№3, 2016, volume 12

The aim: to study the frequency of birth defects in Perinatal Center of the Saratov region from 2014 till 2015, the possibility of prognosing, early diagnosis and optimization of programs for the prevention and correction of congenital malformations, the evaluation of treatment outcomes. Materials and Methods. The study included newborn babies and fetuses with birth defects for the period 2014-2015 according to data received from Perinatal Center. The data on ultrasound examination of pregnant women and about 149 fetuses with malformations in case of early terminated pregnancies were analyzed. Results. In 2014 Perinatal Center of the Saratov region found 77 newborns with congenital malformations, in 2015-72; 24 children (16.1%) required early surgical intervention. The comprehensive assessment of the health status of women and their children, the assessment of placental blood flow and fetal development, the identification of chromosomal and genetic abnormalities were conducted. 5 children of 149 children with congenital malformations died at the stage of the maternity hospital where average mortality accounted for 3.3%. Congenital malformations of central nervous system and sense organs accounted for 13.4%, malformations of the face and neck — 5.4%, malformations of the cardiovascular system — 28.8%, malformations of the respiratory system — 2.7%, malformations of the gastrointestinal tract — 4%, malformations of the musculoskeletal system — 9.4%, malformations of the urinary system — 27.5%, genital malformations — 4%, defects of the skin and its appendages — 1.3%, other malformations — 2.7%. Multiple malformations accounted for 4.7%. During 2014-2015 due to congenital malformations 311 births (4.4%) were interrupted, the main cause was determined as chromosomal abnormalities. Training, diagnosis, management of pregnant women and their delivery is carried out in Perinatal Center of the Saratov region in accordance with the complex program and algorithm methods for the prevention and correction of congenital malformations. Conclusion: This study has shown that there is a growth of small anomalies and reduction of frequency of multiple malformations. Comprehensive preventative program is possible to reduce the number of infants with untreated birth defects (13,5%), increase the percentage of defects detected by ultrasound from 51.7 to 66.7%.

This article presents a rare case of isolated parotid sialadenitis at a newborn. Possible etiology, classification, frequency, diagnosis and management of the disease are described in orderto determine this pathology. The paper gives the data on observation of a newborn with sialadenitis, the results of examination and treatment.

Objective: to estimate the structure and frequency of detection of secondary diseases in patients with neurological manifestations of HIV infection. Materials and methods. The study involved 304 patients infected with HIV. Results. The defeat of the nervous system in HIV infection occur encephalopathy, cerebral vascular lesions, meningitis, subacute encephalitis, secondary CNS lesions. The number of CD4-lymphocytes in HIV-infected patients with neurological disorders was significantly lower. Most of them have comorbid diseases. The most commonly diagnosed hepatitis С and B, herpes, cytomegalovirus infection, chlamydia, Candida, toxoplasmosis and tuberculosis, mixed infection. Hepatitis В and С and herpes are the most widely represented in patients with HIV-induced encephalopathy and cerebrovascular form of HIV. The presence of cytomegalovirus infection is correlated with the development of subacute encephalitis. Conclusion. Manifestations of nervous system pathology in HIV polymorphic and correlated with the presence of secondary comorbid pathology. Such conditions are due to underlying disease immunological parameters.

Aim: to determine the role of brain-derived neurotrophic factor in the formation and forecasting of psycho-vegetative syndrome in patients with cerebral mild to moderate injury. Material and Methods. There have been 150 patients with contusion of the brain, examined. Indicators of neurological, psycho-vegetative status, quantitative content of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) in the serum were studied. Results. At patients with brain contusion neurological, psycho-vegetative disturbances and decrease neurotrophic factors are determined. It was found to depend of the content of BDNF and psycho-vegetative indicators. Conclusion. The level of brain-derived neurotrophic factor serum (less than 300 pg/ml) is a predictor of psycho-vegetative syndrome in the long term of the brain injury.

The results of the regional studies on the frequency of Parkinson's disease (PD) and the incidence of it in Russia have been generalized, the main factors that determine the quality of the estimates of this disease epidemiological indicators have been identifyd. The article summarizes data from 19 original studies on the epidemiology of parkinsonism and Parkinson's disease in Russia published between 2005-2015. Due to the statistical heterogeneity of the primary results computational analytics was not applied to the data; however, data consolidation allowed to perform a trend analysis of epidemiological indicators. The methodological basis of the majority of studies was medical aid appealabil-ity; two of the studies used door-to-door surveys. One of the studies returned questionably low epidemiological indicators obtained from the medical records, and the rest showed the standardized prevalence of 30.0-139.9/100,000 and incidence of 7.63-21.8/100,000 per year. Contribution of Parkinson's disease to the nosological structure of parkinsonism was >61.3%. Estimate of the number of patients with PD in Russia is approximately 210,000 people. Conclusions are made regarding the prevalence of PD in Russia according to the cross-cutting research on the level of indicators in the Western countries. The prevalence of PD by appealability is 2-3 times less than the prevalence in continuous research, both national and foreign. The incidence of PD, demonstrated in half of the studies, is stable from region to region and is comparable with the universally recognized values.

The aim of the study was assessment of thyroid function in patients with psychiatric and psychological assistance; to study the structure of AR in patients with hypothyroidism, to reveal alexithymical identifying of personality characteristics of patients with hypothyroidism and AP Materials and Methods. 406 patients with AR at the age of 51.3±4.7 years. To verify the useofTSH hypothyroidism rate and to assess depressive disorder — Hamilton Scale and the Montgomery— Asberg; with clinical and psychopathological study: 1) the scale of self-BH alarm Spielberger (Y. L. Hanin), 2) questionnaire G. Shmisheka 3) Toronto alexithymia scale. Results. Hypothyroidism is set at 116 (28.6%) of 406 patients suffering from RA. Among the 374 patients with depressive disorders hypothyroidism was observed in 116: subclinical — in 76 patients (65.5%), symptomatic — in 40 (34.5%). The first group consisted of 258 patients with the presence of depressive disorders and without hypothyroidism; second — 116 patients with the presence of depression and hypothyroidism. TSH in patients suffering AR, without thyroid dysfunction was 5.2 times lower than in patients with the presence of hypothyroidism. Among AP comorbid with hypothyroidism, are predominant depressive with a predominance of mild and moderate forms. Dominating are anxious-depressive, dysphoric, adynamic, sad, depressive disorders. Conclusion. In patients with AR and hypothyroidism predominant types of personality accentuation are dysthymic, anxious, demonstrative and meticulous.

Aim: to study the value of routine methods (clinical symptoms, electrophysiological findings and results of DNA analysis) in diagnostics of hereditary motor sensory neuropathy type IA in outpatient clinics. Material and Methods. The review of foreign literature is represented. The phenotypic polymorphism, genetic heterogeneity and the difficulties of diagnostics are identified. A family with hereditary motor sensory neuropathy of lAtype is presented, which was diagnosed on the base of available methods in outpatient practice (clinical symptoms, genealogical method, electro-physiological findings and DNA analysis results). Results. Routine algorithm (consistent valuation of clinical symptoms, neurophysiologic findings and the results of DNA analysis) helped to verify the diagnosis of hereditary motor sensory neuropathy of lAtype in outpatient practice after more than 20 years of the onset of the disease. Conclusion. The neurologists of outpatient clinics and other specialists must be informed about the availability of diagnostics of hereditary diseases of nervous system.

The aim: analysis of factors influencing the risks of posttraumatic epilepsy (РТЕ). Materials and Methods. The study involved 71 patients with traumatic brain injury of moderate and severe with emerging after her epileptic seizures. Among the subjects was 56 (78.9%) males and 15 (21.1%) females. The average age of the subjects was 65.6±10,3 years. The control group was 25 (71.4%) male patients and 10 (28.6%) females. The average age of the patients was 54.4.±9.3 years. Analysis of factors influencing the risks of РТЕ use nonparametric Spearman correlation and multivari-ate analysis of variance. Results. Among the many factors to be statistically significant risk factors for РТЕ was alcohol intoxication at the time of trauma 27 (38,0%), relative to the control group 2 (5.7%) p<0.01. Localization of the center of the temporal lobe encephalomalacia 11 (15.3%) with values in the control group 6 (17.1%), p<0.02. The increase in the severity of the brain injury also leads to an increase in the risk of head injury. The presence of an open head injury 54 (76.1 %) and 15 (42.9%) in the control group, p<0.03. Conclusion. The severity of traumatic brain injury and aggravating factors when it occurs significantly increases the risk of posttraumatic epilepsy.

The main clinical symptoms of PD are well understood, but it is necessary to continue studying the changes of symptoms as it progresses. The aims of the research were: to study the structure of non-motor symptoms (NMS) at the early and last stages of PD, to determine the frequency and clinical significance of the NMS at different stages of PD, comparing the severity of NMS in PD with the severity of the same symptoms in the natural aging, to study the quality of life (QOL) of patients with the impact assessment of the NMS and the assessment of motor symptoms on this criterion. The material and methods. The study included 79 patients with PDand 25 patients without neurodegenerative disorders (control group). The degree of movement disorders severity was assessed using UPDRS scale. Cognitive function was assessed using the Montreal Cognitive Rating Scale (MoCA). To identify and assess the severity of NMS questionnaire used NMSS. Assessment of quality of life of patients was carried out by PDQ-39 questionnaire. Results. There was a significant difference between the intensity of the NMS in PD patients and the control group. Intensity of NMSs significantly correlated with disease stage, disease duration, with the points on the UPDRS scale. Conclusion. NMS significantly affect the quality of life, their severity and structure varies considerably from early to late stage PD, and they are the result of a neurodegenerative process, inherent in PD, and not the natural aging process.

The aim of the study was the estimation of several biomarkers in differentiation diagnostics of tumour diseases in osseous system. Material and methods. 160 patients with benign (115) and malignant (45) osseous neoformations were investigated. Neopterine, tumour necrosis factor (TNF-а), interleukin-6, adhesion molecules of vessel endothe-lium (sVCAM-1) and vascular endothelial growth factor (VEGF) levels were identified by ELISA solid-phase test and compared with the levels of 20 apparently healthy individuals. Tumor verification was fulfilled by X-ray, CT, MRI and histomorphological essay. Results. Both benign and malignant osseous tumour patients showed increased levels of neopterine, TNF-а and interleukin-6 being more significant with malignant processes. The level of sVCAM was decreased in patients of both groups and VEGF level corresponded to the control, these indexes did not show any differences between the groups. The assessment of diagnostic value of these cytokines indicates that positive results for TNF and neopterine give the ground for the final diagnostic decision while the same results for interleukin-6 give moderate basement for diagnostic decision. Conclusion. Increased TNF-а and neopterine levels allow substantiating the difference between benign and malignant osseous tumours and improving diagnostic quality.