bluuebunny/crossref_metadata_2025 huggingface dataset:
Invalidization in patients with myasthenia, factors affecting disability
Authors: Konkova Darya Yu. , Karnaukh V. N
Published: September 2020

Myasthenia gravis, as a disease associated with impaired neuromuscular transmission and manifested by muscle weakness and fatigue, necessarily leads to the disability of patients. There were analyzed terms and the factors influencing upon disability in 52 patients with myasthenia, 67 per cent of whom had a disability group. The duration of the disease from the beginning to the referral to the examination in the Bureau of the Medical and Social Expertise was revealed to amount in average of 2.68 ± 0.44 years. Out of factors influencing upon more earlier disability there were noted primary or early generalization of the process, severe crisis course and pronounced severity according to MGFA, poor compensation on anticholinesterase drugs, inadequate therapy. There was noted the positive effect of thymectomy on the consequent course of the disease, only 2 out of the 18 operated patients showed its further progression.
Professional education of students with impaired hearing development
Authors: Lotova Irina P.
Published: September 2020

In the article there is presented the analysis of organization and technological assistance of the vocational education of students with impaired hearing development on the example of the Moscow State Technical University named after N. E. Bauman which has long term experience in this area. In particular, there is discovered the content of educational and rehabilitation technologies of educational of the mentioned category of students.
Features of the organization of public service of medical and social expertise at the present stage
Authors: Puzin S. N , Memetov Servir S. , Shurgaya M. A , Baleka L. Yu
Published: September 2020

In the modem society, the state acts as the guarantor ofsocial security of citizens with disabilities. In this direction as an important stage the ratification by the Russian Federation of the Convention on the Rights of Persons with Disabilities in 2012 has turned. Convention was directed to the assurance of the full participation of persons with disabilities in civil, political, economic, social and cultural life of the society. Ratification of the Convention required to insert amendments in the acting legislations of the Russian Federation, including those concerning Medical and Social Expertise (MSE). In particular, there was changed quantitative and qualitative body of specialists, members of the Bureau of the MSE, there was changed the classification and the criteria used for the implementation of medical and social examination of citizens by Federal State MSE institutions. There was the replacement of a paradigm in relation to persons with restrictions in the life activity. The role of health care organizations in terms of examinations and clinical diagnosis in citizens, sent to the medical and social expertise has increased significantly. In the article there is presented an analysis of the current regulatory - legal frameworkfor the implementation of medical and social examination of citizens by Federal State MSE institutions. There was emphasized the importance of quantitative evaluation system of the severity of persistent disorders of the human body functions, caused by diseases, consequences of injuries and defects.
The role and place of social partnership in increasing efficiency of the provision of social services by the State Autonomous Institutions of Moscow «Scientific and Practical Center for Rehabilitation»
Authors: Syrnikova Bela A. , Kobzar I. Z , Storozhenko D. V , Temirov Kh. V , Ashuev Zh. A , Idrisova L. S
Published: September 2020

In the article there are analyzed external links of the large multidisciplinary institution of the social support of the population «Scientific and Practical Center of Rehabilitation» from the point of view of the identification of relationships of social partnership in them. These relationships were shown to have diverse forms and are implemented in terms of the participation of representatives of various sectors in the activity of collective bodies of institution’s management. There is demonstrated the significant role of relationships of the social partnership in the determination kinds, volumes, quality and circumstances of the provision social welfare services to the population.
Features of the alteration of poststimulus thresholds of the pain and its subjective characteristics in patients with neuropathic pain in the process of empatho-technique
Authors: Ishinova Vera A. , Svyatogor I. A
Published: September 2020

In the work there are presented results of the investigation offeatures of the alteration of thresholds of the post-stimulus pain and its subjective characteristics in patients with phantom pain syndrome and psychogenic pain in the process of empatho-technique. There was studied the role ofpsychophysiological autoregulation in the restoration of sensitivity in patients undergone to amputation of lower extremities. The use of empatho-technique was found to allow not only to significantly reduce the intensity ofphantom, and psychogenic pain, but to fully restore sensitivity to ultrasonic stimuli in the psychogenic pain and significantly eliminate cases of its disturbance in the phantom pain. It is assumed that the reducing influence of empatho-technique on the intensity of the perception ofpain can be realized by means of activation of the antinociceptive system, enhancement of its inhibitory effect on the painful stimulus, as well as decline in the activation of the nociceptive system, with a subsequent decrease in the intensity of sensations ofpain and restoration of sensitivity.
The morphofunctional status of the young students at the intersection of the XX and XXI centuries for compliance with the tests of the All-Russian physical-sport complex «Ready for Labor and Defense» («Gotov k Trudu i Oborone» - GTO, in Russian)»
Authors: Shteynerdt S. V , Achkasov E. E , Mashkovskiy E. V , Narkevich A. N
Published: September 2020

According to data of researchers throughout the duration of 2002-2012 the morbidity rate in students increased by 35%. One of the measures aimed at correction of the level of population health is to revive in Russia the all-Russian sports complex «Ready for Labor and Defense» (aRSC RLD). Objectives of the aRSC RLD are the elevation of the efficiency of opportunities of physical culture and sports in promoting health, harmonious and comprehensive development of personality, upbringing of patriotism and the provision of succession in the implementation ofphysical education of the population. In this regard, the study of the current morpho-functional state ofpersons occupying in the ontogeny of human development the special position - adolescence, is a topical and timely study in the accomplishment of the analysis of conformity of kinds of testing aRSC RLD and their regulations with the current physical condition of modern young male students.
DISABILITY DUE TO THE CLASS OF RESPIRATORY DISEASES IN ELDERLY PEOPLE
Authors: Shurgaya Marina A.
Published: September 2020

The main strategic task of the provision for health and social care and alimentation of the quality of life in the elderly patient is the implementation of clinical, diagnostic and preventive measures, taking into account characteristics of the course of different diseases in geriatric population. In an article there are highlighted modern approaches to the diagnosis and treatment of bronchial asthma, which is the leading pathology that determines the morbidity and disability due to diseases of the respiratory system in elderly citizens. Accounting for the morphological and functional features of the elderly age allows provide the medical and social care and achieve quality standards in the treatment of asthma in the geriatric population.
THE QUESTIONS OF DISABILITY AND FORMING LABOUR RECOMMENDATIONS FOR CASES SUFFERED DUE TO OCCUPATIONAL DISEASES IN THE RUSSIAN FEDERATION
Authors: Dymochka Mikhail A. , Andreeva O. C , Omarov M. A , Shakhsuvaryan S. B , Tarasova L. A , Rychkova V. A , Makkaeva S. M , Puzin M. N , Afanas’ev B. G , Lepaev Yu. V , Denishchuk I. S
Published: September 2020

There has been presented an analysis of the contingent of persons suffered due to occupational diseases in the Russian Federation during 2015 year: results of the primary and repeated examination in the bureaus for the medical and social expertise, the structure of the primary and repeated disability in consideration of the age and groups of the disability. There have been formulated in detail the recommendations with respect to indicated and contraindicated conditions of labor in the main kinds of occupational diseases and poisonings.
EFFICIENCY OF THE USE OF TAPE KINESIOLOGY AND HAND TRAINERS IN COMPLEX REHABILITATION OF PATIENTS WITH FOREARM FRACTURES
Authors: Yulov V. V , Kerimov Ullubiy Sh. , Goncharov N. G , Shishkin V. B
Published: September 2020

Fractures of bones of the forearm are the most frequent damage of the bones of the upper limb. A high percentage of unsatisfactory results of the treatment necessitates research on the development of effective methods of medical rehabilitation. Purpose. To evaluate the effectiveness of tape kinesiology and hand trainers in the medical rehabilitation of patients with fractures of the forearm bones. Material and methods. 68 patients (22 men and 46 women) aged of 19-85 years with isolated fractures of the forearm bones were examined. In 65 patients, bone osteosynthesis was performed, external fixation devices were used in 3 patients. All patients were divided into three groups. All patients were divided into three groups. The 21 cases from the control group received standard medical rehabilitation. In 23 patients from the comparison group the standard medical rehabilitation was supplemented by standard kinesiology with standard medical rehabilitation. In 24 patients from the main group hand trainers were used against the background of standard medical rehabilitation and kinesiology. The effectiveness of the treatment was assessed on the basis of the VAS scale, the DASH and SF-36 questionnaires, the Green and O’Brien scoring scheme. Results. The complex application of tape kinesiology and hand trainers in comparison with standard medical rehabilitation and the use of tape kinesiology allows increase the amplitude of movements by 29,1% and 11,0%, rotational movements by 24,11% and 9,12%, to improve the DASH 46,8% and 19,6%; reduce the severity of the pain syndrome by 45,5% and 22,7%, diminish the number of patients with edema by 1,8 and 1,5 times, respectively. In the long-term period surpasses the effectiveness of using kinesiotherapy by the amplitude of movement by 7,9%, rotational movements by 13,4%, DASH by 8,9%, and quality of life by 11,7%. Conclusion. The comprehensive application of tape kinesiology and hand trainers allows significantly reduce the severity of the pain syndrome, contributes both to the cupping of the edema and the most complete restoration of the functions of the wrist joint, as well to the improvement of the quality of life of patients.
ANALYSIS OF THE STRUCTURE OF THE PRIMARY DISABILITY DUE TO MULTIPLE SCLEROSIS IN THE CITY OF UFA OVER 2010-2016
Authors: Ivanova Elena V. , Bakhtiyarova K. Z , Safronova E. V
Published: September 2020

There was performed the analysis of the primary disability of multiple sclerosis in a large industrial city of Ufa during the period of 2010-2016. There was noted the decline in levels of the disability from 0.23 in 2010 to 0,14 per 10,000 in 2016, the prevalence in the structure of disability in young and middle-aged, persons with the third disability group. During the first 5 years from the onset of the disease 36,8% of patients have signs of the permanent disability, after 10 years 62% of cases show signs of the permanent disability. The majority of the disability have secondary progressive and remission-progressive type of the disease.
MEDICAL AND SOCIAL ASPECTS OF THE PHYSICAL REHABILITATION OF THE RECIPIENTS OF THE DONOR KIDNEY
Authors: Achkasov E. E , Shelekhova Тatyana Yu. , Runenko S. D , Sultanova O. A , Minenko I. A
Published: September 2020

Aim of the study. To assess the effectiveness of the physical rehabilitation in the first year in recipients with donor kidney. Material and Methods. The article presents an assessment of the functional state and adaptive body reserves using hardware-software complex (HSC) “Sources of Health” for patients before and after the kidney transplantation. The results of the examination and treatment of 57 recipients (of the mean age - 35±9.65) donor kidney at different times of the postoperative period. Depending on the physical rehabilitation program there were selected 2 groups of patients: in Group I the physical rehabilitation was carried out during the year, in Group II - only in the first week after surgery for the prevention of early postoperative complications. Group III combined 30 relatively healthy people (15 women, 15 men) without the need for an organ transplant and of a mean age of 33.7 ± 8.7 years, keeping a normal lifestyle, not engaged in the regular recreational physical exercises. The functional state and adaptive body reserves were evaluated with HSC “Sources of Health” at 1, 3, 6 and 12 months after surgery. Results. The physical rehabilitation with a personalized approach for one year after the kidney transplantation can significantly improve functional and adaptive body reserves in donor kidney recipients. Conclusion. Patients are shown to need for the physical rehabilitation at least for a year after the kidney transplantation in order to improve the functional state and adaptive body reserves.
MEDICO-SOCIAL ASPECTS OF THE GENERAL AND PRIMARY DISABILITY IN CHILDREN POPULATION LIVING IN THE URBANIZED AREA
Authors: Myachina Olga V. , Esaulenko I. E , Puzin S. N , Zuikova A. A , Pashkov A. N , Shurgaya M. A , Davydov M. A
Published: September 2020

The aim of the investigation was to make an analysis of the primary and general disability in children population living in the industrial Levoberezhniy district of the city of Voronezh under the exposure to the constant anthropogenic load. The analysis was made according to the statistical form №19 «Information about children with disabilities». The duration of the period of the investigation amounted of 9 years (2009-2017). The general disability level in the industrial Levoberezhniy district was determined to be 11.24±0.33 / 1000 of the children population, and primary disability level accounted for - 1.36±0.18 / 1000 of children population. The most number of children with disabilities is in the group of 5-9 years. The majority of disabled children were shown to be boys (60.48±0.86%). Diseases of the nervous system held the 1st position in rank-abundance distribution in the general invalidity structure of children - 24.7%, (cerebral palsy and other paralytic disorders were the most frequently occurred), 2nd was occupied by congenital anomalies - 23.59% (out of them, anomalies of the nervous system), 3rd - diseases of the ear and mammillary tubercle - 17.68%, 4th - endocrine - 11.32% (of them diabetes), 5th - diseases of the bone-muscular system and connective tissue - 5.26% (of them juvenile arthritis). Structure of reasons for the primary disability in different age groups and general age structure have the important practical value for planning of the medico-social inspection and rehabilitation of children with disabilities.
INFLUENCE OF ANTIARRHYTHMIC DRUGS ON THE SPECTRAL ANALYSIS OF HEART RATE VARIABILITY IN PATIENTS WITH ATRIAL FIBRILLATION
Authors: Popova Ekaterina P. , Bogova O. T , Puzin S. N , Matsokin I. S , Gadzhimagomedova A. A , Sychev D. A , Fisenko V. P
Published: September 2020

The use of the spectral analysis of the heart rate variability to assess the effectiveness of therapy is of great attention of researchers and doctors. This method allows you to get knowledge of the influence of the autonomic nervous system on the heart activity, which is an important factor for the manifestation of the effects of antiarrhythmic drugs. In this study, we studied the effect of antiarrhythmic drugs of class III amiodarone and sotalol on spectral indices of the heart rate variability in patients with atrial fibrillation. The power of slow frequencies prevailed in the structure of the spectrum with the introduction of amiodarone and sotalol. This suggests that the sympathetic nervous system have a predominant influence on the heart.
Porphyria cutanea tarda concomitant with chronic hepatitis C
Authors: Teplyuk N. P , Vertieva Ekaterina Yu. , Ignatyev D. V , Dzhavakhishvili I. S
Published: September 2020

Porphyrias form a group of rare metabolic diseases associated with disorders in the heme biosynthesis enzymes, leading to porphyrin accumulation in tissues. The disease is rare and is often diagnosed too late. The most incident is porphyria cutanea tarda. All patients with this condition should be tested for viral hepatites and hemochromatosis. A clinical case is presented: a patient with porphyria cutanea tarda associated with alcohol abuse and viral hepatitis C.
Metatypical basal cell carcinoma in young man
Authors: Snarskaya Elena S. , Plieva L. R , Maximov I. S
Published: September 2020

Malignant epithelial skin tumors are leading among oncological diseases worldwide. In most cases epithelial skin tumors affect areas, susceptible to the action of adverse environmental factors. Metatypical basal cell carcinoma is a variant of basal cell carcinoma that combines the features of basal cell and squamous cell carcinomas. It characterized by infiltrative growth and the destruction of the underlying tissues, pain, bleeding, formation of distant metastases and frequent relapses. Metatypical basal cell carcinoma is more common in women, with the average age is 70.5 years. Historical data, the results of own clinical investigations, rare case of metatypical basal cell carcinoma of the young man, who was successfully treated with recombinant interferon-a2 and prospidinum are presented.
Trace element status of the patients with alopecia areata
Authors: Nikolaeva Tatiyana V.
Published: September 2020

The issue of trace elements participation in the pathogenesis of alopecia areata and the mechanisms of change in bio-concentrated trace remains unresolved and requires further consideration. Goal. To rate trace element balance in patients with alopecia areata. Material and methods. The study group consisted of patients with focal forms of alopecia areata (n = 100), the comparison group - healthy individuals (n = 100). The estimate of trace element status was performed by comparative analysis of the contents 11 trace elements (zinc, iron, copper, cobalt, chromium, manganese, nickel, strontium, bismuth, cadmium, lead) in whole blood and hair in the study group. Results. The study reported a significant decrease in the level of zinc and iron in a patient’s blood and an increase in bio-concentrate iron, copper, chromium and nickel in hair ofpatients compared with healthy participants. Trace element analysis of whole blood and hair allowed to suggeste that a cause of an arising microelement imbalance is probably an autoimmune inflammation in the skin ofpatients suffering from alopecia areata. Confirmation of this hypothesis requires further comprehensive studies.
Expression of heat shock proteins HSP90 on neutrophils peripheral blood in patients with atopic dermatitis
Authors: Elistratova I. V , Morozov Sergey G. , Zakharova I. A
Published: September 2020

HSP90 expression on the neutrophil plasma membrane has been investigated in patients with atopic dermatitis. Methods. Human peripheral blood cells were stained with monoclonal antibodies to the HSP90 and were analyzed using the flow cytometer. Results. Neutrophils obtained from patients with atopic dermatitis have been found to express the more significant level of HSP90 on plasma membrane, and percentage of these cells has been shown to be higherfor atopic patients compared with healthy donors. Both, neutrophil count and HSP90 fluorescence were increased according elevation of index SCORAD for atopic patients. The most significant elevation in percentage of neutrophils expressing HSP90 on plasma membrane has been found during the first and second weeks of acute phase of the disease. We did not found the significant differences for HSP90 expression on neutrophils dependent on IgE level in the blood serum. Conclusion. HSP90 expression is elevated on the neutrophil plasma membrane from atopic dermatitis patients compared with healthy donors. Percentage of these cells were positive correlated with SCORAD index.
Telogen effluvium. New possibilities of correction
Authors: Berechikidze Tamara T. , Pinegin V. B
Published: September 2020

The current understanding of the causes and trigger points, classification, clinical picture, diagnosis and new approaches to the treatment of telogen effluvium are presented. The data of the clinical study of 60 patients with telogen effluvium, developed on the background of iron deficiency anemia, a comparative characteristic of Fe2+salts therapy vs combination therapy with Fe2+salts with topical lotion Qilib are described.
Infantile hemangioma: current classification, clinical picture and effective methods of therapy
Authors: Sheptiy Oleg V. , Kruglova L. S
Published: September 2020

Review of the literature devoted to one of the most common tumors of childhood - hemangioma is presented. Literature search was performed using the NCBI, including PubMed, PubMed Health, and The Cochrane Library databases. Infantile hemangioma is a neoplastic proliferation of endothelial cells, which is characterized by different phases of development: proliferation and spontaneous involution. The types of infantile hemangiomas, variants of the course and possible complications such as ulceration, functional disorders, and the formation of cosmetic defects are described. Incidence associated with infantile hemangioma syndrome is presented. The current views on the pathogenesis of infantile hemangiomas are described. Information about the best methods of diagnostic imaging, as well as medical and surgical therapies, including systemic and topical therapy with β-blockers, corticosteroids and use of lasers are described.
Removal of excess localized fat deposits using non-invasive techniques
Authors: Lipova E. V , Surkichin Sergey I. , Tarasenko G. N
Published: September 2020

Review of modern non-invasive methods of localizedfat deposits removal, classification of liposuction methods, mechanisms of action are described. The basics of biological effects on tissue, the results of clinical trials, efficiency of the methods are presented. The method of cryolipolysis is described in details.
Acanthosis nigricans in patient with breast cancer and hepatocellular carcinoma: case report and review of the literature
Authors: Saribekyan Erik K. , Zubovskaya A. G
Published: September 2020

Acanthosis nigricans (AN) is characterized by hyperpigmented, thickened skin plaques with a velvety texture. The histology of these lesions shows hyperkeratosis and dermal papillomatosis. According to the clinical data the key role in the development of acanthosis nigricans belongs to an excessive concentration of growth factors. Such condition is ofparticular interest because of its association with internal malignancies. Its malignant form is often associated with gastric adenocarcinoma (55-61%), though coexistence with a variety of other malignancies (ovarian cancer, endometrial carcinoma, bladder cancer, etc.) has been reported. Clinical case of patient with AN and coexisting breast cancer and hepatocellular carcinoma is presented. The severity of skin manifestations improved after chemotherapy, mastectomy and radiation therapy. However, skin hyperpigmentation relapsed after development of the hepatocellular carcinoma and the progression of the primary tumor. An underlying malignancy should be suspected in each case of AN.
Hidradenitis suppurativa: treatment (part 3)
Authors: Masyukova S. A , Mordovtseva V. V , Zemlyakova S. S , Gubanova E. I , Ilina Inna V. , Sanakoeva E. G , Alieva Z. A , Grebenyuk D. V
Published: September 2020

Local and systemic methods are used for the treatment of hidradenitis suppurativa, the choice of which depends on the stage of the disease. For local treatment adapalene, clindamycin, azelaic acid, silver preparations in combination with surgical excision, laser therapy and cryo are used. For systemic treatment antibiotics (clindamycin, rifampicin, erythromycin, amoxicillin with clavulanic acid, minocycline), prednisolone, cytostatics (methotrexate, azathioprine, cyclosporine), retinoids, biologicals (etanercept, efalizumab, adalimumab, infliximab), a non-steroidal anti-inflammatory drugs are used. The aim of therapy is to get anti-inflammatory effect, the removal offollicular occlusion and pain, correction of immune and hormonal status, stimulation of healing of skin defects, improving the quality of life of patients.
Clinical and pathological red flat depriving association
Authors: Molochkova Yulia V. , Khlebnikova A. N
Published: September 2020

Knowledge of the morphological structure of atypicalforms of lichen planus is necessaryfor the correct diagnosis of lichen planus. Due to the large number of atypicalforms, diagnosis often requires a histological examination of the affected skin. The article describes pathological features of typical and some atypical forms of lichen planus, observed in recent years in the department of dermatology of Moscow Regional Research and Clinical Institute.
Diagnostic features of chronic urticaria
Authors: Kochergin N. G , Kolkhir P. V , Kosoukhova Olga A.
Published: September 2020

Urticaria is etiologically heterogeneous disease, where the main clinical sign is a wheal. For the duration of the disease course secrete acute and chronic urticaria. If urticaria elements in the skin of the patient are observedfrom several hours to 6 weeks, it is classified as acute urticaria, cutaneous if the process continues for more than 6 weeks, it is a chronic urticaria. The aim of our work was the optimization of diagnosis of chronic urticaria on the basis of the study of clinical and allergological and immunological characteristics of the testing results. The study involved 60 patients between the ages of 18 to 73 years with confirmed clinical diagnosis of chronic urticaria. The study was conducted in the clinic of skin and venereal diseases ofI.M. Sechenov First Medical State Medical University. Conducted clinical and anamnestic examination: medical history, assessment of complaints, determining the severity of urticaria (UAS7), quality of life (CU-Q2oL, DLQI), control of the symptoms of urticaria (UCT); laboratory tests: clinical blood test, C-reactive protein, thyroid hormones and antibodies to thyroid structures, tests to exclude physical urticaria, autologous serum skin test, D-dimer, rheumatoid factor, eosinophil-cationic protein, the total of IgE, antinuclear antibodies , C3 / C4 complement components, protein fractions, coagulation, urinalysis, general analysis offeces, feces on eggs of worms and protozoa. The study was conducted within 1 month and included diagnostic consultation period and 5 consultations every 7 days. Identified specific clinical and laboratory features that can be assigned to the diagnostic criteria for autoimmune form of chronic urticaria, which will continue to pick up these patients rational treatment. The high prevalence of urticaria, a variety offorms of the disease, the presence ofpathology predominantly in patients of working age, often ineffective diagnostic actions cause the urgency of the problem and the need for further study of this disease.
Cromhidrosis: clinical observation
Authors: Tarasenko Grigoriy N. , Kuzmina Yu. V , Sysoeva A. N
Published: September 2020

The clinical case of apocrine sweat glands disease - chromhidrosis, that is characterized by stains on linen and clothes in armpit, brushes, genitals, is presented. Stains can be various color, it depends on the reason that causes the pathology. Authors pay attention of doctors to necessity of inspection of such patients taking into account the anamnesis and a possible pathology of internal organs.
Analysis of the frequency of NRAS and c-Kit gene mutations in patients with BRAF-negative melanoma
Authors: Aksenenko Maria B. , Komina A. V , Ruksha T. G
Published: September 2020

Identification of molecular subtypes of melanoma allowed to use a personalized approach in the treatment of melanoma. One of the most common driver mutations in melanoma is a mutation of the oncogene BRAF, that is determined in 40-60% of all melanomas. However, BRAF-negative tumors require further investigation of mutational status, which can be applied not only to select the means of personalized therapy of tumor, but also for the prediction of disease course. This article presents an analysis of 37 patients with melanoma BRAF-negative for mutations in the genes NRAS and c-Kit. Mutations were identified in the 3 exon of the gene NRAS in 8.1% of cases. In skin melanomas «silent» mutations were identified in 64.7% that confirm the occurrence ofpronounced mutation under the influence of ultraviolet radiation on the skin of the patient. We identified clinical and morphological features ofpatients with NRAS mutation in the 3 exon. This group ofpatients is characterized by a greater thickness of the tumor Breslow. Female gender and older age were dominated clinical characteristics in this group as compared with patients without NRAS mutations (p < 0.05).
Severity assessment of atopic dermatitis in children
Authors: Yanchevskaya Elena Yu. , Bashkina O. A , Ben Mbarek Makrem -
Published: September 2020

The article is devoted to the analysis of methods to assess the degree of atopic dermatitis (AD) severity, of their clinical manifestations and laboratory diagnosis. Treatment and prognosis of atopic dermatitis depends on the assessment of disease severity. The severity of the disease is the main factor for a doctor in the therapy of a child with AD. There are many scientific studies devoted to the objective classification of diseases and the development of the most effective methods of severity assessment. It is not always possible to quickly determine objectively measurable parameters ofpathologic skin process. Because of that assessment methods of skin diseases are often approximate and subjective. The new pathogenetic data of atopic dermatitis and the main types of defects are described. Dermatology indexes of atopic dermatitis severity were considered. The new biochemical methods to assess the degree of atopic dermatitis severity in children by measuring indicators of spontaneous adhesion of neutrophils were analyzed. Immunological method, in which serum of children with atopic dermatitis is determined by the level of total IgE and IgE antibodies to allergens, with using ImmunoCAP 100 and level IgG- and IgE-antibodies against tissue antigens by ELISA, were analyzed. The indicators of oxidative status were examined. The concentration of circulating biological peroxides (PPI) and nukliozida 8-OHdG (8-hydroxy-2’-deoxyguanosine) differed significantly in mild, moderate and severe AD. Bacteriological methods, based on an integrated assessment of microbiological parameters, characterizing the nonspecific resistance of skin and mucous membranes in the assessment of severity and prognosis of atopic dermatitis in children, were performed.
The evolution of views on the erythroderma
Authors: Zaslavsky Denis V. , Rodionov A. N , Chuprov I. N , Nasyrov R. A , Egorova Yu. S , Sidikov A. A
Published: September 2020

Erythroderma is inflammation ofpart or all of the skin. The diagnosis of an erythroderma puts the doctor in very difficult situation as he should solve a problem with many unknowns. The commonly accepted classification of an erythroderma doesn’t exist, and classification by Louis An Jeanne Brock based on separation of erythroderma on primary and secondary, is seldom used in recent years. At the end of the XX century most of authors refused division of erythroderma on primary and secondary. It is considered that “primary” erythroderma is a toxiderma and chronically proceeding malignant lymphoma of skin. Eryhtroderma represent one of the most complex problems of dermatology. First of all, it is explained by variety of the reasons, a pathogenesis ambiguity, and rather monotonous clinical picture, tendency of many forms of an erythroderma to a long and heavy current and resistance to therapy. Molecular immunology, immunophenotyping and genotyping methods help to differentiate various forms of the disease. Evolution of views of erythroderma with the detailed description of historical aspects, modern views and convenient classification are presented.
Expression of protein components desmosomal apparatus and cytoskeleton of the epidermis in disease Hailey-Hailey
Authors: Makhneva Natalie V.
Published: September 2020

Hailey-Hailey disease (benign familial chronic pemphigus Guzhero-Hailey-Hailey) - hereditary vesiculo-bullous dermatosis, where mutation of ATP2C1 gene results in morphological changes, which cause an abnormal location of molecules in intercellular adhesion. It is believed that the pathology may involve both the inner surface of the plasma membrane proteins of keratinocytes and desmosomal and adhesion molecules in epidermal intercellular connections. This present research provides the results of immunohistochemical study on the distribution of desmosomal cadherin (desmogleins 1, 2, 3), desmosomal proteins (plakoglobin, desmoplakin I, periplakin), intercellular junctions molecules (E-cadherin, cadherin complex) in desmosomal apparatus and cytoskeletal proteins (cytokeratins 5, 14, suprabasal layers of epidermis) in clinically intact and affected skin of patients with Hailey-Hailey disease. The research also detected violation in localization of the protein components in the system of intercellular junctions and the cytoskeleton from severe immunohistochemical reaction to disappearance and appearance in places not typical for its localization. Thus, the most severe expression of protein molecules was observed in the areas of acantholysis and the formation of intra-epidermal blisters with the penetration of specific material into the cytoplasm of keratinocytes and some acantholytic cells. Besides, in the clinically intact skin areas of patients the most intense damage (almost complete absence of expression or its “masking”) was identified as a damage with the cadherin adhesion molecules. The paradoxical phenomenon - intranuclear and/or perinuclear luminescence was marked by cytokeratin 5, desmogleins and cadherins. The complex mechanism of Hailey-Hailey disease involving various adhesion molecules and protein components of intercellular connections system requires ongoing detailed study of the expression of multiple adhesion molecules associated with the system of intercellular junctions. The acquired knowledge will bring understanding of the sequence of events in pathology (acantholysis) development and the identification of a number of additional differential diagnostic signs of Hailey-Hailey disease.
Angiogenesis features in patients with melanoma with different BRAf status
Authors: Aksenenko Maria B. , Ruksha T. G
Published: September 2020

Neoangiogenesis is an important factor in the development and progression of cancer. Neoangiogenesis in tumors is necessary for its further growth and subsequent metastasis. Intensity ofangiogenesis depends on a balance ofproangiogenic and antiangiogenic factors. One of these angiogenic factors is matrix metalloproteinase-9 (MMP-9) enzyme family endopeptidases participating in the extracellular matrix degradation and remodeling of vessels. It is known that the BRAF V600E mutation can affect the expression ofpro-angiogenic factors in tumor tissue. The purpose of this study was to investigate the microvasculature density in the tumor andperitumoral area in patients with melanoma with different BRAF-status using counting CD-31 positive stained vascular endothelial cells, as well as detection of the expression of matrix metalloprotieinase-9 in tumor cells and cells of microenvironment, followed by analysis of the relationships among these indicators. The material for the study is based on samples of tumor (n = 57) obtainedfrom patients with melanoma. The study revealed that there was a trend to increased angiogenesis in 2-fold (p < 0.05) with the BRAF-positive lentigo melanoma, compared with BRAF-negative patients lentigo melanoma. Vascularization level change was detected, depending on the primary tumor site: the level of vascularization was statistically higher in BRAF-positive patients with localized tumors on the skin of the trunk (p < 0.05), with no significant differences for other important morphologic parameters such as ulceration of the tumor, the severity of lymphocytic infiltration and tumor thickness by Breslow (p > 0.05). No statistically significant differences in the expression of MMP-9 depending on the BRAF-status in the tumor cells and stromal cells in microenvironment (p > 0.05) were detected. Nevertheless, a tendency to an increase in the expression of MMP-9 in the surrounding stroma cells (fibroblasts, lymphocytes, endothelial cells, polymorph nuclear leukocytes, regardless of BRAF-status) was shown. Despite some features of tumor angiogenesis in the skin melanoma patients with different BRAF status angiogenesis in the tumor is influenced by a variety of proangiogenic and antiangiogenic stimulation that are common patterns regardless of BRAF-status.
CLINICAL CASE OF PALMOPLANTAR KERATODERMA TYPE UNNA-THOST
Authors: Pashinyan Albina G. , Ilienko L. I , Akopyan A. N
Published: September 2020

Palmar-plantar keratoderma is a heterogeneous group of hereditary dermatosis, which can be independent diseases or combined with various congenital malformations, most of ectodermal origin. Approaches to differential diagnosis and clinical features of each form of this pathology are described. Keratoderma, Unna Toast genodermatosis belongs to the group, which is characterized by hyperkeratosis on the palms and soles without migration to other skin areas.
CLINICAL AND EPIDEMIOLOGICAL ANALYSIS OF THE INCIDENCE OF NEUROSYPHILIS IN THE OMSK REGION
Authors: Novikov Yuriy A. , Ochlopkov V. A , Kravchenko E. N
Published: September 2020

Purpose - to conduct clinical and epidemiological analysis of the incidence of neurosyphilis in the Omsk region in the period from 2008 to 2015. Material and methods. The assessment of level of a condition of a case rate of various groups of the population and implication of epidemic process carried out on the basis of the analysis of data of the statistical account on Omsk and the Omsk region and statistical cards of the patients. Complex clinical examination of patients with a lues for the purpose of identification of signs of a lesion of a nervous system is conducted. Results. The analysis of an epidemic situation in Omsk and the Omsk region for the specified period of observations showed that the case rate a neurolues of the population of the region remained stable. Conclusion. Now depression of the general case rate by a neurolues with symptoms against body height of a case rate an asimptomny neurolues is observed. In the conditions of body height of a case rate an asimptomny neurolues closer interaction of dermatovenerologists and neurologists in questions of diagnostics and treatment of a neurolues is necessary.
THE FEATURES OF THE CLINICAL MANIFESTATIONS OF THE VIRAL EXANTHEMA
Authors: Pashinyan Albina G. , Ilienko L. I , Akopyan A. N , Dzhavaeva D. G
Published: September 2020

Currently there are about 200 different studied herpes viruses, only 8 types are pathogenic for humans. They all belong to the family Herpesviridae, which according to the structure of the virion and biological properties is divided into three subfamilies: α, β, and γ. Human herpesvirus 6B belongs to the subfamily of β-herpesvirus, genus Roseolovirus. The overview of current information on the etiology, epidemiology, clinical manifestations of infection caused by human herpesvirus 6B is presented. The diagnosis of the viral exanthema using modern laboratory technology is considered.
THE USE OF TOFACITINIB FOR TREATMENT PATIENTS WITH PSORIASIS IN CONDITIONS OF THE DERMATOLOGICAL HOSPITAL
Authors: Natarova Ella V. , Rudneva N. S , Kuklina M. S , Chumakova Ya. Yu
Published: September 2020

A growing understanding of the cellular and molecular mechanisms of inflammation in psoriasis and psoriatic arthritis opens the way to the treatment these diseases with the help of new small molecules, associated with the blockade of intracellular signal transduction. Jaqinus®/Xeljanz® (tofacitinib, “Pfizer”) is the first oral inhibitor of Janus kinases for the treatment of chronic moderately severe and severe plaque psoriasiswhich was approved for usage in Russia. The authors also present own local data regarding usage of tofacitinib 10 and 20 mg/day by short course for the treatment group of 13 patients with severe forms of plaque psoriasis in a progressing stage with resistance to prior systemic conventional therapy who were treated at the TDVCD. The efficacy of therapeutic strategies with the use of tofacitinib for patients of the dermatological hospital with the aim of improving and stabilizing of acute process is shown. Further prospective and observational studies to refine the dosing and safety profile of this group of drugs are needed.
A CASE OF ACRAL LENTIGINOUS MELANOMA WITH EVALUATION OF С-KIT GENE EXON 11 MUTATION STATUS
Authors: Komina A. V , Aksenenko M. B , Sergeeva O. N , Kirichenko A. K , Ruksha Tatiana G.
Published: September 2020

Acral lentiginous melanoma type is characterized by specific clinical and histologic features therefore it requires a special approach to diagnosis and therapy. c-KIT oncogene mutations are frequent in this tumor type accounting up to 23% of all this type melanoma cases. The presence of exons mutations in c-KIT gene indicates therapy of tyrosine kinase inhibitors. The clinical case of acral lentiginous melanoma with the analysis of the mutational status c-KIT 11th exon that is considered as one of the most significant sites, is presented. The functional role of mentioned substitutes was not described previously although tyrosine kinase inhibitors could be effective for such type melanoma patients. Number of mutations, which role in the activity of c-KIT receptor and therapy response have not been studied, is presented.
CONFOCAL LASER SCANNING MICROSCOPY FOR DIAGNOSES OF MELANOCYTIC SKIN NEOPLASMS
Authors: Sokolova Anna V. , Malishevskaya N. P
Published: September 2020

In cases of complicated differential diagnosis of benign melanocytic neoplasms and skin melanoma, clinical visual examination and superficial dermatoscopy do not always allow to make an accurate diagnosis, which is especially important in cases of suspected skin melanoma. In recent years the method of confocal microscopy (CM) has been used for non-invasive skin examination. In the present study 15 patients with suspected skin melanoma were examined by confocal laser microscopy in cases of complex differential diagnosis (18 melanocytic neoplasms in total). Ten patients were diagnosed with skin melanoma, including two amelanotic melanomas, which were subsequently confirmed by histological examination of the material obtained after surgical excision. The results of the study to determine the effectiveness of differential diagnosis of skin melanoma by laser confocal microscopy showed that differential diagnosis of skin melanoma is possible in the presence of the main criteria of malignancy: cellular atypia at the site of the dermo-epidermal junction (the first main criterion) and abnormality of papillary architecture (the second main criterion). At detection at least one of these criteria, a diagnosis of skin melanoma was made, which in all cases was confirmed by the results of histological examination. Inclusion of CM in the diagnostic algorithm of examination of patients with melanocytic neoplasms, suspicious of melanoma, makes it possible to improve the diagnosis of melanoma at early stages.
SURFACE FORM OF BASAL CELL CARCINOMA OF THE SKIN: BIOLOGICAL BEHAVIOR, MORPHOLOGY AND CLINICAL VARIANTS
Authors: Snarskaya Elena S. , Ibrahim Abdulla
Published: September 2020

The superficial form of basal cell carcinoma (BCC) is a malignant skin epithelial tumor with the most favorable flow profile and the least aggressive morphological structure among all known forms of BCC. Surface variants of BCC are characterized by a long and more benign course, slow, long-term growth. However, in the late stages of development, some researchers note the appearance of severe infiltration and destructive changes, ulceration of the BCC foci. Despite the fact that the surface form of the BCC is characterized by a long-term benign course, data have been obtained according to which the histologically confirmed surface multicentric form of BCC initially localized on the trunk increases the number of foci considerably faster than other localization and histological pattern. Objective: To study clinical and morphological features of the surface form of basal cell carcinoma based on monitoring 2500 cases of basal cell carcinoma. Material and methods. The authors analyzed literature sources and their own clinical and morphological data for 2500 clinical observations of patients with different clinical variants of BCC. Results. 2500 cases of BCC were analyzed. Among them 522 cases of clinical variants of surface form of BCC were revealed. Clinical and morphological monitoring was carried out taking into account the sex and age of patients, the variety and the primary localization of the disease, as well as the number and size of lesions. According to our monitoring data, 2500 cases of BCC registered in Moscow and the Moscow Region over the past 10 years, the frequency of the surface form in the overall structure of all BCC cases is 22.3% (557.5 cases), which is generally consistent with the reports of other authors. According to our data, the surface form of the BCC is localized mainly on the skin of trunk, extremities and much less often on the face. Women suffer from this form of BCC 2 times more often than men (371.6 and 185.8, respectively). We have not received convincing data on the predominant morbidity of this type of BCC of younger age groups, which, however, can be explained by the peculiarities of the patients’ mentality (often long unsuccessful self-treatment, rare medical attention), as well as the long practically asymptomatic course of the disease. The majority (80.3%) of the tumors corresponded to the TIN0M0 characteristic. On the body and limbs, the foci are more localized in men than in women (38.8 and 27.3%, respectively), while in the head (face, neck) - in women (72.7 and 61.2%, respectively). A rare type of surface form is a self-scaring BCC (Pejetoid epithelioma of Little). It is characterized by pronounced centrifugal growth. It is possible to transform the surface form of BCC into a more aggressive - nodular form.
THE EFFECT OF INDIRECT ANTICOAGULANTS IN THE COMBINED USE WITH Β-BLOCKERS AND VASODILATORS ON THE FORMATION OF ROSACEA WITH ANTIHYPERTENSIVE THERAPY
Authors: Karpova Anna V. , Ogurtsov P. P , Batkaev E. A
Published: September 2020

There are vascular changes in the skin of patients in the combined antihypertensive therapy with β-blockers, vasodilators and indirect anticoagulants. Coagulation and the character of pharmacotherapy directly affect physical parameters of the skin and the formation of rosacea.
CUTANEOUS LYMPHOID HYPERPLASIA PROVOKED BY RED PIGMENT OF TATTOO
Authors: Kuklin Igor A. , Volkova N. V , Kokhan M. M , Safonova G. D , Sorokina N. D
Published: September 2020

The data of the prevalence and clinical features of adverse «Tatto reactions» are shown. The case report of cutaneous lymphoid hyperplasia which was provoked by red pigment of tattoo is presented.