Vol 32, No 1 (2015)
- Year: 2015
- Articles: 21
- URL: https://journals.rcsi.science/PMJ/issue/view/188
Articles
OPTIMIZATION OF DETOXICATION THERAPY IN EMERGENCY SURGERY
Abstract
Aim. To determine the efficiency of ultraviolet radiation of blood in correction of endogenous intoxication symdrome in patients with acute cholecystopancreatitis who underwent cholecystectomy for destruction of cholecystitis. Materiams and methods. The study was based on clinicolaboratory material. Results. Patients with acute cholecystopancreatitis operated for destructive cholecystitis against the background of using photomodified autoblood in the early postoperative period were reported to have significant reduction in expression of endogenous intoxication, which was manifested by reliable decline in blood plasma toxic products of hydrophilic and hydrophobic nature, as well as in Kal’f-Kalif leukocytic intoxication index. Along with decrease in inflammatory phenomena in the area of the operation, there was reduction of not only clinical manifestations of acute pancreatitis, but of laboratory data as well, including fall in blood plasma alpha-amylase, phospholipase and protease activity. Conclusions. Ultraviolet radiation of autoblood in patients with acute cholecystopancreatitis, who had undergone cholecystectomy permits to improve significantly the early postoperative course and to stop clinicolaboratory phenomena of acute pancreatitis.
Perm Medical Journal. 2015;32(1):6-11
6-11
PECULIARITIES OF SUBPOPULATION COMPOSITION OF IMMUNOCOMPETENT CELLS IN PLACENTAS AFTER PREMATURE DETACHMENT
Abstract
Aim. To assess the peculiarities of CD20+, CD4+, CD8+, CD56+ expression in placentas after premature detachment. Materials and methods. Histological material of placentas was divided into 4 groups. Group 1 ( n = 9) - placentas after premature detachment in the gestation period from 22 to 27 weeks. Group 2 ( n = 9) - placentas after premature detachment in the gestation period from 28 to 36 weeks. Group 3 ( n = 9) - placentas after premature detachment in the gestation period from 37 to 42 weeks. Group 4 ( n = 15), the control group - placentas of conditionally healthy women with uncomplicated pregnancy and labor. Immunohistochemical study included determination of CD20 (clone L26), CD56 (clone 123C3), CD8 (clone LT8), CD4 (clone W3/25) expression. Results. While analyzing the expression of CD20+ (B-lymphocytes) differentiation cluster in placentas after premature detachment, increase in their quantity is reliably more often assessed in groups 1 and 2. In the study conducted by us, there is statistically reliable difference in the expression of CD4+ differentiation cluster in placentas of women with premature detachment of placenta in the gestation period from 27 to 36 weeks, 19,2 ± 2,4. In the group of women, whose pregnancy resulted in premature detachment of placenta in the gestation period beginning from 37 weeks, this parameter is equal to 3,2 ± 1,1 that significantly differs from the group of conditionally healthy women. It is evident that premature detachment of placentas in the gestation period from 28 to 36 weeks CD4/CD8 index is significantly elevated till 5,33 at the expense of increased T-helpers, whereas in the other cases it is 0,75. Conclusions. 1. Irrespective of pathogenetic aspects predisposing to premature detachment of placenta, the number of NK-cells is growing in all placentas of women with this pathology: group 1 - 4,8±1,73, group 2 - 4,8 ± 1,2, group 3 - 6,4 ± 1,4, vs control - 1,4± 0,6. In groups 1 and 2, CD20+ expression is reliably more marked: 3,6 ± 1,73 and 3,3 ± 1,1, respectively, vs 1,0 ± 0,66 in group 3 and 0,8 ± 1,06 in the control group. In placentas of group 2, expression of CD4+ differentiation cluster is statistically significantly strengthened: 19 ± 2,4, vs 3,1 ± 0,6; 2,4 ± 0,53 and 4,6 ± 1,7 in groups 1, 3 and 4, respectively.
Perm Medical Journal. 2015;32(1):12-17
12-17
DYNAMICS OF CLINICAL LABORATORY TEST INDICES IN PATIENTS WITH POSTOPERATIVE STERNAL AND COSTAL OSTEOMYELITIS
Abstract
Aim. To study the dynamics of the results of traditional clinical laboratory tests in process of surgical treatment of patients with the postoperative sternal osteomyelitis. Materials and methods. Complex clinicolaboratory examination of 57 patients with the postoperative sternal osteomyelitis after cardiosurgical interventions was carried out. Bulk blood analysis, leukocytic formula, C-reactive protein, aminotransferase, whole blood serum protein and whole bilirubin levels at admission to the hospital and in the postoperative period were studied. These analyses were fulfilled using up-to-date hematological and biochemical analyzers. Results. Already at the stage of hospitalization, all patients had significant rise in C-reactive protein level, ESR indices were higher than the referent values. At the same time, leukocytosis was detected only in 9 out of 57 patients (15 %). After the surgery, indices of all investigated nonspecific inflammatory markers significantly increased. Against this background, erythrocyte, hemoglobin and especially serum protein number significantly lowered. Twenty four cultures of five bacterial types were isolated from the wound in 21 patients. There predominated Staphylococcus aureus and Pseudomonas aerugenosa . The same patients indicated a maximum level of nonspecific inflammatory factors. Conclusions. C-reactive protein is the most informative marker of inflammation in patients with the postoperative sternal osteomyelitis. The serum protein level is significantly decreased after surgical intervention. For patients with positive results of bacteriological examination, the terms of hospitalization were essentially longer.
Perm Medical Journal. 2015;32(1):18-23
18-23
PECULIARITIES OF VASCULAR ENDOTHELIUM STATUS IN PATIENTS WITH ULCEROUS COLITIS
Abstract
Aim. To characterize the presence and expressiveness of endothelial dysfunction in patients with ulcerous colitis (UC), to assess the correlation between endothelial lesion and severity of inflammatory process in the bowel. Materials and methods. Ninety patients (48 men and 42 women, the mean age 35,49 ± 10,87 years) with UC in the exacerbation phase were examined. The control group involved 50 healthy subjects comparable by sex and age. Blood serum vasculoendothelial growth factor (VEGF) was studied as the endothelial lesion marker. To estimate the functional status of endothelium, endothelium-dependent vasodilation (EDVD) was determined using finger photoplethysmography and the Software “Pulsware”. Results. The elevated blood serum VEGF level with the concentration median 256,65 (123,3; 375,8) pg/ml was assessed in UC patients that was three-fold higher than this index in the control group. In 95 % of UC patients there was observed disturbance of EDVD with the share of patients with significant decrease in PEF 76 %. Reliable correlation between endothelial dysfunction indices and degree of severity, UC localization as well as clinical and endoscopic activity of the process was revealed. Conclusions. Endothelial dysfunction manifested by elevation of blood serum VEGF level and fall in EDVD was detected in UC patients. The revealed disturbances confirm the hypothesis on participation of endothelial dysfunction in pathogenesis of ulcerous colitis.
Perm Medical Journal. 2015;32(1):24-29
24-29
URINATION DISORDERS AS MANIFESTATION OF VEGETATIVE DYSFUNCTION IN WOMEN WITH POSTMENOPAUSAL DIABETES MELLITUS
Abstract
Aim. To study the functional disorders in the urinary bladder among patients with 2 type diabetes mellitus (DM) as manifestation of autonomous nervous system (ANS) dysfunction. Materials and methods. Sixty four women in the postmenopausal period including 20 with the revealed symptoms of functional urinary disorders confirmed clinically on the basis of survey data and urination diaries as well as instrumentally - by means of uroflowmetry and urinary bladder US were examined. To diagnose vegetative disorders, heart rate variability (HRV) was used. Results. The results showed lower HRV indices and reduced reactivity of sympathetic and parasympathetic ANS regions in patients with functional urinary disorders. Conclusions. Initial hypersympathicotonia and reduced reactivity of both regions of ANS are reflected on urinary function in DM patients.
Perm Medical Journal. 2015;32(1):30-36
30-36
RESULTS OF CATAMNESTIC EXAMINATION OF PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN SIX MONTHS AFTER REHABILITATION COURSE
Abstract
Aim. To study the results of subjective symptoms and quality of life in patients with stage I-II chronic obstructive pulmonary disease (COPD) (mild and medium degree of severity) in 6 months after sanatorium-and-spa rehabilitation course. Materials and methods. 123 persons were under observation. All patients were divided into 2 randomized groups: main group and comparison group. The main group of patients received a basic complex including nitric-siliceous baths with decreased radon content and general magnetotherapy (GMT). The group of comparison had a basic complex alone. The patients filled in a form which was used to assess the manifestation of subjective symptoms and quality of life by “SF-36” test. Results. It was revealed that in the comparison group, growth of the basic subjective symptoms (cough, sputum, dyspnea) was reliably greater than in the main group. In 6 months after sanatorium rehabilitation, the quality of life indices in the comparison group were significantly lower than in the main group. Conclusions. Thus, GMT and nitric-siliceous baths with decreased radon content used for treatment of patients with stage I-II COPD lead to reliable preservation of the reached results by subjective symptoms indices and quality of life test.
Perm Medical Journal. 2015;32(1):37-42
37-42
COGNITIVE STATUS OF PATIENTS WITH DIFFERENT PATHOGENETIC TYPES OF ISCHEMIC STROKE: CHRONOBIOLOGICAL APPROACH
Abstract
Aim. To study the peculiarities of cognitive affective status, quality of sleep, melatonin secretion and chronotype of patients with atherothrombotic (ATS), cardioembolic (CES) and lacunar stroke (LS). Materials and methods. 155 patients (aged 30-82) with acute ischemic stroke who were diagnosed ATS, CES and LS according to TOAST classification were examined. Complex neuropsychological investigation, Pittsburg sleep quality index (PSQI), emotional status investigation (geriatric depression scale, Spilberger-Khanin scale, apathy test) and chronobiological indices (MCTQ) were used. Nocturnal melatonin secretion was determined at the weeks 2-4 of stroke in 96 patients; 6-sulfatoxymelatonin (6-COMT) content was assessed in 96 patients. Results. Differences between ATS, CES and LS patients were obtained as a result of cognitive tests, hypotimia and apathy levels as well as subjective sleep quality estimation. Differences between the groups in relation to chronotype, sleep duration and 6-COMT concentration were also detected. Conclusions. In context of the postinsult cognitive, emotional and somnologic disorders, CES is the most unfavorable variant of IS, whereas in case of LS these spheres remain practically intact. At the same time, CES is developing against the background of relatively preserved circadian rhythms, whereas LS and, especially, ATS are characterized by significant desynchronization.
Perm Medical Journal. 2015;32(1):43-50
43-50
COMPARATIVE ASSESSMENT OF CLINICAL ISOLATES NEISSERIA GONORRHOEAE SUSCEPTIBILITY TO ANTIBACTERIAL DRUGS
Abstract
Aim. To carry out the comparative study of phenotypic susceptibility/resistance levels of clinical stains N. gonorrhoeae to antibacterial drugs used for treatment of gonorrhea in Perm Krai. Materials and methods. Retrospective study of the spectrum of antibacterial drugs used in Perm Krai for treatment of acute gonorrhea was based on analysis of 1675 case histories of patients of different treatment-and-prophylactic institutions over the period of 2012-2014. The patients were divided by sexual character. Antibiotic susceptibility of isolated cultures was assessed with disco-diffuse method according to MG 4.2.1980-04 of RF Ministry of Health (2004). To study the correlation between signs, non-parametric Spirmen Rank Correlation coefficient ( R ) was calculated; the correlations were considered reliable at p < 0,05. Results. The overwhelming majority of strains (95 and 92 %, respectively) preserved a high susceptibility to ceftriaxone, more than 87 % of cultures appeared to be sensitive to spectinomycin and kanamycin. At the same time, more than 85 % of strains in both groups were resistant to azithromycin, ampicillin (87 and 85 %) and doxycycline (82 and 80 %). Conclusions. In Perm Krai, antibacterial phenotypic susceptibility/resistance of N. gonorrhoeae strains isolated from men and women ill with fresh acute uncomplicated gonorrhea of the lower parts of urogenital tract has no reliable differences. High susceptibility of infectious agents to ceftriaxione, spectinomycin was established that correlates with general Russian indices; clinical efficiency of cephalosporins was higher in treatment of men. It was stated that more than 80 % of N. gonorrhoeae strains manifested ampicillin, doxycycline and azithromycin resistance that, according to WHO criteria, makes their use for treatment of gonorrhea in Perm Krai inexpedient.
Perm Medical Journal. 2015;32(1):51-55
51-55
STUDY OF QUANTITATIVE SERUM BRAIN-DERIVED NEUTROPHIC FACTOR CONTENT IN PATIENTS WITH DISSEMINATED SCLEROSIS WHO HAD NOT EARLIER RECEIVED IMMONOMODULATING THERAPY
Abstract
Aim. To study the blood serum brain-derived neutrophic factor (BDNF) concentration in patients with disseminated sclerosis (DS) who had not earlier received immonomodulating therapy. Materials and methods. Forty four patients with reliable DS diagnosis who had not earlier received the drugs changing the course of disseminated sclerosis were examined. BDNF concentration was determined with the method of solid-phase immune-enzyme assay. All patients experienced clinical and psychometric examination. Results. The decrease in blood serum BDNF concentration among DS patients was 16,8 (9,2-24,3) ng/ml (mean control value 28,8 ng/ml) independent of age, sex, duration of disease. Correlation between BDNF and physical health component by MSIS-29 test ( R = 0,37, p = 0,01) was revealed that proves the role of insufficient neutrophic defense in pathogenesis of disease. Conclusions. This study indicates the necessity of including the drugs with neutrophic properties into medical complex used for DS treatment.
Perm Medical Journal. 2015;32(1):56-60
56-60
LEFT ATRIUM MECHANICAL FUNCTION IN PATIENTS WITH ISCHEMIC MITRAL REGURGITATION
Abstract
Aim. To asses the left atrium (LA) mechanical function in patients with ischemic mitral regurgitation (IMR) using technologies of vector analysis of endocardium movement rate. Materials and methods. The study enclosed 82 patients aged 59 ± 7,6 including 49 men (59,7 %). The entry criteria: EchoCG criteria of degree I-III ischemic mitral regurgitation, coronary artery lesions while fulfilling selective angiography corresponding to surgical revascularization criteria, sinus rhythm and normosystolia (heart rate from 60 to 89 per minute) during investigation, superior EchoCG visualization of LA endocardium. We suggest that atrial changes in deformation and deformation rate can be associated with severity of regurgitation. Results. Left atrium mechanical function indices decline proportionally to IMR severity. Longitudinal deformation and LA deformation rate reflect link with IMR greater than conventional indices used for estimation of LA geometry. Conclusions. Left atrium mechanical function indices are associated with IMR and connected with mechanical remodeling of the left atrium.
Perm Medical Journal. 2015;32(1):61-70
61-70
OPPORTUNISTIC INVASIVE MYCOSES IN HIV-INFECTED PATIENTS
Abstract
Aim. To study the peculiarities of the clinical course of invasive mycosis in HIV-infected patients so as to improve early diagnosis and timely adequate antimycotic therapy. Materials and methods. Over the period of 2007-2014. 62 patients including 34 patients with cryptococcosis, 28 - with invasive candidosis were observed at Perm Regional Clinical Infectious Hospital. Life-time diagnosis of invasive mycosis was fixed in 55 patients, postmortem - in 7 patients on the basis of complex clinicolaboratory, instrumental and mycologic methods including isolation and identification of fungous cultures. Results. Invasive fungous infections in HIV-infected patients are characterized by severe course with affection of central nervous system, development of multisystem insufficiency and high lethality (cryptococcosis - 50 %, candidosis - 36 %). Clinical manifestations of cryptococcal meningoencephalitis and invasive candidosis are nonspecific and similar to identical diseases of other etiology. The risk factors are the following: immunodeficiency (CD4 lower than 200 kl/mkl), lack of antiretroviral therapy and presence of superficial candidosis foci. Conclusions. Thus, so as to administer a timely and adequate antimycotic therapy, diagnosis of invasive fungous infections in HIV-infected patients should be complex including clinicoinstrumental studies and obligatory mycologic analysis of blood, liquor and other biological materials.
Perm Medical Journal. 2015;32(1):71-77
71-77
MORPHOLOGICAL CHARACTERISTICS OF EXPERIMENTAL SOFT TISSUE SEPTIC WOUNDS
Abstract
Aim. To study the morphological characteristics of the soft tissue septic wounds obtained by means of the developed models in animal experiment. Materials and methods. Ten Chinchilla rabbits of both sexes with the mass of 3000-3500 g were included in the experiment. During the study, a variant of modeling the submaxillary soft tissue phlegmona and infected musculocutaneous wound was offered by us to carry out experimental studies. Results. The studied morphological picture of septic wound was characterized by positive dynamics while local conservative treatment; by the day 14 after the operation there were practically no morphological signs of inflammation. Conclusions. The obtained data can be used as control during experimental study of new methods for treatment of septic-inflammatory processes of soft tissues.
Perm Medical Journal. 2015;32(1):78-83
78-83
CHLORHEXIDINE AND «PRONTOSAN» EFFECT ON BIOFILM FORMED BY STAPHYLOCOCCUS AUREUS ( in vitro study)
Abstract
Aim. To study the morphological indices of the monospecific biofilm formed by S. aureus after chlorhexidine and “Prontosan®” exposure. Materials and methods. The study objects included referent strain S. aureus ATCC®29213 and clinical isolates S. aureus ( n = 39). Biofilm formation was investigated by O’Toole G.F. and Kolter R. (1998). Results. Anticeptics chlorhexidine and “Prontosan®” caused changes in the structure of staphylococcal biofilm that was characterized by appearance of the areas of discharge and rise in surface roughness index as well as damages of cells which were manifested by decrease in diameter and number of viable bacteria. Anticeptic exposure led to decline in size/massiveness of biofilm formed both on hydrophilic and hydrophobic surface. [Me (Q1-Q3)] index characterizing the size of biofilm on the hydrophobic surface was 0,154 (0,095-0,287) after “Prontosan®” exposure, but after chlorhexidine exposure it was 0,165 (0,118-0,268) un. OP 580. Reliability of differences in the groups was indicated only for control/“Prontosan®” pair ( p = 0,000128). Conclusions. The used drugs, mostly “Prontosan®”, showed a high activity in “surgical” concentrations in relation to bacterial biofilms formed by S. aureus causing changes in its structure. Anticeptic exposure led to decrease in size/massiveness of biofilm formed both on hydrophilic and hydrophobic surfaces. Both drugs are high active in relation to staphylococcal biofilm with a slight benefit of “Prontosan®”.
Perm Medical Journal. 2015;32(1):84-91
84-91
VARIANT ANATOMY OF ADDITIONAL AND MULTIPLE HUMAN RENAL VEINS BY COMPUTER AND MULTISPIRAL COMPUTER TOMOGRAPHY DATA
Abstract
Aim. To reveal the topographo-anatomic peculiarities of the structure of additional and multiple human renal veins by computer and multispiral computer tomography data. Materials and methods. Tomograms of 118 men and women obtained by means of spiral computer tomograph “Ultra Speed JE” and computer tomograms of 111 men and women in coronal projection obtained with computer tomograph “LightSpeed VCT” served as a material for investigation. Results. Kidneys with additional veins from the upper renal pole formed group 1 (12 observations). Kidneys with additional veins, which fell into the postcava higher than the level of the main trunk, but followed, unlike the previous group, from the renal hilum, formed group 2 (9 observations). Group 3 (5 observations) consisted of kidneys with additional veins from the lower renal pole which fell lower than the level of the main renal vein. In all the studied variants, presence of additional vein from the lower renal pole was associated with some peculiarities of topography of the kidney or its vessels. Conclusions. In 83,0 % of cases, a kidney has one renal vein, and in 17,0 % of cases there occur additional perforatory and multiple renal veins: additional veins were detected in 11,0 % of cases, perforatory veins - in 4,2 % of cases and multiple renal veins - in 2,0 % of cases.
Perm Medical Journal. 2015;32(1):92-97
92-97
DEVELOPMENT OF INTERDEPARTMENTAL RELATIONSHIP ALGORITHM FOR PREVENTION AND CONTROL OF SANITARY-EPIDEMIOLOGICAL EMERGENCY SITUATIONS IN CONDITIONS OF MASS MEASURES WITH INTERNATIONAL PARTICIPATION
Abstract
Aim. To develop the algorithm of effective interdepartmental relationship for prevention and control of sanitary-epidemiological emergency situations in conditions of mass measures with international participation. Materials and methods. Relationship algorithm and schemes for organizing interaction with forces and means aimed at providing radiological, chemical and biological protection was analyzed at the example of Kazan Universiada-2013. Results. Mobile reaction groups working in emergency situations of different departments are extraterritorial. Rospotrebnadzor has special groups meant for operative reaction to emergency situations in the sphere of sanitary-epidemiological welfare of people. Command posts of different levels form the organizational structure of the system. The united system of interdepartmental relationship functions in the regime of enhanced readiness and conducts a permanent informative interchange with operative command posts. Conclusions. Interaction is implemented in the framework of interdepartmental operating command post of medical and sanitary-epidemiological protection of mass measures as well as operating command posts of territorial establishments of Rospotrebnadzor. Interconnection on chemical, biological and radiation safety is performed by Interdepartmental Operating Command Post on the basis of Control Center in Emergency Situations.
Perm Medical Journal. 2015;32(1):98-104
98-104
WORKING CONDITIONS OF COMMODITY OPERATORS ENGAGED IN OIL PRODUCT INDUSTRY
Abstract
Aim. To improve the measures for optimization of working conditions and workers’ health protection. Materials and methods. Hygienic studies were carried out in commodity production; instrumental measurements of industrial factor levels were performed according to operating regulations. Industrial environment factors and labor process were estimated by the degree of occupational hazard and danger by the Manual P 2.2.2006-05 “Manual for Hygienic Estimation of Labor Environment Factors and Labor Process. Criteria and Classification of Working Conditions”. Results. Working conditions of commodity production operators are characterized by a complex of factors including harmful air chemicals, noise, vibration, microclimate, light medium, hard and intensive work. At the same time, exposure of such labor factors as noise and operator’s intensity of labor was characterized by high intensity. A short-time excess of single maximum allowable petrol concentration is possible while fulfilling gas dangerous works. Conclusions. The results of this study permitted to ground scientifically the system of sanitation measures including organizational, hygienic, medical-preventive measures aimed at decrease in risk for development of functional disorders in operators’ body and risk for their health so as to prevent diseases.
Perm Medical Journal. 2015;32(1):105-109
105-109
SOCIOHYGIENIC CHARACTERISTIC OF CHILDREN RESTING AT SUMMER CAMPS
Abstract
Aim. To study the factors influencing formation of healthy children, which are necessary for development of a program dealing with correction of unfavorable factors and formation of healthy mode of life during a short-term summer rest. Materials and methods. Complex study of medicobiological factors was performed using questionnaire design and interview of parents. The study enclosed 2234 children from two camps - boys and girls of three age groups: 6-10, 11-13 and 14-16 years. The influence of living conditions and mode of life on children’s and adolescents’ health was studied on the basis of adopted and tested special anonymous questionnaire form “CINDI”. Results. Study of children’s and adolescents’ living conditions and mode of life in the framework of international program “CINDI” proves that every fifth pupil has no breakfast at home, only every seventh pupil has dinner at school. Exceeded maximum-regulated time spent for home work was noted in 34,8 % of pupils. The main elements of pupils’ rest during free time are characterized by passive forms prevailing over active ones. Only 60,8 % of pupils (59,9 % of boys, 85,8 % of girls) keep from drinking alcohol, 87,9 % (84,4 % of boys, 91,4 % of girls, p < 0,0001) are non-smokers. Therefore, anonymous study is added by parents’ questioning. Conclusions. The obtained information gives the possibility to single out the main directions, to develop and inculcate into practice health improving and preventive programs, to raise information level on the factors forming a healthy mode of life and to elevate children’s motivation to healthy way of life.
Perm Medical Journal. 2015;32(1):110-115
110-115
INTERNATIONAL LEGAL ACTS FIXING BASIS OF ACTIVITY IN FIGHT WITH BIOTERRORISM
Abstract
Aim. To develop the proposals for elevation of the efficiency of international-legal mechanisms in fight with bioterrorism. Materials and methods. International-legal acts regulating the basic aspects of fight with bioterrorism were analyzed. Results. The Protocol for Prohibition of the Use in War of Asphyxiating, Poisonous or Other Gases, and of Bacteriological Methods of Warfare, signed in Geneva on July 17, 1925, does not enclose control standards, responsibility measures of states and procedures in case of violation. The Convention on the Prohibition of the Development, Production and Stockpiling of Bacteriological (Biological) and Toxic Weapon and on their Destruction (April 10, 1972) has some essential disadvantages: the types and volume-quantitative parameters of biological agents and toxins to be used in peaceful purposes are not determined; no control mechanism; appeals to U.N. Security Council regarding the fact of violating the Convention positions does not guarantee the triumph of truth; unrecognized states can’t be participants of the Convention; responsibility of states, not participants of the Convention, is excluded. The Resolution 1540 (2004) adopted by the United Nations Security Council also has some drawbacks: lack of control for non-proliferation of biological weapons from specialized international organization having official status. Fulfillment of the Resolution is complicated by absence of well-defined uniform standards of international security effective for most states and absence of obligation to adopt the laws fixing the responsibility of non-official subjects for activity using mass destruction weapons. Conclusions. It is proposed to create a specialized international organization dealing with the problems of non-proliferation of biological weapons and control of international documents regarding the latter. It is necessary to develop and to adopt an international convention on fight with biological terrorism.
Perm Medical Journal. 2015;32(1):116-124
116-124
125-130
AIDS-INDICATOR DERMATOLOGICAL SYNDROME IN HIV-INFECTED PATIENT
Abstract
A clinicolaboratory description of the case of dermatological changes in a patient with terminal HIV-infection stage, which were characterized by development of some opportunistic skin infections (contagious molluscum, vulgar verruca, candidiasis, hairy leukoplakia) against the background of marked immune deficiency, is presented.
Perm Medical Journal. 2015;32(1):131-134
131-134
RISK FACTORS AND PREVENTION OF HOSPITAL-ACQUIRED URINARY INFECTIONS
Abstract
The summarized data of scientific literature concerning the risk factors and prevention of hospital-acquired urinary infections (HAUI) are presented in the paper. The levels of HAUI morbidity, etiological structure and mechanisms of patients’ infection in the hospitals of different profiles are considered. Attention is accentuated at catheterization of the urinary bladder as the basic risk factor for HAUI. The main preventive measures are determined.
Perm Medical Journal. 2015;32(1):135-140
135-140