Vol 36, No 2 (2019)

Aim. To assess the results of distal pancreatectomy for malignant and benign tumors and chronic pancreatitis complications.

Materials and methods. Forty-seven patients, who underwent distal pancreatectomy, were under observation during the period from 01.01.2008 to 28.02.2019.

Results. The long-term results of surgical treatment demonstrated the following complications: pancreatic fistulas – 15 % of observations, pancreatogenic diabetes mellitus – 12.7 %, subphrenic abscesses – 10 %. In the long-term period after the surgery – from 10 years and not less than one year – 30 patients were followed up, constituting 63.8 % of the total number.

Conclusions. To prevent complications in the form of pancreatic fistula with pathological Wirsung duct dilatation more than 4–5 mm in diameter, it is necessary to form anastomosis between the pancreatic stump and the small bowel.

Aim. To study the oncological expediency of using vascular techniques in organ-saving treatment of lung cancer.

Materials and methods. Over the period of 2009–2016, there were performed 92 lobectomies with resection and reconstruction of the pulmonary artery in patients with non-small carcinoma of the lung.

Results. No intraoperative complications and lethal outcomes were fixed. The postoperative complications were registered in 23 cases (25.3 %). Lethality was 3.3 %. The overall one-year survival rate in patients with stage I–III lung cancer after organ-saving surgery was 96.7 %, three-year – 65.1 %, five-year – 36.6 %, median survival rate – 53.1 months. The recurrence-free survival rate in patients with stage I–III lung cancer was: one-year – 89.9 %, three-year – 65.3 %, five-year – 48.8 %. The median recurrence-free survival rate was 49.8 months.

Conclusions.Angioplastic lobectomy provides an acceptable short and long-term result, which does not yield to the analogous indices for pulmonectomy. It confirms our opinion on the expediency of implementing this procedure regarding non-small carcinoma of the lung.

Aim. To improve the results of patients’ treatment after midline laparotomy by reducing the number of the postoperative ventral hernias and eventrations.

Materials and methods.There were examined 111 urgent patients, operated through the median laparotomic approach. The main group included 48 persons, for whom,on completion of intervention,the white line was sutured with a chess-staggered suture(patent of RF № 2644846, 14.02.18). In the control group, for median aponeurosis interrupted sutures were used.

Results. In the early postoperative period, in the control group there were 2 (3 %) eventrations, in the main group – no eventrations. After one year of observations, in the main group – 3 (6 %) patients with aponeurosis defects by the postoperative scar USI and 2 (4 %) patients with hernias were found out. In the control, one year after the surgery, there were 6 (9.5 %) aponeurosis defects and 5 (8 %) postoperative hernias.

Conclusions. Application of interrupted chess suture in combination with staggered sutures is the way to prevent eventrations and postoperative ventral hernias in urgent surgery.

Aim. To assess the rate of sensitization to the grades of apples of various colours and analyze the association of the obtained indices and total sIgE levels of these grades with the severity of atopic dermatitis.

Materials and methods. The blood sera of 215 patients, suffering from alimentary allergy, were studied. The detection rate of sensitization and that of specific immunoglobulin E (sIgE) concentration sum to allergens of apple grades with various coating colours as well as the association of these indices with the degree of severity of atopic dermatitis (AD) was analyzed. Test-systems were used for immune-enzyme analysis of production. Statistical analysis of the obtained results was performed using the program “MedStat” (Donetsk).

Results. It was shown that the detection rate of sensitization to the grades with mixed red colour is reliably higher (p < 0.001) compared to the grades without coating colour. The degree of AD severity correlates with the total quantity of apple grades, to which sensitization has been revealed (p < 0.01), with the quantity of grades with mixed red colour, to which sensitization has been found (p < 0.01) and with sIgE sum to the grades with mixed red colour (p < 0.01). Reliable differences (p = 0.006) in the degree of severity of atopic dermatitis among persons, sensitized to apple grades and with no sensitization to this fruit were established.

Conclusions.The obtained data are to be used when choosing a diet and correcting it for persons with alimentary allergy and atopic dermatitis.

Aim. To study the physiological and neuropsychological features of adaptation to training in conditions of Western Ural among foreign students from India.

Materials and methods. The object of study – first-year foreign students from India and Russian students of E.A. Vagner Perm State Medical University (52 and 47 persons, respectively). There were studied the parameters of physical development and cardiovascular system, including those with loading, as well as hypoxia tolerance tests. The following indices were calculated: body mass index (BMI), Robinson and Kerdo index, cardiac performance index (CPI), strength index (SI). The health level was calculated by G.L. Apanasenko. Peculiar features of students’ neuropsychical status were studied using the following surveys: Spilberger-Hanin Anxiety Scale to determine personal and situational anxiety, Beck Depression Inventory (BDI), scale for assessment of depression symptoms CES-D, scale for assessment of quality of life SF-36 with subscales, Epworth Sleepiness Scale, asthenia scale MFI-20, CAM (cenesthesia, activity, mood).

Results. Among Indian students, dispersion of BMI values and lower dynamometry indices were established. Hypoxia tolerance in the groups was similar. Kerdo index values in the group of Indian students showed a tendency to vagotonia, in the control group – to normotonia. No significant differences in other indices were registered. Health level in the studied groups was in “dangerous” zone regarding the risk for development of chronic noninfectious diseases, especially in the group of Indian students. The situational anxiety level by Spilberg 1 scale, and depression level by CES-D scale were reliably higher in the group of foreign students (p < 0.0001). SF-36 PF and SF-36 GH scores in Indian students were reliably lower versus Russian. Psychical component of health by SF-36 MH subscale was significantly higher in Russian students.

Conclusions. Among first-year students from India, who study at Perm State Medical University, there is observed a complex adaptive syndrome, which needs to be taken into account and corrected to prevent deadaptation disorders and raise progress in studies as well as quality of life and health status.

Aim. To analyze a long-term dynamics of the primary morbidity of circulatory system in the population of Perm and Perm Krai.

Materials and methods. The primary circulatory system morbidity per 1000 of the population of Perm Krai and Perm was analyzed under the materials of Perm Regional Medical Information-Analytical Center. Statistical processing of the data was performed using Microsoft Excel 2016.

Results. Over the period from 2007 to 2017, there was established a growth of the level of primary circulatory system morbidity as a whole and ischemic heart disease in particular among the population of Perm Krai and Perm. Morbidity rate was essentially higher in the inhabitants of Perm Krai but annual gain rate – more significant in the urban population that is explained by availability and quality of medical care and social factors. The growth of the level of primary diseases, characterized by increased arterial pressure, is insignificant during this period of observation. The average annual increase was 1.54 % in the inhabitants of Perm and 0.53 in Perm Krai.

Conclusions. The level of primarily detected circulatory system diseases in the population of Perm Krai and Perm essentially raised for 11 years of observation. Primary IHD morbidity indices as well as average annual rate of their growth is significantly higher than the analogous indices of diseases, characterized by increase in arterial pressure.

Aim. To implement physiologo-hygienic studies regarding the period of remission of chronic diseases after sylvinite therapy for introducing them into medical practice.

Materials and methods. Hygienic assessment of internal environment conditions of modern saline devices taking into account their constructive features was carried out. Physiological functions of the main systems of an organism were analyzed in patients, who received the course of mineral prophylaxis.

Results. In modern sylvinite constructions there is formed a favorable environment, rendering a positive preventive influence on patients’ organism.

Conclusions. Physical properties of natural potassium salts, used to prevent chronic diseases, contribute to prolongation of remission period.

Aim.To assess the growth properties and formation of E. сoli biofilms with different concentrations of cholesterol available.

Materials and methods. E. coli strains were cultivated in the meat-peptone broth with cholesterol added in the concentration of 3, 5, 7 and 9 mmol/l as well as in the nutrient medium without cholesterol. The growth parameters and cholesterol concentration in the samples prior to and after cultivating microorganisms and the effect of cholesterol on biofilm-forming activity of E. coli was determined.

Results. Cholesterol was shown to have no bactericidal effect on E. coli, however, it is able to change the duration of growth phases of the strains that is, possibly, caused by adaptation to the presence of cholesterol and switching of metabolic pathways. Cholesterol has a stimulating effect on accumulation of biomass by the test-strain and its biofilm-forming activity.

Conclusions. In the study performed, the ability of E. coli to metabolize human cholesterol was shown.

The paper presents a case of pregnant woman with polycystic ovary syndrome, which occurred after hemorrhagic stroke and detected dissecting aneurysm of the ascending aorta at the sinus level. Removal of non-viable fetus was performed, coronaroangiography, resection of aneurysm of ascending aorta and replacement of valve-containing conduit was successfully implemented.