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Vol 9, No 1 (2009)

Articles
High technologies in paediatric orthopaedics
Baindurashvili A.G.
Abstract
The Turner Scientific and Research Institute for Children's Orthopedics in Saint-Petersburg is the leading clinic in the Russian Federation for orthopaedics, traumatology and the rehabilitation of children with bone and joint diseases and injuries. The main area of research at the Institute is the scientifically based surgical treatment and rehabilitation of disabled children with congenital and acquired disorders of the locomotion system. The priorities of scientific interest and clinical investigations in Institute are high surgical, technologies in paediatric orthopaedics, including microsurgical technology in hand surgery, neurosurgical operations in neurologically disabled children, cellular technologies, early treatment of spinal deformities. Combination of traditions of Russian school of paediatric ortorthopaedics and contemporary technologies creates unique structure for best results of treatment.
Medical academic journal. 2009;9(1):3-10
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Interaction of neuronal and immune systems during stress
Gavrilov Y.V., Korneva E.A.
Abstract
The present work represents the review of literature resources concerning central mechanisms of neuroimmune interactions during stress as well as the results of experiments carried on by the authors. The mechanisms of development of stress-induced immune dysfunctions are being discussed.The afferent and efferent ways of neuro-immune interactions are being observed. The data of investigations of brain reactions, in particular hypothalamic structures, to administration of different antigens and their alteration by stress stimuli are demonstrated. The intensity of definite hypothalamic structures reactions to antigen injection after electric pain stimulation was shown to be decreased, their algorithm being changed and the quality of the changes depended on the nature of injected antigen (lipopolysaccharide or bovine serum albumin). Complex of cited data suggest that the revealed stress-induced alterations in brain reactions to antigen administration associated with the decrease in the quantity of splenic antibody-producing cells are significant for immunosupression development caused by electric pain stimulation.
Medical academic journal. 2009;9(1):11-27
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Role of muscarinic antagonist methacine metabolites in regulation of inflammation
Sapronoѵ N.S., Nezhinskaya G.I., Vladykin A.L.
Abstract
It is known, that synthetic muscarinic antagonists ipratropium bromide, trospium chloride, oxybutynin chloride form pharmacologically inactive metabolites and have slight side effects compared with muscarinic antagonists, which metabolites possess pharmacological activity. On the model of the quaternary muscarinic antagonist methacine we revealed that this drug undergoes hydrolysis at the ester bond to yield pharmacologically inactive 2-hydroxy-2,2-diphenylacetic acid and pharmacologically active muscarinic/nicotinic cholinoceptor agonist choline. Long-term course administration of methacine increases its antimuscarinic effects, connected with side effects extension. However single administration of methacine with cholinesterase inhibitor is an effective procedure to pathochemical stage of anaphylactic shock prevention. Methacine-induced immune response (non-neuronal effects) limits stress ulcer formation under water immersion stress influence. Obtained data may be significant for mechanism of new muscarinic antagonists action understanding and for scope evaluation of drug metabolites activity therapeutic application.
Medical academic journal. 2009;9(1):28-32
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Current views about reperfusion injury mechanism in infusion therapy of shock and methods its prevention
Remizova M.I.
Abstract
A review of the literature concerning the mechanism of the reperfusion injury in the infusion therapy of the haemorrhagic shock. On the bases of literature data and own investigations were shown that after restoration of circulation develops oxygen paradox, activates peroxidation, damages of cells membranes. The biochemical mechanism of the reperfusion injure was described. Antihypoxants, antioxidants, inhibitors of xanthineoxidase-catalyzed production of superoxide radical, inhibitors of nitric oxide synthesis are effective for treatment of the reperfusion injury in the infusion therapy of the haemorrhagic shock.
Medical academic journal. 2009;9(1):33-42
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An acute cholecystitis - modern surgical problem
Maystrenko N.A., Kurygin A.A., Sheyko S.B., Azimov F.H.
Abstract
In this article considered an acute cholecystitis problem based on treatment experience of 683 patients treated in faculty surgery clinic by the name of S. P. Fedorov MMA. The treatment tactics based on verification of basic disease and its complications, and also on complex patients estimation. The surgical tactics suppose strictly well-founded realization of urgent and deferred radical operations in 82,1% patients and palliative diapevtic operations - in 4,7% instances, that allow to decrease common and postoperative lethality down to 0,44% and 0,53%, accordingly. Presented clinico-pathogenetical and an operative interventions classifications are provide standartization of diagnostic algorithm and therapeutic approach.
Medical academic journal. 2009;9(1):43-49
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Surgery of branches of arcus aorta
Dudanov I.P., Subbotina N.S., Stafeeva I.V., Kaputin M.Y., Abuasab B.S., Orlova R.I., Soboleva N.G., Platonov S.A.
Abstract
Reconstructive surgery of brachiocefal arteries took the durable place in clinical angiologies as method of treatment of ischemic damages of cerebral circulation. In the article the methods of surgical reconstruction of cerebral circulation were considered at the combined stenosis lesions of branches of arcus aorta. For period from 1995 to 2008 in the surgical department of Petrozavodsk Emergency Hospital and also department of ambulatory surgery of Karelian Scientific Medical Center North- West Department of RAMS surgical treatment of patients was organized with damages of cerebral circulation, where more than 1300 patients were examined over the years (1175 is operated patients which 1227 reconstructive operations were realized on the branches of arcus aorta; 915 men and 312 women, middle age of patients-64,7+13,7). At combined stenosis of a few arteries of statement to the reconstructive operation and queue of reconstruction of road clearance of arteries to the present tense in detail not examine and determined by professional preparation of surgeon. The further study of prevalence and correlation of different types of occlusion lesions of main arteries of brain is needed, natural flow of occlusion process and his prognosis, study of cerebral hemodynamics by the modern methods of checkup and careful evaluation of efficiency of postoperative period for specification of statement to surgical treatment.
Medical academic journal. 2009;9(1):50-58
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Cardiovascular problems in rheumatology
Mazurov V.I., Stolov S.V., Vorobyeva O.A., Dolgikh S.V., Martynov І.V., Pobyegai O.V.
Abstract
The article deals with the actual problems of cardiovascular lesions in rheumatologic diseases. We describe the characteristic features of cardiovascular pathology in patients with rheumatoid arthritis, systemic lupus erythematosus, etc. An assessment of the effect of actual and basic therapy on the course of rheumatologic diseases is presented.
Medical academic journal. 2009;9(1):59-65
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Perinatal infections: algorithms of diagnostics and treatment
Savicheva A.M.
Abstract
The article reviews some major problems of diagnosis and treatment of perinatal infections and discusses possible ways of solving them. It is emphasized that there is a demand for standardized approaches to management of pregnant women with infections imposing a risk of adverse effects on the fetus or newborn infant by means of development and implementation of national guidelines on management of perinatal infections.
Medical academic journal. 2009;9(1):66-71
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Perinatal infection caused by group B streptococcus (Streptococcus agalactie)
Totolian A.A.
Abstract
Aim. The matter of presented paper addressed to medical workers with aim to give them modern information on the role of group В streptococcal (GBS) strains in pathology of pregnancy and in perinatal diseases. Basic contents. The review is given on present scientific literature and health care experience concerning leading role of GBS in pathology of pregnancy and newborns. Information is described on the mechanism of GBS carryership, their distribution in genital ways of women and men, ability to cause severe invasive neonatal diseases with high lethality and influence on development of embryo. It is obvious that infection diseases caused by GBS should be considered as infection transmitted through sexual contacts. The high expedience of prophylactic measures was underlined with the aim to diminish the indexes of perinatal morbidity and mortality. Some molecular and genetic subjects on GBS diagnostics and recombinant vaccine construction are discussed. Conclusion. The development of recommendations for prophylactic measures and national regulation scheme against GBS perinatal diseases was grounded.
Medical academic journal. 2009;9(1):72-80
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Opportunities of the estimation of the state of the fetus ising the method of the fetal cardiac signal extraction and analysis
Roshchevsky M.P., Kolomeyets N.L., Kuzivanova A.S., Lebedeva O.N., Murashko M.A., Roshchevskaya I.M.
Abstract
The character of the cardioelectric potential distribution is the diagnostic indication of the cardiovascular system state. Signals recorded from maternal abdomen besides the useful component - the fetal electrocardiogram - also contain artefacts; the maternal electrocardiogram, mother's muscles activity or artifacts resulting from fetal movements. Essential problem is the efficient suppression of maternal electrocardiogram, since its amplitude many times exceeds the level of the useful signal and the frequency bands of maternal and fetal electrocardiographic signals overlapped. A computational scheme is represented for the fetal electrocardiographic mapping. This experience will allow us to come up with a system for effective diagnostics of early symptoms of fetal distress on the basis of recording and analysis of the bioelectrical signals recorded only from the abdomen.
Medical academic journal. 2009;9(1):81-86
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Ekologo-epidemic aspects of the centre tick-borne encephalitis in Republic Komi and preventive maintenance questions
Glushkova L.I.
Abstract
The epidemiological situation on disease virus tick-borne encephalitis in the Russian Federation continues to remain strained, the area of distribution of this infection extends. In the present research by authors an object in view to study ekologo- epidemiological aspects of the centre virus tick-borne encephalitis in republic Komi, efficiency of spent preventive actions and to plan directions of the further interdepartmental preventive actions.
Medical academic journal. 2009;9(1):87-91
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Experience of surgical treatment of cerebrovascular diseases in the Komi Republic
Smyslov A.N., Epifanov D.E., Kuznetsov A.V.
Abstract
According to the latest WHO recommendations, it is considered that ischemic brain lesions due to obliterating lesions of aortic arch branches constitute 85% of all cerebrovascular pathology. The recent advancements in diagnostics and active surgical treatment of cerebrovascular diseases (CVD) allow solving this problem on a new level, in the past three years, we have performed operations in 161 patients. The number of operations on brachiocephalic arteries, the percentage of complications and lethality in the Komi Republic are comparable to those in neighboring regions.
Medical academic journal. 2009;9(1):92-94
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Coronary shunting on working heart
Epiphanov D.E., Kuznecov A.V.
Abstract
From 2006 for 2008 in branch of vascular surgery of Komi of a republican cardiological clinic 569 operations of coronary shunting are executed at an ischemic heart trouble. From them 389 operations are executed on working heart without application of the device of artificial blood circulation that has made 68,3% from total of the operated patients.
Medical academic journal. 2009;9(1):95-97
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Our experience transcatheter corrections of congenital heart diseases
Korotkov D.A., Kuznecov A.Ѵ.
Abstract
Development of medical technologies has led to occurrence of the devices, allowing to carry out transcatheter correction of congenital heart diseases. With 06.2005 on 11.2008 transcatheter correction of congenital heart diseases it is executed 164 patients at the age from 2 years till 64 years. In the remote period at 1,2% of patients after transcatheter corrections presence significant is left-right interatrial the shunt is revealed. In other cases the full reduction.
Medical academic journal. 2009;9(1):98-100
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Vulnerable atherosclerotic plaques
Naumova E.J., Naumov E.S.
Abstract
The initial pathogenesis moment in development of an acute sharp coronary thrombosis is break, so-called vulnerable atherosclerotic plaque. The combination of an inflammation, distraction a collagenic skeleton, refind tire covers plaque and a spasm of arteries leads to break of a surface plaque therefore process thrombogenesis is started, leading development of a heart attack of a myocardium.
Medical academic journal. 2009;9(1):101-105
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Arterial hypertensia and pregnancy, influence on outcomes of sorts
Misheneva E.A., Karpenko A.P., Ilyinych E.L., Gatin A.P.
Abstract
The arterial hypertension of pregnant women takes a special place among pressing questions modern medicine. We analyse outcomes pregnancy 223 women with an arterial hypertensia and the hypertensive illness, passing inspection in a cardiological clinic in various terms of pregnancy. Following outcomes were analyzed: perinatal destruction of a fruit, gestosis, a delay of pre-natal development, premature birth, a fruit pathology.
Medical academic journal. 2009;9(1):106-111
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Characteristic features of the clinical course of ischemic heart disease in women with osteoporosis
Mazurov V.I., Matveeva L.P., Dolgih S.V.
Abstract
In this review the given researches, devoted to features of coronary heart disease at women with an osteoporosis are presented. The data of densitometry, an echocardiography, daily monitoring of an electrocardiogram, biochemical markers of formation of a bone fabric and resorbtion is estimated. Also influence bisphosphonates on current osteoprose and coronary heart disease is analysed.
Medical academic journal. 2009;9(1):112-117
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Morphological characteristics of lesions of the lowerextremity arteries in diabetes mellitus patients in Russia
Kaputin M.Y., Ovcharenko D.V., Platonov S.A., Dudanov I.P.
Abstract
Endovascular techniques are widely used in many countries to treat peripheral artery lesions in diabetes mellitus patients suffering from neuroischemic foot ulcers and foot gangrene. However, the most comprehensive studies on this issue were carried out in Italy, where the incidence of peripheral atherosclerosis-is relatively low. In order to be able to apply the Italian findings in Russia, we have studied the morphology of lesions of the lower-extremity arteries in the Russian population of diabetes mellitus patients, and have compared our observations to the Italian data. Our study has revealed a greater severity of lesions of the lower-extremity arteries in the Russian population of diabetes mellitus patients. This, in addition to the often inadequate postoperative care, explains the higher incidence of recurrent critical ischemia of the lower extremities in the Russian patients.
Medical academic journal. 2009;9(1):118-120
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