Vol 2, No 2 (2017)

Articles
INFLUENCE OF INTERMITTENT PNEUMATIC COMPRESSION ON ARTERIAL BED
Diachkov V.A., Rubanenko A.O., Gritsin A.V.
Abstract
Aim - to estimate the influence of intermittent pneumatic compression on arterial bed. Material and methods. The paper presents a literature review concerning the use of pneumatic compression in patients with peripheral artery disease. Results. Possibilities of pneumatic compression for prophylaxis and treatment of chronic ischemia in patients with peripheral artery disease are under discussion. Conclusion. The rapid growth of investigators’ interest in nonmedical methods of influence on arterial bed, and also the search for new and efficient methods and regimens highlight the significance of medical pneumatic compression. Currently, there is limited literature available about customization of pneumatic compression in accordance with nosology and individual indicators of blood circulation in lower extremities. As mentioned above, the most relevant and perspective direction is investigation of complex key indicators of arterial biomechanics with possibilities of the regimen correction, i.e. with implementation of feedback mechanism.
Science and Innovations in Medicine. 2017;2(2):6-9
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EPIDEMIOLOGICAL FEATURES OF HIV INFECTION IN MODERN CONDITIONS ON THE EXAMPLE OF THE SAMARA REGION)
Borisova O.V., Agafonova O.V., Eremenko E.P., Borodulina E.V.
Abstract
High spread of HIV infection (more than 0,5% among the population) was registered in 26 regions of the Russian : Federation, where 41,5% of the country's population live. Aim - to estimate the dynamics of the spread of HIV infection in the region that used to be among the regions most affected by HIV-infection in the Russian Federation; to determine the state of HIV infection among women and children. Materials and methods. The official reporting data ; of the State Regional Clinical Hospital "Samara Regional Center for the Prevention and Control of AIDS and : Infectious Diseases" were used. Results. As of 1 January 2017, Samara region is on the 13th place in terms of morbidity due to HIV (104.1 per 100 000 population). Increase in the birth rate of children born from HIV-infected mothers has been observed since 2002 (10,365 children were born in the Samara Region : since the beginning of the epidemic). The diagnosis of "HIV infection" was confirmed in 494 children. Conclusion. Characteristic features ofthe HIV epidemic in the Samara region are: the greatest prevalence of disease in the big cities of the region with further expansion into smaller towns and rural areas. There is the predominance of the sexual mode of transmission at present time. Evolution of the infection is manifested by an increase in the number of infected women, which account for about 40,0% of HIV cases. The rate of detectable HIV infection in pregnant women is growing at a consistently high level, and the proportion of births among HIV-infected pregnant women is increasing. The total cumulative percentage of perinatal HIV infection was 4,8% (0.8% - in 2016).
Science and Innovations in Medicine. 2017;2(2):10-14
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MORPHOLOGICAL CHARACTERISTICS OF CORONARY AND CAROTID ATHEROSCLEROTIC PLAQUES IN PATIENTS WITH MYOCARDIAL INFARCTION
Slatova L.N., Fedorina T.A., Bormotov A.V., Samychin M.Y., Buklesheva I.M.
Abstract
Aim - to study the correlation between the thickness of the fibrous cap and collagen in the coronary and carotid plaques in patients with myocardial infarction. Materials and methods. The objects of the study were 81 coronary and carotid atherosclerotic plaques obtained during autopsy study of 15 patients who died from complications of myocardial infarction. Histological and morphometric study and immunohistochemistry were performed. Immunohistochemical examination was carried out using monoclonal antibodies against collagen types II, III, IV, VI, VII. Results. There is a combination of complicated, unstable and stable coronary and carotid atherosclerotic plaques in patients with myocardial infarction. Unstable atherosclerotic plaque is characterized by thinning of the fibrous cap mainly in the peripheral areas and the growth of destructive changes in the collagen types III, IV and VI. Conclusion. There is a critical thinning in the caps of unstable carotid and coronary plaques in myocardial infarction with signs of disorganization of collagen, leading to decreased resistance to mechanical stress of this type of plaques.
Science and Innovations in Medicine. 2017;2(2):15-19
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CURRENT ASPECTS OF THE CONCEPT, ETIOLOGY, PATHOGENESIS AND PREVENTION OF SUDDEN CARDIAC DEATH
Fatenkov O.V., Rubanenko O.A., Yashin S.S., Avezova D.B.
Abstract
Aim - to highlight current aspects of the concept, etiology, pathogenesis and prevention of sudden cardiac death. Discussion. Sudden cardiac death in a wide sense is known as non-violent death due to cardiac pathology, with the rapid development of circulatory arrest, which is preceded by loss of consciousness. Sudden cardiac death is often the first and only manifestation of coronary heart disease, and it occupies a vast niche in mortality from cardiovascular pathology. Despite the high prevalence, there are many controversial and unresolved issues regarding the pathogenesis of the sudden cardiac death. There are some difficulties with the precise definition of this diagnosis. Conclusion. The review considers the concept of sudden cardiac death, presents several theories of pathogenesis, risk factors, which are thoroughly analyzed and synthesized. Methods of primary and secondary prophylaxis are analyzed, and comparative characteristics of medicinal substances used for prevention of sudden cardiac death are given.
Science and Innovations in Medicine. 2017;2(2):20-25
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EVALUATION OF EFFECTIVENESS OF ACLIDINIUM BROMIDE FOR PATIENTS WITH OCCUPATIONAL CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)
Vakurova N.V., Azovskova T.A.
Abstract
Aim - evaluation of effectiveness and safety of the innovative medicinal product aclidinium bromide for patients with occupational COPD (chronic obstructive pulmonary disease). Materials and methods. The research was performed during 2015-2016 in the Samara Regional Center for Occupational Pathology. The study included 44 patients with the diagnosis of occupational chronic obstructive pulmonary disease. The diagnosis was based on the history of professional data, sanitary characteristics of working conditions, and complete clinical, functional and instrumental examination of the patients. The patients were randomly divided into two groups: 22 patients were given 322 micrograms of aclidinium bromide via inhalation twice a day during 24 weeks, while 22 patients from the comparison group were given 50 micrograms of glycopyrronium bromide once daily. The respiratory function test was carried out both before and after the treatment; the dynamics of dyspnea was measured and the quality of patients’ life was estimated. The following aspects were examined: the quantity of days when emergency medicinal treatment was not required; the quantity of required daily inhalations of rescue medications; the frequency of exacerbations; the period before the first exacerbation happens; compliance; adverse drug reactions. Statistical processing of the data was performed using SPSS 21 software package. Results. Aclidinium bromide has advantages over glycopyrronium bromide concerning the following aspects: functional indices (FEV1 forced expiratory volume during the first second), clinical data (dyspnea), quality of patients’ life, frequency of exacerbations, the period before the first exacerbation happens, and patients’ compliance. Conclusion. Aclidinium bromide has proven to be an effective and safe medication for medical treatment of patients who suffer from moderately severe occupational COPD.
Science and Innovations in Medicine. 2017;2(2):26-29
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GENERATION OF IL-17 IMMUNE RESPONSE IN OBESE PATIENTS WITH ASTHMA
Nurdina M.S., Kupaev V.I., Sazonova O.V.
Abstract
Aim - to investigate the influence of IL-17, IL-10 on the level of asthma control among obese patients. Materials and methods. 79 patients with asthma aged from 18 to 65 years were enrolled in our study and categorized into three groups according to their body mass index (BMI): group 1 - normal BMI (27 (34,2%) patients, age 50±13,8), group 2 - overweight (28 (35,4%) patients, age 44±16,5) and group 3 - obese (24 patients (30,4%), age 57,3±8,2). These patients underwent spirometry and were compared for clinical characteristics, plasma level of IL-17 and IL-10 using ELISA assay. Results. IL-17 concentrations were higher in the obese and uncontrolled asthmatics. Statistically significant correlation between the level of IL-10 and BMI was not found. Conclusions. Our study shows that cytokines IL-17 play an important role in the immune response of asthma in obese patients, and represent an important therapeutic target for the asthma treatment.
Science and Innovations in Medicine. 2017;2(2):30-33
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CLINICAL AND DIAGNOSTIC FEATURES OF OSTEOARTICULAR TUBERCULOSIS IN HIV-INFECTED PATIENTS
Borodulina E.A., Kolacheva A.Y., Kolacheva N.V.
Abstract
Aim - to study the features of osteoarticular tuberculosis (OAT) in patients with HIV-infection. Materials and methods. 118 patients with OAT treated by phthisiosurgeon in the TB dispensary in 2014-2016 were examined. Two groups were formed: the 1st group (study group) included 54 patients with HIV/OAT; the 2nd group (comparison group) included 64 patients with OAT without HIV-infection. Results. OAT was diagnosed in HIV patients aged 37-38 years at stage 4 of HIV-infection; pulmonary tuberculosis was detected in 50%, with MDR-TB in 11.1%, in 92.6% tuberculous spondylitis was prevalent, complicated by the formation of abscesses in 75.9%. Conclusion. Patients with HIV/OAT were 1.8 times more frequently detected in fastigium with widespread forms of spinal cord lesions, the process impaired 3 times more often in patients with ART failure and hepatitis C.
Science and Innovations in Medicine. 2017;2(2):34-38
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DISSEMINATED PULMONARY TUBERCULOSIS: ACTUAL PROBLEMS
Borodulina E.A., Yakovleva E.V.
Abstract
In the structure of disseminated pulmonary diseases tuberculosis accounts for 3 to 35%, and in the structure of the newly diagnosed tuberculosis disseminated forms account for about one third of all cases. Differential diagnosis of the pulmonary dissemination syndrome is a problem for physicians of various specialties. The frequency of diagnostic errors can reach 80%. Aim - to review the literature on the diagnosis of disseminated pulmonary tuberculosis over the past 10 years and to identify actual issues on this problem for further study. Methods. We have done bibliographic search on the PubMed/Medline and Elibrary databases over the past 10 years (2007-2017).
Science and Innovations in Medicine. 2017;2(2):39-43
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METHODS OF SPECIFIC DIAGNOSIS OF TUBERCULOSIS: A MODERN VIEW ON THE PROBLEM
Prylutskyi O.S., Rogovaya Y.D.
Abstract
This review presents modern views on the problems of immunodiagnosis of tuberculosis. We have examined the advisability of the use of immunological methods for diagnosis of active tuberculosis and detection of latent tuberculous infection. It is shown that nowadays the use of serological diagnostic methods is not recommended because of contradictory information about their accuracy and limited diagnostic significance. Advantages and disadvantages of current methods of assessment of cell-mediated immune response that are used as screening tests for diagnosis of latent tuberculosis have been analyzed. We point to advisability of combination of different methods that are available nowadays with the use of skin tests as the first step of diagnosis, and improvement of techniques of antigens injections that are used for them.
Science and Innovations in Medicine. 2017;2(2):44-51
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PROBLEMS OF A TB PATIENT AND HIS FAMILY DURING THE PERIOD OF THE ECONOMIC CRISIS
Puzyreva L.V., Mordyk A.V., Batishcheva T.L.
Abstract
Aim - to identify the main social and medical problems of a patient with tuberculosis (TB) and his family that are connected with the economic changes in the country. Materials and methods. We conducted a solid sociological study involving 200 new TB cases during hospital treatment. The analysis of the obtained data was performed. Results. Only one third of the patients were married, even fewer were officially employed. About half of the patients had unrecorded employment, which caused some problems. These patients showed decreased motivation for long-term hospital and sanatorium treatment, as they were afraid of losing their jobs. For the majority of the patients, their professional activity is associated or was associated with unfavourable factors. Some of the respondents blamed their employers for the onset of the disease. The main reason of dissatisfaction of the patients was carelessness of health workers. Furthermore, every third patient with tuberculosis demanded from the phthisiatrician to recognize a disability category in order to improve their financial situation. Conclusion. Changes in the labour legislation have caused the emergence of private organizations that do not comply with requirements for protection of employees, which can affect their health.
Science and Innovations in Medicine. 2017;2(2):52-55
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RADICAL LUNG RESECTION IN TREATMENT OF PULMONARY TUBERCULOSIS
Rogozhkin P.V., Borodulina E.A.
Abstract
Aim - to analyze afterhistory of TB patients who had radical lung resection. Methods of research. On the basis of the results of surgical treatment of 273 patients in 2010-2011, two groups were formed: the first group - patients who were deregistered due to their recovery; the second group -patients who had tuberculous process reactivated after surgery as recurrence or acute condition. Results. The effectiveness of tuberculosis surgical treatment in long-term period was proved in more than 90% of cases. Reactivation process started in 7.7% of cases, in patients who had multiple and extensive drug resistant MTB (53.3%), in patients who had destruction in the lung tissue (62%); in patients with fibrous-cavernous tuberculosis (33.3%), with comorbidity (52.4%), with complications in the early postoperative period (9.5%). Reactivation occurred more often in cases of wide surgical intervention, including cases with follow-up remedial thoracoplasty. If there are indications for surgical treatment, it is better to decide upon surgery within the first year of supervision.
Science and Innovations in Medicine. 2017;2(2):56-59
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INFLUENCE OF MEDICO-SOCIAL RISK FACTORS ON PSYCHOEMOTICAL STATE AND SELF-ESTEEM OF FEMALE PATIENTS OF REPRODUCTIVE AGE WITH TUBERCOLOSIS OF THE RESPIRATORY SYSTEM
Rusanovskaya G.F., Shprykov A.S., Pavlunin A.V.
Abstract
Aim - to study the influence of medical and social risk factors on the psychoemotional state and selfesteem of female patients of reproductive age with tuberculosis of the respiratory system. Material and methods. The main group consisted of 93 women aged 18-44 with tuberculosis of the respiratory system who received treatment in one of the anti-tuberculosis institutions of the Nizhny Novgorod region in 2013. The comparison group consisted of 82 almost healthy women of the corresponding age. To assess the psychoemotional state, we carried out a survey using the SAM test method (state of health, activity, mood); to evaluate personality traits - the test «Self-assessment of the personality» by O.I. Motkov. The questionnaire included additional questions of medical and social nature. Results. It was proven that the presence of unfavorable medical and social risk factors in this category of patients causes a decrease in self-evaluation of the positive aspects of the personality, and has a negative impact on the psychoemotional state of patients, causing poor health (lowest evaluated), low activity, bad mood. In the course of long-term treatment, women feel tired and exhausted. Among the medical and social risk factors that have adverse impact on the psychoemotional state and self-esteem of women, the following factors should be highlighted: low level of education, poor financial situation, lack of awareness about prophylaxis of tuberculosis, intense interpersonal relationships in the family, frequent exposure to stress and rueful feelings, irregularity of the prophylactic chest X-ray examinations, violation of the work-rest regime, dietary regimen and quality of nutrition, the history of tubercular contact and incarceration. Conclusion. The results of the research demonstrate the need for developing and implementation of measures of providing psychological assistance to the female patients of reproductive age with active tuberculosis of the respiratory system, as well as new approaches to the prevention of this disease, based on established psychological risk factors for the emergence of tuberculous process and its recurrence.
Science and Innovations in Medicine. 2017;2(2):60-65
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ACTUAL ISSUES OF PERSONNEL TRAINING ON TUBERCULOSIS ASSOCIATED WITH HIV INFECTION
Frolova O.P., Polesskiy V.A., Stakhanov V.A., Butylchenko O.V.
Abstract
During the period of registration of tuberculosis associated with HIV infection in Russia (since 1999), its morbidity rate has increased 82.2 times. Changes in pathogenesis of tuberculosis in condition of deep immunodeficiency in patients with HIV infection require improvement of approaches to the training of medical workers who provide anti-tuberculosis care. Aim - improving approaches to personnel training on TB care for people with HIV infection. Methods. Accounting forms 263y-TB "Personal records of patients with TB comorbid with HIV infection" (65,000 records) and reporting forms of Rosstat No. 61 "Data on the population of patients with HIV infection" were analyzed for the period of their validity in the Russian Federation. The study included statistical analysis of the general totality using a computer database, revision of individual records and interview with patients. conclusions. In order to improve the training of personnel on the issues of TB care in HIV infected patients, it is essential to bring the textbooks and regulatory documents in line with the current medical knowledge.
Science and Innovations in Medicine. 2017;2(2):66-70
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POST-RADIATION OSTEOMYELITIS OF THE STERNUM: CURRENT TREATMENT OPTIONS
Korymasov Е.A., Medvedchikov-Ardiya М.A.
Abstract
Background. Post-radiation sternal osteomyelitis is a late local complication of radiation therapy for chest cancer. Due to a chronic process and low reparative capacity, the conservative therapy of post-radiation osteomyelitis of the sternum is ineffective, and often there is a need for surgery. It is a two-step surgery that includes elimination of purulent inflammation followed by plastic reconstruction of the chest wall. Materials and methods. Two clinical observations of post-radiation osteomyelitis of the sternum were presented. The vacuum therapy was applied at the stage of controlling purulent inflammation in the chest wall. Result. The use of vacuum therapy had a positive effect on the rapid cleansing of the wound. Conclusion. Application of vacuum therapy is indicated at the first stage of treatment, after debridement and after plastic phase as an additional method of stabilization of the chest wall, and in case of postoperative infectious complications.
Science and Innovations in Medicine. 2017;2(2):71-74
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