Vol 21, No 6 (2015)

The article considers resulting materials of examination and treatment of 20 patients (main group) aged 22-45 years (5 males, 15 females) addressed to the Research center of surgery for application of herniaplasty and who were detected urogenital clamidiosis after bacterioscopic, cultural and serological analysis. The relapsing ventral hernia was diagnosed in 9 patients, relapsing inguinal hernia - in 3 patients and femoral hernia - in 1 female patient. The control group included 20 patients with hernia of anterior abdominal wall without any chronic infection. The analysis of indicators of cellular and humoral chain of immune system established that patients with chronic clamidiosis are characterized by occurrence of suppression in T-cell chain and imbalance of indicators of humoral immunity. The occurrence of clinical signs of immunodeficiency in patients with hernia of anterior abdominal wall is a direct indication for prescription of immune correctional therapy during preoperational period. In patients with chronic clamidiosis Imunofan provides significant immune correctional effect manifesting as positive dynamics of indicators of cellular and humoral immunity. At the same time, therapy by Imunofan combined with 0. 33% tincture of saffron is more effective method of immune correction.

For the first time the diagnostic significance of total nonsaturation of lipids of blood plasma (double bonds) was analyzed in 25 newborns, including small premature infants with extremely low body mass at birth. The detection of nonsaturation of lipids of blood plasma was implemented using quick-test of ozonization at the analyzer "ADS-5M". The comparison group included 7 examined healthy full-term newborns. The normal level double bonds for newborns was established for the first time on the basis of analysis of level of double bonds in healthy full-term newborns. The random sampled 18 children treated in the department of reanimation and intensive therapy of newborns were examined. The comparison of level of double bonds in ill newborns established that singled out groups of ill newborns with course of congenital infection of different degree of severity (down to sepsis) are differentiated reliably on degree of nonsaturation of lipids. This occurrence can be explained by alteration of structure of fatty acids both in free condition and composition of lipid complexes. The alterations should be considered in treatment because nonsaturation of fractions of lipids relate to stabilization of membranes and content of essential fatty acids in neutral lipids is related to mechanism of blood clotting. The presented materials demonstrate availability of further application of indicator of double bonds as an additional criterion in laboratory diagnostic and monitoring for adequate tactic of treatment of newborns being in the department of reanimation and intensive therapy of newborns (antioxidant, hypoglycemic and membrane-stabilized pharmaceuticals) and also with purpose of prognosis of complications.

Within the framework of international pilot project in four cities - Minsk, Moscow, Novosibirsk and Samara - the stomatological examination and questionnaire survey was carried out concerning 850 children of key age groups, 12 and 15 years using the European indicators of stomatological health proposed by EGOHID, records of stomatological status and questionnaires of WHO-2013. The most of 15 applied indicators demonstrated high informativeness and specificity in detecting risk factors related to development of stomatological diseases and problems of inadequate effectiveness of community programs of dental caries prevention. The recommendation is substantiated concerning application of complex of subjective indicators as an addition to studies of stomatological status of children of school age.

The results of study testify that in women obesity and diabetes mellitus type II are accompanied by dyslipidaemia of atherogenic character with activation of processes of lipid peroxidation and disorders of system of antioxidant defense. The diabetes mellitus type II conditioned by imbalance in system POL-AOA is accompanied by higher concentration of peroxided lipoproducts. decreasing of parameters of antioxidant systems and utilization of glucose by cells. The obesity and diabetes mellitus type II is accompanied by modification of content of free and esterified fatty acids of blood plasma. This occurrence can result in alterations of functional activity of cell membranes and therefore in decreasing of functional activity of insulin receptors and insulin-dependent glucose transporter. The results of study convincingly testify the important role of fatty acids and their metabolites in pathogenesis of obesity and diabetes mellitus type II. This is to be accounted in development and choosing of corresponding preventive and therapeutic activities targeted to prevention or elimination of detected disorders.

The issues of social characteristic of patients with urogenital chlamydiasis are covered rather sufficiently in actual scientific medical publications. However, the social aspects of respiratory chlamydiasis proper consideration is still to be given. The absence of information concerning characteristics of health and social characteristics of members of families in the focus of family respiratory chlamydiasis became a reason of targeted study of this problems. The article presents characteristics of medical social conditions of members of families of patients with diseases of upper section of respiratory tract associated with chlamydia infection. The sampling consisted of 87 families 44 out of them with verified chlamydia infection (main group) and 43 families of ENT-patients with unverified respiratory chlamydiasis (control group). The total number of composition of families made up to 245 individuals. The chlamydia infection was diagnosed using complex of such laboratory techniques as direct immune fluorescent and immune-enzyme analysis, polymerase chain reaction. The evaluation of medical social conditions of members of family was implemented using questionnaire survey technique. The originally developed questionnaire included sections reflecting health condition, health risk factors and social characteristic of members of families of ENT-patients. The study established high degree of contagiousness of chlamydia infection in focus of respiratory chlamydiasis. It is demonstrated that in family focuses of respiratory chlamydiasis there were more family members frequently and continuously sick with acute diseases and suffering from chronic pathology of different organs and systems. Also in these families chronic pathology of of ENT-organs was diagnosed at the expense of larger number of family members with throat diseases. In the focus of respiratory chlamydiasis families having "good diet" were in much less number and families evaluated their social well-being as low were in by far higher number. Therefore, results of study demonstrated that medical and social condition of families having focus of respiratory chlamydiasis s much worse than of families without the mentioned focus.

Nowadays, the issue of choosing the mode of hernioplasty of inguinal hernia is to be actual. The proposed multiple alternatives of reconstruction of anterior or posterior walls of inguinal canal using local tissues are not quite effective ones. The reason is that under primary inguinal hernia relapses occur with rate of 10-30% and especially in case of such complex forms of inguinal hernia as sliding, combined, giant, relapsing and repeatedly relapsing. The number of relapses make up to 40-45%. The nonstrain modes of inguinal hernioplasty using mesh alloprothesis decreased rate of relapses up to 1-5%. However, aggression of operation, possibility of development of chronic pain syndrome and long term of physical and psychological rehabilitation served as an occasion for developing mini-invasive techniques of surgery. During last 15 years the laparoscopic techniques of surgery are applied in surgical practice. The laparoscopic transabdominal and preperitoneal and total extraperitoneal inguinal hernioplasties combine mini-invasive access and nonstrain prosthetics of posterior wall of inguinal canal. the both techniques are effective in view of decreasing of aggression of operative intervention, amelioration of aesthetic results and decreasing relapses up to 2% in case of both techniques. However, the well-formulated criteria of choice of laparoscopic technique are absent. There is not enough data concerning comparative results of treatment in remote post-operative period.

The article for the first time in Russia describes the case of extensive and long-course melanin-hyper-pigmentation in female patient with thyroid ectomy in anamnesis. The patient permanently takes euthyrox and carrying out on her own peeling with glycolic acid before her trip to Dominican Republic. The inflammatory reaction of skin underlaid pathogenesis of development of melanin-hyper-pigmentation. the inflammation was conditioned by interaction of glycolic acid and intensive ultraviolet radiation in the equatorial region against the background of substitutive hormone therapy. The problems of prevention of complications related to chemical peeling in tourists planning to visit tropical countries.