bluuebunny/crossref_metadata_2025 huggingface dataset:
Barriers to addiction prevention and treatment in communities with organized crime: the perspective of health providers
Authors: Gómez San Luis Anel Hortensia ,   Unidad Académica de Trabajo Social y Ciencias para el Desarrollo Humano, Universidad Autónoma de Tamaulipas, Ciudad Victoria, Tamaulipas, México., Almanza Avendaño Ariagor Manuel
Published: May 2018

Introduction. The presence of organized crime may encourage an increase in the supply of illicit substances, the incorporation of young people into crime, the promotion of substance-oriented lifestyles, and the use of violent tactics to control territories that generate insecurity and loss of social capital are generated. Objective. The purpose of this study is to determine the barriers related to the presence of organized crime for the prevention and treatment of addictions from the perspective of health staff. Method. Based on a grounded theory study, eight semi-structured focused interviews were conducted with the staff of a primary addiction care center. In the interviews, the characteristics of the center, type of services, user profiles, the most successful treatments and barriers to care were explored, emphasizing those related to the presence of organized crime in the community. The data obtained were subjected to a thematic analysis with the help of MAXQDA software version 12. Results. Thematic analysis shows that criminal organizations determine which substances are used, encourage distribution within educational contexts, establish control processes in communities, limit preventive actions and treatments, and promote lifestyles associated with consumption, which especially affect vulnerable young people at the familial, social, and economic level. Discussion and conclusion. Membership of organized crime is also linked to substance use, so those affected seek treatment in spaces where there are insufficient safety conditions and health providers to create personal strategies for their protection. The article concludes that addiction prevention implies the recovery of communities and educational spaces by state institutions, while care requires better safety conditions for users and health staff.
Internal and inter-rater reliability of the ASQ-3 in Mexican preschoolers
Authors: Ortiz-León Silvia ,   Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México., Granados-Rojas Armida , Cavazos-Olivo Josefa , De Benito-Avendaño Leonardo , Obregón-García Victor Hugo , Duran-Avendaño Xenia Margarita , Ramírez-Pérez Rosario Viridiana , Cárdenas-Medina Juan Alberto , Vargas-Terréz Blanca Estela , Luna-Guevara Gerardo , Rodríguez-Machain Ana Carolina , Jaimes-Medrano Aurora Leonila ,   Hospital Psiquiátrico Infantil Juan N. Navarro, Ciudad de México, México.,   Centro Comunitario de Salud Mental Cuauhtémoc, Ciudad de México, México.,   Instituto de Neurociencias, Investigación y Desarrollo Emocional, Ciudad de México, México.,   CISAME Chimalhuacán y CISAME Ixtapaluca, Estado de México, México.,   Hospital Nacional de Niños Benjamín Bloom (HNNBB), San Salvador, El Salvador.,   Grupo Paidos, La Paz, Baja California Sur, México.,   Neurocom, Ciudad de México, México.,   Universidad La Salle, Unidad Benjamín Franklin, Ciudad de México, México.
Published: May 2018

Introduction. Monitoring child development includes the promotion of development in the healthy child and the detection of delays and early indicators of disorders that begin in the first five years of life through easy-to-use, easy to mark, and low-cost screening tests. Objective. To evaluate the internal reliability and inter-rater reliability of the ASQ-3 in Mexican preschool children. Method. The ASQ-3 was applied to parents and/or teachers of 33 - 60 month old children who attended the Centros de Desarrollo Infantil (Child Development Centers-CENDIS) in the public and private sectors of Mexico City. Results. A total of n = 1052 questionnaires were obtained, grouped into six age groups (33, 36, 42, 48, 54, and 60 months of age) according to the Ages and Stages Questionnaire-3 (ASQ-3). The levels of reliability of the ASQ-3 for each of the age groups were acceptable, with a range of α = .77 to α = .88. Regarding inter-rater reliability (parents vs. teachers), moderate correlation levels were observed. Discussion and conclusion. The results obtained suggest that this is a screening instrument that reliably evaluates the five areas of development that make up the ASQ-3 in pre-school children. This represents an opportunity to continue studying the psychometric characteristics of validity of this instrument in representative samples of Mexican children to optimize the process of early childhood development monitoring.
Effective therapies for the treatment of complex posttraumatic stress disorder: A qualitative systematic review
Authors: Fernández Fillol Carmen ,   Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Centro de Investigaciones Biomédicas (IBIMA), Universidad de Málaga, Málaga, España., Serrano-Ibáñez Elena Rocío , Ruiz-Párraga Gema Teresa , Ramírez Maestre Carmen , Esteve Zarazaga Rosa , López Martínez Alicia Eva
Published: May 2018

Background. Current literature shows that posttraumatic stress disorder and complex posttraumatic stress disorder symptoms differ. Although the psychological treatments available for posttraumatic disorder are well established, little is known about the effectiveness of those aimed at the treatment of complex posttraumatic stress. Objective. To evaluate the efficacy of psychological treatments for complex posttraumatic stress disorder. Method. A systematic qualitative search was conducted according to PRISMA guidelines, searching four psychological and health electronic databases: Medline, Pilots, PsycINFO, and Pubmed. Three reviewers independently selected the studies in two phases: preselection (criteria for complex posttraumatic stress disorder, replicable psychological treatment, and treatment effect) and selection (additional criteria: type of study, participants, and treatment). Results. Of the 615 studies reviewed, 25 were preselected, eight of which met the inclusion and methodological quality criteria. Five studies explored adult populations (with one exception, all were randomized clinical trials) and three child populations (clinical studies with pre- post-treatment design, with and without control group). Most studies with adult populations included psychoeducation, cognitive restructuration, and exposure therapy. The studies with child samples included EMDR and mindfulness as the most frequent treatment components. Discussion and conclusion. The evidence was insufficient to determine the most effective treatment. More research on this issue is required.
Binge eating disorder in men. A review of the relevant variables in the literature
Authors: Velázquez López Héctor Julián ,   Proyecto de Investigación en Nutrición, Facultad de Estudios Superiores Iztacala. Universidad Nacional Autónoma de México, Estado de México, México., Vázquez Arévalo Rosalía , Mancilla Díaz Juan Manuel
Published: May 2018

Background. Although binge eating disorder (BED) formally appeared in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), after nearly two decades of research, it is still considered understudied in men. Objective. To carry out a literature review with the variables that have been relevant in research on BED in men, from 1994 to 2015. Method. The article search was conducted in Medline and PsycINFO databases. Results. Twenty-eight articles were analyzed, none specifically investigated male population. Men engage less in restrictive dieting than women (29.8% and 57.3%, respectively). Regarding body image, both men and women are prone to body dissatisfaction, although the ideal body is not necessarily the same. Regarding comorbidity, anxiety disorders are the most common ones in men with BED, in addition to the fact that they are more susceptible to substance abuse. Discussion and conclusion. Investigation on BED has mainly been conducted on female population, which suggests the need for more research on men that provides more empirical evidence.
SURGICAL TREATMENT OF PATIENTS WITH FOLLICULARTUMOR OF THYROID GLAND
Authors: Simbirtsev S A , Tatarkin V V , Trunin E M , Smirnov A A , Davidov D V , Sultanova F M
Published: May 2018

In this work, based on the research of treatment results of 646 patients that were operated for nodular and multinodular nontoxic goiter in Hospital St. Elizabeth endocrinology center, in the period from 1997 to 2013, an analysis of the malignant tumor frequency in patients with follicular thyroid tumors who underwent surgical treatment for the nodular goiter was performed. In this group gender and age characteristics of patients with follicular thyroid tumors were identified, and also an evaluation of surgical treatment safety in patients operated for follicular thyroid tumors was performed.
FEATURES OF SURGICAL TACTICS IN WOUNDS OF THE ANTERIORABDOMINAL WALL AND LUMBAR REGION WITH LIVER DAMAGE
Authors: Sigua B V , Zemlyanoy V P , Badalova Zh E , Yalda K D , Gorbunov G N
Published: May 2018

We analyzed the results of treatment of 339 patients with wounds of abdominal and lumbar regions, that were treated during the period from 1991 to 2010. For the purpose of continuity in providing of the specialized surgical care we used the scales, evaluating the severity of multiple and combined injuries, developed by military surgery department (VPH-P ((R) and (OR))) and the classification of liver damages by E. Moore. Abandonment of liver injury packing in favor of suturing allowed to achieve a significant reduction of post-operative complications in patients with injuries of the abdomen and lumbar region with liver damage from 24.1% (40) to 9.2% (16) (p <0,001), and the level of mortality from 6.1% (10) to 1.2% (p <0.05).
THE VALUE OF HIGH EFFECTIVE LIQUID CHROMATOGRAPHYIN THE DIAGNOSIS OF PRIMARY HYPERALDOSTERONISM
Authors: Rebrova D V , Vorokhobina N V , Velikanova L I
Published: May 2018

Primary hyperaldosteronism is considered to be the most common cause of secondary hypertension. Therefore a relevance of early diagnosis of primary aldosteronism is obvious. The article discusses the possibility of using the determination of precursors of aldosterone in blood and urine samples by high effective liquid chromatography as an additional diagnostic criterion. The method is safe for the patients who have contraindications to recommended confirmatory tests. It can be used in patients with uncontrolled hypertension and high risk of cardiovascular complications. Our data showed that increased levels of blood corticosterone, 18-hydroxycorticosterone in blood and urine samples are laboratory signs of primary aldosteronism. We consider measurement of 18-hydroxycorticosterone blood level for early differential diagnosis of various types of primary aldosteronism.
INSULIN AND CERTAIN STEROIDS SECRETION IN PATIENTSWITH VARYING SEVERITY OF BURN DISEASE
Authors: Pugachev M I , Dobrovolskaya L M , Ivanov V V , Shustov S B
Published: May 2018

The results levels of insulin, testosterone and cortisol in patients with burn disease are presented. The analysis of the secretion hormones in groups with varying severity of the injury are provided. It was shown that in male burned patients was accompanied with prolonged decrease in testosterone secretion. Degree of inhibition testosterone secretion depends on the severity of burn injuries. Also there were revealed that burn disease was accompanied with prolonged increase in cortisol secretion. It was shown that increase IRI-activity on the 6 th and 14 th day of hospitalization, which may indicate emerging insulin resistance in this period disease. Severe burn injury were observed to hormonal failure, which may reduce the chances of survival of the injured.
INFLUENCE OF THE DEGREE OF OBESITY AND HIGH-VOLUME LIPOSUCTIONON BODY COMPOSITION, HEMODYNAMIC CHANGES, BLOOD OXYGEN
Authors: Nikolaeva I P , Kapranova A S , Popova V B , Lodyagin A N , Frolova T A
Published: May 2018

To evaluate the influence of the degree of obesity and high-volume liposuction on body composition, hemodynamic, blood oxygen. The actual values of the cardiac index and stroke index, as well as the calculation of these indicators on a body surface area of the "ideal subject" showed a significant correlation with body mass index, which confirms the impact of obesity on hemodynamic changes, myocardial dysfunction and the development of severe arterial hypoxemia. Analysis of the parameters of liquid sectors body showed insufficient increase in total, extracellular fluid and blood volume by a significant rise of fat and muscle mass. It is believed that the increase in blood volume in obesity is adaptive in nature and occurs in response to expansion of the vascular bed with increasing body weight. After liposuction large volume of significant hemodynamic changes were not obtained. In the late period against reduction in fat mass oxygenizing improved lung function. Carrying a large volume liposuction are not adversely impact on the reserve possibilities myocardial hemodynamics in the long term. Timely diagnosis of adaptive changes in hemodynamics and fluid sectors organism, which can be considered as prognostic risk factors must be considered when choosing the volume lipoaspiration.
DINAMICS OF HAEMODIYNAMIC INDExES IN PATIENS WITH AN AORTIC STENOSIS IN A PERIOPERATING PERIOD DEPENDING ON ANATOMIC FEATURES OF VALVULARVEHICLE
Authors: Slepenok E V , Stolov S V
Published: May 2018

The aortal stenosis is the most widespread diseases among valvate damages of heart. The hypertrophy of the left ventricle which degree correlates with weight of the defect in many respects defines outcomes of an aortal stenosis. Thus in the literature there is no precise communication between in thickness myocardium left ventriculum and initial valve the device (the size of a ring aortic the valve), as well as speeds of regress of a hypertrophy in the postoperative period and the size of an implanted artificial limb. In work the analysis of dynamics of haemodynamic parameters of heart in a perioperating period depending on anatomic features of the valvate device is carried out (the diameter of a ring aortic the valve). In surgical practice at implantation of an aortal artificial limb estimate body surface area, thus try to provide as much as possible physiological needs for warm emission. Therefore most often to them plan artificial limbs the sizes more than №23. However owing to expressiveness of a kaltsinoz of an aortal ring and deformation it owing to fibrosis it is not always possible to establish artificial limbs of the corresponding diameter. Our research is directed on detection of features of haemodynamic indicators in postoperative the period, as forecast predictors depending on diameter of an aortal artificial limb. It is established, that patients with implantation of prosthetic appliance sizes №19-23 in early operational period had a higher gradient of pressure on an aortic valve, more slow reduction of degree of hypertrophy of myocardium as compared to the group of patients with prosthetic appliances more than № 23. At comparison hemodynamic parameters of both groups in the remote timeframes the increase of a gradient of pressure of an artificial limb aortic the valve in group with artificial limbs less than №23 in comparison with preoperative periods is revealed. At patients with artificial limbs more than № 23 intracardial characteristics in the remote period especially did not change. The given features, probably, are connected with shaped dysfunction of an artificial limb (pannus) or with more expressed load on left ventriculum (at slower regress of a hypertrophy left ventricuulum), that the trancevalve a gradient of pressure tends to increase.
STUDY OF REINNERVATION PROCESS IN PATIENTS WITH 2 TYPEOF SPINAL MUSCULAR ATROPHY: CLINICAL EXPERIMENTAL STUDY
Authors: Sokolova M G , Penniyaynen V A , Rezvantsev M V , Lobzin S V , Aleksandrov N Yu
Published: May 2018

Spinal muscle atrophy (SMA) of type 2 is an autosomal-recessive disease defined by a degenerative change in alpha-motor neurons of anterior horns. The disease is manifested in weakness of proximal muscles, pareses, respiratory disturbance and early death. Study of reinnervation process in patients with 2nd type of SMA can provide valuable information on a condition of adaptive mechanisms within the limits of neuron plasticity. According to electroneuromyography study in patients with 2nd type SMA reinnervation process is low intense. It was found out that concentration NGF (nerve growth factor) in serum of patients with 2nd type SMA is considerably higher than in control group. We studied the influence of blood serum of patients with 2 type SMA on growth neurites of sensory ganglia of 10-12 days old chicken embryos in organotypic culture. For the first time it was shown that blood serum of patients with 2nd type SMA dose-dependent inhibits of growth neurites of sensory ganglia. Apparently, neurite-inhibitory effect is caused by high concentration of neurotrophins in patient serum, due to that the reinnervation mechanisms in 2 type SMA patients are not so efficient.
APPLICATION OF CELLULAR TECHNOLOGIES FOR RESTORATIONOF PROCESS OF REGENERATION AT PEOPLE OF THE SENIOR AGE GROUPS
Authors: Pechersky A V , Pechersky V I , Smolyaninov A B , Velyaninov V N , Adylov S F , Semiglazov V F
Published: May 2018

This manuscript is devoted to the vital topic - restoration of process of the regeneration at people of the senior age groups. Cells-predecessors and differentiated cells can divide a limited number of times and are not capable of providing regeneration of tissues during all of ontogenesis. The updating of tissues during such a long period is impossible without the participation of a specialized system responsible for regeneration. The given system is submitted by stem cells which are capable of being differentiated in all types of somatic cells and in a line of genital cells, and also have ability to self-update during the whole life of an organism. Results of research allow to consider, that the number of a pool of pluripotent stem cells at people of the senior age groups can be restored by a transfusion of mononuclear fraction of peripheral blood from young donors of 18-23 years of one blood types and a floor with the recipient (The patent of the Russian Federation № 2350340).
EMPATHIC ABILITIES AND EMOTIONAL BURNOUT SYNDROMEAT SPECIALISTS OF PSYCHIATRIC PROFILE: RISK FACTORS AND CORRECTIION
Authors: Gorodnova M Yu
Published: May 2018

The study of communication burnout and empathic abilities of 270 specialists of child and adult psychiatry were examined during postgraduate study, selected corrective factors of the educational process. Emotional exhaustion and professional success at the output of the educational process are determined by their initial values. Level of output is determined by the depersonalization emotional exhaustion at the entrance. The risk factors for the development of burnout in men are a high level of empathy, intuition, identification, and the women high emotional involvement. Developments of empathic attitudes, ability to create an atmosphere of trust, to see the world through another’s eyes, spontaneous interest reduce the risk of the syndrome. The personal experience of supervision and participation in personal growth groups reduce symptoms of emotional burnout syndrome
VIDEO ASSISTED OPERATIONS IN THE TREATMENTOF COMPLICATED FORMS OF COLON CANCER IN ELDERLYAND SENILE PATIENTS
Authors: Glushkov N I , Gorshenin T L
Published: May 2018

Article presents the results of the treatment of complicated forms of colon cancer in patients with elderly using laparoscopic technology. The authors analyzed the data and showed the effectiveness of minimally invasive technologies in treatment of colon cancer.
PATIENT-ORIENTEDMODEL OF DELIVERY OF HEALTH CARE AS INSTRUMENT OF IMPROVEMENT OF QUALITY OF MEDICALAND DIAGNOSTIC PROCESS
Authors: Gilvanov V A , Minaycheva N E , Lebedev I A , Filatov V N
Published: May 2018

On the basis of the employees given questioning and patients of versatile hospital, influence of patient-oriented model of delivery of health care on its quality is shown. The most important results of introduction of this model are high commitment of health workers to clinic and increase of a self-assessment of employees, and also improvement of quality of medical and diagnostic process, according to repeatedly hospitalized patients. One of the most significant components of the work of medical institution focused on the patient is observance of the principles of corporate culture.
PERSONAL SPACE: PATIENT, DISEASE, PHYSICIAN
Authors: Khurtsilava O G , Khubulava Gr G
Published: May 2018

This article represents a brief review of the development of the doctor’s and the patient’s attitudes towards each other. Where does the estrangement stage start, when a patient turns from an individual into an interesting medical case? What unites and distinguishes these images? How does the image of the doctor change from healer shaman into a specialist wearing the medical uniform? What unites and distinguishes these two images?
ADRENAL MYELOLIPOMA
Authors: Fedorov E A , Sablin I V
Published: May 2018

Myelolipoma is a rare benign tumor that is usually asymptomatic, one-sided as a rule and hormonally inactive. It consists of mature adipose tissue with inclusion of hematopoietic cells. Most often it occurs in the adrenal gland. Patients with incidentally identified myelolipoma require careful examination in order to plan optimal management tactics. Using highly informative methods of radiodiagnostics (ultrasound, CT, MRI) allows to establish the correct diagnosis in most cases. Currently, the choice of the optimal survey algorithm, which allows not only to diagnose myelolipoma, but also to differentiate it from malignant tumors of adrenal glands, has not lost its relevance. The issues of follow-up of these patients, indications for surgery and methods of surgical interventions are also relevant.
CRANIOVERTEBRAL ABNORMALITIES: THE SYSTEMATIZATION PRINCIPLES,THEORIES, CLINICAL MANIFESTATIONS (LITERATURE REVIEW)
Authors: Lobzin S V , Yurkina E A
Published: May 2018

The authors analysis of the scientific literature on the problem of craniovertebral abnormalities has been conducted. In this article the history of research on craniovertebral abnormalities, the classification, theories of pathogenesis have been described.
SUBTOTAL ESOPHAGECTOMY WITH SIMULTANEOUS GASTRIC TRANSPLANT PLASTICSIN A PATIENT WITH PREVIOUSLY FORMED GASTROSTOMY
Authors: Zemlyanoy V P , Sigua B V , Oblapenko P G , Kotkov P A
Published: May 2018

Currently, the best operative method of esophageal resection in cases of its scar stenosis is performing one-stage resection with gastric transplantat plastics. However, in some cases, gaster is compromised by various pathological processes, and the use of such stomach as plastic material is questionable. Often, the presence of "defective" stomach promotes the selection of colon as a plastic material. The article presents a case report of successful one-stage esophageal resection with gastric transplant plastics in a patient, which was formed earlier gastrostomy.
MODERN IMAGING TECHNIGUES IN THE DIAGNOSIS OF BRAIN ALVEOCOCCOSIS(OWN OBSERVATION )
Authors: Kholin A V , Amanbaeva G T
Published: May 2018

The Brain Alveococcosis is a rare parasitic disease of the central nervous system, caused by the larval stage of the Echinococcus multilocularis. Alveococcus characterized by prolonged chronic course, severe organ and systemic disorders, extensive damage, leading to disability and often to the death of a patient, by the difficulty of diagnosis and surgical treatment. There is brain alveococcosis of the young man living in rural areas of Kyrgyzstan. The radiologic diagnosis methods significantly improve the quality of brain alveococcosis’ diagnosis, thus is a highly MRI study.
THE RESULTS OF WORK OF THE SPECIALIZED CENTER FOR MANAGEMENTOF PREGNANCY AND DELIVERY IN MINORS
Authors: Mikhailin E S , Ivanova L A , Savitsky A G , Berlev I V
Published: May 2018

The article is devoted to the first results of the specialized Center for management of pregnancy and childbirth in minors «Little Mother» based in SPbGBUZ «Maternity Hospital №10». Results of the study generally confirmed the literature data on the high frequency of complications of pregnancy and childbirth in adolescents but for those who were regularly observed in the center, especially from the early pregnancy, severity of complications was lower (dominated by light level of preeclampsia and anemia); intrapartum frequency of rapid delivery, perineotomy, abnormal bleeding, forceps or vacuum - extraction of the fetus, as well as frequency of child birth in a state of asphyxia was significantly less. Since the establishment of the Center, no minor patient did not abandon the child in a maternity hospital. Improvement in the quality of medical care for adolescents is demonstrated if they are concentrated in one institution, where the atmosphere and organization of medical care takes into account clinical, social and psychological characteristics of pregnant adolescents.
DYNAMICS OF CYTOKINS AND THEIR INTERRELATION IN LIVER CIRRHOSIS
Authors: Fishman B B , Toneeva M A , Kulikov V E , Kornilova V A , Antonova E R
Published: May 2018

The research objectives are to determine serum interleukins (IL-2, IL-6) and tumor necrosis factor alpha (TNF - α) and evaluate their interrelation in liver cirrhosis (class A, B, C according to Chad - Pugh). 117 patients were examined and their cytokines levels were determined using enzyme-linked immunosorbent assay.Elevation of cytokine levels IL-2, I-6 and TNF-α within reference values was found in liver cirrhosis cases, expect for level IL-6 in liver cirrhosis cases of class C. In these cases IL-6 level exceeds reference values and is within the limit of 9,94 - 25,21 pg / ml with average concentration of 14,89±4,96 pg / ml. Correlation is found between TNF- α and IL-6 (r = - 0,499) in liver cirrhosis of class A and correlation between TNF- α and IL-2 (r = 0,421) is found in liver cirrhosis of class B.
CYTOKINES PROFILE BRONCHOALVEOLAR LAVAGE PATIENTS WIHT BRONCHIAL ASTHMA
Authors: Murasov E G , Stolov S V , Totolian A A
Published: May 2018

To assess the extent of inflammatory process in 80 patients with bronchial asthma examined the content of several cytokines in bronchoalveolar lavage enzyme analysis. Found that the exacerbation of bronchial asthma accompanied by increase of IL-4, IL-6, IL-8 and GM-CSF in bronchoalveolar lavage. Production of cytokines in patients with atopic form bronchial asthma is higher than in patients with mixed form. After a course of antiviral therapy levels have declined, and the contents of cytokine IFN-γ.
ASSESSMENT OF EFFICIENCY OF INTRODUCTION OF THE TARIFF FOR CARRYING OUT THROMBOLYTIC THERAPY IN WORK OF THE PRE-HOSPITAL STAGEOF THE EMERGENCY MEDICAL SERVICE
Authors: Barsukova I M
Published: May 2018

In article the high importance of standardization and tariffing of services of an emergency medical service, and also statistics of successful introduction of tariffs at a pre-hospital stage of an emergency medical service in subjects of the Russian Federation, including, in St. Petersburg is proved. It is shown that existence of a specialized tariff for carrying out thrombolytic therapy in territorial subjects of the Russian Federation was the stimulating factor of introduction of this modern technology in work of an emergency medical service that promoted reduction of algorithm of delivery of health care by the patient with a sharp and repeated myocardial infarction in compliance with the approved standard, to improvement of quality of delivery of health care.
PHARMACOECONOMIC ANALYSIS OF THE CONVENTIONAL PHARMACOTHERAPYOF dEEP VEIN THROMBOSIS
Authors: Petrov V I , Shatalova O V , Smuseva O N , Gorbatenko V S
Published: May 2018

The cost analysis of treatment of deep vein thrombosis was performed in conventional therapy. The estimation of the cost of treatment of DVT in conventional treatment was done, using clinical-economic analysis - the «cost of illness» (COI). The study took into account only the direct costs of state and patients during 6 month treatment course. The cost analysis of DVT in conventional treatment was held, the economic burden of DVT is 1,8 billion rubles, in structure of cost it is occupying 98%. The cost of purchase of warfarin is occupying only 2%. At the present stage DVT and its complications are the serious problem, spending resources. In the cost`s structure of DVT outgoings of hospital treatment are 83%, if we reduce hospitalization costs, we can reduce state costs of DVT treatment.
THE CASE OF DIFFICULTY DIAGNOSIS OF ACUTE APENDICITIS IN ATYPICAL POSITION ON THE APPENDIX ON THE BACKGROUND OF THE MALFORMATION OF ABDOMINALCAVITY
Authors: Sultanov M S , Litvinov A N , Nakhumov M M
Published: May 2018

The article presents a clinical case of acute destructive appendicitis on the background of the anomalies of the abdominal cavity. This observation demonstrates the significant difficulties in the diagnosis of acute appendicitis occurring against the background of an atypical location of the appendix if you can not perform a diagnostic laparoscopy.
RESISTANT HYPERTЕNSION PATIENT WITH PRIMARY ALDOSTERONISM
Authors: Ivanova N V , Aerinchek V P , Grishkin Y N
Published: May 2018

Mineralocorticoid hypertension, including Conn's syndrome, occurs significantly more frequently than is recognized. Despite modern diagnostic capabilities and the availability of treatment methods, it cannot be diagnosed simply because (they) know little about it. Recall clinico-pathological variants of mineralocorticoid hypertension and the peculiarities of their management. Here is a fairly typical clinical case Conn's syndrome, recognized for many years later than it needed to be done. Pay attention to the fact that mineralocorticoid hypertension should be considered in patients with resistant nature of the response to treatment.
COMORBID CONDITIONS IN PRIMARY OBESITY AS A POSSIBLEPREDICTOR OF METABOLIC SYNDROME IN CHILDREN
Authors: Mazurov V I , Gonchar N V
Published: May 2018

Obesity and its attendant neurohormonal regulatory violations and play a leading role in the development and progression of insulin resistance (IR), which is the principal risk factors of the metabolic syndrome (MS). Identifying predictors of MS in childhood is of great clinical importance, since the adequate treatment of this condition is reversible. The aim of the study was to investigate the clinical manifestations, metabolic and hormonal disorders in primary obesity, depending on the presence of comorbid conditions in children. In the endocrinology department at Children's Hospital №1 of St. Petersburg in 2008-2011 observed 20 children aged 8 to 17 years (boys - 14, girls - 6) with primary obesity. The survey included children study of heredity; objective examination of the analysis of physical development, evaluation of blood pressure; study hemogram, biochemical analysis of blood parameters and hormonal status; the results of instrumental studies of the cardiovascular system and digestive tract. Patients have formed two groups: 13 children with primary obesity without comorbid conditions (group 1) and 7 children with complicated comorbidity primary form of obesity (group 2). Isolation of children in Group 2 of the total weight of obese patients was conducted taking into account the identification of IR. Studies have shown that the complicated form of primary comorbidity of obesity was more common in males and is characterized by hemodynamic and hormonal changes indicating a possible risk of developing MS. At the same time, the expression of lipid metabolism, the frequency of functional pathology of the cardiovascular system and digestive tract diseases did not differ among children in group 1 and group 2.
CLINICAL SIGNIFICANCE OF SLC22A1 RS622342 GENETIC POLYMORPHISMIN TYPE 2 DIABETES MELLITUS PATIENTS, TAKING METFORMIN
Authors: Baranov V L , Vorokhobina N V , Abulula M , Zagorodnikova K A , Topanova A A
Published: May 2018

One of the key proteins that determine the pharmacokinetics of metformin is OCT1. rs622342 polymorphism in the gene SLC22A1 (OCT1) can reduce the expression of this protein. The aim of this study was to evaluate clinical significance of rs622342 in people with diabetes mellitus (DM) type 2, taking metformin. In 94 patients dynamics of the main indicators of glycemic control and body mass index were sudied over 6 months of treatment. At the end of the study 33 of 49 patients (67,3%) with wild-type variant of rs622342 (genotype AA) and 17 of 45 (37,7%) with polymorphic variants of the gene SLC22A1 (AC- and CC-genotypes) were taken metformin only and had Hb A1c levels less than 7,0%. Remaining patients required a second hypoglycemic agent or had Hb A1c levels 7,0% or more. Calculating odds ratios showed that the presence of AC- or CC- genotypes of rs622342 in the gene SLC22A1 increases the risk of poor clinical effect of metformin 3,4-fold (p = 0,004). Conclusion: The presence of a polymorphic allele C ( rs622342 ) in the gene SLC22A1 in patients with type 2 diabetes is associated with poor clinical effect of metformin monotherapy.
EFFECT OF CYTOCHROME P450 2C9 GENE POLYMORPHISMS ON INDIVIDUAL SENSITIVITY TO GLICLAZIDE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS
Authors: Abulula M , Baranov V L , Vorokhobina N V
Published: May 2018

Cytochrome P450 2C9, encoded by the gene CYP2C9 , is a key enzyme for the metabolism of most sulfonylurea (SU). It is known that the polymorphisms CYP2C9*2 and CYP2C9*3 are associated with decreased activity of cytochrome, which leads to an increase in plasma concentrations of SU and reduction in its clearance. The aim of the study was to assess the impact CYP2C9 polymorphisms on individual sensitivity to gliclazide in patients with type 2 diabetes. The study included 74 patients with newly diagnosed diabetes. For all patients gliclazide in a dose of 30 or 60 mg/day was prescribed. Dose titration was carried out for 6 months of observation. If necessary other glucose-lowering therapy (a combination of drugs or insulin) were prescribed. Following the results of study, all patients had achieved the target values of Hb A1c. In comparison with patients who had a polymorphic allele in the gene, patients with wild-type CYP2C9 had lower effective dose of gliclazide, more often required prescription of large (90-120 mg) doses of drug or other antihyperglycemic therapy. Conclusion: The presence of a polymorphic allele in the gene CYP2C9 in homo- or heterozygous state is associated with a decrease in the effective dose of gliclazide, used as monotherapy in patients with type 2 diabetes.
LATERALIZATION CRITERIA IN ADRENAL VEIN SAMPLING IN PATIENSWITH PRIMARY ALDOSTERONISM BY HIGH EFFECTIVE LIQUID CHROMATOGRAPHY
Authors: Rebrova D V , Shafigullina Z R , Lisitsin A A , Velikanova L I , Vorokhobina N V , Obedkova E V , Asadulaev S M
Published: May 2018

Analysis of the use of adrenal vein sampling for differential diagnosis of the main forms of primary aldosteronism is presented in the article. Coefficient of lateralization was specified by high effective liquid chromatography of blood corticosteroids. This data is useful for differential diagnosis of the main forms of primary aldosteronism in the cases with boundary values of coefficient of lateralization.
EFFICIENCY OF THE LOW-DOSE FORMS ESTROGEN-GESTAGEN DRUG TREATMENTTO WOMEN WITH COMPENSATED HYPOTHERIOSIS AND EUTHYROIDISM
Authors: Gromova V A , Vorokhobina N V , Malygina O F , Kuznetsova A V
Published: May 2018

The article presents research results of 61 perimenopausal and postmenopausal women with diffuse nodular nontoxic goiter and autoimmune thyroiditis, who in the 12 months received treatment low-dose combined estrogen-progestin drug, which includes a 1 mg 17-β estradiol and 2 mg drospirenone. The effect of hormone replacement therapy on coagulation and platelet hemostasis, lipid profile, pituitary-ovarian system, thyroid status were studied. Using of low-dose estrogen-progestin therapy does not worsen diffuse nodular nontoxic goiter and autoimmune thyroiditis flow, does not change the dose of thyroid medications and may be recommended for the treatment of menopausal symptoms in women with thyroid disease.
ATRIAL FIBRILLATION IN PATIENTS WITH INFERIOR MYOCARDIAL INFARCTION
Authors: Radha B , Sayganov S A , Gromiko T Y
Published: May 2018

Objective: To elucidate the mechanism of atrial fibrillation and evaluate left atrium function after restoration of sinus rhythm in patients with acute posterior wall myocardial infarction ( MI). Materials and Methods: The study included 53 patients with posterior wall MI.All patients were divided into 2 groups. The first group consisted of 33 a people with paroxysms of atrial fibrillation (AF), and the second included 20 control subjects without arrhythmia. All percutaneous intervention was performed within the first 24 hours. Patients were evaluated for time and duration of paroxysms, the size of the heart chambers and the recovery time of the left atrium (LA)function. Results: Patients with posterior wall myocardial infarction developed AF in the early stages of the disease (in 91% on the first day), with short duration of paroxysms, stopped spontaneously and often within 1 hour (in 11 people). There were no significant differences in the size of the heart chambers, left ventricular contractility and hemodynamic disturbances in patients of both groups. AF in most cases developed in patients without left ventricular failure (in 27 people; 82%). Wherein the proximal right coronary artery occlusion was observed more frequently in patients with atrial fibrillation, than in the control group (17 vs 2; p <0,001). Approximately half patients(16 ) with AF before the appearance of atrial fibrillation bradysystolya of atria (less than 50 in 1 min) was recorded, due to acute sinus node dysfunction. After the reversion of sinus rhythm mechanical function of the LA was absent in only 4 people with left ventricular failure. Effective systole of LA was restored only 7 days after reversion to sinus rhythm. The rare occurrence of mechanical dysfunction after discontinuation of arrhythmia indicates a low probability of thrombosis and embolism in the systemic circulation. Conclusion: In cases of patients with posterior wall localization of MI main causes of AF include acute ischemia of atria due to occlusion of the right coronary artery above the branches supplying atrium. Atrial bradysystolya due to acute sinus node dysfunction often contributes to the development of AF as a substitute atrial rate (acute syndrome of tachy-bradycardia). In case of patients with posterior wall MI AF episodes were rarely accompanied by hemodynamic disturbances and the risk of systemic thromboembolism after reversion to sinus rhythm was low.
POSSIBLE ROLE OF GENETIC POLYMORPHISMS FOR INDIVIDUALSENSITIVITY TO SIMVASTATIN IN INITIAL THERAPEUTIC DOSE
Authors: Zagorodnikova K A , Topanova A A , Natas M A , Shumkov V A
Published: May 2018

Despite proven benefits of statins their effects and tolerability differ significantly in different patients. Genetic polymorphisms in genes of metabolizing enzymes, especially CYP3A5, and transporter proteins, especially OATP1B1, represent important factor for these changes. In our study we investigated influence of genetic polymorphisms on effects and safety of simvastatin 20 mg daily in 60 patients with dislipidemia. We observed reverse correlation of effects and adverse effects of simvastatin in our patients. Among CYP3A5*1 carriers we observed a tendency to less pronounced lipid-lowering effects (1,2 vs 2,9 mcmol/l). Our data may indicate importance of genetic polymorphisms even when statins are use in minimal therapeutic doses.
FEATURES OF INTRAHEPATIC MICROCIRCULATION IN PATIENTSWITH ISHEMIC HEART DISEASE AND ESSENTIAL HYPERTENSION
Authors: Manasyan A G , Ermolov S U , Dobkes A L , Manasyan S G , Serdyukov S V
Published: May 2018

This research is devoted to revealing features of the intrahepatic microcirculation in ischemic heart disease and essential hypertension. Disturbance of the liver microcirculation were found by polihepatography.Three group patients were examined: I group - patients with stable form ischemic heart disease in combination with hypertension; II group - patients with essential hypertension stage II without ischemic heart disease; III group - control - healthy people. There were found significant differences in the groups depending on the location intrahepatic blood flow disturbance. This research shows that necessary differentiated approach to treatment these diseases.
HEMODYNAMICS IN THE BRANCHES OF THE AORTIC ARCHIN CHRONIC LIVER DISEASES
Authors: Kulikov V E , Emelina T A , Kornilova V A , Toneva M A , Antonova E R
Published: May 2018

With cirrhosis of the liver statistically significant violations of cerebral hemodynamic parameters observed in intracranial department due to hemispheric asymmetry of blood flow. Hemispheric asymmetry of blood flow is marked by the development of vascular resistance and lability of the process of atherosclerosis. Hemispheric asymmetry between blood flow and stages of hepatic encephalopathy observed a noticeable positive relationship.
PREBIOTIC THERAPY IN COMPLEX TREATMENT OF PATIENTSWITH STEATOHEPATITIS MIXED
Authors: Grinevich V B , Kravchuk Y A , Sas E I , Reshetneva E M
Published: May 2018

The efficiency of the use of prebiotic eubikor in complex treatment of patients with steatohepatitis mixed (alcoholic and metabolic) etiology. The additional use of a prebiotic complex optimization by intestinal microbiota has led to reduced levels of serum cytokines (TNF-α and IL-1β), reduction of insulin resistance according index calculated QUICKI and HOMA-IR. The result of treatment was significant regression eubikorom severity of clinical symptoms (abdominal pain, flatulence), the positive dynamics of biochemical parameters of blood serum (AST, ALT, GGT), improved morphological picture of the liver (steatosis reduction in the degree of activity and hepatitis).
PHARMACOLOGICAL AUGMENTATION OF LUNG RECRUITMENT EFFECTS LN THE THERAPY OF ACUTE RESPIRATORY DISTRESSSYNDROME AFTER CARDIAC SURGERY
Authors: Bautin A E
Published: May 2018

The aim. To estimate efficacious of combined application of lung recruitment maneuver (LR) and surfactant administration for the treatment of ARDS after cardiac surgery. Materials and methods. 33 cardiac surgery patients with ARDS were included in to prospective, controlled non-randomized study. LR technique was used in 14 patients, who were included into the "LR" group. In 19 cases LR were combined with endobronchial administration of surfactant (Surfactant-BL, ”Biosurf” Russia), these patients were included into the "LR and surfactant" group. Results. Significant difference from baseline FiO 2 observed after 12 h in "LR and surfactant" group and after 24 h in "LR" group. Significant decrease from the baseline PEEP was observed after 48 h in "LR and surfactant" group and after 72 h in "LR" group. The duration of respiratory support was shorter in the "LR and surfactant" group: 87,5 ± 35,3 h vs 175,3 ± 52,5, p <0,001. There was significant difference in the incidences of ventilator-associated pneumonia (VAP): 10.5% in the "LR and surfactant" group and 42.9% in the "LR" group, p <0,05. Furthermore, we found significant difference in the ICU stay period between groups: 132,5 ± 42,2 h in the "LR and surfactant" group vs 282,5 ± 110,2 h in the "LR" group, p <0,01. There was no significant difference between two groups In mortality rate: 3 (15.8%) in the "LR and surfactant" group and 3 (21.4%) in the "LR" group. Conclusions. The combination of LR and surfactant administration decrease the time of respiratory support and ICU stay, reduce the risk of VAP.
COMPARATIVE ESTIMATION OF LASER COAGULATION EFFICIENCY IN MACULAR AND MICROPHOTOCOAGULATION OF HIGH DENSITYIN DIABETIC MACULOPATHY TREATMENT
Authors: Izmaylov A S , Kotsur T V
Published: May 2018

The modern standard of treatment of clinically significant diabetic macular edema is macular laser photocoagulation was suggested in the reports of the Early Treatment of Diabetic Retinopathy Study (ETDRS, 1985-1990). Subthreshold microphotocoagulation (MicroPulase) leads to developing barely visible or invisible retinal burns and also has been shown to be effective in treating macular edema with no side effects comparing with ETDRS methodic (retinal pigment and choroidal atrophy, decreasing of retinal sensitivity). Effectiveness of microphotocoagulation may arise in high density laser applications, however in modern literature exists rare publications concerning this question.
USE OF CROSS-SECTIONAL DATA TO ESTIMATE FORCE OF INFECTIONFOR HIV INFECTION AND HEPATITIS C - ABSENCE OF CONSTANT RISK
Authors: Barinova A N , Plavinski S L , Vingradova N H
Published: May 2018

Injecting drug users (IDU) have high risk of acquisition of HIV and other blood-borne viruses, because they frequently share needles, syringes and other injecting paraphernalia. The article describes methodology of estimating force of infection for blood-borne diseases from data on prevalence and injection length. Based on results from 5429 IDU surveyed between 2006 and 2013 it was found that force of infection is at maximum during first months after starting injecting - 0,38 (95%CI=0,24 .. 0,51) for HIV infection and 1,03 (95%CI=0,61 .. 1,46) for hepatitis C. After that risk of infection significantly decrease but is not zero. Also basic reproductive rate by regions and periods of study was estimates. Importance of this approach for public health is demonstrated.
CONDITION OF RESPIRATORY MUCOSA AT CHILDREN WITH RESPIRATORY DISTRESS
Authors: Starevskaya S V , Goloborodko M M , Berleva O V , Barashkova S V , Melnikova I Yu , Detkov V Yu , Molodtsova V P
Published: May 2018

42 children with the diseases of respiratory organs complicated by respiratory failure have been examined to determine the nature of inflammatory changes of a tracheobronchial tree and a condition of mucoсiliary system . At children with acute diseases of respiratory organs the neutrophillic inflammation of tracheobronchial tree mucous has been revealed more often, at children with chronic diseases of lungs has been more often noted lymphocytic eosinophilic an inflammation of tracheobronchial tree mucous , obvious thaumatropy and dystrophy of ciliate epithelium. At 10% of children primary motor disturbance of the mucoсiliary system (total immobility of cilia) has been revealed.
NEUROTROPHINS-MARKERS REPARATIVE-DESTRUCTIVE PROCESSESIN CHILDREN WITH CEREBRAL PALSY
Authors: Sokolova M G
Published: May 2018

The article provides results of complex clinical and laboratory examination of 66 children with cerebral palsy (CP). It was found that the level of nerve growth factor (NGF) and ciliary neurrotrophic factor (CNTF) in blood serum are authentically higher in children with CP and syndrome of localization related epilepsy, thus brain-derived neurotrophic factor (BDNF) have no significant differences from the results of control group.
MATHERNAL ANEMIA AND BIRTHWEIGHT
Authors: Kozlovskaya A V
Published: May 2018

Author has studied the average birth weight using the birth register from Syktyvkar and Vorkuta of Komi Republic. The prevalence of anemia was higher in Vorkuta. Infants born to woman with anemia were heavier than infants of non-anemic mothers were (Sykvyvkar, р<0,001). Babies of anemic mothers from the third or more deliveries were heavier than from the first deliveries (Vorkuta, p<0,001).