bluuebunny/crossref_metadata_2025 huggingface dataset:
Correction of microcirculation disturbances in the wall of the urinary bladder in women with urination disorders
Authors: Neymark A I , Razdorskaya M V , Sizov K A
Published: November 2019

Aim. To assess the dynamics of the microcirculation indices in the mucous layer of the urinary bladder on the background of conservative treatment of women with urination disorders. Methods. Examined were 40 women with complaints of urination disorders, who were repeatedly treated regarding this reason. 20 female patients who underwent standard complex conservative therapy represented the first group. The second group included 20 patients who in addition received an α1-adrenergic blocker terazosin in a dose 2 mg at night. The course of treatment ranged from 1 to 3 months. Results. 9 (45%) women of the first group and 16 (80%) patients of the second group observed a positive effect of the treatment. In the patients of the second group registered was a more rapid normalization of clinical signs and indicators of laser Doppler flowmetry: an increase in neurogenic tone in precapillaries, in the bypass index and in the index of effectiveness of microcirculation, an increase in the microcirculation parameter and in the coefficient of variation, which indicates an improvement in the microhemocirculation. Conclusion. The study of blood flow through the capillary vascular bed by laser Doppler flowmetry makes it possible to study the microcirculation in the mucosa of the urinary bladder wall in order to monitor the effectiveness of the conducted therapy.
Changes in the vaginal microbiota in women with cervical diseases
Authors: Andosova L D , Kachalina O V , Belov A V , Kudel’kina S Yu
Published: November 2019

Aim. To study the relationship between the condition of the vaginal microbiota and the severity of pathological changes of the cervical epithelium. Methods. Studied were 99 female patients aged from 18 to 56 years with secondary and precancerous cervical processes: the first group - 20 women with cervical ectopias; the second group - 20 females with cervical intraepithelial stage I neoplasia; the third group - 19 women with stage II neoplasia; the fourth group - 20 patients with cervical intraepithelial stage III neoplasia (cancer in situ); the fifth group - 20 women with invasive cancer. The investigation of the vaginal biocenosis was conducted by the real-time polymerase chain reaction technique. Results. Established was a correlation between the dysbiotic vaginal changes and cervical lesions. In the first group normocenosis was reported in 4 women (20%), in the groups with cervical intraepithelial stage III neoplasia (cancer in situ) and with cervical cancer - only in 1 woman, accounting for 5% of the total number of patients in the group. In the first group in 16 women out of 20 (80%) noted was the dominance of Lactobacillus, in the groups with cervical intraepithelial neoplasia the proportion of such patients decreased, reaching for the fourth and fifth groups - 45 and 50% respectively. Conclusion. Imbalance of the urogenital tract microbiota may contribute significantly to the development and progression of cervical lesions.
Substantiation of the tactics of recurrent surgical interventions in the surgical treatment of concomitant strabismus
Authors: Zhukova O V , Yamschikov N V , Stepanov V K
Published: November 2019

Aim. To substantiate the recommendations on the tactics of recurrent operations for strabismus in children on the basis of histological investigation of the fragments of «weakened» muscles. Methods. Conducted was a retrospective analysis of recurrent surgical treatment of 2 patients with concomitant convergent strabismus. In order to determine the cause of dysfunction of the muscles conducted was a histological study of 80 fragments of the lateral rectus muscles, which were excised during surgical treatment of convergent strabismus. Results. Muscle fibers were found only in the distal sections during the resection of the lateral rectus muscles at a distance of 8.5-9 mm. Taking into consideration the fact that at point were the muscle transitions into the tendon located are the palisade nerve endings, which may play the major role in the contraction process, the exceedence of the above mentioned amount of muscle resection during strabismus surgery is dangerous, since it can lead to the disruption of the eye mobility. Conclusion. During recurrent operations for strabismus correction it is recommended to use major recessions of the «strong» muscles, and for ease of muscle fixation at a great distance from the attachment point - the technique of the «sliding noose».
Analysis of the causes of a stably high incidence of tick-borne borreliosis in rural districts of Udmurtia
Authors: Guznischeva N G , Zakirov I G
Published: November 2019

Aim. To identify of the most active centers of infection of tick-borne borreliosis in Udmurtia and to determine the causes of high morbidity level. Methods. Conducted was a comparative analysis of the dynamics of the incidence of tick-borne borreliosis in various administrative districts of Udmurtia, taking into consideration the confinedness to the landscape and geographical areas, identified were the risk groups for tick-borne borreliosis. The incidence tick-borne borreliosos and the indices of spontaneous infection of donors with borreliae in various landscape-geographical zones of Udmurtia were subjected to a comparative assessment, studied was the medical and economical effectiveness of preventive measures. The study was carried out by conventional methods. Results. It was established that in all the administrative districts of Udmurtia at risk of tick-borne borrelliosis are schoolchildren, pensioners and unemployed people, the risk of the disease increases after 41 year of age regardless of gender or place of residence. Established was a higher medical and economical effectiveness of emergency chemoprophylaxis of borreliosis in the first 48 hours after the tick bite in comparison with the currently used acaricidal treatment. Conclusion. The reasons for high incidence of tick-borne borreliosis in rural districts of Udmurtia - low appealability of the population for medical care after tick bites and a lack of motivation for chemoprophylaxis in school children, pensioners and unemployed people.
Diagnostic tactics for thyroid nodules
Authors: Timofeeva L A
Published: November 2019

Aim. To determine the optimal diagnostic tactics for nodules of the thyroid gland. Methods. Examined were 1124 patients with thyroid nodules in the age from 14 to 60 years and older, of whom 159 - with malignant tumors, 180 - with adenomas, 620 - with colloid nodes, 165 - with cysts. Among the surveyed group were 844 women and 280 men. The group of healthy individuals included 400 people. The material for cytology was obtained by fine-needle aspiration biopsy (1004 studies), from smears from the cut surface of the tumor (76 studies) and from puncture biopsies of enlarged regional lymph nodes (44 studies). Results. During ultrasound investigation hypoechoic, heterogeneity, roughness and blurred contours, the presence of the internal structure of small echo-negative inclusions are characteristic for thyroid cancer. As the number of these features increases the likelihood of confirmation of a malignant tumor of the thyroid increases as well. The ultrasound picture of nodular colloid goiter is characterized by a single nodule or multiple nodules in the tissue of the thyroid gland of low or isoechoic density, sometimes with a limiting «rim». The presence of the latter feature causes difficulties in the differential diagnosis between nodular goiter and thyroid adenoma. Out of the 907 informative cases in 144 patients (15.8%) cancer was diagnosed cytologically. Conclusion. A complex diagnostic approach to the examination of thyroid nodules using fine-needle aspiration puncture biopsy of the nodules under the control of ultrasound and subsequent cytological investigation of the punctate provides valuable information on the nature of pathological changes of the thyroid gland.
The effect of new derivatives of tietan-1,1-dioxide on some mediator systems of the brain
Authors: Ivanova O A , Nikitina I L , Alekhin E K , Miftahova A F
Published: November 2019

Aim. To study the effect of new derivatives of 3 substituted tietan-1,1-dioxide on some mediator systems of the brain in order to determine the possible mechanism of antidepressant effect of these compounds. Methods. In an experiment with male mice studied was the effect of three most active derivatives of tietan-1,1-dioxide, which exhibit antidepressant properties [3 methooxytietan-1,1-dioxide (H14), 3-(2-isopropoxy-5-methylphenoxy)-tietan-1,1-dioxide (H40) and 3-phenylsulphonyltietan-1,1-dioxide (N69)] on the neurotransmitter systems of the brain. In the experiments used were the tests of pharmacological interaction with a sympatholytic reserpine, with a nonselective agonist of dopamine receptors apomorphine, with a dopamine receptor antagonist haloperidol, with a precursor of serotonin 5-oxytryptophan, with a precursor of dopamine levodopa, with an α2-adrenoceptor agonist clonidine, and with an agonist of M-cholinoceptors arecoline. Results. It has been shown that the spectrum of neuropharmacological effects of new derivatives of tietan-1,1-dioxide (H14, H40, N69) is diverse and is associated with the effects on the adrenergic, dopaminergic and serotonergic brain structures. Thus, H14 reduces the severity of hypothermia induced by reserpine, apomorphine, clonidine, and levodopa, as well as the severity of reserpine ptosis, haloperidol catalepsy and 5- oxytryptophan hyperkinesis. H40, in contrast to H14, has no effect on haloperidol catalepsy and hypothermia induced by levodopa, while H69 has no effect on clonidine-induced hypothermia. All the compounds do not alter the latent period and duration of the arecoline tremor. Conclusion. New derivatives of tietan-1,1-dioxide possess properties, which are inherent to antidepressants, and may be recommended for further in-depth study of their antidepressant activity.
The condition of the hepatobiliary system in children with cystic fibrosis
Authors: Kondratieva O V , Rylova N V
Published: November 2019

Presented was an overview of domestic and foreign literature on the condition of the hepatobiliary system in children with cystic fibrosis. Due to an increasing life expectancy of cystic fibrosis patients in the last decade, the frequency of complications from the hepatobiliary system (cholestatic hepatitis, portal hypertension, liver cirrhosis), which, according to various authors, range from 20 to 80%, also increases. The most pronounced changes in the liver and the gall bladder are characteristic for children with moderate pulmonary symptoms and predominantly with the intestinal form of the disease. The risk factors for liver damage in cystic fibrosis are - pancreatic insufficiency, «severe» mutation, male sex, meconium ileus in the past medical history and earlier age at which the disease was diagnosed. Complex ultrasound assessment of the liver parenchyma and blood flow in the portal vascular system and in the celiac trunk make it possible to specify the severity of fibrosis and to identify early signs of portal hypertension. Magnetic resonance imaging can confirm the presence of liver cirrhosis and determine collateral circulation associated with portal hypertension. Magnetic resonance cholangiography and radionuclide imaging make it possible to determine the status of intra- and extrahepatic biliary system. There is currently no effective treatment that could prevent the progression of liver damage. There are reports of the beneficial effects of ursodeoxycholic acid drugs. Perspective directions of treatment - liver transplantation and genetic engineering. Methods of conservative, endoscopic and surgical treatment of bleeding esophageal varices are used during the portal hypertension syndrome.
Dynamics of the volume and structure of hospital admissions for emergency indications in surgical hospitals of the Stavropol territory with disorders of the digestive organs
Authors: Mikhaylova J V , Son I M , Muravev K A
Published: November 2019

Aim. To determine the volume and structure of hospital admissions for emergency indications in the surgical hospitals of the Stavropol Territory, of the North Caucasus Federal District and of the Russian Federation with disorders of the digestive organs over a 10-year period. Methods. Conducted was a comparative analysis of the volume and structure of hospital admissions for emergency indications in surgical hospitals over a 10-year period. Results. The number of individuals admitted to Russian hospitals for emergency medical treatment for disorders of the digestive system from 2001 to 2010 has increased by 4.6%. There was a significant reduction in the number of cases of acute appendicitis and perforated gastric and duodenal ulcers, while the share of acute pancreatitis and acute intestinal obstruction increased. Conclusion. Acute pancreatitis, appendicitis and cholecystitis - are the most common emergency conditions in the Stavropol Territory in the pathology of the organs of the abdominal cavity.
Scientific methodological justification of organization of an inter-district center of perinatal medicine
Authors: Aberhaeva L S , Gilmanov A A
Published: November 2019

Aim. To evaluate the effectiveness of the implementation of an organizational model of providing medical care for pregnant women, women in labor, new mothers and newborns care at an inter-district level. Methods. In the process of an organizational experiment evaluated were the quantitative and qualitative indices of the obstetrical services in the districts of the Zakamskiy region of the Republic of Tatarstan for the period 2005-2010. In order to assess the medical and social effectiveness used were the sociological, statistical methods and the method of expert evaluations. Results. The inter-district center of perinatal medicine makes it possible to concentrate in one place a significant number of pregnant women and newborns from a group of «moderate risk» with an economically justified staffing and logistical stocking of this center. An important indicator of the medico-social effectiveness of work of the Centre after the modernization during the period 2006-2010 was a statistically significant increase in the proportion of women who completed pregnancy with childbirth, from 756 to 972, births in due period - from 89.3 to 96.4%, a decrease in the proportion of preterm births from 4.7 to 3.2%. The new medical organizational technologies, which were implemented in the Center, have reduced the number of diseased newborns, which were sent for the second stage of treatment to the Pediatric hospital, to 15.6% during the surveyed period. The proportion of satisfactory evaluations of the organization of observation and treatment, which were given by the female patients of the Chistopol inter-district Center of perinatal medicine, has increased from 68.8 to 87.7%. Conclusion. Reorganization of the work of the obstetrical institutions into the type of an inter-regional perinatal center and the introduction of new technologies contributes to the improvement of qualitative parameters of the work of the prevention and treatment facility, as well as to the increase in patient satisfaction with the quality of care.
A case of a single double inlet cardiac ventricle with transposition of great vessels
Authors: Oslopov V N , Makarov M A , Khabibullina R T , Afanaseva T Yu
Published: November 2019

Presented was an observation of a 19-year old patient with a congenital heart defect (a single double inlet right cardiac ventricle in combination with a corrected transposition of the great vessels), which was complicated by acute heart rhythm disturbance (atrial flutter), and heart failure. With the help of echocardiography (2D-, M-mode, color Doppler scan) diagnosed was the single ventricle with transposition of the great vessels (a rare variant of B III). The peculiarity of this clinical case is the preservation of the sinus rhythm during 19 years, despite the marked remodeling of the myocardium. The sharp deterioration in clinical status of the patient was due to a disturbance of the cardiac rhythm: atrial flutter with a 2:1 conduction on to the ventricle. Clinical improvement was achieved by pharmacological blockade of atrioventricular conduction in combination with an increase of the inotropic myocardial function.
Left ventricular wall myocardium structural and functional indices change in patients with arterial hypertension and subclinical hypothyroidism treated with hypotensives
Authors: Soldatenko N V , Yeliseyeva L N , Zhdamarova O I
Published: November 2019

Aim. To assess the left ventricular wall myocardium structural and functional indices change over time in patients receiving hypotensive treatment for arterial hypertension associated with subclinical hypothyroidism. Methods. Sixty eight patients with arterial hypertension and subclinical hyperthyroidism were distributed to two groups. Patients of the group 1 (37 patients) received amlodipine (5-10 mg/day) and indapamide (1.5 mg/day), patients of the group 2 (31 patients) received lisinopril (5-10 mg/day) and indapamide (1.5 mg/day). Carotid artery ultrasonography and echocardiography were performed using «Philips» HD-11 XE (USA) scanner on the baseline and after 18 months of treatment. Results. Initial parameters of the left ventricular wall myocardium in all patients were comparable. Significant increase in early diastolic left ventricular filling velocity by 5.2%, decrease of late diastolic filling velocity by 11.4%, increase of peak velocities ratio on the mitral valve by 19.7% were revealed in patients of group 1 after 18 months of treatment compared to baseline. Increase in early diastolic left ventricular filling velocity by 7.0%, increase of peak velocities ratio on the mitral valve by 13.9% were registered in patients of group 2. No signs of concentric left ventricle remodeling were revealed. The share of patients with eccentric hypertrophy was not altered (18.9 and 12.9%, respectively). Conclusion. Treatment with amlodipine + indapamine and lisinopril + indapamine during 18 months improves left ventricle diastolic function.
Association of hypertension and abdominal obesity with some features of gynecologic history
Authors: Sadykova A R , Shamkina A R , Gizyatoullova R I
Published: November 2019

Aim. To study the association of some gynecologic history data in hypertensive women with abdominal obesity. Methods. A cohort of 315 women aged 21-59 years, including 53 healthy volunteers with normal blood pressure, 63 female patients with prehypertension and 197 hypertensive women, was examined. The mean age of hypertensive women was 47.0±7.0 years. Patients with symptomatic hypertension were excluded from the study. The patients were questioned about gynecologic history data (the number of pregnancies, abortions, miscarriages, history of gestational hypertension) and anthropometry. Patients were divided to 2 groups according to presence (137 female patients, mean age 47.8±6.3 years) or absence (178 female patients, mean age 44.4±7.3 years) of abdominal obesity. Results. There was a significantly higher number of women who had had pregnancies (97.3 versus 83.0%), deliveries (94.7 versus 76.5%), including two and more deliveries (69.9 versus 38.2%), and two and more abortions (64.6 versus 34.0%) among hypertensive women with abdominal obesity compared to non-obese women with normal blood pressure; higher mean rates of pregnancies, deliveries and abortions, more frequent history of gestational hypertension (51.3 versus 14.9%) were revealed as well. Conclusion. The combination of abdominal obesity and hypertension in women aged 21-59 years is associated with higher number of previous pregnancies, abortions, miscarriages and pregnancies, abortions, miscarriages, and history of gestational hypertension.
Prevention of pregnancy loss after appendectomy
Authors: Khvorostukhina N F , Stolyarova U V
Published: November 2019

Aim. To optimize preventive measures for miscarriage after appendectomy based on a study of the gestation course pathogenetic features in acute appendicitis. Methods. 78 pregnant women who had underwent surgery for acute appendicitis during gestation (gestation term from 4 to 30 weeks) were examined. The control group consisted of healthy 37 women with normal gestation. Serum prolactin level was measured by ELISA. Leukocyte intoxication index, combined endotoxin titre, coagulation tests (fibrinogen, soluble fibrin monomers, activated partial thromboplastin time, fibrinolysis time) were also examined. serum cytokine levels (interleukine-1β, -2, -4, -6, interferon γ, tumor necrosis factor α) were measured by solid-phase enzyme immunoassay. Patients of comparison group (n=42) received standard treatment targeted on pregnancy prolongation after the surgery. Discrete plasmapheresis was added to treatment offered for patients of the main group (n=36) at 3rd and 5th days after the appendectomy. Results. Endogenous intoxication syndrome development in association with hyper coagulation and simultaneous fibrinolysis inhibition and increase of paracoagulation products levels combined with pro-inflammatory cytokines level increase was noted in pregnant patients with appendicitis. Prolactin level increased by 1.5-1.8 times at 5-7 days after surgery with further decrease at 10-14 day accompanied by risk of miscarriage. The use of discrete plasmapheresis at 3rd and 5th days after surgery contributes to maintaining stable concentrations of prolactin in pregnant women in all terms during the postoperative period, as well as endogenous intoxication indicators decrease, hemostasis and cytokine profile normalization, allowing to increase the rate of successful pregnancy outcomes after appendectomy. Conclusion. Addition of plasmapheresis as a component of complex treatment in pregnant women after appendectomy allowed to reduce the risk of miscarriage by 4 times, and the rate of miscarriage by twice, suggesting this method as a safe and effective way to prevent miscarriage.
Role of genetic factors in the development of congestive heart failure
Authors: Bulashova O V , Khazova E V , Oslopov V N
Published: November 2019

The article reviews studies of gene polymorphisms effects on the phenotype and the prognostic value of the genotype determination in patients with congestive heart failure. The results of studies analyzing the impact of angiotensinogen, angiotensin-converting enzyme, β2-adrenoreceptor genes polymorphism on the development of hypertension, myocardial and carotid arteries damage, and congestive heart failure prognosis are surveyed. However, despite the large number of studies addressing the association of polymorphic markers of candidate genes and phenotype, no consensus on the impact of candidate genes on the major systems involved in the pathogenesis of congestive heart failure has been achieved so far. Due to gene distribution variability in different populations, the studies of ethnic and geographical association of candidate genes with congestive heart failure development, as well as studies of phenotypic markers of the disease, are still relevant.
Clinical manifestations of community-acquired pneumonia according to data of Samara region hospitals
Authors: Sivakova O D
Published: November 2019

Aim. To describe the clinical manifestations of community-acquired pneumonia in patients of the Samara region. Methods. The retrospective clinical data analysis of 241 patients’ [130 (53.9%) males, 111 (46.1%) females, mean age 41.8±0.8 years] medical charts (case histories and out-patient cards) who were treated from 2007 to 2012, was performed. Specially developed individual registration cards were used for data collection. Results. Patients had the following concomitant diseases: hypertension - 10 (4.8%) patients, coronary heart disease - 10 (4.8%) patients, chronic non-obstructive bronchitis - 9 (4.3%) patients, chronic obstructive pulmonary disease - 6 (2.9%) patients, HIV infection - 5 (2.4%) patients, malignancies - 5 (2.4%) patients, bronchial asthma - 3 (1.4%) patients. Patents called for medical aid at 7.8±1.3 day after the disease onset, 48 (26.7%) were using self-administered drugs before going to medical professional. The leading clinical signs were fever - in 97 (53.9%) patients and cough - in 89 (49.4%) patients. 36 (20.0%) patients reported a chest pain, 55 (30.5%) - shortness of breath, 71 (39.4%) - productive cough. Typical X-ray symptoms were present in all cases. Conclusion. The main clinical manifestations of community-acquired pneumonia were cough and fever, patients called for medical aid at the late stages of the disease and extensively used self-administered drugs.
The strategy of improving medical service for sports and physical culture in the Republic of Tatarstan on the eve of 2013 Summer Universiade
Authors: Vafin A Y , Aukhadeev E I , Sadykova R S , Bodrova R A
Published: November 2019

The problems of healthcare system formation and management for physical culture and sports are discussed within the framework of prevention and rehabilitation areas development in the Republic of Tatarstan. The 2013 Summer Universiade is acknowledged as the largest event in the international sports, involving 13 000 sportsmen participating in 27 different summer sports. Physical culture and sports healthcare is known to be the one of the most crucial factors influencing sporting achievements. Since 2013 the Centre for Medical Prevention has started to create the informational and analytical system required for integral, in-depth and systemic image of physical culture and sports healthcare status and problems in the Republic of Tatarstan. A multi-layer matrix of the data gathering within the healthcare system, including the elements of physical culture and sports healthcare. We offer to create a national program the basing on the modern methodology of science for studying and solving complex social problems. The development of the local program devoted to physical culture and sports healthcare improvement can be a model of similar methodology-based program formation with a wider coverage, allowing to provide the preventive and rehabilitation healthcare for the whole population.
Role of quality of life estimation in early diagnosis of abdominal angina
Authors: Barkhatov I V
Published: November 2019

Aim. To assess the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire as an ambulatory screening test for early diagnosis of abdominal angina. Methods. An assessment of abdominal symptoms severity and quality of life was performed using the GSRS questionnaire in 110 patients with abdominal angina. No sings of abdominal angina and no vascular abnormalities were found at Doppler sonography in 39 (35.5%) of patients (main group). In 71 (64.5%) patients distributed to the second group signs of insufficient blood flow (including vascular wall calcification and thickening, medium and small arteries compression and narrowing up to 40-70%, and inadequate blood flow after exercise. Results. There were no statistically significant differences found in prevalence of abdominal pain, reflux and diarrhea between two groups. Dyspepsia was noted in 29 (74.4%) patients of first group and in 71 (100%) patients of the second group. Average GSRS scores were 3.67±0.51 and 5.07±0.32 accordingly in those patients. Constipation was present in 16 (41%) patients of first group and in 54 (76.1%) patients of the second group, with the GSRS score 1.33±0.31 and 3.04±0.32 accordingly in those patients. Average total GSRS score was significantly higher in patients with abdominal angina - 13.51±0.84 points versus 9.94±1.13 in patients without signs of abdominal angina on Doppler sonography. Conclusion. The use of GSRS questionnaire allows to detect syndromes characteristic for abdominal angina.
Choosing the surgical treatment method for benign prostatic hyperplasia
Authors: Sitdykov R M , Shaidullin E N , Zubkov A Y
Published: November 2019

Aim. To assess the surgical treatment outcomes for benign prostatic hyperplasia. Methods. The surgical treatment outcomes for benign prostatic hyperplasia were analyzed in 72 patients. 44 patients underwent transvesical prostatectomy ended with blind urinary bladder stitch, 28 patients with a prostate volume of less than 60 ml were offered transurethral resection of prostate. The patients’ mean age was 73.6 years. Inclusion criteria were: average urination flow rate (Qav) 10 ml/sec, total international prostate symptom score (I-PSS) 19, residual urine volume 50 ml. Prostate volume ranged from 29 to 150 ml. All interventions were performed using regional anesthesia. The effect of surgical treatment was assessed 3 months after the surgery was performed. Results. Self urination was restored at 2-3rd day. All patients had no residual urine. Urine flow parameters in patients after transvesical prostatectomy were: maximum urination flow rate (Qmax) - 24±1.3 ml/sec, Qav - 11.6±1.1 ml/sec; in patients after transurethral resection of prostate: Qmax - 17.2±0.8 ml/sec, Qav - 11.4±1.2 ml/sec. I-PSS index in the transvesical prostatectomy group was 2.3±0.3 compared to 9.7±1.1 points in transurethral resection of prostate group. Irritative symptoms prevailed in patients from transurethral resection of prostate group, 23 (82%) of them have improved after 1 month treatment with α1-adrenoblockers. Conclusion. Transvesical prostatectomy ended with blind urinary bladder stitch is still a radical and effective option for benign prostatic hyperplasia surgical treatment. Transurethral resection of prostate is effective in patients with prostate volume less than 60 ml and requires additional medical correction of irritative symptoms during the postoperative period.
Central nervous system involvement at the onset of systemic sclerosis
Authors: Gabitov S Z , Sakhovskiy P I
Published: November 2019

A rare clinical case of a 23-year old patient with central nervous system damage at the onset of systemic sclerosis at the age of 14 is presented. The patient was born with cerebral damage which was taken as a reason of the neurological manifestations that developed long later (epileptic attacks at 14 years of age, autism at 17 years of age). At the clinical examination diffuse asymmetric scleroderma as face and hand teleangiectasias, chest hyper pigmentation and shin skin hyper pigmentation and hardening were present. A characteristic look with reduced mimics, significant jaw movement limitation, tongue mobility limitation (patient was not able to touch the palate with the tongue) were also present. Patient had swollen fingers with limited finger motions, reduced hand muscular strength due to sclerodactyly. A shadow in the right lung middle lobe on the chest X-ray was found. According to physical examination results and laboratory data the following diagnosis was set up: «Juvenile systemic sclerosis, chronic form with slow progression, spreading stage: leg induration, sclerodactyly, chest hyper pigmentation, face teleangiectasias, basal pneumosclerosis, myocarditis, myocardiosclerosis, glomerulonephritis, esophageal achalasia, hepatitis, autism, epileptic attacks, polyarthritis, left elbow periarticular calcinosis, complicated relapsing aspiration pneumonia». The characteristical features of this case are the atypical clinical course, appearance of the diagnostic markers after 8 years of the disease with multisystemic involvement of internal organs, skin and joints. Because of the late start of the corticosteroid treatment, relapsing aspiration pneumonia, low corticosteroid treatment compliance the patient has succumbed.
Serum apelin-12 in bronchial asthma
Authors: Mineev V N , Lalaeva T M , Kuzmina A A
Published: November 2019

Aim. To evaluate the serum level of apelin-12 in patients with bronchial asthma. Methods. 11 healthy controls and 29 patients with bronchial asthma were examined (among them 19 with atopic asthma and 10 with non-atopic asthma). Serum apelin-12 levels were measured by enzyme immunoassay (ELISA, MyBioSource, USA). SPSS (Statistical Package for the Social Science, V. 13) for Windows was used for statistical analysis. Results. The phenomenon of low apelin-12 serum levels was revealed in patients with bronchial asthma. The most significant decrease of apelin-12 levels was noticed in atopic bronchial asthma. The apelin-12 levels were significantly correlated with a number of indices of bronchial obstruction. Apelin-12 levels correlated with a number of indicators characterizing the grade of bronchial obstruction. Moreover, low apelin-12 levels were suggesting bronchial obstruction. Besides, significant reverse correlation of apelin-12 levels and allergic sensitization was revealed. In addition, statistically significant relation between apelin-12 serum level and peripheral blood eosinophil and lymphocyte counts was revealed. There was an inverse association between apelin-12 serum level and peripheral blood neutrophil count. Conclusion. Literature analysis and our own results allow us to suppose the possible protective role of apelin-12 in bronchial asthma flare. Further studies of apelin-12 and of other isoforms of adipokines are needed for better understanding of the disease.
Extragenital diseases in patients with preterm delivery caused by preeclampsia and/or fetal growth restriction
Authors: Fadeeva N I , Buryakova S I , Belinina A A
Published: November 2019

Aim. To determine the influence of extragenital diseases and their combinations on the development of placental insufficiency manifesting as heavy preeclampsia and/or antenatal distress of fetus as indications for preterm delivery. Methods. The retrospective study based on medical charts of patients with delivery term of 28 to 36 weeks of gestation caused by heavy preeclampsia and/or antenatal distress of fetus was performed. Results. In case of the deliveries at 28-33 weeks of gestation caused by preeclampsia and fetal growth restriction, arterial hypertension was present in 42.8% of cases, combination of arterial hypertension and obesity - in 33.3%; at 34-36 weeks of gestation hypertension was revealed in 40%, obesity - in 22.5% of cases. In case of the deliveries at 28-33 weeks of gestation caused by preeclampsia, diabetes was present in 42.6% of cases, the combination of arterial hypertension and obesity - in 17.6%; at 34-36 weeks of gestation obesity was registered in 34.1% of cases. In patients with fetal growth restriction who delivered off at 28-33 weeks of gestation, arterial hypertension was diagnosed in 20.2% of cases; in patients who delivered off at 34-36 weeks of gestation, chronic diseases of upper respiratory tract were revealed in 21.4% of cases. Conclusion. The risk factors of pregnancy complicated by heavy preeclampsia and fetal growth restriction are arterial hypertension and obesity, whereas the combination of these factors increases the risk for pre-term delivery before 33 weeks of gestation eight-fold. The risk factors of pregnancy complicated by heavy preeclampsia without fetal growth restriction are diabetes mellitus type I and obesity (it increases the risk for pre-term delivery before 33 weeks of gestation four-fold if associated with arterial hypertension). The risk factors of pregnancy complicated by fetal growth restriction and antenatal distress of fetus are chronic diseases of upper respiratory tract, whereas arterial hypertension increases the risk of pre-term delivery before 33 weeks of gestation three-fold.
Secretion level of some endogenous antimicrobial peptides and certain cytokines in type 2 diabetes mellitus
Authors: Azizova G I , Gasanova Sh I , Niyazova N K , Dadashova A R , Azizova U G
Published: November 2019

Aim. To assess plasma levels of antimicrobial peptides (defensin and endotoxin) and some cytokines (interleukin-6, tumor necrosis factor α and transforming growth factor β) in type 2 diabetes mellitus. Methods. Blood samples of 87 patients with type 2 diabetes mellitus were examined. All patients were assigned to three groups depending on blood glucose and glycosylated hemoglobin levels: compensation - 36 subjects, sub-compensation - 34 subjects, decompensation - 17 patients. Plasma levels of endogenous peptides - defensin (HNP) and endotoxin - were measured. Enzyme-linked immunosorbent assay test was used to measure the levels of cytokines («Bender Medsystems» kits, Austria) and antimicrobial peptides (set «Hycult Biotech»). Results. In the first group (diabetes mellitus type 2, compensation), defensin level was 120.0±0.9 ng/ml, which is 17.6% higher than in the control group. The second group (sub-compensation) showed a 4-fold increase in defensin level compared to the control, the third group (decompensation), defensin level was 1443.1%, or 14.4-fold compared to the control. Endotoxin level was 1.18±0.05 ng/ml in the first group, 1.57±0.14 ng/ml in the second group, and 18.2±0.09 ng/ml in the third group compared to 0.33±0.12 ng/ml in the control group. Patients with decompensated and sub-compensated diabetes showed statistically significant increase in plasma levels of interleukin-8, tumor necrosis factor α and transforming growth factor β compared to the controls. Conclusion. There was an interrelation revealed between the secretion of antimicrobial peptides and cytokines - interleukin-8, tumor necrosis factor α and transforming growth factor β; concentration of antimicrobial peptides and cytokines reflects the stage of development of type 2 diabetes mellitus.
Oral mucosa lichen planus: clinical forms, treatment
Authors: Chuykin S V , Akmalova G M
Published: November 2019

Despite the fact that lichen planus was firstly described over 150 years ago, the disease still remains an important issue of clinical dentistry. The article reviews the clinical features of various forms of oral mucosa and vermilion border lichen planus: typical, hyperkeratotic, exudative and hyperemic, erosive with ulcerations, bullous and atypical. The main pathologic element in all forms of lichen planus is papule of milky white or grayish color. Papules may be single or merge into intricate carvings forming lace, mesh, fern leaves (Wickham mesh). Compared with skin forms, oral mucous membrane lesions are more resistant to medical treatment and rarely undergo spontaneous remission. Treatment of lichen planus is a difficult task because the etiology and pathogenesis of the disease is not completely understood. This article reviews the methods and drugs used to treat oral mucosa lichen planus, and their side effects. At the moment, no single method of treating lichen planus can be considered as a cure. Existing comprehensive treatments help to reduce severity of the disease, which is seen as prolongation of remission, reduction of terms of pathological elements epithelialization, reduction of their number and size. To achieve consistent results in the treatment of oral mucosa lichen planus, complex treatment should be periodically repeated. Selection of optimal methods of general and local therapy should be based on an individual approach to each patient.
Diagnostic imaging techniques for diagnosing bone metastases of non-small cell lung cancer
Authors: Laryukov A V , Laryukova E K
Published: November 2019

Lung cancer bone metastases hold one of the leading positions. At the same time, data of the rate of lung cancer bone metastases are scarce. Clinical symptoms of bone metastases in the early stages may be missing. Time of bone metastases appearance, as well as localization depending on the size of primary lesion and its histological structure are not well-covered. According to domestic and foreign literature data, the advantages and limitations of radiological and nuclear methods in detecting bone metastases of non-small cell lung cancer are presented, their resolution and sensitivity are discussed. The analysis of comparative results of various diagnostic imaging techniques in detecting lung cancer bone metastases (X-ray, bone scintigraphy, computed tomography, magnetic resonance imaging, single-photon emission computed tomography, positron-emission tomography) is of undoubted interest. These data are necessary for choosing the appropriate diagnostic tactics and selecting an adequate sequence of using high-tech radiology methods for early detection of lung cancer bone metastases. However, the comparative data presented in the literature are generally based on a scarce clinical material; mostly comparisons of diagnostic capabilities of only two methods were held. There is no data on the rate of bone metastases of peripheral non-small cell lung cancer and its association with the localization, size and histological structure of the primary tumor.
Ovarian stromal hyperthecosis
Authors: Khasanov A A , Zhuravleva V I , Lipatova I O
Published: November 2019

The review analyzes the data on pathogenesis, prevalence, pathomorphology, clinical manifestations, diagnosis and treatment of ovarian stromal hyperthecosis. This condition is characterized by severe hyperandrogenism and impaired glucose tolerance, and it is mostly occurs in postmenopausal women. Main cause of androgenic hyperproduction in women of reproductive age - the polycystic ovary syndrome - is thoroughly studied; standards for diagnostics and treatment for such patients are developed. Little is known about stromal hyperthecosis, which is a more rare cause of hyperandrogenism that had been considered as a severe form of polycystic ovary syndrome. However, it became an independent nosological form after a detailed study of the pathomorphology. Currently, there are no generally accepted diagnostic criteria for stromal hyperthecosis. This is not only because the disease is rare, but also due to the difficulty of making the final diagnosis. Patients with stromal hyperthecosis are at high risk for developing malignancies - endometrial cancer or breast cancer. So, the need for further investigation and developing treatment approaches is undoubted. In majority of cases, the diagnosis of stromal hyperthecosis is set on histological examination of ovarian tissue from patients with idiopathic severe hyperandrogenism, infertility or cancer. The practicing obstetrician-gynecologist must be aware of this condition to suspect the ovarian stromal hyperthecosis when its typical clinical features manifest, to perform meticulous laboratory and instrumental investigation and to choose the correct management tactics for such patients.
Experience of the Republic of Tatarstan in the implementation of early intervention model to support infants with developmental disorders and disabilities
Authors: Farrakhov A Z , Ignashina E G , Sadykov M M , Zubova E P
Published: November 2019

Aim. To evaluate the effectiveness of implementing the program of early intervention in the Republic of Tatarstan, which provides medical and psycho-pedagogical support of infants with developmental disorders and disabilities. Methods. The following methods were used: analytical, expert, comparative and systematic approach. Results. Gained results indicate the high efficiency of new forms and approaches for supporting infants with diseases and developmental disabilities with a focus on early intervention techniques in a background of phased health care. The advantages of an embedded algorithm of prenatal diagnosis of development disorders in children, as well as neonatal screening for hereditary pathology of infants, audiologic and electrocardiographic screenings of newborns, are shown, allowing timely diagnosis and early correction of disorders, including high-tech methods use. The positive trends of the performance of early intervention offices in children’s’ outpatient departments are stressed, resulting in infants harmonious and optimal neuro-psychological development and improvement of their quality of life. The positive aspects of children’s rehabilitation institutions of social security system activities are highlighted, which include the use of modern technologies of medical and social rehabilitation. The positive changes of disability rate for many nosologic forms, mortality, as well as the number of cases of abandoned newborns, were registered. Conclusion. Implementing the program of early intervention provides an opportunity to influence the health status and quality of life in infants with developmental disabilities and handicapped infants, to promote their social integration, to prevent disabilities in infants and parents refusals to educate their children (social orphanage).
Organization and financing of the zemstvo health care in the Kazan province
Authors: Morozova E V , Sozinov A S
Published: November 2019

«The Statute on the provincial and district local government» (1864) started a significant social and economic changes in the country. Before the introduction of zemstvo self-government the organization of health care was administered by various departments. So there was no unified system of health care provision. With the introduction of the territorials authority in the area of «national health» were divided between governmental and territorial authorities. State management covered issues of sanitary improvement and anti-epidemic measures. The task of medical care organizing was on the territorial self-government, although they did not have sufficient administrative permissions. Throughout the whole period of activity the territorials created various administrative authorities for the organization of the effective system of management: the provincial and district councils of public health, provincial and district committees of public health, medical boards. Financing of the health care system was negligible in the early years of territorials. It was carried out from the provincial and district territorial budgets, with major financial expenses fell on the county local governments. They paid for the costs of the medical personnel and medical facilities, carrying out sanitary measures. Most of the funds were spent on treatment measures. The organization of an emergency anti-epidemic measures in case of the threat of spreading epidemics as well as the organization of mental health care and provision of the provincial hospital and paramedic school were funded from the provincial budget. The amount of financing of the territorial health care increased almost annually, reflecting the strategic importance of the health care sector for territorial self-government.