2014, volume 10

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.

The article presents the review of literature for the period from 1987 till 2012. It has been shown that the spread of acute respiratory viral infections (ARI) and the incidence of complications is of great social and economic importance worldwide. Therefore, the identification of etiological factors and associated development of ARI is an urgent task for practical health care. It is of great importance to determine both the type of pathogen and the presence of its pathogenic factors. The etiological agent of bacterial complications of ARI becomes Moraxella catarrhalis, featuring a large set of markers of virulence. In the development of the pathological process in the respiratory tract, adhesins, a number of enzymes and toxins produced by M.catarrhalis are important. It allows to persist and multiply in the body of the patient. Dangerous strains of M.catarrhalis, resistant to (3-lactam antibiotics and characterized by multiresistance greatly reduce the effectiveness of the therapy. Lack of laboratory studies in acute inflammatory diseases of the respiratory tract leads to the reduction of the etiological interpretation of these diseases, inadequate etiotropic treatment and as a consequence — the development of complications that reduces the effectiveness of therapy. In conclusion it is necessary to improve the system of microbiological diagnostics and tactics of treatment of ARI patients.

The aim is to study the paracoagulation phenomenon and stomach erosive ulcerous lesions relationship in patients with acute coronary syndrome. Material and methods. 443 patients with acute coronary syndrome were analyzed. 223 patients had positive paracoagulation samples. Anamnesis, coronary angiography, fibrogastroscopy, paracoagulation sample determination have been studied. Results. Positive paracoagulation samples in coagulogram of patients with acute coronary syndrome in 76% of cases associated with the stomach erosive ulcerous lesions. The phenomenon of paracoagulation is more likely to occur in smokers with diabetes and myocardial infarction (as the outcome of acute coronary syndrome), with multiply coronary arteries stenosis. Conclusion. The paracoagulation products investigation in acute coronary syndrome can be used to prognose stomach erosive ulcerous lesions.

The aim of the study was to assess the quality of cardiovascular pathology prevention among penitentiary employees of the Saratov region using ACCF/AHA (2009) measures. Material and Methods. The data of 1014 employees (829 male and 185 female) aged 33.4±6.8 years were included in the single-step cohort study. All participants underwent an annual preventive health examination in Center of Medical and Social Rehabilitation of Russian Federal Penitentiary Service in the Saratov Region in the period from 01.10.2012 to 01.10.2013. 13 measures by ACCF/AHA (2009) were used to assess the quality of initial prevention. Results. ACCF/AHA (2009) measures revealed deficiencies in the control of the following cardiovascular risk factors in the studied group: low physical activity, high blood pressure and dys-lipidemia. Conclusion. ACCF/AHA (2009) measures were useful for assessment the quality of cardiovascular pathology prevention in organized cohorts (among penitentiary stuff in particular).

Lipids are one of the main components of cellular membranes. Lipids make up 30-55% of the cell content depending on the types of cells. Phospholipids, sphingomyelins, cholesterol, etc. are characteristic to cellular membranes. The composition of lipids of the both sides of the membranes differs. This fact determines asymmetry of the structure of bili-pid layer. The reason for many pathologies is the changes in the properties of cellular membranes with the modification of their components. The study of structure and functioning of cellular biomembranes is essential for many researchers. The condition of membranes, their quality, their quantitative composition and modification under the influence of different factors as well as their interaction with carbohydrate and protein component are of great importance for the functioning of both membranes, cells and the body in general. Analysis and structuring of lipids and their functions in biological membranes are studied.

The aim of the study is to analyze the influence of combination of pyrimidine and 3-hydroxypyridine derivatives — xymedon and mexidol, in comparison with kardioxane on the myocardial bioelectric activity and arterial pressure level in rats with Walker-256 carcinoma at the doxorubicin and paclitaxel chemotherapy. Material and Methods. Experiments have been carried out on 100 Wistar female rats of weight of 150-250 grams. Doxorubicin and paclitaxel were administered intraperitoneally in a dosage of 4mg/kg and 6mg/kg respectively on the 11th day of experiment. Xymedon (100mg/kg) and mexidol (50mg/kg) were administered separately and in combination with each other, starting with the 11th day of experiment for 10 days. Kardioxane was injected in the dosage of 80mg/kg 20 min before cytostatics. We estimated a myocardial bioelectric activity and arterial pressure level changes on the 11th and 22d day of the experiment. The results. Xymedon and mexidol combination has limited the development of myocardial electrical instability comparable to kardioxane action. This combination has prevented the appearance of metabolic changes of ischemic genesis in the heart more efficiently than kardioxane. Xymedon and mexidol have normalized QT interval dispersion corrected by heart rate less efficiently than kardioxane. Conclusion. The combination of xymedon and mexidol has reduced cardiotoxicity of antitumor therapy more efficiently than the separated use of these medicines or the use of cardioxane.