Vol 68, No 10 (2013)

EDITORIAL
CONCEPTUAL BASES OF BIOLOGICAL SAFETY. PART 1
Onishchenko G.G., Smolenskii V.Y., Ezhlova E.B., Demina Y.V., Toporkov V.P., Toporkov A.V., Lyapin M.N., Kutyrev V.V.

Abstract

Up to date there is a narrow and broad interpretation of the term biological safety (BS) the world over. In the narrow sense it is defined as availability of international regulations applied to diagnostic, manufacturing, or experimental works with pathogenic biological agents (PBA) in accordance with specified levels of biological hazard and BS. In a broader context it has no national, conceptual, terminological or defying basis. Therewith, establishment of this framework has become the core issue of the study. Investigations have revealed that BS should conceptually cover the whole sphere of sanitary-and-epidemiological welfare as well as related fields such as veterinary-sanitary, phytosanitary provision, ecological safety, environmental conditions (occupational, socio-economic and geopolitical infrastructures, ecological system), and be exercised to prevent and control emergency situations (ES) of biological character. It is demonstrated that this type of ES differs from ES in the sphere of public health care of international concern which is formalized in IHR (2005), in the way that it is characterized by high socio-economic and geopolitical significance of the negative influence on human vital activities, comparable with national and international security hazard. Elaborated is the conceptual, terminological and defying toolkit of the BS broad interpretation (27 terms).

 

Annals of the Russian academy of medical sciences. 2013;68(10):4-13
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NEUROLOGY AND NEUROSURGERY: CURRENT ISSUES
PHYSICAL REHABILITATION IN MULTIPLE SCLEROSIS: GENERAL PRINCIPLES AND HIGH-TECH APPROACHES
Peresedova A.V., Chernikova L.A., Zavalishin I.A.

Abstract

In a chronic and disabling disease like multiple sclerosis, rehabilitation programs are of major importance for the preservation of physical, physiological, social and professional functioning and improvement of quality of life. Currently, it is generally assumed that physical activity is an important component of non-pharmacological rehabilitation in multiple sclerosis. Properly organized exercise is a safe and efficient way to induce improvements in a number of physiological functions. A multidisciplinary rehabilitative approach should be recommended. The main recommendations for the use of exercise for patients with multiple sclerosis have been listed. An important aspect of the modern physical rehabilitation in multiple sclerosis is the usage of high-tech methods. The published results of robot-assisted training to improve the hand function and walking impairment have been represented. An important trend in the rehabilitation of patients with multiple sclerosis is the reduction of postural disorders through training balance coordination. The role of transcranial magnetic stimulation in spasticity reducing is being investigated. The use of telemedicine capabilities is quite promising. Due to the fact that the decline in physical activity can lead to the deterioration of many aspects of physiological functions and, ultimately, to mobility decrease, further research of the role of physical rehabilitation as an important therapeutic approach in preventing the progression of disability in multiple sclerosis is required.

 

Annals of the Russian academy of medical sciences. 2013;68(10):14-21
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PEDIATRICS: CURRENT ISSUES
CHARACTERISTICS OF THE СOURSE OF MAXILLARY SINUSITIS IN CHILDREN WITH VERIFIED CHLAMYDIA INFECTION
Kapustina T.A., Belova E.V.

Abstract

Aim. To explore the detection rate of chlamydia infection and immunological features of children with acute maxillary sinusitis. Patients and methods. Сlinical epidemiologic characteristics of the course of acute maxillary sinusitis were studied in the way of medical examination provided for 58 children in the ages from 3 to 15 years, patients of ENT department. In order to identify Chlamydia structures and specific antibodies we used direct (polymerase-chain reaction, direct immune fluorescence) and indirect (immune enzyme analysis) methods. The research for cellular link of immunity was carried out by indirect immune fluorescence technique, using monoclonal antibodies. Results. The authors report on high level of Chlamydia infection in epithelium of nasal mucosa, and also type structure of verified Chlamydia, clinical signs and peculiarities of immune response in children with acute maxillary sinusitis associated with this infection. Conclusions: Chlamydia was detected in 48 % of children with acute maxillary sinusitis infection with prevalence of Chlamydophila pneumoniae. Optimal for detection of chlamydia infection is a disease duration not exceeding 2 weeks. The special features of clinical and immunological manifestations in children with acute sinusitis, paired with Chlamydia infection are the more frequent complaints of pain in the affected sinuses, expressed symptoms of intoxication, and the presence of an imbalance in cellular immunity , manifested a relative lymphopenia and activation of T-lymphocytes CD8+.

 

Annals of the Russian academy of medical sciences. 2013;68(10):22-25
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NITRIC OXIDE, ITS METABOLITES, AND GLUTATHIONE SYSTEM IN CHILDREN WITH CHRONIC VIRAL HEPATITIS В AND С
Korkotashvili L.V., Romanova S.V., Kolesov S.A.

Abstract

Aim. To detect changes in the concentration of nitric oxide and its metabolites – nitrites and nitrates in conjunction with the  indices of the glutathione system in  the children with chronic hepatitis В and С.    Patients and methods. In the research took a part 76 patients (boys or girls) with chronic hepatitis В and С aged  from 7 up to 16 years. Nitric oxide and its metabolites  determined by method of V.A. Metel’skaya and N.G. Gumanova; level of  reduced glutathione – the titrimetric analysis; activity of glutathione transferase – the method of spectrophotometry.  Results. The content of nitric oxide and its metabolites– nitrites and nitrates – in serum and urine of children with chronic viral hepatitis В and С have increased. Correlations were revealed between nitric oxide and its metabolites  in serum and urine, as well as between these indices and glutathione system parameters – reduced glutathione concentration and activity of enzymes of glutathione transferase of erythrocytes and plasma. Conclusions. In the children with chronic viral hepatitis В and С the increase of the concentration of  nitric oxide and its metabolites in serum and urine is accompanied by decrease of reduced glutathione concentration and increase of glutathione transferase activity in erythrocytes and plasma. These findings suggest the presence of oxidative stress due to which the therapy should be strengthened by antioxidant effect.

Annals of the Russian academy of medical sciences. 2013;68(10):26-30
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FORWARD-MORPHOLOGICAL CRITERIA OF ULCERATIVE COLITIS RELAPSE AND CONTINUOUS FLOW IN CHILDREN
Fedulova E.N., Zhukova E.A., Kuznetsova T.A., Shumilova O.V., Fedorova O.V., Tutina O.A.

Abstract

Inflammatory bowel disease is one of the most difficult groups of pathologies in pediatric gastroenterology, due to the steady growth of their prevalence, offset debut at an earlier age, the increase in the incidence of severe complicated forms. Established clinical, genetic, serologic criteria for progression of ulcerative colitis are contradictory, and some - the reach of most medical institutions. Aim: to evaluate the prognostic significance of morphological features of ulcerative colitis relapse and continuous flow. Materials and methods: a retrospective study conducted histological kolonobioptatov 26 children with recurrent, 20 - with a continuous flow of ulcerative colitis during their primary treatment in a hospital, the comparison group consisted of 50 children without inflammatory bowel disease. Results: morphological characteristics identified predictors of recurrent ulcerative colitis in the form of severe eosinophilic infiltration of the epithelium, lamina propria of the mucosa. For a continuous flow was characterized: high density cell infiltration of the lamina propria mucosa epithelium predominantly under represented plasma cells, fibroblasts, sclerosis of the basal membrane, the presence of epithelial arcades deformed crypt abscesses. Conclusion: the extended study of biopsy material, including assessment of the composition and location of infiltration, fibroblast pool of epithelial- connective relationships in the colonic mucosa of children with ulcerative colitis will not only assess the inflammatory process, but also to predict the course of disease, thereby defining a long-term tactics treatment.

 

Annals of the Russian academy of medical sciences. 2013;68(10):32-36
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PHYSIOLOGY: CURRENT ISSUES
CHANGING THE CONTENT OF TESTOSTERONE IN THE BLOOD OF PEOPLE OF DIFFERENT LEVEL OF FITNESS IN TERMS OF POWER LOAD
Chernozub A.A.

Abstract

In the work the results of the research aimed to determine the peculiarities of changes in the content of testosterone in the blood of people of different level of fitness under the influence of acute power load in the process of long trainings athleticism. The surveys were performed with the participation of 20 athletes age of 19-20 years, regularly engaged in athleticism over 3 years, and 20 young men of similar age are not contraindications to study with weights. A change in the level of ability, the morphometric parameters of the organism and the parameters of body composition was evaluated using the techniques of power testing, anthropometry and impedansometriya. Laboratory studies serum testosterone at rest and after the acute power load was carried out during 3 months of practice athleticism. The concentration of testosterone in the blood serum was determined by enzyme immunoassay. During the research it was established that despite the fairly low primary basal level of testosterone (9,89 nmol/l) in blood trained athletes, power load high intensity increase the content of the investigated hormone after a workout in comparison with the state of rest. Such positive dynamics of the level of testosterone in response to an acute power load is observed among non-trained young men. Simultaneously revealed that despite the high level of adaptation of trained athletes to power the load, there is almost identical to the positive dynamics of morphofunctional parameters of members of both groups.

 

Annals of the Russian academy of medical sciences. 2013;68(10):37-40
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SURGERY: CURRENT ISSUES
SURGICAL TREATMENT OF PATIENTS WITH SPINAL DEFORMITIES WITH SHORTENING OF THE LOWER LIMB
Kolesov S.V., Baklanov A.N., Shavyrin I.A.

Abstract

Aim. Determination of the optimal diagnostic and treatment strategy in patients with scoliosis and having an anatomic shortening of the lower limb. Patients and methods. Surgical correction of scoliosis held 8 to patients with lower limb shortening caused by congenital dislocation of the hip (n = 3), anatomic shortening of the lower extremities due to the hip (n = 1), the shin bone (n = 4). Shortening before correction and fixation of scoliosis ranged from 6 to 14 cm, after surgery on the spine has been reduced by 2-4 cm achieved reduction or removal of pelvic obliquity . The second stage, after 8-12 months, performed surgery to address shortening of the lower extremity. Osteotomy of the femur with the imposition of a spoke - rod device held 4 tibial osteotomy with the imposition of external fixation device Spoke - and 4 patients and in the subsequent limb lengthening was performed by compression-distraction osteosynthesis. Results. After the dorsal stabilization and fixation of the spine scoliosis correction averaged 64% (from 76 to 27 °), the value of breast / thoracolumbar kyphosis after surgery failed to bring to the physiological (average 43 °). Misalignment of the pelvis is reduced by 67 % (from 24 to 8 °), which reduced the shortening of the lower limb by an average of 3 cm (compensation relative shortening by reducing or eliminating the distortion of the pelvis). Further compensation shortening held on the second stage of treatment, representing an osteotomy and subsequent elongation of the femur or tibia bones by transosseous compression-distraction osteosynthesis by Ilizarov. Conclusions. Multi-stage treatment reduced the degree of spinal deformity, to normalize the balance of the body, restore the function of distance without the use of orthotic devices and means of support.

 

Annals of the Russian academy of medical sciences. 2013;68(10):41-45
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SHORT MESSAGES
RESULTS AND PROSPECTS OF INTERFERONE INDUCERS USING IN INFECTIOUS DISEASES TREATMENT
Ershov F.I., Shul'dyakov A.A., Romantsov M.G., Lyapina E.P., Soboleva L.A.

Abstract

There is represented  the current classification of interferon inducers of various chemical groups related to antiviral agents, described the mechanisms of synthesis of different types of endogenous interferon in blood serum. The effectiveness of methylglucamine acridonacetates  in integrated treatment of chronic hepatitis C, tuberculosis with  HIV infection background, chronic brucellosis, arboviral diseases, including West Nile fever , as well as influenza and acute respiratory infections are shown.  For successful treatment of acute and chronic diseases with  endogenous interferon inducers should be applied as early as possible, at an average level of viremia , to enhance the effect of drugs with the directed etiotropic action and immunomodulators , which achieves the optimal pharmacotherapeutic effect.


Annals of the Russian academy of medical sciences. 2013;68(10):46-52
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FEATURES OF THE FUNCTIONING OF THE THYROID GLAND IN HIV-INFECTED
Timofeeva E.V., Leshchenko O.Y.

Abstract

In the article the current literature, devoted to the peculiarities of functioning of the thyroid gland in patients with HIV infection, is analyzed. Based on the analysis of literature data bases demonstrated the structure of thyroid function disorders in HIV-infected, as well as the mechanisms of the pathogenesis of these disorders. In the structure of thyroid function is dominated by hypothyroidism, euthyroid pathological syndrome, Graves' disease, for which the opportunistic infections are triggers immune activation.  It should be noted that the step of acquired immunodeficiency syndrome is accompanied by the development of inflammatory and neoplastic processes in the thyroid gland. Convincingly demonstrated the negative impact of highly active antiretroviral therapy in HIV-positive for the development of thyroid dysfunction, in connection which the expediency of forming risk groups and the timely correction of the projected thyroid diseases.

 

Annals of the Russian academy of medical sciences. 2013;68(10):53-56
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ELECTROPHYSIOLOGICAL MARKERS OF MIDDLE CEREBRAL ARTERY BLOOD FLOW VELOCITY IN HEALTHY SUBJECTS
Fokin V.F., Ponomareva N.V., Kuntsevich G.I.

Abstract

Aim: to determine electrophysiological markers of middle cerebral artery blood flow velocity (BFV). Patients and methods: transcranial Doppler registration of middle cerebral artery BFV and direct current  (DC) potentials recording from surface of head were performed in 30 healthy volunteers. Analysis of correlation between the BFV and DC potentials was used. Results: significant correlation between BFV and DC potential characteristics was observed. The highest correlation was found between BFV in middle cerebral artery and the difference of DC potentials between central and temporal areas of head (r =0,55; p =0,003). These areas coincide with the location of middle cerebral artery and the correlation observed may be connected with streaming potential generated by the blood flow in middle cerebral artery. If electrode placement did not coincide with blood current, DC potentials and BFV were not correlated. Conclusions: it is assumed that electrical field created BFV in middle cerebral artery may contribute to the generation of DC potentials registered from the head.

 

Annals of the Russian academy of medical sciences. 2013;68(10):57-60
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