Vol 24, No 1 (2018)

Articles

THE TREATMENT OF PATIENTS WITH ARTERIAL HYPERTENSION IN AN ACTUAL OUT-PATIENT PRACTICE

Andreeva O.Y., Melekhov A.V., Gendlin G.E., Nikitin I.G.

Abstract

The arterial hypertension is considered as a serious disease both in Russia and many other countries. The level of target arterial pressure is reached far from in all patients receiving hypotensive therapy. The article presents the data concerning efficiency of hypotensive therapy applied to 144 patients. Their level of arterial pressure was evaluated during its office measurement and day monitoring. The group comprised out-patients observed in polyclinics of one of the Moscow okrugs and in departmental polyclinic of Moscow oblast. to all patients’ evaluation of compliance was applied considering gender, age and type of professional activity. The analysis established that in actual clinical practice the target values of arterial pressure are reached in 22%-50% of patients receiving hypotensive therapy. The level of arterial pressure in young people and patients of older age factually had no difference. The high compliance to applied treatment was established only in one third of patients. The target level of arterial pressure was reached only in one third of young patients. Therefore, in today's actual clinical practice a successful treatment of arterial hypertension remains ineffective as 17 years ago.
Medical Journal of the Russian Federation. 2018;24(1):4-8
pages 4-8 views

THE CHARACTERISTICS OF PROCESS OF RE-POLARIZATION OF MYOCARDIUM OF VENTRICLES IN CHILDREN WITH MINOR HEART MALDEVELOPMENT

Isaev I.I., Mustafaeva A.I., Fatalieva M.M.

Abstract

The study was carried out to investigate characteristics of re-polarization of ventricles at ECG in children with various modifications of minor maldevelopments of heart development. The sampling consisted of 378 schoolchildren aged from 6 to 17 years. The schoolchildren with minor anomalies of heart development were separated in three groups according results of echo-ECG: 108 children with minor maldevelopments of sub-valvular structures of mitral valve; 92 children with minor maldevelopments of tricuspid valve; 82 children with minor maldevelopments of left ventricle. The rest of schoolchildren formed a control group. The various elements of early re-polarization of ventricles at ECG were more frequently observed in children with minor maldevelopments of sub-valvular structures of mitral valve and minor maldevelopments of left ventricle with specific alterations in leads V2-V4. The presence of junction point of ST segment was more frequently observed in children with minor maldevelopments of sub-valvular structures of mitral valve and minor maldevelopments of left ventricle. The shifting of "transitional" zone of R/S wave to the right and fast increasing of amplitude of R wave in leads V2-V4 were reliably registered more frequently in case of minor maldevelopments of left ventricle. The shortening of P-Q wave lesser than 0.12 seconds was observed more frequently in children with minor maldevelopments of sub-valvular structures of mitral valve. The children with various modifications of minor anomalies of heart development (2.2-12.2%), independently of clinical modifications and having on ECG stably conserved moderate and maximal elements of syndrome of early re-polarization of ventricles, are to be included into risk group of development of cardiovascular complications.
Medical Journal of the Russian Federation. 2018;24(1):9-12
pages 9-12 views

THE EVALUATION OF RISK FACTORS OF CARDIO-VASCULAR DISEASES IN PATIENTS WITH DIABETES MELLITUS TYPE II DEPENDING ON DEGREE OF COMPENSATION OF CARBOHYDRATE METABOLISM AND IN TREATMENT DYNAMICS

Stryuk R.I., Sviridova M.I., Golikova A.A., Lobanova E.G.

Abstract

The study was carried out using sampling of 74 patients (20 males and 54 females) aged from 48 to 75 years (average age 61.5±7.4 years) with diabetes mellitus type II. The analysis was applied to anthropometric parameters, lipid metabolism condition, level of highly sensitive C-reactive protein, tumor necrosis factor-α depending on degree of compensation of carbohydrate metabolism-level of glycosylated hemoglobin (HbA1c). In patients with diabetes mellitus type II with worse compensation of carbohydrate metabolism (HbA1c>7,5%) their body mass, waist circumference, body mass index occurred higher than in patients with HbA1c≤7,5%. The level of highly sensitive C-reactive protein corresponding to risk of development of cardio-vascular diseases was established in 97% of patients and increased level of tumor necrosis factor-α was established in 66% of patients independently of indices of glycemia. The patients were divided in 2 groups. The group I included 50 patients whose treatment was supplemented with mimetic of glucagon-like peptide Exenatid in the mode of double subcutaneous injections in dosage of 5 mkg 2 t per day during a month and then 10 mkg 2t per day during 5 months. The control group included 20 patients receiving a standard sugar-decreasing therapy. The initially analyzed indices had no statistically reliable differences in both groups. In patients of both groups a reliable decreasing of HbA1c was established in 6 months. Only in patients of group I statistically reliable amelioration of lipid specter, decreasing of body mass, waist circumference and level of markers of non-specific inflammation: highly sensitive C-reactive protein and tumor necrosis factor-α.
Medical Journal of the Russian Federation. 2018;24(1):13-18
pages 13-18 views

THE RESULTS OF SCANNING ELECTRONIC MICROSCOPY OF ULTRA-THIN ENDOKERATOTRANSPLANT FORMED BY FEMTOSECOND LASER ON PART OF ENDOTHELIUM

Oganesyan O.G., Yakovleva S.S., Baranchikov A.E., Ivanov V.K.

Abstract

Nowadays, the posterior keratoplasty is an operation of original choice in treatment of patients with pathology of endothelium. The purpose of study. To analyze, in ex vivo conditions and using scanning electronic microscopy technique, the quality of stromal surface of transplant formed by femtosecond laser on part of endothelium (invertedly). Material and methods. The series of scanning electronic microscopy of surface of stroma of cornea after femtodissection were applied to investigate effect of parameters of femtodissection and also impact of viscoelastic on quality of stromal surface. Six pairs of eyes of donors unfitted to keratoplasty were used. To form a transplant the femtosecond laser platform LDV Z6 (Ziemer, Switzerland) was applied.
Medical Journal of the Russian Federation. 2018;24(1):19-24
pages 19-24 views

THE EVALUATION OF CONDITIONS OF STORAGE AND APPLICATION OF MEDICATIONS IN HOSPITAL

Ryzhova O.A., Moroz T.L.

Abstract

The issues of provision of medical organizations with qualitative, safe and efficient medications are important and actual ones. Recently, medical organizations gave no consideration to these issues because a number of activities in area of circulation of medications was not regulated for medical organizations. In 2017, to provide security of circulation of medications the order № 646n «On approval of the Rules of due practice of storage and transportation of medications for medicinal application» was issued. To evaluate readiness of medical organizations for implementing requirements of the given document, medical organizations of the Irkutsk oblast and the Trans-Baikal krai were analyzed for the purpose of availability of drugstores. The study established that in average drugstores are only in 50% of medical organizations. Among medical organizations with number of beds less than 100 beds, almost 100% of them have no drugstores. The carried-out questionnaire survey concerning awareness of medical specialists about rules of circulation of medications demonstrated inadequate knowledge of rules of prescription and storage of medications. Therefore, it was established that medical organizations are not ready for implementing requirements of the order № 646n from 31.08.2016 of Minzdrav of Russia that can result in decreasing of quality and safety of medications applied in medical organizations. Therefore, a particular attention in medical organizations is to be attended to development and implementation of system of quality targeted to maintenance of rules of circulation of medications. The step-by-step instructions or standard operational procedures are to be developed for all stages of of circulation of medications including receiving, taking-over, storage and application.
Medical Journal of the Russian Federation. 2018;24(1):25-28
pages 25-28 views

THE CLINICAL-PHYSIOLOGICAL INDICES OF APPLICATION OF INTERRUPTED PNEUMO-COMPRESSION IN PREVENTION OF THROMBOSIS OF DEEP VEINS AND THROMBOEMBOLISM OF PULMONARY ARTERIES

Sorokina N.D., Selitcky G.V., Podgornaya O.A., Zherdeva A.S.

Abstract

The review presents analysis and generalization of studies concerning therapeutic effect of interrupted pneumo-compression. The physiological differences underlining mechanisms of effecting of ascending and descending pneumo-compression are emphasized. The comparison with static pneumo-compression is carried out. The various technical approaches to application of pneumo-compression and molecular aspects of involvement of fibrinolytic mechanisms into effects of interrupted pneumo-compression are analyzed. The review uses both national and foreign scientific studies and monographs and tutorials. This comprehensive approach permits to analyze sufficiently wide specter of data confirming efficiency of preventive application of interrupted pneumo-compression for preventing thrombosis of deep veins and thromboembolism of pulmonary arteries.
Medical Journal of the Russian Federation. 2018;24(1):29-34
pages 29-34 views

THE EVALUATION OF IMMUNOGENIC POTENTIAL OF VARIOUS MEDICATIONS OF INSULIN

Philippova A.V., Chzhao V., Kolbin A.S.

Abstract

The article presents a review of publications implemented with the purpose to characterize immunogenic potential of medications of insulin: from preparations of animal origin to modern genetically engineered products. The review is presented concerning regulative requirements regulating control of insulin products safety. It is established that during evaluation of safety of insulin products the main attention is focused on issues of immunogenicity. The analysis of publications from open access in information database MEDLINE (Pubmed) was carried out, permitting to characterize immunogenic potential of insulin preparations. On balance, the review included 17 articles according the results of selection. It is established that information about immunogenic potential of insulin products is contradictory enough that can be determined by both characteristics of studies and technological particularities of production of medicinal insulin products. The modern preparations of analogs of insulin are in general comparative by their safety characteristics with medicinal preparations of human genetically engineered insulin. Among analogs of insulin the most immunogenic potential is specific to aspart and glargin. The cases of development of cross-reactive antibodies between various medicinal preparations of insulin are observed.
Medical Journal of the Russian Federation. 2018;24(1):35-40
pages 35-40 views

THE LICANTHROPY: THE PSYCHO-NEUROLOGICAL AND SOMATIC ASPECTS

Damulin I.V., Sivolap Y.P.

Abstract

The review article considers syndrome of lycanthropy when patient considers oneself as an animal (more often as a wolf). The clinical picture of lycanthropy is typical for such mental diseases as schizophrenia, bipolar disorder, psychotic depression. The lycanthropy can be developed against the background of dementia and epilepsy. In number of cases, concept of lycanthropy, especially in the past, was related with expressed hirsutism or severe congenital porphyria and also with diseases manifesting expressed changes of face (leprosy, syphilitic gumma). The lycanthropy can be developed after intake of psycho-active substances, in case of intoxication with vegetable alkaloid or against the background of alcohol abuse. Therefore, it is necessary to carry put a corresponding examination of patients to exclude neurological or somatic cause of this syndrome. The anti-psychotic medications, antidepressants, electroconvulsive therapy and psychotherapy are applied for treatment in case when lycanthropy is caused by mental pathology.
Medical Journal of the Russian Federation. 2018;24(1):41-44
pages 41-44 views

THE MINERALIZATION OF BONE TISSUE IN PATIENTS WITH GENERALIZED PERIODONTITIS AGAINST THE BACKGROUND OF METABOLIC SYNDROME

Sabirova A.I., Mamytova A.B., Murkamilov I.T., Sabirov I.S.

Abstract

The article considers issues of disorders of mineralization of bone tissue under generalized periodontitis and metabolic syndrome. The data is presented illustrating two-way character of relationship of disorders of processes of mineralization of bone tissue, including alveolar crest under the given pathologies. The development of osteoporosis and osteopenia testifies that generalized periodontitis promote progression of metabolic syndrome. At that, moderate deviations in components of metabolic syndrome are in turn accompanied by progression of inflammatory processes in periodontium.
Medical Journal of the Russian Federation. 2018;24(1):45-49
pages 45-49 views

THE INTESTINAL LYMPHANGIECTASIA

Artamonov R.G., Paunova S.S., Polyakov M.V., Blagovidov D.A.

Abstract

The article presents description of observation of case of intestinal lymphangiectasia in girl aged 17 years.
Medical Journal of the Russian Federation. 2018;24(1):50-54
pages 50-54 views

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