Vol 13, No 5-6 (2013)

We studied 468 patients with bronchial asthma and cardiovascular disease. Outpatients are provided with drugs under the federal and regional programs of preferential drug supply. As a result of the conducted pharmacoepidemiological comparative analysis, some differences in quality and quantity of medications administration in the treatment of patients with bronchial asthma and consumption tendencies in the most significant pharmacotherapeutic groups have been established.

This article describes the different types of artifacts that may be encountered during polysomnography. The features of registration polysomnographic parameters for subsequent processing of their fractal measures with the aim of building hypnogram are analyzed. The methods for eliminating or reducing the known types of artifacts in the application of fractal measures for automated recognition of sleep stages are offered.

This article presents data on genotypic structure of viral hepatitis C in 824 patients living in the Samara region. The Samara region common genotypes are 1b and 3а. Among the possible ways of getting infected the use of intravenous drugs is the dominated risk of infection. Clinical features were characterized by a predominance of asthenovegetative syndrome and dyspeptic in patients with mixed and genotype 1а, lb HCV.

Stage 1 of the study was designed to estimate the incidence of abdominal obesity among 960 schoolchildren aged between 11 and 17 years using the percentile tables for the waist circumference (WC) in the children’s population of the United Kingdom and from the WC/height ratio that makes it possible to identify children at the highest risk of metabolic disturbances. The incidence of abdominal obesity based on the criterion of WC≥90th percentile (PC) for the age and the sex was estimate to be 33.7% for the entire group in the absence of significant difference between boys and girls (37.7% vs 35.8%). The incidence of abdominal obesity based on the criterion of WC/height ratio with a threshold value of ≥0.5 was 11.0% for both sexes in the entire group it was significantly higher in the boys than in the girls (14.1% vs 7.9%). At the second stage of the study, the group of the children having WC>90th PC show significantly higher systolic and diastolic arterial blood pressure, blood triglyceride and insulin levels and HOMAIR index but lower HDL levels than control patient with WC<90-го PC. The results of the study suggest the high incidence of abdominal obesity among schoolchildren residing in large cities. Moreover, such children tend to develop metabolic disturbances and at risk of cardiovascular diseases.

Allergic asthma and allergic rhinitis some of the most common forms of atopic diseases. Despite the wide range of pharmaceutical products for the treatment of allergic diseases, the main point of their application remains symptomatic treatment. Allergen-specific immunotherapy to date remains the only method of pathogenic effects on the course of allergic diseases. The aim of our work was to evaluate the effects of sublingual formulations for allergen-specific therapy on the level of control and quality of life of patients suffering from allergic form of bronchial asthma and proven sensitization to pollens of trees. The study involved 37 patients who had been previously examined by carrying out skin prick tests with allergens to detect sensitization to pollen of birch, alder and hazel. Evaluated the following parameters: the results of ACT (Asthma Control Test) test, ACQ-5 (Asthma Control Questionary) test parameters were evaluated quality of life using the SF-36 questionnaire (The Short Form 36), and spirometry. Carrying sublingual immunotherapy significantly improved the quality of life of patients and increase the performance of control of their disease.

On the basis of the complex examination of 76 patients with meningovascular neurosyphilis in the conditions of neurologic department it is established that the high frequency of early mesenchymal and vascular syphilis is noted. Considerably the specific number of patients with neurosyphilis with the complicated anamnesis increased: alcoholism, drug addiction, the craniocereberal traumas, accompanying somatic diseases, asocial way of life. For early neurosyphilis affection of oculomotor group of cranial nerves, meningo-radicular, asteno-vegetative syndromes, pupillary disturbances are characterized. Considering not expressiveness and atipizm of the clinical picture of neurosyphilis, as the main criterion of diagnostics it is necessary to have a combination of change of proteinaceous and cellular structure and positive serological tests in spinal liquid. For early identification of neurosyphilis and the correct differential diagnostics of a disease it is reasonable to use head and spinal MRI, a transcranial dopplerografy both laboratory tests of blood and spinal liquid on syphilis.

The article presents data pharmacoepidemiological analysis of the treatment of community-acquired pneumonia patients treated in hospital. The questions of rationality empirical antibiotictherapy compliance pharmacotherapy existing clinical guidelines and treatment standards are considered. The ways of optimizing the treatment of patients with community-acquired pneumonia admitted to major hospitals in Samara are revealed.

This review concerns to “Chronic kidney disease-mineral and bone disorder” (CKD-MBD). This term is used to describe a set of biochemical abnormalities, bone disturbances that may lead to fractures, and extraskeletal calcification in soft tissues and arteries seen in CKD. Renal osteodystrophy (ROD) is a part of the CKD-MBD, the bone biopsy is the gold standard to diagnose it, but it is not clinically practical for studying continuous changes in bone morphology. The recent studies concern to the noninvasive diagnosis of renal osteodystrophy to predict fracture risk and optimize the therapy.

Among the deaths of newborns children with extremely underweight dominate. Children born prematurely are at high risk of development of various complications, affecting their quality of life in the neonatal and subsequent periods, most of which can be prevented or controlled. Materials on nursing of premature newborns with extremely underweight are summarized, the retrospective analysis of data is carried out. It is necessary to develop measures aimed at further reducing mortality among this group.

The aim of the study was to estimate the most significant risk factors of cervical insufficiency (CI). Sixty retrospective chart reviews were made in patients with CI. Control group consisted of fifty pregnant women who had a threat of miscarriage in the second term but didn‘t have CI. As a result we estimated the cause-effect association between CI and curettage of uterine cavity, late spontaneous miscarriage, polycystic ovarian syndrome, hyperandrogenism, the use of uterine device, and ovariotomy.

The analysis of literature data about the use of immunological parameters as markers of severity and prognosis of fat embolism syndrome was performed. The information on the pathogenesis, clinical manifestations, and diagnosis of this condition is presented. The absence of specific laboratory tests which help to diagnose fat embolism is indicated. Recent research is characterized by immunological mechanisms study this pathology, with more and more attention of the authors turn to production of cytokines, particularly interleukin-6 (IL-6). Several studies have shown that increased levels of lung inflammatory mediators in the development of fat embolism, including the concentration of IL-6, the expression of CD-11b, TNF-α. It is noted that a number of authors believe that inflammatory changes in pulmonary fat embolism syndrome mediated immunological disorders. It is found that disorders of the IL-6 transcription may also lead to an altered response to fat embolism in the lungs, and by the development of the full fat embolism syndrome. It is concluded that the new understanding of the mechanisms of this disease with the immunopathogenesis will provide new opportunities to use markers for the early diagnosis of the syndrome improving existing schemes prevention and treatment of traumatic fat embolism.

The effectiveness of pharmacoeconomic general combined anesthesia on the basis of inhalation anesthetics and total intravenous anesthesia with mechanical ventilation during cholecystectomy of minimal access was studied. The study involved 120 patients with different concomitant diseases, aged 25 to 75 years (mean age 41, 84 ± 1, 01 years) who underwent cholecystectomy from mini-approach in a planned manner: under combined anesthesia on the basis of modern inhaled anesthetics (Sevoran or isoflurane) - 40 patients under anesthesia based on a combination of inhaled anesthetics (nitrous oxide) - 40 patients, and total intravenous anesthesia with mechanical ventilation - 40 patients. Clinical and economic analysis showed that the combined anesthesia on the basis of modern inhaled anesthetics was clinically and economically viable during cholecystectomy of minimal access.

Fluorescent diagnostics and photodynamic therapy in 45 patients with cancer of the lower lip using a photosensitizer Photosens, which was introduced in a dose of 0.5 mg / kg and 0.8 mg / kg. were held. In 24 hours after the administration of Photosense fluorescence the intensity in tumor cancer in the lower lip cancer patients increased dramatically and was 150.8 rel. u., diagnostic contrast ratio was 1.7. With increasing doses of the injectable preparation (from 0.5 to 0.8 mg / kg) fluorescence intensity in tumor lesions and in healthy mucosa was increased. While evaluating the overall effect of the treatment was reported in 69% of patients, a partial response was observed in 25% of patients and 6% of patients recorded stabilization. According to the results of the therapy there was a slight deviation from the norms of physiological indices studied the functional status of the liver and kidneys.

The treatment of 55 patients with gastric, duodenal and anastomotic suture leakage after operations for gastric and duodenal ulcer complicated by hemorrhage, perforation, pyloroduodenal stenosis and Mallory-Weiss syndrome is analyzed. The causes of suture leak were technical difficulties during the surgical intervention, irrational methods of the operation, severe related diseases and disturbance of homeostasis in the patient's body. The comprehensive approaches to prophylaxis of postoperative gastric, duodenal and anastomotic leaks have been considered.

Clinical peculiarities of mucous oral cavity of pregnant women with hypertrophic gingivitis in comparison with pregnant women without inflammatory diseases of oral cavity are described in this article. The role of inflammatory diseases of oral cavity is show n as a risk factor of pregnancy hypertrophic gingivitis in the Samara region. It is shown that during pregnancy the negative influence of local factors of hypertrophic gingivitis is increased for certain.

Unilateral or bilateral loss of the posterior teeth, and loss of the last pair of teeth antagonists may cause a decreasing of lower facial height. There are many different points of view to its reconstruction. The main aim of the study was the analysis of the current approaches to the prosthetic treatment of patients with partial dental loss and reduced lower facial height. The analysis shows that nowadays there is no one opinion about treating patients with reduced lower facial height, types and timing of the use of temporary structures, which makes it relevant to the further improvement and the search for new techniques of treating patients with this pathology.

Optimum results in the fixation of fractures of the mandible using the method of external transosseous osteosynthesis were achieved by the regulation of the temperature in the area of bone preparation using the selection of optimum cutting angle, as well as the shape of the cutting edge of the spokes. The effectiveness of osteo-locks with a combined cutting edge was experimentally demonstrated on the bone blocks. The temperature at the focus of the osteotomy was 34 ± 0,7 degrees Celcium. The results of the study optimize the operation of transosseous osteosynthesis spokes in the treatment of mandibular fractures.

The article presents analysis of dental profile hospitalizations volumes by various financing sources in medical organizations of different ownership forms for the population of retirement age. It is established that the share of hospitalizations among elderly persons is less than 7% in total dental profile hospitalizations of the adult population.

The results of the implementation of the “maternity certificate” in the Volgograd region: the contribution of the project to strengthen service delivery and childhood in 2006 to 2011 is estimated.

The article analyzes the applications of citizens in the health department of Nizhny Novgorod. Obstetric and general medical care complaints were studied. Based on documents the conclusions about the structure of complaints were drawn. Such parameters as primary and secondary reason for the application, gender of the patients, social status of citizens, and the profile of medical care were analyzed. The results of the study showed that the complaints of the population of Nizhny Novgorod on obstetric care had a number of features compared to similar treatment of Nizhny Novgorod, were not satisfied with the general medical health facilities network.

Within the organization of radiation-hygienic monitoring a comprehensive evaluation of the radiological situation in the oil and gas companies, taking into account the impact on staff of ionizing radiation sources is carried out. The most irradiated staff contingents, most dangerous manipulation substantiated system of preventive measures aimed at reducing the radiation risks are identified.

The search of new methods of treatment of acute renal failure is an important task of pharmacology. Diuretics are one of the main groups of nefroprotectors. The studies have proved that the natural diuretics, gravitational influence and sharing in varying degrees reinforce the excretory function of the kidneys. The use of magnesium humate, gravitational factors and their combinations contribute to more rapid recovery of animals with acute renal failure, normalization of parameters are excretory functions of the kidneys.

Morphological comparison study of autopsy hearts has been performed in 69,4 middle aged patients died with ischemic cardiomyopathy (37 patients), diabetic cardiomyopathy (35 patients). Heart separate weight, morphometric study and creation of 3D-model are used. It is established that in case of ischemic cardiomyopathy remodelling of left ventricular performed prominently in dilatation way, the connecting tissue increases. In case of diabetic cardiomyopathy remodelling of left ventricular is performed prominently in hypertrophic way. Obtained data can become the base to insure the role of cardiomyopathy in death genesis.

Blood samples taken from 539 children aged from 4 days to 17 years of life and divided into five groups according to the age are analyzed. The concentration of 11 amino acids is determined. The concentration of most of the studied amino acids is reduced from 10 days of age up to 1 year. The reduced level relatively to the neonatal period remains in all other age groups concerning amino acids such as glycine, leucine, proline and tyrosine. The concentration of arginine and citrulline, on the contrary, in all stages of ontogenetic development is higher than in the newborn period.