bluuebunny/crossref_metadata_2025 huggingface dataset:
The origin, development and current concepts of «comorbidity» and «polymorbidity»
Authors: Nurgazizova A K
Published: November 2019

The article aims to study the current concepts of polymorbidity and comorbidity by a literature review. This article presents the terms used to denote a combination of several diseases for one person, named as «combined», «concomitant», «associated» diseases or conditions, «comorbidity», «polymorbidity», «multimorbidity», «multifactorial disease», «polypathia», «co-disease», «dual diagnosis», «plural diseases». Definitions for currently commonly used terms «comorbidity», «polymorbidity» and «multimorbidity» are given, the historical aspects of their occurrence are discussed. The differences between the concepts of «comorbidity» and «polymorbidity», despite their frequent use as synonyms, are listed. The existing classifications of comorbidity, including definitions of trans-systemic, trans-nosologic and chronological comorbidity, are reviewed. The classification developed by H.C. Kraemer and M. van den Akker (1998), which presents a causal, complicated, iatrogenic, unclear and random comorbidity, is described. The assessment scales for the evaluation of this phenomenon, such as Cumulative Illness Rating Scale, Kaplan-Feinstein index, Cumulative Illness Rating Scale for Geriatrics, Index of Co-Existent Disease, Geriatric Index of Comorbidity, Functional Comorbidity Index, and Total Illness Burden Index, are presented. Detailed description of the comorbidity assessment by Charlson index as the most used and having the least disadvantages, is given. Description of the quantitative evaluation of polymorbidity is given, variation of the number of diseases depending on patient’s age is shown. The list for the most common pathologies that can be combined in a single patient is outlined. Diseases typical for the patients of elderly and senile age are described. The problem of comorbidity becomes more and more important in the areas where social conditions promote the increase of the life expectancy of elderly and senile patients, which requires a common approach to the problems of comorbidity.
50 years in search of the «longevity» gene
Authors: Chugunova D N , Oslopov V N
Published: November 2019

In many countries of the world mean life expectancy has lately significantly increased from 50 to 70-80 years. Twin studies have shown that genetic differences account for about 25% of the variance in adult human lifespan. However, the association with the life expectancy was proven for the only candidate gene - apolipoprotein gene, playing a great role in regulating lipoproteins metabolism. E2 allele of this gene is much more prevalent compared to E4 allele in people over 100. In animal models, single-gene mutations in genes involved in insulin/insulin-like growth factor-1 abnormal activation pathway and target of rapamycin signaling pathway have considerably extended the lifespan. The key link in regulating the insulin/insulin-like growth factor-1 abnormal activation pathway is the human forkhead box O3A transcription factor. A clear rel ationship between the lifespan and GG genotype of this gene in Japanese, German and French population was found. However, although candidate longevity genes are defined, their effects on the lifespan are still to be confirmed. Questions of gene products’ mutual influence and gene penetration are still undecided. Ethnical and geographical associations of different polymorphic alleles with aging and longevity are not completely clear. Therefore, further search and genetic and phenogenetic markers examination determining the lifespan is needed. Na+-Li+-сountertransport speed in the erythrocyte membrane, which is a genetically determined intermediate phenotype, may be one of those markers.
Influence of dynamic and static physical activity features on respiratory system of junior schoolgirls
Authors: Zayneev M M , Ziyatdinova N I , Martiyanov O P , Zefirov T L
Published: November 2019

Aim. To study the influence of different types of physical exercise on components of gases convective transport in junior schoolgirls. Methods. Twenty two 9 year old schoolgirls were included. The functional condition of respiratory system was estimated based on pulmonary function tests and respiratory volumes. Isometric physical exercise test was performed by the left hand compression of a dynamometer with the effort equal of 50% from maximum possible effort within 1 minute. Dynamic physical load was dosed as 1,0 W per 1 kg of body weight while pedalling a stationary exercise bicycle ergometer. Statistical difference between groups was determined using Student’s t-statistics. Results. Influence of dynamic and static physical exercise on respiratory function tests in 9 year old schoolgirls was studied at the beginning, in the middle and at the end of the school year. The comparative analysis of respiratory function tests in 9 year old schoolgirls at the beginning of academic year showed that isometric physical exercise caused the breath rate increase, and dynamic physical exercise led to decrease of this parameter. At the same time both types of physical exercise caused decrease in expiratory time to total breath cycle time ratio. In the middle of the academic year isometric physical exercise caused the breath rate decrease and maximum voluntary ventilation increase. As a whole, both in the middle and at the end of the academic year the respiratory system of 9 year old schoolgirls reacted adequately in reply to different types of physical exercise to optimize the performance. Conclusion. The most unfavorable reaction of respiratory system in 9 year old schoolgirls in reply to static and dynamic physical exercise at the beginning of the academic year was registered as a decrease of expiratory time to total breath cycle time ratio. The optimal reaction of respiratory system in 9 year old schoolgirls in reply to dynamic physical exercise was registered both in the middle and at the end of the school year, to static physical exercise - at the end of the school year.
The experience of polyradiomodification with the use of ozone-oxygen mixture in complex treatment of the squamous cell cervical cancer
Authors: Panov A V , Burmistrov M V , Raginov I S , Berdnikov A V , Mindubaev E Y , Mannenkov P M , Gabitova S E
Published: November 2019

Aim. To improve the results of complex treatment of stage IIb squamous cell cervical cancer. Methods. 53 patients with stage IIb squamous cell cervical cancer were included. All patients underwent combined radiotherapy (teletherapy plus brachytherapy) and were treated with intravenous cisplatin followed by hysterectomy by Wertheim. As a pre-surgical treatment 31 patients (main group) underwent rectal insufflations of ozone-oxygen mixture as a radio modifier. The original method and machine pulse oxymetry of the tumor tissue oxygenation were used. 22 (41.5%) who were included in the control group underwent combined chemoradiotherapy without use of ozone-oxygen mixture. A comparative analysis of tumor tissue post-treatment pathomorphism, chemoradiotherapy side effects rate and post-surgical complications rate was performed in both of the groups. Results. All complications were transient and could be easily managed symptomatically. Hence, there was a tendency of side effects rate and complications rate decrease in the main group. Cystitis as a complication of radiotherapy was observed in 1 (3%) patient of the main group and in 2 (9%) of the control group, proctitis - in 5 (16%) patients of the main group and in 4 (18%) patients of the control group. Leukocytopenia (I-II degree) as the most frequent hematological chemotherapy complication was registered in 7 (22%) patients of the main group and in 17 (72.2%) patients of the control group. Flu-like syndrome was observed in 1 (3%) patient of the main group and in 2 (9%) patients of the control group. There were no grade III and IV toxicity events. Proposed pre-surgical chemoradiotherapy of the localized stage IIb cervical cancer with an ozone-oxygen mixture as a radio modifier was characterized by high (grade IV) tumor tissue post-treatment pathomorphism level reaching 44.8%. Conclusion. The use of rectal insufflations of ozone-oxygen mixture allowed to decrease the rate of chemotherapy and radiotherapy complications, but the difference was not statistically significant. To increase the power of the study, more subjects are needed to be recruited with a longer follow-up.
Atomic-force microscopy in studyng hard tissues of orofacial area
Authors: Moskovskiy S N , Korshunov A S , Shestel I L , Konev V P , Hamov M A , Markovskyi S O
Published: November 2019

Aim. To study the use of atomic-force microscopy for morphological diagnosis of a bone tissue and hard tooth tissue pathology. Methods. Dental occlusion, enamel crowns and bony tooth sockets shape and size, as well as embrasures’ size and their depth, and crown height were estimated by the means of atomic-force microscopy. 30 teeth and bony fragments removed due to blunt maxillofacial trauma with signs of connective tissue hypermobility and 27 removed teeth and bony fragments from the control group were analyzed. Results. Abnormal collagen structure in hypermobility syndrome was associated with the increase of inter-fiber space to 98 nm and decrease of mineral matrix content in the bone. Enamel crowns shape and size alterations [(5.5±0.3)×(5.4±0.1) μm] as well as inter-crown space increase to 1.5±0.1 μm were found out. At the bone tissue analysis, the main distinctive feature between the control group and the patients with hypermobility syndrome was the presence of cystic lesions in the hypermobility syndrome group, accompanied by change of bone mineral structures disposition, trabeculae formation and changes of bone mineral density. In patients with hypermobility syndrome low mineralization of hydroxyapatite crystal structure, changes in spatial crystal structure as well as organic matrix disposition, all leading to enamel structure malformation due to change of interrelation between enamel organic and mineral components which is not typical for that certain period of teeth ontogenesis were found at enamel examination. Thus, in patients with connective tissue hypermobility signs of bone and enamel mineralization and structure change were found. Conclusion. The use of atomic-force microscopy allows to study the native cell cultures, including bone and hard tooth tissues, that can be used as a basis to diagnose connective tissue hypermobility as well as for identification of personality.
Complex rehabilitation of patients with cleft lip and palate at the Kemerovo center of maxillofacial area congenital pathology prevention and treatment in children
Authors: Bulgakova E A , Te IA Igor' Anatol'evich , Ahapkin S M
Published: November 2019

Aim. To increase the quality and access of children with a congenital pathology of maxillofacial area living in the Kemerovo region to the dental aid in the specialized center. Methods. Actions for reorganization of structure and activity of the Kemerovo Regional Center of maxillofacial area congenital pathology prevention and treatment in children were developed and an estimation of the efficiency of their introduction was performed using the most relevant indicators of medical, social and economic activity by the comparison of these indicators in two periods: 1999-2003 and 2005-2009. Also the quality of life of over than fifty 15-18 year old patients who have completed the treatment course in the centre was assessed using standard questionnaires. Physical, mental, social and economical well-being was assessed. Results. The structure of the Kemerovo Regional Center of maxillofacial area congenital pathology prevention and treatment in children was improved and the objectives of the Centre were corrected. The system for the patients’ account and monitoring was created, adequate diagnostic, medical and rehabilitation technologies were developed and introduced. Up to 95% of the disabled children are registered in a center’s database within the first months of life, the age of children in whom corrective surgeries (cheiloplasty and palatoplasty) are performed decreased, corrective surgeries in patients 15-18 years of age are completely over in 84.5% of the cases, 2.2% of patients still have physical disability at the age of fifteen, 48.0% of children are completely satisfied by a treatment course, their appearance and social adaptation. Conclusion. The introduction of the proposed measures allowed to provide a high quality healthcare for children with a congenital pathology of maxillofacial area, their early rehabilitation, decrease of physical disability and reduction of the state payments.
Herpes simplex infection as a risk factor for dental caries progression
Authors: Andreeva J V , Bulgakova A I , Valeev I V
Published: November 2019

Aim. To determine the individual risk of caries debut and specific features of the primary caries in patients infected with herpes simplex virus. Methods. 51 patients with primary caries (112 teeth), ICD-10 diagnosis K02.0 (Caries limited to enamel) aged 18 to 49 (female - 42) were examined, all patients were divided into two groups: patients infected with herpes simplex virus and with clinical symptoms of herpes simplex infection (main group, 33 patients), patients infected with herpes simplex virus and without any clinical symptoms of herpes simplex infection (comparison group, 18 patients). Clinical, biochemical, immunological, laser (laser fluorescence spectroscopy) diagnostic techniques were applied. Results. High titers of blood immunoglobulin G to herpes simplex virus were found in 98% of patients examined with initial caries (K02.0). The medium risk was defined in 45% of patients of the main group and in 44% of the comparison group. The navy blue indicator color was the sign of the high risk in 49% in the control group and in 50% of the comparison group. Among the patients with high risk of caries debut the mean local enamel demineralization value according to DIAGNOdent pen was 11.5±1.6 (main group) versus 7.2±1.2 (comparison group). Conclusions. The risk of further caries progression in patients with clinical manifestations of herpes simplex infection is higher compared to patients with persistent infection without signs of active virus reproduction. Biochemical rapid test Clinpro Cario L-Pop (3M ESPE) helps to obtain objective data on oral microflora activity. The use of KaVo «DIAGNOdent pen» device is necessary for the further monitoring of caries progression.
Influence of the local anesthetics solutions’ temperature on muscular action potential amplitude decrease at brachial plexus block
Authors: Safin R R , Anisimov O G
Published: November 2019

Aim. To study influence of temperature of local anesthetics solutions on effectiveness of brachial plexus block using axillary access. Methods. Patients who underwent arm and hand surgeries were randomized either to the main group (n=25) or to the control group (n=25). In the main group, 1% lidocaine (20 ml) and 0.25% ropivacaine (40 ml - males, 30 ml - females) at 38 °C were used for brachial plexus block using axillary access. In the control group, anesthetics at room temperature were used. Brachial plexus block was performed using the axillary access at m. pectoralis major margin above the a. axillaris pulsation point. To register provoked muscular action potentials, a portative neurodiagnostic system «Nicolet One» was used. The percentage of provoked muscular action potential amplitude decrease was counted with results of a measurement before the block as a baseline. For additional analgesia and sedation phentanylum 0.005% was used until Ramsay sedation score II was achieved. «EZSAT-E» software package was used for data analysis. Results. In the main group brachial plexus block was achieved 14.2±3.4 minutes earlier than in the control group. Phentanylum dose required to provide psychic and emotional comfort was 45.4% lower in the main group (3.0±0.9 μg/kg per hour) compared to the control group (5.5±1.7 μg/kg per hour). Conclusion. The use of local anesthetics solutions at body temperature increases the efficiency of brachial plexus block and reduces the time of it’s achievement, increases it’s analgesic potential and decreases the need for narcotic analgesics to provide psychic and emotional comfort for the patient.
Predictors of epileptic seizures - retrospective analysis
Authors: Kruchkova M V , Porunov A A , Ismagilov M F , Gamirova R G
Published: November 2019

The article surveys the data from domestic and international studies regarding the evolution of thoughts and contemporary point of view at epileptic seizure predictors, considering data from experimental and laboratory studies as well as from clinical studies. The provisional epileptic seizure predictors classification is proposed. The characteristics of the included predictors is given, the need for direct comparison considering results of laboratory studies on biological models as well as clinical trials on biologic objects is underlined.
Clinical pharmacology - one of the world health organization strategies in promoting rational use of medicines
Authors: Shaydullina L Y , Ziganshina L E
Published: November 2019

The review covers the history of Clinical Pharmacology discipline origin from the thirties of the twentieth century until now. Establishment of the research group on clinical pharmacology by the World Health Organization in 1969 is surveyed. The current status of clinical pharmacology in Russia is described with emphasis on potential impact of the discipline on health system in the rational use of medicines and access to medicines. The connection between clinical pharmacology development and pharmaceutical regulation and «thalidomide tragedy» of the sixties is traced. The main developing sections of the discipline of Clinical Pharmacology: pharmacoepidemiology, pharmacoeconomics, pharmacogenetics, pharmacovigilance and drug clinical trials are presented. The objectives and phases of clinical trials, the current problems of their conduction - global and Russian - are presented. Perspectives for the clinical pharmacology development using the evidence-based medicine approach are reviewed. Review reveals the multidisciplinary nature of clinical pharmacology, its bridging role between the fundamental and practical clinical disciplines, and a close connection with the development of healthcare system. Problems of clinical pharmacologists’ training and employment are discussed. The review presents the current status and development of the discipline in different countries and in the Russian Federation with reference to the federal regulations and laws. The potential of clinical pharmacology as a research, teaching and practicing medical discipline allowing the healthcare system to ensure the rational use of medicines providing drug efficiency, safety and affordability for the population is described. The results of the own authors’ research of the impact of clinical pharmacology services introduction in the practice of internal diseases departments of Kazan municipal hospitals on the outcome of coronary heart disease are presented with consideration of the various confounding factors. Review explains the need for wide use of clinical pharmacology potentials on all levels of healthcare system, particularly for administrative decision-making
Clinical and epidemiological features of neonatal hepatitises
Authors: Khaertynov Kh S , Anokhin V A , Nizamova E R
Published: November 2019

Neonatal hepatitis is one of the most actual problems of children under 6 months of age. The term «neonatal hepatitis» includes infectious liver injury which develops in antenatal period or occurrs during first 3 months of life. The most common causes of liver damage in newborns are viral infections including cytomegalovirus, herpes simplex virus, enteroviruses, parvoviruses, hepatitis B and C viruses. Nowadays the most frequent perinatal infection is cytomegalovirus (1-2% of all newborns). It manifests clinically in 10-15% of cases, with liver involved in 40-63,3% of cases. Mother-to-infant transmission of hepatitis B and C viruses is usually intranatal, transplacental transmission is rare. Mother-to-infant transmission of other hepatotropic viruses (A, D and E) is very rare. A number of hereditary diseases associated with metabolic disorders (amino acids, carbohydrates, lipids, bile acids) and enzyme deficiencies (arginase deficiency, hemochromatosis), etc. can mimicry the clinical picture of neonatal hepatitis. Liver damage can be the only manifestation of perinatal infection (hepatitis B and C, herpes viruses) or come along with other organ damage (generalized herpes virus infection, bacterial infections, toxoplasmosis). Perinatal hepatitis B and C are usually chronic. Neonatal hepatitis caused by herpes simplex virus is usually an acute, possibly fulminant infection. Neonatal hepatitis caused by cytomegalovirus has a variety of clinical subtypes: from a non-jaundice type (with a good prognosis) to a cholestatic form (with possible formation of biliary atresia and liver cirrhosis). Thus, different neonatal hepatitises have their particular features. Wide spectrum of laboratory tests available nowadays allows to define the exact reason for neonatal hepatitis and its clinical course.
Primary arterial hypertension in athletes
Authors: Sadykova D I , Lutfullin I Y
Published: November 2019

Intensive sports does not exclude the development of primary arterial hypertension in athletes, even considering that physical activity is considered as one of the primary preventive factors for this disease. Key features of interrelation between blood pressure regulation and intense physical activity are surveyed, features of etiology and pathogenesis of arterial hypertension in athletes are covered, data on specific arterial hypertension factors for athletes are provided in the article. The international criteria of primary arterial hypertension diagnosis in athletes (according to 36th Bethesda Conference, 2005) are listed, as well as local 2011 recommendations. Medical treatment algorithms of primary arterial hypertension in athletes are given, considering international anti-doping requirements for different sports. The principles of athletes with primary arterial hypertension medical admission to competitive sports are described, criteria for physical exercise limitations and complete retirement from sports are provided.
Sarcoidosis of the orbit as the first manifestation of systemic sarcoidosis (clinical case)
Authors: Tezeva A S , Samoylov A N
Published: November 2019

A clinical case of sarcoidosis of the orbit as the first manifestation of systemic sarcoidosis is presented. A patient (born 1961) was referred with diplopia, gradual visual acuity of both eyes decrease during the last 8 years. The objective status at the ophthalmologist examination in 2009: temporal deviation of both eyes (10° right, 15° left), I degree left-side ptosis. Refraction -2,5 dioptre. Eye convergence and abduction impairment. Oculus Uterque - cornea is transparent, conjunctive appears normal, the anterior chamber is of medium depth, aqueous humor is transparent, iris is structured, the pupil is round, light reaction is normal, nuclear sclerosis. «String of pearls» opacity of vitreous body. The fundus of the eye: optic disc is pale pink with temporal discoloration, temporal border is not sharp, arteries are contracted, twisted, veins are of different caliber, macular reflex is fuzzy. Consolidation locus 0.9 mm with an acoustic above the optic nerve projection and posterior acoustic enhancement were found on the B-scan ocular ultrasonography. No signs of a mass were observed. Retroocular tissues are of normal density, with hyperintense 0.5-0.9 mm focuses in the internal segment (ultrasonographic signs of fibrosis). A diagnosis of orbital granulomas was proposed, the preliminary diagnosis: «Eye sarcoidosis, orbit sarcoidosis, sarcoid angiopathy». In June 2009 patient developed a nodular erythema on lower limbs, reported the joint pain, fever. Lung dissemination was determined on the chest X-ray, the patient was referred to phtysiologist and pulmonologist. The Mantoux test of 2 TU was negative, the diagnosis of tuberculosis was ruled out. The adequate therapy was administered. Thus, the eye involvement can be the first and only clinical feature of sarcoidosis and make the physician think about the systemic disorder debut.
The influence of air pollution on children’s eye
Authors: Amirov A N , Saifullina F R , Plotnikov D Y
Published: November 2019

An intensive man-made emission is typical for a modern world. Air pollution has a great impact on public health. Children are the most vulnerable to the influence of unfavorable environmental factors that affect different organs and systems. Not only physical, but also mental health is affected. There are little data on the impact of environmental pollution on the eye diseases in children available. When analyzing the eye diseases in children living in unfavorable environment, functional and organic changes of visual system were found as an evidence of negative role of air pollution. Microcirculation and metabolism impairments affecting the characteristics of the sclera can occur. The influence of man-made pollution on children’s eye may be indirect and cause different eye diseases including development of refractive vision defect.
Educational process at the department of ophtalmology of Kazan state medical university. Stages of establishment and set up
Authors: Nugumanova A M , Khamitova G K , Samoilov A N
Published: November 2019

In 2012 it will be 205 years since the teaching of ophthalmology was started in Kazan. Since that time the teaching methodic has passed different stages starting from simple passive teaching to complex interactive teaching using the curricula modules. The method was introduced at the department in 2010 according to the latest state educational standard. The curricula is formed by several modules (practical skills, emergencies in ophthalmology, terminology) that are scored separately. The approach allows to increase the students’ activity at the classes, motivates for advanced reading and out-of-class studying and helps to acquire all the skills and knowledge better.
Features of tear production in patients with chronic hepatitis C
Authors: Akberova G E , Saifullina F R
Published: November 2019

Aim. To study the features of tear production in patients with chronic hepatitis C, depending on the duration of infection. Methods. 40 patients (80 eyes) with chronic hepatitis C infection (first group - 11 patients, chronic hepatitis C duration up to 3 years, second group - 10 patients, chronic hepatitis C duration 3 to 5 years, third group - 19 patients, chronic hepatitis C duration over 5 years). The control group consisted of 20 healthy subjects (40 eyes). All study subjects underwent standard ophthalmic examination, a set of clinical, epidemiological and laboratory studies; the level of total tear production was examined by the Schirmer’s test. Results. Eye pathologies were determined in patients with chronic hepatitis C. Total tear production in patients with chronic hepatitis C was 1.82±0.09 mm compared to 2.2±0.06 mm in the control group. At the early stages of chronic hepatitis C (duration up to 3 years) tear production has changed diversely: it increased in 27.2% of patients and decreased in 18.8% of patients. At the later stages of chronic hepatitis C (duration over 5 years) tear production increased only in 15.8% of patients and decreased in 52.6% of patients. Conclusion. In patients with chronic hepatitis C total tear production changes depending on the duration and the severity of infection, which should be considered in the diagnosis, monitoring and treatment of ophthalmic diseases in patients with chronic hepatitis C infection.
Medical and social factors impact in myopia development
Authors: Mingazova E N , Samoilov A N , Shiller S I
Published: November 2019

Aim. To elaborate a mathematical model of individual myopia development and progression risk in school students who study using innovative programs. Methods. 372 students of №19 gymnasium, Kazan, Russia, were examined. Students were divided into two groups: the first group - students with emmetropia (180 subjects) and the second group - students with myopia (192 subjects). Age distribution (junior students aged 7-9 years - 111 subjects, middle school students aged 12-14 years - 147 subjects, senior students aged 16-17 years - 114 subjects) was taken into account. Results. Factors influencing the visual acuity deterioration in school students were combined into five groups: medical and biological, social and hygienic, visual load, behavioral and alimentary. The visual load had the highest impact (52.8% - for male students, 51.7% - for female students), with behavioral factors on the second place (39.0% - for male students, 41.61% - for female students), alimentary factors on the third place (36.46 and 41.38% accordingly), medical and biological factors on the fourth place (24.80 and 29.09%) and with social and hygienic factors at the bottom (20.69 and 27.74%). Conclusion. The overall sum of the prognostic coefficients allows to define the risk of myopia on case-to-case basis and to distribute the student to a prognosis group. Basing on this approach. it is possible to develop personalized recommendations for myopia prevention targeting on the most important unfavorable prognostic factors.
Microcirculation disorders in bulbar conjunctiva of patients with chronic viral hepatitis
Authors: Akberova G E , Saifullina F R , Khaertynova I M
Published: November 2019

Aim. To study the features of microcirculation in bulbar conjunctiva of patients with chronic hepatitis C depending on the duration of the infection. Methods. 40 patients (80 eyes) with chronic hepatitis C were observed: the first group consisted of 11 patients, chronic hepatitis C duration up to 3 years, second group - 10 patients, chronic hepatitis C duration 5 to 3 years, third group - 19 patients, chronic hepatitis C duration over 5 years. The control group consisted of 20 healthy subjects (40 eyes). The microcirculation in bulbar conjunctiva was assessed using biomicroscopy. Arterioles, veins and capillaries were distinguished by the direction and speed of the blood flow, the vessel diameter, configuration and branching, observed changes were scored. Liver enzymes levels were assessed, as well as levels of immunoglobulins M and G to hepatitis C virus, polymerase chain reaction was performed to define the presence of viral RNA. Results. Microcirculation disorders (perivascular, vascular and intravascular changes) in bulbar conjunctiva were found in all of the patients with chronic hepatitis C compared to the control group. There was a link between total conjunctiva index and the duration of the infection as well as liver enzymes levels. In the first group total conjunctiva index was scored as 11,52±0,7, 14,0±1,18 - in the second group, 19,3±0,84 - in the third group. Conclusion. Microcirculation disorders are present in all patients with chronic hepatitis C, that should be considered while monitoring and choosing the optimal treatment.
Effectiveness of 0.02% pentahydroxyethylnaphtoquinone (hystochrome) in patients with active and fibrous stages of retinopathy of prematurity
Authors: Petrova N I , Rascheskov A Y , Bolgova L P , Habibullina N M
Published: November 2019

Aim. To study the effectiveness and safety of pentahydroxyethylnaphtoquinone (Hystochrome) in patients with active and fibrous stages of retinopathy of prematurity. Methods. 281 prematurely born babies: first group - 63 patients with retinopathy of prematurity stages I-II and vast non-vascular area; second group - 201 baby with stage III retinopathy of prematurity and posterior aggressive form of retinopathy after the performed retinal laser photocoagulation; third group - 17 babies with subtotal intraocular hemorrhage - were followed up. In addition, 29 children with fibrous stage of retinopathy of prematurity were observed. Pentahydroxyethylnaphtoquinone (Hystochrome) was used as epibulbar instillations and peribulbar injections. To assess the treatment results, examination using the «RETCAM-120» system, B-scan ultrasonography using the «AVISO» scanner and visual evoked potentials examination with flash light stimulus using the «Neuro-MVP» device were performed. Results. In babies from the first group the improvement of electrophysiological parameters was observed in 20% of cases after treatment with pentahydroxyethylnaphtoquinone, compared to 4% in control group. In the second group pentahydroxyethylnaphtoquinone improved the electrophysiological parameters in 39% of cases. In the third group (17 babies with subtotal intraocular hemorrhage) the hemorrhage degradation was twice more rapid compared to controls. There was no effect from pentahydroxyethylnaphtoquinone treatment at the late stages of the disease. No adverse effects were registered. Conclusion. Pentahydroxyethylnaphtoquinone (Hystochrome) has shown good effectiveness and safety while treating patients with non-proliferative stages of retinopathy of prematurity and vitreous hemorrhage.
Change of electrical impedance measurements on brain in patients with the «dry» form of age-related macular degeneration treated with polarized polychromatic non-coherent light and dynamic electromyostimulation
Authors: Saifullina F R , Sharafieva R Z , Pogorel’tsev V I , Abdulaeva E A
Published: November 2019

Aim. To study the change of electrical impedance measurements in brain in patients with the «dry» form of age-related macular degeneration before and after combined treatment with polarized polychromatic non-coherent light and dynamic electromyostimulation. Methods. Two groups of patients with the «dry» form of age-related macular degeneration were examined. 40 patients (80 eyes) from the main group were treated using combined treatment and 39 patients (78 eyes) in the group of control who were treated conventionally. Results. Before the treatment, decreased blood flow in the internal carotid artery was found in 77.2%, and in the vertebral arteries in 82.2% of patients. Peak amplitude and the stress ratio index at rheoencephalography in the anterior cerebral circulation were 0.83±0.04 Ω and 27.46±0.40%, in the posterior cerebral circulation - 0.70±0.04 Ω and 23.78±0.35%. Peak amplitude values and the stress ratio index have improved significantly right after treatment and after 6 months in the main group compared to the control group. Mean visual acuity in the main group before treatment was 0.87±0.02, right after the treatment - 0.96±0.01 (p 0.001), 2 months after the treatment - 0.95±0.01 (p 0.001), 6 months after the treatment - 0.96±0.01 (p 0.001), 12 months after the treatment - 0.95±0.01 (p 0.001). In the control group mean visual acuity was 0.91±0.02 before the treatment, 0.95±0.02 (p 0.05) - right after the treatment. 2 months after the treatment - 0.94±0.02 (p 0.05), 6 months after the treatment - 0.92±0.02 (p 0.05). 12 months after the treatment mean visual acuity decreased and equaled 0.89±0.02. Decrease of anterior cerebral circulation was found in 77.2% of patients with the «dry» form of age-related macular degeneration, mean peak amplitude value was 0.83±0.04 Ω and the stress ratio index was 27.46±0.40%, decrease of posterior cerebral circulation was found in 82.2% of patients, mean peak amplitude value and the stress ratio index were 0.70±0.04 Ω and 23.78±0.35%. Conclusion. In patients with the «dry» form of age-related macular degeneration posterior cerebral circulation has improved significantly and visual acuity has improved 6 months after combined treatment with polarized polychromatic non-coherent light and dynamic electromyostimulation.
Eye vessels doppler sonography and optical coherence tomography in assessing the effectiveness of treatment of patients with diabetic retinopathy
Authors: Samoilov A N , Khafizjanova R H , Gainutdinova R F , Gilyazova A R , Tukhbatullin M G
Published: November 2019

Aim. To study the properties of eye vessels Doppler sonography and retinal optical coherence tomography in assessing the treatment effectiveness in patients with diabetic retinopathy. Methods. 122 patients (244 eyes) with type 2 diabetes mellitus and nonproliferative diabetic retinopathy aged 41 to 55 years were examined. The disease duration ranged from 2 to 15 years. All patients were treated with glibenclamide and supportive therapy: eye drops of 1% methylethylpiridinol - 1 drop 3 times a day, 20% pyracetam solution - 5 ml intravenously for 14 days. Patients were divided into 4 groups: 1st group included 30 patients who were administered with Hirudo powder, 2nd group consisted of 32 patients treated with Hirudo powder in combination with laser photocoagulation, 3rd group included 30 patients treated by laser photocoagulation and 4th group consisted of 30 patients who were treated with glibenclamide and supportive therapy only. All patients were examined before and 4 days after treatment, examination included standard ophthalmic examination, retinal optical coherence tomography and eye vessels pulsed color Doppler sonography. Results. Improvement of circulation parameters resulting in increased blood flow speed and decrease of vascular resistance index, as well as visual acuity improvement, reduction of macular edema were registered in the first group after the treatment. In the 2nd group, significant improvement of circulation parameters as increased blood flow speed and decrease of vascular resistance index, visual acuity increase, reducing of the area and height of macular edema were observed. In the 3rd group, deterioration of circulation parameters as decreased blood flow speed and increase of vascular resistance index, slight visual acuity increase and reducing of the area and macular edema height were observed. In the 4th group improvement of circulation parameters was non-significant as well as visual acuity change and retinal condition. Thus, combination of Hirudo powder and retinal laser photocoagulation was the most effective method, leading to improvement of circulation parameters, visual acuity increase, reduction of macular edema. Conclusion. Quantitative analysis of retinal optical coherence tomography and eye vessels Doppler sonography parameters and their link to visual acuity testing allows to assess completely the effectiveness of conducted treatment.
Features of ophthalmic disorders in patients with chronic viral hepatitis C before and after antiviral treatment
Authors: Akberova G E , Saifullina F R , Khaertynova I M
Published: November 2019

Aim. To study the features of ophthalmic disorders in patients with chronic viral hepatitis C before and after antiviral treatment. Methods. 40 patients (80 eyes) with chronic hepatitis C were observed (the main group). The control group consisted of 20 healthy subjects (40 eyes). To diagnose chronic hepatitis C infection and to assess liver damage a set of clinical, epidemiological and laboratory tests was performed. All patients underwent liver ultrasonography. The diagnosis of chronic hepatitis C was set up according to presence of immunoglobulin M and G to hepatitis C virus and presence of viral RNA on polymerase chain reaction in peripheral blood. Along with standard opthalmic examination, visual field testing using the white and chromatic light and visual lability testing were performed. Results. Color vision impairments were diagnosed in 50% of patients with chronic hepatitis C, with decreased visual lability for the red and green colors in 100% of cases. After 6 months of antiviral treatment restoration of visual function was observed. The durability of visual impairments in patients with chronic hepatitis C depended on the severity of the disease. Conclusion. In patients with chronic hepatitis C with the short term of the disease ophthalmic disorders such as decreased peripheral vision, color vision impairments, decreased visual lability are reversible.
Dynamics of the content of histamine in the blood cells of patients with angina under the influence of low intensity laser exposure
Authors: Sapozhnikov M Yu , Sapozhnikova A A , Pavlov A F , Sapozhnikova S Yu , Sofronova E V
Published: November 2019

Aim. To study the dynamics of the content of histamine in blood cells of patients with angina under the influence of laser therapy. Methods. Investigated was the effect of continuous low-intensity laser radiation on the content of histamine in blood cell of 124 patients with stable angina and 32 practically healthy individuals. Results. In patients with angina the content of histamine in blood cell was higher than in healthy individuals. Under the influence of laser therapy, which was applied to acupuncture points - the «meridians» of the heart and pericardium, the content of histamine decreased and by the end of treatment was the same as in healthy individuals. Conclusion. Laser therapy has a favorable effect on the content of histamine in patients with angina.
Results of surgical treatment of cardiac myxomas
Authors: Korostelev A N , Kiprensky A Yu , Kiprensky Yu V , Gerasimov A N
Published: November 2019

Aim. To determine the algorithm of in vivo diagnosis and surgical treatment of cardiac myxomas. Methods. Summarized was the experience of diagnosis and surgical treatment of 65 cases of cardiac myxomas. Examination of patients included electrocardiography, phonocardiography, radiography, angiocardiography, selective coronary angiography, two-dimensional transthoracic echocardiography, transesophageal echocardiography, computed tomography and magnetic resonance imaging with contrast, a biopsy, and a morphological study. Results. Among the examined patients (mean age 42.4±1.5 years) cardiac myxomas were diagnosed, which were localized in the left and/or right chambers of the heart. All patients underwent surgery. The tactics of surgical treatment were dependant on the tumor size, its mobility, involvement of the valve apparatus and conduction pathways of the heart into the pathological process, and concomitant diseases. The prognosis of the natural course of cardiac myxomas is unfavorable. In the diagnosis of space-occupying lesions (myxomas) of the heart chambers, which are often combined with valvular pathology, the most informative are echocardiography, computed tomography and magnetic resonance imaging. The final verification of the diagnosis should be made using emergency and routine pathological studies. Conclusion. Timely surgical removal of the myxomas with simultaneous correction of the concomitant cardiac pathology makes it possible to restore the intracardiac haemodynamics and to prevent thromboembolic complications.
Endoscopic ultrasonography in the diagnosis of thrombosis of the portal blood vessels in patients with infected pancreatic necrosis
Authors: Andreev A I , Anisimov A Yu
Published: November 2019

Aim. To study the effectiveness of endoscopic ultrasound investigation in the diagnosis of thrombosis of blood vessels of the portal system. Methods. Endoscopic investigation using an ultrasound gastric videoscope manufactured by «Olimpus» was performed in 35 patients who had suffered from infected pancreatic necrosis (the main group) and in 10 healthy volunteers (the control group). Results. In the control group of healthy volunteers no signs of thrombosis of the blood vessels of the portal system were revealed. In the main group thrombosis of the blood vessels of the portal system was detected in 12 patients (34.3% of cases) during endoscopic ultrasound investigation, of which in 3 patients (25%) the thrombus was localized in the splenic vein, and in 9 patients (75%) - in the portal vein. In 10 (83.3%) patients identified were varicose veins of different localization and degrees of severity, including 4 patients (40%) - with esophageal varices, and 6 patients (60%) - with dilated varicose veins of the gastric cardia. Conclusion. Endoscopic ultrasound investigation, being a highly informative non-invasive diagnostic method, provides objective information about the presence of portal vein thrombosis and the extent of transformation of varicose veins of the esophagus and stomach.
The effect of preoperative chemoradiotherapy on the latency of the genital nerve and the contractility of the anal sphincter
Authors: Shelygin Yu A , Rasulov A O , Dzhanaev Yu A , Boyko A V , Droshneva I V
Published: November 2019

Aim. To study the effect of chemoradiotherapy on the latency of genital nerves and contractility of the anal sphincter in patients with rectal cancer. Methods. Analyzed were 20 cases of rectal cancer T2-3NXM0 (12 males, 8 females). Complex treatment included preoperative chemoradiation therapy (total focal dose 47 Gy, fluorouracil - 2.5-3 g, cisplatin - 90 mg), surgical intervention and postoperative adjuvant chemotherapy for the period from 2009 to 2010. Before the initiation and after the chemoradiotherapy conducted was an evaluation of latency of the genital nerve and needle electromyography of the anal sphincter. Results. Due to the conduction of chemoradiotherapy the median latency of the right branch in males increased significantly from 2.9 to 4.3 ms, in females from 2.1 to 2.4 ms. The increase in the latency of the left branch of the genital nerve was observed in males (from 5.4 to 10.9 ms), while in women registered was a decrease of the indices (from 4.3 to 2.5 ms). A significant reduction of the potential of the external sphincter at rest (from 226.5±157.3 to 196.9±141 mV) and during conation (from 369.7±226.4 to 262.4±138.1 mV), regardless of gender. Conclusion. Conduction of preoperative chemoradiotherapy for cancer of the lower and middle ampullary part of the rectum leads to a decrease in the conduction speed along the genital nerve predominantly in male patients, and is accompanied by a decrease in electrical potentials of the external anal sphincter.
Lipid criterion of hardness as an auxiliary parameter during investigation of the lens nucleus in cataract patients
Authors: Chuprov A D , Kudryavtseva J V
Published: November 2019

Aim. To identify the lipid markers of changes in the mechanical characteristics of the lens nucleus on the example of sulfur gland secretions of the ear canal. Methods. Examined were 50 patients aged from 52 to 83 years with cataracts of varying degrees of maturity. Studied was the composition of the higher fatty acids of the lens nucleus and of the earwax in patients. The evaluation of lens nucleus hardness was performed on an original device. Results. Palmitic acid, stearic acid and polyunsaturated fatty acids were dominant in the earwax, less was the content of lauric and linolenic acids. Revealed was a strong correlation between the content of polyunsaturated fatty acids in the earwax and the hardness of the lens. Developed was a method for predicting the hardness of the lens nucleus and for evaluating lipid metabolism in the lens. Conclusion. Lipid composition of the earwax may serve as an auxiliary parameter for determining the hardness of the lens nucleus and for justification of the choice of lens phacoemulsification method.