Vol 35, No 6 (2018)

Cover Page

Clinical studies

Characteristics of adaptive responses and status of newborns depending on degree of parturient genital colonization with Ur. Urealyticum

Melnikova T.A., Padrul M.M., Gorovits E.S., Rabotnikova G.I.


Aim. To study the characteristic features of newborn status depending on the level of parturient genital colonization with Ur. urealyticum.

Materials and methods. The characteristic features of newborns’ status were studied in 112 puerperas, who by the results of repeated microbiological examination for ureaplasmosis, in the period of 30–34 weeks of pregnancy were divided into 3 groups: group I included 38 persons with negative results of PCR and bacteriology; group II (risk) joined 39 women, infected with Ur. urealyticum to 104 CFU/ml and PCR 5·104 DNA copies per ml; and group III – 35 pregnant women with bacterial inoculation less than 104 CFU/ml. The comparison group – 40 pregnant women, uninfected with ureaplasmas when examined for the first time.

Results. In newborn children from puerperas of risk group, Apgar scores at 1 and 5 minutes were statistically significantly lower, than in children, born from mothers of the other groups. In this group, birth of premature newborns and those with hypotrophy as well as newborns with fetal development retardation syndrome were registered significantly more often. Perinatal encephalopathy was detected in 50.0 % of newborns. When discharged from maternal home, nearly a half of infants from this group had no the initially required body mass, but in the other groups there were 2–2.5 times more such newborns.

Conclusions. Newborns from mothers infected with Ur. Urealyticum in high, etiologically significant titers, are characterized by decrease in adaptive responses that is proved by Apgar scores and by retarded body mass growth after birth. High level of parturient genital colonization with Ur. urealyticum has a negative effect on the newborns’ health status. Low, etiologically insignificant Ur. urealyticum titers in mothers practically don’t influence the newborns’ health status.

Perm Medical Journal. 2018;35(6):5-9
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Peculiar features of inflammatory process in gastric mucosa with different character of its bacterioviral infection in adolescents with chronic gastritis

Spivak E.M., Manyakina O.M., Akkuratova I.S.


Aim. To characterize the inflammatory process in gastric mucosa among adolescents with chronic gastritis in different variants of its bacterioviral infection.

Materials and methods.Clinicoanamnestic, laboratory, endoscopic and morphological examination of 200 adolescents (age range 12–18 years) with chronic gastritis was carried out. In all patients, clinicoanamnestic data, standard laboratory study, esophagogastroduodenoscopy, gastrobiopsy followed by morphological analysis with visual analogue scale were assessed. According to the results of examination, all adolescents were divided into 4 groups depending on the character of bacterioviral infection of gastric mucosa.

Results. No statistically significant differences were detected while comparing the rate of clinical manifestations of pain abdominal, dyspeptic, intoxication and asthenovegetative syndromes as well as changes, revealed in laboratory and ultrasound studies in the above mentioned groups of adolescents. Maximal presentation of macroscopic and pathohistological changes was registered in patients of group 4 (association between colonization of GM with highly pathogenic Hp strains and EBV persistence).

Conclusions. The character of bacterioviral infection of gastric mucosa significantly determines the manifestation degree and activity of inflammatory process. The least degree of manifestation and activity of inflammatory process is registered when mucosa is colonized by low pathogenic Hp strains. Maximal presentation of macroscopic and pathohistological changes in the gastric mucosa is registered in adolescents with associated infection by high pathogenic Hp strains and Epstein-Barr virus. It is manifested by domination of marked and highly active inflammation and appearance of the signs of mucosal atrophy of gastric body and antrum.

Perm Medical Journal. 2018;35(6):10-15
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Regarding the subject of degradation of femoral medial condyle cartilaginous tissue in damaged knee joint medial meniscus

Denisov A.S., Zagorak D.P.


Aim. To reveal the influence of patient’s connective tissue state and body mass on the development of damage of the cartilaginous tissue of femoral bone medial condyle in case of medial meniscus rupture.

Materials and methods. The study included 85 patients, undergoing arthroscopic treatment of the knee joint in connection with damaged medial meniscus. The damage degree of femoral medial condyle cartilaginous tissue was estimated using Outerbridge classification (1961). The body mass was calculated by the body mass index kg/m2. To assess the connective tissue elasticity, “the method of express diagnosis of dysplastic state of connective-tissue structures in conditions of ambulatory traumatologo-orthopedic service” was used.

Results. The present paper is devoted to a widespread problem – the damage of femoral medial condyle cartilaginous tissue in case of medial meniscus rupture. The aim of the study was to find out the influence of connective tissue state and body mass on the damage of the femoral medial condyle cartilaginous tissue. Seventy patients were examined. As a result of analysis, it was established that an excess body mass as well as low connective tissue elasticity provoke destruction of the cartilaginous tissue of femoral bone medial condyle. Patients with connective tissue dysplasia are more tolerant to cartilaginous tissue degradation. The risk group for cartilaginous tissue damage includes persons with low connective tissue elasticity and obesity.

Conclusions. When medial meniscus is ruptured, most patients during the first 6 months after trauma experience damage of femoral medial condyle cartilaginous tissue. The most favorable for the outcome is the state when patients have a normal body mass. Dysplastic state of connective tissue somehow eliminates the damaging factor at the expense of elevated elasticity of cartilaginous tissue. The most unfavorable is the situation, when patients have excess body mass and low connective tissue elasticity. For this group of patients the most optimal variant is hospitalization and arthroscopic treatment taking into account urgent indications.

Perm Medical Journal. 2018;35(6):16-22
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Methods of diagnosis and technologies

Changed content of heat shock proteins and antibodies to them in blood and nasal mucosa cells in rhinites and rhinosinusites of different etiology

Ivanov M.O., Ivanova N.M., Maksimenya M.V., Karavaeva T.M., Egorova E.V., Fefelova E.V., Tsybikov N.N.


Aim. To determine the content of heat shock proteins with molecular weight 70 kDa (HSP 70) and antibo dies to them in blood and nasal secretion in patients with allergic rhinites and infectious rhinosinusites of different etiology.

Materials and methods. The paper presents the results of examination of 10 patients with allergic rhinitis and 30 patients, infected with rhinosinusites(the age range 25–35 years). The patients with infectious rhinosinusites were divided into 3 groups according to nosologic form of disease. The control group included 10 practically healthy persons in the ratio, comparable by their gender and age with sick persons.

Results.The analysis showed that in the nasal secretion of all patients, HSP 70 level significantly raised compared to the control. Maximum values were registered in patients with bacterial rhinosinusitis and were higher than in patients with viral and fungous ones by 1.9 times (p = 0.015) and 2.9 times (p = 0.001), respectively. In blood serum, HSP 70 concentration compared with the control increased in patients with allergic rhinitis and bacterial rhinosinusitis by 103.67 % (p = 0.015) and 32.11 % (p = 0.049), respectively; these values in the last two groups exceeded the latter in patients with fungous RS by 2.37 times (p = 0.01) and by 1.54 times (p = 0.035).

Conclusions. It was detected that in the group of patients with allergic rhinitis and chronic bacterial rhinosinusitis in the nasal secretion and blood serum, HSP 70 values were the highest. In the nasal secretion, HSP 70 level was higher than in blood. The amount of autoantibodies to HSP 70 in blood grew in allergic rhinitis, fungous and viral forms of rhinosinusites that reflects the immunological effect of chaperone proteins.

Perm Medical Journal. 2018;35(6):23-28
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Relationship between electrokinetic parameters of red blood cells and acute coronary syndrome

Martynova T.A., Maksimov N.I., Glavatskikh M.M.


Aim. To assess the state of electrokinetic properties of red blood cells in different variants of the course of acute coronary syndrome (ACS).

Materials and methods. The study deals with the assessment of clinical and laboratory-instrumental data from 201 patients with ACS, the results of electrokinetic parameters of red blood cells, their predictors.

Results. According to electrokinetic indices of erythrocytes, no reliable differences between the groups were found out. The mean red blood cell oscillation amplitude (MRBCOA) in group 1 was 1.83 ± 0.05, in group 2 – 1.75 ± 0.06 (t = 0.955, p = 0.341). Stationary red blood cell percentage (SRBCP) in patients with NSTE-ACS was 15.6 ± 1.45, in patients with STE-ACS – 13.54 ± 1.64 (t = 0.957, p = 0.339). The methods of multiple disperse and regressive analysis were used. Predictors of SRBCP indices in NSTE-ACS group appeared to be intima-media complex thickness (IMCT), left ventricle diastolic dysfunction, coronary insufficiency index (CII); in STE-ACS group – IMCT, MRBCOA, troponin I and AST levels. In STE-ACS group, predictors of MRBCOA were SRBCP and troponin I level, in NSTE-ACS – no predictors, influencing MRBCOAwere revealed.

Conclusions. In NSTE-ACS group, the following predictors, influencing SRBCP were detected:IMCT, CII, LV diastolic dysfunction. In patients of STE-ACS group, there were found the predictors, influencing electrokinetic properties of red blood cells: IMCT, AST, troponin I. In acute coronary syndrome, changes in electrokinetic parameters of red blood cells are mainly influenced by atherosclerotic process, however, in NSTE-ACS, structural-functional status of myocardium is of primary significance, and in STE-ACS – the degree of manifestation of resorptive-necrotic syndrome.

Perm Medical Journal. 2018;35(6):29-35
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Preventive and social medicine

Population aging is characteristic component of modern demographic processes

Podluzhnaya M.Y., Voronova E.A., Isaeva N.V., Rudakova E.A.


Aim. To analyze the demographic indices in connection with aging of the population in Perm Krai and the Russian Federation and as a result – to single out problems and ways of solution.

Materials and methods. Calculation and dynamic analysis of reproduction of the population in Perm Krai and the Russian Federation over the period of 2005 – 2017 was performed using official statistic data in connection with gender-and-age-specific characterization of the population.

Results. The processes of aging of the population were estimated from demographic positions. Socioeconomic problems, associated with them, were singled out, the ways of their solving were determined in accordance with national projects regarding health and health care.

Conclusions. At the expense of growing index of expected average life, decrease in fertility and birth rate there is observed accumulation of older age groups of the population, i.e. process of aging. It, naturally, results in growth of chronic pathology, mortality not only in the older age periods but also in the able-bodied part of the population, thus, reducing working potential.

Perm Medical Journal. 2018;35(6):36-42
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Clinical approbation of biologically active supplement in patients with vegetovascular dystonia

Vekovtsev A.A., Podzorova G.A., Poznyakovsky V.M.


Aim. To study the possibility of using and estimate the efficiency of a new tablet form of biologically active supplement in patients with vegetovascular dystonia syndrome.

Materials and methods. One hundred patients with vegetovascular dystonia syndrome, including 50 patients of the main group and 50 patients of the control group were examined. There is presented the composition of prescription formula of biologically active supplement, based on participation of its components in the correction of disturbed metabolic processes of the nervous system.

Results. Additional application of biologically active supplement in combination with drug significantly improves cerebral blood flow, decreases blood viscosity and risk of cellular membrane impairment, normalizes arterial pressure, elevates initiative and attention, reduces headache in patients of the main group with vegetovascular dystonia syndrome.

Conclusions. Use of biologically active supplement has a positive effect in complex therapy of patients with vegetovascular dystonia syndrome.

Perm Medical Journal. 2018;35(6):43-48
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Quality of life in young men with abdominal obesity depending on androgen deficiency

Karataeva O.V., Panova E.I., Zhdankina N.V., Morozova E.P.


Aim. To reveal the changes in the quality of life among young men with visceral obesity depending on androgen deficiency manifestation.

Materials and methods. Examination of 80 men with the mean age of 45.5 ± 7.7 years with abdominal type of obesity was carried out. The total blood serum testosterone level was determined in all patients and their life quality was assessed using SF-36 health survey.

Results. In the examined group, 72.3 % of patients had statistically significant (p = 0.03) testosterone deficiency, and their life quality indices were characterized by lower scores of social functioning (SF) and psychological component of health compared to the group of persons with normal testosterone level.

Conclusions. In most men with abdominal obesity, there was observed androgen deficiency that leads to significant limitation of social contacts, decrease in communication level, caused by impairment of physical and emotional status. Therefore, normal testosterone level is required to support good physical and mental health in men.

Perm Medical Journal. 2018;35(6):49-52
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Clinical case

Cerebral amyloid angiopathy, associated with inflammation: clinical observation and literature review

Kulesh A.A., Gorst N.K., Drobakha V.E., Kaileva N.A., Bykova A.Y., Shestakov V.V.


Cerebral amyloid angiopathy, associated with inflammation (CAA-I) is a rare syndrome, described rather long ago. The course of disease varies from conditionally asymptomatic, very seldom diagnosed forms to severe lethal cases with intracerebral bleedings and brain edema. The basic clinical symptoms of CAA-I are cognitive disorders, convulsions, headache, consciousness impairment, often ignored or wrong interpreted. Manifestations of CAA-I are a part of clinicoradiological continuum, significantly influencing the course of other cerebrovascular diseases. The paper presents description of a clinical case of symptom-free or preclinical form of CAA-I, incidentally detected while realizing magnetic resonance tomography. Analysis of this clinical case and literature data demonstrates difficulties of CAA-I differential diagnosis, value of neurovisualization in patients with cognitive disorders and accentuates the need of expanding the existing diagnostic criteria of CAA-I.

Perm Medical Journal. 2018;35(6):53-60
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Review of literature

Conservative-and-preventive stomatology: modern trends of development

Gileva O.S.


The paper presents a detailed analysis of global trends and subtrends of modern conservative-and-preventive stomatology, based on survey-analytical methods of study in interconnection with performed earlier, realized nowadays and planned scientific and practical elaborations of Perm therapeutists-stomatologists school.

Perm Medical Journal. 2018;35(6):61-72
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Influence of polychemotherapy on cognitive functions in patients with lymphoproliferative diseases: literature review and personal clinical observations

Teregulova D.R., Bakirov B.A., Akhmadeeva L.R.


The factors, influencing the development of cognitive defects in patients after chemotherapy are the following: personal individual intellectual and genetic characteristics, immune dysfunction and neurotoxicity. Cognitive domains, disturbed to a greater extent, are memory, attention, thinking rate and executive functions. Sixty one patients, diagnosed lymphoproliferative disease, (chronic lympholeukosis – 28 persons, multiple myeloma – 33) were examined; patients’ mean age was 63.87 ± 9.76 years. Reduced cognitive function was revealed in 73.77 % of patients, a mean score by MoCA scale was 22.87 ± 4.08. Cognitive defects negatively influence patients’ quality of life, significantly reduce their physical and mental working ability, everyday activity, make execution of professional duties difficult, besides they can complicate nursing.

Perm Medical Journal. 2018;35(6):73-81
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Pathologic carotid arteries tortuosity

Danilova M.A., Baidina T.V., Karakulova Y.V., Trushnikova T.N.


The pathology of carotid arteries takes a significant place in the structure of cerebral vascular diseases. The review of literature on pathologic tortuosity of carotid arteries is presented in the paper; the influence of this state on cerebral circulation disturbance is discussed; the etiology, diagnosis and methods of treatment of pathologic deformity of magistral arteries of the head are considered.

Perm Medical Journal. 2018;35(6):82-88
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The 80th anniversary of the department of therapeutic stomatology and propedeutics of dental diseases

Gileva O.S., Zadorina I.I., Sivak E.Y., Libik T.V., Korotin S.V., Syuzeva D.V.


The paper deals with historical information on the formation and development of the Department of Therapeutic Stomatology of Academician Ye. A Vagner Perm State Medical University – “Alma-mater” for several generations of dentists. It is the history not only in figures and factors but regards people, who contributed to the development of native stomatology in the Ural region.

Perm Medical Journal. 2018;35(6):91-99
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