Saratov JOURNAL of Medical and Scientific Research

2011, volume 7

Genetic pathogenesis of essential arterial hypertension (the review)

Year: 2011, volume 7 Issue: №1 Pages: 083-087
Heading: Internal Diseases Article type: Review
Authors: Shevchenko O.V., Svistunov А.А., Borodulin V.B., Ruta A.V., Bychkov E.N.
Organization: Saratov State Medical University, First Moscow State Medical University n.a. I.M. Sechenov
Summary:

It is proved that genetic factors may be considered as fundamental in the development of essential arterial hypertension (AH). Important role in this process belongs to the genes whose products are involved in regulating blood pressure - adrenergic, renin-angiotensin-aldosterone, and homocyclic bradykinin systems. These systems are closely connected by serial and parallel chemical reactions that enable to use genetic testing to determine the state of the whole system. Analysis of polymorphic markers of different groups of genes encoding components of the renin-angiotensin-aldosterone system allows to define the role of each of the pathogenic factor of hypertension in the development of the disease

Keywords: renin-angiotensin-aldosterone system, polymorphism, arterial hypertension

Characteristics study of cardiac neuropathy formation in patients with metabolic syndrome and carbohydrate metabolism disturbance (according to cardiac rhythm variability analysis data)

Year: 2011, volume 7 Issue: №1 Pages: 079-083
Heading: Internal Diseases Article type: Original article
Authors: Minakov E.V., Kudaeva L.A.
Organization: Voronezh State Medical University n.a. N.N. Burdenko, Railway Clinical Hospital ad st. Voronezh-1
Summary:

The research goal is to study the aspects of cardiac neuropathy (CN) of early formation in patients with metabolic syndrome (MS) and carbohydrate metabolism malfunction according to the data of cardiac rhythm variability analysis (CRV). Vegetative status assessment in patients with MS and glucose tolerance disturbance (GTD), MS and type 2 diabetes mellitus (DM-2) has been done relying on the investigation of CRV analysis conventional features, such as RMSSD, pNN50, new approach application based on the determination of rhythmogram short period variations (RSPV), and average rhythmogram variations (RWMV). RSPV monotony raise failure has been revealed by decrease of heart contraction rate in patients with MS and GTD, MS and DM-2. Considerable decrease of RWMV has been observed in patients with MS and DM-2. RWMV values determined within 24 hours have been diminished in the morning in patients with MS and DM-2 and normal at night. RMSSD and pNN50 features have appeared to be significantly diminished in patients with MS and DM-2, they ranging within the normal readings in patients with MS and GTD, though in the morning pNN50 values have been found at the lower tolerance. Primary and completely reversible manifestations of CN have been revealed in patients with MS and GTD; new RWMV feature has been noted to have advantages over the conventional characteristics when diagnosing the signs of CN in patients with MS and GTD

Keywords: metabolic syndrome, glucose tolerance disorder, diabetic cardiac neuropathy, cardiac rhythm variability

Importance of hemodynamic factors in vascular remodeling of muscular elastic type in arterial hypertension

Year: 2011, volume 7 Issue: №1 Pages: 076-079
Heading: Internal Diseases Article type: Original article
Authors: Melnikova L.V.
Organization: Penza Institute for Advanced Training of Physicians
Summary:

The research goal is to investigate the relationship between hemodynamic factors and parameters of remodeling of common carotid arteries. 102 patients with essential hypertension of l-ll stage (49 men, 53 women, average age 47,5±11,2 years, duration of hypertension 7,8±1,5 years) have been examined. The study has revealed the relation between blood flow velocity in the common carotid artery (CCA) and the parameters of vascular remodeling, depending on the degree of hypertension. With the increase in systolic blood pressure dilation of common carotid arteries has been observed, reducing the rate of blood flow and wall thickness of the intima-media complex, accompanied by increased stiffness of the vascular wall. The increase in systolic blood pressure is accompanied by decrease in the rate of blood flow and wall tension on the endothelium, which contributes to thickness of the intima-media complex and increases the rigidity of the vascular wall

Keywords: vascular remodeling, hemodynamic factors, arterial hypertension

Identification of acute lower respiratory tract infections by transresonant functional topography in medical military post

Year: 2011, volume 7 Issue: №1 Pages: 073-076
Heading: Internal Diseases Article type: Original article
Authors: Lebedeva M.N., Streltsova E.V., Terehov I.V., Khatskevich V.L.
Organization: Saratov Military Medical Institute, Medical Unit 21222
Summary:

Community-acquired pneumonia (CAP) is usually characterized by absence of clinical signs. Rapid diagnostic tests with high sensitivity for lower respiratory tract infections (LRTI) could lead to improved patient care. 97 servicemen with LRTI were analyzed to compare radiological, clinical and transresonant functional topography (TRFT) findings in the differential diagnosis of CAP The research data revealed that TRFT findings improve the assessment of pneumonia based on carefully taken case history and physical examination. TRFT data contributed to development of treatment course algorithm in case of acute respiratory tract infection

Keywords: trance-resonant functional topography, lower respiratory tract infection, differential diagnosis, community acquired pneumonia

Multiorgan dysfunction syndrome in patients in acute period of coma

Year: 2011, volume 7 Issue: №1 Pages: 069-072
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: Sadchikov D.V., Kuligin A.V.
Organization: Saratov State Medical University
Summary:

The aim of the study was an integration of functional changes in acute period of coma, based on a unite conception. A retrospective analysis of 120 case histories was performed. Functional tests were used for assessment of brain injury and functional status of an organism. These studies allow to divide patients into 4 groups: patients with hypoxic, toxic, diabetic and intracranial genesis of coma. We came to conclusion that patients in acute period of coma do not have isolated brain injury. All these patients have multiorgan dysfunction syndrome, determined by coma. Patients with toxic, hypoxic and diabetic comas have similar functional changes

Keywords: multiorgan dysfunction syndrome in patients in coma

Monitoring of iodine intake and thyroid status of pregnant women in Saratov region from 1999 till 2008

Year: 2011, volume 7 Issue: №1 Pages: 065-068
Heading: Obstetrics and Gynecology Article type: Original article
Authors: Naumova Yu.V.
Organization: Saratov State Medical University
Summary:

The article presents the results of monitoring of iodine intake and thyroid status in pregnant women in Saratov region according to the two cross-sectional studies in 1999 and 2008. The study involved 229 pregnant women. It has been established that there is a decrease in frequency of endemic goiter in pregnant women from 52,8 to 23,6% and increase in median urinary ioduria from 33,0 to 115,5 ug/l. However, iodine intake in pregnancy remains insufficient, as currently the median urinary ioduria is 150-249 ug/l (WHO, 2007). The frequency of maternal hypothyroxinemia, the most significant iodine deficiency disorders in pregnant women, has not changed in a 10-year period (1999 - 46,3%; in 2008 - 55,7%; p>0,1). The research has not obtained significant differences in the frequency of interrelated with pregnancy and delivery complications within two groups of patients

Keywords: thyroid status, pathological course of pregnancy and delivery, maternal hypothyroxinemia, iodine intake, iodine deficiency

Modern review of pathogenesis of urgent uterine bleedings in obstetrical and gynecological practice

Year: 2011, volume 7 Issue: №1 Pages: 059-065
Heading: Obstetrics and Gynecology Article type: Review
Authors: Rogozhina I.E.
Organization: Saratov State Medical University
Summary:

The article presents modern data concerning mechanisms of uterine bleedings in undeveloped pregnancy, hystero-myoma, and cervical carcinoma. Hemostasis system malfunctions appeared in case of dead foetus in uterus have been considered in the work. They are manifested by consumption coagulopathy and haemorrhagic complications. Uterine bleedings in case of hysteromyoma are caused by dilation of arterial vessels and deprivation of their contractile function and malfunction myometrium contraction. Complications that occur in oncological uterine bleedings arrest have been described. They are caused by individual uterine blood supply and developed network of collateral anastomoses between branches of internal iliac arteries

Keywords: undeveloped pregnancy, hysteromyoma, hemostasis, cervical carcinoma, bleeding

Prognosis and diagnostics for placental insufficiency according to markers of endothe-lial dysfunction, deciduation, apoptosis and cellular proliferation

Year: 2011, volume 7 Issue: №1 Pages: 052-059
Heading: Obstetrics and Gynecology Article type: Original article
Authors: Lipatov I.S., Tezikov Yu.V.
Organization: Samara State Medical University
Summary:

Objective. The research goal is to estimate prognostic and diagnostic possibilities of markers of endothelial dysfunction, deciduation, apoptosis and cellular proliferation concerning realization of placental insufficiency. Material. 154 women of high risk group of severe placental insufficiency development have been examined in dynamics of the second and third trimesters of pregnancy. 30 healthy pregnant women have made the control group. Research methods are clinical, immunological, instrumental. Results. It is established that prognosis and early diagnostics for severe placental insufficiency can be carried out with application of monitoring of the maintenance of endothelial dysfunction markers, placental fibers of a mother placenta membrane, apoptosis and cellular proliferation in blood. In the second trimester of pregnancy prognostically significant criteria have included an increase of an index of cytotoxicity of antien-dothelial antibodies, the general IgE, lymphocytes, expressing Fas/APO-1/CD 95-receptor, TNFb and decrease of FGP. Conclusion. Therefore the forms of realization and severity level of placental insufficiency have been caused by the beginning and degree of damages in adaptation of endothelial systems, activation of the immunopathological reactions in the placenta manifested by trophoblastoma programmed cellular destruction of lymphocytes

Keywords: prognosis, placental insufficiency, diagnostics

State of newborns according to prenatal iodine intake

Year: 2011, volume 7 Issue: №1 Pages: 049-052
Heading: Obstetrics and Gynecology Article type: Original article
Authors: Kurmacheva N.A., Naumova Yu.V., Rogozhina I.E.
Organization: Saratov State Medical University, Saratov Regional Centre of Family Planning and Reproduction
Summary:

Comparison analysis of the state of newborns in the conditions of the absence of prenatal iodine prevention (group 1); irregular receiving inadequate preventive doses of iodine-containing drugs (group 2); adequate prenatal iodine prevention (group 3) has been carried out. It is shown that only an adequate consumption of iodine by pregnant women (at least 250 ug of potassium iodide per day) can significantly reduce the frequency of neonatal disorders of adaptation (in 2,3-2,5 times), disharmonious physical development (in 2,5-2,8 times), perinatal encephalopathy (in 1,5-1,7 times), acute infectious diseases (in 1,5-1,6 times) and neonatal hyperthyreotropinemia (in 4,2-9,4 times)

Keywords: state of newborns, quality of prenatal iodine prevention, neonatal hyperthyreotropinemia, iodine deficiency

Modern practice in preparation of pregnant women to maternity (from interview with gynecologists)

Year: 2011, volume 7 Issue: №1 Pages: 045-049
Heading: Obstetrics and Gynecology Article type: Original article
Authors: Aranovich I.Yu., Andriyanova Е.А., Novokreschenova I.G.
Organization: Saratov State Medical University
Summary:

The article issue is the formation of maternity readiness as one of the main aims in the work of a gynecologist. The results of introduction of birth certificates and dynamics in the field of quality of medical aid have been analyzed. The necessity evaluation of pregnant women in professional social and psychological assistance has been revealed. Types of women who are ready for maternity have been obtained. The complete representation of the importance, the maintenance and the ways of realization of social and psychological help to pregnant women has been clearly identified by gynecologists

Keywords: social and psychological aid for pregnant women, readiness for maternity, pregnancy, activity of gynecologists in preparation of pregnant women for maternity