Vol 88, No 4 (2012)

Authors discuss issues of the update of current accounting documents for the evaluation of activities of such structural subdivisions of medical organizations as day hospitals.

The article covers issues related to the development of laboratory methods used for the diagnostic of syphilitic infection in the historical aspect as well as for the nearest and remote future. Priorities of the application of several diagnostic methods have been highlighted depending on the stage and form of syphilis, on the performed specific treatment and the contingent of examined patients. The authors give recommendations for its use reflected in modern Russian and foreign manuals and standards of syphilis diagnostics. Laboratory methods such as immunochemiluminescence assay, хМАР-technology and aspects of their clinical application are specially highlighted. The authors provide data on applied methods of molecular typing of Т. pallidum and detection of genetic determinants of the resistance of the syphilis pathogen to antimicrobial substances.

Goal. Study of clinical and laboratory signs of adrenal hyperandrogenism in women with acne. Маterials and methods. 303 women with acne have been examined at the age of 20—40 years. The anamnesis has been studied and tests have been performed in order to determine the life quality as well as dermatologic and gynecologic examination with pilosis evaluation based on the Ferriman-Gallwey score , anthropometric and general clinical examination, endocrine profile studies, urine steroid profile, biochemical blood composition, as well as pelvic ultrasound and sebumetry. Results. The authors identified a group of women (n = 31) with the early onset of acne, hirsutism, android adiposity, prevalence of non-inflammatory skin eruptions, seborrhea, endocrine profile diseases according to blood test results and determination of the urine steroid profile, metabolic deviations, ineffective treatment with oral contraceptives. Conclusion. The authors revealed specific clinical and laboratory signs that can be referred to diagnostic criteria of adrenal hyperandrogenism in women with acne, which will make it possible to select the rational treatment for this category of patients in future.

The article contains results of the molecular and genetic research of genes ompA, ct135 and tarp c. trachomatis in 50 samples of clinical material containing DNA c. trachomatis from patients (women and men) from the Moscow region with the diagnosed urogenital chlamydial infection (UGCI) confirmed by PCR method. The sequencing of the gene ompA allowed to establish, that the prevailing serovar c. trachomatis in the examined selection of UGCI patients was serovar Е (48,0%); other serovars were less often (G — 18,0%, D — 14,0%; F and J — by 8%, К — 4%). The authors revealed authentic associations of the frequency of spreading of Е serovar with non-complicated clinical course of UGCI and the association of the frequency of spreading concerning rare serovars c. trachomatis (G, D, J) — with complications of UGCI in women. Significant mutations of the gene ompА in rare c. trachomatis serovars, аs well as significant mutations of genes ct135 and tarр were revealed more often is samples from women with PID. The obtained data are sufficient to make a conclusion about the possible existing relation between peculiarities of c. trachomatis genotype and the character of the clinical course of the urogenital clamidiosis.

The authors present the results of application of UVA1-therapy in complex treatment of patients with atopic dermatitis, psoriasis and scleroderma. Course of treatment has made 20 procedures of UVA1-therapy with the maximum single dose of irradiation 40 J/ш 2. The general dose of an irradiation 130—400 J/ш 2. Comparison groups received medical therapy with usage of standard doses and reception schemes, and did not differ from the basic groups on age of patients, duration and the disease form. Clinical efficiency estimated on dynamics of indexes SCORAD, PAS! and results of ultrasonic scanning of the scleroderma zones. High efficiency and safety of UVA1-therapy in complex treatment atopic dermatitis, psoriasis and scleroderma is established.

Etiology, pathogenesis, clinical and pathomorphological criteria of diagnostics of lymphomatoid papulosis are described. The case of own supervision is presented.

The article covers modern concepts of the influence of calcineurin inhibitors on formation and liberation inflammatory cytokines and their immunomodulating ability. Goal: to estimate efficiency and bearableness of 0,1 % Tacrolimus ointment (Protopik) at treatment of atopic dermatitis of moderate severity and eczema of hands as supporting therapy, and also influence of a preparation on microcirculation in skin. Materials and methods. In research took part 35 patients having atopic dermatitis (ATD) of moderate severity. The preparation Protopik (0,1% ointment) was used externally by daily thin layer on well cleared skin 2 times a day before clinical improvement, but not less than 2 weeks. Further, at achievement of clinical remission, it was recommended to use a preparation 2 times a week on the sites of skin which are usually struck at aggravations. In other days it was recommended to patients to use a relipidant. To patients with atopic dermatitis before the beginning of treatment and in 1 month from the beginning of application of a preparation by means of Doppler monitoring research microcirculation level in skin (volume speed of a blood-groove) was estimated. Results. High activity of a preparation as means of long supporting therapy is shown. Continuous application of a preparation within 2 weeks allows to reach in most cases almost complete remission. According to Doppler monitoring research, microcirculation in skin at patients with ATD after external application of 0,1% Tacrolimus ointment (Protopik) amplified that it is possible to explain decrease in an infiltration in a dermis. Use of a preparation differs sufficient comfort, and individual complaints to local irritation in the area where the ointment was applied were transient by nature.

Target. Research of the efficiency of Isida substances in the complex therapy of psoriasis. Маterial and methods. The research comprises 30 patients with psoriasis, treated in hospital (15 — with limited vulgar psoriasis and 15 — with palm and foot psoriasis) with Isida substances (cream gel for dry and sensible face and body skin and cream gel for hands). Results. The good efficiency and tolerance are highlighted: the decrease of PASI index by 53,6% at patients with limited vulgar psoriasis and by 47,4% at patients with palm and foot psoriasis. The dermatologic life quality index at all patients has decreased by 55,9%.

The article covers issues of ethiology and pathogenesis of papilloma viral infection, modern perceptions of the role of immune mechanisms in the development of the infection process. Were submitted results of the comparative clinical research for the study of efficiency and safety of Ingaron substance (γ-interferon) in the comprehensive therapy of the anogenital papilloma viral infection.

The article covers issues of age-related changes of the skin. The efficiency and safety of the use of Isofil cosmeceuticals for the correction of age-related changes have been evaluated. Data confirming the clinical efficiency of the use of cosmeceuticals by patients with light and moderate developments of age-related changes of the skin have been provided.