bluuebunny/crossref_metadata_2025 huggingface dataset:
Two-staged surgical treatment of hip septic arthritis
Authors: Ismailov H G , Mazdykov A F , Shushaniya B A
Published: November 2019

Hip arthritis (coxitis) is the inflammatory process in the hip, requiring complicated and lengthy treatment. At some cases it is associated with serious complications, up to patient’s disability due to the femoral head destruction. The treatment goal is to halt inflammation for further hip arthroplasty and functional rehabilitation. Arthroplasty is performed using the commercially available cement antibiotic-impregnated articulating spacers. The article reviews a number of clinical examples of two-staged surgical treatment of hip septic arthritis using articulating spacers with further hip arthroplasty. Experts, including native specialists, in the periodicals and clinical practice question the effectiveness of two-staged treatment. The experience of effective use of commercially available bone cement antibiotic-impregnated articulating spacers is presented. The method allows to halt the inflammation, to avoid the significant femoral shortening and acetabulum filling by scar tissue, to preserve hip function and provides the patient an opportunity to move with a partial load on the operated limb while waiting for the arthroplasty, as well as improves the conditions for hip implant consolidation. After suppressing the inflammation, the described method, providing a moderate load on the affected bone, enhances the bone mineral density increase both of femur and acetabulum. Two-staged treatment of septic coxitis decreases the risk for infective complications after the total hip replacement.
Traumatic amputation of penis
Authors: Abdurakhmanov A K , Kopylov V A
Published: November 2019

7 patients with penile traumas (4 - with penile fracture, 2 - degloving penile injury, 1 - traumatic amputation of the penis) were observed in the department of urology of the Municipal Hospital №5, Naberezhnye Chelny, Russia from 2009 to 2013. The penile trauma, regardless of its cause, is the major physical and mental trauma for the patient. It causes psychological distress, and impacts the subsequent quality of life in males. In domestic and foreign literature, there are few reports about the traumatic amputation of the penis as suicidal attempt in mental patients. At the presented case, patient himself performed the traumatic amputation to remove the strangulating ring. The patient used a metal ring to increase erection, after the coitus it caused the pathologic erection, and patient could not remove it. To decrease the edema, the patient cut the penile skin, but did not reckon the knife sharpness and the force, and performed the traumatic amputation of penis; the stump was thrown away by the patient. The described case can be distinguished because of the rare trauma mechanism in mentally healthy patient.
Life journey and scientific heritage of professor M.B. Vurgaft (to the 100th anniversary)
Authors: Amirov A N , Vurgaft Ya M , Tokinova R N
Published: November 2019

In 2013 it is 100th birthday anniversary of M.B. Vurgaft - world known scientist, one of the founders of the aqueous humour production and drainage examination by compression tests and tonometry in a normal eye and in glaucoma patients. Moisey Bencionovich Vurgaft, professor, PhD, headed the department of ophthalmology of Kazan State Institution for Post-Graduate Medical Education, later renamed to Kazan State Medical Academy. The student of outstanding scientists - academician V.P. Filatov and professor S.F. Kalf, M.B. Vurgaft has devoted all his life to studying one of the leading problems of ophthalmology - glaucoma. He was the first in The Soviet Union who has started to study the eye fluid flow, and developed original and easily assessable study methods that are still important nowadays. A new direction of scientific research of the department targeted on glaucoma studies was formed under the guidance of M.B. Vurgaft. Moisey Bencionovich had always tried to link the scientific research with the needs of healthcare practice. He was an outstanding diagnostician, clinician and ophthalmic surgeon. Professor M.B. Vurgaft had always shared his experience and had mentored a number of outgoing students, who are currently working all over the country. He is the author of over 140 academic papers, 6 textbooks, several patents covering various questions of ophthalmology. Using the scientific data, originally gained by M.B. Vurgaft, 16 master and 6 doctoral degrees (PhDs) were completed in different institutions of CIS, Bulgaria and Hungary. During 13 years he was an eternal head of the Tatarstan Scientific Society of Ophthalmologists, an honoured member of All-Russia and Soviet Union Scientific Society of Ophthalmologists, member of the expert board of the Central (awarded with the order of Lenin) Institution for Post-Graduate Medical Education of the responsible for the development of post-graduate educational programs in ophthalmology, member of the of surgical faculty of Kazan State Institution for Post-Graduate Medical Education.
Improving the local treatment effect in oral lichen planus
Authors: Ron G I , Akmalova G M
Published: November 2019

Aim. To assess the clinical efficacy of local use of titanium glycerosolvate aqua-complex (Tisolum) in combination with hyaluronidase as a component of the complex treatment of oral lichen planus. Methods. The study included 49 patients with typical form of oral lichen planus aged 29 to 65 years. The first group included 25 patients, who received the local treatment with glycerosolvate aqua-complex (Tisolum) in combination with hyaluronidase as a component of the complex treatment. The second group included 24 patients who were treated conventionally. Results. The patients of the treatment group reported the decrease of the oral mucosa tightness and roughness sensation 5.78±0.26 days after the treatment initiation, which was 1.5 times faster compared to the control group (8.6±0.34 days, р 0.05). On the seventh day of treatment, there was a significant papule deflorescence in 19 (76.0%) out of 25 patients of the main group, compared to 11 (45.8%) out of 24 patients of the control group (р 0.05). On the 10-th day, disappearance or downsizing of lesions without signs of active inflammation was observed in all 25 patients of the treatment group, compared to 16 (66.7%) of the control group patients (р 0.05). On the 14-th day, no mucosal lesions were observed in all 25 patients of the treatment group, which was significantly better compared to 9 (37.5%) out of 24 patients of the control group (р 0.05). Regression of clinical signs of the disease at the treatment end was registered in all patients of the main group and in 14 (58.3%) patients of the control group. Conclusion. Local use of composite gel containing titanium glycerosolvate aqua-complex (Tisolum) in combination with hyaluronidase as a component of the complex treatment of oral lichen planus is highly effective.
Surgical treatment for pelvic organs prolapse
Authors: Gasparov A S , Babicheva I A , Dubinskaya E D , Lapteva N V , Dorfman M F
Published: November 2019

Aim. To estimate and compare the features and efficacy of different surgical methods of pelvic organ prolapse correction. Methods. 120 patients with stage 4 of pelvis organ prolapse were included in the study. The different types of surgical procedures were performed («Manchester» surgery, vaginal hysterectomy, sacropexy, laparoscopic ventrosuspension). Surgical method was selected accounting the patient’s age, desire to save the uterus, presence of uterine or adnexal pathology and concomitant diseases. For long-term outcomes evaluation, patients were followed up for 6-36 month after surgery. Results. The long-term outcomes of the different types of surgeries performed in patients with stage 4 of pelvis organ prolapse were comparable. Minimal surgery time, blood loss and the hospital stay were registered in patients, in whom laparoscopic ventrosuspension combined with colpoperineorrhaphy and levatorplasty was performed, compared to «Manchester» surgery, vaginal hysterectomy and sacropexy with colpoperineoplasty. No cases of serious complications were registered. Patients with stress incontinence observed before surgery reported improvement in urination, although 6 patients (10%) still reported rare episodes of incontinence. Conclusion. In elderly patients with stage 4 of pelvis organ prolapse, laparoscopic ventrosuspension of uterus or vaginal stump with further colpoperineorrhaphy and levatorplasty could be performed; this type of surgery is technically simple, not time-consuming, and it’s results are comparable with the effectiveness of sacropexia. Thus, it could be recommended to under-trained young surgeons.
Probit-analysis for assessing the effectiveness of various treatment methods for chronic liver failure
Authors: Kutepov D E
Published: November 2019

Aim. To estimate the validity of probit-analysis for assessing the effectiveness of various treatment methods for chronic liver failure. Methods. The study included 292 patients with chronic liver failure. All patients were distributed to four groups, conventional treatment was performed in all patients. Patients of the 2nd group were additionally administered plasma exchange, of the 3rd group - plasma exchange and high volume continuous veno-venous hemofiltration, of the 4th - molecular adsorbent recirculating system (MARS). To determine the medium lethal time (time at which 50% of patients pass away, ТL50), probit-analysis based on studying the association between the time logarithms and probits corresponding to the observed effects, was used. Results. Standardization of patients’ mortality rate, allowing to exclude biases associated with differences of chronic liver failure severity at admission, was performed. Probit-analysis showed that there were no significant differences in between male and female patients regardless of used treatment methods. ТL50 in patients of any gender treated only by conventional methods was significantly lower compared to other methods of treatment. There was a trend of ТL50 increase in the following sequence: conventional treatment → plasma exchange → plasma exchange and high volume continuous veno-venous hemofiltration → molecular adsorbent recirculating system. Conclusion. Probit-analysis allows to determine the time of 50% mortality (ТL50) in patients with chronic liver failure. Treatment using extracorporeal methods of treatment (plasma exchange, plasma exchange and high volume continuous veno-venous hemofiltration, molecular adsorbent recirculating system) is significantly more effective compared to conventional treatment.
Clinical and functional features of the nasal cavity, paranasal sinuses and pharynx in patients with chronic obstructive pulmonary disease in remission
Authors: Gilifanov E A , Nevzorova V A , Artyushkin S A , Pavlush D G , Ardeeva L B
Published: November 2019

Aim. To assess functional condition of the nasal cavity, paranasal sinuses, pharynx in patients with remission of chronic obstructive pulmonary disease. Methods. Patients were distributed to 2 groups. The main group included 49 patients with stages II and III of chronic obstructive pulmonary disease in remission, control group included 50 healthy non-smoking volunteers without any known respiratory diseases. Patients underwent general examination, completed by rigid endoscopic examination, examination of ciliary clearance, anterior active rhinomanometry, olfactometry, nasal cavity and paranasal sinuses computed tomography. Pharynx examination included nasal cavity posterior endoscopy, mesopharyngoscopy, lower part of the parynx was examined by rigid endoscope with viewing angle of 70°. Results. Ciliary clearance was 26.7±3.06 minutes in patients of the main group, compared to 16.4±1.11 minutes in patients of the control group. Smell acuity was 1.86±0.11 units in patients of the main group, compared to 2.3±0.15 units in patients of the control group. Signs of nasal and pharyngeal diseases, including signs of chronic inflammation of nasal mucosa and chronic catarrhal pharyngitis was found in 30 patients. Conclusion. Patients with chronic obstructive pulmonary disease had higher prevalence of chronic rhinitis and pharyngitis, worse smell acuity and impaired ciliary clearance compared to healthy controls.
Community-acquired pneumonia treatment: predictors of fatal outcomes
Authors: Khamitov R F , Malova A A , Grigorieva I V
Published: November 2019

Aim. To analyze the quality of the medical aid in cases of community-acquired pneumonia with fatal outcomes and further development of recommendations for optimizing treatment strategy and tactics. Methods. Retrospective analysis of 62 medical charts of in-patients who passed away from community-acquired pneumonia during the calendar year. Results. The major part of all fatal outcomes of community-acquired pneumonia were seen at the intensive care units, to which the majority of such patients (41 cases, 66.1%) were admitted right from the admission ward. Differences of treatment tactics in patients with community-acquired pneumonia were revealed depending on the department type (internal diseases, intensive care unit, pulmonology) where the patients were admitted. The treatment manipulations structure and common mistakes made in administrating antibacterial and non-anti-infective drugs in cases of community-acquired pneumonia with fatal outcomes were analyzed. Anti-microbial treatment was assessed as completely adequate only in 18% of cases. In cases of severe community-acquired pneumonia with fatal outcomes the most commonly administered antibacterial drug was ceftriaxone (41 cases, 66.1%). At the same time, the potential of semisynthetic aminopenicillins was not unlocked (only 9 cases, 14.5%). The most common contraventions of rational anti-microbial treatment principles were irrational combinations, inadequate daily dosage and antimicrobial treatment change sequence. A trend for inappropriate administration of corticosteroids in patients with severe and extremely severe community-acquired pneumonia in the intensive care units was observed. The use of other non-anti-infective drugs (anticoagulants, diuretics, mucolytic agents and bronchodilators) as components of complex treatment in patinets with life-threatening community-acquired pneumonia should be strictly limited by their indications for use. Conclusion. Rational anti-bacterial treatment performed in compliance with national recommendations (2010) is the cornerstone of treating community-acquired pneumonia.
Gender differences of left ventricular remodeling in patients with chronic heart failure
Authors: Dadashova G M
Published: November 2019

Aim. To determine the gender differences in risk factors of left ventricular remodeling in patients with chronic heart failure associated with arterial hypertension and coronary heart disease. Methods. The study included 112 patients aged 45 to 60 years with myocardial scaring after myocardial infarction and functional class I-III of heart failure by NYHA. Patients were distributed to 2 groups: 1st included 60 males (mean age 54.8±3.3 years), 2nd - 52 females (mean age 55.8±3.1 years). To assess the cardiac function, all patients underwent echocardiography (B- and M-modes). Models of left ventricle architectonics were identified according to such parameters as left ventricle wall relative thickness index and left ventricular mass index. Results. Leading causes for heart failure in female patients were hypertension (50% of cases) and ischemic heart disease (23.1% of cases, 79.5% of ischemic heart disease cases were not associated). In males, ischemic heart disease was the leading reason for chronic heart failure (78.3% of cases, among them 80.9% with a history of survived myocardial infarction). In females, chronic heart failure was more often associated with isolated diastolic dysfunction (78.8% of cases versus 65% in males, p 0.05), and left ventricle ejection fraction was stable. Unfavorable types of left ventricle remodeling in terms of prognosis were more common among females, including eccentric left ventricle hypertrophy (67.3% of cases versus 53.3% in males, p 0.05) and concentric left ventricle hypertrophy (21% of cases versus 18.3% in males, p 0.05). Conclusion. There are gender differences in patients with chronic heart failure: prevalence of hypertension in women, and coronary heart disease in men; higher rate of isolated diastolic dysfunction prognostically unfavorable types of left ventricle remodeling (eccentric and concentric left ventricle hypertrophy) in females.
Attitude of medical students to alcohol and nicotine
Authors: Marianian A Y , Kolesnikova L I , Protopopova N V , Belousova L P , Korolkova T P
Published: November 2019

Aim. To determine the attitude of medical students to alcohol and nicotine. Methods. An anonymous survey of 118 5th year students (43 male students, 75 female students; mean age 22.6±0.9 years) of Irkutsk State Medical University was conducted. A self-composed questionnaire allowing to evaluate the students’ attitude to alcohol and nicotine was used. No cases of turndown were observed. Results. 17 (39.5%) out of 43 male students and 31 (41.3%) out of 75 female students were active smokers. 29.4% male students and 58.1% female students smoked up to 5 cigarettes per day, 58.8 and 38.7% - 5 to 10 cigarettes per day, 11.8 and 3.2% - over 10 cigarettes per day, accordingly. The majority of students (88.2% amle and 70.9% female students) smoked «light» cigarettes, 11.8 and 29.1% - «superlight». 25 (58.1%) male students and 47 (62.7%) female students reported that they were alcohol takers. Most of male students (84%) were drinking beer, most of female students (74.5%) - wine. 96% male and 36.2% female students took strong spirits. 17 (39.6%) male and 22 (29.3%) reported episodes of partial amnesia after alcohol consumption. 5 (20%) out of 25 male and 16 (34%) out of 47 female students reported they would like to reduce their alcohol consumption. Conclusion. The study showed that alcohol consumption and tobacco smoking is a rather common in the respondents; this problem requires further study.
Low proliferative level is a poor prognostic factor for colon adenocarcinoma
Authors: Raskin G A , Petrov S V
Published: November 2019

Aim. To match up the proliferative activity of colon adenocarcinoma cells with tumor stage and survival rate. Methods. Ki-67 protein expression was evaluated by immunohistochemical methods in 217 patients with primary colon adenocarcinoma. After epitope retrieval and endogenous peroxidase inhibiting by 3% solution of hydrogen peroxide, histologic samples were stained by antibodies to Ki-67 protein (clone SP6, dilution 1:300) and polymer systemic detection with diaminobenzidine as a chromogenic substrate. Nuclear counterstain was performed using Mayer’s hematoxylin solution. Results. Assessment of colon adenocarcinoma proliferative activity showed a significant difference between the number of cases with high (70%) and relatively low (≤30%) proliferative levels in groups with metastatic cancers and non-metastatic tumors. In patients with no relapses, colon adenocarcinoma proliferative activity assessment showed proliferation level exceeding 70% in 21 (95%) out of 22 cases, in a single case proliferation level of 60% was found according to Ki-67, no cases of proliferation level lower than 50% was found. Statistical analysis showed that proliferative activity was significantly lower in patients with metastatic colon adenocarcinoma compared to cases of adenocarcinoma without metastases (p= 0.0019). We observe one clinical case of aggressive colon adenocarcinoma with omental, peritoneal, paraumbilical metastases in 28-year old patient, in whom proliferative activity by Ki-67 was measured as 20%. Conclusion. Low proliferative level in colon adenocarcinoma is a poor prognostic factor for possible metastasing and cancer recurrence.
Comparative analysis of modeled femoral fractures osteosynthesis stability
Authors: Yamshchikov O N , Markov D A , Emelyanov S A , Zvereva K P , Bychkov A E
Published: November 2019

Aim. To perform the comparative analysis of osteosynthesis stability in splintered fractures on the example of modeled fractures of femur with metalwork. Methods. Bone fragments fixation methods using internal fixators, blocking intramedullary nails, external fixation devices. Round wooden rod with external diameter of 35 mm, internal diameter of 25 mm, which was saw in the middle with two cuts directed at an angle of 45° to the rod axis to form the triangle fragment, was picked for femur model for the purpose of experiment. The stability of bone fragments fixation using plates with angle stability, pin- and nail-type external fixation devices and blocking intramedullary nails was assessed. To test the stability of the «bone-fixing device» complex, torsional test machine КМ-50-1 №66, power press П-10 №92, pull test machine Р-10 №1677 were used. Results. Compared to external fixation device, fixation using plates with angle stability was 6 times more stable at axial load and by 43.5% at lateral load. The stability of blocking intramedullary nail at axial load was higher compared to external fixation device. At rotary load, the stability of blocking intramedullary nail was 2 times lower compared to external fixation device. Conclusion. On a model of splintered double-lever femur fractures, fixation using plates with angle stability was the most stable fixation mode.
Influence of toxoplasma gondii antigens on features of immune status at prenatal and early postnatal periods: experimental study
Authors: Sokolova T F , Novikov D G , Indutny A V
Published: November 2019

Aim. To detect the features of immune status at prenatal and early postnatal periods under the influence of Toxoplasma gondii antigens. Methods. The experimental study was performed on Wistar white rats, who were the offspring of the female rats who were sensitized by T. gondii corpuscular antigen during the III trimester of pregnancy - group 1 (n=96) and on animals who were administered T. gondii corpuscular antigen at firs day of life - group 2 (n=103). Control group consisted of intact rats. Common blood test, levels of antibody-forming cells and CD3+ cells were assessed at 60 day after birth. Results. Neutrophil blood count was 1.9 times higher in the group 1 rats compared to group 2. Eosinophil blood count was 1.4 times lower in the group 1 compared to control group (р=0.01), and 2 times lower in the group 2 compared to control group (р=0.002). At the same time, lymphocyte count was comparable in the group 1 rats and control group, while it was 1.4 times lower in the group 2 compared to control group (р=0.04). Together with that, there was a reduction of CD3+ cells and antibody-forming cells in blood and spleen, which was more marked in the 2nd group. Lymphoadenopathy, thymus dysgenesia, reduced blood and spleen T-cells levels, low humeral immunity were found in Wistar white rats, who were the offspring of the female rats who were sensitized by T. gondii corpuscular antigen during the III trimester of pregnancy. Conclusion. The influence T. gondii corpuscular antigen on rats during perinatal period results in secondary immunodeficiency, persisting at 60 day of life.
Liver and skeletal muscle ceramides in alloxan-induced diabetes
Authors: Bagautdinov M R
Published: November 2019

Aim. To study of liver and sceletal muscle ceramides in alloxan-induced diabetes at different periods after alloxan exposure. Methods. Repeated experiments were performed on white male rats. Diabetes was modeled by alloxan hydrochloride solution intraperitoneal injection. The disease development was monitored using clinical and laboratory parameters. Ceramides in tissues were determined in intact animals (control), at the 10, 20, 30, 45 and 60 day after the alloxan injection. Ceramides level in the plates was determined by thin layer chromatography using the external standard. Results. In intact animals, ceramides level in liver was twice as high as in muscle. At all terms after alloxan injection, ceramide level was significantly higher compared to controls, and was in muscle compared to liver, with similar change pattern. Up to the 20th day, a significant increase of ceramide level was observed compared to control (eightfold in liver and sevenfold in muscle). By 30th day, a partial recovery was registered, followed by subsequent increase of ceramide level. This indicates the influence of compensation mechanisms in the early stages of the experiment with further decompensation on late stages. Conclusion. In alloxan-induced type 1 diabetes, ceramide level in insulin-dependent tissues depends on the term after the alloxan injection; the findings are of great importance for the research of secondary insulin resistance, as well as other diabetes-associated pathological conditions, exact mechanisms.
Cancer incidence and mortality in the Amur oblast
Authors: Agarkova O A , Voit L N
Published: November 2019

Aim. To analyze the incidence and mortality from malignancies in the Amur Oblast. Methods. The evaluation was based on statistical data analysis of incidence and mortality from malignancies. Results. Incidence of malignancies in the last 5 years in the Amur Oblast increased up to 346.3 per 100 000 in 2012. Main localizations for malignancies were: the first place - lung malignancies; the second - skin malignancies; the third - breast malignancies; the fourth -stomach malignancies (41.1, 39.7, 37.3, 23.9 per 100 000 accordingly). The areas with the highest prevalence of cancers - Konstantinovsky, Zavitinsky, Bureysky, Zeysky districts - were outlined, with the prevalence of 441.9; 438.7; 420.6 and 384.4 per 100 000 per year. Mortality from cancer in the Amur Oblast in 2012 was 180.7 per 100 000, one-year mortality rate increased to 31.8%. The most frequent cancer types leading to unfavorable outcomes were malignancies of digestive organs - 34.9% of all fatal outcomes, respiratory system organs - 24.2%, female reproductive system - 6.6%, breast - 6.5%, kidneys and urinary tract - 6.01%. Conclusion. The incidence and mortality from malignancies in the Amur Oblast increased in 2012 compared to 2008.
Characteristics of mineral composition of food used in primary schools
Authors: Tkachuk E A , Tarmaeva I Yu , Tsyrenzhapova N A , Boeva A V
Published: November 2019

Aim. To define the mineral content in foods supplied for preschool facilities in Irkutsk by laboratory methods. Methods. Food samples (whole cow milk, white bread, potato, apple, beef, «Gerkules» oat) were analyzed. The results were compared with data of food chemical contents used as reference values by «Center for Biotic Medicine» for evaluating food mineral contents. Analytic tests were performed using atomic emission spectroscopy with inductively coupled argon plasma and mass spectroscopy with inductively coupled argon plasma. Results. Food samples analysis in preschool facilities of Irkutsk revealed that these samples have significant differences in mineral contents compared with foods used in the European part of Russia. In common, examined foods contains less macro- and microelements, especially Ca, Fe, P, Si. In animal products (milk, meat) the differences were more significant both in number of elements and in absolute differences, compared to plant food (bread, potato, apple, cereal). Animal products contains less zinc. Conclusion. The gained data highlight the need for improving children’s catering, as well as for development and use of preventive measures aimed to reduce risks for diseases associated with macro- and microelements deficiencies.
Actual aspects of medical ethics in training of the pediatrician
Authors: Pikuza O I , Zakirova A M , Shoshina N K
Published: November 2019

Nowadays the problems of medical ethics are gaining the special significance as a result of changes in social and economic relations, healthcare modernization due to appearance of new effective methods for instrumental and laboratory examinations, treatment approaches, development of market relations in medicine. The aim of the presented paper is to cover the actual aspects of medical ethics in pediatrics. The paper reviews the ethical aspects of the work of a in detail. Differentiated approach in choosing pediatrician interns, which is based not only on academic progress, but also on professional and moral qualities of the medical university alumni and continuity in their upbringing starting form the first years of the medical school until the end of post-graduate education, seems rationale. It is during the student years when the cognitive and moral values of a forthcoming specialist are formed, which may be a criterion of a suitability of working with children. The roles of the competition, including the modular approach to knowledge evaluation, professional competencies and rating system are stressed. Considering the modern requirements to a young professional, the accent is made on the role of the leading tutor in a forthcoming specialist formation. The requirements to a higher education teacher and the importance of the moral atmosphere in hospitals and faculties for forming the ethical features of a forthcoming pediatrician and improving his/her professional level according to the medical progress are outlined. Thus, teaching pediatrics has a lot of particularities, including teaching the basics of medical ethics, having an extremely important role in professional education of pediatricians for proper forming of the young professional according to contemporary life requirements.
Association between the systolic arterial blood pressure level and inter-arm asymmetry
Authors: Petrov P I
Published: November 2019

Aim. To determine the association between the systolic arterial blood pressure level and the inter-arm asymmetry measurements in healthy individuals. Methods. 580 healthy volunteers aged 20 to 60 years (401 females, 179 males) were included in the study. Arterial blood pressure was measured in both left and right wrists using an automatic blood pressure sensor with the detector of hand position in a quiet, comfortable environment. Depending on the systolic arterial blood pressure level on the left arm, subjects were distributed to 5 groups: the 1st - blood pressure of 99 mm Hg and lower; 2nd - 100-119; 3rd - 120-129; 4th - 130-139; 5th -140 and over. Each group were further subdivided to 3 subgroups depending on the inter-arm blood pressure level asymmetry (difference of blood pressure levels on both arms): 1st - symmetry, 2nd - acceptable asymmetry (not exceeding 15 mm Hg), 3rd - abnormal asymmetry (16 mm Hg and over). Results. The major part of the examined subjects had systolic arterial blood pressure level between 100 and 119 mm Hg, systolic blood pressure below 99 mm Hg was registered more rarely. Among 580 examined subjects, abnormal asymmetry was more frequently seen in patients with blood pressure below 99 mm Hg and exceeding 140 mm Hg, the lowest frewuency was in the group with blood pressure between 120 and 129 mm Hg. The right arm was the dominating arm for the asymmetry in subjects with blood pressure below 119 mm Hg, in other cases the dominating arm was not determined. Conclusion. The study demonstrates the presence of vascular inter-arm asymmetry in systolic blood pressure in individuals who perceive themselves as healthy. Inter-arm asymmetry depended on the level of systolic arterial blood pressure.
Prognostic value of serum erythropoietin in the correction of anemia using recombinant erythropoietin drugs in patients with lymphoproliferative diseases
Authors: Romanenko N A , Berkos M V , Bessmeltsev S S , Potikhonova N A , Abdulkadyrov K M
Published: November 2019

Aim. To evaluate the prognostic significance of the baseline content of endogenous erythropoietin in the blood serum of patients with lymphoproliferative diseases while using recombinant erythropoietin drugs to correct the anemia. Methods. 69 patients with lymphoproliferative disorders (chronic lymphocytic leukemia, indolent forms of non-Hodgkins lymphoma and multiple myeloma) in combination with anemia, ages from 24 to 81 years, were under our observation. Treatment with recombinant erythropoietin was performed in the first group (48 patients), the second (control) group consisted of 21 patients without treatment with recombinant erythropoietin. In all patients the hemoglobin concentration was reduced to 37-100 g/l. Results. A positive response to treatment with recombinant erythropoietin for 6-16 weeks was noted in 30 out of 48 patients treated with epoetin alfa (62.5%, p 0.05). The monthly increase in hemoglobin level was 19.1±14.4 g/l, while in patients who were not responding to therapy - 2.1±4.3 g/l. In the control group of patients not receiving recombinant erythropoietin drugs the monthly increase in hemoglobin level was 2.0±4.4 g/l, which is the same as in the group who did not respond to recombinant erythropoietin and is significantly lower (p 0.01), than in patients with a positive response. In the control group, the increase in hemoglobin level 20 g/l during 20 weeks was observed only in 5 of 21 (23.4%) patients. A reduced level of endogenous erythropoietin was detected in 28 (58.3%) patients, while increased and correlating with the severity of anemia was detected in 20 (41.7%) patients. An inverse correlation was established between the positive response to treatment with recombinant erythropoietin and the baseline endogenous erythropoietin (r=-0.36, n=48, p 0,05). The positive effect of epoetin alfa was observed more frequently in patients with low serum erythropoietin level [22 of 28 (78.6%) patients responded, p 0.01], than in patients with high erythropoietin level [only 8 out of 20 (40%) patients responded to treatment, p 0.05]. Conclusion. Low concentration of endogenous erythropoietin suggests a positive response to recombinant erythropoietin products and can therefore be used as one of the predictors of response; in cases of high (above 500 mIU/ml) levels of endogenous erythropoietin the response occurs very rarely; an intermediate level of erythropoietin (130-500 mIU/ml) may also be justified for the administration of recombinant erythropoietin.
Treatment of patients with primary open angle glaucoma with the use of myotherapy
Authors: Korobitsin A N
Published: November 2019

Aim. To evaluate the effectiveness of myotherapy, which is conducted to stabilize the glaucoma optic neuropathy in patients with primary open-angle glaucoma. Methods. Treatment with the use of myotherapy was performed in 50 patients (94 eyes) with open-angle glaucoma of the I-II stage with decompensation of intraocular pressure b-c, at the age of 45 to 67 years. The control group consisted of 50 patients (100 eyes) with similar stages of glaucoma, at the age of 47 to 60 years who were treated with vascular drugs. The complex ophthalmologic examination included visometry, auto-refractometry, biomicroscopy, gonioscopy, direct ophthalmoscopy with medical mydriasis, the Heidelberg retinal tomography of the optic disc, computer static perimetry, 24-hour tonometry, tonography, Doppler ultrasound. Repeated complex examination of all patients was performed 6-12 months after treatment. Results. In the first group stabilization of the visual function and morphological parameters of the optic nerve disc was registered in 19.1% of cases (18 eyes), a positive dynamic was registered in 74.4% of cases (70 eyes). In the second (control) group stabilization was achieved in 16% of cases (16 eyes), a positive dynamic was achieved only in 8% of cases (8 eyes), while a negative dynamic was noted in 76% of cases (76 eyes) compared with 6.4% in the first group. Conclusion. Treatment of the reflex spasm of the ciliary muscle after removal of the muscle blocks of the upper cervical spine leads to stabilization of the visual function, morphological parameters of the optic nerve and visual field expansion due to restoration of the hydrodynamic parameters as well as the cerebral and regional hemodynamics of the eye.
Results of complex treatment of patients with knee osteoarthritis and varicose diseases of the lower extremities
Authors: Shcheglov E A
Published: November 2019

Aim. To evaluate the results of complex treatment with application of methods of correction of chronic venous insufficiency in patients with osteoarthritis of the knee joints in combination with varicose disease of the lower extremities. Methods. Examination of a cardio-vascular surgeon, orthopedist or rheumatologist, triplex scanning the veins of the lower extremities, arthrosonography and X-ray imaging of the knee joints, assessment of the severity of chronic venous insufficiency according to a CEAP scale [Clinical signs, Etiologic classification, Anatomic distribution, Pathophysiologic Dysfunction (1984)], and the degree of gonarthrosis according to the special Leken’s index and WOMAC index (Western Ontario and McMaster Universities Arthritis Index). The investigations were performed before treatment and repeatedly during the year in the course of treatment. According to the indications both conservative therapy and surgical treatment were used. Results. As a result of the complex treatment of patients achieved was a reduction in the severity of symptoms of gonarthrosis, which manifested with a decrease in the total value of the Leken’s index and the WOMAC functional index. Positive results were obtained in the group of patients who underwent surgery, and in the group of patients who received conservative treatment. Conclusion. Inclusion in the treatment of the methods aimed at eliminating manifestations of chronic venous insufficiency leads to improved results of treatment of osteoarthritis of the knee joints.
Small cell lung cancer: effectiveness of different treatment regimens, long-term results and prognosis
Authors: Ramazanova M S , Kislichko A G
Published: November 2019

Aim. To evaluate the efficacy and safety of different treatment regimens of patients with small cell lung cancer. Methods. Examined were 76 patients, 17 (22.4%) females and 59 (77.6%) males, mean age 62±4.87 years, divided into two groups. The first group consisted of 46 (60.5%) individuals with a generalized form of the disease, the second group consisted of 30 (39.5%) patients with localized cancer. Results. In patients with a localized form of lung cancer the most effective treatment method was a combination of surgical treatment with chemotherapy. In this group in the near-term period noted was a complete regression of the disease, while in the long-term period - a statistically significant improvement of 2- and 3-year survival compared with patients receiving chemotherapy alone. In patients with a generalized form of small cell lung cancer the best immediate and long-term results were observed after chemoradiotherapy compared with chemotherapy alone, which was reflected in statistically significant improvement of parameters of partial remission and stabilization of the disease, as well as improved 1- and 2-year survival. Conclusion. The use of chemotherapy in combination with surgical treatment for localized forms and chemoradiotherapy for generalized forms of small cell lung cancer is characterized by higher indices of treatment efficacy compared to administration of just chemoradiotherapy or chemotherapy, respectively.
Diagnosis and perfection of the complex treatment of patients with neuromuscular dysfunction syndrome of the temporomandibular joints
Authors: Sidorenko A N
Published: November 2019

Aim. To improve the complex treatment of patients with neuromuscular dysfunction syndrome of the temporomandibular joints. Methods. Clinical examination, electromyography of masticatory muscles, computed tomography in 24 patients (main group) with a neuromuscular dysfunction syndrome of the temporomandibular joints. The control group included 10 healthy individuals aged 18 to 32 years with intact tooth rows, orthognatic bite, and without pathology of the temporomandibular joints. In cases of deviation of the mandible at the time of opening the mouth in 7 (29.2%) patients the complex of therapeutic measures included a myo-gymnastic exercise, which consisted of shifting the mandible with the palm of the hand towards the opposite side of the deviation. During zigzag movements of the mandible in 12 (50%) patients assigned was myo-gymnastic exercise, aimed at keeping the lower jaw with the palms of both hands in the sagittal plane during a vertical opening of the mouth. In 5 (20.8%) patients with a small limitation of mouth opening and lateral displacement of the mandible myo-gymnastics were used that included exercises designed to stretch and cause reflex relaxation of the masticatory muscles, as well as the displacement of the mandible in the palm of the hand to the side opposite to its deviation. All patients from the start of treatment were prescribed a course (10 sessions) of therapeutic massage of the masticatory muscles and 10 sessions of transcranial electrostimulation in 8 (33.3%) patients to relax the chewing muscles in its hypertonicity, to relieve spasm of the lateral pterygoid muscle, and removal the significant pain syndrome. Results. By the 5-6th session of transcranial electrostimulation the pain and tension in the masticatory muscles on the affected side with neuromuscular dysfunction disappeared, the range of motion of the mandible was restored, atypical movement of the mandible stopped. Examination of 24 patients at 2 years after treatment showed that 22 patients had a sustained, positive result, no complaints or recurrences were observed. In 2 patients after treatment noted was significant tension in the masticatory muscles, they were re-appointed for transcranial electrostimulation. Conclusion. Developed and proposed was an improved method of complex treatment of patients with neuromuscular dysfunction syndrome of the temporomandibular joints without the use of drugs, which has shown high effectiveness.
Evaluation of the effectiveness of personality-oriented educational programs for rehabilitation of young patients with chronic non-calculous cholecystitis
Authors: Khismatullina G Ya , Ulyamaeva V V , Volevach L V , Bashirova E S
Published: November 2019

Aim. To study the effectiveness of personality-oriented educational program in the rehabilitation of young patients with chronic non-calculous cholecystitis. Methods. Examined were 64 people aged 18 to 35 years with a diagnosis of «chronic non-calculous cholecystitis in the remission phase». Conducted was a comprehensive examination and a clinico-psychological evaluation of the levels of personal and reactive anxiety, according to the method of Spielberger-Hanin, psychological diagnosis of types of attitudes to the disease, assessment of the quality of life according to the «ESADA» (Evaluation of the Situation of Adaptation, DysAdaptation). All patients participated in the educational personality-oriented program, which included individual counseling, coming up with a treatment and rehabilitation plan, visiting the «gastro-school». Results. As a result of educating of 64 patients the number of people with high levels of reactive anxiety decreased from 5 (7.8%) to 2 (3.1%), with a moderate level - from 27 (42.2%) to 21 (32.8%) and the number of individuals with low levels of anxiety increased from 32 (50.0%) to 41 (64.1%). The proportion of patients with high levels of personal anxiety decreased significantly: from 57.8 to 29.7% (p 0.001). Noted was an increase in the number of people with moderate and low levels of anxiety: from 32.8 to 43.8% and from 9.8 to 26.6%, respectively (p 0.001). The number of individuals with the type of attitude to the disease of the first block increased, with a clear trend towards an increase in patients with an ergopathic type attitude to the disease by the end of classes: from 6.3 to 25.0% (p 0.001). Among the type of attitide to the disease of the second block the largest positive trend was registered among individuals with anxious (from 23.4 to 12.5%) and hypochondriacal (from 43.8 to 29.7%) types. Before training only 9 (14.1%) patients were compliant with guidelines on therapeutic nutrition, 19 (29.7%) patients maintained the diet, but not on a regular basis; and after the training 41 (64.4%) individuals started maintaining the diet, 23 (35.9%) people - not on a regular basis. Prior to the training 7 (10.9%) patients had regular physical exercise, 18 (28.1%) - occasional physical exercise; upon completion of the training 18 (28.1%) patients engaged in regular physical exercise, 39 (60.9%) - in occasional physical exercise. 4 (6.3%) patients were able to «cope with the stress» prior to training, and 34 (53.1%) patients - upon completion of training. Conclusion. The developed personality-oriented educational program for patients with diseases of the biliary system has proven its effectiveness: the features of the psycho-emotional area have improved, favorable healthy lifestyles habits have developed.
Features of social adaptability and autonomic stability of adolescents with metabolic syndrome
Authors: Chervinskikh T A , Kolesnikova M B , Naymushina E S , Zhuikova G V
Published: November 2019

Aim. To identify the features of social adaptability and autonomic stability of adolescents with metabolic syndrome. Methods. The parameters of social adaptation and autonomic stability of 300 obese adolescents were studied. The main group included 150 adolescents (mean age 14.0±0.12 years) who were diagnosed with metabolic syndrome. The comparison group consisted of 150 adolescents (mean age 13.9±0.14 years) with primary uncomplicated obesity. A two-factor personality questionnaire of M. Gavlinova («society - autonomic nervous system») was used. Anthropometric indices (body weight, body mass index, height, waist circumference, hip circumference, waist/hip circumference ratio) were evaluated, the blood pressure was measured. General and biochemical blood tests and urine tests were performed (determination of the level of glucose, insulin, triglycerides, cholesterol, lipoproteins of high and low density, uric acid), as well as instrumental investigations. Results. In the group of adolescents with metabolic syndrome the mean body mass index 29.21±0.37 was significantly higher (p 0.001) compared to 26.07±0.46 in the group of patients with uncomplicated obesity. The waist/hip circumference ratio was significantly higher in adolescents with metabolic syndrome: 0.89±0.41 vs. 0.80±0.12 in the control group. In 92.71% of adolescents with metabolic syndrome arterial hypertension was diagnosed. In adolescents of the first group found were and laboratory markers of the metabolic syndrome: dyslipidemia in the form of hypertriglyceridemia (2.04±0.08 mmol/l) and decrease of the concentration of high-density lipoproteins (1.1±0.04 mmol/l). The average fasting blood glucose level was 5.78±0.02 mmol/l, the index of the model of homeostasis assessment for insulin resistance was 6.64±0.21. In the group of adolescents with metabolic syndrome the average score on the scale of social adaptation was low (8.48±0.13), whereas in the group without metabolic syndrome it was 13.51±0.22, which was significantly higher than in the main group (p 0.001), and was evidence of normal social adaptation. Low level of social adaptation was observed more frequently in girls than boys in both groups. Established was a correlation between the body mass index and social adaptability (r=-0.358), and with autonomic stability (r=0.378), p 0.05. Conclusion. Social adaptability and autonomic stability of adolescents with metabolic syndrome depend on the severity of clinical and metabolic changes and on the sex, thus this must be taken into account during treatment and rehabilitation.