bluuebunny/crossref_metadata_2025 huggingface dataset:
Atrial fibrillation in patients after radiofrequency ablation of
cavotricuspid isthmus.
Authors: Steklov V. I. , Emel’yanenko Mikhail V. , Chernykh S. V.
Published: November 2020

The article presents the clinical, instrumental and electrophysiological features of patients who develop atrial fibrillation after cavotricuspid isthmus ablation in 209 patients with typical atrial flutter. Taken together, these features make up a peculiar clinical, instrumental and electrophysiological portrait of patients with post-ablative atrial fibrillation. Comparative analysis of these parameters was made, and it was found that some of them are prognostically significant. Also, we describe the technique of modified intraoperative electrophysiological test of atrial fibrillation induction in patients with typical atrial flutter. We investigated the role of this technique in the occurrence of post ablative atrial fibrillation.
Pathogenetic substantiation of approaches
to the treatment of non-alcoholic fatty liver disease.
Authors: Bogomolov P. O. , Macievich M. V. , Kokina Ksenia Y. , Mayorov A. Yu. , Mishina E. E.
Published: November 2020

Non-alcoholic fatty liver disease (NAFLD) affected 20-40% of the adult population in high developed countries. Active form of the disease - non-alcoholic steatohepatitis (NASH) - is characterized by damaged hepatocytes, inflammation of the liver tissue, can be accompanied by liver fibrosis, and is one of the most common causes of liver cirrhosis, liver failure and hepatocellular carcinoma. Moreover, there is a close link between NASH and metabolic syndrome, thereby among this category of patients the high risk of developing diabetes mellitus, cardiovascular complications and cancer. Weight reduction of 10% by observing dietary recommendations and performing regular physical exercises contributes to the reduction or complete resolution of NASH in some patients. However, in practice, it is not always possible to eliminate inflammation in the hepatic tissue. Existing drugs such as vitamin E, pioglitazone and pentoxifylline have limited efficacy, and can cause a few side effects, including hepatotoxicity, and not to reduce the severity of liver fibrosis. However, basic and translational studies have improved our understanding of the pathogenesis of NASH, thereby opening new promising therapeutic targets. Currently, several drug agents are in Phase II and Phase III clinical trials and may enter practice in the foreseeable future. In this article, we consider modern concepts of pathogenesis, existing therapeutic approaches and new directions of pharmacy in the field of NASH treatment.
Pathogenesis, clinical manifestation, diagnosis of hypergonadotropic
hypogonadism in women of reproductive age with hyporandrogenia.
Authors: Akhundova Natavan E. , Aliyeva E. M. , Mamedgasanov R. M.
Published: November 2020

Aim. To explore clinical diagnostical criteria of hypergonadotropic hypogonadism in patients with hyperandrogenia in reproductive period. Material and methods. 21 women with hyperandrogenia and hypergonadotropic hypogonadism were examined (basic qroup). Comperative qroup was presented by 20 practically healthy women of reproductive age. The following indicators were investigated family history, the severity of hirsutism, blood levels of folliculostimulating (FSH), luteinized (LH), thyroid stimulating (TSH) hormons, the ratio of LH/FSH, prolactin, cortizol, 17-oxyprogesterone (17-OP), dehydroepiandrosterone sulfate (DHEA-S), androstentione, total testosterone, free triyoitironin (T2), thyroxine (T4), estrone (E1), estradiol (E2), sex hormone binding globuline (SHBG), antimullerian hormone (AMH). Results. There was confirmed that patients of reproductive age with hypergonadotropic hypogonadism with hyperandrogenia have significant elevation of FSH, LH, E1, An, K, 17-OP, DHEA-S, free testosterone leveles, and decreasing of E2, SHBG and AMH livels. Timely diagnosis of hypergonadotropic hypogonadism significantly reduces the risk of premature ovarian failure, and increases probability of spontaneous pregnancy.
Prognostic markers of remission of cushing's disease after transsphenoidal endoscopic adenomektomii.
Authors: Gussaova Natalia V. , Choi W. A. , Cerebillo V. Yu. , Paltsev A. A. , Savello A. V. , Ryazanov P. A. , Mitrofanova L. B. , Solntsev V. N. , Grineva E. N.
Published: November 2020

Aim. To study the role of prognostic oral high-dose dexamethasone suppression test (HDDST) and pituitary MRI in the prognosis of Cushing’s disease (CD). remission after transsphenoidal endoscopic surgery (TSS). Material and methods. 59 patients with Cushing’s disease (9 men, 50 women, mean age 40 years (15-72) underwent TSS were included. Before the TSS HDDST and pituitary MRI were performed in all cases. Postoperative examination was done one year after surgery. Remission criteria were: combination of normal midnight serum cortisol levels, normal 24 hour urine free cortisol (UFC) excretion and serum cortisol suppression less than 50 nmol/l in 1-mg dexamethasone test or secondary adrenal insufficiency (the need for glucocorticoid replacement). The optimal threshold value of serum cortisol suppression in the HDDST for prediction of CD remission after TSS was calculated by ROC-analysis. Results. One year after surgery CD remission was confirmed in 39 patients, whereas in 20 patients hypercortisolism persisted. The optimal threshold value of serum cortisol suppression in the HDDST for prediction of CD remission after TSS was 72%. Test’s sensitivity and specificity were 82% and 84%, respectively. The probability of wrong prediction was 17% (p=0,0001). In our study, the results of TSS did not correlate with MRI adenoma size.
Dosed walking as a method to increase physical activity and improve quality of life for recipients of donor kidney.
Authors: Shelekhova Tatiana Y. , Achkasov E. E. , Tsirulnikova O. M. , Volodina K. A.
Published: November 2020

Background. Aim of this study was to evaluate the role of dosed walking to improve on physical activity (PA) and the quality of life (QOL) of people after kidney transplantation. Material and methods. Analyzes the results of treatment of 57 recipients (mean age - 35 ± 9,65) donor kidney at different times of the postoperative period. Depending on the physical rehabilitation program allocated 2 groups of patients: II group - physical rehabilitation was carried out only in the first week after surgery to prevent early postoperative complications, in group I - during the year. In group III combined 30 relatively healthy people do not need an organ transplant and with a mean age 33,7 ± 8,7 years, leading a normal life, not engaged in regular recreational physical culture.Physical activity was assessed using a pedometers OMRON WalkingStyleOne HJ-152. Quality of life was assessed using a questionnaire SF36 at 1, 3, 6 and a 12 months after surgery. Results. One year after surgery in both groups compared with preoperative indicators marked improvement physical activity (PA) and the quality of life (QOL). However, in the first group indicators of PA and QOL were higher than in the second group from 50,46 to 32%, and even some items indicators PA and SF-36 is higher than in Group III, which is associated with the physical rehabilitation. Conclusions. Dosed walking is an important part of treatment and rehabilitation after kidney transplantation and allows you to increase physical activity and significantly improved quality of life due to a physical component.
Ventricular premature beats as a rare onset of sarcoidosis.
Authors: Yazev E. E. , Lebedeva Marina V. , Strizhakov L. A. , Pasha S. P. , Mukhin N. A. , Sholomova V. I. , Brovko M. Yu.
Published: November 2020

Cardiac sarcoidosis is of predictive value, but its diagnostics is difficult in view of the lack of pathognomonic clinical signs and the high frequency of cases with subclinical course. In this article, we present an algorithm of clinical examination and treatment strategy using combined immunosuppressive therapy of cardiac sarcoidosis in a young women whose only symptom was frequent premature ventricular beats. In this clinical case cardiac sarcoidosis was diagnosed practically at the onset of the disease and the use of massive immunosuppressive therapy allowed to reach considerable positive dynamics even before development of irreversible changes both in myocardium and lungs.
Modern clinical and epidemiological characteristic of systemic lupus erythematosus based on the data of the territorial registry
Authors: Shaduro Denis V. , Beloglazov V. A. , Petrov A. V. , Aliev K. A.
Published: November 2020

Systemic lupus erythematosus (SLE) is a severe rheumatic disease characterized by polysymptomatic clinical picture. At the present stage, there are no updated epidemiological data due to the low prevalence of the disease. The aim of the study was to examine the current clinical and epidemiological characteristics of patients with systemic lupus erythematosus based on the information contained in the territorial register, analysis of occurrence and symptoms at the early stage of the disease. This study demonstrated the epidemiological and clinical characteristics of SLE from the analysis of 107 cases during the period from 2011 to 2013 and retrospective analysis of the cases for 1980-2013. The epidemiological situation was evaluated based on extensive and intensive indicators using statistical software license. The current SLE prevalence was estimated at 5,59 per 100 000 population in 2013, the incidence between 1994 and 2003 at 0,29 per 100 000 population and between 2004 and 2013 at 0,49, with the peak in 2010 up to 1,35 per 100 000 population. The average absolute growth and growth rate of SLE in the first decade was 0,05% and 0,24%, in the second decade 0,001% and 0,006% respectively, with the female to male ratio being 9:1, mean age of the patients 37,62±11,65 years), and ethnic composition of 87 Slavs and 15 Crimean Tatars. The most common symptoms at the early (polyarthritis, fever, dermatitis) and advanced (polyarthritis, Raynaud's syndrome, carditis, myalgia) stages differed from those specified by American College of Rheumatology (1997). The difference between early and late symptoms of SLE was documented . Based on the data obtained, the division of the disease into clinical subtypes (phenotypes) is proposed.
Cardiovascular diseases: evaluation of persisting disorders in the blood circulation system and disability, criteria for severity of invalidism
Authors: Shurgaya Marina A.
Published: November 2020

A most important indicator of population health, its social and economic wellbeing is premature disability. 10.3 mln people had to retire from their jobs due to disability during the ten-year period from 2005 to 2014. The number of elderly subjects among them was twice that of the younger ones, with the leading cause of disability being blood circulation disorders (61,9%). At the same time, the fraction of old subjects in the group of invalids suffering from coronary heart disease and idiopathic hypertension accounted for only 58,9% and 40,9% respectively. The quantitative evaluation of persistent dysfunction of the cardiovascular system related to circulatory disturbances included in ICD class IX and to those referred to other classes is based mainly on an assessment of the following clinical andfunctional manifestations: pain syndrome (cardialgia or angina); hypertensive syndrome; pulmonary hypertension; arrhythmia; syncope. Other aspects of pathological process are taken into consideration, such as its form and severity, presence andfrequency of exacerbations, magnitude, involvement of target organs, complications. The gerontological slant of disabling cardiovascular pathology accounts for its social significance (idiopathic hypertension, coronary heart disease, chronic heart failure) which requires the adequate solution of the problem of healthcare provisions taking account of the current demographic situation and increased life expectancy within the older population suffering from a number of chronic diseases.
Wilson’s disease - hepatocerebral dystrophy
Authors: Tsimmerman Ya. S.
Published: November 2020

The review is focused on definition of Wilson’s disease, terminology, prevalence, etiology and pathogenesis including hereditary predisposition, and polymorphism of clinical forms (liver, brain, kidneys, eyes, etc.). The author proposes a clinical classification of Wilson’s disease, describes methods for its comprehensive clinical, laboratory and instrumental diagnostics, pathogenetic and adjuvant treatment.
The role of diffuse neuroendocrine system of the digestive tract in the
development of disorders of proliferation and apoptosis in the stomach of patients with Helicobacter pylori infection
Authors: Svistunov A. A. , Kireeva N. V. , Osadchuk M. A.
Published: November 2020

In the implementation of oncogenesis and, in particular, the cascade of Correa, a significant role is played by the relationship of proliferation and apoptosis with the system functioning of the digestive tract of the diffuse neuroendocrine system and Helicobacter pylori
The influence of non-invasive lung ventilation on functional and immune characteristics in patients with severe exacerbation of chronic obstructive pulmonary disease
Authors: Makarova E. V. , Shumilova S. V. , Vakhlamov V. A. , Kasatova E. S. , Men’kov N. V. , Lukovnikova N. B. , Varvarina G. N. , Tyurikova L. V. , Karaulov A. V. , Novikov V. V.
Published: November 2020

We studied the influence of spontaneous/timed non-invasive ventilation (NIV) on the functional and immune characteristics of patients with severe exacerbation of chronic obstructive pulmonary disease (COPD). Symptoms, pulmonary function test, O2 saturation (SpO2) were investigated; serum content of soluble differentiated leukocyte molecules was measured using ELISA. NIV led to a more significant improvement of general state, dyspnea, and respiratory function in comparison with the control group, increased SpO2, and decreased initially elevated concentrations of soluble sCD95, sCD50, sCD16 molecules reflecting the reduction of inflammatory activation of immune cells. The use of NIV allowed to lower the doses of systemic corticosteroids that caused inhibition of 6 out of 13 studied soluble antigens in the control group (oligomeric and total sCD95, total sCD38, sCD25, sCD50, sHLA-DR) due to non-selective immunosuppressive action. This procedure may be recommended for a wider use in pulmonological practice.
Relationship between immune and oxidant disorders
associated with acute non-obstructive pyelonephritis
Authors: Konoplya A. I. , Shatokhin M. N. , Mavrin M. Yu. , Gavrilyuk V. P.
Published: November 2020

Acute pyelonephritis is the most common disease of urinary system in all age groups resulting from an infectious-inflammatory process leading to mobilization of the immune system. A key event is the contact of the pathogen with the cells of the immune system that form the first line of defense and are capable of phagocytosis and destruction of microbial agents that cause oxidative disorders. The aim of the study was to establish the relationship between the immune and oxidant disorders at the systemic and local level in acute obstructive and non-obstructive pyelonephritis. 56 patients with acute serous and serous non-obstructive acute obstructive pyelonephritis confirmed by instrumental methods were under constant observation. Plasma and urine concentrations of cytokines (TNFα, IL-1β, IL-6, IL-8, IFNα, IFNγ, IL-4, IL-10, IL-1RA), components of the complement system (C3, C3a, C4, C5 and C5a, Factor H, C1-inhibitor) were determined along with activity of neutrophils in peripheral blood, concentration of peroxidation products (malonic dialdehyde, acylhydroperoxide), catalase and superoxide dismutase activities. The level of immune inflammation and oxidative stress were higher in acute obstructive pyelonephritis than in acute non-obstructive pyelonephritis. The close correlation between the studied oxidant and immune parameters at the systemic and local levels can be used to assess the severity of the disease, its prognosis, treatment and preventive measures.
Systemic steroid treatment of acute inflammation of ear and
upper airways
Authors: Slavsky A. N. , Meitel I. Yu. , Toporkova L. A. , Fatiyanova V. I.
Published: November 2020

This article was designed to review data on systemic steroid therapy of acute tonsillopharyngitis, acute rhinosinusitis, acute otitis media and mastoiditis borrowed from clinical recommendations, guidelines and scientific research.
Rivaroxaban: comparative analysis of information on adverse reactions from Russian and international databases
Authors: Zatolochina K. E. , Kazakov A. S. , Kolesnikova E. Yu. , Polivanov V. A. , Alyautdin R. N. , Romanov B. K. , Olefir Yu. V.
Published: November 2020

Information about rivaroxaban adverse reactions (ADRs) submitted to the national spontaneous reporting database from 1 January 2008 to 31 March 2016 was analyzed and compared with the international database (VigiBase) for the same time period. The marked increase in reporting ADRs after rivaroxaban treatment was detected in the Russian database. The comparison of the two databases showed that the relative ratio of ADRs from organs and body systems did not differ significantly except for ADRs of the cardiovascular system that predominated according to the Russian database. Moreover, the Russian database contained much fewer reports of hemorrhagic complications than the international database.
Hyperuricemia and cardiovascular diseases in elderly patients
Authors: Topolyanskaya S. V. , Vakulenko O. N. , Semashkova A. E. , Kupina L. M. , Strizhova N. V.
Published: November 2020

Results of the clinical study on the prevalence of hyperuricemia and its association with cardiovascular pathology in elderly patients with coronary artery disease (CAD) and in patients with CAD younger than 60 years are presented. Increased serum level of uric acid was observed in 37.4% of the 320 elderly patients. Hyperuricemia more frequently occurred in women (41.5% of the cases) than in men (25%) (p=0.02). In the group of elderly patients, hyperuricemia was associated with clinically significant heart failure (OR=5.01; 95% CI=2.39-10.73; p<0.0001) and with the history of stroke (OR=2.02; 95% CI=1.1-3.8; p=0.02). The prevalence of atrial fibrillation in patients with hyperuricemia was higher than in subjects with normal uric acid level (OR=2.2; 95% CI=1.3-3.6; p=0.001). Significant positive correlation between serum uric acid level and left atrium diameter was demonstrated (r=0.25; p=0.00004). In the group of patients with CAD younger than 60 years hyperuricemia was significantly associated with myocardial infarction (OR=8.81; p=0.002) and with congestive heart failure (OR=6.86; p=0.003) in the medical history. The study demonstrated high prevalence of hyperuricemia in patients suffering from CAD. Significant association between high uric acid level and the incidence of cardiovascular diseases was documented.
Classifications in medicine: principles of their structure and clinical significance
Authors: Kuznetsov N. A.
Published: November 2020

The article deals with theoretical aspects of medical classification research and quantitative perioperative prognostication for the purpose of planned surgical treatment. Classification is regarded as a cultural phenomenon related to all sides of everyday life. Also, it is part of the modern experience exchange mechanism. Under the term classification is understood both the classification proper and the development of classification. The natural classification is built up based on the inherent properties of objects and the relationships between them. The essential properties are identified with the use of a specialized mathematical apparatus (correlation, factorial and cluster analysis).
Membrane proteins of erythrocytes and diameter-thickness ratio in patients with essential arterial hypertension complicated and non-complicated by metabolic syndrome
Authors: Pivovarov Yu. I. , Sergeyeva A. S. , Babushkina I. V. , Dmitrieva Lyudmila A. , Bogdanova O. V.
Published: November 2020

Changes in structural and functional qualities of membrane proteins of erythrocytes in patients with essential arterial hypertension (EAH) can promote development of severe dysfunction of these cells and complicate the course of systemic disease. Aim. To elucidate the character of correlation between sphericity and membrane protein levels in erythrocytes and its relation to the biochemical and hemostasiological indices in patients with EAH complicated and uncomplicated by metabolic syndrome. Materials and methods. 51 male patients (average age 42 ± 1,5 years) with stage I and II EAH were included in the study. They were divided into two groups: group 1 - with EAH complicated by metabolic syndrome (29 patients); group 2 - with uncomplicated EAH 22 patients). We estimated the spectrum of 10 membrane proteins of erythrocytes and main biochemical and hemostasiological blood parameters. Results.The study revealed a decrease in the level of spectrins and the loss of correlation between the levels of erythrocyte membrane proteins in patients with EAH complicated by metabolic syndrome. The fraction of patients with the diameter-thickness ratio < 3,4 suggesting the presence of the pool of cells prone to spherocytosis in group 1 (29,4%) was twice that in group 2 (13,7%).The study of diameter-thickness ratio and the level of membrane proteins in patients with stage I and II EAH allowed to reveala significant regressive relationship between the diameter-thickness ratio and conditions of spherical cell formation. The change of diameter-thickness ratio significantly correlated with the levels of α-spectrin, anion-transport protein and glyceraldehyde 3-phosphate dehydrogenasein group 1 and with those of glyceraldehyde 3-phosphate dehydrogenase and anion-transport protein in group 2. Conclusion. Major factors involved in the development of acquired spherocytosis are structural and functional dissociation of membrane proteins such as α-spectrin, anion-transport protein and glyceraldehyde 3-phosphate dehydrogenase in patients with EAH complicated by metabolic syndrome and anion-transport protein, glyceraldehyde 3-phosphate dehydrogenase and actin in patients with uncomplicated EAH.
The use of optical coherent tomography
for diagnostics of the coronary plaque structure
Authors: Mustafina I. A. , Zagidullin Naufal Sh. , Palvov V. N. , Ishmetov V. Sh. , Jia H. , Hu S. , Yu B.
Published: November 2020

Optical coherence tomography (OCT) is a high-resolution method for intravascular imaging of coronary arteries based on interferometry. This review presents technical features of OCT systems and basic characteristics of OCT images with reference to its diagnosis value for the study of atherosclerosis in comparison with intravascular ultrasound. The experience with detection of vulnerable plaque and elucidation of plaque morphology as a mechanism of acute coronary syndrome is analyzed. This review focuses on the applicability of OCT to research and clinical practice in the field of invasive cardiology.
Predictors of lethality in young patients with acute myocardial infarction
Authors: Garganeeva A. A. , Borel Kseniya N. , Okrugin S. A. , Kuzheleva E. A.
Published: November 2020

The profile and combination of risk factors vary among patients with acute myocardial infarction (AMI) in different age groups. Their screening may help to improve prognosis in a young population. Aim. To identify the predictors of lethality in young patients with AMI. Material and methods. Using the data from the acute myocardial infarction registry, two groups of patients under 45 years were formed: deceased (group 1) and survivors (group 2) after AMI. Results. Patients in group 1 were younger than in group 2. Atypical pain syndrome or syncope were documented in 21,1% of the patients in group 1. For patients who died in different hospitals (n=13), duration of period between pain onset and ambulance call and between ambulance call and arrival were shorter in group 1. Only 38,5% of them were delivered to specialized units. The fraction of patients admitted to cardiological departments among survivors was 93,3% (p<0.001). Some patients of both groups reported changes in the state of health before AMI. In group 1, they often were nonspecific (weakness, blood pressure changes etc.). The risk of death for smokers was twice that for non-smokers. Hospitalization in a specialized hospital as well as timely seeking medical aid in case of unstable angina increased the chance of survival. Conclusions. An early appeal for help is very important for young patients with new/worsening symptoms threatening rapid onset of death. As far as patients having no histories of coronary disorders are concerned, efforts of the medical community should be focused on extensive screening of risk factors and their effective correction with the development of stratification scales for the early evaluation of the likelihood of adverse outcomes.
Prophylaxis of pain syndrome associated with inguinal hernia alloplasty
Authors: Chernykh Viktor G. , Krainyukov P. E. , Skorobogatov V. M. , Simonenko A. V. , Oshmarin S. V. , Bondareva N. V.
Published: November 2020

Prolonged pain syndrome after hernia alloplasty may be due to the capture of an inguinal nerve within a suture loop. We propose a method to fix the upper edge of the mesh to the aponeurosis of abdominal external oblique muscle from inside. To this effect, a hook is used to roll up the dissected aponeurosis and thereby to form a fold from the mobilized portion of aponeurosis. Fixation of the upper mesh edge to the inner aponeurosis surface allows to avoid injury to the vessels, include n. ilioinguinalis in the suture, achieve stronger connection of the sieve graft with the aponeurotic tissue, and reduce the amount of suture material remaining in the tissues. No prolonged pain syndrome was documented in 170 patients treated by the proposed method in the period from 2010 to 2014 .
A clinical study from patient’s perspective: Motivation, Expectations, and Perception
Authors: Kulikov Evgeny S. , Deev I. A. , Kobyakova O. S. , Zvonareva O. I. , Fedorova O. S. , Kirillova N. A. , Starovoytova E. A. , Zhukova N. G. , Zhukova I. A. , Esip V. V. , Schastny E. D. , Khurkhurova N. V. , Nikitina L. Yu. , Golosova T. G. , Pimenov I. D. , Netaeva M. A. , Fedosenko S. V.
Published: November 2020

Introduction. Pharmaceutical market and clinical trials (CTs) industry are growing rapidly in Russia, but little is known about perceptions of patients involved in medical experimentation, about their expectations regarding trial participation, and associated fears and reservations. Material and methods. A multicenter cross-sectional study was conducted in different cities of the Russian Federation. Patients who had previous experience in CTs (or were enrolled in a CT at the time of this study) were asked to complete a questionnaire. Results. Likert-style questions were used to evaluate factors influencing the perception of CTs by the patients. The most important factors to decide whether to participate in the clinical trial or not for the patients included professional monitoring services, regular condition monitoring, better medical care, and free treatment. Three most significant factors that have adverse effect on the interest to participate in the study were: the risk of side effects, study of new medication and the risk of getting into the placebo group. The most important motivating factors to continue CTs for the patients were as follows permanent monitoring of condition, personal relationships with medical researchers, improvement of physical condition, as well as free medical examinations and medical assistance. Conclusion. Results of the study showed that expectations, motivations and experiences of patients participating in clinical trials in Russia are comparable with the world's data. The findings suggest more significant role of the researcher in almost all aspects of patient participation. After the end of the study the majority of respondents were still in contact with doctors.
Changes of nonspecific proteinases and their inhibitors in different clinical types of myocardial infarction
Authors: Soldatova Olga V. , Kubyshkin A. V. , Ushakov A. V. , Gordienko A. I.
Published: November 2020

Purpose: to elucidate the relationships between serum levels of nonspecific proteinases and their inhibitors in patients with complications of myocardial infarction (MI). Material and methods. This prospective short-term study included 82 patients with uncomplicated non-Q wave MI (n=27), Killip I-II Q-MI complicated by acute left ventricular failure (ALVF) (n=30), Killip III-IV Q-MI, and Killip III-IV ALVF (n=17) as well as non-survivors due to development of cardiogenic shock (n=8) and healthy controls (n=12). Serum levels of elastase-like (ELA) and trypsine-like (TLA) activities and of proteinase inhibitors (antitrypsin activity and acid-stable inhibitors) was evaluated by enzymatic method within 24 hours, 3 and 14 days after the onset of symptoms. Risk stratification was done at admission according to the GUSTO Score. Results. The levels of all nonspecific proteinases were elevated in MI patients in comparison to controls. Mean baseline ELA (0.29 vs 0.37 nMol/mL min; р<0.05) and TLA (0.33 vs 0.40 mcMol/mL min; р<0.05) were higher in patients with MI complicated by ALVF than in those with uncomplicated MI. Non-survivors showed significantly higher ELA and TLA and lower levels of proteinase inhibitors than patients with uncomplicated MI. Discussion. Proteolytic enzyme activities varied parallel to the changes of proteinase inhibitor levels. Proteinase activities were much more elevated in non-survirvors than in patients with uncomplicated MI. Decreased proteinase inhibitor levels can be considered as a marker of imbalance of proteinase-inhibitor system. Conclusions. Increase of nonspecific proteinase serum levels within 24 hours after the onset of MI is associated with the development of ALVF and unfavorable prognosis; it suggests the involvement of the proteinase-inhibitor system in pathogenesis of MI.
Prognostic value of blood group specificity and IL-28в genotype for the assessment of liver fibrosis in patients with chronic genotype 1 hepatitis C, non-responders to the treatment with pegylated interferon α-2 and ribavarin
Authors: Kukhareva Elena I. , Ogurtsov P. P.
Published: November 2020

Aim. To evaluate the prognostic value of blood group and IL-28B genotype with respect to dynamics of liver fibrosis (LF) in patients with chronic genotype-1 hepatitis C (HCV-1) who did not respond to antiviral therapy (AVT) with pegylated interferon alpha 2 (peg-IFN-α-2) and ribavarin (RBV) Material and methods. The study included 122 primary patients with HCV-1 who underwent paired liver biopsy or elastometry steam. The main group (n=66) consisted of patients who received AVT (peg-IFN-α-2/RBV) but failed to achieve a sustainable virologic response (SVR). Control group (n=56) comprised patients treated without AVT. Results. Negative dynamics of LF in patients of the main group occurred significantly more frequently than in the placebo group (p=0.025, φ2 criterion). LF dynamic patterns in patients of the main group varied depending on the IL-28B genotype and blood group, p=0.001 and p=0.014 respectively. Factorial analysis of negative LP dynamics in the main group revealed the relationship between blood group (fr=0,931) and IL-28B genotype (fr= 0.960) while classification analysis demonstrated the predictive value of combination of gene IL-28B polymorphism and blood group (p<0.0001). The assessment of probability of negative LF dynamics in the main group (logistic analysis) showed that IL-28B gene genotypes ST/TG, TT/TT,TG,GG and blood group A(II) alone or their combination increase the odds ratio of LF negative dynamics in SVR(-) under conditions of interferon therapy. In patients having blood group 0(I) and combination of gene IL-28B genotypes CC/TT, CT/TT with blood group A(II) the odds ratio of negative dynamics in SVR(-) is reduced under the same conditions. Conclusions. Blood group and IL-28B genotype predict dynamics of liver fibrosis in patients with HCV-1 not responding to interferon therapy.
Acute aortic syndrome
Authors: Podzoklov V. I. , Vargina Tat’yana S.
Published: November 2020

The authors discuss etiology, pathogenesis, and diagnostics of acute aortic syndrome characterized by the lesion of the aortic wall and report a case of this condition with a strikingly dramatic clinical picture with reference to its etiological causes (arterial hypertension and atherosclerosis), risk factors, clinical course, difficulty of diagnostics and treatment. This observation confirms the necessity of timely diagnostics and treatment of aortic syndrome for the prevention of severe vascular complications.
The value of highly sensitive troponin in the early diagnosis of acute myocardial infarction.
Authors: Borovkov N. N. , Golitsyna Natalya A.
Published: November 2020

Aim. Study the immediate clinical significance of determination of highly sensitive troponin (high sensitive cardiac troponin - hscTn) in the early diagnosis of acute myocardial infarction (AMI). Material and methods. The analysis of nosological diagnosis in 92 patients with acute coronary syndrome (ACS), urgently hospitalized in the coronary care unit of the Nizhny Novgorod regional hospital. N.A. Semashko. The time from the moment of development of pain syndrome, hospitalization in a hospital ranged from 40 minutes to 4 hours, averaging 2.5 ± 0.32 hours. During hospitalization of patients in the complex diagnosis of AMI in addition to General clinical examination, ECG was determined by the content hscTn and troponin I. All patients in the hospital was performed selective coronary angiography (SCG). Evaluated the sensitivity, specificity and diagnostic accuracy hscTn in comparison with troponin I. Analysis results were represented as a percentage and using a software package "STATISTICA 10.0" (StatSoft, Inc., USA). Results. AMI is diagnosed in 74% of cases (n=68), and the rest 26% (n=24) unstable (progressive) angina (NS). Transmural myocardial infarction or Q-wave myocardial infarction detected in 54% (n=37) of patients. Intramural myocardial infarction or non Q-wave myocardial infarction - in 46% (n=31). AMI re-seen in 27% (n=18). Importance of the study of both cardiac troponin in the early diagnosis of AMI showed the following. Sensitivity hscTn reached 98%, while troponin I - 88%. Specificity hscTn was 79%, and troponin I, only 66%. Overall diagnostic accuracy hscTn was 92%, troponin I less - 83%). Conclusion. The results of the study indicate a predominant clinical significance hscTn in comparison with troponin I in early diagnosis of AMI in the parameters of sensitivity, specificity and diagnostic accuracy.
Comorbid pathology and prognosis of breast cancer in women in menopause.
Authors: Asfandiyarova Nailya S. , Kulikov E. P. , Skopin A. S. , Demko A. N. , Nikiforov A. A.
Published: November 2020

Comorbid pathology is important in the survival of patients with breast cancer. The main aim of the present study was to investigate prognostic criteria of the 5-year survival menopausal women with breast cancer, including both the classic criteria (age, tumor size, lymph node status, hormonal status) and the presence of comorbid pathology (arterial hypertension, visceral obesity, diabetes mellitus, metabolic syndrome, immunodeficiency). A prospective cohort study included 98 patients with breast cancer (aged 63 ± 9 years, BMI 31.6 ± 4.8 kg/m2). Criteria favorable short-term (5 years) of the cancer prognosis of breast cancer in menopausal women are the size of the tumor less than 5 cm, the absence of metastases in regional lymph nodes, and the absence of the metabolic syndrome, dyslipidemia, high activity of suppressor cells. Age, anthropometric indices (BMI, waist circumference etc.), presence of arterial hypertension do not give information about the 5-year survival rate in breast cancer.
Optimization of choice of respiratory support the intensive care severe community-acquired pneumonia.
Authors: Borodulina Elena A. , Chernogayeva G. Yu. , Borodulin B. E. , Vdoushkina E. S. , Povalyaeva L. V. , Abubakirova L. F.
Published: November 2020

The purpose of study is the optimization of the choice of method of respiratory support in patients with severe community-acquired pneumonia (CAP) on admission to intensive care unit (ICU) on the basis of acid-alkaline indicators and arterial blood gas analysis. Material and methods. Depending on the method of the choice of respiratory support two groups of 350 people were formed. The first group (n = 350) - by the results of pulse oximetry (SatO2). The second group (n = 350) - in terms of acid-base and arterial blood gas analysis (pH, PO2, PCO2). To determine hypoxemia, pulse oximetry (heart monitor GOLDWAY G40), acid-alkali and gas composition of arterial blood (gas analyzer «MEDICA EasyStat») were used. In the ICU there were conducted three types of respiratory support: 1) oxygen therapy via orinasal mask 2) non-invasive mechanical ventilation (respirators «VENTimotion 2» and «Bipap Vision») 3) mechanical ventilation («Engstrom Carestation»). The criterion of effectiveness: recovery performance pulse oximetry, acid-base balance, and arterial blood gas analysis, the presence of positive clinical dynamics. Results. Choice of method of respiratory support in the gas composition of blood allowed to expand the indications for use NIV as a method of respiratory support in the treatment of patients with severe CAP, to ensure timely transfer and reduce the time finding patients on mechanical ventilation, to avoid damage due to hypoxia bodies - «target» with the development of multiple organ failure, and thus 4.3 times to reduce mortality and length of stay in the ICU of 1.7.
Diagnostic, clinical and prognostic aspects determine the concentration of C-reactive protein in chronic heart failure.
Authors: Bobylev Andrey A. , Rachina S. A. , Avdeev S. N. , Petrov A. A.
Published: November 2020

A lot of mechanisms in development and progression of cardiac dysfunction are associated with changes of multiple markers and high-sensitivity C-reactive protein is one of them. The role of this inflammatory marker in heart failure pathogenesis requires further study. However, various recent reports have suggested that C-reactive protein assessment may be used for prediction of incident heart failure, its prognosis and estimation of the disease severity.
A polymorphism +936C>Т of vascular endothelial growth factor as a marker of susceptibility to the obliterating atherosclerosis of arteries of the lower extremities.
Authors: Orlova Angеlica Yu. , Artyushkova E. B. , Sukovatykh B. S. , Bushueva O. Yu. , Polonikov A. V. , Gordov M. Yu.
Published: November 2020

Purpose. Studying of interrelation of the polymorphisms +936C>T, -460C>T, 534C>T и -2578C>A VEGFA gene with risk of development of the obliterating atherosclerosis of the lower extremities arteries in population of the russian residents of the Central Russia. Material and methods. The research was performed on selection of the unrelated individuals of the Russian nationality living in Kursk region (all natives of the Central Russia) with a total number of 350 people from which is 202 patients (176 men and 26 women) with the obliterating atherosclerosis of the lower extremities arteries and 148 rather healthy individuals who was control group. The studied groups were comparable in agree of the sex and age (р>0,05). Genomic DNA was emitted with the standard method of the phenolic and chloroform extraction. Genotyping of the polymorphisms +936C>T (rs3025039), -460C>T (rs833061), 534C>T (rs25648) and -2578C>A (rs699947) of the gene VEGFA was performed using PTsR method in the regime of «real time». For assessment of the associations alleles and genotypes with risk of the obliterating atherosclerosis of the lower extremities arteries used criterion χ2 and odds ratio (OR) with 95% confidence interval (CI). Results. It is for the first time revealed that the homozygous carriage on the normal allelyu + 936CC had protective effect concerning risk of development of the disease in women: OR=0,25; 95% Cl=0,07-0,93; р=0,03. At the same time the genotype + 936CT was associated with the increased risk of development of the disease in women: OR=4,79; 95% CI=1,14-20,21; р=0,02. At men associations of the studied polymorphisms with development of the disease were not revealed. Conclusion. The polymorphism + 936CT of the gene VEGFA is factor of the risk of the development obliterating atherosclerosis of the lower extremities arteries in the russian women of the Central Russia.
Systemic lupus erythematosus in the practice of dermatology.
Authors: Tlish M. M. , Naatyzh Zhanna Y. , Sycheva N. L. , Kuznetsova T. G.
Published: November 2020

Systemic lupus erythematosus (SLE) - an autoimmune disease of unknown etiology with multivariate manifestations, course and prognosis characterized by hyperproduction wide spectrum of organ autoantibodies and immune complexes that cause immunological damage to internal organs with the development of multiple organ failure Increased frequency of occurrence of the manifestations of autoimmune disease in dermatology practice, the complexity of creating diagnostic algorithms and untimely appointment of targeted erapii put this problem in a number of the most pressing. Skin rashes are often the leading symptom in the clinical picture of most cases of SLE. In the 20-33% of cases of SLE begins with cutaneous manifestations of the syndrome, with the result that patients are directed to the primary dermatological reception Submitted 3 clinical observation of patients with systemic lupus erythematosus, the diagnosis of which require a comprehensive survey to include histological examination of skin biopsies and immunological studies: blood analysis antinuclear factor on HEp-2 cells with determination of the type nucleus luminescence lupus anticoagulant in blood plasma, IgG antibodies to phospholipids and Ig class , Double-stranded DNA, antinuclear antibody class IgG, IgG autoantibodies to AMA-M2 (by immuno-blot), antibodies to cardiolipin and lupus anticoagulant. Due to the fact that in practice the conducting patients RAC no standardized criteria for determining the severity and degree of disease activity, use of prognostic indicators (clinical, laboratory and constitutional parameters) unfavorable course of RAC in dermatology practice would improve the quality of diagnosis. Thus, we have presented clinical studies have shown that early diagnosis of this disease is the determining factor of a favorable prognosis of the disease.
Evaluation ankle-brachial index in patients with ischemic stroke: annual forecast.
Authors: Sumin A. N. , Kolmykova Julia Alekseevna , Kukhareva I. N. , Ott M. V. , Vodop’yanova N. I. , Trubnikova O. A. , Kovalenko A. V.
Published: November 2020

Introduction. Ischemic stroke is the most common disease of the brain vessels worldwide. In recent years, we began to pay attention to the fact that the evaluation of the ABI may have prognostic value in different cohorts studied, not only in epidemiological studies, but also in patients with the presence of cardiovascular disease. The aim of the study was to investigate the prognostic role of abnormal ABI in patients with ischemic stroke. Material and methods. The study included 345 patients with a diagnosis of ischemic stroke. All patients underwent the study status of peripheral arteries using VaSera VS-1000 device. Groups of normal (n = 193) and abnormal ABI (n = 152). Patients were followed up for 1 year, assessed cardiovascular events were compared by the presence of risk factors, severity of neurological deficit, and according to laboratory tests and ultrasound data of the peripheral arteries. Results. The frequency of adverse outcomes (death, recurrent stroke, cardiovascular events) in 1 year after ischemic stroke were 15.6% of patients with a normal ABI and 46.7% of patients with abnormal ABI (p = 0.0001). In patients with abnormal ABI often preserved neurological deficit and the degree of its severity was higher compared to patients with normal ABI. When carrying out logistic regression analysis revealed strong correlation with pathological ABI adverse stroke outcome (OR 4.7; 95% CI 2,8-7,9, p = 0.00008). Conclusions. Evaluation of the ABI can help to identify a group of patients with ischemic stroke with increased risk of subsequent cardiovascular events requiring additional effort on their secondary prevention.
Method of selective resonance stimulation in the treatment of acute adhesive small bowel obstruction.
Authors: Pikuza V. I. , Khalidov O. Kh. , Fomin Vladimir Sergeevich , Yakovenko V. N. , Fomina V. M.
Published: November 2020

Aim. Demonstration of the technique of resonant stimulation of peristaltic activity in patients with acute adhesive intestinal obstruction with the aim of correcting enteral insufficiency. Material and methods. The outcome of treatment of 46 patients with adhesive intestinal obstruction (2015-2016) is analyzed. The 1st group (21 patients - prospectively) and the 2nd group (25 patients - retrospectively) are fully commensurable. In the 2nd group - standard therapy. Patients of group 1 for the correction of enteral insufficiency, prevention of progression of intraperitoneal hypertension, stimulation of peristaltic activity, in addition to standard therapy, sessions of resonant stimulation were conducted. Results. By the end of the first session (about 70% of patients), and at the 2 nd session in group 1, responses of all stimulated departments were obtained, with synchronization of sensitivity and preservation of activity in background stimulation regimes. The maximum sensitivity increased to M110 ± 13 mcV. In the course of enterography, the passage to the distal ileum was 6.2 ± 2.1 hours in Group 1 and 8.1 ± 2.3 hours (p≤0.05) in Group 2. By the end of the second day of treatment, by all patients in 1 Group the transvesical-measured pressure was 5.8 ± 1.3 mm Hg, while the mean value of abdominal pressure in group 2 was 10.3 ± 3.9 mm Hg (р≤0,05), and 7 patients showed signs of grade 1 hypertension. Conclusion. These data allow us to look optimistically at the improvement of the results of surgical treatment of acute adhesive intestinal obstruction, avoiding excessive and sometimes vain surgical activity, reducing the risk of further trauma to the peritoneum and the formation of adhesions.