№2, 2014, volume 10

Research goals were to evaluate the etiological structure of symptomatic epilepsy in children, age structure of period of disease manifestation, average length of latent period among children with different characters of lesions, dependence between frequency of seizures and character of lesion. Material and methods. A total of 180 case-records of patients with symptomatic epilepsy were analyzed by the next criteria: anamnesis, materials of electroencephalogram and neurovisualization. Results. The hypoxic-ischemic encephalopathy was dominated among other etiologies. The most frequent age of manifestation was period from 1 to 14 years of life. The most frequent localization of epileptic focus was determined in the temporal and frontal lobes of brain. The longest latent period was in case of brain injury, the shortest period was in case of neuroinfection and the result of prenatal infections. Conclusion. The research shows that symptomatic epilepsy in children is a multi-factorial disease, which character and manifestation in greater extent depends on the initial damage as a cause of this pathology.

Objective: to evaluate the adherence to therapy and treatment outcomes in patients with spondylitis (SpA) in which activity of the disease managed remotely. Material and Methods. 193 patients with axial SpA were randomized into 3 groups with the different ways of the disease activity monitoring: 96 patients were managed in free way, 26 patients visited rheumatologist every 12 weeks, 69 patients managed remotely — we called them every 4 weeks. After the first year of follow up we made 3-month break in the telephone monitoring. The data on the treatment and SpA activity (indexes BASDAI, PASS, ESR, CRP) were collected. Results. In patients managed in a free way SpA activity was severe after a year. In groups managed remotely and once in 3 month the significant reduction in the disease activity was achieved with maximal decrease in remote monitoring group. Positive PASS group 3 was found in 15 patients (57.69%, n=26), in group 2 — in 4 patients (20%, n=20), in group 1 — no patients (0%). NSAIDs intake was arbitrarily changed by 5 (19.23%, n=26), 15(75%, n=20), and 93(96.87%, n=96) patients of groups 3, 2 and 1, respectively. After a 3- month break in remote monitoring in 13 patients with initial BASDAI>4 disease activity significantly increased, in 33 patients with BASDAK4 disease activity decreased. 17 (51.5%) patients independently changed the drug intake regimen after the break in monitoring. Conclusion. Remote monitoring is associated with better adherence to therapy and the best results of treatment of patients with SpA than the other modes of observation. Remote monitoring frequency must be determined individually.

The article presents the structure of personal features of students decided to devote their life to medical profession, their personal readiness for a profession of a doctor. 241 students going to enter the Saratov Medical University in 2013 serve as an object of research. Methods of research included psychology tests on a self-assessment of a mental state, ability to empathy, a motivation orientation. Result. It was revealed that the majority of respondents low level of uneasiness, low level of frustration, the average level of aggression, the average level of a rigidity, and also high rates on an empathy scale. The types of the personality in relation to work are emotive and intuitive. Prevalence of motive of achievement of success or motive of avoiding of failures directly depends on specifics of a situation. Conclusion. Students possess qualities which are necessary in professional activity for doctors, namely high resistance to stress, absence of fear before difficulties, low level of rigidity, high level of empathy, the average level of aggression. Students are motivated on success, in situations when they are fully confident.

Purpose: to study the correlation between the results of the macular area responses by multifocal-electroretinog-raphy (mf-ERG) and the retina thickness obtained by the spectralis optical coherence tomography (ОСТ) in patients with age-related macular degeneration (AMD). Material and methods. 28 patients (32 eyes) where enrolled in the main group. The control group was up to 10 patients without any AMD's pathological sign in retina. All patients were examined by the optical coherence tomography (ОСТ) and multifocal electroretinography (mf-ERG). Results. The data showed a high level of negative correlation between the retinal thickness and electrical amplitudes of the fovea. With the group of "dry" AMD the rise of the macular thickness (drusen) not over 290 urn showed a moderate reduction of the amplitude on mf-ERG The group with "wet" AMD showed that a higher rise of the retinal thickness (edema, fibrosis) of the macular zone negatively influences the bio-electrical activity of this area and this fact was confirmed by a considerable decline of the amplitude on the mf-ERG. Conclusion. The AMD's pathological changes that have been observed by ОСТ are objectively confirmed by mf-ERG. The mf-ERG in supplement of ОСТ can be used as an important element in the complex studies and objectively monitoring of patients with AMD.

The systems of evaluation for severity and prognosis of the disease course constitute an important resource for the improvement of treatment parameters in patients with gastroduodenal bleeding. Although in practice more common methods with limited accuracy and high percentage of subjectivity are often used. The work shows the analysis of the situation and possible ways of resolution.

The systems of evaluation for severity and prognosis of the disease course constitute an important resource for the improvement of treatment parameters in patients with gastroduodenal bleeding. Although in practice more common methods with limited accuracy and high percentage of subjectivity are often used. The work shows the analysis of the situation and possible ways of resolution.

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.

The aim of the article is to describe the case of congenital cystic adenomatoid malformation. The definition of this pathology, its morphology, classification, frequency and clinical forms are considered in the work. The data of the observation of a newborn with a complicated form of the defect have been determined: the peculiarities of the neonatal adaptation, the results of examination and treatment.

This article discusses one of the problems of oncology diagnosis of melanoma. Relevance of the topic has been supported by the fact that the annual incidence of patients with cancer pathology is constantly increasing. Various methods of diagnostics have been determined, but at the same time early diagnosis of melanoma is a problem. The aim is to reveal the possibilities of automated data processing during digital dermoscopy of melanoma in a specialized center. To solve this problem, the following materials and methods have been used: records for the period of 16 years (1996-2010), annual reports of Samara Regional Clinical Oncology Center of newly diagnosed melanoma of skin, annual statistical reports to the State Statistical Committee. The results indicate higher diagnostic accuracy in a specialized center and the advantages of digital dermoscopy in comparison with visual inspection, comparable with a qualified inspection in a specialized center. The article concludes that the possibility of use of this expert system on specialized levels is considered as a secondary factor in the diagnosis and the choice of treatment.