Vol 88, No 6 (2012)

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Objective. To assess the efficacy of activities carried out by a dermatovenerology dispensary after the implementation of histological diagnostics of dermatoses with the use of the HISTODERM partner expert system. Materials and methods. The authors studied the results of activities carried out by two dermatovenerology dispensaries (in Surgut and Kazan) where histological diagnostics was implemented on the basis of the HISTODERM partner expert system. A dermatovenerologist used the system in the first institution while an anatomic pathologist used it in the second institution. Results. The quality of diagnostics in both dispensaries grew by 50,5 and 28,0%, respectively. The authors also studied the results of the system use by a consultant performing diagnostics remotely. Being in St. Petersburg, the consultant analyzed scanned imaged of skin histological samples sent from a regional dispensary in Krymsk (the samples were a part of the TELEDERMATOPATHOLOGIST telemedical system). The quality of the diagnostics activities of the dispensary grew by 26.6% in the process of such activities.

The authors present the results of a study of literature sources for such indices as assessment of the efficacy and quality of medical services in medical care institutions based on quantitative parameters being quality indices. The authors demonstrate that indices for assessing the quality of work at medical institutions can involve information about materials, technical and other resources and personnel available at institutions, state statistics accounting forms, data from information and analytical systems and patient registers as well as additional indices developed by experts. Incidence indices are currently the key indicator for assessing the work quality of institutions dealing with syphilis diagnostics. No indicators and criteria for assessing the quality of laboratory assistance rendered to syphilitic patients have been developed yet.

Objective. To reveal additional laboratory criteria for assessing the affection of the nervous system in case of neurosyphilis. Materials and methods. There was a study of 49 patients with a specific affection of the nervous system. The complex study comprised a clinical examination performed by a dermatovenerologist, a neurologist and an ophthalmologist as well as serologic examination of blood and spinal fluid. The level of IL-6, IL-17 and TNF-α in parallel blood and spinal fluid samples was determined. Results. The authors obtained statistically significant results for the concentration of IL-6 and TNF-α. The increased level of these indices was observed in the spinal fluid of patients with the most severe neurological manifestations of the specific process. Thus, it is evident that changes in this index reflect the severity of affection for all components of the nervous tissue. The described changes demonstrate the autoimmune nature of pathological processes taking place in the nervous system.

Objective. To assess the clinical efficacy of an antioxidant therapy with Mexidol for the treatment of patients suffering from lichen acuminatus in the mucous coat of the oral cavity. Materials and methods. The study involved 62 patients suffering from the erosive and ulcerative form of lichen acuminatus in the mucous coat of the oral cavity. The severity of dermatosis was assessed based on the determination of the affected area of the mucous coat of the oral cavity. The activity of antioxidant protection was assessed based on the determination of the level of lipid peroxidation products, total antioxidant activity and individual antioxidants in the peripheral blood. Results. The use of Mexidol contributed to the remission in 53.13% and substantial improvement in 37.50% of the patients, which corresponded to the indices for the group of patients to whom Metypred was administered. The share of adverse effects when Mexidol was used was twice as low as in the group of patients who were taking Metypred. Conclusion. The use of an anti-oxidizing agent such as Mexidol reduces the intensity of inflammations and adverse effects and contributes to the epithelialization of erosions.

The authors present a clinical and histological description of two clinical cases of a rare inherited disease, Buschke — Ollendorff syndrome. In both cases, the disease was not accompanied by the bone tissue dysplasia but at the same time it was characterized by a clear histological pattern specific of this syndrome. The authors provide literature data and discuss issues related to the pathogenesis and particular features of the clinical picture and diagnostics of the disease.

Objective. To assess the effect of local corticosteroid therapy and Tacrolimus on the morphological and functional skin indices of different phototypes. Materials and methods. The authors conducted a complex assessment of the morphological and functional skin condition of different phototypes among healthy volunteers under the impact of corticosteroids and Tacrolimus. The study involved 20 healthy volunteers (10 people of the 1st and 2nd skin phototypes and 10 people of the 5th and 6th skin phototypes; 14 males and 6 females; mean age: 2з years). The morphological condition of the skin was assessed with the use of optical coherent tomography (Applied Physics Institute, Russian Academy of Sciences, Nizhny Novgorod) while the functional condition was assessed with the use of Multi Skin Test Center MC 750 (Courage+Khazaka Cologne, Germany). Results. The authors revealed that the application of local corticosteroids is accompanied with a reliable reduction in the epidermis thickness developing earlier in the subjects belonging to the 5th and 6th phototypes and, at the same time, increased transepidermal water loss and reduced corneous layer humidity. An increase in the corneous layer thickness accompanied by an increase in the humidity factor was registered in all phototypes in the areas where Tacrolimus was applied. It is possible to select the correct tactics of the anti-inflammatory therapy on the basis of monitoring the morphological and functional skin condition in the process of applying local corticosteroids: to determine the optimum duration of the corticosteroid therapy and switch to calcineurin inhibitors on a timely basis when there is a need to perform an antiinflammatory therapy to achieve the maximum efficacy with the minimum risk of complication development.

A complex approach to the treatment of psoriasis, which includes topical drugs improving regenerative processes immediately in the skin in addition to systemic drugs, proves to be the most efficient one. The objective of the study was to assess the clinical efficacy of a medical complex including exogenous melatonin and Kartalin ointment for psoriatic patients. The study was based on the results of a study of 201 psoriatic patients who underwent treatment at the Dermatovenerology Clinic of the Siberian State Medical University. The clinical efficacy of the combination treatment for 35 days including joint application of standard treatment techniques, Kartalin ointment and exogenous melatonin was assessed. As a result of the study, the authors established that joint application of standard treatment techniques, Kartalin ointment and exogenous melatonin improves the treatment efficacy by 16.6%.

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