Vol 38, No 1 (2021)

Objective. To study the possibility of using N-terminal pro-BNP fragment as a screening criterion of hemodynamic significant of the functioning arterial duct in extremely premature newborns. Hemodynamically significant functioning arterial duct (HSFAD) is a reason of the development of various complications in extremely premature newborns. The basic method for HSFAD diagnosis is Echo CG. The limited technical abilities of ultrasound devices can prevent from an early diagnosis and timely treatment of this state. The search of additional markers of hemodynamic significance the functioning arterial duct (FAD) is actual.

Materials and methods. A continuous prospective observational study included patients aged 1 to 3 days with FAD, gestation period of 25–32 weeks and birth weight from 500 to 1500 g. Hemodynamic significance of FAD was determined according to generally accepted Eco CG criteria. The level of NT-pro-BNP was identified with IFA on the third day of life. Mathematical modelling was used to calculate a “threshold” value of NT-pro-BNP, corresponding to 6500 pg/ml, at which the probability of hemodynamic significance of the functioning arterial duct exceeds 80 %.

Results. The assessment of NT-pro BNP concentration on the third day of life permitted to establish the following reliable differences: in the main group, the median concentration for NT-pro BNP was 15000 [IQR 2 587; 26 500] pg/ml, in the comparison group – 1920 [IQR 1379; 3467] pg/ml, р = 0.001. Mean force direct correlation, r = 0.52, between Echo CG results and NT-pro-BNP values was stated.

Conclusions. The obtained results make it possible to use NT-pro-BNP as a screening criterion of FAD hemodynamic significance in extremely premature newborns.

Objective. To study the indicators of the dental status in professional athletes.

Materials and methods. The object of the study was 200 professional female athletes representing various kinds of sport and 200 practically healthy female individuals who are not involved in sports. The total sports experience of the subjects was on average 13–15 years. The prevalence of periodontal diseases among female athletes was determined using the CPITN index. The prevalence and intensity of caries was determined by the CPI index. The hygienic state of the oral cavity was determined using the oral hygiene efficiency index (PHP). In the main group, patients were administered applications of a drug based on propolis and vegetable oil for two weeks; in the comparison group, the traditional antiseptic, chlorhexidine bigluconate, was used for the same period.

Results. In the control group, the prevalence of chronic generalized gingivitis was on average two times less than in the main group, in which the value of this indicator varied within 50 %. Among all the studied diseases of the oral cavity in athletes in general, the most essential and significant differences were observed in relation to the prevalence of dental caries and its complications, which were more common in the group of athletes than in the control group – 95.0 ± 1.54 %, versus 89.5 ± 2.17 %, respectively (p < 0.001). The need for treatment of moderate and severe inflammatory periodontal diseases in the main group was approximately 1.5 times higher than in the control group (77.0 ± 2.98 vs. 42.5 ± 3.50 %, p < 0.001), and for gingivitis almost 2 times higher than in the control group (61.5 ± 3.44 vs. 39.0 ± 3.45 %, p < 0.001). The results of the study showed that among the oral diseases in sportswomen, the most essential and significant differences were observed in the prevalence of dental caries and its complications. The intensity of periodontal tissue damage over the entire period of sports career in athletes of the older age group corresponded to moderate and severe periodontitis. The high percentage of cases of major dental diseases detected among female athletes indicates their high need for periodontal care.

Conclusions. Regular use of a biologically neutral propolis-based preparation for preventive purposes leads to a relatively more pronounced improvement in laboratory and clinical indicators of the oral cavity status.

Objective. The aim of the study is to investigate the peculiarities of changes in the immune status of individuals with active and latent forms of herpesvirus infections. Herpesvirus infections are an urgent problem of modern health care.

Materials and methods. The prospective longitudinal cohort study included 92 permanent blood donors who were examined twice at 6-month intervals for the presence of specific IgM and IgG antibodies and antigens of herpes simplex viruses 1, 2, Epstein-Barr, cytomegalovirus, human herpesvirus type 6, as well as humoral immunity indicators.

Results. In the period from October to April, 68.5 % of blood and its components donors were found to have markers of active herpesvirus infection caused by HSV 1, 2, EBV, CMV, and HHV6. The combination of the detected markers in the absence of clinical manifestations and changes in General and biochemical blood tests indicated asymptomatic reactivation of latent infection. The frequency of reactivations in the autumn and spring months is the same. The absence of IgG production after asymptomatic reactivation of HSV-2 and HHV-6 infections and an increase in IgG concentrations to HSV-1, EBV, and CMV were revealed. EBV infection is the most common among the studied nosologies (98.91 %) and is characterized by statistically significantly higher levels of specific IgG. The effect of asymptomatic reactivation of herpesvirus infections on the levels of total IDA, IgM, IgG, IDE, and CEC was not established.

Conclusions. Asymptomatic reactivation of herpesvirus infections does not significantly affect the changes in immune status indicators, and the absence of clinical manifestations, and significant changes in General and biochemical blood tests cause epidemiological risks associated with difficulties in identifying the sources of infection.

Chronic non-infectious diseases are the leading cause of premature death according to the WHO data. This review considers the evolution of studying and modern views of domestic and foreign authors on the role of skeletal muscles in maintaining health and preventing chronic non-infectious diseases. An idea regarding the nervous and reflex influence from the working muscles on both individual organs and the body as a whole is presented. The role of myokines, specific proteins produced by skeletal muscles, capable of influencing the state of many organs and systems, is described.

Objective. To assess the efficiency and realizability of the surgical technique of aortic valve reconstruction using autologous pericardium treated by glutaraldehyde in different aortic valve diseases such as aortic stenosis, aortic regurgitation, rheumatic and degenerative diseases of aortic valve. In 2014, Ozaki presented the technique described.

Materials and methods. In this work we analysed 10 cases of ministernomy combined with Ozaki procedure in patients operated at “Sukhanov Federal Center for Cardiovascular Surgery”.

Results. No hospital mortality was registered in our study. Intraoperatively, transition to a full sternotomy was not required. A mean time of aortic cross-clamping was 84.6 (± 14.4) minutes, a mean value of artificial circulation was 103.1 (± 17.7) minutes, a mean time of ventilation was 8.4 hours, and a mean time of staying in intensive care unit room was 1.6 days.

Conclusions. Minimally invasive approach combined with Ozaki procedure is realizable; it is an alternative to conventional sternotomy and should be used for patients in grave condition having concomitant diseases.

Objective. To study the sanitary and parasitologic state of environmental objects in Astrakhan Region for 2015–2019 at the example of studying the samples of soil, water and solid surface washes.

Materials and methods. Over the period from 2015 to 2019, at the laboratory departments of “The Center for Hygiene and Epidemiology in Astrakhan Region”, 15253 samples from different environmental objects were taken, 21850 studies were carried out. The number of samples, which did not satisfy the hygienic norms, was 2.5 % (383 samples).

Results. For the analyzed period, 4002 samples (26.2 %) of soil from the territory of Astrakhan and Astrakhan Region were taken and studied; 8004 investigations were performed. The number of samples, which did not satisfy the hygienic standards, was 7.5 % (300 samples). The number of samples of the washes from the solid surfaces was 56.7 % (8656 samples). Unsatisfactory samples made up 0.01 % (1 sample) – in this sample, teniid oncospheres were detected (2019). The study of water samples taken from different water objects formed 17.0 % (2595 samples) out of the number of all sanitary and parasitologic studies carried out in 2015–2019. Water was taken from different sources of water supply including centralized water supply, water from swimming pools, water from open reservoirs and wastewater.

Conclusions. The presence of moving larvae of palisade worms and toxocar eggs in the soil confirms the infested animal fecal contamination of this object, and the presence of ascarid, opisthorchis, Hymenolepis nana, teniid oncospheres eggs and dysentery amoeba cysts in the soil – the infested human fecal contamination. The presence of teniid oncospheres in the solid indoor washes demonstrates the contact of the infested person with this object. The presence of helminth eggs and larvae, typical for animals and human being in the samples taken from the open reservoirs indicates, first of all, contamination of these objects by feces of infested human beings and/or animals as well as the supposed version of water contamination by wastewater. The presence of eggs and larvae of helminths in the wastewater, dangerous for animals and human beings, testifies to a low-quality work of treatment facilities.

Objective. To study the sanitary and parasitological state of food products in Astrakhan Region for their contamination with eggs and larvae of helminths, as well as cysts of pathogenic intestinal protozoa.

Materials and methods. The work was carried out on the basis of the Laboratory of Bacteriological and Parasitological Research of the Center for Hygiene and Epidemiology in the Astrakhan Region in 2015–2019. A total of 1.430 food samples were examined and 2207 studies were performed during the analyzed period. The number of unsatisfactory samples was 4.6 % (n = 66) – the following was found: larvae of Strongyloides stercoralis – 84.8 % (n = 56), eggs and metacercariae of Opisthorchis felineus – 4.5 % (n = 3), cysts of Entamoeba histolytica, larvae of Strongyloides stercoralis + Ascaris lumbricoides – 3.0 % (n = 2), eggs of Ascaris lumbricoides and Enterobius vermicularis – 1.5 % (n = 1) and larvae of Strongyloides stercoralis + Toxocara Canis – 1.5 % (n = 1).

Results. The largest number of selected and investigated food samples was accounted for fruit and vegetable samples – 54.3 % (n = 777), of which 8.4 % (n = 65) of the samples were unsatisfactory. In these samples, larvae of Strongyloides stercoralis were found – 86.2 % (n = 56) of all positive findings of fruit and vegetable products, eggs of Opisthorchis felineus and cysts of Entamoeba histolytica – 3.1 % (n = 2 each), as well as unfertilized eggs of Ascaris lumbricoides and eggs of Enterobius vermicularis – 1.5 % (n = 1 each). In addition to isolated findings, there were noted cases of mixed invasion: larvae of Strongyloides stercoralis + unfertilized eggs of Ascaris lumbricoides-3.1 % (n = 2) and larvae of Strongyloides stercoralis + eggs of Toxocara canis – 1.5 % (n = 1).

Conclusions. The presence of Toxocara eggs and strongylid larvae on the samples of fruit and vegetable products indicates soil contamination with feces of invasive animals. The presence of ascarid eggs on food indicates contamination of the soil with the feces of infested persons. The presence of opisthorchis eggs on the samples of cucumbers and tomatoes, and cysts of dysentery amoeba on the samples of cucumbers and cabbage indicates contamination of water used for watering these products with eggs and cysts of pathogenic intestinal protozoa. The presence of pinworm eggs on cucumbers indicates contact of an infected person with this product. Contamination may have occurred when the product was transported to the laboratory.

Ahterosclerosis of vessels of the lower extremities is widely distributed in the population. Open surgical revascularization is an efficient method for treatment of this pathology. One of the rare postoperative complications is an anastomosis aneurysm development. We report about a clinical case of a 74-year-old male with a giant (25 cm in diameter) aneurysm of the proximal anastomosis after femoropopliteal bypass. Open aneurysmectomy was performed, and the postoperative period was uneventful.

Hyperparathyroidism is an endocrine disease characterized by excessive production of parathyroid hormone in the main cells of the parathyroid glands. Depending on the cause of this disease, there are primary, secondary (SHPT) and tertiary hyperparathyroidism. The most common causes of SHPT are vitamin D deficiency and chronic kidney disease (CKD). Vitamin D is converted to its active form by hydroxylation in the renal tubules. Developmental abnormalities and chronic kidney diseases lead to atrophy of the tubular epithelial cells that causes a violation of vitamin D metabolism and the development of SHPT, which in turn are accompanied by a violation of calcium-phosphorus metabolism and a syndrome of musculoskeletal disorders. This article presents an analysis of a clinical case of a patient diagnosed secondary hyperparathyroidism against the background of vitamin D deficiency combined with polycystic kidney disease. This clinical case reflects the complexity of the differential diagnosis of the disease and the tactics of patient's management.