All Posts in Category: Medical Herald №022-2016

New approaches in male infertility diagnosis: examination of biopsy material from testicle with normal and disturbed spermatogenesis

Testicle biopsy is still the most important and conclusive stage of male infertility diagnosis in the presence of azo-ospermia. Applying new advanced techniques of histological analysis allows us to evaluate spermatogenesis disturb-ance from a new angle. As a result there is a need for new seminiferous tubules signification that should use data from immune histochemical tests and be based on their phenotypic characteristics. Besides, adopted in the 1970s outdated criteria for spermatogenesis disturbance evaluation also have to be revised. As follows from the conducted study, fol-lowing classes of seminiferous epithelium should be considered: a) normal spermatogenesis; b) hypospermatogenesis; c) meiotic block to spermatogenesis; d) spermatogonial (focal case of SCO-syndrome); e) SCO-syndrome; f) tubular atrophy. Available from the tests data on spermatogenesis condition will be helpful in appropriate idiopathic male infer-tility treatment planning and in choosing the optimal assisted reproductive technology (TESE, MD-TESE, MESE, PE-SA, ICSI, IVF).

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Paranasal sinuses parameters measurement procedure in the context of intravital cephalometry using cone beam computed tomography (CBCT)

Paranasal sinuses parameters standardized measurement procedure in the context of intravital cephalometry is suggested in the paper. Optimal cone beam computed tomography reformats and points of beam application for maxillary, sphenoidal and frontal sinuses’ cavities measurement have been found, substantiated and presented. In nasal cavity anatometry for ethmoidal air cells indirect size features have been applied.

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Medical experts’ opinion on organizing specialized medical aid for children with epilepsy and convulsive disorders in zabaykalsky krai

Goal of the research is to assess medical and social factors in the system of organizing medical aid for children with epilepsy in Zabaykalsky Krai with the participation of medical experts. Research methods and data: questionnaire data from 24 medical experts in Zabaykalsky Krai was analyzed. Findings. According to the medical experts, condition of specialized medical aid for patients with epilepsy and convulsive disorders in Zabaykalsky Krai at the present time based on compliance with the standard of care (100,0 %) and availability of drugs in chemists shops (95,8%) appears satisfactory and good. According to the medical experts, the weakest spot of the current organization of medical aid is interaction with social services (33,3%, low estimate). Epileptologist’s consultation is necessary in all cases; otolaryngologist’s consultation is the least needed by the patients (54,2 %, low estimate). Additional diagnostic techniques, which are needed by the greater part of the patients: electroencephalography (EEG) (95,8%), plain brain magnetic resonance imaging (MRI) (91,7%). The medical experts consider conducting regular long-term antiepileptic therapy the most significant arrangement (87,5%) among those necessary to improve treatment outcomes and to improve the quality of life of patients with epilepsy. Conclusion. According to the medical experts, the current organization of specialized medical aid for children with epilepsy and convulsive disorders in Zabaykalsky Krai based on compliance with the standard of care and availability of drugs is good and satisfactory. Condition of interaction of the organization of specialized medical aid with social services has been evaluated as unsatisfactory. The medical experts consider epileptologist the most essential specialist in the context of treatment for children with epilepsy and convulsive disorders. Demand for comprehensive treatment (incl. consultations of neurologist, epileptologist and psychiatrist) amounts to 20,84 %. Regular longterm antiepileptic medication is the basic arrangement for improvement of treatment outcomes and improvement of the quality of life of children with epilepsy and convulsive disorders.

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Problems in managing medically induced headache

Medically induced headache (MIHA) is not only an important clinical issue, but it is also a management issue that is not yet close to be solved. Taking into account that MIHA doesn’t occur particularly often in general and occur often (more than one third of the cases) in the presence of chronic daily headache, its treatment expenses are at an average three times heavier then treatment expenses for headache of other nature. In addition, for 30–58 % of patients with MIHA the treatment is ineffective, and they often (up to a half of the cases) suffer a relapse. The most common factors that lead to MIHA contraction are patients’ preference for selftreatment and the possibility to acquire analgesics without a prescription. The most common drugs that cause MIHA are combination analgesics, especially those containing codeine, in Russia and barbiturates combined with caffeine and triptanes in foreign countries.

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Speech therapy for children and adolescents with deviant behaviour within an audiology facility

The article concentrates on reviewing of the specific features of speech therapy for children and adolescents with deviant behaviour within an audiology facility. Basic and special methods and techniques in speech therapy activities on speech pathology diagnosis and treatment in the context of diminished hearing are listed in the paper. Methods and techniques in deviant behaviour detection and prevention among children and adolescents are also listed.

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Medical organizational arrangements towards health gain for infertile women of late reproductive age

The article presents a research on the management of medical care for infertile women of late reproductive age in the Samara Region that consists of statutory regulation of activities, organizing structure, personnel, performance, obstetrics and gynecology doctors’ opinion on the medical care management. Based on the results of the research a system of medical organizational arrangements was developed, implementation of which would give an opportunity to improve medical care practices for infertile women of late reproductive age and to improve their reproductive health condition. Following the developed procedure of the delivery of medical care for women of late reproductive age with the consideration of estimate health group, new health technology adoption, flexible system of management, fertility-challenged couples register management automation, a new personalized strategy for treatment was suggested.

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Contraceptives with abortive action: professional and moral aspects in the work and training of pharmaceutical specialists

The article reads about contraceptives with abortive action from professional, spiritual and moral positions in the relation to the work and training of pharmaceutical specialists in the context of the implementation of the “Agreement on Cooperation between the Russian Federation Ministry of Health and the Russian Orthodox Church” on forming the spiritual foundations of professional medical practice and training of specialists in the sphere of health, and maternal and child health protection, including the matters of reproductive health protection and the promotion of family values (art. 5 and 9).

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Influence of hypertensive crisis on evaluation of quality of life of patients with arterial hypertension

In accordance with the concept of the WHO one of the main objectives of patient treatment is the reduction or elimination of disease symptoms, control over them and over the factors of the risk. However, this goal cannot be fully achieved if the patient sense of well-being – physical, mental and socialis not taken into account. The dynamics of clinical indicators during the process of treatment is less important for a patient than the impact of the disease on his functioning in the society, in the family and his sense of life satisfaction. The life quality criteria are used for evaluation of these health components. The quality of life as an integral multifactorial indicator allows estimating individual importance of different components for the certain patient, including the economic, sociological, psychological and medical aspects.
The life quality analysis conducted on the non-specific questionnaire SF-36 showed that most of the patients feel themselves completely healthy after having hypertensive crisis. The presence of severe symptoms of hypertensive crisis significantly lowers the quality of life, but only for the period of the crisis. The hypertensive crisis, roughly reducing the working ability, makes people draw their attention to their own health. After relieving the symptoms of the disease only older patients have lower indicators of the quality of life caused by longer period of the disease as well as the presence of comorbidity. As our survey of the quality of life showed the majority of patients admitted the relief of hypertensive crisis symptoms as a recovery that was evidenced by the presence of 100-point assessment of the state of their health before their discharge on the scale of physical functioning, role functioning connected with both health and emotions, and the intensity of pain. Only patients with a long clinical record and comorbidity evaluate the results of the treatment and the prognosis of their health state for the future more modestly.

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Investigation of molecular ultrastructure of biological membranes of lymphocytes in case of BLV-infection

Viral leukemia of cows is a chronic infectious disease characterized by neoplasia of hematopoietic tissue. The agent of disease BLV is found in infected lymphocytes as a provirus. The infected lymphocyte is not destroyed in the susceptible organism. The goal of our research is comparison of the structural and functional state of the cytoskeleton of lymphocytes of healthy and BLV-infected cattle using the method of atomic force microscopy. It was found out that the surface of healthy lymphocytes is smoother, their average volume is 21.5 % bigger and Yung’s module is 37% higher than those of the infected cells. So, membranes of lymphocytes of BLV-infected cattle are characterized by increased rigidity with less elasticity.

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