Saratov JOURNAL of Medical and Scientific Research

2019, volume 15

Current state and prospects of antibiotic prophylaxis in patients after burn injury

Year: 2019, volume 15 Issue: №1 Pages: 108-113
Heading: Parmacology Article type: Review
Authors: Barsuk A.L., Lovtsova L.V., Nekaeva E.S., Sorokina Yu.A.
Organization: Privolzhskiy Research Medical University
Summary:

The review is devoted to antibiotic prophylaxis of infectious complications in burns. Severe burn injury often results in death. Infectious complications are the most common cause of mortality in these patients. Systemic antibiotic prophylaxis is actively used in practical medicine, but is not recommended by national and international clinical guidelines for the treatment of patients affected by burns. The principles of such prevention have not been developed yet. The data of studies of systemic antibiotic prophylaxis are inconsistent. A number of studies confirm the rationality of use of systemic antibiotic prophylaxis in persons on artificial ventilation with severe burns. This approach has been reported to reduce mortality and incidences of pneumonia significantly. There are evidences of perioperative antibiotic prophylaxis effectiveness in some surgical procedures associated with burn injury. Studies also demonstrate antibiotic prophylaxis and intestine decontamination combination effectiveness in preventing from complications in burn patients. Besides antibiotic prophylaxis, other pharmacological approaches currently are being developed in order to reduce the incidence of infectious complications in burns. Preclinical studies have shown the effectiveness of statins and topical probiotics in the prevention of burn sepsis in the experiment. The development and implication of early diagnostic methods for infectious complications is one another possible way to prevent severe infections in patients with burn injury.

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Features of angiogenesis in skin tissue regeneration

Year: 2019, volume 15 Issue: №1 Pages: 104-107
Heading: Physiology and Pathophysiology Article type: Review
Authors: Pronina Е.А., Stepanova T.V., Kiriyazi T.S., Maslyakov V.V., Ivanov A.N.
Organization: Saratov Medical University "Reaviz", Saratov State Medical University, Saratov State Technical University n.a. Yu.A. Gagarin
Summary:

Restoration and regeneration of tissues are complex processes involving a large number of signaling mechanisms. In this study possible mechanisms of angiogenesis during tissue regeneration are presented. One of these mechanisms is the creation of a new capillary layer by angiogenesis. Previously it was believed that high and rapid levels of capillary growth are necessary for optimal healing of tissues. But several studies have demonstrated that a period of vascular regression occurs after the growth of blood vessels in a wound, and the number of the newly formed vessels decreases until the number of the blood vessels is equal to the density of the vascular network in the intact tissue. Reduced inflammation and angiogenesis are features of optimal healing.

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Comparative characteristics of microcirculatory changes in white rats during subcutaneous implantation tests of polycaprolactone scaffolds containing vaterite and hydroxyapatite

Year: 2019, volume 15 Issue: №1 Pages: 98-103
Heading: Physiology and Pathophysiology Article type: Original article
Authors: Ivanov A.N., Kurtukova М.О., Chibrikova Yu.A., Kustodov S.V., Tyapkina D.A., Bugaeva I.O., Norkin IA.
Organization: Saratov State Medical University
Summary:

Objective: comparative evaluation of skin microcirculatory functional changes over the implantation area of polycap-rolactone scaffolds with mineral carriers: vaterite and hydroxyapatite. Material and Methods. The experimental study was performed on 43 rats divided into three groups: two test groups and one negative control group. Polycaprolactone PCL-scaffolds containing ovalbumine and of no biocompatibility were implanted into the rats of negative control group (n=15). The implantation of PCL- scaffolds containing vaterite under their skin was performed on rats of the first test group, and animals of the second test group were implanted with PCL-scaffolds containing hydroxyapatite. The method of laser Doppler flowmetry was used to study the microcirculatory flow. Results. The constant increase in the perfusion index has been observed in the area of non-biocompatibile scaffolds implantation. Thechanges in local skin blood flow modulation have been also detected. The transient character of local microcirculatory responses with total normalization of skin perfusion and its mechanisms has been noticed by the 21st day of the trial following PCL-scaffolds with vaterite and hydroxyapatite implantation. Conclusion. The dynamic monitoring has allowed finding that mineralization of PCL-scaffolds with vaterite as well as hydroxyapatite leads to no prominent changes in skin perfusion at subcutaneous implantation tests on white rats suggesting the biocompatibility of these scaffold types.

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Morphometric parameters of cerebral arteries in the elderly

Year: 2019, volume 15 Issue: №1 Pages: 94-97
Heading: Human anatomy Article type: Original article
Authors: Fomkina О.А., Gladilin Yu.A.
Organization: Saratov State Medical University
Summary:

Objective: to identify the features of morphometric parameters of cerebral arteries in adults aged 55-74 years. Material and Methods. As a material of the study we used samples of anterior (АСА), middle (MCA), posterior cerebral (PCA), posterior connective (PCoA), basilar arteries (BA) and vertebral arteries (VA), seized at autopsy 21 corpses of adults who died in old age. External diameter, wall thickness and length of arteries were studied by morphometry. The lumen diameter was calculated as the difference between the outer diameter and the doubled wall thickness. The material was processed by variational-statistical method. Results. The article presents the average values and parameters of variability of the main morphometric parameters of arteries supplying the brain. The results of the comparative analysis with the average values typical for adults aged 21-90 years are presented. Conclusion. The length, wall thickness, outer diameter and lumen diameter of the cerebral arteries in adults 55-74 years are characterized by significant variability. In the studied age range, АСА and PCA are characterized by the same wall thickness; MCA and VAare the same wall thickness, outer diameter and lumen diameter. The wall thickness of BA and VA in the elderly is 28.1 and 17.9% higher than the average value typical for people 21-90 years.

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Morphometric parameters of the width of dental arches of lower jaw in doli-chomorphic skull by gender characteristic

Year: 2019, volume 15 Issue: №1 Pages: 91-94
Heading: Human anatomy Article type: Original article
Authors: Efimova E.Yu., Krayushkin A.l., Efimov Yu.V.
Organization: Saratov State Medical University
Summary:

Objective was to study the characteristics of the indicators of the width of the dental arches of the lower jaw at the dolichomorphic form of the skull. Material and Methods. The morphometric parameters of the width of dental arches of the lower jaw have been studied. The work was performed on 28 preparations of skulls of people of both sexes of mature age with physiological occlusion of teeth and dolichomorphic form of the skull. The width of the dental arch was measured between canines, premolars and molars. Results. The maximum value of the width of the dental arch in both men and women was observed in the region of the second molars from the vestibular side. The minimum value of the investigated parameter was revealed in the region of canines on the palatal side. The indicator of the width of both the vestibular and lingual dental arches increased from the level of the canines to the molar level. Conclusion. A significant increase in the parameters of the width of the vestibular dental arch of the lower jaw in men over similar indicators in women was revealed only at the level of canines and first molars, and the parameters of the lingual dental arch only at the level of the second premolars.

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Key tendencies in health of citizens of military age

Year: 2019, volume 15 Issue: №1 Pages: 86-90
Heading: Health Service Organization Article type: Original article
Authors: Sogiyaynen А.А.
Organization: The National Research Institute of Public Health n.a. N.A. Semashko
Summary:

Aim: to study key trends in the health status and number of people of military age. Material and Methods. The research materials were official open statistical data and analytical materials of the public health authorities of the Moscow Region, Primorsky Krai and the Russian Federation, statistical data from the Rosstat (www.gks.ru), EIISS (https://fedstat.ru). To solve the tasks in the study, a statistical analysis of the level, dynamics and structure of primary and general morbidity of young men of military age (15—17 years old), as well as dynamic characteristics of the number of people of military age (18- 26 years old) was carried out. Results. The study revealed a negative trend in the number of people of military age (-1,723 thousand people, or-18.5% from 1995 to 2017). The reduction in the number of troops by 2028 will be -43.5% compared with 2010 The overall morbidity among young people aged 15- 17 years from 2006 to 2015 in the Russian Federation increased by 15.2% and amounted to 2247.2. In the structure of general morbidity among young people aged 15-17 years, respiratory diseases dominate in the Russian Federation 33.3%, in the second rank eye disease and accessory apparatus 9.3%, in the third digestive organs (8.8%), on the fourth and fifth musculoskeletal system and connective tissue (7.9%) and injuries, poisoning and other consequences of external factors (7.7%). In the structure of the primary incidence of this category of young people, as in the case of general morbidity, respiratory diseases dominate 47.8%, injuries, poisoning and other consequences of external causes (12.4%) prevail in the second ranking place; on the third diseases of the digestive system (5.7%); in the fourth, diseases of the urogenital system (4.6%); on the fourth and fifth, there are diseases of the eye and its adnexa (4.6%) and diseases of the musculoskeletal system and connective tissue (4.3%), respectively. The incidence of citizens of military age has pronounced regional features. An analysis of the overall incidence in these regions shows that there is a heterogeneous picture in different regions. Thus, the average level of general morbidity in Primorsky Krai among citizens ofmilitary age in 2006-2015 with certain infectious and parasitic diseases exceeds this indicator in the Moscow Region by 49.7%, and in the Russian Federation by 18.1%; neoplasms by 37.8 and 12.9%, respectively, mental disorders and behavioral disorders by 19.1 and 8.6%; diseases of the genitourinary system by 54.7 and 14.5%; other diseases 5.9 and 5.2%. Conclusions. Negative tendencies of primary (+16.0%) and general morbidity (+15.2%) were detected for almost all classes of diseases, significant regional features of the status of recruits, a negative trend in the number of men of military age (by 2028 the decline will be -43.5% compared with 2010). The level of primary incidence of this contingent is currently 1373.8%o and the growth of this indicator over 10 years was 16.0%. When analyzing the incidence of the studied contingent, classes of diseases require the most attention: eye and its adnexa diseases, respiratory diseases, digestive diseases, diseases of ear and mastoid process and nervous system, as well as the genitourinary system diseases.

Epidemiological characteristics of rhegmatogenous retinal detachment in the Central Black Earth region

Summary:

Aim: to estimate the frequency of rhegmatogenous retinal detachment among the population of the Central Black Earth region. Material and Methods. A retrospective study on the study of patients with myopia, who turned to the rhegmatogenous retinal detachment (RRD) in "S. Fedorov Eye Microsurgery Federal State Institution" in the period from 2006 to 2017 The epidemiological characteristics of patients who have applied to the RRF from five regions of the Central Black Earth Region (Belgorod, Voronezh, Kursk, Lipetsk, Tambov) are presented. Results. There is an annual increase in the number of patients with myopia complicated by RRD. The highest number of cases of myopia complicated by RRD was recorded in the age group of 50-59 years and 60 years and older, the smallest — in the age group 0-19 years. The female population suffers from a myopia complicated by the RRD equally with the male, but in the age groups 20-29 years, 30-39 years, men suffer more often, in the age groups 50-59 years, 60 years and older, women suffer more often. Among the patients from the Voronezh region, the largest number of cases of RRD was registered in the age group of 50-59 years, among patients from Tambov, Lipetsk and Kursk regions — in the age category of 60 years and older, from Belgorod region — in the age category of 30-39 years. The majority is represented by pensioners (60.3%), working people — 20.8%, disabled people — 15.8%, others 3.1%. Conclusion. Among the population of the regions of the Central Black Earth region, there is an annual increase in the number of patients with RRD, while the number of such patients will only increase, which indicates the need to improve the organization of eye care to the public.

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Medico-social performance of health centers to identify risk factors for major chronic non-communicable diseases

Year: 2019, volume 15 Issue: №1 Pages: 77-82
Heading: Health Service Organization Article type: Original article
Authors: Krasnikova N.V., Shemetova G.N., Kazban O.G., Кап А.О., Savinov T.Kh.
Organization:
Summary:

Objective: to study the frequency of occurrence of risk factors for cardiovascular disease among the working population of Saratov and to analyze the effectiveness of measures to promote a healthy lifestyle in the district health Center. Material and methods. The study was conducted on the basis of thehealth Center of the Saratov city polyclinic №17. For 2013-2017 surveyed 50301 patient of working age. The plan of the survey included the collection of anamnesis to identify risk factors for cardiovascular disease, physical examination with the implementation of anthropometry (determination of growth, calculation of body mass index), measurement of blood pressure, determination of total cholesterol and glucose in capillary blood. The total risk of fatal cardiovascular complications was assessed on the SCORE scale. Portable peripheral Doppler analyzer Smart Dop 30 EX with automatic measurement of systolic blood pressure and calculation of ankle-brachial index was used for angiological screening. Results: The most common risk factors were poor nutrition and physical activity, hypercholesterolemia, hyperglycemia, overweight and obesity. A decrease in the number of smokers since 2013 by more than 1.5 times: from 12.9 to 7.5%. The incidence of hypertension increased from 29.1 to 41.7%. Conclusion. It was found that more than 70% of patients who applied had risk factors for major chronic noncommunicable diseases. Overweight and obesity, irrational nutrition, low physical activity were detected in more than 50% of cases; hypercholesterolemia was determined in 45% of cases, hyperglycemia in 25%. Over the past 5 years, the incidence of hypertension among patients of working age has increased, primarily due to improved detection. It is important to carry out preventive programs, starting with students and young people, to inform citizens and motivate them to lead a healthy lifestyle.

Keywords: -
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Social and demographic characteristics and health status of women of fertile age in Moscow region

Year: 2019, volume 15 Issue: №1 Pages: 72-77
Heading: Health Service Organization Article type: Original article
Authors: Breusov A.V., Konovalov О.Е., Kharitonov A.K., Kharchenko V.V., Breusov R.A.
Organization: Bauman Moscow State Technical University, Kursk State Medical University, Peoples' Friendship University of Russia
Summary:

 . SObjective: analysis of the state of health, medical activity, social and demographic characteristics of women of child-bearing age to develop a set of medical and organizational measures aimed at reducing the loss of maternal and child health, improving the system of maternal and child health. Material and Methods. The following methods were used in the work: bibliographic, analytical, mathematical- statistical, sociological (questioning). The material of the study was 596 questionnaires of a sociological survey of women — patients of the regional perinatal center. Each questionnaire included 48 questions combined into 6 blocks (social, demographic characteristics, state of health, medical activity), which were processed using the statistical program PASW (Predictive Analytics Software) Statistics 22 Results. It was found that the majority of respondents considered themselves to be in the healthy group, every fifth considered that they had chronic diseases and 11.9% felt sick. In the structure of chronic pathology, the largest proportion was accounted for by respiratory diseases, ENT organs, circulatory system diseases, gynecological diseases. Conclusion. On the basis of the obtained data, the directions for improving the system of maternal and child health have been proposed, such as: strengthening preventive activities, improving the quality of clinical examination of the female population; improvement of continuity in the work of institutions of the maternal and child welfare system; introduction of interactive forms of education for pregnant women.

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Characteristics of clinical findings and diagnostics of acute cerebral venous circulation disorder in immediate period following neurosurgical intervention for peripheral lung cancer metastasis into brain

Year: 2019, volume 15 Issue: №1 Pages: 67-71
Heading: Traumatology and Orthopedics Article type: Case report
Authors: Bazhanov S.P., Ulyanov V.Yu., Matveeva O.V., Tolkachev V.S., Shuvalov S.D.
Organization: Saratov State Medical University
Summary:

A rare case of cerebral venous circulation disorder in a female patient with peripheral cancer metastasis of the right lung upper lobe to the area of precentral and postcentral gyri of the left cerebrum hemisphere in the immediate post- surgical period is present. It has been shown that the diagnostics of impaired circulation throuth the superficial cerebral veins is rather complicated due to the lack of clinical symptoms specificity and poor sensitivity of neurovisualization methods.

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