Journal of Clinical Medicine of Kazakhstan

Clin Med Kaz 2015; 4(38):6-11

Authors: Turlybek Tuganbekov, Nasrulla Shanazarov, Niyaz Malayev

The review deals with one of the topical issues of modern oncology: treatment of patients with unresectable liver cancer. The possibilities of a common endovascular treatment - hepatic artery chemoembolization (TACE). A comparison of the properties of the most used saturated microspheres (Hepasphere, Ds Bead, Tandem), describes the options angioarchitectonics tumors and the possibility of using the microspheres according to the blood supply.

J Clin Med Kaz 2015; 4(38):17-20

Authors: Bolat Nagymanov, Ardak Nurmikhanov, Marat Dzhetpissov

The article presents the contemporary questions correcting scoliosis spine in young children by using modern surgical techniques such as the use of hook and screw steel structures. Reviewed the achievements and shortcomings of existing methods correction of spinal deformity. The problems of using endocorrector a dynamic system in young patients with scoliosis and implementation of technology represented in the practice of pediatric orthopedics which aims at improving the indicators of child health, reduction of disability, increasing international status and level of medical care to the population of the Republic of Kazakhstan.

J Clin Med Kaz 2015; 4(38):25-29

Authors: Abdurashid Mussayev, Marat Aripov, Serik Alimbayev, Gulnara Zhussupova

The aim: To study the effect of renal artery denervation on blood pressure and insulin resistance in patients with resistant hypertension Methods: Sixty-three patients underwent denervation of the renal arteries with resistant hypertension. We investigate blood pressure, glucose tolerant test, HOMA-IR and the level of glucose in blood. Results: It showed a significant reduction in office systolic (-36,1 ± 22,2 mm Hg; P <0.0001) and diastolic (-22,3 ± 14,2 mm Hg; P <0.0001) blood pressure; no statistically significant reduction in glucose tolerant test (6,7 ± 2,5 to 6,1 ± 1,9; P = 0,25). Insulin resistance index fell from an average of 3,0 ± 4,6 baseline to 2,5 ± 3,7 (p = 0.007) at 12 months after denervation of the renal arteries. Conclusions: renal artery denervation is a safe and effective method of treatment for resistant hypertension, which also has a positive effect on glucose metabolism

J Clin Med Kaz 2015; 4(38): 37-41

Authors: Janek Belekov, Ulukbek Djapiev, Nurdin Mamanov

The аim: to study of effectiveness of reconstructive operations at the iatrogenic injuries and strictures of extrahepatic billiary tracts. Methods: Experience of surgical treatment of 47 patients with iatrogenic damages of extrahepatic bile ducts (latest trauma - 22 (46.8%), stricture – 25 (53.2%)) is presented. Recovery operation is made to the 1 (2.1%) patient, reconstructive interventions – 42 (89.4%), an external holangiostomy – 4 (8.5). Roux biliodigestive operations are executed at 38 (80.8%) patients. Results: Postoperative complications are registered at 5 (10.6%) patients: failure of sutures of the bihepatikojejunoanastomosis – 1, acute adhesive intestinal obstruction – 1, stenosis of the bihepatikojejunoanastomosis – 1, suppuration of an operational wound – 2. Postoperative lethality made 2,1%. Conclussion: Roux biliodigestive operation is the main final method of reconstructive treatment of iatrogenic damages of the extrahepatic bile ducts.

J Clin Med Kaz 2015; 4(38):46-49

Authors: Saltanat Eshimova, Zhaksygul Tulegenova, Nurzhamal Kenzhebayeva, Aigul Dinmukzamedova

The aim of this study: Study of antibiotic susceptibility strains of Enterococcus faecalis, isolated from patients with urinary tract infections. Methods. Isolated microorganisms were identified to species, determined their sensitivity to antimicrobial agents in accordance with the methodological guidelines and using bacteriological analyzer WalkAway (USA). Results. The results of microbiological Studies have shown that the most effective drugs against Enterococcus faecalis is vancomycin, streptomycin Cinergy, norfloxacin, chloramphenicol. Conclusions. The choice of antibiotic therapy until bakteriogrammy urine should be based on the data of the local microbiological monitoring, taking into account the spectrum of infectious agents and their level of antimicrobial resistance.

J Clin Med Kaz 2015; 4(38):56-59

Authors: Nelya Bissenova, Natalya Mitus, Elmira Tuleubayeva, Aigerim Yergaliyeva

The aim of this study. The analysis of microbiological parameters intestine in children in the first year of life. Materials and methods. During 2012 and 2014 conducted prospective bacteriological examination of the large intestine 318 children in the first year of life. Primary inoculation of clinical material was performed quantitative method to culture media in accordance with the regulations. The identification of isolates was performed by microbiological analyzer Vitek 2 (bioMerieux). Results. During from 2012 to 2014 bacteriological examination for intestinal dysbiosis characterized by a decrease the number of obligate microflora. Escherichia coli with normal enzymatic activity normally have been allocated 60.6% of the surveyed children, bifidobacteria were detected at 59.4%, only 24.8% of infants were identified in normal lactobacilli. As a consequence, there was an increased colonization of pathogenic staphylococci (47.4%), opportunistic enterobacteria (27.3%) in particular bacteria of the genus Enterobacter, Klebsiella, yeast fungi of the genus Candida (12.5%). Conclusions. Intestinal microflora of infants is characterized by a decrease in the number of lactobacilli, bifidobacteria and E.coli with normal enzymatic activity. As part of intestinal microbiota of children surveyed increased the number of opportunistic enterobacteria, Candida and E.coli with reduced enzymatic activity.

J Clin Med Kaz 2015; 4(38):65-73

Authors: Gulziya Ismailova, Tairkhan Dautov, Mukhtar Tuleutayev, Sergey Ushakov, Yerbol Zhapparov, Ainagul Zharipova, Bakhyt Duysenbayeva, Bakhytzhan Bimbetov, Sholpan Myrzakhmetova

Objective: To assess the possibility of low-dose computer tomography (LD-CT) in diagnosis of an early lung cancer in patients of risk group. Methods: Patients concerning existence of risk factors were selected: age from 50 to 75 years, smoking anamnesis more than 35 packs/years and real smokers or patients with smoking cessation less than 15 years. Basic screening to 36 patients, aged from 57 till 71 year was done, average age was 63 years. The number of male was 32 (88,9%) that prevailed over number of female 4 (11,1%). Researches were conducted on the computer Somatom Definition AS tomography, 64 cuts, and high resolution with a reformatting step 1,0 mm. A number of patients with smoking experience more than 15 years had a proportion of 57,4%, average quantity of smoked packs is 23,26±3,9 per year. A percentage of people who gave up smoking was 26,1% and of current smokers was 63,1%. Results: Symptoms of chronic bronchitis are revealed at all 29 patients, in 16 cases emphysema of lungs (55%) is diagnosed, bullous changes were revealed at 5 patients (17,2%), bronchiectasis are registered at 2 patients (6,9%), pneumofibrosis – at 9 patients (31%), at 2 patients the expressed residual fibrous and focal changes in lungs (6,9%) were revealed. Infiltrative tuberculosis of lungs is registered at 1 patient (3,5%). For 1 patient it was diagnosed idiopathic pulmonary fibrosis (3,5%). With suspicion on a lung cyst 1 patient (3,5%), the accompanying mediastinal lymphadenopathy at 4 patients (14%), atherosclerosis of coronary arteries at 10 patients (35%). Conclusions: By results of basic screening to 8 patients with symptoms of emphysema, pneumofibrosis and focal fibrous changes are made half- positive diagnosis and the repeated computer tomography in 3 months is recommended. One patient is sent to a TB dispensary for 3-fold bacterial crops on Koch’s bacillus. Repeated LD-CT screening is recommended of 21 patients after 12 months.

J Clin Med Kaz 2015; 4(38):79-82

Authors: Anatoliy Kolos, Zhaksylyk Dzhieshev, Aigul Aitbayeva, Maria Gerassimova

Foreign bodies of the thoracic cavity is a rare phenomenon in most cases they enter into the trachea, bronchi, and the bulk of them fall on the children’s age. Ways of penetration of foreign bodies into the chest of an adult patient is different, most often due to injury. The clinical picture of foreign bodies in the thoracic cavity depends on the size of the subject and the bottom of his introduction into the lung tissue and mediastinum. Small foreign bodies may not manifest themselves for many years. A more severe clinical picture observed in patients with medium and large foreign bodies. The article presents the case of a foreign body in the chest.