bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of GSTM1, GSTT1 and GSTP1 xenobiotic metabolism genes polymorphisms on treatment efficiency in patients with chronic hepatitis C
Authors: Ostapchuk E V , Godovan V V
Published: November 2019

Aim. To analyze the influence of GSTT1, GSTM1 and GSTP1 genes polymorphism on treatment effectiveness in patients with chronic hepatitis C in Odessa Region using different treatment protocols. Methods. Three groups of patients with chronic hepatitis C were included. Patients of the first group (n=33) were treated with peginterferon alfa-2a and ribavirin, of the second group (n=18) - with tilorone and ribavirin, of the third group (n=26) - with silybi mariani fructuum extract. GSTT1, GSTM1 genes polymorphisms, as well as A313G polymorphism of GSTP1 gene were determined. The treatment effect was assessed by changes of biochemical parameters and viral load. Results. Patients of the first group with AG + GG genotypes had higher rate of rapid and early virologic response (73.7 and 27.3% respectively, р=0.013). Level of alanine transaminase also normalized earlier, and was significantly lower after 12 weeks of treatment in patients with AG + GG genotypes (0.57±0.28 mmol/l×h) compared to patients with АА genotype (0.99±±0.77 mmol/l×h, р=0.033). There was no influence of GSTT1 and GSTM1 genes polymorphisms on the chance of rapid and early virologic response and alanine transaminase levels. No response was found only in 4 patients with GSTT1+/GSTM1+ genotype. Conclusion. GSTT1 and GSTM1 deletion genes polymorphisms did not influence the speed of virologic response in patients with chronic hepatitis C treated with peginterferon alfa-2a and ribavirin. No virologic response in patients with chronic hepatitis C treated with peginterferon alfa-2a and ribavirin was only found in patients with GSTT1+/GSTM1+ genotype. AG + GG GSTP1 genotype was associated with more rapid alanine transaminase level normalization and rapid virologic response in patients treated with peginterferon alfa-2a and ribavirin. GSTT1+, GSTM1+ genotypes and АА genotype of GSTP1 gene are associated with better treatments results in patients treated with silybi mariani fructuum extract.
Effect of subtotal transurethral resection of prostate performed prior to high-intensity focused ultrasound on risk of urological complications in patients with localized prostate cancer
Authors: Pryanichnikova M B , Nizamova R S , Gubanov E S , Zimichev A A , Boryaev E A
Published: November 2019

Aim. To assess the rate and reasons for urological complications of subtotal transurethral resection of prostate performed prior to high-intensity focused ultrasound. Methods. The study included 101 patients with localized prostate cancer treated by high-intensity focused ultrasound. Two groups of patients were allocated. Patients, who did not undergo transurethral resection of prostate prior to high-intensity focused ultrasound, were included in group 1 (21 patients). Second group included patients in whom subtotal transurethral resection of prostate was performed prior to high-intensity focused ultrasound to decrease anteroposterior diameter of the prostate and urethral canal compression. The impact of treatment tactics on complications rate was defined by factor analysis. Results. Early post-surgical complications were rare, complications mostly occurred at late period. The most frequent, severe and poorly controlled complications included urinary incontinence [58 (57.8%) patients] and urethral stricture [30 (29.7%) patients]. Most of complications were registered in second group of patients compared to the first: first group - in 10 (12.5%) of cases, second group - in 77 (95.0%) of cases. Urinary incontinence was observed in 7 (33.3%) patients and urethral stricture - in 4 (19%) of patients in the first group; in 51 (63.7%) and 26 (32.5%) patients in the second group respectively; the difference was statistically significant. Conclusion. Comparative analysis of different approaches to treatment of localized prostate cancer using high-intensity focused ultrasound revealed that subtotal transurethral resection of prostate performed prior to high-intensity focused ultrasound significantly increases the risk for developing urinary incontinence and urethral strictures.
Relationship between basic dental polymethyl methacrylate polymer roughness and surface topography and microbial biofilm formation using different polishing techniques
Authors: Arutyunov S D , Ippolitov E V , Pivovarov A A , Tsarev V N
Published: November 2019

Aim. To determine the relationship between surface roughness and surface topography of the basic dental polymethyl methacrylate polymer polished by different methods and microbial adhesion of microorganisms (Porphyromonas gingivalis, Fusobacterium nucleatum and Streptococcus sanguis) and fungi (Candida albicans) causing periodontal diseases. Methods. Surface topography of the basic dental polymethyl methacrylate polymer was studied by atomic force microscopy; microbiological methods were used to study the adhesion of bacteria and Candida fungi causing periodontal diseases to the surfaces of the samples polished by different methods. Results. It was shown that Streptococcus sanguis had the highest adhesion degree to the polymer surface after milling, Porphyromonas gingivalis and Candida albicans had moderate, and Fusobacterium nucleatum - low adhesion degree. The adhesion dropped significantly after the sample had been polished in dental laboratory or using the «Ergo Boxing» compared to dental unit polishing, where the decrease was less significant. The article contains 2D- and 3D-atomic force microscopy pictures of polymer surface after different polishing methods use. Images obtained by atomic force microscopy clearly display the surface of the basic dental polymethyl methacrylate polymer polished by different methods. Conclusion. Polymer samples processed by «Ergo Boxing» and dental laboratories are characterized by minimal microbial adhesion when compared with other methods.
Clinical and psychological characteristics and quality of life in teenagers with а long-lasting low-grade fever both associated and not associated with hypothalamic syndrome
Authors: Semenova L Yu , Kolesnikova M B
Published: November 2019

Aim. To describe clinical and psychological characteristics and quality of life in teenagers with a long-lasting low-grade fever associated with hypothalamic syndrome. Methods. Life history, objective status were assessed, clinical, laboratory and instrumental examinations were performed, quality of life and psychological status were estimated throughout the study. Clinical and laboratory investigations included complete blood count, urinalysis, stool examination; blood immunochemistry for mycoplasma, chlamydia, herpes virus, cytomegalovirus; blood biochemistry; bacteriology of nose and the pharynx swabs. Instrumental investigations included skull and cervical spine X-Ray, neurophysiological examinations (electroencephalography, echoencephalography, rheoencephalography), cranial and cervical blood vessels ultrasonography. The quality of life was estimated using special pediatric questionnaires (proposed by Molchanova L.F., Izhevsk State Medical Academy). Psychological status was assessed by questionnaires of H. Eysenck (temperament assessment) and C.D. Spielberg (research of personal and situation anxiety). Results. All teenagers underwent a complex treatment according to diagnosis, including antimicrobial treatment in case of chronic infections, antimicrobial treatment and immunostimulators in case of upper and lower airway infections caused by chlamydia and mycoplasma, correction of functional conditions of central nervous system (nootropics, vasoactive drugs, diuretics, anxiolytics, metabolic medications, hypotensives), massages, exercise therapy, physiotherapy, herbal treatment. After the course of treatment relapse of low-grade fever was 4-fold more often in teenagers with hypothalamic syndrome compared to those without. Teenagers with low-grade fever associated with hypothalamic syndrome had higher rates of melancholy, higher anxiety levels, leading to significant alterations of physical and mental health. Those changes may lead to mental and social adaptation problems, borderline social and family behavior, and increased rate of psychosomatic diseases. Conclusion. As it was revealed that relapsing low-grade fever might lead to reduced quality of life, further exacerbations of borderline mental problems, aggravate mental adaptation and social and family behavior problems, these teenagers require family and individual mental therapy, repeated treatment with nootropics, vasoactive drugs, diuretics, anxiolytics.
Assessing the structure and importance of medical and social risk factors in pipeline companies’ employees
Authors: Pyltsova S V , Pozdeeva T V
Published: November 2019

Aim. To assess the influence of medical and social risk factors in pipeline companies’ employees and to design measures to reduce unfavorable influence. Methods. The study included 369 employees of OJSC «Volgogaz» working on pipelines at 2007-2009. A special form for social and hygienic study was designed, including information about health and living conditions, eating habits, family relationship, obsessive habits and family history. Results. Employees aged 30-49 years and older (190 subjects, 51.4%), with technical secondary education (151 subjects, 40.8%) were the most common. The majority of employees assessed their job as hard, 48 (13.0%) and 261 (70.7%) patients reported significant and extreme fatigue after the working shift. 260 (70.5%) subjects lived in a separate apartments, mostly in rural areas (216 subjects, 58.5%), most have complete families with children (297 subjects, 80.5%), despite most having one-parent family at childhood. Over a half of all employees (192 subjects, 52%) had 3 meals per day, 310 (84%) subjects slept for 6-7 hours per day, 222 (60.2%) subjects are current smokers, 27 (7.3%) subjects drink alcohol more than 1 time per week. 149 (40.5%) assessed their living conditions, and 50 (40.7%) - their fare as satisfactory. The majority of all employees (175, 47.5%) were ailing less than 2 times per year, 228 (61.8%) assessed their health status as satisfactory. Thus, medical and social risk factors in pipeline companies’ employees were associated with significant physical efforts, bad working conditions, including rotational team method, and unhealthy behavior. Conclusion. Rehabilitative measures should include improving the social factors (work, living and leisure conditions), healthy behaviors, increasing motivation for perceiving information of healthy way of living and measures to improve health.
Comparative analysis of echocardiography, multispiral computed tomography, myocardial perfusion scintigraphy in left ventricular mass evaluation
Authors: Galyavich A S , Rafikov A Y , Saifullina G B
Published: November 2019

Aim. To perform a comparative analysis of multispiral computed tomography, echocardiography and myocardial perfusion scintigraphy in the evaluation of left ventricular mass. Methods. The study included 44 patients (15 female, 29 male) aged of 21 to 73 years (mean age was 55±11 years). Left ventricular mass was assessed by noninvasive multispiral computed tomography coronary angiography using the 64-slice «Aquillon 64» (Toshiba, Japan) scanner. Echocardiographic evaluation was performed on the «Vivid-7» (GE, USA) ultrasound system. Scintigraphic analysis of left ventricular mass was performed on the single-detector gamma camera «Millenium-MPR» (GE, USA) using the «4-D MSPECT» (University of Michigan Medical Center) software. Results. A comparative analysis of left ventricular mass showed that the differences in median values were statistically significant between all the methods presented. The differences in left ventricular mass calculated using the Bland-Altman method were as follows: between multispiral computed tomography and echocardiography -32±41 gr, between multispiral computed tomography and myocardial perfusion scintigraphy «4-D MSPECT» 34±48 gr. Conclusion. Multispiral computed tomography, echocardiography, myocardial perfusion scintigraphy assess left ventricular mass differently, with myocardial perfusion scintigraphy giving the lowest and echocardiography giving the highest mass. Results gained at multispiral computed tomography lies in between the myocardial perfusion scintigraphy and echocardiography.
Under-24-hour mortality from acute coronary syndrome in emegrency hospital
Authors: Valeev Z G , Belyakov V G , Salyahova L Y
Published: November 2019

Aim. To identify the factors influencing the strategy and tactics of treating patients with acute coronary syndrome; to define the impact of various stages of emergency care in total rate of under-24-hour in-patients mortality. Methods. The retrospective analysis of the in-patients medical charts, ambulance accompanying sheets and autopsy protocols of 303 patients who died during the first 24 hours after admission to the department of cardiology at Municipal Emergency Hospital №1, Kazan from January 1st, 2009 to December 31th, 2011. Results. The level of under-24-hour in-patients mortality in the emergency hospital remains considerably high without a tendency to fall. In economically active group of population male to female mortality ratio exceeds 1,8. Most patients are being brought to the hospital by ambulance crews which are not enough qualified and equipped to care for patients in a critical condition. Only 48.3% of admitted patients get medical aid before admission, although the share of patients admitted in a poor, critical or agonal condition is 89.8%. Conclusion. Decreasing under-24-hour mortality is a multidimensional and multifactorial problem, which demands a complex approach in all stages of providing medical care to be solved.
The modern way to prevent complications in laparoscopic antireflux surgery
Authors: Sharapov T L , Burmistrov M V , Sigal E I , Moroshek A A , Ivanov A I , Berdnikov A V , Sigal A M
Published: November 2019

Aim. To improve the results of surgery on patients with hiatus hernia. Methods. Case histories of patients who underwent surgeries at the department of gastric and esophageal surgery from 1996 to 2011 were analyzed. 626 laparoscopic fundoplications in patients aged form 15 to 78 years were performed, among them - 57 using transillumination with fiber optic sensor tube. All patients were present with signs typical for hiatus hernia and gastroesophageal reflux disease (heartburn, belching, early satiety, epigastric discomfort etc.). Pre-surgical examination included X-ray and esophagogastroduodenoscopy. Most patients underwent Nissen fundoplication. The surgery duration varied from 30 to 180 minutes (mean time 65 minutes). Results. Surgical complications such as hollow organs perforation were registered in 4,3% of cases (27 cases out of 626 surgeries). No such complications were registered in group where surgery was performed using transillumination with fiber optic sensor tube. In 12 cases laparotomy for perforation closure was required, in other 15 cases perforation was closed using laparoscopy. No serious events were registered in early post-surgical period, with all patients discharged from the hospital at days 5-7. Such complications as dysphagia and gas-bloat syndrome were predominant in early post-surgical period after laparoscopic fundoplication. The incidence of the early post-surgical complications in patients who underwent surgery without transillumination with fiber optic sensor tube was: dysphagia - 28,8% (164 out of 569 patients), gas-bloat syndrome - 23,7% (135 patients). In cases when transillumination with fiber optic sensor tube was used, dysphagia was diagnosed in 1 case (1,8%), gas-bloat syndrome - in 9 (15,8%) cases. The incidence of late post-surgical complications including dysphagia, relapses and situations when fundoplication becomes undone over time: without transillumination with fiber optic sensor tube - 10,2% (58 out of 569 patients), using transillumination with fiber optic sensor tube - 3,5% (2 out of 57 patients). Conclusion. Preliminary results show that using transillumination with fiber optic sensor tube in laparoscopic fundoplication in patients with hiatus hernia reduces the incidence of post-surgical complications.
Gender motivational traits of the disabled with lower limbs structural and functional deficiencies
Authors: Biktimirova F M , Nichiporenko N P
Published: November 2019

Aim. To define the motivational and gender differences in patients with limb loss. Methods. 318 patients [male - 267 (83.3%), female - 51 (16.7%)] with lower limbs structural and functional deficiencies admitted for prosthetics surgery to prosthetic and orthopedics center «Reabilitaciya invalidov», Kazan, Russia, from 2008 to 2010 were included in the study. Empiric data on motivational features were gained using questionnaires and test examinations of 191 patients aged form 18 to 66 years. Quality of life, personality traits, emotional and motivational health, natural, and social and cultural environment were assessed. Results. Marked need for affiliation was typical for patients with high anxiety levels (r=0.15, p 0.05) and emotive (r=0.17, p 0.01) personalities and is decreased in rigid personalities (r=-0.26, p 0.01). There was a negative correlation between the urge of being accepted by others and the need for success (r=-0.19, p 0.05). Affiliate need in women was relevantly higher compared to men (t=2.87, p 0.05). The strong negative correlation of the need to be accepted by others and motivation for achievement was noticed in women (r=-0.46, p 0.01), in men the difference was not significant (r=-0.11). Demonstrative (r=0.21, p 0.05) and hyperthymic (r=0.24, p 0.01) personalities were more often focused on achievement and success. Pedantic (r=-0.23, p 0.01), anxious (r=-0.28, p 0.01) and cyclothymic (r=-0.28, p 0.01) traits were associated with the motivation for tranquility. Motivation for achievement was relevantly higher in men (t=-2.82, p 0.05). High personal anxiety (r=-0.38, p 0.05) and depression (r=-0.36, p 0.05) were characteristic for women with predominant tranquility motivation. A negative correlation of degree of motivation for achievement and situational (r=-0.23, p 0.01) and personal (r=-0.19, p 0.05) anxiety, as well as depression (r=-0.36, p 0.001) was found in men. This concludes that depression and anxiety decrease the willingness to success in patients of both genders. Conclusion. When planning a rehabilitation program for disabled, gender differences should be taken into account, because connection between motivation for achievement, affiliation, personal traits, emotional traits and physical activity parameters are different in men and women.
Sleep apnea in real clinical practice
Authors: Khamitov R F , Palmova L Y
Published: November 2019

The article is addressed to attract the attention of the physicians mainly dealing with out-patients to the actual problem - sleep apnea. This condition is commonly masked by widespread internal diseases and other conditions, like cardiovascular and respiratory diseases, obesity, diseases of pharynx and larynx. At the same time, its’ timely diagnosis and treatment are extremely important, because it may lead to non-responsiveness to arterial hypertension treatment, increases the risk of arrhythmias and other fatal complications. The article presents the case report of primary diagnosis of sleep apnea (from author’s practice) and its possible treatment options.
Past, present and future of the department of ophthalmology of the Kazan state medical academy (to the 90th anniversary of the foundation of the department)
Authors: Amirov A N , Saifullina F R , Abdulaeva E A
Published: November 2019

The history of the department of ophthalmology of the Kazan State Medical Academy for the 90-year period was analyzed. The department was founded in September, 1922. The reason for the foundation of the department was the trachoma that was rampant at that time in the Volga region. Academician V.V. Chirkovskiy (1874-1956), who headed the department from 1922 to 1928, was the founder and the first director of the first in USSR Trachoma Institution based in Kazan. From 1929 to 1932 professor Valentin Yemel’yanovich Adamyuk (1877-1950), the honoured Scientific researcher of the republic of Tatarstan was the head of the eye clinics of the medical academy and of the Scientific and Research Trachoma Institution. In 1932 professor, the honoured Scientific researcher of the republic of Tatarstan Alexandr Nikolaevich Murzin (1885-1954) has won the elections and headed the department. He secured the merging of the Scientific and Research Trachoma Institution and the eye clinics of the medical academy into the one institution. Thanks to the proper healthcare management and treatment and prevention measures trachoma was eliminated in republic of Tatarstan in 1964. Later, the department was chaired by Alexandr Nikiforovich Kruglov (1952-1964), Kamilya Islamovna Gafarova (1964-1967), Moisey Bencionovich Wufgart (1967-1987), Liyuda Bakhtigareevna Galiaskarova (1987-1996), Marina Vladimirovna Kuznetsova (1996-2012). Since March 2012 the department is headed by PhD, Principal out-of-staff ophthalmologist of the Ministry of Health of the Republic of Tatarstan Aidar Nailevich Amirov. Nowadays the department staff completes over 5000 complicated eye microsurgeries yearly, and also consults the patients form Republic of Tatarstan and nearby regions with complicated cases of different eye diseases at the out-patients clinic and departments of the hospital.
Laser trabeculoplasty - the first choice surgery for treatment of primary open angle glaucoma
Authors: Akhmetshin R F , Bulgar S N
Published: November 2019

Aim. To analyze the results of laser trabeculoplasty in patients with first and second stage of primary open angle glaucoma with the disease duration over 6 years depending on nature of sclera sinus blockade. Methods. 251 patients aged 38 to 78 years (121 female, 130 males, 285 eyes) with primary open angle glaucoma were observed. The early stage of the disease was observed in 188 eyes, promoted stage of the disease - in 97 eyes. Hypertension, atherosclerosis, diabetes mellitus were among the comorbidities. Visual acuity testing, visual field testing, ocular tonometry and tonography, ophthalmoscopy were performed, sclera sinus blockade features were defined. Laser trabeculoplasty was performed with an argon laser using the universal three mirror lens (600 to 1000 mW, laser beam diameter 50 μm, exposure time 0.1 sec, average number of iterations - 100). Laser linear trabeculoplasty by Wise modified by Mamedov was performed. In case of narrow anterior chamber angle an additional laser gonioplasty by Krasnov and laser peripheral iridotomy were performed prior to trabeculoplasty. Results. In patients with the first stage of the disease in case of a functional blockade the remote hypotensive effect was reached in 81.7% of cases, in case of organic blockade - in 46.7% of cases. In the second stage of an open angle glaucoma decrease in intraocular pressure in functional blockade was reached in 65% of cases, in organic blockade - in 33.3% of cases. Visual acuity decreased in 22.1% of cases. In patients with sclera sinus functional blockade the remote hypotensive effect was twice as better compared to patients with organic blockade. Visual field stabilization in patients with organic blockade was achieved 5.5 times rarely compared to patients with functional blockade. Conclusion. Laser linear trabeculoplasty is still the first choice surgery for primary open angle glaucoma treatment. Defining the nature of sclera sinus blockade allows to predict the laser trabeculoplasty results.
Eye sarcoidosis. Literature review
Authors: Tezeva A S , Samoylov A N
Published: November 2019

A review of the literature devoted to eye sarcoidosis is presented. Sarcoidosis is a systemic granulomatous disease of unknown etiology, with a pathognomonic feature of non-caseous granuloma formed mainly by epithelium cells and single Langhans giant cells. Sarcoidosis has many synonyms: Besnier-Boeck-Schaumann disease, benign Schaumann’s granulomatosis, nodular reticular disease. Primary targets of sarcoidosis are lungs, intrathoracic lymph nodes, eyes and skin. During the last years eye sarcoidosis is registered more frequently, that is probably associated with better diagnosis. The frequency of the eye involvement in patients with sarcoidosis, according to different authors, is 5-69% (3rd or 4th among all the target organs involved). The eye manifestations of sarcoidosis are multiple with the uvea most frequently affected, especially iris and ciliary body. The involvement of the back of the eye includes granulomatous uveitis, vitreitis, periphlebitis. It is worth noticing that only minor non-granulomatous precipitates can be found in the acute stage of the disease. In case of chronic inflammatory process, precipitates become granulomatous. The treatment can influence both precipitates’ size and shape. In case of termination of the inflammation, precipitates are undergoing a complete resorption or decrease in size, become pigmented of transparent («precipitate shades»). The feature of sarcoidosis is the tendency to comissure formation, the pupil is hardly dilated by medicines, leading to the secondary glaucoma. Conjunctiva, extraocular muscles, retroocular tissues, lacrimal gland can be involved, as well as the optic nerve, chiasma, leading to meningovascular infiltrates formation. When diagnosed, a complex treatment with topic, symptomatic drugs and the drugs with the systemic action is used. The search of new effective treatment options is still ongoing.
Complex treatment of retinal veins occlusion
Authors: Abdulaeva E A , Amirov A N , Beriya-Dzhorgzhikiya E P , Korobitsyn A N
Published: November 2019

Aim. To assess the efficacy of complex treatment of retinal veins occlusion with anti-angiogenic - ranibizumab, and laser retinal photocoagulation. Methods. 36 patients (36 eyes) with occlusion of central retinal vein and its branches were included. Patients with central retinal vein occlusion (n=17) were included in the first group, patients with retinal vein branch occlusion (n=19) were included in the second group. All the patients underwent visual acuity testing, ocular tonometry, ophthalmoscopy, biomicroscopy, spectral optical coherence tomography, intravenous fluorescein angiography at the baseline, 1 and 3 months after treatment. Treatment included intravitreal ranibizumab injection (0.5 mg) and laser retinal photocoagulation 1 month after intravitreal injection. Results. In 94.4% of cases good treatment effect was observed. Visual acuity improved from 0.06±0.03 at baseline to 0.22±0.08 (p 0.05) at the end of treatment in the first group and from 0.31±0.06 to 0.64±0.05 (p 0.05) in the second group. Central retinal thickness reduced from 752.2±98.4 μm to 309.21±45.57 μm (p 0.05) in the first and from 689.12±64.08 μm to 235.37±46.07 μm (p 0.05) in the second group. Conclusion. The results indicate high effectiveness of suggested complex treatment of retinal vein occlusion with anti-angiogenic - ranibizumab and laser retinal photocoagulation.
Electrophysiological parameters in patients with the «dry» form of age-related macular degeneration treated with polarized polychromatic non-coherent light and dynamic electromyostimulation
Authors: Saifullina F R , Sharafieva R Z , Pogorel’tsev V I , Abdulaeva E A
Published: November 2019

Aim. To study the electrophysiological parameters in patients with the «dry» form of age-related macular degeneration before and after combined treatment with polarized polychromatic non-coherent light and dynamic electromyostimulation. Methods. Two groups of patients with the «dry» form of age-related macular degeneration were examined. Patients in the main group (40 patients, 80 eyes) were treated with a combination of polarized polychromatic non-coherent light and dynamic electromyostimulation, patients in the control group (39 patients, 78 eyes) were treated conventionally. Mean age of the patients was 71.3±1.1 years. All patients underwent standard ophthalmic examination. To assess the functional status of the macula, electroretinography was performed using the «Neuro-MVP» device (Ivanovo, Russia). A-wave amplitude and latency on the red light stimulus were examined. Results. A-wave amplitude on macular electroretinogram was 11.9% lower and A-wave latency was 20.8% higher in patients with age-related macular degeneration compared to healthy subjects. A statistically significant improvement of the A-wave amplitude and latency was observed on macular electroretinogram after the combined treatment. A-wave amplitude increased from 13.22±1.36 to 17.17±1.59 µV (p 0.01) after 2 months and up to 17.80±1.60 µV (p 0.05) after 6 months of treatment. A-wave latency decreased from 19.32±0.41 to 18.51±0.36 ms (p 0.01) after 2 months and down to 18.31±0.45 ms (p 0.05) after 6 months of treatment. There was a relevant increase in A-wave amplitude from 13.15±1.09 to 16.3±1.09 µV (p 0.01) and decrease in A-wave latency from 19.23±0.30 to 18.64±0.30 ms (p 0.05) in patients of the control group 2 months after the end of treatment. Conclusion. There were relevant increase in A-wave amplitude and decrease in A-wave latency observed on macular electroretinography after treatment. The proposed treatment method does not cause any complications and can be used as a treatment option in patients with allergic reactions to standard drugs.
Tear fluid vascular endothelial growth factor level as a marker of effectiveness of proliferative diabetic retinopathy combined treatment
Authors: Samoilov A N , Mustafin I G , Korobitsyn A N
Published: November 2019

Aim. To assess the tear fluid level of vascular endothelial growth factor in patients with proliferative diabetic retinopathy in case of panretinal photocoagulation and intravitreal ranibizumab treatment. Methods. Panretinal photocoagulation was performed in 20 patients (40 eyes) with proliferative diabetic retinopathy (first group). In the second group, which included 20 patients (40 eyes) with the same stage of diabetic retinopathy, panretinal photocoagulation was combined with intravitreal ranibizumab treatment. 20 healthy subjects (40 eyes) were examined as a contol group. There were no adverse events registered during the treatment. At the follow-up, 4 patients from the first group were diagnosed with partial intraocular hemorrhage; a posterior vitrectomy was required in 1 eye, in 3 eyes intraocular hemorrhage has resolved spontaneously. A complex of clinical and laboratory examinations included visual acuity testing, biomicroscopy, indirect ophthalmoscopy using Mainster wide field lens, fluorescein angiography, optical coherence tomography, tear fluid ELISA. Results. There was a complete regression of retinal neovascularization (no blood flow in newly grown blood vessels) in 14 (35%) eyes of patients from the first group after the first procedure. In the second group a complete regression of retinal neovascularization was observed in 100% of cases after the first procedure. The tear fluid level of vascular endothelial growth factor increased from 398.6±112.2 to 668.2±102.2 pg/ml (p 0.05) in 40 (100%) eyes of patients from the first group, in the second group the level of vascular endothelial growth factor decreased after the angiogenesis inhibitor injections in 40 eyes (100%) from 332.1±98.2 до 314.6±44.4 pg/ml (p 0.05). 1 month after treatment the visual acuity in the first group the visual acuity improved in 40% of cases (16 eyes), was stable in 45% (18 eyes), decreased in 15% (6 eyes) with the mean value changed from 0.22±0.12 to 0.24±0.08 (p 0.05); in the second group the visual acuity improved in 40% of cases (16 eyes), was stable in 45% (18 eyes), decreased in 15% (6 eyes) with the mean value changed from 0.22±0.12 to 0.24±0.08 (p 0.05). Conclusion. The use of panretinal photocoagulation combined with intravitreal ranibizumab treatment in patients with proliferative diabetic retinopathy decreases the tear fluid vascular endothelial growth factor level, improves the visual acuity and thickness of the retina. There was a marked and prolonged effect after the combined treatment, that allows to recommend this treatment method to all patients with proliferative diabetic retinopathy.
Study of contact correction of vision among medical students
Authors: Nugumanova A M , Khamitova G H , Samoilov A N
Published: November 2019

Aim. To study the hygienic and medical aspects of refractive error correction in medical students. Methods. Ophthalmic examination and questionnaire poll of 80 5-year students of Kazan State Medical University diagnosed with myopia and using the contacts. The questionnaires included questions about the type of contacts, wear schedule, usage and care rules, adverse effects and complications, reasons for drop off. Results. Different myopia degree (low - 46%, medium - 51%, high - 3%) was diagnosed in the observed students. The term of contacts use differed from 6 months to 5 years, in 57% of students the term was over 3 years. Soft lenses (hydrogels - 40%, silicone hydrogels - 57%) were preferred with only 3% of students using rigid lenses. Students have often chosen lenses by themselves (49%). It was found out that 60% of students examined did not comply with terms of use, over 60% of students examined did not comply with hygienic regulations while wearing contacts. In 67% of cases the following eye disorders were diagnosed at examination: chronic conjunctivitis - in 32% of cases, initial stage of keratoconjunctivitis sicca - in 27% of cases, allergic conjunctivitis - in 8% of cases. Conclusion. The examination conducted and impairments diagnosed in students using the contacts have shown low level of education and neglecting basic hygienic rules for use of contacts, that requires the developing of novel educational programs for young people with refractive error.
Comparative treatment results of non-penetrating surgeries for treating primary open-angle glaucoma
Authors: Bulgar S N , Akhmetshin R F , Malinin D E
Published: November 2019

Aim. To assess the effectiveness of combined non-penetrating surgery: non-penetrating deep sclerectomy and ab externo trabeculectomy in patients with primary open-angle glaucoma depending on type of aqueous humor retention. Methods. Results of surgeries on 72 patients (83 eyes) with primary open-angle glaucoma were analyzed. Patients were divided into 2 groups. Standard ophthalmic examination was added by fluorescein lymphography of the anterior eye to determine the surgery type as well as for hypotensive effect long-term prognosis. Non-penetrating deep sclerectomy and ab externo trabeculectomy were conducted in the first group (67 eyes). In the control group (16 eyes) standard non-penetrating deep sclerectomy was performed. A cytostatic was used as a subconjunctival injections in the post-surgical period. Results. Intraocular pressure was fully compensated in 52 eyes out of 67 (77.6%) in the long-term period after non-penetrating deep sclerectomy and ab externo trabeculectomy in the first group. In 15 eyes (22.4%) topical hypotensive drugs were required for complete compensation of intraocular pressure. Complete compensation of intraocular pressure was registered in patients with moderate aqueous humor flow reduction (trabecular and mixed with prevalence of trabecular forms). Topical hypotensive drugs were required in severe aqueous humor flow reduction (mixed form with prevalence of intrascleral). In the second group, compensation of intraocular pressure was achieved only in early post-surgical period in 12 eyes (75%) with further decrease of hypotensive effect after 4-6 months. There was no complete compensation of intraocular pressure at late post-surgical period. To normalize the intraocular pressure, topical hypotensive drugs were required in 15 eyes (93.8%), surgery was repeated in 1 (6.2%) case. Conclusion. Combined surgery (non-penetrating deep sclerectomy and ab externo trabeculectomy) is more effective compared to non-penetrating deep sclerectomy and is indicated in patients with open-angle glaucoma and moderate aqueous humor flow reduction.
Features of haemostasis in patients with coronary heart disease
Authors: Galyautdinov G S , Chudakova E A
Published: November 2019

Aim. To identify the nature of changes in the hemostasis system in patients with chronic and acute ischemic heart disease. Methods. The first group was comprised of 46 patients with stable angina of the II-III functional class, the second group was comprised of 42 patients with acute coronary syndrome, the control group included 28 healthy individuals. In all of the examined individuals determined were the number of platelets, the amount of antithrombin III, activated partial thromboplastin time, international normalized ratio, fibrinogen content, soluble fibrin monomer-complexes, von Willebrand factor, protein C and S in blood plasma. Results. In patients with stable angina of the II-III functional class originally noted was an increase in the level of the von Willebrand factor in plasma by 43%, while in patients with acute coronary syndrome - by 67% compared with the control figures, the content of fibrinogen in blood plasma exceeded the control values by 18.8% and 68.8%, respectively. In patients with acute coronary syndrome the concensoluble fibrin monomer-complexes was initially increased. In the evaluation of plasma hemostasis in patients of both groups revealed was a significant decrease of the international normalized ratio and activated partial thromboplastin time values, which was more pronounced during acute coronary syndrome than in the control group. Conclusion. In patients with ischemic heart disease present was a thrombogenic shift of the hemostasis indices toward hypercoagulation, which is most evident in acute coronary syndrome, suggesting the presence of chronic intravascular blood coagulation.
The metabolitic role of the iron porphyrin complex in the development of anemic syndrome in patients with minor form of β-thalassemia
Authors: Baytaeva D A , Bessmeltsev S S
Published: November 2019

Aim. To determine the significance of the main indicators of metabolism of porphyrins and markers of iron metabolism in the development of anemic syndrome during β-thalassemia minor. Methods. Examined were 58 patients with β-thalassemia minor with a concomitant deficiency of the enzyme glucose-6-phosphate dehydrogenase and 150 patients β-thalassemia minor without the concomitant enzymopathy. Hemoglobin electrophoresis was used to verify the diagnosis of β-thalassemia. Evaluated were the main indicators of porphyrin metabolism in the erythrocytes and urine in comparison with the reserve pool of iron in the blood serum, bone marrow and liver. Results. It has been shown that the assessment of soluble transferrin receptors and zinc protoporphyrin - is an alternative to assessing serum iron. Changes in the metabolism of iron is not the only cause of hypochromic microcytic anemia in patients with β-thalassemia minor. A large role is played by the fluctuations of the concentration of free forms of porphyrins in erythrocytes. With their help developed were differential diagnostic criteria, which distinguish the minor form from other forms of β-thalassemia and other iron deficiency states. During β-thalassemia minor, regardless of concomitant enzymopathy present was the instability of the main indicators of metabolism of the iron porphyrin complex. Conclusion. Extended evaluation of indicators of iron metabolism in conjunction with the assessment of precursors of porphyrin metabolism and free erythrocyte porphyrins is of high diagnostic value in determining the severity of anemia.
Age-related comparative evaluation of laboratory-functional parameters of vascular endothelial dysfunction in patients with arterial hypertension
Authors: Popova A A , Mayanskaya S D , Grebenkina I A , Luksha E B , Lebedeva L S
Published: November 2019

Aim. To conduct a comparative complex evaluation of the vasomotor and metabolic functions of the vascular endothelium in patients of different age groups with arterial hypertension. Methods. Examined were 98 young men and 60 elderly people with arterial hypertension of the I and II degree. The control group included 44 practically healthy young men and 45 elderly men. The endothelial function was assessed by Doppler measurements of brachial artery diameter at rest and during the test with reactive hyperemia and nitroglycerin, as well as by determining serum levels of the total amount of nitric oxide. Secondary stable products of lipid peroxidation were determined by the level of malondialdehyde. Antioxidant activity of blood was determined by evaluating the spontaneous chemiluminescence response. The diameter of the common carotid artery and the width of the intima/media complex was evaluated at rest using an ultrasound scanner. Results. Disturbance of the endothelium-dependent vasodilation in young and elderly patients with arterial hypertension of the I and II degree was accompanied by a significant decrease in production of endothelial nitric oxide. The expression of vascular endothelial dysfunction in patients of different ages with arterial hypertension of the I and II degree was in close correlation with the indicators of imbalance between the prooxidant activity and the antioxidant activity of blood, which manifested in an increase in the concentration of malondialdehyde in blood serum and in the decrease of the «antioxidant activity of blood/malondialdehyde content in blood serum» coefficient compared to groups of healthy individuals in response to pathological vasoconstriction. Conclusion. Arterial hypertension is accompanied by a progressive dysfunction of the vascular endothelium, which is more pronounced in the elderly due to reduced production of nitric oxide by the endothelium and due to the imbalance of the prooxidant-antioxidant system.
Dynamics of the content of biologically active substances in peripheral blood neutrophils in patients with ischemic heart disease during the course of laser therapy
Authors: Sapozhnikov M Yu
Published: November 2019

Aim. To study the dynamics of the content of catecholamines, serotonin, histamine and heparin in peripheral blood neutrophils of patients with ischemic heart disease under the influence of laser therapy. Methods. Examined were 124 patients with angina, who were divided into two groups: those receiving basic treatment (β-blockers, antiplatelet drugs, nitrates, statins) with a course of laser therapy - 76 people, and those receiving only basic treatment - 48 people. The control group included 32 healthy individuals. Results. In patients with angina the content of catecholamines, serotonin, histamine is higher, while the content of heparin is lower than in healthy individuals. Under the influence of laser therapy, which was conducted simultaneously with the basic treatment, a decrease occurred in the level of catecholamines by 1.6 times, of serotonin by 1.5 times, of histamine by 1.6 times and an increase occurred in the amount of heparin by 1.9 times. Conclusion. Laser therapy effects the contents of all studied biologically active substances, bringing them closer to those of healthy people.
Surgical treatment of patients with osteoarthritis of the ankle joint
Authors: Plakseychuk Yu A , Salikhov R Z , Soloviev V V
Published: November 2019

Aim. To evaluate the results of treatment using the authors’ proposed method of arthrodesis of the ankle and subtalar joints, based on the combination of bone grafting with compression in the Ilizarov apparatus. Methods. Conducted was a clinical and radiographic evaluation of the results of arthrodesis in the Ilizarov apparatus in 286 patients with osteoarthritis of the ankle and subtalar joints (during the last 15 years). 36 (12.6%) patients (the main group) were operated on using the authors’ proposed technique. Results. Bone adhesion as a result of arthrodesis was achieved in all patients of the main group. Excellent functional results were achieved in 11 out of 36 patients (30.5%), good results - in 22 (61.1%) patients, satisfactory results - in 3 (8.4%) patients. Bone adhesion as a result of arthrodesis in 250 patients of the comparison group was achieved in 243 patients (97.2%). In this group excellent functional results were achieved in 76 out of 250 patients (30.4%), good results - in 145 (58%) patients, satisfactory results - in 21 (8.4%) patients, poor results - in 8 (3.2%) patients. Conclusion. The proposed method of biarticular arthrodesis makes it possible to improve the trophism of the arthrodesis zone, to conduct the correction of posttraumatic deformities in the region of the ankle and subtalar joints, provides a durable and solid bone ankylosis of the ankle and subtalar joints, and makes it possible to achieve adhesion even in severe forms of osteoarthritis of the ankle and subtalar joints.
Guided correction of posttraumatic deformities of the vertebral column
Authors: Tomilov A B , Kuznetsova N L
Published: November 2019

Aim. To improve the results of treatment of patients with post-traumatic deformity of the vertebral column. Methods. Analyzed were the results of treatment of 400 patients with fractures of the thoracic and lumbar vertebrae. Lesions of types A2, A3 and B according to the classification of the Association of osteosynthesis were seen in 70% of cases, lesions of type C - in 30%. The external transpedicular «Crab» construction was used in 100 patients. An internal transpedicular construction of the Scientific Research Institute «Syntez» was used in 300 cases. Transpedicular spondylosynthesis with intraoperative correction of the deformity with an original repositioning device was performed in all patients. Explosion fractures with the destruction of the vertebral body and stenosis of the spinal canal demanded the implementation of decompressive-stabilizing interventions in 25% of the cases. Conducted were clinical and radiological (spondylography, computed tomography, magnetic resonance imaging) studies. Results. Proposed was a technique of guided correction of posttraumatic deformities of the vertebral column. Unstable fractures and dislocation-fractures, lesions of intervertebral discs in the thoracic and lumbar segments of the vertebral column, inveterate lesions, posttraumatic deformities of the thoracic and lumbar segments of the vertebral column served as indications for using guided correction. Kyphotic deformity at the level of the damaged segment was corrected in 98% of observed cases with hypercorrection in the range of 2°. The vertical size of the vertebral body was restored up to 100% in the early posttraumatic period and up to 82.3% in the remote posttraumatic period. Subluxation was corrected in 86.9%, while dislocation of the fractured vertebra was corrected in 96.7% of cases. Conclusion. The proposed method of correction of posttraumatic deformities of the vertebral column makes it possible to provide similar treatment results of patients operated both with using the external fixation device of the vertebral column «Crab» and using the submersible transpedicular construction of the Scientific Research Institute «Syntez».
Prevention of complications of transvesical adenomectomy with a blind suture of the urinary bladder
Authors: Zubkov E A , Sitdykova M E
Published: November 2019

Aim. To determine the frequency and develop methods for prevention of possible complications of transvesical adenomectomy. Methods. Conducted was an analysis of results of surgical treatment of 492 patients with prostate adenoma. One-stage suprapubic transvesical adenomectomy with a primary blind suture of the urinary bladder and hemostasis of the adenoma bed was performed in 347 patients. Results. In the postoperative period inflammatory complications of the urinary tract were observed in 5 (1.4%) out of 347 operated patients. It was established that the frequency and nature of both early and late pyo-inflammatory and obstructive postoperative complications of the suprapubic adenomectomy depend on the method of hemostasis of the bed of the adenoma and on the time of urination recovery. Conclusion. The main measures of prevention of complications during suprapubic adenomectomy are hemostasis of the bed of the adenoma by temporary retriganization with removable hemostatic ligatures, early recovery of urethral voiding (2-4 days) and application of antibiotics to the bed of the adenoma via the drainages of the deference ducts.