bluuebunny/crossref_metadata_2025 huggingface dataset:
Non-invasive mechanical ventilation for reperfusion myocardial injury prevention after endovascular surgeries in patients with ST-elevation myocardial infarction (STEMI)
Authors: Neimark M I , Zayashnikov S V , Kalugina O A , Berestennikova L N
Published: November 2019

Aim. To determine the need for pressure controlled non-invasive mechanical ventilation for reperfusion myocardial injury prevention in patients with ST-elevation myocardial infarction (STEMI). Methods. The study enrolled 61 patients admitted to the intensive care unit within 6 hours from the debut of chest pain, ST-segment elevation on electrocardiogram and oxygen saturation less than 90%. A percutaneous coronary intervention on an affected coronary artery was performed in all patients 30-90 minutes from admission. Non-invasive mechanical ventilation using the «MAQUET Servo-s» machine was started in patients of the first group (31 patients, mean age 66.3±10.7 years, males - 19, females - 12) with positive end expiratory pressure of 2-6 cm H2O, pressure support of 6-10 cm H2O, 40-60% O2 gas mix. Patients of the second group (comparison group, 30 patients, mean age 63.5±9.8 years, males - 16, females - 14) were offered a conventional treatment of ST-elevation myocardial infarction, including inhalations of humidified oxygen (6-8 liters per minute) using a nasal cannula. Results. Systolic, diastolic blood pressure and heart rate were 123.0±9.4 mm Hg, 81.2±11.3 mm Hg, 70.1±6.1 beats per minute in patients of the first group in 6 hours after admission. In patients of the comparison group the following parameters were measured as 157±12.4 mm Hg, 90.2±10.1 mm Hg, 92.6±10.2 beats per minute. The absolute risk increase of arrhythmias related to reperfusion myocardial injury was 17.8% (р 0.05) for the patients from the second group. Ejection fraction on a transthoracic echocardiogram (Teichholz method) was measured as 47.0±4.0 and 60.5±7.4% in patients from the first and the second groups respectively (р 0.05). Conclusion. Non-invasive mechanical ventilation decreases the risk for arrhythmias related to reperfusion myocardial injury, and increases the ejection fraction compared to conventional treatment and can be applied in patients with STEMI.
Prevalence of atopic dermatitis symptoms and its relation to respiratory allergy in preadolescent children
Authors: Shamov B A , Safiullina I G , Beshimova A B
Published: November 2019

Aim. To study the prevalence of atopic dermatitis symptoms and its relation to bronchial asthma symptoms in children of 7-8 years of age. Methods. 8880 children aged 7-8 years were examined (3000 children - in 2002, 2865 children - in 2006, 3015 children - in 2010). A questionnaire survey for atopic dermatitis symptoms was conducted as a part of international unified program «International Study of Asthma and Allergy in childhood». Results. Significant differences in prevalence of atopic dermatitis symptoms according to the questionnaire survey and as documented in medical charts were determined. The prevalence of atopic dermatitis symptoms has raised from 12.5±0.4% in 2002 to 20.4±1.5% in 2010 (р 0.001). The prevalence of atopic dermatitis symptoms early onset (younger than 2 years of age) decreased from 7.6±1.0 to 4.9±0.8% (p 0.05). The prevalence of atopic dermatitis relapses during the past calendar year increased from 3.2±0.6 to 4.8±0.8% (p 0.05). Meanwhile, the diagnosis of atopic dermatitis was set up in preadolescent children 7-8 years of age fore frequently: to 4.0±0.7% in 2002 compared to 13.8±1.3% in 2010 (p 0.001). The prevalence of atopic dermatitis and bronchial asthma combination increased from 3.4±0.4 to 7.8±1.0% (p 0.001). A strong relation between presence of atopic dermatitis symptoms and bronchial asthma symptoms was discovered (from 0.76 to 1.00, p 0.05). Conclusion. The prevalence of atopic dermatitis symptoms and bronchial asthma symptoms is still growing in preadolescent children 7-8 years of age, a relation between presence of abovementioned diseases symptoms was discovered.
Increased activity of poly(ADP-ribose)-polymerase in PML-depleted cells - novel perspectives for cancer therapy
Authors: Boichuk S V , Ramazanov B R , Mustafin I G , O Gjoerup
Published: November 2019

Aim. To investigate the relationship between PML expression and poly(ADP-ribose)-polymerase (PARP) activity in physiological conditions and at genotoxic stress induced by chemotherapy and ionizing radiation. Methods. The study was conducted on BJ fibroblasts cultured in DMEM/199 medium supplemented with fetal bovine serum, L-glutamine and antibiotics. PML down-regulation was achieved by short interfering ribonucleic acid transfection. To induce deoxyribonucleic acid (DNA) damage in BJ fibroblasts, doxorubicin and hydroxyurea or ionizing radiation were used. PARP activity, formation of DNA double-strand breaks and DNA damage response were examined by Western blotting and immunofluorescence microscopy. Results. PML knockdown was accomplished with an increased PARP activity, confirmed by an increased expression of poly-ADP-ribose (PAR) polymers. At PML knockdown ant DNA damage caused by chemotherapy and ionizing radiation, there is a significant increase in PAR polymers expression as well as increase in the number of cells containing PAR foci. Conclusion. Increased activity of poly(ADP-ribose)-polymerase at PML knockdown and DNA damaging conditions indicates the compensatory response due to insufficiency of the homologous recombination mechanisms. The phenomenon found widens the spectrum of malignancies that might be potentially sensitive to the therapy with poly(ADP-ribose)-polymerase inhibitors.
Features of anesthesia in pregnant women with subarachnoid hemorrhages
Authors: Bayalieva A Z , Shpaner R Y , Bogdanova E I , Ganeeva I R
Published: November 2019

The review of the literature on anesthesia in pregnant women with subarachnoid hemorrhage is presented. Physiological changes of pregnancy should by undoubtedly taken into consideration while performing anesthesia and surgery because of the comorbidities. Particularly, the oxygen intake is higher in pregnant. Adequate systolic pressure is also a very important parameter maintaining the intrauterine blood flow and fetus perfusion during the whole term of pregnancy. Medications used in pregnant women can also influence the fetus. From the clinical point of view, the selection of anesthetics and other medications allowed for use in pregnant women should be limited to medications that are proven to be safe. Pharmacological effects of the medications, used for anesthesia and treatment of pregnant women with subarachnoid hemorrhage are covered in the review, including their influence on fetus. Surgical treatment options for pregnant women at different pregnancy terms with different conditions requiring neurosurgery are surveyed. Post-surgical rehabilitation of pregnant women with subarachnoid hemorrhage is reviewed. In each particular clinical case an individual anesthesia plan should be created considering the pregnancy term and features of the disease.
The role of pro-inflammatory cytokines in diabetic nephropathy in pregnant women with type 1 diabetes mellitus
Authors: Gazizova G R
Published: November 2019

Diabetic nephropathy is one of the most frequent and unfavorable complications of pregnancy in terms of prognosis in patients with diabetes mellitus. The combination of pregnancy and uncompensated diabetes with such complications as diabetic nephropathy, diabetic retinopathy, diabetic neuropathy, leads to overproduction of pro-inflammatory cytokines, thromboses and ischemic necroses of the fetoplacental tissues, and low blood level of immunosuppressive cytokines increases the severity of the disease. This mechanism may be one of the reasons of the spontaneous abortion and pregnancy loss in early pregnancy term in women with diabetes. For a long time the leading role in diabetic nephropathy formation was acknowledged for hyperglycemia, dyslipidemia, oxidative stress, and arterial and renal intraglomerular hypertension. Diabetic nephropathy was recognized as non-immune and non-inflammatory process. Currently diabetic nephropathy is considered as a series of inflammatory reactions involving inflammatory cytokines and chemokines, consisting in the migration of monocytes or macrophages to the kidneys and glomerular and interstitial fibrosis development. Recent studies prove the role of immune-inflammatory reactions in diabetic kidney damage development and confirm an imbalance of the collagen exchange regulating factors, even at the stage of reversible renal dysfunction - microalbuminuria. The close relationship found between hyperglycemia, overproduction of growth factors and nephrosclerosis development in diabetes mellitus. The detection of pro-inflammatory cytokines and fibrogenic growth factors in the urine of patients with diabetes, especially in pregnant women with diabetes, can be used to prompt diagnosis and evaluation of processes occurring in the kidneys, to study the degree of sclerosis, and as a consequence, to predict kidney functional disorders development. Keywords: diabetes mellitus, pregnancy, diabetic nephropathy, cytokines, growth factors.
Analysis of in-hospital stage of emergency medical care and 24-hour mortality in emergency patients
Authors: Valeev Z G , Belyakov V G , Salyahova L Y
Published: November 2019

Aim. To reveal the management defects of timely and sufficient emergency care provision at emergency patient admission. Methods. The mortality among the adult Kazan city inhabitants who were urgently admitted to Municipal Emergency Hospital was examined in a retrospective cohort study. The retrospective analysis of in-patients medical charts, ambulance accompanying talons and autopsy protocols of 543 patients who has succumbed during the first 24 hours after being admitted to Municipal Emergency Hospital №1 Kazan, Russia since January 1st, 2009 to December 31, 2011, was performed, emergency medical care on the pre-hospital stage was analysed. Results. The number of patients who got the out-patient care in the admission department of the emergency hospital has increased during the last several years, distracting admission department staff form their primary job and causing errors in medical care. The number of errors due to the medical care mismanagement can be estimated as 23.3%. Low staff qualification, lack of subspecialty consultations or councils and lack of case monitoring are among the reasons. Conclusion. Providing high quality medical aid in out-patients clinics would allow Emergency hospitals to focus on admitting and treating patients with life-threatening emergencies.
Risk factors for frequently relapsed ulcerative colitis
Authors: Tsurcan S I
Published: November 2019

Aim. To define the factors for frequently relapsed ulcerative colitis . Methods. The clinical course of ulcerative colitis in 306 patients with the diagnosis of ulcerative colitis confirmed by endoscopy and histology was assessed in the 5-year prospective cohort study. A positive clinical course with long periods of remission and rare relapses (≤1 per year) was registered in 184 (60.1%) of patients, a progressive clinical course with frequent relapses (over 2 per year) was registered in 122 (39.9%) patients. A list of possible risk factors of unfavorable course were analyzed, univariate and multivariate stepwise discriminant comparative analysis was used for statistical processing. Results. Age at onset younger than 30 years, non-smoking, high disease activity at the onset, complications and extraintestinal manifestations, disease duration over 6 months until the specific treatment start, inadequate treatment at disease onset, over 6 months required to achieve remission, and a short maintenance treatment period are the risk factors for frequent ulcerative colitis relapses. When combined, the relative risk for frequent ulcerative colitis relapses is 75.8%. No demographic, social, hygiene factors, family and medical history data, comorbidities were associated with certain clinical types of ulcerative colitis. Conclusion. The most significant risk factors for frequently relapses ulcerative colitis - disease duration until the specific treatment start, treatment at disease onset, disease duration before remission is achieved - are modifiable factors, therefore, the adequate and timely treatment can improve the disease prognosis.
Diagnosis of abnormalities of upper dental arch and its segments
Authors: Ayupova F S
Published: November 2019

Aim. To improve the graphic method of analysis of the upper dental arch and its segments, to increase the accuracy of upper dental arch abnormalities detection and to minimize orthodontist’s man-hours. Methods. The plaster models of 32 maxillae with dentoalveolar abnormalities were studied before and after treatment. The graphs of individual normal dental arches and its sizes were created by using the geometric and graphic method by Hawley-Herber-Herbst. The regularities were found based on the gained data; graphs of individual normal dental arches (stereotyped patterns) were created using the Adobe Photoshop CS3 software. Dentoalveolar abnormalities were visually examined by directed applying the stereotyped patterns and pictured before and after treatment. 64 models were examined overall. Results. A relation was found: incisors and canines dental crowns half-sum relates to the length and width of Hawley-Herber-Herbst individual normal dental arch graph as 1:2,3:1,3. Considering the relation found, the set of stereotyped patterns was created. The pattern was chosen for the studied model according to the patient incisors and canines dental crowns width. The visual examination allows to recognize and to record (take a picture) teeth malposition, abnormalities of the upper dental arch and its segments in transverse and sagittal planes for correction control. The photos of the models at different stages of orthodontic treatment with stereotyped patterns applied can be added to the patients’ medical chart, indicating the present occlusal rehabilitation success. Conclusion. The offered way of detection of upper dental arch and its segments abnormalities does not require significant time to be performed, is informative and can be implied to clarify the dentoalveolar abnormalities treatment plan.
A rare case of intestinal obstruction as a result of phytobezoar
Authors: Bolshakov D V , Valiullin N Z , Burganov R R
Published: November 2019

Intestinal obstruction (ileus) due to bezoar is a rare condition. Its combined prevalence among all cases of intestinal obstruction varies from 0.5 to 1%. An observed case is reported. A patient was admitted at the emergency ward with abdominal pain,nausea, bloating, and constipation. At examination - bloating, abdominal distention, moderate abdominal muscular defense at palpation, paraumbilical tenderness. Colon cleansing was started with a good effect. Gastrointestinal fluoroscopy: at 4 and 8 hours after introduction of barium contrast it is located in the dilated loops of small bowel with persisting air fluid levels. The diagnosis of unresolved intestinal obstruction was set up. The midline laparotomy, small bowel decompression by Abbott-Miller, peritoneal drainage with two tubes were performed. Final diagnosis: «Intestinal obstruction (phytobezoar), non-infected peritonitis».
Etiological and pathogenetic aspects of diagnosis and treatment of viral hepatitides
Authors: Fazylov V Kh
Published: November 2019

The commencement address highlights the results of the long-term scientific research of the department of infectious diseases of the Kazan State Medical University on the problems of viral hepatitides diagnosis, treatment and prevention. The era of research of the acute viral hepatitides was based primarily on the clinical and biochemical differential diagnosis, considering epidemiologic data and specific prevention (vaccination) of hepatitis A and B. The development of modern technologies opened up new opportunities for etiologic decoding and morphologic evaluation of the infectious process activity in chronic viral hepatitis B, D and C. The results of hepatitis B and C genotyping, opening new opportunities for epidemiologic evaluation of their prevalence and antiviral treatment efficacy prediction, especially in family settings, are presented. A serious contribution is made to the study of latent HBV-infection, which is forming the long-term outcomes to cirrhosis and primary hepatocellular carcinoma. Pathogenetic connection of the systemic endotoxinemia, gastrointestinal bacterial overgrowth syndrome and immune dysfunction defined the morphologic and clinical and pathogenetic activity of the chronic viral hepatitis considering its molecular biologic verification. Contemporary diagnostics of chronic viral hepatitis (including HIV-coinfection) allowed to obtain the encouraging results in the development of the modern methods of antiviral (interferone, cytokines, nucle-os(t)ide analogs) and pathogenetic (metabolic correction - dimethyloxobuthylphosphonyldimethylate (dimephosphon), medical ozone, hepatoprotectors) treatment, in perspective - clinical use of direct antiviral agents (inhibitors of protease, polymerase etc.).
Peripheral blood flow in patients with graves’ disease depending on level of thyroid status compensation
Authors: Kulabukhova I S , Eliseeva L N
Published: November 2019

Aim. To study the features of peripheral blood flow using laser Doppler flowmetry in patients with Graves’ disease depending on level of thyroid status compensation. Methods. 45 patients with Graves’ disease were divided into three groups 15 patients each depending on level of thyroid status compensation. The first group included patients with compensated hyperthyroidism, the second - with subcompensated hyperthyroidism, the third - with decompensated hyperthyroidism. All patients received combined thyrotropic (thiamazole 15-30 mg, average dose 22.4±1.7 mg) and cardio- and vasotropic therapy (metoprolol 50-100 mg, average dose 72.1±3.3 mg, and fozinopril 10-20 mg, average dose 17.8±2.4 mg), doses were individually adjusted. Results were compared with the control group (15 healthy patients). The peripheral blood flow was evaluated using LAKK-01 («LAZMA», Russia) device. Results. The comparison of control group and patients with Graves’ disease depending on level of thyroid status compensation demonstrated substantial differences. Doppler flowmetry registered increased blood flow, square deviation, variation coefficient in patients with diffuse thyrotoxic goitre, reflecting increase of tissue blood perfusion and reduced vascular tone. The analysis of the frequency histogram showed that the increase of average blood flow amplitude in case of hyperthyroidism was initiated by increase in amplitudes of all flaxmotions characterizing metabolic processes in capillaries. The relevant correlation between registered variables of blood flow and level of thyroid status compensation was registered. The most marked changes were revealed in patients with subcompensated and decompensated hyperthyroidism. In patients with compensated hyperthyroidism, the blood flow was altered the least compared to control group. Increased impact of active blood flow modulation mechanisms due to neurogenic activity and vascular tone was revealed. At the same time, endothelial activity was decreased. Predominance of sympathetic stimuli and compensatory mechanisms intensifying were discovered. Conclusion. The changes of peripheral blood flow in patients with Graves’ disease were typical for congestive-hyperemic type of microcirculation. Intensity of blood flow alterations is defined by thyroid status compensation. However, even the complete clinical and laboratory compensation doesn’t result in total recovery of capillary blood flow compared to healthy people.
Cardiovascular comorbidity and free radical mediated processes imbalance in patients with acute stroke
Authors: Orlova A S , Men’shova N I , Rumjanceva S A , Silina E V , Stupin V A , Orlov V A , Sinel’nikova T G , Bolevich S B
Published: November 2019

Aim. To study the free radical imbalance in patients with acute cerebrovascular disease and cardiovascular comorbidity and to determine its prognostic value. Methods. 141 patients with acute cerebrovascular disease of different severity aged 28-94 years (mean age 65.48±13.44 years) with various concomitant conditions were included. Ischemic stroke was diagnosed in 87 (61.7%), haemorragic stroke - in 35 (24.8%), transient ischemic attack - in 19 (13.5%) patients. Free radical processes in blood serum were examined repeatedly based on oxidative and peroxidative markers of oxidative stress. Results. Among the observed patients, 25.5% had one or no cardiovascular diseases, 24.8% had two, 27.0% had three and 22.7% had four and over. The increase in free radical imbalance was related to the increase in concomitant conditions number - there was a decrease of leukocyte chemiluminescence basal intensity by 1,76 times in patients with 4 cardiovascular diseases and above compared to 1 cardiovascular disease; increase of zymosan-stimulated leukocyte chemiluminescence intensity by 1.44 times; depression of antiperoxide activity of secondary serum by 1.36 times and increase of malondialdehyde by 1.5 times (р 0.05). Unfavorable outcome was observed in 9.7% of patients with 1 cardiovascular disease, which is 2.66 times lower compared to patients with acute cerebrovascular disease and 2 cardiovascular diseases (р 0.05), 3.55 times lower compared to patients with 3 cardiovascular diseases (р 0.05) and 2.67 times lower compared to patients with ≥4 cardiovascular diseases (р 0.05). Conclusion. Indices of free radical processes may be used as additional markers for prognosis and functional outcome evaluation of acute cerebrovascular disease with concomitant cardiovascular diseases.
A method of surgical treatment of unstable severe forms of juvenile femoral head epiphysiolysis
Authors: Pulatov A R , Mineev V V
Published: November 2019

Aim. To analyze the long-term results of the designed method for the open epiphysis reduction in patients with severe unstable forms of juvenile femoral head epiphysiolysis. Methods. The article describes the method of surgical treatment of severe forms of unstable juvenile femoral head epiphysiolysis and long-term outcomes in 21 patients. The indications for the method were the unstable form of juvenile femoral head epiphysiolysis and slipped capital femoral epiphysis with a slip angle of more than 40 degrees. The age of patients at time of treatment ranged from 11 to 16 years, follow-up period - from 2 to 15 years. Five patients underwent a comprehensive biomechanical study within one year after surgery. Results. The early and late results of the femoral head epiphysis open reduction were analyzed. Positive results were obtained in 19 cases (good results in 17, satisfactory in 2). The complication rate was 14.3% and included 3 cases of avascular femoral head necrosis, no cases of chondrolysis were revealed. According to biomechanical examination data performed in five patients 1 year after the surgery, almost complete functional recovery of the musculoskeletal system was revealed. Conclusion. Analysis of the results showed that being properly executed the open reduction of the femoral head with a corrective femoral neck osteotomy allowed to restore normal anatomic proportions and function of the affected joint, positive result was maintained for the entire follow-up period.
Comparative assessment of different methods of congenital glaucoma surgical treatment considering patient’s age
Authors: Toykuliev T K
Published: November 2019

Aim. To study the effectiveness of antihypertensive operations of trabeculotomy ab externo and sinus trabeculoectomy in our modification in patients with congenital glaucoma and to justify its application. Methods. The following surgeries were performed: trabeculotomy ab externo - on 57 eyes of 51 patients, sinus trabeculoectomy - on 46 eyes of 42 children, classic trabeculoectomy - on 23 eyes of 19 patients, and trabeculoectomy with elements of intrascleral autodrainage in our modification - on 23 eyes of 23 patients. Among them, 22 patients were younger than 1 month, aged from 1 to 6 months - 30, from 6 months to 1 year - 18, from 1 to 3 years - 15 and from 3 to 5 years old - 8 patients. Results. Long-lasting hypotension was achieved in 86.95% of patients after sinus trabeculoectomy, in 80.39% of patients after trabeculotomy ab externo. The best results were obtained in patients younger than 6 months. In the older age groups, antihypertensive effect of trabeculotomy ab externo markedly decreased and was only 50% at the age of 3-5 years. The results after sinus trabeculoectomy were comparable in all age groups. Conclusions. Trabeculotomy ab externo can be recommended as an operation of choice during the first months of life in congenital glaucoma patients, based on the characteristics of the anterior chamber angle.
The changes of anatomic and topographic characteristics of eye anterior segment after uncomplicated cataract phacoemulsification
Authors: Ryabtseva A A , Yugaj M P , Nikitina N S
Published: November 2019

Aim. To study the changes of anatomic and topographic characteristics of the eye anterior segment after uncomplicated cataract phacoemulsification using corneal incision with intraocular soft lens implantation. Methods. The data of ultrasound biomicroscopy and noncontact tonometry of 58 eyes (56 patients, 32 females, 24 males aged 54 to 78 years) before and after cataract phacoemulsification were analyzed. Paitents with survived ocular trauma, refractive keratoplasty, glaucoma, uveitis, and surgical complications (incomplete capsulorrhexis, posterior capsule rupture, ciliary zonule disinsertion, corneal burn). Apart from the common examinations (visual acuity testing, tonometry, tonography, eye A- and B-ultrasonography, biomicroscopy), all patients underwent eye ultrasound biomicroscopy. Results. Anterior chamber depth increased from 2.73±0.10 to 4.17±0.06 mm (p ≤0.001). Trabecula-iris distance measured at 500 μm from the scleral spur, increased from 0.38±0.02 to 0.47±0.02 mm (p ≤0.001). Anterior chamber angle increased from 28.69±1.87 to 42.73±1.56 degrees (p ≤0.001), the angle between the iris and the sclera increased from 32.78±1.39 to 41.36±0.84 degrees (p ≤0.001), the angle between the sclera and ciliary processes increased from 39.48±1.29 to 45.30±1.16 degrees (p ≤0.001). Intraocular pressure according to the non-contact tonometry data decreased from 18.16±1.29 to 13.55±0.95 mm Hg (p ≤0.001). Conclusion. Anterior chamber depth, trabecula-iris distance, anterior chamber angle, the angle between sclera and iris and the angle between sclera and ciliary processes increased significantly after phacoemulsification with intraocular lens implantation. Intraocular pressure decreased significantly according to the non-contact tonometry data.
Indicators of mental health of pre-school children in Irkutsk amid the wide introduction of information technologies
Authors: Tkachuk E A
Published: November 2019

Aim. To assess the mental activity of pre-school children amid the wide introduction of information technologies. Methods. 176 children aged from 5.5 to 6.5 years were observed at the institution of pre-school education of Irkutsk central district from 1998 to 2012. Two groups were formed: the first group included 101 child who attended childcare center in 1998, the second group - 76 children who attended childcare center in 2012. Age groups of pre-school children were formed according to their age (from 5 years 5 months 30 days of age to 6 years 5 months 30 days of age). The mental activity was assessed using the figure tables by V.Y. Anfilov assessing the number of made mistakes and number of lines run through. Every missed line was equal to one mistake made. The productivity coefficient Q was calculated as Q=c2/c+d, where с - the number of lines run through; d - the number of mistakes (mistakes were not standardized). Results. The parameters of productivity did not change significantly in 2012 compared to 1998. The number of lines run through at Anfilov’s test increased by 1.8 times (р 0.05) in children of the second group (examined in 2012), the number of mistakes made increased by 7.5 times (р 0.05). Among the girls of the second group, the number of lines run through increased by 1.6 times (р 0.05), the number of mistakes made increased by 6.3 times (р 0.05). The trend was clearer in boys, in whom the number of lines run through increased by 2.0 times (р 0.05), the number of mistakes made increased by 8.3 times (р 0.05). Conclusion. The speed of information processing has increased, and the quality of information processing has dropped in contemporary pre-school children. The overall productivity did not change.
Predominantly single-channel funding of healthcare institutions: experience of the Republic of Tatarstan
Authors: Shavaleeva Ch M
Published: November 2019

In accordance with the Constitution of Russian Federation, the state guarantees health protection and access to free medical care in state healthcare institutions to each citizen. The questions of healthcare funding in Russia seem to be a topic of interest, especially considering the ongoing conversion to predominantly single-channel funding of healthcare institutions. Despite the lengthy discussions about the pros and cons of that system, experts have not come to a consensus about the need for universal introduction of predominantly single-channel funding of public healthcare institutions so far. The article reviews the experience of predominantlysingle-channel funding of healthcare institutions introduction and realization in the Republic of Tatarstan. The differentiation of funding duties in the region was studied; the ratio of funding sources of the Program of state guarantees for access to free-of-charge medical aid for Russian citizens was analyzed. The analysis showed that switching to predominantly single-channel funding of healthcare institutions does not lead to a major changes in healthcare funding system of Russian Federation and does not contribute to the immediate solution of the existing problems.
The modeling of seasonal fluctuations of demand for medications to treat bronchial asthma for the hospitals of the Republic of Tatarstan
Authors: Shakirova D Kh , Kamaeva A Z
Published: November 2019

Aim. To model the seasonal fluctuations of demand for medications to treat bronchial asthma for the hospital use in healthcare facilities of the Republic of Tatarstan. Methods. Statistical methods of absolute and relative differences, seasonality index construction, ABC/XYZ- analysis, modeling of seasonal fluctuations were used for the assessment. Results. By using ABC/XYZ-analysis the estimation of the consumption of certain medications to treat bronchial asthma in hospitals of the Republic of Tatarstan was given. The AX group was the largest share in the total trade (48.27%), but contributed only to 5.88% of the total nomenclature positions number. BX and CX groups, accounting for 0.73% and 0.21% of total consumption respectively, contributed to 1.96% of the nomenclature positions each. 7.84% of assortment positions provided 22.34% of turnover (group AY). Drugs of BY group provided 8.36% of the total sales, and 11.76% of assortment positions, the proportion of CY group (19.61% of items) accounts only for 2.93% of the sales; anti-asthmatic drugs of group Z, the largest by assortment positions number (AZ - 1.96%, BZ - 9.80%, CZ - 39.23%) provided a total of 17.16% of turnover. Assortment positions for modeling the seasonal fluctuations of the demands (AY, BY) were selected. According to the proposed algorithm, the presence of seasonality for each drug was checked. 90 models of seasonal fluctuations were designed and their reliability was tested. The prognosis based on the designed models of demand for medications to treat bronchial asthma for the hospital use in healthcare facilities of the Republic of Tatarstan was given. Conclusion. Assessment of the future demand for anti-asthmatic drugs based on the designed models may allow to optimize the use of funding allocated for the drug provision of patients with bronchial asthma while treated as in-patients.
A new way of interaction between a teacher and a student as a factor for self-development of teachers and students on the example of biochemistry course
Authors: Gubareva A E
Published: November 2019

Aim. To develop and introduce a new educational method for theoretical subjects stimulating creativity of students and teachers on the example of biochemistry course. Methods. The new educational method is based on close and creative cooperation between a teacher and a student while creating situational, professionally and personally-oriented tasks reviewing molecular mechanisms of the human body processes. The feedback from teachers participating in program was gained using questionnaires. Results. Basing on the described method, the «Creative Personality» program was developed, serving as a tool for the development of professional competencies and creativity in highly motivated students and as an andragogy tool stimulating teachers’ self-development. The abovementioned studying form inculcating the students and developing in teacher the vitally important skill of creating a quality products. Apart form the activating the cognitive activities in teachers and students and increasing the study progress, the method is a great help to the faculty staff, as it increases the bank of the tasks used in studying process as an educational or control tool. The best situational tasks created by students who were surveyed by their mentors, were included in the «Biochemistry» textbook (2012) written by a group of authors edited by S.E. Severin, noting the students’ authorship. Conclusion. The new method of cooperative creative work of teachers and students was created for development of creative activity in highly motivated students and improving teachers’ self - development while creating situational, professionally and personally-oriented tasks that can be used in a study process and can deepen the students’ knowledge and create conditions for the development of professional competencies both in students and teachers.
Prevention of fatal pulmonary embolism in a patient with stomach cancer
Authors: Kamalov I A , Aglullin I R , Tukhbatullin M G , Safin I R , Rodionova A Yu
Published: November 2019

A clinical case of a 71-year old patient with stomach cancer and concomitant lower extremity deep venous thrombosis diagnosed before the surgical treatment is presented. The patient was administered anticoagulants, and despite the treatment, a diagnosis of deep venous thrombosis with high risk for thromboembolism was set up. Considering high risk for pulmonary embolism, an inferior vena cava filter was implanted in infrarenal part of inferior vena cava at the first stage. On the second day after the cancer surgery (subtotal stomach resection with lymphadenectomy), clot detachment and its dislocation from the left common femoral vein to the area where the cava filter was implanted with further fixation were diagnosed. Accurate diagnosis of lower extremity deep venous thrombosis with high risk for thromboembolism set up by ultrasonography and timely inferior vena cava filter implantation saved the patient with cancer from developing pulmonary embolism.
Cytokines regulate HIV-1 replication and lymphocyte apoptosis in vitro
Authors: Boichuk S V , Dunaev P D , Mustafin I G
Published: November 2019

Aim. To study the ability of cytokines - interleukin-2, interleukin-7 and tumor necrosis factor alpha to induce human immunodeficiency virus type 1 (HIV-1) replication and lymphocyte apoptosis in vitro. Methods. Peripheral blood mononuclears were separated by centrifugation on a ficoll paque solution specific density gradient. Lymphocytes were cultivated in RPMI 1640 medium with addition of L-glutamine, embryonal bovine serum, antibiotics and cytokines (interleukines-2, -4, -7, tumor necrosis factor alpha). To infect the lymphocytes, a laboratory strain of HIV-1 NL4-3 (NIH ResReag. Prog., USA) was used. HIV-1 replication was assessed by р24gag viral protein level in culture supernatants (ELISA) and its cytozolic level in lymphocytes (flow cytometry). Lymphocyte apoptosis was assessed by flow cytometry using the following parameters: (1) decrease of transmembrane mitochondrial potential; (2) increase in phosphatidyl serine molecules expression. Lymphocyte activation was assessed by CD25 and HLA-DR molecules expression (flow cytometry). Results. Cytokines induce the HIV-1 replication in lymphocytes in vitro. HIV-1 replication was noted only if inactivated lymphocytes were present in the culture. At the same time, lymphocytes not expressing the classical activation markers (CD25 and HLA-DR) were present among the lymphocytes producing HIV-1 indicating the possible alternative mechanism of HIV-1 replication, not dependent on cell activation. This fact might also be an evidence of viral replication processes in the pool of latently-infected lymphocytes, not expressing the classic activation markers. The abovementioned cytokines promote apoptotic death of uninfected lymphocytes in vitro, backing up the infected cells viability and thus promoting HIV-1 replication. Conclusion. Cytokines (interleukines-2, -4, -7, tumor necrosis factor alpha) which are known as factors supporting the immune system homeostasis and immune response formation, might also play a negative role in HIV-1 pathogenesis - induce HIV-1 replication in lymphocytes and, probably, lead to reactivation of the pool of latently-infected lymphocytes, deepening the lymphopenia and leading to disease progression.
Statins and primary prevention of cardiovascular diseases: is there any point?
Authors: Safina D D , Ziganshina L E
Published: November 2019

Increased blood cholesterol level is one of the most studied risk factors for cardiovascular diseases. While benefits of statins in secondary prevention are shown, their role in primary prevention is not clear. To assess the potential benefits of statin use in primary prevention of cardiovascular diseases, we searched databases for published data in English language for secondary analyses of clinical trials of statin use in primary prevention of cardiovascular diseases. The data on clinical outcomes were extracted to calculate the ratio of beneficial effect to no effect (benefit/no effect ratio - BNER). One Cochrane systematic review and 5 meta-analyses were found, including 27 clinical trials. The authors of four out of six reviews declared potential conflict of interests with pharmaceutical companies manufacturing statins. We could not extract data on individual outcomes because they were not reported. For deaths of all causes, the BNER was 3:3 as assessed in 6 analyses. Only three reviews examined the effects of statins on coronary events and all reported positive effect of statins. Four out of six reviews reported data on coronary heart disease mortality and all found no positive effect of statins. Cardiovascular events and mortality were evaluated in two and three reviews, respectively, which showed positive effect of statins. Thus, there is no convincing evidence for statin use in primary prevention. The new studies, if carried out, should be of longer duration and follow-up, should use individual outcomes. Prevention with statins in patients with no history of cardiovascular disease should be performed with great caution, if considered at all.
Radio-endovascular methods in prevention and treatment of arrosive bleedings in patients with destructive pancreatitis
Authors: Zainutdinov A M , Malkov I S , Valeev A A
Published: November 2019

The review decribes the radio-endovascular methods in prevention and treatment of arrosive bleedings in destructive pancreatitis. The importance of non-surgical treatment in patients with aseptic forms of destructive pancreatitis is presented. It is stressed that the problem of an optimal surgical treatment choice in patients with pancreatolysis is not solved. Efficiency of minimally invasive surgery for treating destructive pancreatitis is shown. Radio-endovascular treatment methods, including intraarterial drug infusions and pancreatic arteries embolization to prevent and treat pancreatic inflammation and arrosive bleedings from visceral arteries aneurisms, are among such options. Researches of domestic and foreign authors give the clinical basis for selective drug introduction into coeliac artery in destructive pancreatitis treatment. Clinical cases of visceral arteries (lienal, gastroduodenal, left colonic, intrahepatic) embolization are reviewed as a way of hemorrhagic complications prevention and emergency treatment in destructive pancreatitis. The problem of arrosive bleedings in destructive pancreatitis at the present stage can be adequately controlled in the conditions of specialized surgical ward equipped with operational radio-endovascular facilities and multispiral computed tomographic scanner.
Clinical features of enteroviral infection in pregnancy
Authors: Geydarova N F
Published: November 2019

Aim. To explore the modern clinical features of enteroviral infection in pregnancy. Methods. Comprehensive survey of 262 pregnant women was carried out. 203 patients were diagnosed with enteroviral infection, control group consisted of 59 pregnant women without enteroviral infection. All patients underwent ultrasonic fetometry, cardiotocography, placentography, ultrasonic fetometry, amniotic fluid quantitative and qualitative analysis, feto-placental, utero-placental and fetal circulation Doppler ultrasound. Results. Asymptomatic form of enteroviral infection was more frequently found in pregnant women aged 30-39 years, typical and atypical forms - in the age group of 20-29 years. The onset of menarche and the duration of the menstrual cycle were not associated with the risk for enteroviral infection. Enteroviral infection was often seen in combination with other infections and gynecological diseases. The rate of multi-infection was significantly higher in the group with typical form of entroviral infection, while atypical form of infection were mostly seen along with comorbidities. Conclusion. Immune status has a great influence on developing of clinically manifesting forms of enteroviral infection in pregnant women. Co-existence of enteroviral infection with other infectious and gynecological diseases may alter the clinical features, lead to development of atypical forms and become a significant burden to the pregnancy.
Reasons for immunologic inefficiency of antiretroviral therapy in patients with HIV
Authors: Oleynik A F , Fazylov V Kh
Published: November 2019

The main component of the treatment of patients with HIV infection is highly active antiretroviral therapy (HAART), which can help to control the disease. The main goal of HAART is to increase the life duration and to maintain the quality of patients’ life. Improved survival among HIV-infected patients receiving highly active antiretroviral therapy is achieved mainly by a decrease of HIV RNA viral load, which increases CD4 lymphocytes count. However, some patients may present with discordant response to treatment, when there is no CD4 lymphocyte count elevation associated with the virus disappearing from the blood. Such patients retain immunodeficiency, despite long-term treatment. The risk of opportunistic infections on the background of insufficient immunological response, despite viral replication suppression, is higher than in patients with good immunological response to treatment. Consistently low CD4 cell counts are associated with an increased risk of AIDS diagnosis. Furthermore, this group of patients shows a slight increase in mortality not associated with AIDS-defining illnesses. The reasons for the low CD4 lymphocytes count increase in some patients achieving virologic response to HAART remain unclear. The immunological efficacy of treatment depends on many factors: baseline CD4 count, duration of HIV infection prior to HAART initiation, age, co-infection with HCV, presence of secondary diseases and comorbidities, HAART regimens, IL-2 use and others. Literature review covers the phenomenon of immunological «non-response» to HAART, factors leading to its development, and possible methods of correction. Currently, there are more questions than answers in the area of immunological non-effectiveness of HAART in HIV-infected patients.
To the 100th anniversary of the Kazan imperial university clinic of mental disorders
Authors: Sozinov A S , Mendelevich D M
Published: November 2019

The article is devoted to the history of Kazan Imperial University clinic of mental disorders form its foundation to the modern days. The priority of V.M. Bekhterev in claiming the need for building the contemporary clinic of mental disorders for Kazan Imperial University is highlighted. The role of University professors N.M. Popov, V.P. Osipov, G.Ya. Troshin, T.I. Yudin, M.P. Andreev, clinic’s head doctor S.V. Kurashov in construction, arrangement and organizational management of the hospital, is outlined. Construction decision-making and its timeline, including functioning difficulties during the First World War and Soviet Union establishment, are described. The mental disease studying process management is described, as well as the order and terms of other Kazan University departments’ temporary accommodation in the building of the hospital. The activity of the clinic during the Second World War, as well as the structural post-war and modern time changes are depicted.
Outstanding representative of Kazan scientific school of ophthalmology: professor V.V. Chirkovsky (dedicated to the 140th anniversary of his birth)
Authors: Nugumanova A M , Khamitova G Kh
Published: November 2019

Article is devoted to the jubilee of V.V. Chirkovsky, who headed the Department of Ophthalmology of the Kazan University from 1922 to 1929, and was a rector of the University from 1923 to 1925. He was also the director of the wWorld’s first Trachoma Research Institute named after E.V. Adamyuk (Kazan). The article outlines his outstanding organizational skills, resulting in creating ophthalmologic departments and scientific schools of ophthalmology in Tomsk, Irkutsk, Perm, Kazan and Leningrad (Saint Peterburg). During his work in Kazan, V.V. Chirkovsky was elected as a rector of the Kazan University, in this position he served until 1925. He led the university during a harsh period: the country experienced economic collapse, university professors led a beggarly life, but he managed to preserve the two most important faculties of the university - medical and physic-mathematical, and to keep the professors of the university. The creation of Trachoma Research Institute allowed not only to strengthen the fight against trachoma in Tatarstan, but also to completely eliminate it in our and neighboring regions (Republic of Mari El, Bashkortostan, Udmurtia, etc.). In 1929 professor V.V. Chirkovsky moved to Leningrad, where he headed the Department of Ophthalmology of the 1st Leningrad Medical Institute and headed the Leningrad Research Institute of Ophthalmology named after Girschman until 1952. During his active life, professor V.V. Chirkovsky authored about 100 scientific papers on various aspects of ophthalmology. His main publications were related to the study of trachoma, the disease that he has defeated.