Vol 33, No 2 (2016)

Aim. The aim of the study was to evaluate the contribution of atrial fibrillation into development of chronic renal disease in patients with hypertension. Materials and methods. Eighty patients divided into 3 groups were examined. Group 1 included patients with sinus cardiac rhythm ( n = 30), group 2 - patients with persisting form of atrial fibrillation ( n = 30), and group 3 - patients with constant one ( n = 20). Results. Presence of atrial fibrillation was revealed to contribute to development of chronic renal disease. Decrease in glomerular filtration rate progresses when a patient is moving (by the stages of natural atrial fibrillation course) and correlates with patient’s age, left atrium size and cardiac output fraction. Conclusions. Patients with atrial fibrillation should be considered as patients with a threat of development of chronic renal disease.

Aim. The aim of the study was to investigate the status of vegetative nervous system in adolescents with different types of headaches. Materials and methods. Ninety seven adolescents suffering from headache during the interictal period were examined. To assess the status of segmental and suprasegmental structures, the induced cutaneous sympathetic potentials were carried out. Results. Adolescents with cervicogenic headaches experienced increase in indices of the latent period as compared with healthy adolescents and patients suffering from tension headache and migraine. Significant growth in indices of the latent period of the induced potential in patients with cervicogenic headaches was established. Reliable reduction in the first phase amplitude in the group of female adolescents with cervicogenic headache was revealed. Significant rise in duration of the first phase of the induced potential from the girls’ left arms in this group was found. Duration of the ascending part of the second phase in female adolescents with migraine increased. Conclusions. Parasympathotonia is developing in adolescents with cervicogenic headaches, predominantly girls. Sympathotonia, prevailing in migraine, is proved by indices of duration of the ascending part of the second phase of the induced cutaneous sympathetic potential. Absence of statistically reliable differences when comparing the indices of duration of the ascending part of the second phase, duration of the descending part of the second phase and maximum amplitude in persons of different groups testifies in favour of the integrity of equilibrium position.

Aim. The aim of the study was to ground an optimal variant of anesthetic management when performing cholecystectomy from mini-approach in patients with metabolic syndrome. Materials and methods. The results of studying hemodynamic indices in 90 patients during cholecystectomy from mini-approach in conditions of anesthetic management using “Isoflurane” or intravenous anesthesia on the basis of “Propofol” are presented in the paper. All patients underwent general clinical and special methods of investigation; in the perioperative period hemodynamic indices were monitored and additionally, the basic hemodynamic indices were estimated using calculated method. Results. It was detected while analyzing hemodynamics that in patients with metabolic syndrome, the initial systolic, diastolic and mean pressure was by 30 % higher versus the control group. The calculated indices such as stroke volume, circulatory minute volume, cardiac index were initially reduced (stroke volume - by 39 %, circulatory minute volume - by 37 %, cardiac index - by 44 %) in patients with metabolic syndrome as compared to the control group at all the stages of observation. Conclusions. Anesthetic management on the basis of “Propofol” changes to a lesser extent hemodynamic profile in patients with metabolic syndrome when performing cholecystectomy from mini-approach. Irrespective of the type of anesthetic management, maximum changes in hemodynamics are observed at the beginning of anesthesia in all patients with metabolic syndrome.

Aim. The aim of the study was to investigate the peculiar features of clinicoechographic picture of the testicle abscess. Materials and methods. The work is based on retrospective analysis of 10 testicle abscess cases observed over the period of 2005-2015. Standard clinicolaboratory studies and high resolution ultrasonography were applied. Results. Among acute inflammatory diseases of the testicle and appendage, the incidence of testicle abscess was 1 %. In 4/5 of cases, testicle abscess occurred as a complication of acute epididymoorchitis among patients over fifty with burdened immunodeficient background and different inflammatory urogenital diseases. According to ultrasonography data, testicle abscess at its acute stage was detected in 1 patient, subacute - in 2, chronic - in 7. The testicle abscess sizes were 28,4 (12-65) mm or 2,6 (1,3-5,5) cm3. Abscess occupied one segment of the testicle in 1 patient, two segments - in 5, total purulent melting of the testicle - in 4. By their acoustic signs, testicle abscess did not differ from those of the other localization. In its clinical course, testicle abscess at the acute and subacute stages was manifested as acute inflammatory disease of the testicle or appendage, at the chronic stage - as abscess and scrotal purulent fistula. As a result of clinicolaboratory study, testicle abscess was supposed in 4 patients, as a result of ultrasound study - testicle abscess was diagnosed in all patients. Pathomorphological study performed in 8 patients following orchiectomy indicated verification of testicle abscess in all of them. At the same time, in 1 case abscess was combined with testicle cancer, not revealed during the preoperative examination. Conclusions. Patients with acute inflammatory testicle and appendage diseases burdened by immunodeficient background (age over 50) have an increased risk for the development of testicle abscess and should be taken under a strict dynamic clinicolaboratory and echographic control in the course of mana-gement.

Aim. The aim of the study was to carry out clinicoelectrometric assessment of the efficiency of using remineralizing gel when treating dentin caries. Materials and methods. Complex dental study included 135 patients aged 21 to 37 years (56 men and 79 women). Dental caries prevalence and severity indices and oral hygiene status were studied; pulp status was estimated by excitability index; mineralization degree of dentin of the pulp floor was studied using dentin electric conductivity (DEC) data with the unit “Dentest” (Geosoft Firm). Dental roentgenological investigation was performed with visiograph (Planmeca Firm). Results. Successful treatment of dentin caries requires active remineralizing therapy. As a result of preliminary biopharmaceutical, technological and clinical studies, the composition of gel for dentin remineralization was offered; technology of its preparation was developed; standardization was fulfilled according to authenticity and quantitative content of the basic reactants, technological parameters and microbiological purity. By means of the offered drug, a complex problem including simultaneous presence of calcium, phosphorus and fluorine ions is solved. Remineralizing gel used at the first stage of deep caries treatment contributes to intensive mineralization of dentin and permits to fill carious cavities without therapeutic basis. Conclusions. The studies on the use of remineralizing gel for treatment of dentin caries make it possible to recommend it as an effective remineralizing remedy at the initial stage of dentin caries therapy.

Aim. The aim of the study was to investigate the activity of L, H cathepsins with assessment of changes in permeability of lysosomal membranes of the rat tibial muscle and thoracic aorta wall in conditions of experimental marked hyperhomocysteinemia when introducing L-arginine and carnitine. Materials and methods. Ninety six homogenized samples of muscular tissues (48 tibial muscle samples and 48 thoracic aorta wall samples) from white convectional Wistar male rats served as a material to be studied. Modelling of severe hyperhomocysteinemia was realized by means of a daily intragastric introduction of methionine suspension twice a day. In experimental and control groups, arginine and carnitine were introduced with a six-hour interval from introduction of the corresponding suspension. Results. Blood serum homocystein content in animals receiving methionine (hyperhomocysteinemia modeling) statistically significantly increased versus the corresponding control group (293,10 [273,10; 318,20] and 5,90 [5,50; 6,70] mcmol/l). In the samples of animals receiving L-arginine and carnitine against the background of methionine, homocysteine concentration significantly decreased versus the animals with hyperhomocysteinemia, but did not reach the control group values. Marked hyperhomocysteinemia is accompanied by growth of activity of skeletal and smooth muscle L, H cathepsins, development of lysosomal membrane permeability. Conclusions. Arginine reduces cathepsin H and acid phosphatase activity, has a stabilizing effect on lysosomal membrane in the skeletal muscle and decreases cathepsin L activity with no stabilizing effect on lysosomal membranes in the smooth musculature. Carnitine reduces cathepsin L activity and has a stabilizing effect on lysosomal membrane of the muscular tissues studied.

Aim. The aim of the study was to determine the clinical efficiency of local use of “Miliacyl” and EHF-therapy for the treatment of purulent wounds against the background of alloxan diabetes in experimental conditions. Materials and methods. One hundred and forty white outbred rats were studied. In the main group, miliacyl and EHF-therapy were used for the treatment of purulent wounds. In the control group I no therapy of wounds was carried out; in the control group II “Miliacyl” was used; EHF-therapy was applied in 24 rats of the control group III. Results. In experimental animals, damage of pancreatic islet cells during the early period of observation was reflected in different types of structural changes, predominantly of the degenerative type. Comparative study of tissue structures of purulent wounds in different conditions showed a high therapeutic efficiency of combined use of “Miliacyl” and EHF-therapy. Strengthening of leukocytic and macrophagal reactions, faster arrest of inflammatory process and separation of necrotic masses was revealed. Conclusions. Potentiation phenomenon of anti-inflammatory and regenerator effect when using miliacyl and EHF was stated.

Aim. The aim of the study was to analyze the association of somatic indices with salivary cortisol (SC) level in healthy young adults. Materials and methods. Examination of 154 healthy students aged 20-23 years (102 women, 52 men) was conducted. Anthropometric study included the measurement of the body length and mass, waist and femur circumferences. Salivary cortisol content was determined using immunoenzyme method. Results. Salivary cortisol level in the examined persons (4,87 nmol/l) was reduced, but did not exceed the standard variation limits. No significant associations of SC content with the body length and mass and mass-height indices were revealed. The waist circumference to femur circumference ratio correlated with salivary cortisol level in men ( Rsp = -0,29; p = 0,036), but not in women. Conclusions. The results agree with the data of publications and confirm the hypothesis that cortisol production is associated with healthy human somatic characteristics.

К 95-летию кафедры дерматовенерологии Пермского государственного медицинского университета