The problem of the risk of development of infection of surgical obstetric wound after cesarian section in women of the Kirov region.

Over the past decade, the frequency of abdominal delivery in Russia has increased to an average of 25 %. The widespread use of abdominal delivery has not been without an increase in the incidence of complications. Among them is an infectious complication of a surgical obstetric wound (ICD O86.1) on the anterior abdominal wall after a caesarean section, which in some regions reaches 43 %. The development of complications is facilitated by various clinical and laboratory risk factors, the analysis of which in women of the Kirov region is the subject of this article. The analysis of clinical and laboratory risk factors was carried out on the basis of the data presented in the case histories of women hospitalized in the gynecological departments of the city of Kirov. Statistical data processing was carried out on a personal computer using the R-4.0.2 statistical program and Excel spreadsheets. When assessing the relevance of the problem for the Kirov region, it was found that the frequency of caesarean section over the past 10 years from 2011 to 2021 increased from 27,0 % to 34,0 %. The incidence of infectious complications in the Kirov region can be presented as follows: infection of the surgical obstetric wound (ICD O86.1) on the anterior abdominal wall after caesarean section - 27,0 %; peritonitis after caesarean section - 0,94 %-1,01 %; diffuse sepsis - 0,93 %-0,97 %. An important role, according to reports, in the addition of an infection of a surgical obstetric wound after cesarean section is played by the general morbidity and obstetric history in women with abdominal delivery, a detailed statistical analysis of which is presented in the materials of the article. The results of the study substantiated the problem of the development of an infection of a surgical obstetric wound after a caesarean section for the healthcare of the Kirov region, comparable to that for the healthcare of the entire Russian Federation. The analysis of clinical and laboratory risk factors showed the feasibility of using a comprehensive analysis of infection of a surgical wound after cesarean section at an early stage of its development to quickly resolve complications, reduce the duration of hospitalization of women after cesarean section, and subsequently preserve the reproductive function of a woman.

[Depressive disorders and diabetes mellitus in children and adolescents]. / Depressivnye rasstroistva i sakharnyi diabet u detei i podrostkov.

AIM: To clarify the role of depressive disorders and personality traits in the pathogenesis of diabetes mellitus type I in children and adolescents. MATERIAL AND METHODS: One hundred and three patients with diabetes, aged from one year nine months to 17 years, mean 9.7±0.7), with diabetes mellitus and depressive disorders were studied using clinical-psychopathological, psychometric, paraclinical and statistical methods. RESULTS: Biological and psychosocial risk factors of a somatic disorder have been identified. Mental disorders are represented by affective disorders and personality features of the patients. Affective disorders include mild psychogenic anxiety and asthenic-anxiety depression, personality features are represented by hysterical signs and emotional lability. Clinical variants of these mental disorders and their diagnostic assessment according to ICD-10 are presented. CONCLUSION: The dynamics of diabetes mellitus correlate with characteristics of depressive disorders. This result can be used to optimize the therapy of diabetes mellitus.

[Cognitive therapy of depressive rumination]. / Kognitivnaia terapiia depressivnykh ruminatsii.

Modern approaches to the therapy of depressive ruminations are reviewed. Depressive ruminations are thought to underlie and maintain depression. The authors describe different forms of ruminations and present the analysis of depressive ruminations and the role of childhood experience in their development as well as cognitive-behavioral techniques used for their correction.

[Emotional disorders in patients with controlled hypertension]. / Émotsional'nyi status patsientov s kontroliruemoi gipertonicheskoi bolezn'iu.

AIM: To conduct a comprehensive examination of patients with controlled hypertension, including assessment of the functional state of the cardiovascular system, vegetative and psycho-emotional status. MATERIAL AND METHODS: The study involved 80 patients (51 men, 29 women) divided into 2 groups: 60 patients with essential hypertension (EH) without concomitant severe pathology and normal blood pressure during the preceding 3 months (group 1) and 20 healthy patients without EH (group 2). Anthropometric parameters (height, weight, body mass index), parameters of central hemodynamic (heart rate, systolic and diastolic blood pressure), vegetative status (vegetative Kerdo index), mental and emotional status (SCL-90R, Leonhard questionnaire, HADS, SF-36, MPQ) were assessed. RESULTS AND CONCLUSION: There were significant differences in the psycho-emotional status between patients with hypertension and patients with normal blood pressure. Significant correlations between anthropometric indicators, the state of the autonomic nervous system and psycho-emotional status of patients with hypertension were shown.

[The risk of atherosclerosis and osteoporosis development in post-ovariectomy syndrome women during hormone replacement therapy].

AIM: To study the formation of and trends in risk factors (RFs) for cardiovascular disease (CVD), their influence on the occurrence of early (preclinical) atherosclerotic lesions, a combination of these changes with osteoporosis (OP) in women following bilateral oophorectomy depending on whether hormone replacement therapy (HRT) is performed. SUBJECTS AND METHODS: The investigation enrolled 50 women with surgical menopause after bilateral oophorectomy in combination with hysterectomy who received estrogen monotherapy (a study group) and 37 patients who underwent the same operation, but had no HRT (a control group). The study group patients were examined twice (before and 10 years after HRT); the comparison group was examined once in the same period postsurgery. The investigators conducted Doppler study of the great arteries of the head and neck and measured pulse wave velocity, as well as they made dual-energy X-ray densitometry to estimate bone mineral density and a detailed analysis of the most common RFs for CVD. RESULTS: There was an increase in the prevalence of RFs for CVD and a change in their structure, which were particularly marked in the women who received no HRT, their impact on the development of early atherosclerotic changes naturally progressing with the number of RFs. The similar trend was observed for bone tissue changes: a higher incidence of osteopenia and OP during the follow-up. CONCLUSION: The high percentage of a concurrence of osteoporosis and atherosclerosis argues for that there are common pathogenic mechanisms.

[Efficacy of catalin eyed drops in age-related cataract agents].

The present investigation studied the efficacy of Catalin eye drops (Senju Pharmaceutical Co, Osaka, Japan) in patients with early senile cataract. An objective procedure for the densitometric analysis of lens transparency images with a Pentacam apparatus (Oculus GmbH, Germany) was used to assess the results of the investigation. Unlike the control group, the patients using Catalin had a lower optical density in the anterior and posterior cortical lens layers and beneath the posterior capsule in the first months of therapy. In the other lens layers, the transparency remained unchanged whereas in the controls it was increased throughout the follow-up.

Sexual dimorphism of the interhemispheric asymmetry dynamics during the processing of the transcallosal signal.

The characteristics of the dynamics of the functional interhemispheric asymmetry (FIAs) of the transcallosal influences in male and female rats were compared in this study through an analysis of the amplitude-temporal parameters of the homotopic transcallosal responses (TCR) in the course of their multiple topographical pickup from the dorsolateral surface of the cortex of both hemispheres in the time interval of the realization of the components of the responses. Two principal types of patterns of hemispheric dominance have been distinguished. The first type was described in accordance with the rule of the right-left-right shift of FIAs; the second type was described in accordance with the rule of its left-right-left shift. The changes in the FIAs of the temporal parameters of the positive components and the amplitude parameters of the positive and negative fluctuations were characterized by the identical type of dynamics in rats of both sexes. The dynamics of the FIAs of the temporal parameters of the negative components unfolded in accordance with the first type in the females, but in accordance with the second type in the males. The dominance of the investigated zones of the cortex of the right hemisphere was expressed more markedly in the females at the initial and terminal stages of the processing of transcallosal information. The phases of the dominance of the left hemisphere, by contrast, were identified and detected in a relatively larger territory of the neocortex examined in the males by comparison with the females. The results obtained suggest the relatively greater participation of the cortex of the right hemisphere in the females, but of the left hemisphere in the males during the processing of a transcallosal signal.

[The ontogenetic dynamics of hemispheric asymmetry in controlling the behavior of rats of either sex]. / Ontogeneticheskaia dinamika asimmetrii polusharnogo kontrolia povedeniia u krys razlichnogo pola.

Dynamics of behavioural control in the open field was studied in Wistar rats of different sexes in the course of postnatal ontogenesis. Ethological analysis of behaviour in the open field was used combined with the temporary inactivation of the hemisphere cortex by means of spreading depression. Two main types of the ontogenetic dynamics of asymmetry were established. The first one was characterized by the right-left-right pattern of asymmetry, the second one by the left-right-left pattern. The first type of asymmetry dynamics prevailed in females, the second type was dominant in males. During different periods of ontogenesis, asymmetry of hemisphere control over the same behavioural acts in rats of opposite sexes could be both counterphasic and synphasic. The first type of the asymmetry dynamics is supposed to be connected with hemisphere control of avoidance behaviour, whereas the second one seems to be involved in exploratory behaviour. In males the open field behaviour is more determined by the exploration component, whereas in females avoidance component prevails.

[The sex dimorphism in the dynamics of interhemispheric asymmetry during the processing of a transcallosal signal]. / Polovoi dimorfizm dinamiki mezhpolusharnoi asimmetrii pri obrabotke transkallozal'nogo signala.

Two main patterns of interhemispheric domineering were distinguished: the right-left-right shift type and the left-right-left one. The domineering of the right hemisphere at the beginning and the end of processing of a transcallosal signal, was stronger in female rats in some areas, whereas in the majority of the areas under study domineering of the left hemisphere occurred more frequently in male rats. The data obtained suggests a greater participation of the right hemisphere cortex in females and the left hemisphere in males.

[The dynamics of interhemispheric asymmetry during the processing of a transcallosal signal]. / Dinamika mezhpolusharnoi asimmetrii pri obrabotke transkallozal'nogo signala.

Multiple homotopic transcallosal responses were led from the visual, temporal, auditory and motor cortical areas in Wistar rats. Temporal parameters of positive as well as negative components of the responses revealed alteration of the interhemispheric asymmetry by the rule of right-left-right shifting. By the amplitude parameters of negative components the asymmetry was right-left-right whereas by the positive oscillations amplitude it was left-right-left. The data obtained suggest a right-left-right pattern of domineering of the hemisphere cortex in processing of transcallosal signal.

[The treatment of patients with imported helminthiases]. / Lechenie bol'nykh zavoznymi gel'mintozami.

The authors treated helminth infestation in 856 patients who have arrived to Russia from tropical countries. Early diagnosis and treatment of helminthiasis in such patients reduce their susceptibility to other diseases in the course of relevant adaptation to new climatic conditions. The authors point to high efficacy of the drugs mebendazol, albendazol, medaminol (against ancylostomiasis, ascariasis, trichocephaliasis), praziquantel (against schistosomiasis and hymenolepiasis).

[The clinico-immunological characteristics of hymenolepiasis]. / Kliniko-immunologicheskie osobennosti gimenolepidoza.

Clinical manifestations were observed only 16 out of 61 patients aged 15-32 years who had hymenolepiasis. Despite their degree, there was impaired dexylose absorption, lower serum lysozyme activity and higher serum complement activity, depressed immunological reactivity parameters (the count of T- and B-lymphocytes, their functional activity), decreased IgA titer and increased IgE titer in the sera in all the patients observed. Six months after the effective dehelminthization, varying immunodepression still remained in all the convalescents. There types of restoration of immunological reactivity were identified: torpid, reactive and highly reactive. The torpid type was significantly more frequently observed in patients with subclinical (asymptomatic) hymenolepiasis course than in patients with its clinical manifestation.

[Patterns in the formation of transcallosal connections in the projection and associative areas of the cat cortex]. / Nekotorye zakonomernosti formirovaniia transkallozal'nykh sviazei proektsionnykh i assotsiativnykh oblastei kory koshki.

In acute experiments on immobilized 2-15-day old and adult cats, regularities of the ontogenetic callosal connexions maturation were studied in projection (somatosensory, auditory visual) and associative (sensorimotor, parietal) areas of the cortex by means of topographic recording of the transcallosal responses in symmetrical points of the opposite hemisphere. The data obtained suggest a heterochrony and different rate of the functional callosal connexions maturation in projection and associative areas of the cortex.

[Ontogenesis of the asymmetry of transcallosal responses in the cat parietal cortex]. / Ontogenez asimmetrii transkallozal'nykh otvetov v temennoi kore koshki.

In acute experiments on 2-24 days old immobilized kittens and adult cats, studies have been made on the development of functional interhemispheric asymmetry of homotopical transcallosal responses in the parietal cortex. It was found that the number of animals with evident asymmetry increases with age. Alongside, with respect to such characters as asymmetry coefficient, mean amplitude of components of transcallosal components and the ratio of zones of direct and inverse domination, the increase in functional interhemispheric asymmetry was observed during the second week of postnatal life of kittens, which was accompanied by the inversion of its sign; in adult cats, the decrease in the asymmetry up to its complete absence was found. The data obtained are discussed with respect to peculiarities of the development and functional properties of the associative parietal cortex in cats.

Ontogenesis of transcallosal responses in cats: I. Formation of interhemispheric connections in kittens in the first month of life.

In acute experiments on kittens at the age of 1 to 30 days, anaesthesized with nembutal and immobilized with diplacine, multiple transcallosal response (TCR) recording from different cortical areas was performed. In 2-15-day kittens homotopical TCRs appeared earlier, were wider represented, and revealed a greater configuration maturity and amplitude-time parameters in associative (parietal and sensorimotor) areas as compared to projection (somatosensory, visual and auditory) zones. It has been established that interhemispheric relations in the kitten associative cortex are mediated, not only by the callosal, but also by the extracallosal system, which was evidenced by the presence of late negative components preserved after callosotomy. The results of per-layer analysis of interhemispheric responses in 1 month kittens have shown that in the parietal cortex, in the course of development, the drains of surface-positive oscillation shifted from the V to the III layer, whereas the drain of surface-negative deviation remained at the level of II-III layers. The late component was registered at the depth of layers III-IV, having a drain in the I-II layers. In the sensorimotor cortex, the surface-negative oscillation had a drain in the I-II layers, whereas the surface-positive oscillation had a drain in the II and V-VI layers. The data obtained reflect the dynamics of the formation of interhemispheric relations in the first-month-of-life kittens and testify to an increased level of their integrative interaction.

Ontogenesis of transcallosal responses in cats: II. Formation of interhemispheric asymmetry.

Experiments were performed on 59 kittens of both sexes at the age of 1 to 30 days after birth, anaesthesized by nembutal and immobilized by diplacinum, using the technique of multiple topographical TCR recording. TCRs being recorded from symmetrical points of the right and left hemispheres, interhemispheric asymmetry of their amplitude time parameters was revealed, which arose immediately following TCR appearance. In the kittens' sensorimotor cortex TCR asymmetry was individual, whereas in the parietal cortex it was species-specific. One-hemisphere dominance in kittens possessed a partial character. During interhemispheric asymmetry formation, the callosal and the extracallosal systems participated. Asymmetry dynamism was revealed in asymmetry changing with kittens' age according to form (individual/species-specific) and magnitude (intensification/weakening up to changing its sign), and it was conditioned by differences in mechanisms of hemispheric interaction in the course of the cat's ontogenesis. The process of TCR asymmetry formation was characterized by zonal specificity. The general tendency of asymmetry development during ontogenesis in the cat was intensification, with age, of the integrative interaction of those systems which supported it.

[Ontogenetic characteristics of the development of homotopic transcallosal responses in the associative and projectional areas of the cat cerebral cortex]. / Ontogeneticheskie osobennosti razvitiia gomotopicheskikh transkallozal'nykh otvetov assotsiativnykh i proektsionnykh oblastei kory golovnogo mozga koshki.

Multiple recordings of homotopical transcallosal responses (TCRs) from the whole dorsolateral surface of both hemispheres have been made in acute experiments on 2-15-day kittens. In sensorimotor and parietal cortex, TCRs were observed from the 2nd day of life, being mainly of a positive-negative form, whereas in the visual and auditory cortex these responses emerged at the 7th day and were presented mainly by a positive oscillation. TCRs in the associative zones (parietal and sensorimotor) were recorded from a relatively greater cortical area than in the projectional zones. On the contrary, foci of maximum activity were usually also located in the associative zones. The latent period of TCRs was longer in the auditory cortical area than in other zones, while positive and negative component peaks were of a longer latency in the auditory and visual cortex as compared to those in the parietal and sensorimotor ones. Interhemispheric asymmetry which was revealed from the moment of response emergence and exhibited an individual pattern, was observed in TCRs recorded in associative and projectional zones. The data obtained suggest that in 2-15-day kittens, functional development of the callosal system in the associative area takes place earlier than that in the projectional zones.