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"vestnik vsmu" 2012  vol. 11 №3

Review

Litvyakov M.А., Litvyakov A.M., Shmakov A.P.
Clinicopathogenetic peculiarities of the development of vascular bed atherosclerotic lesions in adults and children in infectious diseases at the therapeutic and surgical clinics

Abstract. This paper reviews current information on the impact of inflammation in acute and chronic bacterial and viral infections on the structural and functional changes of blood vessels and the formation of proatheromatous status in children and adults at the therapeutic and surgical clinics. We discuss the current understanding of the etiology, pathogenesis and diagnosis of atherogenic processes complications initiated by an infectious factor. The bibliographic reference-book includes 106 sources issued mainly during the last 15 years.

Belyaeva L.E.
Can regular consumption of «functional food» slow down atherogenesis rate?

Abstract. In this review the influence of the most important «functional food» components (amino acid L-arginine, polyphenols, I-3 polyunsaturated fatty acids, dietary fibers, probiotics and phytosterols) on the basic pathogenetic mechanisms of atherosclerosis development: vascular endothelial dysfunction, systemic inflammation and inflammation in the vascular wall, disorders of lipid metabolism and blood vessels remodelling processes is discussed.

Physiology

Gorodetskaya I.V.
The role of iodine-containing thyroid hormones in the formation of organism`s response reaction under the influence of chronic stress

Abstract. The long crowded keeping of rats (18 animals in cages sized 20Ч30Ч40 cm within 3 months) causes, on the one hand, adaptive changes (increase in relative weight of adrenal glands, concentration increase of glucose, total protein, lipids in blood), tension of adaptive mechanisms (increase of the corticosteroid / insulin ratio, caused by increase in the concentration of corticosteroids and decrease of insulin concentration in blood), and on the other hand, changes having the character of a damage (ulceration of gastric mucosa, decrease in relative weight of the spleen and the thymus, physical endurance of rats, their death). Hypothyroidism (intragastric introduction of 1,2 mg/100 g of mercazolil per body weight within 14 days, then in half dose) decreases, whereas near-physiological thyroxin doses (3-5 mkg/kg per body weight within 28 days, then in half dose) enhance the organism`s resistance to chronic stress influence. Mechanisms of protective action of iodine-containing thyroid hormones under chronic stress are discussed.

Kolbasova E.A.
Тhe role of vasomotor and NO - producing endothelial function in the development of climacteric disturbances in postmenopausal women

Abstract. We have investigated the endothelial function in 23 women of late reproductive and premenopausal age (the control group), 54 women with surgical menopause (I group), 48 women with natural menopause (II group). Postmenopausal women, unlike women of late reproductive and premenopausal age were found to have decreased functional activity of endothelial system of nitrogen monoxide synthesis, manifesting itself in the reduction of the concentration of stable products of nitrogen monoxide by 25%, in the disturbance of vasoregulating vascular endothelial function in the form of inadequate (60,3%) or paradoxical (9,7%) reaction of brachial artery to shift tension.

Gusakova E.A., Gorodetskaya I.V.
The effect of iodine-containing thyroid hormones on the system of proteolysis

Abstract. The analysis of literature data was made to determine the effect of iodine-containing thyroid hormones on the status of the system of proteolysis. The change in the level of iodine-containing thyroid hormones in the body was found to cause lysosomal dysfunction. The possible mechanisms of this effect were also determined – the impact on:
1) lipid peroxidation processes; 2) the structure and function of the liver; 3) choline- and adrenoreactive structures. The determination of this effect of iodine-containing thyroid hormones reveals a new aspect of their anti-stress action.

Internal medicine

Volkova M.V.
Undifferentiated arthritis: the possibilities to prognosticate the outcomes on the basis of the evaluation of serum deoxyribonuclease and hyaluronidase activity

Abstract. The study of serum DNase and hyaluronidase activity in patients with undifferentiated arthritis was performed. We conducted the prospective study within 12 months with the assessment of undifferentiated arthritis outcomes. On the basis of the outcomes all patients of the studied group were stratified into 4 subgroups: patients who had developed rheumatoid arthritis, patients who had developed some other disease (not rheumatoid arthritis), patients who had the diagnosis of undifferentiated arthritis and the recovered persons.
We used the binary logistic regression method to elaborate prognostic models, including the studied values of serum activity. The quality of the developed model is «excellent» according to the expert’s scale.
Elevated serum DNase and hyaluronidase activity in patients with undifferentiated arthritis is a likely predictor of chronic inflammation development in the joints and its transformation into rheumatoid arthritis.

Kunder E.V.
Osteoporosis in ankylosing spondylitis: does the problem exist?

Abstract. This article presents literature review of the current state of the problem of osteoporosis in ankylosing spondylitis. We elucidate the data concerning the epidemiology of osteopenia, osteoporosis and osteoporotic vertebral fractures in patients with ankylosing spondylitis. We also describe the main questions of the bone remodelling pathogenesis and pathomorphology of osteoporotic processes in this disease. We specify osteoporosis risk factors in patients with ankylosing spondylitis and emphasize the role of the inflammatory process. The recommendations with respect to the selection of method for bone tissue mineral density assessment in ankylosing spondylitis are made. The dynamics of bone tissue mineral density depending on the provided treatment is also described.

Palguyeva А.Y, Podolinskaya N.A.
The condition of arteries in patients with rheumatoid arthritis

Abstract. 75 patients with rheumatoid arthritis (RA) and 29 healthy subjects without clinical manifestations of atherosclerosis or risk factors of its development were studied. All patients underwent ultrasonic investigation of the arterial vessels with the 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 patients` age, duration of the disease, Ritchie index, C-reactive protein level, proatherogenic changes in serum lipid profile.

Surgery

Fedyanin S.D., Okulich V.K., Konopelko E.A., Kovalenko A.A., Krishtopov L.E., Sachek M.G., Sokolovsky V.O.
The comparative analysis of the etiological structure and sensitivity to antibiotics of the main causative agents of surgical infections at the in-patient departments of the town of Vitebsk

Abstract. Over a period of time from 2010 till 2012 we examined 258 patients with surgical infections treated at the Vitebsk Regional Clinical Hospital and 49 patients from the Vitebsk Central Town Hospital in the bacteriological laboratory. Strains of microorganisms were identified with the help of commercial biochemical test-systems ATB Expression of the firm «bioMerieux» (France) and with the use of the original test-system «ID-ENTER» for the identification of enterobacteria. Sensitivity to antibiotics was determined with the help of the above-mentioned test-system ATB Expression and by means of our own original test-systems «AB-STAPH», «AB-PSEU», «AB-GRAM(-)» and «AB-ENTER» designed for sensitivity determination of staphylococci, pseudomonads, enterobacteria and gram-negative flora. We found the reliable differences in the etiological structure and strains sensitivity to antibiotics between the investigated hospitals and developed the empiric antibiotic therapy scheme for the treatment of surgical infections at the Vitebsk Central Town Hospital.

Neurology and neurosurgery

Zabrodets G.V., Kulikov A.A., Peresada O.A., Barsukov A.N.
Dysfunction of pelvis organs in women – neurophysiologic aspects

Abstract. Pelvic floor in women is a poorly studied area of the body from biomechanical and neurophysiologic points of view. Literature data analysis emphasizes the importance of conducting the electromyographic examination, which is the best neurophysiologic method to detect pelvic floor muscles pathology in women.

Ear, nose and throat diseases

Semenov S.A., Kunitsky V.S.
Algorithms of diagnosis and treatment of nasal bones fractures

Abstract. Diagnosing of nasal bones fractures is based on the patient`s clinical and instrumental examination data. By means of clinical method the diagnosis becomes possible only in 50% of the admitted patients. Correct diagnosing requires an adequate algorithm of instrumental investigation to timely reveal complications development. The most frequent complication of nasal bones fracture is external nose deformation. Optimum treatment tactics choice helps to avoid unfavourable cosmetic and physiolological consequences of the trauma. Proper anesthesia enables painless surgical intervention. This review contains the epidemiologic data, diagnostic and surgical approaches associated with nasal bone fractures. Diagnostic algorithms, variants of treatment, the choice of anesthesia providing the efficacy of medical care are also discussed.

Dentistry

Kolchanova N.E., Sakharuk N.A., Tikhonovskaya I.V.
The evaluation of the stomatological status and the presence of odontogenic infection foci in patients with dermatological pathology (psoriasis, eczema, sclerodermia)

Abstract. The etiology and pathogenesis of many chronic skin diseases are not fully understood. Chronic odontogenic infection focus can be a source of autosensibilization or a factor depressing non-specific resistance of the organism. Dental health can affect the course of skin diseases. The orthopantomogram is necessary to make the diagnosis of odontogenic infection. This article deals with the results of dental examination of dermatological patients (34 patients with psoriasis, 9 patients with nummular eczema and 11 with morphea). The reliably low levels of oral hygiene (OHI-S index), high values characterizing the periodontal tissue state (GI and CPI indices) and the intensity of caries (DEF index) compared with the control group (p<0,05) were revealed. The low interest of dermatological patients in a special dental examination (orthopantomogram) was also noticed, that significantly reduces the quality of dental check-up.

Pharmacy

Bychkovskaya T.V., Khishova O.M.
The study of rheological properties of 2,5% calcium gluconate gel

Abstract. The article is devoted to the study of rheological properties of 2,5% calcium gluconate gel based on complex emulsion. When choosing a rational technology of production and optimization of soft medicinal agent 2,5% calcium gluconate gel, used to eliminate the impact of hydrofluoric acid, it is important to study its rheological properties. The conducted researches enabled us to determine viscosity, deformation kinetics of the studied gel and characterize it as a structured disperse system. The presence of the revealed rheological properties of 2,5% calcium gluconate gel insures its good spreading capacity and readiness to be squeezed out of tubes.

Yaremchuk А.А., Khishova O.M., Polovko N.P.
The study of anti-inflammatory and reparative activity of Combisept ointment

Abstract. The article presents the results of the study of the pharmacological activity of the combined action ointment on polyethylene oxide basis, containing benzalkonium chloride, dexpanthenol and levomycetine (chloramphenicol) as active constituents.
Using carrageenan inflammation and thermal burns models it has been found that the studied ointment has expressed anti-inflammatory activity. On linear incised wound model it has also been determined that this ointment possesses reparative activity.
On the basis of the received data it has been concluded that further preclinical and clinical trials are necessary for the registration of COMBISEPT ointment in the Ministry of Health of the Republic of Belarus and its introduction into clinical practice.

Pedagogics and psychology of higher school

Konevalova N.Y., Gorodetskaya I.V., Zagnoyko E.A., Gerasimenko Y.E.
Rating system for assessment of knowledge as the students see it

Abstract. With the purpose of clearing out the attitude of the students to the introduction of rating system for assessment of knowledge and for its improvement an anonymous poll was conducted by the students’ sector of innovatory pedagogics laboratory of VSMU. Students of the medical, pharmaceutical and stomatological faculties took part in it. The overwhelming majority of the students consider the use of «lowering» coefficient to be inexpedient. The major part of the students supported the idea of recalculation of their rating after retaking of an examination. The students were not unanimous with respect to the question whether only 50% of the best marks should be considered on rating calculation: more than a half of the medical and pharmaceutical students consider it to be rational, but the majority of the stomatological students have an opposite opinion. The majority of the students of the medical and pharmaceutical faculties and practically all the students of the stomatological faculty consider expedient to increase their rating at the expense of extracurricular activities. Thus, the great bulk of the students are interested in the introduction of rating system to assess their knowledge. At the same time, the results of the poll have shown that further work aimed at its improvement is necessary.

Kirpichenok L.N., Skreblo E.I., Golovko E.S., Tikhon T.V.
Subject contest on clinical laboratory diagnostics as a means of forming students` professionally motivated thinking

Abstract. The experience of holding subject contest on clinical laboratory diagnostics has shown high efficiency of using this form of extracurricular training for creative element stimulation in learning and cognitive activity, development of creative thinking, formation of professional and scientific competences of a higher medical school graduate. Contest results revealed the problem of the mismatch between the level of personal and professional development of some students with high rating and the level of practice requirements from them – effectively integrate their theoretical knowledge into the solution of practical problems. Comparative analysis of module ratings with contest results in modules and semi – final rating with a total contest mark has shown that the objectiveness of the module-rating system of knowledge assessment can be improved by taking into account the results of subject contest in the final rating.

History of VSMU

Vasilenko N.I., Nebylitsin Y.S., Vasilenko S.G.
Scientific session of VSMI held in 1941

Abstract. This article provides information about scientific session of Vitebsk State Medical Institute, held in June 14-16, 1941, at which the results of scientific researches of the staff members of Vitebsk Medical Institute and those of other scientists were presented. It also describes the life of the participants of the scientific session held in 1941, their scientific activity, scientific schools founded by them. The participants of the scientific session of 1941 courageously defended their motherland, saving the wounded soldiers of the Red Army. Many of them became famous scientists, honoured doctors, honoured men of science.

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