Vol 22, No 5 (2016)
- Year: 2016
- Articles: 10
- URL: https://journal-vniispk.ru/0869-2106/issue/view/2249
Articles
One step forward, two steps back
Abstract
The article presents the history of Russian system of maternity and children care, including pediatric education organized for the first time in the world. the particular considerations concerning post-graduate training are exposed.
Medical Journal of the Russian Federation. 2016;22(5):228-231
228-231
The etiology of agents of infectious complications after transplantation of liver and kidneys and their resistance to antibiotics
Abstract
The study was carried out to investigate etiology and rate of prevalence of nosocomial strains of microbes in biosubstrates of patients in case of development of infectious complications and level of their resistance to various groups of antibiotics. The retrospective analysis of agents of post-operational infectious complications and their sensitivity to antibiotics in 99 patients after operations of transplantation of liver and kidneys in 2013. The patients were allocated on three groups: group I - patients of department of reanimation and intensive therapy after mentioned operations (17 individuals); group II (42 individuals) - after orthotopic transplantation of liver (19 patients) and orthotopic transplantation of kidneys (23 patients); group III (57 patients) - after kindred transplantation of hepatic lobe from living relative donor. The retrospective analysis of agents of post-operational infectious complications in patients underwent transplantation of liver and kidneys demonstrated that out of 1285 identified strains of microbes, 60.8% were presented by Gram-positive microflora with predominance of coagulase-negative staphylococci and enterococci. Among Gram-negative microflora, enterobacteria comprised the largest percentage (61%). The analysis of antibioticgrams of agents of infectious complications established low level of sensitivity of strains of both Gram-positive and Gram-negative microbes isolated from patients of department of reanimation and intensive therapy and to carbapenems and average level of sensitivity to Tigacil. In overall, poly-resistance of strains was established. The differences in antibiotics resistance for strains of pathogens isolated in department of reanimation and intensive therapy and specialized departments were established. The received data can be used for correction of application of antibiotics in prevention and therapy of post-operational infectious complications.
Medical Journal of the Russian Federation. 2016;22(5):232-237
232-237
The characteristics of magnesium homeostasis and remodeling of heart in patients with ischemia of myocardium against the background of non-differentiated dysplasia of connective tissue
Abstract
The study was carried out to evaluate dynamics of level of magnesium of blood serum and structural functional parameters of heart in patients with acute myocardium infarction developed against the background of non-differentiated dysplasia of connective tissue. The study included 90 patients with myocardium infarction with Q wave and with and without nondifferentiated dysplasia of connective tissue. The control group consisted of healthy persons and comparison group included patients with non-differentiated dysplasia of connective tissue without cardiovascular pathology. The clinical and phenotype examination including echocardiography testing of heart, detection of level of magnesium in blood serum in dynamics of myocardium infarction course were implemented. In patients with myocardium infarction, independently of occurrence of non-differentiated dysplasia of connective tissue during the first day of study decreasing of level of magnesium in blood serum was observed. In the group of patients with myocardium infarction, and non-differentiated dysplasia of connective tissue, up to twenty-eighth day, reliable decreasing of magnesium occurred as compared with control group and comparison group. In group of patients with myocardium infarction and non-differentiated dysplasia of connective tissue expressed increase of size of cavity of left ventricle was established including decreasing of its pumping function in combination with tendency to less expressed increasing of index of myocardium mass of left ventricle as compared with patients with myocardium infarction and without non-differentiated dysplasia of connective tissue. In patients with myocardium infarction occurring against the background of non-differentiated dysplasia of connective tissue hypomagnesemia is associated with development of desadaptive alternative of post-infarction remodeling of heart characterized by prevalence of processes of dilatation of cavity of left ventricle with decreasing of contractive capacity over processes of hypertrophy of myocardium.
Medical Journal of the Russian Federation. 2016;22(5):238-242
238-242
The empiric antibacterial therapy of postpartum endometritis
Abstract
The purpose of study. To ameliorate results of treatment of postpartum endometritis if puerperals labored in Moscow as a result of prescription of effective empiric antibacterial therapy Material and methods. The sampling of 50 puerperals with endometritis as complication during postpartum period was examined. In all female patients, the inoculation of secretion of uterine cavity was taken and successive determination of sensitivity to antibacterial pharmaceuticals was applied using agar diffusion method. The results. In all inoculations in diagnostic significant titers (≥105 CFU/ml), in overwhelming majority of cases the associations of microorganisms were secured where leading positions occupied by Enterococcus faecalis and faecium, Escherichia coli and Staphylococcus aureus. Conclusion. The Amoxicillin/Clavulanic acid is pharmaceutical of choice in treatment of postpartum endometritis of average degree of severity. The combination of Levofloxacin and Metronidazole is an alternative scheme of treatment of postpartum endometritis of average degree of severity. Under severe endometritis with syndrome of systemic inflammatory reaction carbapenems are pharmaceuticals of choice.
Medical Journal of the Russian Federation. 2016;22(5):242-246
242-246
The microbiological monitoring as a most important component of system of epidemiological control of nosocomial infections
Abstract
The etiologic structure and level of resistance of etiologically significant agents isolated from patients of multi-field hospitals of Kursk during 2012-2015 were analyzed with purpose of epidemiological control of nosocomial infections. The bacterial associations are prevailing in the structure of clinical flora (61.8%) that has no matching with publications data. The fungi of species Candida spp. are the dominating associate. In the association with fungi dominate Gram-negative microorganisms (P.aeruginosa and E.coli - 21,1%) and Staphylococcus spp. (18,4%) as a Gram-positive microorganism. The common tendencies of increasing of antibiotic resistance to common pharmaceuticals are established that results in development of hospital strains. Conclusion. The microbiological monitoring is the sole reference point of choosing appropriate therapy off nosocomial infections, preventing development of hospital strains and adjusting scheme of anti-epidemic activities.
Medical Journal of the Russian Federation. 2016;22(5):247-249
247-249
The hyperprolactinemia
Abstract
The hyperprolactinemia is one of the most frequent symptoms of pathology of hypophysis. This pathology is accompanied with by prolactinomas (60%), sterility (40%) galactorrhea, metabolic disorders (65%). The article deals with modern techniques of diagnostic, clinic and treatment of hyperprolactinemia in women. The particular attention is paid to tactics of treatment with prolactin and also pregnancy.
Medical Journal of the Russian Federation. 2016;22(5):250-259
250-259
The differential diagnostic of anemia unrelated to iron metabolism
Abstract
The anemia continue to be actual problem of health care all over the world, occurring in almost half of population of terrestrial globe. The anemias are very various by their etiology, pathogenesis and clinical hematological manifestations. They are differentiated by leading pathogenic mechanism of development with purpose of choosing schemes of diagnostic and treatment. However, morphological classification and classification by color index are considered for facilitating diagnostic and differentiated diagnosis. The modern diagnosis and differentiated diagnostic of anemia bounded and unbounded with iron metabolism. The differentiated diagnosis of anemia is based on analysis of clinical, laboratory and instrumental data. In case of anemia, the blood analysis is to account indices of Hb, size of erythrocytes, their Hb saturation, average volume of erythrocytes and average content of hemoglobin in erythrocytes, color index, number of reticulocytes, etc., permitting judging about character and activity of erythropoiesis. The article presents algorithm of examination in case of occurrence of normocytic anemia, anemia in case of deficiency of diet, anemia in case of chronic renal insufficiency, hemolytic anemia; diagnostic criteria of autoimmune hemolytic anemia, inherent hemolytic microspherocytic anemia, deficiency of pyruvate kinase, paroxysmal night hemoglobinuria, deficiency of glucose-6-phosphatedehydrogenase, anemia due to primary disorders of bone marrow, aplastic anemia, hyperchrome and macrocytic anemia, deficiency of vitamin B12 (pernicious anemia) and also folic acid.
Medical Journal of the Russian Federation. 2016;22(5):259-266
259-266
The neurological disorders under schizophrenia: clinical characteristics and pathogenic aspects
Abstract
The review considers neurological disorders diagnosed in patients with schizophrenia. It is emphasized that these disorders can occur in patients without treatment with neuroleptics. The light neurological disorders are quite often given no proper consideration. The development of these disorders is based on phenomenon of uncoupling of frontal lobes with other sections of brain, both cortical and sub cortical ones. The description of disorders of motor functions is presented. At that, particular attention is paid to parkinsonism, dyskinesia, oculomotor disorders. The pathogenic aspects of neurological disorders in patients with schizophrenia are considered. The results of study applied to this category of patients using technique of structural and functional neurovisualization are presented. It is emphasized that further investigation of this problem will permit bettering comprehend pathogenesis of this disease with the purpose of development of more effective therapy.
Medical Journal of the Russian Federation. 2016;22(5):267-271
267-271
The family hypercholesterolemia
Abstract
The family hypercholesterolemia is among causes of premature development of cardiovascular diseases in patients of young age. At this disease, high level of cholesterol of lipoproteins of low density are registered and family anamnesis is traced. However, nowadays there is no unified international criterion for diagnostic of hypercholesterolemia. The issue of diagnostic and treatment of hypercholesterolemia continues to be actual. With every year, new and yet new gene mutations resulting in hypercholesterolemia are discovered. The actual article presents review of publications presenting modern view on this problem.
Medical Journal of the Russian Federation. 2016;22(5):272-276
272-276
The sphincter-preserving resection of rectum with distal sacrumectomy
Abstract
The described observation is demonstration of sphincter-preserving resection of rectum with distal sacrumectomy under locally widespread cancer of rectum with isolated involvement of distal portion of sacrum and absence of data proving affection of sphincter.
Medical Journal of the Russian Federation. 2016;22(5):277-280
277-280