bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical features of primary multiple eyelid basal cell carcinoma
Authors: Panova I E , Suslo I S , Kuchenkova I A , Arakelyan A E
Published: November 2019

Aim. Identification of clinical and epidemiological features of primary multiple eyelid basal cell carcinoma. Methods. 53 patients with multiple eyelid basal cell carcinoma were included in the main group, the control group included 98 patients with solitary forms of eyelid basal cell carcinoma, who were not diagnosed with primary multiple lesions during 7 years of follow-up. Diagnosis of a malignant disease of the eye was based on the disease history, complex ophthalmic clinical and instrumental examinations, the diagnosis of multiple eyelid basal cell carcinoma was verified by cytological and histological examination. Magnetic resonance imaging and computed tomography of the orbit, brain, abdominal cavity were used to assess the area of malignancy. Results. Primary multiple eyelid basal cell carcinoma was diagnosed mainly in elderly patients over 70 years old (58.49% of patients), whereas a solitary basal cell carcinoma was significantly more common in patients of the younger age group - from 30 to 59 years old (24.49% of patients). Neoplastic process in primary multiple eyelid basal cell carcinoma was mainly localized on the skin of the outer canthus (13.20%), presenting mainly as nodular form (64.15%), with differentiated tumor dominating morphologically. Primary multiple eyelid basal cell carcinoma is diagnosed in 1.64% of patients with tumors of organ of vision, with two metachronous tumors in most of the cases (69.81%), associated with skin epithelial malignant tumors, breast, uterine, kidney and rectal cancer. Conclusion. The clinical features of primary multiple eyelid basal cell carcinoma are the following: age of 70 years and over, verification at T1N0M0 cancer stage, predominantly nodular form (64.15%), with differentiated tumor dominating morphologically.
Local and systemic antioxidant status in experimental purulent corneal ulcer
Authors: Kolesnikov A V , Shchulkin A V , Barenina O I , Konopleva V I
Published: November 2019

Aim. To examine the systemic and local (corneal) free radical status in rabbits with experimental purulent corneal ulcers. Methods. The study was performed on the male chinchilla rabbits with an average weight of 3500±200 g 10 intact rabbits (10 eyes) served as controls. Staphylococcal purulent corneal ulcer was modeled on 40 animals (40 eyes) as described by N.A. Adamova (1999). The animals were euthanized at 3rd, 7th, 14th, and 21st day of the experiment. The concentration of malondialdehyde, protein-free thiols, as well as superoxide dismutase, glutathione peroxidase and glutathione-S-transferase activity were determined in cornea homogenate and erythrocyte lysate. The obtained data were processed by the one-factorial dispersive analysis (ANOVA), Newman-Keuls test. Results. In all animals the purulent ulcer occurred 12-24 hours after staphylococcus culture introduction. From day 1 to day 3 of the experiment, the clinical picture of a purulent ulcer corresponded to an infiltration stage. From day 3 to day 7 of the experiment, palpebral edema developed, the purulent discharge lasted out, and in some cases even intensified. From day 7 to day 21 of the experiment, corneal infiltration decreased both by area and intensity. In 11,1% scaring corneal opacity formation began. Experimental purulent corneal ulcer development was accompanied by lipid peroxidation activation both in cornea and in erythrocytes, shown by increased malondialdehyde concentration, decreased protein-free thiols level and antioxidant glutathione peroxidase, glutathione-S-transferase and superoxide dismutase enzymes activity. There was a strong direct relationship between the erythrocyte malondialdehyde level and corneal malondialdehyde concentration, and inverse relationship between erythrocyte malondialdehyde level and erythrocyte superoxide dismutase activity. Conclusion. The development of experimental staphylococcal corneal ulcers is accompanied by the development of local and systemic oxidative stress.
Integral stiffness of arterial system in patients with arterial hypertension of different genesis
Authors: Teregulov Yu E , Teregulova E T , Khusainova D K , Mukhametshina F N , Abdulganieva D I , Mangusheva M M
Published: November 2019

Aim. To study and comparatively analyze the integral stiffness of arterial system in healthy subjects and in patients with hypertensive heart disease, hypothyroidism associated with arterial hypertension and rheumatoid arthritis associated with arterial hypertension. Methods. The study included 32 healthy volunteers and 178 patients with arterial hypertension, including 63 patients with hypertensive heart disease of 1-3 degree, 82 patients with hypothyroidism associated with arterial hypertension, 33 patients with rheumatoid arthritis associated with arterial hypertension. All patients underwent echocardiography; modulus of volume elasticity (MVE), pulse pressure, mean arterial pressure (MAP), total peripheral vascular resistance (TPVR), and MVE/TPVR ratio were calculated. The stiffness of arterial system was considered the main component if MVE/TPVR ratio exceeded 1; if MVE/TPVR ≤1, TPVR was considered the leading component. Results. Patients with arterial hypertension had higher rates of stiffness of arterial system in comparison with control group by MVE and pulse pressure. In control group, 87.5% persons had prevalence of TPVR, and in 12.5% arterial stiffness prevailed. In 77.8% of patients with hypertensive heart disease prevalence of TPVR was found, and in 22.2% arterial stiffness prevailed. In patients with combination of rheumatoid arthritis and hypertension arterial stiffness prevailed, while patients with combination of hypothyroidism and hypertension had higher TPVR. Conclusion. All patients with combination of rheumatoid arthritis and hypertension had arterial stiffness prevailing over TPVR. In patients with hypothyroidism associated with arterial hypertension TPVR prevailed over arterial stiffness.
Clinical and metabolic status index as an indicator of complex treatment efficiency in patients with type 2 diabetes mellitus
Authors: Alieva T T
Published: November 2019

Aim. To study the performance of clinical and metabolic status index for estimating the results of treatment in patients with type 2 diabetes mellitus by monitoring their condition. Methods. Treatment results of 70 patients with type 2 diabetes mellitus (28 females, 42 males) were analyzed. Body height and weight, body mass index, systolic and diastolic pressure (while seated) were measured in all patients. Mean arterial pressure was calculated using systolic and diastolic pressures. Clinical and metabolic status index (CMSI) was defined as following: CMSI=а1х1+а2х2+а3х3+а4х4, where x1 - body mass index; x2 - blood glycated hemoglobin level; x3 - mean arterial pressure; x4 - MM-atherogenic index of plasma; a1-a4 - discriminant factors. Results. Baseline value of clinical and metabolic status index in female patients ranged between 45.8 to 70.2 (mean value 53.8±5.69), at the end of the study it ranged from 41.3 to 56.3 (mean value 47.8±3.86, р 0.001). In male patients, baseline value of clinical and metabolic status index ranged from 58.1 to 82.2 (mean value 68.8±6.08), endpoint value - from 54.0 to 66.8 (mean value 47.8±3.86, р 0.001). Conclusion. Developed clinical and metabolic status index allows to make comprehensive estimation and monitoring of the course of type 2 diabetes mellitus.
Clinical and epidemiological factors of internal diseases in females of reproductive age
Authors: Konyshko N A
Published: November 2019

Aim. To identify the factors of internal and nutrition-related diseases in females of reproductive age. Methods. A comprehensive general physical examination of 383 pregnant women aged 16 to 46 years old with the following internal diseases at pregnancy: gestational arterial hypertension (n=183), essential arterial hypertension (n=66), obesity (n=134) was conducted. Control group consisted of 153 pregnant women without any signs of internal diseases. Results. Combination of social and demographic, psychosomatic and inherited factors may define the risk of neurohormonal mechanisms deregulation, obesity, and type of arterial hypertension. Females with internal diseases had significantly lower level of physical activity compared to females of the control group. The largest number of long-term and heavy smokers was revealed in groups of female patients with gestational and essential arterial hypertension, patients with obesity and mature nulliparous women. Multivariate analysis showed that income level and physical activity of pregnant women have a significant impact on excessive fat body mass in pregnant women during gestation and before it. No statistically significant relationships between educational level and body mass index before pregnancy and at gestation were found. Conclusion. Factors influencing the risk for internal and nutrition-related diseases in females of reproductive age were: (1) the increased demand for nutrients and energy in developing placenta-fetus system, leading to irrational nourishment; (2) decreased body reserves, caused by repeated pregnancies and childbirth; (3) smoking; (4) social and economic status; (5) living area; (6) hereditary factors and constitutional features.
Changes in quality of life in adolescents as an indicator of treatment efficiency
Authors: Adzhablaeva D N
Published: November 2019

Aim. The research is targeted for estimating quality of life in adolescents with different types of tuberculosis. Methods. Quality of life in 30 adolescents aged 13-17 years was evaluated using Pediatric Quality of Life Inventory - PedsQL questionnaire. Parents were evaluated separately. An initial level of a quality of life before the treatment initiation and quality of life right after in-patient treatment completion (56 days) were compared. Results. Adolescents had pessimistic and emotionally limited subjective estimations of their clinical condition and its influences on all types of activities. The change in Pediatric Quality of Life Inventory scores (49.4±2.1 before treatment, compared to 51.9±2.0 after treatment) confirmed that recreation and treatment of tuberculosis significantly raised the subjective scores for all aspects of patient’s quality of life. Quality of life indicators by different functional scales were higher if assessed by parents compared to patients themselves (p 0.001). Parents were sure in positive influence of the prolonged course of the specific treatment on «school life» scale parameters. Comparative assessment of quality of life trend showed that improvement after treatment was observed according to assessment both by parents and patients themselves. All quality of life indicators were higher in female patients (score of all types of activities - 55.7±2.7 points) compared to males (48.3±2.8 points). Conclusion. Revealed trends confirm the need for performing recreational, medical, social, rehabilitative actions and psychosocial correction considering the age features of adolescents, their subjective estimations and functioning in a hospital.
Influence of interleukin-1 receptor antagonist on dynamics of the glutathione system, energy metabolism and oxydative protein modification in experimental hyperglycemia
Authors: Suprun A S , Belenichev I F
Published: November 2019

Aim. To study the dynamics of glutathione system, energy metabolism and the oxidative protein modification indicators in rat brain tissue in case of experimental diabetes mellitus and use of metabolic action cerebroprotector Piracetam + Thiotriazoline (Tiocetam) and cytokine medication - recombinant interleukin-1 receptor antagonist. Methods. Studies were conducted on 40 white Wistar rats, divided into four groups of 10 animals each. First group - intact animals, second - animals with experimental diabetes mellitus, the third - animals with diabetes mellitus treated with Piracetam + Thiotriazoline (Tiocetam) administered at a dose of 500 mg/kg, the fourth - animals with diabetes mellitus treated with recombinant interleukin-1 receptor antagonist at a dose of 7.5 mg/kg. Experimental diabetes mellitus was induced by injection of an aqueous solution of alloxan monohydrate. Blood glucose concentration was measured on the 11th day after alloxan injection. Brain tissue specimens were used for biochemical studies. Statistical data analysis was performed using the Statistica 6.0 software package, the comparative analysis in the groups was performed using ANOVA. Results. The development of hyperglycemia in experimental animals was accompanied with glutathione system destabilization (increased levels of oxidized glutathione along with a marked decrease in its reduced form, glutathione peroxidase and glutathione reductase activity). Ischemic lesion of the brain tissue of animals with experimental diabetes mellitus was characterized with an increase of markers of oxidative protein modification (aldehyde and carboxyl products) and energy deficit in brain homogenate. Treatment with Piracetam + Thiotriazoline (Tiocetam) and interleukin-1 receptor antagonist contributed to the normalization of the glutathione peroxidase and glutathione reductase activity, stabilization of energy phosphates and indicators of oxidative protein modification. Maximal activity was observed in case of interleukin-1 receptor antagonist. Conclusion. The activity of the interleukin-1 receptor antagonist in terms of glutathione system stabilization and inhibition of oxidative and nitrozilizing stress manifestations exceeds those of Piracetam + Thiotriazoline (Tiocetam).
DNA repair profile in gastrointestinal stromal tumors (gists) - novel perspectives for therapy
Authors: Boichuk S V , Ramazanov B R , Galembikova A R , Galeev O R , Mustafin I G , Duensing A
Published: November 2019

Aim. To assess the expression of various types of DNA repair proteins in gastrointestinal stromal tumors (GISTs) to identify the possible defects in DNA repair pathways and therapeutic targets. Methods. The study was performed on the human fibroblasts, imatinib-sensitive vs imatinib-resistant GISTs and leiomyosarcomas (LMS) cell lines, as well. The cell lines indicated above were cultured in the corresponding culture medium supplemented with fetal bovine serum, L-glutamine and antibiotics (37 °C и 5% СО2). Protein expression level and its intracellular localization were assessed by Western blotting. Results. The reduced BRCA1 expression was observed in most of the GIST cell lines, which was associated with an up-regulation of Rad51, thereby indicating about the potential abnormalities of homologous recombination pathway in these cells. This phenomenon was typical for GISTs and was not observed in LMS cells lines. In contrast to LMS cell lines, all GIST cells showed an upregulation of O6-methylguanine DNA methyltransferase (MGMT), the key enzyme involved in alkylated DNA damage repair pathway. Most GIST cells exhibited high level of MSH6 known as a key member of mismatch repair pathway. Most notably, topoisomerases were over-expressed in all of GIST cell lines. Conclusions. We found several striking alterations in expression levels of DDR pathway enzymes in GISTs. For instance, an up-regulation of topoisomerases in all GISTs indicates that these cells might be sensitive to topoisomerase II inhibitors and could be potentially targeted therapeutically.
Clinical and epidemiological features of imported malaria in the Republic of Crimea for a twenty-year period (1994-2014)
Authors: Karimov I Z , Los’-Yatsenko N G , Midikari A S , Gorovenko M V , Arshinov P S
Published: November 2019

Aim. To identify the main clinical and epidemiological features of imported malaria in the Republic of Crimea for a twenty year period (1994-2014). Methods. Archival case reports, results of thin and thick blood films for malaria, a set of general clinical and biochemical laboratory parameters were assessed. Results. Over the past 20 years, 48 patients (including 47 men) aged 21 to 61 years were treated for imported malaria in the department of infectious diseases of the 7th City Clinical Hospital in Simferopol. 34 patients were diagnosed with Plasmodium falciparum malaria, 7 - with Plasmodium vivax malaria, 1 - with Plasmodium ovale malaria, 2 - with Plasmodium malariae malaria. Mixed infection (Plasmodium falciparum and Plasmodium ovale, Plasmodium falciparum and Plasmodium vivax) was revealed in 2 patients; in 2 cases the diagnosis was based on clinical and epidemiological data. Malaria was imported form Sierra Leone, Angola, Mali, Guinea, India, Yemen, Nigeria, Congo, Ghana, as well as from neighboring countries - Azerbaijan and Tajikistan. The clinical picture of Plasmodium falciparum malaria was characterized with diverse fever, absence of manifest chills and sweats, challenging the diagnosis. Plasmodium vivax malaria cases were typical with repeated fever, but were diagnosed late. Self-intake of antimalarial and antibacterial drugs, as well as inadequate chemoprophylaxis distorts the clinical picture of the disease and worsens the quality of laboratory diagnosis. Difficulties in film examinations were most common in cases of mixed-malaria and Plasmodium ovale malaria, requiring repeated tests performed by experienced professionals. Intravenous quinine should be added to treatment together with pyrimethamine + sulfadoxine (Fansidar) and artemisinin in cases of severe course of Plasmodium falciparum malaria associated with increasing parasitaemia. Conclusion. Imported malaria, mostly Plasmodium falciparum malaria, which is associated with the most severe clinical course, increased risk for complicated forms development and unfavorable outcome, is quite common in the Republic of Crimea. Mandatory testing of non-immunized persons returning from endemic areas with any change in well-being and active detection of malaria carriers among residents of endemic areas, arriving in non-endemic areas, are crucial for the early diagnosis of malaria.
Pathomorphology of colonic mucosa in patients with chronic post-parasitic colitis
Authors: Scherbakov I T , Leonteva N I , Chebyshev N V , Gracheva N M , Khrennikov B N , Saharova T V , Larina S N
Published: November 2019

Aim. To identify pathologic features of the colonic mucosa in patients with chronic post-parasitic colitis. Methods. Under the observation were 80 patients aged 38-42 years (38 men and 42 women) 1.5-2 years after undergoing parasitic diseases (amebiasis, giardiasis, diphyllobothriasis). In 19 patients due to the presence of dyspeptic phenomena colon mucosa was evaluated by morphometric parameters using grid of Avtandilov. The control group consisted of 6 patients with adaptive norm, in which by complex evaluation (bacteriology, parasitology, endoscopic, histologic) the pathology has not been revealed. Biopsies of colon mucosa were fixed in 10% neutral formalin solution and embedded in paraffin. Histological sections were stained with 1% aqueous solution of Alcian blue, Mayer’s hematoxylin and eosin; for morphometric analysis of 24 objective indicators - azure II-eosin by Romanovsky, with eosin methylene blue and thionine by Nicolas. Results. It was found that the mucosa in chronic post-parasitic colitis in all cases different from the normal colonic mucosa by registered parameters: the amebiasis - in 50% of cases, giardiasis - in 54.1%, with difillobotriosis - in 70.8%. In post-difillobotriosis colitis the number of fibroblasts in the lamina propria was reduced. Post-lyambliotic colitis characterized by hypertrophy of the surface epithelium and a high mitotic activity of the epithelium of intestinal glands. Conclusion. After undergoing parasitic diseases, in the colon mucosa preserved histological changes corresponding to chronic ulcerative colitis; post-amebiasis chronic colitis characterized by catarrhal-haemorrhagic inflammation, chronic post-lyambliotic - catarrhal-follicular, post-difillobotriosis - catarrhal-haemorrhagic inflammation with high activity of the pathological process and moderate atrophy of the intestinal glands.
Neopterin - a potential diagnostic and prognostic marker in infection diseases
Authors: Dudina K R , Kutateladze M M , Znoiko O O , Bokova N O , Shutko S A , Kozina A N , Ogarev V V , Yushchuk N D
Published: November 2019

Clinical significance of determining the neopterin concentration in body fluids is reviewed. The results of researches on determining the neopterin concentrations in various infectious diseases (vector-borne diseases, herpes, respiratory and intestinal infections, as well as human immunodeficiency virus infection) conducted over the past 2 years are discussed. Neopterin is a biologically stable metabolite, which gives an advantage of its detection to assess the activity of the immune response. Previously neopterin was determined mainly by high-performance liquid chromatography. In recent years, enzyme-linked immunosorbent assay was introduced and frequently used for determining neopterin concentrations. It was shown that neopterin concentrations can vary also in the absence of the pathological process. In particular, some general factors such as race, age, body mass index, smoking and arterial pressure may influence on the concentrations of neopterin in the human body. Increased level of neopterin in body biological fluids and the kynurenine/tryptophan ratio are measured in diseases involving interferon-γ-mediated immune response activation. In this regard, the highest concentrations of neopterin and increased kynurenine/tryptophan ratio are observed in cases of infectious diseases, malignancies, transplant rejection, a number of cardiovascular and autoimmune diseases. It was shown that neopterin can be regarded as a highly specific marker of viral infection, and its blood concentration reflect the prognosis of the disease. Monitoring neopterin level may be useful to assess the severity and activity of an infectious disease, its clinical course, and to control the effectiveness of etiological treatment for many infectious diseases.
The stages of the glorious path: to the 200th anniversary of Kazan state medical university
Authors: Sozinov A S , Ivanov A Yu , Ivanova R G
Published: November 2019

Aim. To describe the main stages of formation and development of one of the leading scientific and educative medical centers in Russia - Kazan State Medical University. Methods. Comparative historical analysis was applied. Results. The article depicts the main stages of university formation, main scientific interests and outstanding discoveries of the scientists representing Kazan medical school. The main attention is devoted to formation of the clinical education. The specific factors influencing the development of medical faculty of Kazan Emperor’s University and putting in new facilities, including anatomy theatre, laboratories of physiology, university hospital, the participation of medical scientists in foundation and development of leading spheres of public health and hygiene are showed. In this context, the impact of outstanding medical scientists of the second half of the XIX century representing Kazan medical school in development of basic medical sciences is described. The specific development of higher medical education in Kazan during social disasters associated with revolution of the beginning of XX century is characterized. The role of Kazan State Medical Institute in medical training and science development during the Second World War and post-war period is presented. The development of Kazan State Medical Institute (University) during second half of the XX century is described. Conclusion. The modern state of education and researches at Kazan State Medical University as the result of long-term efforts of consolidated team developing 200-year old educational and scientific traditions is described.
The department of normal anatomy - veteran department of the Kazan medical school
Authors: Valishin E S
Published: November 2019

Kazan State Medical University, Kazan, Russia. The development of the Kazan anatomy scientific school from its foundation to modern days is shown. The period when the department was headed by E.F. Aristov, an outstanding medic, tutor, reformist, the alumna of Moscow Medical and Surgical Academy, who founded the basis of teaching descriptive and general anatomy and pathology in Kazan University, raised several generations of doctors and is rightly considered to be the founder of Kazan anatomy scientific school, is traced. The period when the faculty was headed by an outstanding anatomist and further founder of physical culture science, progressive public man P.F. Lesgaft is also described. The activity of V.N. Tonkov, an outgoing expert in anatomy and related sciences - comparative anatomy, histology and embryology, who has published the first part of the «Handbook of normal anatomy», which was the beginning of a considerable book series for students, is detailed. The works of the brilliant anatomist and medicine historian, excellent lecturer and great tutor V.N. Ternovsky are overlooked. His scientific legacy consists of over 100 works on morphology and history of medicine. The translations, publishing and editorship of treatises of the ancient doctors made by him are of special value. The activities of the department headed by the student of V.N. Ternovsky - professor V.N. Murat, who was a talented scientist, manager and tutor, is described. He was surpassed by A.G. Korotkov, E.S. Valishin, A.P. Kiyasov. Nowadays O.N. Eremeeva heads the department of normal anatomy. The history of the senior department that had laid the foundation of higher medical education in Kazan over than 200 years ago, still continues.
Risk factors and clinical features of recurrent stroke in the Tyva Republic
Authors: Mongush Kh D , Ondar A B , Chylbak-ool R Ch , Balchir M B , Mongush Ch O
Published: November 2019

Aim. To determine risk factors and clinical features of the recurrent stroke. Methods. A prospective 3-year cohort study was conducted including 120 patients with stroke admitted to the neurological department of the Republican Hospital №1 of Kyzyl at 2010-2012, 60 of whom had recurrent stroke (group 1), and 60 had primary stroke (group 2). Results. Recurrent stroke was by 16.66% more common in men. The mean age of males having recurrent stroke was younger compared to females (р 0.05). Patients with family history of arterial hypertension in closest relatives were significantly more prevalent among those with recurrent stroke (70 versus 35%, p 0.05). The rate of excessive alcohol consumption was also significantly higher in patients with recurrent stroke (18.33 versus 6.67%, p 0.05). Mortality associated with the recurrent stroke was higher in males of all age groups, difference was statistically significant in male patients over 70 years of age (p 0.05). Combined first 28-day mortality was 26.67% (32 cases), and was higher in patients with primary stroke (p 0.05). Only 21.67% of patients took antihypertensives regularly prior to the primary stroke, among patients with recurrent stroke this share reached 70%. Antiplatelet drugs were taken by 5% of patients prior to the primary stroke, in patients who suffered the stroke the share was higher and reached 53.33%. Conclusion. Family history of arterial hypertension was the most important risk factor for recurrent stroke. Male patients had higher risks of recurrent stroke and fatal outcome, which may be associated with lower drug compliance (including antiplatelet drugs and anticoagulants, antihypertensives) and higher exposure to other risk factors (smoking, excessive alcohol consumption).
Features of tissue doppler ultrasonography in patients with viral liver cirrhosis
Authors: Chistyakova M V , Govorin A V , Radaeva E V
Published: November 2019

Aim. To study the influence of pulmonary hypertension, viral load, and presence of ascites on indicators of longitudinal global and segmental systolic and diastolic ventricular functions in patients with liver cirrhosis as an outcome of viral hepatitides. Methods. The study included 75 patients with liver cirrhosis class A, В, C by Child-Pugh as an outcome of viral hepatitides who were distributed into 3 groups depending on the presence of pulmonary hypertension, ascites, and of viral load. All patients underwent Doppler echocardiography and tissue Doppler echocardiography. Results. Decreased global longitudinal systolic and diastolic function of the left and right ventricles was revealed in patients with virus-related liver cirrhosis, which decreased in the presence of pulmonary hypertension, moderate viral load and ascites. While studying an association between the structural and functional heart indices and hepatic and portal blood flow, it was found that average mitral and tricuspid valve peak systolic velocity was associated with left ventricle ejection fraction (r=0.71, p 0.05), liver veins diameter and blood flow speed parameters (r=0.32-0.81, p 0.05), pulmonary artery pressure (r=0.37-0.84, p 0.05), and viral load (r=0.92, p 0.05). Conclusion. Patients with virus-related liver cirrhosis have decreased global longitudinal systolic and diastolic function of the left and right ventricles, deteriorated by pulmonary hypertension, ascites, and moderate viral load.
Management of intraperitoneal hemorrhage bleeding as a complication of a gynecologic disease
Authors: Nazarenko O Ya , Timofeyeva S V
Published: November 2019

Aim. To evaluate the effectiveness of intra- and post-surgical resuscitation targeted at blood loss replacement in patients with moderate, severe and profuse intraperitoneal hemorrhage caused by ectopic pregnancy and ovarian apoplexy. Methods. Heart rate variability and cardiac intervals assessment were used as additional criteria for patient monitoring. 97 female patients with intraperitoneal hemorrhage of 500-1500 ml underwent endoscopic surgery. Autologous blood transfusion, as well as packed blood products and blood substitutes were used for blood loss replacement. Heart rate variability assessment and analysis of cardiac intervals indicate that pathogenesis of adaptation and blood loss compensation in female patients with intraperitoneal hemorrhage exceeding 500 ml depends on blood loss volume and methods of blood loss replacement. Results. Parameters of adaptation and blood loss compensatory mechanisms in patients with moderate and severe blood loss, who underwent intrasurgical autologous blood transfusion, were close to normal values at days 7 and 14 after treatment. Patients with severe and profuse intraperitoneal hemorrhage treated with packed blood products had the longest red blood count and heart rate variability recovery period. Conclusion. Heart rate variability assessment allowed effectively estimating the treatment effect in female patients with intraperitoneal hemorrhage as a complication of a gynecologic disease exceeding 500 ml.
Clinical and functional rationale for the use of intraosseous composite materials-covered screw retainers for mandibular fracture osteosynthesis
Authors: Safarov S A , Shcherbovskih A E , Petrov Yu V , Bayrikov I M
Published: November 2019

Aim. To increase the effectiveness of mandibular fracture osteosynthesis by using the composite materials-covered intraosseous screw retainers with active combined cutting edge. Methods. 282 patients with mandibular fractures were examined and operated in the clinic of Oral and Maxillofacial Surgery and Dentistry of Samara State Medical University from 2011 to 2013. Surgeries were performed in 257 (91.1%) patients, including plate osteosynthesis - in 133 (47.2%), intraosseous composite materials-coated screw retainers - in 42 (14.9%), uncoated pins - in 65 (23.0%), bone sutures - in 17 (6.0%). Orthopedic and other methods of bone fragments fixation were used in 25 (8.9%) patients. Proposed composite materials-coated osteosynthesis retainer is a square pin with cutting angle of 60-80° and 4 longitudinal grooves of 5-10 mm. The main part is a two-tier helical ribbon with alternating cutting portions, wherein some areas have the same diameter as the main part of the retainer, and the others are 20-100 microns thinner and are covered with TiC0, 65+25% Ca10(PO4)OH2. RESULTS. A comparative analysis with the traditionally used methods was carried out. The main advantages of the proposed method are rigid fixation of mandibular bone fragments and optimal osteogenesis in complex treatment of patients with trauma. Conclusion. The use of the proposed method of mandibular fractures surgical treatment using intraosseous screw retainers with bioactive coating reduced the risk of complications and the length of hospital stay.
Age-related variation of lung intervascular connective tissue at different stages of postnatal histogenesis
Authors: Nickel’ V V , Kasimtsev A A , Efremova V P
Published: November 2019

Aim. To study the structure of lung intervascular connective tissue at different stages of postnatal histogenesis. Methods. Lung autopsies from 20 mature males aged 22-35 years, 30 males aged 61-74 years and 30 males aged 75-89 years who died of causes unrelated to respiratory diseases were studied using standard histological techniques. Results. In lungs of young males, two separated zones of intervascular connective tissue - the central and peripheral, which differ in fiber quantity and their spatial orientation - were revealed. Collagen fibers were the main component of the extracellular matrix of lungs, accounting for 69.9% [69.5, 70.7] of matrix. The share of the base material was 30.1% [29.4, 30.5]. For older age, the share of collagen fibers increased together with decrease of the shares of elastic and reticular fibers up to the complete absence of the latter in subjects over 75 years of age. Strands of collagen fibers were strongly deformed, twisted spirally, clustered in thick bundles. Conclusion. Described age-related changes of lung intervascular connective tissue may reduce the vascular wall contractility, affecting the pulmonary circulation.
Epidermis of amputated limbs in patients with diabetes mellitus - immunohistochemical study
Authors: Gorshunova G N , Dzamukov R A , Valiullin V V
Published: November 2019

Aim. To examine the skin morphological changes in different areas of the amputated lower limbs of patients with diabetes mellitus. Methods. Skin samples of lower limbs of 6 patients with diabetic foot syndrome were studied using immunohistochemistry methods. Proliferation of epidermal cells, their resistance to apoptosis, as well as the degree of cells differentiation (using antibodies to proliferating сell nuclear antigen, Bcl-2 anti-apoptotic activity marker, epidermal cells terminal differentiation marker cytokeratin 1) were assessed. The color intensity was assessed using ImageJ software and was displayed as «mean greyscale intensity» (an integral value summarizing color intensity of three basic colors - red, green and blue - by V=0,299R+0,587G+0,114B formula, where V - mean intensity of a mean pixel, R, G, B - color intensity of red, green and blue pixels appropriately). Results. Patients with diabetic foot syndrome had reduced proliferative activity of epidermal cells as they approach the sphacelous area of the affected limb, together with decreased resistance to apoptosis in the same areas. The share of cells positive for proliferating cell nuclear antigen was 58.74±4.8% in skin samples from the area of necrosis (n=6) compared to 77.41±3% (p 0.005) in skin samples of the healthy controls. The study of Bcl-2 marker expression by cells of the sphacelous area (n=6) revealed that mean greyscale intensity in patients with diabetic foot syndrome was 57.74±4.3, which was significantly lower compared to skin samples of the healthy controls (n=6, 89.69±3.4, p 0.005). Based on the expression of cytokeratin, it was shown that suprabasal layers of the epidermis cells were less differentiated in case of diabetic foot syndrome compared to the same cells of the epidermis of the control group. Conclusion. In advanced stages of diabetes, the combined effect of the disease is reduced number of epidermis proliferating cells, the reduction of their anti-apoptotic activity and loss of skin as an organ.
Health problems of the region with low population density according to data of the Amur oblast
Authors: Agarkova O A , Voyt L N
Published: November 2019

Aim. To estimate the present health status of the population of Amur Oblast. Methods. The evaluation was based on analysis of statistical data on mortality, morbidity, disability in population. Intensive and extensive statistical parameters were calculated and compared. Results. The top three reasons for death in Amur Oblast were: cardiovascular conditions, external factors and malignancies (in Russia overall, malignancies rated the 2nd and external factors the 3rd). Mean survival rate has increased significantly both in Russia and Amur Oblast over the last 5 years (by 4.5 and 1.5 years accordingly). Overall disease prevalence has increased by 1.1 times over the last 5 years, with disease prevalence among children and adolescents increasing the most. Tuberculosis prevalence and mortality rate in Amur Oblast have dropped, although still higher compared with the whole Russia (prevalence - by 1.5 times, mortality rate - by more than 2 times). Syphilis prevalence rate has also dropped, although still exceeding the prevalence in Russia by 2.9 times. The prevalence of malignancies in Amur Oblast increased by 1.1 times, but it is by 1.1 times lower compared to Russian. Malignant tumors of lungs, skin, breast and stomach are the most prevalent types. Conclusion. Positive changes of public health characteristics can be expected at improving the life conditions and quality of life, the active promotion of healthy lifestyles and the high quality of medical care.
Accessibility and quality of medical care in public out-patient clinics and private medical centers of the Amur oblast as reported by patients with back pain
Authors: Dobrovinskaya K Yu , Voyt L N
Published: November 2019

Aim. To study the opinion of patients with low back pain of judgement of assessibility and quality of medical care in public and private medical centers. Methods. Back pain patients to assess the quality of medical care filled in specially designed questionnaires for each type of medical facilities (two types of questionnaires for each patient who underwent treatment in both outpatient public clinics and private medical centers, total of 600 questionnaires). The poll was anonymous and was performed at one of the private medical centers in august 2013. Patients were randomly picked out from all patients who seek for medical aid in private center being unsatisfied with the quality of medical aid offered at public medical centers or who were on the waiting list for a doctor visit, or with disease worsening not within the working hours of public medical centers (600 questionnaires). The poll included patients of active working age: men aged 20 to 60 years (118 patients, 39.3%) and females aged 20 to 55 years (182 patients, 60.7%). Results. The majority of patients were more satisfied with the quality of the treatment, examination and attitude of medical personnel in private medical centers compared to public institutions. The following issues of providing medical aid to back pain patients were discovered both in private and public settings: untimely referral to specialist, or consultation only by general practitioner without subsequent consultation of neurologist, long waiting lists, incomplete neurologic examination, and low qualification of doctors in choosing appropriate examinations, treatment approach and further prophylaxis. Abovementioned issues were more significant in public settings. Conclusion. The research showed that there is a need in developing uniform standards of medical care in case of a back pain in outpatients that do not yet exist.
Current structure, organization and evaluation of effectiveness of the specialized outpatient medical care for patients with blood diseases in a metropolis
Authors: Zhiguleva L Yu
Published: November 2019

Aim. To analyze the structure, organization and effectiveness of outpatient medical care for patients with blood diseases in St. Petersburg, Russia. Methods. 83 reports submitted by the heads of hematological offices at 2000-2012 were analyzed. The effectiveness was evaluated using routine statistical tests. The prevalence of the diseases was assessed by registration forms №7, 35, the data provided by information and analytical center of the Healthcare Committee and the City cancer registry. Medical aid provided to patients at 2010-2012 was studied, for this purpose 250 outpatient files (025/y form) were randomly picked out, the data were collected using specially designed registration cards (254 parameters). Results. Municipal, federal and departmental institutions provide hematologic outpatient medical care in St. Petersburg. The major burden of providing medical care to hematologic patients lays on interdistrict hematological offices, which actively follow-up and treat patients with hematologic cancers. Every sixth patient has complications, and 75% - comorbidities. During the period of study, the attendance rate increased by 33.4% (from 64 766 in 2000 to 86 405 in 2012), the number of the newly-diagnosed patients with hematologic cancers increased by 13.9% (p 0.05), the share of patients with hematologic cancers increased from 28.0 to 50.4%. Cumulative incidence of lymphomas increased from 69.9 to 96.0 per 100 thousand of population; leukemia - from 49.7 to 79.3. Mortality due to lymphomas decreased from 8.1% in 2001 to 5.3% in 2012, and due to leukemia - from 9.2% to 3.6%. Five-year survival rate of patients with leukemia increased from 56.6% to 63.2 % over the period of 2010-2012. Conclusion. The study shows the effectiveness of outpatient hematologic care in St. Petersburg. To further improve the efficiency of outpatient hematologic care in metropolis, it is important to improve the knowledge of hematologic diseases by doctors and pediatricians of general healthcare network, to review the workload of hematological office staff, to focus on preventive component of hematologic care (quality of occupational medical examinations), to develop and implement the new organizational techniques providing costs reduction and improving quality of life.
The experience of access application to recurrent laryngeal nerve and parathyroid glands as the way of the postoperative complications prevention in case of video-assisted surgery
Authors: Slavin L E , Chugunov A N , Khasanshin M M
Published: November 2019

Aim. To justify the application of surgical access to thyroid and parathyroid glands by means of videoendoscopic equipment. Methods. 14 video-assisted surgeries on thyroid and parathyroid glands were performed during the period of 2011-2014 using low-invasive midline cervical access by means of videoendoscopic equipment. Results. The surgery was carried out with a skin access of less than 3 cm, the section was made 1.5-2 cm above than jugular notch. Tissue dissection was performed by means of «channel» formation with mobilization of tissues while looking for recurrent laryngeal nerve and parathyroid glands up to allocation of the superior pole of a thyroid gland lobe under the laparoscopic control. In case of parathyroidectomy due to adenoma special attention was paid to presurgical topical diagnostics which included neck organs ultrasound examination with the use of expert class equipment as well as thyroid and parathyroid glands scintigraphy. Intrasurgical ultrasound examination of the area of surgery to specify the pathologically changed parathyroid gland location was performed in some cases. Jugular notch of sternum, lower pole of thyroid gland, lateral surface of trachea, tracheo-oesophageal groove, and inferior thyroid artery were used as reference points for identification of recurrent laryngeal nerve and parathyroid glands while using video equipment. As a rule, the recurrent laryngeal nerve was located behind and below the parathyroid glands. The distance from a skin section to a recurrent laryngeal nerve and lower parathyroid glands was 3.6 and 3.1 cm respectively. Conclusion. Use of video endoscopic equipment allows to reduce traumatic surgeries on neck organs and promotes the better visualization of anatomical structures in an area of surgery.
Assessment of angiogenic factors activity variation in the prediction of diabetic retinopathy progression after phacoemulsification
Authors: Kuntysheva K E
Published: November 2019

Aim. To evaluate the variations of vascular endothelial growth factor and pigment epithelium-derived factor balance as a prognostic factor for diabetic retinopathy progression after phacoemulsification. Methods. The study analyzed 4 samples of tear fluid taken from 2 patients (2 examples per patient). Clinical and functional tests, such as visual acuity test, tonometry, refractometry, visual field test, biomicroscopy, direct ophthalmoscopy, immunoassay, optical coherence tomography, fluorescein angiography, were performed. Clinical and laboratory parameters of homeostasis, including tear concentration of vascular endothelial growth factor and pigment epithelium-derived factor, blood glycosylated hemoglobin level were examined before and after phacoemulsification. Dynamic ophthalmologic control of diabetic retinopathy clinical course was performed. Results. The concentration of pro-angiogenic vascular endothelial growth factor was noted in both cases after the surgery. Hence, in one patient its growth (375 pg/ml before surgery, 467 pg/ml after surgery) exceeded the changes of pigment epithelium-derived factor concentration (2.08 ng/ml before surgery, 1.6 ng/ml after surgery). The progression risk index was estimated as 1.245 for vascular endothelial growth factor and 0.77 for pigment epithelium-derived factor. In second patient, vascular endothelial growth factor also increased after surgery, although, it’s increase (from 335 pg/ml before surgery to 358 pg/ml after surgery) was similar to pigment epithelium-derived factor change (2.15 ng/ml before surgery, 2.02 ng/ml after surgery). The progression risk index in second patient was estimated as 1.07 for vascular endothelial growth factor and 0.94 for pigment epithelium-derived factor. These changes allowed to predict pro-angiogenic potential increase and progression of vascular damage from diabetic retinopathy, in first patient. The second patient had stable balance of pro- and anti-angiogenic factors, allowing to predict a favorable clinical course. Conclusion. The change in vascular endothelial growth factor and pigment epithelium-derived factor ratio over time may be used as a prognostic factor for diabetic retinopathy progression after phacoemulsification.
Effects of alcohol on pregnancy and the fetus. the role of preventive measures in daily practice of an obstetrician
Authors: Marianian A Yu
Published: November 2019

Alcohol consumption during pregnancy can cause serious birth defects and developmental disorders. The article reviews scientific literature describing modern conceptions of alcohol-associated teratogenicity. Problems of public awareness of alcohol negative impact on pregnancy and the fetus (particularly by informing women of reproductive age and pregnant women) are raised. Literature review revealed that there is a lack of information on fetal disorders associated with alcohol consumption by the mother. Nowadays, alcohol consumption in Russia is one of the highest in the world (15.8 liters per capita per year, including newborns, 2011), which is significantly higher than the absolute level of alcohol consumption associated with serious health risk for an individual and for the population as a whole. Awareness among women of reproductive age and pregnant women is very low. Therefore, it is necessary to inform and teach physicians screening methods of medical problems associated with alcohol intake and brief intervention strategies that will help to identify and inform women at risk for having children with fetal alcohol syndrome and fetal alcohol spectrum disorders and prevent the birth of mentally retarded children. The problem of fetal alcohol syndrome and the whole spectrum of fetal alcohol disorders is of great theoretical and practical significance in Russia.