Vol 22, No 3 (2016)

Articles

The dynamics of indicators of inflammation, antioxidant defense and myocardium ischemia under coronary bypass surgery using artificial blood circulation and on functioning heart

Rubanenko O.A., Fatenkov O.V., Khokhlunov S.M., Limareva L.V.

Abstract

The article considers evaluation of indicators of inflammation, antioxidant defense and myocardium ischemia in patients with ischemic heart disease exposed to coronary bypass surgery using artificial blood circulation or on functioning heart. The sampling included 96 patients distributed to two groups. The first group included 84 patients (81% of males, average age 62,2±7,7 years) exposed to coronary bypass surgery in conditions of artificial blood circulation. The second group included 12 patients (91,7% of males, average age 59,8±8,0 years) exposed to coronary bypass surgery on functioning heart without artificial blood circulation. The study demonstrated significant increasing of level of interleukin-6 in patients with ischemic heart disease after application of coronary bypass surgery with extra-corporal blood circulation that confirms high activity of inflammation factors at the given disease. The reconstructing operations on hearts in conditions of artificial blood circulation are accompanied by decreasing of concentration of superoxiddismutase. At that, the level of analyzed bio-marker remains as compared with operation on functioning heart. This occurrence testifies activation of oxidative process and intensified consumption of as factor of antioxidant defense in the course of direct re-vascularization of myocardium. The concentration of troponin increases in post-operational period of reconstructing operation but differences are unreliable when analyzed groups are compared.
Medical Journal of the Russian Federation. 2016;22(3):116-120
pages 116-120 views

The metabolic syndrome as factor of additional cardio vascular risk under ischemic heart disease

Dontsov A.V.

Abstract

The sampling of 331 patients with ischemic heart disease was included in the study to evaluate biochemical, immunologic indicators of blood, affective condition. The analysis of blood serum of patients with ischemic heart disease revealed presence of increased levels of total cholesterol, triglycerides, leptin, insulin, HOMA-IR index, total oxidizing ability of blood, oxidized low-density lipoproteins, proinflammatory cytokines interleukins-1, interleukins-6, tumor necrosis factor, adrenocorticotrophic hormone, cortisol, lowered content of total cholesterol high-density lipoproteins, total antioxidant activity of blood, superoxiddismutase. Also, increased level of depression was established, especially expressed in case of presence of concomitant metabolic syndrome.
Medical Journal of the Russian Federation. 2016;22(3):120-124
pages 120-124 views

The technical characteristics and immediate results of laparoscopy trans-peritoneal and total extra-peritoneal hernioplasty

Sazhin A.V., Klimiashvili A.D., Kochiay E.

Abstract

Over the time of recent years, in surgical treatment of inguinal hernia such revolutionary changes occurred as implementation of Lichtenstein's nonstrain prosthetic inguinal hernioplasty (1986) into surgical practice and application of laparoscopic hernioplasty (Arregui M.E., 1992; McKernan and Ferzli, 1993). The study was carried out to evaluate reliability and effectiveness of application of trans-peritoneal and total extra-peritoneal hernioplasty in case of inguinal hernia. During 2012-2015, in the municipal clinical hospital №4 and the Russian gerontological research clinical center (Moscow) 12 patients underwent 12 hernioplasties using technique of total extra-peritoneal hernioplasty and 65 patients underwent 73 hernioplasties using technique of trans-peritoneal hernioplasty (in 8 cases herniae were bilateral). The technical intra-operational characteristics of procedures were analyzed. The evaluation of intra-operational and post-operational complications during earlier post-operational period and in a year after operation was carried out. The single patient in the group of total extra-peritoneal hernioplasty inguinal hernia was relapsing after herniotomy with plasty with local tissues. All herniae were one-sided. The average duration of operation made up to 62.5 minutes. The conversion was never required. In the group of trans-peritoneal hernioplasty average duration of operation made up to 58.5 minutes. The conversion was never required too. The rate of intra-operational complications in both groups was low. The most of the patients in main group (total extra-peritoneal hernioplasty) were ready to be discharged from the hospital at second day after operation. The total rate of post-operative complications made up to 20.6%. Only in the group of trans-peritoneal hernioplasty single relapse was observed after three months after operation. According to results of study, the laparoscopic inguinal hernioplasty is the most preferable and rational treatment of most of the types of inguinal herniae. The total extra-peritoneal hernioplasty is more preferable than trans-peritoneal hernioplasty because of number of reasons i.e. the post-operative pain is less expressed; operation is performed in retroperitoneal way; the risk of damaging of internal organs and development of peritoneal commissures is minimized.
Medical Journal of the Russian Federation. 2016;22(3):125-129
pages 125-129 views

The activity of renin-angiotensin system in patients with arterial hypertension in population of the Gornaia Shoria

Mulerova T.A., Uchasova E.G., Chigisova A.N., Ogarkov M.Y.

Abstract

The study was carried out to investigate characteristics of pathophysiological variants of arterial hypertension depending on activity of plasma renin in indigenous (Shors) and non-indigenous population of the Gornaia Shoria.The clinical epidemiological study was carried out concerning indigenous population of hard-to-reach regions of the Gornaia Shoria. The continuous sampling technique was applied on the basis of nominal lists to select 837 residents of the mentioned villages (513 personf of indigenous population (Shors) and 324 of non-indigenous population). The particular sampling consisted of adult population, including individuals of 18 years and older. The activity of plasma renin was evaluated using test-systems of BRG (Germany). All examined patients were separated in two groups. The first group included patients with arterial hypertension with concentration of plasma renin > 47,85 picograms per ml (development of disease is related to excessive release of renin and activation of renin-angiotensin system). The second group included patients wit arterial hypertension with content of plasma renin < 47,85 picograms per ml (arterial hypertension is related to suppression of release of renin and retention of sodium in organism). The renin - dependent arterial hypertension more was often found among representatives of non-indigenous nationality (89,8 % against 65,5%) and the volume-dependent arterial hypertension - among representatives of indigenous nationality (34,4 % against 10,1%). In the indigenous ethnic group of Shors the renin - dependent arterial hypertension was associated with younger age and expressed structural functional alterations of heart in the form of increased index of myocardium mass of left ventricle. The volume-dependent arterial hypertension was associated with average age and increased indicator of thick- Clinical medicine ness of complex of intima-media. In non-indigenous ethnic group the renin - dependent arterial hypertension was associated with increased level of index of waist/thigh. The volume-dependent arterial hypertension was associated with expressed structural functional alterations of heart in the form of increased index of myocardium mass of left ventricle.
Medical Journal of the Russian Federation. 2016;22(3):129-133
pages 129-133 views

The dimness of intraocular lens of endothelium keratoplasty

Oganesyan O.G., Chentsova E.V., Yakovleva S.S., Gridikanyan A.A.

Abstract

The endothelium keratoplasty of various modifications (DSEKTDMEK) is the first operation of choice under endothelium pathology of cornea of different genesis. The endothelium transplantation is most often implemented against the background of pseudophakia or at the same time instant with extraction of cataract and implantation of artificial crystalline lens. The clinical cases of damage of transparency of artificial crystalline lens after a routine extraction of cataract are known for a long time while dimness after endothelium transplantation is a new occurrence and related publications are singular. The study was carried out to present cases of damage of transparency of artificial crystalline lens after endothelium transplantation. During 2006-2015 more than 500 patients underwent endothelium transplantations in modifications of DLEK, DS(A)EK, FS-DSEK, invFS-DSEK and DMEK. The most of them (n=291) continue to be under regular or periodic observation. During average period of observation (78±16.8 months) four cases of dimness of artificial crystalline lens after endothelium keratoplasty were established. The biomicroscopy, visiometry and photoregistration were the main analysis techniques of establishing and studying of dynamics of dimness of crystalline lens. It is extremely difficult to establish the nature of dimness of intraocular lens after endothelium keratoplasty because explantation of intraocular lens is required. The surgical inflammatory reaction and presence of air in front camera are common for all cases of dimness of intraocular lens. The damage of transparency of intraocular lens is a complication of remote period after endothelium transplantation. The application of original technique of pneumocorneopexia promotes significant reduction of recurrent injections of air and possibly decreasing of probability of damage of transparency of intraocular lens.
Medical Journal of the Russian Federation. 2016;22(3):134-138
pages 134-138 views

The national manufacturers of the Republic of Kazakhstan in resolving problems of production of anti-tuberculosis pharmaceuticals

Sataeva L.G., Kelimkhanova S.E., Garankina R.Y.

Abstract

The article presents the possibilities of national manufacturers of pharmaceuticals to provide with medicines patients with tuberculosis in the Republic of Kazakhstan
Medical Journal of the Russian Federation. 2016;22(3):139-141
pages 139-141 views

The moral purity of medicine: Is it time to get rid of eponyms related to Nazism?

Damulin I.V.

Abstract

The article considers eponymic names of predominantly diseases of central nervous system (Hallervorden-Spatz disease, etc.) which origin is related to physicians actively cooperated with Nazis during the Second world War. The participation of these physicians in euthanasia program and also in inhuman experiments on people implemented by Nazis in concentration camps is emphasized. The conclusion is made that the reason of all this is lacking of moral standards. It is proposed to exclude a number of eponymic names related to physicians actively cooperated with Nazis.
Medical Journal of the Russian Federation. 2016;22(3):142-145
pages 142-145 views

The surgery correction of presbyopia: the modern possibilities

Pershin K.B.

Abstract

The article presents review of actual publications' data concerning surgical correction of presbyopia. The data is presented related to social significance of presbyopia alongside with other disorders of refraction. The techniques applying monovision include thermokeratoplasty and such its modification as laser and radio-frequency thermokeratoplasty. All of them have number of deficiencies. The exdmer-laser ablation of cornea in the form of Laser-Assisted in Situ Keratomileusis (LASIK) or Photorefractive keratectomy (PRK) are considered as kerato-refractional techniques of correction of presbyopia. The femtosecond laser intrastromal correction of presbyopia (INTRACOR) is also labeled as kerato-refractional technique of correction of presbyopia and it is based on making intrastromal concentric rings in the central optical zone of cornea. The deficiency of INTRACOR is a relatively high cost of procedure due to application of femtosecond laser. The implantation of inlays (artificial devices) into cornea permits correcting presbyopia with less financial expenses. However, there are number of contraindications for implementing. The Tornton and Schachar operations are referred to the group of sclerotic operations of correcting presbyopia. However, nowadays these interventions are practically out of application. The implantation of intraocular lenses, including accommodating, multi-focal and monofocal by the principle of monovision ones, can be considered as the most adequate mode of correction of presbyopia. The advantages and disadvantages of implantation of various types of intraocular lenses are considered in detail.
Medical Journal of the Russian Federation. 2016;22(3):146-152
pages 146-152 views

The clinical diagnostic aspects of acute pancreatic encephalopathy

Strutsenko A.A., Damulin I.V., Mazurtchik N.V., Ogurtsov P.P.

Abstract

The pancreatic encephalopathy is characterized by various focal neurological symptomatic and sporadic fast development of dementia is considered as a rare complication of acute pancreatitis developing in 9-35% of patients with diseases of pancreas. Factually every patient with acute pancreatitis has a risk of development of pancreatic encephalopathy that significantly makes severer course of disease and increases lethality. The review article considers particular aspects of clinical manifestations and probable diagnostic algorithm of neurological disorders observed in patients with acute pancreatitis. The actuality of development of diagnostic algorithm of pancreatic encephalopathy is emphasized. This algorithm will permit ultimately early, probably at pre-clinical stage, discover the mentioned complication of acute pancreatitis with the purpose of not only ultimate early detection of pancreatic encephalopathy but also development of pathogenically conditioned therapeutic algorithm considering all chains of pathogenesis.
Medical Journal of the Russian Federation. 2016;22(3):153-156
pages 153-156 views

Chronic kidney disease: pathophysiological role of dysbiosis of intestine and renoprotective effectiveness of interventions concerning its modulation

Aytbaev K.A., Murkamilov I.T., Kaliev R.R.

Abstract

The review presents data concerning disorders of quantitative and qualitative content of intestinal microbiota in patients with chronic kidney disease. The causes enhancing development of intestinal dysbiosis and sub-clinical inflammation under chronic disease of kidneys are considered. The results of preliminary studies concerning investigation of particular approaches to therapy of chronic kidney disease directed to restoring of intestinal symbiosis and neutralization of bacterial endotoxins and adsorption of uremic toxins of intestinal origin are presented.
Medical Journal of the Russian Federation. 2016;22(3):157-162
pages 157-162 views

The development of system of professional information about pharmaceuticals: Quo vadis?

Alyautdin R.N., Romanov B.K.

Abstract

The modern technologies provide broad possibilities for acquiring information about pharmaceuticals. However, reliability of this data has no guarantee. The document about pharmaceutical developed by manufacturer and regulatory authorities is taken very often for the source of official information. The quality of content of these documents is criticized by professional community. In the European Union it is taken for trusting the short characteristic of product (SmPC) that is an official source of information about pharmaceutical. The review presents sections of SmPC criticized more often.
Medical Journal of the Russian Federation. 2016;22(3):162-165
pages 162-165 views

N.V. Polunina

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Medical Journal of the Russian Federation. 2016;22(3):166-166
pages 166-166 views

To the seventy anniversary of M.Sh. Khubutiya

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Medical Journal of the Russian Federation. 2016;22(3):167-167
pages 167-167 views

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