bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnosing breast cancer based on radiotracer uptake at planar scintigraphy
Authors: Malchugina E L , Diomidova V N , Agafonkina T V
Published: November 2019

Aim. To study the radiotracer uptake at breast planar scintigraphy using a special gamma camera for breast cancer detection. Methods. The study included 120 women aged 53±9 years. Breast planar scintigraphy was carried out by BSGI (Breast Specific Gamma Imaging) method using DILON 6800 gamma camera with 99mTc-methoxyisobutylisonitrile ( 99mTc-MIBI) as radiotracer. All scintigraphy results were further confirmed by cytological and morphological verification of biological material. Results. According to nature and intensity of radiotracer accumulation in the breast, all examined patients were divided to three groups. Of 120 women, a homogeneous breast structure with no lesions was detected in 34. In 32 patients, a heterogeneous breast structure with zones of low and medium radiotracer accumulation was revealed, indicating benign breast disease. In 54 women, heterogeneous breast structure with high and ultra-high focal radiotracer uptake was found. In 36 cases, a benign disease was diagnosed, and in 18 (33%) of 54 cases, the scintigraphy results showed breast cancer, which was confirmed by the results of morphological verification of postoperative material. Breast planar scintigraphy by BSGI allowed to reveal the breast cancer, including small tumors (less than 1 cm) as focuses of 99mTc-MIBI accumulation. Sensitivity of breast planar scintigraphy in diagnosing breast cancer was 95%, specificity - 98%. Conclusion. High informative values of breast planar scintigraphy by BSGI allows to use this diagnostic method as a component of a diagnostic algorithm for breast cancer early detection.
The use of phosphodiesterase type 5 (pde-5) inhibitors in treatment of erectile dysfunction in patients with diabetes mellitus of different age groups
Authors: Mehtiyev T V
Published: November 2019

Aim. To study the effect of phosphodiesterase type 5 inhibitors used to treat the erectile dysfunction in patients of different age groups with concomitant diabetes mellitus. Methods. The study included 293 patients with diabetes mellitus type I and II aged 17-60 years, with duration of diabetes varying from 6 months to 29 years, duration of erectile dysfunction - from 6 months to 12 years. To diagnose the erectile dysfunction, an international index of erectile function, together with routine and special methods were used. Patients were administered phosphodiesterase type 5 inhibitors: sildenafil, taladafil and vardenafil. The control group included men with the erectile dysfunction without diabetes. To identify the male hypogonadism, patients were examined depending on the age group: 18-29 years, 30-39 years, 40-49 years, 50-59 years. Patiens were tested for sex hormones level, male ageing questionnaires were administered. Results. The increased rate of hypogonadism (from 12.5 to 54%) was associated with older age in patients with diabetes mellitus. The androgen status index in patients with diabetes mellitus, according to the Aging Males’ Symptoms rating scale, was 37.1±1.4 points. Phosphodiesterase type 5 inhibitors were more effective in younger age groups (57.1-91.7%) compared to older (36.8-67.3%). When comparing the study drugs, vardenafil showed better effect and relatively few side effects. Conclusion. Androgen deficiency, developing with increasing age is accompanied by a decrease in phosphodiesterase type 5 inhibitors efficiency. The use of small doses of these drugs corresponding the circadian rhythm of testosterone in males with normal testosterone blood level has the same effect as large doses.
Non-alcoholic fatty liver disease in patients with chronic viral hepatitis
Authors: Tkachenko L I , Maleev V V
Published: November 2019

Aim. To estimate the prevalence of non-acloholic fatty liver disease in patients with chronic hepatitis B, and the association of non-acloholic fatty liver disease with the biochemical, virological and metabolic faсtors. Methods. 53 patients with chronic hepatitis B observed in the regional hospital of infective diseases, Stavropol, at 2008-2012, were included. Patients were distributed to 2 groups according to the results of liver biopsies: group I - patients with hepatosteatosis (5%) and group II - no signs of steatosis (≤5%). Anthropometric, histological, biochemical, virological, and metabolic determinants were compared. Results. Of 53 patients, 18 (34%) liver biopsies had signs of steatosis. Patients with steatosis (group I), compared with group II, were older (43±13 vs 34.5±10.9 years, р=0.015), had higher body mass index (30±5.3 vs 22.9±4.3 kg/m 2, р=0.015), higher level of triglycerides (1.6±0.8 vs 1.06±0.7 mmol/l, р=0.014), higher level of cholesterol (5.6±0.7 vs 4.97±0.9 mmol/l, р=0.012), and higher serum insulin (13±7.9 vs 8.2±3 mkME/l, р=0.002) and leptin levels (16.2±15.6 vs 6.5±5.2 ng/ml, р=0.001). The values of HOMA (Homeostasis Model Assessment) and QUICKI (quantitative insulin sensitivity check index) indices corresponded to insulin resistance (НОМА 2.9±1.8 and 1.9±0.8, р=0.007; QUICKI 0.33±0.02 and 0.35±0.03, р=0.014). There were no differences in histological activity scores by Knodell and fibrosis scores by METAVIR scale between the groups. No reliable differences in virological parameters (viral load and HBeAg status) were obtained. Conclusion. Non-alcoholic fatty liver disease is observed in one-third of patients with hepatitis B and is associated with host metabolic factors, which correspond to the parameters of metabolic syndrome.
Effects of triphenyltetradecylphosphonium bromide and tributylhexadecylphosphonium bromide on cellular permeability in patients with hereditary cellular membrane hyperpermeability
Authors: Orlova O V , Oslopov V N , Sidullina S A
Published: November 2019

Aim. Comparative analysis of effects of novel biologically active agents: triphenyltetradecylphosphonium bromide and tributylhexadecylphosphonium bromide on cell membrane permeability for sodium by determination of of Na +-Li +-countertransport speed in erythrocyte membrane at patients with genetically determined high membrane permeability for sodium. Methods. Blood samples of 8 healthy volunteers who were classified as persons belonging to IV population quartile according to Na +-Li +-counter-transport speed in erythrocyte membrane, i.e. persons with high membrane permeability, were studied. Effects of different concentrations of triphenyltetradecylphosphonium bromide and tributylhexadecylphosphonium bromide (known by antibacterial and antifungal action) on Na +-Li +-counter-transport speed in erythrocyte membrane in vitro according to the method proposed by M. Canessa et al. Results. Effect of triphenyltetradecylphosphonium bromide (С 14) and tributylhexadecylphosphonium bromide (С 16) on cell membrane permeability for sodium depends on the genetically determined baseline cell membrane state. С 14reduced the erythrocyte membrane permeability for sodium in studied patients belonging to IV quartile of Na +-Li +-counter-transport speed if administered in a concentration of 0.05 μm. C 16increased membrane permeability for sodium in the same group if administered in concentrations of 0.001 and 0.005 μm. Thus, tributylhexadecylphosphonium bromide is better suitable for designing a drug with antibacterial and antifungal action for patients belonging to IV quartile of Na +-Li +-counter-transport speed, if Na +-Li +-counter-transport speed reduction is wanted. If Na +-Li +-counter-transport speed increase is wanted, triphenyltetradecylphosphonium bromide is better suitable. Conclusion. Cand Csubstances affect cell membrane permeability for sodium in patients with genetically determined high membrane permeability for sodium.
Laser doppler flowmetry for human blood microcirculation assessment
Authors: Barhatov I V
Published: November 2019

The prevention and treatment of various microcirculation disorders are one of the most important problems of medical practice. The difficulties of studying the microcirculation are related to the blood vessels small size and extensive branching within organ tissues. At present, various methods of microcirculation assessment using the laser Doppler flowmetry are applied in active clinical practice in our country. The review covers the main methods of laser Doppler flowmetry used for the diagnosis of various microcirculation disorders. The method is based on the determination of tissue blood perfusion by measuring the Doppler frequency shift while tissue is illuminated by a laser beam, followed by the registration of the reflected radiation from moving and stationary tissue components. Microcirculatory oscillation rhythm plays an important role, especially in early diagnosis of many diseases. The loss of certain types of oscillations at laser Doppler flowmetry is interpreted as «spectral narrowing» and serves as a diagnostic criterion for microcirculation deregulation, which is directly related to decreased blood perfusion and tissue hypotrophy. The use of amplitude-frequency analysis of blood flow oscillations can non-invasively evaluate the impact of the various components of microvascular tone, allowing to calculate an index of neurogenic and myogenic tone and bypass index. The amplitude-frequency analysis of the laser Doppler flowmetry spectrum uses normalized parameters determining the maximum amplitude of the blood flow oscillation in different bands, as well as their ratio - microcirculation effectiveness index. Hyperemic, spastic, spastic-atonic, structural and degenerative, congestive and stasic forms of various microcirculation disorders are marked out. Each of these microcirculatory disorders is characterized by a certain ratio of structural and functional changes and changes in blood velocity, as well as impaired barrier function. The main principles of the microcirculatory disorders are described.
Pathogenetic features of the hepatobiliary system damage in patients with metabolic syndrome
Authors: Gaus O V , Akhmedov V A
Published: November 2019

A review of articles covering the modern views on the hepatobiliary system damage features in patients with clinical manifestations of metabolic syndrome. 196 original papers published over the last 6 years were found using PubMed, MEDLINE, E-library databases, from which 50 articles were picked out for the review. Considering high prevalence of metabolic syndrome, the studied problem seems important. The influence of obesity and associated insulin resistance at launching the systemic inflammation leading to activation of immunological cascade resulting in terget organs damage in such patients is highlighted. The pathogenesis of liver, gall bladder and bile ducts damage at presence of metabolic disorders is outlined. The role of inflammatory and anti-inflammatory cytokines in liver tissue damage is described. Based on the data of literature review and own data, it was shown that the lipid metabolism alterations are associated with liver functional damage, and liver in patients with metabolic syndrome is not only participating in atherogenic dislipoproteinemia development, but also damaged as the target organ. It was revealed that the key link in the gall bladder pathology in patients with metabolic syndrome is the lipid metabolism alterations that lead to the excess cholesterol bile excretion and cholesterol monohydrate crystals sedimentation. It was also shown that the functionally affected hepatocytes produce imperfect bile micelles with high cholesterol and low phospholipid levels, increasing the bile lithogenicity. High bile cholesterol level stimulating the mucin secretion by gall bladder wall, which is the important component of bile sediment and increases the bile crystalloids aggregation.
Extracorporal methods for liver failure treatment
Authors: Kutepov D E
Published: November 2019

A mortality rate in patients with liver failure remains high. Currently the main causes for liver failure are viral hepatitis and alcoholic liver disease. As a result of liver detoxification malfunction a number of complications, including hepatic encephalopathy, hepatorenal syndrome, circulatory disorders develop. Different types of extracorporeal therapies and their combination are used to treat the liver failure for a long time. Figuratively, extracorporeal liver support systems can be divided into two groups: biological and non-biological. Biological methods are based on the use of isolated hepatocytes suspension. Non-biological methods include dialysis, hemofiltration, plasma exchange, hemosorption, Molecular Adsorbent Recirculating System (MARS) and fractionated plasma separation and adsorption (FPSA or Prometheus). Modern technologies allowed to combine liver support systems into a whole and to create an additional method of liver failure treatment — Molecular Adsorbent Recirculating System (MARS). Currently, MARS is a promising trend of liver failure treatment, as it allows support the liver function for a long time until restored or an optimal donor will be found.
Prospects of using P2 receptors agonists and antagonists as drug substances
Authors: Kalinina O S , Ziganshin A U
Published: November 2019

P2 receptors are detected in different tissues and organs, which makes them a potential target of pharmacological action. A number of studies confirming the maturity of purinergic theory are currently published. Literature review focuses on P2 receptors characteristics, their main current agonists and antagonists, as well as on the possibilities of pharmacological action on these receptors. The most important studies addressing new chemical compounds important for studying P2 receptors and also compounds with potential for medical use are analyzed. Data on current successes of P2 receptors pharmacology and introduction of P2Y receptors antagonists into clinical practice are presented. Over the last decades a certain progress was observed in studying P2 receptors agonists and antagonists. There is a growing interest to pathophysiology and therapeutic potential of purinergic neurotransmission. Nevertheless, there is a need for developing new compounds acting selectively to these receptors both in vivo and in vitro. Despite the large number of P2 receptors agonists and antagonists, most of them have certain drawbacks, including incomplete of non-selective antagonism, or significant effect on ecto-ATPase activity. Thus, studying P2 receptors to find novel compounds acting on these receptors is of significant clinical value. Apparently, this trend of developing novel drugs — P2 receptors agonists and antagonists — is particularly promising.
Actual aspects of studying athlete’s body composition
Authors: Rylova N V
Published: November 2019

The review of the literature presents the existing methods of the body composition estimation, including the area of their use and information they provide, the role of the body composition monitoring in athletes, as well as the main factors influencing the body composition, are outlined. Over time, in professional sports there is a trend of the significant improvement of the results, sophistication of the technical sporting programs, leading to tougher training and competition, resulting in morphological changes of the athletes’ body composition. Thus, the importance of the athletes’ body composition assessment increases. Athletes’ body composition monitoring allows to assess the athletes’ health and physical fitness, allowing to adjust the training. The development of the new methods, changes in basic principles and the possibilities of determining body composition, which today have become more accurate and reliable, is an important step towards the proper athlete’s health support and enhancing the performance. Currently, there are a lot of methods of tissue body composition assessment at different levels of organization (elemental, molecular, cellular, tissue and organ levels, whole body level). However, despite the variety of existing methods, each of them has a number of advantages and disadvantages for use in sports practice. Therefore, to choose the proper body composition assessment method, it is necessary to focus on research objectives, as well as the accessibility and availability of the research method. Introduction of new technologies and examination methods allows increasing the specificity and promptness of the body composition estimation, but the novel methods are high-cost, needs standardization and validation to be widely used in common practice.
Stent retriever for iatrogenic cerebral thromboembolism treatment
Authors: Volodyukhin M U
Published: November 2019

Thromboembolism is one of the dangerous complications of cerebrovascular endovascular surgeries, often resulting in severe disabilities. A clinical case of using stent retriever for treating iatrogenic cerebral thromboembolism occurred as a complication of diagnostic cerebral angiography is presented. Patient M., 49 years, was admitted in the department of neurology with referral diagnosis of subarachnoid hematoma. No pathologic changes of intracranial arteries were revealed on multi-spiral computed tomography, so cerebral angiography was administered. After administration of heparin (100 U/kg), selective cerebral angiography of all the intracranial vascular beds was performed using a diagnostic cerebral catheter with some technical difficulties. After the intervention was finished, the patient developed non-focal neurological symptoms, left-sided hemianopsia. Angiography of posterior circulation system was repeated immediately, left posterior cerebral artery occlusion was found. Stent retriever was used to restore the intracranial blood flow. An intracranial stent retriever Solitaire (EV3) was delivered to the occlusion and deployed with exposition of 5 minutes and further removal. Control angiography showed complete restoration of the intracranial blood flow without signs of distal embolism. The neurologic deficit had completely resolved during first 24 hours after the surgery. The presented clinical case illustrates the effect of stent retriever use to to restore the intracranial blood flow and stresses the need for such devices availability in departments performing cerebral surgeries in patients with cerebrovascular diseases.
Sanitary and hygienic situation in educational institution and its influence on student’s protests at the turn of the XX century (on the example of the kazan theological seminary)
Authors: Khokhlov A A
Published: November 2019

In 1899 in the Kazan Theological Seminary the wave of student’s protests arose. Uproar were extreme forms and were accompanied by a window shattering, furniture crash and threats to authorities. Shortly before this, the Seminary rector, archimandrite Kirill (Lopatin) submitted the report to the Kazan archbishop Arseny (Bryantsev) in which he described difficult sanitary and hygienic situation of seminary and that it negatively affects the educational process. The document reveals a heavy student life: extreme overcrowding, lack of rooms, high humidity and lack of fresh air. As a special problem, absence of own bath was mentioned, forcing students to visit city baths, that led to increase of number of contagious diseases cases. The petition of the seminary students, handed over to the Kazan archbishop, confirmed that radical moods of pupils were motivated by worsening sanitary conditions in educational institution. However, despite recommendations of the bishop to the Seminary Board to find a solution of the problems rising, no efforts were made due to different reasons. The commission appointed for investigation of incidents, consisted of teachers, but didn’t include a medical worker, that indirectly indicates authorities’ formalistic approach to the problem. On the other hand, the considerable fault in sanitary and hygienic situation deterioration in Seminary lays on students, who by the end of the XIX century were not yet aware of simple sanitary rules importance.
Cardiovascular risk and unproportional high weight of left ventrical myocardium in climacteric women
Authors: Sadykova A R , Shamkina A R , Gizyatoullova R I
Published: November 2019

Aim. To study the distribution of cardiovascular risk factors, target organ damage, associated clinical conditions and to stratify the 10-year risk of arterial hypertension complications in menopausal females depending on presence of inappropriately high left ventricular mass. Methods. 107 females from city of Kazan aged 42-59 years entered the study, including 11 women with normal blood pressure, 16 patients with high normal blood pressure, and 80 patients with hypertension according to All-Russia scientific Society of Cardiologists classification (2010) with disease duration of 0-34 years. Mean age of patients with hypertension was 51.4±4.0 years. Patients with secondary hypertension were excluded from the study. All patients underwent a questionnaire survey, physical examination, biochemical blood test, ECG, echocardiography, and cervical extracranial vessel ultrasonography. Actual left ventricle mass was calculated according to R.B. Devereux et al. (1977) and was adjusted to the body surface area. Proper left ventricle mass was defined by G. Simone et al. (1998). Disproportion coefficient was calculated as a ratio of actual left ventricle mass to proper left ventricle mass. Left ventricle hypertrophy was diagnosed using the Sokolow-Lyon index and left ventricle mass index ≥ 110 g/m2 (Echo-signs of left ventricle hypertrophy). Results. In menopausal women, inappropriately high left ventricular mass was associated with significantly (р 0.05, Fisher exact test) higher frequency of obesity, especially its abdominal type, as well as target organ damage, including Echo-signs of left ventricle hypertrophy, very high added 10-year risk of developing arterial hypertension complications. It was also associated with significantly (р 0.05, the U-criterion) higher mean values of waist circumference, waist to hip circumference ratio, body mass index, total number of damaged target organs and 10-year risk for developing arterial hypertension complications. Conclusion. Distinguishing the patients with inappropriately high left ventricular mass among menopausal women is important for planning the measures to prevent cardiovascular events.
Immunological aspects of pathogenesis of metabolic syndrome-related arterial hypertension
Authors: Salikhova A F
Published: November 2019

Aim. To analyze the link between levels of adipocytokines (leptine), non-specific cytokines (interleukin-6, tumor necrosis factor-α) and arterial hypertension. Methods. 123 subjects, including 100 patients with metabolic syndrome (according to 2005 Criteria of International Diabetes Federation) and 23 healthy subjects, were examined. General examination was performed, body weight, height and waist circumference were measured, body mass index was calculated. Following laboratory test were performed: serum leptin, interleukin-6, tumor necrosis factor-α, main classes of immunoglobulin, C-reactive protein levels were measured. Results. In patients with metabolic syndrome, increased body weight was associated with increased risk of arterial hypertension. A 10-fold increase of serum leptin level (44.69±8.96 ng/ml) compared to healthy controls (4.72±1.33 ng/ml, p 0.01), was revealed. Leptin level elevation was strongly associated with increased body mass index (r=0.77; p 0.001). Tumor necrosis factor-α concentration in patients with metabolic syndrome exceeded 2 pg/ml, while in healthy controls it didn’t reach this level. Interleukin-6 level was elevated in patients with metabolic syndrome (7.32 [3.25; 7.17] pg/ml) compared to controls (1.53 [1.19; 2.49] pg/ml, Fisher’s exact test, p 0.001). Examination of immunoglobulin levels in patients with metabolic syndrome revealed decreased serum level of immunoglobulin E (97.12±66.24 IU/ml) compared to controls (60.47±19.04 IU/ml, p=0.01). Concentration of immunoglobulin G in patients with metabolic syndrome was also higher (14.61±3.50 g/l) compared to controls (12.57±2.07 g/l, p=0.009). Increased interleukin-6 and immunoglobulin G levels were associated with presence of arterial hypertension. Conclusion. Increased interleukin-6 and immunoglobulin G might be an important factor for arterial hypertension onset and progression.
Effect of L-arginine on endothelial dysfunction in patients with congenital mitral valve prolapse
Authors: Shodikulova G Z
Published: November 2019

АIM. To study the effect of L-arginine on endothelium-dependent vasodilatation in patients with congenital mitral valve prolapse and different degrees of regurgitation. Methods. The study included 86 patients [36 (41.9%) males and 50 (58.1%) females aged 15-25 (mean age 19.9±1.42) years] with signs of congenital mitral valve prolapse. The first group included 41 patients were L-arginine (Tivortin) as a prophylaxis medication. The second group included 45 patients who were not taking L-arginine. Subgroup A of each group included 20 and 22 patients with stage I of mitral regurgitation, accordingly; subgroup B of each group included 21 and 23 patients with stage II of mitral regurgitation, accordingly. Results. In patients of the first group with mitral valve prolapse and stages I and II of mitral regurgitation, distinct positive changes were observed after 6 months of treatment with L-arginine. Compared to baseline data, in patients of the first group with stage I of mitral regurgitation brachial artery diameter increased by 1,44 times (р 0.001), resistance index - by 1.5 times (р 0.001); in patients with stage II of mitral regurgitation the following parameters increased by 1.65 and 1.39 times (р 0.001 and р 0.01) accordingly. At the same time, parameters of NO-system also improved in patients of the first group with stages I and II of mitral regurgitation after 6 months of treatment: endothelial NO synthase activity increased by 1.18 and 1.29 times (р 0.05 and р 0.02) accordingly, NO level decreased by 1.17 and 1.18 times (р 0.05), inducible NO synthase activity - by 1.17 and 1.29 times (р 0.05 and р 0.02), and there was a reduction of peroxynitrite levels by 1.23 and 1.34 times (р 0.02 and р 0.01), endotheline-1 - by 1.07 and 1.26 times (р 0.05 and р 0.02), vascular endothelial growth factor - by 1.08 and 1.24 times (р 0.05 and р 0.01) accordingly. Conclusion. Recommended doses of L-arginine restores the stream-dependent vasodilation, activity of the NO-system and process of angiogenesis after 6 months of treatment.
Association of blood level of inflammatory mediators and morphology of coronary artery stenosis in patients with stable angina
Authors: Mahmudov R M , Mammadov V S , Mirzakhanova L R
Published: November 2019

Aim. To study the association of morphology of coronary artery disease and pentraxin-3, tumor necrosis factor α blood levels in patients with stable angina who undergo coronary artery bypass surgery. Methods. The study included 92 patients aged 44-73 years with stable angina of II-III functional class. The coronary artery disease type was classified by AHA/ACC criteria: type A - concentric stenosis with flat plague and plague length less than 10 mm, type B - eccentric stenosis or blunt-edged stenosis with moderate calcinosis or signs of mural trombosis, with length not exceeding 200 mm, type C - stenosis with plague length over 20 mm, plague ulceration, marked calcinosis, diffuse lesions, chronic coronary artery occlusion. Pentraxin-3, tumor necrosis factor α blood levels were measured by ELISA in all patients before the surgery, 8 and 24 hours after the surgery. Results. There was a relation found between the type of stenosis and pentraxin-3 and tumor necrosis factor α blood levels. In patients with С type stenosis, pentraxin-3 blood level was 4 times higher (p 0.001) 24 hours after the coronary artery bypass surgery compared to patients with A type stenosis, and by 1.8 and 1.3 times higher compared to patients with В1 and В2 stenosis type, accordingly. Conclusion. There was a close relation revealed between the morphology of coronary artery stenosis and pentraxin-3 and tumor necrosis factor α blood levels in patients with stable angina.
Awareness of patients seeking a medicogenetic counseling as a factor for prevention of hereditary and congenital diseases
Authors: Kasimovskaya N A , Yakushina I I
Published: November 2019

Aim. To evaluate the awareness of patients of questions of medical genetics at the stage of family planning before pregnancy. Methods. Sociological, statistical and analytical analysis was performed. 350 respondents participated in the survey, including 304 pregnant women. Results. 219 (62.6%) of 350 respondents reported that they didn’t know the risk factors for hereditary and congenital diseases. Smoking as a risk factor was noted by 32 (9.1%) of all respondents, alcohol abuse - by 7 (2%), drug abuse - by 3 (0.9%), medication intake - by 24 (6.9%), infections - by 20 (5.7%), the presence of disease with hereditary predisposition - by 25 (7.1%), malnutrition - by 20 (5.7%) respondents. Approximately half of all respondents reported that they «know about the threads associated with hereditary and congenital diseases for the health status of their future child», 39.1% «knew, but not enough», 11.2% «didn’t know». Out of 350 respondents, 299 (85.4%) have never seek for medicogenetic counseling for pregnancy planning before. The main reasons for seeking for medicogenetic counseling were: abnormal biochemistry test results found at screening - in 169 (55.6%) of cases, seeking for prognosis of the future child health - in 61 (20.1%) of cases, age over 35 years - in 39 (12.8%) cases. Almost one-third of all responders (33.2%) did not know about methods for hereditary and congenital abnormalities prevention, 41.2% «knew, but not enough», and only 25.6% thought that they knew about those methods. Conclusion. The patients are seeking for the medical and genetic counseling in retrospect, when they already have health problems, and they are not informed about medical and genetic counseling, as well as are unaware of the importance of risk factors and methods for hereditary and congenital abnormalities prevention.
Effect of dynamic electroneurostimulation in treatment of community-acquired pneumonia in preschool children
Authors: Ibragimova Zh R , Pikuza O I , Vahitov Kh M
Published: November 2019

Aim. To assess the effect of dynamic electroneurostimulation in treatment of community-acquired pneumonia in preschool children. Methods. The main group consisted of 45 preschool children with community-acquired pneumonia, in whom 7-day treatment course of dynamic electroneurostimulation was included as the component of the complex treatment. The control group included 55 children in whom conventional tactics was applied. Results. General intoxication syndrome was resolved at 3.2±1.1 day in children of the main group compared to 7.7±1.4 day in the control group. The use of dynamic electroneurostimulation reduced the duration of respiratory distress by more than 1.5 times (6.8±1.3 day), regression of physical lung changes was observed at 10.3±1.4 on average, compared to the end of the second week at the control group. Resolving of the clinical symptoms in children of the main group was accompanied by statistically significant (p 0.05) reduction of basic parameters of systemic inflammation (increased white blood cells count, high neutrophil count, left shift) by 7th day of treatment. The level of C-reactive protein reduced by 7 times in children of the main group, compared to 2.3 times in comparison group (p 0.05). Chest X-ray on the 7th day showed complete resolving of inflammatory changes in 20 (44.4%) patients of the main group, while no such cases were observed in control group (p 0.001). At the same time, no positive change of X-ray picture was revealed in 25 (45.5%) children of the control group, while there were no such cases in the main group (p 0.001). On the 11th day of treatment complete resolving of inflammatory changes was found in 43 (95.6%) children of the main group, compared to 34 (61.8%) children of the control group (p 0.05). Conclusion. Including of dynamic electroneurostimulation in complex treatment of community-acquired pneumonia in children reduces the recovery time, hospital stay and treatment cost.
Clinical and experimental background for new method of bowel anastomosis
Authors: Nesterov M I , Ramazanov M R , Magomedov A M
Published: November 2019

Aim. To improve the results of bowel resection using newly designed bowel anasthomosis method. Methods. A new method of forming enteroenteroanastomosis was proposed and developed, based on calculating the vitality index for suture strip, arterial blood hemoglobin saturation and microcirculation after preparing the suture strip. After that, holder sutures are overcast at the preserved major vessel at mesenteric and counter-mesenteric edges of suture strips of efferent and afferent bowels. A running sero-muscular suture is formed between the edges, followed by 1-2 nodal sero-muscular side sutures and invagination of suture strips to the efferent loop. After that, a running sero-muscular suture is formed on the front of the anastomosis. Results. Pre-clinical testing was performed on 40 dogs, with no cases of anastomosis leak. Clinical testing included 30 patients who underwent colectomy. Enteroenteroanastomosis was formed by the proposed method, preceded by suture strip microcirculation examination. In patients of the control group who underwent colectomy, enteroenteroanastomosis was formed by classical double-row suture without examining suture strip microcirculation. No cases of anastomosis leak were registered in the main group, compared to 4 cases in the control group. Conclusion. Clinical and experimental studies have shown the effectiveness of the developed enteroenteroanastomosis.
Effect of calcium channel blockers long-term use on blood level of luteinizing hormone and estradiol in rats
Authors: Kazimova A U , Garaeva K G
Published: November 2019

Aim. To define the effect of calcium channel blockers long-term use on blood level of luteinizing hormone and estradiol in female rats. Methods. 82 mature female outbreed rats were distributed to seven groups. The rats of the first (control) group were administered 0.2 ml of 0.9% saline intraperitoneally for 21 day. Instead of saline, 5 and 25 mg/kg of verapamil were used in rats of the second and third groups, 5 and 10 mg/kg of nifedipine - in rats of the 4th and 5th groups, 5 and 20 mg/kg of diltiazem - in rats of the 6th and 7th groups accordingly. Blood levels of luteinizing hormone and estradiol were determined by ELISA after animals were withdrawn from the study. Results. In rats treated with calcium channel blockers, a dose-dependent decrease of luteinizing hormone and estradiol blood levels were observed. High doses of verapamil (group 3) decreased the level of luteinizing hormones and estradiol by 50% compared to control group, high doses of diltiazem (group 7) - by 50%. Only minor changes were observed in rats who were administered nifedipine, even in high doses. Conclusion. Observed decrease of blood estradiol level indicate the influence of calcium channel blockers directly on ovarian function; decrease of blood luteinizing hormone level might by secondary due to positive feedback between the estradiol and luteinizing hormone secretion and reflect decreased estradiol blood level.
Change of acute stage reactants level in experimental intramedullary osteosynthesis
Authors: Akhtyamov I F , Shakirova F V , Zubairova L D , Gatina E B , Aliev E I
Published: November 2019

Aim. To assess the plasma protein fractions as organism’s reaction to osteosynthesis by medical devices made of medical steel and of medical steel coated by titanium and gafnium nitrides mixture. Methods. Diaphyseal tibial fracture was modeled on 30 rabbits with further assessment of animal organism reaction to osteosynthesis by pins made of medical steel and of medical steel coated by super-hard metal nitrides mixture. The change of blood plasma protein fractions and acute phase reactants was used as an indicator. Measurements were performed before the osteosynthesis and on the 5th and 180th day after the surgery. Results. Together with the stable level of total blood protein, dysproteinemia characteristic for acute phase of the inflammation was observed after the trauma and reparatory process induction. Two-waived reaction was registered. The first developed at the 5th day after the surgery and was characterized by the drop of blood albumin level together with α- and β2-globulin levels increase, the reaction was observed in the intervention group earlier compared to control group. The second wave developed at the 180th day and was characterized by β2- and γ-globulin levels increase. The registered changes corresponded with the phases of acute non-specific response, which includes the overproduction of «positive» and decreased production of «negative» acute phase reactants by liver, influenced by cytokines, as well as later adaptive immune response. Conclusion. Overall, the intensity of acute phase reactions was lower in the intervention group, indicating less damage associated with titanium and gafnium nitrides coated implants use.
The role of primary care physicians in diagnosis and follow-up of patients with chronic viral hepatites B, C and D
Authors: Enaleeva D Sh , Fazylov V Kh
Published: November 2019

By 01.01.2013 in the Republic of Tatarstan there were 23 970 Hepatitis B Surface Antigen carriers and 4546 patients with active Hepatitis B out of 28 516 registered patients who were infected with Hepatitis B. Our experience shows that not only inactive chronic Hepatitis B Surface Antigen carriers, but also patients with different clinical forms of Hepatitis B might be estimated as Hepatitis B Surface Antigen carriers. The feature of chronic viral hepatitides is a discrepancy between the scarce clinical picture and presence (in 15-30% of cases) of active inflammation in liver tissue. Since 2009, patients with positive ELISA test for antibodies to Hepatitis C virus are no longer registered in the national registry of infective diseases of Russian Federation. In the Republic of Tatarstan, such patients with antibodies to Hepatitis C virus were still registered up to 2012 (50 266 patients were registered by 01.01.2012). According to our own data, Hepatitis C viral RNA was found at polymerase chain reaction to Hepatitis C virus in 61% of cases out of 957 patients tested. According to our own data, when using the combined treatment (interferon alpha and ribavirin), lasting virologic response was obtained in 65.7% cases of type 1 genotype of Hepatitis C and almost in 100% of cases of other genotypes out of 163 cases of chronic Hepatitis C, which corresponds to worldwide standards. By 01.01.2013, 295 patients with liver cirrhosis as the result of chronic Hepatitis C were followed up at the consultative and diagnostic center of Republican Clinical Hospital of Infective Diseases with the upward trend. The retrospective analysis of 130 case histories of patients with liver cirrhosis revealed that Hepatitis C was firstly diagnosed at the stage of established liver cirrhosis in 57.7% of cases. Timely diagnosis and periodic medical examination in cases of chronic Hepatitis C allows to implement the individual, personalized approach in such patients and to choose the adequate treatment and follow-up.
Method for recurrent gastrointestinal bleeding prognosis
Authors: Simutis I S , Boyarinov G A , Mukhin A S , Deriugina A V , Prilukov D B
Published: November 2019

Aim. To assess the clinical value of continuous monitoring of rheographic parameters in patients with high risk of recurrent gastrointestinal bleeding for early pre-clinical diagnosis of recurrent bleeding. Methods. The study included 50 patients with upper gastrointestinal bleeding aged 50 to 70 years who were admitted having hemorrhagic shock III after endoscopic hemostasis. Continuous integral whole body rheography by «Diamant-M» computer complex was used for systemic circulation assessment. Results. Three types of hemodynamic reactions were revealed at integral whole body rheography: hypertonic (35 cases: increased integral tonicity coefficient up to 86 units and total peripheral vascular resistance over 3000 dyn/s·cm-5), hypotonic (35 cases: decreased integral tonicity coefficient down to 77 units and less, total peripheral vascular resistance less than 1500 dyn/s·cm-5, possible M-like waves of rheography curve) and intermediate (integral tonicity coefficient between 77 and 83 units, total peripheral vascular resistance between 1500 and 2000 dyn/s·cm-5). Integral tonicity coefficient between 80 and 113 units and total peripheral vascular resistance between 1500 and 3000±120 dyn/s·cm-5 were important indicators while monitoring for possible recurrent gastrointestinal bleeding. Conclusion. Blood loss compensation monitoring by continuous non-invasive rheography in patients at high risk for recurrent gastrointestinal bleeding allows not only diagnose recurrent gastrointestinal bleeding in a timely manner, but also to assess the effect of the treatment conducted.
A method of reconstruction of female genitalia in girls with virilization
Authors: Akramov N R , Zakirov A K
Published: November 2019

The most common cause for female virilization is congenital adrenal hyperplasia. For anticipating the serious psychological distress related to ambiguous genitalia, these patients require plastic surgery. At present, two-step methods are preferred as more reliable. However, the surgical treatment in this case extends over several years, and can greatly affect patient’s psychosocial status. Based on the analysis of known surgical treatments, we proposed a one-step method of feminizing genitoplasty. The advantages of the proposed method allows one-step surgical treatment of girls with virilized genitalia at an earlier age, before the child reaches the period of sexual self-identity. This approach provides less psychosocial distress and reduces the number of interventions, maintaining the adequate sensitivity of the clitoris, providing moist and age-appropriate vaginal opening by using the preputium of the penis homolog and urogenital sinus mucosa at genitoplasty. The abovementioned advantages increases the surgical treatment quality and quality of life in girls with virilized genitalia. The method is reproducible by pediatric surgeons with basic knowledge of children’s anatomy. Yet, a lengthy follow-up is needed to assess the long-term treatment results.
Endoscopic vein harvesting in coronary artery bypass surgery
Authors: Varlamov A G , Sadykov A R , Dzhordzhikiya R K
Published: November 2019

The greater saphenous vein is the most available and frequently used conduit for coronary artery bypass grafting. Conventional (open) vein harvesting procedure requires the longitudinal skin and subcutaneous fat incision along the full conduit length. Endoscopic vein harvesting has been developed in the middle-1990s as less invasive alternative for open vein harvesting. Using this novel technique allows to harvest the whole greater saphenous vein through 3 cm long skin incision. The article reviews the history, the role and current status of endoscopic vein harvesting in coronary artery bypass surgery. Literature data of the impact of that minimally invasive approach on infective and non-infective leg wound complications, as well as postoperative pain, patient satisfaction and live quality are presented. The cost-effectiveness data of the method, resulting in reduction of treatment costs of leg wound complications both at the hospital and after patient’s discharge are mentioned. The influence of endoscopic vein harvesting on morphologic and functional conduit quality is discussed. Special attention is devoted to mid- and long-term outcomes after coronary artery bypass surgery with endoscopic vein harvesting. The majority of research including angiographic control gives evidence of comparable parameters of bypass patency after the conventional vein harvesting and endoscopic vein harvesting procedures. Recent multicenter trials showed no statistically significant differences between the conventional vein harvesting and endoscopic vein harvesting procedures in such indirect graft patency indicators as mortality, myocardial infarction rate, need for repeated revascularization and recurrence of angina pectoris. Recent findings advocate safety and clinical effectiveness of endoscopic vein harvesting.
Actual issues of deontological ethics in surgical oncology
Authors: Akhmetzyanov F Sh
Published: November 2019

Issues of deontological ethics in medicine were discussed in numerous papers, including publications of special conferences. N.N. Petrov in his book wrote: «Surgery depends on science, which is continuously growing and expanding. It also depends on the technique: hand, instrumental, electric, continuously developing and simplifying facing seemingly insurmountable difficulties. Teachers provide information about the science, and techniques to young surgeons, of whom all are keenly interested in it. But surgery is not limited to science and technology. Painfully affecting the human body, getting deeply inside it, surgery reaches the top of its opportunities only in case when it is decorated with the highest manifestation of selfless care of the sick person, and that not only of his body, but also about the state of his mind». Much has changed during this period of time, more accurate diagnostic methods appeared, unprecedented success was achieved in anesthesiology and critical care. The article covers questions related to ethics arising while treating patients with malignancies. Various aspects of deontological ethics, i.e. proper attitude and decisions while treating patients with malignancies, have certain features specific for surgical oncology. Questions of contraindications to surgery are solved at different stages of the patient treatment: during outpatient examination, exploration, at operation itself, after completing surgery. Some examples of ethical errors are given. Conclusion on refusing the surgery should be, in every case, absolutely reliable, rigorously documented, which prohibits false solutions. Decision should be based on a clear understanding of the pathogenesis of the patient’s body changes in each case. The questions of indications for surgery, its feasibility and extent should be decided ex concilio.
The effect of oil phytopreparations on the lipid status in an experiment
Authors: Berdgaleeva A K , Aldiyarova N T , Sakhanova S K
Published: November 2019

Aim. To study the effect of oil extracts of the burdock root and elecampane on the lipid profile in an experimental model of cholesterolosis. Methods. Experiments were performed on 60 white nonlinear rats, weighing 180-300 g. The oil extract from the burdock root was administered intragastrically at a dose of 2.5 ml/kg, and an extract from the root of elecampane - at a dose of 1.0 ml/kg during the last 30 days on the background of a cholesterol diet. After removal of the animals from the experiment the levels of cholesterol, triglycerides, high and low density lipoproteins, phospholipids, free fatty acids were determined in the blood serum and in liver homogenates with the use of standardized sets. Results. Administration of oil extracts of the burdock root and elecampane on the background of a cholesterol diet resulted in a significant reduction in serum cholesterol level by average of 1.48 times, triglycerides level - by 1.9 times, low-density lipoproteins level - by 1.8 times, as well as in a significant increase in the level of high-density lipoproteins on average by 1.5 times compared with the pathology model. In the same conditions the oil extracts of the burdock root and elecampane significantly increased the phospholipid content in the liver tissue by 1.4 and 1.7 times, respectively, the content of free fatty acids - by 2 times in average, the content of esterified cholesterol - by about 1.5 times as compared with the pathology model. Conclusion. The studied oils have a unidirectional positive effect on the lipid content in blood serum and liver in an experimental cholesterolosis; the oil extract from the root of elecampane has a more pronounced effect.