in children with epilepsy. Similarly, psychological stability was worse in children with epilepsy despite absence of significant statistical differences between the groups. The number of children with normal memory volume in epilepsy group was significantly less than among healthy children. Epilepsy even being in remission keeps a persistent negative influence on the processes of memory, that does not exclude the presence of normal or even high results in individual children with this disease. In persistent remission of epilepsy attention suffers to a lesser extent compared to memory.
Key words: эпилепсия, дети, внимание, память, pilepsy, children, memory, attention
POTENTIALS TO IMPROVE COMPLIANCE, QUALITY OF LIFE AND PSYCHOLOGICAL STATUS OF ARTERIAL HYPERTENSION PATIENTS WITHIN A LOCAL OUTPATIENT DISTRICT
Philippova U.M., Nikitin G.A., Yakunin K.A.,
UDC: 616.12-008.331.1
Abstract: The study was primarily focused on methods affecting patents’ compliance, quality of life and psychological status of arterial hypertension patients. A series of methods was used: attendance of special arterial hypertensions schools, physical exercises as well as psychological trainings. The study results clearly demonstrate that special trainings organized at the Arterial Hypertension School, involvement of patients into certain physical trainings and exercises as well as psychological trainings provide an opportunity to improve patients’ compliance, quality of their life and psychological status. Physical exercises can have a greater impact on indices of quality of life associated with somatic pathologies; whereas psychological trainings can influence patients’ psychological status. The obtained data should be taken into consideration when the activities are recommended to patients. Investigation of correlation between patients’ compliance, quality of life and psychological status revealed on examination of patients and in one year following the course of treatment demonstrated that the correlation is rather slight and unstable and witnesses more complicated ways to form arterial hypertension patients’ compliance.
Key words: артериальная гипертония, комплаентность больных, качество жизни, психологический статус, корреляционные связи, arterial hypertension, patients’ compliance, quality of life, psychological status, correlation
INFLUENCE OF PSYCHOLOGICAL TRAININGS ON ARTERIAL HYPERTENSION PATIENTS’ COMPLIENCE WITHIN AN OUTPATIENT DISTRICT
Philippova U.M., Nikitin G.A., Yakunin K.A.,
UDC: 616.12-008.331.1
Abstract: The study involves effect of psychological training on arterial hypertension patients’ compliance and therapy results. Such psychological methods as progressive muscular relaxation, mind setting and creative visualizations were used to perform the study which clearly demonstrates that non-medical treatment of patients with arterial hypertension causes certain changes in their behavior making them more follow doctor’s recommendations. Changes in psychological status can improve patients’ compliance and result in positive clinical, social and economic effects. The positive effect of psychological trainings on the behavior of patients with arterial hypertension is rather moderate and should be confirmed with other methods.
Key words: артериальная гипертония, комплаентность, психологические тренировки, arterial hypertension, compliance, psychological training
ROLE OF PSYCHOLOGICAL PROTECTION MECHANISMS AND PERSONALITY STRUCTURAL COMPONENTS IN CLINICAL MANIFESTATIONS OF PERSONALITY AND BEHAVIOR DISORDERS IN YOUNG MEN OF THE CALL-UP AGE
Severova E.A., Okhapkin A.S., Fyodorova E.A.,
UDC: 616.89-053.7
Abstract: Mechanisms of psychological protection and structure of the personality combined with types of personality and behavior disorders in young men of military age have been studied. Three main types of personality and behavior disorders of the young men referred to the military psychological and psychiatric examination were revealed (emotional unstable (F60.30), anxious (deviating) (F60.6) and dependent (F60.7) personality and behavior disorders). Targets of psychotherapeutic treatment were defined as well: aggression, alarm, combination of various types of psychological protection. Persons with personality and behavior disorders more often utilize the following combinations of psychological protection: reactive reaction and replacement, compensation and displacement. Alarm and aggression in the structure of the personality in persons of the studied group were of the deficiental and destructive character unlike the control group where these features of the personality were of the adaptation value.
Key words: расстройства личности и поведения, юношеский период, механизмы психологической защиты, агрессия, тревога, психотерапевтическая мишень, personality and behavior disorders, youth, mechanisms of psychological protection, aggression, alarm, psychotherapeutic target
BEHAVIORAL REGULATION IN YOUNG MEN WITH PERINATAL HYPOXIC LESIONS OF THE CENTRAL NERVOUS SYSTEM
Kosenkova T.V., Schelkova O.J., Fedorova E.A., Gombalevskay M.S., Ovchinnikov B.V.,
UDC: 616.8-005.4-053.7
Abstract: Young men of the call-up age can have certain consequences because of a perinatal hypoxic brain injury of the central nervous system. Their peculiarities and behavioral regulation were studied. We investigated the prevalence and characteristics of the types of a minimal brain dysfunction, levels of the military occupational orientation, tendency to have addictive, delinquent behavior and the risk of suicide using the methods of Toulouse-Pierron and "The research of the deviant behavior". It was found that the patients most frequently had asthenic and subnormal types of the minimal brain dysfunction having the disturbances in cognitive and personal development, the formation of the volitional qualities and the level of the behavioral regulation. The young men have low adaptation to the military service. Their physical activity does not meet army conditions and awareness of the reluctance to submit to the orders of the commanders and superior officers. For the young men with a reactive type and the tendency to commit a suicide normally had asthenic and rigid types of the minimal brain dysfunction. The young men with an asthenic type of the minimal brain malfunction have the lowest level of the military occupational orientation. The young men with the asthenic type of the minimal brain dysfunction have the lowest level of the military professional orientation. They do not demonstrate their interest in becoming solders. They have the low adaptation to the requirements of military service, low physical activity and awareness of the reluctance compliancy to obey the orders of the commanders and superior officers. The signs of a trend to demonstrate delinquent and addictive behavior are more common in young men with a reactive type and risks of suicide with asthenic and rigid types of the minimal brain dysfunction. Thus, the study performed clearly demonstrates that perinatal hypoxic brain injury of the central nervous system, asthenic, reactive and rigid types of the minimal brain malfunction are unfavourable characteristics to become an army solder.
Key words: перинатальное поражение центральной нервной системы, юноши, минимальная мозговая дисфункция, поведение, perinatal insult of the central nervous system, young men of the military age, minimal brain dysfunction, behavior
FASTING NORMOGLYCEMIA (AT REST AND DURING FUNCTIONAL ACTIVITY): CLASSIFICATION AND PARAMETERS
Pereverzev V.A., Welcome M.O., Mastorakis N., Pereverzeva E.V.,
UDC: 612.352.12-053.8
Abstract: Classification of normal levels of glucose in the blood of healthy adults on fasting (at rest and during functional activity) has been developed and offered for scientific consideration: low (3.33-3.84 mmol/L and 3.33-4.44 mmol/L, respectively), optimal (3.85-4.44 mmol/L and 4.45-6.67 mmol/L, increased (4.45-5.10 mmol/L and 5.01-6.67 mmol/L) and high (5.11-5.55 mmol/L and 5.56-6.67mmol/L) normoglycemia. The substantiation of this classification of normoglycemia in a context of physiological and biochemical mechanisms of its regulation, as well as clinically significant risks of diabetes mellitus and hypoglycemic conditions are also presented. For optimum level of fasting normoglycemia at rest, it is suggested to consider the blood glucose concentration (3.85-4.44 mmol/L), at which there is minimal secretion of major hormone regulating blood sugar level, namely insulin and its antagonists (glucagon, epinephrine, cortisol , growth hormone), and no or minimal risk of hyper- and hypoglycemic conditions. In a working human, optimum fasting blood glucose level on the background of the functional load or rest after work is proposed to increase to 4.45-6.67 mmol/L, which is due to the need for adequate supply of the nervous system. Elevated fasting normoglycemia is different from the optimal level only by higher value of glucose level at rest. High level of normoglycemia is characterized by a fasting glucose of 5.1 mmol/L at rest, which is accompanied by an increased risk of diabetes, particularly in people older than 30 years, while maintaining good performance. Low-level normoglycemia is characterized by a reduced level of blood glucose at rest (3.33-3.84 mmol/L) and during functional load (3.33-4.44 mmol/L). This causes the activation of the direct synthesis and secretion of counter-regulatory hormones glucagon, adrenaline and cortisol, and also accompanied by a significant reduction in performance and increased risk of neuroglycopenia or hypoglycemic coma.
Key words: глюкоза, уровни нормогликемии, классификация, glucose, levels of normoglycemia, classification
SILVER IN TOPICAL TREATMENT OF INFECTED WOUNDS
Privolnev V.V., Zabrosaev V.S., Danilenkov N.V.,
UDC: 616.91-003.9
Abstract: The article discusses preparations of silver, used for the treatment of infected wounds: silver nitrate, silver sulfadiazine, silver sulphathiazole, and silver nanoparticles in detail. The mechanism of effective antibacterial, antiviral, antifungal and anti-inflammatory action, positive and negative effects on the wound process, as well as data on cytotoxicity and inhibition of migration and proliferation of fibroblasts in the wound are presented in the paper. The study discloses the problem of antimicrobial resistance to silver substances. Certain practical recommendations on application of silver-containing medicines in the treatment of wounds and wound infection, taking into account the phases of wound healing are formulated. Critical review on various combinations of sulfonamides with silver in development of topical treatment of wounds and wound infections is provided. Advantages and disadvantages of the substances are demonstrated. Common errors in application of these topical drug forms in clinical practice due to over- or underestimation of their wound-healing action are shown. Potentials of topical silver-containing drug forms in diagnosis and surgical treatment of diseases, as well their application in various implants are discussed. Certain challenges in application of the drug forms booster further research.
Key words: ана, раневой процесс, раневая инфекция, серебро, wound, wound process, wound infection, silver
HYGIENIC ASPECTS OF PREVENTION OF HEALTHCARE ASSOCIATED INFECTION IN MATERNITY HOMES
Avchinnikov A.V., Egoricheva S.D.,
UDC: 613:616.9+618.2/.7
Abstract: Review on publication and reports of Russian and foreign authors involving etiology and epidemiology of infections associated with health care service (HAI) in maternity hospitals is presented in the paper. Urgency of the problems is disclosed. The main risk factors for the development of HAI in newborns and postpartum are considered. The main sanitary areas of the HAI prevention as a part of epidemiological supervision are determined.
Key words: инфекции, связанные с оказанием медицинской помощи, профилактика, родовспомогательные учреждения, новорожденные, гнойно-септические инфекции, больничная гигиена, hygiene, healthcare associated infections, prevention, maternity home, newborns, purelent-septic infections, hospital hygiene
ETYMOLOGY AND SEMANTICS OF SOME MEDICAL TERMS
Agafonov A.N.
UDC: 61(091)
Abstract: The article outlines key lexical layers of medical terminology: Indo-European and Old Church Slavonic, Latin and Greek, as well as formation of neologisms and foreign borrowings. Historical events that initiated introduction and systematization of ancient medical terminology in the Russian language are also provided in this paper. Detailed analysis of etymology and semantics of Slavic medical terms relating to sections of anatomy, internal disease cases, epidemiology, dermatology and psychiatry is given in the study. Different semantic concepts of individual lexemes, stylistic figures of speech and sustainable expressions to the field of medicine were also analyzed in this article.
Key words: медицинская терминология, латинский язык, старославянский язык, этимология, эвфемизмы, medical terminology, Latin language, old Slavonic language, etymology, euphemisms