bluuebunny/crossref_metadata_2025 huggingface dataset:
POSTTRAUMATIC PNEUMACEPHALUS: ETIOPATHOGENESIS, DIAGNOSTICS, METHODS OF SURGICAL TREATMENT. CLINICAL CASE
Authors: Оконешникова  , Okoneshnikova Alena , Калинин  , Kalinin Andrey , Бывальцев  , Byvaltsev Vadim , Будаев  , Budaev Anatoliy
Published: April 2017

Studying an opportunity to optimize the treatment of the patients with severe traumatic brain injuries is a topical issue in modern neurosurgery. Traumatic tension pneumocephalus is one of life-threatening conditions which accompanies severe TBI and is often complicated with posttraumatic liquorrhea and mass effect. Materials and methods. We carried out systematic search in Russian and foreign medical databases (Medline, Russian Science Citation Index, EMedicine, UMKB) concerning our theme. We included the following words in our search request: tension pneumocephalus, mass effect, valve mechanism, treatment. The result of conducted review of literature was writing the clinic lecture, studying current status of the problem of etiopathogenesis, diagnostics and surveillance of the patients with tension pneumocephalus. The article presenas clinical case of successful surgical treatment of a patient with traumatic tension pneumocephalus. Conclusion. There are no uniform standards of urveillance of the patients with tension pneumocephalus. Based on our own experience, we determined that minimally invasive surgery is a method of choice among reconstructive craniofa-cial surgeries in the treatment of patients with traumatic tension pneumocephalus. It decreases the risks of intra- and postoperative complication. Compliance, using external ventricular drainage and repeated lumbar punctures with prevention of inflammatory complications helped stopping nasal liquorrhea and eliminating mass effect which caused absolute regression of neurological signs
EXPERIENCE OF SURGICAL TREATMENT OF SECONDARY HYPERPARATHYROIDISM
Authors: Рожанская  , Rozhanskaya Elena , Махутов  , Makhutov Valeriy , Булгатов  , Bulgatov Dmitriy , Жаркая  , Zharkaya Anastasiya , Ильичёва  , Ilicheva Elena , Папешина  , Papeshina Svetlana
Published: April 2017

Surgical treatment of secondary hyperparathyroidism (HPT) in patients having renal replacement therapy (RRT) is a current problem. The aim of our study was to optimize the treatment of secondary HPT based on the comparative analysis of effectiveness of the surgeries with different extents. We conducted a retrospective analysis of the results of surgical treatment of uremic HPT in 34 patients. 36 surgeries were performed including 34primary (16subtotal parathyroidecomies (PTE), 13total parathyroidecomies (total PTEI), 5total parathyroidecomies with central neck dissection and resection of superior mediastinum and superior thymus horns (total PTEII)) and 2repeated surgeries (total PTEII and parathyroidadenomectomy). Gross examination of 134 surgical specimens revealed dyssynchronous pathological changes in parathyroid glands (PTG), normal PTG structure was found in 2cases. Recurrent HPT was found in 3 cases, persistent HPT – in 9cases, hypoparathyroidism – in 5cases after subtotal PTE and in 9 cases after total PTE with autotransplantation (p=0,267). Target values of parathyroid hormone were registered in 8patients, including 4 patients after subtotal PTE and 4 patients after total PTE (p>0,95). Morbidity was similar in all types of surgeries (p>0,5). Analysis of morbidity determined that simultaneous surgery of thyroid gland increased the risk of laryngeal paralysis (р=0,028). The decrease in occurrence of secondary HPT persistence (with the source accessible for removal through cervical approach) at total PTE based on the removal of parathyroid glands of all localizations accessible through cervical approach (including thyroid gland lobes with diagnosed ectopia, central cervical fat pad, superior mediastinum and superior thymus horns) was registered (NNT=4).
FUNCTIONAL DIAGNOSTICS AND ACUPUNCTURE IN PATIENTS WITH CERVICAL OSTEOCHONDROSIS
Authors: Арсентьева  , Arsenteva Nataliya , Верхозина  , Verkhozina Tatyana , Ипполитова  , Ippolitova Elena , Кошкарёва  , Koshkareva Zinaida , Сороковиков  , Sorokovikov Vladimir , Скляренко  , Sklyarenko Oksana
Published: April 2017

We developed an algorithm for spinal diagnostics to optimize the diagnosis and treatment of patients with cervical osteochondrosis. This algorithm includes physical and neurological examination of a patient, radiological methods, multi-layer spiral CT (MRI) of cervical spine, densitometry and electroneuromyography (ENMG) and is used in practical work of neurosurgical unit of Irkutsk Scientific Center of Surgery and Traumatology. We managed 40patients with cervical osteochondrosis in period I–III localized in CIII–CIV, CIV–CV, CV–CVI, CVI–CVII segments and with severe muscular tonic syndrome (cervicalgia, cervical cranialgia, cervicobrachialgia). Patients with osteochondrosis in period I–II had medium decreased conduction of peripheral nerve motor fibers on both sides of spine, which indicates the lesion of some motor fibers. In patients with osteochondrosis in period III in case of protrusion and herniation of intervertebral discs the ENMG values corresponded to the increase in neurility and conduction velocity of motor nerve and muscle fibers in diseased segment.Conservative treatment was conducted up to the Standard approved by the Ministry of Health of the Russian Federation and was supplemented with acupuncture (9–10 sessions) based on the changes in ENMG values. Performed treatment caused significant decrease in pain syndrome, reduction of neurological manifestations and, as a consequence, positive dynamics of ENMG values. Proposed algorithm for management of patients with osteochondrosis allowed to diagnose the localization of diseased functional spinal unit, to reveal problem peripheral nerves and, as a result, to choose adequate treatment tactics and to estimate its effectiveness.
ANALYSIS OF THE RESULTS OF INTRAOPERATIVE NEUROPHYSIOLOGICAL MONITORING IN THE CENTER OF NEUROSURGERY OF RAILWAY CLINICAL HOSPITAL AT THE IRKUTSK-PASSAZHIRSKIY RAILWAY STATION OF RUSSIAN RAILWAYS LTD.
Authors: Борисов  , Borisov Aleksey , Левина  , Levina Galina , Калинин  , Kalinin Andrey , Бывальцев  , Byvaltsev Vadim
Published: April 2017

The reduction of postoperative complication rate is a significant trend in modern surgery. One of the most important methods of intraoperative diagnostics is intraoperative neurophysiological monitoring (IONM). The aim of the research was to assess capabilities of intraoperative neurophysiological monitoring in neurosurgical practice considering literature data and experience of IONM application in the Center of Neurosurgery Railway Clinical Hospital at the Ir-kutsk-Passazhirskiy Railway Station of Russian Railways Ltd. We conducted 17 surgeries using IONM. We described the procedure, analyzed data of monitoring and patients’ condition in early postoperative period. No deviations requiring modifications in surgical manipulations were found during neuromonitoring. No iatrogenic neurological disorders were registered in postoperative period. Intraoperative neurophysiological monitoring is an additional effective method which allows reducing the risk of postoperative complications and indirectly improving the results of surgical manipulations.
USING BIODEGRADABLE SCREWS IN TREATMENT OF HALLUX VALGUS
Authors: Леонова  , Leonova Svetlana , Усольцев  , Usoltsev Ivan
Published: April 2017

The aim of the research was to assess using biodegradable screws in treatment of hallux valgus. We managed 40female patients (average age 50±2.51) with hallux valgus who where admitted to the orthopedic unit of Irkutsk Scientific Center of Surgery and Traumatology for operative treatment.All patients had X-ray, MRI and intraoperational examination of affected foot before the surgery and in postoperative period. All patients were operated using own surgical technique.Patients were divided into two groups: group1 (22patients) – osteosynthesis using biodegradable (PLGA) screws; group2 (18patients) – osteosynthesis using metal cannulated screws.In group1 postoperative values of M1P1 angle were within normal range (9.67±0.78°). According to MRI, proximal articular set angle (PASA) was corrected from 21.5±0.35 to 4.17±0.09°. 6patients of the group1 were complaining of pain and discomfort in the area of screw-head contacting soft tissues. The result of operative treatment in the group2 resulted in the correction of M1P1 angle from 34±1.63 to 7.67±0.75°. After the surgery intraoperative PASA was back to the normal range (4.33±0.34°).The comparison of the results of treatment of patients of groups1 and 2 didn’t reveal any statistically significant dif-ferences in the values of М1Р1, М1М2, М1М5 angles and PASA.The advantage of using biodegradable screws, compared to the metal ones, in the treatment of hallux valgus is the possibility of postoperative MRI of the foot with calculation of PASA to evaluate treatment results. The disadvantage of using biodegradable screws is engineering deficiency preventing screw-head from dipping into bone tissue and causing soft tissue traumatizing. Biodegradable and metal screws allow to obtain similar results of hallux valgus treatment.
LEVEL OF MEMBRANE-BOUND HEMOGLOBIN AND RED-CELL MEMBRANE PROTEINS IN PATIENTS WITH ESSENTIAL HYPERTENSION COMPLICATED AND NOT COMPLICATED WITH METABOLIC SYNDROME
Authors: Горохова  , Gorokhova Viktoriya , Корякина  , Koryakina Larisa , Бабушкина  , Babushkina Inna , Сергеева  , Sergeeva Anna , Кузнецова  , Kuznetsova Emma , Пивоваров  , Pivovarov Yuriy , Андреева  , Andreeva Elena
Published: April 2017

We studied the effect of different levels of membrane-bound hemoglobin on the level of red-cell membrane proteins and also their interrelation in patients with essential hypertension with and without metabolic syndrome. It was found that high membrane-bound hemoglobin is closely related to the low level of high-density lipoproteins and high level of low-density lipoproteins in patients with essential hypertension complicated with metabolic syndrome. In patients with essential hypertension not complicated with metabolic syndrome high membrane-bound hemoglobin is related to the increased prothrombin time and decreased blood urea nitrogen. In patients with essential hypertension com-plicated with metabolic syndrome high membrane-bound hemoglobin significantly influences the level of membrane contractile proteins (actin, tropomiosine). In patients with essential hypertension without metabolic syndrome high membrane-bound hemoglobin is accompanied by the decrease of structural and integral membrane proteins levels (anion-transport protein and protein 4.1). As the result of quantitative changes in these proteins and change in their interrelations in patients with ssential hypertension complicated with metabolic syndrome more intensive disorders of structural and functional organization of red-cell membrane can appear.
SEVERAL ASPECTS OF CONSERVATIVE TREATMENT OF PATIENTS WITH CERVICAL OSTEOCHONDROSIS
Authors: Скляренко  , Sklyarenko Oksana , Кошкарёва  , Koshkareva Zinaida , Cороковиков  , Corokovikov Vladimir
Published: April 2017

The aim of the research was to develop an algorithm of complex conservative treatment of patients with cervical osteo-chondrosis. We examined and provided conservative treatment to 40patients with cervical osteochondrosis in periods I–II with severe pain syndrome. The treatment was mainly aimed at pain management. For this purpose, we assigned non-steroidal anti-inflammatory drugs (NSAID) to the patients. NSAID are the most effective medicinal agents, first of all due to their analgesic effect. Also, the treatment included physiotherapy and acupuncture. As a result of the treatment, neurological manifestations were reduced. Number of cervicalgia cases decreased from 12 (before the treatment) to 6 (after the treatment), number of cervical cranialgia cases – from 12 to 7, number of cervicobrachialgia cases – from 16 to 8 correspondingly. Developed complex of conservative treatment measures al-lows to obtain successful treatment results in most cases. It is important to note that proposed treatment regimen is available, simple and can be applied in all neurological and neurosurgical units and hospitals.
CLINICAL USE OF ORTHO-SUV TRANSOSSEOUS HEXAPOD IN TREATMENT OF LOWER LIMB FALSE JOINTS
Authors: Тишков  , Tishkov Nikolay , Пусева  , Puseva Marina , Рудаков  , Rudakov Aleksey
Published: April 2017

We studied the use of Ortho-SUV hexapod in the treatment of 15patients with lower limb false joints. All patients were at active working age – from 22 to 50years. In 12patients, the period from the moment of trauma was 1 to 3years, in 3patients – 3 to 6years. 5patients had femoral false joints, 10patients – shin false joints. In 98% of cases, the formation of false joints was caused by inadequate treatment of initial trauma. In 100% of cases, false joint localized at diaphyseal level and was accompanied with shortening of injured segment for 2.5±1.0cm in 13patients, and for 0.5 and 0.8cm in 2cases. We also registered recurvatum and valgus deformity in 5patients, recurvatum and varus deformity in 8patients, and antecurvatum and varus deformity in 2patients. Combined contracture in knee and ankle joint was found in 90% of patients. Using combined transosseous osteosynthesis along with Ortho-SUV hexapod allowed us to correct hip deformity for 35±10days and ankle deformity – for 20±5days on the average. When shortening of femoral bone for more than 5.0cm, the deformity was corrected in two stages. At the first stage, we reconstructed the length of a segment using methods of transosseous osteosynthesis at discrete-continuum distraction. At the second stage, we corrected deformity using Ortho-SUV hexapod within specified time limits. Duration of femoral and shin false joint consolidation was 194±16days. We registered inflammatory complications in the areas of transosseous elements contacting soft tissues in 3(0.2%)patients. These complications didn’t have an effect on the treatment results.
BACTERIOLOGIC EXAMINATION OF WOUND EXUDATE IN PATIENTS WITH LOCAL AND DISSEMINATED CHRONIC OSTEOMYELITIS
Authors: Рехов  , Rekhov Aleksey , Леонова  , Leonova Svetlana , Камека  , Kameka Aleksey
Published: April 2017

The aim of our research was to analyze the results of bacteriologic examination in patients with local and disseminated chronic osteomyelitis. We performed retrospective analysis of the results of bacteriologic examination of wound exudate in 80patients who were admitted to the clinic of Irkutsk Scientific Center of Surgery and Traumatology for operative treatment of shinbone shaft fractures complicated with local and disseminated chronic osteomyelitis. We used common methods of mono- and bilocal osteosynthesis which resulted in different terms of fracture union and bone defect replacement. Bacteriologic examination of exudate from bone and soft-tissue wounds was performed in all patients at their admission to the clinic. In patients with local chronic osteomyelitis and with usual terms of fracture union, the most common were pure cultures (93.%) with dominant S.aureus (60%). In patients with delayed fracture union, the most common were microorganism associations (55.5±11.7%). In patients with disseminated chronic osteomyelitis with usual terms of defect replacement, pure cultures were registered in 90% of cases. In patients with delayed defect replacement pure cultures were found in 57,2% of cases. Comparative analysis showed that in patients with delayed fracture union and defect replacement, bacterial associa-tions were more common than in patients with usual terms of defect replacement. Preoperative bacteriologic examination showed that S.aureus was the dominant flora of wound exudate in patients with local and disseminated chronic osteomyelitis. Bacterial associations in wound exudate of patients with delayed fracture union and defect replacement is associated with significant circulation failure in affected extremity and is an unfavorable factor for reparative process disorder at chronic osteomyelitis.
CLINICAL TRIALS IN IRKUTSK SCIENTIFIC CENTER OF SURGERY AND TRAUMATOLOGY: RESULTS AND PROSPECTS
Authors: Демкова  , Demkova Olga , Апарцин  , Apartsin Konstantin , Горохова  , Gorokhova Anna
Published: April 2017

Clinical drug trials in Irkutsk Scientific Center of Surgery and Traumatology began in 2005. In 2013, the laboratory of clinical trials was established in the science department of clinical surgery. We analyzed the experience of Irkutsk Scientific Center of Surgery and Traumatology in international multicentre trials. Participation in international mul-ticentre trials allows the Irkutsk Scientific Center of Surgery and Traumatology to get affiliated with the publications in first quartile scientific journals. The experience of the laboratory in clinical trials is projected into practical work of other institutes – Hospital of Irkutsk Scientific Center SB RAS and Irkutsk Regional Clinical Hospital. The important objectives of the laboratory of clinical trials are developing the protocols, performing drug clinical trials and medical device clinical trials. The laboratory carries out admission of patients for observational trial PROTOCOL. One of the fields of work of the laboratory is the prospect of clinical testing of developed clinical technologies.
FECAL CALPROTECTIN AND MICROBIOTA OF THE GUT
Authors: Богородская  , Bogorodskaya Svetlana , Чашкова  , Chashkova Elena , Горохова  , Gorokhova Viktoriya , Кузнецова  , Kuznetsova Emma , Пак  , Pak Vyacheslav
Published: April 2017

Analysis of the literature and our research showed that an imbalance of the intestinal microbiota is associated with many diseases. We present some of the mechanisms of disease. Using non-invasive, simple, affordable method of deter-mination of fecal calprotectin reveals the presence and progression of chronic non-specific inflammatory bowel disease, and can be widely used in clinical practice
DIAGNOSIS AND MINIMALLY INVASIVE TREATMENT OF COMPLICATIONS OF ACUTE AND CHRONIC PANCREATITIS WITH THE USE OF MEDICAL IMAGING (USG, CT AND ENDOSONOGRAPHY): LITERATURE REVIEW
Authors: Чижова  , Chizhova Elena , Тюрюмина  , Tyuryumina Elena , Гумеров  , Gumerov Ruslan
Published: April 2017

The article describes the modern literature data on the incidence of acute, chronic pancreatitis and its complications. The current classification of complications of acute and chronic pancreatitis. The possibilities of digital diagnostic methods (ultrasonography, computer tomography, endosonography) this pathology. Considered the advantages and disadvantages of these methods of diagnosis. Describes the types of minimally invasive interventions under the con-trol of the means of medical imaging, the indications and contraindications to them, deals with the complications. The selection criteria method of digital diagnosis of complications of acute and chronic pancreatitis and type minimally invasive treatment
characteristics of liver enzyme in various pathologies of the pancreas
Authors: Дьякович  , Dyakovich Olga , Кузнецова  , Kuznetsova Yuliya
Published: April 2017

Diseases caused by disturbance of endogenous and exogenous pancreatic functions (endocrine function – diabetes mel-litus (DM) and exocrine function – chronic pancreatitis (CP)), are widely distributed in the world due to alcohol abuse, unhealthy lifestyle and negative influence of the environment. These pathologies often associate with abnormal liver functions. The goal of the study was to explore the features of the liver enzymes in 47 patients with a diagnosis of DM and CP. We revealed increase in the content of liver enzymes (aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transferase) in disturbance of pancreatic endocrine function. This dysfunction may be caused by hepatitis B and C, and fatty liver disease. Concentration of liver enzymes in the blood of individuals with hepatitis B and C was also increased. Levels of liver enzymes in patients with exocrine pathology ranged in the reference values. The reason could be the remission of CP in the examined patients. These studies require involvement of larger number of patients with the remission of the disease, and a new group of patients with CP exacerbation stage. Also additional functional and biochemical studies are necessary to identify the diagnosis of fatty liver.
early diagnosis of the hemodynamic regulation disorders in orthostasis
Authors: Мартынов  , Martynov Ilya
Published: April 2017

The article deals with the informative content of spectral analysis of heart rate variability in the assessment of the regulatory impacts on the systemic hemodynamics during orthostatic test. It was observed that the patients who suffer from neurogenic syncope already at a young age had had a decrease in low frequency oscillations, as well as a decrease in peripheral vascular resistance during the test. It allows us to make a conclusion about the sympathetic vasomotor regulation dysfunction, even before the symptoms of orthostatic hypotension were evident. The decrease in the tonic vagal effect which follows from the depression of high-frequency oscillations, makes for increasing the chronotropic function of the heart and keeps a relative sympathetic predominance in order to maintain adequate level of blood pressure
Analysis of tuberculosis sick rate in siberian federal district
Authors: Хромова  , Khromova Polina , Жданова  , Zhdanova Svetlana , Кощеев  , Koshcheev Mikhail , Астафьев  , Astafev Viktor
Published: April 2017

The paper presents the materials of the complex epidemiological evaluation of tuberculosis process by its main indicators (incident cases, prevalence and mortality) in the Siberian Federal district over the period of 2002-2014. The ranking of the territories included in the Siberian Federal district was performed by the integral index. That allowed to identify three groups of territories by the level of intensity of TB epidemiological process (favorable, typical, unfavorable). The most favorable epidemiological situation was registered in Tomsk region, the most unfavorable one – in the Republic of Tuva.
assessing the quality of Medical care and developing the ratings of health services: experience of using Medicare prograM in the usa
Authors: Григорьева  , Grigoreva Nataliya
Published: April 2017

To provide patient’s security is the main goal in some spheres of health care, that is why methods of statistical moni-toring were developed to detect abnormalities in the course of medical work quickly and confidentially. This includes, for example, excessive intervention even without further damage to a patient’s safety. Therefore, it is very important to determine whether the risk to a patient’s life exists or how abnormal the situation is.At the present moment health care in Russia has already passed the initial stage of formation of ratings to assess the quality of medical care services. Almost all regions of the Russian Federation have their own ratings. The question is how objectively they reflect the quality of medical services. The article presents main features to assess the quality of health care to rate medical organizations on the example of state program Medicare (USA) in order to compare them with the ones used in Russian ratings.
problems of organization and financing of high-tech medical care in 2017
Authors: Колесников  , Kolesnikov Sergey , Перхов  , Perkhov Vladimir
Published: April 2017

The authors analyzed the essence of new federal laws, which change some implementation aspects of other basic federal laws, such as Law on Compulsory Medical insurance in the Russian Federation, Law on Basics of health protection of citizens in the Russian Federation, Budget Code, Tax Code and other legal acts, determining the peculiarities of financ-ing of high technology medical care since January 1, 2017 onwards. The main challenges and risks of Compulsory Medical Insurance Federal Foundation was identified, it becoming the sole holder of the funds intended for the financing of high-tech medical care. The main risk is that federal and regional authorities are not only being excluded from financing, but are losing the role of health care state customer. And in the conditions of financial crisis in the country it will happen. In this case there is a great possibility of financial deficit for high technological medical care in the federal medical scientific institutions. A number of measures for planning indicators of high-tech medical assistance in the scientific medical organizations was proposed. These measures can prevent corruption and defend federal (state) segment of health care system, providing the complex and high level assistance for the most severe ill patients.
new bIologIcal model of moderate InhIbItIon of tumor and metastases growth wIth prolonged leukopenIa In mIce
Authors: Зуева  , Zueva Elena , Разина  , Razina Tatyana , Ермакова  , Ermakova Natalya , Рыбалкина  , Rybalkina Olga , Скурихин  , Skurikhin Evgeniy
Published: April 2017

A new biological model of moderate inhibition of tumor growth and metastases with prolonged leukopenia on C57Bl/6 mice with the Lewis Lung Carcinoma was designed. The model was created by the injection of cyclophosphamide (dose 83.3mg/kg) on 6th, 12th, 18th days after tumor cells transplantation on animals. Experiment showed that 3-fold cyclo-phosphamide use leads to growth of primary tumor and metastases inhibition. Tumor growth inhibition was 34% on 21st day after cyclophosphamide inject. The number of metastases decreased by 4.7times (p<0,01). Metastatic area reduced. Metastasis frequency made 100%. In addition, the course of cyclophosphamide application caused inhibition of granulocytic and lymphoid hematopoiesis. The reducing the number of segmented neutrophils and lymphocytes was showed on the 3rd day after 1, 2 and 3 injections of cyclophosphamide. The model can be used to study the efficacy of drugs in tumor therapy and in correction of such toxic manifestation of chemotherapy as leukopenia.
characterIstIcs of an antIoxIdant actIvIty of YERSINIA PESTIS wIth dIfferent plasmId spectrum
Authors: Токмакова  , Tokmakova Elena , Витязева  , Vityazeva Svetlana , Иванова  , Ivanova Tatyana , Мухтургин  , Mukhturgin Gennadiy , Корытов  , Korytov Konstantin , Дубровина  , Dubrovina Valentina , Юрьева  , Yureva Olga , Балахонов  , Balakhonov Sergey
Published: April 2017

Experimental data concerning complex study of antioxidant activity of Y. pestis with different plasmid spectrum (wild-type Yersinia pestis subsp. pestis, Yersinia pestis subsp. altaica and their isogenic variants) are represented in the article. Superoxide dismutase activity of the tested Y.pestis strains was from 6.0 to 9.0×109 microbe cells. Signifi-cant differences between the Y.pestis strains with different plasmid composition were not detected by this parameter. Our results, consistent with the data of other authors, tell that superoxide dismutase activity is a thermo-inducible feature and does nоt depend on a plasmid spectrum. High peroxide destroying activity was also detected in all tested Y.pestis strains. The differences between the strains regarding their common peroxide destroying activity were found. This parameter of the plague microbe strains lacking pYP plasmid was at least 3times lower than common peroxide destroying activity in strains with this plasmid in the genome. In our opinion these revealed differences were caused by characteristics of plasmid spectrum. The common peroxide destroying activity’s degree of Y.pestis strains can be associated with the presence of pYP plasmid in the genome. The isogenic variants of Y.pestis strains lacking one of the plasmids had smaller pathogenic activity. This fact points to the need for further study of these strains.
High prevalence of genotype B0/W148 of Mycobacterium tuberculosisamong hiv-tB patients in perm krai and irkutsk region
Authors: Огарков  , Ogarkov Oleg , Савилов  , Savilov Evgeniy , Хромова  , Khromova Polina , Новицкая  , Novitskaya Olga , Варецкая  , Varetskaya Tatyana , Сармометов  , Sarmometov Evgeniy , Сергевнин  , Sergevnin Viktor , Жданова  , Zhdanova Svetlana , Микова  , Mikova Oksana , Кощеев  , Koshcheev Mikhail , Шмагин  , Shmagin Dmitriy
Published: April 2017

The population with HIV-infection plays significant role in ongoing tuberculosis pandemic. Immunosup-pression due to HIV-infection is one of the causes of TB disseminated forms in this group of people. Having low immune status is also often associated with a polyclonal M.tuberculosis infection. Aim of the research: comparative assessment of epidemic genotypes of M.tuberculosis prevalence and mixed genotypes identification within HIV-TB co-infected patients in two Russian regions.Materials and methods. The DNAs of 78 clinical isolates from Irkutsk Region (IR) and 64strains from Perm Krai (PK) have been genotyped by MIRU VNTR 24 and RD105/RD207. Strains were obtained from patients who did not have significant age and sex differences. In the PK age of the patients was 34.5±0.9, in IR – 34.4±1.5 years. The samples were obtained from 67.2 and 65.4% of men, respectively.Result. The study of the M.tuberculosis indicates significant predominance of Beijing genotype strains in patients with TB-HIV of PK (92.2%) compared to the IR (59.5%) (χ2=18.0; p<0.01). The prevalence of MDR pathogens in TB-HIV patients exceeded 50%. The mixed genotype detection in the PK and IR was high (14.1 and 12.7% respectively). The level of virulent strains B0/W148 was 34.4% in PK patients and 25.3% in IR ones. Analysis of the results suggests the epidemic spread of MDR-TB in the immunocompromised individuals.Conclusions: The identified trends may indicate that Perm Kray have a process of active dissemination of transmissible strains of M.tuberculosis within HIV-infected population.
analysis of phago- and antibiotic sensitivity of Enterobacteriaceae bacteria isolated from women of reproductive age
Authors: Немченко  , Nemchenko Ulyana , Григорова  , Grigorova Ekaterina , Ракова  , Rakova Elena , Данусевич  , Danusevich Irina
Published: April 2017

Pelvic inflammatory diseases occupy a special place in the structure of general morbidity, and are polymicrobial in nature with dominance of opportunistic microorganisms, in particular bacteria of the family Enterobacteriaceae.The aim was to study the composition of the vaginal microbiota in women of reproductive age with pelvic inflammatory diseases, as well as to determine the sensitivity of isolated microorganisms to antibiotics and bacteriophages.The study included 70women of reproductive age, among them 37were diagnosed with colpitis and cervicitis, 33women in the comparison group (women screened for a diagnosis). Isolated microorganisms were identified by abdominoperineal methods, including the disk diffusion method to determine the sensitivity of microorganism cultures of Enterobacteriaceae family to antibiotics, and the method of crosses (evaluation of lytic activity of bacteriophages by the number of crosses) to determine the sensitivity to specific therapeutic bacteriophages.Vaginal biocenosis was characterized by deficit of lactobacilli (<106CFU/ml in 100%), the presence of conditionally pathogenic microflora: bacteria of Enterobacteriaceae family, coccal flora and Candida fungi. From 60.0 to 89.3% of Enterobacteria strains were resistant to aminoglycosides and quinolones, but also had a low level of sensitivity to therapeutic bacteriophages.The obtained data indicate the reduction of colonization resistance of vaginal mucosa in pelvic inflammatory diseases and specify the need to use medicinal drugs only under medical supervision to prevent clinically significant drug resistance.
detection of membrane-bound proteases of FRANCISEllA TUlARENSIS
Authors: Мазепа  , Mazepa Andrey , Марков  , Markov Evgeniy , Козлов  , Kozlov Stanislav , Николаев  , Nikolaev Valeriy , Корнева  , Korneva Aleksandra , Попова  , Popova Yuliya
Published: April 2017

Sterile preparations of membrane fractions were prepared by processing of live Francisella tularensis cells of different subspecies with 4.5M urea solution and differential centrifugation. For the first time, proteolytic activity was detected and studied by tests of radial enzyme diffusion and substrate polyacrylamide gel electrophoresis using gelatin as a substrate. Spectrum of gelatinases in the resulted preparation were detected. Quantitative inter-strain differences in the protease activities and their qualitative composition in membrane preparations of various virulent F.tularensis strains was analyzed. Avirulent F.tularensis 21/400 subsp. holarctica (I-214) strain demonstrated the greatest gelatinase activity in enzyme diffusion method and the lowest hydrolytic activity was seen in F.tularensis B-399 A-Cole subsp. tularensis (I-386) and F.tularensis Utah 112 subsp. novicida (I-384), other preparations showed intermediate activity. Enzyme electrophoresis in the protease spectra determined the presence of proteins with proteases activity 50–100kDa, and in the spectrum preparations of F. tularensis I-386 and I-384 were detected additional bands of proteases.
comparative characteristics of nasopharynx microbiota and vaginal biotope in women with reproductive disorders
Authors: Лещенко  , Leshchenko Olga , Кунгурцева  , Kungurtseva Ekaterina , Приставка  , Pristavka Aleksey
Published: April 2017

Nasopharyngeal flora contributes much to the development of many diseases, including the urinary system diseases. The aim was to compare the vaginal microbiota biotope and nasopharynx microbiota in women with reproductive disorders (RD). The study involved 97women with RD (infertility, miscarriage). The control group comprised women with chronic endometritis (CE), RD and chronic tonsillitis (CT) (n=65), mean age was 31.0±5.3. CE was diagnosed using histologic analysis and ultrasound studies. The comparison group consisted of 32 women with RD without CE and HT, representative by age. Endometrial sampling was conducted by endometrial pipelle biopsy taken on 5–11th days of the menstrual cycle. Nasopharyngeal swabs were taken on an empty stomach. Due to reduced indigenous microbiota in the studied habitats the number of opportunistic pathogenic microflora such as Staphylococci, Enterococci, fungi, E.coli and etiologically significant Streptococcus (in nasopharynx) was increased. Streptococci in the nasopharynx indicate that the troubles are in vaginal biotope, which leads to inflammatory diseases and reproductive disorders. Everything mentioned demonstrates common etiopathogenic mechanisms for the development of pathological processes of various localizations. Thus, it is important to pay close attention to all rehabilitation centers specializing on chronic infections, which will improve the treatment of СE.
Polymorphism of gene glutathion-s-transferase Pi in teenagers from Buryat ethnic group living in the irkutsk region
Authors: Беляева  , Belyaeva Elena , Ершова  , Ershova Oksana
Published: April 2017

Human glutathione-S-transferases play an important role in phase II detoxification process. But poly-morphism in the GSTP1 gene has not been studied in certain populations.Aim: to determine the distribution of allele and genotype frequencies of GSTP1 gene in teenagers from Buryat ethnic group.Materials and methods. Blood samples were obtained from 55 teenagers from Buryat ethnic group. There were 28 males and 27 females with an age of 14.05±0.99 years over the range of 13 to 16. DNA was isolated from blood samples. The polymerase chain reaction was used to amplify A313G and C341T markers of the GSTP1 gene. Chi-square testing was used to evaluate the significant difference of the GSTP1 genotype frequencies between observed and expected values.Results. Allele and genotype frequencies of A313G and C341T markers GSTP1 were determined in teenagers from Buryat ethnic group. The study showed that the frequencies of A and G alleles at the A313G marker were 0.809 and 0.191 while those of C and T alleles at the C341T marker were 0.973 and 0.027, respectively. The distribution of the genotype frequencies at the A313G marker were consistent with expected in a Hardy–Weinberg equilibrium (χ2=0 .77; d.f.=1; p>0.05). However, the distribution of the genotype frequencies at the C341T marker were not consistent with expected in a Hardy – Weinberg equilibrium (χ2= 0.043; d.f.= 1; p<0.05). It was because the homozygous of T allele was not found in the ethnic group of Buryat.
Polycystic ovary syndrome – 80 years of research and new directions in the study (literature review)
Authors: Дамдинова  , Damdinova Lyudmila , Лещенко  , Leshchenko Olga
Published: April 2017

The article presents the current data of history of polycystic ovary syndrome (PCOS) study. It contains studies of genetic susceptibility of PCOS, PCOS symptoms and connection with development of anxiety and depressive disorders. The article covers ethnic differences in the phenotypic manifestations of PCOS. The papers describes the study of endocrine causes of infertility in Russian and Buryat women. Several theories of PCOS, including the theory of PCOS connection with intestinal bacterial flora disorders (“dysbiotic intestinal microbiota”) are being discussed. The article also provides an overview of various scientific research in this area and the data of the relationship of PCOS and the risk of cardiometa-bolic disorders, insulin resistance, metabolic syndrome, obesity and sleep apnea. It highlights modern aspects in the study of PCOS etiology – studies of adipose tissue as an endocrine organ. The article reflects study of PCOS relationship with the level of the gastrointestinal tract hormones: leptin, insulin, ghrelin, cholecystokinin, peptide YY. The effect of short-term low-dose hormonal contraceptives on appetite levels in PCOS is covered. The scientific articles on the severity of hypertension in menopausal women with PCOS history and the presence of overweight are reviewed. The scientific work determines molecular genetic markers of PCOS in the aspect of the influence of environmental factors on the expression of genes.
metabolic syndrome: some results and prospects for solving the problem
Authors: Чу  , Chu Syaoyan , Киргизова  , Kirgizova Oksana
Published: April 2017

Lifestyle changes associated with reduced physical activity, increased caloric content of food and a steady increase in emotional stress load cause potentiation of risk factors for cardiovascular disease. Metabolic syndrome combines hypertension, dyslipidemia, diabetes and obesity. Primary systemic insulin resistance and concomitant systemic hyper-insulinemia underlie the pathology. Insulin resistance triggers a vicious cycle of symptoms that lead to the emergence of severe cardiovascular complications. Metabolic cascade can also be initiated by obesity, which in its turn predisposes to the development of hypertension and reduction of the sensitivity of peripheral insulin receptors with subsequent accumulation of excess body weight. Treatment of metabolic syndrome should be pathogenetically substantiated and include antihypertensive, lipid-lowering, anti-thrombotic drugs on the background of a rational diet and lifestyle changes.
Peculiarities of physical development of preschool children in irkutsk
Authors: Кирилова  , Kirilova Irina , Осипова  , Osipova Elena
Published: April 2017

The article describes the assessment of the physical development (PD) of the children attending preschool educational institution kindergarten N148 of Irkutsk. It was established that different types of deviations in development had 42.0% of children from 3 to 7 years. Among deviations in PD of preschool children most frequently we noted high body weight at normal body length (10.1%); also lowered (8.0%) and low body length (9.0%) were established. The results of the examination of Irkutsk preschool children revealed deviations of their PD parameters from normal figures towards reduction of growth and increase in body weight, and also showed that morphometric changes were more characteristic of boys.
EFFECT OF ANTI-VEGF THERAPY ON THE STRUCTURAL STATE OF THE RETINA IN DIABETIC MACULAR EDEMA
Authors: Бикбов  , Bikbov Mukharram , Файзрахманов  , Fayzrakhmanov Rinat , Зайнуллин  , Zaynullin Rinat
Published: April 2017

Objective: to analyze the structural state of the central area of the retina in diabetic macular edema in the background anti-VEGF therapy.Methods. The study included 38patients (40eyes) with diabetic macular edema. All patients received anti-VEGF-ranibizumab therapy at a dose of 0.05ml. The results were analyzed after three intravitreal injections with 1month interval. We assessed visual acuity, morphological and anatomical structure of the macular area, the sensitivity of the retina and macular pigment optical densityResults. Analyzing optical density of the macular pigment we revealed a significant increase of all parameters in 73% of patients after the therapy. The average value of the optical density before treatment was at 0.102±0.01du, on the background of anti-VEGF-therapy this figure went up to 0.213±0.01 (p<0.05). According to the optical coherence to-mography average retinal thickness before treatment made 404.62±15.23μm, after the treatment – 300.91±6.43μm (р<0,05). When comparing data of optical coherence tomography and macular pigment optical density we revealed more pronounced decrease in the macular pigment optical density in the area of the retinal edema and a significant increase in the basic parameters on the background of the therapy.Conclusion. Anti-VEGF-therapy significantly improves visual acuity, the recovery profile of macular edema and reduces the zone in patients with diabetic macular edema.
EFFECTIVENESS OF EX-PRESS AND AHMED DRAINAGE DEVICES IN PATIENTS WITH SECONDARY NEOVASCULAR GLAUCOMA
Authors: Бикбов  , Bikbov Mukharram , Хуснитдинов  , Khusnitdinov Ilnur
Published: April 2017

The purpose of the study was to compare the efficacy of Ex-Press and Ahmed drainage devices for the secondary neo-vascular glaucoma (NVG) in patients with diabetes mellitus. We observed 25patients (25eyes) with secondary NVG in the setting of proliferative diabetic retinopathy. The first group consisted of 10patients (10eyes) who underwent Ex-Press drainage implantation. The second group consisted of 15patients (15eyes) who were implanted Ahmed valve FP7 model. As a result the maximum value of IOP in the analyzed groups decreased by 66.8% and 64.2% respectively immediately after the surgery. By the end of 18months follow-up period, the absolute hypotensive effect in patients of group1 was 20% (2/10) whereas in group2 – 60% (9/15). Normal intraocular tension during treatment with glaucoma medications established in 30% of cases in group1 (3/10) and in 80% of patients in group2 (12/15). Thus, the use of Ex-Press drainage device for secondary NVG in patients with diabetes was ineffective in 70% of cases. We can recommend choosing implantation of Ahmed valve for secondary NVG in patients with diabetes mellitus as the number of unsuccessful outcomes using Ahmed valve was observed only in 20% of cases.
THE HYPOTHESIS OF THE INTERDEPENDENCE OF THE INCIDENCE OF MEDICAL PROFESSIONALS AND THE SYNDROME OF PROFESSIONAL-PSYCHOLOGICAL DISADAPTATION
Authors: Хаптанова  , Khaptanova Valentina , Ильин  , Ilin Vladimir , Гольменко  , Golmenko Aleksandr , Выговский  , Vygovskiy Evgeniy
Published: April 2017

The impaired adaptation is a dynamic condition, structurally comprising the combination of independent components: the syndrome of professional-psychological disadaptation (SPPD) (psychological component), morbidity (somatic component), and psychosomatics, including the interaction of the above components. Thus, a psychological compo-nent is the initial phase, and a somatic one, to a more marked degree, leading to further disruptions in the increase of psychological disorders and morbidity, i.e. disadaptation. The study found that the highest rates of the syndrome of professional psychological disadaptatiion are noted in the group with work experience of 0–5 years. The cause is a long period of not working in their specialty, which leads to a decrease in self-regulation, psychological defenses, general theoretical and practical professional level.Preventive work in the organization should focus on psychological trainings, refresher courses or the introduction of mentoring.
PROSTAGLANDINS ANALOGUES DURING CATARACT PHACOEMULSIFICATION ON THE BACKGROUND OF PRIMARY GLAUCOMA
Authors: Иошин  , Ioshin Igor , Толчинская  , Tolchinskaya Anna
Published: April 2017

We analysed the effect of prostoglandins analogues application on the course of postoperative period of cataract phakoemulsification in 58patients with primary open-angle glaucoma. All patients before the operation had normal intraocular pressure (on average 15.6±0.07mm Hg), the optical coherent tomography showed normal parameters of retina thickness in 1mm zone and the macula volume in 6mm zone. Instillation of nonsteroid anti-inflammatory drug after the operation lasted 6–8weeks, and prostoglandins analogues continued to be instillated during all period of observation. The course of the early postoperative period was areactive. Average visual acuity on the first day was 0.69±0.05, in 6–8 weeks – 0.85±0.05. The average level of intaocular pressure during application of prostoglandins analogues on first day was 16.9±0.37mm Hg, and in 6–8weeks – 15.1±0.28mm Hg. Optical coherence tomography revealed little change of retina thickness and macular area volume before the operation and in 6–8weeks after it was regarded as an error of measurement method.Thus, continuation of instillations of prostoglandins analogues in pre- and postoperative period in uncomplicated phakoemulsification in patients with primary open-angle glaucoma promote continuity in treatment, support com-plience and provide stable intraocular pressure without the expressed reactive hypertensia. Application of nonsteroid anti-inflammatory drug during 6–8 weeks after phakoemulsification in patients with primary open-angle glaucoma serves as an effective measure of prevention of inflammation of an anterior and posterior eye segment during pros-toglandins analogues treatrment.
ANTISEPTICS AT INTRAVITREAL INJECTIONS
Authors: Толчинская  , Tolchinskaya Anna , Иошин  , Ioshin Igor , Оздербаева  , Ozderbaeva Ayna
Published: April 2017

Authors analyze efficiency of application antiseptics of a miramistin in prevention of infectious complications in case of repeated intravitreal injections of VEGF inhibitor Ranibizumab in 156 patients with the age related macular de-generation. 0,01% solution of antiseptic Miramistin (Okomistin®) was instillated 4 times per day two days before operation to all patients for the purpose of infection prevention. Just before the operation (60 and 30 minutes before) and right after it instillations of antiseptic continued within a week after intravitreal injection. During the operation in the conditions of the operating room with keeping of all rules of aseptic, three minutes prior to operation the surgery field and the conjunctival cavity of the patient were twice processed by 5% povidone-iodine solution (Betadine). The results analysis showed no expressed signs of irritation of the eyes connected to miramistin treatment preceding the operation. In the postoperative period all patients endured antiseptics well. Within a week of applications there were no complaints about pain, burning, foreign body sensation or hazy vision after the medicine instillation, and biomicroscopic research revealed no signs of inflammatory injection of conjunctiva or sclera, no cornea epitheliopathy, there was no cellular response in moisture of the anterior chamber and vitreous body. Thus, the authors state that antiseptics Okomistin® as an additional measure of prevention of infectious complications in case of intravitreal injection provide high level antimicrobic protection with no risk of development of microbial resistance.