"vestnik vsmu" 2012 vol. 11 №2
Errors in the work with photopolymerizing devices in dentistry
Abstract. In this article possible errors in the work with photopolymerizing devices used in dentistry are analyzed. Complications that may result from the infringement of the principles of their operation and filling materials polymerization technique are also described. Errors connected with the devices for polymerization: unsystematic measuring of the intensity of the light flux, irregular substitution of the interference light filter, and forgetting to clean the reflecting mirror, usingmechanically damaged contaminated light guide in the work are described in detail. This publication also presents the errors connected with the technique of polymerization: the function «soft start», the principle of «directed polymerization», the technique of «finish» light-striking, light gearbox wedges, focusing nozzles, protective devices are not used; «oxygen inhibited layer», the intensity of the light source and material polymerization time, the influence of C-factor on the quality of restorations are not considered.
The Framingham Heart Study: 65 years of studying atherosclerosis causes
Abstract. The Framingham Heart Study lasting for almost 65 years is one of the longest epidemiological researches in the history of medicine. The results of this study have helped to determine primary risk factors of cardiovascular diseases. The Framingham Heart Study has thrown light on some aspects of atherosclerosis pathogenesis and has laid the foundation for preventive cardiology. In the present literature review the basic achievements of the Framingham Heart Study in determining primary risk factors of atherosclerosis are shown.
Kovalyova M.V., Anisovich M.V., Afonin V.Y.
Hematologic and cytogenetic characteristics of lisinopril and captopril effect in genetically induced arterial hypertension
Abstract. Antiinflammatory, antithrombotic, cytoprotective effect of such generic medicinal agents (MA) as lisinopril and captopril in genetically induced arterial hypertension (AH) in rats was studied. The administration of low dose of lisinopril exerted cardioprotective influence, decreased body, heart mass, absolute and relative number of monocytes, granulocytes and the amount of cells with micronuclei.
Captopril in its turn was characterized by greater safety compared to lisinopril. Low doses of MA protected the heart by lowering body mass and absolute number of monocytes, granulocytes, platelets, thrombocrit and the amount of cells with apoptosis. High doses of captopril reduced body, heart mass and the number of cells with apoptosis. The administration of these medicinal agents in all investigated doses caused the increase in the number of cells in the S+G2/M -phase.
As a result of the conducted investigation it is possible to conclude that different doses of lisinopril and captopril can produce cardioprotective effect. The choice of MA and adjustment of drug dosage depend on the lesion component in genetically induced AH.
Histology, cytology, embryology
Myadelets O.D., Sobolevskaya I.S.
Features of allocation of epidermal lipids and skin surface lipids in human beings, rats and pigs
Abstract. All lipid-containing and lipid-synthesizing structures of skin integument are divided into three functional groups: superficial skin and epidermis lipids, sebaceous glands lipids related to hair follicle and lipids in adipocytes of derma and hypoderm fat tissues. For the first time fluorochromes (Nile red, Filipin) were applied for studying the localization and composition of lipid-containing and lipid-synthesizing structures.
The results of the researches show that fluorescence method is more responsive than optical microscopy and enables more accurate determination of localization, better description of tissues histological structure, selective differentiation between polar, non-polar lipids and free cholesterol.
The data received can be used in dermatology, cosmetic medicine and forensic medicine.
Some morphometric parameters of lipid-containing and lipid-synthesizing structures of human skin
Abstract. This article deals with morphometric parameters of lipid-containing and lipid-synthesizing structures of human common integuments, depending on topography, sex and age affiliation.
The producers of skin lipids are firstly, adipocytes of fat tissue; secondly, keratinocytes, which produce fats in terminal differentiation; and thirdly, sebocytes of oil glands, which produce sebum in the course of holocrine secretion.
Marked differences in the lipid content of the skin of the mentioned three zones depending on sex, age and skin topography have been determined as a result of the conducted research.
Samokhina A.V., Pivchenko P.G.
The main features of histostructure and morphometric characteristics of different parts of extrahepatic biliary ducts in human beings
Abstract. The aim of this research was to study the main features of histological structure and morphometric characteristics of different parts of extrahepatic biliary ducts in human beings.
17 liver samples of gall – bladder and biliary ducts complexes were studied by means of histologic and morphometric methods.
As a result of this study the dependence of wall thickness on the cut level has been revealed; the presence of sphincters of extrahepatic biliary ducts in the initial parts of cystic duct as well as in the final part of common biliary duct and also in the confluence area of choledochus and duodenum has been detected; thickened duct wall in the region of the left and right hepatic ducts junction and in that of common hepatic and cystic ducts has been identified.
Morphologic features of muscular tissue of the human prostate in the prenatal period of ontogenesis
Abstract. The aim of this work was to study the special features of the structural organization of muscular tissue, the formation of the prostate lobes and their tissue components in 20-40-week human fetuses on appropriate histologic specimens by means of light microscope.
19 prostates of 20-40-week human fetuses served as a material for the investigation.
As a result of this research it has been determined that 20-week epithelium germs and myocytes do not have any visually determined connection with each other. By the 24th-26th week single myocytes surround epithelium clusters, by the 35th week the bundles of myocytes surround the formed glands, making up muscular-glandular complexes.
Thus, the prostate of 40-week fetuses represents the organ which has tubular glands with developing alveoli.
Usovich A.K., Krasnobayev V.A.
Structural organization of muscular tissue of the human prostate in the postnatal period of ontogenesis
Abstract. The aim of the present study was to reveal the features of structural organization of muscular tissue of the human prostate in the postnatal period of ontogenesis.
89 human prostates have been investigated.
The results of the research show that the muscular tissue elements of the human prostate are formed in accordance with the development of basic structural components of the organ. They change in the periods of structures reformation.
It has been concluded that the development of muscular tissue of the human prostate is observed from birth till the first period of mature age. It occurs periodically and is accompanied by the change in the thickness of myocytes bundles, their orientation and the interval between them.
Treatment of patients with postoperative ventral hernias
Abstract. In this article the treatment results analysis of 326 patients with postoperative ventral hernias is presented. As a result of researches necessary rehabilitation measures and the sequence of their carrying out in patients with concomitant diseases in the preoperative period have been determined. Early results of hernioplasty in case of postoperative ventral hernias have been studied. The algorithm of preoperative preparation, intra - and postoperative management of patients with postoperative ventral hernias has been elaborated. The way of antibiotic prophylaxis has also been determined. The combined performance of abdominoplasty and non-tension hernioplasty of the anterior abdominal wall has been estimated, pathogenetic validity of the application of the given type of operation for the achievement of good functional and aesthetic result has been shown.
Obstetrics and gynecology
Zanko A.S., Arestova I.M., Barkun G.K.
The analysis of perinatal diseases and infant mortality from intrauterine infections in Vitebsk region and the ways of their reduction
Abstract. The article presents the analysis of infant mortality from intrauterine infections in Vitebsk region for the period 2009-2011 as well as the detailed analysis of pregnancy course and delivery in mothers of dead children. The attention is drawn to the high percentage of chronic inflammatory diseases, particularly of the urinary tract in these women. On the basis of pathohistological investigations protocols analysis the important role of TORCH-infections and urogenital infections in the development of diseases of the fetus and placenta has been proved. Special attention is paid to the role of U. urealiticum in the occurrence of bronchopulmonary dysplasia in low-birth-weight infants.
The analysis of the main drawbacks and medical errors in the management of pregnant women with various infectious diseases has been made and on the basis of its results the ways of reducing infant mortality from intrauterine infections have been proposed.
The peculiarities of placental blood flow in placentitis
Abstract. The aim of this study was to investigate the characteristics of placental blood flow in placental inflammation of different origin by means of 3D power Doppler imaging. 3D power Doppler imaging of placental blood flow with the determination of its parameters (vascularization index, flow index, flow vascularization index) was performed in 72 patients with placentitis and 32 women with physiological single pregnancies at 35–38 weeks time. The results of the investigation showed that the decidua and chorionic inflammation of the placenta was characterized by hypovascularization. The generalized inflammation of the placenta was associated with the simultaneous detection of hypo- and hypervascularization in different placental zones. Minimal changes in the vascularization and blood flow indices were revealed in the chorionic placental inflammation, marked changes in these indices were found in generalized placentitis. Thus, 3D power Doppler imaging of placental blood flow is a method of early diagnosis of placental hemodynamic disturbances, which can be used not only for prediction of the fetus and newborn condition, but also for the timely administration of therapy aimed at the improvement of placental perfusion.
Zuyeva O.S., Zuyev N.N.
The use of vitamins and minerals complexes in children: substantiation of administration
Abstract. This literature review presents the generalized data on vitamins and trace elements supply of children and teen-agers at the present time. There are many important reasons for the development of vitamin deficiency in children such as alimentary insufficiency, disturbances of food absorption in intestines, metabolic disorders, etc. In this article the consequences of the deficiency of vitamins and trace elements in the daily diet for a growing organism are described. The authors give characteristics of various ways to correct vitamins and trace elements deficiency both by creating maximally balanced diet, enriching manufactured food-stuffs with vitamins and by using vitamins and minerals complexes. The importance of polyvitamines use in children and teen-agers is substantiated, indications and recommendations concerning the choice of concrete preparation, duration of vitamins and minerals complex intake are also specified.
Infectious and parasitic diseases
Pashinskaya E.S., Bekish L.E., Semenov V.M., Bekish V.Y., Zorina V.V.
The peculiarities of combined treatment for trichinellosis
Abstract. Average severity trichinellosis in human beings is accompanied by genotoxic and cytotoxic effects in lymphocytes of patients peripheral blood which are characterized by the growth of the amount of damaged nuclear DNA up to 9,84% and apoptotic cells up to 8,15%. The use of albendazole or mebendazole within 14 days in the therapy of average severity trichinellosis does not completely eliminate the symptoms of invasion (eosinophilia, muscular pains, allergic eruption, edemas), results in the decrease of genotoxic and cytotoxic effects in patients blood lymphocytes, but these values are reliably higher than those of donors blood. The application of mebendazole with ibuprofen and vitamins complex with Se for treatment of trichinellosis within 7 days can’t lower completely the genotoxic effect of invasion in patients lymphocytes. The combined treatment with albendazole (during 7 days), ibuprofen (during 5 days) and vitamins complex with Se (during 7 days) for average severity trichinellosis is an effective way to protect patients’ genome, because it reliably decreases the levels of DNA and apoptotic cells primary damages up to the values of donors blood and leads to complete elimination of the basic symptoms of the disease as well.
Oxidation stress and the changes of trace elements content in the embryos tissues of female rats in experimental trichinellosis
Abstract. Trichinellous invasion is accompanied by oxidation stress in the embryos cells of female rats which is characterized by the increase in the level of diene conjugates by 63,12% and malondialdehyde by 71,32%, as well as the decrease in the activity of catalase by 46,62%, superoxide dismutase by 36,47%.
The infection of pregnant female rats with invasion culture of larvae Trichinella spiralis in their embryos tissues has shown the decrease in the content of vitamins: A – 9,66 times, Е – 1,63 times, В1 – 1,29 times, carotin provitamin – 9,75 times and the reduction in the concentration of trace elements: Mn – 1,37 times, Fe – 7,22 times, Co – 1,43 times, Se – 3,33 times.
Therapy of experimental trichinellosis with only one helminthic agent (albendazole or mebendazole) does not lead to the normalization of vitamins and minerals levels in the embryos tissues. Vitamin A decreases 58-29 times, vitamin E –1,49-3,18 times, В1 – 1,46-2,23 times, carotin provitamin – 19,5 times. The content of Mn in the embryos tissues has reliably decreased 1,69-1,71 times, Fe – 1,86-1,83 times, Co – 1,66-1,61 times, Se – 10-30 times compared to the control values.
The application of vitamins complex with selenium for combined therapy of experimental trichinellosis in pregnant female rats neutralizes vitamins and minerals disbalance in the embryos tissues as well as negative action of reactive oxygen form.
Hygiene and ecology
Ushkov S.A., Shevlyakov V.V., Ehrm G.I., Chernyshova Е.V., Buynitskaya А.V.
Sensibilizing capability of albuminiferous substances of different types of groats dust
Abstract. Albuminiferous substances of pearl-barley, fine-ground barley, oat and buckwheat groats dust in unified conditions of endermic sensitization of guinea-pigs cause expressed sensitization of an organism (the 2nd class of allergenic activity) with homotypic activation of mixed mechanisms of anaphylactic, cell-mediated, caused by antibody cellulotoxic and immunocomplex types of allergic reactions on the background of blood granulocyte phagocytic function depression and hemotoxic manifestations.
Allergology and immunology
Karpuk N.A., Karpuk I.Y., Novikov D.K.
The diagnosis of allergy to cobalt and copper in vivo in patients with intolerance to metals
Abstract. The aim of this work was the establishment of optimum concentrations of CoCl2 and CuCl2 salts as allergens by means of patch tests to determine the presence of allergy to them.
Patients with allergy to metals (n=61) and patients without any allergy to metals (n=40) were examined.
It has been established that 0,5% concentration of CuCl2 salt and 1% concentration of CoCl2 salt are nontoxical, but diagnostically significant. 1% concentration of CuCl2 salt and 3% concentration of CoCl2 salt while carrying out patch tests are toxic, that leads to the development of nonspecific inflammation which not always can be differentiated with positive skin tests.
The suggested approach to the diagnosis of allergy to metals helps to avoid the false-positive reactions the occurrence of which can result from toxic concentrations of metal salts.
Karpuk N.A., Karpuk I.Y.
The analysis of the diagnosis results of allergy to metals by means of various in vitro and in vivo methods
Abstract. The aim of this work was the analysis of the diagnosis results of allergy to metals with the use of patch tests, reactions of allergen induced damage of leukocytes and degranulation reaction of mast cells and the enzyme-linked immunosorbent assay.
Patients with intolerance to metal products, with positive results of patch tests, to salts NiCl2 (n=20), CrCl3 (n=20), CoCl2 (n=20), CuCl2 (n=20) and patients without any allergy to metals (n=20) were examined.
Direct correlation between the results of identification of sensitization to metal ions in patch tests and in vitro methods has been established: with reaction of allergen induced damage of leukocytes: with NiCl2 (R=0,75; p=0,0001), with CrCl3 (R=0,79; p=0,002), with CoCl2 (R=0,9; p=0,00001), with CuCl2 (R=0,67; p=0,001); with degranulation reaction of mast cells: with NiCl2 (R=48; p=0,03), with CrCl3 (R=0,44; p=0,04), with CoCl2 (R=0,55; p=0,01); with enzyme-linked immunosorbent assay results: with Ni2+ (R=0,45; p=0,04), with Cr3+ (R=0,49; p=0,02) and with Co2+ (R = 0,45; p=0,04).
Psychiatry and narcology
Kirpichenko A.A., Obyedkov V. G., Nesterovich A.N.
The dimensional model of schizophrenia: confirmatory factor analytic study of symptoms
Abstract. The problem of clinical heterogeneity of schizophrenia can be solved by means of subidentification of its symptomatic structure using factor analysis method to reveal specific psychopathologic dimensions. In the present study the object of which was 90 patients with paranoid schizophrenia confirmatory factor analysis of the SAPS/SANS symptom scores has been applied. As a result four psychopathologic dimensions have been revealed: paranoid, disorganization, psychomotor poverty and social dysfunctioning.
The role of family environment in the development of alcohol dependence in teen-agers and young males
Abstract. In this article the results of the study of 397 subjects of adolescent and young age (14-25 years) suffering from alcohol dependence (AD), and 213 subjects of the comparison group of the same age without alcohol-related problems are presented. The impact of family social environment on the development of AD in this cohort has been studied. The influence of family mode, relationships, and financial status as the risk predictors of AD has been revealed. The prognostic protective model of family factors with regard to early AD development has been determined.
Lutskaya I.K., Kavetsky V.P.
Complex assessment of the quality of the adhesive fiber-reinforced composites
Abstract. The given article presents the results of complex assessment of the quality of the adhesive fiber-reinforced composites produced with the use of various types and various position of fiber framework. The obtained data of the laboratory investigations aimed at determining the strength of the adhesive «tooth-prosthesis» connection using specimens with various fiber framework type and position have been reviewed. The criteria for assessing the quality of the adhesive composites for perspective have been developed. Short- and long-term results of fabricating adhesive composites have been considered. The results of introducing the recommendations for the production of the adhesive fiber-reinforced composites have been analyzed. Practical recommendations have also been given.
Fisyunov A.D., Chernyavsky Y.P.
The results of «Holisal» preparation application in ambulatory dental practice
Abstract. On the basis of the conducted researches high therapeutic efficacy of «Holisal» preparation for the treatment of chronic simple marginal gingivitis, acute pericoronitis has been determined. The application of this medicine has considerable advantages in comparison with the traditionally used therapy and can be recommended for the treatment of inflammatory diseases of periodontium.
Modern approach to the choice of materials in the treatment of chronic inflammatory – destructive processes of apical periodontium tissues
Abstract. This article is devoted to the comparative analysis of the composition, properties and results of clinical application of materials on the basis of calcium hydrooxide and hydroxyapatite on endodontic treatment of chronic inflammatory – destructive processes of apical periodontium tissues. The characteristics and clinical examples of the use of calcium containing preparations and osteoplastic materials on the basis of hydroxyapatite in therapeutic stomatology are given.
The efficacy evaluation of topical treatment of herpetic stomatitis in children with the use of knitted medical reticulated material for salve dressings
Abstract. The article is dedicated to the issues of treatment of herpetic stomatitis; the method of local therapy of herpetic stomatitis with the use of knitted medical reticulated material impregnated with acyclovir has been described. This method was developed at the chair of restorative stomatology and the chair of infectious diseases of Vitebsk State Medical University. Its efficacy was proved in various degrees of disease severity. The method was applied in 48 patients with mild, moderate and severe degrees of herpetic stomatitis, thereafter the results were analyzed. The new treatment technique allows to achieve the decrease of erosion area on the third day 1,8 times (p<0,001), on the fifth day 4 times (p<0,001) in comparison with the conventional treatment group. Faster terms of epithelization and improvement of stomatological indices, characterizing the degree of the gums inflammation and oral hygiene were observed.
Pedagogics and psychology of higher school
Korolkova N.K., Medvedeva L.Z., Volkovich T.K., Pristupa V.V., Morkhat M.V.
Role-play sessions as a method of clinical subjects teaching
Abstract. This article deals with role-play sessions as a method of teaching. A variant of using it together with case discussion sessions at the chair of ophthalmology of the educational establishment «Vitebsk State Medical University» is described. The role-play scheme, algorithm of actions and features of results assessment are presented. Advantages of the suggested method of teaching are also analyzed.
History of medicine
Artyomenko N.A., Petrishche T.L.
Historical and genetic analysis of doctors` activity in the system of primary medical care
Abstract. The article describes the main stages of doctors’ activity in the system of primary medical care on the basis of historical and genetic analysis in the second half of the XX century – the beginning of the XXI century. The main achievements in the field of medical attendance ofthe rural population and theworkers in the Russian Empireare discussed herein by the example ofZemstvo and insurance medicine.The conditions for introductionof general medical practiceinto the system of Belarusian health service are also analysed.