Medicine of Extreme Situations
Scientific and Practical reviewed Journal
of FMBA of Russia

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№1, 2012 (March)

Some approaches to rationalize the use of funds in health care institutions.

Year: 2012 (March) Number: №1 Pages: 5-10

Heading: Organization and improvement of medical care and the state sanitary and epidemiological supervision. Prevention and liquidation of consequences of emergency situations.

Article type: Scientific article.

Authors: L.P. Radchenko, V.M. Chernyshev, K.A. Esipova, T.A. Leygan.

Organization: Federal State Institution Siberian regional medical center of FMBA of Russia, Novosibirsk.

Annotation: 

The objectives are to identify shortcomings in the existing system of distribution of financial resources in health care on the basis of the analysis of literature data and experience of Novosibirsk medical institution and to suggest approaches to the establishment of schemes of their movement that will ensure rationalization of payment units and optimize structure medical organization. Currently economic methods of management providing material interest in the qualitative performance of obligations are rarely used in health care institutions. The article describes the main principles of the organization of movement of funds in medical institutions, which allow to increase the efficiency of their use and ensure that fair payment for units is done with regard to quality of performed work.
Conclusions: In conditions of reforms in health care for a more rational use of possibilities of the medical institutions wider application of economic methods of management should be performed, based primarily on economic calculation, to ensure rational use of funds and optimization of organizational structure.

Keywords: 

Economic calculation, economic management methods.

Urgent therapy of arrhythmias in children.

Year: 2012 (March) Number: №1 Pages: 11-21

Heading: Organization and improvement of medical care and the state sanitary and epidemiological supervision. Prevention and liquidation of consequences of emergency situations.

Article type: Scientific article.

Authors: L.M. Makarov.

Organization: Syncope and arrhythmia centre for children and adolescents of FMBA of Russia on the basis of Federal State Budgetary Health care Institution Central children's clinical hospital of FMBA of Russia, Moscow.

Annotation:

The article presents the main algorithms of emergency treatment of arrhythmias in children, clinical and electrocardiographic signs of arrhythmias requiring emergency antiarrhythmic therapy (AAT). The sequence of doctor's actions in child assessment and emergency action plan of treatment in sudden cardiac arrest and heartbeat attack were defined. The main methods of emergency AAT (medical, non-drug, combined) are indicated. The main classes of drugs, the sequence and dosage of drugs used in emergency AAT in children, possible complications and the ways of prevention were characterized.

Keywords: 

Arrhythmias in children, emergency antiarrhythmic therapy, antiarrhythmic drugs in children.

The prevalence of metabolic syndrome when carrying out additional medical examination of water transport employees in the Sakhalin region.

Year: 2012 (March) Number: №1 Pages: 22-26

Heading: Organization and improvement of medical care and the state sanitary and epidemiological supervision. Prevention and liquidation of consequences of emergency situations.

Article type: Scientific article.

Authors: V.A. Vagin, V. V. Koroteeva.

Organization: Federal State Institution Holmsk hospital "Far Eastern Medical Center of FMBA of Russia", Holmsk, Sakhalin region.

Annotation:

Objective: The study sought to characterize the prevalence of metabolic syndrome (MetS) when carrying out the additional medical examination (AME) of the working population of the Sakhalin region.
Material and methods: The analysis of 297 medical cards of outpatients (form №025/u-04) that underwent AME in Holmsk hospital "Far Eastern Medical Center of FMBA of Russia" in 2009 was performed. Age of the subjects was from 22 to 75 (average age – 44,3±0,67 years), including 104 men (average age is 47,9±1,14 years) and 193 women (average age is 42,4± 0.8 years). Examined males were on 5, 55 years older than females (p < 0.001).
Results: During AME MetS was detected in 12, 8 ± 1, 9% with no significant differences among men (13, 5 ± 3, 4%) and women (12, 4 ± 2, 4%), (p >0, 05). Thus three components of MetS were found in 3.0 ± 1,0% of examined subjects, including 8,7 ± 2, 8% of men; four components of MetS were in 4,7 ± 1,2% (1,0 ± 1,0 % in men and 6,7 ± 1,8% in women); five components of MetS were in 5, 1 ± 1,3% (3,8 ± 1,87% in men and 5,7 of ± 1,7% in women). The following components of MetS were identified: abdominal obesity (AO), hypertension (HT), hyperglycemia (HG), elevated triglycerides (ET), low highdensity lipoproteins (LHDL). LHDL was in 15 cases (5,1 ± 1,3%); AO, HT, ET, LHDL were in 13 cases (4,4 ± 1,2%); AO, HG, LHDL were in 7 cases (2,4 ± 0,9%); AO, HT, LHDL were in 2 cases (0, 7 ± 0,5%), AO, HT, HG, LHDL were in 1 case (0,3 ± 0,3%). Higher MetS prevalence was found in the age group of 50-59 years - 23,0 ± 4,5% (18,9 ± 8,2% in men and 26,0 ± 6,2% in women) and 60 years and older - 21, 7 ± 8, 6% (6,7 ± 6,4 % in men and 50,0 ± 17,7% in women). At the age of 40-49 years the index was 13,6 ± 4,2% (18,2 ± 8,2 % in men and 11,4 ± 4.8% in women); at the age of 30-39 years the index was 4,54 ± 2,2% (8,7 ± 5, 9% in men and 3,1 ± 2,1% in women). MetS was not revealed in subjects with the age up to 30 years.
Conclusions: AME of working population within the priority national project "Health" MetS was detected in 12,8% and in people over 30 years in 14,4 % of cases without gender differences with the greater frequency in the age groups over 50 years old. In women five or four components of MetS were predominated and men were more likely to have three components of MetS. The MetS prevalence was significantly less than in Europe (20%) (p < 0, 05) and the USA (25%) (p <0, 001). The obtained results are very important for secondary prevention of cardiovascular diseases and diabetes in employees.

Keywords: 

Metabolic syndrome, additional medical examination, priority national project "Health", water transport employees.

Energy-informational methods of complex diagnostics and recovery of functional state of organism.

Year: 2012 (March) Number: №1 Pages: 27-31

Heading: Organization and improvement of medical care and the state sanitary and epidemiological supervision. Prevention and liquidation of consequences of emergency situations.

Article type: Scientific article.

Authors: N.N. Kalinichenko.

Organization: Federal State Institution "Southern Regional Medical Center of FMBA of Russia", Rostov-on-don.

Annotation: 

Computerized diagnostic according to the Nakatani method is based on investigation of abnormalities of energy homeostasis, revealing the degree of the energy saturation of patient meridians to determine the level of functional abnormalities in organs and systems, controls the accuracy and effectiveness of treatment. Methods of complex energoinformational quantum and bioresonance system, local and acupuncture exposure are successfully carry out therapy of intractable nosology, for example, ulcer, osteochondrosis, endarteritis, diabetes mellitus and others.

Keywords: 

Energoinformational diagnostics and complex quantum and bioresonance therapy.

Medical and sanitary maintenance of works at test stations of liquid rocket engines.

Year: 2012 (March) Number: №1 Pages: 32-37

Heading: Organization and improvement of medical care and the state sanitary and epidemiological supervision. Prevention and liquidation of consequences of emergency situations.

Article type: Scientific article.

Authors: V.N. Кulyga, V.G. Fedorov, V.S. Gorbachevskiy, N.D. Vasilkova, N.V. Kovalenko, N.L. Arbuzov.

Organization: Federal State Healthcare Institution Central Medical and Sanitary Unit №119 FMBA of Russia, Moscow; Medical and Sanitary Unit №6 of Central Medical and Sanitary Unit №119 FMBA of Russia, Korolev; Interregional department №170 of FMBA of Russia, Korolev.

Annotation: 

Scientific data of high toxicity of new components of rocket fuels, the potential risk of acute and chronic occupational morbidity, a significant number of personnel working with harmful and (or) dangerous production factors require system organization of medical and sanitary services for employees that are working at the Federal Space Agency enterprises. The objective is to show that proper organization of preventive health care for employees that work with harmful and (or) dangerous production factors provides positive results.
Results: The reduction of general and professional morbidity, primary disability is the indicator of quality of health care for employees involved in hazardous and unfavorable working conditions.

Keywords: 

Periodic medical examinations (PMO), components of rocket fuel (CRF), liquid rocket engines (LRE), hazardous and unfavorable working conditions, occupational morbidity.

Sanitary-Hygienic monitoring of working conditions, the air in working zones of industrial rooms, atmospheric air of residential areas, soil when implementating industrial activity by open joint stock company "Altaikhimprom" Yarovoe, Altai territory.

Year: 2012 (March) Number: №1 Pages: 38-45

Heading: Organization and improvement of medical care and the state sanitary and epidemiological supervision. Prevention and liquidation of consequences of emergency situations.

Article type: Scientific article.

Authors: N.P. Preobrazhenskiy, M.V Zakharova, G.N. Sumina, T.A. Volkova.

Organization: Regional department №128 of FMBA of Russia, Yarovoe, Altai territory.

Annotation: 

The objective is to analyze the sanitary and hygienic condition, working conditions, the environment near production activity of chemical substances and to conduct state sanitary control and supervision in chemical enterprises.
Results: The carried out analysis of control and supervising actions in three years of laboratory researches of air and physical factors on workplaces, conditions of atmospheric air, soil in a residential areas, occupational morbidity and morbidity with temporary loss of disability at the open Joint Stock Company "Altaikhimprom" chemical enterprise allows to tell that when carrying out the state sanitary and hygienic supervision the integrated approach is necessary and it helps to take prompt and adequate actions for elimination of sanitary and hygienic violations and for an exception of their adverse effect on employees health and to prevent environmental impact.
Conclusions: The Requirement of the Federal law of 26.12.2008, №294 - FZ "About protection of rights of legal entities and individual entrepreneurs when exercising state supervision and municipal control" says that planned inspections of legal entities, including enterprises with very severe labor conditions must be done not often than once in three years. This statement does not give possibility to supervise proper control of hazardous production facilities. For a proper assessment of the sanitary and epidemiological condition at chemical enterprises in carrying out the state sanitary and hygienic supervision requires a comprehensive approach to the implementation of such control activities as: carrying out of laboratory and instrumental studies of harmful factors on workplaces and the environment, analysis of the results of medical examinations, analysis of occupational diseases and poisoning, analysis of morbidity with temporary disability of employees, the analysis of overall morbidity of workers and the population of the city. This will allow to develop specific technical measures for improvement of sanitary and hygienic conditions in the controlled objects and the environment.

Keywords: 

Sanitary and hygienic control, harmful factors, health of employees, the objects of control, condition of air in working zones, atmospheric air, soil.

Comparative assessment of the content of Alpha-active nuclides, heavy metals and arsenic in the soil on the territory of Novouralsk. According to researches for 2006-2010.

Year: 2012 (March) Number: №1 Pages: 46-52

Heading: Organization and improvement of medical care and the state sanitary and epidemiological supervision. Prevention and liquidation of consequences of emergency situations.

Article type: Scientific article.

Authors: T.G. Mironova, I.L. Potapova.

Organization: Regional department №31 of FMBA of Russia, Novouralsk Federal State Healthcare Institution №31 of FMBA of Russia, Novouralsk.

Annotation: 

The objectives are to define the level of soil pollution of various districts of the Novouralsk city and to make comparative assessment of alpha-active nuclides, heavy metals and arsenic in soils.
Materials and methods: The assessment of quality of the soil was carried out on groups of territories in residential areas of the city. Soil sampling, their storage, transportation and preparation for the analysis were made according to GOST 17.4.4.02-84[4] and GOST 17.4.3.01-83[5]. The gross content of chemical elements (heavy metals and arsenic) and the content of alpha-active radionuclides were defined in soil samples. As rationing of the content of metals in the soil at present is developed insufficiently concentration limit for lead and arsenic was used as standard [2]. For other studied chemicals for the standard it was taken the admissible concentration (AC) [3]. Besides, the content of chemicals in the soil was carried out with the comparison of its contents in soils of Ural. For Novouralsk territory the comparison sample was the average contents of chemical elements in the earth's crust, received from data (including the Ural authors) on geochemistry of landscapes and soils of Ural and provided by PGO "Uralgeologiya" for methodical indications of Gossanepidnadzor centers in Sverdlovsk region MU 2.1.7-001-98[7]. Concentration coefficients (Kc), characterizing levels of pollution and a total indicator of pollution of the soil (Zc) were counted [7, 8]. As the hygienic standard of the radioactive substances in the soil is not established, this indicator was compared with the content of radioactive materials in a background point, the village "Palniki" located in 30 km from the city (360 Bq/kg). Laboratory results were analized according to MU 2.1.7-001-98 and MU 2.1.7.730- 99[7, 8], and also SanPiN appendices one 2.1.7.1287-03 [9].
Results: According to the actual content of chemicals the soils on examined territories belong are very polluted, dangerous and extremely dangerous. At the same time the total indicator of pollution demonstrates that contamination category is admissible, reasonably dangerous and dangerous. Obtained results show that concentration of uranium radionuclides in various districts of the city exceeds the background contents. There is no evidence of alpha-active nuclides accumulation. The content of heavy metals and arsenic for the observed period (5 years) has decreased.
Conclusions:
1. The levels of nickel, arsenic and copper in soils reach their maximum on the Novouralsk territory.
2. Background contents excess for more than twice on many examined elements, demonstrates high anthropogenous pollution of the soil.
3. The content of heavy metals and arsenic during the period from 2006 to 2010 has decreased in Novouralsk territory.
4. There is no accumulation of radioactive materials in soils of Novouralsk territory.

Keywords: 

Soil quality, hygienic assessment, category of soils pollution.

The morbidity associated with micronutrient deficiency in Seversk closed administrative and territorial formation.

Year: 2012 (March) Number: №1 Pages: 53-56

Heading: Organization and improvement of medical care and the state sanitary and epidemiological supervision. Prevention and liquidation of consequences of emergency situations.

Article type: Scientific article.

Authors: N.N. Pertseva, N. G Tagarkina, D.E. Verevkin.

Organization: Regional department №81 of FMBA of Russia, Seversk, Tomsk region.

Annotation: 

The retrospective analysis of separate forms of the diseases during the period of 10 years was presented. The development of disease is associated with the nature of nutrition and certain nutritional factors. Healthy food consumption, development for the population of educational programs on problems of healthy food, the most important components of the healthy lifestyle which have found in the doctrine of food security of the Russian Federation №120, approved by the president of the Russian Federation on 30.01.2010. This doctrine requires urgent implementation among the population.

Keywords: 

Nutritional factors, micronutrients, iodine deficiency.

The organization and implementation of supervisory activities in the regional office №42 of FMBA of Russia in relation to the federal law from 26.12.2008 №294-fz and Russian federation code about administrative offences.

Year: 2012 (March) Number: №1 Pages: 57-61

Heading: Organization and improvement of medical care and the state sanitary and epidemiological supervision. Prevention and liquidation of consequences of emergency situations.

Article type: Scientific article.

Authors: A.S. Alexandrov, M.V. Stolyarova, O.G. Lavrukhina.

Organization: Regional department №42 of FMBA of Russia, Zelenogorsk, Krasnoyarsk region.

Annotation: 

The objective is to develop algorithm of actions for officials in supervision activities.
Results: During an audit that defined by the Federal law from December 26, 2008 №294 – FZ "About protection of rights of legal entities and individual entrepreneurs when performing state and municipal supervision" and the following violations detection involved persons should be punished according to administrative offences code from 30.12.2001 №195 - FZ. Other procedures that are not regulated by the Federal law №294 - FZ of 26.12.2008 may be implemented when received information is analyzed by state control department.
Conclusions: During the supervision it is necessary to use all legislative and carefully analyze the information, which served as the basis for examination.

Keywords: 

Entrepreneurship supervision.

The morbidity and primary disability owing to tuberculosis in the Orenburg region in 2008-2010.

Year: 2012 (March) Number: №1 Pages: 62-68

Heading: Organization and improvement of medical care and the state sanitary and epidemiological supervision. Prevention and liquidation of consequences of emergency situations.

Article type: Scientific article.

Authors: T.V. Voloboyeva, T.N. Smagina, A.V. Gavrilov.

Organization: Federal State Institution, The main office of medical and social examination of the Orenburg region of FMBA of Russia, Orenburg.

Annotation:

Objective: To determine the effectiveness of the implementation of regional target program "The fight against tuberculosis in Orenburg oblast", adopted in 2006 and acting on now.
Materials and methods: The analysis is based on index of quality of work of the antituberculosis service. Data were submitted by the regional Ministry of health and informational and analytical press service of the Government of the Orenburg region, and also on the basis of primary adult and child disability in the Russian Federation. All data were published in the analytical collections of medical and social examination office.
Results: Regional indicators of quality of work of antitubercular service showed positive dynamics during the period 2008 - 2010. Total number of TB infection rate has decreased by15.6%. Number of TB patients in penitentiary system has reduced by 27.2%. Number of homeless people also has decreased by 9.1%. During medical examinations identification of patients with TB increased by 4%. Occurrence rate of early relapse of TB has reduced to 1, 7 per 100 thousand of the population (decreasing rate is 26.1%). Mortality rate in hospitals reduced to 10, 3 (decreasing rate is 18,9%). Primary disability has also decreased (decreasing rate is 24, 4%). However, the number of tuberculosis cases in the region remains high: 96, 1 on 100 thousand populations (2010), in RF - 82, 6(2009). The level of primary disability (PD) in adult population in 2010 is above 26, 7%. In the Russian Federation PD is 2.2 per 10 thousand and in the region is 3, 0, it is the 18th rank place among the 83 subjects of the Russian Federation. In primary adult disability total amount of working population is increasing (2008 - 94, 9%, 2010 - 96,3%). The level of primary child disability is above the national average almost in 4 times (region – 1, 4, RF - 0, 4) - 3rd rank place after the Chechen Republic and the Republic of Khakassia.
Conclusions: The state of the epidemiological situation of TB is directly depends on the direction of social policy. Despite of the difficult social and economic situation caused by the global financial crisis, prompt actions in the region to combat TB caused positive changes in the main indicators of incidence and disability; but still they remain above the average values in Russia that requires not only the continuation of TB activities, but also their strengthening and expansion.

Keywords: 

Tuberculosis (TB), causes, prevalence, incidence, morbidity, primary disability.

The consequences of nuclear tests at the Semipalatinsk polygon.

Year: 2012 (March) Number: №1 Pages: 69-75

Heading: The results of research works in the field of studying the influence on the humans especially dangerous and harmful production factors.

Article type: Scientific article.

Authors: N.V. Alishev, B.A. Drabkin, V.M. Shubik, N.A. Nikolaeva, E.N. Puchkova.

Organization: The scientifically and therapeutic center of the veterans of the special risk subdivisions; Federal State Healthcare Institution Medical and Sanitary Unit №144 of FMBA of Russia, St. Petersburg.

Annotation: 

The objective is to characterize the influence of nuclear tests at the Semipalatinsk polygon on health of trial participants and the population of the regions near the trial site.
Materials and methods: The frequency of various diseases and their treatment (medical records data) were studied in veterans under the supervision and treatment in the Scientific-medical center of the veterans of the special risk subdivisions. The data of clinical examination were compared with the incidence of congenital and acquired cellular and humoral immunity in population of Kazakhstan and the Altai territory that are located near the test site. The analysis of literature data and the results of their own research of immune system and population health of Kazakhstan and the Altai territory near the test site were held.
Results: The increase in frequency of a number of diseases is observed in veterans. Changes in parameters of T - and B - systems immunity are found; also shifts in humoral and cell immunity are detected. There are evidences that indicate on immune and health disorders of the population areas adjoined to the polygon. Investigations have demonstrated the presence of autoimmune disorders for a long period of time.
Conclusions: Immune system and health disorders in veterans of special risk subdivisions and in population have long-term nature and occur decades after nuclear tests.

Keywords: 

Nuclear tests, immunity, autoimmune changes, stress.

Leukoreduction of components using domestic devices to remove leukocytes.

Year: 2012 (March) Number: №1 Pages: 76-84

Heading: The results of research works in the field of studying the influence on the humans especially dangerous and harmful production factors.

Article type: Scientific article.

Authors: V.N. Melnikova, E.A. Selivanov, G.U. Kiryanova.

Organization: The Federal State Institution Russian research Institute of Hematology and Transfusiology of FMBA of Russia, St. Petersburg.

Annotation: 

The article demonstrates necessity of leukocyte depletion of components for improving immunological and infectious safety of their transfusion. The stages of domestic devices development are presented; these devices reduce leukocytes, erythrocytes and plasma.

Keywords: 

Leukocyte depletion, haemocomponents, domestic devices, safety.

Fumarate containing infusion solutions as drug of choice in emergency.

Year: 2012 (March) Number: №1 Pages: 85-94

Heading: The results of research works in the field of studying the influence on the humans especially dangerous and harmful production factors.

Article type: Scientific article.

Authors: E.A. Selivanov, L.V. Slepneva, N.N. Alekseeva, G.A. Chmylova, M.L. Gerasimova.

Organization: The Federal State Institution Russian research Institute of Hematology and Transfusiology of FMBA of Russia, St. Petersburg.

Annotation: 

Application of infusion solutions containing antihypoxant - sodium fumarate for emergency medical care is based in this work. Clinical data of the positive effect of the saline solution "Mafusolum" and colloid blood substitute "Polyoxyfumarinum" on hemodynamics, oxygenation and acid-base balance of the body during the course of the critical state (trauma, burns, hemorrhagic shock and others) are provided in this article. Solutions are also demonstrate antihypoxic and antioxidant properties. The effectiveness of new fumarate containing solution "Konfuminum" in infusion-transfusion treatment as antihypoxia component and low volume correction is showed.

Keywords: 

Antihypoxants, hypoxia, hypovolemia, emergency medical care, fumarate containing infusion solutions, Mafusolum, Polyoxyfumarinum, Konfuminum.

Dynamics of population ageing in Ozersk city (1953-2007).

Year: 2012 (March) Number: №1 Pages: 95-105

Heading: The results of research works in the field of studying the influence on the humans especially dangerous and harmful production factors.

Article type: Scientific article.

Authors: V.I. Telnov, F.D. Tretyakov.

Organization: Federal State Unitary Enterprise South - Ural Institute of Biophysics of FMBA of Russia, Ozersk, Chelyabinsk region.

Annotation: 

The purpose is to evaluate in dynamics the demographic ageing of the population in Ozersk for the period from 1953 to 2007, according to the traditional and alternative indicators.
Material and methods: Information on the demographic and age and sex composition of the population of Ozersk obtained in the statistics Department of the city administration, census results, the urban population of the Chelyabinsk region and the Russian Federation from 1959 to 2002 and the other statistic materials were used. Dynamic analysis was performed of absolute and relative number of elderly and old population; the pace of population ageing; the system of structural, age and alternative indicators of population ageing; comparisons with other regions.
Results: During the study of the dynamics of demographic ageing in Ozersk from 1953 to 2007 it was shown that its original state in the observed period was more favorable compared to the Chelyabinsk region and Russia in general. However, following the result of higher rates of aging, noted in the evaluation of different indicators, by 2002 this process in Ozersk was the same or even a slightly more pronounced than in the Chelyabinsk region and Russia. This fact is confirmed by high ageing index of the population of Ozersk. The dynamics of traditional indicators of aging in Ozersk and in Russia in General correspond to the general global trends; the dynamics of the alternative metrics of ageing has the opposite direction, namely the increase of prospective median age and the proportion of persons with an expected life expectancy (ELE) 15 years or less; the decrease in the average age at which ELE is 15 years or less and mediumweighted expected number of years of life. The main reasons for such discrepancies, obviously, are higher mortality rates and lower average age of death from the main reasons in Ozersk and Russia, which leads to a corresponding decrease in ELE.
Conclusions: Dynamic increase of the traditional indicators of the population ageing in Ozersk meets national and global trends. In contrast, the dynamics of alternative indicators of aging in Ozersk, as in Russia in general, has the opposite direction regarding global trends, reflecting different quality of ageing in our country.

Keywords: 

Demographic ageing, coefficients and indexes of demographic ageing, index factor analysis, structural chart, alternative indicators of ageing.

The role of hyperhomocysteinemia in development of thromboembolic complications.

Year: 2012 (March) Number: №1 Pages: 106-117

Heading: The results of research works in the field of studying the influence on the humans especially dangerous and harmful production factors.

Article type: Scientific article.

Authors: V.M. Shmeleva, S.I. Kapustin, M.N. Blinov, A.P. Polyakova, N.B Saltykova, L.P. Papayan.

Organization: The Federal State Institution Russian research Institute of Hematology and Transfusiology of FMBA of Russia, St. Petersburg.

Annotation: 

The purposes of the study are to find out the role of hyperhomocysteinemia (GHZ) in development of thromboembolic complications and detect associative links of GHZ with other hereditary and acquired risk factors for blood clots.
Materials and methods: 447 patients were examined with vein thrombosis (VT) in anamnesis and 260 people in the control group. Homocysteine (HZ) was determined by chromatography under high pressure column. Polymerase chain reaction (PCR) was used in molecular and genetic testing of I, II, V, XII blood coagulation factors, tissue plasminogen activator (tPA), inhibitor of plasminogen activator type I (PAI – 1), glycoproteins la, Iba , IIIa, platelet ADP receptor (P2 YI2), methylentetrahydrofolatereductase (MTHFR), apolipoprotein E (ApoE), endothelial synthase of nitrogen oxide (eNOS), angiotensinogen, angiotensinconverting enzyme, angiotensin II receptor first type.
Results and conclusions: It is shown that hyperhomocysteinemia is a frequent and independent risk factor in development and recurrence of vein thrombosis. High level of HZ in plasma increases the influence of other prothrombotic factors on the risk of thrombosis. The relative risk of vein thrombosis in combination with GHZ and the factor V Leiden mutation is greater than isolated carriage of these risk factors and demonstrates synergic effect in inducing VT. There are more frequently marked genotypes I/I in the gene t-PA (45% vs. 25%, p = 0, 04), C/C in the gene eNOS (18% compared with 9, 5%, p=0, 04) and T/ T in the gene MTHFR (20, 8 % versus 6 %, p = 0, 01) in patients with GHZ. There is a higher incidence of carriage genotype 4G/ 4G in the gene PAI - 1 (42% vs 30%, p = 8, 07) and D/ D in the gene ACE (30% vs. 20, 6 %, p =0,08) in patients with GHZ. GHZ is effectively eliminated by treatment with folic acid. The level of HZ must be examined in patients with thrombotic complications.

Keywords: 

Homocysteine, hyperhomocysteinemia, vein thrombosis and thrombophilia.

Complex phisiobalneotherapy treatment of gallbladder dyskinesia, proceeding on a background of psycho-emotional stress.

Year: 2012 (March) Number: №1 Pages: 118-123

Heading: The results of research works in the field of studying the influence on the humans especially dangerous and harmful production factors.

Article type: Scientific article.

Authors: O.A. Poddubnaya, I.N. Smirnova, O.I. Ugolnikova, T.E. Levitskaya, L.V. Barabash, O.E. Golosova, S.V. Alaiceva, O.V. Dostovalova, I.G. Skurlatova, N.U. Lyapunova.

Organization: Federal State Institution Tomsk Research Institute of balneology and physiotherapy of FMBA of Russia, Tomsk; GOU VPO Siberian State Medical University of Roszdrav, Tomsk.

Annotation: 

The objective is to develop complex phisiobalneotherapy treatment of gallbladder dyskinesia, proceeding on a background of psychoemotional stress.
Material and methods: The study included 59 patients divided into 2 groups (main and control). Several examinations were performed in the dynamics of the conducted research:ultrasound examination of volume and contraction of the gallbladder, the determination of the level of resistance and cortisol level, psychological testing, calculation of health indexes.
Results: Dyskinesia in patients from the main group who received treatment according to the plan was stopped 74,1% of cases; increase on 16,05% in the number of high level of reactivity; decrease to normal the elevated levels of cortisol, p=0,041), marked decline of anxiety (p = 0,036), stress level (p=0,005) and emotional stress (p = 0,001); the mean values of health index after treatment were significantly higher than in the control group (p = 0,006); effectiveness of treatment was 90,87%.
Conclusions: Treatment in accordance with the developed scheme promotes normalization of motor function of the gallbladder, improves mental and emotional status, increase of adaptational possibilities of the organism and, therefore, prevents the development of chronic cholecystitis and cholelithiasis.

Keywords: 

Gallbladder dyskinesia, phisiobalneotherapy treatment, the level of reactivity, cortisolum, emotional status, health index.

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