№2, 2009, volume 5

The analysis of clinical course influence on life quality and patients dependance on supporting therapy of chronic biliary dependent pancreatitis is represented. It has been determined that increase of life quality is in close correlation with exacerbation frequency, dyspepsia syndrome evidence and manifestations of exocrinous insufficiency of pancreas. Patients with chronic biliary dependent pancreatitis do not carry out doctor’s recommendations in appropriate manner.

Pharmacological effects of immunomodulators produce normalization of immunochemical function of homeostasis. This phenomenon determines optimization of Helicobacter pylori eradication. The combination of immunomodulators with antibiotics has a double effect. Antibiotics destress the functional activity of microorganisms and increase it’s sensitivity to the effect of phagocytes. On the other hand immunomodulators increase functional activity of phagocytes to eliminate microorganizms Оptimization of Helicobacter pylori eradication by using of immunomodulators is necessary for clinical practice. It includes prophylaxis of recurrences and complications caused by drugs action on immune system in patients with chronic diseases.

On the basis of the conducted research, prevalence of tobacco smoking and its intensity according to the gender and age descriptions among the urban population in the Middle Volga region (Samara as an example city) is described in the article. It is proved, that among men and women under study 49,37% and 14,17% smoke accordingly, 22,80% and 8,86% smoked before, 27,83% and 76,97% never smoke. The education level and family status have considerably contributed to the epidemiology of tobacco smoking addiction. Authors consider, that the development of public and medical measures directed to the fight against smoking must be realized taking into account the gender, age, social and mental points, that is difficult, but necessary process.

Expiration function, cardiohemodynamics and blood viscosity indices have been investigated in 178 patients in order to evaluate the efficacy of plasmapheresis application in complex therapy of acute bronchial asthma combined with arterial hypertension. Complex therapy proved to be advantageous.

The aim of present work is to study the frequency of hypertension and the peculiarity of 24-hour blood pressure monitoring in patients with rheumatoid arthritis. We studied 584 patients with rheumatoid arthritis. Daily blood pressure monitoring was carried out in 46 patients with arthritis and 18 patients with essential hypertension. Frequency of hypertension was higher in patients with arthritis then in general population. Elevation of systolic blood pressure, heart rate and arterial blood pressure adequate decrease at night were developed to associate with advance of the disease.

The article presents the research findings concerning the importance of changes of the contents in blood serum of interferon gamma (INF-?), interferon alfa (INF-?), the tumor necrosis factor alfa (TNF-?), interleukin 4 (IL-4), interleukin8 (IL-8) and clinical parameters at patients with community-acquired pneumonia before the end of treatment (basic therapy and with immunomodulator tiloron). Tiloron positive influence on clinical manifestations and immunological parameters (profile of cytokines– IL-4, IL-8, INF-?, INF-? and INF-?) has been detected in patients with slightly complicated community-acquired pneumonia in 95 % of cases.

Research objective is to detect hydrosectoral disorders of patients in birth in eclamptic coma. It has been shown that hyper-hydration of isotonic character in patients in eclamptic coma has been revealed. Total liquid volume has been in 31,26 % higher than the normal one and it has occured due to extracellular fluid expansion. The expansion has been due to hyper-hydration in the interstitial sector in all cases, its volume has been in 97,4% higher than the normal one. The volume of blood circulation has been reduced and its deficiency has been due to plasma circulation volume reduction. It is worth mentioning that these indices are much lower than those of normal pregnancy. The state of eclamptic coma is characterized by considerable decrease of protein — 80% of norm which is manifested by the low collodno-oncotic pressure.

Research goal: to identify defects of rendering anaesthetic and reanimation aid, resulting in the development of tromboembolism of pulmonary artery (ТЕРА) and subsequent death of patients with tumours of reproductive system. The development of thromboembolic complications in the post-operative period of gynaecological patients is the result of medical aid defects at all the stages of the post-operative period. The identified defects call for the revision of significance of various factors of ТЕРА risk. Prophylaxis of thromboembolic complications has demonstrated the ungrounded concentration in plasma and thrombocyte part of haemostas without due attention to significance of vascular wall condition. The dose calculation of injected anti-coagulators based on a patient’s weight only neglecting such factors as original haemostas condition, activated partial thrombin time (APTT) control or finding out endogenous heparin titre can not be considered rational.

The quality of postoperative anesthesia in urologic patients has been analyzed. Correlation between pain intensity and postoperative complications has been revealed. Nonsteroid antiinflammatory and narcotic drugs don’t provide high-quality anesthesia after urological operations. Continued postoperative pain is the cause of development of pathological reactions and complications. An important role of prevention and treatment of postoperative pain comes to prolonged epidural analgesia composed of multimodal pain management. Usage of similar tactics significantly decreases the risk of negative reactions for organs and systems in response to operative stress, excludes the necessity of narcotic drugs, prevents the development of complications during the early postoperative period and provides comfortable conditions for patients.

The analysis of military medical commissions (MMC) of the Russian Federation Subjects of the Southern Federal District Military Commissariat activity as well as an anonymous questionnaire of 12 chairmen and 39 medical experts of MMC has revealed the process of military medical expert examination to be in great need of optimization that is to be achieved by authors’ technology realization.