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"vestnik vsmu" 2013  vol. 12  №1


Sheybak V.M., Pavlyukovets A.Y.
Arginine and the immune system – possible mechanisms of interaction

Abstract. In this article the review of literature data on the role of arginine in the functioning of the immune system is presented.
Keywords: arginine, immune system.


Yankovskaya N.N.
Clinical importance of blood serum lipid profile in patients suffering from psoriasis with and without liver lesion by B and C hepatites viruses

Abstract. The aim of this work is to evaluate the clinical significance of blood lipid profile in psoriatic patients with and without liver lesion produced by B and C hepatites viruses for the enhancement of therapy efficiency.
The research methods such as clinical, biochemical, immunological, molecular, genetic and statistical were used.
As a result of the study it has been proved that the psoriatic patients have reliably (p<0,01) increased level of total cholesterol and triacylglycerol. Lipid profile of patients with chronic hepatitis C is characterized by reliable (р≤0,05) decline in LDL-C, HDL-C, HDL-PL content, significant (р≤0,05) increase of total cholesterol and VLDL-C. Combined therapy with interferon and ribavirin contributes to the reliable (р≤0,05) rise of serum triglycerides and cholesterol levels as well as ratio of LDL-C to HDL-C. Essential phospholipids promote reliable (р≤0,05) rise of PL-HDL/HDL-C and PL-HDL/TC indices as well as the drop of atherogeneity indices (TC - HDL-C/ HDL-C and TC/HDL-C) in patients with chronic hepatitis C.
The results obtained may be used in the development of new methods of treatment of patients with psoriasis and concomitant chronic hepatitis. The fields of their application are dermatovenereology, infectology.
Keywords: lipid profile, psoriasis, B and C hepatites.


Gorodetskaya I.V., Gusakova E.A.
The peculiarities of behavioural activity of animals with the changed thyroid status at different stages of stress reaction

Abstract. In the experiments on 130 mongrel male rats it has been established that the alarm stage of «free swimming in a cage» stress is characterized by the decrease of the total vertical (V) motor activity (MA), the disappearance of the stands without the support on the wall and the central component of the horizontal (H) MA in the «open field» test, stage of resistance – by the restoration of behavioural reactions of animals, stage of exhaustion - by the suppression of all kinds of locomotor activity, that testifies to the passive-defensive tactics in behaviour and the reduction in research reactions intensity. Experimental hypothyroidism caused by intragastric administration of 25 mg mercazolil per kg body weight for 20 days, is followed by a more significant decrease in MA and the change of its structure at the alarm stage of stress; practically eliminates the normalization of MA at the stage of resistance and causes the greatest disturbances of MA at the stage of exhaustion of stress reaction. The administration of L-thyroxine in the doses from 1,5 to 3,0 mcg per kg body weight for 28 days increases the MA of rats and provides its higher level and conservation of behaviour structure at all stages of stress reaction.
Keywords: thyroid status, stress, animal behaviour.

Internal medicine

Bondarenko V.M., Marchuk V.P., Pimanov S.I., Mikhaylova N.A., Makarenko E.V.
Correllation between the content of visceral fatty tissue by computed tomography findings with anthropometric measurements and the results of ultrasound investigation

Abstract. The prevalence of obesity is increasing in the world population, so the problem of overweight is acute. General and abdominal obesity is associated with cerebrovascular diseases, coronary heart disease, increase of over-all mortality and mortality from cardiovascular diseases. The development of obesity leads not only to increased fat deposits in classical adipose tissue sites but also to the appearance of ectopic fat. Obesity can be assessed by using anthropometric data and imaging. The reference method for measuring the amount of visceral  and subcutaneous fat is computed tomography. However, this method is relatively expensive and it is accompanied by exposure to ionizing radiation.
The purpose of this study was to establish correlation between anthropometric data and ultrasonic methods of measuring visceral adipose tissue with the results of the evaluation of visceral fat area by computed tomography.
Anthropometric and ultrasound methods of assessing the content of visceral and ectopic fat correlate with the standard method of diagnosis – measuring the area of visceral fat with computed tomography. A closer correlation between anthropometric and ultrasound measurements and the data of computed tomography occurred in men.
Ultrasound investigation methods can be used in medical practice to estimate the amount of visceral fat.
Keywords: visceral adipose tissue, ultrasound diagnosis, anthropometric measurements, computed tomography, correlation.

Pathologic anatomy

Pchelnikova E.F., Yankovsky I.A., Tishkovskaya T.V.
Determination of gestational age of the placenta by its morphometric indices

Abstract. The aim of the study was to determine the most reliable morphometric indices for establishing gestational age of the placentas of ante- and intranatal died fetuses at different terms of gestation with the retardation of intrauterine growth and without it. The results of 224 researches of placentas of ante- and intranatal died fetuses from 1999 to 2010 according to the materials of Vitebsk regional clinical pathoanatomical department, were analyzed.
This research resulted in regression mathematical formula for determination of placental gestation age taking into account the presence or absence of retardation of fetal intrauterine growth.
Keywords: placenta, gestational age, morphometric indices, regression equation.

Obstetrics and gynecology

Lysenko O.V., Rozhdestvenskaya T.A.
Measurement of endometrial volume in the diagnosis of endometrial hyperplasia in women of reproductive age

Abstract. 3D ultrasound examination allows to visualize cross sections that cannot be seen when only 2D scanning is made. Three-dimensional reconstruction of endometrium is a technique that enables with a higher probability in comparison with two-dimensional echography the diagnosing of endometrial hyperplasia. Data of the investigation of 90 women (42 with endometrial hyperplasia and 48 women of the control group) are shown in this article. The ultrasound examination was carried out using the modern equipment of expert class. Three-dimensional reconstruction of uterus and endometrium by means of the Virtual Organ Computeraided AnaLysis was produced in both groups. The volume of uterus and endometrium was calculated.
Keywords: endometrium, hyperplasia, ultrasound investigation. volume, 3D-reconstruction.

Rozhdestvenskaya T.A., Silyava V.L., Lukyanova E.A.
The comparative analysis of extragenital morbidity based on the materials of hospitals of Vitebsk region and Minsk

Abstract. The comparative retrospective analysis of the proportion and basic structure of extragenital pathology in pregnant women based on the materials of hospitals of the town of Vitebsk and Vitebsk region during the period from 2007 to 2012 and the 6th Clinical Hospital of Minsk was made. It has been established that in 73% of cases pregnancy in women was accompanied by extragenital pathology. The cardiovascular diseases and hypertensive conditions haven’t any trend towards reduction over the last years. The most promising way to solve this problem is qualifed and timely treatment and prevention of extragenital pathology in women of reproductive age.
Keywords: pregnancy, extragenital pathology, cardiovascular diseases.

Fomina M.P.
The peculiarities of volumetric placental blood flow in abnormal umbilical cord insertion

Abstract. The purpose of this study was to determine the features of volumetric placental blood flow in abnormal umbilical cord insertion (marginal, velamentous) using 3D power Doppler ultrasound. 3D power Doppler ultrasound of placental blood flow with the determination of its parameters (vascularization index, blood flow index, flow vascularization index) was performed in 95 pregnant women with marginal umbilical cord insertion, in 14 patients with velamentous umbilical cord insertion and in 144 cases with the central and paracentral umbilical cord insertion in single pregnancies at 18-22 and 28-34 weeks. The results of the research have shown that the abnormal umbilical cord insertion at 18-22 weeks of pregnancy is characterized by reduced placental vasculature, vertical placental heteromorphism disturbances. The diagnosis of marginal umbilical cord insertion in the second trimester of pregnancy promotes effective therapy of abnormal uteroplacental blood flow, whereas the detection of velamentous umbilical cord insertion predetermines ineffective drug therapy of abnormal uteroplacental blood flow in such patients.
Keywords: placental blood flow, 3D Power Doppler ultrasound, abnormal umbilical cord insertion.


Marochkov A.V.
The development of cognitive disorders in patients after abdominal surgical interventions with multicomponent endotracheal anesthesia

Abstract. The aim of this study was to determine the incidence and predictability of postoperative cognitive disorders (POCD) after multicomponent balanced endotracheal anesthesia.
A prospective, randomized study, which included 60 women at the age of 40 - 80 years, who underwent laparoscopic cholecystectomy under general multicomponent endotracheal anesthesia with propofol, fentanyl and sevoflurane was conducted. One day before and 20-24 hours after the anesthesia, these patients were subjected to a neuropsychological test (we used the Mini Mental State Examination (MMSE)). On the basis of the MMSE results, the patients were divided into two groups: group 1 – patients without POCD (no reduction in MMSE score, or 1 point reduction compared with preanesthetic MMSE score) and group 2 – patients with POCD (more than 1 point reduction).
POCD were observed in six patients (15%). Patients in group 2 were older (66,2±11,4 years compared with 54,1±12,5 years in group 1 (p<0,05)). Only age and preanesthetic MMSE scores (28,4±1,5 in group 1 and 25,5±1,3 in group 2 (p = 0,05)) were reliably different between patients with or without POCD. The logistic regression analysis revealed as a predictor of POCD development only preanesthetic score on MMSE scale.
Thus the incidence of POCD in women older than 40 years after general anesthesia in abdominal surgery made up 15%. Only preanesthetic MMSE score is a significant independent predictor of POCD development.
Keywords: cognitive disorders, anesthesia, MMSE scale.


Asiryan E.G.
The use of enzyme-linked immunosorbent analysis to study the dynamics of antibodies in the treatment of atopic dermatitis in children

Abstract. The aim of our study was to determine the features for the detection of antibodies of E, G class to food allergens (cow’s milk, hen’s egg-white, cod, tangerine) in blood serum in atopic dermatitis in children as well as their dynamics after the provided treatment. During our research we examined 68 children with atopic dermatitis. Antibodies to food allergens in blood serum were determined by ELISA before and after treatment. As a result of the done work we identified the features of antibodies classification in children with atopic dermatitis and also studied the variation of E, G antibodies in the treatment process.
Keywords: atopic dermatitis, antibodies, food allergens, enzyme-linked immunosorbent analysis.

Belyaeva L.E., Pendo L.V., Ligetskaya I.V., Smirnova O.I.
The analysis of health status of fourteen-eighteen-year-old children, who have received different Apgar scores at the fifth minute after birth

Abstract. Retrospective clinical «case-control» study of 200 patient’s cards of children at the age of 14-18 years, who received different Apgar scores at the fifth minute after birth has been performed. It has been determined that the occurrence rate of different forms of the nervous and cardiovascular systems pathology in children at the age of 14-18 years who received 7 and less Apgar scores at the fifth minute after birth is higher than that in the group of children who received the high Apgar score. The obtained results agree with the data of other researchers  and testify to long-term effects of prenatal programing of human pathology.
Keywords: Apgar score, hypoxia, long-term effects.

Matsuk O.N.
Treatment of atopic dermatitis in children by means of immunotherapy

Abstract. Atopic dermatitis (AD) is one of the wide-spread allergic diseases in children. This pathology is characterized and determined by changes in the immune system against the background of genetic predisposition to allergic and pseudoallergic reactions. Many studies are devoted to atopic dermatitis. Etiology and pathogenesis of this disease, its clinical picture are investigated, diagnostic criteria are developed. In this article the schemes of treatment for atopic dermatitis, depending on the immune status and concomitant pathology are proposed.
Keywords: atopic dermataitis, kids, immunotherapy.

Strupovets I.N., Shishko G.A.
Optimization of organizational approaches to rendering medical aid to premature infants with hyperbilirubinemia at the ambulant-polyclinic stage

Abstract. Catamnesis of premature infants with hyperbilirubinemia was studied. The frequency of the most wide-spread pathological conditions in infants, depending on the level of bilirubin on Cockington scale over the neonatal period was analyzed.
Keywords: catamnesis of infants, neonatal period.


Gayduk A.V., Bizunok N.A.
Pharmacodynamic potential of amitryptyline and venlafaxine combination (experimental study)

Abstract. Effective treatment of patients with depression remains an urgent need in psychiatry and one of the most promising strategies for increasing therapeutic efficacy is the use of synergic antidepressants combination. The purpose of the present study was to estimate pharmacodynamic potential of TCA amitryptyline and SNRI venlafaxine combination in the conditions of non-avoided aversive impact.
In tail suspension test (TST) carried out on male C57Bl/6 mice and in forced swimming test (FST) carried out on male Wistar rats we determined dose-dependent synergic effect of amitryptyline and venlafaxine combination on animals’ behavior dependent on monoaminergic neurotransmission.
Combination of amitryptyline with venlafaxine is needed for subsequent studies with the purpose of future using as a new combined antidepressant drug.
Keywords: antidepressant, combination, amitryptyline, venlafaxine.

Pravada N.S., Budritsky A.M., Seregina V.A.
The evaluation of clinical efficacy and unfavourable adverse reactions of Cycloferon medicinal preparation tablets in patients with pulmonary tuberculosis

Abstract. In this article we have analyzed clinical efficacy and adverse effects of Cycloferon medicinal preparation tablets taken by patients with severe disseminated forms of pulmonary tuberculosis with bacterial discharge. As a result of the conducted studies we have revealed that Cycloferon administration allows to achieve the disappearance of intoxication signs, pulmonary symptoms and auscultation manifestations within a shorter time. The positive dynamics of peripheral blood indices (white blood cells count, lymphocytes count, the quantity of segmented leucocytes and ESR) was also observed. In patients taking Cycloferon we revealed the decrease of pulmonary infiltrative changes and the closure of destruction cavities in a shorter space of time. The adverse reactions on Cycloferon tablets use occurred extremely rarely (0,3% of cases). The data received give us the grounds for Cycloferon tablets use in complex therapy of patients with pulmonary tuberculosis.
Keywords: Cycloferon, tuberculosis, antituberculous drugs, efficacy.


Kabanova A.A.
Free radical oxidation in pyo-inflammatory processes of maxillofacial area

Abstract. The purpose of the research was to study the processes of free radical oxidation in the blood serum of patients with odontogenic phlegmons of maxillofacial area. 22 patients with acute odontogenic osteomyelitis of the mandible complicated by the phlegmon of the adjacent cellular spaces, and 11 healthy persons were examined. The increase of the levels of diene conjugates and malondialdehyde in blood serum was revealed in patients with odontogenic inflammatory process of maxillofacial area. The activity of free radical oxydation of blood serum increases, and antioxidant defense decreases when pyo-inflammatory process of maxillofacial area develops.
Keywords: free radical oxidation, inflammation, maxillofacial area.


Nikolayeva A.G., Kolbasova E.A., Solkin A.A., Soboleva L.V., Zaytsev O.N.
Life quality of the patients after the course of periodic hypobaric adaptation

Abstract. Life quality parameters of the patients have an independent prognostic value and are more accurate predictors of survival and condition of the patients during treatment, than somatic status. Hypobaric adaptation, based on realization of the potential of the body, improves life quality of the patients. The method of periodic hypobaric hypoxia can be widely used in dermatology, neurology, gynecology as an effective and relatively safe method of rehabilitation.
Keywords: hypobaric adaptation, life quality.

Pedagogics and psychology of higher school

Gorodetskaya I.V., Konevalova N.Y.
Innovatory pedagogics laboratory of VSMU

Abstract. Service experience of innovatory pedagogics laboratory of VSMU was generalized. This laboratory was founded with the purpose of improving the quality of education and training of specialists, capable to bridge a gap between the knowledge of disciplines of natural sciences cycle, biomedical researches and clinical practice, this serving as the most important criterion of the degree of innovation of those technologies which are employed in the educational process at a higher medical school.
Keywords: innovatory pedagogics, medical education.

Usovich A.K.
Standardization of criteria and credit rating systems for evaluation of students’ competencies in the discipline «human anatomy»

Abstract. Unified criteria for the students of different faculties used to evaluate junior students’ competencies while studying human anatomy are shown in this research. The components of educational and creative rating worked out at the Chair of Human Anatomy are directed at obtaining clinically oriented competencies beginning with the 1st semester of training. The principle of obtaining rating estimation for each kind of educational and creative activity of a student is based on multiplication of the mark received for a certain work by a corresponding factor. It was suggested to minimize the rating for attending practical classes by junior students, on the other hand maximum grades are given for their active work with preparations at the lessons.
Keywords: criteria for evaluation of competencies, credit-rating system, human anatomy.


Leonid Ivanovich Bogdanovich (to the 90-th anniversary of birth)


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