Vol 22, No 6 (2016)

Articles

The risk of infection transfer during blood transfusion

Polunina N.V., Gubanova M.N., Zhiburt E.B.

Abstract

The article presents the results of studying techniques of evaluation of risk of transmission of viral infection under blood transfusion. The linguistic search was carried out in libraries of Russia and the USA concerning such notions as "risk", "infection" and "blood transfusion". It was established that estimate of risk of transmission of infection from donor to recipient is optimal in case of application of pre-valence, incidence and duration of "window period" of hemo-transmissible infections. These indices are to be included into system of examination and infection control of population and blood donors.
Medical Journal of the Russian Federation. 2016;22(6):284-286
pages 284-286 views

The progress in study of results of treatment and prevention of comissures of knee joint

Skoroglyadov A.V., Haixiao U., Chao Zhang -., Kochiay E., Germanov A.V.

Abstract

The commissures of knee joint develop after operation or knee trauma at the expense of abnormal proliferation of fibrous tissue provoking limitation of amplitude of motion, arthralgia and joint stiffness. So far, pathogenesis of commissure of knee joint remains unclear. however, there is information that after operation increased secretion of fibroblasts accelerates deposit of extracellular matrix as main mechanism of development of commissures. The application of innovative medical technologies to operate knee joint ameliorated outcomes of treatment and quality of life of patients. However, after surgical operations some patients experience painful sensations and limitation of amplitude of motion of knee joint. The study was targeted to ameliorating of prognosis of operative interventions by means of investigation of pathogenesis of commissure process and possible modes of its prevention.
Medical Journal of the Russian Federation. 2016;22(6):287-291
pages 287-291 views

The effectiveness of reperfusion therapy of myocardium infarction under different organization of functioning of roentgen-endovascular service: five-year observation

Gazaryan G.A., Zakharov I.V., Ermolov A.S.

Abstract

The study was carried out to implement comparative estimate of effectiveness of reperfusion therapy of myocardium infarction with elevation of segment ST under various organization of functioning of Z-Ray endovascular service in conditions of single clinic. The study included all patients with frontal myocardium infarction with elevation of segment ST (n=997) applied during two periods: 2003-2007 (n=446) and 2008-2011 (n=551). In period I, service was represented by department of x-Ray endovascular diagnostic and treatment of ischemic heart disease in the department of emergency cardiology. In mode of 8 hours’ workday 155 (34%) various types of x-Ray endovascular coronary interventions were implemented. At that, predominantly postponed (after 24-72 hours after inception of myocardium infarction) and at initially increased risk of death. In period II, service was represented by x-Ray surgery department of large profile functioning in twenty-four-hours mode. In these conditions, 400 (72%) x-Ray endovascular coronary interventions were implemented. The comparison group comprised patients with myocardium infarction and without x-Ray endovascular coronary intervention (n=442). The received data testifies advantage of x-Ray endovascular coronary service organized at the basis of emergency cardiology. It became model for successful application of x-Ray endovascular coronary interventions, development of new reperfusion, optimization of treatment process. The success of x-Ray endovascular coronary interventions under myocardium infarction with elevation of segment ST determines by combined characteristics of reperfusion by way of accelerated evolution of indices of ECG directly following restoration of blood flow in infarction-related artery. The conserved elevation of of segment ST is associated with worse prognosis. The angiography evaluation is subjective and it cannot reflect achievement of myocardial reperfusion. At the same time, at restoration of blood flow in infarction-related artery without convincing signs of reperfusion the prognosis is better than in case of conservative treatment.
Medical Journal of the Russian Federation. 2016;22(6):291-298
pages 291-298 views

The morbidity of obliterating atherosclerosis of arteries of lower extremities in workers of enterprise of nuclear industry

Azizova T.V., Kuznetsova K.V., Bannikova M.V., Sumina M.V., Bagaeva Y.P., Azizova E.V., Fotyeva N.P., Krupenina L.N.

Abstract

The purpose. The evaluation of indices of morbidity of arteriosclerosis obliterans of arteries of lower extremities in cohort of workers exposed to professional chronic radiation. Material and methods. The retrospective cohort study included 22 377 workers of enterprise of nuclear industry "Maiak" with verified diagnosis of arteriosclerosis obliterans of arteries of lower extremities. The "crude" and standardized indices of morbidity were calculated. The indirect technique of standardization was applied for standardization of indices. The results. In the studied cohort of workers, at the end of period of observation (December 31 2008), 938 cases of arteriosclerosis obliterans of arteries of lower extremities were registered. It is demonstrated that morbidity of arteriosclerosis obliterans of arteries of lower extremities in studied cohort of workers statistically significant depended on gender, attained age, status of smoking, alcohol consumption (in males) and body mass index (in females). The morbidity of arteriosclerosis obliterans of arteries of lower extremities is statistically significant higher in males exposed to chronic external gamma-radiation in total dose higher than 1.0 grays and/or internal alpha-radiation from incorporated plutonium in total dose absorbed by liver dose more than 0.025 grays. Conclusion. The morbidity of arteriosclerosis obliterans of arteries of lower extremities in cohort of workers exposed to professional chronic radiation depended on both non-radiation and radiation factors.
Medical Journal of the Russian Federation. 2016;22(6):298-305
pages 298-305 views

Epidemiology, detection and problems of control of coinfection of HIV and tuberculosis in the republic of Karelia

Markelov Y.M., Pakhomova E.V.

Abstract

The dynamics, characteristics of prevalence of HIV-infection combined with tuberculosis during last 5 years were investigated on the territory of the Republic of Karelia. The sampling of 107 medical records of patients with HIV-infection combined with tuberculosis during 2001-2014 was analyzed. It is established that against the background of wide prevalence of strains of mycobacteria of tuberculosis with multiple medicinal resistance in the region (primary multiple medicinal resistance - 46.5%) occurs late diagnostic of HIV-infection combined with tuberculosis in the Republic of Karelia (IV-V stage of HIV-infection - 72.9%). This situation, along with significant annual influx of patients with combined infection from the system of Federal penitentiary service of Russia into civil sector, facilitates further prevalence of this infection on the territory of the Republic of Karelia. The revealed characteristics of social structure and prevalence of combined infection require development of special programs of accurate monitoring of risk groups including measures of social support concerning persons without fixed address and persons leaving Federal penitentiary service of Russia into civil sector. With regard to frequent addition of other consecutive infections and atypical clinical radiologic picture of tuberculosis. frequent detection of multiple medicinal resistance of mycobacteria of tuberculosis it is necessary, for accelerated etiologic diagnostic, implementing molecular genetic diagnostic (Gene X-pert) in case of suspicion of occurrence of this disease in individuals with combined pathology (tuberculosis and HIV-infection).
Medical Journal of the Russian Federation. 2016;22(6):305-310
pages 305-310 views

The problems of interchangeability of inhibitors of calcinevrin: safety and effectiveness of preparations of Ciclosporin and Tacrolimus

Pasternak E.Y., Zatolotchina K.E., Kazakov A.S., Alyautdin R.N., Asetskaya I.L.

Abstract

The article considers problems of evaluation of interchangeability of referent and reproduced medicines inhibitors of calcalcineurin. The analysis of 849 spontaneous reports in the Russian database from 2009 to 2015 containing information about undesirable reactions occurring at replacement of mentioned medicines. The clinical picture of undesirable reactions and their distribution by systemic organ classes is assessed. Various alternatives of replacement are considered. The implemented analysis demonstrated that problems mostly occurred ad replacement of original medicine to reproduced one that required returning to initial therapy. It is established that 20.9% of all entered reports about cases of undesirable reactions at replacement of medicines of cyclosporine and 12.2% of medicines of tacrolimus contained information about problems occurred at replacement of medicine within the framework of one international unlicensed item.
Medical Journal of the Russian Federation. 2016;22(6):311-316
pages 311-316 views

The infusion therapy in surgical patients with regard to monitoring of stroke volume and cardiac output

Manevskiy A.A., Sviridov S.V.

Abstract

The infusion therapy is the most important element of complex treatment of surgical patients at the stage of preparation to operation and narcosis directly during operation and also in post-operational period. Number of clinical situations dictates necessity of implementation of massive infusion therapy for urgent replacement of volume of circulating blood. In these cases, is extremely important comparison of velocity and volume of introduction of infusion mediums with capacity of human cardiovascular system adequately receive infusion load. This is an important clinical problem especially because of increasing in the structure of surgical patients of elder age and persons suffering with cardiovascular diseases. The article considers actual approaches to monitoring of stroke volume and cardiac output during infusion therapy in surgical patients under out-cardiosurgery operations.
Medical Journal of the Russian Federation. 2016;22(6):317-324
pages 317-324 views

The role of genetic polymorphisms and growth factors in pathogenesis of urgent and mixed urinary incontinence in women

Smolnova T.Y., Lukyanova D.M.

Abstract

The purpose of study. To analyze genetic polymorphisms of receptors of bladder, structural components of intercellular matrix of urinary excretion organs, molecular biochemical mechanisms of regulation of function of bladder and urethra resulting in urinary incontinency. Materials and methods. The analysis of publication data concerning genetic polymorphisms and molecular biochemical mechanisms of development of urinary incontinence in women. The results. The publication data is presented concerning impact of genetic polymorphisms of receptors of detrusor on development of urgent and mixed urinary incontinency in women. The corresponding molecular genetic and biochemical processes underlying detrusor sphincter dyssynergia in women are considered. Conclusion. The urinary incontinence is a multifactorial pathology developing due to alterations at systemic, organic, tissular and cellular levels. Such growth factors as bFGF, TGFβ, CTGF contribute into pathogenesis of urgent and partially mixed urinary incontinency resulting in intensification of unstripped muscle cohesions of detrusor, obstructive miohypertrophy and fibrosis of bladder wall. The altered adrenalin reactivity of urinary excretion ways plays particular role in pathogenesis of urgent component of urinary incontinence. And vice versa, damage of structure of connective tissue in patients with polymorphism COL1A1 or disorder of molecular biochemical mechanism of action of cytokines TGFβ and CTGF provoke insufficiency of sphincter apparatus of urinary excretion ways. The totality of enumerated mechanisms results in development of stress urinary incontinency. The elaboration of individual approach to selection of treatment method requires consideration of mentioned mechanisms of development of urinary incontinence including form and severity of disease.
Medical Journal of the Russian Federation. 2016;22(6):325-328
pages 325-328 views

The manifestation of HIV-infection in oral cavity of children

Sundukova K.A., Kiselnikova L.P., Gadzhikulieva M.M.

Abstract

The article presents publication review concerning the most typical affections of oral cavity in HIV-infected patients of children age. Among them are diseases of mucous tunic, salivary glands and also affections of solid tissues of teeth. The degree of their manifestation directly depends on immunity condition and viral load in blood. The effect of anti-retroviral therapy on condition of oral cavity in children with HIV-infection is demonstrated too.
Medical Journal of the Russian Federation. 2016;22(6):329-331
pages 329-331 views

The disease (syndrome) of Marchiafava-Bignami

Damulin I.V., Strutsenko A.A.

Abstract

The article considers etiopathogenetic, clinical, diagnostic and therapeutic aspects (characteristics) of disease (syndrome) of Marchiafava-Bignami. It is emphasized that this condition in most of the cases is related to chronic alcoholism though it can occur and under other diseases (diabetes mellitus, sepsis, etc.). Despite to previous opinion about inevitable lethality of disease (syndrome) of Marchiafava-Bignami, broad implementation in clinical practice of methods of neurovisualisation and especially NMR technique, demonstrated that this disease can have not so negative prognosis, It is not excluded that in medical clinical practice more light forms of disease (syndrome) of Marchiafava-Bignami are not diagnosed. The differentiated diagnostic is implemented in relation to a number of neurological diseases, including acute disorders of cerebral circulation, lymphoma, multiple sclerosis. The results of NMR of brain play major role in proper diagnostic of disease (syndrome) of Marchiafava-Bignami. The treatment of disease requires vitamins of group B, especially vitamin B1 (thiamine) and corticosteroids. However, estimate of effectiveness of similar treatment requires further investigations.
Medical Journal of the Russian Federation. 2016;22(6):332-336
pages 332-336 views

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