bluuebunny/crossref_metadata_2025 huggingface dataset:
To the question of the population health assessment methodology
Authors: Artyukhov I P , Medvedeva N N , Nikolaev V G , Sindeeva L V , Nikolaeva N N
Published: November 2019

Aim. To develop a methodology for individual, group, regional and population health estimation. Methods. Offered methodology includes physical health assessment and assessment of morphologic and functional condition of organ systems in a healthy human. Physical health assessment was performed in 808 young males aged 17-21 years in the city of Krasnoyarsk. Anthropometry, body mass index calculation, Tanner maturation index, ageing speed coefficient calculation by B.B. Gorelkin and A.G. Pinhasov, bioelectrical impedance analysis and statistical analysis were performed. Results. Youth males had a height of 176.87±0.26 sm, body weight of 69.23±0.45 kg. According to calculated body mass index, healthy weight was found in 71.41% males, 12.75% were overweight, 3.96% were obese, 11.88% were underweight. Shoulders and pelvis diameters were assessed as 37.01±0,11 and 27.72±0.09 sm respectively. Tanner maturation index calculation has shown that 54.83±1.20% males were andromorphous, the others had different types of gender inversions: 18.69±0.94% were hynecomorphous, 26.49±1.07% were mesomorphous. Ageing speed coefficient calculation has revealed the discrepancy of calendar and biologic age (the latter was higher) in all hynecomorphous young males, meaning that hynecomorphism can be estimated as a predictor of early ageing and can be used in complex health assessment. The core of the offered methodology for population health estimation is the health assessment on all stages of ontogenesis, including all levels from organism to molecular, that would allow to develop the standards for health assessment and assessment of morphologic and functional condition of organ systems. Conclusion. The listed methods would allow to estimate organism’s morphologic and functional condition, and revealed physical development abnormalities would allow to correct them timely before the clinical onset of any diseases.
Results of the targeted program «Social support for providing access to prosthetic dentistry for certain citizen categories of the Republic of Вashkortostan» evaluation
Authors: Bulgakova A I , Dumeev R M , Islamova D M , Aznagulov A A
Published: November 2019

Aim. Тo study the oral health among the poor citizens and the implementation of the program of preferential prosthetic dentistry in the Republic of Bashkortostan. Methods. The study involved 80 patients with prosthetic dentistry in the past who were asked to complete a survey questionnaire and underwent clinical examination. Statistical processing was performed using Microsoft Excel and Statistica 6.0 software. Results. Secondary partial adentia prevailed in poor, reaching 83.75%, with secondary complete adentia reaching 16.25%. The average age of patients was 63.4 years: female patients - 64.66 years, male patients - 67.25 years. 100% of patients had concomitant somatic diseases, with most of the patients having 2-3 comorbidities. Among concomitant conditions, musculoskeletal diseases were observed in 71% of cases, cardiovascular diseases - in 50% of cases, endocrine diseases - in 35% of cases. 86.25% of patients named financial strait as the main cause of a late visit to a dentist, the remaining 13.75% indicated a lack of time, poor health and unwillingness to care for themselves as the reason. Conclusion. Low-income patients need further support in preferential dentistry and oral health examination.
The experience of treating locally advanced metastatic renal cell carcinoma with inoperable metastases to retroperitoneal lymph nodes
Authors: Akhmetzyanov F S , Idrisov M N
Published: November 2019

Aim. To list and review the combined treatment options in patients with locally advanced metastatic renal cell carcinoma with inoperable metastases to retroperitoneal lymph nodes based on the results of diagnosis and treatment of two patients. Methods. Patients underwent primary tumor resection with further immunotherapy in first case and further immunoradiotherapy in second case. Results. The results of locally advanced metastatic renal cell carcinoma successful treatment are presented. Patient U., aged 73 years was admitted to the oncology department with Karnofsky performance-status score of 50-60 points. The diagnosis of right kidney cancer was set up in 2008, but the patient has refused surgery. At the end of 2011 after general status worsening she was hospitalized for planned surgery. Upper and medium midline laparotomy was performed using the general anesthesia. Enlarged right kidney in retroperitoneum and a batch of paraaortic and paracaval metastatic lymph nodes 13-15 cm in diameter were found at revision, right kidney was substituted by tumor tissue with areas of normal kidney parenchyma at the upper kidney pole, the tumor diameter was 10 cm. Renal artery and vein were gradually separated out of lymph nodes batch with a lot of technical difficulties and stitched and tied up. The specimen was removed as a whole together with paranephric tissues. Post-surgical treatment was complicated by an endogenous intoxication. Immunotherapy with intramuscular oxodihydroacridinylacetate sodium 500 mg every 48 hours i/m could only be started in a month after the surgery. Nowadays the patient is alive and continuing the treatment with oxodihydroacridinylacetate sodium, that induced the clinical improvement and reduced the size of the rest of the affected lymph nodes. Patient K. aged 50 years was admitted by ambulance with the same diagnosis as the first patient, and was treated using the same principles with an addition of radiotherapy. The overall patient’s condition improved after the treatment, there was a reduction of low back pain intensity and reduction of paraaortic and paracaval metastatic lymph nodes aggregate on palpation. Conclusion. Primary tumor resection in presence of inoperable metastatic retroperitoneal lymph nodes with further immunotherapy and radiotherapy can lead to clinical improvement and increase of the patient’s life duration.
Orthoses in diabetic foot treatment and prevention
Authors: Klyushkin I V , Koreyba K A
Published: November 2019

Aim. To define the role of orthoses in the treatment and rehabilitation of patients with diabetic foot syndrome. Methods. The review of the literature addressing the use of special orthopedic shoes in the treatment and rehabilitation of patients with complicated diabetes mellitus was performed. Results. The common requirements for orthopedic shoes for patients with complicated diabetes mellitus are the following: (1) rigid sole with an artificial curvature; (2) boot-tree elevated by 8 mm due to arch supporter, adequate volume, wide sole, removable insole; (3) insole without functional memory; (4) thermally variable elastic material, advisably with silver ions, for the lining; (5) minimal number of sutures at the lining; (6) no elastic material at the front of the shoe and at the lining at the toes; (7) increased volume and enough space for the toes; (8) front slant of 15°; (9) potential ability to adjust the inner volume of the shoe; (10) hard counter - stabilizing hard back with additional softening at the lining side; (11) heel with a front slant or a solid sole without a heel; (12) smooth non-traumatic surface suitable for scrubbing including cleansing with antiseptics. The indications for orthopedic relief in patients with diabetic foot syndrome are explained. Economic superiority of organ-preserving approaches in such patients is shown. There is an opposition for conservative methods of treatment of patients with diabetic foot syndrome, nevertheless, an amputation can not be estimated as a positive treatment outcome in such patients. Almost 70-90% of ulcers in this group of patients are healed without amputation. Limb-saving treatment and the use of specially selected shoes are cheaper and more cost-effective compared to the limb loss. Conclusion. The use of orthopedic shoes in patients with diabetic foot syndrome is used both for treatment and rehabilitation. This technique can reduce the risk of ulceration and prevent organ-sparing surgeries.
Behçet’s disease in clinical practice
Authors: Khamitov R F , Palmova L Y , Yakupova Z N , Khasanova E R
Published: November 2019

Behçet’s disease is a chronic relapsing multisystemic vasculitis involving vessels of different diameter. The disease is characterized by involvement of skin and mucosa, eyes, gastrointestinal tract, joints, vessels, genitourinary system and neurological symptoms. According to data, male/female ratio is 2-10:1 The etiology of the disease is still unclear. Diagnosis is mainly based on thorough analysis of clinical manifestations. According to the International Study Group for Behçet’s Disease Diagnostic Criteria, combination of recurrent oral aphthosis and at least any two of the following: severe or scarring genital aphthosis, eye lesions (posterior uveitis, retinal vasculitis), skin lesions (nodular erythema, pseudofolliculitis, acne-like lesions) and positive pathergy test is needed to classify the patient as a patient with Behçet’s disease. Several clinical subtypes of Behçet’s disease are distinguished depending on predominant involvement of different organs and systems, including skin and mucosa, joints, eyes, or neurological manifestations. There are no specific laboratory tests for Behçet’s disease. The treatment approaches are variable depending on clinical manifestations. The effect of systemic corticosteroids, colchicine, azathioprine, chlorambucil, cyclophosphamide, sulfasalazine, methotrexate, cyclosporine, infliximab was proven. All the abovementioned requires the good clinical knowledge on Behçet’s disease from practicing doctors of different specialties, particularly - physicians. A case of highly active acute Behçet’s disease with nose, pharynx, eye and oral cavity mucosa, scrotum skin involvement is presented in the article. Questions of differential diagnosis are reviewed, specific treatment program with efficacy analysis is presented.
Anxiolytic effect of 2-oxyindolin-3-glyoxylic acid derivatives: computer prediction and experimental confirmation
Authors: Lutsenko R V , Bobyrev V N , Devyatkina T A
Published: November 2019

Aim. To complete the computer prediction of possible spectrum of biological activity of simple amides of 2-oxyindolin-3-glyoxylic acid derivatives and to test their anxiolytic activity in experiment. Methods. The prediction of possible spectrum of biological activity of simple amides of 2-oxyindolin-3-glyoxylic acid derivatives was performed using PASS (Prediction of Activity Spectra for Substances) software. The experimental part was performed on 140 adult rats of both sexes. Animals were distributed to subgroups (n=10 in each subgroup) according to age and gender. Experimental screening for anxiolytic action was performed using the Vogel’s «conflict situation» method. Results. 12 compounds highly potential for anxiolytic activity were selected after the computer prediction. Glutamate, serotonin, aspartate receptors blockade, gamma-aminobutyric acid (GABA)-receptors stimulation and depression of GABA-aminotransferase were in the list of possible mechanisms of action. Along with anxiolytic activity anticonvulsive, antipsychotic, antihypoxic and hypnotic effects were predicted. During the Vogel’s «conflict situation» test, 2-Hydro-N-naphthalen-1-yl-2-(2-oxo-1,2-dihydro-indol-3-ylidene)-acetamide, 2-Hydro-2-(2-oxo-1,2-dihydro-indol-3-ylidene)-N-phenyl-acetamide and N-[(2-Oxo-1,2-dihydro-indol-3-ylidene)-phenethylcarbamoyl-methyl]-benzamide had significantly decreased the latent time for taking water from drinking place. At the same time, 2-Hydro-N-naphthalen-1-yl-2-(2-oxo-1,2-dihydro-indol-3-ylidene)-acetamide, 2-Hydro-2-(2-oxo-1,2-dihydro-indol-3-ylidene)-N-phenyl-acetamide, N-[(2-Oxo-1,2-dihydro-indol-3-ylidene)-phenethylcarbamoyl-methyl]-benzamide and 3-Hydroxy-3-(2-oxo-cyclohexylmethyl)-1-piperidin-1-ylmethyl-1,3-dihydro-indol-2-one compounds had significantly increased the number of punished attempts for getting water, assuming anxiolytic activity. Among 2-oxyindolin simple amides derivatives 2-Hydro-N-naphthalen-1-yl-2-(2-oxo-1,2-dihydro-indol-3-ylidene)-acetamide had the strongest anxiolytic effect in test with punished behavior. Conclusion. Computer prediction of 2-oxyindolin-3-glyoxylic acid derivatives anxiolytic effect was confirmed experimentally.
Sexual activity significance for male gender self-identity after surviving myocardial infarction
Authors: Winter V L , Alekseev B E
Published: November 2019

Aim. To study the influence of sexual activity for male gender self-identity in patients after surviving myocardial infarction. Methods. Original Clinical Structured Interview, «Gender Differential», «The Hospital Anxiety and Depression Scale» (HADS), «The Method for Diagnosing the Types of the attitude to an Illness» were used as the research methods. The study included 130 in-patients (mean age 53.5±7.09 years) who were undergoing rehabilitation for survived myocardial infarction in the department of cardiologic rehabilitation of the Municipal clinic №40 of Kurortny administrative district of Saint-Petersburg, Russia. A model of short-term psycho-corrective program for sexual rehabilitation for male patients who survived myocardial infarction was developed. The effectiveness of the program was estimated by a comparison of results in experimental (30 patients) and control (30 patients in whom sexual aspects were not incorporated in rehabilitation) groups. Results. At structured interview, over a half of all subjects (62.2%) highly estimated the importance of sexual relations, considering them as an essential part of life and a delight. The large majority of the questioned patients (76.9%) reported the desire for renewing sexual activity after the disease. Psychosexual characteristics for male patients, who survived myocardial infarction, were: predominance of male identity (75.4%) and particular features of relation to own sexual activity after the disease, manifesting as a decrease of gender self-satisfaction (53.8%). Addition of psycho-correction program of the sexual rehabilitation to the conventional treatment of male patients who survived myocardial infarction contributed to the positive results observed in the experimental group. Conclusion. Rehabilitation of patients after myocardial infarction requires new approaches, including those considering aspects of sexual rehabilitation; classes for better restoring of sexual activity, being added to conventional program of rehabilitation, increased the number of persons with balanced attitude to disease.
Cardiac masses due to tumors (diagnosis, clinical manifestations and surgical treatment)
Authors: Kranin D L
Published: November 2019

Aim. To summarize the experience on the diagnosis and surgical treatment of primary benign and malignant cardiac tumors. Methods. The paper describes 37 clinical observations of endocavitary primary benign and malignant cardiac tumors: 26 (70.3%) cases of cardiac myxoma, 5 (13.5%) - rhabdomyosarcoma, 2 (5.4%) - angiosarcoma, 1 (2.7% ) - leiomyosarcoma, 1 (2.7%) - fibrosarcoma, 1 (2.7%) - liposarcoma. Patients were 15 (40.5%) males and 22 (59.5%) females aged 18 to 65 years. Endocavitary cardiac tumors were diagnosed by noninvasive tests: echocardiography, computed tomography, magnetic resonance imaging. Results. Patients with primary benign and malignant cardiac tumors had variable clinical manifestations. Symptoms of astenoneurotic syndrome, auscultatory and cardiophonographic signs simulating acquired or congenital valvular heart diseases, which often have a positional relationship; low-grade fever of unknown origin, weight loss were registered. Paraneoplastic syndrome was characterized by an increase in erythrocyte sedimentation rate, leukocytosis, monocytosis, dysproteinemia, polycythemia, hypochromic anemia, increased levels of C-reactive protein. Surgical excision of 25 cardiac myxomas and 8 malignant tumors of the heart was performed with cardiopulmonary bypass, pharmacological cardioplegia and general hypothermia. In 1 case the tumor resection was combined with coronary artery bypass grafting. In 3 patients suffering from malignant tumors, explorative thoracotomy was performed. Surgical revision, emergency and planned microscopic studies of removed cardiac tumors allowed to establish the final clinical diagnosis. Hospital mortality among patients operated for cardiac myxomas was 4.0%, for cardiac malignant tumors - 27.3%. Conclusion. Timely surgical treatment of patients with primary cardiac benign tumors (myxomas) leads to recovery and is accompanied by a relatively low mortality; better results of patients with cardiac endocavitary tumors treatment depend on the early detection and timely radical surgical excision.
Diagnosis and surgical treatment of heart valve non-mixoma tumors
Authors: Kiprenskiy A Yu , Nechayenko M A , Kuznetsova L M , Fyodorov D N
Published: November 2019

Aim. To study the clinical, diagnostic, surgical and morphological features of non-mixoma primary tumors of the heart valves, the possibilities of their early diagnosis and to develop an optimal surgical approach. Methods. The surgical treatment of 331 patients with tumors of the heart was analysed, of which 45 (13.6%) were radically distant primary tumors of the heart valves including 33 (73.3%) myxoma and 12 (26.7%) non-myxoma tumors. Among considered in this study 12 non-myxoma tumors 9 cases were papillary fibroelastoma, 1 - neurolemmoma, 1 - lipoma, 1 - fibroma. Results. The leading non-invasive preoperative diagnostic procedures for non-myxoma primary tumors of the heart valves were transthoracic and transoesophageal echocardiographic studies, the sensitivity of which were 91.7 and 100% respectively. In unclear cases, a computer and magnetic resonance imaging were used. Additionally, electrocardiography, phonocardiography, radiological methods were performed, clinical and biochemical blood tests were analysed. Intraoperative revision and morphological verification ensures the establishment of tumors final clinical diagnosis. Patients with non-myxoma tumors of the heart valves had polymorphic symptomatic picture which included circulatory failure, false angina, arrhythmias, clinical signs imitating heart defects, embolic syndrome, dizziness and/or syncope, causeless fever. Surgical removal of the 12 non-myxoma tumor was performed by cardiopulmonary bypass and pharmacological cold cardioplegia, in 4 cases, the intervention combined with the replacement of the affected valves by artificial prostheses, in 1 case - coronary artery bypass grafting. Hospital mortality of patients was zero. Quality of life of operated patients was rated as good in 9 (75%) patients, satisfactory - in 2 (16.7%), unsatisfactory - in 1 (8.3%) patients, which was due to the death of the patient 13 months after removal of neurolemmoma in connection with multiple metastasis in the brain and spinal cord. Conclusion. Timely surgical intervention helped to stabilize the functional state of the patients, to create a favorable prognosis to improve the quality of life and increase its length.
Treatment of chronic urogenital infection in woman using the methods of extracorporeal blood correction
Authors: Gevorkyan L S , Gorin V S , Bogun O G , Dzyubinskaya E S
Published: November 2019

Aim. To study of the effectiveness of treatment of patients with chronic urogenital infection by antibiotic therapy and extracorporeal immunotherapy. Methods. Clinical, microbiological, immunological and statistical methods were used. The main group consisted of 70 women with chronic urogenital infection previously treated with conventional treatment. Women received the extracorporeal antibiotic therapy and immunotherapy using moxifloxacin and metronidazole in combination with local therapy - suppositories with chlorhexidine, metronidazole and miconazole. For antibiotic and extracorporeal immunotherapy selected leukocyte cell suspension was incubated with an antibiotic and was stimulated by leukinferon and then was returned to the patient. In a control group patients received conventional drug treatments, ornidazole administered in conjunction with local therapy. When mixed infection was diagnosed josamycin additionally was administered. The diagnosis was verified by means of the polymerase chain reaction, bacteriological and microscopic methods. Results. The main complaints of the patients were excreta from the genital tract, itching, burning. The results of treatment were evaluated at 2 weeks, 1 and 2 months. After 2 weeks, in the main group more rapid regression of clinical manifestations and the improvement of the general state were registered, in the control group the symptoms persisted in more than 50% of women. After one month there were no complaints in the main group, while in the control group, the symptoms persisted in 30% of patients. After 2 months, patients of the main group had no complaints, but 0.4% had leukocytosis in the smear and marked growth of Trichomonas. In the control group excreta was maintained in 6.7%, positive culture on Trichomonas registered in 3.3% of patients. Conclusion. Our research indicates the clinical efficacy of extracorporeal antibiotic therapy and immunotherapy in the treatment of chronic urogenital infections compared with traditional methods, it promotes more rapid bacterial eradication and relief of the inflammatory process.
Peculiarities of cerebral blood flow in patients with chronic diffuse liver diseases of viral etiology
Authors: Morozova T S , Grishina I F , Gurikova I A
Published: November 2019

Aim. To study the features of cerebral blood flow at different structural and functional levels of the brain vascular system in patients with chronic hepatitis and cirrhosis of viral etiology. Methods. A comprehensive ultrasound examination of the brain vascular system using an algorithm of cerebral arterial and venous blood flow examination based on the concept of the brain vascular system construction considering five structural and functional levels was performed in 65 chronic viral hepatitis patients and 61 patients with liver cirrhosis of viral etiology. The examination of the main brain arteries was performed using duplex scanning ultrasound SSD-5500 scanner («Aloka», Japan) with 5-12 MHz linear transducers. Examination of intracranial vessels was performed by transcranial color duplex scanning using ultrasonic SSD-5500 and «Sonoline G60» scanners («Siemens», Germany) with linear and phased 2.1-2.5 MHz transducers. Control group consisted of 50 healthy persons. Results. Remodeling of the cerebral arteries: the expansion of the lumen of the main cerebral vessels, reduction of blood flow in the carotid and middle cerebral arteries, decreased elasticity and increased vascular wall rigidity and, as a consequence, a change in vascular resistance and cerebral blood flow disturbance occurs in patients with chronic viral liver diseases. Identified changes of blood flow parameters at all levels of structural and functional brain perfusion indicate the presence of cerebral microangiopathy and arteriopathy based on the development of arteriosclerosis of main arteries and all penetrating arteries and arterioles in patients with chronic diffuse liver diseases. Conclusion. Adaptive remodeling of the vascular wall of the main cerebral arteries which provides an adequate regulatory response is found in patients with hepatitis B and C-associated liver cirrhosis. The reduction of blood supply to the brain, depletion of functional vascular reserve and development of intracranial venous circulatory distress are seen in patients with liver cirrhosis associated with viral hepatitis.
Indicators of primary disability due to musculoskeletal and connective tissue diseases in Russian Federation and Volga federal district in 2011-2013
Authors: Chikinova L N , Boltenko Zh V
Published: November 2019

Aim. To distinguish the regularities for primary disability occurrence due to musculoskeletal and connective tissue diseases in Russian Federation and Volga Federal District in 2011-2013. Methods. Data copying, comparative analysis of indicators of primary disability due to musculoskeletal and connective tissue diseases in Russian Federation, and federal districts ranking by level of disability due to musculoskeletal and connective tissue diseases in 2011-2013 were performed. Results. Central Federal District of Russian Federation had a high level of primary disability due musculoskeletal and connective tissue diseases registered in 2011-2013. Southern, North-Caucasian and Volga Federal Districts had low levels of disability due to the same diseases. Among the subjects of the Russian Federation included in the Volga Federal District, high levels of primary disability due to musculoskeletal and connective tissue diseases in 2011-2013 were registered in the Kirov region (17.1-15.3-11.1 per 10 000 of the adult population), low levels of primary disability - in the Saratov region (4.1-3.4-3.5 per 10 000 of the adult population). Conclusion. The trend for reducing the primary disability in the Volga Federal District in 2011-2013 (6.6-6.3-5.9 per 10 000 of the adult population) indicates the success of regional rehabilitation programs for persons with disabilities.
Role of connective tissue dysplasia in obstetrics and gynecology
Authors: Gasparov A S , Dubinskaya E D , Babicheva I A , Lapteva N V , Dorfman M F
Published: November 2019

A review of literature on the problem of connective tissue dysplasia in obstetric and gynecological practice is presented. The questions of terminology, classification, clinical manifestations and diagnosis are surveyed. Currently, many experts note the change of the classical clinical course of a significant number of internal diseases, increased prevalence of allergic and autoimmune diseases. Since the 90s of the last century, connective tissue dysplasia is considered one of the main reasons of the above mentioned conditions. Connective tissue dysplasia is the malformation, which is the basis of a significant number of internal diseases, with diverse symptoms and no clear diagnostic criteria. Researches on connective tissue dysplasia are mainly focused on cardiologic and pulmonary diseases, musculoskeletal diseases, and autoimmune processes. Researches addressing connective tissue diseases in a number of gynecological diseases and conditions in obstetrics appeared only recently. The presence of connective tissue dysplasia in women is a major problem in obstetrics and gynecology. Most reliable biochemical and molecular genetic studies are currently unavailable to a practicing doctor due to technical difficulties and considerable cost. So clinical-genealogical method of examination of patients and their families, as well as the widespread use of instrumental diagnostic methods are of special importance. Obstetricians and gynecologists while managing such patients should pay close attention to the phenotypic features of connective tissue dysplasia and carefully evaluate the cardiovascular and pulmonary systems, blood coagulation to avoid possible serious, often life-threatening, complications.
Peculiarities of HIV-positive patients coinfection with hepatitis C virus
Authors: Pavlov D V , Shakirova D Kh , Galiullin N I , Nagimova F I
Published: November 2019

The review of publications on human immunodeficiency virus (HIV) «satellite» infections - hepatitis B and C was made. 1329 articles published in the last 10 years concerning the problem of HIV and hepatitis B and C co-infection were found in PubMed database. The problem of viral hepatitis in HIV-infected patients remains extremely relevant nowadays. Results of numerous European studies indicate that chronic hepatitis C is ranked fifth in the list of death causes of HIV-infected patients. Most researchers agree on a more severe course of chronic hepatitis C in HIV-infected patients. Viral hepatitis is found in 7 out of 10 HIV-infected patients. The problem of antiretroviral drugs hepatotoxicity is still not resolved. Hepatitis C viral load is generally higher in HIV-infected patients than that of HIV-negative, and the probability of progression to cirrhosis, liver failure and hepatocellular carcinoma in HIV-infected patients is 3 times higher. So the problem of HIV and viral hepatitis co-infection requires a better understanding of co-infection treatment features, the definition of clear criteria for effectiveness and safety of therapy of HIV-infected patients co-infected with viral hepatitis B and C.
The clinical significance of acute phase proteins as inflammatory markers in infectious diseases
Authors: Dudina K R , Kutateladze M M , Znoiko O O , Bokova N O , Shutko S A , Filina L D , Ogarev V V , Yushchuk N D
Published: November 2019

The article reviews the clinical significance of measuring acute phase proteins (procalcitonin, C-reactive protein and neopterin) for differential diagnosis between bacterial and viral infections. The results of researches preformed at 1984 to 2014, which measured the levels of C-reactive protein, procalcitonin and neopterin in body biological fluids in infectious and non-infection diseases, are analyzed. Most frequently the clinician encounters a situation when it is necessary to differentiate the bacterial infection from other possible causes of increased body temperature, in particular, from viral infections. In some cases, the diagnosis of bacterial infection is possible only after the results of bacteriology, therefore, laboratory markers of bacterial infection, which would allow differentiating the causes of fever and minimizing the number of cases of unjustified antibiotic use, are actively sought out. Combined measuring of three acute inflammation markers was performed in patients with both infectious and non- infectious diseases. In was revealed that the levels of those blood markers correlate with the inflammation severity. Higher diagnostic value of simultaneous measurement of C-reactive protein, procalcitonin and neopterin, as well as the predictive value of procalcitonin and neopterin in monitoring the course of a number of diseases, was shown. Comprehensive analysis of the concentrations of the studied biomarkers in relation to clinical and microbiological data may help to identify patients at high risk of an unfavorable course of some diseases, allowing timely administration of all necessary treatments.
Trends for incidence of chronic hepatitis B monoinfection and chronic hepatitis B+D co-infection in the Kyrgyz Republic for the period of 2010-2012
Authors: Nogoybaeva K A , Tobokalova S T , Kasymbekova K T , Zairova G M
Published: November 2019

Aim. To assess the trends for the epidemiological situation of chronic hepatitis B monoinfection and chronic hepatitis B+D co-infection in the Kyrgyz Republic for the period of 2010-2012 for the development of anti-epidemic measures depending on the intensity of the process. Methods. The analysis of a database of national reporting forms on the treated cases of chronic viral hepatitis B monoinfection and chronic hepatitis B+D co-infection in primary health care units, cumulated by Republican Medical Information Center of the Ministry of Healthcare of the Kyrgyz Republic for the period of 2010-2012 was performed. Results. The incidence of chronic viral hepatitis D is identical to that of chronic viral hepatitis B (23 and 21 per 100 000 of population respectively) in the Kyrgyz Republic. Over the period of 2010-2012 the high level of total chronic hepatitis B incidence was reported in the northern part of the country (the Issyk-Kul region, 71 per 100 000, and chronic hepatitis D - in the southern part of the country (Osh, 62 per 100 000 of population). Statistically significant increase in the incidence of chronic hepatitis B in almost all regions of the country was recorded whereas only an upward trend was revealed in chronic hepatitis D incidence. Conclusion. Separate registration of patients with chronic viral hepatitis B and D in the Kyrgyz Republic starting from 2010 allowed evaluating the trends for the epidemiological situation of these diseases in different areas and developing preventive and anti-epidemic measures in regions of Kyrgyz Republic.
Clinical and pathogenetic aspects of the side effects of chronic viral hepatitis C alpha-interferon antiviral therapy
Authors: Aripkhodzhaeva G Z
Published: November 2019

Aim. To investigate the relation of prooxidant and antioxidant systems with adverse effects of antiviral alpha interferon treatment in chronic hepatitis C. Methods. The study included 67 patients with chronic hepatitis C aged 19 to 45 years [males - 28 (41.8%), females - 39 (58.2%)] who were receiving antiviral treatment. Prooxidant (diene ketones and diene conjugates, malon dialdehyde) and antioxidant (catalase, superoxide dismutase, glutathione and glutathione-dependent enzymes) systems indicators were measured. According to the severity of side effects, patients were distributed to two groups. The first group consisted of 19 (28.4%) patients with transient passing adverse effects, usually manifesting as short-term flu-like syndrome after the medication injection, lasting no longer than 2-3 weeks of treatment. The second group consisted of 48 patients (71.6%) with prolonged side effects, registered throughout the whole treatment period. Results: Flu-like syndrome with intense myalgia and asthenic syndrome were the most frequent side effects (89.5 and 83.3% of cases, respectively). Dyspepsia, psychopathy and arthralgia were less common (79.2, 72.9 and 68.7%, respectively). Over than a half of the patients lost weight (7-9 kg compared to baseline weight), and also had alopecia and autoimmune thyroiditis. Most of the patients could not tolerate the treatment, 33 (49.2%) patients aborted the treatment. In patients with long-term side effects, low baseline levels of glutathione reductase, glutathione peroxidase, glutathione transferase were revealed (p 0.05). Patients with long-term side effects of antiviral treatment preserved high levels (p 0.05) of diene ketones and diene conjugates and statistically significant (p 0.05) suppression of antioxidant system at the 10-12 weeks of treatment. Conclusion. Examined patients with chronic hepatitis C had diverse activity of antioxidant system. Long-term side effects were seen in patients with low levels of parameters of antioxidant protection at the baseline.
The founder of russian gynecology Alexander Alexandrovich Kieter
Authors: Kira E F , Fatkhullin I F
Published: November 2019

In 2013, it is 200th birthday anniversary of the first student of the outstanding N.I. Pirogov, brilliant Russian doctor and scientist, surgeon, obstetrician and gynecologist, the founder of the Russian surgical obstetrics Alexander-Ludwig Alexandrovich von Kieter. He was born on August 20, 1813 in Venden (nowadays - Latvia), studied at Riga gymnasium and medical faculty of Tartu University, from which he graduated magna cum laude, after that he was offered a job at the surgical clinics, where he was an assistant and a student of N.I. Pirogov. In 1839 as a successor of N.I. Pirogov, he took charge over the department of surgery in Tartu University. In 1840 he had transferred to Kazan, where he got the position of associate professor, and in 1848 - ordinary professor of the department of theoretical surgery of Emperor’s Kazan University. Apart from surgery, he was also interested in obstetrics. Together with F.I. Elachich, he performed the transvaginal oncotomy with a favorable outcome. Published description of that case made the authors globally famous. In 1849, he returned to Saint Petersburg as a professor of the department of obstetrics, gynecology and children’s diseases of the Emperor’s Medical and Surgical Academy and headed the department of obstetrics in 2nd Infantry hospital. In 1858, he took a charge over «Pirogov’s» department of hospital surgery, and was appointed as the head doctor of the surgical department in 2nd Infantry hospital. He retired in 1870, and died on March 22, 1879. He was buried at Volkovo Lutheran Cemetery of Saint Petersburg.
Analysis of risk factors for developing complications while treating pulpitis
Authors: Aksenova T V , Bondarenko A N
Published: November 2019

Aim. To study the influence of different risk factors on complications rate while treating pulpitis. Methods. Retrospective analysis of 130 patients with pulpitis outpatient’s cards, who were treated by vital and devitalized pulp extirpation without additional rehabilitation (63 patients) and with addition of individually selected rehabilitation program (67 patients), was carried out. The presence and rate of risk factors for complications in both study groups were analyzed, the level of their impact in complications formation was assessed. The data were processed by analysis of variance. Results. The most significant risk factors for developing complications while treating pulpitis were low local dental and general recovery potential, multiple foci of dental and periodontal infection, mastication muscles malfunction, malocclusion, mental disorders. 60% of patients had the combination of 3 and more risk factors, which in half of all cases were associated with developing complications, if endodontic treatment of pulpitis was not associated with individually selected rehabilitation. Rehabilitation included physiotherapy (if indicated), e.g. low-frequency alternating magnetic field, intra-channel iodine electrophoresis, individually selected homeopathic drugs, Bach flower essences and kinesiotherapy in addition to full mouth debridement. Conclusion. The impact of a range of risk factors, which can be revealed in conditions of common outpatient dental practice, on pulpitis treatment effectiveness was revealed. The addition of individually selected rehabilitation program, targeted on revealed risk factors elimination, to traditional pulpitis treatment decreases the complications rate.
Improving medical care in patients with chronic catarrhal gingivitis while using fixed orthodontic appliances
Authors: Khaliullina G R , Blashkova S L , Mustafin I G
Published: November 2019

Aim. To study the immunostimulating effect of glucosaminyl muramyl dipeptide in the treatment of chronic catarrhal gingivitis in patients undergoing orthodontic treatment using fixed appliances. Methods. The data of clinical and laboratory examination of the oral health status in 54 patients aged 14-24 years with inflammatory periodontal diseases, undergoing orthodontic treatment using fixed appliances were analyzed. The first group included 26 patients in whom glucosaminyl muramyl dipeptide (1 mg sublingual tablets daily for 10 days) was additionally administered. The second group included 28 patients receiving standard treatment. The treatment efficacy estimation was based on subjective assessment, clinical, microbiological and immunological examinations. Results. After 6 weeks of treatment, there was a statistically significant reduction of simplified oral hygiene index (OHI-s) to 0.85±0.03 in patients of the first group, compared to 1.64±0,061 before treatment. Periodontal index (PI) and PMA index values were 0, reflecting good level of hygiene and no inflammation in periodontal tissues. In the second group, the OHI-s was 1.5±0.06, PI 0.71±0.04 and PMA 18±1.046%, reflecting mild gingivitis after the 6 weeks of treatment. Bacteriology showed that the number of colonies in the first group was reduced by 1-2 orders of magnitude on average after 6 weeks of treatment. Patients of the second group showed a significant (p 0.05) increase in the number of bacterial colonies potentially causing the periodontal inflammation. The level of secretory IgA after 6 weeks of combined treatment in the first patients group was 249.5±39.1 mg/ml, whereas in the second patients group it was 182.2±14.9 mg/ml, indicating the immunostimulating activity of the complex treatment administered in patients of the first group. Conclusion. This study shows the effectiveness of glucosaminyl muramyl dipeptide as immunostumulating drug in combined treatment of chronic catarrhal gingivitis in patients with dental braces.
Introducing adaptation program for nursing staff to a new work environment and the work place
Authors: Kasimovskaya N A , Efremova V E
Published: November 2019

Aim. To find a scientific rationale and to develop a comprehensive system to adapt nursing staff at federal healthcare facilities. Methods. The following methods were used: direct observation, sociological, expert evaluation, analytical, statistical. The study included 526 nurses, among them 8 were principal chief nurses, 114 - senior nurses of the departments, 328 - ordinary nursing staff, 79 - newly accepted employees who completed the developed adaptation program for nursing staff. Special questionnaires were designed for adaptation program development. The existing system of nursing staff professional development was assessed by processing «Nursing staff adaptation program» documents. Results. A new program of adaptation of new employees to the workplace and professional requirements for a future position was designed while improving nursing staff management, according to the study results. The program includes the use of modern adaptation process methodology and contains teaching materials. The comparative analysis of the answers of executive nursing staff revealed that principal chief nurses admitted the need for the program: 7 (87.5%) out of 8 nurses considered it necessary before it was introduced, 100% of principal chief nurses recognized the importance of adaptation program after it was introduced. Senior nurses admitted the need for introducing the program in 70 (61.4%) of cases, however, after its introduction 108 (94.7%) of respondents confirmed that it was necessity. Conclusion. Adaptation program to a professional environment and new workplace for nursing staff is actual and is a necessary part of preparing the new employees to a professional environment and activities at the new workplace.
Evaluating the provision of antihypertensive drugs in the Republic of Kazakhstan on example of Almaty
Authors: Abuov J Zh , Kalmatayeva Zh A , Stepkina E L , Rustemova A Sh
Published: November 2019

Aim. To study the opinion of doctors and pharmacists of providing free prescriptions for antihypertensive drugs in primary healthcare in Almaty. Methods. Medical and demographical data of the Agency of the Republic of Kazakhstan on Statistics on prescribing free antihypertensive drugs to special categories in primary healthcare in Almaty in 2008-2012, as well as the data of special questionnaires filled in by doctors authorized to make free prescriptions and by pharmacists supplying patients with free antihypertensive drugs were analyzed. The data were collected in primary healthcare facilities of Almaty in 2012. Results. Sociological survey showed that 90.8% of primary healthcare facilities were adequately equipped for entering free and preferential drug prescription data to the national database. In 9.2% of cases, facilities were underequipped (not every examination room had a computer). Examples of correctly filled in prescriptions for free and preferential drug supply were available in every facility. The question «Do you think that the system of preferential/free drug prescription provision improves the treatment effectiveness?» was answered positively by over a half of the respondents (50.6%), 31.6% believed that it provided better compliance for medication intake. Conclusion. 21.0% of physicians and 21.4% of pharmacists rated the current system as «excellent», and 47.4% and 53,6% accordingly - as «good». At that, 5.3% of physicians who rated the work as «unsatisfactory» expressed the willingness to switch to the system of 50% preferential provision.
Prediction of community-acquired pneumonia complications in military men
Authors: Borisov I M , Shapovalova T G
Published: November 2019

Aim. To develop diagnostic algorithm to predict the risk of community-acquired pneumonia development. Methods. 2000 patients with community-acquired pneumonia (male conscripts aged 18 to 22 years, mean age 19.2±0.19). A comparative analysis of two groups of patients to assess the algorithm for toxic shock syndrome, acute respiratory failure and acute kidney injury prediction was performed. In the comparison group (n=782, 1998 to 2003), prediction of complications was based on doctors’ personal knowledge and experience without using the prediction algorithms. In the main group (n=1218, 2003 to 2008), the established prediction algorithm was used. Results. The introduction of community-acquired pneumonia complications prediction algorithm allowed to decrease the incidence of such complications significantly. Toxic shock syndrome was diagnosed in 8.8% of patients in the comparison group and in 3.7% of patients of the main group (р 0.05), acute respiratory failure - in 43.1% of patients of the comparison group and in 19.5% of patients of the main group (р 0.05). The effectiveness of the algorithm for toxic shock syndrome prognosis was 90.8%, sensitivity - 91.8%, specificity - 89.7%, accuracy - 94.5%. The effectiveness of the algorithm for acute kidney injury prognosis was 90.7%, sensitivity - 90.7%, specificity - 90.8%, accuracy - 95.1%. Conclusion. Offered prediction algorithms can help a physician to suspect a possibility of potentially dangerous and lethal complications development in patients with community-acquired pneumonia at the early stages of the disease. It allows to adjust the treatment, to simplify the estimate for transportation need, to detect the indications for patients admission, including the admission to intensive care unit, and improve the results of treatment.
Role of selenium in development of tumors
Authors: Nagieva S V
Published: November 2019

Aim. To investigate the possible relationship between content of selenium in environmental objects (soil and foods) and prevalence of tumors in the Republic of Azerbaijan. Methods. Atomic absorption spectroscopy was used for quantitative determination of selenium in soil of some economical regions of the country and in foods of every day’s local diet that are the natural nutritional sources of selenium. Serum selenium level in patients with tumors was assessed using X-ray fluorescence spectroscopy. Results. Soil and food analysis revealed low contents of selenium in them. Difference in selenium concentrations in soils from studied economic regions and in food products farmed in these regions was discovered. The serum selenium level of patients with malignancies was 37.3 μg/l (38.6 μg/l - females, 34.3 μg/l - males). There was a reverse relationship found between selenium concentrations in soils and food of the region and prevalence of tumors, as well as with serum selenium level in patients with tumors and tumor stage and malignant potential. Conclusion. The territory of Azerbaijan Republic may be considered as the region with selenium deficiency. Our research supposes that selenium deficiency can be associated with increased prevalence of malignancies in the region.