No 4 (2012)
EDITORIALS
ORIGINAL RESEARCHES
13-17 208
Abstract
The paper provides the pharmacoeconomic analysis of cost-efficiency of therapy programs applied to children suffering from allergic rhinitis that included combined application of Levocetirizine (Xyzal) and seawater isotonic saline (Marimer), and monotherapy with Sodium cromoglycate (CromoHEXAL). The authors have monitored biomarkers of allergic inflammation, dynamics of clinical and immunological cost-efficiency criteria. As reported, to ensure surveillance in case of isolated allergic rhinitis of moderate severity in children, the costs for every additional symptom-free day and integrated value of clinical immunological and cytological efficiency, while applying Levocetirizine and seawater isotonic saline, are considerably lower than those measured when using Sodium cromoglycate.
18-20 236
Abstract
The paper reviews the results of integrated sanitary hygienic examination of 9 supplementary education centres to study the state of health in 1726 children aged 14-17 years, based upon the analysis of medical case histories and parents’ questioning. The temperature conditions in the study rooms and the noise level did not correspond to the hygienic standards. The harmonic development was observed in 48.8 % of pre-school-aged children and 33.3 % of school-aged children. 53.6 % of children under study had complaints of various pains, 18.8 % of children had chronic diseases, and 20% of children were fallen under health group III. This information can serve as the scientific substantiation for revising the existing regulatory framework.
21-24 230
Abstract
The paper studies the state of bloodstream of extracranial sections of carotid and vertebral arteries, linear, volume and total characteristics of the cerebral circulation in 133 patients with hypertensive heart disease. As shown, the early stages of the disease with low degree of the arterial hypertension are characterized by apparent symptom-free atherosclerotic changes in the cerebral vessels and macrovascular changes like deformations followed by the moderate changes in the cerebral blood flow parameters. The compensatory responses in the form of the increasing total cerebral blood flow have been determined in patients with cardiac remodelling. The rate of atherosclerotic changes correlated with the level of the arterial pressure, its insufficient night-time decrease of the arterial pressure decrease and intima-media thickness.
25-28 278
Abstract
The experiment conducted on 62 laboratory rats with isolated severe traumatic brain injuries allowed to analyze the therapeutic efficiency of Alpha lipoic acid. The morphologic and neurovisual methods of investigation confirmed reduction in the cerebral tissue edema in the area where the secondary injury occurred. The authors believe the brain protective effects of the drug resulted from the nitric oxide-producing function of the brain microvessels.
29-31 192
Abstract
The paper reviews the randomized uncontrolled investigations involving 250 patients aged 47 to 65 years old undergone coronary artery bypass surgery or cardiac valve replacement and provides data on the application of inhalation anaesthetic Sevoflurane during the assisted circulation. Applying Sevoflurane allows preventing negative effects of the intravenous anaesthetics on the myocardium likely to be observed after the cardiac resuscitation when the hemodynamics is stabilized by the cardiac output, and the anaesthetic drug known to have the least cardiodeppresive effect is more preferable. In case of Sevoflurane, more rapid post-anaesthesia recovery of the central nervous system ensures early activization of patients and decrease of artificial lung ventilation period.
32-34 212
Abstract
The paper reviews the integrated biochemical and functional examination of 187 school-aged children. Using bioimpedance, the authors have detected quantitative disturbances in the structure of body composition: 1/3 of children had increased body mass index and fat mass; 2/3 - increased volume of extracellular fluid. This group of school-aged children was characterized by dislipidemy: increasing levels of triglycerids, low-density lipoproteins and the atherogenic index against the decreasing high-density lipoproteid concentration in blood serum. The correlations between the lipid profile parameters and various body components allow suggesting metabolic syndrome in this group of adolescents.
34-36 225
Abstract
Early anaemia of newborn children is a frequent pathological state in premature born children, and the method of its elimination remains to be very crucial in the health care practice. The paper reviews the comparable data about the cell-mediated immunity responses in newborn children with very low body weight at birth with respect to the use of conservative treatment methods (recombinant human erythropoietin) and hemotransfusion. As reported, the transfusion of adult donor’s blood components allows the considerable decrease of the newborn children’s cell-mediated immunity parameters.
37-39 250
Abstract
The paper is targeted to improve efficiency of the anaesthesia during the oncologic surgeries by means of parenteral infusion of Paracetamol. The authors have examined 39 patients undergone surgeries on the oncologic pathology. In the main group (20 patients) the central analgesia was maintained with intravenous infusion of 1.0-1.5 g Paracetamol at 10-15 mL/hr. The inhalation anaesthesia with Forane was conducted under the low flow normoventilation conditions. The authors have monitored the BIS-index and hemodynamic parameters. The pain intensity was estimated during the post-operative period. As reported, the Paracetamol anaesthesia determined the sufficient depth of analgesia and led to no related effects on the central hemodynamic parameters during the extended surgeries.
V. G. Rapovka,
S. E. Gavrina,
A. F. Ponomarev,
E. S. Rogatkina,
L. S. Denisenko,
O. K. Shkouratova,
O. A. Sobolevskaya,
S. P. Ivanov
39-42 240
Abstract
The paper analyzes the results of surgery in 455 patients at old (60-74 years) and elderly (75 years and more) ages suffering from colon cancer. In an effort to objectify the estimation of the patients’ state and influence of a complex of associated diseases upon the perioperative period, the authors have assessed the risk for post-operative complications and lethality using the modified POSSUM scale and modified Glasgow Prognostic Score (mGPS). As shown, maintaining the diagnostic and treatment algorithm and standards for antibiotic prophylaxis allow decreasing the number of post-operative complications in patients at old age and achieving rather good results of the surgical recovery by implementing radical resections and primary anastomosis, even in case of complicated forms of the neoplastic process.
43-44 432
Abstract
The authors have conducted the experiment on sea urchin Strongylocentrotus intermedius to study effects from the electromagnetic radiation of extremely high frequencies on the fertilization and early development of embryos. Before being exposed to the electromagnetic radiation, a part of oocytes were incubated in cytoactive drugs (pentoxyl and prospidinum) in seawater. The infertile eggs appeared to be most sensitive to radiation. The pre-incubation of oocytes in pentoxyl of different concentration did not have any effect on the rate of fertilization and total number of fertilization membrane discharge abnormalities. The fertilization rate of oocytes incubated in the seawater containing prospidinum decreased 1.5-1.8 times and more, depending on the solution concentration. The protective effects of pentoxyl derived from pipiridine containing structural elements of nucleic acids appeared to arise from its activating effects on the nucleic-acid and protein metabolism.
45-49 218
Abstract
The paper analyzes changes in the peritoneal peroxidation and anti-oxidative protection in case of surgery-related injury and inflammation, and when treated with natural saline solution and sodium hypochlorite solution. As shown, the factors under study appear to cause the unidirectional shifts in the ‘lipid peroxidation-anti-oxidants’ system. This notwithstanding, in case of peritonitis, the sodium hypochlorite solution allows to activate anti-oxidative resources.
49-51 265
Abstract
The paper aims at analyzing the clinical approbation of the approach to conducting combined general anaesthesia in oncologic patients in case of the extended surgeries. The target group comprised 85 patients aged 40 to 70 years old. The authors used combined inhalation (Sevoran, 0.7-1%) and intravenous (Recofol, 1525 mL/hr) anaesthetics; the Fentanil was infused in sub-narcotic doses (0.2-0.3 mg). This method ensured adequate level of anaesthesia under minimum risk for side effects and post-narcosis complications.
51-54 251
Abstract
The retrospective analysis of medical histories of 1374 women was carried out; from them the control group (170 women), the group of women with dystocia of labor (96 women) were chosen. Based on the theory of adaptive reactions by Garkavi L.H., Kvakinoj E.B. and Ukolovoj M.A. (1978, 1990), the assessment ofthe adaptation condition was carried out: type of adaptive reaction, level of reactivity and level of health in points for women during pregnancy, labor and postpartum period using the author>s computer software «Antistress». A leukocytic formula was used as an alarm indicator of adaptative reaction and criteria of the conditions synchronization. The received results have revealed authentic dependence between level of health before labor and the frequency of dystocia of labor development.
54-56 280
Abstract
The paper describes data about the epidemiological monitoring of tuberculosis and estimates the diagnostic role of Mantoux test with two tuberculin units in Primorsky Krai children during 2000-2008. As shown, only hyperergic responses to tuberculin are convincingly indicative of the infection with Mycobacterium tuberculosis in case of junior age group children. The Mantoux test appears to be most informative, when applied to children aged 7-14 years old. The marked conversion of the tubercular tests can be observed from the age of 11. From the age of 12 the percentage of hyperergic and cumulative responses to tuberculin tends to increase that confirms great number of children infected with Mycobacterium tuberculosis during 2 years and more.
57-59 283
Abstract
The paper offers the method of approximating the reference-point dependence between two variables to estimate dependences between the medial cerebral artery of the vertebrates, thickness of its middle membrane and density of effectory innervations. The authors have examined bony fish, amphibians, reptiles, birds and mammals, determined the cholinergic nerve fibres by Kelley’s histochemical method on acetylcholinesterase on the total preparations, and calculated the density of nerve plexuses at 1 mm of the vessel surface. As reported, the density of the cholinergic innervations increases in parallel to the increase of the artery diameter and thickness of its middle membrane. The cholinergic innervations of the middle cerebral artery intensify from lower vertebrates to superior vertebrates, and reach their maximum in mammals.
60-62 248
Abstract
The authors have performed analysis of plasmid characteristics of 299 Salmonella enteritidis, strains isolated in 2005-2011 from different ecological sources in the Kamchatka region. It is found that the population of S. enteritidis in the Kamchatka region is heterogeneous and is represented by 20 plasmid types of pathogen. It is found that 87.4 % of all studied strains isolated from patients with sporadic disease, represented by six major plasmid types that were isolated for all the years of observation. The population structure differentiated local and imported types of microbe, and the types of imported, identified types of microbe of unknown origin. It is shown that the cause of increasing morbidity of salmonellosis caused by S. enteritidis, in the Kamchatka region in 2008 is relapse of the epizootic process in a local poultry farm.
63-64 294
Abstract
Somatic gastrointestinal diseases play an important role in developing stomatopathy. The paper provides analysis of the state of microbiocenosis in the dentogingival sulcus in 37 patients with chronic inflammatory diseases of paradontium occurred against the background of chronic gastrointestinal diseases. As reported, the marked character of the oral cavity dysbacteriosis ap-pears to be determined by the nature of the background diseases. In case of gastric and duodenal ulcer, the dysbacteriosis is more marked than that associated with the chronic gastritis and chole-cystopancreatitis.
65-67 266
Abstract
The paper provides comparative analysis of the results of standard and optimized approach to performing surgery on acute appendicitis with retroperitoneal location of the vermiform appendix in 95 patients. In 1998-2002 the appendectomies through the laparotomy incision were performed, as a rule, without previously performed laparoscopy. With respect to the patients group with the optimized approach (2003-2011) the method of surgery was chosen, depending on the location of the appendix and the appendicitis-associated complications detected during the laparoscopy. The laparoscopy, laparoscopic and video-assisted appendectomy and post-operative sanitation laparoscopy were used as methods of optimization. The wide application of the optimized approach allowed in 84.4 % of cases to accurately diagnose, decrease the frequency of median laparotomies from 46.2 to 10.7 % of cases, and reduce the frequency of post-operative wound complications from 23.1 to 8.9 %.
67-69 335
Abstract
The aim of this study was to investigate of pulmonary hemodynamics and arterial blood gases in patients with isoleited chronic obstructive pulmonary disease (C0PD) and associated with chronic stable coronary artery disease. The study included of 103 patients (54 patients with isolated C0PD and 49 patients with C0PD associated with chronic stable coronary artery disease). Arterial blood gases, the pressure in the right heart are investigated. Results of the correlation analysis of arterial blood gases and pressure in the right heart are presented.
70-72 312
Abstract
The authors have examined 1429 patients with burn injuries. According to local microbiological monitoring, staphylococcus bacteria - Staphylococcus aureus and Staphylococcus epidermidis (62.3 % of cases) and non-fermenting gram-negative bacteria -Pseudomonas aeruginosa, Acinetobacter baumannii and Acinetobacter spp. (21 % of cases) played a leading role in the aetiology of suppurative-septic complications. There was a tendency towards the increase of a share of non-fermenting gram-negative bacteria, as the pathology progressed; the etiological role of staphylococcus bacteria reduced. 16.7 % of all the strains were accounted for by Enterobacteriaceae and Staphylococcaceae bacteria. The monitoring allowed detecting high resistivity of P. aeruginosa bacteria to the antimicrobial drugs (meropenem, imipenem, cefepime, amikacine, and ceftazidime). All the A. baumannii strains were resistant to ceftazidime and gentamicin.
72-74 238
Abstract
The author has conducted retrospective analysis of 2083 case histories of children suffered from enteric diseases aged 1 to 14 years old stayed in the infectious diseases departments of the Far Eastern Federal District. The antimicrobial drugs were administered in 76.1% of cases. 32.3% of patients undergone antimicrobial treatment had no indications for antimicrobial drugs. The infectious disease doctors most often applied nitrofurans (36.3±1,2 %), aminoglycosides (28.8±1.1 %) and cephalosporins (26.5±1.0 %). The major part of hospital departments has used to apply low-efficient or toxic drugs (furazolidone, chloramphenicol, rifampicin, and gentamicin). The infectious disease doctors have not agreed on a united approach to choosing the initial antimicrobial drugs that is bound to be reflected in the expediency and safety of drug therapy.
74-77 230
Abstract
The paper studies clinical, biochemical and virological parameters and immunological indicators of liver fibrosis in 120 patients with chronic viral hepatitis of different aetiology (B, C and mixed В+С, В+D, B+C+D). The mixed viral involvement caused more massive changes in the clinical picture of the disease. All the cases were characterized by the decrease in the matrix metalloproteinase-9 content in blood serum. Its deficit correlated with the progression of fibrotic changes in liver. Contrariwise, there was an increase in the protease with inhibitor level. The high indices were detected in case of viral hepatitis B of both mono- and mixed infections that could be explained by progressive fibrotic changes and marked cancer-causing potential of this pathogen. The authors indicate the direct dependence between the degree of viral load and degree of liver fibrosis.
78-81 235
Abstract
The paper provides the comparative investigation of cytokine level in blood serum, and spontaneous and induced cytokine production in patients with short-term tick-borne encephalitis-related antigenemia, vaccinated and unvaccinated against the tick-borne encephalitis. At the early stage of the infection, the unvaccinated people had the content of pro-inflammatory cytokines increased, both in vivo and in vitro. The group of the vaccinated patients was characterized by the increased production of immunoregulatory cytokines. The high cytokine-producing activity of the peripheral blood cells in patients under examination detected at the early stage of the infection is one of the crucial factors for rapid elimination of the virus.
82-84 234
Abstract
The authors have examined the initial tonus of the involuntary nervous system in 270 pregnant women: 80 women, the perinatal risk of whom did not exceed 4 points (control group), and 190 women with average and high perinatal risks (5-20 points). The vegetative tonus was estimated with the automated complex ‘AR-DK-Mediscreen’ used to measure electrical parameters of the skin. All the women belonging to the main group, irrespective of the parity, had had the tonus of the parasympathetic nervous system that indicated the stress in the adaptation mechanisms. The duration of labor directly depended on the initial vegetative tonus; the more marked were the normo- and sympathicotonia on the ‘uterine segments’, the less duration of labor occurred. In case of the initial segmental parasympathicotonia, the uterine activity intensified lower. As reported, the estimation of the initial vegetative tonus is rather informative to be used to predict the course of labor.
LECTURES
7-12 255
Abstract
The paper describes the issues of biopsy diagnostics in modern clinic and capabilities of pathological anatomical laboratories of the Far East to introduce innovative research methods into practice, as well as possibilities of immunohistochemical studies in oncology, haematology, obstetrics and gynaecology, gastroenterology, in case of infectious diseases, in nephrology, etc. The authors highlight the role of ‘routine’ methods as the basis of diagnostics in pathological anatomy, and pre-diagnostic treatment of biopsy and operative material needed to obtain exact morphological conclusions, and surmise that there is a need of certifying diagnostic departments of medical institutions. Creating large pathological anatomical associations (institutes of pathology) will allow developing and introducing the entire up-to-date methods of pathological anatomical diagnostics into health care practice.
PUBLIC HEALTH ORGANIZATION
84-87 328
Abstract
The data of anamnesis at 1439 invalid children are analyzed. The high level of pregnancy, childbirth and neonatal pathology was revealed. The strongly variability of antenatal and perinatal risk factors in deferent pathology forms was displayed. It is shown that a major focus of prevention of childhood disability in the Khabarovsk Territory should become a widespread organization of available skilled obstetric and neonatalogical care.
METHODS
87-89 277
Abstract
The paper provides the analysis of the short-term postoperative mental disorders caused by the total multi-component anaesthesia in 50 oncologic patients after intestinal cavity surgeries. During the surgery, 25 patients underwent BIS-monitoring combined with the standard intra-operative monitoring, and 25 patients underwent the standard intra-operative monitoring, only. The mini-mental state examination (MMSE) test was used to estimate the short-term postoperative cognitive disorders. As resulted, the BIS-monitoring allowed the anaesthesiologist to control the hypnogeic component of the anaesthesia at a required level and decrease the possibility of appearing short-term post-operative cognitive disorders.
90-92 230
Abstract
The paper summarizes the experience of puncture aspiration removal of non-traumatic hypertensive intracerebral hematomas and local fibrinolysis in 15 patients and highlights the high efficiency of this method to treat non-traumatic intracerebral hematomas in comparison with the traditional encephalotomies. This method can be used in the neurosurgical hospital departments, given the 24-hour computer tomography and required fibrinolitic drugs.
92-94 254
Abstract
The paper reviews the experience of examination of 35 patients aged 48 to 62 years with spondiloartrosis of lumbar spine against the dorsopathy treated with chondroitin sulphate by means of pharmacopuncture and intramuscularly (control group). The pharmacopuncture allows arresting the pain and muscular tonic manifestations much faster, withdrawing from non-steroid anti-inflammatory drugs or considerably titrating their dose down. When applying the pharmacopuncture, the rate of side effects correlates to the intramuscular infusion of the chondroitin sulphate. The side effects are inconsiderable and do not require withdrawing the therapy.
95-98 298
Abstract
Using сardiointervalography, the authors have studied stress degrees of the tense carboxyperitoneum during laparoscopies. Initially, they recorded the vegetative normotony, followed by the excess of central (hypothalamic) and sympathetic effects on the cardiac rhythm regulation at the carboxyperitoneum height. In 5 minutes after the desuflation, there was a decrease of sympathetic prevalence. In 15 minutes after the desuflation there was a parasympathetic shift of vegetative balance. 10 % of patients had the cardiac rhythm disturbed. These changes in the cardiointervalograms have arisen from the disturbed gas composition of blood and acid-alkali balance, and blood redistribution in channels caused by the carboxyperitoneum. The paper discusses the way of minimizing these negative effects using authors’ original insufflator model.
G. A. Shabanov,
A. A. Rybchenko,
A. L. Maksimov,
A. A. Savintseva,
A. I. Volkov,
A. F. Belyaev,
N. G. Shabanova
99-100 322
Abstract
The paper reviews the issues of diagnosing the internal organ diseases via spectrum analysis of the cerebral bioelectric activity and offers the concept of functional status matrix multiple arousal with reticular brain formations. This allows creating the methods of the spectrum analysis of diffuse bioelectrical cerebral activity and substantiating the system of frequency-topical coordinates used to display and analyze the information produced. The authors have developed basic principles for functional topical diagnostics of the internal organ diseases and identified indices of the integral estimates of human health.
ISSN 1609-1175 (Print)