Aim. To conduct a comparative analysis of used anesthesia methods in patients with acute pancreatitis in intensive care units settings using pain scales.Methods. Depending on the anesthesia type, 44 patients with acute pancreatitis were divided into three groups: the first group received intramuscular injections of nonsteroidal anti-inflammatory drugs and spasmolytics, the second group - intramuscular injections of non-steroidal anti-inflammatory drugs and opioid analgesics, the third group - epidural anesthesia with local anesthetics. Comparative analysis of pain character, intensity was conducted, its dynamics in patients of all groups amid anesthesia was evaluated using a visual analogue scale, verbal rating scale, verbal descriptor scale, McGill pain questionnaire.Results. Baseline pain intensity in patients of all groups was high. Patients estimated this pain as «very strong». The time and the level of pain intensity reduction for various anesthesia types had differences. Pain syndrome was eliminated slower in patients of the second group. By the end of the 1st day, patients of this group continued to complain of «strong» pain. Pain intensity decreased only on the 2nd day - patients reported «moderate» pain. Pain syndrome was not completely eliminated in these patients for 2 days of anesthesia. 97.7% of patients reported that the visual analogue scale is the most acceptable pain assessment scale for them.Conclusion. In patients with acute pancreatitis, the most optimal anesthesia types are intramuscular nonsteroidal anti-inflammatory drugs with spasmolytics and prolonged epidural anesthesia with local anesthetics; intramuscular administration of opioid analgesics with non-steroidal anti-inflammatory drugs is less effective in relieving pain.
Aim. To determine possibilities of malignant neoplasms procoagulant activity detection by idiopathic thrombosis ultrasound imaging.Methods. 587 patients were examined. 347 patients with malignant neoplasms diagnosed in the outpatient clinic settings of the Tatarstan Regional Clinical Cancer Center (Kazan), were included in the main group. 240 patients, in which cancer pathology was excluded, were included in the control group. The groups were matched on age, sex and frequency of venous thromboembolic complications development risk factors not caused by malignant neoplasms. Both groups underwent clinical examination and ultrasound examination of the inferior vena cava, distal abdominal aorta, iliac arteries and veins, lower extremities arteries and veins.Results. Thrombosis clinical manifestations were detected in 12 patients, including 9 patients of the main group and 3 patients of the control group. In most cases of venous thrombosis in the main group (34 people, 79%) there were no clinical signs of thrombosis and it was detected only by ultrasound examination, which allowed to detect venous thrombus in 43 patients of the main group (12.4%) and in 5 patients of the control group (2.1%; t=3.2, p <0.05).Conclusion. The inferior vena cava system venous thrombosis frequency in patients with malignant neoplasms was significantly higher than that in patients without cancer, which indicates malignant neoplasms high procoagulant activity; ultrasonography has high sensitivity in the idiopathic thrombosis detection in cancer patients, and it should be performed regardless of the presence or absence of venous thromboembolic complications clinical manifestations.
The article presents data on the main stages of formation and development of the pathological anatomy department of Kazan (Imperial) University from department approval under the auspice of Professor A.V. Petrov in December, 1965 to its reorganization by merging of two departments - Pathological Anatomy and Pathological Physiology in June, 2014. Data on the department heads for the 150-year history are summarized, the main directions of scientific research conducted under the department heads supervision are described. Particular consideration is given to the Kazan scientists-pathologists achievements and contribution in fundamental and practical pathological anatomy, related subjects, clinical practice, social sciences, students’ education and doctors of various specialties training. Joint General Pathology department faculty new challenges are identified, namely transition plan generation, educational process radical restructuring in order to optimize it according to modern requirements for the higher and postgraduate education system. Initiated and conducted measures in connection with the department reorganization in the framework of new General Pathology discipline allowing to preserve the pathological anatomy structural and organizational integrity as a basic science, which is also of great practical importance, are presented.
Aim. The aim of the study was to evaluate the population mortality seasonal dynamics in the settings of emergency medical care availability.Methods. The study was conducted in Sumgait based on the medical certificates of death data analysis for 2013. The average daily number of deaths from all causes and from circulatory system diseases, the monthly number of death cases proportion in the structure of annual death cases, the proportion of deaths from circulatory system diseases among the total number of deaths were calculated.Results. The average daily number of deaths from all causes was 4.42, including 2.72 cases - from circulatory system diseases. The average daily number of death cases from all causes below the annual average rate was observed in June, July, August and September, and when performing the seasonal analysis - in summer and autumn; from circulatory system diseases - in January, June, September and December. The winter and spring increase in all-cause mortality rate was registered, whereas the mortality rate peak was characteristic for February and March. In the seasonality analysis the largest proportion of death cases number from circulatory system diseases in the structure of total annual mortality rate was in the spring. The proportion of deaths from circulatory diseases among the death causes of Sumgait population was 61.5±1.2%. In winter, the proportion of deaths from circulatory system diseases in the structure of causes of death from all causes was minimal (53.3±2.3%), and in the summer - the maximum (68.9±2.4%).Conclusion. The regularity of mortality seasonal dynamics in Sumgait is the winter-spring increase and summer decrease in all-cause mortality rate; distinctive feature of the mortality seasonal dynamics in Sumgait is associated with mortality risk increase in spring due to circulatory system diseases.
An analysis of published data on the possibilities of the positron emission tomography method application in complex diagnostic and treatment activities in metastatic breast cancer was performed. The possibilities are described and the method characteristics according to series of studies, in particular with regard to the various localization metastases identification are given. It is noted that, compared with conventional imaging techniques, positron emission tomography is more sensitive and specific method of distant metastases diagnosis. The results of clinical studies on assessment of the method application possibilities in the detection of breast cancer metastases in lymph nodes, various organs and bone metastases are given. It has been shown that the introduction of sodium fluoride into practice allowed to use this agent as bone tissue biomarker, which can be used in positron emission tomography performing. The data that the simultaneous use of positron emission tomography with 18F-fluorodeoxyglucose and computed tomography has a high diagnostic value in relation to the breast cancer distant metastases detection are presented. The method possibilities for the various forms of primary invasive breast cancer identification, including invasive ductal and lobular cancer are considered. The prospects analysis for a further increase of opportunities for positron emission tomography application is performed, in particular, reports on the possibility of so-called hybrid scanning using positron emission tomography and magnetic resonance imaging are considered. It is highlighted that the most important aim of the method use in clinical practice in the prospect may be local-regional recurrence and distant metastasis monitoring after primary treatment for breast cancer.
Aim. To determine the effectiveness of indirect antibiotics and lymphotropic therapy for the systemic inflammatory response syndrome correction in patients who underwent abdominal surgery.Methods. There were two groups with systemic inflammatory response syndrome in the postoperative period: 212 patients with various diseases of the abdominal cavity, who received conventional systemic complex therapy, and 146 patients whose complex treatment included antibiotics and lymphotropic therapy (administration of the cephalosporin antibiotics with lymphotropic mixture into the tibia subcutaneous tissue with the prior venous stasis creation). In both groups, patients with destructive forms of cholecystitis and appendicitis complicated by local or general peritonitis dominated. The dynamics of systemic inflammatory response syndrome clinical indicators, as well as laboratory parameters were assessed: the white blood cells count, leukocyte intoxication index, C-reactive protein and blood albumin. The data obtained on the 1st, 3rd and 5-6 days after surgery were analyzed.Results. In both groups clinical and laboratory symptoms positive dynamics was noted, which was more pronounced in the main group. In the control group leukocyte intoxication index increased on the third day and then decreased, but did not reach normal values on 10th day, while in the main group leukocyte intoxication index decreased already on the third day with its full normalization to 10th day. A faster normalization of white blood cell count, albumin level and C-reactive protein concentration decrease are also observed in the main group. Using indirect lymphotropic therapy was associated with reduction of postoperative complications and lethality rates.Conclusion. Lymphotropic therapy is an effective method of the systemic inflammatory response syndrome correction and can be recommended for the postoperative management of patients with abdominal surgery.
AIM. To improve treatment results of patients with ligature fistulas of the anterior abdominal wall by the development of pyo-inflammatory wound complications diagnosis and prevention methods.METHODS. During the period from the beginning of 2001 to June, 2015, 34 patients with a ligature fistulas of the anterior abdominal wall were admitted to the Department of Surgery of Hospital for War Veterans, Kazan. Terms of ligature fistula occurrence ranged from 3 months to 5.5 years after surgery. 7 (20.6%) patients previously underwent herniotomy, 20 (58.8%) - laparotomy for various acute surgical diseases of the abdominal cavity, 2 (5.9%) - appendectomy, 5 (14.7%) - pelvic organs surgery. The patients mean age was 59±4.5 years. Patients were divided into two groups: the first - the comparison group, 23 (67.6%) patients. In this group suturing was performed with polypropylene or absorbable suture filaments, wound debridement was performed by the conventional technique using different antiseptics types: 0.5% chlorhexidine (chlorhexidine bigluconate) and 3% hydrogen peroxide solutions. The second group - the main one, included 11 (32.4%) patients. In this group polyglycolide-co-lactide (purple), USP 2/0 (3 Matric) 75 cm with the atraumatic tip suture materials were used and the wound debridement was performed with 10% aqueous hydroxyethyldimethyldihydropyrimidin (xymedon) solution using a device developed by us.RESULTS. The postoperative pyo-inflammatory complications rate in the control group was 17.4% (4 cases), in the main group - 9.1% (1 case); thereby infiltrates were registered in 3 patients of comparison group and in 1 patient of main group, seroma - in 1 patient of comparison group. Monoculture was isolated in microbiological assay of material from the surgical wounds in 86% of patients. Staphylococci, enterobacteria and non-fermentative Gram-negative bacteria were detected most often. Our results of microbiological assays point to the need for perioperative antibiotic prophylaxis.CONCLUSION. The infectious wound complications rate when using conventional methods of anterior abdominal wall ligature fistulas prevention and treatment is 17.4%, which makes it relevant to search for new methods of treatment and wound surface debridement; the author’s technique offered by us allowed to significantly reduce the wound complications rate.
Aim. To study immune system state, hemostasis system, the neuropeptide level (substance P) and their interrelation in respiratory diseases in frequently ill children.Methods. 340 frequently ill children, 125 rarely ill children and 30 apparently healthy children aged 6 months to 6 years were studied in the acute period of the disease, and in the period of clinical remission. Diagnosis was made on the basis of medical history, clinical signs, instrumental and laboratory assessment results. CD3+, CD4+, CD8+, CD19+ lymphocytes count, serum immunoglobulin classes A, G, M, E levels, interleukin-1β, -2, -6, -8, tumor necrosis factor α, substance P were determined.Results. Strong negative correlation was revealed between the CD4+-cells level, interleukin-2, interferon γ and hemostasis system parameters. Substance P, interacting mainly with interleukin-1β and -2, CD4+-cells, interferon γ, indirectly interacts with the hemostasis system. In recurrent obstructive bronchitis and complicated acute pneumonia course substance P content increase was higher (4.6-fold compared with healthy children). The fact that the immune system indicators, including cytokine status, substance P and hemostasis system do not normalize during respiratory disease clinical remission in frequently ill children indicates the infection persistence, the inflammatory process continuation during clinical remission.Conclusion. Along with the immune system, the nervous system and hemostasis system play an important role in respiratory diseases severity in frequently ill children, their complications, prolonged duration, recurrence and transition into a chronic condition.
Owing to the commonality of a number of pathogenetic mechanisms, cardiovascular system and kidneys diseases often occur together, mutually exacerbating the severity. The circulatory system and the circulating plasma amount are in many respects regulated by the kidneys functional activity. The parameters of systemic hemodynamics and left ventricular function influence on renal function. The discovery of the mechanisms of renal function impairment influence on the heart state and activity contribute to a fuller understanding of the two systems mutual influence. Currently it is recognized that the frequent combination of cardiovascular and renal diseases based primarily on common pathogenic mechanisms of both forms of pathology and their mutually aggravating influence. In accordance with the modern classification there are five types of cardiorenal syndrome: (1) acute renal dysfunction amid acute-onset cardiac dysfunctions; (2) chronic renal dysfunction due to chronic cardiac pathology; (3) acute cardiac dysfunctions due to acute renal impairment; (4) long-term cardiac and cardiovascular system disorders in patients with chronic renal dysfunction; (5) combined cardiorenal pathology due to other organs and systems dysfunction. The clinical significance of this disease is that doctors of various specialties might face it in their practice: physicians, cardiologists, endocrinologists, resuscitators. Cardiorenal syndrome diagnosis is based on patient constant monitoring in several ways, including laboratory and instrumental indicators, allowing timely suspect the initial stages of this pathology development. This increases the research relevance in this field and clinical value of obtained through them practical conclusions and recommendations, reflected in a number of international documents.
Aim. To specify clinical and pathophysiologic features and prognostic significance of cerebral hypertensive crisis.Methods. The study involved 44 patients with cerebral hypertensive crisis, 53 people with coronary artery disease and 14 healthy volunteers. All patients underwent complete blood count and biochemical blood tests, vegetative status determination using questionnaire survey and recording heart rate variability parameters. In patients with cerebral hypertensive crisis systemic inflammation parameters (concentration of interleukin-6 and -8, C-reactive protein in the blood plasma) were determined. Catamnesis was specified by telephone interview.Results. In cerebral hypertensive crisis, in contrast to coronary artery disease, the parasympathetic autonomic nervous system tone decreases, which is combined with inflammatory changes in the blood (increase in segmented leukocytes number and erythrocyte sedimentation rate), and an increase in the level of systemic inflammation markers: interleukin-6 and C-reactive protein. Vegetative regulation changes closely correlated with the inflammation level and the latter correlated with the clinical symptoms severity and determined poor prognosis in terms of recurrent transient episode. 90-day risk of ischemic stroke after cerebral hypertensive crisis was 2.3%.Conclusion. In patients with cerebral hypertensive crisis the autonomic nervous system parasympathetic tone reduction combined with increased levels of inflammation markers in blood were revealed; adverse prognostic significance for recurrent ischemic attacks occurrence were leukocytes rate increase, band shift in leukocyte blood count, serum total calcium concentration reduction and blood plasma total protein level decrease.
Aim. To analyze the long-term dynamics and assess incidence territorial and age structure of infection caused by the human immunodeficiency virus (HIV-infection) in women in the Tatarstan Republic for the period from 1987 to 2015.Methods. Statistical and graphic-analytical methods were used. Intensive rates of HIV-infection incidence in women (aged 18 years and older), including certain age groups, were calculated and incidence territorial and age structure was analyzed. The incidence average prognostic index in 2016 and its possible maximum and minimum values were determined.Results.From 1996 to 2015 the incidence increased from 0.1 to 31.2 cases per 100 thousand female population. The incidence average prognostic index in 2016 was 37.2 per 100 thousand female population. In adult population (over 18 years) incidence structure the proportion of HIV-infected women in 2001 increased by 2.5 times: from 14.8±0.7% in 2001 to 36.3±1.3% in 2015 (pConclusion. Long-term dynamics of HIV-infection incidence in women in the Tatarstan Republic has a significant upward tendency; the shift to older age groups and significant rates variability by Republic districts in the incidence structure in women were revealed.
AIM. To assess coronary calcification nature in patients with rheumatoid arthritis using digital radiography.METHODS. Chest and distal upper extremities X-ray examination results of the 60 patients with rheumatoid arthritis were retrospectively analyzed. The patients mean age was 54.3±7.8 years, mean disease duration - 8.34±0.3 years. The correlation closeness assessment of qualitative features in the observed group was performed by Pearson correlation coefficient.RESULTS. When performing distal upper extremities X-ray examination, in 9 (15.0±4.6%) patients stage I, in 16 (26.7±5.7%) - II, in 21 (35.0±6.2 %) - III, in 14 (23.3±5.5%) patients - stage IV rheumatoid arthritis was found. In 19 (31.7±6.0%) patients coronary calcifications were visualized in the anterior interventricular branch of the left coronary artery, in 14 (23.3±5.5%) patients - in the circumflex branch of the left coronary artery, in 10 (16.7±4.8%) - in the right coronary artery, in 10 (16.7±4.8%) patients - the main trunk of the left coronary artery. In 7 (11.7±4.1%) patients aortic arch calcifications were found. It was found that the coronary calcifications incidence was higher in more prolonged disease course. Correlation relationship between coronary calcifications and rheumatoid arthritis stage was determined: in 7 (77.8±4.1%) patients with stage I, 14 (87.5±4.8%) patients with stage II and in all patients with stage III and IV coronary and aortic calcifications of various nature were identified. The coronary calcification incidence and prevalence had a direct correlation with the patient’s age: in most cases (66.7±10.3%) patients aged 55-60 years had multivessel calcification (≥3).CONCLUSION. There is a close correlation relationship between coronary calcifications and rheumatoid arthritis stages; coronary calcification incidence and prevalence in patients with rheumatoid arthritis depends on age, as well as the disease duration and stage, which is particularly important in the treatment strategy determination.
Aim. To study the mechanisms of doxorubicin genotoxic effects in terms of poly-(ADP)-ribose-polymerase (PARP) and the ATM-kinase (Ataxia Telangiectasia Mutated) inhibition in cell lines with different p53 status.Methods. The study was conducted on BJ and BJp53DD human fibroblasts cell lines, cultured in DMEM medium supplemented with fetal bovine serum, L-glutamine and antibiotics. Inhibition of PARP and ATM-kinase activity was attained by adding synthetic inhibitors Nu1025 and Ku55933 respectively. Chemotherapy drug doxorubicin was used to induce deoxyribonucleic acid (DNA) damages. Cell viability analysis was performed using MTS-test. Repair system proteins and apoptotic markers expression was assessed by western blotting. Cells distribution by cell cycle phases was performed by flow cytometry.Results. Adding PARP and ATM-kinase inhibitors to the BJ p53DD cell line culture resulted in a significant reduction in the viable cells number amid DNA damage induction caused by doxorubicin. Cell death in these samples occurs according to the apoptosis mechanism, what was confirmed by the increase in hypodiploid cells number and increased expression of cleaved forms of PARP-1 and caspase-3. The above-described effects of the type II topoisomerase inhibitor doxorubicin were significantly higher in BJ fibroblasts line with non-functional p53 protein (p53DD) compared with conventional BJ human fibroblasts line.Conclusion. In the context of the failure of p53-dependent mechanisms of cell cycle regulation in BJ p53DD human fibroblasts, PARP and ATM-kinase activity inhibition leads to increased cell death by apoptosis mechanism induced by the doxorubicin action.
Aim. To study the interrelation of ventricles echocardiographic parameters and signal-averaged electrocardiogram indicators in patients with postinfarction cardiosclerosis and dilated cardiomyopathy.Methods. 28 patients with postinfarction cardiosclerosis (men aged 49 to 71 years) and 29 patients with dilated cardiomyopathy (men aged 24 to 61 years) were examined. All patients underwent echocardiography, by which left ventricle final diastolic and systolic volumes with ejection fraction calculation, right ventricle end diastolic and systolic volumes were determined. According to the signal-averaged electrocardiogram, filtered ventricular complex duration, the ventricular complex with an amplitude of less than 40 mV terminal part duration and signal root-mean-square (rms) amplitude of the ventricular complex last 40 ms were evaluated.Results.. According to the correlation analysis, increase in left ventricle end-diastolic and systolic volumes and decrease in its ejection fraction, as well as an increase in right ventricle end-diastolic and systolic volumes were associated with an increase in the filtered ventricular complex duration and the ventricular complex with an amplitude of less than 40 mV terminal part duration in patients with postinfarction cardiosclerosis. The left ventricle volumes increase and ejection fraction reduction were also associated with the signal rms amplitude of the ventricular complex last 40 ms reduction in patients with postinfarction cardiosclerosis. Similar interrelation was not found in patients with dilated cardiomyopathy.Conclusion. In patients with postinfarction cardiosclerosis cavities dilation and reduced systolic ventricular function are accompanied by the myocardium electrophysiological properties deterioration; in patients with dilated cardiomyopathy interrelation between structural and electrophysiological indicators of myocardial remodeling was not found.
The review highlights the issues of etiology, pathogenesis, clinical and laboratory picture, radiodiagnosis, treatment and prognosis of fulminant perineum gangrene, or Fournier’s gangrene. According to modern concepts, Fournier’s gangrene is one of the rare forms of necrotizing fasciitis of polymicrobial etiology with a primary lesion of the skin, subcutaneous tissue and superficial fascia of the scrotum, penis, and perineum. Fournier’s gangrene refers to acute surgical diseases of pyonecrotic nature and is characterized by rapid septic course, high mortality, reaching 80%, in spite of the modern antibiotic therapy advances. Over the last decade the Fournier’s gangrene incidence increased in 2.2-6.4 times, due to the increasing number of immunocompromised patients in the population. The disease most often occurs in older men with diabetes, alcoholism and obesity. The Fournier’s gangrene occurrence is preceded by different inflammatory diseases of the colon, urinary organs, scrotum and perineum skin. The disease diagnosis in full-scale stage usually is not difficult. In rare cases, namely in the disease early stages, various radiological methods of investigation, laboratory tests and exploratory surgery with affected soft tissues express biopsy are used with differential diagnosis purposes. The cornerstone in the Fournier’s gangrene treatment is an emergency surgical intervention in combination with a powerful anti-bacterial and anti-shock therapy. To improve the wound healing course and reduce the septic complications risk, new methods of adjuvant treatments such as hyperbaric oxygen therapy and vacuum therapy are used. Hospitalization duration in Fournier’s gangrene is usually lengthy, due to the need to use repeated sanitation necrectomy and reconstructive plastic surgery and are associated with considerable economic costs for treatment. The Fournier’s gangrene prognosis depends on the timing of specialized medical care provision and, above all, on the time interval between the disease onset and surgery performing.
The article considers the «compassionate widows» activities and training at the beginning of the ХIХ century - the time of «Compassionate Widows’ Institute» formation in the Russian Empire. Empress Maria Fedorovna set up hospitals for the poor in St. Petersburg and Moscow, in each of which 200 patients in need of medical care were treated. Patients in the vast majority claimed to not only the close attention of the doctors who performed treatment at their time level, but also careful care. That is why in these hospitals quite many «khozhatyy» and «sidel’nitsa» worked. There should be quite intent control over them. In 1815, in St. Petersburg after a year of testing of «volunteered widows of the St. Petersburg Widows’ House», who cared for the sick at St. Petersburg hospital for the poor, after a solemn oath the title of «compassionate widow» was given to 16 of 24 widows. In January, 1818, Empress Maria Fedorovna ordered to engage «compassionate widows» to the patients care in the Moscow hospital for the poor, what was put into practice by this hospital main physician Kh.F. Oppel’. In the same year «compassionate widows» (two experienced and four under consideration) were taken to this hospital, sent to the two-week duty from Moscow Widow’s House. The probationary period lasted for a year, after which «compassionate widows» took the oath in the temple of the church. In the hospitals for the poor (in 1828 known as the «Marian») both in St. Petersburg and in Moscow «compassionate widows» who voluntarily devoted themselves to «look after the sick», were trained and instructed by clinicians. Evidence of «compassionate widows» extensive training in Moscow is a famous physician Kh.F. Oppel’ guidance «Guidelines and rules, how to look after the sick, for the benefit of everyone engaged in this duty, and in particular for compassionate widows, especially dedicated themselves to this title». This is the first Russian book, dedicated to the upbringing in female nursing staff the feelings of mercy and humanity when practicing their professional and civic duty. Kh.F. Oppels’ book is a remarkable historical and medical literary monument. It is the first medical guidance for the patients care, published in our country in Russian and addressed directly to the female medical staff.
Diagnosis and description of rare congenital heart anomalies are great challenges for the ultrasonographer. The biggest difficulties arise in hospitals, which do not have specialization in pediatrics or cardiac surgery. A rare form of congenital heart defects is a group of anomalies, unitedly defined as «single ventricle». Severe hemodynamic disturbances and unfavorable course of the disease reduce the possibility to detect this defect in adolescence or adulthood. Single ventricle, as the anomaly main feature, can occur in different forms of pathology. The most commonly single ventricle syndrome includes left heart hypoplasia, tricuspid atresia, and double inlet single ventricle syndromes. The most favorable course have cases when a single ventricle anatomically is left ventricle along with separate and properly formed atrioventricular valves, in the absence of main arteries significant stenosis and their normal location. This variant of a double inlet single ventricle is known as the «Holmes heart». Echocardiographic diagnosis allows to detail the anatomical and functional defects that are present in each case. Detailed identification of diagnostic features allows to specify the diagnosis and avoid inconsistencies in the obtained data interpretation. We present a clinical case of one of the most rare forms of these disease. The described case feature, in addition to its rarity, is long compensated course of defect. The lack of obvious signs of heart failure in this case may be due to a number of factors, such as a balance between the pulmonary and systemic circulation, absence of progressive changes in the pulmonary circulation blood vessels, atrioventricular valves functional adequacy, the absence of stenosis and valves changes of the main arteries, anatomically left ventricle with sufficient contractility.
Aim. To study the skin microbiota of pregnant women suffering from atopic dermatitis.Methods. 53 women of reproductive age suffering from atopic dermatitis (28 pregnant and 25 non-pregnant) were examined. The control group included dermatologically healthy women (25 pregnant and 25 non-pregnant). Prior to treatment initiation and on 15-day of study pathological process spread, the SCORAD index (scoring of atopic dermatitis - atopic dermatitis severity assessment), dermatology life quality index determination were conducted. In addition, microbiological study of material taken from the forehead, elbow bend skin and visually unaltered forearm skin was performed.Results. In women (pregnant and non-pregnant), suffering from atopic dermatitis skin total bacterial load is increased. In all groups, the skin microbiota is presented mainly by staphylococci: in dermatologically healthy people - coagulase-negative, in atopic dermatitis - Staphylococcusя aureus. In atopic dermatitis Staphylococcus aureus is isolated from both lesions and visually unaltered skin. In pregnant women with atopic dermatitis skin bacterial load was higher, Staphylococcus aureus was found more commonly. The skin microbiota in dermatologically healthy women was more diverse in respect of species comparing with patients with atopic dermatitis. Basic care remedies use leads to clinical improvement and a decrease in the skin total bacterial load and Staphylococcus aureus load. Daily use of emollients has no effect on saprophytic microorganisms.Conclusion. In pregnant patients with atopic dermatitis higher skin total bacterial load and higher rate of skin colonization by Staphylococcus aureus are observed.
