bluuebunny/crossref_metadata_2025 huggingface dataset:
The nature of the course of the retention period in adolescents after orthodontic treatment depending on the state of the autonomic nervous system
Authors: Singatullina D R , Khamitova N Kh
Published: November 2019

Aim. To study the condition of the autonomic nervous system in groups of adolescents in the period of retention after active orthodontic treatment with non-removable equipment. Methods. Examined were 100 adolescents aged 13-17 years in the period of retention after active orthodontic treatment. The baseline autonomic tone was assessed according to the combined table of sympathetic and parasympathetic reactions (Wayne A., 1981) in the modification of N.A. Belokon’ et al. (1986) for children and adolescents, taken into account were the heart rate, respiratory rate, systolic and diastolic blood pressure. In order to evaluate the adaptation of the organism used was a mathematical analysis of the heart rhythm (cardiointervalography), determined was the mode (Mo), the amplitude of the mode (AMo), and the variational span (ΔX). Results. Revealed were two groups of patients with different variants of the course of retention: favorable course without recurrence (53%) and unfavorable course with recurrences (47%). In the group of patients with recurrences cardiointervalography most frequently showed a asympaticotonic (41.7%) or hypersympaticotonic (58.3%) type of autonomic reactivity. In all patients of the group with recurrences noted was a disturbance of the adaptation processes. The state of adaptation is regarded as unsatisfactory in 72.6% of cases, as the complete adaptation failure - in 27.4%. Conclusion. A recurrence during the period of retention after active orthodontic treatment occurs significantly more frequently in the group of patients with high constraint and overload of the autonomic reactivity, with a mismatch of cardiac rhythm management processes, with a reduction of the adaptive capacity of the organism to the level of complete failure of adaptation; patients who have expressed sympathicotonia, are at risk for destructive periodontal disease and require special attention during the retention period.
Role of genetic polymorphism in the pathogenesis of cerebrovascular disease
Authors: Gayfullina R F , Katina M N , Rizvanova F F , Kravtsova O A , Rizvanov A A
Published: November 2019

Presented was a review of the most recent literature devoted to the main genes responsible for the formation of atherothrombosis of the cerebral vessels. The aim was to analyze the data in the literature regarding several genetic factors responsible for the development of cerebrovascular disease, particularly ischemic stroke. Conducted was an electronic search of full-text and abstract-only versions of articles, which cover the aspects of genetic susceptibility to ischemic stroke, according to the databases PUBMED, OMIM and GENE using the following main keywords: «cerebrovascular disease», «ischemic stroke», «cerebral atherosclerosis», «gene polymorphism», «mutation». Medical diagnostics today has modern technologies of genotyping, which make it possibe to accurately determine the genotype of a person, thus opening up wide prospects for the development of personalized medicine. The majority of genetic variations is due to single nucleotide substitutions that lead to quantitative changes in expression or affect the biological properties of the proteins. Approximately 10 million single nucleotide polymorphisms are known, however their biological significance is not always obvious. Currently hereditary predisposition to atherosclerosis is being actively studied, identified were the genetic variants of genes of blood lipid metabolism, endothelial dysfunction, hemostatic system, and proteins involved in platelet aggregation and thrombosis. An individual «genetic passport» makes it possible to determine the risk factors for atherosclerotic lesions of blood vessels in a specific individual long before the development of the disease. Determination and investigation of groups of genes that are responsible for the development of atherosclerosis in people living in specific areas is still of utmost relevance. Based on these studies it is possible to establish specific test systems for the Republic of Tatarstan for diagnosing predisposition to the development of certain forms of atherosclerosis, the widespread introduction of which will significantly reduce the mortality and disability of the population, the economic and social damage.
The experience of using botulinum toxin in neurological practice in the Republic of Tatarstan
Authors: Zalyalova Z A , Khasanova D M , Kalashnikova O S
Published: November 2019

Aim. To assess the dynamics of botulinum therapy in the treatment of patients with severe disorders of movement in Tatarstan according to the data of the Clinical and Diagnostic Center for Extrapyramidal Pathology and Botulinum Therapy of the Republic of Tatarstan. Methods. Epidemiological, clinical and statistical analysis of the results of using botulinum therapy in the Republic of Tatarstan. Results. During the period 2004-2010 569 people were referred to the Clinical and Diagnostic Center for Extrapyramidal Pathology and Botulinum Therapy. Meanwhile, given the prevalence of major conditions, in which botulinum therapy is indicated, the number of people needing these injections in the Republic of Tatarstan is at least 1514 pe-ople. With the inclusion of botulinum toxin in 2008 to the list of additional drug provision botulinum therapy become more affordable, this being reflected in the statistics of growth of this type of medical care. Over 80% of those in need of care are young patients of working age, able to return to work through regular botulinum therapy. Botulinum therapy in a number of neurological diseases is virtually the only effective means of symptomatic treatment, which reduces the level of disability. Its advantages are not only its high effectiveness, but also the possibility of conducting the procedure on an outpatient basis. Conclusion. Based on the assessment of the dynamics of botulinum therapy it is considered necessary to establish regional programs, which would provide botulinum toxin to patients who are not disabled, but acutely in need of injections.
Modulation of cell life cycle during exposure to phenols
Authors: Zaitseva N V , Dolgikh O V , Dianova D G
Published: November 2019

Aim. To evaluation the life cycle characteristics of cells under conditions of exposure to phenols. Methods. Examined were 128 people: the main group included 90 people with an occupational specialty «insulator», the control group included 39 people with no exposure to industrial hazards. Materials of working environment attestaion, the results of industial control, data of analytical chemical analysis on the content of substances (phenol) in the working area were used. Using a capillary gas chromatograph the content of organic compounds in the blood (phenol, o-cresol, m-cresol, p-cresol) was determined. Phenotyping of lymphocytes was performed by flow cytometry. Populations and subpopulations of lymphocytes (CD3+, CD4+, CD8+, CD19+, CD95+, CD3+CD16+CD56+, CD4+CD25+, CD4+CD25+127-) were determined by membrane immunofluorescence using a panel of labeled monoclonal antibodies. Registration of apoptosis of lymphocytes was performed by determining the expression of phosphatidylserine using annexin V conjugated with fluorescein isothiocyanate. Results. Among those who work in conditions of exposure to phenols (main group) noted were changes in the quantitative and qualitative composition of the cell-lymphocytic link of the immune system. Revealed were signs of activation of the immune system, which is expressed in a significant (p 0.05) increase in the expression of early activation antigens on the immune cells (11.33±0.33%) compared with the control values (7.82±0.39%). At the same time, the number of regulatory lymphocytes (0.81±0.05%) increased with statistical significance (p 0.05), providing suppressive effect on various types of immune cells with respect to the values obtained in the control group (0.55±0.06%). Registered was a significant reduction in the number of markers that characterize apoptotic cell death: the expression of a receptor for the tumor necrosis factor-alpha type I (1.39±0.11%), transcription factor p53 (1.44±0.11%) compared with such in the the control group (3.31±0.27% and 3.42±0.29% respectively, p 0.05). Analysis of the immunograms has demonstrated that those who work in conditions of phenol exposure have significantly (p 0.05) reduced levels of apoptotic (2.17±0.09%) and necrotic (7.69±0.25%) cells with respect to such numbers registered in the control group (apoptotic - 4.77±0.42%, necrotic - 13.06±1.17%). Noted was a statistically significant negative relationship between indicators that determine the activation-induced cell death and the content of phenol in the blood of the main group of examined individuals. Conclusion. Exposition of phenols leads to the development of immune disorders, in particular changes in the quantitative and qualitative composition of the cell-lymphocytic link of the immune system and can induce apoptotic death of immunocompetent cells.
Diagnostic value of cystatin c urine level as an early marker of diabetic nephropathy in children with type 1 diabetes mellitus
Authors: Senatorova A S , Muratova E G
Published: November 2019

Aim. To improve the diagnosis of early stages of diabetic nephropathy by examining cystatin C urine excretion in children with type 1 diabetes mellitus. Methods. 83 children aged 11 to 18 years with type 1 diabetes mellitus were included in the study. Children were divided into 3 groups according to the duration of diabetes mellitus: group 1 - 1 to 2 years (n=18), group 2 - 2 to 5 years (n=24), group 3 - over 5 years (n=41). Results. The average values of glycated hemoglobin did not differ significantly between the groups and were assessed as following: group 1 - 8.61±2.1%, group 2 - 8.91±1.5%, group 3 - 8.84±2.5% (p 0,05). Development of «symptomatic» diabetic nephropathy occurred in 10% of children with type 1 diabetes with disease duration over 5 years. Cystatin C urine excretion was the highest in children with long clinical course of type 1 diabetes mellitus (p 0.01). Significant variability of cystatin C urine excretion was observed even in children with diabetes duration of 1 to 2 years. Pairwise comparison of cystatin C urine excretion levels and glycated hemoglobin values of children with type 1 diabetes did not show any statistically significant difference. Conclusion. Cystatin C urine excretion level can be an early marker of kidney damage and depict the state of tubular renal function in children with type 1 diabetes mellitus. Tubular dysfunction in children with type 1 diabetes mellitus might be diagnosed when observed cystatin C urine excretion level is over 21.9±1.4 ng/ml (sensitivity 70%, specificity 60%).
Comparative assessment of blood circulation at critical zones of anastomoses in urinary bladder reconstruction with iliac graft
Authors: Nesterov M I , Akhmedov R A , Ramazanov M R , Galeev R Kh , Ramazanov M M
Published: November 2019

Aim. To improve the instant results of urinary bladder reconstruction with iliac graft by examination of critical zones. Methods. Urinary bladder reconstruction using the iliac autograft was performed in 15 patients without special examination of critical zones (control group) and in 25 patients in whom these zones were examined (main group). Mean age of patients was 58 years (from 44 to 68). All patients underwent cystectomy because of urinary bladder cancer (stages T2-4N0M0). Blood microcirculation at the stitch area was performed by M.Z. Sigal, tissue viability index by M.R. Ramazanov was calculated, oxygen saturation of arterial blood was measured and microcirculatory blood flow was examined by the LAKK-01 machine. The same surgery and research methods were performed in 70 dogs with regular assessment of microcirculation at the stitch area (stitch color, arterial pulsation) and using the tensiometry by M.Z. Sigal, microcirculation at the stitch area, oxygen saturation of arterial blood and stitch tissue viability index were also determined. Results. In patients of the control group, in whom the condition of critical zones was not examined, 3 has developed a stitch dehiscence at the zones of anastomosis, with no such events registered in patients from the main group, in whom critical zones were examined. In dogs stitch dehiscence was not observed only in the group where microcirculation was assessed by tissue viability index calculation. Conclusion. It is important to examine critical zones of the iliac autograft and calculate the stitch tissue viability index performing urinary bladder reconstruction with iliac graft to prevent the stitch dehiscence.
Optimization of proper diagnosis of thromboses associated with high risk of embolism in patients with neoplasms
Authors: Kamalov I A , Agliullin I R , Tukhbatullin M G
Published: November 2019

Aim. To optimize a proper diagnosis of thromboses associated with high risk of embolism and pulmonary embolism prevention in patients with neoplasms. Methods. Ultrasonography of veins of lower extremities, iliac veins and the distal part of inferior vena cava was performed in patients with and without neoplasms in a prospective study to detect thromboses associated with high risk of embolism and thrombophlebitis. Ultrasonography was performed once in control group subjects, and before and during specialized antineoplastic treatment (surgical, chemotherapy, radiotherapy) in patients of the main group, the results were compared. A detection of a new thrombus in previously intact venous segment of inferior vena cava system was assessed as a high risk for pulmonary embolism. Results. Thromboses associated with high risk of embolism and thrombophlebitis were found in 6 patients of control group, in 5 patients of the main group before and in 27 patients of the main group while at specialized antineoplastic treatment. Specific measures for pulmonary embolism prevention were taken immediately in all of the cases according to ultrasonography results after the detection of thromboses associated with high risk of embolism. No fatal cases of pulmonary embolism were registered both in main (before and while at treatment) and control groups. Conclusion. Ultrasonography of veins of lower extremities, iliac veins and the distal part of inferior vena cava in patients with neoplasms before the start of specialized antineoplastic treatment allows to optimize the choice of prevention measures for pulmonary embolism and thus significantly decreases mortality from pulmonary embolism.
Psychological profile, dietary preferences and reproductive history of pregnant women with obesity
Authors: Derdyay O S , Khlybova S V
Published: November 2019

Aim. To study the psychological profile and determine dietary preferences of pregnant women with various stages of diet-induced obesity and to evaluate the relationship between the determined features and reproductive function. Methods. 120 women who were at the 1st trimester of normal pregnancy were administered the modified Life Quality Self-Assessment Questionnaire for Overweight Patients. Women were divided into groups according to body mass index (group 1 - women with normal weight, group 2 - overweight women, group 3 - women with class I obesity, group 4 - women with class II obesity). The data from exchange cards of pregnant women were also included in the analysis. Results. Women with class I and class II obesity had higher rates of concomitant diseases, complications during pregnancy and cesarean sections. The main causes of obesity were genetic predisposition, decreased physical activity, increased dietary energy supply. Such traits as hypochondria, frequent mood changes, desire to be at the center of attention were present in obese women. They evaluate their health as poor. Conclusion. The questioning makes it possible to mark out a high risk group for complications of pregnancy and delivery. A questionnaire survey and monitoring by a psychologist and a dietary specialist are recommended for this group of patients.
Epilepsy in patients with ischemic brain disease
Authors: Khasanova D R , Danilova T V , Latypova Z K
Published: November 2019

Epilepsy is one of the most actual social problems in modern neurology and psychiatry. According to the results of the domestic and foreign studies, the risk of developing epilepsy increases with age. The increased rate of nervous system vascular and degenerative diseases as well as brain tumors and head injuries in elderly patients is one of the reasons for it. The review is devoted to the development of epilepsy in adults having an active cerebrovascular disease. Epilepsy is the disease with multiple causative factors. Among the etiological factors of epilepsy development in adults, the predominant place belongs to vascular diseases. The article presents the epidemiological aspects of the problem, the questions of pathophysiology, the variability of epileptic syndromes developing as a result of ischemic brain disease. It describes the characteristics of epileptic process as a result of a vascular lesion. The role of the cerebrovascular reactivity in brain vascular diseases development is described. A place of different research methods (such as electroencephalography, transcranial and extracranial duplex ultrasonography scanning of the major brain vessels, different modes of magnetic resonance imaging, functional magnetic resonance imaging and magnetic resonance spectroscopy) in identifying risk factors for seizures in patients with cerebrovascular pathology is reported. Possible exogenous and endogenous precipitants (cerebral atherosclerotic vascular disease, hypertension, cerebrovascular deregulation, increased convulsive predisposition, the external epileptic triggers, etc.) are described.
Some features of acute myocardial infarction fatal outcomes on pre-admission stage
Authors: Paikov V L , Ishmetov R P
Published: November 2019

Aim. To study the structure of pre-admission mortality and features of fatal outcomes due to acute myocardial infarction happened in the presence of emergency squad. Methods. In 2011, 324 fatal outcomes that happened in the presence of emergency squad were registered in Kazan, Russia, 96 of them were due to acute myocardial infarction. Ambulance charts for these 96 cases were picked out and examined. Ambulance way time, ambulance set-off time and ambulance waiting time were analyzed. Results. In 147 (45.4%) of 324 cases acute cardiovascular conditions were the reason for the fatal outcome, with acute myocardial infarction as a leading cause (96 cases, 65.3%). Fatal outcomes due to acute myocardial infarction were registered mainly at early term (first 3 hours of the disease onset) in men regardless of age (under 60 years - 9 of 15 cases, 60%; 60 years and older - 18 of 37 cases, 48.7%) and in elderly women (24 of 39 cases, 61.5%). Pre-admission fatal outcomes due to acute myocardial infarction were somewhat more frequent in winter (33.3%) and springtime (30.2%). During the day the cases of acute myocardial infarction occurred predominantly from 00:00 to 02:59 and from 09:00 to 11:59 (32.3% of all the acute myocardial infarction fatal outcomes). Ambulance waiting time varied depending on time of the call, lying between minimum of 5.6 minutes at night (from 00:00 to 05:59) and maximum of 21.2 at evening (from 18:00 to 23:59, р 0.05). Conclusion. Acute myocardial infarction is the leading cause of mortality in the presence of emergency squad, with the highest mortality rate at the first several hours of the disease, especially in males and elderly females. Mortality rate depends on time of the day and time of the year, ambulance waiting time and pre-admission aid timeliness for patients with acute myocardial infarction varies depending on time of the call.
The use of a functional technique for neo-chords’ length determination during reconstructive operations for degenerative mitral regurgitation
Authors: Mukharyamov M N , Dzhordzhikiya R K , Abdul’yanov I V , Vagizov I I , Safarova D F , Akhunova S Yu
Published: November 2019

Aim. To evaluate to effectiveness and safety of the functional technique of measuring the length neo-chords during reconstructive operations on the mitral valve for degenerative mitral regurgitation. Methods. The study included 34 patients, in whom the method of chord prosthesis with polytetrafluoroethylene sutures was used for correction of the anterior and/or posterior mitral valve leaflet prolapse. In order to determine the length of the chords a technique of functional hydraulic tests with a sliding suture knot was used by pressure infusion of a cold isotonic sodium chloride solution into the left ventricle until optimal geometry and competence of the valve leaflets was achieved. Results. No perioperative deaths were registered. The average postoperative length of hospital stay was 10±3.1 days. In 97% of the cases this technique made it possible to obtain immediate satisfactory hemodynamic results of the reconstruction. In long-term follow-up (13 months) 1 (3%) patient was re-operated for severe mitral regurgitation that was associated with the detachment of a native anterior leaflet chord, which was discovered during the operation. The two neo-chords epithelialized, became macroscopically indistinguishable from the native chords, and could be identified by the knots on the atrial side of the leaflet, their integrity was not compromised. In all other cases long-term follow-up after the operation showed a satisfactory hemodynamic functionality of the mitral valve. 76% of the operated patients had postoperative echocardiographic examination performed in our center. In 42% of patients there was no insufficiency, 44% of the patients had 1st degree regurgitation, in 14% of patients the regurgitation was classified as 1-2 degree with no signs of left atrium volume overload, left ventricular dysfunction or symptoms of heart failure. Conclusion. The functional technique for determining the length of neo-chords is an effective and safe method that makes it possible to successfully perform reconstructive operations for degenerative mitral regurgitation.
Perioperative serum cortisol levels at different operative accesses to femoral segment arteries
Authors: Maximov A V , Feiskhanov A K , Plotnikov M V , Begicheva E V , Tuisheva E V
Published: November 2019

Aim. To compare invasiveness of reconstructive operations on arteries of aortofemoral segment using different accesses to surgical site. Methods. The analysis of the post-operative period was carried out in 40 patients who underwent aortofemoral bifurcation bypass surgery. Patients were assigned to 4 groups, each containing 10 patients. In group I surgeries were performed using mini-access of 5-7 cm, group II - mini-laparotomic access of 8-12 cm, group III - retroperitoneal mini-access, group IV - standard laparotomy. For invasiveness objectification, serum cortisol levels, forced lungs vital capacity and postoperative pain levels were measured. Results. All surgeries were performed as planned without inoperative complications. No deaths were registered. After mini-access surgeries intestinal peristalsis was defined by auscultation as soon as on 18-24 hour after the operation. Prolonged (more than 3 days) post-operative ileus was diagnosed in 3 patients, all operated using standard laparotomy. Serum cortisol level was typically elevated at the end of the surgery, but the difference was only statistically significant in patients from the group IV compared to baseline level as well as to patients with mini-access surgeries. Serum cortisol level reduced to normal at the second 24-hours after the surgery. Patients in which standard laparotomy was used reported more intense pain at the second day. Forced lungs vital capacity at day 4 was significantly reduced in patients of groups I, III and IV, with the significantly worse reduction in patients who overcame standard laparotomy compared to others. Conclusion. Mini-access reconstructive surgeries on aortofemoral segment arteries provide significant reduction of surgical trauma, which is proved by objective measurements.
Combined inhalational and intravenous anesthesia at surgeries in patients with gastrointestinal cancers
Authors: Neimark M I , Tanatarov S Z , Adylkhanov T A
Published: November 2019

Aim. To define efficiency and safety of the combined inhalational and intravenous anesthesia (isoflurane + propofol) in patients operated due to gastrointestinal cancer. Methods. 163 patients who were operated due to gastric cancer (119 patients), cancer of the head of the pancreas (24 patients) and colon cancer (20 patients) were examined. Central circulation parameters, autonomic nervous system status, serum cortisol and glucose levels, bispectral index in patients who underwent inhalational or combined inhalational and intravenous anesthesia were compared. Results. There was no significant difference of the examined parameters in patients who underwent combined inhalational and intravenous anesthesia (isoflurane + propofol) compared to patients in whom only inhalational anesthesia with isoflurane was used. Combination was characterized by less change of the examined parameters compared to baseline levels and prolonged emergence from anesthesia. Conclusion. Combined anesthesia is quite safe and effective if used in oncosurgery.
Breast cancer immunophenotype dynamic change
Authors: Druzhkov O B , Gataullin I G , Druzhkov M O
Published: November 2019

Aim. Comparative analysis of primary breast cancer and breast cancer local relapse phenotypes. Methods. 5808 patients with confirmed diagnosis of breast cancer, including 108 (1,86%) with local relapses, underwent surgical treatment from 2000 since 2011. 26 tumors were prospectively examined by histological and immunohistochemical methods using monoclonal antibodies to estrogen and progesterone receptors and to Her2/neu oncogene protein. Results were compared with corresponding parameters of primary tumours. Results. Local relapses occurred in 1,2% of cases after total mastectomy, and in 5,1% - after incomplete mastectomy. Surgical approach to patients with local relapse of breast cancer depended on tumor size. Ectomy of the relapsing tumor at the post-operation scar site or at anterior chest wall was preformed in 60 (55,6%) cases, simple mastectomy after incomplete mastectomy - in 33 (30,5%) cases, repeated incomplete mastectomy with breast reconstruction - in 12 (11,1%) cases, and loco-regional relapsing tumor ectomy - in 3 (2,8%) cases. Immunohistochemical phenotypes of primary and relapsing tumors were different in 15 out of 26 studied cases. Switch from hormone-negative to hormone-positive tumor was registered in 46,7% of cases, from hormone-positive to hormone-negative tumor - in 40%, isolated change of Her2/neu oncogene protein expression - in 13,3%. Conclusion. The hypothesis of change of breast cancer phenotype after treatment has been confirmed; changes of immunohistochemical parameters after the local relapse should be taken into consideration for defining the treatment tactics.
Effectiveness of sporobakterin probiotic in patients with chronic hepatitis C
Authors: Knyaz’kina O V , Kagan Yu D , Skachkov M V
Published: November 2019

Aim. To assess the effect of Sporobacterin probiotic for correction of bowel dysbiosis syndrome in patients with chronic hepatitis C. Methods. Bacteriological examination of stool samples from 100 patients with chronic hepatitis C was performed to detect the bowel dysbiosis syndrome. Some immunity parameters such as CD3+, CD4+, CD8+ and CD19+ blood counts, serum immunoglobulin A, G and M levels, phagocytic coefficient and phagocytic index, metabolic activity of neutrophils, serum circulating immune complex levels were also examined. Viral load was assessed using a polymerase chain reaction. These measurements were repeatedly done in patients who received Sporobacterin (main group, 50 patients) and compared to results of 25 patients taking Bifidumbacterin as well as 25 patients who were not taking probiotics. Results. Bowel dysbiosis syndrome was present in 85% of patients with hepatitis C. In patients taking Sporobacterin during three months, moderate degree of dysbiosis significantly reduced from 1.88±0.15 to 0.38±0.1. Majority of patients from this group recovered intestinal microbiota - 72±6.35%, while initially only 14±4.91% of these patients had normal intestinal microbiota level. Before the treatment 38±6.86% of patients were diagnosed with III degree of bowel dysbiosis syndrome, compared to absence of such diagnoses after the treatment period. After 1 month of the treatment, number of patients with normal count of bifidobacteria in 1 g of stool was significantly higher in the group treated with Sporobacterin (50±7.07%), compared to the group treated with Bifidumbacterin (24±8.54%), as well as number of patients with marked reduction of lactobacteria in 1 g of stool (0 vs 16±7.3%). There was a marked and significant reduction of viral load in patients treated with Sporobacterin, which decreased from 8.3±3.46×106 copies/ml initially to 0.8±0.24×106 copies/ml after 1 month of treatment and to 0.094±0.022×106 copies/ml after 3 months of treatment. After 3 months of treatment the number of patients with the following conditions reduced significantly: elevated leukocyte count from 32.5±7.41 to 6.25%, decreased CD8+ count - from 42.5±7.82 to 6.25%, increased serum immunoglobulin G level - form 25±6.85 to 18.75±9.76%. Conclusions. Use of Sporobacterin for treatment of bowel dysbiosis syndrome in patients with chronic hepatitis C is highly effective and superior to treatment with Bifidumbacterin, Sporobacterin may modulate the immune response and decrease the viral load in patients with chronic hepatitis C.
Clinical signs, diagnosis and complex treatment of temporomandibular joint osteoarthritis
Authors: Sidorenko A N
Published: November 2019

Aim. To improve complex treatment of temporomandibular joint osteoarthritis. Methods. 45 patients with temporomandibular joint osteoarthritis aged 18-75 years were examined. The main group consisted of 25 patients who were treated using transcranial electric stimulation. Comparison group consisted of 20 patients in whom standard treatment was applied. Control group consisted of 10 healthy volunteers and was used to compare blood cytokine and β-endorphin levels. Clinical examination, computed tomography, immunological blood analysis were performed in all patients. Results. After the complex treatment all the symptoms resolved, and the position of mandibular condyles in mandibular fossae of the temporal bone and results of immunological blood analysis normalized. The baseline level of β-endorphin of patients with temporomandibular joint osteoarthritis did not differ from control group. After transcranial electric stimulation β-endorphin serum levels were significantly raised at day 6 and especially at day 9, while in patients with standard treatment the β-endorphin serum levels were only slightly higher compared to baseline levels. Decrease of interleukin-6 serum levels was more significant in the transcranial electric stimulation group. Transcranial electric stimulation has also leaded to elevation of interleukin-10 serum levels up to normal ranges at day 9, compared to low level (5 times below normal range) at all times in the standard treatment group. After 2 years of treatment there was no symptoms of the disease, normal ranges of motion in temporomandibular joints and no relapses registered in 24 out of 25 patients from transcranial electric stimulation group compared to 11 out of 20 patients from standard treatment group. In 1 patient from transcranial electric stimulation group and 9 patients from standard treatment group clicking on the involved side was still present, those patients were re-treated. Conclusion. Usage of transcranial electric stimulation as a component of complex treatment of patients with temporomandibular joint osteoarthritis increases the effectiveness of their treatment.
Comparative assessment of marginal adjoining of fillings and dental inlays in patients with xerostomia
Authors: Komarova K V , Polenichkin V K , Ratkina N N
Published: November 2019

Aim. To study change of electrometric index of fillings and dental inlays marginal adjoining on the border with hard tooth tissues in patients with xerostomia over time. Methods. 40 patients (male - 11, female - 29) aged from 28 to 56 years with xerostomia, in whom 80 dental restorations were completed. Inclusion criteria were the following: signed informed consent, diagnosis of xerostomia, preserved chewing function of mandibular and maxillar teeth, and presence of an antagonist of the examined tooth. Patients were divided into two subgroups (40 patients each) depending on the treatment method used: dental filling (1st group) or dental inlay (2nd group). Both fillings and inlays were made of packed restorative composite Filtek P60. Dental dam was used to isolate restored tooth from saliva. Marginal adjoining control at the border «tooth-composite» was made by «DentEst» (Geosoft, Russia) electrometric device. Comparative evaluation of marginal adjoining quality at «tooth-filling» and «tooth inlay» border was performed at 3, 6, 9 and 12 months after treatment. Results. 10 minutes after treatment mean values of marginal permeability in the first group did not significantly differed from the second group, indicating good marginal adjoining. 3 months after the treatment at electrometry marginal adjoining was incomplete in 1 filling out of 40, compared to the second group where marginal permeability was still good at 12 months after treatment. The functional examination of restored teeth with good marginal adjoining at a period from 3 to 12 months after treatment showed that this number reduced from 98 to 45% in the first group and from 100 to 95% in the second group. Differences between groups were statistically significant. Conclusion. In patients with xerostomia tooth reconstruction using dental inlay is more effective than use of dental filling.
Problems of healthy lifestyle forming in children and young students
Authors: Yakovleva T V , Ivanova A A , Terletskaya R N
Published: November 2019

A review of literature concerning various aspects of children’s and young students’ health and behavioral risk factors affecting its forming is presented. The significant role of pre-school and school education factors in maintaining and improving of younger generations’ health is revealed. Negative aspects of the educational process are: overload with the additional classes adapted from primary school programs at kindergartens, academic overload, irrational schedule, use of innovative teaching methods and technologies that are not suitable for students’ age and physiological features; authoritarianism of modern school, sanitary and epidemiologic requirements noncompliance. Additional risk factors are present in older adolescents: high incidence of out-of-school labor activities (up to 50% of pupils), bad habits, the emergence of occupational exposures, low levels of knowledge in the sphere of self-safety behavior, as well as external causes. Apart from irrational day regimen, academic overload, intensity of exams, behavioral factors are also in the basis of students’ health decrease. The absence of system approach and continuity in solving of the children’s and young students’ healthy lifestyle problems is demonstrated.
Clinical and immunological parallels in patients with drug addiction
Authors: Hamitov R F , Mustafin I G , Chernova O L
Published: November 2019

Drug addiction is a current serious medical and social problem. The continuing all over the world during the last several decades tendency of narcotic drug use growth has leaded to significant increase in the number of patients with drug abuse and number of associated internal diseases. A huge number of diseases have the particular features of clinical course in drug addicts with chronic drug intoxication compared to patients without it, which is related primarily to serious disorders of drug addicts’ immune system, i.e. with marked immunodeficiency. Immunotropic drug effects were and still are closely studied, a lot of data concerning various cellular and humoral immunity impairments in patients with substance abuse were gained, but most of them are controversial, scattered and not systemic. Because of immunity reconstitution developing in patients with drug abuse, different infections including viral hepatites, HIV-infection, pneumonias, tuberculosis, infective endocarditis and septicemia are characteristic for this patient subgroup. Further research on etiology, immunopathogenesis and clinical features of those diseases in drug addicts are still actual.
The analysis of the drug supply system for patients with bronchial asthma in the Republic of Tatarstan
Authors: Shakirova D H , Fassakhov R S , Kamaeva A Z
Published: November 2019

Aim. To analyze the current drug supply system for patients with bronchial asthma in the Republic of Tatarstan. Methods. Systematic, marketing, statistical, retrospective, situational analysis was performed. Bronchial asthma incidence data, data of drug supply system for patients with bronchial asthma in the Republic of Tatarstan were analyzed. Results. From 2005 to 2011 the number of patients with a diagnosis of bronchial asthma has increased by 23.9%, and there were 25 700 newly diagnosed cases. Out of 215 medications to treat bronchial asthma registered in the country, 68 are produced in Russia. The rate of inhaled medications produced by domestic is only 15.91%. Outpatients are provided with drugs under the federal and regional programs of preferential drug supply. In 2010 - over 81 thousand, in 2011 - over 87 thousand of prescriptions were issued under the program of vital drug supply for patients with bronchial asthma. The cost of drug supply exceeded 60 million rubles in 2010, in 2011 it was about 67 million rubles. There was a 5.87% increase of number of patients covered by drug supply in 2010-2011. If the patient denies the drug supply, he/she is responsible to pay for his medication, the approximate cost of treatment of patient with bronchial asthma is over 28 000 rubles per year. In 2011 the number of patients supplied under the regional supply program has significantly increased by 76.29% leading to decrease of cost of medications supplied per 1 patient. Conclusions. The need to find evidence-based solutions to the problems of drug supply system for patients with bronchial asthma at the regional level was identified.
Atypical clinical course of pneumonia in a patient with ummunodeficiency, iron-deficient anemia and dietary supplement intake
Authors: Saifutdinov R G , Minnullina Z S
Published: November 2019

A clinical case pneumonia and multiple organ dysfunction syndrome in a patient with iron-deficiency anemia and previous intake of a dietary supplement for weight loss is presented, including results of examinations, observation and treatment. A 22 years old female was admitted with complaints on dyspnea, dry cough, malaise, «pulsing» head ache at the back of the head, vertigo while walking, fever up to 39 °С during the previous 3 days. Basing on the results of chest X-ray and laboratory examination the diagnosis of «Community-acquired subtotal right-sided pneumonia of mixed origin, severe clinical course, respiratory failure grade III, complicated by toxic shock syndrome, toxic pulmonary edema, disseminated intravascular coagulopathy stage I. Acute cardiac failure, acute respiratory distress syndrome. Acute iron-deficiency anemia. Acute erosive hemorrhagic gastritis. Obesity, II degree» was set up. In spite of active treatment patient’s condition deteriorated due to intoxication, cardiac failure and respiratory distress progress. Autopsy revealed that the patient has died of severe viral pneumonia, although such an extensive pneumonia is not typical for a 22-year old patient. Severe pneumonia development may be explained by immunodeficiency intensified by acute iron-deficiency anemia, which can be a possible side effect of previous intake of a dietary supplement for weight loss and alimentary factors.
Assessment of pancreatic secretory function in children with cystic fibrosis in the Republic of Tatarstan
Authors: Timoshenko J V , Rylova N V
Published: November 2019

Aim. To assess the pancreatic secretion in children with cystic fibrosis. Methods. 38 children with cystic fibrosis aged from 1 to 18 years were included. Pancreatic elastase-1 stool level, as well as blood lipase and amylase activity were assessed by ELISA in 34 children. Results. Children were distributed to 3 groups depending on degree of elastase-1 stool level decrease: first group - with severe pancreatic insufficiency (50%), second group - with slight pancreatic insufficiency (8.8%), third group - with normal pancreatic function (41.2% of patients). Blood lipase and amylase activity was within normal ranges in all children, that can be explained by ongoing enzyme replacement treatment. The way to detect the elastase-1 stool level by ordinary non-invasive method seems to be very valuable, especially in pediatrics. Elastase test allows to reveal pancreatic malfunction without canceling enzyme replacement treatment and to supervise the pancreatic secretion. Conclusion. In children with cystic fibrosis pancreatic secretory function is affected in most of the cases. A combined examination including the elastase-1 stool level detection allows to assess the pancreatic status of patients with cystic fibrosis more precisely and to adjust the doses of pancreatic enzymes.
Endothelium-dependent vascular tone regulation mechanisms in patients with ischemic stroke
Authors: Dolgov A M , Ryabchenko A Y , Denisov E N , Gumanova N G
Published: November 2019

Aim. To study the role of nitroxidergic reactions of the circulatory system in the development of ischemic stroke. Methods. 51 patients (both males and females) with the diagnosis of ischemic stroke were examined. All patients were distributed to 3 groups according to the severity of neurological deficit. All patients underwent brain computed tomography or magnetic resonance imaging. Cerebral blood flow was examined by extra and transcranial ultrasonic dopplerography. Central hemodynamics was evaluated by echocardiography. General clinical examination, neurological and neuroophthalmological examinations were also performed. Vasomotor endothelial function was assessed using a 7 MHz linear transducer on the ultrasound unit «Medison SonoAce X8». The level of nitric oxide was assessed using its stable metabolites, nitrite and nitrate definition in serum. Neurological status was assessed according to the USA National Institutes of Health Stroke Scale. Results. Disorders of nitroxidergic mechanisms of blood vessels regulation were observed in patients with ischemic stroke. Endothelium-dependent brachial artery dilation disorders and nitric oxide persistent metabolites level decrease were related to the severity of the disease and the neurological deficit degree. Conclusion. The study of endothelium-dependent vascular tone regulation mechanisms revealed that these mechanisms are involved in the pathogenesis of ischemic stroke; the study of these mechanisms can be used to clarify the severity of neurological deficit, and possible prognosis.
Changes of intestinal microbiota in patients with HIV
Authors: Khasanova G R , Anokhin V A , Bikkinina O I , Shakhbazova E N , Kotlyar E Y , Nagimova F I
Published: November 2019

Aim. To assess the changes in intestinal microbiota in patients with HIV. Methods. The cultures of stool samples of 317 patients with different stages of HIV [13 (4.1%) patients - with the acute infection stage (2A, 2B, 2C), 217 (68.5%) - with the stage III, 87 (27.4%) - with the stages IVA-B according to classification by Pokrovsky V.I., 2001] were examined by plating on the growth medium and further microbiologic examination. Results. Changes in intestinal microbiota were found in 94% of the patients. The decrease in the obligatory microorganisms quantity, especially in bifidobacteria (lower than reference ranges in 70.3% of patients) was the most frequent finding. Bacterial overgrowth of conditionally pathogenic biota (mainly S. aureus and Candida) was registered in 57.1% of patients. The intestinal microbiota composition did not depend on the clinical stage of HIV infection and presence of opportunistic infections, with only CD-4 count associated with the degree of intestinal microbiota changes. Conclusion. Intestinal microbiota changes are typical for patients with HIV infection at all stages of the disease regardless of opportunistic infections presence. Low CD-4 count is associated with higher severity of intestinal microbiota changes.
Comparative analysis of echocardiography, multispiral computed tomography, myocardial perfusion scintigraphy to evaluate left ventricular volume and left ventricular ejection fraction
Authors: Galyavich A S , Rafikov A Y , Saifullina G B
Published: November 2019

Aim. To perform a comparative analysis of multislice computed tomography (MSCT), echocardiography and single photon emission computed tomography (SPECT) in the evaluation of left ventricular end-diastolic volume (LV EDV) and left ventricular ejection fraction (LVEF). Methods. The study included 44 patients (15 female, 29 male) aged of 21 to 73 years (mean age 55±11 years). LV EDV and LVEF were assessed by noninvasive MSCT coronary angiography. echocardiography and SPECT were also performed. Results. There was a statistically significant difference found between the LV EDV medians for the following pairs: MSCT vs Quantitative Gated SPECT (QGS), MSCT vs SPECT using 4D MSPECT regimen, MSCT vs echocardiography. There was no statistically significant difference determined for the following pairs: echocardiography vs SPECT, QGS SPECT vs 4D MSPECT. Difference between the LV EDV were calculated using the Bland-Altman method as following: MSCT vs echocardiography - 55±33 ml, MSCT vs QGS SPECT - 38±29 ml, MSCT vs 4D MSPECT - 30±33 ml. Differences in the LVEF evaluation methods were: MSCT vs echocardiography - 2,5±7,2%, MSCT vs QGS SPECT - 0,9±8,3%, MSCT vs 4D MSPECT - 1,2±8,1%. The highest LV EDV values were registered by MSCT, the lowest - by echocardiography, with the values registered by SPECT lying in between MSCT and echocardiography volumes. Conclusion. MSCT, echocardiography and SPECT present different left ventricular volume and similar LVEF data.