Vol 20, No 4 (2014)

Articles
The bio-impedance screening of population in health centers: prevalence of surplus body mass and obesity
Soboleva N.P., Rudnev S.G., Nikolayev D.V., Eryukova T.A., Kolesnikov V.A., Melnitchneko O.A., Ponomareva E.G., Starunova O.A., Sterlikov S.A.
Abstract
In 2010-2012, the primary data of bio-impedance measurements in 2 092 695 patients in 484 health centers was used to evaluate prevalence of obesity and surplus body mass in population of Russia depending on age and gender by WHO criteria. The standardized rate of occurrence of obesity in children and adolescents aged 5-17 years old made to 6.8% for males and 5.3% for females and 21.9% and 29.7% in adults correspondingly. The localized criteria of bio-impedance diagnostic of obesity according percent content of fat in body mass was developed. The low diagnostic sensitivity (50% for males and 65% for females) and high specificity (90%) of WHO criterion of obesity diagnostic according body mass index was revealed.
Medical Journal of the Russian Federation. 2014;20(4):4-13
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The training to laparoscopic appendectomy
Sajin A.V., Mirzoyan A.T., Klimiashwili A.D., Mosin S.V., Laiypanov B.K.
Abstract
The training to laparoscopic appendectomy provides to novice surgeons an opportunity to acquire and assimilate main skills of laparoscopy operation techniques. However, nowadays there is no clear criteria of qualification level of surgeons for safe implementation of this operation. The present study was targeted to evaluate both the results of laparoscopic appendectomy implemented by novice surgeons and effectiveness of training to these operations' technique according surgery results. The study included random patients underwent laparoscopic appendectomy implemented by eight training surgeons during 20092011. The study considered clinical and histological forms of disease, duration of operation, number of complications and conversions. All patients were separated in three groups. The first group included the first 20 patients operated in 2009. The second group included next 20 patients operated in 2010. The third group included 20 patients operated in 2011. The totality of 480 laparoscopic appendectomies were implemented. The mean duration of operation added up to 64.9±20.1 minutes. In 7.3% of cases conversion to open appendectomy was needed. The significant decrease of number of complications and conversions related to increase of experience of surgeon was marked. At that, duration of operation and mismatch between clinical and histological diagnoses remained unchanged.
Medical Journal of the Russian Federation. 2014;20(4):14-17
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The information value of certain biochemical indicators of blood in patients with sarcoma of soft tissues at stages of dynamic observation
Goroshinskaya I.A., Vaschenko L.N., Mashurova S.A., Shalashnaya E.V.
Abstract
The article presents data of comparative study of level in blood of C-reactive protein, a number of other proteins of acute phase of inflammation response of organism (haptoglobin, a1-antitrypsin), marker of tissue destruction of myoglobin and activity of certain enzymes of energy metabolism (creatine kinase, alkaline phosphatase, lactate dehydrogenase) in the course of dynamic observation of course of malignant process in 42 patients with sarcoma of soft tissues. The possibility of implementation of examined indicators as biochemical criteria of generalization of process was analyzed. It is demonstrated that under monitoring of patients with sarcoma of soft tissues the most prognostic information value is attached to detection of C-reactive protein. The clinical examples of application of this indicator to forecast the course of disease in patients with sarcoma of soft tissues.
Medical Journal of the Russian Federation. 2014;20(4):18-22
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The prognosis of development of sepsis in puerperae with syndrome of systemic inflammation reaction
Penjoyan G.A., Prokhorova I.N., Muzytchenko V.P., Sinkov S.V., Zabolotskih I.B.
Abstract
The article presents results of examination of 55 puerperae aged from 19 to 43 years with syndrome of systemic inflammation reaction given a course of treatment in departments of anesthesiology and reanimation in the Krai hospital No. 2 of Krasnodar in 2010-2013. The complex evaluation of state of system of homeostasis was made using biochemical coagulogram and thromboelastography. The prognostic hemostasiologic markers of progression of systemic inflammation reaction in sepsis are both such thromboelastography parameter AS maximal amplitude and such indicator biochemical coagulogram as prothrombin time.
Medical Journal of the Russian Federation. 2014;20(4):22-25
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The antibodies of class IgG to virus of simple herpes type I and II and disorders of female reproductive system
Abdulmedjidova A.G., Melnitchenko A.V., Tzibisov A.S., Krasnopolskaya K.V., Lvov N.D.
Abstract
The article presents results of comparative analysis of levels of IgG-antibodies in serums of women who are positive to simple herpes virus. All female respondents were of reproductive age and were divided in two samplings i.e. women up to 12 weeks of pregnancy (n = 89) and women with barrenness in marriage (n = 123). In infertile female patients and pregnant women the virus-specific antibodies and their avidity were detected under simultaneous analysis of serums using method of enzyme-linked immunosorbent assay. The concentration of antibodies was expressed min coefficients of positivity and in titers. The mean value of concentration of serum IgG-antibodies in female patients with barrenness was statistically higher (coefficient of positivity = 6.67 ± 3.48; titer 1:800-1:3200) than in pregnant women (coefficient of positivity = 2.29 ± 1.48; titer 1:100, p = 0.001). The analysis of content of antiviral antibodies in female patients with barrenness depending on effectiveness of programs of extracorporal fertilization demonstrated that highest rate of pregnancy onset (36.1%, 30/83) was observed in female patients with low level of antibodies (n = 83, coefficient of positivity = 3.48 ± 2.4; titer 1:800). Whereas, in female patients with high level of IgG-antibodies to simple herpes virus (n = 40, coefficient of positivity = 10.0 ± 2.05; titer 1:3200) this indicator consisted 17.5% (7/40, p = 0.039). The supposition was made that high level of IgG-antibodies to simple herpes virus is associated with frequent episodes of productive herpes viral infection. To confirm this assumption the experiments with lab animals were organized. The evaluation was made of dynamics of levels of IgG-antibodies in serum of pubertal females mice DBA/2J infected with reference-strain L2 of simple herpes virus type I intravaginally in two groups. Virus was introduced to animals from first group (n = 14) once and to animals from second group (n = 14) twice with interval of 4 weeks. The concentration of antibodies was evaluated using method of enzyme-linked immunosorbent assay with application of pair serums of animals with twice outtake of blood after every 4 weeks after virus inoculation. Out of 28 animals of both groups 6 mice (22%) were seronegative (no detection of antibodies in whole serum), 22 mice (78%) were seropositive (coefficient of positivity > 1.0, titer 1:50). Out of 22 immune mice only 4 female mice (19%) had expressed antiviral immune response (coefficient of positivity > 4.0) whereas in 18 out of 22 mice (81%) level of synthesis of mentioned immunoglobulins was significantly lower (coefficient of positivity = 1.7 ± 0.41). The increase of concentration of IgG-antibodies occurred only in the group with two-time introduction of simple herpes virus (titer 1:200- 1:400). The content of serum antibodies in female mice with single infection had no changes in course of time. These data indicates that in overwhelming majority of cases increase of level of IgG-antibodies is conditioned by synthesis of viral antigens de novo. Summing up obtained results makes it possible to conclude that high concentration of IgG-antibodies to simple herpes virus testifies productive herpes viral infection and has greater diagnostic value than it considered before. The fact that level of mentioned antibodies is statistically higher in sampling of women with barrenness indicates the negative effect of virus on female reproductive system.
Medical Journal of the Russian Federation. 2014;20(4):26-30
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The multi-criterion mathematical evaluation of condition of cellular immunity under acute endometritis
Agarkov N.M., Afanasova E.P., Snopkov V.N., Gontarev S.N.
Abstract
The evaluation of parameters of cellular immunity at systemic level was made using monoclonal antibodies. The sampling consisted of 132 patients with acute endometritis. The multi-criterion mathematical analysis was applied to detected alterations. The leading diagnostic value of absolute number of T-helpers and natural killers and relative content of T-helpers was established. The other six examined indicators of cellular immunity in blood have secondary value for diagnostic of acute endometritis. The implemented multi-criterion mathematical evaluation made it possible to reduce number of determinate immunologic parameters under given pathology.
Medical Journal of the Russian Federation. 2014;20(4):31-33
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The relationship between process of peroxidation of lipids, activity of antioxidant system and fatty-acid composition of blood in patients with diabetes mellitus type I and under its complications
Mikaeliyan N.P., Gurina A.E., Nguen H.Z., Terentiyev A.A., Mikaeliyan K.A.
Abstract
The results of study testify that in patients the diabetes mellitus type I is accompanied by dyslipidaemia of atherogenic character. The activation of processes of lipid peroxidation is also present and results in increasing of content of both primary and secondary products of peroxidation of lipids and disorders in system of antioxidant defense. In patients with diabetes mellitus increase of total content of saturated fatty acids mainly at the expense of myristinic acid accompanied by decreasing of total content of unsaturated fatty acids. This occurrence was mostly expressed in patients with complications of diabetes mellitus. The study marked direct correlation relationship between activity of superoxide dismutase and level of a-linolenic acid (r=0.53, p<0.05), and also between level of diene conjugates and enzyme activity of glutathione peroxidase (r=0.47, _p<0.05). The direct correlation relationship existed between concentration of malondialdehyde and content of linolenic acid (r=0.67, p<0.05). The total ratio of content of omega-6/omega-3 decreased (p<0.05) at the expense of increase of total activity of superoxide dismutase and catalase (r=-0.763, p<0.05). Therefore, in patients with complicated diabetes mellitus against the background of dyslipidaemia significant alterations were established concerning both level and content of fatty acids, rising of concentration of free radicals and decrease of activity of enzymes of antioxidant defense.
Medical Journal of the Russian Federation. 2014;20(4):33-38
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The clinical criteria and dynamics of dysthymia
Bardenshtein L.M.
Abstract
The lecture is devoted to dysthymia as a sub-type of chronic unipolar affective disorder resulting in decrease of quality of life, disability and premature death of patients. Nowadays, this pathology represents serious medical problem. The data is presented concerning clinical and epidemiological aspects of dysthymia. The publication is focused on diagnostic criteria of dysthymia according ICD-10 making possible to distinguish low-level sub-depressive disorder from major depression. The actual approaches to problem of differentiated diagnostic of dysthymia, particularly in adolescent age, are considered.
Medical Journal of the Russian Federation. 2014;20(4):38-40
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The provocation broncho-constricting tests in modern pulmonological practice
Krasnovskiy A.L., Grigoriyev S.P., Aleksandrov O.V., Loshkareva E.O., Korviyakov S.A., Korotkova E.S.
Abstract
The provocation broncho-constricting tests are largely applied all over the world with the purpose of diagnostic and differentiated diagnostic of bronchial asthma and chronic obstructive disease of lungs and control of effectiveness of applied therapy. The review presents actual data concerning application of provocation tests in pulmonology.
Medical Journal of the Russian Federation. 2014;20(4):41-46
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The diabetic cardiomyopathy in children
Smirnov V.V., Naumov Y.A.
Abstract
The cardiomyopathy is an actual problem in children with diabetes mellitus. In many children with diabetes mellitus develops cardiomyopathy resulting in development and progression of cardiac insufficiency. The cardiovascular complications take first place in the structure of mortality of patients with diabetes mellitus. Hence, early diagnostic of diabetic cardiomyopathy is needed. In children suffering from diabetes mellitus echocardiography is to be applied to detect final diastolic index, stroke index and other indicators. The electrocardiography is to be applied too. The detection of ratio of intima and media thickness in carotids is needed for maximally early detection of cardiomyopathy.
Medical Journal of the Russian Federation. 2014;20(4):47-52
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The mode of neurorrhaphy excluding kinking and disorientation of fascicles in zone of anastomosis in patients with old trauma
Mescheriyagina I.A.
Abstract
Nowadays, problem of inconsistency of neurorrhaphy is actual. The results of nerve suturing depend on preservation of possibility of regeneration, degree of further cicatrization, intention of zone of anastomosis, precision of approximation of fascicles. Lately, various options of stimulation of axonal growth are applied more broadly. Among them are direct combined electrostimulation of peripheral nerves, in aggregate with mechanotherapy and introduction of anticholinesterase preparations. In the academician G.A. Ilizarov Russian research center “The restorative traumatology and orthopedic” different versions of electrostimulation of peripheral nerves are developed and implemented. The mode of neurorrhaphy enabling exact coaptation of fascicles groups. This mode can be recommended to be applied in neurosurgery and traumotology departments and under microsurgery reconstructive interventions on damaged peripheral nerves.
Medical Journal of the Russian Federation. 2014;20(4):53-56
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