Vol 7, No 4 (2015)

It was revealed that in development of a coronary atherosclerosis, participate the immune-mediated mechanisms. In blood of patients with coronary atherosclerosis the maintenance of the basic classes cytokines (IL-1 β, IL-2, IL-6, IL-8, TNF-a) were increased. Development of acute coronary insufficiency is accompanied by additional increase of levels of the data cytokines. The accessory of the cytokine activity to a coronary atherosclerosis was confirmed at studying the maintenance mRNA cytokines in a vascular wall. Thus in a zone atheromatous (aorta) it was synthesized mainly mRNA IL-2, while in a zone lipomatosis (a beam radial artery) it is formed nonspecific immune reaction with development of the mRNA IL-1 and IL-6. For patients with rheumatoid arthritis typically more active defeat of a coronary arteries, in comparison with healthy persons. Chronic immune-mediated process in frameworks of the autoimmune pathology can serve a trigger for accelerated development ischemic heart disease. The General immune-inflammatory mechanisms which participate in pathogenesis of the ischemic heart disease and rheumatoid arthritis, allow to spend the certain parallels between atherosclerotic process and autoimmune pathology.

The results of dental examination 1000 people (370 men and 630 women) aged 40 to 89 years, who were divided into three groups: middle age - from 40 to 59 years; Seniors - from 60 to 74 years; senile - from 75 to 89 years. They have assessed the prevalence of diseases of the temporomandibular joint and masticatory muscles studied symptoms and the intensity of the flow of these diseases. Based on the clinical data improved methods for evaluating the degree of severity of the disease and the effectiveness of treatment of temporomandibular joint and masticatory muscles, methods of registration of sound phenomena in the pathology of the temporomandibular joint, and developed techniques to identify groups at risk among adults in relation to the studied pathology.

Under our observation were 71 patients with a spastic diplegia in the age of 3-16 years. Patients are parted on 2 groups. The first group have made 38 children received a treatment complex with application of a functional programmed electrical stimulation on apparatus «ACorD», the second - 33 children received a complex of treatment with application of an electrostimulator «Miorithm-040». Electrical stimulations in both groups of patients were exposed the weakened muscles of legs and a back. Both groups of patients received paraffinic applications, manual massage, a specialized complex of medical physical training, employment in a corrective suit «Adeli». Before and after a complex of procedures function of walking by a technique of research children's orthopedic institute was investigated. At observable patients after application of a rehabilitational complex with including various kinds of a muscle electrical stimulation improvement of gait parameters is noted. Authentically best results are received at application of a rehabilitational complex with including a functional programmed electrical stimulation of muscles.

The article provides an analysis of the use of immunoassay methods, high performance liquid chromatography and gas chromatography-mass spectrometry in the differential diagnosis of adrenal incidentalomas. Criteria of subclinical Cushing’s syndrome, primary hyperaldosteronism, adrenal incidentalomas without hypersecretion of hormons, early signs of malignant tumors of the adrenal glands are obtained.

Platelets activation and aggregation play an important role in the pathogenesis of atherothrombotic disease and its most important complications such as coronary artery disease and myocardial infarction. In clinical practice it is well-known that, in spite of the documented presence of advanced atherothrombotic disease, only a subset of patients develops acute myocardial infarction during their life-course. The reasons for individual differences in susceptibility to MI are poorly understood. Subjects with hypercoagulability and an increased tendency to form blood clots may be at increased risk. However, this is difficult to assess in clinical practice, since we lack a unique and reliable laboratory marker of hypercoagulability. Moreover, functional tests evaluating concentration and function of blood coagulation proteins are often subjected to multiple transient interferences, e.g. due to the use of antithrombotic and anticoagulant agents or the presence of concomitant inflammation. Genetic polymorphisms with a documented functional effect on blood coagulation proteins may represent a useful diagnostic and prognostic tool. During the last decade the study of polymorphisms as a risk factor for coronary artery disease and myocardial infarction were given largely convincing results. It demonstrated that gene polymorphisms of hemostasis and especially their combined effects are a risk factor for coronary heart disease and its major thrombotic complication - myocardial infarction. Hemostasis as a complex phenomenon modulated by the interaction of multiple genetic factors that do not have predominant action. Polygenic approach as a tool to identify subject at increased risk of developing complications suggests that the simultaneous presence of multiple genetic variations with a weak but significant effect on the process of hemostasis can affect the risk of serious thrombotic complications and that the number of prothrombotic alleles correlates with the risk of myocardial infarction in patients with advanced atherothrombotic disease.

In view of the increasing demands from stakeholders (patients, management, insurance companies, media, etc.) to ensure the quality of health care and the implementation of the program of state guarantees in the current difficult conditions of increasing importance is the efficient and performance management of medical organisation (MO). As part of these requirements has been widely discussed question of the necessity of building a system of quality management MO. Practical experience shows that building a systematic approach to quality management depends primarily on the availability of managerial competencies for managers and heads of departments MO, as well as their level of motivation, or resistance to organizational change. One of the tested and proved to be a reliable tool in the management of the quality of medical practice is a process approach. With this management tool, it is possible to present the activities of MO as a chain of interrelated processes. It defines the criteria for the quality of the product, the necessary resource and regulatory support, introduces the institute of internal and external customer, which ultimately has a positive effect on the performance indicators and efficiency MO.

The article presents its own clinical observation of the аssociation of neurotropic herpes viruses with demyelinating process in the central nervous system. An in-depth immunological and immunogenetic examination is carried out as an etiologic and pathogenetic diagnosis.