Goal. To study the features of complaints in young women with idiopathic arterial hypotension (IAH) and determine their frequency.

Materials and methods. A comparative analysis of the frequency of complaints between two groups of women aged 18-23 was conducted: a test group with IAH (n=210) with SBP 97(92-98 mmHg), and control group (n=96) with normal arterial pressure at SBP 123(121-125) mm Hg.

Results. 58% of women with IAH, which is more often than women with normal blood pressure, walk less than 5 km per day. Women with IAH with moderate physical and emotional stress often report complaints of shortness of breath (25%) and pain (40%) in the chest. With IAH, they often complain of pain in the legs, especially when walking (35%), dizziness (38%), pain and blanching of the fingers or toes in the cold (36%). 12% of women with IAH have a nocturia.

Conclusions. Young women with IAH per day are walking less than 5 km, often complain of complaints of shortness of breath and chest pain, pain in the legs, dizziness, pain and blanching of fingers or toes in the cold. 12% of women with IAH note nocturia.

Aim. To study the left atrium (LA) remodeling in patients with different body mass, suffering from chronic obstructive lung disease (COLD).

Materials and methods. Seventy two patients with COLD, who were divided into 3 groups, underwent echocardiography: group 1– patients with normal body mass (n = 31), group 2 – patients with excessive weight (n = 21), group 3 – patients with degree I obesity (n = 20).

Results. Among patients with COLD, belonging to group 3, indexed parameters of minimum (15.43 ± 1.62 ml/м2, р = 0.004) and presystolic (20.52 ± 1.88 ml/м², р = 0.03) volumes of LA increased; these patients also demonstrated growth of maximum upper-lower size of LA with elevation of its linear maximum and minimum sizes, when compared with patients of group 1. Patients with different body mass, suffering from COLD, have similar volumes of passive and active depletion and their corresponding fractions. COLD patients with excessive body mass and obesity showed moderate pulmonary hypertension.

Conclusions. Patients with obesity, suffering from COLD, have significantly elevated indexed parameters of presystolic and minimum LA volumes, which can be considered as early markers of impaired function of LA. Increased minimum LA volume can be one of the factors of gas exchange impairment.

Aim. To analyze the regulating documents and work out the algorithm of prescribing combined medicinal preparations, containing small quantities of narcotic drugs, psychotropic substances, their precursors and other pharmacological active substances.

Materials and methods. The normative documents, regulating the order of prescribing and selling combined medicinal preparations, containing narcotic drugs, psychotropic substances and their precursors were analyzed.

Results. Some normative documents to regulate the order of prescribing combined medicinal preparations, containing narcotic drugs and psychotropic substances, present problems. To simplify the procedure of prescribing such medicinal preparations, there was suggested an algorithm, explaining: the choice of prescription form; conditions of prescribing combined medicinal preparation by trade name; terms of prescription validity and possibilities of their prolongation; regulated possibilities for exceeding norms of prescribing medicinal preparations and order of their registration.

Conclusions. The suggested algorithm of the order of prescription will promote observation of requirements of the existing normative acts.

The materials, reflecting the course of life and creative work of Ye.A. Vagner, are presented in the paper. His work as a talented surgeon, great scientist, first Academician of the Academy of Medical Sciences of the USSR in the Ural, State prize winner, founder of scientific surgical school, remarkable pedagogue and tutor, experienced head of higher medical school is shown. During 25 years he was the head of Perm State Medical Higher School, named now after him. The contribution of Ye.A. Vagner into development of not only national, but also world surgery, medicine, public health is invaluable.

Aim. To ground and estimate the efficiency of using nonmedicamentous methods of treatment in patients with occupational radiculopathy of lumbosacral level.

Materials and methods. Sixty seven patients, diagnosed occupational lumbosacral radiculopathy, were examined; patients’ neurological status, manifestation of pain syndrome by 10-score visual analog scale and neuromuscular state by stimulation electroneuromyography data prior to and after treatment were assessed.

Results. Treatment-and-rehabilitation complex included magnetic-laser therapy, acupuncture, combined with curative gymnastics. By the completion of treatment, positive dynamics regarding nearly all neurological states, including reduced manifestation of painful sensations, increased volume of active movements in the lumbar spine, decreased hyperesthesia rate and hypoesthesia intensity in the zone of injured roots, decreased occurrence of Lasegue test was observed. Dynamics of electroneuromyographic parameters was expressed by improved conduction of nerve impulses through the peripheral low extremity nerves and roots L4, L5, S1 of cerebrospinal nerves.

Conclusions. Application of the offered complex provided positive effect by the end of treatment in 82.3 % of cases.

Aim. To present the hygienic assessment of foreign students’ living conditions in the hostel of Perm State Medical University.

Materials and methods. Sanitary-epidemiological estimation of arrangement, equipment and maintenance of the hostel for Indian students was performed. Hygienic assessment of the hostel territory, rooms and accommodations for common use, equipment and facilities of the building and rooms was presented. In the living and auxiliary rooms, sanitary-hygienic tests (measurements) regarding microclimate (90), infrared radiation (20), noise level (45), electromagnetic radiation (40), natural and artificial light (65) were fulfilled.

Results. Objective assessment of social factor and living conditions, influencing adaptation of foreign students to new climatico-geographic conditions was obtained. The living conditions for foreign students in the hostel of Perm State Medical University correspond to sanitary-epidemiological rules and standards, except for the level of noise.

Conclusions. Favorable social and living conditions, offered to Indian students in the student’s hostel, help them to overcome difficulties, connected with adaptation of foreign medical students.

Aim. To determine the peculiarities of distributing antigens of major histocompatibility complex in children with atopic dermatitis and children with bronchial asthma.

Materials and methods. Serologic typing of HLA class I-complex antigens and molecular typing of HLA class II-complex antigens was fulfilled in 52 children (age range 5 to 14 years) with disseminated moderate and severe atopic dermatitis and 122 children (age range 5 to 14 years) with moderate and severe atopic bronchial asthma.

Results. Among children with atopic dermatitis, there was found high incidence rate of HLA-complex antigens B15, B16, B17, DRB1*13 and DQB1*0602-8, presentation of which was associated with elevation of relative risk for the development of disease by 3.3–8.4 times. In children with atopic bronchial asthma, the observed high incidence rate of HLA-complex antigens A26, B18 and DRB1*17 was associated with rise of relative risk for the development of disease by 3.0–9.1 times.

Aim. To assess the laboratory indices of calcium-phosphorous metabolism in patients with early infantile caries (EIC).

Materials and methods. Complex clinicolaboratory examination of 34 children (age range 36 to 72 months), diagnosed early infantile caries, was carried out. Patients’ dental status was stated; a number of laboratory studies to estimate calcium phosphorous metabolism with further mathematical processing of the obtained material was fulfilled.

Results. The analyzed laboratory studies showed the absence of pathological regulation of calcium-phosphorous metabolism in the body of the examined patients. The correlation analysis of caries intensity and daily urinary calcium and phosphorus levels in patients of type I revealed weak correlation feedback, r = –0.21, r = –0.25. The analogous analysis in patients of types II and III detected moderate feedback and the similar statistical data, namely, r = –0.26, r = –0.34 and r = –0.27, r = –0.29, respectively.

Conclusions. Interaction between the deficit of the excreted calcium and phosphorus in the daily urine and the risk for development of early infantile caries was found in patients with EIC. Laboratory diagnostic studies, so as to administer adequate drug therapy for correction of separate indices of calcium-phosphorous metabolism, are necessary. It should be also noted that among patients with decompensated form of caries course, low calcium indices are more often associated with low phosphorus indices in the urine against the background of hematological parameters, which keep within the standards.

Aim. To determine the risk factors for the development of external pancreatic fistulas in the outcome of infected pancreatonecrosis, which do not close as a result of conservative treatment.

Materials and methods. The results of treatment were analyzed in 44 patients with pancreatonecrosis. The influence of different risk factors for the development of external pancreatic fistulas after surgery for infected pancreatonecrosis was studied, using Spearman’s correlation coefficient.

Results. The repeated surgeries one year after pancreatonecrosis were required by 9 % of patients in connection with pancreatic cysts and for 11.36 % – with external pancreatic fistulas. There was observed a positive correlation of a mean value between the formation of external pancreatic fistulas, which did not close after intensive conservative therapy and the localization of necrosis zone in the region of isthmus (r = 0.31, p = 0.00), its depth 50 % and more (r = 0.46, p = 0.00), quantity of outflow (r = 0.55, p = 0.00) with amylase activity > 1000 units (r = 0.53, p = 0.00).

Conclusions. Localization of necrosis zone in the region of isthmus, necrosis depth 50 % and more, quantity of control drainage outflow > 150 ml, high amylase activity in drainage > 1000 units are predictors of the formation of external pancreatic fistulas in the outcome of acute destructive pancreatitis, which need surgical correction.

Aim. To study the clinical and economic efficiency of treatment in patients with tuberculosis in conditions of day hospital when compared with treatment of patients in conditions of 24-hour hospital.

Materials and methods. The results of treatment of patients with first-ever lung tuberculosis in conditions of day hospital were analyzed.

Results. 76.7 % of patients, by the moment of discharge from the hospital, successfully completed the course of treatment.

Conclusions. Clinical efficiency of treatment in the day hospital did not differ from specialized indices of antituberculous work that confirms its significant economic efficiency.

Aim. To study the peculiar features of complaints among young women with idiopathic arterial hypotension (IAH) and determine their frequency.

Materials and methods. Comparative analysis of complaints frequency between two groups of women aged 18–23 was carried out: the test group of patients, suffering from IAH (n = 210) with SAP 97 (92–98) mm Hg and the control group (n = 96) with normal arterial pressure with SAP 123 (121–125) mm Hg.

Results. 58 % of women with IAH walk less than 5 km a day that is reliably more frequently compared to women with normal arterial pressure. Women with IAH, having moderate physical and emotional load, more often have complaints of dyspnea (25 %) and thoracic pains (40 %). When suffering from IAH, patients more often complain of pain in their legs, especially while walking (35 %), dizziness (38 %), pain and paleness of hand and leg fingers in cold (36 %); 12% of women with IAH have nocturia.

Aim. To study the peculiar features of roentgenological picture of pulmonary tuberculosis in patients with polymorphous HLA-DRB1 allels in the genotype in associations with pro-and-antiinflammatory cytokines concentration.

Materials and methods. The complex clinicoimmunogenetic examination of 64 patients with pulmonary tuberculosis was carried out. The patients’ age ranged 18 to 52 years. The gene HLA-DRB1 polymorphism was determined using the method of polymerase chain reaction with DNA, previously extracted from blood samples. Cytokine concentration was determined in the peripheral blood before specific treatment, using the assay kits of “Vector-BEST Company” (Russia).

Results. The prevailing clinical form of pulmonary tuberculosis among patients was infiltrative one – 40 (62.5). Bacterioexcretion was stated in 89.5 % of cases. Roentgenological picture of pulmonary tuberculosis in patients with HLA-DRB1 *04, *13, *14, *16 alleles was characterized as disseminated injury of lung tissue with destructive changes, the concentration of IL-1b, TNF-α exceeded the standard values by more than 3 times (r = 0.88; р = 0.040), IL-2, IL-10, g-INF was lower than standard values by more than 4–5 times (r = 0.75; р = 0.003).

Conclusions. When studying HLA-DRB1 gene polymorphism and pro-and-antiinflammatory cytokines concentrations in patients with pulmonary tuberculosis, it was established that patients with HLA-DRB1 *01, *07, *08, *10, *15 alleles more often, compared to the others, had disseminated injury of lung tissue, in most cases with its destruction as well as dysbalanced cytokine balance in the direction of deep immunosuppression.