Vol 30, No 2 (2013)
- Year: 2013
- Articles: 21
- URL: https://journals.rcsi.science/PMJ/issue/view/191
Articles
MODERNIZATION OF SURGICAL TACTICS IN NODULAR GOITER FORMS
Abstract
Aim. To improve the results of treatment of patients with nodular thyroid neoplasms by means of modernizing surgical tactics. Materials and methods. The study was carried out at Perm Medical Unit № 1 and Perm Regional Oncological Dispensary; it is presented by retrospective analysis of work over the period from 2009 to 2011. During this period, 4360 patients including 44% of repeated ones were consulted annually. Gender composition: 298 (6,8%) men and 4062 (93,2%) women (women/men ratio – 9,6/1). Patients’ age ranged from 15 to 82. Peak of detecting nodular goiter fell to the age group from 41 to 50 years old (36,3%). Duration of disease was from 1 to 40 years. Results. An important aspect is constant dynamic control of patients with nodular neoplasms aimed at dispensary examination of this category of patients including regular examination by surgeon and endocrinologist with the interval from 6 to 12 months. Nine hundred and eighteen (21,1%) patients underwent surgical treatment with subsequent histological investigation. The following operations were performed: subtotal thyroid resection – in 48% of patients, thyroidectomy – 4%, hemithyroidectomy with isthmus resection – 32%, subtotal resection of thyroid lobe – 16%. Conclusion. Complex of treatment and diagnostic measures, modernization of indications to surgical treatment permitted to reduce the number of thyroid surgeries for nodular lesions to 25% of the examined patients. Rational tactics for treatment of thyroid “nodular neoplasms” is possible when creating endocrine surgery units with obligatory specialized polyclinic reception allowing to choose patients for surgical treatment, follow them up and conduct conservative treatment.
Perm Medical Journal. 2013;30(2):6-9
6-9
NEW POSSIBILITIES FOR PROGNOSIS OF ACUTE PANCREATITIS COMPLICATIONS AND ASSESS OF TREATMENT EFFICIENCY
Abstract
Aim. To study the level and dynamics of changes in blood plasma VEGF and desquamated endotheliocytes (DEC) in patients with severe course of acute pancreatitis both complicated and uncomplicated. Materials and methods. Vascular endothelial growth factor ( VEGF ) and quantity of desquamated endotheliocytes (DEC) were investigated in dynamics in 33 patients with severe acute pancreatitis. These investigations were performed during the first 10 days from the onset of disease and later with the interval of 5–7 days. Patients were divided into 2 groups: group 1 included patients without pyo-septic complications ( n =13), group 2 – patients with pyo-septic complications ( n =20). Results. No reliable differences in DEC number between the groups of patients and between the investigations were revealed. VEGF level in patients with acute pancreatitis is significantly higher than in healthy persons ( p <0,01). Reverse correlation between sepsis severity and blood plasma VEGF level in patients of group 2 was detected (Spirmen method r =–0,38, 95% Ci –0,124 and –0,584, p =0,003). Conclusion. Decease in blood plasma VEGF level or absence of its growth demonstrates aggravation of sepsis and unfavorable prognostic significance.
Perm Medical Journal. 2013;30(2):10-15
10-15
RESTORATIVE OPERATIONS ON HAND FINGERS FLEXOR TENDON
Abstract
Aim. To optimize the results of operations on hand fingers’ flexor tendon. Materials and methods. Treatment of 100 patients with damaged hand fingers’ flexor tendon restored by means of primary sutures or single stage secondary tendoplasty was analyzed. The following two groups of patients were selected: comparison group ( n =60) who underwent traditional surgical tactics and main group ( n =40) operated with author’s surgical technique (preoperative adaptive preparation, new methods of tendinous suture and units for controlled functional rehabilitation). Results. Comparative analysis of efficiency of treatment for different groups of patients was carried out. The author’s technique of restorative treatment was proved to have positive long-term results in 93,7%. Efficiency of treatment in comparison group was 12,5%. Conclusion. The developed complex of reconstructive-restorative treatment of patients with damaged flexor tendons and their consequences including preoperative preparation, surgical aids with new technical solutions and rational rehabilitation permitted to optimize surgical rehabilitation of patients with this pathology.
Perm Medical Journal. 2013;30(2):16-21
16-21
RESULTS OF PATIENTS’ COMPLEX EXAMINATION IN SURGICAL TREATMENT OF HIP JOINT INJURIES AND DISEASES
Abstract
Aim. To assess the results of complex examination of patients with hip joint injuries and diseases, to develop criteria of severity of socio-psychological disadaptation in this pathology. Materials and methods. Eighty patients aged 20–88 underwent surgical treatment (endoprosthesis). The following modern informative methods of investigation were used: clinical, laboratory, roentgenological, ultrasonic, Spilberger-Hanin as well as Zung experimental psychological methods. Results. Women (61,8%) prevailed among the examined patients, there was a high percentage of patients (79,2%) aged 55–65, high share of somatic diseases (5,1 per one patient). As a result of surgical treatment of patients with hip joint injuries and diseases, moderate and severe socio-psychological disadaptation was registered in 73,8% of observations. Conclusion. The criteria developed for the degree of severity of developing socio-psychological disadaptation are recommended to be used in postoperative rehabilitation programs that will permit to hasten patients’ reintegration and improve their quality of life.
Perm Medical Journal. 2013;30(2):22-26
22-26
GASTROESOPHAGEAL REFLUX DISEASE AND OBESITY: CHARACTERISTICS OF QUALITY OF LIFE
Abstract
Aim. To assess the quality of life (QL) in patients with gastroesophageal reflux disease (GERD), obesity and their associated course. Materials and methods. One hundred and five patients aged 22–65 were divided into two groups and examined. They included subjects with gastroesophageal reflux disease, those with different variants of overweight and subjects with combination of these pathologies. The quality of life indices were estimated using questionnaire SF-36. Results. Differences in QL level in case of isolated and associated course of disease were found. The obtained data indicate a significant mutual burdening influence of associate pathology on patients’ QL. Conclusion. The associated pathology has a particularly pronounced negative effect on psychological component of health.
Perm Medical Journal. 2013;30(2):27-33
27-33
PERIODONTAL DISEASES IN HIV-INFECTED PATIENTS: PREVALENCE AND PECULIARITIES OF CLINICAL MANIFESTATIONS DEPENDING ON ADHERENCE TO ANTIRETROVIRAL THERAPY
Abstract
Aim. To study the prevalence and clinical structure of periodontal diseases in HIV-infected patients depending on adherence to antiretroviral therapy (ART). Materials and methods. The study was based on the results of complex dental examination of 222 HIV-infected patients of “Perm Regional AIDS Center” over the period from 2009 to 2011. Results. Prevalence of classical inflammatory periodontal diseases in HIV-infected patients was 69,7% and that of specific HIV-associated periodontal diseases 27,0%. Patients who underwent antiretroviral therapy had reliably lower prevalence of HIV-associated periodontal diseases and less severe course of classical gingivitis and periodontitis. Conclusion. Dental status of HIV-infected patients is characterized by higher prevalence and intensity of periodontal diseases. Periodontal diseases in HIV-infected patients are characterized by polymorphism, they can be specific and nonspecific, conditioned by typical periodontopathogenic flora. Periodontologic status of HIV-infected patients not adherent to ART is compromised to a greater extent than in subjects receiving the corresponding antiviral therapy.
Perm Medical Journal. 2013;30(2):34-42
34-42
MAIN RISK FACTORS OF DEVELOPING EARLY RESPIRATORY TUBERCULOSIS RELAPSES
Abstract
Aim. To study the causes of developing early relapses of respiratory tuberculosis while comparing patients’ data with those of subjects clinically cured from respiratory tuberculosis and having no early relapses later. Materials and methods. Three hundred and forty four cases of early respiratory tuberculosis relapses (ERTR) in patients aged 18 and older constantly living in Moscow were studied. Results. The following 7 factors significantly influencing their development were singled out: drug resistance of tuberculous mycobacteria in initial disease, incomplete basic chemotherapy course, absence of antirecurrent courses of treatment, intercurrent diseases, chronic alcoholism, stable disability, absence of permanent place of employment and as a result, low material income. Among the mentioned factors, medical factors played a great role in development of early relapse, social ones – a lesser role. Drug resistance of tuberculous mycobacteria in initial disease and stable disability caused by severe associated diseases had the most pronounced effect on their development. Thus, a significant role in development of early relapses belongs to endogenous reactivation of tuberculous process in respiratory organs. Analysis of character and frequency of risk factors of developing respiratory tuberculosis relapses showed that they are influenced by not a separate factor but their combination. Three and more medical and social factors combined in one patient raise the probability of developing early relapse up to 93%. Conclusion. For phthiciatric practice, it is necessary to form risk groups from clinically cured socially disadapted persons with drug resistance of tuberculous mycobacteria in initial disease associated with severe chronic concomitant diseases and their follow-up at antituberculous dispensary during the first five years from the moment of ascertaining clinical recovery with obligatory antirecurrent course of treatment and sanatorium rehabilitation, considering this contingent as having a great threat of developing early respiratory tuberculosis relapses.
Perm Medical Journal. 2013;30(2):43-49
43-49
DETERMINATION OF BIOLOGICAL AGE IN PREGNANT AND RECENTLY CONFINED WOMEN USING ANTHROPOMETRIC INDICES
Abstract
Aim. To determine the biological age and ageing rate in pregnant women of I, II, III trimesters of pregnancy, in the puerperal period on the days 3–10 and 1 year after the first investigation. Materials and methods. Thirty five women in I, II, III trimesters of physiological pregnancy, puerperal period on the days 3–10 and 1 year after the first investigation were examined. Patients were divided into 2 age groups. Group I (20–29 years old) included 24 pregnant women with a mean age of 25,4±0,49 years, group II (30–39 years old) included 11 women with a mean age of 34,02±0,71 years. Biological age (BA) was determined with anthropometry method using L. M. Belozerova method. Results. Analysis of the obtained data showed that only in group I biological age reliably exceeded the proper biological age in I, III trimesters and in the puerperal period (3–10 days after the delivery), in II trimester no reliable difference between biological and proper biological age was observed. In group II, biological age also prevailed over the proper biological age throughout the investigation without reliable difference. In age group I, there is a reliable difference between trimester I biological age and puerperal period. In group II, no reliable difference between biological ages throughout the investigation was noted. Thus, the accelerated rate of age changes is typical for group I in I, III trimesters of pregnancy and in the puerperal period. The second trimester of group I is characterized by a mean rate of age changes. In group II, a mean rate of age changes throughout the investigation was registered. Conclusion. Biological age by anthropometric indices investigated reliably exceeds the proper biological age in group I during I, III trimesters of pregnancy and in the puerperal period. The rate of age changes has an accelerated character in I, III trimesters and in the puerperal period among women of group I. In group II, a mean rate of age changes throughout the investigation was observed.
Perm Medical Journal. 2013;30(2):50-54
50-54
STRUCTURAL-FUNCTIONAL PECULIARITIES OF CARDIOVASCULAR SYSTEM IN PATIENTS WITH ARTERIAL HYPERTENSION
Abstract
Aim. To assess the peculiarities of structural-functional status of heart and vessels in patients with arterial hypertension (AH). Materials and methods. The study included 62 patients with stage I–II arterial hypertension. Survey, biochemical blood analysis, echocardiographic investigation and ultrasonic duplex investigation, vascular investigation with estimation of remodeling types were carried out. Results. Analysis of the revealed changes indicates a significant contribution of hypertensive factor. The group with unsupported target level of arterial pressure is characterized by a greater frequency of developing left ventricle hypertrophy with concentric (60%) and diastolic function prevailing. Increase in rigidity of elastic and muscular arteries was revealed in AH patients with with prevalence of eccentric variant of hypertrophy. Conclusion. Higher prevalence of prognostically unfavorable variants of cardiac and vascular remodeling in patients with unsupported target level of arterial pressure was found.
Perm Medical Journal. 2013;30(2):55-60
55-60
CEREBRAL OXYMETRY AND TRANSCRANIAL DOPPLEROGRAPHY IN OPTIMIZATION OF ACUTE CEREBRAL INSUFFICIENCY PROGNOSIS
Abstract
Aim. To improve the prediction of the results of treatment in patients with acute cerebral insufficiency using noninvasive cerebral oxymetry and transcranial dopplerography. Materials and methods. Over the period from 2005 to 2009, a prospective controlled nonrandomized investigation of 116 patients (62 men and 55 women) with acute cerebral insufficiency was performed on the basis of Republican Clinical Hospital named after G.G. Kuvatov. Results. On the basis of monitoring cerebral oxymetry, transcranial dopplerography and central hemodynamics, the authors fixed prognostic survival determinants in case of cerebral insufficiency. Conclusion. The results of the study indicate that use of cerebral oxymetry and transcranial dopplerography permits to optimize prediction of acute cerebral insufficiency outcomes.
Perm Medical Journal. 2013;30(2):61-66
61-66
OTsENKA VYRAZhENNOSTI AVTONOMNOY KARDIAL'NOY NEYROPATII PRI SAKhARNOM DIABETE 1-go TIPA METODOM RITMOKARDIOGRAFII
Abstract
Aim. To assess manifestation of autonomic cardial neuropathy (ACNP) in type 1 diabetes mellitus using rhythmocardiography method. Materials and methods. The study included 147 patients with type 1 DM, 87 men and 61 women with a mean age of 36,3±13,0 years. Duration and age of DM1 onset was 11,1±10,3 and 24,8±12,3 years. HbA1c – 9,9+2,5%. ACNP diagnosis was confirmed by The Toronto Consensus Panel on Diabetic Neuropathy Criteria with assessment of heart rate variability (HRV) indices using rhythmocardiography (RCG) method and apparatus-program complex “Micor”. The control group included 41 persons. Data processing was performed by means of STATISTICA 6.0 and SPSS 17.0 for Windows. Results. Significant ( p <0,001) fall in HRV indices among DM1patients versus the control was revealed: general variability – SDNN (c) 0,026±0,017 and 0,058±0,01, amplitude of respiratory arrhythmia ARA (c) 0,037±0,03 and 0,095±0,03, root-mean-square deviation in three types of waves – humoral-metabolic σ l (c) 0,015±0,01 and 0,028±0,01, sympathetic σ m (c) 0,012±0,01 and 0,025±0,01, parasympathetic σ s (c) 0,014±0,01 and 0,042±0,02; sample reactivity was decreased. ACNP was diagnosed in 35 (24%) patients including 15 (10%) patients with severe stage 3 ACNP, 10 (6,8%) – stage 2, 12 (8%) – stage 1. Conclusion. Marked disorders of peripheral HRV regulation caused by inhibition of reflex sympathy-parasympathetic regulation in sinus node of the heart were detected with RCG method. ACNP was observed among the most critical patients. The basic factors of ACNP worsening were DM duration and RCG-parameters of reaction to the effect of stimulus.
Perm Medical Journal. 2013;30(2):67-74
67-74
RESULTS OF STUDYING ISOSORBIDE MONOTITRATE PHARMACODYNAMICS IN PATIENTS WITH FUNCTIONAL CLASS 1 AND 2 STABLE ANGINA BY HEART RATE VARIABILITY ANALYSIS
Abstract
Aim. To study the effect of isosorbide monotitrate (ISMN) on heart rate variability (HRV) in patients with functional class 1 and 2 (FC) stable angina (SA). Materials and methods. Eighty five male patients with FC 1 and 2 SA at the age of 53,1±5,56 years old were examined. The control group included 42 healthy men. All the examined subjects underwent rhythmocardiographic investigation ( RCI ). HRV in 1 and 2 FC SA was assessed before and 1 hour after taking ISMN in the dose of 20 mg. Results. In the group of 1 and 2 FC SA patients, there was observed dysregulation of sinoatrial node manifested by 2,5 fold decrease in total HRV at the expense of fall in humoral-metaboic amplitude ( l ) on average by 1,5 times, sympathetic ( m ) – 2,5 times, parasympathetic ( s ) – 3–4,5 times, shift of vegetative regulation to the side of humoral-metabolic one with decreased parasympathetic one, reduced manifestation of reaction to stimulus. After taking ISM, total HRV increase at the expense of growth of σl, σm amplitude with decreased σs, shift of vegetative regulation pattern to the side of humoral-metabolic effect, sympathetic effect with reduced protective parasympathetic peripheral regulation link was registered. At the same time, under ISMN effect, reaction to stimulus in Valsalva test significantly increased from 17,056±8,609 to 25,411±12,681%, in active orthostatic test – from –20,733±9,508 to –23,522 9,886%, in stress – ( PWC 120) rehabilitation time after stimulus effect decreased from 45,177±10,732 to 42,198±6,251 that is beneficial from positions of HRV. Conclusion. Thus, taking into account peripheric vegetative dysregulations arising with ISMN, it is rational to use RCG-investigation for choosing and monitoring the conducted therapy with organic nitrates, in particular ISMN.
Perm Medical Journal. 2013;30(2):75-82
75-82
EXPERIMENTAL ASSESSMENT OF ESTHETIC EFFECT OF CARIESINFILTRATION IN FOCAL ENAMEL DEMINERALIZATION
Abstract
Aim. To assess in experiment the possibility and expediency of using an additive color model ( RGB ) for characterization of the color of demineralized enamel and its changes after photocomposite infiltration. Materials and methods. The material to be investigated included 14 human intact teeth (labial teeth) extracted by orthodontic indications. Experimental studied were performed using the developed model of «artificial caries», experimental analysis of color characteristics of teeth –with additive model. Results. Treatment of initial dental caries with infiltration method reliably decreases color difference indices ( GM and BY ) between the infiltrated part of enamel and its perifocal zone that provides an optimal esthetic result of treatment. Conclusion. As a result of qualitative analysis of color characteristics of vestibular surface of intact tooth and «artificial» demineralization before and after cariesinfiltration, high esthetic effect of infiltration before and after cariesinfiltration was reached.
Perm Medical Journal. 2013;30(2):83-88
83-88
LUNG PATHOMORPHOLOGY IN INTRAUTERINE PNEUMONIAS ACCORDING TO AUTOPSY DATA
Abstract
Aim. To study the pathomorphological signs of intrauterine pneumonia according to autopsy data. Materials and methods. On the basis of pathologoanatomic post-mortem examination protocols, retrospective analysis of clinicopathologic peculiarities of the lung tissue in 94 infants with intrauterine pneumonias was carried out. The study group included infants who died at the age of 0 to 15 days with the body mass not less than 900 g. Gestation terms varied from 28 to 41 weeks. Macro-and microscopic picture of lungs was studied. Histological investigation was performed with traditional methods. Results. It was established that microscopic signs of pneumonia in the dead infants during the days 1–3 were expressed insignificantly. They were growing by the 5 th day when lung tissue lesions are more extensive, have more precise contours, rather often acquiring the character of pneumonias with confluent foci. Microscopic picture in most cases was characterized by circulation disorders in the lung tissue, presence of distelectasis foci, polymorphonuclear leukocyte infiltration, quite often with erythrocyte admixture, small fibrin accumulation, hyalin membranes formation. The character and degree of manifestation of changes in lung tissue in case of intrauterine pneumonias were revealed to be significantly determined by etiological agent. The most severe course and the earlier lethal outcome were registered in bacterioviral infection. Conclusion. Intrauterine pneumonia is characterized by changes in micro-and macroscopic picture of lung tissue with the latter growing by the 5 th day. Circulation disorders and polymorphonuclear leukocyte infiltration as well as hyaline membranes formation should be attributed to microscopic signs. Viral bacterial pneumonia is characterized by more severe course.
Perm Medical Journal. 2013;30(2):89-93
89-93
COMPARATIVE ANATOMY OF DYNAMIC CHANGES IN MALE MEDIAN AND SCIATIC NERVE EPINEURIUM IN POSTNATAL ONTOGENESIS
Abstract
Aim. To compare the changes in male median and sciatic nerve epineurium in the period of postnatal ontogenesis. Materials and methods. Autopsy material from 80 men aged 17–90 who died from cerebrocranial injuries and had no peripheral nervous system pathology in anamnesis was investigated. The material was divided into age groups according to human age ontogenesis periodization. Median and sciatic nerve epineurium in ontogenesis was investigated and compared using micromorphometrical and histological methods. Results. In process of ontogenesis, 1,7 fold (by 41%) increase in thickness of sciatic nerve epineurium and 2,1 fold (by 52,7%) of median nerve epineurium was registered.. Conclusion. Age dynamics of epineurium consists in its even increase and two periods of intensive growth: sciatic nerve – the second period of mature age and old age, median nerve – the first period of mature age and elderly age.
Perm Medical Journal. 2013;30(2):94-97
94-97
COMBINED APPLICATION OF OZONIZED PHYSIOLOGICAL SODIUM CHLORIDE SOLUTION AND LOW DOSES OF CONSTANT ELECTRIC CURRENT IN COMPLEX TREATMENT OF INFECTED PANCREONECROSIS
Abstract
Aim. To study the effect of the low doses of constant electric current (20–25 mkA) combined with ozonosanation of omental bursa on inflammatory course in pancreas and omental bursa. Materials and methods. Sixty eight case histories of patients operated for infected pancreonecrosis at the surgical units of Aktyubinsk region in 2002–2001 were analyzed. Anamnesis of all patients was studied, complex of objective investigations was carried out, clinicolaboratory indices, USI and computer tomography results were analyzed. Clinical types of pancreonecrosis were classified according to The International Symposium Classification (Atlanta, 1992). Two groups of patients were formed: group I (control group) – 36 patients with pancreonecrosis treated with traditional methods, group II (main group) – 32 patients who were exposed to local use of constant electric current (CEC) in combination with ozonosanation of omental burse along with antibiotics of wide spectrum. Efficiency was estimated by the number of purulent complications, cessation of microbial semination of omental bursa, multiplicity of sanations and period of purification of omental bursa. Results. During the investigation, faster elimination of pain syndrome in the main group –2,3±0,17 days ( p <0,001) than in the control – 4,5±0,21 days was noted. While treatment, the amount of purulent complications decreased to 43,8% in the main group compared with the control – 69,4%. CEC and ozonized physiological solution applied in complex therapy permitted to reduce the period of wound purification from 16,7% to 12,5%. Conclusion. The proposed method of treatment contributes to decrease in purulent complication rate, fall in wound purification terms and acceleration of regeneration processes as well as reduction of patients’ staying at the hospital by 1,3 times and lethality by 1,5 times.
Perm Medical Journal. 2013;30(2):98-102
98-102
ASSESSMENT OF EFFICIENCY OF COMPLEX TREATMENT OF PATIENTS WITH PERIODONTITIS BASED ON CLINICOROENTGENOLOGICAL AND BIOCHEMICAL INDICES
Abstract
Aim. To carry out comparative assessment of the efficiency of complex treatment of patients with chronic generalized periodontitis using drugs for osteotropic therapy. Materials and methods. Complex examination and treatment of 112 patients with chronic generalized periodontitis aged 20–49 was performed. In the main group (72 patients), complex treatment included the course of osteotropic therapy using a new drug «Calcium-vit D 3C» containing calcium carbonate 750 mg (equivalent to 300 mg of calcium), cholecalcipherol (vitamin D 3) 100 ME, ascorbic acid 50 mg, hips and licorice root extracts followed by gel «Holisal» application. In comparison group (40 patients), treatment was conducted applying the drug «Calcium D 3» (Nikomed , Norway) and 3% aspirin ointment. Results. Positive effect of treatment manifested by stabilization of pathological process in periodontium tissues of 75% of patients of the main group in the nearest and remote terms, reliable improvement of clinical roentgenological and biochemical indices was stated. Conclusion. Safety and efficiency of using «Calcium-vit D 3C» regarding blood serum total calcium, inorganic phosphorus and active-alkaline phosphatase content as well as dynamics of cytokine indices influencing periodontium bone tissue status was proved.
Perm Medical Journal. 2013;30(2):103-108
103-108
BROILER CHICKENS’ OPPORTUNISTIC PATHOGENIC MICROFLORA AS POSSIBLE SOURCE OF INFECTIOUS CONTAMINATION FOR BATTERY FARM PERSONNEL
Abstract
Aim. To study the composition of opportunistic pathogenic intestinal and inner organs microflora in broiler chickens kept in industrial conditions. Materials and methods. One hundred and sixty one broiler chickens aged 1 to 42 days with the symptoms of different diseases and 30 chick embryos with developmental defects were investigated. Intestinal, hepatic tissue, heart and spleen content received while “sanitary slaughtering” of chickens and embryos was studied. Microbiological analysis of 16 forage and forage ingredients samples, 6 drinking water samples was carried out. Microbial cultures were secreted and identified using generally accepted methods. Results. Microbiological analysis of microflora secreted from debilitated chickens permitted to detect the prevailing bacterial genera such as E. coli, Staphylococcus spp., Streptococcus spp., Proteus spp. Among broiler chickens, there is a rather high degree of organs contamination with opportunistic pathogenic flora including pathogenic one. In the course of life, chickens’ contamination increased that is connected with weakening of their protective properties and additional infection at the expense of alimentary factor and water. In these conditions there occurs a danger of cross-infection for personnel looking after sick chickens. Conclusion. Opportunistic pathogenic microflora in the form of E. coli, Staphylococcus spp., Streptococcus spp., Proteus spp. associations was secreted from the intestine and inner organ tissues of sick broiler chickens. The critical age is the third week of their life which is characterized by the greatest bacterial damage of the inner organs. Hepatic and heart tissues are severely impaired with opportunistic pathogenic microorganisms (OPM). The essential role in contamination of industrial poultry is played by alimentary factor and quality of drinking water. The revealed microbial OPM associations prevailing among chickens can be the source of infectious agent for battery farm personnel.
Perm Medical Journal. 2013;30(2):109-114
109-114
LONG-TERM CHANGES IN BODY SIZES AND PUBESCENCE AGE OF RUSSIAN POPULATION IN PERM TERRITORY
Abstract
Aim. To analyze the changes in the body length (BL) and body mass (BM), thorax circumference (TC) and pubescence age (menarche age – MA) in different social groups of the Russian population of Perm Territory in the cohorts of persons born from 1861/65 to 1990. Materials and methods. The study was based, first of all, on the data of anthropometric studies of the population of Perm Territory carried out during 1984–2010; secondly, on the materials of medical documentation (health cards of pregnant women for 2006) of Obstetrics Unit of one of Perm hospitals as well as anthropometric data of inhabitants of Perm Province at the end of the XIX – beginning of the XX century. Results. BL of rural men for 125 years increased by 14 cm; for 100 years (cohorts of 1885–1985 years of birth) – by 7,7 cm. BL of rural women for 100 years increased by 5,6 cm. In Perm men BL for 125 years increased by 10,9 cm, in women for 100 years – by 3,6 cm. The rate of BL growth is maximal in the generation of 1965–1985 years of birth. In the cohort of persons born from 1985 to 1990, mean male BL did not significantly change, female – fell. From the thirties to the middle sixties of the 20 th century MA in Perm women lowered from 14,5 to 13,25 years. In women of 1976/1985 years of birth MA moved to the later terms (mean value 13,38 years). Conclusion. Differences in BL between citizens and village born are reduced but citizens exceed rural inhabitants by BM and stably retard by TC. Long-term changes in parameters are near to those fixed in other groups of the Russian population as well as in Europe.
Perm Medical Journal. 2013;30(2):115-124
115-124
WORKING EFFICIENCY OF ROOM FOR PREVENTING TOBACCO-SMOKING IN CONDITIONS OF KRASNODAR HEALTH CENTER
Abstract
Aim. To estimate the efficiency of the developed program for treatment of tobacco dependence in conditions of room for preventing tobacco-smoking on the basis of “RCH № 2” Health Center. Materials and methods. Six hundred and thirteen health cards of patients who attended a room for tobacco-smoking prevention in 2012 were retrospectively analyzed. All patients were divided into three groups according to the degree of nicotine dependence: group 1 included 98 (16%) persons with mild degree of dependence, group 2 – 177 (19%) with moderate degree of dependence, group 3 – 398 (65%) with high degree of dependence. The doctor of prevention room gave recommendations to each smoking patient taking into account their individual peculiarities and health status. Results. No age differences among smokers were observed: mean age of men was 47,0±3,7, women – 46,08±3,01, p <0,05. Patients with low degree of dependence were suggested nonmedicamentous refusal from smoking based on behavioral therapy, individual conversation and group studies in conditions of health schools. Patients with moderate and severe tobacco-dependence underwent antinicotine therapy combined with individual conversations and group studies at health schools. Six months later, the number of successful refusals in group 1 was 35,5%, in groups 2 and 3 – up to 65,0%, about half of them had relapses against the background of stress situations and in 2/3 of cases they were men. Conclusion. Thus, creation of rooms for preventing tobacco-smoking in conditions of health centers is an effective measure helping smoking patients.
Perm Medical Journal. 2013;30(2):125-129
125-129
ANTIMICROBIAL DRUGS FOR TREATMENT OF ABDOMINAL SURGICAL INFECTIONS
Abstract
Review of literature data on antibacterial treatment of abdominal infections is presented. Summary of the main categories of intra-abdominal infections is given. It is shown that the schemes of antibacterial therapy of abdominal infections are based on an assessment of microbial landscape defined in the wound content. The major agents of abdominal infections and complications in surgical patients are Gram-negative bacteria. Gram-positive microorganisms are one-third of intra-abdominal infections’ overall structure. The problem of using natural compounds with antibacterial activity (bacteriophages, low molecular peptides and leukocytic cell proteins) is considered as one of alternative methods for antimicrobial treatment of surgical diseases. The conclusion about expediency of further laboratory and clinical studies on effectiveness of natural antibacterial drugs used for treatment of abdominal infections was made.
Perm Medical Journal. 2013;30(2):130-140
130-140