МЕДИЦИНСКИЕ АСПЕКТЫ ЧЕРНОБЫЛЬСКОЙ КАТАСТРОФЫ
The article analyzes the contemporary achievements in the field of assessment of doses and radiation risks, concepts of residence in regions suffered from the Chernobyl disaster and also the fundamentals of provision of radiation safety, optimization of life activity and preservation of health in people who live in the contaminated territories for a long time.
The aim of the study: to revile statistic dependence of the trance factor soil to milk on the density of soil contamination in rural settlement. The data of measurements on milk activity from Gomel region for the period of 1992-1996 have been used. The methods of applied statistics, such as correlation and regression analysis, was applied. The inverse statistical relation of radionuclides transfer factor from soil to milk on density of contamination has been defined. In territories with high density of contamination it is noneffective to conduct countermesures, directed to decrease specific activity of milk because of low values of transfer factor of radionuclides from soil into milk in these territories.
The general statement of the conception is stated here based on long-term research and the core is in forming at population of radiation threat of information-psychological nature determining addition to stress. Further the main risk factors are set out influencing on health, health status criteria, the psychosomatic pathology and rehabilitation model. The strategy of the latter is the decrease of stress level through the impact on social, adaptive and medical aspects. The criteria on assessment of rehabilitation measures, scientific support directions and monitoring of conception efficiency are proposed.
CLINICAL MEDICINE
High caries intensity patients (N=112) were invited for this study. We performed observation using complex of clinical and laboratory methods, such as indexes УИК, ИОЗН, РКВЭ and also saliva parameters (flow rate, test for oral viscosity, buffer capacity), and assessment of urine fluoride excretion and oral health habits, dental plaque pH measurement. Based of results of the present study the complex of clinical and laboratory diagnostic methods is recommended for supporting therapy of patients with high caries intensity due to represent of main pathogenesis aspects of caries process (assessment of dental plaque, oral health habits, fluoride excretion level and saliva factors).
Aim of this work is to study acupuncture influence to the fatty acids level in oral fluid. We carried out clinicolaboratory tests for 513 persons at the age from 15 to 25 years. All of them were subjected to the oral fluid examination in order to determine level of fatty acids (pabnitic acid, palmitoleic acid, stearic acid, oleic acid, linoleic acid). Oral fluid samples were placed in liquid nitrogen under the temperature of -196°C. Results of investigation were evident of positive acupuncture influence to biochemical processes in oral fluid. It gives to suggest that acupuncture is one of component of complex caries preventive procedures.
The article reveals the reasons and features of the commonly met in the references and practice misunderstanding in the diagnosis and treatment of the transacetabular displaced fracture of the caxal bone with the medial subluxation of the femoral head at the roof of the acetabulum. It is mistakably called the central hip dislocation resulting in inadequate and, therefore, ineffective treatment: conservative, with doubled skeletal traction.
The paper represents the results of retrospective study of medical histories of elderly patients who died after surgery in abdominal cavity organs. The reasons for fatal outcomes, different changes of biochemical and immunological indicators in post-operative period are revealed.
The peculiarities of anatomic relations between the organs of hepapancreaduodenal zone and the results of surgical palliative treatment, performed on 89 patients with the cancer of the head of the pancreas, complicated by obstructive jaundice were closely studied. It turned out, that supraduodenal choledochoduodenal anastomoses with minorlaparotomic access have considerable advantages over biliary-enteric anastomoses in gallbladder in the patients from this category. They are less traumatic, have less complications and lethality.
The analysis of lethality and morphological variations in organs of 9 patients with high external non-formed small intestinal fistulas has been carried out. In 3 patients with long-lived (from 1 to 2 months) existence of high non formed small intestinal fistula the marked parenchymatous dystrophy of internal organs was detected. Other 6 patients died from purulent - septic complications in the period from 7 to 15 days from the moment of high small intestinal fistula formation.
The paper presents technique of application of different non-medical methods used at medical rehabilitation of the patients with central pareses. Special attention is paid to neuromuscular stimulation and arrest of pain syndrome of central genesis.
Analysis of intensive care and anaesthesiological supply of urgent deliveration of pregnants suffered from combined hestosis is presented in the report. Objective clinical and laboratory criteria of hestosis are presented. Set of treatment is used for management of pregnants suffered from combined hestosis. Deliveration of pregnants suffered from severe combined hestosis is performed only under general anesthesia.
Lactoferrin - it is a iron-binded protein, found on a surface of mucous membranes, in specific granules of polymorphonuclear leukocytes, in biological secrets. Participates in a metabolism of iron. Possesses antibacterial, antiviral, antifungi and anti-inflammatory activity. In obstetrics it can be used as early marker of infectious attack, and as а control parameter of efficiency of treatment also.
Morphological research of 153 placentas of women with chronic placentary insufficiency has been diagnosed during pregnancy was carried out. Features of the initial clinical characteristic of patients, current of pregnancy, delivery, postnatal and early neonatal periods, morphological changes in placentas and ways of infection were analysed. It is established, that at a combination of histologic attributes of placentary insufficiency and inflammatory changes in placenta the complicated current of pregnancy is observed, worsen perinatal outcomes.
By means of multiprimer modification of polymerase chain reaction 92 women with clinical and subclinical signs of papillomaviral infection, I-III stage dysplasia of the cervix, preinvasive and microinvasive (Т1a1NоMо) cervical carcinoma have been examined. Toolkit «Ampli-Sense High Risk HPV» made in Moscow Research Institute of Epidemiology was used. The toolkit is designed for detection and differentiation of HPV DNA of high and medium carcinogenic risk: 16, 18, 31, 33, 35, 39, 45, 52, 56, 58, 59, 66 type. In patients with III stage dysplasia, intraepithelial and microinvasive carcinoma we detected significant increase of high oncogenic risk HPV in comparison with patients with I-II stage dysplasia, koilocytosis, condylomas and latent form of PVI (85,7 ± 5,0% versus 62,7 ± 7,3%) (р < 0,05). It is typical that with the increase of severity of dysplasia of the cervix in patients with intraepithelial and microinvasive carcinoma the reliable growth of HPV associations (2 and more types of HPV) and predominance of high oncogenic risk viruses in them (53 ± 7,1% versus 25,6 ± 6,6%) (р < 0,01) was observed.
The analysis of histological examinations and colposcopic signs in 400 patients with I-III stage dysplasia and preinvasive carcinoma cervix has been conducted. In young women the appearance of combined papillomaviral infection in the form of dysplasia in lower and koilocytosis in upper layers of epithelium is more frequently observed. With age, isolated signs are more frequently diagnosed. Various range of recurrence rate of dysplasia of cervix after surgical invasion is explicable by the age of the women who formed the surveyed group. The younger are the women with PVI signs, the higher is the risk of the recurrence development due to combination of subclinical forms: dysplasia, koilocytosis and acanthosis with dyskeratosis.
The paper describes possible types of nutrition for people with body overweight. Constructive diets for steady weight lose are suggested.
Research of heart rhythm variability at patients with the metabolic syndrome is carried out. Communication between parameters of heart rhythm variability, psychological status and heart rhythm infringements on type extrasystoles is shown. The method of a course general magnetotherapy for correction of independent nervous system disbalance is offered.
The extent and severity of histological changes in liver specimens in 76 patients with chronic hepatitis С (CHC) depending on biochemical activity were evaluated. In patients with CHC of moderate activity more often periportal necrosis, periportal inflammation, acidophilic Councilman bodies, destruction or proliferation of biliary ducts were found. We met balloon dystrophy, fibrosis with formation of porto-septal septs and false lobules only in patients with moderate activity. The majority of compared morphological changes were more expressed in CHC patients with moderate activity, but only inflammatory infiltration of portal tracts was significantly higher.
At this work we presented the results of studying of S. pneumoniae carriage frequency in children from organized collectives of Republic Belarus. These frequency reaches 74,74±2,57%. We have determined the susceptibility of S. pneumoniae clinical isolates to penicillin (77,58±5,48%), amoxycillin and cefotaxime (100% both), macrolides and lyncosamides (91,38±3,68%). We demonstrated some differences in the susceptibility of S. pneumoniae isolates received from children of the closed collectives, which is significantly lower and composes 28,29±3,14% to penicillin, 66,83±3,29% to erythromycin, 65,85±3,31% to azytromycin, 70,25±3,19% to clarytromycin, 73,17±3,09% to midecamycin and clindamycin.
The information on antibiotic resistance distribution of Salmonella spp. in the world and mechanisms of Salmonella spp. resistance to clinically significant antibacterial preparations - quinolones and 3rd generation cephalosporins is submitted. The results received during microbiological monitoring of Salmonella spp. drug resistance in the Gomel region are presented. High level resistance of S.Typhimurium strains to ceftriaxon are marked.
The data of the X-ray and echocardiographycal examination of 98 patients ( from 8 to 15 years old) with dysplasia of the spine are analised. The predominance of the dysplasia of the articular process and facet, pedicle. High frequency of minor cardiae anomalies among the patients of this group is noted (94%). In the minor cardiac anomalies the combination of the false tendons and mitral valve prolaps is typical. High incidence of minor cardiac anomalies in children with displasia of the spine may prove the role of connective tissue dysplasia in genesis of this state.
Submitted morphological and morphometrical parameters allow to establish patterns of structural transformations of the lateral ventricles of brain during the fetal period of prenatal development of man.The received data can be used as a normative base of morphological and channel parameters for revealing deviations of prenatal development and structure of the lateral ventricles of head brain of the man.
Reports from the department of general expertise and forensic-chemical laboratory of the Gomel Regional Administration of State Forensic Medical Expertise for the period of 1998-2004 have been examined. The reports state acute ethylene glycole poisoning to be the main death factor. The analysis of the expertise conducted will allow to improve the quality of biological material sampling to perform forensic chemical research, reduce the expertise conduction terms and will expand their possibilities to detect ethylene glycole.
ПРОБЛЕМЫ ОБЩЕСТВЕННОГО ЗДОРОВЬЯ И ЗДРАВООХРАНЕНИЯ
The paper outlines problems of natural reproduction, migration and urbanization of the population. The analysis of morbidity and demographic mechanisms and tendencies in the Gomel region.
Here we examine a group of factors provoking the phenomena of psychological stress and frustration of the group of people working in train crews. We offer some measures alleviate the unfavourable sides of the work.
NEW TECHNOLOGIES
In experiment was developed the method of the soft tissue augmentation using fascia allograft and bovine collagen. We performed 60 operations with collagen fascial allograft in experiment. We studied clinical features of the graft postoperative adaptation and morphological structure changes of the allograft and recipient soft tissues on experimental biological model in terms from 7 days to 6 month after operation.
Authors describe a surgical technique of the plastic replacement of the perioral region penetrating defects. This method is based on the using of the flat epithelized skin graft (O. Chudakov, 1975). The surgical technique of the formation plastic material was studded at the experimental clinic. 15 sea-pigs and 24 rabbits were treated using this method. A 19-year-old man presented with a tumor of the lower lip. The operative procedure used is follows: designing of the organetypical plastic material; the resection of the tumor with the reconstruction. Microscopic analysis and electromyography have showed save fibers of the muscle including into the flap. This method provides a satisfactory oris sphincter function and has good aesthetic results.
The author gives the brief review of use of materials on the basis of cellulose in medicine. Results own toxic-hygienic researches of new polymeric fibrous materials are stated on the basis of cellulose for replacement of soft fabrics in maxillofacial surgery. It is established, that the investigated materials are chemically stable, do not cause processes hydrolytic destruction and do not possess sharp toxicity in vitro with use of sperm of the bull as test-object. The received positive results of the lead researches enable the further estimation of biological action of materials.
In conformity with national standard, design of diagnostics and monitoring methods to qualifying control of virus hepatites В according to the basis of ELISA technology. Creation оf test manual documentation, techniques of tests are prepared, preliminary researches in ELISA test-systems for revealing HBsAg with high sensitivity, and also standard national panels with various contents HBsAg.
ИСТОРИЯ МЕДИЦИНЫ
The paper dwells upon the history of the development of physical training and sports system in BSSR (1921-1941).
ISSN 2708-6011 (Online)