Vol 21, No 1 (2015)


The application of Ipilimumab in treatment of patients with metastatic melanoma

Samoilenko I.V., Harkevitch G.Y., Demidov L.V.


The article presents intermediate results of analysis of effectiveness and tolerance of Ipilimumab applied within the framework of program of broadened access CA184-089 EAP. Ipilimumab is a new immune stimulator blocking receptors of CTLA4 om lymphocytes and regenerating anti-tumor immune response. The analysis covered 52 patients receiving treatment from October 2011 to August 2012 in the N.N. Blokhin Russian oncologic national center. The effectiveness of pharmaceutical corresponded to previously published data. The median of total survival in all population of patients made up to 13.7 months (confidence range 95% from 8.0 to 19.5 months). The six-moths total survival made up to 77.5±5.9%, one-year survival made up to 45.9±7.9%. No new undesirable occurrences were detected. Altogether, 9 severe undesirable occurrences were registered (from third to fifth degrees of severity according CTCAE V4.0) in seven patients (13.5%), one with lethal outcome (1.9%).
Medical Journal of the Russian Federation. 2015;21(1):4-9
pages 4-9 views

The optimization of surgical treatment of patients with varicose disease of lower extremities

Bokeria L.A., Mikhailichenko M.V., Kovalenko V.I.


The comparative analysis was implemented concerning endo-venous laser obliteration (group I, n=290), and combined phlebectomy (group II, n=112) in complex surgical treatment of patients with varicose disease of lower extremities of class C2-C4. In group I 97.4% of patients developed obliteration of trunk of great saphena. In group II lack of great saphena was detected in 90.2% of patients. The post-operation complications (pain, paresthesia, haematoma) were more distinctly expressed in group I. To evaluate quality of life of patients in one year after operation questionnaire CIVIQ-2 and scale VCSS were implemented. The indicators in group I made up to correspondingly 16.8±0,5 and 1.2±0.3 and in group II - 20.2±1.1 and 1.9±0.4. Therefore, as compared with patients after combined phlebectomy, in patients after endo-venous laser obliteration quality of life increased and severity of clinical occurrence of varicose disease decreased in more degree. The article affirms that in patients operated on the occasion of varicose disease of lower extremities it is not enough to apply only physical methods of prevention of thrombosis of saphena. Under choosing method of anti-thrombotic prevention and determination of its volume the approach is to be strictly individual. The treatment is to be implemented as task-oriented and is to consider domination of different factors determining hemoreology and hemostasis. Two different technical alternatives of endo-venous laser obliteration were applied. In group I, it was laser with wave length 1030 nm, butt-end optical conductor, linear density of energy 80-100 J/cm. In group II it was laser with wave length 1470 nm, radial optical conductor with automated traction (0.7 mm/s, linear density of energy 80-100 J/cm). In patients of group II the post-operation period was accompanied with less expressed pain syndrome, lower rate of development of haematoma in early post-operative period and also better results in remote times.
Medical Journal of the Russian Federation. 2015;21(1):10-14
pages 10-14 views

The endoscopic hemostasis in patients with ulcer gastro-duodenal bleedings

Lebedev N.V., Klimov A.E., Petukhov V.A.


The article presents analysis of results of treatment of 698 patients with successfully implemented primary endoscopic hemostasis with purpose to stop or to prevent bleeding. The comparative analysis of results of prevention of relapse of ulcerous bleeding depending on specific technique of endo-hemostasis (electrical coagulation, radio-wave coagulation, orgonoplasm coagulation) revealed no statistically reliable advantage of any mode. All methods are equal alternatives.
Medical Journal of the Russian Federation. 2015;21(1):15-18
pages 15-18 views

The correction of micro-circulatory disorders in strategies of management of osteoarthritis and osteohondropathies

Vanov A.N., Fedonnikov A.S., Norkin I.A., Puchinian D.M.


The article presents international and Russian data revealing necessity of development of new approaches to medical management under diseases of musculo-skeletal system because of considerable medical social consequences. The role of micro-circulatory disorders as a point of application of therapeutic strategies under treatment of osteoarthritis and osteohondropathy is substantiated using results of modern scientific research studies. The article presents comprehensive analysis of public statistic data, experimental and clinical studies permitting concluding that effective correction of micro-circulatory disorders can level medical and social economic consequences of considered nosologic forms. The necessity to expand studies of micro-circulation in corresponding category of patients is for development of new schemes and algorithms of treatment is substantiated. The perspective of considering correction of micro-circulatory disorders as a significant direction of management of diseases of musculo-skeletal system is demonstrated.
Medical Journal of the Russian Federation. 2015;21(1):18-23
pages 18-23 views

The indicators of lipoprotein metabolism and their association with psycho-emotional factors in healthy individuals

Bastrikov O.Y.


The article deals with studying indicators of lipoprotein metabolism in relationship with psycho-emotional factors in healthy individuals. The sampling included 107 healthy individuals of able-bodied age from organized population (46 males and 61 females) with mean age made up to 43.4±10.8 years. All examined individuals were applied clinical psychological study using such questionnaires as Spielberger-Khanin test, Center for Epidemiological Studies Depression cale (USA), visual analogue scale-modified version of Dembo-Rubinstein technique, social frustration scale, Holmes-Rahe social adaptation test. To analyze indicators of lipidogram venous blood was taken. The most of lipid indicators were higher in individuals with clinically significant levels of depression, personal anxiety and accumulated stress independently of gender. In female group statistical reliability was reached by mean indicators of total cholesterol, cholesterol lipoproteins of low density, cholesterol not bounded with lipoproteins of high density. In male group statistical reliability was reached by ratio apoB/apoA. The most prevalence of dislipoproteinemia was established in male group and at that reliable differences were reached by rate of hypertriglyceridemia and higher level of apoB100. The rate of personal anxiety and clinically significant stress measured by Holmes-Rahe scale was reliably higher in group of examined females and made it up to 75% and 36% correspondingly. In both groups association of psycho-emotional factors with indicators of lipid profile was established. At that, in males the study detected an independent relationship between both of level of personal anxiety and social frustration and apoproteins and between cumulated stress and level of cholesterol not bound with lipoproteins of high density as well. In females association of accumulated stress according Holmes-Rahe scale with level of total cholesterol and atherogenity index was established. The study data indicate at necessity to determine means of development of complex primary prevention of stress-induced disorders of lipoprotein metabolism with consideration for psycho-emotional factors and gender characteristics of their effect.
Medical Journal of the Russian Federation. 2015;21(1):24-27
pages 24-27 views

The prevention of development of syndrome of hyperstimulation of ovary in program of extra-corporeal fertilization

Scherbakova L.N., Ivanova N.V., Bugerenko A.E., Panina O.B.


The article presents results of comparative analysis of procedure of extra-corporeal fertilization in female patients with early (before embryo transfer) and late (after embryo transfer) syndrome of hyper-stimulation of ovary. The common risk factors for early and late syndrome of extra-corporeal fertilization (age less than 32 years, body mass index less than 24.5 kg/m2, syndrome of poly-cystic ovary) and specific risk factors for early form (male sterility, application of agonists of gonadotropin -releasing hormone) and late form (onset of multiple pregnancy) of syndrome of extra-corporeal fertilization are established. The techniques of prevention of early and late syndrome of extra-corporeal fertilization are presented.
Medical Journal of the Russian Federation. 2015;21(1):28-31
pages 28-31 views

The clinical immunologic effectiveness of application of complex immunoglobulin preparation in children aged less than 1 year with acute obstructive bronchitis

Kustova Y.Y., Tyurin N.A., Aleshkin V.A., Kuzmenko L.G., Vaganov P.D., Ponurina R.L., Yanovskaia E.Y.


The article considers application of complex immunoglobulin preparation in comprehensive treatment of acute obstructive bronchitis in children of infancy age with purpose to develop intestinal local immunity. The complex immunoglobulin preparation is a pharmaceutical for enteric application derived from donor blood. In contrast, with normal human immunoglobulin, the preparation includes immunoglobulines of three classes (50% IgG, 25% IgM, 25% IgA) and is characterized by increased content of antibodies to different pathogenic and opportunistic agents.
Medical Journal of the Russian Federation. 2015;21(1):32-34
pages 32-34 views

The new respiratory viral infections

Isaeva E.I.


Nowadays more than 200 agents of acute respiratory viral infections - viruses relevant to different families of orthomyxoviruses (influenza virus), paramyxoviruses (parainfluenza virus, respiratory syncytial virus, human metapneumovirus), adenoviruses, rhinoviruses, coronaviruses, human bocaviruses, etc. The viruses of respiratory viral infections through droplet way penetrate cells of epithelium of mucous membrane of upper respiratory ways where replicate and affect other organs and tissues and bring on rise of temperature, shiver, rhinitis, headache, throat pain and cough. Besides feverish forms of respiratory viral infections, complications in form of encephalitis, paralysis and lethal outcome are described. The review considers data concerning diagnostic and clinical epidemiological characteristics of new viruses of respiratory viral infections. The human metapneumovirus is a recently identified human paramyxovirus. The diagnostic of infection of human metapneumovirus is based on detection of viral RNA using reverse transcription combined with polymerase chain reaction and immune enzyme analysis to identify specific antibodies. The human bocavirus is a new parvovirus bringing on respiratory viral infections in children in various countries of the world. This virus also is capable to bring on acute gastroenteritis and persist in children asymptomatically. The detection of human bocavirus DNA using polymerase chain reaction remains the most reliable technique of diagnostic in clinical samples.
Medical Journal of the Russian Federation. 2015;21(1):35-39
pages 35-39 views

The role of multi-detector computer tomography in diagnostic of venous thromboembolism

Yudin A.L., Uchevatkin A.A., Afanasieva N.I., Yumatova E.A., Kulagin A.L.


The venous thromboembolism comprising thrombosis of deep veins and thromboembolism of pulmonary artery remains one of main problems of modern medicine. The multi-detector computer tomography - angiopulmonography is the most effective technique of diagnostic of thromboembolism of pulmonary artery and as appropriate it can be amplified with indirect multi-detector computer tomography - venography of pelvic and abdominal veins which visualization can be complicated under ultrasound examination. The article considers characteristics of application of mentioned above techniques of radiodiagnostics on suspicion on venous thromboembolism. The advantages, limitations and technical difficulties of these techniques are considered too.
Medical Journal of the Russian Federation. 2015;21(1):40-43
pages 40-43 views

The gene diagnostics of thrombophilia conditions in women of reproductive age

Munkoeva D.M., Kolesnikova L.I., Suturina L.V., Bairova T.A.


Nowadays, the thrombophilia conditions quite often is contingent with high risk of development of obstetric and gynecologicalcomplications. A number of authors admit as incontestable the signifi cance of genetic predisposition to thrombus formationin development of complications of pregnancy. The other authors negate the significance of genetic abnormalities reasoningthe not always discernible relationship of these occurrences. Apparently, a search of group of genes with potentially maximuminput into pathogenesis of thrombophilia is needed. The purpose is to evaluate more precisely the role of genetic polymorphism. The implementation of data of molecular genetic testing in determination of mechanisms of development of hereditary thrombophiliais the earnest of effective diagnostic and treatment of thrombophilia complications.
Medical Journal of the Russian Federation. 2015;21(1):43-48
pages 43-48 views

The arterial pressure and technique of its measurement

Manvelov L.S., Kadikov A.V.


The article discusses technique of measurement of arterial pressure as issue of large value in examination of every patient. The historical prerequisites of development of method applied nowadays are presented. The pathophysiological mechanisms of regulation of arterial pressure, external and internal factors impacting arterial pressure, characteristics of technique of measurement of arterial pressure and modes of interpretation of obtained results are discussed.
Medical Journal of the Russian Federation. 2015;21(1):49-51
pages 49-51 views

The activities of hospital nurses of the House of Romanov during the First World War: To the centenary of beginning of the First World War

Blokhina N.N.


The article considers activities of hospital nurses of the House of Romanov during the First World War. The works of Empress Alexandra Fedorovna and her daughters from the very first days of the First World War. The article covers selfless activities of the August hospital nurses as common hospital nurses in the Tsarskoye Selo hospital.
Medical Journal of the Russian Federation. 2015;21(1):52-56
pages 52-56 views

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