Vol 30, No 1 (2013)
- Year: 2013
- Articles: 20
- URL: https://bakhtiniada.ru/PMJ/issue/view/196
Articles
MINIINVASIVE TECHNIQUES IN TREATMENT OF NONPARASITIC HEPATIC CYSTS
Abstract
Aim. To improve the results of treatment of patients with nonparasitic hepatic cysts and to determine optimal treatment technique depending on concomitant pathology, terms of hospitalization, number of relapses and postoperative complications. Materials and methods. Experience of complex examination and treatment of 175 patients with nonparasitic hepatic cysts for the period of 1999-2012 was analyzed. Depending on treatment tactics, patients were divided into 3 groups. Group 1 consisted of 50 patients who underwent open operations, 54 patients of group 2 experienced laparascopic fenestration of cysts with diepithelization of internal lining using diathermic coagulation and 98% ethanol treatment, 71 patient of group 3 underwent transcutaneous puncture and 96% ethanol hepatic cyst sclerosing under ultrasound control. Results. Mininvasive techniques were used for treatment of 125 (71,4%) patients. Postoperative complications in group 1 were noted in 11 (22%) patients that increased the time of hospital treatment and was accompanied by essential economic losses. In patients of group 2, relapse of cysts requiring transcutaneous puncture and 96% ethanol sclerosing was detected in 5 (9,3%) observations 5-12 months after the surgery. In one case the postoperative toxic hepatitis was diagnosed that needed conservative hepatoprotective therapy. Full cyst obliteration in group 3 was reached in 32 (45,1%) patients and 8 patients (11,3%) had no complaints but preserved small-volume cysts that allows to draw a conclusion about the reached clinical effect. The terms of hospital stay in patients of group 1 were 14,7±5,5 days, group 2 – 7,1±3,8 days, group 3 – 4,6±2,7 days. Conclusion. Patients with nonparasitic hepatic cysts <50 mm in diameter without any signs of compression of adjoining organs and disturbance of basic liver functions should be dynamically observed (USI of liver) every 8–12 months. Active treatment tactics for prevention and elimination of complications is indicated to patients with cysts >50 mm in diameter. Taking into account benign character of nonparasitic hepatic cysts, low probability of their malignization and hepatic function disturbance, preference should be given to miniinvasive techniques (laparoscopic, puncture) which do not yield to open operations by their efficiency, but are accompanied by less number of complications and shorter time of hospitalization.
Perm Medical Journal. 2013;30(1):5-10
5-10
APPLICATION OF TENDINOUS AUTOTRANSPLANT TENDOPLASTY IN PATIENTS WITH TRAUMATIC HAND FINGER AMPUTATION DURING REPLANTATION
Abstract
Aim. To improve the results of surgical treatment of patients with incomplete traumatic amputation of hand finger at the expense of increasing strength of deep flexor tendon with the help of superficial flexor tendon of hand finger. Materials and methods. The paper presents the results of treatment of 72 patients with incomplete traumatic amputation of hand fingers and damage of finger deep flexor tendon in the region of proximal phalanx. In 38 patients of the main group, within the synovial sheath, defect replacement using tendinous autotransplant with the distal end of the superficial tendon attached to it was carried out during replantation. To estimate the results of treatment the method of measuring the total volume of active movements in the finger joint offered by The American Society of Hand Surgery was used. Results. The obtained data showed that in the main group the developed technique of surgical treatment permitted to decrease the level of unsatisfactory results from 2,9% to their full absence, to lower the level of satisfactory results by 14,2%, to increase the level of good results by 12,3% and excellent results by 4,8%, to reduce the terms of the postoperative training from 48,43±5,21 to 37,82±6,81 ( p <0,01) days. Conclusion. The suggested technique reduces the terms of the postoperative finger training by 10,61 days ( p <0,01), lowers the level of unsatisfactory results by 14,2%, raises the level of good results by 12,3% and excellent results by 4,8% ( p <0,05) and can be an alternative technique for preventing development of cicatrical contraction of the replanted finger in patients with incomplete traumatic amputation of hand finger.
Perm Medical Journal. 2013;30(1):11-14
11-14
PECULIARITIES OF TREATMENT OF DEEP BURNS
Abstract
Aim. To study the efficiency of modern antiseptics used for complex treatment of deep burns and their effect on microbial composition of burn wounds. Materials and methods. Retrospective study of the results of complex treatment of 211 persons with burn injuries including 93 (44%) sufferers with deep burns which later on needed operative treatment was carried out. Taking into account the effect of traumatic factors patients were distributed in the following way: flame burns formed the largest group – 58 cases (62,37%), hot water burns – 21 persons (22,6%), contact burns – 7 (7,5%), hot fluid – 4 (4%), electric burns – 2 (2%) and chemical burn – 1 (1%). Results. In all cases with deep burns patients underwent staged deferred necrectomies, in most cases, after chemical necrosis with 40% salicylic ointment. First necrectomy was performed on the day 11,7±4,9 (mean data). The terms for autodermoplasty were 23,9±9,5 days, bed day – 40,6±15 days. In 78,5% of patients, 1% iodopiron solution was used as antiseptic. The results of bacteriologic inoculations from burn wounds were mainly the following: Pseudomonas aeroginosa - 30%, Staphylococcus aureus - 21%, Acinetobacter baumani - 17%. It turned out that in case of degree IIIB-IV burn, microorganisms in the wound are present more often as components of 2-component associations. Conclusion. Since pathogenic microflora in burn wounds very rapidly acquires resistance to local antimicrobial drugs, it is necessary to use them rationally, renew permanently and to study efficiency of additional complex and combined methods of influence on infection.
Perm Medical Journal. 2013;30(1):15-19
15-19
LADASTEN INFLUENCE ON ASTHENIA DEGREE AND QUALITY OF LIFE IN TICK-BORNE BORRELIOSIS RECONVALESCENTS
Abstract
Aim. To assess the influence of ladasten on the degree of postinfectious asthenia and quality of life in tick-borne borreliosis reconvalescents. Materials and methods. Two groups of patients with postinfectious somatogenic asthenia were investigated. Group 1 consisted of 36 reconvalescents receiving the preparation ledestan in the dose of 100 mg during 25 days. Group 2, the group of comparison, included 37 reconvalescents who did not apply drugs. Before and after treatment, examination using visual analog asthenia scale, inquire for revealing signs of vegetative changes, score subjective sleep disturbance questionnaire, quality of life questionnaire MOS SF-36, hospital anxiety and depression scale (HADS) was carried out. Results. After taking ladasten, patients had significant dynamics of decreasing scores by visual analog asthenia scale. Reconvalescents of group 1 after treatment had a significant increase in indices by all SF-30 questionnaire scales ( p =0,001). When analyzing HADS scale data for «depression» parameter, it was established that in the first group there was a positive dynamics of this index after treatment ( p =0,001) which was not registered in the second group ( p =0,931). During ladasten therapy, manifestation of vegetative disorders in the first group decreased ( p =0,001). Analysis of subjective evaluation of sleep disturbance detected normalization of this index after therapeutic course ( p =0,001) as compared to the control ( p =0,146). Conclusion. Efficiency of ladasten in borreliosis reconvalescents is displayed by antiasthenic, anxiolytic, vegetostabilizing properties, normalization of sleep, improvement of quality of life indices. Ladasten in the day dose of 100 mg can be recommended during rehabilitation period for patients after borreliosis with residual effects in the form of postinfectious somatogenic asthenia.
Perm Medical Journal. 2013;30(1):20-25
20-25
CLINICOROENTGENOLOGICAL AND MORPHOLOGICAL ASPECTS OF INTERSTITIAL LUNG DISEASES
Abstract
Aim. To assess the clinicoroentgenological and morphological signs of fibrosing processes in the lungs in primary diagnosis of different IIP forms, as independent pulmonary intersticial diseases. Materials and methods. One hundred and thirty nine patients observed after complex examination including pathomorphological verification were diagnosed idiopathic fibrosing alveolitis (IFA). Results. Additional profound pathomorphological investigation had the following results: usual interstitial pneumonia (UIP) as IFP basis, acute interstitial pneumonia (Hamman-Rich) and nonspecific interstitial pneumonia (NSIP). It was established that peculiarities of these IIP variants were revealed both in the early and late period of disease. Simultaneously, available inflammatory pulmonary reaction with marked sclerosis, even at the late stage of disease, proves alveolitis activity. Conclusion. Essential differences, absent in clinicoroentgenological manifestations of exacerbation of pulmonary process in chronic IIP permit to consider pathomorphological method to be the main method of nosologic ILD diagnosis.
Perm Medical Journal. 2013;30(1):26-33
26-33
RISK FACTORS AND PROGNOSIS OF NEUROPSYCHIC DEVELOPMENT RETARDATION IN INFANTS WITH HYPOXIC-ISCHEMIC LESION OF CENTRAL NERVOUS SYSTEM AND CONGENITAL HEART DISEASES
Abstract
Aim. To reveal the rate, structure and significance of perinatal risk factors of neuropsychic disturbance in infants with hypoxic-ischemic lesion of central nervous system (CNS) and congenital heart diseases (CHD). Materials and methods. Forty two infants with hypoxic-ischemic lesion of central nervous system and congenital heart disease operated before the age of one using artificial circulation were prognosticated the risk degree of developing neuropsychic retardation with Wald sequential analysis by means of calculation of Kulbac prognostic coefficient and information coefficient. Investigation of infants’ neuropsychic status was carried out applying G.V. Pantyukhina – K.L. Pechera – E.L. Frukht method. Results. Specific and nonspecific perinatal risk factors disturbing neuropsychic development of infants with hypoxic-ischemic lesion of central nervous system and congenital heart disease were revealed. Conclusion. Detection and determination of significance of each of the factors of perinatal risk and organization of modern rehabilitation measures permit to predict deviations in infants’ neuropsychic development and conduct a purposeful prevention.
Perm Medical Journal. 2013;30(1):34-39
34-39
OBSTETRIC UTERINE CERVIX INJURIES IN FIRST LABOR IS RISK FACTOR FOR DEVELOPING UTERINE CERVIX BACKGROUND AND PRECANCEROUS DISEASES
Abstract
Aim. To improve the results of treatment of uterine cervix background and precancerous diseases in primipara women with cervical rupture using differential approach to treatment methods. Materials and methods. One hundred and sixty five women underwent complex examination using clinical, histomorphological and instrumental methods of investigation. Results. The investigation showed that cervical rupture is the cause of occurring background and precancerous diseases in 91,4% of primipara women in the remote period. Conclusion. The offered system of measures applied permits to reduce twofold the risk of developing uterine cervix background and precancerous diseases and, thus, to prevent risk of occurring uterine cervix cancer.
Perm Medical Journal. 2013;30(1):40-45
40-45
PARTICULARITIES OF DIURNAL ARTERIAL PRESSURE MONITORING IN PERSONS WITH BRONCHIAL-OBSTRUCTIVE SYNDROME OF DIFFERENT DEGREE OF MANIFESTATION
Abstract
Aim. To study the particularities of diurnal arterial pressure (AP) monitoring in patients with chronic obstructive lung disease with bronchial-obstructive syndrome of different degree of manifestation. Materials and methods. Diurnal monitoring of arterial pressure was carried out in 109 patients with chronic obstructive lung disease of 2-4 degree of severity using GOLD-2010 criteria and 16 practically healthy subjects with forced expiratory volume (per minute) (FEV 1) > 80% of due values. The obtained indices were estimated depending on manifestation of bronchial-obstructive syndrome. Results. Marked bronchial obstruction is accompanied by hypertensive changes in diurnal arterial pressure profile. Among the monitoring indices, the most significant are dynamics of mean values and that of hypertension time index as well as degree of night systolic arterial pressure fall. Conclusion. Diurnal arterial pressure monitoring data in patients with chronic obstructive lung disease permit to predict development of not only arterial hypertension but of systemic bronchodilatation effects, as well.
Perm Medical Journal. 2013;30(1):46-53
46-53
INTRARENAL BLOOD FLOW DYNAMICS IN PATIENTS WITH ARTERIAL HYPERTENSION ASSOCIATED WITH SUBCLINICAL HYPOTHYROIDISM AGAINST THE BACKGROUND OF ANTIHYPERTENSIVE THERAPY
Abstract
Aim. To assess the dynamics of intrarenal blood flow in patients with arterial hypertension (AH) associated with subclinical hypothyroidism (HT) against the background of antihypertensive therapy. Materials and methods. Sixty eight patients divided into 2 following groups were examined: group 1 during 18 months took amlodipin + indapamide, group 2 – lisinopril + indapamide. Results. Eighteen months later, against the background of combined therapy including amlodipin + indapamide, renal arteries’ resistance indices increased (right RI 0,659±0,03 and 0,677±0,035; p =0,03); left RI 0,665±0,038 and 0,689±0,033); p =0,005) and renal venous blood flow became worse (right dV ven 20,33±5,72 and 23,73±3,66; p =0,003; left dV ven 21,52±5,90 and 25,23±3,71; p =0,003). Combined lisinopril + indapamide therapy significantly improved renal magistral venous blood flow (right dV 19,78±3,43 and 18,10±2,87; p =0,04; left dV22,07±5,12 and 19,53±4,36; p =0,04). Conclusion. Lisinopril combined with indapamide should be recommended as an antihypertensive therapy to patients with AH associated with SH.
Perm Medical Journal. 2013;30(1):54-59
54-59
COMPARATIVE EVALUATION OF METHODS FOR DETERMINATION OF GLOMERULAR FILTRATION RATE IN CHILDREN WITH TYPE 1 DIABETES MELLITUS
Abstract
Aim. To compare the methods for estimating glomerular filtration rate (GFR) in children with type 1 diabetes mellitus (DM) by means of determining blood serum creatinine and cystatin C concentrations so as to optimize early detection of diabetic kidney disease. Materials and methods. Thirty four DM1 patients (18 girls and 16 boys aged 8-18) with disease duration for more than 2 years were examined. GFR was assessed by creatinine level using Schwarz formula and serum cystatin C level – by means of special tables. Results. Reliable dependence of mean serum cystatin C concentration on DM «history» was found. In children with disease lasting for more than 5 years, cystatin C level was significantly higher than in patients with DM duration for less than 5 years: 1,05±0,28 mg/l versus 0,70 ±0,21 mg/l ( p =0,001). No statistically significant differences regarding creatinine indices (59,8±18,1 mmol/l and 52,3±15,4 mmol/l, respectively) were obtained. GFR calculated by cystatin C in the group of children suffering from DM for more than 5 years was 80,3±33,5 ml/min and was significantly lower than in children with disease «history» less than 5 years (123,8±44,5 ml/min; p =0,001). Correlation dependence between cystatin C level, GFR calculated by cystatin C, disease duration and age of DM debut was established. Conclusion. Early changes in GFR in children with diabetic lesion of kidneys can be diagnosed by means of cystatin C. According to our data, serum cystatin C is a more exact GFR marker than serum creatinine.
Perm Medical Journal. 2013;30(1):60-65
60-65
TECHNIQUE OF SURGICAL TREATMENT OF ESOPHAGEAL AND GASTRIC VARICOSE VEIN HEMORRHAGE
Abstract
Aim. To modify the Sugiura operation for the purpose of decreasing the probability of esophagoesophagoanastomosis and dysphagia in the nearest postoperative period. Materials and methods. The modified variant of azygoportal separation (Sugiura operation) aimed at stopping hemorrhage from esophageal and gastric cardial varicose veins was used to operate 42 patients: 39 – with hepatic cirrhosis and 3 – with extrahepatic portal hypertension. Child-Pugh cirrhosis compensation degree was determined as class A – in 4 (10,2%) patients, class B – in 13 (33,3%), class C – in 22 (56,5%). Results. In the nearest postoperative period, all patients experienced full surgical hemostasis. The postoperative lethality was 33,3% and depended on the degree of hepatocellular insufficiency and severity of hemorrhage. No lethal outcomes were fixed among class A patients, in class B – 15,4%, class C – 50%. Conclusion. The main reasons of lethal outcomes were progressing hepatic insufficiency and infectious surgical complications.
Perm Medical Journal. 2013;30(1):66-72
66-72
DYNAMICS OF BIOMECHANICAL AND ELECTROMYOGRAPHIC CHANGES IN CONSERVATIVE TREATMENT OF CHILDREN WITH IDIOPATHIC LOW LIMB SHORTENING
Abstract
Aim. To study the dynamics of biomechanical and electromyographic changes in conservative treatment of children with minor shortening of the low limbs. Materials and methods. Sixty five children aged 3-15 were examined. Computer optic topography (COT) and electromyography (EMG) were used for diagnosis. Results. Shortening of one of the low limbs caused side pelvic slope. Vertebral column formed a compensatory arc of curvature at the expense of changing statodynamic status of spinal-pelvic angle so as to preserve axis of vertical position. In 20% of cases adaptive responses of motor system were preserved in the form of pelvic defect and spinal deformations and conservative additional therapy was necessary after elimination of unevenness of legs by means of orthopedic shoes. Conservative complex treatment included ozocerite applications, massage, therapeutic physical training and electrostimulation of lumbar spine muscles, calcium ion-parametric magnetotherapy. Positive dynamics of basic COT and EMG indices was registered. Decrease in average limb shortened was 10%. Decline in pelvic defect angle in the frontal plane was 21% and total integral bearing defect index was 2,5-fold lower. Pathologic rotation index at the top of scoliotic arc decreased by 44% and asymmetry coefficient was two times less. Conclusion. Minor one-sided shortening of the low limbs’ length leads to secondary changes in spinal biomechanics. An adequate conservative treatment normalizes biomechanical and electromyographic indices preventing occurrence of scoliotic spinal deformations in children.
Perm Medical Journal. 2013;30(1):73-78
73-78
HEALTH PARAMETERS ASSESSMENT IN PRESCHOOL AND SCHOOLCHILDREN WITH ACUTE AND CHRONIC RESPIRATORY PATHOLOGY USING FUNCTIONAL METHODS OF INVESTIGATION
Abstract
Aim. To assess the health parameters in preschool and schoolchildren with acute and chronic respiratory diseases using functional methods of investigation. Materials and methods. Functional testing of 143 children (aged 5-15) divided into two groups was carried out. Group I joined 22 children with recurrent acute diseases of the upper and lower airways (RAD UaLA) and 20 patients with bronchial asthma (BA). Group II included schoolchildren: 45 – with RAD UaLA, 42 – with BA. The following methods were used: anthropometric, functional, quantitative assessment of physical health status (PHS), general capacity for work (GCW), estimation of adaptation abilities by means of adaptive potential (AP) and endurance coefficient (EC). Results. Anthropometric data indicate prevalence of children with body deficit among patients with RAD ULA and body weight excess among patients with BA, irrespective of age. According to physiometry data, children with RAD UaLA more often than BA patients demonstrated low parameters of respiratory and strength tests. More than a half of preschool children with RAD UaLA had low PHS parameters and significantly lower adaptive abilities of the body with regard to AP and EC. Conclusion. Children with respiratory diseases, irrespective of nosologic form, should have a corrected diet and/or nutritive support, should strengthen locomotor system, elevate physical readiness and reserve abilities of respiratory and cardiovascular system of the body. The initial physical health status assessed in preschool and schoolchildren with acute and chronic respiratory pathology using functional methods of investigation will permit to understand deeper the causes of their “ill health” and to develop an individual complex of rehabilitation measures.
Perm Medical Journal. 2013;30(1):79-86
79-86
SIGNIFICANCE OF BLOOD BIOCHEMICAL INDICES IN CHILDREN WITH ASSOCIATED INJURY
Abstract
Clear concept of pathobiochemical processes caused by severe injuries can be beneficial for optimization of treatment of sufferers with associated injuries. Biochemical investigations acquire special actuality in childhood in conditions of a growing organism. Aim. To assess the blood biochemical indices in children with associated injury. Materials and methods. One hundred and four patients after traffic accidents were admitted to pediatric surgery hospital and observed. Craniocerebral injury (CCI) was diagnosed in 72,1% of sufferers, abdominal injuries – in 61,5%, thoracic injuries – 26%, fractures – 53,8%. Laboratory investigations included bulk blood test, biochemical blood test: glucose, creatinine, urea, total amylase, alanine (ALT) and asparaginic transferases (AST), total bilirubin, whole protein and albumin in blood serum. These analyses were investigated on the days 1, 4, 7 and 10 after the accident. Results. The associated injury was stated to have a negative effect on carbohydrate, protein and pigment metabolism, to be accompanied by functional hepatic and pancreatic disorders increasing by the days 3–5 of traumatic disease and to be characterized by elevated activity of blood aminotransferases and α-amylase as well as disturbances of functional kidney status. CCI, as a component of associated injury, had unfavourable effect on restoration of the disturbed functions. Conclusion. Hypoalbuminemia, hypoproteinemia, increased ALT activity are prognostically unfavorable criteria for associated injury. These indices acquire special significance when CCI is one of the components of associated injury.
Perm Medical Journal. 2013;30(1):87-91
87-91
CLINICAL SYSTEM OF MACROGLOSSIA DIAGNOSIS
Abstract
Aim. Development of scientific and practical system of diagnosis of macroglossia with use of medical information systems. Materials and methods. 551 persons aged from 18 till 70 years were examined by the offered system of diagnosis of macroglossia, divided into two groups: the first group (200 people) – without clinically expressed pathology, the second group – with various clinically expressed therapeutic pathology. Statistical analysis and mathematical modeling of results of research was carried out. Results. Macroglossia prevalence among people of the first group made 6%, of the second group – 27%, if the author's system of diagnostics was used. Conclusion. Use of the author's system of diagnosis of macroglossia allows to reduce considerably subjectivity of its manifestations in an oral cavity, to increase quality of the treatment-and-prophylactic help to patients with disgnatiya, and also to use it for an expert assessment.
Perm Medical Journal. 2013;30(1):92-97
92-97
HISTOLOGICAL AND MORPHOLOGICAL HIPPOCAMP CHARACTERISTICS IN DIFFERENT AGE PERIODS
Abstract
Aim. To study the histological structure of hippocamp in different age periods in the postnatal ontogenesis. Materials and methods. The material for investigation was obtained from 50 corpses of both sex (25 to 89 years old) dead due to accidental reasons which were not connected with cerebral lesions or pathology. To carry out histological and morphological investigation, the right and left hippocamps were taken; generally accepted histological methods were used. Results. While studying hippocamp morphology in different age categories, it was established that in elderly and old persons there are structural signs of the lesion of pyramidal neurons and gliosis foci. While performing morphometric investigations, it was stated that there are statistically nonsignificant differences in the sizes of pyramidal neuron bodies in the corresponding fields of hippocamp in the right and left hemispheres. The neuron sizes in CA1 field are subjected to statistically significant changes – at old age their sizes are significantly smaller than in other age groups. The revealed tendency is true both for the right and left hemispheres. Conclusion. Old and elderly persons have structural signs of pyramidal neuron lesions and glia reaction. Regularities of changing pyramidal neuron body sizes at old age were detected in morphometric investigations.
Perm Medical Journal. 2013;30(1):98-103
98-103
EPIDEMIOLOGICAL ASPECTS OF PNEUMONIA IN CHILDREN OF PERM TERRITORY
Abstract
Aim. To estimate a long-term dynamics of pneumonia morbidity among children aged 0–14 years in Perm Territory. Materials and methods. A long-term dynamics (1995–2010) of primary morbidity among children aged 0–14 years in Perm Territory was estimated on the basis of statistical data on the registered cases. The data concerning Perm Territory, Privolzhsky Federal District and the Russian Federation were compared. The obtained data proved increase in primary pneumonia morbidity rate in Perm Territory from 10,6 to 15,6% for 16 years. Results. Analysis of primary morbidity dynamics for 15 years detected 1,9-fold growth in prevalence of respiratory diseases and 1,6 – of pneumonia. The mean growth rate was 6,14, annually. Conclusion. Growth of pneumonia morbidity occurred against the background of increased general rate of primary respiratory diseases, with 18,6% reduction in the share of pneumonias in their structure. Pediatric morbidity indices in the region 1,5–2-fold exceed the mean rate in the Russian Federation and Privolzhsky Federal District.
Perm Medical Journal. 2013;30(1):104-108
104-108
NEWBORN BODY MASS IN GROUPS WITH DIFFERENT DEGREE OF URBANIZATION IN PERM TERRITORY
Abstract
Aim. To carry out the analysis of body mass in newborns presenting different by urbanization degree groups of Perm Territory population. Materials and methods. In Perm Territory, newborn body mass (NBM) was analyzed by WHO criteria. Open materials of RF Social Insurance Fund database were used. The data concerning 14561 children from 14 settlements (city agglomeration, large cities, middle and small towns) born from 01.01.2007 to 01.01.2008 were included. Results. The NBM in subsamples for each of the types of the population is within the «desired» range of fluctuations of WHO «weight-for-age» index. Mean NBM without birthplace taken into account corresponds to 51,9 centils (WHO standards). Mean NBM values by subsamples according to birthplace are grouped into three reliably different clusters: 1) infants of city agglomeration, 2) infants born in cities, 3) infants born in middle and small towns and villages. Conclusion. The obtained data prove dependence of the body mass at birth on the size of settlement. The live-born body mass should be estimated as satisfactory in Perm Territory.
Perm Medical Journal. 2013;30(1):109-113
109-113
LABORATORY CRITERIA FOR DIAGNOSIS OF EARLY HEALTH STATUS DISTURBANCES IN AGROINDUSTRIAL COMPLEX WORKERS
Abstract
Aim. To determine the informative laboratory criteria for early revealing of disturbed health status in conditions of chronic aerogenic load, to estimate hemostasis indices regarding trend and intensity of correlations between the components. Materials and methods. The data of profound examination of 360 workers of large poultry complex in conditions of periodic medical examination were analyzed. Activity of hepatocyte cytolysis markers was determined, blood serum lipid spectrum was investigated, different components of immunity were assessed using levels I-II immunological tests. Group 1 consisted of 215 persons of main professions, group 2 – 145 additional professions. Results. The most frequently diagnosed diseases among poultry farm workers are the diseases of locomotor system (vertebrogenic cervicoischia-dorsalgia, osteochondroses, osteoarthroses). This pathology was detected in 68,8±0,22% of the examined patients of group 1 and 58,6±0,34% – group 2. Cardiovascular disorders are mostly presented by arterial hypertension – 23,7±0,2% in the group of main workers and 31,03±0,3%b – in group 2. When comparing prevalence of cardiovascular diseases and lipid profile disturbances in the workers of main professions it was established that hypercholesterinemia occurred more often than clinical manifestations of disease (53,0% and 38,1%, respectively). Aggregate of increased total cholesterol and glucose levels, excess body mass characterize development of metabolic syndrome in the examined patients. Taking into account the results of clinical investigation, diabetes mellitus and thyroid diseases are diagnosed only in 6,6% of the examined patients. Conclusion. Patients exposed to industrial factors were found to have significant disturbances of lipid and carbohydrate metabolism that proves presence of metabolic syndrome. Among workers of main professions, changes in immunoresponsiveness of the body are noted significantly more often.
Perm Medical Journal. 2013;30(1):114-120
114-120
121-127