bluuebunny/crossref_metadata_2025 huggingface dataset:
THE DIET OF PERSONS ENGAGED IN SPORTS AT THE AGE OF 40 YEARS AND OLDER
Authors: S.N. Cherkasov , G.Yu. Grigoriev , A.V. Fedyaeva
Published: September 2021

The purpose of the study: to analyze the nutritional characteristics of people aged 40 years and older who are engaged in sports (athletics, participation in competitions at distances of 10 km or more). Materials and methods. Nutrition characteristics were studied based on information obtained from a survey of amateur athletes aged 40 years and older competing in track and field events at distances of 10 kilometers or more. In total, 1800 questionnaires were distributed, 1649 completed questionnaires were collected. The following food characteristics were taken into account: the presence or absence of adherence to any diet, the frequency of meals, the regularity of meals, the nature of the food, the significance of the quality of the food consumed, as well as the presence of the fact of eating flour, sweet. The analysis was carried out in three age groups: 40–49 years, 50–59 years and 60 years and older. Results. According to this study, the desire to eat exclusively healthy food with lots of fresh vegetables and fruits, the commitment to diet, the desire to control the quality of food in the group of veteran athletes does not increase, but decreases. People who are engaged in sports, aged 40 years and older, try to eat often and at the same time. In men, with increasing age, the number of people who want to take the largest amount of food for breakfast decreases, while in women, the opposite trend is observed. The commitment to snacks is more characteristic of women than men. The majority of respondents involved in sports, aged 40 years and older, do not deny themselves frequent use of sweet and flour products and with age this desire increases.
EFFECTIVENESS OF AN INTRAUTERINE CONTRACEPTIVE CONTAINING LEVONORGESTREL (MIRENA) IN THE TREATMENT OF HEAVY MENSTRUAL BLEEDING
Authors: O.B. Kalinkina
Published: September 2021

Levonorgestrel-containing intrauterine system Mirena refers to the first-line therapy of heavy menstrual bleeding (OMC) according to the recommendations of different countries. The efficacy, acceptability, and quality of life of women using Mirena are similar to those in the surgical treatment of abnormal uterine bleeding, including endometrial ablation and hysterectomy. The clinical case presented in this study of the management of a patient with heavy menstrual bleeding allowed us to demonstrate the effectiveness of the levonorgestrel-containing Mirena intrauterine system in OMC. The patient was observed in the consultative polyclinic of the V. D. Seredavin State Medical University. At the initial treatment, she complained of heavy menstruation, decreased performance, weight gain, and periodic increases in blood pressure. After a comprehensive clinical examination, taking into account heavy menstruation, a decrease in the quality of life, as well as the need for contraception, the introduction of the Mirena IUD was recommended. A year after the introduction of the IUD, the patient had amenorrhea. 5 years after the introduction of the Mirena IUD, the patient developed hot flashes, increased sweating, vaginal dryness, mood swings, sleep disorders, accompanied by an increase in FSH levels. The intrauterine system was removed and a new IUD - Mirena-was installed as a component of menopausal hormone therapy. After 2 months from the beginning of therapy, the complaints were completely stopped, the state of health is satisfactory, dryness in the vagina does not bother. Thus, the use of the LNG – IUD Mirena was effective for the relief of heavy menstrual bleeding, in addition, in women of this age group, it is possible to continue using the levonorgestrel-containing intrauterine system Mirena as a component of menopausal hormone therapy.
THE STATE OF THE NITRIC OXIDE SYNTHESIS SYSTEM IN THE COMORBID COURSE OF BRONCHIAL ASTHMA AND HYPERTENSION
Authors: A.N. Stafeev , N.I. Logvinenko , P.P. Tereshkov , A.V. Markovsky
Published: September 2021

Comorbidity is a common condition in medical practice. The presence of comorbid conditions in a patient makes a great contribution to the course and prognosis of the underlying disease, as well as the development of complications [12]. At the same time, diseases occurring with broncho-obstructive syndrome and arterial hypertension syndrome are widespread throughout the world [13, 14]. The aim of this study was to assess the degree of endothelial dysfunction associated with impaired nitric oxide synthesis, based on the state of the NO/NOS/ADMA system and genetic polymorphisms of the nitric oxide synthetase gene in patients with bronchial asthma combined with essential hypertension. Materials and methods Three groups of patients, 96 people each, were formed, corresponding in age and gender structure with a diagnosis of bronchial asthma (BA group), essential hypertension (EH group) and their joint course (BA+EH group). Serum concentrations of asymmetric dimethylarginine, symmetric dimethylarginine, genetic polymorphisms of nitric oxide synthase (synthases NOS3 786T/C and NOS3 894G/T) were determined. To determine the role of other factors in increasing the concentration of ADMA and SDMA, multiple linear regression analysis was performed. Results: according to the results of the study, for a group of patients with a combination of bronchial asthma and hypertension, there are increased levels of ADMA and SDMA, the T allele NOS3 786C/T is more common in hypertension, in multiple linear regression significant factors in increasing ADMA are the presence of hypertension, bronchial asthma, body mass index and glomerular filtration rate, for SDMA - the presence of hypertension, asthma and glomerular filtration rate. Conclusions: The comorbidity of bronchial asthma and arterial hypertension is associated with an increased serum concentration of ADMA and SDMA. The presence of the TT genotype of the NOS3 786C/T polymorphism is associated with an increased incidence of arterial hypertension in patients with asthma.
CASE OF AORTOCORONARY BYPASS SURGERY IN A PATIENT WITH ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION, MULTIVESSEL CORONARY LESIONS AND LOW EJECTION FRACTION
Authors: A.K. Jalilov
Published: September 2021

For decades, coronary artery bypass grafting (CABG) has been the main method of myocardial revascularization in patients with coronary artery disease, including those with acute coronary syndrome (ACS). Over the past decades, with the development of endovascular interventions and the development of drug-eluting stents, percutaneous coronary intervention (PCI) has become the main method of revascularization after ACS. [1,6]. Acute coronary syndrome (ACS) includes clinical manifestations such as unstable angina pectoris (NS), acute non-ST-segment elevation myocardial infarction (STEMI), and ST-segment elevation myocardial infarction (STEMI). Approximately 40% of all patients diagnosed with ACS have multivessel coronary artery disease, for which coronary artery bypass grafting (CABG) is better than PCI. [2]. The majority of studies comparing PCI and CABG have mainly included patients with stable coronary artery disease who underwent planned myocardial revascularization, rather than those requiring emergency or urgent myocardial revascularization. Thus, the results of these studies have limited applicability to patients with ACS. However, the long-term results of these studies, in particular the low need for re-revascularization, a lower rate of re-myocardial infarction, and the survival benefits of CABG, still need to be considered when determining the best course of treatment for ACS. The current recommendations for treatment in most patients with ACS give preference to early revascularization using PCI or CABG [3, 4]. Thus, our main goal here is to provide the current indications and options for surgical revascularization of the coronary arteries, including current guidelines and the latest published literature. In STEMI patients, early PCI of the main lesion remains the gold standard because it provides the fastest revascularization of the ischemic myocardium and is generally better tolerated than emergency CABG [5]. Since up to 50% of STEMI patients have multivessel coronary artery disease, early arterial revascularization without myocardial infarction has been recommended to provide optimal opportunities for myocardial rescue, reduction of ischemic watershed and improvement of left ventricular function [6,7]. A clinical case of successful beating coronary artery bypass grafting in a patient with ST-segment elevation myocardial infarction, multivessel coronary artery disease and low ejection fraction. The patient was discharged on the 11th day after surgery without complications.
LEARNING OF THE RELATIONSHIP BETWEEN EXACERBATION OF CARDIOVASCULAR PATHOLOGY AND METEOROLOGICAL FACTORS
Authors: O.V. Klepikov , T.A. Berezhnova , Ya.V. Kulintsova , N.M. Kolyagina
Published: September 2021

Relevance. The problem of weather dependence, including diseases of the circulatory system, is debatable, and, therefore, requires research in order to find ways to improve the provision of medical care to the population and improve its quality.
Aim: to study the influence of meteorological factors on the treatment of the population with diseases of the cardiovascular system for medical care.
Material and methods. The ratio of the average number of cases of requests for medical care on unfavorable days for meteorological factors to the average number of cases of requests per day for medical care during 2018 was calculated.
Results. The average number of cases of requests for medical care on hot days when the air temperature rose above + 300C, which is abnormal for the territory of the city of Voronezh, due to such diagnoses as hypertension without heart failure, brain vascular lesions (specified), cerebrovascular disease, hypertension with heart failure, is 1.1-1.4 times higher than the average number of cases of requests per day for the same reasons (diagnoses) during the year. At the same time, low air temperatures, which are not typical for this area, can also act as a factor contributing to the exacerbation of diseases of the cardiovascular system.
Conclusion. The assessment of the relationship between the treatment of patients with leading forms of cardiovascular diseases for medical care and meteorological indicators showed that with the advance of the case of the disease by 1 day with meteorological indicators, according to the results of the correlation analysis, statistically significant links of weak and medium strength were revealed.
ASSESSMENT OF THE TREATMENT OF PATIENTS WITH DISEASES OF THE CARDIOVASCULAR SYSTEM FOR MEDICAL CARE IN UNFAVORABLE WEATHER FACTORS DAYS
Authors: N.M. Kolyagina , T.A. Berezhnova , Ya.V. Kulintsova , O.S. Elistratova , M.A. Drapalyuk
Published: September 2021

Relevance. The impact of weather factors on the occurrence of exacerbations of diseases in weather-dependent people is currently one of the actively studied problems of medicine. A number of authors draw attention to the need to correct the functional status of weather-dependent patients with cardiovascular diseases in unfavorable weather conditions.
Aim: to assess the possible relationship between the manifestations of exacerbations of cardiovascular pathology and adverse weather factors.
Material and methods. The materials of the regional center for Hydrometeorology and environmental monitoring were used, and a database was formed that includes information on the average daily, maximum and minimum atmospheric air temperatures, and atmospheric pressure for each day of 2018.
Results. Meteorological risk factors for exacerbation of cardiovascular diseases in the Central European part of Russia include uncharacteristic heat (above +30 0C) or severe frost (below -20 0C), sudden changes in air temperature (by 8 0C or more, both in the direction of its increase and decrease), atmospheric pressure drops of more than 6 mm Hg during the day. It is established that the range of changes in meteorological indicators during the annual cycle is quite wide.
Conclusions. Evaluation of the relationship between the treatment of patients with leading forms of cardiovascular diseases for medical care and meteorological indicators (average daily, maximum and minimum atmospheric air temperatures, atmospheric pressure) showed that with the advance of the case of the disease by 1 day (hypertensive disease without heart failure, brain vascular lesions, cerebrovascular disease, hypertensive disease with heart failure, angina pectoris), statistically significant links of weak and moderate strength were revealed.
ANALYSIS OF THE EFFECTIVENESS OF THE PREVENTION OF DISEASES OF THE UPPER RESPIRATORY TRACT IN CHILDREN IN THE PUBLIC AND PRIVATE HEALTH SECTOR OF THE MOSCOW REGION
Authors: A.V. Oleynik , D.L. Mushnikov , N.A. Sadovnikova
Published: September 2021

The relevance of the research topic is determined by the high prevalence of diseases of the upper respiratory tract in children. The purpose of the study: to assess the effectiveness of the prevention of upper respiratory diseases in children in the public and private health sector. The analysis of morbidity by circulation and primary morbidity of children in the Moscow region and the city of Ramenskoye as a whole and by class "Respiratory diseases" is carried out. The material of the study is based on the analysis of the primary documentation of the children's polyclinic and the private children's medical center in Ramenskoye, Moscow region. Differences between public and private medical organizations were established: the number of episodes of upper respiratory tract diseases in the observation of children in a state medical organization is 1.4 times higher than in a private medical organization (3.8, against 2.8); the duration of episodes of diseases of the upper respiratory tract per 1 observed child per year in a state medical organization is 39.0% higher than in a private medical organization; the average duration (exacerbation) of the case of diseases of the upper respiratory tract in children in the state medical organization is 2 times higher than when observed in a private medical organization, which is associated with the use of modern treatment technologies and an individual approach. When analyzing the preventive work of children's polyclinics, it was revealed that in the context of the region there are significant fluctuations in the volume of visits made for the purpose of rehabilitation. At the same time, the share of those in need of rehabilitation from the number of those examined in the order of planned rehabilitation amounted to 65.7% in the region, in the city of Ramenskoye 65.4%. Satisfaction of this need was noted at the level of 60.6% in the region, in the city of Ramenskoye 72.3%. The results of the study showed the need to study the factors that determine the high incidence of children with diseases of the upper respiratory tract.
FEATURES OF THE COURSE OF PREGNANCY, CHILDBIRTH AND PERINATAL OUTCOMES IN WOMEN WITH VIRAL HEPATITIS C
Authors: T.V. Bragina , Yu.A. Petrov , G.Yu. Spiridenko
Published: September 2021

This article presents data from a review of literature sources on the peculiarities of the course of pregnancy, childbirth and perinatal outcomes in women with viral hepatitis C. The current problem is due to the high prevalence of hepatitis C virus infection among the population, the possibility of a clinically asymptomatic course of the disease, the possibility of a transplacental route of transmission of the virus to the fetus. So, viral hepatitis C can be diagnosed during pregnancy as a result of the determination of immunoglobulins of classes M and G to the antigen of viral hepatitis C three times - in each trimester of pregnancy. Viral hepatitis C can have an adverse effect on the course of the gestational period, childbirth, and the neonatal period. Viral hepatitis C provokes the following complications: the threat of termination of pregnancy, preeclampsia of moderate severity and severe, fetoplacental insufficiency, which leads to chronic fetal hypoxia, intrauterine growth retardation of I and II degrees, and in the early neonatal period the development of cerebral ischemia of I and II degrees, moderate asphyxia or severe, impaired course of the adaptive reactions of the newborn, impaired neurological status of the newborn. This proves that the problem of the course of pregnancy against the background of viral hepatitis in a woman has not only important medical, but also social significance. The teratogenic effect of drugs used in the treatment of viral hepatitis C and the lack of drugs that are safe for use during pregnancy emphasize the integral role of pregravidar preparation to exclude or minimize the risk of complications during the gravidar period, childbirth, and unfavorable perinatal outcomes.
INVESTIGATION OF BACTERIOTROPIC PROPERTIES OF JUICE FROM GREEN WHEAT SPROUTS
Authors: V.A. Neschiclyaev , M.D. Hohryakova , T.B. Bronnikov
Published: September 2021

Juice «vitgrass» made from green wheat sprouts is a valuable biologically active product that has a stimulating effect on the physiological state of a person. Hydroponically grown raw materials for juice production contain proteins, fats, carbohydrates, a large group of vitamins, macro- and microelements, antioxidants, enzymes and other substances. As a part of health programs, the use of this juice is recommended for overweight people to optimize the metabolic processes of the macroorganism. A healthy lifestyle involves reducing the negative impact of environmental factors, including diet correction, on the microbiota of the gastrointestinal tract. The cumulative biological assessment of wheatgrass juice should take into account the results of its effect on the indigenous microflora. Lacto- and bifidobacteria, including industrial strains for the manufacture of probiotic preparations, represent an adequate model for studying the bacteriotropic effect of any plant-based product. The experimental results indicate a pronounced stimulating effect of juice from green wheat sprouts on the growth parameters of probiotic bacterial cultures.
Strains of lacto- and bifidobacteria when cultivated under conditions of maximum limitation of nutrients in the composition of the "poor" nutrient medium with the addition of "Vitgrass" juice reacted with an increase in the level of accumulation of cell biomass and a higher activity of acid formation in comparison with the control. The analysis of the results obtained makes it possible to estimate the magnitude of the effects of stimulation in relation to both bacterial cultures as quite comparable, taking into account the known intersstrain differences in growth parameters and their biochemical aspects. This is confirmed by an almost similar increased level of carbohydrate utilization in both variants of culture liquids in the presence of juice.
The potential of the positive bacteriotropic activity of "Vitgrass" juice in relation to the representatives of the indigenous microflora can be realized in different ways. It seems expedient to use the product from green wheat sprouts more widely as part of programs for the complex health improvement of the macroorganism, including the prevention and correction of dysbiotic conditions.
LABORATORY STUDY OF THE EFFICIENCY OF THE RECREATION OF THE AGE FEATURES OF THE CONTACT SURFACES OF THE POSTERIOR TEETH BY DIRECT COMPOSITE RESTORATION
Authors: A.I. Nikolaev , A.N. Ginali , E.V. Petrova
Published: September 2021

The methods of aesthetic restoration of posterior teeth with composite materials currently used in practical dentistry make it possible to create only a point contact, which does not correspond to the age characteristics of the patients' teeth, therefore, it is important to develop methods for creation and positioning the contact areas, taking into account the age characteristics of structures of the teeth. A laboratory study of the effectiveness of the method of recreation of the age-related characteristics of the contact areas of the posterior teeth using the method of direct aesthetic restoration using light-cured composite materials with a specially developed tool – a contact-former was carried out. Phantom models were used to evaluate the significant characteristics of 40 restorations of posterior teeth with cavities of class 2 according to Black, performed in accordance with the traditional method, 80 restorations performed in accordance with the developed algorithm for restoring the contact points of posterior teeth by the method of direct composite restoration, taking into account age characteristics: 40 restorations with using a contact former with a working part of 1×2 mm (S = 2 mm2), 40 restorations - using a contact former with a working part of 1.5×3 mm (S = 4.5 mm2). It was found that the usage of the approved method of restoration of the contact points of posterior teeth using the method of direct composite restoration, taking into account age characteristics with the use of a contact-former in the process of tooth restoration, allows to obtain the required planar shape of the contact area (95.0±2.44%) to obtain its desired localization (90.0±3.35%), to form the functional configuration of interdental embrasures (86.7±3.79%) with a high degree of probability. There was a significant (p˂0.05) difference in indicators characterising the quality of positioning and restoration of the contact areas of the posterior teeth when using the tested technique in comparison with the traditional technique of restoration of teeth with carious defects of class 2 according to Black. The effectiveness of the tested method of direct restoration of the contact surfaces of the posterior teeth while taking into account age characteristics has been proved. The efficiency and ergonomics of the contact-former developed by us for this technique have been confirmed. It is concluded that it is advisable to study the effectiveness of the proposed technique in a clinical setting.
EISENMENGER'S SYNDROME AND PREGNANCY: ASPECTS OF ETIOPATHOGENESIS AND THERAPEUTIC TACTICS
Authors: Yu.A. Petrov , G.Yu. Spiridenko , N.V. Palieva
Published: September 2021

In the modern world, the problem of maintaining a woman's reproductive potential and preserving the resulting pregnancy comes to the fore. An important aspect remains the increasing number of concomitant extragenital diseases. The most common pathology of the cardiovascular and respiratory systems. A rare and often fatal complication is Eisenmenger's syndrome. Eisenmenger's syndrome is a pathological process that occurs due to bidirectional blood discharge or right-left blood discharge due to the presence of a message between the right and left parts of the heart, clinically manifested by severe pulmonary hypertension with diffuse cyanosis. It occurs against the background of an existing decompensated heart defect - a defect of the atrial septum, interventricular septum, open arterial duct, anomalies of the pulmonary veins. Previously, it was believe that the threat of developing Eisenmenger syndrome is an absolute indication for termination of pregnancy, and this pathology is not compatible with gestation. Currently, the effect of pregnancy on the cardiovascular system has been study and recommendations for the management of such patients have been develop. It found that due to an increase in the volume of circulating blood, cardiac output, a decrease in total peripheral resistance and blood pressure, there is an increase in the load on the cardiovascular system and a change in the pharmacokinetics of drugs, which leads to a revision of the treatment tactics used before pregnancy. The situation is aggravated by an increase in blood clotting factors, fibrinogen, platelet aggregation and a decrease in fibrinolysis factors, which, together with the restriction of taking low-molecular-weight heparins due to the tendency of patients with Eisenmenger syndrome to bleeding and thrombosis, causes difficulties in determining the tactics of patient management, emphasizing the importance and relevance of the problem.
MENTAL AND COMORBID CHRONIC SOMATIC DISEASES IN CHILDREN AND ADOLESCENTS
Authors: O.P. Shmakova
Published: September 2021

The need to analyze the phenomenon of a combination of diseases of various nature is dictated by its high prevalence and insufficient knowledge; it is known, that their comorbidity aggravates the course of the underlying disease, worsening its prognosis. Information about comorbidity is insufficiently systematized, materials about particular combinations of certain mental disorders with somatic ones prevail, there is clearly not enough information about the coexistence of mental and somato-neurological pathology recorded in children and adolescents. Objective: to study the prevalence and nosological distribution of chronic somatic, neurological, infectious comorbid diseases detected in children and adolescents suffering from mental disorders; analyze the social adaptation of these patients. Material and methods. We examined 602 patients, 410 boys (68%) and 192 (32%) girls, who were observed on an outpatient basis in one of the neuropsychiatric dispensaries in Moscow. The study included only cases of a combination of mental and chronic somatic, neurological, infectious and other diseases. To rank patients according to the level of social functioning in adolescence, the «Map of registration of social skills and abilities of adolescents with chronic mental disorders» was used. Research methods: clinical-psychopathological, statistical. Results. The most common comorbid pathology was orthopedic diseases, in the second place was the pathology of vision, in the third place was endocrine pathology, the fourth place was taken by neurological diseases, the fifth place was the pathology of the ENT organs. In combinations of mental and comorbid disorders, pathogenetic variants were observed: 1. comorbid diseases accompanied mental disorder; 2.comorbid and mental disorders were pathogenetically associated with each other, or occurred as a result of a single primary disorder or disease; 3. somatic diseases were mental complications; 4. The occurrence of somatic diseases was explained by the side effects of psychotropic therapy. The severity of social inadequacy depended both on the severity of mental pathology and on the severity and number of somatic diseases. A comorbid disorder can cause more significant difficulties in certain areas of life than the underlying disease. Conclusion. Comorbidity is a multicomponent negative phenomenon. To reduce the incidence of comorbid pathology and achieve its maximum compensation, a multidisciplinary approach is required.
DYNAMICS AND STRUCTURE OF CONGENITAL MALFORMATIONS AND HEREDITARY DISEASES IN NEWBORNS OF KURSK REGION
Authors: D.P. Solodoukhina , I.I. Shlyapcev
Published: September 2021

The article presents analysis of congenital malformations and hereditary diseases in newborns of Kursk region from the position of public health. Methodology of work includes retrospective analytical study of screening lists and discharge records in case-histories of the Regional perinatal center of Kursk; content-analysis of medical-statistical reports of the medical-genetic consulting center of Kursk regional clinical hospital. In the result of the study there were detected trends in main congenital pathologies of newborns in Kursk region during the years 2015-2019, as well as structure of birth defects by localization. The most prevalent congenital malformations in newborns in Kursk region were cardiovascular pathology, urinary system anomalies, chromosome diseases and central nervous system anomalies. Factors detected as associated with congenital malformations in newborns included low birth weight and living in rural area. The results of the study are applicable for the development of public health programs aimed at improvement of preventive services and organization of medical care for children with birth defects.
HUMAN IMMUNODEFICIENCY VIRUS AND PREGNANCY: PATHOMORPHOLOGICAL FEATURES AND OBSTETRIC AND GYNECOLOGICAL TACTICS
Authors: G.Yu. Spiridenko , Yu.A. Petrov , T.V. Bragina
Published: September 2021

Currently, due to the increase in the incidence of HIV infection in women of reproductive age, the number of desired pregnancies in such patients has increased. This makes it necessary to study the pathological effect of the human immunodeficiency virus on the placenta, fetus and the female body as a whole. HIV belongs to retroviruses and contributes to the discoordination of a woman's immune mechanisms. Using the gp41 and gp120 glycoproteins, reverse transcriptase, integrase, and protease, the virus destroys CD4 cells and increases the viral load. It founded that the risk of infection of the fetus decreases from 45% to 1% with HIV infection before pregnancy and with antiretroviral therapy throughout its duration. Vertical infection is possible in the intrauterine, intranatal and postnatal periods, the main of which is the period of childbirth-up to 70%. Viral, maternal, placental, fetal, obstetric and neonatal factors contribute to an increased risk of transmission of the pathogen to the fetus. High viral load and antiretroviral therapy lead in the 3rd trimester of pregnancy to the development of chronic placental insufficiency due to the formation of focal and diffuse deciduitis, membranitis, intervillusitis and chorionamnionitis and damage to the hematoplacental barrier. Early diagnosis before 12 weeks of gestation, timely therapy with nucleoside and non-nucleoside reverse transcriptase inhibitors, as well as protease inhibitors during pregnancy, childbirth and in the postpartum period are the main aspects of preventing HIV infection and further disorders of the child's growth and development. The timely choice of the method of delivery, indications and contraindications to delivery through the natural birth canal helps to reduce the risk of infection in a particularly dangerous period - the intrapartum.
REGIONAL FEATURES OF DEATHS FROM CARDIOVASCULAR DISEASES IN THE CONTEXT OF REGIONAL PROGRAM TO REDUCE CARDIOVASCULAR MORTALITY
Authors: D.O. Ermolaev , Yu.N. Ermolaeva
Published: September 2021

The relevance is determined by the high proportion of diseases of the circulatory system in the structure of the total mortality of the population, as well as the potential modifiability of external factors of pathology. The aim of the research is to study the regional epidemiology of mortality from diseases of the circulatory system in the context of a regional program to reduce it. Materials and methods - аn analysis of the structure and dynamics of mortality rates from diseases of the circulatory system and the peculiarities of the organization of medical care for the population of the Astrakhan Region with cardiovascular diseases for the 7-year period from 2014 to 2020, based on the data of the Medical Information and Analytical Center and the Office of the Federal State Statistics Service for the Astrakhan Region, was carried out. Results and discussion - diseases of the circulatory system rank first in the structure of total mortality in the Astrakhan region, which accounted for about half (48%) of all deaths in 2020. During the study period, an increase in mortality from diseases of the circulatory system was established by 2.8% with a sharp increase of 17.6% in 2020 compared to 2019, which is associated with the spread of coronavirus infection. At the same time, the proportion of deaths outside the hospital was 65% in 2020. It’s indicates both the late seeking of medical care and the shortcomings of dispensary observation of the category of citizens with the maximum risk of developing cardiovascular complications. In the structure of mortality from diseases of the circulatory system, ischemic heart disease is steadily leading, with an increase of 5.8% over the reporting period. The second place is occupied by cerebrovascular diseases, which showed a slight decrease by 3.3%. In addition to the infectious threats associated with the spread of the coronavirus COVID-19, it is necessary to take into account such a stable phenomenon as the progressive aging of the population when predicting the mortality rate for the coming years. Conclusion. Research findings can be used to adjust activities to health care organizations for patients with cardiovascular diseases at the regional level.
ADVERSE METEOROLOGICAL SITUATION AS A RISK FACTOR FOR CARDIOVASCULAR DISEASES
Authors: N.M. Kolyagina , T.A. Berezhnova , Ya.V. Kulintsova , O.S. Elistratova , M.A. Drapalyuk
Published: September 2021

Relevance. Exacerbation of the disease, as a rule, leads to the patient seeking medical help. In this regard, data on the population's access to medical care can serve as an indicator of the exacerbation of the disease.
Aim: to analyze meteorological risk factors that contribute to the development of cardiovascular diseases.
Material and methods. The ratio of the average number of cases of requests for medical care on unfavorable days for meteorological factors to the average number of cases of requests per day for medical care during the year was calculated. Using software tools (STATISTICA Base V6. 1), the type of data distribution was estimated, and a correlation analysis of the likely relationship between the number of medical care requests and the indicators of meteorological factors was carried out.
Results. As a result of the study, it was found that the average number of cases of medical care requests on hot days (air temperature over + 300C) is 1.1-1.4 times higher than the average number of cases of requests per day for the same reasons (diagnoses) during the year and is abnormal for the territory of the city of Voronezh, due to such diagnoses as hypertension without heart failure, brain vascular lesions (specified), cerebrovascular disease, hypertension with heart failure.
Conclusions. Thus, it was found that one of the meteorological risk factors for the formation of cardiovascular pathology is high air temperature (above + 300C), which is the goal for the implementation of the main directions of prevention of increased weather sensitivity and treatment of weather-dependent patients.
REPRODUCTIVE POTENTIAL OF WOMEN WITH PREMATURE OVARIAN INSUFFICIENCY
Authors: G.Yu. Spiridenko , Yu.A. Petrov , N.V. Palieva
Published: September 2021

Infertility is currently a priority problem for women of reproductive age. One of the reasons for this condition may be premature ovarian insufficiency. This is a pathological process causes by primary hypogonadism that occurs in women under 40 years of age. Its prevalence varies from 1:10,000 at the age of 20 to 1:100 at an older age. The absence of specific clinical manifestations of the disease complicates its early diagnosis and timely treatment. This pathological process manifests itself as secondary oligo-or amenorrhea, infertility. Less often, before the onset of reproductive disorders, there are manifestations of estrogenic insufficiency - vasomotor disorders - hot flashes, hyperhidrosis, cephalgia, tachycardia, arterial hypertension, emotional and vegetative disorders-irritability, asthenic manifestations, anxiety, depression, hypo - thymia, decreased libido. The lack of accurate data on etiological factors makes it harder to find methods for preventing this disease. The main direction of treatment is hormone replacement therapy, aimed at eliminating the insufficiency of natural estrogens in the woman's body. The chances of successful realization of the reproductive potential depend on the value of the follicle-stimulating hormone, since its high concentration affects the mitotic activity of granulosa cells of the follicle, which confirms the validity of hormone replacement therapy. The non-occurrence of pregnancy after therapy forces the patient to use assisted reproductive technologies using donor embryos and oocytes, while the effectiveness of in vitro fertilization does not exceed 58%. To prevent this outcome, if a woman has risk factors for developing premature ovarian insufficiency, it is necessary to timely assess the ovarian reserve with the preservation of her own oocytes for subsequent assisted reproductive technologies.
KIDNEY FUNCTION DURING THE MYOCARDIAL INFARCTION WITH RECURRENT EPISODES OF ISCHEMIA IN YOUNG AND MIDDLE-AGED MEN
Authors: A.V. Gordienko , S.Yu. Epifanov , B.B. Tassybayev
Published: September 2021

Relevance. Changes in renal function and their significance in reinfarction and early postinfarction angina have not been insufficiently established.
Aim. To evaluate renal function changes in men under 60 years old with recurrent myocardial infarction and early postinfarction angina to improve prevention and outcomes.
Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with recurrent myocardial infarction and/or early postinfarction angina - 110 patients; II - control, without it - 555 patients. A comparative assessment of renal function changes in first 48 hours (1) and the end of third week disease (2), also risk analysis of recurrent ischemia and poor outcome in selected groups were performed.
Results. The study group was distinguished by high levels of creatinine1 (0.11±0.03 (mmol/l)), lower - glomerular filtration rate (74.2±20.6 (ml/min/1.73 m2)) from the control (0.10±0.02 (mmol/l) and 78.3±17.9 (ml/min/1.73 m2), respectively; p=0.04). In both groups, there was a deterioration in indicators (creatinine, I: 2.3%; II: 5.9%; glomerular filtration rate - I: -5.8 and -6.3%, respectively; p<0.0001) during the observation period. The risk of recurrent ischemia increases with creatinine1 levels≥0.11 mmol/l and a glomerular filtration rate1˂70 ml/min/1.73 m2. In the study group, the risk of poor outcome is high with normal renal function. In the control group, it increased at creatinine1 levels≥0.10 mmol/l, glomerular filtration rate1˂65 ml/min/1.73 m2.
Conclusions. Patients with recurrent ischemia have higher creatinine levels than controls. In both groups, during the study, there was a slight increase in creatinine and a decrease in glomerular filtration rate. The above values of renal function indices should be used in the formation of groups at high risk of early recurrence of ischemia and poor outcomes, as well as for predictive modeling of these complications.
FEATURES OF PASSING AND FETAL CONDITION WITH MULTIPLE PREGNANCY, WHICH IS COMPLICATED BY FETO-FETAL TRANSFUSION SYNDROME
Authors: T.V. Bragina , Yu.A. Petrov , N.V. Palieva
Published: September 2021

Problem of multiple pregnancy is one of the most relevant in obstetrics nowadays,being not only a medical, but also a socially significant problem. The problem of pregnancy management is of scientific and practical interest, it is caused by an increase in the number of multiple pregnancies. The current trend towards all cases of multiple pregnancies is explained by the activity of assisted reproductive technologies, the ever-increasing age of women in labor. This article discusses the features of the gestation period in multiple pregnancies, characteristic complications, as well as the features of the condition of the fetus and newborn in this condition. Multiple pregnancy is a model of fetoplacental insufficiency, which is explained by the fact that evolutionarily a woman's body is adapted to bear one fetus. According to research data, the course of multiple pregnancies is more often associated with the presence of various complications than the course of a singleton pregnancy. One of the most serious complications of multiple pregnancy is fetal-fetal transfusion syndrome. The occurrence of this complication requires the use of special tactics of pregnancy management, continuous monitoring of the condition of the mother and fetus, readiness to make emergency correct decisions about prolonging pregnancy or delivery, readiness to provide highly specialized assistance to the fetus and subsequent newborns. Clinical management of pregnancy, treatment and prognosis depend on the extent of development of feto-fetal transfusion syndrome, gestation, on which has developed the syndrome, presence or absence of the mother's genital or extragenital pathology, as well as the fetus. The main methods of treatment of feto-fetal transfusion syndrome are methods of fetal surgery, the most effective of which is the method of fetoscopic coagulation of placental anastomoses.
PROVIDING REHABILITATION ACTIVITIES TO PATIENTS WHO UNDERWENT CARDIOVASCULAR EVENTS IN THE ASTRAKHAN REGION
Authors: D.O. Ermolaev , Yu.N. Ermolaeva , Zh.Yu. Zolotokopova
Published: September 2021

The relevance of the study is explained by the need to increase attention to the situation with acute cardiovascular diseases and the creation of an accessible system of medical rehabilitation for patients with cardiovascular diseases in the region. The aim of the study is to analyze the provision of rehabilitation measures for patients who have suffered cardiovascular accidents in the Astrakhan region. Materials and methods - based on the data of the annual reporting statistical forms No. 12 "Information on the number of diseases registered in patients living in the service area of the medical institution" and No. 14 "Information on the activities of the hospital", the calculation and analysis of indicators of general and primary morbidity was carried out ( on appeal), hospitalized morbidity, hospital mortality, the need for rehabilitation measures and their provision of adult patients aged 18 years and older with diseases of the circulatory system, including cardiovascular accidents in the Astrakhan region. Results and discussion - the article shows the general situation with the incidence of diseases of the circulatory system of the adult population, including acute coronary syndrome and acute cerebrovascular accident in dynamics from 2014 to 2020, discloses the organizational and structural aspects of the existing system of organizing rehabilitation care in the region. The results of assessing the satisfaction of the needs of the adult population of the region in neuro- and cardiac rehabilitation by medical organizations licensed for medical activities with an indication of the work (services) for medical rehabilitation and participating in the federal and territorial program of state guarantees of free provision of medical care to citizens in the region are presented. It was revealed that less than half of those in need receive medical rehabilitation assistance at the expense of the mandatory medical insurance fund. Proposals have been formulated to increase the availability of rehabilitation care for patients who have undergone cardiovascular accidents. Conclusion. The obtained research data can be used for further organizational, methodological and coordination work to provide modern medical and rehabilitation care to patients with acute cardiovascular accidents at the regional level.
AGE RELATED PECULIARITY OF THE CONTACT POINTS OF THE POSTERIOR TEETH FROM THE POINT OF VIEW OF RESTORATIVE DENTISTRY
Authors: A.N. Ginali , A.I. Nikolaev , A.V. Permyakova
Published: September 2021

Reconstruction of the age-related anatomical and physiological features of the contact surfaces and contact points inherent in natural teeth in the treatment of caries of posterior teeth with a direct restoration with light-cured composite is one of the unsolved problems of practical dentistry. The study is devoted to the determination of age-related characteristics of the localization and shape of contact points of posterior teeth in permanent dentition. The assessment of localization and shape of 1224 contact points of posterior teeth in 236 patients aged 20 to 59 years was carried out. Comparison of data about the surface area, shape, vertical and horizontal positions of contact points related to teeth anatomic structures in the interdental space was performed. The analysis of interproximal intraoral radiography data, examination and measurement of the parameters of interdental contacts using dental floss, analysis of the display of contact points on dental impressions made according to a special technique were carried out. The localization of the contact areas of the posterior teeth with a displacement in the vestibular direction, the associated asymmetry of the buccal and lingual (palatal) interdental embrasures, as well as a gradual increase in the surface area of contact areas and a decrease in the depth of the occlusal interdental embrasures, correlated with the age of the patients, were recorded. The average numerical values of the listed parameters are derived, taking into account the age of the patients. Anatomical and topographic features of the interdental spaces of the posterior teeth in adult patients are characterized by the following features: the contact areas of the posterior teeth are displaced in the vestibular direction, the buccal and lingual (palatal) interdental embrasures are asymmetric; dynamics of the depth of occlusal interdental embrasures, linear dimensions and area of contact areas is expressed as average digital values for different age groups: 20-40 years: contact areas – 1×2 mm, S = 2 mm2, depth of occlusal interdental embrasure – 1.5 mm; over 40 years old: contact pads – 1.5 × 3 mm, S = 4.5 mm2, the depth of the occlusal interdental embrasure – 1.0 mm.
PATIENT CULTURE AS A FACTOR IN ENSURING THE QUALITY OF MEDICAL CARE
Authors: A.V. Oleynik , D.L. Mushnikov , Z.Z. Germakhanov , E.V. Drobysheva
Published: September 2021

The relevance of the study is due to the insufficient development of improving the structural component of the quality of medical care in terms of the cultural characteristics of the participants in their provision. The purpose of the study: to determine the contribution of the patient's culture factor to ensuring the quality of medical care of different profiles. The collection of material was carried out by the method of sociological survey of patients on the original questionnaires and the method of expert assessment of cases of medical care. The volume of the sample population formed by random selection amounted to 256 patients of dental profile, 320 therapeutic, 196 surgical (urological), 210 pediatric profile, respectively. An expert assessment of the quality of medical care was carried out according to the methodology that takes into account the implementation of its individual properties, for 984 cases of assistance. It is established that the quality of medical care is reliably influenced by the state of the cultural profile of patients. It was found that the assessment of the patient structural component of the quality of medical services without taking into account their profile was reduced to 40.6% relative to the maximum assessment, especially the characteristics of the sanological and information culture of the patient. The analysis of the role of patient cultural characteristics in the formation of the structural component of the quality of medical services showed the presence among them of characteristics that have a significant impact on the decline in the quality of services. The revealed differences in the value of the relative risk of the same patient cultural risk factor for reducing the quality of medical services in their different profiles substantiated the need to differentiate factors into high-risk and low-risk. The basis for managing the culture of patients should be measures to transform low gradations of cultural characteristics of patients into high ones, through medical information and education, socio-psychological counseling, patient education and the formation of behaviors focused on the preservation and promotion of health.