CONTENTS
IMMUNOREGULATˇRY INTERACTIONS IN THE SYSTEM OF Th1-Th2 LYMPHOCYTES - THE BASIS OF DEVELOPMENT OF PATHOLOGIC PROCESS AS WELL AS THERAPEUTIC EFFECT OF XIMEDONE IN PATIENTS WITH ATOPIC ALLERGIC DISEASES91 patients with atopic allergic diseases are examined. Atopic bronchial asthma of mild persisting course was revealed in 52 patients, pollinosis was revealed in 39 patients. The level of IL4, IL6, IL8, IL10, IL12 g-interferon as well as general IgE level in blood serum was determined by immunoenzyme analysis. The improvement of the course of bronchial- obstruction syndrome as well as allergic rhinitis symptoms was noted on therapy with ximedone. Distinct clinical dynamics was accompanied by reliable decrease of the level of IL6, significant increase of concentration of g-interferon and IL12 along with decrease of the level of total IgE and eosinophilia. The obtained results show the change of immune response during therapy with ximedone from primary Th2 phenotype in patients with atopic allergic diseases to Th1. TO THE MECHANISM OF THE EFFECT OF DOMESTIC MEDICATION DIMEPHOSPHONEThe effect of dimephosphone on endocrine system organs and immunity function is studied in experiment. It is shown that the medication has adaptogenic, immunomodulating, thyroactivating, antoxidant properties and improves microcirculation. PHARMACOEPIDEMIOLOGY AND INDIVIDUALIZATION OF PHARMACOTHERAPY - NEW TECHNOLOGIES OF IMPROVING THE USE OF DRUGSThe results of studying the use of psychotropic medications including antiepileptic drugs, nonsteroid anti-inflammatory, antibacterial drugs and drugs for treatment of bronchial asthma in children are given. The individualized therapy methods with nonsteroid anti-inflammatory drugs based on biochemical response type and the dosage optimization methods of psychotropic drugs based on studying of the individual genetically determined variability of their biotransformation reactions are developed. The efficiency of promotion of new technologies for improvement of the use of drugs in wide chinical practice is shown. The results of pharmacoepidemiologic analysis of estimation of the efficiency of new technology of teaching clinical pharmacology to doctors are discussed. IMPORTANCE OF RADIOLOGY DIAGNOSIS IN CURRENT MEDICINEPossibilities of radiology diagnosis in current medicine are analyzed. The ways of training doctors-radiologists in current conditions of the development of high medical technologies are suggested. EVOLUTION OF TACTICS OF THE TREATMENT OF PATIENTS WITH COMPLICATED FORMS OF CHOLELITHIASISThe retrospective analysis of results of the treat-ment of 161 patients with gall bladder stones, complicated by choledocholithiasis and stenosis of the major duodenal papilla is performed. Correction of bile outflow in duodenum was carried out by intraoperative endoscopic papillosphincterotomy in 35 cases. In 45 patients this operation was made either after cholecystectomy or before it. Recovery and reconstructive methods using transduodenal papillosphincterotomy and choledochoduodenostomy were used in 81 patients. Advantages of endoscopic treatment manipulations including the use of the developed method of endoscopic papillosphincterotomy were shown. SURGICAL PECULIARITIES OF KIDNEY TRANSPLANTATION IN VARIANT FORMS OF RENAL VESSELSVariant forms of renal arteries on 500 lifetime angiograms and on 100 cadavers are studied for estimation of arterial blood supply in kidneys. Clinical material included 114 operations on kidney transplantation performed from 1988 to 2004. The average observation period after kidney autotransplantation was 5,3 years (maximum 16 years), after kidney transplantation from the living related donor - 3,4 years (maximum 6 years). There were no any complications due to vascular anastomoses in patients with variant forms of renal vessels. URGENT PROBLEMS OF SURGICAL AND COMBINED TREATMENT OF PATIENTS WITH RECTAL CARCINOMAIndications to extended operative interventions in rectal carcinoma are justified and developed. It is shown that extended aorto-iliopelvic lymphade-nectomy combined with preoperative macrofractional irradiation significantly improves longterm results of the treatment of patients with rectal carcinoma in comparison with those in standard radical operations. Prognostic criteria in radically treated patients with rectal carcinoma are developed. MYCOPLASMA INFECTION IN OBSTETRIC AND PERINATAL PATHOLOGYRisk factors of development of mycoplasma and mixed infections resulting in complications of pregnancy and labor are considered. The structure of basic signs of clinical pathomorphism of mycoplasma and mixed infections as well as complications of somatic nature, pregnancy, labor and neonatal period is presented. Methods of antimycoplasma therapy and prevention in pregnants, women in labor, puerperas as well as examination of newborns of mothers with mycoplasma infection are justified. CLINICONEUROPHYSIOLOGIC ASPECTS OF PATHOMORPHISM OF CLASSIC NEUROLOGIC SYNDROMESBasic mechanisms of formation of myalgia and fascial and ligamentous pain are presented. The role of myofascial hypertonus in pathogenesis and formation of the clinical picture of myofascial pain syndrome and fibromyalgia is postulated. Clinico-neurophysiologic diagnosis criteria of myogenic and fascial and ligamentous hypertonus, classification and clinical manifestations of fibromyalgic syndrome are given. The methodic recommendations on treatment of fibromyalgic syndrome are presented. CLINICAL AND IMMUNOLOGIC PECULIARITIES OF CHRONIC VIRAL HEPATITIS C IN H‘V-MONOINFECTION AND IN HCV+HIV-COINFECTIONClinicobiochemical peculiarities of the course of chronic viral hepatitis C (CVHC) in groups of HCV+HIV-coinfectioned patients are studied. Data on dynamics of change of humoral immune response on specific antigens HCV in patients with chronic viral hepatitis C of the indicated groups are analyzed. Comparative study of the ratio of specific antiviral antibodies in serum and in circulating immune complexes is performed. Peculiarities of specific antibody formation at the stage of immunodeficiency in HCV+HIV coinfected patients are discussed. REMOTE RESULTS OF EARLY DETECTION AND REHABILITATION OF CHILDREN WITH DISORDERS OF GROWTH AND DEVELOPMENT OF MAXILLODENTAL SYSTEMProfound study of dispensarization method in comparison with doctor hours was performed to estimate the efficiency of dynamic examination and rehabilitation of children in orthodentistry. In the second period of changeable occlusion among children in Kazan the age norm of maxillodental system was 1,8 times more often than in inhabitants of Tatarstan Republic. In comparison of groups of persons with permanent occlusion this difference increased twice. Early detection of morphofunctional disorders of maxillodental system development, differentiated standartization of rehabilitation measures complexes determine two fold decrease of incidence of maxillodental pathology in permanent occlusion. ON STUDY OF HEALTH OF ECONOMICALLY ACTIVE POPULATIONStudy of health of economically active population from wide medicosocial and economical point of view started from 1960-th. Study materials on the problem are widely introduced in practice of organs of state authorities, health care and pedagogic activity of higher educational institutions. The necessity to implement the aimed complex program "Health of working population of Russia" is obvious, and the regional research institutes on Health can serve as the methodologic center for its realization. IMPORTANT PROBLEMS OF ADOLESCENTS MEDICINEComplex study of medicosocial problems in teenagers of Tatarstan Republic is carried out. State of their health, nature and cause of diseases, basic sociopathic effects at school and at home are estimated. Discrepancy between official statistics data and profound examination is shown. The presented data suggest the crisis state of health of teenagers in recent years. For valuable characteristic of health of teenagers and choice of individual preventive measures both medical and social factors should be considered. PREDICTION OF REPRODUCTIVE POTENTIAL OF YOUNG MOTHERS ON OUTCOME OF PREGNANCYLarge statistical material on morbidity of girls-teenagers, on estimation of reproductive health state and its disorders due to abortions and labor is analyzed. Accents are made on peculiarities of observation over young pregnants. Measures on optimization of medical and psychologic evaluation of girls and teenagers are suggested. STATE AND PERSPECTIVES OF POSTGRADUATE TRAINING OF MEDICAL STAFF OF THE VOLGA FEDERAL REGIONData on the state of postgraduate and supplementary professional education of specialists of health care of the Volga federal region are presented. The most urgent problems of postdiploma education are noted. The analysis of certification and attestation of medical staff is performed, the ways of improvement of postdiploma education and optimization of training of staff in current social and economic conditions are suggested. THE SERVICE OF CATASTROPHY MEDICINE IN PROVISION OF SAFE VITAL FUNCTIONING OF POPULATION IN TATARSTAN REPUBLICThe results of research work of the department of catastrophy medicine and first medical aid of the Kazan State Medical Academy on development and introduction of the concept of organization of service of catastrophy medicine on territorial level in occurrence and overcoming of consequences of emergency are presented. CLINICOEPIDEMIOLOGIC ASPECTS OF VIRAL HEPATITIS B AND CClinicoepidemiologic characteristics of viral hepatitis B and C in the region with increased indices of their registration are studied. It is established that their significant differences can be used in the diagnosis of various forms of viral hepatitis and for subsequent development of the programme of prevention of this pathology. CURRENT SIGNS OF EVOLUTION OF SEXUALLY TRANSMITTED INFECTIONSFactors of evolution of epidemic process of sexually transmitted infections are considered on two levels: hierarchypopulational and organic. The structure of basic signs of clinical pathomorphism of these infections which should be taken into account in determination of diagnostic route of patients and prescription of their treatment is presented. Risk factors resulting in formation of complications of urogenital sexually transmitted infections are described. Realization of interdisciplinary approaches to diagnosis and treatment of patients, promoting control of the disease and improving of health, treatment process and preventive measures program is suggested. |