bluuebunny/crossref_metadata_2025 huggingface dataset:
PARTICULAR QUALITIES OF PSYCHOSOMATIC RELATIONSHIPS IN PATIENTS WITH ACTIVE RHEUMATOID ARTHRITIS
Authors: Octiaborskaya I V , Tashlykov V A , Belyaeva I B
Published: May 2018

In 120 patients with active rheumatoid arthritis evaluated psychosomatic relationships Anxiety and depressive disorders were found in 80 (66.2%) patients. There was a positive correlation relationship between the number of patients with anxiety and depressive disorders and values of activity index dAS 28, functional health assessment index НAq, disease duration and quantitative values of rheumatoid factor. Combination therapy with methotrexate and infliximab has obvious advantages over monotherapy with methotrexate in patients with active rheumatoid arthritis and leads to significant clinical improvement, increase functional ability of joints, improve the quality of life and decreased fatigue and somatization depression.
FIBROBLAST GROWTH FACTOR (FGF) 21 AT MULTIMORBID CARDIOVASCULAR PATHOLOGY WITH ANXIETY AND DEPRESSIVE DISORDERS IN YOUNG AND MIDDLE-AGED MEN
Authors: Partsernyak A S , Proshyai G A , Partsernyak S A , Aflitonov M A , Mironenko A N , Topanova A A
Published: May 2018

Evaluate (FGF) 21 at multimorbid cardiovascular pathology (MCVP) (coronary artery disease (CAd), hypertension, metabolic syndrome (MS)) with non-psychotic mental disorders (NPMd) anxiety/ depressive type. Identify the effectiveness of visual-auditory effects in the treatment of these pathologies. design and methods: The study included 70 men (mean age 37,46±6,74) with MCVP divided into 4 groups by simple random sampling, and 20 healthy men (mean age 38,3±6,73 g). Patients in Group 1 (n = 22) received standard therapy CAd, hypertension and NPMd, in group 2 (n = 25) standard therapy CAd, hypertension, NPMd and visual-auditory correction. Patients of group 3 (n =23) received standard therapy CAd, hypertension, NPMd, visual-auditory correction and psychotherapy. used in the study: complex psychological test methods and laboratory-instrumental evaluation of the cardiovascular system. definition of FGF21 performed by ELISA using kits BCM diagnostics SK00145-01 (BCM diagnostics, uSA). Results: Identified a two-fold increase in the concentration of serum FGF 21 after the course of standard therapy in the first group. In the other groups showed a statistically significant decrease FGF21 after psychopharmacological and visual-auditory therapy. In all groups after treatment was observed significantly change the type of NdP «severe depression»,«clinical anxiety» to «mild depression»; «subclinical anxiety» (p <0,001). Conclusions: FGF21 may be important biomarker for early diagnosis of metabolic abnormalities in this pathology. Results indicate benefits of combined therapy MCVP with the use of psychotropic drugs and visual-auditory correction method. Choose the method of complex treatment given the side effects of pharmacological agents.
CAPABILITIES AND PERSPECTIVES OF THE PRENATAL NEUROSURGERY(FETAL NEUROSURGERY)
Authors: Iova A S , Garmachov Y A , Crukov E Y , Iova D A
Published: May 2018

Capabilities and perspectives of the prenatal neurosurgery in hydrocephalus and myelomeningocele are presented, which were based on experimental and clinical studies. Reasons of the decreasing of interest for surgical treatment of hydrocephalus and «revolution» in the field of surgical treatment of fetus myelomeningocele are analyzed. Requirements to medical centers that are planing the introduction of technologies of surgical treatment of myelomeningocele are presented. Prospects of introducing of the technology in fetal neurosurgery in St. Petersburg are analyzed.
GLOBAL AND RUSSIAN TENDENCIES IN THE HUMAN RESOURCE MANAGEMENTIN HEALTH CARE
Authors: Hurtsilava O G , Luchkevich V S , Avdeeva M V , Filatov V N , Samodova I L
Published: May 2018

The article analyses the main directions of development of human resource management in the health sector, both in Russia and abroad. Through the example of the Russian and foreign health care service it shows that the main problem is the deficit of nurses and physicians. The world experience in solving this problem is analysed in the article. The research shows the current classification of availability of medical personnel and characterises system of training of medical personnel in Russia. In conclusion the prospects of development of human resources policy and medical personnel management on the basis of strategic planning in health care are given.
COMPARISON OF PROLIFERATION AND IMMUNOPHENOTYPE OF MSC, OBTAINEDFROM BONE MARROW, ADIPOSE TISSUE AND UMBILICAL CORD
Authors: Aisenstadt A A , Enukashvili N I , Zolina T L , Alexandrov L V , Smoljaninov A B
Published: May 2018

Mesenchymal stem cells (MSC) can be applied for treatment of different diseases. Human MSC have been isolated from bone marrow, adipose tissue, umbilical cord blood. umbilical cord MSCs (uC- MSC) are obtained during birth with non-invasive, non-traumatic methods and thus seem a good candidate for clinical practice instead of bone-marrow MSC (BM-MSC). It is yet unknown wheth- er the immunophenotype and proliferation capacity of uC-MSC are similar to adipose-derived stem cells (AdSCs) or BM-MSC. The goal of this research was to study the immunophenotype and prolifer- atiion capacity of uC-MSC, AdSCs and BM-MSC. The results indicated that MSC of different origin had similar morphological and immunophenotypic characteristics with minor differences. uC-MSC differed from other cultures by constant level of Cd105 expression, the presence of minor Cd10 - and Cd13 - populations and higher proliferative activity. BM-MSC were characterized by reduced expres- sion levels of Cd90, compared with the uC-MSCs and AdSCs. These data confirm the similarity of uC-MSC with BM-MSCs and AdSCs and the possibility of their use in clinical practice instead of hard-to-obtain BM-MSC.
MITOGENIC ACTIVITY AND REGENERATION
Authors: Pechersky A V , Pechersky V I , Smolyaninov A B , Velyaninov V N , Adylov S F , Shmelev A Yu , Pecherskaya O V , Semiglazov V F
Published: May 2018

After 40 years at people decrease in a pool of pluripotent stem cells and increase of risk of development of oncological diseases is observed.To 11 patients aged from 52 till 76 years with a cancer of a kidney, bladder, prostatic gland III-IV stages of disease the chemotherapy or target therapy was carried out. To 4 patients of 60-82 years for restoration of regeneration it was carried out from 4 to 7 transfusions of mononuclear fraction of peripheral blood from young donors of 18-23 years, same-gender and blood types with recipients.In 1 month after carrying out chemotherapy or target therapy after development of a leukopenia in 11 patients the level of the bFGF increased on average by 1,74 times. At 4 patients from them the increase in level of the human VEGF-A on average by 1,25 times was observed, the 3rd of them had an increase in the human EGF on average by 1,13 times. In 3-6 months after the last transfusion of mononuclear fraction of peripheral blood the maintenance of hemopoietic cells predecessors of Cd34+ in peripheral blood increased on average by 3,25 times. At 4 patients the level of the bFGF decreased on average by 1,78 times, at 2 patients from them reduction of level of the human VEGF-A on average by 1,48 times was observed, the 3rd of them had a reduction an human EGF on average by 4,12 times. At all 4 patients in a buccal epithelium to decrease in an expression of p53 on average by 6,02 times, at the 3rd of them to decrease in an expression of Bcl-2 on average by 60,0 times.Violation of updating of tissues is the main reason for development of carcinogenesis in people is more senior than 40 years. The excess stimulation of mitotic activity at them can be reduced to normal level by means of restoration of number of a pool of pluripotent stem cells at transfusion of mononuclear fraction of peripheral blood from young donors of 18-23 years of identical with the recipient by blood types and a sex (The patent of the Russian Federation № 2350340).
ROLE OF THE COMPLEMENT AND CYTOKINES IN THE EARLYDIAGNOSIS OF MULTIPLE SCLEROSIS
Authors: Lobzin S V , Serebryanaya N B , Ischenko A M , Golovkin V I , Fomintseva M V , Kula I I
Published: May 2018

In the article are presented the results of the study of blood and cerebrospinal fluid for cytokines and the complement proteins in 22 patients with clinically isolated syndrome in accordance with the subsequent development of the disease. It is find out the differences between the concentration of some complement proteins in patients with the developed during the observation the definite multiple scle- rosis in comparison with the patients with clinically isolated syndrome, and cytokine status. The de- termination of immunological predictors of multiple sclerosis development may help to understand the dynamics of pathological process and to start the early treatment.
ORTHOSTATIC TORTUOSITIS TRANSFORMATION OF THE NECK’S MAIN ARTERIES
Authors: Zakhmatova T V , Shchedrenok V V , Moguchaya O V
Published: May 2018

Among 350 surveyed deformations of internal carotid arteries revealed in 38.6% of cases. At pathological deformation observed acceleration of flow speed indicators from 55% to 65% in part of tortuosity, average value of systolic speeds of a blood flow was 166±28.3 cm/s at the left and 174±30.2 cm/s at the right side. In vertical position in 31.6% of cases at pathological deformation observed transfor mation of tortuosity form. deformation corners became blunt, the gradient of flow speed indicators decreased or was absent, in some cases course of internal carotid arteries became rectilinear. Artificial deformations of vertebral arteries course revealed in 79.4% of people, average value of systolic speed of a blood flow was 92±15.3 cm/s at the left and 76±12.5 cm/s at the right side. In vertical position in deformations of the vertebral arteries, which carried to pathological, in 28.8% of cases a form of deformation was transformed to unpathological tortuosity. duplex sonography in vertical position in patients with tortuosity discovered new approaches in diagnostics of pathological deformations and defines indications to operative treatment.
STUDY THE REGULATION OF PERIPHERAL BLOOD FLOW IN PATIENTSWITH CARDIOVASCULAR DISORDERS
Authors: Manasyan A G , Dobkes A L , Manasyan S G , Ermolov S U , Serdyukov S V , Boldueva S A , Lipunova A S , Ermolova T V , Zaxarova O V , Nikitin D N
Published: May 2018

A new approach to evaluating of the state of cardiovascular system for patients with verified diagnosis of coronary heart disease (CHd), cardiac syndrome X (COAG) and hypertension (GB) by modification of known techniques of the PAT (peripheral arterial tonometry) is represented in the article. The results of studies by the method of us PAT patients with various cardiovascular disease indicate a particular clinical significance is not only the assessment of local «endothelial dysfunction» (the known value of reactive hyperemia index RHI), but also assess the nature of the Central system response regulation of blood circulation. In the article it is shown that more convenient for this relatively simpleCtrlmeasure R(relative change in the amplitude of pulsations in case of occlusion of the blood supplyto the sample identified on the hand are not subjected to occlusion). For patients without evidenceCtrlof cardiovascular disease the index value Rwas close to unity. The hypertensive patients, as a rule,observed values of R<1, and in CHd patients, in contrast, R>1. The differences associated, pre-CtrlCtrlsumably, with the changing balance between the degree of disturbance of peripheral blood circulationand degree of preservation of the reserves of the pumping function of the heart. This allows to consider the index RCtrl as an additional feature, an essential for individual selection of therapy in patients with cardiovascular pathology.
POST-INFARCTION CARDIAC RUPTURE: EPIDIMIOLOGIC AND CLINICAL (BASED ON MATERIALS «ST.-PETERSBURG SCIENTIFIC RESEARCH INSTITUTEFOR EMERGENCY CARE» NAMED I.I. DZHANELIDZE)
Authors: Kovalchuk E Yu , Soroka V V , Ryse A V
Published: May 2018

Several risk factors allows us to evidentiate those patients which are highly exposed to the myocardial rupture. Whereas ponderate synthesis and analysis of the epidemiological data and of those risk factors as well, enables us to fetch out the most informative and sustainable post-infarction myocardial rupture predictors. Article contains epidemiologic and clinical information about 81 case of post-infarction myocardial rupture occurred in Saint-Petersburg Research Institute of Emergency Care n.a. I.I.Dzhanelidze in 2009-2012 years. Diagnoses were confirmed in autopsy. Analyzed comorbidity in patients with AMI complicated by rupture of the myocardium.
POSSIBILITIES OF CYTOLOGICAL AND IMMUNOCYTOCHEMICAL MARKERSOF INDUCED SPUTUM IN THE EVALUATION OF AIRWAY INFLAMMATION IN PATIENTSWITH DIFFERENT LEVELS OF ASTHMA CONTROL
Authors: Pospelova S N , Sobchenko S A , Kravtsov V Yu
Published: May 2018

Were analyzed cytological and immunocytochemical data of induced sputum 43 patients with dif- ferent levels of asthma controlResults of cytological research showed lack or presence of eosinophilic airway inflammation (rela- tive number of eosinophils> 3%), but were not helpful in distinguishing uncontrolled from partially controlled asthma, these data could not be used for determination of level of asthma control. Objective indicator of the severity of airway inflammation, significantly correlated with the levels of disease con- trol, is the ratio of IL-1Ra/IL-1 in AM.
FIRST EXPERIENCE OF CELL TECHNOLOGIES IN THORACIC SURGERY
Authors: Egorov V I , Ionov P M , Jurkiewicz Y V , Smolyaninov A B , Besedina N K , Akopov A L
Published: May 2018

Bronchoscopic bronchial fistulas closing tactics, despite the merits, is not sufficiently developed and is of limited use. One of the new ways of improving this area may consist of endobronchial bronchus occlusion of the fistula using cellular technology. The purpose of this study was to evaluate the effectiveness of endoscopic treatment of postoperative bronchial fistulas using cultured allogeneic fibroblasts. The study included 10 patients with bronchopleural fistula after pneumonectomy transferred for lung cancer and infectious and destructive process. The diameter of the defect bronchial stump averaged 5 mm. Endobronchial intervention consisted of submucosal injection of a suspension allofibroblastov human bronchial stump fistula zone. Introduction of cell suspension was carried out in an isotonic saline submucosal fistula bronchus area 2-5 points total volume of 1.5 ml. Concentration allofibroblastov - 3 x 10 6 cells / ml. State of bronchial stump and residual pleural cavity to monitor the implementation of bronchoscopy, chest X-ray, CT scan. It is shown that after endobronchial administration fibroblast suspension clearance fistula was not detected in 6 cases out of 10. obturation of the lumen of the bronchus occurs within 7-9 days after cell transplantation. In the remaining patients fistula persisted, requiring re-cellular infiltration. Follow-up bronchoscopy in two cases the fistula ended blindly and do not communicate with the pleural cavity, the diameter of the fistula opening in two patients decreased significantly, but not completely closed. Thus, bronhoendoskopic submucosal administration of a suspension allofibroblasts in projection bronchial fistula should be considered as a promising method of conservative treatment failure bronchial stump after radical operations on the lungs, allowing 60-80% of cases, to avoid re-open surgery.
ROLE OF CYTOKINE ACTIVATION IN THE DEVELOPMENT OF CARDIOVASCULARDISORDERS IN PATIENT WITH GRAVES DISEASE AND CHRONIC HEART FAILURE
Authors: Frolova A V , Rodionova T I
Published: May 2018

The aim of the study is to assess the ability to influence immunological changes on the formation of cardiovascular complications of hyperthyroidism by determining the level of thyrotropin-receptor antibodies (TRAb), 6,8,10 interleukins (IL-6,8,10) and tumor necrosis factor-alpha (TNF-) in patients with Graves’ disease (Gd) and chronic heart failure (CHF) and without it. 68 patients were investigated with Gd, CHF diagnosed in 38 patients (55.9%), stage 1- in 12 patients (31.6%), stage 2A - in 19 (50%) patients, stage 2B - in 7 (18,4%) patients. For the analysis, patients were divided into 3 groups: 1 - with no signs of heart failure, 2 with CHF 1 stage (because the clinical signs characteristic of heart failure stage 1 can also be symptoms of hyperthyroidism, these patients were in separate group), 3 - CHF 2A and step 2B. In all three patients groups showed a significant increase in the levels of cytokines and TRAb compared with the control group. The development of CHF in patients with Graves’ disease is associated with increasing of IL-6, IL-8 and IL-10 concentration. direct correlation between the level of TRAb, TNF- and development of the cardiovascular complications in patients with Gd have not been identified.
MORPHOLOGICAL CHARACTERISTICS ANd CLINICAL MANIFESTATIONSOF THE PANCREAS dISEASES IN PATIENTS WITH VIRAL HEPATITIS
Authors: Zemlanoy V P , Syngaevskiy A B , Sidorov R S , Letina U V , Labazanov V M
Published: May 2018

The study analyzed the protocols autopsies of patients with decompensated forms of viral hepatitis. According to the autopsy 60% of patients with decompensated forms of viral hepatitis had pathological changes in the pancreas of which 2/3 were morphologically classified as acute pancreatitis. We performed retrospective analysis of medical records of patients who was found to have changes of the pancreas at autopsy. The clinical picture typical for pancreas involvment was scanty and concealed by severe clinical manifestations of decompensated liver failure due to progression of chronic viral hepatitis.
HEMODYNAMIC STATUS OF PREGNANT WOMEN WITH OBESITY
Authors: Matlubov M M , Semenixin A A , Ruzibaev S A , Zakirova N I , Kim O V
Published: May 2018

In order to study the state of hemodynamics in pregnant women with obesity of varying severity were examined 84 pregnant women aged between 23 and 28 years at 36-38 weeks gestation. The control group included 21 pregnant women of similar age and gestational age with normal body weight. All observed patients, pregnancy according obstetrical consultation was recognized uncomplicated. The degree of obesity was assessed by body mass index. Researches conducted showed that overweight as its progression has a very adverse effect on hemodynamics and functional state of the cardiovascular system as a whole, reduces coronary reserve. The most pronounced violation of the functional state of the cardiovascular system occur in obesity 2nd and 3rd degree.
FEATURES OF HEMODYNAMICS AND PECULIARITIES OF ADAPTATION IN INDIVIDUALS WITH DIFFERENT TYPES OF EMOTIONAL BALANCE
Authors: Nikolaev V I , Denisenko N P , Denisenko M D , Isakova A V
Published: May 2018

Peculiarities of hemodynamics in dependence of individual psycho-physiological features are examined among patients with acute disorders of cerebral circulation and healthy volunteers remaining in the situation of emotional stress. It was demonstrated that formation of “negative” emotional balance (prevailing of personal anxiety on reactive anxiety) promoted occurrence of the excessive tension and/ or overstrain of the adaptive mechanisms. It was either revealed that “negative” emotional balance facilitated the appearance of signs of the adaptive systems overexertion regardless of the type of the initial hemodynamics. It was detected that the psycho-physiological parameters, the peculiarities of hemodynamics and the level of tension of adaptive mechanisms in patients with acute disorders of cerebral circulation were comparable with the similar indices of healthy volunteers characterized by “negative” emotional balance in the situation of the emotional stress.
THE COPING STRATEGIES CHOICE IN THE PSYCHO-EMOTIONAL STRESS AMONG MENAND WOMEN OUTSIDE OF MARRIAGE
Authors: Bulgakova O S , Nikolaev V I , Denisenko N P , Sibilev O P
Published: May 2018

The aim of this work was to study the choice of coping strategies divorced men and women in a state of emotional stress. Thus, the research identified that there are differences in men and women in the choice of coping strategies in divorce, they are socio-behavioral forms of protection, in the basis of which is the adaptation to changing environmental conditions. Survey data must be taken into account in the work of doctors and psychologists when performing correction of this type of psycho-emotional stress.
CLINICAL AND NEUROLOGICAL CRITERIA FOR THE DIAGNOSISOF MYASTHENIA GRAVIS
Authors: Kosachev V D , Lobzin S V , Alekseeva T M , Kreis O A
Published: May 2018

927 patients suffering from myasthenia gravis have been examined. A long-term follow-up analysis of the various forms of myasthenia in its clinical and neurological development has been conducted. Systematization and evaluation of the results have revealed major and frequent diagnostics criteria appropriate of myasthenia gravis. There are fatigable muscular weakness (92,3%), formula motor dis- turbances (91,9%), test with neostigmine (77,5%), generalized muscular weakness (76,3%), “flutter” and «migration» of the symptoms (71,1%), preservation of eye movements downward while it restricts in other directions (68,3%), combination ptosis and lagophthalmos on one side (50,1%). A diagram of clinical diagnostic, which help us to review a patient diagnosis of myasthenia gravis or suspect this exact disease has been developed.
PREVALENCE OF DEPRESSION IN PATIONTS WITH HYPOTHYROIDISM
Authors: Sinitsina Y V , Kotova S M , Tochilov V A
Published: May 2018

Examination of 125 women with primary hypothyroidism was conducted to specify a prevalence of a depression and its severity and also to reveal change of indicators under therapy of levothyroxiny. The percent of persons without depression before treatment was the least. More expressed depression was revealed in the group of a manifest hypothyroidism at women of middle age. Direct dependence between the TSH level and indicators of a depression is noted. Against treatment there was an improvement of indicators, however symptoms of a depression were eliminated not at all patients.
THE RELATIONSHIP OF CLINICAL AND SOCIO-PSYCHOLOGICAL CHARACTERISTICSOF HOSTILITY AND AGGRESSION IN PATIENTS WITH PSORIASIS
Authors: Solovjeva S L , Ruzhinskikh A G
Published: May 2018

The article presents the current idea of the relationship between negative emotions and severity of psoriasis. It concludes investigations of the relationship between such negative feelings as hostility, ag- gressiveness and severity of chronic dermatosis; consideration of various variants of aggressive behavior and their relation to hostility. The article gives recommendations for enhancing the quality of care in hospitals for patients with psoriasis with a hostile, aggressive behavior.
CLINICAL AND IMMUNOLOGICAL INTERACTIONS IN THE RECURRENT MISCARRIAGEAND THEIR CORRECTION METHODS
Authors: Belyaeva M A , Bobrov S A , Lapin S V
Published: May 2018

The review is devoted to the problem of reproductive losses associated with impairment of the immune mechanisms which ensure the normal pregnancy progression. Increased expression of cytokines by T-helper type 1 cells underlies the immune etiology of reproductive losses. Decrease in regulatory T- cells activity leads to the development of recurrent spontanious abortion . The most important mechanisms of pregnancy progression cytokine regulation are presented. The main autoimmune conditions leading to fetal death are: antiphospholipid syndrome, increased activity of natural killer cells, compatibility in the HLA system, the presence of antinuclear, antigiston, sperm antibodies and Human chorionic gonadotropin antibodies. The modern methods of pathogenetic therapy of recurrent spontanious abortion are reviewed.
THE VALUE OF THORACOSCOPY IN IMPROVING THE RESULTS OF EXAMINATION AND TREATMENT OF PATIENTS UNDERGOINGCHEST TRAUMA
Authors: Zaycev D A , Movchan K N , Lishenko V V , Velikorechin A S
Published: May 2018

This paper describes a system of therapeutic and diagnostic measures in patients with chest trauma of various kinds. The basis of the system included the use of primary thoracoscopy under local anesthesia during drainage of the pleural cavity and the feasibility of building a medical-diagnostic help for syndromic basis.The aim of the study was to improve the results of examination and treatment of patients with chest injury on the basis of the development of optimal therapeutic - diagnostic algorithm using different types of thoracoscopy.Materials and Methods: Among the clinical findings (330 patients) identified 2 groups: control and research. In the control group (175 victims) were used traditional methods of examination (175 victims) and treatment in the study group medical-diagnostic program included the implementation of the various options thoracoscopy.Comparing the results and effectiveness of treatment in the two groups can be stated that diagnostic and treatment algorithm (using primary thoracoscopy during the regular drainage of the pleural cavity), used in patients at the study, reduces the number of thoracotomies 2 times. In the control group, thoracoscopy was performed in vain 4 (14.3%) among the 28 victims, and thoracotomy 3 (9.4%) of the 32 victims. When the primary TC contraindications for its implementation were not in any case that suggests TC necessary «elements» during the drainage of the pleural cavity in cases of medical care to patients with chest trauma. The time spent on diagnosis and definition of further tactics in the study group was 5 - 10 min., While in the control group required 20 to 60 minutes.Use of a complex diagnostic and treatment activities providing hour emergency surgical care for patients with chest injury, admitted to the health facility, where the state does not provide separation of Thoracic and thoracic surgeon on duty, justified because it is based on reasonable use of both traditional methods of examination of patients and survivors, and the broad introduction into clinical practice of innovative technology diagnostic and treatment process (US pleural cavity and pericardium, the rational use of thoracoscopy in the implementation of the drainage of the pleural cavity, and others.).
SURGICAL ANATOMY OF PARATHYROID GLANDS IN PATIENTS WITH SECONDARY HYPERPARATHYROIDISM
Authors: Novokshonov K Yu , Fedotov Y N , Karelin V Y , Pridvizhkin T S , Chernikov R A , Sleptsov V I , Sour P N , Timofeeva N And , Sinchuk I K , Uspensky A A , Semenov A A , Makarin V A , Fedorov E A , Malugov J N , Bubnov A N , Nikulin M O
Published: May 2018

Ectopic or supernumerary parathyroid glands (PTg) can be the reason of surgical failure in treat- ment of secondary hyperparathyroidism in patients, who underwent dialysis. The aim of this study is to estimate the number and localization of PTgs in patients with secondary hyperparathyroidism. We included 165 patients, who underwent total parathyroidectomy with heterotopic autotransplantation of parathyroid gland tissue or subtotal parathyroidectomy. All identified PTgs were separated in two groups: eutopic and ectopic. Preoperative localization was performed by multispiral computed tomog- raphy of neck and mediastinum, neck ultrasonography, two-isotope Tc99 MIBI of PTgs. In postopera- tive period, we estimated the level of parathyroid hormone in the serum and performed morphological verification. There were found 659 PTgs. 12 (7,2%) patients had 3 parathyroid glands, and 11 (6.7%)had 5 PTgs. 4 Ptgs were found in 142 (86,1%) patients. 520 (78,9%) PTgs were eutopic, 139 (21,1%) - ectopic. The most common ectopic place for upper PTgs were paraesophageal and retrotracheal spaces, carotid sheath. Ectopic lower PTgs were most commonly located in the horns of the thymus. All super- numerary PTg were ectopic and often located in area between lower pole of the thyroid lobe and the thymus.Conclusion. During the operation in case when ectopy is suspected, upper PTgs should be located in in paraesophageal and paratracheal areas or in carotid sheath, if it necessary. If lower PTgs is absence, surgery should be completed cervical thymectomy.
THE INTENSITY OF THE FORMATION OF ADHESIONS IN THE PROCESSOF INRA-POMINALNOM STRENGTHENING OF THE ABDOMINAL WALL IN THE EXPERIMENT SYN-THETIC MESH IMPLANTS, DIFFERENT PHYSICAL-TO-CHEMICAL BASISOF THE STRUCTURE
Authors: Chistyakov D B , Movchan K N , Yaschenko A C
Published: May 2018

In the experiments 60 rabbits explored intra-abdominal implantation in the abdominal wall with synthetic prostheses with different physico-chemical basis of the structure. Results of implantation of the prosthesis was assessed primarily in relation to the development or absence of adhesions. In experiments (6 groups of animals were evaluated 4 types of implants made of polypropylene, polyvinylideneftuoride, polyvinylideneftuoride layer with a collagen coating and PVDF coated carboximetilcelulosa. The pronounced formation of adhesions (worst results) marked with the strengthening of the abdominal wall implants created from polypropylene. Best of all (rare formation of adhesions in the peritoneal cavity) were the results when implanted in the abdominal wall prostheses, consisting of PVDF materials.
BONE DENSITY PARAMETERS CHANGING IN POSTMENOPAUSAL WOMEN WITH DIFFUSE SITES NONTOXIC GOITER AND AUTOIMMUNE THYROIDITIS IN TREATMENTLOW-DOSE ESTROGEN-PROGESTOGENS MEDICATION
Authors: Gromova V A , Vorokhobina N V , Malygina O F , Kuznetsova A V
Published: May 2018

Postmenopausal osteoporosis - multifactorial disease, on the pathogenesis of which affect not only the estrogen deficiency, but functional state of other endocrine glands, particularly the thyroid gland. The article presents the results of a research 74 women with autoimmune thyroiditis and diffuse nodular nontoxic goiter, which during perimenopause and menopause for 12 months received low-dose estrogen-progestin preparation containing 2 mg drospirenone and 1 mg of 17-estradiol. The control group consisted of 40 women of similar age without thyroid disease who were not receiving drugs hormone replacement therapy (HRT). To study the effect of HRT on bone metabolism all women at baseline and after 12 months of follow-conducted study of bone mineral density (BMD) with dual en ergy X-ray absorptiometry (DXA). As a result of the treatment received reliable increase in BMD in the lumbar spine L1-L4 9-10% (p <0.001) in the proximal femur - by 2.8-3.5% (p <0.01) in the bones forearm - by 1.8-2.1% (p <0.01).Conclusion: The use of low-dose estrogen-progestin drugs for 12 months in women with autoimmune thyroiditis and diffuse nodular nontoxic goiter in peri- and postmenopausal period helped gain in BMD in both trabecular and cortical bone structure.
SOME FEATURES OF THE DEVELOPMENT OF URGENT COMPLICATIONSAFTER CHEMOTHERAPY IN PATIENTS WITH MALIGNANT LYMPHOMA
Authors: Yurkin A K , Maximov A G , Shegolev A V , Yurkina E A
Published: May 2018

The article investigates the features of urgent complications in patients with malignant lymphoma after chemotherapy. The study included 151 patients. Indolent lymphomas diagnosed in 68 people aggressive lymphomas - in 83 people. The study identified the most important urgent conditions af fecting patients and mortality. In patients with aggressive lymphoma we revealed the following lifethreatening condition (i.e. critical condition under which the patient can die without treatment in the anytime soon): acute heart failure, pulmonary edema, hemorrhagic stroke.The most common urgent conditions in patients with indolent lymphomas are following: ischemic stroke, acute renal failure and DIC syndrome. There were significant predictors of urgent complications that allow to predict their development and define the scope and order of pre-emptive intensive care, as well as to create a matrix of information for the development of learning mathematical matrix for model urgent complications after chemotherapy in patients with malignant lymphoma during neutropenia.
EFFECT OF DIFFERENT TYPES OF LEUKOCYTE FILTERSON ERYTHROCYTE DONOR BLOOD PRODUCTS AT THEY PRODUCTIONSTAGE LEUKODEPLETION
Authors: Belyaev A E , Mironenko A N , Platonov S M
Published: May 2018

To evaluate the side effects of “production” leukofilters (LF) on filtering blood components, in particular - determine the degree of loss of hemoglobin at leykodepletion (LD) of erythrocyte blood components with various types of LF. The study of this parameter is necessary for determining reasonable criteria for selecting the type LF for everyday work in the production of red blood cell suspension (RBC’S), which would be most consistent with the concept of the “ideal”. Materials and Methods: Blood systems «Leukotrap RCPL» (production of «Pall Medical», USA) with integrated LF and «Demotec» (production of «Demophorius», Cyprus), which fluster LF “Leykosep» (production Company NLP «Interoko», Russia) were used for collection of donor blood. Results and discussion: 22 samples of leukodepleted RBC’S with LF “Leykosep” and 20 samples of RBC’S after LF «Pall» were examined for. Prior to the LD groups were quite comparable. The process of executing the LD leads to a significant reduction in the volume of the container contents and, accordingly, the loss of hemoglobin in the system with a reduction of its content in a dose of RBC’S. However, indicators of volume loss and reduction of hemoglobin in the “Interoko” group were significantly greater than in the group «Pall», which appear to be associated with the design of the LF. Accordingly, in the group “Interoko” amount of hemoglobin per dose of RBC’S was significantly less than in the group «Pall». At the same time revealed the difference between the groups in hemoglobin concentration after LD was on the damage trend without reaching statistical significance (p = 0.053), which may indicate an insufficient value of groups. However, indicators of hemoglobin concentration were within adequate values (N > 40 g / dose) to meet the requirements of Technical regulations. Conclusions: Given the increasing number of proposals on the market LF existing assessment criteria (subjective convenience for staff, the producer price) becomes clearly insufficient, moreover it turns out that the use of different types of systems at least makes it necessary to clarify the accounting for losses of erythrocyte blood products in the LF. The study makes it clear that the manufacturer’s instructions to the LF and work instructions for the LD of erythrocyte blood components should include additional criteria - a loss of volume in the LF, which entails a significant reduction in hemoglobin content.
THE BILATERAL EPICUTANEOUS ELECTROSTIMULATION OF THE LOWERLIMB MUSCLES CONTRIBUTES TO INTRADIALYTIC HYPOTENSION PREVENTIONAND HEMODIALYSIS EFFICIENCY IMPROVEMENT
Authors: Vishnevskii K A , Belyaev A E , Mironenko A N
Published: May 2018

The study researches the effectiveness of bilateral epicutaneous electrostimulation of the lower limbs muscles (BEEM) for purification intensification and improvement of the hemodynamic stability during the procedure in patients receiving hemodialysis (HD). The study included 71 patients (test group N=37; control group N=34). BEEM performed during hemodialysis three times per week for 30 minutes in the first 3 hours of each hemodialysis session for 3 months. The control group received standard HD therapy. The BEEM group in contrast to the control group showed a significant increase in the efficiency of dialysis (spKt/V), as well as lower levels of predialysis uremia. Also, the BEEM contributed to reduce the frequency of intradialytic hypotension episodes in patients who had a history of such episodes.
MELATONIN EXCHANGE AT MULTIMORBID CARDIOVASCULAR PATHOLOGYWITH ANXIETY AND DEPRESSIVE DISORDERS IN YOUNG AND MIDDLE-AGED MEN
Authors: Aflitonov M A , Partsernyak S A , Mironenko A N , Partsernyak A S , Topanova A A
Published: May 2018

Evaluate melatonin (MT) patterns excretion at multimorbid cardiovascular pathology (MCVP) (coronary artery disease (CAD), hypertension, metabolic syndrome (MS)) with non-psychot- ic mental disorders (NPMD) anxiety/ depressive type. Identify the effectiveness of visual-auditory ef- fects in the treatment of these pathologies. Design and methods: The study included 70 men (mean age 37,46±6,74) with MCVP divided into 4 groups by simple random sampling, and 20 healthy men (mean age 38,3±6,73 g). Patients in Group 1 (n = 22) received standard therapy CAD, hypertension and NPMD, in group 2 (n = 25) standard therapy CAD, hypertension, NPMD and visual-auditory correction. Patients of group 3 (n = 23) received standard therapy CAD, hypertension, NPMD, visual-auditory correction and psychotherapy. Used in the study: complex psychological test methods and laboratory-instrumental evaluation of the cardiovascular system. Definition of 6-sulfatoxymelatonin (6-SMT) performed by ELI- SA using kits BÜHLMANNEK-M6S. Results: Identified change normal «dipper» pattern to «non- dip- per» and «night-peaker» (daily index blood pressure and 0-10% <0% (p <0,001) in all treatment groups. Patients 3 group observed achievement reference values of the night excretion after treatment 458±64-» 798±32 (before and after treatment, respectively) (p <0,001). In all groups after treatment was observed significantly change the type of NDP «severe depression», «clinical anxiety» to «mild depression»; «sub- clinical anxiety» (p <0,001). Conclusions: Patients with MCVP have abnormalities of MT content char- acterized by a decrease in nocturnal excretion of 6-SMT. Night pattern of 6-SMT excretion significantly correlated with severity of anxiety/ depression before and after treatment. Results of patients treated with visual auditory correction significantly better than patients of other groups (obtained reference intervals MT excretion, biochemical indices and normalization of psychological tests).
PROVIDING THE POPULATION WITH PRIMARY CARE PHYSICIANS:FACTS, TRENDS AND PROGNOSIS
Authors: Hurtsilava O G , Luchkevich V S , Avdeeva M V , Logunov D L
Published: May 2018

To ensure the availability of primary health care compliance with regulatory requirements, taking into account population density, and personnel stability are very important. Methods. According to the reporting form №30 analyzed accordance staffing table one of the polyclinic of St. Petersburg regulatory and target indicators, presented in the Orders of medical care. Analyzed frequency of layoffs of doctors from polyclinic throughout the year, taking into account the duration of the employment relationship. Results. The population living in the polyclinic area of health care, is extremely insufficient provided by dentists, rheumatologists, urologists, oncologists and psychotherapists, as their numbers on 57,5-80,8% below the regulatory and target indicators. Insignificant shortage of staff identified among allergist, cardiologists, gastroenterologists, infectious disease specialists, general practitioners and otolaryngologists precinct because the lack of individuals working in these fields, is 10-30%. There is no shortage of such specialists as endocrinologists, ophthalmologists and neurologists. Over the last year 20,5% of doctors quit from a polyclinic and the newly employed at 1,5% less than retired from work. Conclusion. The current staffing table does not fully meet the regulatory requirements on the number of posts and the number of actually working doctors on 10 thousand of population. Another problem is the turnover of medical staff, which exacerbates the staffing imbalance.
IMPROVED NEUROLOGICAL ASSESSMENT OF SEVERE INTRAVENTRICULARHEMORRHAGE IN NEWBORNS WITH VERY LOW AND EXTREMELY BIRTH WEIGHT
Authors: Schugareva L M , Iova A S , Kryukov E Y , Sotnikov S A
Published: May 2018

Neurological outcomes in severe intraventricular hemorrhage in infants with very prematurity de- termined by correctable and uncorrectable factors of bleeding. The aim of the study was to develop an optimal clinical diagnostic algorithm in selection of treatment of severe intraventricular hemorrhage in infants born with critical immaturity. During the period 2005-2010. He received treatment at the hospi- tal in 1150 infants with very low birth weight (VLBW), and extremely low birth weight (ELBW). We used clinical methods of evaluation: neurological examination, pediatric Glasgow Coma Scale / Saint Petersburg (Iova A.S. et al., 1999). Diagnostic methods: ulrasonografiya (US), computed tomography (CT), magnetic resonance imaging (MRI).Ways of improving diagnostic tactics depending on the risk factors and the dynamic clinical and ultrasonographic evaluation. Adoption subgaleal drainage when post-hemorrhagic ventriculodilatation improves early neurological outcomes in children.
CICATRIZATION AND REGENERATION
Authors: Pechersky A V , Pechersky V I , Shpilenya E S , Gaziev A H , Semiglazov V F
Published: May 2018

Introduction. The cicatrix as the local site of a sclerosis, replaces wound defect or focus of a necrosis. Lead to cicatrization various type of a trauma, including operational, and also some of diseases. Cicatrization quite often leads to stricture and other complications.Materials and methods. The methodology of stimulation of regeneration for reduction of intensity of cicatrization of the damaged tissues is shown on the example of the patient from a stricture urethra.Results. In 5 months after an endoscopic urethrotomy of a stricture of bulbous part of urethra of 3 mm and the developed recurrence - the stricture of bigger length - 5 mm the repeated endoscopic urethrotomy was carried out. In 5 months after carrying out a repeated endoscopic urethrotomy and the beginning of the complex treatment directed on stimulation of regeneration and prevention of formation of cicatricial tissue according to a control urethrography the bulbous part of urethra was passable.Conclusion. Complex stimulation of regeneration taking into account a role of immune system in this process, on an equal basis with purpose of proteolytic ferment preparations, can be used for reduction of expressiveness of sclerosis of the damaged tissues.
FEATURES OF DIAGNOSTICS AND PLASTY OF LARGE LEFT-SIDED POSTTRAUMATIC DIAPHRAGMATIC HERNIA
Authors: Zemlyanoy V P , Sigua B V , Nikiforenko A V , Kotkov P A
Published: May 2018

Post-traumatic diaphragmatic hernia often develop as a result of an open or closed chest and abdomen injury, thoracoabdominal and iatrogenic. A clinical observation of successful diagnosis and treatment of patient with major post-traumatic diaphragmatic hernia, developed after laparoscopic splenectomy, accompanied by technical features, is exampled. Operative treatment of large post-traumatic diaphragmatic hernia is a complex reconstructive operation and requires the use of alloplastic materials for adequate correction.
POST-INFARCTION CARDIAC RUPTURE
Authors: Kovalchuk E Yu , Rysev A V
Published: May 2018

The field of post-infarction myocardial ruptures is still a nearly blind spot of cardiology; there are many facts about it which are ambiguous and simply too vague. For example, the dispersion in frequency rate is quite self-explanatory: from 0 to 30 or even 35 per cent. A number of clinical studies concerning the 30 days mortality due to acute myocardial infarctions just ignores myocardial ruptures as being the cause of death. This probably comes from a certain confusion as the post-infarction myocardial ruptures and the cardiogenic shock have almost similar manifestations. However pathologists participating in those not so numerous clinical studies concerning the 30 days mortality due to acute MIs presume that the real frequency rate of myocardial ruptures is much higher and stands at 20 to 36 per cent among all cases.
VARIANT OF HERPES-ASSOCIATED DEMYELINATIONWITH MULTIPLE SCLEROSIS SYNDROME
Authors: Lobzin S V , Golovkin V I , Fomintseva M V , Yurkina E A , Kula I I
Published: May 2018

The article presents its own clinical observation of the аssociation of neurotropic herpes viruses with demyelinating process in the central nervous system. An in-depth immunological and immunogenetic examination is carried out as an etiologic and pathogenetic diagnosis.
THE PARTICIPATION OF IMMUNE AND INFLAMMATORY MECHANISMSIN THE PATHOGENESIS OF CORONARY ATHEROSCLEROSIS
Authors: Mazurov V I , Stolov S V , Belyaeva I B , Trofimov E A
Published: May 2018

It was revealed that in development of a coronary atherosclerosis, participate the immune-mediated mechanisms. In blood of patients with coronary atherosclerosis the maintenance of the basic classes cytokines (IL-1 β, IL-2, IL-6, IL-8, TNF-a) were increased. Development of acute coronary insufficiency is accompanied by additional increase of levels of the data cytokines. The accessory of the cytokine activity to a coronary atherosclerosis was confirmed at studying the maintenance mRNA cytokines in a vascular wall. Thus in a zone atheromatous (aorta) it was synthesized mainly mRNA IL-2, while in a zone lipomatosis (a beam radial artery) it is formed nonspecific immune reaction with development of the mRNA IL-1 and IL-6. For patients with rheumatoid arthritis typically more active defeat of a coronary arteries, in comparison with healthy persons. Chronic immune-mediated process in frameworks of the autoimmune pathology can serve a trigger for accelerated development ischemic heart disease. The General immune-inflammatory mechanisms which participate in pathogenesis of the ischemic heart disease and rheumatoid arthritis, allow to spend the certain parallels between atherosclerotic process and autoimmune pathology.
AN ALGORITHM FOR THE FACIAL COMPOSITE TISSUE ALLOGRAFT TRANSPLANTATION.THE FIRST RUSSIAN EXPERIENCE
Authors: Fisun A Y , Ujba V V , Khurtsilava O G , Belskih A N , Volokh M A , Manturova N E , Khubulava G G , Turchenjuk S N , Lesnyakov A F , Skvortsov A E , Samojlov A S , Voskanjan S Je , Gubarev K K , Vinogradov V L
Published: May 2018

The article presents the first Russian experience in a facial composite tissue allograft transplantation. An algorithm for the interaction of government agencies such as the Ministry of Healthcare and the The Ministry of Defence of the Russian Federation was being reviewed . The basic aspects of the preparation and conduct of the operation, followed by immunosuppressive therapy were being presented.
OPTIMIZATION OF DIAGNOSIS AND ASSESSMENT OF EFFECTIVE TREATMENTOF DISEASES OF THE TEMPOROMANDIBULAR JOINT AND MASTICATORY MUSCLESIN DENTAL PRACTICE
Authors: Iordanishvili A K , Ovchinnikov K A , Soldatova L N , Serikov A A , Samsonov V V
Published: May 2018

The results of dental examination 1000 people (370 men and 630 women) aged 40 to 89 years, who were divided into three groups: middle age - from 40 to 59 years; Seniors - from 60 to 74 years; senile - from 75 to 89 years. They have assessed the prevalence of diseases of the temporomandibular joint and masticatory muscles studied symptoms and the intensity of the flow of these diseases. Based on the clinical data improved methods for evaluating the degree of severity of the disease and the effectiveness of treatment of temporomandibular joint and masticatory muscles, methods of registration of sound phenomena in the pathology of the temporomandibular joint, and developed techniques to identify groups at risk among adults in relation to the studied pathology.