CONTENTS
THE COMPLIANCE OF PATIENTS RECEIVING ANTIRETROVIRAL THERAPYRelationship between patient compliance to antiretroviral therapy and individual patient peculiarities was studied. 105 HIV-infected patients who received outpatient treatment were included in the study. 72 patients showed to be compliant to the therapy. It was found that the compliance to antiretroviral therapy is significantly improved by the absence of depression, a harmonic of euphoric response type, medical consultation by an "equal" and surrounding support. Depression or anxious or/and obsessive-phobic response types towards the illness have a negative effect on treatment compliance. CLINICAL CHARACTERISTICS AND PECULIARITIES OF LIPID METABOLISM DISORDERS IN PATIENTS WITH CHRONIC HEPATITIS C WITH CHOLESTEROSIS OF THE GALL BLADDERThe peculiarities of lipid metabolism disorders and there role in the pathogenesis of cholesterosis of the gall bladder have been studied in patients with chronic viral hepatitis C. It was found that in patients with chronic viral hepatitis C with cholesterosis of the gall bladder the most significant elevation of the coefficient ApoB/ApoA-1 is present. This indicates that a greater amount of cholesterol enters the cell. EVALUATION OF THE IMMUNE SYSTEM REACTIVITY IN PATIENTS WITH CHRONIC HEPATITIS C RECEIVING COMBINED ANTIVIRAL THERAPYThe cytokine spectrum was studied in 45 patients with chronic hepatitis C receiving combined antiviral therapy. 30 other patients with hepatitis C infection receiving basic therapy were monitored and were considered as the control group. In patients receiving combined antiviral therapy on the second week of treatment a more rapid decrease of IL-1b, TNF-a was seen compared to the control group. This can be explained by the antifibrotic action of the a-interferon and ribavirin, which is linked to suppression of the hepatic star-shaped cells activity. After completion of the antiviral therapy a significant rise of IFN-a, IFN-g was seen compared to the respective level before treatment. Beside the antiviral action also immuno-regulative effects of antiviral therapy were established. A significant rise of IFN-a, IFN-g in patients with a stable virological response on the second week of antiviral therapy can be considered as an early criteria of the effectiveness of antiviral therapy. ON THE PECULIARITIES OF REUTER DISEASE ASSOCIATED WITH METABOLIC TYPES OF CHLAMYDIA TRACHOMATISAn interrelation between metabolic types of C. trachomatis isolated from the genitourinary tract of patients with Reuter's disease and the intensity of clinical, biochemical and immunological shifts within the organism was established. It was found that the significance of disturbances of lipid peroxidation, the antioxidant system, development of endogenous toxicosis and shifts of the humoral immune system are interlinked with metabolic types of C. trachomatis isolated from the genitourinary tract of patients with Reuter's disease. The worsening of the shifts in metabolism and immune status in monitored patients took place along with inhibition of metabolic processes in C. trachomatis and was most clearly seen with the persistent type of the infective agent. DIAGNOSIS OF THE ENDOGENOUS INTOXICATION IN OBSTETRICAL-GYNECOLOGICAL DISEASEThe dynamics of the endotoxicosis indicators during treatment of different types of obstetrical-gynecological disease were studied in 458 patients and in 40 healthy women. Significant changes in the described parameters of endotoxicosis during treatment of studied types of obstetrical-gynecological disease were found. The usage of described methods gives an opportunity to reveal in more details the pathogenetic link of endotoxicosis and to administer proper complex therapy. EVALUATION OF THERAPY EFFECTIVENESS AND SUBSTANTIATION OF TREATMENT TACTIC OF WOMEN WITH LESIONS OF THE NECK OF UTERUS CAUSED BY CHLAMYDIA TRACHOMATISIt was established that high incidence of uterine neck lesions in women with C. trachomatis infection requires complex treatment focused directly on the etiological agent and on the concomitant microflora with control of degree and character of changes in the exo- and endocervix. HEPATIC FAILURE AS AN IMPLEMENTATION FACTOR OF PSORIASIS IN DISASTER CONSEQUENCES FIGHTERSThe relation between psychosomatic disorders and the implementation of the severity and clinical peculiarities of the course of dermatoses in disaster consequences fighters suffering of psoriasis was studied on 25 patients with diffuse psoriasis. The severity of psoriasis and the effectiveness of the therapy were evaluated by the PASI index. The laboratory investigations included the general and biochemical blood and urine analysis. Besides a psychometric test and an examination by a neurologist were conducted. In these patients the leading implementation factor of psoriasis was hepatic failure. The psoriatic disease in disaster consequences fighters is a marker of severe hepatic disorder including hepatic encephalopathy. The treatment of established psychosomatic disorders requires a differential and pathogenically substantiated approach. THE USAGE OF PROPHYLACTIC METHODS OF CONGENITAL DISORDERS110 women were questioned to study their attitude to prophylactic methods of congenital disorders. Results highlighted insufficient impact of women consulting rooms as organizers of prophylactic measures since 75,5% of women had harmful factors in first trimester and 30% had a non-planned pregnancy. THE SIGNIFICANCE OF DYNAMIC PARAMETERS OF PORTAL BLOOD FLOW IN PREDICTING THE COURSE OF CHRONIC HEART FAILURE176 patients have been examined with different forms and stages of chronic heart failure along with 50 patients of the control group. During the ultrasound examination of the liver in patients with chronic heart failure of IIB-III stages with an alimentary test 3 types of portal blood flow reactions were found: hypo-, normo- and hyper reactive. The worst rates of central blood circulation and haemodynamic disturbances in the liver were seen in patients with a hyper reactive type of portal blood circulation. The important criteria in the formation of such a reactive type were the decrease of blood flow parameters in the spleen vein and of spleno-portal index. The worst in clinical prognosis by the average survival rate was the hyper reactive type of portal haemodynamic disturbance. PATHOMORPHOLOGICAL ASPECTS OF RECURRENT MYOCARDIAL INFARCTIONRetrospective analysis of 147 lethal outcomes from myocardial infarction has been conducted. The localization, size of the myocardial lesion and the cause of death of patients has been analyzed in primary and recurrent myocardial infarctions taking into account the sex and age of the patients. A more frequent involvement of the posterior ventricular wall in recurrent myocardial infarction was established. The most targeted age was the patients older than 70 years. The main reasons of lethal outcomes were cardiogenic shock, pulmonary edema, arrhythmias and rupture of the myocardium. THE POSSIBILITIES OF PHARMACOTHERAPY TARGETED ON THE NEUROPLASTICITY PROCESSES AND ON THE COGNITIVE DISTURBANCES IN ELDERLY PATIENTS WITH CHRONIC ISCHEMIA OF THE BRAIN100 patients have been investigated with a chronic ischemia of the brain of the II-III stages. In all patients cognitive disturbances of varying severity were found. 50 of patients received Lucetam in a dose of 2,4 grams twice a day. A significant therapeutic effect of the drug on the cognitive functions has been established. Regulation of these disturbances will help activate the mental activity in elderly patients and will help establish a better quality of life. THE USAGE OF ARTIFICIAL INTELLIGENCE SYSTEMS FOR DIAGNOSTIC PURPOSES IN VERTEBRONEUROLOGYThe usage of automated system of artificial intelligence in vertebroneurology is described. The importance of the patterns, produced by the indistinct neuronal net, its comparison with the results obtained with statistical analysis of the data and with the experts conclusions is discussed. SUBCLINICAL LESIONS OF THE PYRAMIDAL TRACTS IN PATIENTS WITH VERTEBROGENIC RADICULOPATHYThe evaluation of condition of the pyramidal tracts in patients with vertebrogenic radiculopathy using the method of transcranial magnetic stimulation made it possible to establish a group of patients with subclinical lesions of the pyramidal tracts. It was shown that in patients with subclinical lesions of the pyramidal tracts the recovery of clinical and neurophysiological parameters was much slower. ENDOSCOPIC APPLICATION OF ALLOGENIC MATERIAL "BIOPLANT" ON THE ULCERATIVE LESIONThe results of complex treatment of patients with gastric and duodenal ulcers by additional endoscopic application of allogenic material "Bioplant" were shown. 53 patients of the main group received complex treatment which included application of "Bioplant" material, while the 100 patients in the control group received traditional pharmacological therapy. In the control group the healing progressed by developing granulation tissue with a further transformation of the tissue into a cicatrix (by substitution), while in the main group the healing progressed by restitution with a full regeneration of the structure and functional activity of the mucosa. After the endoscopic application of "Bioplant" material improvement was seen earlier than in control group with a significant improvement of the general condition in 60,4% of the patients. In a long term course of the disease good results were achieved in 90,4% of the cases in the main group of patients, while in the control group only in 27,5% of the patients. FUNCTIONAL PECULIARITIES OF CELL MEMBRANES IN CHILDREN WITH BRONCHITIS AND PNEUMONIAThe peculiarities of the sodium-lithium counter-transport through the erythrocyte membrane were studied in 99 children with bronchopulmonary disease. It was established that the velocity of the sodium-lithium counter-transport in most patients with pneumonia is maximally high, unlike patients with bronchitis. In general children with bronchopulmonary disease usually have a high velocity of sodium-lithium counter-transport as shown by absolute values data. The results can be explained not only by genetic determinants, but also by the influence of environmental factors. LONG TERM CITOSTATIC CARDIOTOXIC TREATMENT CONCEQUENCES IN ACUTE LEUCOSISWe observed 51 patients with a more than 5 year acute leucosis remission. All those patients during treatment were given cardiotoxic medicines. The study showed that patients undergoing intensive chemotherapy of acute leucosis need to be examined carefully to reveal possible specific damage of the cardiovascular system in order to carry out prophylactic actions and treatment. PERIOPERATIVE REGIONAL INTRAPORTAL CHEMOTHERAPY METHOD IN GASTRIC CANCERPerioperative regional intraportal chemotherapy method was developed to treat gastric cancer. 107 patients with gastric cancer who underwent standard and extended radical operations were under investigation. A method of perioperative regional intraportal chemotherapy by 5-fluorouracil was established. The analysis of results has shown that perioperative regional intraportal chemotherapy by 5-fluorouracil in a dose of 500 mg/m2 does not have any negative effects on hepatic and renal function. Local recurrences and remote metastasizing of the gastric cancer in the studied group after 5-6 courses of chemotherapy was not seen. THE PECULIARITIES OF THE VISUAL ANALYZER IN CHILDREN LIVING IN INDUSTRIAL AREAS OF A BIG CITYA complex study of the functional state of the visual analyzer in 200 school kids (400 eyes) living in industrial areas of Kazan city was carried out. The control group was the 50 school children from city districts without industrial factories. In all of the studied children the acuity of vision measurement, refractometry, biomicroscopy of the eye balls, perimetry, ophthalmoscopy and examination the lability of the visual analyzer were conducted. The results showed that a disturbance of the functional state of the visual analyzer is present in school children living in industrial areas of the city. These disturbances are probably due to toxic chemical pollution which is discharged by plants and factories into the atmosphere and to hypoxia of the organism tissues. ANTIOXIDATIVE ACTIVITY OF BLOOD SERUM AND LACRIMAL LIQUID IN PATIENTS AFTER CATARACT EXTRACTION AND THE POSSIBILITIES OF CORRECTION WITH XYMEDONThe clinical course of postoperative period after cataract extraction has been studied along with the antioxidative activity of blood serum and lacrimal liquid while treated with xymedon. It is shown that the incidence of severe postoperative uveitis in patients receiving xymedon is seen twice two times lesser than in patients receiving placebo. Blood serum analysis showed a significant decrease of antioxidative activity to the 5th day of the postoperative period in both groups of patients. In the lacrimal liquid on the 1st postoperative day a rise in the antioxidative activity was seen with a sharp drop by the 5th day. Comparative analysis showed that in patients receiving xymedon the antioxidative activity was tended to be higher. In order to obtain significant results the period of treatment by xymedon should be increased up to 14 days. FORMATION FACTORS AND PREVENTION PECULIARITIES OF THE AGGRESSIVE FEMALE BEHAVIOR IN THE FAMILYSocio-demographic factors with clinical and psychological parameters have been studied during forensic expertise of women who have committed a murder or have caused severe injuries to their children. All cases of outpatient and inpatient women expertise in the Republican Clinical Hospital during the period from 1994 until 2004 have been analyzed. Is has been shown that in child-murder the prevailing mechanisms are personal-decompensative and psychopathological. It has been concluded that in the women child-murder a complex of negative socio-psychological factors plays a major role, which forms a defective maternity pattern. PROGNOSIS OF OCCURRENCE OF EMERGENCY SITUATION CONSEQUENCESThe structure of medical consequences of emergency situations is shown, along with approaches for organizing of the statistical count of medical consequences in the form of the International Disease Classification. Given is the data on medical consequences of emergency situations on the territory of the Republic of Chuvashiya. CHARACTERISTICS OF POPULATIONAL HEALTH OF ORENBURG REGION INHABITANTSThe dynamics of the main indices of public health of the Orenburg region inhabitantsis are shown. The demographic indices are given in detail including the static and dynamic and also indices of morbidity and incapacitation rates of the region's inhabitants. A worsening of the main public health indices in the region is established. ORGANIZATIONAL PRINCIPLES OF OPTIMIZATION OF CARDIO-OBSTETRICAL AID TO PREGNANT WOMEN WITH CARDIOVASCULAR DISEASEIn order to improve the quality of obstetrical aid to pregnant women with cardiovascular disease a system of treatment and diagnosis including different tactical measures and perinatal audit has been developed and tested in clinical practice. The study was carried out in 2 groups of pregnant women: the main group included 7887 women, to whom the cardio-obstetrical investigation was carried out by the scheme developed by authors, the control group included 2712 pregnant women, who were investigated by the standard methodology. The comparative analysis of the maternal and perinatal outcomes in the studied groups has shown a very high effectiveness of the proposed system of measurers: in the course of 6 years maternal mortality has been totally prevented, perinatal mortality was reduced from 26,2 to 5,3 %, and the incidence of Caesarian section decreased from 32,1 to 22,6 %. PECULIARITIES OF HIV INFECTION PROGRESS IN THE REPUBLIC OF TATARSTANRetrospective epidemiological analysis of disease for the last 19 years (1987-2005) based on personified data bank on 7858 cases of HIV was conducted. 3 periods of the epidemiological process have been defined. It was established that a subtype A HIV-1 prevales among the HIV infected patients in the Republic of Tatarstan. © 1995-2008 Kazan State University |