STRUCTURAL FEATURES OF THE RATS TESTES ON EXPOSURE TO BACTERIAL LIPOPOLYSACCHARIDE IN EARLY TIMES FOLLOWING EXPOSURE
Poplavskaja E.A., Poplavskij D.Ju., Hilmanovich E.N.
UDC: 591.463.2:[577.114/.115:579.842.21]-092.9
Abstract: Objective. To study the influence of bacterial lipopolysaccharide Serratia marcescens , administered to male rats, on the structure of the testes in early terms following exposure. Methods. Male rats were once injected LPS S. marcescens at a dose of 50 мg/kg of mass intraperitoneally. Paraffin sections were prepared and stained with hematoxylin and eosin. Studies of histological specimens, their microphotography, morphometry were carried out at different magnifications of the Axioskop 2 plus microscope (Zeiss, Germany), the Leica DFC 320 digital camera (Leica Microsystems GmbH, Germany) and the ImageWarp image analysis software (Bit Flow, USA). Evaluation of the reliability of changes in numerical values was carried out using nonparametric statistics of the computer program Statistica 6.0 for Windows.Results. As a result of the study, it was established that on the 3rd day after exposure to LPS S. marcescens in the testes of male rats, the following structural changes developed: an increase in the number of destructive seminiferous tubules on the cut by 2.9 times (p<0.05); swelling of the interstitial stroma and an increase in the diameter of peritubular hemocapillaries by 37.17% (p<0.05), a decrease in the number of interstitial endocrinocytes and a decrease in the area of their nuclei by 24.42% (p<0.05) and by 20, 70% (p<0.05), respectively; in the convoluted seminiferous tubules - a decrease in the number of sustentocytes and a decrease in the area of their nuclei by 25.92% (p <0.05) and by 17.27% (p<0.05) respectively, as well as a decrease in the number of spermatogenic epithelium cells - spermatogonia and spermatocytes by 24.01% (p<0.05) and by 21, 85% (p<0.05), respectively.Conclusion. It was concluded that in the testes of male rats a variety of structural changes occurs: an increase in the number of destructive seminiferous tubules on the cut; swelling of the interstitialstroma and an increase in the diameter of peritubular hemocapillaries, a decrease in the number of interstitial endocrinocytes and a decrease in the area of their nuclei; in the convoluted seminiferous tubules - a decrease in the number of sustentocytes and reduction of the area of their nuclei, as well as a decrease in the number of cells of spermatogenic epithelium.
Key words: липополисахариды, cеменник, сперматогенез, крысы, lipopolysaccharide, testes, spermatogenesis, rats
IODINE DEFICIENCY: ISSUE, PREVENTION, SOLUTION
Mikheeva Anna V., Dyakov Mikhail Yu., Krikova Anna V.
UDC: 615.1
Abstract: Objective. To study the possibility of using iodine-containing drugs and iodized salt as measures to prevent the development of iodine deficiency diseases. Methods. A regulatory framework content analysis was carried out, a patient survey was conducted and data on the epidemiological situation in the Smolensk Region concerning the number of iodine deficiency diseases were studied. Results. Prevention and treatment of iodine deficiency play an important role in maintaining the socio-economic potential of the country. The experience of many countries suggests that the use of iodine and iodine drugs is the most effective way to solve the problem of iodine deficiency. Conclusion. The prevalence of iodine deficiency diseases among children and adolescents in the Russian Federation is increasing, which may lead to a decrease in the country's socio-economic potential. That stimulates the creation of a number of new policy initiatives of the Ministry of Health of the Russian Federation aimed at combating thyroid diseases caused by insufficient consumption of iodine.
Key words: public health, iodine deficiency, children, iodized salt, общественное здравоохранение, йододефицит, дети, йодированная соль
FEATURES OF PHYSICAL DEVELOPMENT OF CHILDREN AND ADOLESCENTS OF DAGHESTAN LIVING IN VARIOUS NATURAL CLIMATIC CONDITIONS
Magomedova M.A., Gazimagomedova M.M., Arbugaeva M.S., Osmanov S.O., Abdulatipov A.I.
UDC: 612
Abstract: Objective. To study physical development characteristics of children and adolescents of Dagestan living in different climatic conditions. This is necessary for the age periodization, the organization of a rational regime for schoolchildren. The aim of the study is to develop recommendation of optimal educational and labour loads for a child with reference to various environmental conditions. Methods The object of the study were children and adolescents living on the plain of Dagestan (Makhachkala) at the age of 7, 9, 10, 11, 12, 13, 14, 15 and 17 years. Age-related morphofunctional and physiological indicators as well as body weight, body length, lung capacity, heart rate were assessed. Results. An extensive factual material was obtained that characterizes the maturation of various body systems of children and adolescents. The study results were processed by the standard method of variation statistics by Student-Fisher, described by Asatiani V.S. (1965). Conclusion It was revealed that children and adolescents living in plain conditions are ahead in physical development of those living in high mountains.
Key words: дети, подростки, равнина, объем груди, жизненная емкость легких, пульс, масса тела, children, adolescents, plain, breast volume, lung capacity, pulse, body weight
POINTS OF HOMEOSTASIS AND THE METHOD TO FIND THEM
Prudnikov I.M.
UDC: 519.6-519.83-519.86
Abstract: Objective. The purpose of this work was the development of numerical methods for finding equilibrium points in the model, damage, loss or income functions of the objects of which are described by convex functions. Such models can be found in medicine, economics, game theory, and biology. Knowledge of the equilibrium points is important for our life, since all complex structures, such as any highly developed living organism, our society and also multi-competitive organizations in economics, biology and game theory strive for them. Methods. To reduce a more complicated case with nonsmooth functions describing the state of each element of the system as damage, loss, or profit, to a case with smooth functions, the Steklov average integrals are used that turn nonsmooth functions into smooth ones, for which previously developed numerical methods can be used for finding equilibrium points. In the process of optimization, the diameters of the sets over which the averaging takes place are decreased. Results. A numerical method for finding the equilibrium points in a more general non-smooth case is constructed. The convergence of all limit points to the equilibrium points is proved. Conclusion. It is concluded that it is necessary to apply new methods for finding Nash equilibrium points in the nonsmooth case, as well as to obtain a set of all the points in order to analyze it and select the most optimal solutions.
Key words: точки равновесия Нэша, метод покоординатного спуска, интеграл Стеклова, точка некооперативного равновесия, точки гомеостаза, equilibrium points by Nash, method of coordinate descent, Steklov integral, noncooperative equilibrium points, homeostasis points
STRESS-INDUCED CHANGES IN THE LIFE OF THE BODY
Kolesnikova L.R.
UDC: 616-092.19
Abstract: Objective. Analysis of literature sources in which the questions of the organism's response to any adverse effect are discussed, as a result of which a multilevel reaction that causes the development of stress and, as a consequence, adaptation, is manifested. Methods. The main direction of the study was collection and analysis of domestic and foreign literature on the subject of changes in vital functions of organs and systems under stress. Results. Stressful reaction of the organism is a process that takes place at the cellular, tissue and systemic levels. The mechanism of changes in immunoreactivity in stress is associated with the activation of the mediators of the stress system - corticorilizing hormone, adrenocorticotropic hormone, glucocorticoids and catecholamines. With a moderate increase in the secretion of mediators, the blood system is mobilized and the immune response is activated. With increased secretion of these mediators, inhibition of immunoreactivity occurs. When studying the response to stress, the reaction of quantitative and qualitative changes in the composition of blood cells is noted, which can reveal compensatory mechanisms of adaptation of the organism to stress. Conclusion. Stress causes such a restructuring of metabolism and physiological functions, which increases the body's resistance to acute death. Thus, the physiological meaning of the stress reaction is the urgent mobilization of the energy and structural resources of the body and the creation of a positive background for the implementation of reactions aimed at maintaining homeostasis in extreme situations.
Key words: стресс, перекисное окисление липидов, иммунная система, сосуды, stress, lipid peroxidation, immune system, blood vessels
ASPECTS OF COMBINED CHRONIC OBSTRUCTIVE PULMONARY DISEASE - ASSESSMENT TOOL APPLICATION BY PATIENTS WITH ALCOHOL DEPENDENCE SYNDROME
Ivanova M.A., Punin A.A., Vaulin S.V.
UDC: 616.24+613.81
Abstract: Objective . The purpose of the investigation was to clear up the potential impact of alcohol dependence syndrome on the correct application of the combined obstructive pulmonary disease. Methods. One humdred and ten men with the diagnosis of chronic obstructive pulmonary disease at the age from 40 to 88 years were examined. According to the available guidelines, spirometry with the assessment of standard data and the test for the reversibility of obstruction with the use of 400 mg of salbutamol; assessment of the impact of the disease on everyday life (CAT-test), the level of dyspnea by the modified questionnaire of the British medical research Council, the six-minute walk test were performed. The distribution of patients by stages of alcohol dependence syndrome was carried out on the basis of the criteria set out in the National recommendations in Narcology (2008). Statistical processing was performed using the licensed program SPSS 17. Results. The number of patients of group A among alcohol-dependent patients was by 2,4 times higher than that in the group of persons not exposed to alcoholism. Patients with COPD with mild and moderate degree limited ventilation formed the majority of the sampling frame. A high percentage of individuals with alcohol dependence in this population was consistent with the trend toward preferential distribution of patients in group A. This result is associated with a more positive subjective evaluation of symptoms by persons exposed to alcohol abuse obtained in the questionnaires. The divergence between the objective and questionnaire data allowed to reveal the underestimation of the severity of the somatic status of alcohol-dependent persons with light and moderate degree of bronchial obstruction. Conclusions. Therefore, a decrease in the objectivity of the distribution of patients exposed to alcoholism in strata A, B, C, D (GOLD 2014) due to underestimation of the severity of shortness of breath and the impact of the disease on everyday life was revealed. The six-minute walking test made it possible to objectify the severity of the patient's condition to determine the further treatment plan.
Key words: хроническая обструктивная болезнь легких, синдром алкогольной зависимости, ABCD - классификация, chronic obstructive pulmonary disease, alcohol dependence syndrome, ABCD - assessment tool
ANTIRETROVIRAL THERAPY INFLUENCE ON BIOLOGICAL MEMBRANES CONDITION IN PATIENTS WITH TUBERCULOSIS AND HIV CO-INFECTION
Makarov P.V.
UDC: 616.153.915-07
Abstract: Objective. To study antiretroviral therapy influence on the state of biological membranes in patients with tuberculosis/HIVco-infection. Methods. Blood serum phospholipids spectrum was analysed in 100 patients with tuberculosis/HIVco-infection and in 50 healthy patients. The relative content of the following fractions of total phospholipids was assessed: lisophospholipids, sphingomielin, phosphotidilholin, phosphatidiletanolamin. Results. The patients with tuberculosis / HIVco-infection not receiving antiretroviral therapy one month following the onset of treatment, had lower values of phospholipase activity, membrane permeability coefficient, coefficient of membranes destruction and high coefficient of membranes viscosity compared to healthy persons. Under the influence of antiretroviral therapy, the patients with tuberculosis/HIVco-infection had a more pronounced phospholipase activity, microviscosity and membrane destruction. The digital values of membrane permeability coefficient were lower, than in patients, who did not undergo the treatment. Conclusion. Antiretroviral therapy of patients with tuberculosis / HIV co-infection causes active destruction of lung tissues membranes, promotes maintenance of higher medical effect, as there is an intensive destruction of tissues damaged with tubeberculosos mycobacterium. In the absence of antiretroviral therapy the patients with tuberculosis / HIV co-infection had a low or no destruction of damaged tissues, that does not interfere with distribution and infiltration of pulmonary fields with tubeberculosos mycobacterium.
Key words: ко-инфекция ВИЧ-инфекция, туберкулёз, антиретровирусная терапия, co-infection HIV-infection, tuberculosis, antiretroviral therapy
POSTOPERATIVE COMPLICATIONS OF ECHINOCOCCECTOMY OF THE LIVER AND THEIR PREVENTION
Kalybekov T.A., Aliyev M.Zh.
UDC: 616.36-002.951.21-089:615.28
Abstract: Objective. To determine the effectiveness of preventing inflammatory complications after echinococcectomy. Methods. There were 2 groups under observation: the 1-st one - 122 people, in which the prevention included antibiotics intramuscularly: and the 2-nd group of 68 patients, whose prevention included wound treatment with ozonized solutions, infrared laser irradiation of the operating wound (5-6 sessions) and perioperative administration of antibiotics. Results. In the 1-st group, inflammatory complications were detected in 19 (15.6%), and in the 2-nd group in 4 (5.9%) cases. The advantages of including infrared laser radiation in the complex of measures for the prevention are presented. Conclusions. The traditional administration of certain antibiotics after liver echinococcemy is ineffective in the prevention of inflammatory complications, and treatment of the wound with ozonated solutions, perioperative intravenous administration of broad-spectrum antibiotics (cefazolin or ceftriaxone) combined with infrared laser irradiation of the operating wound can reduce the incidence of complications threefold. Echomorometry of the wound is a valuable indicator of the course of the wound process and can be used in abdominal surgery.
Key words: эхинококкоз печень, оперативное лечение, инфракрасное лазерное облучение, эхинококкэктомия, liver echinococcosis, operative treatment, infrared laser irradiation, echinococcectomy
METHOD OF STERNOCLAVICULAR JOINT FIXATION WITH A FIGURED PLATE IN DISLOCATION OF THE STERNAL END OF THE CLAVICLE
Kesyan G.A., Urazgil'deev R.Z., Karapetyan G.S., Arsen'ev I.G., Dan I.M., Shuyskiy A.A.
UDC: 616-001.68+617.3
Abstract: Objective. To study the effectiveness of treatment of dislocation of the sternal end of the clavicle using a proposed novel method. Methods. Between 2009 and 2018, 36 patients (21 males and 15 females) aged 18 to 63 years with dislocations of the sternal end of the clavicle of different post-injury periods were treated through open reduction of dislocation followed by fixation of the sternoclavicular joint using an original curved plate. In the postoperative period external immobilization with a Desault's bandage was carried out with early rehabilitation of the patients. Results. The follow-up period ranged from 3 to 12 months. Adequate stability of the sternoclavicular joint fixation, reduced pain syndrome and excellent functional results were observed in all patients. All patients were satisfied with the functional results, returned to everyday activity and work on average after 1-3 months, and to athletic activity after 1-1.5 years. In one patient of 25 years a hypertrophic scar formed, which caused her psychological discomfort. In one patient with complete dislocation of the clavicle, surgical intervention was carried out according to the proposed procedure, supplemented by fixation of the acromioclavicular joint with a hook-shaped plate. There were no postoperative complications. The proposed method does not require removal of the plate later on. Plate removal was performed in 2 cases one year after surgical treatment at the personal request of the patients with no recurrence of joint instability. Conclusion. The advantages of the proposed fixation method include the possibility of early initiation of active and passive movements. The proposed approach allows to shorten the period of patient rehabilitation, achieve good functional results, reduce the risk of complications, and achieve adequate cosmetic effects.
Key words: вывих ключицы, грудино-ключичное сочленение, фиксирующая пластина, хирургическое лечение, clavicle dislocation, sternoclavicular joint, plate fixation, surgical treatment
URGENCY OF THE PROBLEM OF REDUCING THE STRENGTH OF BONES IN CHILDREN WITH ONCOPATHOLOGY
Krutikova N. Yu., Yudenkova O.A.
UDC: 616.71-007.234-006.6-053-08
Abstract: Objective. To analyze the features of bone loss in children who have had cancer. Methods. During the study we examined 271 children aged 5-15 years who were in remission. We analyzed their case histories, history of life and disease. We perfomed objective examination, analysed the conclusions of narrow specialists. The level of bone strength was evaluated by quantitative ultrasound. Results. Children who had hematooncology, had fractures in the anamnesis (20.9%) and paresthesia (17.3%) more often than children who had neurooncology (20.9% and 17.3% respectively). In children with neuro-oncological profile disease the indicators of bone strength are significantly lower than in children of the hematological profile (6,7%, z-score = -3,6±1,1 and 11,3%, z-score = -2,5±1,2, p=0,03, respectively). The greatest decrease in bone strength was observed in 2 years after the end of treatment. Conclusions. Knowing the patterns of bone strength reduction in children who have had cancer, it is necessary to conduct early diagnosis and correction of this complication. That will help improve the results of treatment of cancer and improve the quality of life of patients.
Key words: дети, прочность костной ткани, онкологические заболевания, children, bone strength, oncology
ECTOPIC ACTIVITY OF MYOCARDIUM AND AUTONOMIC REGULATION OF CARDIAC FUNCTION IN WOMEN WITH CORONARY ARTERY DISEASE IN POSTMENOPAUSE
Tsareva V.M., Novitskiy N.I., Evseev A.V., Ivanishkina E.V., Sundukova K.A.
UDC: 616.127-005.8:618.173
Abstract: Objective. To study ectopic activity of myocardium and autonomic regulation of cardiac function in women with coronary artery disease (CAD) in postmenopause. Methods. We examined 141 postmenopausal women with chronic forms CAD (mean age 64.9±7.8 years). The first group included 98 women with CAD and ventricular arrhythmias (VA) and the second group - 43 patients with coronary artery disease without ventricular arrhythmias. The first group was divided into subgroups: 1A - high grade VA (n=37) and 1B - low-grade VA (n=61). The patients underwent holter monitoring of the ECG (“Cardiotechnics-04-8 (m)”, Inkart, Russia), with assessment of cardiac arrhythmias and time analysis of heart rate variability. The statistical data were processed using the STATISTICA 6.0 software package. Results. Low grade VA were found in 61 women (62.2%). Lower grade arrhythmias were class I. At the same time, in 37 (37.8%) patients, ventricular ectopic activity was represented by high grade arrhythmias. The structure of this arrhythmia was dominated by a single polymorphic (14.3%) and polymorphic pair (12.2%) ventricular extrasystoles (III and IVB gradation). V gradation was detected in 6.1% of patients and presented by unstable paroxysms of ventricular tachycardia. Most women of groups I and II (93.9% and 95.3%) had supraventricular arrhythmias (SA). In subgroup 1A the SDNN index is 15% lower compared to women of group II (109,3±21,5 ms and of 128.6±23.8 ms, respectively) and 13.5% less compared to patients of subgroup 1B (126,3± 22.4 ms); (p<0,016). Significant differences (p<0.016) were also found in the parameter PNN50 (in women in subgroup 1A the index was 48.4% lower compared to patients without MS (3.3±2.6% and 6.4±2.5%). There were no significant differences in the SDNN, SDNN, PNN50 and RMSSD parameters between the IB subgroup and group II. Conclusions. In 37.8% of postmenopausal women with CAD, ventricular ectopic activity is represented by high-grade arrhythmias. Single polymorphic and polymorphic pair ventricular extrasystoles (III and IVB gradation) dominate in the structure of the arrhythmias. The most pronounced vegetative disbalance is found in the group of patients with VA III and above gradation.
Key words: ИБС, женщины, постменопауза, желудочковые аритмии, вариабельность сердечного ритма, coronary artery disease, women, postmenopause, ventricular arrhythmias, heart rate variability
CLINICAL USE OF HIGH-TECH IMPLANTED PORTS FOR INTRAVENOUS ACCESS
Mikhalik D.S., Zhukov G.V., Gerasimov S.A., Makarov Yu.A., Borshchyov S.V.
UDC: 615.47:616-072.7
Abstract: Objective. To present initial four clinical cases of effective implantation of high-tech intravenous ports for multiple infusion chemotherapy in cancer patients. Methods. The authors analyzed four clinical case histories of cancer patients with intravenous ports implanted at the Surgical Department originally among medical institutions in Smolensk region. Modern intravenous accesses convenient either for patients or medical stuff were discussed. Results. For the first time in Smolensk region, four high-tech intravenous port-systems for multiple chemotherapy were implanted in cancer patients at the Surgical Department of Smolensk Railway Station Hospital. Three of four patients with implanted ports go on receiving their specific intravenous cancer treatment. One patient died in two months after discharge due to the tumor progression. None of the patients had postoperative complications in the intravenous port implantation site. Conclusion. Infusion of oncostatic chemotherapy into the peripheral vein often causes an irritation of vascular inner wall producing phlebitis/phlebothrombosis and tissue necrosis while extravasation of medical preparations. Regarding to these facts implantable intravenous ports make a significant advantage. These devices are not affected by any external factors between infusions. They provide maximum comfort and life quality for cancer patient. Once implanted intravenous port is enough for the entire treatment period, and it serves for many years.
Key words: внутривенные имплантируемые порты, клинический случай, онкология, intravenous implanted ports, clinical case, oncology
EFFECT OF LIPID PROFILE ON VARIOUS FORMS OF HYPOTHYROIDISM
Nikonorova I.V., Kozyrev O.A.
UDC: 616.12-008.46-055.2:616.441
Abstract: Objective. In the modern world, the number of patients with latent and overt hypothyroidism is constantly increasing. The presence of this disease among women is 19 per 1000 people. A link has been established between an increase in the level of thyroid-stimulating hormone (TSH) and atherogenic dyslipidemia and the progression of heart disease. The aim of our study was to determine the relationship between left ventricular diastolic function, thyroid-stimulating hormone and lipid spectrum in postmenopausal women with various forms of hypothyroidism. Methods. The present study was performed at the Department of Hospital Therapy of Smolensk state medical university in the period of 2016-2018. The study involved 70 women with various forms of compensation of hypothyroidism and diastolic dysfunction of the left ventricle. All women were divided into 3 groups: the control group consisting of 28 people, the first group - 35 patients with subclinical hypothyroidism confirmed by laboratory; the second group included 35 women with compensated hypothyroidism. Results. In the course of our study, the following results were obtained: the presence of an increase in the waist/hip ratio in women of the first and second groups, an increased body mass index indicating a pathological deposition of fat in the abdominal area, especially in patients of the second group, despite the fact that the group with subclinical hypothyroidism showed an increased level of thyroid-stimulating hormone compared to the group with compensated hypothyroidism. There were no significant differences in left ventricular diastolic function in the groups of study. Conclusion. The presented study, conducted on an outpatient basis, revealed interrelations of thyroid-stimulating hormone against the background of subclinical and compensated hypothyroidism with lipid profile and diastolic function, which indicated the need for prescribing drugs that affect the metabolic syndrome and reduce low-density cholesterol.
Key words: диастолическая функция левого желудочка, липидный профиль, компенсированный гипотиреоз, субклинический гипотиреоз, left ventricular diastolic function, lipid profile, compensated hypothyroidism, subclinical hypothyroidism
HYPOTHYROIDISM AND ITS EFFECT ON THE DEVELOPMENT OF DYSCIRCULATORY ENCEPHALOPATHY
Nikonorova I.V., Kozyrev O.A.
UDC: 616.12-008.46-055.2:616.441
Abstract: Objective. In modern scientific literature, there are works devoted to the study of individual aspects of hemodynamics in hypothyroidism, however, there is a lack of information about the features of the cerebral circulation in conditions of deficiency of thyroid hormones. The aim of our study was to identify dyscirculatory encephalopathy and factors affecting its development in various forms of hypothyroidism. Methods. This study was carried out at the Department of Hospital Therapy at Smolensk State Medical University in the period 2016-2018. The study involved 60 women with clinical and subclinical hypothyroidism. All women were divided into 3 groups: the control group consisting of 30 people, the first group - 30 patients with subclinical hypothyroidism, confirmed by laboratory tests; the second group included 30 people with clinical hypothyroidism. Results. During our work, the following results were obtained: in the group with decompensated hypothyroidism, changes in neck vessels were associated with neurological symptoms, in the group with subclinical hypothyroidism, changes were less pronounced and, accordingly, less severe clinical symptoms were reavealed (p<0.05). Conclusion. The presented study was conducted on the basis of clinical observations in the clinic - in some patients with hypothyroidism neurological deficit was exacerbated, which suggested the presence of dyscirculatory encephalopathy. The markers of progression of atherosclerosis and, consequently, endothelial dysfunction were indicated by dyslipidemia, an increase in vascular intima-media in the groups with hypothyroidism.
Key words: гормоны щитовидной железы, липидный статус, клинический гипотиреоз, субклинический гипотиреоз, дисциркуляторная энцефалопатия, thyroid hormones, lipid status, clinical hypothyroidism, subclinical hypothyroidism, dyscirculatory encephalopathy
FIXED COMBINATIONS OF DRUGS IN TREATMENT OF PATIENTS WITH ARTERIAL HYPERTENSION AND CORONARY HEART DISEASE
Ageenkova O.A., Milyagin V.A., Chudayeva O.V.
UDC: 616.12-008.331.1+615.015.2
Abstract: Objective. To study the effect of fixed combinations of antihypertensive drugs on the structural and functional features of the heart and vessels in patients with arterial hypertension and coronary heart disease. Methods. The open single-center uncontrolled observational study involved 63 patients (45 men and 18 women) with AH (I-II degree) and IHD (stable angina, postinfarction cardiosclerosis) aged 40 to 67 years, average age was 55,1±7,6 years. The patients were divided into 2 groups: group 1 received a fixed combination of angiotensin converting enzyme inhibitor (ACE inhibitor) perindopril and diuretic (D) indapamide in addition to basic therapy, group 2 - a fixed combination of ACE inhibitor perindopril and calcium antagonist (AK) amlodipine. Result. The study showed that the use of fixed combinations of drugs led to a decrease in systolic, diastolic, pulse pressure, and stiffness indicators for elastic and muscular types of vessels during therapy with ACE +D and mainly in vessels of elastic type during therapy with ACE+AK. Conclusion. The study revealed a pronounced hypotensive effect of fixed combinations of drugs, organoprotective capabilities of these combinations, potentially helping to reduce the risk of developing cardiovascular complications in patients with hypertension and coronary artery disease.
Key words: артериальная гипертония, ишемическая болезнь сердца, ингибиторы АПФ, антагонисты кальция, диуретики, arterial hypertension, coronary heart disease, ACE inhibitors, calcium antagonists, diuretics
LYMPHOSTIMULATION AND BACTERIOPHAGES IN THE TREATMENT OF PURULENT COMPLICATIONS OF DIABETIC FOOT SYNDROME
Zholdoshbekov E.Zh., Avasov B.A.
UDC: 617.586-02:616.379-008.64 (575.2)(04)
Abstract: Objective. To study the effectiveness of the use of lymphotropic antibiotic therapy in combination with phagotherapy in the treatment of purulent complications of diabetic foot syndrome.Methods. On the first day, 2500 IU of heparin + 1 ml of a 0.25% solution of novocaine was strictly subcutaneously injected on the first and second interdigital intervals after treatment with 70% alcohol, and then 2.5 mg of chymotrypsin dissolved in 2.0 ml of physiological saline were injected.After the injection, without taking out the needle, they waited for 5 minutes, with subsequent injection of antibiotic, cephalosporin series 1.0. On the second day, a tourniquet was applied to the lower third of the thigh 15-20 minutes before the beginning of the above procedure. After that, in the same sequence, it was injected into the middle third of the thigh from behind.The type of pathogen and its sensitivity to antibiotics was determined by the disco-diffuse method using the Mueller-Hinton medium. Results. The observation was conducted for 151 patients with purulent complications of diabetic foot syndrome. Lymphotropic antibiotic therapy with phage therapy significantly reduces the time of cleansing, the appearance of granulation and epithelialization of the wound compared with the control group in which traditional treatment was applied.Conclusions It was concluded that the use of regional lymphostimulation in combination with bacteriophage "Fagio" in most cases prevented the progression of the inflammatory process and contributed to a more rapid cleansing and epithelialization of the wound compared with the control group that received traditional treatment.
Key words: диабетическая стопа, гной, бактериофаг, лечение, diabetic foot, pus, bacteriophage, treatment
FEATURES OF UPPER JAW IDENTAL ARCH WIDTH IN WOMEN IN THE STRUCTURE OF THE CRANIOFACIAL COMPLEX
Efimova E.Yu., Krayushkin A.I., Efimov Yu.V.
UDC: 611.714
Abstract: Objective. To determine the features of the indices of the width of the dental arches of the upper jaw in mature women and to reveal correlative relationships with certain parameters of the skull. Methods. The morphometric parameters of the dental arch width of the upper jaws were studied. The work was performed on 75 preparations of skulls of various craniotypes of mature females with physiological occlusion of teeth. When examining dental arches, the main points were established on the medial and distal angles of the tooth crowns from the vestibular and palatal sides. The width of the dental arch was measured between the canines, premolars, 1 and 2 molars at the established points of the vestibular and palatal contours. Results. It was revealed that the width of the dental arches from the side of the vestibular and palatal surfaces in women at all levels of measurement was significantly less than the width of the face and the jaw pointer (p<0.001). From the palatal surface, the width of the dental arches at all levels of measurement of each craniotypic was less than the upper height, width of the face, its intergnatic part (p<0.001) and more than the height of the dental alveolar part (p<0.001). Conclusion. The analysis of the correlation of the dental arches with the parameters of the skull revealed the superiority of the value of the width of the dental arches of the upper jaw from the vestibular side in the females of mature age at the level of molars in the brachicranial and dolichocranial type of the skull. The parameter of the dento-alveolar part of the upper jaw and the height of the intergnatic part were less than the width of the arches, both from the vestibular and palatal surfaces in all craniotypes. This allows to assert about the revealed regularities of the dental arches width.
Key words: ширина зубных дуг, краниофациальный комплекс, краниотип, морфометрия, width of dental arches, craniophatic complex, craniotype, morphometry
OPTIMIZATION OF THE USE OF SKIN TESTS FOR DIAGNOSIS AND EVALUATION OF THE EFFECTIVENESS OF TREATMENT OF VARIOUS FORMS OF TUBERCULOSIS INFECTION IN CHILDREN
Mjakisheva T.V., Rashkevich E.E., Avdeeva T.G.
UDC: 616-002.5-053.2-07-08:576.8.077.3
Abstract: Objective. To compare the sensitivity of Mantoux’s test with 2TE PPD-L and Diaskintest in the diagnosis and evaluation of the treatment efficacy of tuberculosis infection in children. Methods. Analytical cohort observational study. There were 100 children with latent tuberculosis infection and 40 patients with local forms of pulmonary tuberculosis. All patients underwent a TB diagnostic test including Mantoux test with 2 TE and Diaskintest. These samples were performed initially and in the dynamics of treatment or chemoprophylaxis. Results. The data of Mantoux and Diaskintest in children with latent tuberculosis infection and local forms of tuberculosis were not significantly different. Dynamics showed a significant decrease of Diaskintest after 6 months of chemoprophylaxis and no significant changes of Mantoux. In children with local forms of tuberculosis, there was a decrease of Diaskintest by 1 and 3 months of treatment. Conclusion. Diaskintest showed a higher sensitivity in assessing the effectiveness of treatment of latent tuberculosis infection and local forms of tuberculosis. Reliable decrease of Diaskintest was established only after 3 months of chemotherapy. Thus, it is advisable to administer two immunological samples simultaneously and to conduct control immunodiagnosis in 3 and 6 months after the course of chemoprophylaxis, when a reliably dependent decrease in the Mantoux and Diaskintest samples is registered.
Key words: туберкулез у детей, иммунодиагностика, Диаскинтест, childhood tuberculosis, immunological tests, Diaskintest
STRUCTURE OF RISK FACTORS OF INFECTIVE ENDOCARDITIS IN RUSSIAN FEDERATION
Danilov A.I., Kozlov R.S., Lyamets L.L.
UDC: 616.126-002 + 615.33
Abstract: Objective. To study the structure of risk factors for infective endocarditis (IE) in the Russian Federation. Methods. A multicenter study of the etiology, antibiotic resistance and pharmacoepidemiology of infectious endocarditis, consisting of 2 parts: prospective (September 2011 - December 2016) and retrospective (January 2006 - August 2011). The study included patients of both sexes of all age groups with certain and probable IE. The diagnosis of IE was set according to the Duke criteria. The study included 406 (in the prospective part - 166, in retrospective - 240) cases of IE. Patients were hospitalized in 11 medical institutions in 9 cities of the Russian Federation (Arkhangelsk, Kazan, Moscow, Omsk, St. Petersburg, Smolensk, Tyumen, Yakutsk, Yaroslavl). All hospitals that took part in the study have a multidisciplinary nature and have their own microbiological laboratory. Results. In the general structure of the study among the risk factors of IE in most cases were noted: injection drug addiction - 39,2%, acquired heart disease - 33,2%, previously suffered IE - 18,3%. In the prospective part of the study, among the risk factors, the most common were acquired heart disease - 36,1%, injection drug addiction - 30,4%, previously undergone heart surgery - 19,4%, previously underwent IE -18,8%. In a retrospective study among the risk factors most often observed injecting drug addiction - 42,7%, acquired heart disease - 31,3%, previously suffered IE - 18,0%. Conclusions. In recent decades, there have been significant changes in the etiological structure of IE. The main of these changes is that the leading pathogen was Staphylococcus aureus. This trend is observed in most countries, including the Russian Federation. According to the study, the frequency of Staphylococcus aureus was 46.5%. This, in turn, is explained by changes in the ratio of risk factors for this pathology. Among them, injecting drug addiction, invasive diagnostic and therapeutic manipulations on the heart and large vessels are of paramount importance, while dental manipulations and poor oral hygiene play a secondary role.
Key words: инфекционный эндокардит, факторы риска, этиологическая структура, антимикробная терапия, infective endocarditis, risk factors, etiological structure, antimicrobial therapy
CLINICAL CASE OF GRAVES' DISEASES IN THE PATIENT HAVING A GIGANT GOITER
Nikulin M.O., Sudnitsyna A.S., Makarova O.B., Suplotova L.A.
UDC: 616.441-089.87
Abstract: The objective of the article is to demonstrate a clinical case of surgical management of the patient suffering from Graves' diseases (GD) and having a gigant goiter for a long time. Methods. The long term course of GD is accompanied by its different specific complications. It prevents from carrying out a radical treatment and it has some difficulties in postoperative observation of a patient. For example, the formed endocrine cardiomyopathy and heart rhythms disturbances can make giving narcosis difficult and worsen the postoperative couse. It is difficult and sometimes is not available to carry out radioiodine therapy if the thyroid gland has a large volume. The surgical intervention is complicated by intra- and postoperative hemorrhage, injury of the larynx nerve and parathyroids. However, in spite of these difficulties adequate treatment gives a considerable relief to the patient and improves the life quality. Results. Extrafascial thyroidectomy was performed. The intraoperative blood loss was 400 ml. The weight of the removed thyroid gland was 875 g. The postoperative period was uneventful. The histological study of the removed gland showed the toxic goiter. Conclusion. This clinical case demonstrates that the administration of the late radical surgical intervention is not admitted. The treatment of patients with antithyroid medications and their long term observation lead to a complicated course and treatment of the disease.
Key words: болезнь Грейвса, зоб, тиреотоксикоз, медикаментозное лечение, лечение радиоактивным йодом, хирургическое лечение, Graves' disease, goiter, thyrotoxicosis, treatment with medicine and radioactive iodine, surgical treatment
CHANGE OF EPIDEMIOLOGICAL CHARACTERISTICS OF ROTAVIRUS INFECTION WITH INTRODUCTION OF ROTAVIRUS VACCINE IN THE WORLD AND IN THE REPUBLIC OF TAJIKISTAN
Nazurdinov A.B., Azizov Z.A., Tursunov R.A., Mirzoev A.C.
UDC: 616-036.22; 616.98; 616.34-008.3144
Abstract: Objective. To analyse scientific literature on the issue of rotavirus infection in children in the light of the introduction of rotavirus vaccine. Methods. Review of modern research on the study of epidemiology and prevention of rotavirus infection. Results. The introduction of the rotavirus vaccine into the National Immunization Program in more than 90 countries of the world, and in particular in the Republic of Tajikistan, compared with the pre-vaccination period, showed its effectiveness and led to a positive change in the epidemiological situation and a significant reduction in the number of rotavirus infection laboratory-confirmed hospitalizations, frequency and severity of the disease, as well as mortality in the overall structure of acute intestinal infections. Conclusions. Currently, the main and most effective method of preventing rotavirus infection among children under 5 years of age is the use of rotavirus vaccine.
Key words: острые кишечные инфекции, ротавирусная инфекция, ротавирусный гастроэнтерит, вакцинация, моновалентная ротавирусная вакцина Rotarix, пентавалентная ротавирусная вакцина RotaTeq, acute intestinal infections, rotavirus infection, rotavirus gastroenteritis, vaccination, monovalent rotavirus vaccine Rotarix, pentavalent rotavirus vaccine RotaTeq
ON DEPENDENCE OF THE COURSE OF CHRONIC GASTRODUODENITIS ON THE SOMATOTYPE IN CHILDREN
Balko O.A., Sapoghnikov V.G.
UDC: 616.33-002.2
Abstract: Objective. To study the constitutional features of the course of chronic gastroduodenitis in children. Methods. Collecting, systematization and analysis of modern data in domestic and foreign scientific literature devoted to the features of the course of chronic gastroduodenitis in children with various somatotypes were carried out. Results. A review of publications on the concepts of the constitution through the prism of which features of the course of chronic gastroduodenitis are considered, is presented in the article. It is revealed that now the concept of constitution is fundamental in anthropology as within the anthropological approach of constitutional features of the body present an integral component in studying the state of health of the person. Conclusion. In spite of the fact that the constitutional norm of reaction marked by a certain somatotype does not change the essense of the disease, it allows to find out the constitutionally dependent symptoms of the disease giving the individual character to the disease. As the interitance and constitutional factor is essential in development of the chronic gastroduodenitis, it should be considered by the physician within the individual personified approach to the patient.
Key words: конституция, типы конституции, хронический гастродуоденит, H.pylori, дети, constitution, somatotypes, chronic gastroduodenitis, H.pylori, children
DEVIANT BEHAVIOR (ACTIVITY): ETIOPATHOGENIC ASPECTS, CLASSIFICATION
Vlasenko V.I., Pereverzev V.A., Razvodovsky Y.E.
UDC: 316.624-02
Abstract: Objective. To suggest a new classification of deviant activity of healthy adults on the basis of etiology and pathogenesis of this phenomenon. Methods. Analysis of scientific data about deviant behavior (activity) from the literature, the results of our own observations and researches on this subject with the revealing of definitions, etiological and pathogenic factors, as well as existing classifications, possibilities of diagnostics and correction of deviant activity were carried out. Results. On the basis of analysis of the literature data, the results of our own observations and researches it is proposed to define all kind of activity of healthy adults as “activity”, which is characterized by consciousness, results framework, socially useful outcomes and responsibility. Upbringing, education, self-development and self-improvement belong to the useful outcomes of human’s activity. The defects in upbringing and education constitute the etiological factors of deviant activity. Interpersonal conflicts, inability to cope with them, frustration, deprivation and aggression acts as the pathogenic factors. Conclusion. A new classification of deviant activity of healthy adults, based on the factor of “aggression”, which has a direction (address), strength and specificity was developed. According to the direction of aggression, the deviations are divided into autodestructive and heterodestructive (delinquent). In its turn, autodestructive deviations are divided into addictive (chemical and nonchemical), and suicidal (ideations and acts) forms, while heterodestructive deviations are presented by all possible conflicts (personality-personality, personality-group, personality-group).
Key words: поведение, деятельность, девиации, внутриличностный конфликт, агрессия, behavior, activity, deviation, interpersonal conflict, aggression
HISTORY OF DIAGNOSTICS IMPLEMENTATION FOR IDENTIFICATION OF IMPAIRED BONE DENSITY
Krutikova N.Y., Vinogradova A.G., Yudenkova O.A., Davidenkova A.S.
UDC: 616-71
Abstract: Objective. In this article, our goal was to analyze historical data on diagnostics of variations in bone density status. Methods. The article presents information on the incidence of osteoporosis and the factors that encouraged scientists to develop ways for identification of bone pathological conditions at the initial stages of the disease onset. The problems that have arisen because of insufficient number of literary sources, on the way to finding the "gold standard" for diagnosis of osteoporosis, are described. The criteria for diagnostics and their changes are considered. The information on quantitative ultrasonic osteodensitometry is presented as a screening method for bone density deviations. Results. The obtained data demonstrate significant changes in the approaches to the diagnosis of bone system disorders, leading to impaired bone density, including osteoporosis. Conclusions. The search for the optimal solution of determining changes in the bone system at an early stage led to a wide range of diagnostic procedures.
Key words: рентгенография, денситометрия, количественная ультразвуковая остеоденситометрия, radiography, densitometry, quantitative ultrasound
EVOLUTION OF CYSTIC FORM MASTOPATHY METHODS OF TREATMENT
Arabachyan M.I., Solovyev V.I., Borsukov A.V.
UDC: 618.19-006.2
Abstract: Objective. To analyze literature on the issue of studying the cystic form of mastopathy and the evolution of its methods of treatment. Methods. The study is based on a review of modern foreign and domestic literature on this issue. The article gives the pilot results of the use of modern minimally invasive methods of treatment of patients with cystic mastopathy. Results. The study revealed a trend in the transition from traumatic treatment of breast cysts to minimally invasive interventions to avoid complications and preserve the quality of life of patients after treatment. Conclusion. The development of mammology as a science in general and interventional mammology in particular has led to the emergence of new minimally invasive methods of treatment of breast cysts, the arsenal of which is constantly updated. The most effective methods of treatment are ozone therapy and interstitial laser photocoagulation.
Key words: киста молочной железы, мастопатия, фиброзно-кистозная болезнь, cyst of the breast, mastopathy, fibrocystic disease
ANALYSIS OF THE RANGE OF INTRANASAL DOSAGE FORMS AND FORECASTS ON ITS EXPANSION
Gladkaya Y.V., Losenkova S.O., Evseev A.V., Mikheeva A.V.
UDC: 615.454.1:615.07
Abstract: Objective. To study the range of intranasal dosage forms registered in the Russian Federation. Method. Content analysis is carried out; the range of intranasal dosage forms registered in the State register of medicines of the Russian Federation for 13.09.2018 is studied. Results. The pharmaceutical industry currently produces a fairly limited number of dosage forms for intranasal use. This suggests the need to introduce new methods of drug delivery, as well as the problems associated with the development of innovative scientific innovations in this field of pharmacy. Conclusion. Given the widespread interest in new non-invasive drug delivery methods and the potential benefits of the intranasal route of administration, it is expected that new intranasal dosage forms will actively conquer the pharmaceutical market in the near future.
Key words: интраназальные лекарственные формы, фармацевтический рынок, контент-анализ, назальные лекарственные формы, интраназальный способ доставки, intranasal dosage forms, pharmaceutical market, content analysis, nasal dosage forms, intranasal delivery method
BIOPHARMACEUTICAL STUDY OF THE DEGREE OF 2-ETHYL-6-METHYL-3-HYDROXYPYRIDINE SUCCINATE FROM INTRANASAL GEL BY DIALYSIS
Gladkaya Y.V., Losenkova S.O.
UDC: 615.07:615.014.047
Abstract: The development of new intranasal dosage forms, allowing to provide a general systemic effect on the body, with antioxidant, antihypoxant and neurotropic activity in particular is a relevant area in pharmaceutical practice and combined therapy of acute ischemic disorders of cerebral circulation. Objective. To study the degree of release of 2-ethyl-6-methyl-3-hydroxypyridine succinate from 2.5% intranasal gels made in laboratory conditions using various gelling agents. Methods. In vitro biopharmaceutical study by dialysis through a semi-impermeable membrane with subsequent determination of the dialysate substance was performed spectrophotometrically at a specific wavelength. The objects of the study were gel compositions with 2-ethyl-6-methyl-3-hydroxypyridine succinate (Mexidol) prepared according to the technological scheme developed by the authors using a magnetic stirrer and ultrasound. The obtained data were statistically processed with the "Statgraphics Plus 5.0" program. Results. The authors determined the degree of release of 2-ethyl-6-methyl-3-hydroxypyridine succinate from three different gel compositions. According to the data obtained, the kinetic release curves were constructed and analyzed, based on which, the optimal gel composition was selected. Conclusion. Among the formulations developed, the most optimal in terms of the degree of release are: Mexidol 2.5, Sodium metabisulfite 0.5, Carbopol 940 4.0, Sodium hydroxide 0.1 M 4.6, Polyvinyl alcohol 1.0, Purified Water to 100.0.
Key words: интраназальная лекарственная форма, 2-этил-6-метил-3-гидроксипиридина сукцинат, интраназальный гидрогель, гелеобразователи, биофармацевтический метод in vitro, биофармацевтическое исследование, intranasal dosage form, 2-ethyl-6-methyl-3-hydroxypyridine succinate, intranasal hydrogel, gelling agents, biopharmaceutical dialysis method, biopharmaceutical study
Teremov D.D., Nagornaya S.V., Ostapenko V.M., Pashkov K.A., Parenkova O.R.
UDC: 616.31(09)
Abstract: Objeсtive. The aim of the research was to study the history of the Smolensk State Dental Institute (SSDI), organized in 1936. Methods. The work is performed using historical-genetic and problem-chronological research methods. Archival materials, published documents and literature sources (monographs and research articles) were studied. Results. Previously unknown information about the dental Institute in the city of Smolensk was discovered: the history of foundation and activities of its departments, the peculiarities of organization of educational process and scientific research. The article presents information on the Institute staff, including doctors and scientists, well-known in domestic science, medical education and public health practice (S.E. Gelman, E.E. Platonov, M.F. Datsenko, etc.). Conclusion. It was confirmed that the foundation of the dental Institute in the city of Smolensk in 1936 was due to the pronounced shortage of dental professionals. It was established that the managers and employees of SSDI were prominent Russian scientists and doctors. The Institute was established during the critical phase of the reform of dental education in Russia and contributed to the preparation of personnel for practical health care and medical science. The termination of the activity of the Institute is connected with the beginning of the Great Patriotic war.
Key words: Смоленский государственный стоматологический институт, история, стоматологическое образование, Smolensk State Dental Institute, history, dental education
ETYMOLOGY AND SEMANTICS OF SOME MEDICAL TERMS OF THE GREEK-ROMAN ORIGIN
Agafonov A.N., Agafonov V.A.
UDC: 61(091)
Abstract: Objective. To study the origin and development of the medical nomenclature of the Greek and Latin genesis, to observe the etymological relationship of a number of professional concepts with social and cultural events of classical antiquity, the Middle Ages and Renaissance. Methods. According to the given thematic material an etymological analysis representing a set of methods, the leading method being comparative-historical was applied. The basis of this method is a study of the origin of words on the basis of revival of initial forms and values, since the most ancient preliterate period of evolution of language. References of the 8th century BC - 19th century were the substratum for the application of this method. Results. Historical prerequisites to the merge of the Hellenic and Latin cultures are mentioned in article. The main stages of the development of the Greek-Roman language and medical nomenclature are noted. Various semantic versions of separate terms and lexemes are given. Classical and original concepts of etymology of diverse logos are considered. The words of the antique origin, being the ancestors of the modern medical terms are specified. A detailed analysis of etymology and semantics of concepts and terms in sections of anatomy, infectious diseases and pharmacognosy is made. Some episodes of scientific and social development which became the basis for emergence of new medical terms are given. Conclusion. Hippocrates' works marked the onset of medical nomenclature. Medicine of Ancient Rome was only further development of medicine of Hellas and to a lesser extent represented the original phenomenon. Emergence of the enormous terminological layer in Renaissance is bound to the development of natural sciences. Modern medical nomenclature is a result of the development of doctoring through centuries.
Key words: медицинская терминология, латинский язык, древнегреческий язык, античность, анатомия, инфекционные болезни, лекарственные травы, medical nomenclature, Latin, Ancient Greek language, antiquity, anatomy, infectious diseases, medicinal herbs