2013, volume 9

The purpose of the article is to identify the epidemiological and clinical features of disseminated sclerosis (DS) in Perm region. Material and methods: Data have been analyzed in 932 patients with DS. Among them there were 607 women (65%) and 325 men (35%). The age of patients with DS varied from 17 to 68 years, in average 44,5±4,5years. All the patients have experienced comprehensive clinical and neurological study, MRI study of brain and spinal cord. Calculation of prevalence and incidence has been conducted among 100,000 people. Results: The prevalence of DS in Perm region on January 1, 2011 amounted to 35.1 cases perthe population of 100,000 people, which can be attributed to our region to the zone of medium risk of DS developing. The growth of incidence of DS in Perm region has been revealed. It has been determined that in 1997 the incidence of DS averaged 3.2. Risk factors have been identified. Conclusion: The data on the prevalence and incidence of disseminated sclerosis help improve the quality of treatment and preventive care for patients with disseminated sclerosis.

The purpose of the article is to study the state of cardiovascular system of sportsmen involved in rowing and canoeing, both before and after training. Material et methods: The research has been performed by means of the developed mobile devices that allow non-invasive screening assessment of the potential risk of collapse complications. Results: The article outlines the results of the survey carried out to determine the presence of vagotonic tone with deficient activity supply and abnormal pulse wave that may lead to circulatory collapse in exercise. Conclusion: The technique of pulse wave and vegetative regulation assessment before and after training enables to prevent the circulatory collapse development in stressful physical exertion in sportsmen.

The Research Objective: Comparative assessment of informational content of various techniques, respiratory tests for Helicobacteriosis detection. Methods et methods: Research of existence of H.pylori in stomach has been conducted by respiratory tests in 106 patients with various diseases of stomach and duodenum. All researches have been conducted on an outpatient basis. Esophagogastroduodenoscopy with mucous biopsy and determination of H.pylori in biopsy materials have been followed by respiratory tests. Respiratory tests 13C UBT and 14C UBT have been carried out. The comparative analysis of respiratory tests for Helicobacteriosis detection has been performed. Results: The conducted researches have showed that, the respiratory tests are favourable for H.pylori diagnostics. They are methodically simple and short-term. Conclusion: Results of comparative researches showed that ammoniac respiratory tests for Helicobacteriosis detection in stomach possess lesser sensitivity than the 13C UBT — respiratory test and may be used for the primary diagnostics which results demand carrying out additional methods of diagnostics. Low specificity of these techniques and inauthentic results do not control the efficiency of eradication of H.pylori and do not present any value in medical examination of the population.

The objective of the article is to review the current data on the method of quantitative evaluation of cardiac mechanics — assessment of myocardial strain and strain rate according to the results of the tissue Doppler echocardiography and prospects of its clinical application.

The purpose of the article is to establish adequacy of protection of energy metabolism in a patient under anaes-thesiology in cholecystectomy from mini-access. Material et methods: 122 patients subjected to cholecystectomy from mini access have been surveyed. Among them 92 patients have got intravenous general anaesthesia with AVL, 30 patients have got prolonged epidural anaesthesia on spontaneous breath with insufflations of oxygen through an obverse mask with sedatations. Monitoring of energy-plastic metabolism has been carried out in all patients. Results: Groups of patients have been compared by anthropometrical data, traumatic interventions. In both groups of patients loss of energy to traumatic to an operation stage has insignificantly increased, but after the anaesthesia termination in the group of patients with intravenous anaesthesia loss of energy continued to rise, and in the group of patients with prolonged epidural blockade it has returned to the initial level. After the anaesthesia termination the energy metabolism became essential higher in the first group of patients in comparison with the second one (p <0,01). The energy-plastic metabolism increased in the first group of patients and decreased in the second. PEA during cholecystectomy from mini access provided a stable condition of energy and energy-plastic metabolism. The conclusion: The inspection of 122 patients subjected to cholecystectomy from mini access has established the following data: PEA on spontaneous breath with insufflations of oxygen through an obverse mask in comparison with intravenous general anaesthesia and AVL allows keeping on an optimum level of energy and energy-plastic metabolism.

The purpose is to evaluate the effectiveness of stimulation of delivery in first mature age period of pregnant women mechanically in different somatotypes. Materials and Methods: 658 patients at 38-41 weeks of gestation of the first period of mature age (22-35 years) have been considered. Differentiation by somatotypes has been performed by the method of HT Kaarma (1991). All patients of each somatotype have been divided into primiparous (n = 402) and multiparous (n = 256). Preparation for delivery by mechanical means: on the 1 st day it was introduced into the cervical canal for 16 hours, on the 2nd day — Foley catheter for 8-16 hours (before the birth). Results: In multiparous women the application of mechanical preparation of the birth canal has been effective regardless of somatotype. The percentage of operative delivery in mechanical induction has been lower in multiparous women and also not related to somatotype. In nulliparous women of asthenic and normosthenic type greater efficiency of mechanical induction in preparation for delivery has been revealed. In asthenic and pyknictype mechanical induction has been inefficient and therefore has not been recommended for the use. Conclusion: Application of mechanical means of stimulation of delivery in nulliparous pregnant women should be performed according to their somatotype.

Objective: To study the effect of atorvastatin on the values of endothelial condition and acute inflammation in patients on program hemodialysis (PHD). Material and methods: The patients were divided into two groups: 28 PHD patients (main group) received atorvastatin, 20 mg once a day for 30 days, and 26 patients (control group) had PHD only. Endothelin 1-21 (ET) level and von Willebrand factor (vWF) activity were determined by enzyme immunoassay, nitric oxide (NO) levels — spectrophotometrically, C-reactive protein (CRP) — by immunoturbidimetric method, fibrinogen — by Clauss method. Results: After 30 days of observation, control patients were found to have NO and ET increase, as well as the reduced activity of vWF relative to initial data, while fibrinogen and CRP levels scarcely changed. The main group patients had similar changes of endothelial condition values, and their fibrinogen and CRP levels decreased. The correlation between the changes of ET and fibrinogen levels was recorded in the patients of the main group. Conclusion: 30-day administration of atorvastatin, 20 mg per day, lowers CRP and fibrinogen levels in PHD patients. It proves the applicability of statins in this group of patients in case of signs of inflammation.

Vibratory disease is one of the leading pathologies in the field of professional diseases, Polymorphism of manifestation is its peculiarity, including disorders of bone remodelling process. The goal of this study was to define peculiarity of bone interchange in patients with vibratory disease of common and local impact. Material and methods. 272 patients took part in the research; they were subjected to determination of mineral density level of bone tissue, markers of osteosis and bone resorption and cytokine profile. Three variants of treatment were used in the period of 12 months. Results. Positive dynamics of ultrasonic densitometry indices, osteogenesis markers (ionized calcium, alkaline phos-phatase), osteoprotogerine in sub-groups with vibrating disease treated with calcium medication and vitamin D was revealed. Conclusion. Research of mineral density of bone tissue and markers of bone remodelling is necessary for prescription a pathogenetic therapy at osteoporosis and osteopenic syndrome in patients with vibrating disease from general to local impact.

The purpose of the article is to define variants of anterior cerebral artery (АСА) of adults depending on typological and combined variability of its morphological and biomechanical features. Material and methods: The research has included 228 samples of anterior cerebral arteries, 115 corpses of people aged 21-84 years received on autopsy. The following points have been under the research: external and internal diameters, wall thickness, general strength, strength range, absolute and relative deformation of an artery. Results: According to the studied parameters 3 groups of variants of arteries have been allocated: with average size of a sign (M±s), with lesser size of a sign ( M + s). Combined variability of morphological and biomechanical features of АСА has been presented. Conclusion: АСА groups with higher variability, especially at men, have been observed in 2,2-2,6 times more often, than at women. As exception, thin-walled АСА which in 1,7 times more often taped at women have been considered. It has been revealed that subjects of alternative group III in 1,2-1,7 times older than those of alternative group I of arteries. Age of subjects who have been classified according to biomechanical parameters of АСА wall has been approximately identical (r=0,28-0,51). The experimentally received data about morphological, deforming and strengthening features may be of great value in studying of blood flow modeling and in optimization of intravascular interventions on cerebral arteries.

The aim of the study is to evaluate the possibilities of immunohistochemical revealing of colorectal cancer micro-metastases in liver and to determine their prognostic significance. Material et metods. The material of the research was fragments of liver tissue with metastases of 36 patients with colorectal cancer who had undergone resection of liver (main group), and randomly chosen fragments of liver tissue without macro metastases of 18 patients with colorectal cancer who had died in early postoperative period. 5-6 fragments of the liver tissue taken from the margins of the largest macro metastasis with the interval 1-2 cm were investigated in each case. The detection of micro-metastases on the paraffin sections with the thickness of 4 microns was carried out with the use of antibodies to cytoceratin-20. The results showed that micro-metastases in liver in the main group had been found in 75,9%, in the comparative group — just in one observation with accidentally revealed macro metastasis. Correlative analysis showed the direct definite link between the appearance of micro-metastases and the presence of macro metastases in liver. The significance of multimicrometastatic spreading for the development of intrahepatic progression and the worsening of the long term prognosis of the patients with colorectal cancer were noted. Conclusion: the possibility of use cytoceratin-20 for revealing micro-metastases in liver.