bluuebunny/crossref_metadata_2025 huggingface dataset:
Examination and hygienic assessment of health risk depending on heavy metals content in foods
Authors: Kazimov M A , Alieva N V
Published: November 2019

Aim. To determine total daily intake and absorbed doses of some heavy metals with subsequent hygienic assessment of health risks associated with exposure to them. Methods. To determine the levels of heavy metals (lead, cadmium, chromium, nickel, copper and zinc) in food products included in the daily diet, actual nutritional status of 57 individuals was studied using questionnaire survey method in accordance with the existing guidelines. Samples of 18 food items were chemically analysed. Bio-materials (blood and hair) taken from randomly selected study subjects were analysed to determine the levels of heavy metals. The heavy metal levels in food products and biological media were determined by atomic absorption spectrometer («Shimadzu», Japan). Actual intake and absorbed daily doses of heavy metals were calculated using the quantitative data on the daily diet and metal levels in individual products according to the existing guidelines. Health risk values were estimated based on the gained results. Results. Various levels of heavy metals in food products were revealed. Their ranking order by levels present in basic food products (in bakery and meat products) is as follows: Zn Cr Ni Cu Pb Cd. High levels of heavy metals intake with daily diet (compared with the reference values) were revealed. Furthermore, high absorbed doses of heavy metals, particularly chromium and nickel, were accompanied by increased concentrations in blood and hair. The dose risk ratios for chromium and nickel were assessed as 1.31 and 3.77 respectively (for other metals - 0.15-0.58). Conclusion. The daily dietary intake and absorbed doses of chromium and nickel represent respectively low and increased risk to human health among the studied heavy metals.
Predicting adherence to antiretroviral therapy in HIV-infected patients
Authors: Fedyaeva O N , Yushchuk N D , Sirota N A
Published: November 2019

Aim. To develop a way for predicting adherence of HIV-infected patients to antiretroviral therapy, applicable in medical practice. Methods. The survey included 280 patients with verified diagnosis of HIV infection stage 3-4B, receiving antiretroviral therapy. Clinical manifestations of HIV infection and laboratory data were evaluated. Psychological testing using a Sheehan self-rating scale of anxiety was conducted. Statistical processing was performed using SPSS (version 17) statistical software package. Results. Among the factors that were not related to the primary disease (HIV), risk factors for non-compliance were: single/unmarried status of the patient and living on parents; no higher education. Factors associated with medical treatments included no motivation for switch from one treatment regimen to another, and a high drug load while receiving therapy (more than 7 pills a day). Presence of polyneuropathy on stage 4B and fever of unknown origin at stage 4B were also affecting compliance to antiretroviral therapy. Among laboratory signs, anemia and the level of viral load (independently on the stage of HIV infection), and the number of CD4+-lymphocytes in stage 4A affected the compliance. Assessment of anxiety in HIV-infected patients by using Sheehan self-rating scale of anxiety was more informative. Conclusion. The questionnaire was formed based on the identified factors. Each of the answers to the questionnaire’s questions is assessed by the coefficients of it influence to the adherence to antiretroviral therapy. The obtained data form the basis of the developed algorithm for determining adherence to antiretroviral therapy.
The organization of medical care for patients with chronic viral hepatitis in the Republic Sakha (Yakutia)
Authors: Sleptsova S S , Tihonova N N , Semenova V K , Rahmanova A G
Published: November 2019

Aim. To identify the risk factors for primary liver cancer in patients with chronic viral hepatitis in the Republic of Sakha (Yakutia) and develop an organizational model of treatment and prevention of viral hepatitis and primary liver cancer. Methods. Clinical, epidemiological and molecular biological methods were used. Results. There is a high prevalence of chronic viral hepatitis B, C and D in the Republic of Sakha (Yakutia), as well as their distant adverse outcomes. Disclosed the problem of the combined effects of risk factors for primary liver cancer in people indigenous nationality of the Republic of Sakha (Yakutia), mostly male, living in rural areas, which is the simultaneous replication of hepatitis viruses B, C and D in patients with genetically predisposed changes in the activity of alcohol dehydrogenase and aldehyde dehydrogenase. The modernization of the training algorithms of patients for liver transplantation and management of patients with cirrhosis and liver cancer in the outcome of chronic viral hepatitis, liver transplantation is justified from a related donor with a high level of specific antibodies of patients with primary liver cancer, as well as phasing held medical diagnostic and organizational and methodological measures. Created was an annual Republican «liver-school» for physicians, gastroenterologists, internists, pediatricians, epidemiologists, introduced the publication of conference materials for use on the entire territory of the Republic of Sakha (Yakutia). Conclusion. Multi-component structural-functional model of service prevention and control of viral hepatitis has allowed to develop a program to address the medical and social protection of different groups of the population to create a unified register «Chronic viral hepatitis in the Republic of Sakha (Yakutia)», as well as long-term programs for complex vaccine prophylactics and modernization of services for prevention and control of viral hepatitis.
Hospital-acquired acute viral hepatitis C
Authors: Suranbaeva G S , Murzakulova A B , Anarbaeva Zh A , Zhakisheva E M
Published: November 2019

Aim. To investigate clinical, epidemiological and laboratory features of acute viral hepatitis C hospital outbreak, registered in Aksy District, Kyrgyz Republic. Methods. The study was performed at department of infective diseases of Aksy Territorial hospital. 20 patients with acute hepatitis C were surveyed. All these patients were treated in the department of neurology of the same hospital (first one was admitted on 31.07.2006, last one - on 06.10.2006) for the mean term of 32 days before being admitted to the department of infective diseases. Epidemiologic, clinical and biochemical, serologic, virologic and instrumental methods were applied. Results. Acute hepatitis C was present as single infection in 19 cases, in was case it was associated with presence of surface antigen of the hepatitis B virus (HBSAg). All patients with acute hepatitis C had typical clinical pattern of the disease, moderate disease severity was the most common. Epidemiologic investigation revealed that all these patients while beain treated at the department of neurology, got injections using disposable syringes, no acupuncture was administered. None of them had parenteral and surgical interventions, blood transfusions, dental treatments 6 months prior to the admission. All of them denied any contact with any patients with known hepatitis C. One patient had survived acute viral hepatitis in childhood. It appears that this hepatitis C infection outbreak was related to parenteral transmission because all patients were admitted to the infectious department from a neurologic department only and all reported a history of receiving intravenous drugs.
Clinical and biochemical rationale for ozone therapy in patients with chronic viral hepatitis B and C
Authors: Galeeva N V , Fazylov V Kh , Valeeva I Kh
Published: November 2019

Aim. To explore the clinical and pathogenic role of lipid peroxidation, protective antioxidant system in association with biochemical indicators of liver functional state, and the effect of intravenous ozone therapy on these processes in patients with chronic viral hepatitis B and C, with the presence of liver cell cytolysis. Methods. Lipid peroxidation, antioxidant protection and biochemical indicators of liver functional state and their relation to liver functional state were studied in 184 patients with chronic viral hepatitis B and C using comprehensive clinical and biochemical methods. Intravenous ozone therapy was used in 50 patients with chronic hepatitis B and C to correct membrane disaorders. Results. Ozone therapy has shown a positive effect on lipid peroxidation processes and activity of antioxidant system, stimulating oxygen-dependent processes, improving liver function and well-being of patients with chronic viral hepatitis B and C. The association between lipid peroxidation products blood level and the intensity of liver cell cytolysis was revealed, there was no such association with the viral load level. Conclusion. In patients with chronic viral hepatitis B and C with active liver cell cytolysis, ozone therapy leads to clinical remission and normalizes liver functional state, lipid peroxidation and antioxidant enzymes activity.
Autoantibodies to activated blood coagulation factors in patients with ischemic heart disease
Authors: Gatiyatov Yu F , Tsybikov N N , Tereshkov P P
Published: November 2019

Aim. To study the content of autoantibodies to activated blood coagulation factors IIa, VIIa and IXa during ischemic heart disease. Methods. The investigation of autoantibodies was performed in 31 patients (mean age 57.6±7.8 years, male to female ratio 4:1). The patients were divided into three groups: the first - patients with myocardial infarction in the acute stage (9 people), the second - patients with myocardial infarction in the subacute stage (9 people), the third - patients with stable angina (13 people). The control group included 18 practically healthy subjects comparable by age and sex. The study of the content of autoantibodies to blood coagulation factors was performed by an original immunoassay method of Tsybikova N.N. et al. Results. Established was a decrease in the content of the following autoantibodies: class M immunoglobulins to fac-tor VIIa, class G immunoglobulins - to factor VIIa, classes M and G immunoglobulins - to factor IXa in the acute phase of myocardial infarction compared with the controls, as well as a decrease in the content of class G immunoglobulins to the factor IXa in the acute stage of myocardial infarction compared with the subacute stage and stable angina. Conclusion. During ischemic heart disease a decrease in the content of autoantibodies to the activated blood coagulation factors IIa, VIIa and IXa occurs, which is presumably due to their binding with excessively formed activated coagulations factors.
The search for genetic factors of predisposition to the development of liver cirrhosis in the course of viral hepatitis B in patients from the Republic of Bashkortostan
Authors: Gusmanova G T , Kalimullina D Kh , Bakirov A B , Khusainova R I
Published: November 2019

Aim. To identify the clinical and genetic associations of polymorphisms of the detoxification of xenobiotics genes during liver cirrhosis that developed as a result of viral hepatitis B. Methods. The study randomly included 38 patients with liver cirrhosis at the age of 25 to 54 years. The control group consisted of 147 healthy individuals. Conducted was an analysis of mutations in the deletion polymorphism of gene CYP1A1, leading to the replacement of the amino acid isoleucine with valine (Ile462Val) in position 462 of the cytochrome P-450 CYP1A1 and polymorphism of the gene GSTM1, which codes an enzyme antioxidant enzyme from the family of glutathione-S-transferase in patients with liver cirrhosis, which developed as a result of hepatitis B with the aim to identify possible associations with an increased risk and severity of the disease. Results. Revealed was a statistically significant increase in the proportion of patients with genotype Ile-Val/(+) compared to genotype Ile-Ile/(+), established was an association between the genotype S65C/N with polymorphism S65C of the gene HFE and liver cirrhosis of combined genesis (viral B + toxic). Conclusion. Ile462Val genotype of the CYP1A1 gene of the cytochrome P450, as well as the presence of a deletion of the glutathione-S-transferase M1 gene are risk factors for the development of liver cirrhosis secondary to hepatitis B.
The functions and geometry of the left ventricle in patients with chronic glomerulonephritis
Authors: Sigitova O N , Shcherbakova A G
Published: November 2019

Aim. To study the functions and the geometry of the left ventricle in patients with chronic glomerulonephritis at different stages of chronic kidney disease, depending on the presence of arterial hypertension and dyslipidemia. Methods. Observed were 156 patients with chronic glomerulonephritis (80 men and 76 women, mean age 40.23±1.1 years), including 91 people with arterial hypertension (observation group), 65 patients without arterial hypertension (comparison group). The observation and comparison groups were divided into subgroups depending on the stage of chronic kidney disease: the first subgroup - stage 1-2, the second subgroup - stage 3-4, the third subgroup - stage 5. The control group consisted of 30 healthy people. Conducted were general clinical, laboratory and instrumental investigations. Results. Left ventricular hypertrophy was formed at stage 1-2 of chronic kidney disease in 52.5% of patients with chronic glomerulonephritis with arterial hypertension, at stage 3-4 - in 69.2%, at stage 5 - in 80.0%. The dominant type of hypertrophy was concentric; with the decrease in kidney function the frequency of eccentric hypertrophy increased. In the early stages of chronic kidney disease the incidence of left ventricular dysfunction was almost similar in arterial hypertension (62.5%) and normal blood pressure (60.0%). With the decline of the kidney function in the presence of arterial hypertension the incidence of left ventricular dysfunction reached up to 84.6% at stage 3-4 and up to 88.0% - at stage 5 of chronic kidney disease. No influence of the lipid profile on the function and the geometry of the left ventricle were found. Conclusion. In patients with chronic glomerulonephritis with arterial hypertension with the decrease in kidney function increases the frequency of left ventricular hypertrophy; in the early stages of chronic kidney disease the incidence of left ventricular dysfunction is the same in patients with and without hypertension, increasing with the decline in renal function in patients with hypertension.
Urogenital manifestation of climacteric syndrome, its treatment
Authors: Neymark A I , Razdorskaya M V , Shelkovnikova N V
Published: November 2019

Aim. To study of the effectiveness of the drug mesodiethylethylendibenzosulfonate (Sagenit) in women with urination disorders in the climacteric period. Methods. During the years 2009-2010 at the Department of Urology and Nephrology of Altai State Medical University were examined, treated and followed-up 40 women of the climacteric period (aged 43 to 64 years) with urination disorders. All patients were prescribed Sagenit, 1 tablet a day for 1-6 months. Results. Sagenit was well tolerated by female patients for a long period of time, had no significant side effects, which would require discontinuation of the drug. After the conducted treatment the time of urination lengthened, the volume of urination increased and the maximal urinary flow rate decreased. The positive effect of therapy (improvement of the quality of life) was reported by 75% of the surveyed women. Conclusion. Sagenit was shown to be effective in treating women with urination disorders in climacteric period.
Clinical and epidemiological features of pyo-inflammatory diseases in the newborns
Authors: Khaertynov Kh S , Mingalieva R I , Girutskaya I V
Published: November 2019

Aim. To study the clinical and epidemiologic features of pyo-inflammatory diseases in the newborns. Methods. Examined were 60 newborn infants who were admitted to hospital for treatment of pyo-inflammatory diseases in the department of pathology of the newborns of the Republican Clinical Infectious Diseases Hospital. In order to determine the etiology of the disease a bacteriological culture analysis from a variety of epitopes - skin, eyes, navel, nose, throat, intestine was conducted in all children. Results. The vast majority (76.7%) of the infants were born full term and as a result of natural childbirth. The most frequently reported were the infections of the skin and mucous membranes - vesiculo-pustulosis (40%), purulent conjunctivitis (20%) and omphalitis (15%), less frequently - pneumonia (6.7%), pyoderma (5%), felon (5 %) and urinary tract infections (8.3%). In 81.7% of cases the pyo-inflammatory diseases had a moderately severe course. Inflammatory changes in the blood were found only in 26.7% of cases, they manifested by leukocytosis and neutrophilia with varying degrees of severity. The vast majority (81.6%) of cases the disease developed in the first 3 days after birth, indicating either an intranatal or intrauterine mechanism of infection of these newborns. In 42.5% cases the women experienced infectious diseases of the urogenital tract during pregnancy. During microbiological investigation of the external epitopes S. aureus and S. epidermidis were the most frequently seeded strains. Conclusion. The most common pyo-inflammatory diseases in newborn infants, who are hospitalized in an infectious diseases hospital, were diseases of the skin and mucous membranes - vesiculo-pustulosis, purulent conjunctivitis and purulent omphalitis, the development of which occurred in the first 3 days after birth, and the main etiological factors of their emergence were S. aureus and S. epidermidis.
Surgical correction of severe forms of hypospadias in children
Authors: Kagantsov I M
Published: November 2019

Aim. To search for an optimal method of surgical correction of proximal forms of hypospadias in children. Methods. During the period between 1998 and 2011 at the department of urology treated were 51 children with severe forms of hypospadias. Of the 51 patients under observation 13 patients had 21 operations performed out of our medical institution, at our hospital the patients underwent 98 operations: 7 types of urethroplasty in 51 patients. Results. The best results were obtained with a tubularized incised plate urethroplasty. After this intervention significantly fewer complications developed compared to the Duplay operation (p 0.001) and the techniques involving skin flaps - the so-called «flap» methods (p 0.05). After many years of applying various techniques for correction of proximal forms of hypospadias, in the author’s arsenal remain three: the tubularized incised plate urethroplasty, the Snodgraft intervention, and the two-stage Bracka operation. All of these operations bring together one key point - urethroplasty is performed from the urethral plate. Conclusion. The formation of the urethra from the urethral plate provides a positive functional and cosmetic result.
Refraction characteristics of the vision organ of school children living and studying in the area with high intensity of automobile traffic
Authors: Zainutdinova I I , Saifullina F R , Dautov F F
Published: November 2019

Aim. To conduct an analysis of the refraction of the vision organ of school children living and studying in an area with high intensity of automobile traffic, and in children living in a more environmentally clean area. Methods. The investigation of eye refraction in 62 children (124 eyes) of school age, living and studying in an area with high intensity of automobile traffic. Hygienic assessment of the environment in the study areas. Results. In the majority of the school children living and studying in an area with high intensity of automobile traffic a myopic refraction was revealed in contrast to the control area, where the frequency of myopia was less. The obtained data on the frequency of myopic refractive disorders in the children’s population were above the average statistics for the Russian Federation. A significant relationship between the nature and intensity of air pollution and the occurrence of myopia in children was established. We assume that one of the risk factors for myopia development is air pollution emissions by a complex of hazardous substances. Conclusion. Prophylaxis of eye diseases of children living in ecologically unfavorable areas of large cities is much needed; therapeutic measures for vision organ dysfunctions of this cohort should be implemented taking into account the influence of adverse environmental factors.
Diagnostic significance of ethanolamine content in blood and urine during nephropathies
Authors: Maksudova A N
Published: November 2019

Aim. To assess the significance of changes in the content of ethanolamine in biological fluids in the diagnosis of nephropathies. Methods. Examined were 246 patients (56% men, 44% women) aged 17 to 68 (41.1±13.1) years and 75 healthy subjects (49% men, 51% women) aged between 16 and 72 (31. 4±12.4) years. The first group consisted of 55 patients with essential hypertension, the second - 47 patients with insulin-dependent diabetes mellitus in the compensation stage, the third - 65 patients suffering from gout. The fourth group included patients with secondary (due to systemic lupus erythematosus - 29 people) and primary chronic glomerulonephritis. We used non-parametric statistical methods: analysis of the differences between the two groups was performed using U-criteria of Mann-Whitney, among three or more groups - the Kruskal-Wallis test; to identify the dependencies - Spearman correlation analysis was used. Results. The content of ethanolamine in the blood correlated poorly with the age, but only in patients with gout (r=-0.3, p=0.03). The concentration of ethanolamine in the blood was significantly lower in the first three groups, in urine was not significantly different from controls only in patients with gout (p=0.05). It is in the first, second and third groups that the majority of patients had a higher body mass index, arterial hypertension and metabolic disorders. There was an inverse relationship between the content of ethanolamine in the blood and the body mass index (r=-0.35, p=0.0001), the concentration of cholesterol in the blood (r=-0.27, p=0.02), weak positive - with creatinine levels (r=0.14, p=0.04). The ANOVA analysis revealed a negative relationship between the concentration of ethanolamine in the blood and body mass index (at f=20.3; p 0.001). Established were significant differences in terms of ethanolamine level in blood and urine when compared to patients with arterial hypertension and without it (p=0.01), as well as when comparing patients with and without dyslipidemia (p=0.02). Conclusion. The decrease in the concentration of ethanolamine in the blood may be a predictor of hemodynamic disturbances in the glomeruli of the kidneys; the content of ethanolamine in the blood is closely related with hypertension and obesity, and in the urine - is not associated with diseases of the diseases of the kidney glomerular apparatus, but correlates with the severity of tubular disorders in gout.
The properties and role of tumor necrosis factor alpha in the pathogenesis of HIV infection
Authors: Dunaev P D , Boychuk S V , Mustafin I G
Published: November 2019

This review presents the current understanding regarding the tumor necrosis factor alpha: its origin, receptors, main properties and its role in the pathogenesis of HIV infection (the infection, caused by the Human Immunodeficiency Virus). Tumor necrosis factor alpha induces viral replication in CD4+ T lymphocytes, monocytes and macrophages, promotes death of uninfected CD4+ T lymphocytes as well as CD8+ by the mechanism of apoptosis, allowing the progression of immunodeficiency. Tumor necrosis factor alpha maintains the viability of infected CD4+ T lymphocytes, contributing to the formation of the viral reservoir in the patient. Elevated levels of the tumor necrosis factor alpha in the blood plasma of HIV-infected individuals should be regarded as a marker of disease progression.
Modern diagnostic methods in diabetic foot syndrome
Authors: Klyushkin I V , Fatykhov R I
Published: November 2019

Presented was the comparative characteristic of modern methods of diagnosing tissue viability in the diabetic foot syndrome with the assessment of their advantages and disadvantages. An analysis of articles was conducted devoted to diagnostic methods that are used in diabetic foot syndrome. Doppler ultrasound investigation of lower extremity arteries makes it possible to determine the level of trophic disturbances, the degree of stenosis, the type of blood flow, however the informativeness of the method decreases during distal forms of lesions, mismatch of indicators of regional ischemia and hemodynamic severity with the clinical picture is possible. Duplex scanning makes it possible to evaluate the hemodynamics, the condition of the arterial wall, the presence of atherosclerotic plaques, gives an idea about the state of small vessels including collaterals, but does not always provide an opportunity to solve the problem of topical diagnosis. The method of radiopaque angiography and duplex scanning with contrast is not suitable for routine control of the vascular bed condition because of the invasiveness, toxicity of contrast agents and radiation exposure to the patient. In assessing the speed and volume of the out-flowing peripheral lymph and blood using rheolymphovasography the volume of the limbs and the development of subcutaneous fat, the ambient temperature, the psycho-emotional condition of the patient - all have a significant impact on the result. Impedance measurement can clearly identify the trophic disorders in the soft tissues, but can not be used to evaluate the bones. Thermal imaging study is characterized by its rapidness and objectivity, however, makes it impossible to determine the boundaries of trophic disorders. The state of the peripheral innervation can be assessed by electromyography, and chronaxiemetry electro-diagnosis. The first method is not widely used due to high equipment cost, complexity and lack of selectivity, the second one is still poorly understood. Laser Doppler flowmetry makes it possible to evaluate the level of macro- and microcirculation, even in preclinical stages, but it requires specially trained personnel. Biopsy of soft tissues with histological, histochemical, ultrastructural studies make is possible to assess the latent forms of diabetic foot syndrome; limitations are due to the invasiveness of the methods. In order to improve the quality of diagnosis of the diabetic foot syndrome is necessary to develop new methods of medical imaging, which should have the advantages superior to those of the traditional methods and have a minimum of contraindications.
Atex allergy in health care workers
Authors: Garipova R V
Published: November 2019

Presented was a review of the literature devoted to allergy to the components of latex among health care workers. Described were three types of reactions to natural rubber latex: (1), contact dermatitis, (2) type I allergic reactions associated with immunoglobulin E, and (3) type IV allergic reactions. Clinical symptoms of latex allergy can manifest as local [contact dermatitis (dermatitis from irritation), allergic contact dermatitis, contact urticaria] and/or systemic (rhinitis, conjunctivitis, difficulty in breathing attacks, widespread urticaria, Quincke’s edema to the extent of an anaphylactic shock) reactions. For the diagnosis of latex sensitization the applicational («glove») test is of particular importance, which consists of controlled wearing of latex gloves for 1 hour or more before the onset of symptoms of skin irritation, local and systemic allergic reactions become evident. Prick test - the most unified, technological and highly sensitive (up to 97% in the diagnosis of latex sensitization) method out of all the skin tests, virtually eliminates the occurrence of nonspecific reactions due to skin irritation or the reactions of its vessels. In the Russian Federation the prick test for the diagnosis of allergy to latex is not yet available, as the latex allergen has not yet been registered. There are publications, indicating the high sensitivity of the nasal provocation test in the diagnosis of latex allergy. The latex-specific immunoglobulin E is mainly detected by the radioallergosorbent test and enzyme immunoassay, sometimes by immunoblotting. The elimination of contact with latex products is the basis of the etiological treatment. The issue of the rational employment of health workers is very relevant. With latex allergy elimination diet is recommended to eliminate the products with cross-allergenic properties with latex: bananas, avocado, kiwi, chestnuts, peaches, tomatoes, shrimp, walnuts, etc. The usage of powder-free gloves with low allergenic potential led to a sharp reduction in the incidence of allergic reactions to latex among health care workers.
Substantiation of the use of tseloform sorbent in the treatment of pyo-inflammatory diseases of maxillofacial area
Authors: Khadyeva M N , Galimov R A , Ksembaev S S
Published: November 2019

Aim. To study the characteristics of composition of the new sorbent tseloform by the method of electron paramagnetic resonance and to evaluate its impact on the content of free radicals in the gum tissue during experimental periodontitis. Methods. Using the method of electron paramagnetic resonance studied were the characteristics of the composition of the sorbent tseloform, as well as its influence on the content of free radicals in the experimental model of periodontitis. Results. The method of electron paramagnetic resonance made it possible to determined that the sorbent tseloform initially contains a large amount of free radicals (up to 4.6±0.3×1020 for 1 cm3 of a sample), and that is 4.6-4.8 times (p 0.01) greater than in the samples of raw materials and the antiallergenic preparation from cotton cellulose nazaval (England). On the model of acute periodontitis in rats shown was a dramatic increase in the content of nitrogen oxide (II) in the pathologically altered gingival tissue: up to 7.5±0.61×10-7 M (р 0.05). During local treatment with the sorbent tseloform the level of nitric oxide significantly decreased in the gum: up to 3.12±1.85×10-7 M (р 0.05). Conclusion. The sorbent tseloform contains significantly more free radicals than the original raw material, and during local use has a positive effect on the course of the pathological process in an experimental model of periodontitis.
Methodological aspects of studying predisposition to allergic diseases in children of agricultural workers
Authors: Yusupova N Z
Published: November 2019

In this article presented was the substantiation of the methodology of studying the work environment factors among parents, particularly the mothers, and their influence on the development of allergic diseases in children taking into account the specifics of the working conditions in the agricultural sector. The proposed study algorithm includes investigation of sanitary conditions of labor and adverse industrial factors in women of the reproductive age, employed in the agricultural sector, as well as investigation of the incidence of disease, including allergic disease, among their children. Analysis of variance allows us to quantitatively determine the significance and share impact of the industrial environment factors and of the working process of parents, as well as the of the social and hygienic conditions on the incidence of allergic disease of their children. Complex studies make it possible to determine the clinical and immunological features of allergic diseases in children of agricultural industry workers, to develop and validate the criteria for long-term effects of the factors of professional activity of parents of the agricultural industry on the formation of allergic diseases in children, as well as to determine the proportion of the effect of individual risk factors on the parameters and structure of allergic diseases of preschool children with their isolated and combined effects. The study of the relationship «professional female hazards - allergic diseases of the child» is based on the usage of a united methodological approach, which includes hygienic, sociological, allergological, immunological methods of investigation and makes it possible to determine the significance of occupational exposures of parents in the implementation of mechanisms of allergic diseases development in children and to develop a model of priority measures for improving prevention of allergic diseases in children of agricultural workers.
Williams syndrome (syndrome of idiopathic hypercalcemia)
Authors: Fayzullina R A , Shoshina N K , Galimova R M , Moroz T B
Published: November 2019

Williams syndrome was first described in 1961 by J.C.P. Williams et al. The population frequency is 1:7500-10 000 live births; the ratio of boys and girls is about 1:1. The nature of this genetic disease is the loss of genetic material (microdeletion) of the long arm of chromosome 7. During microdeletion the loss of elastin, LIM-kinase-1 and replication factor C2 (RFC) genes occurs, some of the «lost» genes have not yet been identified. A more rare form of the syndrome exhibits deletions on chromosomes 11 and 12 - 11q13-q14, and 22q. Presented was the authors’ clinical observation. A child was born from the second pregnancy (the first one ended in miscarriage at 12 weeks of the term), which had a physiological course, first childbirth was given at the term of 40 weeks, the newborns body weight at birth was 2600 g, body length 49 cm. At 1 year 8 months the baby’s height was 80 cm, body weight was 10 kg 800 g, head circumference - 50 cm, chest circumference - 51 cm. Multiple stigmas of dysembryogenesis were present. The head was irregularly shaped, the large fontanelle was closed. A marked face dysmorphism: a broad forehead, the unusual shape of the eyes with swelling around them, epicanthal fold, drooping full cheeks, the characteristic shape of the nose with a rounded blunt end and anteriorly open nostrils, a small pointed chin, a large open mouth, full lips, especially the lower one, progeny, small teeth, jagged, and affected by caries. The thorax was narrow, a depressed sternum in the form of a «сobbler’s chest». The muscle tone was moderately reduced. The psychomotor development at the level of a 8-9 months old. Cardiologist’s conclusion: a congenital heart defect, hypoplasia of the isthmus of the aortic arch. Conclusion of the geneticist: multiple stigmas of dysembryogenesis, a characteristic phenotype. Karyological analysis 46,XY - without karyotype abnormalities. Chromatography of the amino acids - without any pathology. Diagnosis: Williams syndrome. Diagnosis of Williams syndrome sometimes possesses known difficulties. The described clinical case illustrates the possibilities of diagnosing the syndrome, based primarily on a careful analysis of the medical history, of the clinical picture and physical examination.
Clinical and morphological characteristics of generalized purulent peritonitis in the terminal stage
Authors: Arsent’ev O V , Kemerov S V
Published: November 2019

The article analyzes the course of generalized purulent peritonitis, taking into account typical errors and reasons that led to lethal outcomes, as well as complications that arise during treatment and have an impact on its result.
Pathogenetic substantiation of infusion therapy using modern methods of visualization in diabetic foot syndrome
Authors: Akhmetyanov L A , Fatykhov R I , Klyushkin I V , Kolesnikov A E , Naumov V V
Published: November 2019

Aim. To propose a pathogenetically substantiated infusion therapy based on the results of a comprehensive evaluation of lower limb ischemia in diabetic foot syndrome. Methods. Energetic Doppler sonography of the blood vessels of the lower extremities in its distal part and electrothermometry in 32 patients with diabetic foot syndrome and critical limb ischemia was conducted in addition to the general clinical imaging studies (radiography, ultrasonography in the «gray scale» mode). Considering the obtained data the treatment strategy in these patients (conservative or surgical) was determined together with a physician-endocrinologist. Results. Presented is an example of tactics formation for conservative infusion therapy of a patient with diabetes mellitus, which is complicated by the diabetic foot syndrome with critical limb ischemia. Compiled was an individual treatment algorithm. At the initial stage crystalloid solutions (slow drip, followed by urination stimulation) were administered. Next prescribed were vitamins from group B (cyanocobalamin 0.25 mg and pyridoxine 50 mg) in order to regulate the metabolism of key neuromediators and amino acids. The complex of treatment included the nonsteroidal anti-inflammatory drug diclofenac (25 mg). This was followed by administration of dextran solutions (reopolyglukine), in combination with an antiplatelet solution (pentoxifylline). At the final stage of therapy administered was prostaglandin E1 (alprostadil, 3-4 infusions per course). Local treatment: osmotic agents were applied to the right foot as semi-alcohol compresses to relieve swelling, improve microcirculation and promote closure of the fistulas. After the conducted treatment noted was an improvement in general condition, pain symptoms subsided, the fistula closed, the soft tissue on the foot had no signs of inflammation. Recovery of the parameters of microcirculation signify the relief of arterial and venous stasis. Conclusion. This treatment scheme will make it possible to improve the course of the disease, reduce the time of treatment and disability of patients, will also improve their quality of life.
Development of a genetic test for evaluating 5-year survival of patients with acute myeloid leukemia and myelodysplastic syndrome
Authors: Glukhanyuk E V
Published: November 2019

Aim. To study the mutations in the gene CEBPA - a transcription factor that plays an important role in myeloid differentiation. Methods. Venous blood or bone marrow biopsy specimen samples from 16 patients with acute myeloid leukemia served as the materials for the study. The method of investigation - polymerase chain reaction followed by sequencing. Results. The obtained data was analyzed; the patients are under active surveillance. Since the most common and prognostically meaningful are the combinations of N- and C-terminal mutations, in the case of a «hot spot» detection (the combination of certain mutations) a more feasible test can be developed. Identifying groups of patients with favorable and unfavorable prognosis will dramatically affect the tactics of patient management: its radicalism, aggressiveness and cost of treatment. Conclusion. A small number of examinees does not yet make it possible to establish a statistically significant correlation between specific mutations and prognostic significance, as well as to identify the combinations of most frequent mutations.
Application of blood salvaging technologies in cardiosurgical patients operated under cardiopulmonary bypass
Authors: Dzhordzhikiya R K , Rakhimullin I M , Khamzin R R
Published: November 2019

Aim. To evaluate the effectiveness of blood salvaging technologies in cardiosurgical patients operated under cardiopulmonary circulation. Methods. Analysis of perfusion protocols and transfusion cards of cardiosurgical patients operated using cardiopulmonary bypass during the period 2010-2011. Two groups of patients were identified: the first group - with the application of blood salvaging technologies (906 patients), the second group - without the application of this technique (122 patients). Blood from the operative wound was collected during the operation, processed, filtered through the «Cell-saver» machine from «Fresenius» company and was then re-introduced into the patient’s bloodstream. After completion of cardiopulmonary bypass the blood remaining in the circuit of the cell-saver machine and blood that was discharged through the drainage tubes was returned to the patient after being processed. Results. In the first group at the end of the operation 314.6±28.6 ml of washed red blood cells were returned to the patient from the heart-lung machine, while during the first postoperative day, the amount of the returned autologous erythrocytes from the drainage tubes was 72.8±12.5 ml. In this group, only 45 (4.9%) patients required donor erythrocyte mass transfusion, its volume per patient amounted to 172.3±31.8 ml. In the first group 182 (20.1%) patients required transfusion of fresh frozen plasma with the aim of achieving hemostasis, its volume amounted to 425±51.3 ml. In the second group 51 (41.8%) patients received erythrocyte mass transfusion in the volume of 346.7±31.1 ml, and 86 (70.5%) - received fresh frozen plasma in the amount of 568.7±41.2 ml. Hemoglobin content and hematocrit at the end of the operation and on the first postoperative day were significantly higher in the first group compared to the second group (p 0.01). These changes were associated with both intraoperative bleeding and with the loss of blood through the drainage tubes on the first postoperative day in the second group of patients. Compensation for these losses required transfusion of blood components significantly more frequently (p 0.001) and in larger volumes (p 0.01) than in the first group. Conclusion. Blood salvaging technologies using the «Cell-saver» machine during cardiac surgery under cardiopulmonary bypass significantly reduce blood loss, reduce the number of postoperative hospital days and complications, and are less expensive.
Key aspects of treatment of multiple organ failure
Authors: Kemerov S V
Published: November 2019

Multiple organ failure syndrome often develops during serious diseases significantly worsening the condition of the patient and creating difficulties in treatment. The authors propose a scheme for treatment of the multiple organ failure syndrome, depending on the dominant pathological condition.
The experience of using infusions of thrombolytic agents in the complex treatment of complicated forms of diabetic foot syndrome
Authors: Koreyba K A
Published: November 2019

The article presents the experience of using infusion thrombolytic agents in the complex therapy of patients with complicated diabetic foot syndrome. Presented was a vivid clinical case. This method made it possible to optimize the treatment of this group of patient.
Current status of training and retraining of the medical personnel on the blood service
Authors: Turaev R G , Khasanova G R
Published: November 2019

There is an urgent necessity to work on optimizing the network of blood services institutions and to address the problem of staffing with highly qualified personnel - physicians-transfusiologists, nurses and technical staff. The authors propose a number of measures that contribute to solving this severe problem.
Infusion-transfusion therapy in the treatment of patients with acute bleedings from the upper gastrointestinal tract
Authors: Khalikova G R , Malkov I S , Fattakhov V V , Nasrullaev M N
Published: November 2019

Aim. To improve the treatment outcomes of patients with acute bleedings from the upper gastrointestinal tract by improving methods of endoscopic hemostasis and prediction of disease recurrence. Methods. The results of treatment of 776 patients with bleedings from the upper gastrointestinal tract have been analyzed. Methods of conservative therapy, endoscopic hemostasis and surgical treatment were used in combination with infusion therapy. Results. Established was the necessity of a differentiated method of endoscopic hemostasis, depending on the localization of the bleeding source, its intensity and effectiveness during ongoing bleedings. Infusion therapy should be initiated from the moment of verification of the diagnosis of acute bleeding from the upper gastrointestinal tract, regardless of the degree of blood loss, and already in the hospital’s emergency department. In cases of mild bleedings the infusion volume is 800-1000 ml: 80% crystalloids + 20% of colloids. The volume of infusion in moderate blood loss is 1500-2300 ml: 60% crystalloids + 20 colloids % + 20% fresh frozen plasma. The volume of infusion in severe blood loss is 2700 ml and more: 20% of crystalloids + 30% colloids + 30% fresh frozen plasma + 20% erythrocyte mass. Replacement therapy requires careful monitoring of the hemodynamic parameters and infusion load due to the unpredictability of body reactions to blood loss and its replacement. In the absence of an effect of conservative treatment within 6-24 hours an emergency operation is indicated with the choice of an optimal method based on an assessment of the physiological status on a POSSUM scale of assessment. Conclusion. Implementation of substitution therapy, which correlates to the degree of blood loss, critically important in order to eliminate ischemia of the wall of the gastrointestinal tract and prevent recurrence of bleeding; the usage of new approaches to the prediction of recurrent bleedings and improvement of methods of endoscopic haemostasis reduces the frequency of their occurrence, duration of in-hospital stay of patients and postoperative mortality.
For the sake of public health (to the 120th anniversary of the honored worker of science, professor Eugeniya Alekseevna Domracheva)
Authors: Faizov T T
Published: November 2019

To the 120th Anniversary of the Honored Worker of Science, Professor Eugeniya Alekseevna Domracheva, an anniversary essay that reflected her life and career. Presented were the biographical data and memories of relatives, friends, students and colleagues. The essay contains photos from the family and the Department’s archives. The article vividly recreates a portrait of Soviet woman - a doctor, a teacher and a scholar, who gave more than 50 years of her life to serving the Motherland.
Perbedaan Kinerja Guru Bimbingan dan Konseling dalam Menyelenggarakan Konseling Individual Ditinjau dari Latar Belakang Pendidikan dan Pengalaman Bekerja
Authors: Barida Muya , Muarifah Alif
Published: November 2019

Abstract: The particular study aimed to determine the differences performance between school counselors in organizing individual counseling services in schools in terms of educational background and work experience. The research approach was descriptive survey through a descriptive comparative study design. The subjects were school counselor in Daerah Istimewa Yogyakarta, especially at Bantul Regency. The data analysis technique used two way ANOVA. Based on the statistical tests, the educational background and work experience did not significantly affect the performance of school counselors in providing individual counseling services in schools.Abstrak: Penelitian ini bertujuan untuk mengetahui perbedaan kinerja guru Bimbingan dan Konseling (BK) dalam menyelenggarakan layanan konseling individual di sekolah ditinjau dari latar belakang pendidikan dan pengalaman bekerja. Pendekatan penelitian dengan descriptive survey melalui rancangan descriptive comparative study. Subjek penelitian ini adalah guru BK di Daerah Istimewa Yogyakarta (DIY), khususnya Kabupaten Bantul. Teknik analisis menggunakan rumus two way ANOVA. Berdasarkan hasil uji statistik diketahui bahwa latar belakang pendidikan dan pengalaman bekerja tidak berpengaruh secara signifikan terhadap kinerja Guru BK dalam menyelenggarakan layanan konseling individual di sekolah.