Vol 23, No 3 (2015)

The article presents a rare clinical case of adenocarcinoma of the minor duodenal papilla at man - 51 years old. This was the first case in our practice since 2002 among the 310 pancreaticoduodenal complexes with varied pathologies studied. Histologically, the tumor is similar to pancreatic ductal adenocarcinoma and ampullar carcinoma (pancreatobiliary type). To avoid diagnostic errors of gross examination, it is highly important to follow the step-by-step algorithm of dissection.

The study showed that the head of the pancreas and duodenum receive arterial blood from the anterior and posterior of the pancreatic-duodenal arcs. Posterior arc gives to the intestine more branches than the anterior one. Its impotent during an operations when elements of the anterior arc were ligated. Also found that the inferior pancreatic artery, dorsal pancreatic artery, arteries are interchangeable. Both arteries in one complex were not found.

Content of ATP, ADP, of AMP and activity of isozyme systems LDH in the cranial cervical sympathetic ganglia (CSSG) rabbits was investigated with partial and complete deprivation of N-cholinergic (N-HE) synapses. Dynamics of activity of LDH and content of macroergs in deprivation N-HE synapses indicates that blockade of N-HE synapses results in sympathetic ganglia to significant energy shortages and disruption of energy homeostasis. It is assumed that changes in energy metabolism are the main cause CSSG hypofunction observed during pharmacological blockade by antagonists N-HE synapses.

The article presents an original method for determining belonging of drugs to the substrates of the transport protein P-glycoprotein (Pgp). This methodics is based on a comparison of the pharmacokinetic parameters of the test substrate before and after a course of administration of the inductor (rifampicin) and inhibitor (verapamil) of the transport protein. If the content of test substance in organism is reduced after Pgp inductor administration, and increased after the inhibitor administration, we conclude that this substance is Pgp substrate. For approbation of developed technique we examined by blind method the pharmacokinetics of fexofenadine - known Pgp substrate at a dose of 67,5 mg/kg, before and after the 14-days administration of rifampicin (40 mg/kg twice daily) and verapamil (a daily dose of 20 mg/kg three times a day). It was revealed that after a course administration of verapamil maximum concentration of fexofenadine, its area under the concentration-time curve and half-life were significantly increased, as well as the time of maximum concentration was decreased. In contrast, rifampicin course administration resulted in a decrease in the area under the curve concentration-time and an increase in total clearance of marker substrate of Pgp, wich proves the adequacy of methods.

The profound study of working conditions of doctors and average medical personnel made possible to conduct their hygienic estimation and find the degree of the influence of production process on the functional state of the organism of the workers in the dynamics of work shift and on the age aspect.

In the article the characteristic of a structure of arrangements about the formation of healthy lifestyle and prophylaxis of noninfectious diseases is given. The main content of complex purpose programs about prophylaxis of noninfectious diseases at a level of Russian Federation subjects is opened. The algorithm of forming healthy lifestyle is performed, and functional reserving of basic elements of medical prophylaxis as well.

The article presents the five-year dynamics of patients with rheumatic heart disease, changes in echocardiographic indicators, quality of life and the course of chronic heart failure. It was found that the negative dynamics of the echocardiography indicators does not lead to progression of heart failure and a significant deterioration in the quality of life of patients. Cases of a combination of type II diabetes, atrial fibrillation, severe mitral stenosis, left atrial dilation lead to an increased risk of death in patients with rheumatic heart disease.

The objective of the research is a comparison of laparoscopic and endoscopic methods of treatment of inguinal hernias. In the period from 2011 to 2012, 44 unilateral inguinal hernia repairs were performed till the IIIa stage according to the classification by L. Nayhus. 24 of these operations underwent a laparoscopic hernia repair method by (TAPP) - the first group, and 20 of them underwent an endoscopic method of hernia repair by (TEP) - the second group. All hernia repairs were performed by standards, using the same tools and mesh prosthesis (polypropylene mesh 15 x 15 cm). The duration of the operation was higher in the second group. The length of hospitalization did not differ. Pain syndrome was higher in the first group. Published experience in this study shows the advantage of the (TEP) method in the postoperative period for patients, which operated in relation to inguinal hernia till the IIIa stage.

Purpose of this open study was the evaluation of rhinosurgery effect on the course of obstructive apnea syndrome (OSA). 25 patients 25-60 years old with nasal obstruction and OSA were examined: neurologic, otorhynolaryngologic studies and cardiopulmonary monitoring were conducted before and 3-4 months after nasal surgery. 50% or more decline of sleep apnea index (SAI) was observed in 6 (24%) persons, in other 6 (24%) persons SAI has grown up 50% or more, no significant difference was shown in 13 patients (52%). No correlation of SAI shift after surgical treatment with physical, anamnestic and respiratory data were demonstrated. Nasal surgery leads to positive results referring to pharyngeal obstruction not more than in 24% of cases. Today we have no proved predictors of high nasal correction effect on the severity of OSA.

Qualitative & quantitative amino-acid composition of urological herbal tea “Uvaur” which includes manzanita leaves, tickseed, birch gemmae. 19 amino acids are determined in the herbal tea, 9 of which are indispensable. The total content of amino acids is 6,998%, in which 12,34% glutamic acid, 10,38% aspartic acids, 8,69% leucine.

The article presents the modern concept of the term "quality of life" and the methodology of his research with the help of general and specific questionnaires for patients with venous disease, including venous thrombosis. Analysis of the quality of life is essential to evaluate the effectiveness of treatment and in conjunction with objective data makes it possible to obtain comprehensive information about the influence of a drug or surgical treatment for the patient in a remote period.

The peculiarities of the course of mouth cavity diseases among elderly and old-aged people with account of gender differences are observed in the article. It is shown that the loss of tooth with the following functional changes heads the list of dental changes in elderly and old-aged patients. The estimation of this group of people’s requirement of orthopedic dental help is provided in the article.