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"vestnik vsmu" 2010  vol. 9 №3

Review

Zharkova O.A.
Modern approaches in the diagnosing of risk factors of caries development

Abstract. Taking into account the carried out analysis of the last decade literature sources this article deals with modern diagnostic methods of risk factors of dental caries development. Modern definitions of the terms concerning caries disease prognosis are given. Diagnostic criteria necessary for the determination of an individual risk of caries development are described. Approaches to curative and preventive measures for the persons, having different degree of risk factors of dental caries development are also given.

Biochemistry

Gurin S.A., Korobov G.D.
Reactivity of blood lipid transport system in inflammation dynamics in rats

Abstract. The influence of aseptic and infectious inflammation on blood lipid profile and biochemical parameters of the liver of rats in dynamics - in 4, 24, 48, 96 and 168 hours was studied. It has been determined that in aseptic inflammation time factor influences dispersion of TC of blood, the content in the liver of DC, protein, lipids, the activity of SOD; in infectious inflammation - dispersion of DC parameters, protein, the activity of catalase in the liver. The factor «kind of inflammation» explains dispersion of TC, ТG, VLDL-C, LDL-C, HDL-C parameters in blood, the activity of SOD, catalase, the content of lipids in the liver in aseptic and infectious inflammation, in aseptic inflammation in addition the influence of this factor on dispersion of DC parameters, protein, МDА in the liver was noted.

Gurin S.A.
Classification of cholesterol profile of rats’ blood and liver in aseptic and infectious inflammation

Abstract. Classification of rats’ cholesterol profile in 4, 24, 48, 96 and 168 hours of the development of aseptic and infectious inflammation was made by means of cluster analysis, the division was made by Vard method.
Typical cholesterol profiles of rats’ blood in 4, 24 and 48 hours of aseptic and infectious inflammation differ on parameters of total cholesterol and LDL-C.
The basic characteristic of the typical blood cholesterol profile of rats in aseptic inflammation is hypercholesterolemia and hyperbetacholesterolemia, in infectious inflammation - hyperalphacholesterolemia.

Cardiology

Kozlovsky V.I., Seroukhova O.P.
The efficacy of antiplatelet therapy with acetylsalicylic acid (aspirin) and the frequency of cardiovascular events development in patients with arterial hypertension

Abstract. It has been shown, that the decrease of indices of aggregation of leukocytic-thrombocytic suspension in the presence of adrenaline according to optical aggregatometry by 50% and more (in 7-8 days of aspirin intake) in comparison with the initial level is associated with reliable reduction in the number of cardiovascular events during 1,4±0,8 y. that allows to consider the given criterion as aspirin resistance. The conclusion is made that the frequency of resistance to ASA revealed by the end of early postcrisis period in patients with arterial hypertension makes up 67%. The quantity of emergency calls and hospitalizations due to diseases of the cardiovascular system is reliably larger in patients suffering from arterial hypertension with revealed on the basis of optical aggregatometry data resistance to aspirin during 1,4±0,8 year.

Internal medicine

Lagutchev V.V., Shchupakova A.N.
The peculiarities of cholesterol profile of blood serum in patients with obliterating atherosclerosis of the lower limbs arteries accompanied by clinical manifestation of atherosclerosis of the brain, coronary and abdominal arteries

Abstract. To determine the peculiarities of lipid structure of blood serum in patients with obliterating atherosclerosis of the lower limbs arteries (ОАLL) accompanied by clinical manifestation of atherosclerosis of other localizations 147 patients (all men) suffering from ОАLL at the age of 55,16±6,9 years, and 40 practically healthy men (mean age 48,9±7,1 years) were examined.
The determined changes of cholesterol profile depending on accompanying clinical manifestation of atherosclerosis of other vascular regions include disturbance of direct transport of cholesterol of various degree of expressiveness in ОАLL and ОАLL in combination with ischemic heart disease, in ОАLL with circulatory disorder of the brain – prevalence of disturbance of return transport of cholesterol, in ОАLL with chronic abdominal ischemia – disturbance of direct and return transport of cholesterol.

Girsa V.N.
Substantiation of clinical manifestation variance in biliary pathology

Abstract. In the majority of 250 examined patients with biliary pathology clinical manifestation was characterized by the presence of gallbladder and Oddi’s sphincter functional disorder syndrome (71,2%) in combination with gallbladder hypokinetic dysmotility (63,2%). Factors of clinical manifestation variance of biliary pathology were established (р<0,05): morphological changes of gallbladder wall, abnormalities of gallbladder contents colloid stability, viral hepatitis serological markers. Нigh diagnostic sensitivity (78,7%) of gallbladder and Oddi’s sphincter functional disorder syndrome was determined for detection of biliary sludge. Pharmacotherapy (Drotaverine) in combination with the course of multifractional duodenal intubation has a wider spectrum of clinical efficiency of biliary symptomatology and functional disorders symptomatologу reduction as compared with some other pharmacotherapy variants (Domperidone, Ursodeoxуcholic acid, essential phospholipids) and hypobaric adaptation.

Palguyeva A.Y., Litvyakov A.M.
Subclinical atherosclerosis in patients with rheumatoid and reactive arthritis

Abstract. 75 patients with rheumatoid arthritis (RA), 41 patients with reactive arthritis and 28 healthy subjects without clinical manifestations of atherosclerosis or any risk factors of its development were studied. All patients underwent ultrasonic investigation of the arterial vessels with the reactive hyperemia test, measurement of the intima-media thickness (IMT) of carotids and sizing up of the total area of atherosclerotic plaques lesion. It has been determined, that RA is accompanied by functional and organic atherosclerotic changes of arterial vessels. These signs of atherosclerosis in RA positively correlate with the patient’s age, duration of the disease, Ritchie index, C-reactive protein level, proatherogenic changes in lipid profile. In patients with RA atherosclerotic plaques were detected. The total area of atherosclerotic plaques lesion is associated with rheumatoid factor and C-reactive protein level. The reliable sings of ReA atherogenesis induction were not revealed. Arterial vessels changes registered in this group reliably did not differ from those found in the control group of healthy persons.

Poplavets E.V.
Clinicolaboratory characteristics of gastroduodenal pathology in adolescents of pre-conscription and military age

Abstract. 239 adolescents of pre-conscription and military age (16-27 years) were examined: 74 – with functional dyspepsia syndrome, 52 – with erosive-ulcerous pathology of the stomach and duodenum, 113 – the control group. Macrotrophic and microtrophic somatotypes in adolescents of pre-conscription and military age are factors increasing the feasibility of gastroduodenal pathology development (р<0,05) and associated (rs>0,3; р<0,05) with the estimation of pain syndrome and immunity parameters. Gastroduodenal pathology influence effects (р<0,05) on the reduction of cellular immunity characteristics and the increase of humoral immunity characteristics were revealed. The content of blood serum transforming growth factor b1 (TGF- b1) in adolescents of pre-conscription and military age is higher (р<0,05) in gastroduodenal pathology and is associated (r>0,3; р<0,05) with the intensity of clinical manifestations, isolated cardiac connective tissue defects, trophology status, proatherogenic changes of blood lipids, adaptation body mechanisms tension, determined by hormonal and psychovegetative status indices and suppression of cellular immunity.

Surgery

Nikitina E.V.
The dependence of IL-1a and TNF-a content on the activity of the pituitary-adrenal system in patients with low vegetative reactivity in the preoperative period and their correction

Abstract. The content of IL-1a, TNF-a, and the activity of the pituitary-adrenal system (PAS) in the preoperative period in patients with low vegetative reactivity and their correction with diazepam were analyzed.
29 patients hospitalized for planned operation and 17 persons of the control group were examined. The vegetative status was evaluated by means of vegetative indices, the level of ACTH and cortisol was determined by RIA method, the content of cytokines was determined by enzymoimmunoassay. It has been established, that in the preoperative period in patients with the prevalence of parasympathetic activity and low vegetative reactivity when PAS activity is practically not changed the indices of IL-1adecrease and those of TNF- increase. Diazepam administration during two days of the preoperative period to such patients reduces parasympathetic influence and PAS activity, raises vegetative reactivity that contributes to increase of the content of IL-1a and decrease of TNF-a . Thus, diazepam administration to patients with the prevalence of parasympathetic activity and low vegetative reactivity during two days of the preoperative period reduces PAS activity, promoting IL-1a synthesis.

Obstetrics and gynecology

Lesnichaya O.V., Semenov D.M., Krylov Yu.V.
Prevention and treatment of uterus neck dysplasia

Abstract. The article concerns the improvement of screening and treatment of patients with cervical intraepithelial neoplasia. The all-inclusive staging scheme of diagnosing and therapy of women with uterus neck precancerous conditions is presented in the research. It increases the efficiency of existing screening by means of sampling patients with the increased risk of cervical carcinoma occurrence. The stages of medical-diagnostic algorithm are presented, the economic efficiency from introduction of the offered scheme is calculated and substantiated.

Pediatrics

Klisho V.E.
The influence of perinatal damage of the central nervous system in newborns on the level of proteins of acute phase of inflammation

Abstract. Dynamics of the level of proteins of acute phase of inflammation in newborn children with perinatal damages of the CNS was investigated. It has been found that such children have a tendency towards growth of concentration of the investigated proteins in the blue blood in comparison with the funic one. The average correlation relationships between the levels of С3 and С4 complement components, ferritin and LDG, МВ – fractions of CPK and LDG have been established. The weak interrelation has been established between С3 complement component and a1 - acidic glycoprotein, С3 complement component and LDG, С4 complement component and a1 - acidic glycoprotein, CPK and its МВ – fraction, CPK and GGT. It has been determined that the presence of perinatal damage of the nervous system in a newborn child does not influence an average level of proteins of acute phase of inflammation, however, the level of С3 complement component, a1-acidic glycoprotein, CPK and GGT in newborns with perinatal damage of the CNS is reliably lower, than in children without any pathology of the nervous system. And on the contrary, the levels of С4 complement component, МВ – fractions of CPK, ferritin and LDG in them are reliably higher in comparison with children of the control subgroup.

Skin and venereal diseases

Kozina Y.V.
Therapeutic effectiveness of sodium dalteparine in patients with torpid generalized common psoriasis

Abstract. Therapeutic effectiveness of low molecular heparin – sodium dalteparine aganist the background of traditional treatment was studied in 33 patients with torpid generalized common psoriasis: 18 persons had often recurrent course of the disease (PASI 25,1±0,5) and 15 – persistent recurrent one (PASI 37,3±0,8).
During 8-10 days sodium dalteparine (2500 IU /d) was injected subcutaneously into the abdominal field. The mean duration of patients staying in the hospital was 19,5±0,2 days. After treatment PASI score less than 8 was determined in patients with often recurrent course of psoriasis and in persons (18-30 years) from general group with torpid course that correlated with the significant improvement of skin psoriatic process (PASI -75).
The administration of sodium dalteparine contributes to the reduction of prothrombin potential of blood plasma in patients with often recurrent course of psoriasis that correlated with the marked clinical effect in this group of patients. No significant effect of sodium dalteparine on the number of thrombocytes, coagulation time of capillary blood was found. Hemorrhagic complications were also not observed in these patients.
In 6 months stable remission after the treatment was preserved in 72,2% of patients with often recurrent psoriasis. During 4-6 months relative remission was noted in 53,2% of persons with persistent recurrent course of the disease.

Adaskevich V.P., Kozina Y.V.
The peculiarities of hemostasis disorders in widespread psoriasis vulgaris with different course

Abstract. The disorders of hemostasis in widespread psoriasis vulgaris are a matter of discussion in medical literature. It remains unclear in which clinical form of generalized psoriasis the changes in hemostasis are most vividly manifested.
The character of hemostasis changes is thought to depend on clinical peculiarities of psoriasis vulgaris course. The most striking changes in hemostasis are revealed in patients with frequently relapsing forms of the disease. In patients with constantly relapsing psoriasis such changes are expressed to a lesser extent than in those with frequently relapsing disease. The hemostasis changes in patients with frequently relapsing disease are manifested mainly by lower levels of the protein С and by the increased concentrations of fibrinogen in the blood serum. This fact testifies to the important role of increasing coagulation potential in the pathogenesis of psoriasis, especially in case of relapsing disease, which requires hemostatic correction by drugs or medical methods reducing the prothrombogenic potential in patients’ blood.

Infectious and parasitic diseases

Bekish V.Ya., Logishinets I.A.
The reaction of hypophysial – thyroid system to sensibilization of host organism with Ascarides somatic proteins

Abstract. The state of the histological structure, morphometric indices of the thyroid gland as well as the levels of thyrotropic hormone, triiodothyronine and thyroxin in the blood serum of Wistar line rats, sensitized with somatic proteins from the skin-muscular sac of adult Ascarides were studied.
It has been established that sensibilization of host organism with Ascarides somatic proteins causes changes of thyroid gland histological structure and its morphometric indices which are characterized by the enlargement of follicles, accumulation of colloid substance in them, reduction of follicular epithelium height and the size of its nuclei. These changes point to suppression of thyroid gland activity that is proved by the decreased levels of hypophysis thyrotropic hormone, triiodothyronine and thyroxin in the blood serum.

Ophthalmology

Samsonova I.V., Volkovich T.K., Morkhat V.I.
Zymozan activated autoserum in the treatment of the primary form of bacterial keratitis

Abstract. The aim of this study was to evaluate the efficacy of zymozan activated autoserum application in complex treatment of the primary form of bacterial keratitis.
The research was conducted on 36 patients with the primary form of bacterial keratitis. The 1st group included 22 patients (traditional treatment), the 2nd group consisted of 14 patients (traditional treatment + autoserum activated by zymozan (АSАZ)). The efficacy of treatment was evaluated with the help of impression cytology of the cornea.
The application of ASAZ in complex treatment of the primary form of bacterial keratitis promoted the development of the early beginning (Ме=2,5; р=0,041) and duration reduction of ulcerous-inflammatory defect epithelization by 3,5 days (р=0,002).
Zymozan activated autoserum application is an effective means to activate phagocytosis, proliferative and reparative processes during bacterial keratitis primary form treatment.

Volkovich T.K.
Application of zymozan activated autoserum in the treatment of experimental bacterial keratitis

Abstract. The aim of this study was to evaluate the efficacy of zymozan activated autoserum application in complex treatment of bacterial keratitis.
The experimental research was carried out on 102 rabbits. Bacterial keratitis was caused by intralamellar trepanation of the cornea and its subsequent contamination. The animals were divided into five groups: the 1st group – the first day after the damage and contamination of the cornea, the 2nd group – without treatment; the 3rd group – antibacterial treatment; the 4th group – zymozan activated autoserum treatment; the 5th group – the combined treatment (antibacterial treatment and that with zymozan activated autoserum).
Cytologic and histologic researches of the cornea were carried out on the 1st, 3rd, 7th, 14th and 30th days of observation. Statistical processing of the obtained data was performed using the program «STATISTICA 6.0».
It was determined that the application of zymozan activated autoserum resulted in positive dynamics of the clinical course of the disease. Its usage promoted clarification of the ulcerous-inflammatory zone due to phagocytosis enhancement as a result of the increase in the number of macrophages, activation of proliferative and reparative processes.
Zymozan activated autoserum application in complex treatment of bacterial keratitis is expedient for the purpose of decrease of the inflammatory reaction and activation of reparative processes in the cornea.

Моrkhat M.V.
Transillumination diagnosing of dystrophic changes in the anterior section of the eye

Abstract. The aim of the study was to assess the diagnostic value of a simplified, inexpensive transillumination (TI) technique as a method to visualize CB glaucomatous changes.
The prospective study involved 57 (105 eyes) patients with the confirmed glaucoma diagnosis. In a darkened clinic room, the transilluminator was placed on the temporal part of the upper eyelid and then moved with the eyelid far behind the globe. The TI effects and CB were studied through the translucent sclera.
In the glaucoma group, TI revealed depigmentation of CB. Characteristic TI defects and narrowing of the plicata band were found in 50% of eyes with mild glaucomatous damage, in 71% with moderate damage and in 85% with severe damage. Tonography revealed correlation of decrease of aqueous humor production with CB changes.
TI indicated the actual condition of CB mass and iris depigmentation. CB visualization can be used as an effective and simple diagnostic method to reveal additional information about glaucomatous damage.

Dentistry

Machkalyan E.L.
Index evaluation of the quality of endodontic post core restoration of teeth crowns

Аbstract. The article is devoted to substantiation of the application in the practical dentistry of the method of index evaluation of the post core restoration quality of the lost tissues of the teeth crowns aimed at the achievement of positive results of treatment. Simplified procedure based on the system of the score calculation in accordance with the elaborated criteria and proposed formula is presented; its distinction is that it doesn’t require special means and also excludes performing of immediate measurements of the crown parameters and subsequent calculations of their results. There is also reference to the known methods of quality estimation of the teeth crowns restoration, reflecting their disadvantages.
At the same time in the form of tables we present: the chart of score evaluation of the clinical state of the post core restoration of a tooth, the evaluation scale of the quality indices of the endodontic post core restoration with the corresponding clinical recommendations which permit to substantiate the applied therapeutic measures according to possible errors and can be joined to the medical documentation as an appendix to the ambulant card of a dental patient.

Clinical laboratory diagnostics

Shilin V.E.
Automated complex for identification of enterobacteria

Abstract. We have designed the test-system “ID-ENTER” for identification of enterobacteria which includes 24 tests for cleavage of dehydrated substrates with the addition of indicator and chromogenic substrates after putting in the microbial suspension. We used the plain photometer “Vityaz” (F300) in automated regimen as a reader for the detection of results (i.e., for determination of samples colour). We have also worked out and registered in the National Center of Intellectual Property the program NewID for the purpose of identification of enterobacteria; it uses cluster analysis which enables full identity (about 97%) of testing results with those produced by «BioMerieux» software (up to genus and species).
The program NewID allows to create microbiologist’s automated working place including photometer adapted for automated results analysis according to sample colour and a personal computer.

Ivanova S.V., Kirpichenok L.N., Kunder E.V.
The correlation analysis of fluorescent and proteolytic parameters in blood serum and synovial fluid in arthritis.

Abstract. In the given work the interrelation between spectral characteristics and parameters of proteolytic and inhibitor activity of blood serum and synovial fluid in arthritis was investigated. The analysis of correlation dependences testifies that in synovial fluids as well as in blood serum of the patients suffering from arthritis parameters of fluorescence are closely connected with proteolytic activity of the given biological fluids. Complex influence of proteolytic and inhibitor activity on fluorescence of blood serum and synovial fluid in arthritis was established. The determined correlation dependences also allowed to draw a conclusion that biochemical and spectral parameters of blood serum reflect the condition of synovial fluid.

Sports medicine

Pitkevich Y.E.
The indices of adaptation of sportsmen organism to highly intensive competitive load

Abstract. The data of investigations of 248 qualified sportsmen adapted for static and dynamic components of physical load were analyzed. High indices of their functional condition and an integral index of the sports-form, activity of energy and plastic exchanges, co-ordination of biorythmological processes in the organism are characteristic of the sportsmen adapted for highly intensive competitive load at low level of tension of regulation mechanisms.

Pharmacognosy and botany

Lyubakovskaya L.A.
The influence of exogenous phenol compounds on the processes of morphogenesis in callus culture of the lilac (syringa vulgaris l.)

Absract. The influence of exogenous phenol compounds (PhC) and their precursors on the content of PhC and realization of the morphogenetic potential in the lilac callus culture of the flower origin has been studied. During the investigation it has been found that when callus is cultured on the media in the presence of exogenous phenol compounds and their precursors on the 20th day of cultivation the content of the amount of phenol compounds in callus culture of the lilac is 6-10 times higher in comparison with the control medium. The most effective medium for the induction of morphogenetic processes turned out to be the medium containing 6,1 mg/l of rutin + 1,65 mg/l of phenylalanine (medium 5). Inclusion of exogenous phenol compounds in the cultivation medium helps to reduce the time of growing callus to maximize accumulation of phenol compounds three times.

Technology of medicines production

Rzheussky S.E., Kugach V.V., Tarasyuk I.V., Sivakov A.A.
The development of structure and technology of aminocalcid tablets for prevention and treatment of osteoporosis

Abstract. In this article the results of the development of structure and technology of aminocalcid tablets are presented. During the research estimation methods of technological properties of powders and tablets according to the State Pharmacopoeia of the Republic of Belarus were used.
It has been shown, that the nature (potato starch, MCC, lactose, aerosil) and quantity of auxiliary substances influence technological properties (durability on compression and attrition, disintegration) of aminocalcid tablets.
It has been determined, that such technology factors as time of mixing tablet mixes, time of chip dusting and the way of vitamin D3 introduction influence the parameters of aminocalcid tablets quality. It has also been shown, that the developed technology with damp granulation application provides for manufacture of the tablets meeting the requirements of the State Pharmacopoeia of the Republic of Belarus during 24 months of storage in natural conditions.

Khomenko F.I., Rzheussky S.E., Zhukharev Y.S., Khomenko A.I., Kugach V.V., Golutvina N.O.
The study of specific activity of the tablets Gamimax in experimental osteoporosis

Abstract. In this article the research results of the influence of the tablets Gamimax on bone tissue restoration processes in experimental osteoporosis are presented. As a result of biochemical researches on 100 white female rats it has been established, that the tablets Gamimax possess specific activity in relation to bone tissue: they reduce resorption of the mineral phase, promote the increase of mineralization, reduce the water phase share. By means of morphological researches it has been proved, that in 3 months after the beginning of treatment with Gamimax activation of young bone substance formation is observed that manifests itself in the increase of the thickness of bone beams diameter on the periphery.

Medical psychology

Devyatykh S.Y.
The dynamics of sexual activity in adolescence (using the students as an example)

Abstract. The peculiarities and age dynamics of sexual behavior of boys and girls at the age from 17 to 21 are considered on the basis of empiric research. According to the data obtained sexual intensity of young people increases at this period and their sexual behavior gains stable character.

Pedagogics and psychology of higher school

Zheleznyak N.V., Danyushchenkova N.M., Zubareva I.V., Berenshteyn T.F., Frolova A.V.
Creative innovation approach to carrying out educational process at the chair of clinical microbiology

Abstract. Modern pedagogics is characterized by creative educational approach encompassing multiple technologies of personality oriented training that stimulates high level of student’s working motivation with positive attitude to the subject studied. A great spectrum of special information provided at the chair of clinical microbiology requires top-score level of teacher’s professional abilities together with proper knowledge of the specific character of student’s future speciality. Innovative methods in higher school training include numerous educational techniques; one of them is the so-called “elective course” that implies strict scrutiny of the selected branch in the field of bacteriology, virology or immunology. This course is based on the principles of close teacher-students communication oriented towards implementation of acquired knowledge and practical skills in their future career. It is evident that the final result of all pedagogical efforts should be the training of highly skilled specialist capable of competing at the international level. An efficient learning is impossible without acquisition of modern comprehensive content of the discipline by students, creative approach to the subject delivery, usage of innovative techniques in the course of clinical microbiology teaching.

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