Vol 17, No 4 (2020)

This article contains information on the use of antibiotics according to the problem of antibiotic-resistance growth in pathogens of infections. Also suggested approaches to the choice and prescription of the rational antibiotic treatment of the most frequent respiratory tract infections in children in outpatient practice based on the modern Russian and Eurasian clinical guidelines.

Pathogenesis connective tissue dysplasia (CTD) is an important pediatric issue. CTD is characterized by polymorpfism of phenotypic and visceral signs. Pathogenetic aspect connected with disbalance of collagenic and non-collagenic proteins deserve special attention when children have non-hereditary forms of CTD. The role of elastin and laminin disbalance and the genome «major proteins» that participate in tissue structures' formation remains an understudied issue.

An assessment of the manifestations of the COVID-19 epidemic process in the Volgograd region in terms of intensity, territorial distribution, structure, and clinical patterns of the disease was carried out. The study used the official data of the Rospotrebnadzor Office in the Volgograd region. From March 24 to October 18, 2020, 17 811 cases of COVID-19 were registered in the region, the incidence rate was 715 per 100 thousand of the population, the case fatality rate was 0,98 %. An uneven distribution of morbidity over the territory was established: 42,3 % of cases were detected in Volgograd, 10,1% in Volzhsky and 6 % in Kamyshinsky district. The age groups 40-49 years old (17,6 %) and 50-59 years old (19,2 %) are most involved in the epidemic process. In the cases structure, the prevalence of females was noted (58,3 %). The clinical patterns of the disease are characterized by the predominance of mild forms (46,8 %), there is a trend to reduce asymptomatic forms and an increase in moderate manifestations. In the Volgograd region, a lower frequency of severe forms and deaths registration has been established in comparison with the Russian Federation. In the social structure of the infected people, the largest share is made up of pensioners (26,3 %) and workers (16,9 %).

We used ELISA and PCR for laboratory verification of West Nile fever (MUC 4.2.3009-12). We analyzed serum and whole blood samples which had been sent to West Nile fever reference monitoring centre in 2018-2019. A total of 270 blood samples obtained from patients with presumed viral encephalitis of unknown etiology, acute respiratory viral infection, acute respiratory viral infection, meningitis, acute gastroenteritis were analyzed. Antibodies against WNV were detected in 193 (71,4 %) blood samples, while 146 samples were found to be capable of developing an immune response with viral RNA not being detected in them. Both WNV antibodies and viral RNA were detected in 47 (17,4 %) samples tested. WNV RNA was detected in only 14 (5,1 %) cases. Thus, laboratory confirmation of WNF was obtained in 76,6 % of cases (207 out of 270).

Aim of the research. To provide retrospective analysis of nearest results of laparoscopic surgery for cardiospasm (according to the materials of the department of thoracic surgery of the «Volgograd Regional clinical Hospital № 1» for 2018-2020). Materials and methods. The research include 32 laparoscopic surgical treatment cases of cardiospasm II-III stage. Results. Analysis of the nearest results of laparoscopic surgery for cardiospasm rated the advantages of the laparoscopic method in perfoming exstramucosal esophagocardiomyotomy are assessed. Conclusion. Marked decrease traumatism and time of the operation. Redused the patients hospital stay and postoperation rehabilitation was also redused in patients with II-III stage of the disease.

The article is devoted to the study of the patients with acute ST-segment elevation myocardial infarction (STEMI) complicated by acute heart failure (AHF). Clinical data were assessed, including the level of stimulating growth factor (ST-2) and growth differentiation factor (GDF-15), depending on the degree of AHF classification of T. Killip. It has been established that ST-2 is a marker of AHF prognosis in STEMI patients at the hospital stage of treatment. GDF-15 reaches high values in acute left ventricular failure.

The caesarean section is an important factor characterizing of obstetric care. In recent decades, the frequency of cesarean section has become pandemic. The large variability of the initial state of women in labor and the variety of indications for surgery do not allow us to identify the main determinants. In order to develop effective measures to reduce the frequency of abdominal delivery, WHO recommends using the M. Robson classification (TGCS). A study using the M. Robson scale identifies the patient population, among which a decrease in the number of abdominal delivery is possible and measures can be developed aimed at reducing the frequency of cesarean section in level II hospitals.

In dental practice, patients with periodontal diseases are quite common. Therefore, to improve the effectiveness of treatment tactics, this article discusses the basic principles of surgical treatment of periodontal pockets using the M-Chip nanomatrix. Laser Doppler flowmetry and index assessment of periodontal tissues were used as diagnostic methods for checking the results.

The study was conducted in the period from January 2018 to December 2018 inclusive, 452 coronary artery bypass grafts were performed in the cardiac surgery department using artificial blood circulation under conditions of cold pharmacoplegia. During the study, 2 groups of patients were identified. The criteria were the timing of the surgical intervention. The first group consisted of patients who underwent elective surgery (n = 59). The second group consisted of patients undergoing emergency surgery.

The aim of the work was a comparative assessment of the functional state of the nervous system of students of secondary schools and specialized educational institutions on the example of the Cossack cadet corps. In the course of the work, 65 students of the cadet corps and 103 students of secondary schools aged 11-13 years were examined using a hardware and software complex for screening and assessing the level of psychophysiological and somatic health, recommended by the Ministry of Health of the Russian Federation. The state of the nervous system of both secondary school and cadet students corresponded to the average values of this age group. The high level of neuroticism in both groups was revealed. Indicators of the speed of complex visual-motor reaction among cadets were significantly higher than among schoolchildren (p = 0,044, student's criterion). Based on the data obtained, the capabilities of the nervous system of the cadets of the Cossack cadet corps are significantly higher than those of secondary school students. The study allows us to draw a conclusion about the need to control the capabilities of the nervous system of children and adolescents studying in both specialized and General education institutions.

The expression of heparan sulfate proteoglycans in eutopic and heterotopic endometrium in patients with ovarian endometriosis was studied using the method of immunohistochemistry. The simultaneous increase in the level of expression of core proteins of all studied heparan sulfate proteoglycans and the content of heparan sulfate in pathological tissues indicates the important role of glycosylated molecules in the pathogenesis of ovarian endometriosis.

The article describes a rare localization of extrapulmonary tuberculosis in the form of a unilateral lesion of the middle ear in a 47-year-old woman without immunodeficiency, but having a history of pulmonary tuberculosis with residual changes. Sluggish middle purulent otitis media in the patient for 1.5 years was regarded as nonspecific, and only surgical intervention with histological examination of the surgical material made it possible to establish a tuberculous etiology of the process.

72 patients (72 eyes) were examined with flat diffuse or focal diabetic macular edema up to 500 microns high. Patients were divided into two groups. The first group included 40 patients (40 eyes) with a treatment using a Supra 532 laser (Quantel Medical, France). The second group (control group) included 32 patients (32 eyes) with a treatment using a Supra 577 laser (Quantel Medical, France). Significant decrease of macular edema and increase of focal threshold were statistically achieved in both groups. At the same time, a statistically significant difference in the treatment efficacy between the first and second groups was not detected.

The parasitic contamination of the soil of rural areas of the Astrakhan region for the presence of eggs and larvae of helminths and cysts of pathogenic intestinal protozoa was studied. The highest number of unsatisfactory soil samples was observed in the Limansky district of the Astrakhan region - 12.2 %, when dead larvae of Strongyloides stercoralis and unfertilized eggs of Askaris lumbricoides were found. The presence of Toxocara canis eggs and dead Strongyloides stercoralis larvae in the soil indicates contamination of this object with the feces of invasive animals. The presence of unfertilized eggs of Askaris lumbricoides in soil samples taken from playgrounds in rural areas of the Astrakhan region indicates that these objects are contaminated with the feces of infected people. Contamination of soil in rural areas of the Astrakhan region eggs and larvae of helminths, in the Krasnoyarsk area above 4.1 times higher than in lymans'ke and 6.7 times compared to Kamyzyaksky.

A disturbed uterine contraction activity is a basic stage in the pathogenesis that result in a pathological or abnormal labor. Now some new ways f uterine activity were discovered that may be helpful to find promising targets for future medications. This article presents a clinical case of pregnancy with an abnormal labor and describes diagnostic and corrective methods for contractile activity disturbance making an impact to purinergic system. A way to predict a protracted pregnancy and special considerations for induced labor management were suggested. The reported clinical case indicates usefulness of protracted pregnancy prevention and introducing of the developed series of preventive measures to a wide practice aiming to obtain healthy newborns and to reduce pathological labor occurrence.

Establishing the causes of chronic pelvic pain in men still remains an urgent task for specialists in various fields. Many etiological factors leading to the onset of chronic pelvic pain syndrome (CPPS) and its further progression provide grounds for scientific discussion. In order to study the possibilities of predicting the development of CPPS, a promising direction can be the study of the features of the course of the perinatal and pubertal periods of development. The analysis of the ratio of the severity of disorders in the perinatal and pubertal periods of development with the risk of CPPS formation in the adult state in 136 men aged 18-40 years was carried out.

Bimanual coordination is necessary for successful performance of monotonous activities accompanied by monotonous complex-coordinated movements. Different types of complex operator tasks require a variety of coordination patterns with different levels of interaction between attention and hand movements. The article presents the results of studying the state of monotony when performing purposeful fine manipulative movements, considering the individual features of perception. The developed method of studying bimanual coordination allows us to establish the development of fatigue and monotony, which directly depends on the psychophysiological characteristics of a person.

The clinical significance of iron deficiency in heart failure patients with preserved ejection fraction is not well understood. 158 patients with chronic heart failure with preserved ejection fraction were examined. The clinical manifestations of heart failure, the level of NT-proBNP, iron, ferritin, transferrin, were studied in all patients, echocardiography was performed in one-dimensional, two-dimensional, and Doppler modes (pulse-wave, constant-wave, and tissue) in standard positions according to the generally accepted technique. It has been established that iron deficiency in patients with heart failure with preserved ejection fraction worsens the indices of central hemodynamics and promotes an increase in the clinical manifestations of heart failure, especially in the development of anemia.

To assess the relationship between the anterior chamber structures, eye hydrodynamics disorders and the accommodation disorders in patients with myopia. 235 patients (235 eyes) with myopic refraction of various degrees were examined. With myopic refraction, an anterior stretch of the eyeball was marked, which is more expressed in patients with high myopia and is more often accompanied by ophthalmic hypertension and excessive accommodation strain syndrome.

This article presents the results of a comparative analysis of the content of individual amino acids in the overground part of Glycyrrhiza glabra L. and Glycyrrhiza echinata L., growing in the Volgograd region. By the HPLC study, 16 amino acids (Ala, Gly, Tyr, Ser, Asp, Glu, Arg, His, Pro) were identified in the plant raw materials, among which 9 are replaceable amino acids and 7 are irreplaceable amino acids (Thr, Val, Met, Ile, Leu, Phen, Lys). At the same time, of the total content, the share of replaceable amino acids in Glycyrrhiza glabra L. is 10,09 %, and irreplaceable ones - 5,84 %. In the overground part of Glycyrrhiza echinata L., these indicators are slightly higher - 11,47 % of replaceable amino acids and 6,80 % of irreplaceable amino acids.

The article highlightsthe main results of the implementation of measures to ensure the deployment of a laboratory testing network for the new coronavirus infection COVID-19 in the Volgograd Region.