Perm Medical Journal

Aim. To estimate the degree of influence of non-motor manifestations on the quality of life among patients with Parkinson’s disease.

Materials and methods. In the study, the “case-control” design was used, processing of the data was conducted with nonparametric methods. Complex examination of 58 patients with Parkinson’s disease was performed. The control group included 15 healthy persons.

Results. Manifestation of cognitive, anxiety-depressive, vegetative symptoms in the main group was significantly higher than in the control. There was revealed a negative correlation dependence between the general manifestation of vegetative disorders and the social functioning indices (R = – 0.5; p = 0.001), pain intensity (R = – 0.5; p = 0.001) and psychical health (R = – 0.5; p = 0.005) that proves aggravation of the data on health components as the severity of symptoms was growing. The analyzed vegetative disorders of separate subsystems demonstrated the analogous tendencies. Severity of depressive symptoms influences the pain indices (R = – 0.4; p = 0.01) and the social functions (R = – 0.3; p = 0.03). According to unified scale, non-motor symptoms negatively influence the general health status (R = – 0.3; p = 0.001), social functioning (R= – 0.23; p = 0.004), pain assessment (R = – 0.5; p = 0.001).

Conclusions. Non-motor symptoms aggravate the quality of life, influencing both physical and psychological component of health. The absence of correlation between the duration of therapy and the severity of non-motor symptoms confirms the independence of this block of symptoms.

Aim. To prove the efficiency of using a new variant of leg tutor for correction of locomotor system pathology in treatment of equvinus foot deformity.

Materials and methods. A mean age of 23 patients with hemiparesis and equvinus foot deformity was 42.5 years. Tonus and strength of legs was assessed. Angulometric and stabilometric studies were realized.

Results. The developed model of leg tutor was used. To eliminate equvinus foot deformity, hyperextension of the knee joint was gradually eliminated using individual choice of the heel form and height, thus strengthening a quadriceps muscle of the thigh. The knee joint stability increased, the intensity of pain syndrome reduced. Arthropathies and deformities of the knee joint were prevented. Innovation of the developed model is the following: a soft glue-based responsive side of textile band “Contact” “Velcro” was stably fixed to the outside surface of posterior third of the plantar part of tutor sleeve. To the responsive side of a textile band, there were fixed removable heel pads (heels from microporous rubber of different height (from 5 to 25 mm) with a responsive hard (with hooks) part of textile band “Contact” “Velcro”). Tutor provided the ability to move and guaranteed stable holding of the extremity segments in the posterior position. There was observed a positive dynamics of changes in the muscular tonus of paralyzed leg.

Conclusions. The developed tutor model can be used in orthopedic-traumatological practice to correct equvinus foot deformity; the model efficiency is confirmed by clinical and stabilometric parameters.

Aim. To study the clinical peculiar features of type b Haemophilus influenza-caused purulent meningites among children in Perm.

Materials and methods. Twenty children with purulent meningitis were examined. Clinical and bacteriological studies, latex-agglutination reaction, polymerase chain reaction (PCR) were used.

Results. Most patients with Hib-meningitis (70 %) were hospitalized in grave condition during the first three days of disease with fever, meningeal symptoms. Spastic syndrome was diagnosed in 5 patients, disseminated intravascular clotting syndrome – in 6 patients.

Conclusions. Hib-meningitis in 80 % of cases is developing in children aged under two, has an acute onset and severe course with general cerebral and meningeal symptoms, changes in blood and liquor, typical for bacterial infection, high neutrophilic pleocytosis and hyperproteinorrhea; it is frequently accompanied by complications. In etiological diagnosis of Hib-meningitis PCR is the most informative method.

Aim. To improve microbiological monitoring of disinfectant-resistance of microorganisms, excreted from clinical material in epidemiological surveillance of HCAI.

Materials and methods. Over the period from 2012 to 2016, while conducting resistance monitoring, 3320 investigations of clinical material were performed. The number of studied microorganisms was 1557. The number of excreted disinfectant-resistant microorganism strains was 337. The studies of microorganisms from clinical material for resistance were realized to 48 disinfectants of 15 groups with different reactants.

Results. During the present study it was established that microbiological monitoring, oriented for continuous monitoring of microorganisms circulation will permit to increase the number of studies in 2016 by 2.6 times, to reduce the total number of disinfectant-resistant flora in 2016 by 62 %. The greatest weight of excreted cultures was in the units of surgical profile – 48.8 %, resuscitation profile – 30 %, therapeutic one – 21.2 %. Clinical material, from which positive results were obtained, was determined by scourage (from 43.5 % in the surgical unit to 74.8 % in therapeutic), blood sterility (from 2.7 % in therapeutic units to 31.4 % in resuscitation units). Microflora, excreted from clinical material is presented predominantly by P. aeruginosa – 24.0 %, Kl. pneumoniae – 30.0 %, E. coli – from 12.9 to 22.1 %, St. aureus – from 3.0 to 7.6 %. The studies regarding disinfectant-resistance to 48 items from 15 groups of chemical compounds are the evidence of growing resistance to QAC, including QAC + amines – 24.7 %, QAC + aldehyde-containing – 6.8 %, chlorine-containing – 21.9 %. The highest resistance to disinfectants used was in Acinetobacter spp., Kl. pneumoniae, P. aeruginosa, E. coli.

Conclusions. The developed algorithm of microbiological study, based on software, permitted to form the database, to monitor epidemiologically significant microorganisms and correct choice of disinfectants and disinfection tactics.

Aim. To compare the maternal mortality (MM) indices in Perm Krai with MM indices in the Russian Federation (RF) and Privolzhskiy Federal District over the past 20 years.

Materials and methods. On the basis of official statistical data, intensive indices and image indices, mean multiyear MM indices, 95 % confidence intervals, median, 25 and 75 percentile indices were calculated. The mean multiyear indices are presented as M (mean value) ± SD (standard deviation).

Results. According to official statistical data, the mean multiyear (1997–2016) indices of MM coefficient in Perm Krai tend to decline, but they do not reliably differ from the analogous indices in RF. During the last 20 years, there was noted a steady and obvious decrease in MM index on the territory of Perm Krai, especially marked for the last 2 years (2015–2016) that resulted in appearance of statistically significant differences regarding this index in Perm Krai compared to these indices in RF as a whole.

Conclusions. Perm Krai is a rather favorable region as far as rendering of medical aid to pregnant, parturient women and puerperas is concerned.

Aim. To determine the availability of social networks for involvement of clients in the sphere of esthetic surgery.

Materials and methods. The data of a social group from The Clinic of Esthetic Surgery “EstMed” in the social network vkontakte were analyzed.

Results. The number of subscribers was 533, the main contingent – women aged 25 to 44 years; 48 % of users look through the group posts by means of mobile devices. The participants of this group were not satisfied with the form and dimension of their breast, pendulous abdomen, wrinkles on the face, “ears” on the femurs and form of buttocks; 95 % voted for plastic surgery as an appropriate way to fight with aging. Most subscribers were ready for surgery; 50 % of interrogated persons consider psychologist’s consultation to be necessary. The greatest number of persons consider buttocks, breast and legs to be the most sexual part of the body. One third of the questioned persons have breast size number one, but the majority of interrogated persons consider that men prefer breast size number three. Posts, containing jokes, arouse the greatest interest, information not concerned with the subject matter of the group – the least.

Conclusions. When used professionally, social networks can be a strong instrument to involve clients.

Cerebral amyloid angiopathy (CAA) is a specific variant of cerebral small vessel disease, associated with high risk of spontaneous intracerebral bleedings, cognitive disorders and hemorrhagic complications of antithrombotic and thrombolytic therapy. One of key markers of CAA is a relatively rare neurovisual phenomenon – cortical superficial siderosis (CSS). Two clinical cases of CAA with CSS are described in the present paper. In the first case, typical CAA complication were observed: intracerebral bleeding and cognitive disorders. In the second case, CAA was symptom-free. Analysis of clinical cases and literature data shows phenotypic heterogeneity of CAA and confirms advisability of routine use of paramagnetic conditions of MRT to examine patients with cerebrovascular disease.

The problems of hepatic fibrosis/cirrhosis diagnosis are discussed in the paper. At the modern stage, diagnosis of chronic hepatic diseases is based on laboratory, instrumental, morphological methods of study and calculated indices. Puncture biopsy of the liver is referred to the most reliable diagnostic methods. However, there are some complexities while implementing this procedure, which do not permit to use morphological studies for dynamic observation. The method of ultrasound elastometry is offered as an alternative to puncture biopsy of the liver. However, it also has some technical limits that resulted in development of noninvasive, in particular, laboratory methods of hepatic fibrosis/cirrhosis diagnosis.