Preview

Health and Ecology Issues

Advanced search
No 3 (2014)
View or download the full issue PDF (Russian)

REVIEWS AND LECTURES 

7-15 308
Abstract
The review presents causes and clinical features of Stevens-Johnson syndrome, toxic epidermal necrolysis (SJS/TEN), in children and analyzes the role of drugs as inducers of the illness. The high risk of SJS/TEN in children is associated with co-trimoxazol (sulfamethoxazol + trimethoprim), other anti-infective sulfonamides, anticonvulsants (phenobarbital, carbamazepin, lamotrigine), non-steroidal anti-inflammatory drugs of the oxicam-type. The highest risk of SJS/TEN development occurs during the first eight weeks of treatment with a subsequent sharp decrease in the incidence rate. Certain genetic factors contribute to SJS/TEN development.
15-18 367
Abstract
The article presents literary data on kidney disease in HIV patients. It discusses questions of assessment of glomerular filtration by the levels of endogenous creatinine and cystatin C and considers advantages and disadvantages of the methods of calculation of glomerular filtration rate by the biomarkers data.
18-25 265
Abstract
The review contains information about the application of echocardiography together with tissue Doppler sonography in the assessment of structural and functional state of the myocardium in patients with combined pathology of coronary heart disease and type 2 diabetes mellitus. We have analyzed the latest achievements in noninvasive diagnostics of atherosclerotic process of coronary arteries, which makes it possible to diagnose the disease at a subclinical level. The article presents up-to-date possibilities and prospects of the application of tissue Doppler method in early diagnosis of coronary atherosclerosis in patients with diabetes.
26-30 249
Abstract
The microorganism Acinetobacter baumannii is a common cause of nosocomial infections, particularly in wards of resuscitation and intensive care. The problem of treatment for these infections is the extremely good resistance of the microorganism to antimicrobial agents. The present article deals with the problems of epidemiology and rational antimicrobial therapy for infections caused by Acinetobacter baumannii.
30-35 285
Abstract
Fundamental medicine uses a plenty of biological patterns and molecular phylogenetic analysis is currently used in medical research, which makes it possible to establish relations among various organisms and draw conclusions about their evolution by studying the changes in the structure of DNA, RNA and proteins. The obtained data can be used to study the etiology, pathogenesis, diagnosis, prevention and treatment of a disease.
35-41 263
Abstract
Aim: based on the data of recent publications to assess the risk of uterine rupture and success of the trial of labor after Cesarean in spontaneous and induced vaginal delivery in patients with a uterine scar. Material and methods. We reviewed and systematized the recent publications on the problem of operated uterine rupture and calculated the chances for successful trial of spontaneous and induced vaginal delivery, risks for its failure and uterine rupture. Results. The article presents the possibilities and safety of vaginal delivery in patients with the operated uterus. It was found out that in modern conditions the uterine rupture occurs in 1,0-2,3 % of cases, the rate of successful vaginal birth after Cesarean section is 69,3-73,2 %. Conclusion. The research showed that the rupture of the operated uterus during vaginal delivery is possible in 0,00006-0,00036 cases, the chances for successful vaginal delivery in patients with uterine scars are 4,47-5,02. Spontaneous labor in women with the operated uterus has a statistically higher risk of failure in natural maternal passages (p < 0,0001), but paired with a significantly lower risk for uterine rupture (p < 0,0001).
41-47 297
Abstract
Obesity is a chronic multifactorial heterogeneous disease characterized by excessive accumulation of body fat (in men - at least 20 % and in women - 25 % of body weight, body mass index (BMI) is more than 25-30). Obesity can also be described as a metabolic disorder in individuals with genetic predisposition leading to excessive deposition of fat in the body weight, overweight being more than 10 % compared to the physiological norm, and may be accompanied by fatty degeneration of internal organs - heart, liver, kidneys.
47-53 318
Abstract
Nowadays, the interest to study of changes in processes of energy supply in physical exercise is associated with the use of modern methods of study of aerobic and anaerobic metabolism in skeletal muscles, and also assessment of energy interchange in sport medicine for correction of training process and diagnostics of overtraining syndrome with high practical significance. This review covers contemporary notions on interaction and adaptation of energy systems in skeletal muscles during physical exercises of different intensity and duration.
53-56 255
Abstract
The review gives a detailed analysis of national and foreign publications and describes the structure and variations of the venous system of the lower leg. It also gives notions and clinical importance of communicating and perforating veins and venous sinuses of the lower leg. The most significant communicating and perforating veins and their localization were described.
56-61 284
Abstract
Colorectal cancer is the second most common cause of death from malignant neoplasm. Most cases of colorectal cancer are caused by sporadic adenoma, and few cases develop in patients with genetically determined polyposis syndromes or inflammatory bowel disease. The article covers modern approaches to screening, testing of asymptomatic men and women who are likely to have adenomatous polyps or colorectal cancer.
62-67 316
Abstract
The diagnosis of osteomyelitis in syndrome of diabetic foot, notwithstanding all modern achievements of medicine, stays a complex task, which is caused by difference of opinions on detection of this state and criteria for diagnosis. The article presents the generalized information about existing methods for the diagnosis of osteomyelitis in diabetic foot syndrome, shows their advantages and shortcomings.
67-71 261
Abstract
The article presents the generalized information about the value of AMH (Anti-Müllerian hormone) level in women with and without various gynecologic diseases from foreign and national literary sources. A lot of studies prove the role of AMH as a marker of ovarian reserve. However, the data on changing of this hormone in pathology remains insufficiently expored.

CLINICAL MEDICINE 

72-77 293
Abstract

The aim of this study was to analyze the neurological manifestations in lumbar osteochondrosis considering the CT (MRI) imaging of the lumbosacral spine. Material and methods. The study included a survey of patients and evaluation of clinical data with respect to the results of CT and MRI neuroimaging of the lumbar spine. We conducted personal interviews, studied medical records and protocols of tomographic studies of 60 patients treated in the neurosurgical department of the Gomel Regional Hospital within 2010-2011. Results . Most patients (42-70.0 %) observed expressed or pronounced symptoms of tension. Lasegue symptom was absent in few cases - in 3 (5.0 %) people. Twelve (20,0 %) patients from the group of patients with neurological manifestations of lumbar osteochondrosis strength detected motor deficit. The paresis of the muscles of the big toe prevailed in 6 (10.0 %) people. In the vast majority of cases (48 people - 80.0 %), the decrease in muscle strength of legs was not found. The lesion of foot flexors prevailed over that of extensors (p < 0.05). Conclusion . Most often the pronounced Lasegue symptom was found in prolapse of herniated disks LV-SI (23.3 %). Absence of tension symptoms was rare (5.0%). The expressed prevalence of clinical symptomatology depending on the level of the intervertebral disc herniation was revealed most frequently in the paresis of foot flexors (75.0 % of all the cases in of hernia at LIV-LV level) (p < 0.05). When analyzing the cases of the paresis of the extensor muscles of the foot and big toe, we did not find any prevalent kind of the herniated disc.

77-82 281
Abstract

Annually, about 6 million people in the world and more than 450 thousand in Russia suffer from cerebral stroke, i.e. every 1.5 minutes a Russian develops this disease. In large megalopolises of Russia, the number of acute stroke is from 100 to 120 per day. Stroke is currently one of the main causes of disability in population. 70-80 % survivors become disabled after stroke, and approximately 20-30 % of them need constant outside care. Among all types of stroke, ischemic brain lesions are predominant. Ischemic strokes account for 70-85 % of the cases, cerebral haemorrhage - 20-25 % of the cases, nontraumatic subarachnoid hemorrhage - 5 % of the cases. Stroke is now becoming a major social and health issue of neurology. In general, stroke is the second leading cause of death (after acute heart disease), and mortality in men is higher than in women.

82-87 244
Abstract
The purpose of the work is to study the role and significance of the research for pro- (TNF-α, IL-23, MCP-1) and anti-inflammatory (TGF-β) blood cytokines in blood and urine in children with uropathy of the upper urinary tracts (UUUT). Material and methods . 52 children with UUUT (1 group) and also 43 children free of UUUT with the infected urinary system (2 group) were examined. The immuno-enzymic method ELISA and the corresponding test-systems were used to study the levels of cytokines in blood and urine. Results. The analysis showed a significant increase in the levels of all the studied pro- (TNF-α, MCP-1, IL-23) and anti-inflammatory (TGF-β 1) cytokines in the blood of the patients in groups 1 and 2. The levels of TNF-α and TGF-β in urine are considered as diagnostic markers of inflammation and fibrosis, including the state after reconstructive surgery, and that of MCP-1 in blood - as acute aggravation of chronic pyelonephritis. Conclusion. The TNF-α and TGF-β levels in blood of the children with congenital uropathy can be additional diagnostic and prognostic markers and also in the dynamics of the treatment with nephroprotection.
87-91 343
Abstract
Objective: to assess the sensitivity of Staphylococcus aureus to main antibacterial preparations in children of Grodno region. Material and methods. The results of the study of all tonsil smears of children suffering from chronic tonsillitis and admitted to the Grodno Regional Center for Hygiene, Epidemiology and Public Health in 2010, were analyzed. The median age of the children was 8, and the interquartile range was 4-13. Inoculation, cultivation, identification and determination of antibiotic sensitivity was conducted in accordance with the existing regulations. Results. 1000 cultures belonging to 14 families, genera and species of microorganisms were received. 578 people identified a monoculture of bacteria, 200 revealed two cultures, and in 7 children - three cultures. In one case the growth of both bacteria and fungi was absent. 289 patients detected Staphylococcus aureus. In 66.7 % of the cases it was combined with other bacteria, and 16.9 % - with Candida fungi. Conclusion. At present, the children of Grodno region detect Staphylococcus aureus reliably more often in the autumn and in children over five. The majority of the identified cultures are resistant to β-lactam antibiotics and clavulanic acid. Metitillinresistent strains are prevalent. Sensitivity to certain antibacterial drugs has seasonal fluctuations and depends on the kind of coinfection.
92-95 269
Abstract
Objective: to develop a landmark, suitable for fast image acquisition of the long sacroiliac ligament in the longitudinal section. Material of research. We assessed the position of the longitudinal axis of the long posterior sacroiliac ligament and the line of spinous processes (determined by the angle formed by the mentioned lines) on MRI scans of 48 patients aged 27 to 80: 23 men (the average age was 62.3 ± 8.5) and 24 women (the average age of 48.4 ± 11.7) and 11 corpses: 6 males (mean age 63,0 ± 4,6 years) and 5 women (mean age 63,6 ± 2,2 years) was evaluated. Results. We received the data that make it possible to get the image of the long posterior sacroiliac ligament in the longitudinal section quickly (using the proximal posterior superior iliac spine as a landmark and orienting the scanning plane of the sensor at an angle of 11.4 ± 2.2 according to the line of the spinous processes).
95-100 236
Abstract
The article describes the effect of pathologic tortuosity of carotid arteries on cerebral circulation, variants of the course of vascular cerebral insufficiency and clinical manifestations, their role in indication for surgical treatment. The pathologic tortuosity of carotid arteries is revealed by the clinical picture of vascular cerebral insufficiency in carotid and/or vertebrobasilar basins. The work assesses the role of spiral computed tomography with contrasting and magnetic resonance imaging in the verification of signs of episodes of focal neurologic deficiency in patients with the tortuosity of carotid arteries and the potential for application of transcranial Doppler for evaluation of cerebral blood flow disorders in different variants of cerebral vascular insufficiency. The article covers the problems of analysis of the received data for indication for surgical treatment for the tortuous internal carotid artery and presents the long-term results of the surgical treatment of the patients with tortuosity of carotid artery (dynamics of neurological symptoms and the absence of cerebral infarction on the area of the surgery).
100-103 277
Abstract
The article deals with the assessment of the quality of life in 46 patients with coronary heart disease after percutaneous coronary surgery. To assess the quality of life, the SF-36 questionnaire was used before and after coronary artery stenting (12 months later). The study showed that the quality of life of the patients after coronary artery stenting reliably increased mainly due to the physical component. The parameters of life quality are directly dependent on the course of coronary heart disease after stenting: when stenocardia was recurrent, all the indicators (both physical and mental health) became dramatically lower, becoming approximate to the original preoperative level.
103-107 264
Abstract
Objective: to study the incidence rate of different genotypes of Helicobacter pylori in children with erosive and ulcerative changes in gastric and duodenum mucosa, as well as to evaluate the effect of toxigenic strains on the morphological changes of the mucosa. Material of study. 230 children aged from 8 to 17 with chronic gastroduodenal pathology associated with Helicobacter pylori were examined. Results. The examined patients revealed the heterogeneity of Helicobacter pylori genome. The persistence of toxigenic strains of Helicobacter pylori is associated with the expressed morphological changes in the mucous membrane. Conclusion. The development of the erosive and ulcerative processes in the stomach and duodenum mucosa in children is associated with the persistence of virulent strains of Helicobacter pylori infection with cagA+vacAs1/m1 or cagA+vacAs1s2/m1m2 genotypes.

EXPERIMENTAL MEDICINE AND BIOLOGY 

107-112 275
Abstract
Objective: to identify the potential of sonography in the assessment of expressiveness of changes in the posterior long dorsal sacroiliac ligament. Material and methods. Posterior long dorsal sacroiliac ligaments from 15 corpses (the age 37 till 87): 11 men (average age 68.0 ± 9.7) and 4 women (average age 51.8 ± 18.3). Results. Criteria making it possible to assess moderate and expressed dystrophic changes were singled out. Conclusion. The conclusion was drawn not only about confirmation of the presence of an injury in the posterior long dorsal sacroiliac ligament, but also about more detailed assessment of expressiveness of the changes revealed in sonography.
112-116 259
Abstract
Objective: to develop a mathematical model for assessment and prediction of current and accumulated internal irradiation doses in the population since 1987 by WBS-measures. Material and methods. The results of the WBS-measures taken from the RRCRM&HE Data Base were analyzed. The method included selection of the statistically reliable average values of internal irradiation doses in a settlement. A value of the mentioned dose was set as a factor for unknown dependences. Results. The experimental data of the dose time dynamics were approximated with a mathematical model as a sum of two-exponents reflecting different regularities of internal irradiation dose forming over different periods after the disaster. Conclusion. The developed model has a relatively high coefficient of correlation with experimental dependences 0.78-0.88, which makes it possible to use it with less cost and acceptable accuracy for development of the Dose catalogue.
116-120 282
Abstract
The purpose of the study : to assess the parameters of central hemodynamics in young people with different types of blood circulation during physical exercise. Materials and methods. 39 male students of Gomel State Medical University were examined by the method of tetrapolar chest reography (impedance cardiography). The following parameters of central hemodynamics were assessed: heart rate, stroke volume, cardiac output, cardiac index, total peripheral resistance and left ventricular filling pressure. The parameters of central hemodynamics were studied in quiescent state and after physical exercise. Bicycle ergometric test with stepwise increasing load was used as physical exercise. Results and discussion. The study showed that the examined students with hyperkinetic type of circulation in quiescent state were characterized by high values of stroke volume, cardiac output, cardiac index and low total peripheral resistance, which are typical for moderate hyperdinamia of cardiac activity. Students with hypokinetic type had low values of stroke volume, cardiac output, cardiac index and high total peripheral resistance, left ventricular filling pressure which characterize more economical mode of heart work. Students with normorkinetic type of circulation were characterized by average values of the studied parameters in quiescent state. The features of the central hemodynamics parameters in young people depending on the type of blood circulation during physical exertion were revealed. Conclusion. In young men with hyperkinetic type of circulation during physical exercise the heart works in the least economical mode, and the range of compensatory possibilities of this type is limited. On the contrary, hypokinetic circulation is the most economical and the cardiovascular system in this type of circulation has a large range of function mobilization.
121-125 246
Abstract
Objective: to study the effect of probiotics on the structural and functional state of the heart in stimulated chronic heart failure in rats. Materials and methods. The experiments were performed on male white rats (n = 38). CHF was simulated by double subcutaneous introduction of isoprenaline hydrochloride (Sigma) at a dose of 80 mg/kg at intervals of 24 hours. For histological examination we seized parts of the left ventricular myocardium, prepared cryostat sections of 10 micron thick and stained them by Mallory's method, followed by morphometry using a light microscope MPV-2 («Leitz», Germany) with the digital camera «Leica». The concentration of CRP in serum was measured by agglutination test with latex. Results. It was ascertained that taking the drugs «Dialakt» and «Bifidumbacterin» contribute to preservation of the CMC diameter, which leads to a decrease in fibrosis evidence and areas of undulating deformation and vacuolization of cardiac myocytes (p < 0.05). All the animals with CHF detected certain serum CRP levels (average 172.8 ± 19.2 mg /l), whereas none of the control group revealed it, as it was beyond the sensitivity of the method. In the group of those who had taken «Dialakt», the number of samples with the amount of protein (48 mg/l) reduced to one compared to the animals of group I, while in the group taking «Bifidumbacterin» it reduced to five (86.4 ± 28 mg/l) in the same comparison.
125-129 264
Abstract
The article studies the changes of antioxidant activity of blood serum and intestinal content in experimental animals 12, 24, 36 hours after simulated acute intestinal obstruction (AIO). The experiment included 77 adult male inbred albino rats, which were included into trial (n = 27) and control (n = 50) groups. AIO in the rats is accompanied by inhibition of antioxidant properties of the serum and intestinal content, the development of endotoxemia already within the first day of AIO. The animals with AIO have unidirectional changes of the antioxidant status in the serum and intestinal content, but later occurring with greater intensity. These data show the need for application of antihypoxic oriented drugs in the comprehensive therapy program of AIO treatment.

PUBLIC HEALTH AND HEALTH CARE, HYGIENE 

129-134 255
Abstract
The article presents the results of the research aimed at determination of dose-forming foodstuffs in daily diet of the population of North-East Gomel region. The internal irradiation dose of the population of Chechersk, Vetka, Dobrush districts within 2009-2012 was formed basically at the expense of milk. The article presents the results of the radiometric research of foodstuffs produced in private and collective farms in the above listed districts.

CLINICAL CASES 

134-139 279
Abstract
The article presents a case of a baby born at the Gomel Regional Clinical Hospital in 2013. The baby, born at the Gomel Regional Maternity Hospital had surgery according to life indications, severe blood loss, hemorragic shock, disseminated intravascular clotting and syndrome of multiorgan disfunction. The patient later developed a large catheter-associated trombus of the right atrium with pulmonary embolism. [1, 2, 3, 5]. We did not have any clinical experience on trombolytic therapy in newborns after hemorragic shock. We could not find any standard recommendations, descriptions of similar cases in information resources. The newborn received a recombinant tissue plasminogen activator and later we removed the central venous catheter with the remains of the trombus. The trombolysis with the recombinant tissue plasminogen activator was successful and without any complications. The baby survived and was discharged from the hospital.
139-144 287
Abstract
Sjögren’s syndrome is a chronic inflammatory systemic autoimmune disease mainly affecting the exocrine and, particularly, the salivary and lacrimal glands. The immune-mediated attack on the salivary and lacrimal glands leads to the development of dry mouth (xerostomia) and dry eyes (keratoconjunctivitis sicca), which takes place in association with lymphocytic infiltration of the glands. That inflammatory process eventually severely damages or destroys the glands. Sjögren’s syndrome can affect people of either sex and of any age, but most cases occur in women. The average age for the onset is late forties, but in rare cases, Sjögren’s syndrome is diagnosed in children.

NEW TECHNOLOGIES 

144-148 242
Abstract
Objective: to develop a method of glossectomy with single-staged glossoplasty in cancer of the mucous membrane of the front one-third part of the tongue. Material. The work is based on the results of surgery of five patients with localization of cancer on the front one-third of the tongue. An up-to-date method of glossectomy of the front one-third of the tongue has been developed. The post-resection defect is eliminated with musculomucosal grafts from the tongue remains with restoration of the volume symmetry of neotongue. Conclusion. The application of the tongue tissues for plastic replacement of the defect minimizes traumatism of the surgery. The preservation of innervation and restoration of the structure ensure good functional effect of the glossoplasty method.
148-152 258
Abstract
The article offers a new methodical approach to synthesis of binary hexacyanoferrate preparations (II) on the matrix of activated charcoal. It presents the experimental results of studies of blocking of cesium radionuclides in simulated water-salt solution. The work suggests a different phase state of binary preparations, depending on the mass ratio copper and iron hexacyanoferrates (II) in the course of synthesis.


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2220-0967 (Print)
ISSN 2708-6011 (Online)