Vol 19, No 3 (2013)

The article demonstrates the suitability of application of distributed automated system of health monitoring under implementation of methodology of personalized medicine in clinical practice. The architecture of system is proposed and its advantages in its application using innovative micro miniature computers μPC are marked. The proposed technologies are tested on such metabolic diseases as osteoporosis and gout under which the significant importance of genetic determinants and gender differences is proved. The need of prolonged sometimes life-long monitoring o patients is substantiated.

The article demonstrates that medical social studies of particular groups of population provide an opportunity to analyze their health conditions, social characteristics and organization of corresponding medical care. In the structure of morbidity adult population of the Russian Federation the maxillofacial traumas take tenth place and are mostly registered among population aged 18-50 years. The most examined patients suffered of domestic traumas. The broad propaganda of basics of healthy life-style can input into decrease of population traumatism.

The article presents the analysis of dynamics of markers of inflammation (C-reactive protein, tumor necrosis factor (α)) and procalcitonin in 66 patients with infectious endocarditis during six months of monitoring. The carried out study and clinical laboratory comparison made it possible to reveal consistent dynamics of indicators among patients with different course of disease at its various stages. The alterations of concentration of indicators are established in dynamics determining unfavorable prognosis under infectious endocarditis. The high sensitivity and informativeness of tumor necrosis factor (α) is established at all stages of course of disease.

The article presents the results of study of informativeness and prognostic value of complex of neuropsychologic, electro-physiologic and clinical data in the evaluation of functional conditions of brain and parameters of mnestic functions in patients with aftermaths of ischemic stroke. The character and degree of memory disorders depends on localization of post-ischemic focus and correlates with characteristics of pathologic activity in brain biorhythmics. This approach makes possible to produce particular prognosis and recommendations in neurorehabilitation of patients with stroke.

The study was carried out to compare dynamics of intra-abdominal pressure and compliance of front abdominal wall after cesarean section depending on method of post-surgery analgesia. The opened prospective randomized study was organized using the sample of 40 female patients divided in two groups. In the first group the post-surgery analgesia was applied using method of prolonged epidural analgesia. In the second group the method of bilateral blockade of nerves of neuro-fascial space of abdomen was applied. The level of post-surgery pain, the degree of sedation, dynamics of intra-abdominal pressure and compliance of front abdominal wall were examined. It was demonstrated that after cesarean section the epidural analgesia and blockade of nerves of neuro-fascial space of abdomen effectively decrease the level of post-surgery pain, increase compliance of front abdominal wall and decrease the level of intra-abdominal preassure. In the groups the examined indicators had no reliable differences.

The article presents the analysis of rate and character of post-surgery infectious complications of bacterial nature in car-diosurgery mainly after coronary artery bypass grafting. The risk factors capable to lead to infectious complications and to aggravate them are presented. The attention is focused on such more frequent post-surgery infectious complications as pneumonia, tracheobronchitis, blood flow infection, wound infection and more rare but severe post-surgery infectious complications as mediastinitis. The agents of various types of post-surgery infectious complications including ones related to mechanical devices of blood flow support are discussed. The importance of specific and non-specific prevention oof post-surgery infectious complications is emphasized. The various schemes of application of antibiotics considering antibiotics resistance are given.

The article presents the summary of results from national and international studies concerning the diagnostic value of proteinuria and microalbuminuria in pregnant women with increased arterial pressure. The physiologic alterations of renal function occurring with progression of pregnancy are described. The pathogenic aspects of hemodynamic and morphologic alterations in kidneys under hypertension of pregnant women are discussed. The evaluation of sensitivity and specificity of different techniques of identification of proteinuria and microalbuminuria is presented. The opposite suggestions concerning the role of mentioned indications of disorders of kidneys functioning in pregnant women with arterial hypertension are presented. The analysis of large factual material made it possible to assess the role of proteinuria and microalbuminuria in prognosis of complications of pregnancy and perinatal outcomes. The conclusion is made about the need of further studies of diagnostic value of development of these symptoms under pregnancy.