№3, 2010, volume 6
Epstein-Barr virus mononucleosis: clinical and dynamic peculiarities of different variants of infection
Heading: Infectious Diseases Article type: Original article
Authors: Khmilevskaya S.A
Organization: Saratov State Medical University
The article reviews the results of observation of 439 patients between 1 and 18 years of age with EBV mononucleosis. The detailed analysis of clinical laboratory peculiarities of primary infection and its reactivation in patients of different age is also supplemented by the overall evaluation of the rehabilitation period in dependence on age and type of infection.
Russian version of CU-Q2oL questionnaire for estimation of quality of life of patients with chronic urticaria
Heading: Immunology and allergology Article type: Original article
Authors: Nekrasova Е.Е., Razvalyaeva A.V., Malyuzhinskaya N.V.
Organization: Volgograd State Medical University
The research objective is to work out the creation of Russian-language questionnaire for assessing quality of life of patients with chronic urticaria by adapting the questionnaire «Chronic Urticaria Quality of Life Questionnaire» (CU-Q2oL) to Russian conditions. The study involved 150 patients aged 18 to 50 years (32,41±6,02) with chronic urticaria. Cultural and linguistic adaptation of the questionnaire was conducted according to international methodology. Evaluation of reliability was conducted by calculating Cronbach's б-coefficient, constructive validity -the method of «known groups» and the identification of mutual correlations with the scales of the SF-36 questionnaire, sensitivity-by comparing the quality of life before and after the treatment. High values of Cronbach's б-coefficient (>0.72) were obtained, the dependence of quality of life on the severity of chronic urticaria was proved to be significant, as well as the sensitivity of the questionnaire to clinical changes. The research findings confirmed good psychometric properties of Russian version of the questionnaire. The developed version of the questionnaire is a reliable, valid and sensitive device for assessing the quality of life in patients with chronic urticaria, and may be used in scientific and clinical research.
Perioperative complications at patients with high anesthesiologic-operational risk (literature review, part I)
Heading: Anaesthesiology and Reanimatology Article type: Review
Authors: Sadchikov D.M., Prigorodov M.V., Vartanjan T.S.
Organization: Saratov State Medical University, Saratov Perinatal Centre, Saratov Military Medical Institute
In the literary review frequency, risk factors, reasons and mechanisms of perioperative complications occurrence are submitted at thorax and abdominal interventions, including common data, cardiovascular complications, data about massive blood loss, condition of respiratory system, hemostasiologic complications; reasons of complications development are specified, consequences of inadequate anesthesia are named, mechanisms of perioperative complications development and consequence of a protein-power failure are considered
Efficacy evaluation of cerebral perfusion pressure in complex treatment of eclamptic coma
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: Podolsky Yu.S., Hapy I.H.
Organization: Moscow Regional Scientific Research Clinical Institute n.a. M.F. Vladimirsky
The aim of this research is to study influence of cerebral perfusion pressure on the effectiveness of treatment of maternity patient in eclamptic coma. Fluctuation of average arterial pressure defines dynamics of the cerebral perfusion pressure. Active hypotensive therapy leads to reduction of cerebral blood flow, breaking perfusion balance of brain. The principal objective of treatment in eclamptic coma is to restore volemic indices by using stabizol, decrease of average arterial pressure (10-15% from the initial one), which is provided by magnesium sulfate and nimodipine. Providing the cerebral perfusion pressure above the level of 75 mm for maternity patient in eclamptic coma allowed to reduce lethality from 15,7 to 4,8%
Modern views on aetiology and pathogenesis of tumor growths and benign ovarian tumors
Heading: Obstetrics and Gynecology Article type: Review
Authors: Serebrennikova K.G., Kuznetsova E.P.
Organization: First Moscow State Medical University n.a. I.M. Sechenov, Igevsk State Medical Academy
The article represents modern data of aetiology and pathogenesis of tumor growths and benign ovarian tumors as systemic diseases of organism. These diseases appear on the cellular level and involve the presence of polymorphous metabolic, endocrine and immune disorders. Exogenous and endogenous risk factors of ovarian carcinomas are considered
Effect of progesterone and utrogestan on functional liver condition in patients with dysfunctional uterine bleeding
Heading: Obstetrics and Gynecology Article type: Original article
Authors: Salekh R.Kh., Peshev L.P., Siprov A.V.
Organization: Mordovian State University
The effect of progesterone and utrogestan on protein synthetical, fermentative and chromogenic functions of liver in patients with dysfunctional uterine bleedings (DUB) has been studied. 106 women ages 18 to 44 years with hormonal insufficiency of ovarial yellow bodies were examined. The functional condition of the liver was estimated through the content of protein, albumin, globulin, general bilirubin and its connective and free fractions, alanin - and aspartatami-notrasferase, gammaglutamiltranspeptidase, phosphatase alkaline, general and nonprotein sulfhydric groups in blood. The general and effective concentration of albumin was defined in blood serum. It is shown that the concentration of general protein, albumin, general and nonprotein sulfhydric groups decreased by the increased activity of indicated enzymes in patients. It was accompanied by endogenic intoxication. Progesterone treatment decreased the activity of protein synthetical function of liver reducing endocellular fermentative reactions and increasing the level of endogenic intoxication. Therapy by utrogestan resulted in hyperfermentation in patients with endotoxicosis and hypoproteinemia. Therefore patients with DUB suffered from disorders in metabolic function of liver
Prospects of application of normobaric hypoxic interval training in treatment of placental insufficiency (literature review)
Heading: Obstetrics and Gynecology Article type: Review
Authors: I.E. Rogozhina, G.E. Makhova, E.V. Prodanova
Organization: Saratov State Medical University
Placental insufficiency represents a syndrome of multifactorial etiology caused by morphological and functional changes in placenta, leading to disturbances in growth rates and development of fetus. Fetoplacental insufficiency is the leading factor in occurrence of fetal hypoxia, arrested development of fetus, traumas during delivery, diseases and complications in postnatal period. Placental insufficiency development is accompanied by disorders in differentiation and extension placental villi. Also processes of angiogenesis are affected. As a result there is a transport, respiratory, trophic, endocrinal and protective dysfunction of placenta. In fetal organism universal adaptative reactions directed on maintenance of homeostasis arise. Application of interval hypoxic therapy is directed on «training» of fetal adaptative mechanisms to hypoxia. Good tolerance of 10% О - gas mix has been revealed. High therapeutic effect is shown by increase in functional reserves of cardio-respiratory system, normalization of acid-base balance, normalization of arterial pressure, mobilization mechanisms of regulation of hypothalamic-pituitary adrenocortical system that results in increase of general resistance of fetus to hypoxia
Diagnostic and prognostic value of analysis of heart rhythm variability in pregnant patients under estimation of fetal hypoxia evidence
Heading: Obstetrics and Gynecology Article type: Original article
Authors: Piskunova L.V., Chekhonatskaya M.L., Arenina N.Yu.
Organization: Saratov State Medical University, Saratov Clinical Hospital №3
The correlation between fetal hypoxia degrees according to the data of cardiotocography and status of mother's vegetative nervous system as a result of heart rhythm variability research have been analyzed. It has been revealed that during the increase of fetal hypoxia severity, mother has observed activation of sympathetic section of vegetative nervous system, which has changed by vagotonia in severe and terminal states. These findings can be used both for indirect estimation of fetal hypoxia severity and for its course prognosis
Health state of pregnant women and newborns depending on quality of iodine prevention
Heading: Obstetrics and Gynecology Article type: Original article
Authors: Naumova Yu.V., Kurmacheva N.A., Rogozhina I.E.
Organization: Saratov State Medical University, Saratov Regional Centre of Family Planning and Reproduction
This article presents the data about the unsatisfactory quality of iodine prevention of pregnant women from Saratov region, about iodine poor consumption of mothers (ioduria median line 115,5 ug/l at recommended definitions 150-249 ug/l by the experts of World Health Organization) against inadequate low preventive dose of iodine medications, and about high frequency of maternal hypothyroxinemia (55,7%) and associated with it complications during pregnancy child bearing, defects of fetus condition and health of newborns.
It was indicated that preventive acceptance of potassium iodine in dosage with 250 ug/day resulted in the decrease of absolute risk by 12-47% and in 2-8 times of ratio of complications during pregnancy and child bearing, damages of adaptation and diseases of the newborns
Состояние фетоплацентарной системы у беременных с недифференцированными формами дисплазии соединительной ткани, носителей семейства герпес-вирусов
Heading: Obstetrics and Gynecology Article type: Original article
Authors: Dorohova L.N., Shaboldin A.M., Narolenko L.N., Mozes V.G.
Organization: Kemerovo State Medical University, Kemerovo Clinical Hospital № 3 n.a. M.A. Podgorbunsky, Kemerovo Children Hospital № 5
The research goal is to determine the risk of infectious process development in placenta of women with undifferenti-ated forms of dysplasia of connective tissue (UFDCT) by agents - herpes viruses (VHG - virus of herpes simplex and cytomegalovirus).
Persistent infection of VHG was revealed in 133 women in the 1 st trimester of pregnancy. All the patients had phe-notypic manifestations of UFDCT; in the 3d trimester of pregnancy immunogram of the second level, histological study of placenta, identification of antigens of VHG family, serological study of placental blood and isolation of DNA of VHG were carried out. All newborns were clinically and laboratory tested on VHG infection.
As pregnant women with UFDCT had high risk of VHG infection development in placenta, they suffered from placental insufficiency. It resulted in unfavourable perinatal outcomes. VHG infection development was caused by disturbances of cellular immunity.
Key words: undifferentiated forms of dysplasia of connective tissue, virus of herpes simplex, cytomegalovirus, cellular immunity, pregnancy