2016, volume 12

The aim of the study was assessment of thyroid function in patients with psychiatric and psychological assistance; to study the structure of AR in patients with hypothyroidism, to reveal alexithymical identifying of personality characteristics of patients with hypothyroidism and AP Materials and Methods. 406 patients with AR at the age of 51.3±4.7 years. To verify the useofTSH hypothyroidism rate and to assess depressive disorder — Hamilton Scale and the Montgomery— Asberg; with clinical and psychopathological study: 1) the scale of self-BH alarm Spielberger (Y. L. Hanin), 2) questionnaire G. Shmisheka 3) Toronto alexithymia scale. Results. Hypothyroidism is set at 116 (28.6%) of 406 patients suffering from RA. Among the 374 patients with depressive disorders hypothyroidism was observed in 116: subclinical — in 76 patients (65.5%), symptomatic — in 40 (34.5%). The first group consisted of 258 patients with the presence of depressive disorders and without hypothyroidism; second — 116 patients with the presence of depression and hypothyroidism. TSH in patients suffering AR, without thyroid dysfunction was 5.2 times lower than in patients with the presence of hypothyroidism. Among AP comorbid with hypothyroidism, are predominant depressive with a predominance of mild and moderate forms. Dominating are anxious-depressive, dysphoric, adynamic, sad, depressive disorders. Conclusion. In patients with AR and hypothyroidism predominant types of personality accentuation are dysthymic, anxious, demonstrative and meticulous.

Aim: to study the value of routine methods (clinical symptoms, electrophysiological findings and results of DNA analysis) in diagnostics of hereditary motor sensory neuropathy type IA in outpatient clinics. Material and Methods. The review of foreign literature is represented. The phenotypic polymorphism, genetic heterogeneity and the difficulties of diagnostics are identified. A family with hereditary motor sensory neuropathy of lAtype is presented, which was diagnosed on the base of available methods in outpatient practice (clinical symptoms, genealogical method, electro-physiological findings and DNA analysis results). Results. Routine algorithm (consistent valuation of clinical symptoms, neurophysiologic findings and the results of DNA analysis) helped to verify the diagnosis of hereditary motor sensory neuropathy of lAtype in outpatient practice after more than 20 years of the onset of the disease. Conclusion. The neurologists of outpatient clinics and other specialists must be informed about the availability of diagnostics of hereditary diseases of nervous system.

The aim: analysis of factors influencing the risks of posttraumatic epilepsy (РТЕ). Materials and Methods. The study involved 71 patients with traumatic brain injury of moderate and severe with emerging after her epileptic seizures. Among the subjects was 56 (78.9%) males and 15 (21.1%) females. The average age of the subjects was 65.6±10,3 years. The control group was 25 (71.4%) male patients and 10 (28.6%) females. The average age of the patients was 54.4.±9.3 years. Analysis of factors influencing the risks of РТЕ use nonparametric Spearman correlation and multivari-ate analysis of variance. Results. Among the many factors to be statistically significant risk factors for РТЕ was alcohol intoxication at the time of trauma 27 (38,0%), relative to the control group 2 (5.7%) p

The main clinical symptoms of PD are well understood, but it is necessary to continue studying the changes of symptoms as it progresses. The aims of the research were: to study the structure of non-motor symptoms (NMS) at the early and last stages of PD, to determine the frequency and clinical significance of the NMS at different stages of PD, comparing the severity of NMS in PD with the severity of the same symptoms in the natural aging, to study the quality of life (QOL) of patients with the impact assessment of the NMS and the assessment of motor symptoms on this criterion. The material and methods. The study included 79 patients with PDand 25 patients without neurodegenerative disorders (control group). The degree of movement disorders severity was assessed using UPDRS scale. Cognitive function was assessed using the Montreal Cognitive Rating Scale (MoCA). To identify and assess the severity of NMS questionnaire used NMSS. Assessment of quality of life of patients was carried out by PDQ-39 questionnaire. Results. There was a significant difference between the intensity of the NMS in PD patients and the control group. Intensity of NMSs significantly correlated with disease stage, disease duration, with the points on the UPDRS scale. Conclusion. NMS significantly affect the quality of life, their severity and structure varies considerably from early to late stage PD, and they are the result of a neurodegenerative process, inherent in PD, and not the natural aging process.

The aim of the study was the estimation of several biomarkers in differentiation diagnostics of tumour diseases in osseous system. Material and methods. 160 patients with benign (115) and malignant (45) osseous neoformations were investigated. Neopterine, tumour necrosis factor (TNF-а), interleukin-6, adhesion molecules of vessel endothe-lium (sVCAM-1) and vascular endothelial growth factor (VEGF) levels were identified by ELISA solid-phase test and compared with the levels of 20 apparently healthy individuals. Tumor verification was fulfilled by X-ray, CT, MRI and histomorphological essay. Results. Both benign and malignant osseous tumour patients showed increased levels of neopterine, TNF-а and interleukin-6 being more significant with malignant processes. The level of sVCAM was decreased in patients of both groups and VEGF level corresponded to the control, these indexes did not show any differences between the groups. The assessment of diagnostic value of these cytokines indicates that positive results for TNF and neopterine give the ground for the final diagnostic decision while the same results for interleukin-6 give moderate basement for diagnostic decision. Conclusion. Increased TNF-а and neopterine levels allow substantiating the difference between benign and malignant osseous tumours and improving diagnostic quality.

Objective: to determine the risk of thromboembolic complications in orthopaedic patients. Material and methods. A survey of 151 patients who had undergone total endoprosthesis of large joints of the lower extremities, aged 25-68, under treatment in Saratov Scientific Research Institute of Orthopedics and Traumatology. Results. The performed research allowed to establish that at values of the content of VEGF-A to 183,6 PG/ml a low risk of thromboembolic complications was predicted and for values above 183,6 PG/ml high risk was prognosed. Conclusion. We have proved high efficiency of using the relationship of VEGF and PAI-1 in serum, which plays a leading role in the development of predisposition to thrombosis.

Objective: to determine the risk of thromboembolic complications in orthopaedic patients. Material and methods. A survey of 151 patients who had undergone total endoprosthesis of large joints of the lower extremities, aged 25-68, under treatment in Saratov Scientific Research Institute of Orthopedics and Traumatology. Results. The performed research allowed to establish that at values of the content of VEGF-A to 183,6 PG/ml a low risk of thromboembolic complications was predicted and for values above 183,6 PG/ml high risk was prognosed. Conclusion. We have proved high efficiency of using the relationship of VEGF and PAI-1 in serum, which plays a leading role in the development of predisposition to thrombosis.

The combination of heart failure, obstructive sleep apnea syndrome and atrial fibrillation is a widespread case. Besides, the correlation between these pathologies has not been accurately determined yet. The aim of the research is to determine the specific features of heart failure in patients with atrial fibrillation. Material and Methods. 174 patients were involved in the research. There were people at the age of 75 and younger suffering with heart failure. 116 of them also experienced artrial fibrillation and 58 sinus rhythm. In addition, all the patients involved had hypertension. The patients underwent echocardiography and respiratory monitoring. Results. Statistical analysis showed that atrial fibrillation was a more powerful predictor of the occurrence of obstructive sleep apnea than heart failure. Furthermore, we have found significant peculiarities in relations between the features of heart failure, presence and severity of obstructive sleep apnea in the group of the patients with atrial fibrillation. Remodeling of the left heart cameras was more typical for the patients with atrial fibrillation. Conclusion. Heart failure has significant features in patients with atrial fibrillation and obstructive sleep apnea.

Objective: to study the individually-typological features of the person of young men with prehypertension. Material and Methods. With the help of complex tests: Reduced Multiple Personality Questionnaire for research (MMPI), the Heck — Hess, Spielberger — Hanin, Index lifestyle were examined 95 healthy young men with different levels of blood pressure: optimal, normal and high normal. Results. It has been shown that people with normal and high normal blood pressure have different individually-typological features of the person and, based on this criterion can not be combined into a single group prehypertension. Men with normal blood pressure values on the studied parameters were similar to individuals with optimal blood pressure value. Persons with high normal level of blood pressure had a psychosomatic predisposition personality profile MMPI, with its fixation on physical sensations, with the increase of anxiety, neuroticism and the overall intensity of psychological protection. Conclusion. It is advisable to carry out a personalized approach to the psychological correction of identified changes in primary prevention of arterial hypertension in young men.

Objective: to prove the role of office hysteroscopy as an important additional method in diagnostics of puberty abnormal uterine bleeding (AUB). Material and methods. The study involved 68 patients with AUB. The average age was 13.4 years (10-17 years). The main complaint of patients concerned bleeding from genital tract during 10-45 days (on an average 28.4 days). Patients were divided into 3 groups according to the type of AUB determined based on the level of serum estradiol, physical and sexual development, internal genitalia ultrasound data: 35 hypo estrogenic girls, 24 girls with normal estrogenic and 9 girls with hyper estrogenic type of AUB. All of the girls took the office hysteroscopy. Results. When performing hysteroscopy it was revealed that there were a clear relationship between the degree of estrogenic saturation and visual picture obtained in the course of the study. Conclusion. Hysteroscopy enables maximum visualization of uterine cavity, which allows to verify the diagnosis, to reduce the "over diagnosis" rate of organic pathology, perform a differentiated approach to treatment of diseases, based on determination of estradiol level in serum and data obtained in the study.