Vol 38, No 2 (2021)

Objective. The aim of investigation was to evaluate the bacteriolytic activity of the peripheral blood of healthy donors against S. aureus. Currently, much attention is paid to the involvement of opportunistic microorganisms in the development of infectious and inflammatory diseases, among which one of the leading places is occupied by the processes of staphylococcal etiology. Staphylococcus aureus possesses a unique spectrum of pathogenic factors, which, together with intracellular persistence, allow staphylococci to avoid exposure to immune factors and other agents.

Materials and methods. The bacteriolytic activity of the peripheral blood of 32 healthy donors, as well as the ability of the whole blood and serum to destroy biofilms, were evaluated. The phagocytic activity of peripheral blood monocytes and neutrophils and the ability to produce hydroxyl radicals were analyzed. For opsonization of S. aureus, a commercial immunoglobulin G or donor serum was used.

Results. It was shown that the whole peripheral blood practically does not have a significant effect on the number of viable cells of S. aureus. However, freshly obtained blood serum significantly destroys the biofilm. It has been established that a fifth part of peripheral blood leukocytes is absorbed by S. aureus. After opsonization of microbial cells with immunoglobulin G, the indices of phagocytic activity of monocytes and neutrophils did not change significantly. When using freshly obtained serum for opsonization of objects, a stimulating effect on the production of hydroxyl radicals by leukocytes was revealed (2758.7 ± 725.3 and 870.6 ± 197.4 related light units, respectively; p < 0.05). After heating the serum at 56 °C, the stimulating effect was leveled (1091.1 ± 234.7 related light units; p > 0.05 for samples with non-opsonized objects). In general, the obtained data indicate that the complement components can be recognized as the most effective system for the elimination of S. aureus.

Conclusions. Thus, S. aureus uniquely adapted to the human body that allows staphylococci to persist for a long time without clinical manifestations. It can be assumed that among the factors of the immune system, the proteins of the complement system, which destroy both S. aureus cells and the biofilm matrix, probably have the most effective bactericidal action. However, the effectiveness of this system depends on the protein-synthesizing function of the liver, the availability of microorganisms to the action of complement.

Objective. To characterize the physical qualities and autonomic regulation in adolescents with postural disorders.

Material and methods. 124 teenagers aged 16-17 including 58 boys and 66 girls were examined. There were 2 groups of patients: with postural disorders in the sagittal (n = 57) and frontal plane (n = 67). The examination program included an assessment of physical development, somatotype, general endurance and static endurance of the large muscles of the back and trunk, autonomic regulation by analyzing heart rate variability, levels of personal and situational anxiety, as well as self-esteem.

Results. Adolescents with impaired posture in the sagittal plane are characterized by the predominance of the asthenoid somatotype, a high frequency of body weight deficiency, a decrease in overall endurance, as well as endurance of the back and abdominal muscles, and a predominance of the activity of the parasympathetic autonomic nervous system. In this category of patients, the thoracic and muscular types of physique predominate in the frontal plane of postural disorders, and there is a significant asymmetry in the static endurance of the lateral muscles of the trunk, and an increase in the functional activity of the sympathetic autonomic nervous system. In both of these variants of postural disorders in adolescents, there is a high frequency of undifferentiated connective tissue dysplasia, sympathetic hyperreactivity, personal and situational anxiety, and a decrease in self-esteem.

Conclusions. Features of physical qualities, vegetative regulation and psychological sphere should be taken into account when developing differentiated programs for correcting posture in adolescents, depending on the plane of its violation.

Objective. The aim of the work was to study the fatigue syndrome in various organic brain diseases.

Materials and methods. Patients in the recovery period of hemispheric stroke, with Parkinson's disease and multiple sclerosis were examined. Along with the clinical one, there was conducted a study using the asthenia questionnaire MFI-20, FIS (Fatigue Impact Scale), FSS (Fatigue Severity Scale).

Results. It has been established that patients with various diseases of the central nervous system have a syndrome of fatigue, which is a nosogenic one, that is, a consequence of organic brain damage.

Vascular endothelial growth factor (anti-VEGF) inhibitors in action have demonstrated efficacy and safety in the treatment of diabetic macular edema (DME), and have changed both the goal and prospects for treatment of this disease. Consequently, the role of focal laser retinal photocoagulation in the treatment of DME has been actively debated. However, technical advances in new laser systems, treatment protocols for anti-VEGF drug research, and the functional impact of modern focal photocoagulation are necessary to assess the role of laser coagulation in the treatment of DME. A wide range of clinical studies of laser therapy was necessary as an additional treatment for 20 to 50 % of patients receiving monotherapy with anti-VEGF drugs in patients with diabetic macular edema. In addition, a lower frequency of repeated treatment and a more stable reduction in retinal thickness have been demonstrated in other studies. However, the lack of information about the laser systems used, their technical characteristics, and application protocols often make it difficult to compare directly the results of anti-VEGF tests. Therefore, the aim of our work was to analyze the currently available data related to the potential role of focal laser photocoagulation in the treatment of DME, including a detailed review of the most commonly used laser systems. The results obtained with sub-threshold diode micro-pulse laser photocoagulation may be a valuable option as an adjunct therapy to treatment with angiogenesis inhibitors. Current evidence suggests that focal laser therapy should still exist as an adjunct therapy for many patients.

The article discusses the features of obstetric and gynecological anamnesis in patients with endometrial polyps in the postmenopausal period, compares the ultrasound protocols and data of morphological examination of the surgical material (n = 100). The results showed that endometrial polyps are detected with the same frequency in patients in the early and late postmenopausal period. It is noteworthy that every five patient with an endometrial polyp in the reproductive age had menstrual dysfunction and a high frequency of using intrauterine contraceptive. In order to verify the pathology of the uterine cavity, ultrasound infusion sonography was not used in the studied group of patients. There was a high frequency of the absence of visualization of endometrial polyps on TV ultrasound, besides, they were frequently verified as endometrial hyperplasia; overdiagnosis took place in more than 7.5 cases; morphological examination confirmed hyperplasia only in 8% of 60 % of patients. It is important to note that in case of malignant endometrial processes, TV ultrasound did not reveal even a suspicion of this. All of the above allows us to say that there is a need for further study of the tactics of managing patients with endometrial pathology in the postmenopausal period.

Objective. Hygienic assessment of the quality of drinking water from two rivers, Kama and Chusovaya, which supply the city of Perm, was carried out. Water in them is different in mineral composition, but similar in terms of anthropogenic pollution.

Materials and methods. Dental status was determined in 142 schoolchildren aged 15-17 years old, who use water from different sources. The concentration of total calcium and magnesium in the oral fluid was determined for all schoolchildren.

Results. The study found that the degree of mineralization of drinking water affects the mineral composition of the saliva. Schoolchildren, who use drinking water of low mineralization, have a low concentration of calcium and magnesium in the saliva and a high intensity of dental caries. Schoolchildren, who use drinking water of increased mineralization, have a high concentration of calcium and magnesium in the saliva, a low intensity of dental caries and a high intensity of periodontal diseases due to an increased formation of tartar. Treatment and preventive measures, carried out among schoolchildren, included the drug «Complivit», plates «CM 1», low-intensity laser light.

Conclusions. The effectiveness of treatment and preventive measures was determined by the activity of the oral fluid enzymes before and after the course of treatment.

Objective. The aim of the study was to estimate the prognostic value of GDNF in acute IS patients. Glial neurotrophic factor (GDNF) is a neuropeptide, which promotes the proliferation and differentiation of the cells of the central and peripheral nervous system, possesses antihypoxic and neuroprotective properties in ischemic stroke (IS).

Materials and methods. 50 patients with first-ever acute IS were examined at the National Institutes of Health Stroke Scale (NIHSS); modified Rankin scale was used on admission to the hospital, 7 and 14 days after stroke. The plasma GDNF level was measured at the first 48 hours and after 7 days of IS onset. GDNF was analyzed by commercially available ELISA kit. The comparison group included 20 healthy persons.

Results. The average GDNF level in the group of patients with IS (3.4 [2.8; 5.0] pg/ml) was significantly higher than in the group of healthy individuals (2.8 [2.6; 2.9] pg/ml), p = 0.02.

The risk of unfavourable functional outcome on the day 14 after IS onset was higher by 2.8-fold in those patients whose level of GDNF was increased on the 7th day of the disease by more than 30% compared to its level in the first 48 hours (RR = 2,8; 95% CI [1,4–5,7]).

The GDNF level less than 2.9 pg/ml was associated with a high risk of death during 14 days after the IS onset (RR = 6,7; 95% CI [1,5–30,5]).

Conclusions. Plasma concentrations of GDNF have a high predictive value for unfavorable functional outcome and risk of death in acute period of IS.

A clinical case was analyzed, the regularity and dynamics of psychoneurological symptoms was studied in a patient with a moderately severe form of the course of a new coronavirus infection with concomitant neurodegenerative disease – Alzheimer's disease.

The patient aged 73 was admitted to the City Clinical Hospital №2 named after F.H. Gral by the team of emergency care with identified COVID-19. When admitted to the hospital, she had disability group 2 regarding neurodegenerative disease – Alzheimer's disease. A multispiral computed tomography of the head revealed the following: internal open substitutional hydrocephalus, moderately expressed bilateral leukoaraiosis, cerebral atrophy, predominantly in temporoparietal region, that is typical for Alzheimer's disease.

The results of tests indicated a decrease in cognitive status. In the test with figures, the patient could not find the required figure for the desired time. When conducting “clock-drawing test” in dynamics, at the second attempt the patient needed about 7 minutes; a worse capability for drawing was noted; apraxia was observed. The result of the test “6CIT” at the second attempt, carried out before discharge from the hospital became worse – she could answer only one of four questions, whereas at the first attempt, when admitted, she could answer two questions of four. By the time of discharge from the hospital, the patient was noted to have more pronounced cognitive disorders than at admission. Emotional lability, nervousness and anxiety also remain.

Objective. To study the sensitivity to chemical disinfectants against Mycobacterium tuberculosis isolated from HIV-infected individuals and patients with monotuberculosis in comparison to the reference strain of Mycobacterium terrae.

Materials and methods. The sensitivity of 12 M. tuberculosis strains isolated from patients with HIV-associated tuberculosis (n = 6) and monotuberculosis (n = 6) to chlorine-containing and quaternary ammonium compound (QAC) disinfectants was studied. The M. terrae strain was used as a reference. Seedings of microbial suspensions treated with disinfectants on the culture medium Levenshtein-Jensen were carried out and were monitored for 3 months.

Results. One, two, three months following the treatment of microorganisms with QAC-containing disinfectant in the absence of growth of the control strain, there was noted growth of M. tuberculosis, particularly intense in the strains isolated from HIV-infected persons.

Conclusions. Thus, the resistance of tuberculosis pathogens to disinfectants can be acquired.

M. tuberculosis strains isolated from patients with HIV-associated tuberculosis are detected to be more resistant to disinfectants than the strains isolated from patients with monotubercular infection.

The paper presents historical stages in the development of the Department of Epidemiology and Hygiene of E.A. Vagner Perm State Medical University. The evolution of technologies, forms and methods used in educational process are described. There are formulated the directions of activity of the department and the experience of work with organs and institutions of public health and Rospotrebnadzor.