Vol 17, No 4 (2011)

Articles
The profession of an anesthetist-resuscitator as viewed by patients
Fursik O.V., Fursik O.V.
Abstract
The paper analyzes the data of a pilot sociological survey conducted to study public concepts of the profession of an anesthetist-resuscitator. The survey could form a patient opinion about the specific features of the professional activity of an anesthetist-resuscitator and his/her social status and role in the therapeutic process. Analysis of the findings has revealed contradictions between the social significance of this profession for society and the public views of the essence of this medical activity. This leads to the inadequate assessment of the job of an anesthetist-resuscitator and to the depersonalization of this medical profession.
Medical Journal of the Russian Federation. 2011;17(4):3-6
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Polluted water sources in the rural areas of developing countries and their impact on human health
Al' Sabunchi A.A., Islam M., Al-Sabunchi A.A., Islam M.
Abstract
The pollution of soil and water sources by arsenic and its compounds was studied in certain regions of South Asian countries. Reasons for the high spread of arsenic are disclosed. Particular emphasis is placed on the possible routes of human exposure to arsenic. Data on the development of chronic arsenic intoxication are given in relation to the duration of residence in the arsenic-polluted areas and to the use of poor-quality water and animal and plant foods. The study has shown the specific features of morbidity in the polluted areas. It underlines the need for preventive measures to remove arsenic from the human environment. Only in this case, there will be a reduction in the number of people living in the arsenic-polluted areas and accordingly in that of persons with chronic intoxications. And this will result in a decrease in morbidity rates.
Medical Journal of the Russian Federation. 2011;17(4):6-9
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Clinical value of pulmocardiac system dysfunction in smokers with persistent asthma
Smirnova A.Y., Gnoevykh V.V., Shalashova E.A., Kupriyanov A.A., Portnova Y.A., Grigor'ev S.P., Aleksandrov O.V., Smirnova A.Y., Gnoyevykh V.V., Shalashova E.A., Kupriyanov A.A., Portnova Y.A., Grigoryev S.P., Aleksandrov O.V.
Abstract
In patients with persistent asthma, tobacco smoking potentiates the worsening of pulmonary ventilation capacity, has an additional negative effect on blood oxygen-transport function, causes adaptive changes in the morphofunctional characteristics of the circulating pool of red blood cells, and enhances autonomic nervous system dysfunctions.
Medical Journal of the Russian Federation. 2011;17(4):9-13
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Clinical and laboratory detection of campylobacteriosis in patients with acute enteric infections
Litvinova O.S., Sokolova L.V., Bulakhov A.V., Sheveleva S.A., Shakhmardanov M.Z., Udalov G.G., Litvinova O.S., Sokolova L.V., Bulakhov A.V., Sheveleva S.A., Shakhmardanov M.Z., Udalov G.G.
Abstract
The paper deals with the problem associated with difficulties in diagnosing campylobacteriosis. One hundred and eleven patients with acute enteric infections, 9 (8.1%) of them had campylobacteriosis, were examined. Clinical and epidemiological analyses were made in the patients with campylobacteriosis. A modified bacteriological test was proposed, by introducing the enrichment stage into the liquid medium. The results of the bacteriological test were compared with those of polymerase chain reaction.
Medical Journal of the Russian Federation. 2011;17(4):13-15
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The sensitivity and specificity of the skin test Diaskintest® in patients with pulmonary tuberculosis and pulmonary
Slogotskaya L.V., Filippov A.V., Kochetkov Y.A., Sel'tsovskiy P.P., Litvinov V.I., Slogotskaya L.V., Filippov A.V., Kochetkov Y.A., Seltsovsky P.P., Litvinov V.I.
Abstract
The aim of the study was to define the sensitivity and specificity of the new skin test Diaskintest® (DST) using the complex antigen consisting of recombinant CFP-10/ESAT-6 proteins. Four hundred and twenty-five patients with respiratory tuberculosis, 37 with dubious pulmonary tuberculosis process activity, and 111 with pulmonary nontuberculous diseases were examined. DST showed a high sensitivity in 84.2% of the tuberculosis patients. 84.2% of 247 patients treated for 1 to 29 days had a positive response to DST and only 38 (55.9%) of 68 patient treated for more than 100 days had it. The response was twice found in 72 patients. Three months before treatment, 32 (48.5%) of 66 patients with a baseline positive reaction showed a decreasing trend in the response and its positive to negative conversion; the average sizes of the first and second papules were 18.4 and 10.1 mm, respectively. In the patients with pulmonary nontuberculous diseases, the specificity of DST was 96.4%: 105 of the 111 patients had negative tests; the positive tests in 2 patients were accounted for by Mycobacterium tuberculosis due to their professional contact with tuberculosis patients. None of 29 cases of inactive focal tuberculous changes showed any positive response to DST. The latter may be used to detect tuberculosis, to determine the activity of the process, and to evaluate the efficiency of treatment.
Medical Journal of the Russian Federation. 2011;17(4):15-18
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Endovideo-assisted sanitation of postinjection purulent foci in gluteal soft tissues: Comparative aspects
Sazhin A.V., Yurishchev V.A., Popov P.A., Sazhin A.V., Yurishchev V.A., Popov P.A.
Abstract
The paper presents the results of treatment in 124 patients with pyoinflammatory postinjection diseases of the gluteal region. All the patients were divided into 3 groups. In the study group, endovideo-assisted purulent focus sanitation was carried out in 35 (28.23%) patients. In control groups, traditional surgical techniques, such as incision, necrectomy, wound closure with primary suture via drainage, were used in 46 (37/1%) patients or delayed primary suture on postoperative days 3-5 in 43 (34.67%) patients. The study proved it possible to use endovideo-assisted techniques for the adequate purulent focus sanitation and drainage in gluteal soft tissues; there was a reduction in the number of complications from 10.89 to 2.86% and from 36.84 to 4.0% in the early and later postoperative periods, respectively (p < 0.05) and a good cosmetic effect.
Medical Journal of the Russian Federation. 2011;17(4):19-22
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Aortic valve replacement using current bivalve prostheses: Immediate and late results On-X and MedEng-2
Shpilevoy N.Y., Vavilov P.A., Zaytseva R.S., Belova A.E., Shpilevoy N.Y., Vavilov P.A., Zaitseva R.S., Belova A.E.
Abstract
The paper gives the results of prosthetic aortic valve replacement using the comparatively new models of On-X and MedEng-2 prosthetic heart valves. The hemodynamic parameters of the above prosthetic heart valves and the long-term results of their implantation are considered in detail. The findings have led to the conclusion that aortic valve replacement by On-X and MedEng mechanical bivalve prostheses yields good postoperative and long-term results. The On-X and MedEng prostheses provide optimal transposthetic hemodynamics with low pressure gradients. No significant differences found in the results of prosthetic heart valve replacement.
Medical Journal of the Russian Federation. 2011;17(4):22-27
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Feasibilities of collapanoplasty during reconstructive operations on the cervical vertebral column
Protsenko A.I., Fazilov S.K., Karanadze A.N., Nikuradze V.K., Gordeev G.G., Mekhtikhanov D.S., Protsenko A.I., Fazilov S.K., Karanadze A.N., Nikuradze V.K., Gordeyev G.G., Mekhtikkanov D.S.
Abstract
The paper analyzes the results of treatment in 104 patients who have undergone, after spinal cord decompression, cervical vertebral body replacement with a carbon implant and or the GAP-containing material CollapAn that fails to affect the regression of myelopathy in the postoperative period. The material has osteoinductive and osteoconductive properties, being properly a neogenic bone matrix. In all cases, the above properties give rise to a carbon-bone block without osteoplasty. The reliability of the carbon-bone block is borne out by the long-term results of a more than 5-year follow-up of 49 patients.
Medical Journal of the Russian Federation. 2011;17(4):27-29
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Treatment of patients with fractures and displacement-fractures of the anterior and middle foot
Kholikov T.V., Korobushkin G.V., Skoroglyadov A.V., Kholikov T.V., Korobushkin G.V., Skoroglyadov A.V.
Abstract
To treat patients with fractures and displacement-fractures of the anterior and middle foot is a topical problem of ambiguous solution. The authors have developed their working classification, an algorithm for treating these patients, and a surgical procedure in accordance of this classification. All damages to the middle and anterior foot were divided into stable and unstable, isolated and multiple. A treatment option was chosen, depending on the functional characteristics of the damaged foot column. To prevent the development of compartment syndrome, if a postoperative wound could not be sutured without tension on its edges, a relaxing incision was made beyond the injury projection for soft tissue decompression; during medical treatment, if elevated interfascial pressures were suspected, dotted incisions were done along the dorsal surface of the foot. The wounds after the relaxing incision were managed openly until the traumatic edema disappeared, and were then sutured. One hundred and forty-two patients with damages to the anterior and middle foot (68 controls and 74 study group patients) were followed up at the Traumatology Departments of City Clinical Hospital Sixty-Four in 2002 to 2008. Assessment of treatment results validly showed an increase in the positive outcomes of treatment and a considerable reduction in complications.
Medical Journal of the Russian Federation. 2011;17(4):29-32
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Analysis of dynamic endothelial cell density loss after corneal endothelial transplantation
Oganesyan O.G., Neroev V.V., Gundorova R.A., Smetanina M.A., Danilova D.Y., Oganesyan O.G., Neroyev V.V., Gundorova R.A., Smetanina M.A., Danilova D.Y.
Abstract
Dynamic endothelial cell loss is an inevitable process that is inherent in the endothelium of the cornea, including transplanted one, and affects late graft survival. The aim of this communication is to analyze endothelial cell density (ECD) loss after endothelial transplantation by modified DSEK and DMEK techniques. The analysis is based on a follow-up of ECD in 163 patients undergoing endothelial keratoplasty by the modified DSEK and DMEK techniques. The follow-up lasted 10-55 months. Endothelial microscopy was performed using an endothelial contactless microscope 1, 3, 6, and 12 months postoperatively and then every year. Dynamic EDC loss was calculated using the preoperative donor ECD. The EDC losses were 20.8±12.9, 26.3±12, and 32.3±12.5% within the first 12, 24, and 36 months after DSEK, respectively. The EDC decreases were 8.4±14.8, 20.5±13.4, 25.1±15.3, and 33.2±15.4% within the first month, the first 6, 12, 24 months following DMEK, respectively. The EDC loss after endothelial keratoplasty (DSEK and DMEK) was less than that given in the literature, which is conjecturally associated with the native pattern of a graft. This communication is the first in the Russian literature on this topic.
Medical Journal of the Russian Federation. 2011;17(4):32-36
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Hematogenic complications of primary tuberculosis in infants
Kiselevich O.K., Bogdanova E.V., Yusubova A.N., Batyrov F.A., Kiselevich O.K., Bogdanova E.V., Yusubova A.N., Batyrov F.A.
Abstract
In infants, tuberculosis is frequently accompanied by the development of generalization of a specific process. Analyzing data on the infants examined and treated at Moscow Tuberculosis Clinical Hospital Seven has revealed that generalized tuberculosis develops in infancy in every ten tuberculosis infants. When generalized tuberculosis develops, every ten infants die. An individual treatment approach and intensive and long-term combination therapy are required. The use of antituberculosis agents in higher daily dosages is warranted.
Medical Journal of the Russian Federation. 2011;17(4):36-40
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The endoscopic and morphological characteristics of the upper gastrointestinal tract mucosa in the presence of abdominal symptomatology in children with exanthematous lupus erythematosus
Sosyura V.K., Ryabova T.V., Shershevskaya A.Y., Sosyura V.K., Ryabova T.V., Shershevskaya A.Y.
Abstract
Esophagogastroduodenoscopy was carried out in 60 children aged 8 to 16 years who had exanthematous lupus erythematosus (ELE) and in 325 children of the same age who had chronic gastroduodenitis and made up a control group due to their complaints of epigastric pain, nausea, vomiting, heartburn, and belching. The results of the study showed that the endoscopic and morphological signs of esophagitis, gastritis, and duodenitis in ELE did not differ from those obtained by esophagogastroduodenoscopy in the patients with chronic gastroduodenitis. The more frequent occurrence of erosions in the gastric and duodenal mucosae in ELE may be associated with the severity of the underlying disease and the long-term use of anti-inflammatory drugs.
Medical Journal of the Russian Federation. 2011;17(4):40-42
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The rate of secretory otitis media in children with allergic rhinitis
Karpova E.P., Pishchenkov D.V., Karpova E.P., Pishchenkov D.V.
Abstract
The paper describes the prevalence of secretory otitis media in children with allergic rhinitis. Five hundred and seven subjects with allergic rhinitis were examined; 91 children with secretory otitis media were identified. This group was analyzed and a risk group identified.
Medical Journal of the Russian Federation. 2011;17(4):42-43
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Effect of serotonin adipinate on gastric vagal reactions
Smirnov V.M., Sveshnikov D.S., Myasnikov I.L., Kuchuk A.V., Smirnov V.M., Sveshnikov D.S., Myasnikov I.L., Kuchuk A.V.
Abstract
The interaction of serotonin-reactive structures that regulated gastric contractions with the parasympathetic part of the autonomic nervous system was studied. Acute experiments were carried out on 35 rabbits under surgical anesthesia, mechanical ventilation, bilateral vagotomy. Gastric mechanical and electrical activities were recorded. During the experiment, the peripheral segment of the vagus nerve was irritated in intact animals and on continuous exposure to serotonin adipinate. Serotonin was ascertained to enhance gastric vagal stimulatory reactions, by increasing both the magnitude of stimulatory reactions and their duration. It is concluded that there is a functional interaction of serotonin-reactive structures that regulate gastric motility with the parasympathetic part of the autonomic nervous system.
Medical Journal of the Russian Federation. 2011;17(4):44-46
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Genetic aspects of cardiomyopathies
Bershova T.V., Bakanov M.I., Bershova T.V., Bakanov M.I.
Medical Journal of the Russian Federation. 2011;17(4):46-50
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Cognitive disorders in neurosyphilis
Damulin I.V., Savushkina I.Y., Damulin I.V., Savushkina I.Y.
Medical Journal of the Russian Federation. 2011;17(4):50-55
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Psychopathological characteristics and nosological entity of seasonal affective disorders
Bardenshteyn L.M., Iksanova D.S., Shcherbakova I.V., Kurashov A.S., Bardenshtein L.M., Iksanova D.S., Shcherbakova I.V., Kurashov A.S.
Medical Journal of the Russian Federation. 2011;17(4):55-56
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