NEW DATA ON STRUCTURE AND FUNCTIONS OF GABA-BENZODIAZEPINE RECEPTOR COMPLEX FOR UNDERSTANDING THE EFFECTS OF CONVULSIVE AND ANTICONVULSIVE DRUGS
Shilov G.N., Bubel O.N., Buznik G.V., Shabanov P.D.
UDC: 616-092.9
Abstract: The methods of quantum mechanic characteristics and molecular geometry reveal that the GABA molecule has three conformational states: linear (GABA-1 conformer), cyclic (GABA-2 comformer) and bucket-like (GABA-3 conformer). They play different functions in the brain neurons: cyclic and bucket-like conformers play the role of endogenous transmitters, and the linear conformer participates in neuronal metabolism. The theoretical conformational analysis shows that there are two types of GABA receptors in the CNS neurons: GABA-2 receptors, agonists of which are cyclic conformers of GABA, glycine and β-alanine and antagonists are bemegride, pentilentetrazol and strychnine; and GABA-3 receptors, agonists of which are bucket-like conformer of GABA and antagonists are picrotoxin and bicuculline. Anticonvulsive and other behavioral effects of derivatives of barbituric acid, benzazepine, benzodiazepine, gidantoine, succinimide and oxasolidindione are probably realized via GABA-2 receptors to activate which the following functional centers of their structure are required: α, γ and [δ-ε] for barbitirates; β, [δ-ε] and γ for carbamazepine; β and [δ-ε] for benzodiazepine derivatives, gabapentine and vigabatrine; α, β, γ and [δ-ε] for gidantoine and oxasolidindione derivatives; α, β, γ for succinimide derivatives. The power of any behavioral effect of anticonvulsants and inhibitory amino acids depends on the power, location and number of hydrogen bounds developed between active centers of anticonvulsant pharmacophore or inhibitory amino acids and active centers of the functional skeleton of GABA-2 receptor complex. These properties determine the absence of nootropic activity in anticonvulsive drugs and presence of them in inhibitory amino acids. It is concluded that there are perspectives of synthesis of compounds, pharmacophore of which resemble the cyclic conformer of GABA, glycine and β-alanine in their quantum mechanic characteristics and molecular geometry.
Key words: ГАМК, конформеры, рецепторы ГАМК, строение рецепторов, противосудорожные средства, судорожные агенты, GABA, conformers, GABA receptors, receptor structure, anticonvulsive drugs, convulsive drugs
ANTIHYPOXIC EFFECT OF NICOTINIC ACID DERIVATIVES IN ACUTE HYPOXIA WITH HYPERCAPNIA AND ACUTE HEMIC HYPOXIA
Gneushev I.M., Novikov V.E., Katunina N.P.
UDC: 612.273+615.2
Abstract: The aim of the pilot study was to evaluate the effect of new antihypoxic zinc-containing nicotinic acid derivatives in acute hypoxia with hypercapnia and acute hemic hypoxia. Experiments were carried out on male mice of the SHR line weighing 22-26 g. Acute hypoxia with hypercapnia was caused by placing the mice in the pharmacy shtanglass made of transparent glass with a ground glass stopper, 250 ml in volume. Acute hematic hypoxia was simulated by subcutaneous administration of sodium nitrite at a dose of 400 mg/kg (LD). We recorded the duration of animal life in minutes. In the series of the new studied derivatives of nicotinic acid, a zinc complex compound with the πQ-1043 code was revealed, which in conditions of acute hypoxia with hypercapnia and acute hemic hypoxia at the dose ranging from 10 to 100 mg/kg increased the survival of mice by 26-41%. This indicator the antihypoxic activity of the compound was higher than that in the sodium hydroxybutyrate and hypoxen. The πQ-1043 compound is of interest as a promising antihypoxant and can be recommended for further more in-depth pilot study of its pharmacological properties and the possible mechanism of action.
Key words: гипоксия, антигипоксанты, цинксодержащие производные никотиновой кислоты, антигипоксический эффект, hypoxia, antihypoxants, zinc-containing nicotinic acid, antihypoxic effect
SOME ASPECTS OF HEALTH STATUS IN INTRAUTERINE GROWTH RESTRICTION INFANTS AT THE AGE OF ONE YEAR
Kozlova L.V., Ivanov D.O., Derevtsov V.V.
UDC: 616-053.36:618.3-06
Abstract: On the basis of clinical, anamnestic, physical, laboratory, electrophysiological, ultrasound and statistical surveys we investigated some aspects of the health status of infants with intrauterine growth restriction at the age of one year. It was found that in infants at the age of one year intrauterine growth restriction induces smaller anthropometric sizes, hypotrophy of various degrees of intensity (especially second-degree hypotrophy (in 73.91%)), higher frequency of ARVI (by 1.39 times higher), lower frequency of anaemia (by 3.45 times lower) and atopic dermatitis (by 4.48 times lower); retardation of the following lines of neurophysiological development: general movements (by 2.3 times more frequent), arm movements (by 2.36 times more frequent), active speech (by 1.92 times more frequent), speech comprehension (by 1.77 times more frequent), and skills (by 1.66 times more frequent); autonomic dysfunction accompanied by depletion of adaptive reserves (in 21,15%); wandering of atrial pacemaker (by 4.97 times more frequent), myocardial repolarization defect and ventricular early repolarization syndrome (by 2.23 times more frequent), comparable frequency of intraventricular conduction defect in the right bundle branch (in 28,57%); anterior mitral leaflet prolapse (by 4.42 times more frequent), and comparable frequency of interatrial communication (in 34.88%). Infants born with IURG and infants born without IUGR, in comparison with healthy infants, encountered identical changes, similar to hypertrophic cardiopathy with myocardial hypocontractility, resulting from hypoxia, which were more intense in those born without IUGR.
Key words: задержка роста плода, дети, здоровье, intrauterine growth restriction, infants, health
MORTALITY ANALYSIS IN PATIENTS WITH STROKE IN SMOLENSK REGION IN 2015-2016
Agafonov K.I., Triasunova M.A., Maslova N.N.
UDC: 616.831-005
Abstract: Analysis of mortality in patients with stroke, treated in Regional vascular service center and primary vascular service departments of Smolensk and Smolensk region was performed. Reports of the regional vascular service center of Smolensk work and work of vascular service of Smolensk region were analyzed. Death reports of patients with stroke also were analyzed. The aim of the study is to make recommendations for treating patients with stroke to decrease mortality in these patients. High percentage of recurrent strokes was identified. It means that primary and secondary prevention of stroke is insufficient. Continuous training of doctors and nurses in regional vascular service centers is needed. It will increase quality of medical service and improve rehabilitation prognosis in patients with ischemic stroke.
Key words: инсульт, заболеваемость инсультом, смертность от инсульта, региональный сосудистый центр, stroke, stroke mortality, stroke morbidity, regional vascular service center
CONSTITUTIONAL PECULIARITIES OF CHILDREN AND ADOLESCENTS WITH BRONCHIAL ASTHMA
Yacheykina N.A., Alimova I.L., Novikova O.B.
UDC: 616.248-053.2
Abstract: The aim of this work was to identify constitutional features in children and adolescents with asthma. We examined 484 children aged 7-14 years. The main group consisted of 237 children and adolescents with asthma, the comparison group - of 247 children without chronic diseases. The study was conducted in the respiratory educational center of MUCH CST polyclinic №4. We calculated and estimated the SDS (standard deviation score) indicators of growth and SDS of body mass index with the help of the Antro Plus program. It was revealed that in patients with bronchial asthma high growth rates and obesity were recorded significantly more often than in the comparison group. We did not reveal any dependences between growth and weight, gender, age, disease severity and taking inhaled corticosteroids. In the dynamics of the disease no changes of growth and weight were observed. 70% of children and adolescents with obesity and bronchial asthma, had a family history of obesity from parents. When conducting a correlation analysis between height and body mass index of children with bronchial asthma and growth as well as body mass index of parents we observed a positive relationship. Thus, the characteristic anthropometric characteristics of children and adolescents with asthma are high growth and obesity, which are determined by constitutional peculiarities of patients.
Key words: рост, вес, дети, подростки, бронхиальная астма, конституция, growth, weight, children, adolescents, bronchial asthma, constitution
RISK FACTORS OF DIGESTIVE SYSTEM DISEASES IN CHILDREN WITH BRONCHIAL ASTHMA
Voytenkova O.V., Legonkova T.I., Stepina T.G., Prohorova G.M., Shtykova O.N.
UDC: 616.2484-053.5+616.3
Abstract: Frequency of allergic diseases in children has been increased in the recent years. Chronic diseases of the digestive system are widespread in children. Digestive system pathology in children with bronchial asthma is the most frequent extrapulmonary visceral pathology. Concomitant gastroenterological pathology has an oligosymptomatic clinical course and bronchial asthma symptoms mask digestive system pathology. Although the criteria and diagnostic methods of digestive system pathology in children with bronchial asthma have not been developed yet for practical health care. The aim of the study was to analyze the frequency and character of digestive system pathology in children with bronchial asthma, to estimate the risk factors of digestive system diseases. The study involved 187 children. All children were divided into two groups. The main group involved children with bronchial asthma (n=107). The control group involved children without digestive system pathology and allergic diseases (n=80). The methods of study used were anamnestic, functional, laboratorial and instrumental. A high frequency of digestive system pathology was proved (98%) and possible risk factors were established in the study. Chronic Hp-associated gastritis and gastroduodenitis were prevalent in the structure of the gastrointestinal pathology (60.5%). Direct correlation of frequency and Hp-infected degree with the severity of bronchial asthma was determined (r=0.38; p<0.05). A high frequency of coincidence of the Hp-infected was revealed by histomorphological and serological methods (immune enzyme assay with determination of antihelicobacter antibodies - 94%). Morphofunctional peculiarities of digestive system pathology in children with bronchial asthma were esophageal, gastric and duodenum mucosa lesions. A high frequency of motor function disorders such as duodenogastric (41.1%), gastroesophageal (20.6%) refluxes; cardiochalasia and pyloric incompetence; gastric hyperacidity (77.6%) was established. The disorders were probably due to the pathogenetic mechanism in bronchial asthma development or conducted therapy.
Key words: бронхиальная астма, дети, желудочно-кишечный тракт, факторы риска, критерии и методы диагностики, bronchial asthma, children, digestive system, risk factors, criteria and diagnostic’s methods
АNALYSIS OF FERTILITY, PRETERM BIRTH AND PERINATAL OUTCOMES IN 2012-2015 IN THE SMOLENSK REGION
Alimova I.L., Kalandia M.R., Stunzhas O.S., Gorbatyuk I.B.
UDC: 618.4:312.1(470.332)
Abstract: The aim of the study was to analyze the dynamics of fertility, preterm birth and perinatal outcomes for the 2012-2015 in the Smolensk region. We studied the official statistic N32 and A05 forms, the primary documentation (pregnancy maps, birth histories, histories of newborns). We established that fertility (10.5-10.8‰) in the region remains at a stable level. The number of premature births and children born with extremely low birth weight in the dynamics decreased within the last 4 years. The greatest amount of preterm infants (64.1-68.9%) was born in Level III institutions providing medical care for newborns. Perinatal mortality has decreased mainly due to the reduction of early neonatal mortality. The proportion of stillbirths in the structure of perinatal losses remains high and hovers around 60.4-64.7%. In the structure of the causes of deaths of term infants congenital abnormalities and bacterial sepsis of newborns dominate. The main cause of death of premature infants with extremely low birth weight is intraventricular hemorrhage, followed by sepsis, and respiratory disorders. The survival rate of children with extremely low body weight has increased from 59.0% to 82.3%. Thus, it is necessary to continue the regional medical and organizational measures aimed at the prevention of perinatal morbidity and mortality.
Key words: новорожденные, экстремально низкая масса тела при рождении, выживаемость, смертность, newborns, very low birth weight and extremely low birth weight, survival, mortality
DETECTION OF TUBERCULOSIS CASES AMONG THE PATIENTS OF SOMATIC HOSPITAL
Punin A.A., Guseva I.I., Korotkova E.A., Punin D.A., Gulyaeva S.A., Pikalova O.S., Horuzhenko O.M., Strelkov A.N., Sakharitova E.A.
UDC: 616.24
Abstract: The aim of the study was to analyze the cases of hospitalization of TB patients into the therapeutic departments to improve the mechanism of anti-epidemic and preventive measures. We have analyzed 147 case histories of the patients treated at the departments of City Clinical Hospital №1 of Smolensk who were suspected and confirmed after the examination to suffer from tuberculosis of different localization in the period from 2012 to 2015. While processing the data we took into account age, sex, clinical form of tuberculosis, bacterial excretion, comorbidities and outcome of the disease. Infiltrative and disseminated forms of tuberculosis and tuberculous pleuritis prevailed among the pulmonary forms. Meningoencephalitis, meningitis, tuberculous lesion of bones, tuberculous sepsis were identified among the extrapulmonary forms. 17% of patients were lost while transferring from somatic hospital to TB dispensary. We revealed the rise in the number of patients with bacterial excretion from 15% to 48% and combination of tuberculosis with HIV from 5% to 29% during 4-year observation. It is concluded that the bacterioscopy of the sputum is a plain routine, but highly informative method of TB detection in modern conditions, and should be conducted to all patients prior to admission to the hospital, and the search for new methods of control the transferring from somatic hospital to TB dispensary is highly required.
Key words: туберкулез, бактериовыделение, ВИЧ, tuberculosis, bacterial excretion, HIV
MYCOBACTERIUM TUBERCULOSIS INFECTION AS A PREDICTOR OF THE DEVELOPMENT, COURSE AND EFFECTIVENESS OF TREATMENT OF RHEUMATOID ARTHRITIS IN CHILDREN
Teshchenkov A.V., Shumilov P.V., Myakisheva T.V., Avdeeva T.G.
UDC: 616-002.5:616.72-002.77
Abstract: The aim of the study was to compare the frequency of latent tuberculosis infection before and in the course of rheumatoid arthritis depending on the therapy and to analyze the coverage of tuberculosis screening for patients with rheumatoid arthritis in the Smolensk region and the central clinic of Moscow. The methods applied in the study were the following: tuberculin diagnostics (Mantoux's test and Diaskintest) and X-ray examination of the chest and spiral computed tomography. The results of the study revealed that about 1/3 of children had latent TB infection before the development of rheumatoid arthritis, the average period of infection with Mycobacterium tuberculosis was 3.5 years. The frequency of latent tuberculosis infection in children with rheumatoid arthritis was 40%, the average term for its development was 2 years 8 months. Tuberculin tests were carried out regularly at ¼ of children with rheumatoid arthritis, in half of them Diaskintest was applied. X-ray examination to exclude tuberculosis was carried out regularly and completely only in 50% of patients. So, rheumatoid arthritis can be considered a risk factor of tuberculosis infection. These children need complete and regular investigation to exclude tuberculosis infection.
Key words: дети, ревматоидный артрит, инфицирование микобактериями туберкулеза, терапия ревматоидного артрита, children, rheumatoid arthritis, Mycobacterium tuberculosis infection, rheumatoid arthritis therapy
APPLICATION OF “POLYGEMOSTAT” DRUG TO ENSURE HEMOSTASIS IN SPONTANEOUS RUPTURE OF CAVERNOUS LIVER HEMANGIOMA (CLINICAL OBSERVATION)
Parhisenko Yu.A., Vorontsov A.K., Kalashnik R.S., Bezaltynnykh A.A.
UDC: 615.273.55, 616.36-006, 616.36-089.84
Abstract: Hemangioma of the liver is considered one of the most common tumors of the organ. It is revealed in 2% of the population according to surveys, but the real figure of prevalence reaches 7%. Each similar case in clinical practice is important for a better understanding of surgical treatment of patients with such complications of cavernous hemangiomas of the liver as its spontaneous rupture, because of the rare occurrence of this pathology. The aim of the article was to describe the clinical cases of spontaneous rupture of cavernous hemangiomas of the liver. A high mortality of patients with spontaneous rupture of cavernous hemangiomas of the liver necessitates the implementation of timely and adequate surgery to ensure stop of bleeding. The ability to use "Polygemostat" drug in combination with mechanical ways to stop bleeding from large vessels in spontaneous rupture of cavernous hemangioma of the liver was demonstrated. The cure of patients is achieved through the implementation of an operational tactics.
Key words: печень, кавернозная гемангиома, хирургия, гемостаз, «Полигемостат», liver, cavernous hemangioma, surgery, hemostasis, «Polygemostat»
NEW INSTRUMENTAL METHOD OF THE CREATION OF THE SURGICAL APPROACH IN PELVIC ORGANS SURGERY
Girev E.A., Zfrivchackiyi M.F., Gulyaeva I.L., Orlov O.A.
UDC: 616.351-006.6-089.616-72
Abstract: Development of the rectal cancer surgery involves the improvement of the instrumental method of formation of the surgical approach to improve radicality, to reduce surgical trauma, intra- and postoperative complications. A comparative evaluation of the quality of the surgical approach created by two original retractors by E.A. Girev, V.V. Ferapontov (RGF-1 and RGF-2) in the surgical treatment of rectal cancer was held. In the same 40 patients with rectal cancer in different instrumental methods of creating a surgical approach using a new retractor RGF-2 (n=40) and the retractor of old design RGF-1 (n=40) we investigated the objective criteria of quality of the surgical approach, such as the depth of the surgical wound, the angle of operation action and the angle of inclination of the operation action. A comparative evaluation of all types of intraoperative complications was analyzed, the value of intraoperative blood loss was considered as well. Using a retractor RGF-2 we decreased the depth of the wound from 67,8±3,8 to 66,8±4,0 mm, increased the angle of operation action by 15 degrees (p=0.01) and the angle of inclination of the operation action axis - by 4.3 degrees, which improved the quality of the surgical approach in lower-middle laparotomy. Intraoperative complications were not observed. The amount of intraoperative blood loss in the study group of patients was 216.5±38.86 ml; in the comparison group - 276±20.79 ml (p=0.1). Using the retractor RGF-2 increases the quality of the surgical approach, improves the activity of the surgeon, thereby, increases the effectiveness of surgical treatment.
Key words: ранорасширитель, операционный доступ, рак, прямая кишка, retractor, surgical approach, cancer, rectum
DIAGNOSTICS AND TREATMENT OF PATIENTS WITH RENAL CANCER IN SMOLENSK REGION (2008-2010)
Zuy V.S., Solovyov V.I., Semkina E.N., Grishina K.V.
UDC: 616.61-006.6-08
Abstract: Outcomes of treatment of 172 patients with different advanced renal cell carcinoma during the period 2008-2010 in "Smolensk Regional Oncology Clinical Dispensary" were analyzed. In the paper data of the official medical reporting documentation and the territorial cancer-register of Smolensk region were used. Patients were stratified by sex, age, location and advance of the tumor process. The results of the research revealed compliance with world, European and Russian indicators of kidney cancer patterns: kidney cancer is more common in men; in the structure of incidence in men left-sided localization process and in the later stages was dominated, in women - right-sided localization and in the earlier stages. The peak incidence for both sexes accounts for the age of 60-69 years. 5-year survival rate of patients with renal cell carcinoma corresponds to those of the world, Europe, Russia.
Key words: почечно-клеточный рак, заболеваемость, смертность, выживаемость, renal cell carcinoma, incidence, mortality, survival rate
DIAGNOSTICS LEVEL AND RESULTS OF TREATMENT LUNG CANCER IN SMOLENSK REGION (2004-2014)
Zuy V.S., Solovyov V.I., Semkina E.N., Grishina K.V.
UDC: 616.24-006.6-084.3
Abstract: The aim of the research is the study of diagnostic level assessment and the results of treatment patients with lung cancer is Smolensk region. The problem is the epidemiological incidence analysis of lung’s malignant neoplasm diseases in Smolensk region from 2004 to 2014. The evidence official accounting and reporting documents and territorial kantserrgistr were used. Patients were stratified by gender age, localization and the prevalence of tumor process and place of their residence. In general morbidity structure lung cancer ranks 3 in Smolensk region. However in men this leading nosology ranks 1while in women lung cancer is not included in the top five malignant neoplasm diseases. A sharp rise in the incidence of lung cancer is marked from 45 years and gets its peak to 65 years. In Smolensk region lung cancer holds leading positions in all oncological diseases wherein in Smolensk region lung cancer is diagnosed in 4 phase in 45%, that in 11,3% higher than the average for Russia, that negatively affects on patients with lung cancer survival rates.
Key words: рак легкого, заболеваемост7ь раком легкого, запущенность, отдаленные результаты, lung cancer, lung cancer morbidity, neglect, late fate
ROLE OF COMBINATIONS OF GENES ON THE PROGNOSIS OF CORONARY ARTERY STENTING COMPLICATIONS IN PATIENTS WITH MYOCARDIAL INFARCTION
Kruglov V.N., Rubanenko A.O.
UDC: 616.127-005.8
Abstract: The aim of the study was to elucidate the effects of genetic variants on the prognosis of coronary artery stenting complications in patients with myocardial infarction with ST-elevation. 171 patients were included in the study who were hospitalized with myocardial infarction with ST-elevation. The patients underwent stenting of the infarction-associated artery (ISA) immediately after admission or after ineffective thrombolytic therapy. The patients presented with clinical recurrence of coronary insufficiency after PCI comprised group I (n=43: 38 males (88.4%) and 5 women (11.6%), mean age - 56.7±10.2. Coronary angiography showed restenosis of the ISA stent in these patients and they underwent repeated stenting. Group II comprised 128 patients (103 males (80.5%) and 25 women (19.5%) with an uncomplicated postoperative period and mean age of 56.3±10.8. The genetic study results for 7 polymorphic genetic variants, coronary angiography data, and risk factors were analyzed. Groups I and II significantly differed in endpoints such as recurrence of myocardial infarctions (9.3% vs. 0%) (p=0.004) and frequencies of reinfarction (21.0% vs. 0%), respectively (p<0.0001). The combination of alleles (4G/4G) of gene PAI-I, (G455A) of gene FI and (Т1565С) of gene ITGB3 was defected in 9 patients (21.0%) of group I and in 11 patients (8.6%) of group II (p=0.03). The combination of alleles (G455A) of gene FI and (Т1565С) of gene ITGB3 was detected in 10 patients (23.3%) of group I. This combination is encountered in 15 patients (11.7%) of group II (p=0.048). The combination of alleles (4G/4G) of gene PAI-I, (G455A) of gene FI, (Т1565С) of gene ITGB3, and (G10976A) of gene VII was observed in 4 patients (9.3%) of group I and in 1 patient (0.8%) of group II (p=0.01). Finally it was concluded that the combinations of genetic variants FI+ITGB3, PAI-1+FI+ITGB3, PAI-1+FI+ITGB3+FVII, and F1+ITGB3+FVII were associated with restenosis of stented ISA in patients with miocardial infarction with ST-elevation.
Key words: генетический вариант, инфаркт миокарда, комбинация, genetic variants, myocardial infarction, combination
EDEMOMETRIYA LIKE A NEW METHOD FOR MICROCIRCULATION STUDY
Kazushchik V.L., Karman A.D.
UDC: 616.16:612.13:616-073
Abstract: The purpose of the study was to develop a method of investigation of microcirculation, enabling the identification of functional changes in this environment in healthy people, certain diseases and effects on the body. For this purpose the apparatus (edemometer) and method (edemometriya). Fundamental differences of edemometriya from the known methods are: to determine the physiological (functional) parameters of microcirculation; the definition in the microcirculatory environment pressure level and the extent of hydration of the tissues; integrated assessment of the identified indicators and the possibility of introducing the method into clinical practice. Edemometriya revealed some previously unknown theoretical principles of microcirculation (system, three components of the microcirculatory environment, functional blockade of cells, etc.). Advantages of this method are: non-invasiveness, ease of implementation, low cost, high information content, the possibility of clinical application. Results: the simple and highly informative method of investigation of microcirculation, the introduction of which into clinical practice will improve the diagnosis and treatment of diseases, and this, in turn, will contribute to further improvement of edemometriya. Conclusions: edemometriya reflects our penetration in the physiological processes of microcirculation and creates an opportunity to influence this vital system and the living environment of an organism; is it reasonable to implement in clinical practice the method of edemometriya to improve the diagnosis and treatment of many diseases, and create conditions for its further study and improvement.
Key words: эдемометр, эдемометрия, микроциркуляторная система, микроциркуляторная среда, гидратация тканей, edemometer, edemometriya, microcirculatory system, microcirculatory environment, hydration of tissues
INTEGRAL INDICATORS OF THE MICROCIRCULATORY ENVIRONMENT
Karman A.D., Kazuschik V.L.
UDC: 617-089:616.16:612.13
Abstract: Integral indicators of microcirculation were estimated by the method of edemometry. The obtained data were compared with the sum of digital values of the pressure in the arterioles, capillaries and venules corresponding to microvascular environment. Diagram of fluid flow in microcirculatory environment that includes 11 areas was presented, and estimated from integral point of view. It was established that the integral edemometrical indicators of the microcirculatory environment really reflect the processes occurring in it. They are summarizing many of the indicators of microcirculation and give the functional parameters of the environment in cases, when it is impossible to identify its components. Diagram of 11 directions of fluid movement is demonstrating this.
Key words: микроциркуляторная среда, эдемометр, эдемометрия, возрастные изменения микроциркуляции, microvascular environment, edemometer, edemometry, age-related changes of microcirculation
EXPERIENCE OF USING RIZEDRONIC ACID IN PATIENTS WITH OSTEOARTHROSIS AND METABOLIC SYNDROME
Vasilyeva L.V., Lakhin D.I.
UDC: 615.036.8
Abstract: The aim of this study was to assess the impact of risedronic acid on the symptoms of osteoarthritis in patients with metabolic syndrome. The study included 45 patients with diagnosed osteoarthritis and metabolic syndrome, which on the background of standard pathogenetic therapy received risedronic acid 35 mg per week throughout the year. The indicators of inflammatory activity (ESR, CRP, TNF-α) were assessed in these patients. The intensity of the articular syndrome was assessed according to the scale VAS at rest and at movement, Lequesne index and WOMAC - initially and after 3, 6 and 12 months. Mineral bone density (BMD) was assessed at the lumbar spine by carrying out densitometry. With the use of risedronic acid, we observed a significant decline in CRP, ESR, TNF-α, positive changes in the articular status indicators, a trend for increasing BMD, reducing the need for nonsteroidal anti-inflammatory drugs.
Key words: остеоартроз, метаболический синдром, ризендроновая кислота, osteoarthritis, metabolic syndrome, risedronic acid
FOVEOLAR (MICROANATOMICAL) SURFACE OF CHILDREN AND ADOLESCENTS GASTRIC MUCOSA WITH FUNCTIONAL DISPEPSIA
Bazhenov S.M., Dubenskaya L.I., Parmenova L.P., Surmenev D.V.
UDC: 616.33-002.2-053.2
Abstract: The aim of the study was a quantitative analysis of the foveolar apparatus of the antrum in children and adolescents, as well as the determination of the area of its foveolar surface. A detailed morphometric evaluation of the biopsy specimens of the antral mucosa in 187 children aged from 7 to 14 years with the diagnosis “functional dyspepsia” was performed. According to the results of the pathology conclusion three groups were formed: 62 children with unchanged mucosa, 65 children with signs of adaptive reorganization and 60 patients with chronic gastritis without atrophy. In the last group we revealed a significant decrease in the relative and absolute foveolar number. Significant increase of surface area of one foveolar was shown. Morphological aspects of the mechanism of foveolar reduction and destruction were studied, and the possible variants of foveolar number reducing were proposed. These results indicate an increase of the foveolar area and, accordingly, the total surface of the mucosa in chronic antral gastritis without atrophy.
Key words: дети, хронический гастрит, слизистая оболочка, фовеолярная поверхность, морфометрия, children, chronic gastritis, gastric mucosa, fovea surface, morphometry
ALEXITHYMIA AS A PHENOMENON, COMBINING SOME ASPECTS OF MENTAL AND PSYCHOSOMATIC DISORDERS
Severova E.A., Okhapkin A.S., Dautova M.A., Reutova E.V.
UDC: 616.89-008.15
Abstract: We carried out examination in 4 groups of patients: those with psychosomatic disorders, traumatic brain injury, organic anxiety disorder and anxiety disorder. The aim of the study was to compare the severity level of alexithymia, the alexithymia identification of linkages with psychiatric and psychological symptoms in different pathologies. High levels of alexithymia were revealed in complicated forms of peptic ulcer of stomach and duodenum, organic anxiety disorder. Significant аassociation of alexithymia with age of patients, anxiety and depressive symptoms was identified. Regularities of the manifestations of alexithymia in mental and psychosomatic disorders were found.
Key words: алекситимия, тревога, депрессивные симптомы, органическое тревожное расстройство, травматическое поражение мозга, осложненные формы язвенной болезни желудка и двенадцатиперстной кишки, alexithymia, anxiety, depressive symptoms, organic anxiety disorder, traumatic brain injury, complicated forms of gastric ulcer and duodenal ulcer
PERSPECTIVES OF USING PROBIOTICS FOR THE PREVENTION OF POSTOPERATIVE COMPLICATIONS
Privolnev V.V., Rodin A.V.
UDC: 615.036.8
Abstract: The paper gives data on potential benefits to a surgical patient from introducing probiotics into clinical practice to treat surgical diseases. Numerous clinical studies have demonstrated the lower risk for surgical site infections, anastomotic incompetence, pulmonary and urologic complications as a result of using probiotics in surgical patients. The evidence-based research data including using the probiotics in abdominal surgery, organ transplantations, pancreatic surgery, and biliary surgery were analyzed, and an attempt was made to give specific recommendations for the choice of a probiotic, its dosage, its composition and the frequency and duration of its use in surgical patients in pre- and postoperative periods. The role of probiotics in diagnostic and therapeutic intraluminal endoscopy was considered as well. The paper covers the problems that have not been resolved up to the present moment and do not allow using probiotics as a routine practice in surgery. This review is aimed at filling the gap in clinician’s knowledge on the problem of prevention of postoperative complications and broadening the ideas of probiotic’s application in surgery.
Key words: пробиотики, послеоперационные осложнения, колоноскопия, инфекции области хирургического вмешательства, предоперационная профилактика, probiotics, postoperative complications, colonoscopy, surgical site infections, preoperative prophylaxis
CHILD DEPRIVATION AND MENTAL ANOMALY FORMATION: CURRENT ISSUES
Ulasen T.V., Bobrov A.E.
UDC: 616.89-092-053.2
Abstract: Current scientific articles give the evidence of the specific childhood features of experiences and traumatic situations overcoming. From a research point of view, the traumatic experiences process in the conditions of deprivation becomes chronic according to the individual features and more or less affects all the aspects of the individuality, which changes their "self-concept” and teenagers’ image of the world and leads to the psycho-social and / or psychosomatic maladjustment, which allows to investigate the problem deeper. The article represents the interdisciplinary (psychological and psychiatric) classification approaches to understanding of the phenomenon of "psychic trauma" and is focused on psycho-traumatic aspects of orphanhood which are due to, first of all, the deprivation mechanisms, frustration, changes in non-specific adaptation reactions of the organism, and as a consequence, the formation of abnormal psychological protection and "coping behavior". The necessity of continuing the study of the multifactor chronic trauma influence on the formation of clinical and psychopathological manifestations and structural personality disorders of adolescents in order to identify the specific pre-clinical signs of the formation of the personality disorders that lead to social and psychological maladjustment is grounded.
Key words: депривация, нарушения психосоциальной адаптации, патология личности, deprivation, psychosocial adaptation disorders, personality pathology
PHARMACEUTICAL MARKET OF THE ANILIDES GROUP AND THEIR APPLICATION IN PRACTICAL MEDICINE
Avdeeva T.G., Krikova A.V., Ivanichkina E.V., Krutikova N.Yu., Myakisheva T.V., Sosin D.V.
UDC: 615.21/.26
Abstract: Currently, nonsteroidal anti-inflammatory drugs refer to a number of effective symptomatic drugs with anti-inflammatory, analgesic and antipyretic actions. In the study the analysis of the drugs market of the anilides group, in particular drugs containing paracetamol was carried out. In the experiment (2014-2015) we used analytical, logical and theoretical methods and content analysis of reference literature. The analysis of the nomenclature of drugs of the anilides group registered and allowed for circulation in the Russian Federation was given. The method of questioning revealed the preferences of consumers, doctors and pharmacists in selecting the drugs of the studied group. The price range of RX and OTC drugs in this group was assessed as well. The use of drugs in the age aspect, the features of consumption of paracetamol-containing products and factors determining their choice were described in the study.
Key words: группа анилидов, парацетамол, ассортимент, применение в медицинской практике, пациенты, anilides, paracetamol, range, application in medical practice, patients
HISTORY OF SURGICAL ANATOMY OF THE HEPATO-PANCREATO-BILIARY ZONE
Parhisenko Yu.A., Vorontsov A.K., Kalashnik R.S., Bezaltynnykh A.A.
UDC: 611.362, 611.366, 611.367, 611.37
Abstract: A search for the origins of the anatomical knowledge of the hepato-pancreato-biliary zone was performed in this study. Also the stages of the development of this field of surgical anatomy, examining the contribution of famous and lesser-known anatomists and surgeons from ancient times until the second half of the 20th century are described in the article. Herophilus first described the pancreas, its location and glandular structure at the turn of the III-IV century BC. The first reliable mention of biliary stones refers to 1341. Subsequent discoveries in the field of surgical anatomy of the organs of the hepato-pancreato-biliary zone were committed during the Renaissance. J. Walaeus and F. Glisson described the portal triad in the 17 century. J. Rhode first described the accessory pancreatic duct, that was later called the Duct of Santorini. Italian anatomist G. Bianchi pointed to the existence of a sphincteric apparatus in the distal common bile duct department, later called the sphincter of Oddi in the 18 century. British surgeons first reported that the cause of obstructive jaundice could be pancreatic cancer and chronic pancreatitis at the beginning of the 19 century. The fundamental works on surgical anatomy of the pancreas and liver belong to Russian surgeons A.V. Martynov and A.V. Melnikov. The works of C.-H. Hjortsjo, J.E. Healey and P.C. Schroy significantly supplementing the data on anatomy of the intrahepatic biliary tree preceded the concept of segmental anatomy of the liver that was proposed in the 1950-ies by C. Kuino.
Key words: хирургическая анатомия, гепатопанкреатобилиарная зона, история, surgical anatomy, hepato-pancreato-biliary zone, history
INTRODUCTION OF INDEPENDENT PRACTICE OF BREASTFEEDING IN THE HIGHER STRATA OF THE RUSSIAN SOCIETY IN XIX CENTURY
Mitsyuk N.A., Pushkareva N.L.
UDC: 618.2-07+396.6
Abstract: The aim of the study was to assess the introduction of practice of independent breastfeeding in everyday life of the Russian noblewomen of XIX century - the beginning of the XX century. Scientific and medical works, women's autodocumentary were the main sources of the study. The study showed that the idea of impossibility of independent breastfeeding for women of high society persisted up to the 1860-70th years. Under the influence of the expert discourse (primarily medical), promoting "conscious motherhood," positive influence of lactation for a female body, the steady social norm began to change. Women's autodocumentary demonstrates that noblewomen began to practice breastfeeding more often. The medicalization of everyday life of the mother and baby led to emergence of new body practices: special hygiene of nipples, the use of special diets during feeding, the use of chest pumps, the use of special devices to hold the breast and bandage chest and sexual abstention during feeding. At the same time the lack of professional medical care contributed to the fact that the noblewoman had no clear ideas about preparation for lactation, could not preserve lactation for a long time, could not withstand the difficulties of breastfeeding and finally they employed special nurses to feed the baby.
Key words: история детского питания, самостоятельное грудное вскармливания, медикализация материнства, лактация, история материнства, history of baby food, independent of breastfeeding, the medicalization of maternity, lactation, history of motherhood
SOCIAL INTELLEGENCE ASSESSMENT IN PSYCHIATRIC IN-PATIENTS
Severova E.A., Okhapkin A.S., Dautova M.A., Reutova E.V., Sokolov N.V.
UDC: 616.89-008.15
Abstract: The aim of this work was to study the level of social intelligence and its parameters in patients with schizophrenia and organic mental disorders. The patients were examined in the psychiatric hospital with the following diagnoses: paranoid schizophrenia of the intermittent course, paranoid schizophrenia (observation period - less than one year), schizotypical disorder, and organic mental disorders. Indicators of social intelligence, cognitive function, which were correlated with factors of social and family adaptation, were studied as well. A decrease in social intelligence among all groups of patients was reveled. In patients with schizophrenia and schizotypal disorder along with low social intelligence, we identified predementia cognitive impairments. In organic mental disorders, low social intelligence was associated with mild dementia.
Key words: социальный интеллект, шизофрения, органические психические расстройства, нарушение социальной адаптации, когнитивные расстройства, social intelligence, schizophrenia, organic mental disorder, impaired social adaptation, cognitive disorders
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