Saratov JOURNAL of Medical and Scientific Research

2011, volume 7

Disturbances in system of cytokines and lipid exchange in patients with psoriasis

Year: 2011, volume 7 Issue: №2 Pages: 434-437
Heading: Clinical Laboratory Diagnostics Article type: Original article
Authors: Akhlupkina M.V., Svistunov A.A., Bakulev A.L, Zakharova N.B., Nikitina V.V.
Organization: Saratov State Medical University, First Moscow State Medical University n.a. I.M. Sechenov
Summary:

Investigation of proinflammatory and antiinflammatory cytokines content in blood serum (IL-1 (3, IL-4, IL-6, IL-8, IL-10, INF-y, IL-17) was carried out for establishment of clinical and diagnostic value of disturbances of immunoregulatory processes and lipid spectrum in patients with psoriasis. Method of solid phase immune-enzyme analysis and indicators of lipid profile on biochemical analyzer Stat Fax were used in the study. It was found out that psoriasis exacerbation was accompanied by change of proinflammatory and antiinflammatory cytokines in blood serum and increase of lipid profile level. The hyperproliferation and inflammatory skin changes in case of psoriasis exacerbation were accompanied by hyperproduction of cytokines and disturbance of immunoregulatory processes to Th-2 cellular answer including autoimmune processes. The described changes led to raised synthesis of lipids and to their entry into peripheral blood flow. Determination of proinflammatory cytokines and lipids level in blood serum in patients with psoriasis can be used for an estimation of severity of disease, its development prognosis and administered therapy

Keywords: psoriasis, lipids, immunoregulatory processes, cytokines

Case report in the modern therapeutic clinic

Year: 2011, volume 7 Issue: №2 Pages: 429-433
Heading: Internal Diseases Article type: Author's opinion
Authors: Sulkovskaya L.S., Papshitskaya N.Yu., Skvortsov Yu.l., Subbotina V.G., Yekimova N.V.
Organization: Saratov State Medical University
Summary:

The article deals with the basic document for evaluation of the patient»s condition and doctor»s qualification — case history. It is well-known that careful and detailed history and physical examination are the cornerstones of an accurate diagnosis. Analyzing a large amount of case histories differences in registration and factual data were found out. Issues on physical examination and its evaluation have been discussed

Keywords: issues, diagnostic errors, case history defects

Correlation of predictors of life quality prognosis of patients with coronary heart disease

Year: 2011, volume 7 Issue: №2 Pages: 426-429
Heading: Internal Diseases Article type: Author's opinion
Authors: Osipov D.A., Rozhdestvenskaya T.V., Krom I.L., Rebrov A.P.
Organization: Saratov State Medical University, Saratov Institute of Social Education, Head of Centre of Medical and Social Research
Summary:

The article presents the research results on the role of leading clinical predictors in follow-up prognosis for patients with ischemic heart disease. The inefficiency of socialization in a non-terminal condition is formed by means of insufficiency of somatic, psychological and social resources in patients. Thus clinical predictors have no significant value

Keywords: predictors, life quality, coronary heart diseases

Researching of cardos activity for chronic heart failure treatment in case of concomitant chronic kidney disease (stage V, conventional hemodialysis)

Year: 2011, volume 7 Issue: №2 Pages: 422-426
Heading: Internal Diseases Article type: Original article
Authors: Chepurina N.G., Kretov М.А.
Organization: Volgograd State Medical University
Summary:

Aim: comparative investigation of cardos (antibodies to angiotensin II receptor subtype 1 (AT.,) C-terminal fragment), diovan (Valsartan) or both drug combination effects (changing of clinical picture, physical exertion tolerance and quality of life) for treatment chronic heart failure (CHF) patients. Methods. 12-month open-label randomized research was performed. CHF patients (NYHA Class l-ll, n=30) with concomitant chronic kidney disease (stage V, conventional hemodialysis) were randomized (10 patients in each group) for 6-month treatment by cardos (group I, average dose 1,8g/day), diovan (group II, average dose 80mg/day)orboth drug combination (group III, cardos 1,8g/day and diovan 80mg/day). CHD basic treatment was prescribed for all patients. In a 6-month drug crossover between groups I and I was performed, group III was divided into 2 subgroups (subgroup IIIA— cardos, subgroup NIB — diovan) followed by next 6-month treatment. Results. Long-term treatment by cardos has improved functional class (NYHA) of CHF patients with concomitant chronic kidney disease (stage V, conventional hemodialysis). cardos, diovan and both drug combination have demonstrated improvement of physical exertion tolerance, quality of life and patient clinical status during 6-min walking test. Conclusion. Cardos and diovan have shown the same efficacy. Cardos can be used as real alternative in case of ARA administration necessity

Keywords: conventional hemodialysis, chronic kidney disease, chronic cardiac insufficiency, cardos

Comparative efficacy of oxygen therapy in patients (smokers and non-smokers) with chronic pulmonary obstructive disease

Year: 2011, volume 7 Issue: №2 Pages: 420-422
Heading: Internal Diseases Article type: Short message
Authors: Starodumov N.I., Zarubina E.G., Prokhorenko I.O.
Organization: Samara Ministry for Public Health and Social Development, Samara Medical Institute «Reaviz»
Summary:

The decrease in clinical efficacy of oxygen therapy takes place in patients suffering from chronic pulmonary obstructive disease who continue smoking even if the intensity of smoking is getting lower. It is explained by the damage of oxygen utilization regardless of normalization of arterial blood saturation indices and perfusion oxygen saturation indices in blood flow

Keywords: smoking, oxygen therapy, chronic obstructive pulmonary disease (OOPD), blood flow

Role of personal psychological profiles in somatic pathology development

Year: 2011, volume 7 Issue: №2 Pages: 415-418
Heading: Internal Diseases Article type: Original article
Authors: Prokhorenko I.O., Zarubina E.G.
Organization: Samara Medical Institute «Reaviz»
Summary:

The research goal is to examine the correlation between psychological profile of patients of senior age groups, levels of stress hormones — adrenaline and noradrenaline — in blood serum and their pathology character. A psychological profile of 247 patients aged from 55 to 82 years has been established with the help of Kettle test, Tsung self-assessment scale and Spilberger-Khanin scale. The rate of adrenaline and noradrenaline in blood serum in the period of exacerbation of somatic pathology and in the period of relative well-being has been estimated by means of immune-enzyme analysis method. The survey has identified three psychological profiles. The first and third groups are less resistant to stress factors psychological types. They are more likely to develop somatic pathology and depression (37,8 and 53,2% respectively), in comparison with patients of the second group (12,5%). The significant increase of catecholamines has been established among patients of the third type of psychological profile both in the period of exacerbation of somatic pathology and in the period of relative well-being. The article concludes that correlations between psychological personality characteristics, rate of catecholamines and structure of somatic pathology have been worked out

Keywords: stress, somatic pathology, psychopathological disorders, psychological profile, catecholamines

Ivabradin and Verapamil Sr efficacy in treatment of coronary heart disease accompanied by bronchial obstructive diseases

Year: 2011, volume 7 Issue: №2 Pages: 410-415
Heading: Internal Diseases Article type: Original article
Authors: Petrov V.I., Magnitskaya O.V., Likhodeeva Yu.V., Malakhov A.I.
Organization: Volgograd State Medical University
Summary:

The aim of the research is a comparative investigation of Ivabradin vs Verapamil SR of antianginal/antiischemic activity, physical exertion tolerance and life quality of patients with coronary heart disease (CHD) accompanied by bronchial obstructive diseases. Parallel groups of patients have been examined for a 16-week period. Ivabradin (average dose — 14mg/day) or Verapamil SR (average dose — 443mg/day) were administered to ischemic patients (n=84) with postinfarction cardiosclerosis, stable angina (class l-ll) and painless myocardial ischemia. Concomitant bronchial obstructive deseases included controlled/partly controlled bronchial asthma or chronic obstructive pulmonary disease (stage II-III). Both medications have demonstrated the same antianginal/antiischemic activity and have improved physical exertion tolerance. Ivabradin was more effective for heart rate (HR) aim level and 24-hour HR control. Ivabradin advantages were more expressed by changing of NYHA class (from class II to class I) and increase of 6MWD. In conclusion Ivabradin has demonstrated its effectiveness in life quality improvement. Ivabradin and Verapamil SR did not cause complications in concomitant asthma/COPD and were good tolerated. It was determined that Ivabradin is a good Verapamil SR alternative for CHD treatment in case of bronchial obstructive concomitant diseases

Keywords: Verapamil SR, Ivabradin, coronary heart diseases, bronchial obstructive diseases

Diagnostic specificity in reanimation (review)

Year: 2011, volume 7 Issue: №2 Pages: 404-409
Heading: Anaesthesiology and Reanimatology Article type: Review
Authors: Sadchikov D.V., Prigorodov М.V., Ivanov R.V.
Organization: Saratov State Medical University
Summary:

The literature review presents the specificity of diagnostic aid given to patients of reanimation departments. It points out the most common difficulties that physicians face in such conditions

Keywords: standardization, resuscitation patients, diagnostics

Delivery in patients with hysteromyoma

Year: 2011, volume 7 Issue: №2 Pages: 401-403
Heading: Obstetrics and Gynecology Article type: Original article
Authors: Khripunova G. I., Gurianiova N. S.
Organization: Saratov State Medical University
Summary:

Objective of the present article is to define optimal tactics and volume of surgical intervention in patients with hysteromyoma during labor process. Evaluation of possibilities and prospects of conservative methods of myomectomy have been determined. 1000 case histories dated 2009 were analyzed. Patients aged from 22 to 43 were under study. During the research it was revealed that hysteromyoma was mostly prevailed in women aged 30 and older (75%). 5% of them were primipara, 44% — bipara. 57% of pregnant patients were delivered by means of cesarean method. Widening of surgical intervention required 29% of 100 observed patients. Conservative myomectomy was conducted for 27 patients (87%), supracervical hysterectomy — for 2 women (6,4%). Natural delivery by vaginal route was marked in 43% of pregnant women with hysteromyoma; it was not a problem for birth and was first diagnosed in the early postnatal period by means of ultrasonic diagnostics. During analysis of the received data attention should be paid to expediency and promising of delivery of patients by means of cesarean method with following conservative myomectomy; it promotes to preserve childbearing function, their quality of life and consequently improves the demographic situation

Keywords: pregnancy, hysteromyoma, delivery

Uterus and cervix uteri changes during pregnancy period (review)

Year: 2011, volume 7 Issue: №2 Pages: 396-400
Heading: Obstetrics and Gynecology Article type: Review
Authors: Bakhmach V. О., Chekhonatskaya М. L, Yannaeva N. E., Zabozlaev F. G., Grishaeva L.A.
Organization: Saratov State Medical University, Russian Medical Academy of Post-graduate Education
Summary:

The review considers the current understanding of mechanisms that regulate uterine contractions and the nemo-dynamic changes in the cervix uteri occurring prior to and during delivery. Disorders in hemodynamic transformation of cervix uteri are the most significant causes of delivery anomalies. The criteria for ultrasound diagnostics of the degree of maturity of cervix uteri have been analyzed. Cervix blood flow parameters have been taken into account. The further research perspectives in this field of scientific problems have been stated

Keywords: maturity of cervix uteri, delivery anomalies, cervix uteri hemodynamics