Danilov A.N.

We presented the review of data from MEDLINE, EMBASE, CINAHL on the mechanisms of therapeutic activity of manual therapy, as well as on studied tissue and systemic responses, and the elaborations on the issue of manual treatment choice in chronic non-specific back pain.

Aim: development of criteria and a method of prognosing of emergence of adverse side effects to the first mode of chemotherapy at patients with for the first time revealed tuberculosis. Materials and Methods: The analysis of the collateral reactions (CR) on tubercular preparations has been carried out at 214 patients receiving treatment at the first mode of chemotherapy. During the treatment an indicator of quality of life by a technique the DIGNITY (health, activity, mood), a condition of intersystem interaction of respiratory and cardiovascular systems of an organism (Hildebrant's coefficient), a vegetative index of Kerdo were estimated at patients. Results. Ufavorable effects on PTP develop at every third patient (33,6%). The CR different types depends on the age and availability of the accompanying pathology. Allergic reactions develop at patients with existence of endocrine pathology (27,8%) authentically more often, toxic — at patients with defeats of nervous system (56,3%). Extent of change of an index of Kerdo of 59,4±2,4%, Hildebrant's coefficient 48,9± 1,6% in the first 4 weeks of treatment of the patient corresponds to emergence of CR in the first 3 months of chemotherapy. Conclusion. Dynamics of coefficient of Hildebrant, Kerdo's index and an indicator of treatment, SAN at the initial stages, are considerably associated with the risk of development of side effects of chemotherapy and were a basis of the developed computer system expert for prognosing the development of these complications. The predictive value of system is 76,3% of sensitivity at 84,7% of specificity.

Aim: to establish the structure of the relationship between the change in regulations of fluorographic regimen and frequency of occurrence of bacillary excretion (MBT+), destructive forms of the disease in patients with newly diagnosed tuberculosis. Materials and Methods. 1,428 cases with newly diagnosed tuberculosis — a form №089u-tub, as well as other types of reports of the Saratov region have been analyzed. Statistical analysis has been performed by computer software «Microsoft Excel» and «Statistica-6.0». Analysis of the data by the test of Kolmogorov — Spirin has showed normality of their distribution. Confidence index was assessed by Student's. Differences were assessed as valid if the probability was 95% (P

The purpose was to implement system analysis of clinical cases for development of healthcare quality indicators for STe-ACS patients, aimed at achievement of clinical result — decrease of in-hospital mortality. Mathehal and Methods. National recommendations on diagnostic and treatment of patients with myocardial infarction with ST-segment elevation on ECG (2007) were used to determine clinical result of treatment and key measures of medical care. To reveal major causes of clinical result non-achievement fishbone diagram was used. Results. Early reperfusion and optimal medical therapy were determined as the key measures of medical care delivered to patients with STe-ACS. The following indicators were developed to control these measures: «Primary reperfusion», «Thrombolysis in 30 minutes», «Primary percutaneous coronary intervention in 90 minutes», «Dual antiplatelet therapy in hospital», «Beta-blockers administration», «ACE-is/ARBs administration». The major causes of in-hospital mortality were separated. Indicators for assessment the major causes of clinical result non-achievement were proposed. Principal stages of performance measures creation were posed. Conclusion. Recommendation-based and clear definition of clinical result of treatment and key measures of the result achievement combined with methods of systems analysis allows development of evidence-based measures for assessment the quality of care delivered to patients with STe-ACS.

The purpose of the article is to evaluate the efficacy and tolerability of the combined inhaled anti-TB preparation Hixozide for improving the effectiveness of medical treatment of patients suffering from tuberculosis of bronchus. Material and Methods. Hixozide (made in Russia), the active substance Hydroxymethylchinoxylindioxydum 100mg + Isoniazidum 250 mg, was delivered via inhalations using a compressor nebulizer within 21 days in the course of the complex chemotherapy. Inclusion criteria: newly diagnosed patients and patients with relapsed tuberculosis with the presence of tuberculousendobronchitis, drug sensitivity saved to isoniazid. Exclusion criteria: the state of preventing the appointment of adequate treatment, HIV-infection (group 1, n=30). The comparison group was consisted of patients receiving standard treatment in combination with inhaled administration of Isoniazid (group 2, n=21). Rezults. The clinical study has figured out: after a course of inhalations of Hixozide the clinical cure of bronchial tuberculosis occurs after the period of 2 months of treatment (according to the results of endoscopy of bronchi); more patients — 69.2% versus 38.1% in the comparison group, p=0,039 showed a positive trend during the nonspecific endobronchitis — 85,7% vs. 52,9%, p=0,017; the treatment and bacteriological conversion were achieved: 143±27 days in the first group vs. 164±32 days in the control group, p=0,019. Adverse reactions to Hixozide demanding its abolition occurred in 13,3%, they were stopped and did not affect the health of patients in the future. Conclusion. Inhaled Hixozide in the complex treatment of patients with tuberculosis accelerates clinical cure of tuberculosis of the bronchi, healing the lesions in the lung tissue and abacillation.

Objective; analysis of the dynamics of the main indicators of the ТВ epidemic in the Saratov region during the 5-year period. Material and Methods. The analysis of major indicators of epidemic (morbidity and mortality) in the Saratov region during the five years of observation. In the work a comparative evaluation of the parameters studied with analogical indicators in the Russian Federation was carried out. Results. During the period from 2009 to 2013 situation of tuberculosis epidemic in the Saratov region has positively stabilized. Over the past five years, the mortality rate in the region has decreased, while in the Russian Federation as a whole only on 25%, the incidence of the population in the region fell by 20%. It has been established that the later detection of a tuberculosis process leads to an increase in mortality and maintains reservoir of ТВ infection. Conclusion. In the Saratov region ТВ infection is thoroughly controlled. There is a well-established system for the detection, diagnosis, treatment and prevention of this specific process.

Purpose is to study the clinical, laboratory and instrumental characteristics of the course of rotavirus infection in children up to 3 years in the acute phase and during the convalescence period. Material and methods. A clinical, laboratory and instrumental examination of 320 children up to 3 years with moderate to severe rotavirus infection. Results. The presence of long-term persistence of rotavirus recovering from rotavirus infection. Identified functional disorders of the digestive system in the acute period and the period of convalescence in children up to 3 years with rotavirus infection. Conclusion. For a long period (up to 3 months), almost half of patients may experience intestinal dysfunction, possibly related to the long-term persistence of rotavirus.

Objective: To analyze the clinical and epidemiological characteristics in the post-pandemic influenza seasons in 2010/11/12/13 years. Material and methods: The analysis of the incidence of acute respiratory viral infections and flu in the Saratov region from 2009 to 2013. A clinical and laboratory examination of 252 patients with a diagnosis of «flu»: 152 pregnant women at different stages of pregnancy at the age of 18 years to 41 years and 100 children aged from 5 months to 14 years. The work was carried out to assess the epidemiological pattern and clinical course of influenza, and the effective operation of antiviral therapy. Results: In the post-pandemic period 2010-2013 simultaneously circulating influenza A viruses (N1N1/09) pd, influenza A (H3N2) and influenza B. In most cases, influenza in adults and children is of moderate form. All serious forms of influenza have been caused by influenza A with the development of viral-bacterial pneumonia, respiratory failure and neurotoxic syndrome. Late hospitalization and absence of antiviral therapy in the prehospital are at risk of severe and complicated forms. Conclusion: Early initiation of antiviral therapy is one of the main factors for the effectiveness of treatment and reduce the risk of influenza complications.

The article presents computations on informational and analytical basis of public health database, that help to perform accurate monitoring, and detection of public health system state, as well as prognosis of further dynamics of public health system parameters for scientifically proved health care organization and decisions in management.

The results of complete clinical and demographic investigation of Volga Region population of long-livers have been presented. Anthropologic, social, clinical, laboratory and instrumental markers of longevity have been determined.