Vestnik Vitebskogo Gosudarstvennogo Meditsinskogo Universiteta

7-16

Authors: Aliakhnovich N.S., Novikov D.K.

Abstract. Titanium dioxide (IV) (TiO2) is a common additive in many consumer goods. After their use TiO2 gets into sewerage and then into the environment and interacts again with living organisms. Diverse routes of TiO2 entry cause a high risk of humans and animals exposure. The traditional view on TiO2 as a poorly soluble low reactogenicity chemical should be revised taking into account the accumulating data on its interaction with proteins and the formation of complex compounds, as well as pathological effects of E171 food dye on the human body. The survey of the obtaining, the properties and application of titanium dioxide has been made. The publications about white food dye use in the food, household, cosmetic and pharmaceutical industries have been analyzed. The available data on TiO2 pathological effects: cancerogenic, immunomodulatory and allergic on the humans’ and laboratory animals’ organisms have been presented. Key words: titanium dioxide, white dye, white coloring, food additive, E171, Р25, TiO2.

27-33

Authors: Zagayko A.L., Briukhanova T.A.

Abstract. Objectives. Metabolic syndrome (MS) is associated with the high risk of cardiovascular complications development on its background. Cardiovascular continuum formation is due to endothelial dysfunction (ED) occurrence that is characterized by the imbalance of vasoconstrictor and vasodilator factors production, with the prevalence of the latter ones. According to several authors’ data, activation of endocannabinoid system (ECS) plays an important role in the ED pathogenesis. Therefore, the aim of our work was to study the effect of the drug based on affinely purified antibodies against type 1 endocannabinoid receptor, on certain parameters of endothelium functional status in the rats with experimental insulin resistance (IR). Material and methods. Wistar male rats which had been kept on the diet enriched by fructose were used in the experiment. Intraperitoneal administration of low dexamethasone doses during 5 weeks on the background of the diet with high fructose content resulted in the IR development. The studied drug was administered intragastrically during 3 weeks. The content of S-nitrosothiols (S-NO), endothelin-1 (ET-1) and their ratio in the blood were determined. The investigations were carried out according to the current principles of bioethics. Results. Long-term administration of dexamethasone low doses on the background of the diet with high fructose content led to the formation of IR syndrome. Animals with MS showed a statistically reliable increase of ET-1 content (2,62 times) with the simultaneous reduction of S-NO content (4,08 times) with regard to the indices of healthy animals. The calculation of the relationship coefficient of ET-1/S-NO testified to the development of endothelial dysfunction on the IR background. A similar though less pronounced dynamics of the examined parameters against the background of the studied drug application was observed that was probably due to the mechanism of the drug action. Conclusions. The dynamics of ED indicators in experimental IR signifies that the search for the new methods to correct the designated changes for the prevention of cardiovascular complications development against MS is promising. Key words: endocannabinoids, endothelial dysfunction, metabolic syndrome, insulin resistance.

44-51

Authors: Trushel N.A.

Abstract. Objectives. Тo determine the morphological patterns of the arterial circle of the human cerebrum (circle of Willis), contributing to the development of cerebral circulation disorders. Material and methods. Macroscopically, histologically, histochemically, immunohistochemically and morphometrically the circle of Willis in 467 dead humans, whose cause of death is not associated with cerebral circulation disturbances as well as the data of computerized tomography in 100 people with this pathology have been studied. Results. Variations of Willis circle, such as the combined type of several non-classic variations of arteries within the circle, aplasia of both (or one) posterior communicating arteries, posterior trifurcation of the interior carotid artery have been found in people with cerebrovascular disease most often (by 8-21%), which allows us to include them into the risk factors. Conclusion. The formation and growth of intimal thickening in the places of vascular branching of the circle of Willis, and the gradual thinning of the tunica media under them is a manifestation of atherogenesis and can lead to the disorders of cerebral circulation. Key words: cerebrum, circle of Willis, arteries, disorders of cerebral circulation.

60-66

Authors: Petukhov A.V.

Abstract. Objectives. To assess the degree of alimentary inanition and biochemical disturbances as well as the life quality of patients with esophageal strictures after chemical burns following balloon dilatation. Material and methods. The total of 36 cases with esophageal burns strictures were treated with balloon dilatation. In all patients their body mass index, the level of the main biochemical parameters of the blood, the level of hemoglobin, erythrocytes as well as the degree of dysphagia were determined. The diagnosis of esophageal stricture was confirmed using both upper endoscopy and contrast radiography of the upper gastrointestinal tract. After the provided treatment the quality of life was estimated using SF-36 questionnaire. Results. The third degree dysphagia was registered in 88,9% of patients and 69,4% of them were underweight. There were no gross deviations in blood analysis such as hypoproteinemia, hypoalbuminemia or decrease in the amount of red blood cells or hemoglobin. Esophageal balloon dilatation allows to safely and effectively restore luminal diameter of the esophagus requiring only 1 to 3 procedures with 1-2 days interval. The quality of life analysis has shown that such indices as general health, emotional health and role functioning are affected most of all. And when calculating general indices the «psychological component of health» suffers more – 40,15 points in comparison with the «physical component of health», which made up 49,61 points. Conclusions. The main indicators of the severity of patients’ condition with post-burn esophageal strictures are body mass index and dysphagia degree. Esophageal balloon dilatation is a safe and effective way to restore luminal diameter of the esophagus thus relieving dysphagia. The reduction of the life quality in patients with post-burn strictures occurs mainly due to the psychological health component. Key words: esophageal stricture, esophageal balloon dilatation, quality of life.

77-86

Authors: Odnokozov I.A., Khorov O.G.

Abstract. Objectives. To evaluate a new method of vocal fold medialization on the larynx restorative operations in patients with unilateral vocal fold mobility restriction. Material and methods. In the course of this study the results of vocal fold medialization by the developed and implemented into practice method of autotransplantation of adipocytes into the fixed vocal fold in 33 patients with unilateral vocal fold mobility restriction in one month, three months and long-term period (from 8 months to 13 years) after surgery have been analyzed. To evaluate the results the research in the dynamics of the maximum phonation time, the degree of huskiness, roughness, hoarseness, tremolo has been applied, the glottal function index and the integral index of the degree of life quality satisfaction loss because of the disturbed functions of the larynx have been determined. Results. According to the obtained data the maximum phonation time and degree of life quality satisfaction improve in the course of time. The best results on determining the degree of huskiness, roughness, hoarseness and tremolo and the glottal function index have been revealed in three months. In the long-term period a slight deterioration of these indicators has been revealed. After the operation the prolonged post-operative patients’ care and their rehabilitation have not been required. Granuloma in the early postoperative period, which had been successfully removed was the only complication found. Conclusions. The developed method of vocal fold medialization with the use of adipocytes cell autotransplantation is effective in treating unilateral vocal fold immobility regardless of its etiology. The method allows to obtain stable morphological and functional effect at short notice. Key words: vocal fold, surgery, adipocytes, fat, transplantation.

93-101

Authors: Shakavets N.V.

Abstract. Objectives. To comparatively estimate the effectiveness of various methods of early childhood caries (ECC) prevention. Material and methods. All in all 642 children at the age of 6-36 months were examined. The d1-4mft and d1-4mfs indices, the indices of oral hygiene, the level of CFU of SM in the saliva were determined. All children were randomized into 7 groups. In the 1st group mothers’ motivating interview and dental examination of the infants 2 times a year (n=129) were conducted. In the 2nd group fluoride varnish applications (5% NaF) 2 times a year (n=123) were made and in the 3rd group – 4 times a year (n=124). The control, the 7th group was made up of 163 children. The children with SM in the number of CFU>103 were randomized into two groups – the 4th group (n=52) with the applications of «Cervitec» varnish 4 times a year and the 5th group (n=51) with the applications of «Cervitec» varnish 2 times a year and fluoride varnish applications (5% NaF) 2 times a year. The children with SM CFU>103 out of the 7th group made up the group 8 – the comparison group (n=31). All the data were statistically analyzed with the use of non-parametric methods (Wilcoxon test, Mann-Whitney U test, Spearman correlation analysis). Results. The increasing of dental caries intensity during three years was 1,82 teeth in the group 1; 0,95 in the group 2; 0,54 in the group 3; in the group 7 – 2,50 (р1-7=0,18; р2-7<0,001; р3-7<0,001). There were no significant statistical differences between the group 2 and the group 3 (р=0,21). The increasing of dental caries intensity in the group 4 was 2,04, in the group 5 - 1,35 and in the group 8 - 3,30 (р4-8=0,12; р5-8=0,001). Conclusions. The applications of fluoride varnish 2 times a year are clinically and economically effective for ECC prevention. The dental caries reduction is 62%. The combined preventive strategy of using high concentrated fluorides and chlorhexidine applications is effective for ECC prevention in children with high caries risk. It allows to achieve 59,1% of the dental caries reduction in this group. Key words: dental caries, infants, fluoride varnish, reduction.

110-117

Authors: Rublevskaya E.I., Divakova T.S., Laptiyeva L.N.

Abstract. For the purpose of the provision optimization of treatment-and-prophylactic institutions with personnel, the role of a medical college in the reducing the level of graduates’ professional disadaptation and the increasing of motivation to the stable professional activity at one working place has been evaluated. The reasons of professional disadaptation development on the duration of job according to place of employment as the paramedical staff of 231 graduates of medical colleges of the Republic of Belarus with the work experience from 4 to 8 years and 68 final-year students of the EE «Mozyr State Medical College» based on the orders analysis through health care institutions about employee’s admission, transfer and dismissal have been studied, the results of questionnairing and filling in self-rating scales of 494 paramedicals with up to 15 years of work experience have been analysed, the investigation of the issues of the training programme for specialists with secondary medical education has been conducted. The analysis of the obtained results has indicated that the lack of stability in staff provision with the paramedical personnel of the treatment-and-prophylactic institutions is based mainly on the problems of the sphere of professional communication: conflicts at the working place, conflicts with patients and their relatives. The level of communicative skills and adaptive reactions of an individual was connected with the duration of his/her professional activity and the structure of an educational programme of the medical college. Thus, the degree of communicative skills and adaptive reactions was the highest in a specialist with the work experience of more than 5 years. However, in case of the work with patients that were in the category of «dying» or «incurable» the degree of communicative skills and adaptive reactions was decreased up to minimum. The working out and introduction of a number of units dealing with communication skills and professional adaptation at the period of training in a college (practical and theoretical lessons, optional courses, workshops, role-plays, modelling the situations of the work of paramedical staff with the specific profile of patients, i.e. when the patient has favourable and unfavourable prognosis for life, work with the patient’s relatives) will improve worker’s professional adaptation and keeping of the staff in the profession. Key words: education in a medical college, paramedical staff, the provision of the treatment-and-prophylactic institutions with staff, professional adaptation, working experience.