Vol 31, No 3 (2014)

Articles
CLINICAL CHARACTERIZATION AND PECULIARITIES OF HEMODYNAMICS AMONG EARLY AGE CHILDREN WITH PREOPERATIVE INTERVENTRICULAR SEPTUM DEFECT
Khabibullina A.R.
Abstract
Aim. To study the perinatal risk factors, somatic status, hemodynamic changes in early age children with congenital heart disease, interventricular septum defect, for the purpose of determining preoperative tactics. Materials and methods. 130 children of early age were examined using anamnestic, clinical and instrumental techniques. The main group included 80 children with congenital heart disease, the control group - 50 children without heart disease. Results. It was revealed while studying obstetric and gynecological anamnesis of children with interventricular septum defect that 71,9% of pregnancies had pathological course. Analysis of concomitant pathology detected that the most frequent pathology in children of the main group was perinatal damage of central nervous system (50%), then followed anemic syndrome (25,5%) and rickets (22,7%). These children more often had neuropsychical anomalies and belonged to the groups with developmental lagging by 1 and more epicrisis periods (<0,001). There was hypertrophy of the vetntricle: the left in 4,3% of cases, the right - 30,4% or both - 2,2%. Significant increase in end-diastolic and end-systolic volume of the left ventricle and growth of the left auricular size was found. Conclusions. In the preoperative period, it is necessary to create individual programs for careful preparation regarding anemia, rickets, micronutrient deficiency and changes in central nervous system.
Perm Medical Journal. 2014;31(3):6-12
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APPLICATION OF 1% METHYLENE BLUE IN COMPLEX WITH HEPARIN IN REVASCULARIZATION OF TRAUMATICALLY AMPUTATED HAND FINGER
Ibragimov R.K., Timerbulatov M.V., Galimov T.R., Kazbulatov S.S.
Abstract
Aim. To increase the efficiency of hand finger replantation during its restoration in patients with traumatic amputations by means of superficial treatment of microvascular anastomosis using 1% methylene blue in complex with heparin. Materials and methods. The results of complex treatment of 62 patients with traumatic amputations of extremity segments are presented in the paper. Patients of the main group (30 patients) underwent replantation including treatment of microvascular anastomosis with 1% methylene blue and heparin. The results were estimated using standard clinicolaboratory studies as well as arterial and venous US. Results. Clinical analysis of the main group of patients showed decrease in the number of microvascular anastomosis thromboses of replanted extremity segments from 43,75% to 23,33% ( p <0,05), increase in the number of satisfactory results of hand finger replantations from 56,25 % to 76,67% ( p <0.05) and shortening of hospitalization period from 29,12±4,11 to 26,21±3,78 bed-days ( F =1,1, p =0,04). Conclusions. Treatment of microvascular anastomosis with 1% methylene blue and heparin during finger replantation contributes to decline in risk of development of microvascular anastomosis thrombosis by 20,42% ( p <0,05), allows to reduce the terms of hospitalization period by 9,99% ( p <0,05) and can be an alternative technique for prevention of microvascular anastomosis thrombosis development in patients with replanted extremities in the early postoperative period.
Perm Medical Journal. 2014;31(3):13-16
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SURGICAL APPROACH TO TREATMENT OF PEDIATRIC DOLICHOMEGACOLON
Saidov F.K.
Abstract
Aim. To determine the volume of surgical intervention in pediatric dolichomegacolon depending of the damaged part of the colon. Materials and methods. The results of examination and treatment of 24 children at the age of 2 to 14 years who were treated for dolichomegacolon from 2006 till now are presented in the paper. There were 15 (62,5%) boys and 9 (37,5%) girls. All children were admitted to the hospital with the symptoms of acute abdomen: acute appendicitis, acute intestinal obstruction, abdominal pain syndrome. Examination was carried out by the accepted clinical standards. Results. Ten (41,7%) children were operated using the technique of length, colon position correction, 14 (58,3%) - the technique of subfascial resection of the distal part of the colon including rectum. Six months later, 2 (20%) patients operated with the technique of length, colon position correction had resumed constipations that was considered as an unsatisfactory result. Twelve months later, 1 (7,1%) patient had stenosis of the zone of colonic anastomosis with constipation relapse that was also regarded as an unsatisfactory result. Conclusions. In patients with dolichomegacolon accompanied by dysplasia of colonic wall nervous apparatus, surgical technique of length, position correction is not always effective. Remission preserving for the first 6 months after the surgery is associated mainly with resection of decompensated parts and temporary efficient propulsion of the above lying colonic parts, of the remaining distal part of sigma and rectum involved into the process and having dystrophic changes in the wall that is the reason of frequent constipation relapses.
Perm Medical Journal. 2014;31(3):17-22
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PATHOLOGICAL CLIMACTERIC COURSE PREDICTORS
Sandakova E.A., Elkin V.D., Kobernik M.Y.
Abstract
Aim. To determine the predictors of pathological climacteric course. Materials and methods. 122 women in the early menopause were examined: group 1 - 62 women with pathological climacteric course (mean age 51,4±1,1years); group 2 - 60 women with physiological climacteric course (mean age 51±1,5 years). Menopausal index (in scores) proposed by Kupperman et al. (1959) and modified by E. V. Uvarova served as a group division criterion. The groups were comparable by their social status. The exclusion criteria were serious extragenital pathology, severe degree of pathological menopause, oncological diseases, smoking and alcohol abuse. Results. Analysis of the level of education and character of professional activity, harmful factors and habits in women with pathological and physiological menopause resulted in no reliable differences revealed. Family status was different in the studied groups: most women with pathological climacteric were unmarried: divorced, widows, never married; women with physiological climacteric were predominantly married. Peculiar features of obstetric anamnesis did not influence the character of climacteric course. Reliable differences between the groups concerning ovarian pathology and menstrual disorders were found: both signs more often occurred in women with pathological climacteric course. In women with physiological and pathological course of crimax, significant differences in relation to GIT diseases and thyroid pathology were detected. In case of pathological climax, GIT diseases were revealed 1,5 times more often ( p <0,05), reduction in thyroid function - 3,5 times more often. Pathological climax was characterized predominantly by excess body mass (BMI 25-30), physiological climax - by normal body mass (BMI 20-25). Conclusions. Unmarried status, menstrual disorders, ovarian pathology in anamnesis, GIT diseases, latent and clinical hypothyroidism, excess body mass are significant for formation of climacteric and are predictors of its pathological course. Educational level, peculiarities of professional activity, occupational hazard, bad habits, number of pregnancies, hormonal contraception do not influence the character of climacteric course.
Perm Medical Journal. 2014;31(3):23-28
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SOME PATHOMORPHOLOGICAL PECULIARITIES OF UTERUSES REMOVED FOR MASSIVE OBSTETRIC HEMORRHAGES
Semenova M.V., Talabadze A.S.
Abstract
Aim. To detect the most significant factors for development of obstetric hemorrhages taking into account morphological changes in reproductive organs of patients of this group. Materials and methods. Retrospective analysis of 108 histories of deliveries complicated by massive hemorrhages as well as protocols of histological studies of surgical material according to the data of medical institutions of Udmurt Republic for 2010-2012 is presented in the paper. Group I involved 48 delivery histories with placental presentation and chorion villi ingrowth (44,5%), group II - 60 histories of deliveries complicated by uterine hypotonia (55,5%). Results. Women’s anamnesis in both groups had indications to high delivery parity (the current pregnancy is the third and more in 80% of women in both groups), intrauterine interventions (curettage of uterine cavity for spontaneous, artificial abortions) - 61,3% of women in group I and 57,4% in group II, presence of small pelvic inflammatory diseases, disturbed menstrual function by algodismenorrhea and menorrhagia types. The results of histological study showed presence of morphological signs of chronic inflammatory processes in the uterus and appendages. Conclusions. Endometrial alteration (consequences of multiple intrauterine interventions) associated with subacute inflammatory processes in small pelviс organs as well as dysharmonal disturbances and adenomyosis can be considered as the possible risk factors for chorion villi ingrowth and development of obstetric hemorrhages during placental and puerperal periods.
Perm Medical Journal. 2014;31(3):29-32
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ROLE AND PLACE OF MODERN TECHNOLOGIES IN DIAGNOSIS AND TREATMENT OF ACUTE APPENDICITIS IN PREGNANT WOMEN
Khasanov A.G., Yanbarisova E.V., Badretdinova F.F., Musina V.V.
Abstract
Aim. To improve the results of treatment of patients with acute appendicitis by means of optimization of therapeutic and diagnostic tactics based on use of ulrasonographic and videolaparoscopic technologies. Materials and methods. Among 1190 patients hospitalized for acute appendicitis, 67 (5,3%) women had pregnancy. During clinicolaboratory study and dynamic observation, appendicitis was not confirmed in 27 of them. Out of 53 pregnant women who underwent preoperative sonographic study, reliable and indirect signs of acute appendicitis were detected in 40 (75,8%) women, 4 were diagnosed abdominal pregnancy. Indirect symptoms of acute appendicitis were observed in 8 (15,1%) patients. According to the results of our study, US sensitivity was 75,8%, specificity - 97,7%, precision - 92,1%; ten pregnant women experienced diagnostic laparoscopy. We managed to visualize the vermiform appendix in 8 (80%) and to determine the absolute signs of inflammation in 6 women. Results. Forty of them were operated - in 34cases using Volkovich-Diakonov traditional access and in 6 cases - laparoscopic appendectomy in the first half of pregnancy. The postoperative complications in the form of infection in the region of operative intervention were observed in 4 (11,6%) women after traditional appendectomy, no complications were noted after laparoscopy. Conclusions. Successive use of ultrasonic and laparoscopic technologies permits to diagnose acute appendicitis and operate pregnant women in proper time and to decrease percent of unnecessary surgeries in case of diseases simulatimg acute appendicitis.
Perm Medical Journal. 2014;31(3):33-38
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BRAIN MAGNETORESONANCE MORPHOMETRY IN PATIENTS WITH POSTINSULT COGNITIVE DISORDERS
Kulesh A.A., Drobakha V.E., Shestakov V.V.
Abstract
Aim. To assess the correlation between some indices of brain magnetoresonance morphometry, neurological, cognitive status and sleep quality in patients with ischemic stroke. Materials and methods. 29 patients aged 48-76 (10 men and 19 women) were examined in the acute period of stroke. Neuropsychological examination included Mini-mental State Examination (MMSE), Frontal Assessment Battery (FAB), Montreal Cognitive Assessment (MoCA), Watch Drawing Test (WDT), Words Test (5) (WT5), Schulte Table (ST) and Categoric Verbal Fluency Test (VF); sleep quality was assessed using Pittsburg Sleep Quality Index (PSQI). Margetoresonance (MR) tomography of the brain was performed; the following MR-morphometric indices were studied: brain volume ( V b), brain ventricular volume ( V v), brain volume to ventricular volume ratio (V b/ V v), leukoareosis square ( S l), infarction focus square ( S f), and hippocampus volume ( V h). Results. The results of correlation analysis of MR-morphometric indices, cognitive tests and sleep quality were received; the role of each index was estimated, morphometric differences between patients with disregulatory, disregulatory-dismnestic and dismnestic variant of cognitive disorders were studied. Conclusions. V v and V b/ V v are connected with global cognitive status and state of most cognitive spheres. Patients with disregulatory type of the postinsult cognitive disorders are characterized by the highest V v unlike patients with dismnestic variant. V f is connected with cognitive activity status as a whole, its executive component and sleep quality. V h is not associated with memory indices, but is associated with global cognitive status and regulatory-dynamic domen state. It is worthwhile to develop a complex of MR-morphometric indices which could have serve as an instrument for differential diagnosis of the postinsult cognitive disorders.
Perm Medical Journal. 2014;31(3):39-45
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DYNAMICS OF COGNITIVE FUNCTIONS AND PSYCHOLOGICAL STATUS AMONG PATIENTS IN ISCHEMIC INSULT ACUTE PERIOD AGAINST THE BACKGROUND OF COMPLEX TREATMENT
Shinkorenko O.V.
Abstract
Aim. To assess the efficiency of complex rehabilitation including transcranial magnetic stimulation of patients with ischemic insult in the acute period. Materials and methods. The effect of transcranial magnetic stimulation on the ischemic focus, opposite hemisphere and left frontal region was studied in patients. In accordance with group distribution, patient underwent placebo procedure of transcranial magnetic stimulation and low-intensive magnetotherapy. Efficiency was assessed by neurological status, branchiocephalic vascular duplex scanning indices, MMSE scale, Images Memory Test and Numbers Memory Test; psychological status was estimated using Hospital Anxiety and Depression Scale (HADS). Results. Studying of cognitive functions by MMSE test data detected mild degree dementia before treatment in both main and comparison groups. By the end of therapeutic course, significant improvement of cognitive indices by MMSE scale was established. Analysis of neuropsychical test using Images Memory Test and Numbers Memory Test showed efficiency of rehabilitation in the studied groups. After the course of treatment was finished, reliable decrease in the level of anxiety and depression among patients of the main group to 9,4±1,1 scores (χ 2>3,8) by anxiety scale and 12,3±0,7 scores (χ 2>3,8) by depression scale was noted. Conclusions. Transcranial magnetic stimulation included into complex rehabilitation improves psychoemotional status, lowers cognitive disturbance level, normalizes cerebral hemodynamics.
Perm Medical Journal. 2014;31(3):46-52
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QUANTITATIVE ELECTROENCEPHALOGRAPHY INDICES DYNAMICS IN CHILDREN WITH SPEECH DISORDERS in the course of PROSPECTICE STUDY
Savelieva N.A., Kalashnikova T.P., Anisimov G.V., Kravtsov Y.I., Gershanok N.V.
Abstract
Speech occupies a special place in formation of cognitive functions. Delay in tempos of speech development can lead to disorders in formation of the highest mental functions. Aim. To study the character of space-time integration of cerebral zones in children with different variants of speech disontogenesis in the course of prospective study by the data of ECG coherent analysis. Materials and methods. 34 children aged 3-11 years were examined by means of quantitative ECG mapping and estimation of mean coherence indices. All children were divided into two groups: group I included children with dysarthria, group II - children with motor dysphasia of development. In each group there were two age subgroups. The first subgroup involved children aged 3-6 years, the second- children aged 7-11 years. Results. It was demonstrated that in process of ontogenesis, different space-time integration models of cerebral zones which determine different clinical pictures of speech dysfunctions were formed. High mean coherence values in preschool children’s left frontotemporal and frontocentral pairs are a positive factor for development of speech in process of ontogenesis. Conclusions. The obtained data give an opportunity to assess the adequacy of therapeutic and correcting measures in age dynamics.
Perm Medical Journal. 2014;31(3):52-58
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CHARACTERIZATION OF BIOLOGICAL PROPERTIES OF NOSOCOMIAL PSEUDOMONAS AERUGINOSA STRAINS
Kuznetsova M.V.
Abstract
Aim. To assess the biological properties of P.aeruginosa strains depending on profilization of hospital and the studied clinical material. Materials and methods. 143 P. aeruginosa strains isolated from patients of large surgical hospitals of the city of Perm and 20 strains of polyclinic patients were studied. Hemolytic and phospholipase activity was determined in all the cultures. Pyocyanine and pyoverdin production was assessed using spectrophotometric method according to Deziel E. et al (2001). Results. Phenotypic patterns of Pseudomonas aeruginosa population did not differ at the units of different profiles of surgical hospitals. Qualitative comparative analysis permitted to detect a weak reliable correlation between presence of phospholipase and “pulmonary” origin of the isolate (φ=0,285; p =0,0006) as well as between pyocyanine production and culture excretion from the wound (φ=0,2374; p =0,00470). When carrying out quantitative estimation of the level of pigment production, statistically significant difference between their synthesis with nosocomial and out-of-hospital isolates ( U -test, p <0,001) as well as its absence, depending on the excreted material ( p <0,05) was shown. Conclusions. It may be assumed that patients hospitalized to Resuscitation and Intensive Therapy Units become the reason for propagation of high-virulent strains when being transferred to the other units of medical institutions. Probably, the studied characters are the dominant ones and are met in the overwhelming majority of natural P. aeruginosa strains, but their manifestation at the level of modification variability depends on environmental conditions that is expressed by phenotypic heterogeneity of P. aeruginosa bacillus.
Perm Medical Journal. 2014;31(3):59-64
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COMPARATIVE HYGIENIC CHARACTERISTIC OF MODERN SALT-THERAPY METHODS
Ryazanova E.A., Barannikov V.G., Kirichenko L.V., Dementiev S.V., Varankina S.A., Khokhryakova V.P.
Abstract
Aim. To present the hygienic assessment of the existing methods of salt-therapy. Materials and methods. The data of hygienic studies carried out in the salt sylvinite ward and halocamera were analyzed. Their therapeutic factors were assessed. Results. Salt sylvinite unit has a complex of physical factors positively influencing a human body. Only Sodium chloride aerosol is the basic parameter of halotherapy. Conclusions. The performed comparative characterization of the basic methods of salt-therapy detected the advantages of sylvinite therapy and its perspective use at medical institutions of different profile.
Perm Medical Journal. 2014;31(3):65-69
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EXPRESSIVENESS ASSESSMENT OF BLOOD CELL PHAGOCYTIC REACTION IN CHICKENS-BROILERS
Khlyzova L.A., Shavshukova O.A., Chetvertnykh V.A., Vinogradov A.B., Maslov Y.N.
Abstract
Aim. To study the phagocytic reaction indices in chickens-broilers of different age groups in case of organ and tissue contamination with opportunistic pathogenic microorganisms (OPM). Materials and methods. The object of the study - 210 chickens-broilers at the age of 1 day, 1, 2, 3, 4, 5, 6 weeks, which were kept in conditions of battery farm “Permskaya”. Chickens were divided into 3 groups: group I - clinically healthy, group II - without any clinical signs of disease, but OPM infected, group III - weakened poultry with massive OPM sowing from the internal organs. Presence of OPM and their organs and tissues was assessed with generally accepted microbiological methods. Phagocytic activity of blood pseudoeosinophiles and monocytes in relation to gram-positive test-microbe St. aureus was studied. Phagocytosis percent (PP), phagocytic number (PN), phagocytic index (PI) and phagocytic activity index (PAI) were determined. Results. In healthy chickens, high PAI level at early terms of their life was detected. Beginning from the second week and till the end of their growing, all blood cell phagocytic activity indices were reliably increasing. Continuous, stable, but less high growth of these indices in all age groups was observed also in clinically healthy, but OPM infected birds. Sick chickens had sharp fluctuations in PP, PI, PN and PAI during all the observed period that proves the reduced functional activity of phagocytes with regard to inactivation of microorganisms. Conclusions. High level of blood cell absorbing activity associated with growth of the share of “true” phagocytes in the group of healthy chickens-broilers shows strengthened with age ability of the body to eliminate antigens, particularly, opportunistic pathogenic ones. Growing with age, but lower ability of blood cells to phagocytosis is noted in the group of clinically healthy, but OPM infected poultry. One of the main reasons for development of generalized infectious process in sick poultry is an essential disturbance of natural resistance of the body revealed already in the first days of their life (by phagocytic reaction data)
Perm Medical Journal. 2014;31(3):70-74
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ASSESSMENT OF ANTIBACTERIAL EFFICIENCY OF DISINFECTANTS AND ANTISEPTICS RECEIVED BY TREATMENT-AND-PROPHYLACTIC INSTITUTIONS
Klyukina T.V., Sergevnin V.I., Volkova E.O., Reshetnikova N.I.
Abstract
Aim. To assess the antibacterial efficiency of disinfectants and antiseptics received by treatment-and-prophylactic institutions. Materials and methods. Bactericidal activity of 30 disinfectants and 31 antiseptics received by treatment-and-prophylactic institutions were assessed. V. V. Shkarin et al. method (2008) was applied; E.coli №1257 and S.aureus № 906 were used as test-strains. Results. Of thirty tested in relation to bacteria disinfectants, three ones appeared to be ineffective including one which contained quarternary-ammonium compounds and two - oxygen. Besides, there were revealed 9 disinfectants (30,0%) with incomplete bactericidal activity. Out of thirty one tested antiseptics, one drug (3,2%) did not correspond to the claimed activity. It was a water antiseptic containing quarternary-ammonium compounds and amine. Conclusions. From among the studied disinfectants and antiseptics received by treatment-and-prophylactic institutions, 10,0% and 3,2% of drugs (respectively) did not correspond to the claimed antibacterial effect, 30,0% of disinfectants were characterized by incomplete bactericidal effect.
Perm Medical Journal. 2014;31(3):75-78
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SOME PSYCHOLOGICAL ASPECTS OF MISCARRIAGE AND STERILITY
Nabeeva D.A.
Abstract
Aim. To study the peculiar features of psychoemotional and psychosocial status in women with diagnosed sterility and pregnant women with miscarriage in anamnesis. Materials and methods. 173 women were under observation. The main group involved 123 patients diagnosed sterility and miscarriage in anamnesis; the control group included 50 patients with physiological course of pregnancy in anamnesis. Express-diagnosis of depressive status using self-rating scales (Depression Scales) was carried out; presence and evidence of depressive symptomatology, the leading mechanisms of psychological defense as well as types of patients’ attitude to their disease based on psychological methods were studied. Results. In case of physiological pregnancy course, the occurring psychovegetative changes should be regarded as reaction directed to adaptation of the body and personality to pregnancy. The states of tiredness, anxiety, depression, private dissatisfaction, emotional instability, intolerance to people around, deterioration of relations between husband and wife were exceeded in the main group. In most women of the main group (94%) there was observed the state of mild depression or bad mood. The distinguishing feature of patients diagnosed sterility and miscarriage in anamnesis was an elevated personal (44% - moderate and high levels, 12% - low level) and reactive anxiety (8% - moderate level and 92% - low level). In the control group, moderate level of personal anxiety was revealed in 30% of women, low level - in 66% and high level - only in 4%. Conclusions. Uncertainty of reproductive status in women with sterility and miscarriage problems is a strong psychotraumatic factor which is displayed in different spheres of women’s life. Women being in chronic situation of uncertainty regarding their reproductive status need specialized psychopreventive and psychocorrecting work directed to decline in neuropsychical tension.
Perm Medical Journal. 2014;31(3):79-82
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“OXIDANT - ANTIOXIDANT” SYSTEM INDICES IN CHEMICAL ENTERPRISE WORKERS
Bakirov A.B., Badamshina G.G., Timasheva G.V., Galimova R.R., Valeeva O.V.
Abstract
Aim. To study the indices of “oxidant-antioxidant” system in workers of enterprises of chemical industry. Materials and methods. To assess the status of “oxidant-antioxidant” system, biochemical and cytochemical investigations were carried out in 208 workers of chemical complex. Biochemical examination of antioxidant component included the determination of catalase activity, general antioxidant activity, blood serum retinol and α-tocopherol content, cytochemical investigation - detection of mean cytochemical neutrophile myeloperoxidase coefficient. Results. Analysis of the obtained results detected disbalance in the “oxidant-antioxidant” system characterized by excessive accumulation of lipid peroxidation products, activation and depression of enzymatic activity of antioxidant component in workers employed in harmful conditions of labour at chemical enterprises. Dynamic changes in indices depending on the workers’ records of service were shown; developmental peculiarities of metabolic disorders were revealed. Conclusions. These disorders in the system of antioxidant protection are developing under the effect of complex chemical factors.
Perm Medical Journal. 2014;31(3):83-87
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DENTAL HEALTH OF STUDENTS OF MEDICAL-PROPHYLACTIC FACULTY
Leonova L.E., Omarova L.V., Kirichenko L.V., Barannikov V.G., Varankina S.A., Khokhryakova V.P.
Abstract
Aim. To assess the dental health of students of Medical-Prophylactic Faculty and to ground the preventive measures directed to decline in oral diseases. Materials and methods. FIfty students of Medical-Prophylactic Faculty (MPF) of Perm State Academy of Medicine underwent complex dental examination. Dental caries prevalence and intensity indices, oral cavity and parodentium tissue hygienic status were studied. 100 MPF students were interrogated by means of the questionnaire containing 23 questions of the open type by the following issues: quality of life, general health, level of knowledge and oral hygiene habits. Results. The conducted studies revealed a high level of prevalence and intensity of the basic dental diseases among students. Negative influence of stress situations and neuropsychical tension while studying, inadequate diet, rare visits to dentists, unsatisfactory habits of individual hygiene among the interrogated students were noted. Conclusions. Use of sylvinite therapy positively effecting oral mucosa and local immunity is one of directions of complex measures for prevention of dental diseases among students.
Perm Medical Journal. 2014;31(3):88-92
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LANGERHANS CELL HISTIOCYTOSIS WITH LUNG DAMAGE (clinical observation)
Barlamov P.N., Kravtsova T.Y., Kharina V.I., Golubeva M.E., Klimova I.V.
Abstract
The case history of a patients with a rare disease, i.e Langerhans cell histiocytosis with lung damage is described in the paper. This case is interesting, since the disease was treated for a long time as disseminated pulmonary tuberculosis, even after histological study. And only immunological study of biopsy material permitted to diagnose it correctly.
Perm Medical Journal. 2014;31(3):93-98
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CELL CYCLE REGULATION IN ECTOCERVICAL PRECANCEROUS PROCESSES
Vetelina V.V.
Abstract
The review of recent literature data concerning the problem of impaired regulation of ectocervical epithelial сell cycle in cervical intraepithelial neoplasias ( CIN ) is presented in the paper. The role of mitogenic (epidermal growth factor - EGF, keratinocyte growth factor - KGF , vascular endothelium growth factor - VEGF , insulin-like growth factor - IGF , cell cycle regulators - cyclines and cycline-dependent kinases - CDK ) and antimitogenic factors (tumor necrosis factor-alpha - TNF-α, transforming growth factor-beta, TGF-ß) in development and progression of CIN is discussed. Significance of TNF-α R1 receptor and epidermal growth factor receptor ( EGFR ) activation in pathogenesis of precancerous ectocervical processes is indicated.
Perm Medical Journal. 2014;31(3):99-104
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