"vestnik vsmu" 2012 vol. 11 №1
Solkin A.A., Belyavsky N.N., Kuznetsov V.I., Nikolayeva A.G.
The main mechanisms of brain protection formation under the adaptation to hypoxia
Abstract. It has been shown in the article that hypoxia causes a complex restructuring of the functioning of various body systems, which is aimed at the ensurance of the delivery of the required amount of oxygen to the tissues. Adaptation to hypoxia exerts a significant influence on the central nervous system, central hemodynamics, microcirculation of blood in various organs, oxygen metabolism, free radical oxidation of lipids, the main systems detoxification enzymes· and immunity. The mechanisms of the effect of adaptation to hypoxia on the brain are considered. The improvement of cerebral circulation was found to be one of the most important protective effects of adaptation to hypoxia.
Dedul M.I., Zanko Y.V.
Rating system of students’ knowledge assessment as one of the optional parameters of the Bologna process
Abstract. The issues of the Bologna process in the Republic of Belarus have become one of the most popular topics to which seminars, round-table conferences, monographs and articles are devoted. Initially, the Republic of Belarus stayed away from the given process. Nevertheless in 2010 our country officially announced its intention to join the Bologna process and sign the Bologna Declaration in 2012.
At present many universities in our country began «step-by-step» introduction of some principles of the Bologna process into the system of higher professional education. In particular,· a two-level educational system, rating knowledge assessment, etc. are being introduced.·
For a more efficient, flexible, qualitative and incentive assesment of the university students’ knowledge, special attention in higher educational establishments is paid to the introduction of parallel evaluation systems including rating and modular-rating systems of students’ knowledge assessment which are actively used in the European educational system. At our university this system was actually reflected in the elaborated regulations of current monitoring of students’ academic achievements (final and interim) and their attendance of practical classes and lectures.
Kulikov V.A., Grebennikov I.N.
Resolvins, protectins and maresins as new mediators of an inflammation
Abstract. The resolution of acute inflammation earlier considered as a passive process is regarded today as an active process developing with the participation of numerous endogenous mediators. Recently identified lipid mediators – resolvins, protectins and maresins, synthesized from w-3 polyunsaturated fatty acids, are active participants of the phase of the outcome of acute inflammation. In the present review data about the structure, biosynthesis and biological action of these new mediators are summed up.
Sheybak V.M., Lyakh I.V., Doroshenko E.M., Smirnov V.Y., Mogilevets O.N.
Free amino acids and their nitrogen-containing metabolites in rats’ hypothalamus in acute intoxication with dinil and their correlation with amino acid spectrum of blood plasma
Abstract. Single administration of dinil to animals in doses of 5 mg or 500 mg / kg leads to disruption of neuroactive amino acids metabolism in the hypothalamus and changes their relationship with amino acid levels in blood plasma. These changes are accompanied by the decrease in utilization of amino acids and disbalance of excitation and inhibition processes, and there is correlation between the dose of injected dinil and the intensity of changes.
The comparative characteristic of atorvastatin and its derivatives distribution in the structure of lipoproteins complexes of healthy volunteers and patients with coronary heart disease
Abstract. Atorvastatin and its biologically active derivatives distribution in blood lipoprotein complexes of the first period of mature age healthy people and the second period of mature age patients with coronary heart disease was compared. Higher content of atorvastatin and its derivatives in lipoprotein complexes in patients with coronary heart disease was noted, except for the content of VLDL and HDL atorvastatin, differences in the content of which were not revealed and that of orthohydroxyatorvastatin which prevails in the structure of VLDL in young men. Dispersion analysis· revealed high degree of age and coronary heart disease influence on atorvastatin and its derivatives distribution in blood lipoprotein complexes.
Histology, cytology, embryology
Zykova O.S., Sobolevskaya I.S., Myadelets O.D., Grushin V.N.
Morphologic peculiarities of free cholesterol allocation in epiderm in psoriasis
Abstract. The present article is devoted to the studying of the peculiarities of free cholesterol allocation in the damaged skin in psoriasis by means of fluorescent microscopy.
Histological slides of healthy skin donors (n=15) and in-patients with generalized psoriasis (n=13) have been studied.
The conducted researches have shown significant differences in the deposition of free cholesterol in the psoriatic plaque epiderm in comparison with that in dermatologically healthy donors from the control group, and also have revealed the peculiarities of its allocation depending on the disease duration by the following criteria: intensity of luminescence (a semi-quantitative method), localization of free epidermal cholesterol, luminescence assessment based on color, character of cholesterol depositions.
Pchelnikova E.F., Yankovsky I.N., Tishkovskaya T.V.
Determination of the gestational age of fetuses and newborns on the basis of mathematical analysis of their antropometric values
Abstract. The aim of this study was to assess the most informative weight and anthropometric values for fetus and newborn gestational age determination.
The results of 123 autopsies of ante- and intranatally died fetuses from 2005 to 2009 and of 303 autopsies of ante- and intranatally died fetuses from 1999 to 2009, investigated at Vitebsk regional pathoanatomical department, were analyzed.
The result of this research was two regressive mathematical formulae for quick and precise determination of fetus gestational age. These formulae may be used in practical work of pathoanatomists, specialists in forensic medicine and neonatologists.
Undifferentiated arthritis: the possibilities to prognosticate the outcomes on the basis of serum DNase activity assessment
Abstract. The investigation of serum DNase activity in patients with undifferentiated arthritis was performed. We conducted prospective study within 12 months with the assessment of the outcomes of undifferentiated arthritis. On the basis of the outcomes patients from the studied group were divided into 3 subgroups: patients in whom rheumatoid arthritis developed, the recovered persons and patients in whom reactive arthritis developed.
The levels of serum DNase activity in patients with rheumatoid arthritis were significantly (p<0,01) higher than the values of serum DNase activity in patients with reactive arthritis and the recovered persons.
The revealing of elevated serum DNase activity in patients with undifferentiated arthritis is a probable predictor of chronic inflammatory process development in the joints and its transformation into rheumatoid arthritis.
Characteristic of variance in biliary pathology
Abstract. The object of the research was 249 patients with clinical manifestation of biliary pathology and 28 healthy persons in the control group. Gallbladder and Oddi’s sphincter functional disorder syndrome is the most specific characteristic of clinical manifestation in patients with biliary pathology (chronic cholecystitis, cholelithiasis, gallbladder dysfunction). Factors of biliary pathology variance have been established: morphological changes of the gallbladder wall, instability of gallbladder contents dispersion, viral hepatitis serological markers. Clinical importance of biliary sludge as a factor of gallbladder and Oddi’s sphincter functional disorder syndrome formation has been determined. Higher efficiency of biliary pathology diagnosis in the presence of biliary sludge is achieved by combination of differentiated assessment of clinical manifestations variation, echographic peculiarities of the gallbladder and microscopic study of the gallbladder bile portion. Therapeutic duodenal intubation inclusion in the treatment scheme increases the efficacy of biliary pathology management by the evaluation of clinical manifestations.
Lyzikov A.A., Achinovich S.L., Krylov Y.V.
Morphological and functional aspects of femoral veins application for aorto-iliac surgery under conditions of experimental subcultural bacteriemia
Abstract. Comparative study of perimysium microcirculation, morphological and functional relationships of the wall and vasa vasorum of different vascular grafts when included in the arterial flow was the purpose of this investigation.
30 mongrel dogs weighing 15,3±3,7 kg were operated during this experimental study. 20 of them were infected with the laboratory strain staphylococcus aureus to model subcultural bacteriemia similar to that present in patients with critical lower limb ischemia and pyo-necrotic changes.
Maximal wall width of the vascular grafts was determined in time of 9 months in all cases. Involution occurred after that. Total surface of smooth myocytes increased slightly in case of non-infected subcutaneous vein and vascular prosthesis. It decreased with the lapse of time in all other cases.
Vascularization in percental relation to vascular wall increased up to 6 months’ term. After that by the 9 months’ term there was a decline which later changed into growth.
The term of 9 months after the implantation is the most risky from the point of view of complications development caused by intimal hyperplasia. Femoral vein is less prone to intimal hyperplasia and to the development of complications caused by it.
The evaluation of the initial state of miocardial perfusion in patients with coronary heart disease
Abstract. For the Republic of Belarus, coronary heart disease (CHD) remains one of the most important medical and social problems, causing 19,2% of the total number of cases of primary disability and accounting for 34,7% of all deaths (Tsybin·A.A, Manak·N.A, Rusetskaya·V.G., 2004). According to the data of the statistical analysis of WHO and the American Heart Association cardiovascular diseases cause more than one third of all deaths, amounting to 7,2 million· patients with coronary heart disease (CHD) out of 16 million people who died in 2001. The urgency of this problem is increasing every year.
Identifying the main criteria for the risk of life-threatening conditions development in patients with stable coronary heart disease will enable the determination of the most effective treatment strategy, the reduction of mortality from coronary heart disease, the decrease in the number of patients of the able-bodied age registered as disabled and the frequency of patients hospitalizations, the reduction of the financial expenditures for the diagnosing of the disease and its treatment.
Leshkevich K.F., Kovsh E.V., Belinskaya Y.A., Darnichenko A.V.
Stenting of coronary arteries with the use of drug-coated and uncoated stents
Abstract. At present in endovascular treatment of coronary arteries stenoses the method of choice is balloon angioplasty and implantation of coronary stents. At the same time over the past eight years, coronary arteries stenting makes up more than 80% of interventions.
However, highly technological method of stenting not to a full extent leads to long-term clinical success. As the studies of several authors have shown, the main problem of using stents without drug coating (SWC) is restenosis in the late period of observation - more than by 50% narrowing of the vessel lumen in the area of implantation· after 6 months or more after the installation of endovascular prosthesis.·One of the main reasons for poor clinical and angiographic success in the late period during stenting of the coronary arteries (CA) is hyperplasia of· entimal layer, including proliferation of smooth muscle cells and their migration in the direction of vessel lumen.·In the world practice, in order to reduce restenosis in stent implantation stents with drug coating (SDC) are used.·However, the data of world literature do not permit to make an unambiguous assessment of the effectiveness of the use of stents in this category of patients.
Obstetrics and gynecology
Divakova T.S., Eliseyenko L.N.
Laparoscopic surgery complications in gynecologic practice
Abstract. The problem of complications arising during laparoscopic operations in gynecologic practice is presented in this article. In recent years endoscopic surgical intervention has taken the basic place among all surgical interventions in gynecology, thus the frequency of endoscopic surgical interventions of high complexity has increased. All these factors taken together create preconditions for the increase in the number of complications, specific for endoscopic surgery in particular. Frequency and types of complications are directly connected with complexity of operation and experience of a surgeon. Taking into account the frequency, structure and the reasons of complications can contribute to the prevention of their development and the elaboration of effective measures aimed at their elimination during the operation or on the first day of the postoperative period. Measures to prevent the formation of adhesions are of great value in favourable outcomes of reconstructive endoscopic operations.
Retrospective analysis of the structure of extragenital pathology of pregnant women of Vitebsk for 2007-2011 years
Abstract. A comparative retrospective analysis of the proportion and basic structure of extragenital pathology in pregnant women based on the materials of· Vitebsk obstetric institutions during the period from 2007 to 2011 was made. It has been determined that pregnancy in 73% of cases is accompanied by extragenital pathology. Cardiovascular diseases and hypertensive conditions do not tend to the reduction over the last 5 years. The revealed peculiarities require differential treatment and diagnostic approach to preconceptive preparation, as well as to the diagnosis and management of pregnancy in women with cardiovascular pathology. The achievement of the set goals will enable the improvement of the outcomes of pregnancy and thus will have a positive effect on demographic indices.
Neurology and neurosurgery
Alekseyenko Y.V., Sharyakova Y.V.
The state of cardiac rhythm regulation in patients with primary cephalalgias against the background of hypobaric hypoxytherapy
Abstract. In order to study the state of autonomic regulation in young patients with primary cephalalgias and to assess the effectiveness of curative and preventive hypobaric hypoxytherapy we studied the parameters of heart rate variability (HRV) in 124 patients suffering from tension-type headache (TTH), migraine, or their combination. It has been found that the indices of initial autonomic tone in patients with all forms of primary headaches are in the normal range. However, during the orthostatic test in all groups of patients the disturbances of autonomic support of activity were found, they were most pronounced in case of migraine or its combination with tension-type headache.
After hypobaric hypoxytherapy course autonomic regulation parameters in patients with chronic tension-type headache were normalized, having reached the control values (p<0,05), which also correlated with clinical improvement. At the same time in patients with migraine and with concomitant headache, despite the positive clinical effect of the procedures, changes in HRV parameters are diverse with the signs of preservation of the imbalance in the interaction of the autonomic nervous system parts.
The influence of hypobaric hypoxytherapy on clinical manifestations of primary cephalalgias and psychoautonomic features in young patients
Abstract. In order to study clinical manifestations and psychoautonomic features in young patients with primary cephalalgias 124 patients aged 18-30 years suffering from migraine, tension-type headache (TTH), or their combination·· were examined. Hypobaric hypoxytherapy was found to lead to a significant reduction of cephalalgia attacks frequency and the severity of pain syndrome in all groups of patients, however, it is most effective in patients with migraine and chronic TTH. Hypobaric hypoxytherapy also contributes to normalization of initially high indices of· reactive and personal anxiety and depression level in patients with primary cephalalgias, although this regress reaches statistical significance only in patients with chronic TTH. Integral indices of the degree of autonomic dysfunction syndrome prior to treatment were also higher than the control values in all groups of patients with primary headaches. After the course of hypobarotherapy autonomic dysfunction severity decreased significantly in all groups of patients, however, in those who had tension-type headache combined with migraine it still didn’t reach the level of the control values.
Allergology and immunology
Karpuk N.A., Karpuk I.Y., Novikov D.K., Kubrakov K.M.
The use of application tests for the diagnosis of allergy in patients with intolerance to nickel
Abstract. The method of application testing with the solution of NiCl2 salt to reveal the sensitization of an organism to nickel has been developed and clinically proved.
Patients with intolerance to metals (n=43) and practically healthy patients (n=40) were examined, who constituted the control group.
It has been established that the optimal concentration of the solution of NiCl2 salt for conducting application tests is 3%. Concentrations of the solution of NiCl2 salt of 0,5 and 1% are insufficient for more reliable detection of allergy to nickel in patients with intolerance to metals. When the concentration of the solution of NiCl2 salt is 5% many positive reactions in the control group are observed that allows to consider the given concentration as toxic.
This approach to the diagnosing of allergy to metals offered by us helps to avoid false-positive reactions the occurrence of which can result from wrong concentration of the solution of NiCl2 salt.
Psychiatry and narcology
Kopytov A.V., Nakonechnaya E.A., Sitko L.Z., Kopytov D.A.
The interrelationship between the behavior disorders and alcohol dependence in adolescents and young people of male sex
Abstract. We conducted a clinical observational and analytical research with the use of directed compilation of research groups of male subjects using the random-control method. The main group consisted of 397 individuals aged 14-25 suffering from alcohol dependence syndrome, the control group included 213 subjects without alcohol-related problems. The clinical diagnosing was made according to the diagnostic criteria of ICD-10, AUDIT, «B-ASI» (version 2.3-3.01.2001), and by means of the «Deviant behavior likelihood assessment» questionnaire. The research results showed that the number of subjects with antisocial behavior in the main group was significantly higher. The data obtained may be used when developing preventive programs taking into account the specificity and peculiarities of disease history.
Volkova M.N., Konopelko E.A.
The analysis of the microbial composition of the subgingival plaque in patients with chronic periodontitis
Abstract. The purpose of the present research was to investigate the prevalence of the microbial kinds of the subgingival plaque in patients with chronic periodontitis (СP). Bacterial samples were collected with sterile hydroscopic paper points from the deepest periodontal pockets of 51 patients with chronic periodontitis: 18 males and 33 females aged 23–65 years. In all patients the following indices were assessed: plaque index (PI), sulcus bleeding index (SBI), periodontal index (PI). CP patients were divided into three groups on the basis of probing pocket depth (PPD), clinical attachment loss (CAL) and roentgenologic examination: mild, moderate, severe degree of periodontitis. Samples of the subgingival plaque were studied under anaerobic conditions using selective and nonselective media.· In the subgingival plaque of patients with CP statistically reliable difference (p<0,01) between strict anaerobic and aerobic bacteria was observed. Prevotella spp. (37,25±6,77%), Peptococcus spp. (31,37±6,49%), Peptostreptococcus spp. (21,56±5,76%), Fusobacterium nucleatum (19,6±5,56%), Gemella morbillorum (19,6±5,56%) were the commonest anaerobes isolated in periodontitis patients. The number of samples associated with monobacterial growth and polybacterial growth was 10% and 90%, respectively. Our data confirm the diversity of anaerobic bacteria and high prevalence of the putative periodontal pathogens in CP. It is concluded, that there is a strong association between bacterial composition of the subgingival plaque and the periodontal lesion.
Marchenko E.I., Chukhray I.G., Baytus N.A.
Osteointegrating materials in restorative dentistry
Abstract. This article is devoted to the use of osteoinductive and osteoconductive preparations in restorative dentistry. The characteristic of composition, properties, the technique of making and the mechanism of action of osteoplastic materials is given. Possibilities and prospects of the use of concrete osteoregenerating materials in the diseases of apical and marginal periodontium, as well as in their сombinative pathology are also enumerated.
Content and structure of conception-stereotype «patient» in the graduates of medical college
Abstract. On the basis of empirical material the structure and content of the stereotype «patient» in the graduates of medical college were revealed. The image of a patient was shown to be loaded with perceptive markers designating negative emotional conditions that as a whole can determine the negative perception of a patient by nurses. The attention is focused on the necessity to develop social and perceptive abilities of public health workers.
Case from practice
Makarenko E.V., Pimanov S.I., Chupakhina O.P., Shilenok A.V., Kutko S.E.
Stress-induced (takotsubo) cardiomyopathy
Abstract. The article presents literature data and a case report of stress-induced (takotsubo) cardiomyopathy characterized by transient apical systolic dysfunction and / or midsegments of the left ventricle with hyperkinesis of the basal segments, similar in clinical manifestations and electrocardiographic signs to myocardial infarction, but in the absence of obstructive coronary artery disease.
Vasilenko N.I., Nebylitsin Y.S., Vasilenko S.G.
Service to the health of people is the purpose of life
Abstract. The article is devoted to medical dynasties of the staff of Vitebsk State Medical Institute. The authors describe the life of the representatives of the medical dynasty of the first dean of VSMI, candidate of medical science, associate professor Gurevich Pavel Markovich, and give a detailed account of their valuable contribution to the maintenance of health, the rescue of the wounded in the period of the Great Patriotic War, the training of specialists for the public health services of Belarus.
Purtov A.V., Petrishche T.L.
Medical service and medication provision of the population of Rossonsky district of Vitebsk region in the period of the district entry into the Russian empire (1772-1918 years)
Abstract. It has been determined during the investigation that the development of medication provision as well as medical aid to the population on the territory of Rossonsky district during the period of 1772-1918 years occurred under the conditions of medicine reformation, health service management body establishing; coming of doctors and paramedical personnel to the rural areas where their medical functions had been previously performed by healers. The article deals with the medical service organization and medication provision under the circumstances of extreme poverty of the peasantry and very low standard of culture of the rural population. The role of the rural hospitals and paramedical units in the provision of the population with medicaments, when free chemist’s shops on the district territory were absent, is shown.
Scientist, educator, teacher (to the 60th anniversary of the head of histology, cytology and embryology chair, Professor Myadelets Oleg Danilovich)