Vol 36, No 3 (2019)

Cover Page
Clinical studies
Content of blood serum bone tissue metabolism indices in patients with prostheses instability after primary knee joint arthroplasty
Galashina E.A., Ulyanov V.Y., Bondarenko A.S.
Abstract

Aim. To assess the separate indices of blood serum bone tissue metabolism content in patients with instability of prostheses after the primary knee joint arthroplasty.

Materials and methods. The main group joined 40 patients with implant-associated inflammation, the comparison group – 40 patients with primary aseptic instability of prostheses, the control – 20 conditionally healthy donors. The blood serum hPTH and 25-OH Vitamin D content was determined using solid-phase immune-enzyme assay.

Results. Among the patients of the main group, blood serum hPTH concentration increased as compared with the control after1 and 12 months following the surgery and compared with each previous observation period; 25-OH Vitamin D level decreased compared with the control before the surgery, after1 and 12 months following the surgical intervention and compared with each previous period of observation. In the patients of the comparison group versus the control values, blood serum hPTH concentration elevated and 25-OH Vitamin D level declined after 1 and 12 months following the surgery and compared with the previous observation period 1 month later.

Conclusions. When estimating the blood serum hPTH and 25-OH Vitamin D content in patients with instability of prostheses after the primary knee joint arthroplasty, there were revealed multidirectional changes in their levels, showing bone tissue metabolic disorders.

Perm Medical Journal. 2019;36(3):5-10
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Surgical tactics for associated chest trauma in acute and following periods of traumatic disease
Denisov A.S., Schekolova N.B., Ladeischikov V.M.
Abstract

Aim. To present in details the surgical tactics in different periods of traumatic disease (TD) for associated chest injury.

Materials and methods. Treatment of 865 patients with associated injuries was analyzed. There were 66.9 % of men (579 persons) and 33.1 % of women. Automobile traumatism dominated. The central and peripheral hemodynamics as well as vegetative disorders were investigated. The blood viscosity and toxicity, lipid metabolism etc. were determined.

Results. The characteristic features of the course of acute and the following periods of traumatic disease in associated chest injury, taking into account the revealed complications, expression of circulatory, hypoxic, metabolic and toxic changes, were studied. The logic of surgical tactics in different periods of traumatic disease was presented. Complications and errors when treating patients were analyzed.

Conclusions. Treatment of injured patients, suffering from associated chest trauma in the acute and following periods of TD is subjected to logic of surgical tactics, taking into account prognostication of occurring possible complications and their prevention.

Perm Medical Journal. 2019;36(3):11-17
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Use of magnetoinfrared laser therapy in severe pediatric bronchial asthma
Illek Y.Y., Mischenko I.Y., Ryseva L.L., Vyaznikova M.L., Tarasova E.Y., Leushina N.P., Mamedova S.M., Suetina I.G., Khlebnikova N.V., Solovyova G.V.
Abstract

Aim. To determine the influence of magnetoinfrared laser therapy on the clinicolaboratory indices in children with severe course of bronchial asthma.

Material and methods. There were observed 82 children aged 5–14 years, who suffered from severe course of atopic bronchial asthma.Bronchial asthma patients of group 1 (41 patients) received a complex standard therapy, bronchial asthma patients of group 2 – a complex treatment, combined with magnetoinfrared laser therapy courses.

Results. Patients with bronchial asthma, attributed to group 2, compared with those of group1 demonstrated a faster positive dynamics of clinical indices, improvement of respiratory function and normalization of most immunologic reactivity parameters, diminished severity of disease course and prolonged clinical remission.

Conclusions. High efficiency of magnetoinfrared laser therapy, safety and availability, absence of complications and side reactions permit to recommend its wide use in complex of medical measures for children with severe course of atopic bronchial asthma.

Perm Medical Journal. 2019;36(3):18-27
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Methods of diagnosis and technologies
Monocyte chemotactic factor content in normal sperm and in samples of ejaculate with diminished fertility
Sosnin D.Y., Galkovich K.R.
Abstract

Aim. To study the dynamics of monocyte chemotactic factor (MCP-1) content in the ejaculate of healthy men and men with diminished spermatozoid concentration.

Material and methods.Sixty-four men were examined. The main group included 16 patients with azoospermia. The comparison group – 24 patients with oligozooasthenospermia (spermatozoid concentration lower than 15 mln/ml). The control group was presented by ejaculate samples of 24 healthy men, characterized by normal parameters. The MCP-1 concentration was determined with the method of solid phase enzyme immunoassay using the assay kit “MCP-1-EIA-BEST” (A8784) (CJSC Vector-Best, Russia).

Results. The mean MCP-1 concentration in the samples of undiluted seminal plasma was 2242.8 ± 672.0 pg/ml versus the blood serum, where MCP-1 content was 18.9 times lower and was 118.8 ± 22.9 pg/ml. No reliable differences were revealed when comparing the mean values of MCP-1 in the studied groups in ejaculates; there were also no statistically significant difference between the indices in MCP-1 groups in the blood serum.

Conclusions. Male seminal plasma is characterized by unusually high MCP-1 content, exceeding more than tenfold the concentration of this protein in the blood serum. High MCP-1 concentration in sperm and the absence of its dependence on the concentration of this protein in blood serum indicates local production of this protein into the seminal plasma by male reproductive organs. Further studies are needed to find out a concrete localization of the sites of production of this protein in male genital organs and to study its probable role in reproductive processes in male and female organisms.

Perm Medical Journal. 2019;36(3):28-37
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Estimation of proinflammatory cytokine and heat shock protein levels in atopic dermatitis
Ivanova N.M., Kibalina I.V., Tsybikov N.N.
Abstract

Aim. To estimate the proinflammatory cytokineI L-17α level, HSP-70 level and autoantibodies to it in pathogenesis of atopic dermatitis (AD) at its exacerbation stage.

Materials and methods. Twenty patients aged 18–35 years were examined; cytokine IL-17α levels, HSP-70 chaperone levels and autoantibodies to it were studied in patients, suffering from typical form of atopic dermatitis at exacerbation stage. Statistical processing of the obtained material was implemented with STATISTICA 6.1 for Windows.

Results. Atopic dermatitis causes chronic inflammatory damage of the skin, the cells are in stress state for a long time that contributes to accumulation of the damaged proteins in them and significant growth of chaperone synthesis.

Conclusions. In the period of active clinical symptomatology, patients with atopic dermatitis demonstrated decrease in blood IL-17α concentration and increase in HSP70 level and autoantibodies to it.

Perm Medical Journal. 2019;36(3):38-42
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Complex ultrasound diagnosis of pelvic organs in girls-adolescents with obesity
Kamilova N.M., Sultanova I.A., Khalilova G.M., Akhmedzade V.A.
Abstract

Aim. To assess the state of pelvic organs in girls-adolescents with obesity.

Materials and methods. The study included the data from 120 girls-adolescents aged 13–17 years with informed agreement of parents. The main group joined 100 girls with obesity of different degrees, the control group – 20 girls without obesity. The study was implemented on the basis of the Department of Obstetrics and Gynecology I of Azerbaijan Medical University, Research Center “SaglamNǝsil”. In addition to general clinical examination, including the study of anamnesis, reproductive function, general and gynecological examination, there were used echography of the small pelvic, US dopplerometry of the utero-ovarian arteries. Statistical analysis was performed using MS Excel, SPSS and Statistica (version 10.0) Software Package.

Results. The compared results of USI of the small pelvis detected significant increase in the size of the uterus and ovaries in girls-adolescents with obesity. After normalization of weight, the sizes of the uterus and ovaries normalized as well.

Conclusions. USI of pelvic organs permits to identify different disorders and take the corresponding measures for their elimination at the right moment.

Perm Medical Journal. 2019;36(3):43-50
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Preventive and social medicine
Organizational and educational program on formation and development of family medical activity
Dymova I.A., Karoyan A.A.
Abstract

Aim. To work out the organizational and educational program on formation and development of medical activity of a family and detect the key factors, determining and prognosticating its level.

Materials and methods.The method of questioning was used to study the medicosocial characteristic of living conditions and education in children of the first year of life, the mechanism of formation and development of medical activity in 244 families. On the basis of the data obtained, there was developed the organizational and educational program, directed to improvement of children’s health through the activity of district pediatrician; 214 women agreed to participate in the experiment.

Results. The paper is devoted to the necessity of improving the level of knowledge in parents of early age children. The growing sickness rate indices among the child population demonstrate the actuality of searching for methods to improve children’s health, in particular, by means of developing family medical activity.There were revealed and presented the factors, determining and forecasting the level of medical activity of a family, which plans to have a child.

Conclusions. To work out educational program on formation of medical activity, it is necessary to consider territorial characteristics of health status indices among child population and results of medicosocial diagnostics of families. Pediatrician, taking into account prognostic factors, can reveal “risk group” mothers and have individual approach to their training and practical formation and development of medical activity.

Perm Medical Journal. 2019;36(3):51-60
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Evaluation of non specific body resistance of children with eye disorder and flatfoot
Mozgovaya L.A., Fokina N.B., Rochev V.P., Mozgovaya S.V., Sivak E.Y., Gavrilenko M.S., Paklin R.
Abstract

Aim. To study the correlation between the value of nonspecific resistance of the organism (NRO) and the rate of visual organ pathology as well as the prevalence of platypodia among pupils.

Materials and methods. The study included 108 pupils aged 10–12 years, residents of Perm (46 boys and 62 girls). To realize the stated targets, there were used immunological, clinical and statistical methods. Nonspecific resistance of the organism was assessed by the antibody titer (AT) value in the saliva. From the total number of the examined patients, the visual organpathology was detected in 15 persons, platypodia – in 9. NRO value in children was evaluated using the developed by the authors express-method, based on the determination of humoral factors of immunity in the saliva – the antibody titer in passive hemagglutination reaction (PHGR) to Shigella sonnei by means of commercial antigen erythrocyte diagnosticum.

Results. It was established that NRO influences the possibility of developing both: visual organ pathology and platypodia in the examined patients.

Conclusion. The obtained results of the study permit to recommend the method of human adolescent NRO assessment, which was worked out by us.

Perm Medical Journal. 2019;36(3):61-66
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Biology and experimental medicine
Characteristic features of lysocim influence on growth kinetics of candida albicans fungi
Godovalov A.P., Pastukhov D.M.
Abstract

Aim.To assess the growth kinetics and biofilm-forming activity of Candida albicans strains when cultivated in nutrient medium with different concentrations of lysocim.

Materials and methods. Growth kinetics of strains was determined by changes in optic density of suspension at 620 nm, and biofilms detected them by their staining with fuchsin. The results were registered on photometer.

Results.Lysocim changes the growth kinetics of C. albicans, reducing the duration of exponential and prolonging the stationary phases of growth. It was established that increased lysocim concentration positively influences the proliferative activity of the fungi. As lysocim concentration is increased, C. albicans biofilm-forming activity is elevating.

Conclusions. Thus, the increased level of lysocim contributes to transition of fungi into the plankton form of growth that should be taken into consideration when treating patients with candidiasis.

Perm Medical Journal. 2019;36(3):67-71
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Review of literature
Peritoneal adhesion: state of issue and modern methods of prevention
Samartsev V.A., Gavrilov V.A., Pushkarev B.S., Parshakov A.A., Kuznetsova M.P., Kuznetsova M.V.
Abstract

Peritoneal adhesion (PA) is still an actual surgical issue. It is known that any surgical intervention causes abdominal adhesion that, in its turn, induces a number of complications such as adhesive intestinal obstruction. There is registered a high lethality among patients with the developed acute adhesive intestinal obstruction. Adhesive intestinal obstruction hurts health of patients, leading to eight (on average) days of hospitalization and intrahospital lethality of 3 % per episode. The cause of the development of a significant number of lethal cases is imperfection of preventive, diagnostic, therapeutic measures; 20 to 30 % of patients with adhesive intestinal obstruction need surgical treatment. Heavy expenses in the system of healthcare are required for treatment of peritoneal adhesions. The review presents the data regarding modern state of the problem, advanced tendencies in diagnosis, prevention and treatment of patients with peritoneal adhesions, their use in practical studies.

Perm Medical Journal. 2019;36(3):72-90
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Clinical case
Clinical case of unfavorable pregnancy outcome for the newborn in immunoincompatible pregnancy: difficulties of diagnosis and treatment
Padrul M.M., Semyagina L.M., Sadykova G.K., Semyagin I.
Abstract

During the whole period of gestation, there occur complicated immunobiological mother-fetus relationships, which to a large extent determine further course of pregnancy and outcome for the newborn. Hemolysis of erythrocytes under the influence of antibodies,formed in mothers to fetal erythrocyte antigens, causes hemolytic disease of the fetus/newborn. The problem of hemolytic disease in immunoincompatible pregnancy,first of all in Rh-incompatibility, can’t be considered completely solved in this country,despite the achievements of perinatal medicine. The paper presents a clinical case of unfavorable perinatal pregnancy outcome in case of rhesus-immunization of the mother against the background of growing titer of highly agglutinable class of antibodies and unstable indices of maximum systolic speed in the medial cerebral artery (growth up to the zone “A” with successive fall to the zone “C”) without any other signs of fetal disorders available. This clinical case demonstrates actuality of the problem and difficulties in diagnosis of hemolytic disease of the fetus.

Perm Medical Journal. 2019;36(3):91-97
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Crohn’s disease complications, requiring surgical treatment
Klimentov M.N., Styazhkina S.N., Neganova O.A., Lyubimtseva M.S., Semibratova E.V., Turbin O.D.
Abstract

Crohn’s disease sickness rate is 0.3–0.2 per 100000 persons, its prevalence is 322 per 100000 persons; Up to 60–70 % of patients with Crohn’s disease undergo this or that type of surgical intervention – from opening of paraproctitis to extensive intestinal resections. Uninterrupted course of disease and probability of severe relapses induce application of long postoperative drug therapy to avoid repeated operations. Repeated resections of the bowel in Crohn’s disease are dangerous from the position of the development of short bowel syndrome, severe digestive disorders. Surgical treatment in Crohn’s disease is aimed at prevention of complications and improvement of patients’ quality of life, if drug therapy is useless.

 

Perm Medical Journal. 2019;36(3):98-105
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