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№2' 2018


Individualization of antibiotic therapy for pneumonia in patients with hemoblastosis from the perspective of antibiotic resistance
5 - 11
The article presents the results of investigation of antibacterial therapy regimens in patients with hemoblastosis. The approaches to the treatment were determined on the basis of establishing the leading bacterial pathogens and investigation of the state of their antibiotic resistance. The patients with hemoblastomas with community acquired pneumonia without the signs of neutropenia can be recommended monotherapy with cefepime and meropenem. Аmikacin + meropenem and amikacin + cefepimum regimens can be recommended to the patients with hemoblastomas under the conditions of pneumonia in hospital conditions and in the context of deep and prolonged neutropenia.
Structural and functional myocardial changes in patients with chronic obstructive pulmonary disease combined with hypertension
12 - 15
Based on the structural and functional evaluation of the myocardium, it was revealed that prognostically unfavorable types of left ventricle geometry and signs of chronic cor pulmonale are more common in patients with a combination of chronic obstructive pulmonary disease and hypertension. This indicates extension of the processes of remodeling of the left and right parts of the heart and is associated with a high risk of cardiovascular complications.
The use of minimally invasive operations in treatment of patients with colorectal cancer complications with intestinal obstruction
16 - 19
The possibilities of use of minimally invasive surgical interventions in patients with complicated forms of colorectal cancer are analyzed. The questions of choosing the method of surgical treatment are highlighted. The results of surgical treatment of this category of patients are presented.
Mechanical invaginated esophagogastric anastomosis in prevention of postoperative complications in patients after esophagus resection
19 - 22
The article compares the results of treatment of patients with esophageal cancer who underwent resection of the esophagus with formation of two variants of mechanical esophagogastric anastomosis: classical and invagination. The number of postoperative complications of anastomosis was assessed, the effectiveness of invagination mechanical anastomosis was proven.
Modern aspects of diagnostic and surgical treatment of pericardial effusion
23 - 28
The literature review devoted to modern approaches to diagnosis, etiology, and tactics of surgical treatment of pericardial effusion of various etiology. Importance of differentiated approach to the choice of optimal surgical tactic depending on the cause of the disease, the patient’s condition and comorbidities is emphasized.
Modern view on the problematic aspects of patent arterial duct in children (literature review)
29 - 34
The literature review is devoted to one of the most important directions of modern surgery − the problem of patent arterial duct in children of different age groups. This is one of the most common congenital malformations of the cardiovascular system, which can occur both as an isolated disease, and as combination with other heart and vessel defects. The existing terminology, classification, diagnostic criteria of hemodynamically significant pathology are presented. Echocardiographic diagnostic criteria are described in detail. The modern approaches to treatment of patent arterial duct, including conservative and surgical methods are elucidated.
Аromathase activity as an objective marker of necessity of cryotherapy of uterine cavity in hyperplastic endometrial processes
35 - 40
The findings of the investigation of women with glandular and adenomatous endometrial hyperplasia are presented. To determine the degree of severity of the pathological process and select the optimal and pathogenetically substantiated therapeutic tactics, the coefficient of aromatase activity was evaluated. If this coefficient was elevated, ablation of the endometrium with precondition cryosurgical treatment of the uterine cavity should be recommended. The method of clinico−laboratory estimation of aromatase activity can be introduced as a marker for determining severity of the pathological process in women with endometrial hyperplasia.
General clinical, biochemical parameters and peripheral blood hormone level in women at ovarian hyperstimulation syndrome
41 - 45
The data of clinical, biochemical, hormonal indices of the blood and ultrasonography of women in a short protocol IVF program were analyzed. The persons with a risk of ovarian hyperstimulation syndrome were determined to demonstrate increase of leucocyte content due to segmentonuclear neutrophils and monocytes; two−fold increase of progesterone and estradiol content. The expedience of determining these indices for timely correction of ovulation stimulation program and complex prevention of the above syndrome was emphasized.
Morphofunctional state of hyaline cartilage at reparative techniques of local knee joint cartilage defects treatment
46 - 48
Based on the differences in the morphofunctional state of the hyaline cartilage, a surgical reparative technique for treatment of local knee joint cartilage defects was substantiated. The reparative surgical technique of deep tunneling to the bone marrow cavity has regenerative advantages over reparative methods by microfracturing and subchondral tunneling. Arthroscopic deep tunneling of local cartilage defects has pathogenetic priority.
Immunohistochemical factors of endometrial cancer prognosis
49 - 52
The results of investigation of molecular−biological markers mt p53, Bcl2, Ki−67, VEGF are presented. Their investigation gives a valuable information about development of endometrial cancer, aggressiveness of its course and therapy efficiency.
Medical rehabilitation in oncology: the current state of the problem
53 - 56
The problem of rehabilitation of cancer patients, which includes several stages, is featured. Along with special treatment, aimed at restoring the functions of the body by physiotherapy, physical therapy exercises, psychological rehabilitation is important. Unsatisfactory statistics on cancer incidence, on the one hand, and advances in the treatment of malignant tumors, on the other hand, determine the relevance of development of rehabilitation in oncology.
Analysis of causes of epilepsy pharmacoresistance formation in children and ways of overcoming it
57 - 60
The article presents the results of the analysis of the factors of absolute and relative epilepsy pharmacoresistance in children. It is shown that asthenogenic and iatrogenic causes of pharmacoresistance are subject to correction.
Current issues in classification of vertebrospinal injury
61 - 63
The problem vertebrospinal injuries and their consequences for neuro−locomotive system are featured. The modern classifications, methods of diagnosis, treatment and rehabilitation of patients with vertebrospinal injury are analyzed; the results of the latest research on this issue are presented.
Lipid metabolism features in HIV−infected persons with chronic hepatitis C and in patients with HIV/HCV co−infection
64 - 67
The results of a study of blood lipids in HIV−infected patients with chronic hepatitis C and co−infection HIV/HCV are presented. The degree of deviation of the studied indicators from the control values was determined, indicating the rank position of each of them.
Cerebrospinal fluid and blood serum beta−2−microglobulin in HIV−associated neurological diseases
68 - 73
The level of beta−2−microglobulin (B2MG) in the cerebrospinal fluid and blood serum were investigated in patients with HIV−associated CNS diseases. The increase of B2MG, direct association with the viral load of HIV RNA and its concentration in the blood was detected. The equation, which allows calculating the average concentration of B2MG in the liquor according to its blood index, was proposed. Differences in the level of B2MG in the cerebrospinal fluid were determined depending on the etiology of the CNS involvement. The prospects of using the B2MG indicator as a prognostic and diagnostic biomarker in HIV−associated neurological diseases were emphasized.
Present−day clinical and laboratory characteristic of acute meningococcal and pneumococcal neuroinfections in adults
74 - 78
Clinical and laboratory features of acute meningococcal and pneumococcal neuroinfections in adults were determined. Clinical and anamnestic data and parameters of clinical test of blood and cerebrospinal fluid of patients in the course of the disease were evaluated. Based on the results of the analysis, the most typical clinical manifestations of acute meningococcal and pneumococcal neuroinfections, laboratory criteria for determining severity of the disease and the prognosis of an unfavorable course of the disease, were determined.
Prediction of chemoresistant pulmonary tuberculosis severity depending on Mycobacterium Tuberculosis genotypes
79 - 83
The article presents the results of predicting the clinical course of chemoresistant pulmonary tuberculosis depending on Mycobacterium Tuberculosis (MTB) genotypes during the intensive phase of treatment using VNTR−genotyping. The obtained results showed the dependence of the clinicolaboratory indicators dynamics on MTB genotype in patients during the treatment.
How to reduce the risks of multicomponent drug therapy
84 - 88
The risks of potentially unsafe variants of drug treatment are analyzed. Main risks and ways of their realization are described. Measures to eliminate or minimize these risks are described in detail. Examples from real practice of different areas of clinical medicine are supplied.
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