bluuebunny/crossref_metadata_2025 huggingface dataset:
Reactions of Subcutaneous Cellular Tissue in Response to the Implantation of a Polypropylene Endoprosthesis Modified with a Polycaprolactone Solution by Electrospinning
Authors: Bereschenko V. V. , Nadyrov E. A. , Lyzikov A. N. , Petrenyov D. R. , Kondrachuk A. N.
Published: November 2021

Objective: to study the morphological features of subcutaneous tissue in response to the implantation of a polypropylene mesh endoprosthesis (PSE) modified with a polycaprolactone solution by the method of electrospinning.

Material and methods. The object of the study was modified polypropylene mesh endoprostheses implanted in experimental animals. The animals were removed from the experiment on the 3rd, 7th, 60th day of the experiment. Subcutaneous fatty tissue along with the implanted material and regional lymph nodes were fixed in a 10 % solution of neutral formalin, followed by histological posting according to the standard technique and filled with paraffin. Histological sections 3-4 μm thick were stained with hematoxylin and eosin. The morphological assessment of reactions to the implantation of the materials was carried out by means of the calculation of the cellular elements of inflammatory and connective tissue origin along the periphery of the implants (neutrophilic leukocytes, phagocytic neutrophilic leukocytes, degenerating neutrophilic leukocytes, eosinophilic leukocytes, lymphocytes, plasmacytes, histiocytes, macrophages, fibrocytes, fibroblasts, multinucleated giant cells).

Results. The study of the cellular composition has showed a statistically significant increase in the content of fibrocytes (p = 0.002) and fibroblasts (p < 0.001) on the 7th day of observation around the modified PSE. On the 60th day, the number of neutrophilic leukocytes at the periphery of the modified PSE was lower than that of the control sample (p = 0.004). The enhancement of the fibroplastic properties of the samples modified with polycaprolactone by electrospinning was characterized by a less pronounced inflammatory reaction of the peripheral tissues.

Conclusion. The obtained data are indicative of the fact that the modification of PSE with polycaprolactone reduces the reactive properties of endoprostheses and make it possible to recommend to introduce this method of PSE modification in clinical practice.
Features of the Organism`s Adaptation of Female Obstetrician-Gynecologists to the Existing Working Conditions
Authors: Lisok E. S. , Naumov I. A.
Published: November 2021

Objective: to establish the features of the organism`s adaptation of female obstetrician-gynecologists to the existing working conditions .

Material and methods. The features of the organism`s adaptation of female obstetrician-gynecologists (main group, n = 64) of in-patient and maternity welfare clinics, therapists of local territorial out-patient clinics (comparison group, n = 31), as well as female employees of health organizations with higher education not providing medical care (control group, n = 31) to the existing working conditions were evaluated on the basis of sociological, hygienic, and statistical research methods.

Results. The obstetrician-gynecologists worked in harmful working conditions: class 3.3. - in the in-patient hospitals and class 3.2. - in the out-patient clinics. Almost half of the examined female obstetrician-gynecologists revealed decreased adaptive reserves of the organism, whose degree of manifestation was reliably different from the women of the control group (p ˂ 0.05).

Conclusion. The harmful working conditions at the workplaces of female obstetrician-gynecologists lead to the breakdown of the organism`s adaptive mechanisms and create a professional risk for the subsequent development of a wide range of somatic pathologies.
Monoclonal Gammopathy of Undetermined Significance and Multiple Myeloma in the Practice of the General Practitioner
Authors: Kozich Zh. M. , Smirnova L. A. , Martinkov V. N.
Published: November 2021

Multiple myeloma is an incurable malignancy of hematopoietic tissue characterized by lesions of the bone marrow, presence of multiple destructive processes within bone tissue, kidney damage, and infectious complications. Up to 60 % cases of newly diagnosed multiple myeloma debut from monoclonal gammopathy.

Monoclonal gammopathies are a large group of diseases whose distinctive feature is the secretion of pathologic immunoglobulins called monoclonal proteins (synthesized in abundant quantities immunoglobulins of one class or/and type whose chemical structure, molecular mass, and immunological features have been changed). Most often monoclonal protein is a biomarker of clonal cell proliferation. Besides plasma cell tumors paraprotein secretion is often common for other lymphoproliferative diseases, some kidney diseases, systemic diseases of connective tissue, primary amyloidosis, solid tumors, liver lesions, sarcoidosis, Gaucher disease, Sjogren syndrome, cold agglutinin diseases, and some meurologic pathologies.

The article presents the main clinical and pathologic features of monoclonal gammopathy and multiple myeloma and describes clinical cases indicative of complicated diagnosis of multiple myeloma and the necessity for continuous monitoring of patients with monoclonal gammopathy.
Ultrasound-Guided Radiofrequency Ablation of Liver Tumors — Analysis of Immediate Outcomes at Gomel Regional Clinical Oncology Center
Authors: Murashko K. L. , Sorokin V. G.
Published: November 2021

Objective:to systematize the existing techniques of ultrasound-guided percutaneous radiofrequency ablation.

Materials.The research subjects were 34 patients with focal liver malignancies who had undergone radiofrequency ablation at Gomel Regional Clinical Oncology Center from 2014 to 2019.

Results.The data about the existing techniques of ultrasound-guided percutaneous radiofrequency ablation have been systematized. The possibilities to increase the ablation efficiency of the liver tumor foci have been determined. The main components of the treatment algorithm that allow to achieve the best ablation results have been identified.

Conclusion.Strict adherence to the described techniques of radiofrequency ablation which takes into account tumor vascularisation makes it possible to achieve complete necrosis of the foci with no complications in 82.4 % of the patients, and minor complications that do not require therapy in 17.7 % of the patients [9].
Efficiency of the Endovascular Correction of Clinically Evident Degrees of Chronic Obliterating Lower Limb Diseases in Multisegment Lesions
Authors: Gorokhovsky S. Yu. , Lyzikov A. A. , Kaplan M. L. , Tihmanovich V. E.
Published: November 2021

Objective: to evaluate the efficiency and extent of endovascular revascularization in patients with multisegment lesions in chronic obliterating diseases of the lower limb arteries.

Material and methods. The outcomes of the endovascular correction of multisegment lesions of the lower limb arteries were analyzed in 10 patients.

Results. After the treatment the patients revealed a statistically significant change (increase of the value) of the ankle-brachial index (ABI) (p = 0.001). The ABI value after the surgical intervention amounted to 0.81 (0.71; 0.87), which was connected with a favourable prognosis for such patients. Аccording to the established criteria, the outcomes of the interventions comprised the decrease of the degree of chronic arterial insufficiency (p < 0.01), all the patients were discharged having no clinical manifestations of critical lower limb ischemia or decreased evidence of intermittent claudication.

Conclusion. The majority of patients with clinically evident ischemia of the lower limbs suffer from multisegment arterial lesion (the number of the segments exceeds 2), which entails the need of multiple corrections in one patient. Meanwhile, the evaluation of the treatment results is possible only in the postoperative period according to the indirect criteria. Therefore, during the operation there arises the need to develop a method of the objective intraoperative evaluation of the extent and efficiency of the performed correction of arterial lesions on each segment.
Role of Caudal Blockade in the Modulation of Stress Response in the Surgical Correction of Congenital Malformations of the Lower Parts of the Urogenital System in Children
Authors: Karamyshev A. M.
Published: November 2021

Objective:to assess the efficiency and safety of an anesthetic technique during the surgical correction of congenital malformations of the lower departments of the urogenital system in children by means of the comparative analysis of laboratory and hemodynamic indices, as well as the course of the early postoperative period, development of adverse effects during the anesthesia.

Material and methods.Depending on the type of anesthesia, all patients (127 boys) were divided into 3 clinical groups: those operated under multicomponent balanced inhalation anesthesia (group 1, n = 37), under general laryngeal mask anesthesia in combination with caudal blockade with a local anesthetic solution (group 2, n = 45), under general laryngeal mask anesthesia with caudal blockade with the combination of a local anesthetic solution and adjuvant (group 3, n = 45).

Results.The performed analysis of the parameters of hemodynamics, levels of cortisol, glucose, lactate and interleukin-6 (IL-6), as well as the quality, duration, depth of anesthesia and the necessity for an inhalation anesthetic, the assessment of complications and the adverse effects have revealed statistically significant differences indicative of a more effective blockade of the pain sensitivity in the combined application of general and regional anesthesia.

Conclusion.The technique of combined anesthesia with the application of the combination of 0.25 % bupivacaine solution and adjuvant to 0.1 % morphine has shown the best efficiency and safety during the surgical correction of congenital malformations of the lower departments of the urogenital system in the children.
Comparative Analysis of the Methods for the Diagnosis of Sleep Disordered Breathing
Authors: Serebrova E. V. , Malkov A. B. , Usova N. N.
Published: November 2021

Objective: to assess the effectiveness of the diagnosis of sleep apnea syndrome by the methods of respiratory monitoring and polysomnogaphу.

Material and methods. 40 patients were examined (19 men and 21 women, their average age was 54 ± 14. All the patients underwent respiratory monitoring and polysomnography.

Results. The comparative analysis of the parameters of sleep disordered breathing obtained by the methods of respiratory monitoring and polysomnography has revealed no significant differences in such main diagnostic indicators as index apnea/ hypopnea, apnea index, hypopnea index, snoring index, desaturation index, average SPO2 (p> 0.05). In the diagnosis of sleep apnea syndrome, the method of respiratory monitoring has showed a sensitivity of 96.7 %, specificity of 70.0 %, accuracy of 83.3 %, positive predictive value of 90.6 and negative predictive value of 87.5.

Conclusion. Respiratory monitoring is comparable to polysomnography in terms of the main significant diagnostic indicators of sleep disordered breathing and taking in account its cheapness and easiness of performance may serve as an alternative to polysomnography.
Surgical Anatomy of the Extraorganic Anastomoses of the Middle Rectal Artery
Authors: Kuzmenko A. V.
Published: November 2021

Objective: to determine the topography variants and quantity of the extraorganic anastomoses of the middle rectal artery.

Material and methods. 206 cadavers of males (aged 22-82) and 113 cadavers of females (aged 32-93) who had died of accidental causes not related to pelvic pathology were used as the research material. The vascular injection, preparation methods, and statistical analysis of the obtained data were used to achieve the aim of the research.

Results. It has been found out that most often the extraorganic anastomoses of the middle rectal artery are formed in the proximal and middle thirds of the artery, significantly rarely - in its distal third. A linear correlation between the sizes of the diameters of the internal pudendal artery and the sizes of the diameters of its extraorganic anastomoses has been detected in the males and females.

Conclusion. The performed research has demonstrated that the extraorganic anastomoses of the middle rectal artery in males and females have a definite pattern of origination.
Variety in Topography of Small Saphenous Vein in the Popliteal Fossa
Authors: Semeniaha S. A. , Zhdanovich V. N.
Published: November 2021

Objective: to describe the possible types of the interrelations of the small saphenous vein and popliteal vein within the area of the popliteal fossa, as well as to study the distribution of the types among patients of both the genders and different somatotypes.

Material and methods. 163 patients (326 extremities) of both the genders without signs of vascular pathology were examined by the method of duplex ultrasound scanning. According to Chernorutsky`s classification, the patients were divided into three groups: dolihomorphs, mesomorphs, brachymorphs. The percentage of different types of the topography of the small saphenous vein was calculated among the examined patients.

Results. The term “saphenopopliteal pattern” has been introduced to characterize the anatomical interrelation of the small saphenous vein and popliteal vein within the area of the popliteal fossa. Five basic saphenopopliteal patterns were described including rare ones when the small saphenous vein opens into the gastrocnemius veins. It has been found that the patterns with the saphenopopliteal junction prevail (65.6 %), and in 28.3 % cases the small saphenous vein did not have any connection with the popliteal vein. The gender factor does not have any effect on the pattern type (р = 0.311) but the somatotype factor does (р = 0.038). It has also been determined that there is no direct connection between the small saphenous vein and popliteal vein in one thirds cases in the dolihomorphic and mesomorphic patients (34.5 % and 35 %, respectively), whereas the saphenopopliteal junction develops in 85.7 % cases in the brachymorphic patients.

Conclusion. The proposed classification of the types of the topography of the small saphenous vein within the area of the popliteal fossa could be applied for the evaluation of the venous beds of the lower extremities by the method of duplex ultrasound scanning.
Bacteriological Profile of Wounds of Patients with Neuroischemic Form of Diabetic Foot
Authors: Silvistrovich V. I. , Lyzikov A. A. , Kaplan M. L. , Yarets J. I.
Published: November 2021

Objective: to assess the results of the microbiological study of wounds in patients with diabetic foot syndrome (DFS).

Material and methods. The microbiological study of the wounds of 76 patients with the neuroischemic form of DFS having undergone inpatient treatment at Gomel Regional Diabetic Foot Center from 2016 to 2019 was performed.

Results. The range of the microbial flora of the wounds of the patients with the neuroischemic form of DFS has been identified, the antibiotic susceptibility of the detected bacteria to antibacterial drugs has been analyzed.

Conclusion. The microbiological profile of the wounds of the patients with the neuroischemic form of DFS was characterized by the variety of bacteria and included Enterococcusfaecalis (29%), Staphylococcusaureus (19%), as well as representatives of Enterobacteriaceae family (25%). The detected bacteria were most sensitive to glycopeptides, aminoglycosides, carbapenems, which makes it reasonable to prescribe these groups of antibiotics as the start antibacterial therapy.
Effectiveness of Palliative Care in Patients with Malignant Neoplasms of II and IV Clinical Groups
Authors: Litvinov G. E. , Usova N. N. , Ksenzov N. L. , Voronina A. P. , Pukhovich O. S.
Published: November 2021

Objective: to evaluate the effectiveness of palliative care in patients with malignant neoplasms of II and IV clinical groups in terms of the changes of the quality of life indicators regardless of the stage of the development of the disease and the degree of its malignancy.

Material and methods. 61 patients of the Palliative Care Ward suffering from malignant neoplasms of II and IV clinical groups were examined at the beginning (day 2) and at the end of the treatment course (day 14). The patients' psychoemotional condition, characteristics of pain syndrome and clinical mobility were analyzed. The effectiveness of the palliative care course was evaluated using the standardized questionnaires and scales: visual-analog pain scale, DN4, Pain Detect, Rivermid Mobility Index, Beck Depression Inventory, Spielberger-Hanin Anxiety Scale (assessment of situational and personal anxiety). The Garkawi Adaptation Intensity Index was used to calculate the body's reactivity to the disease at the beginning and upon completion of the palliative care course. The Calf-Caliph leukocyte index was calculated twice to assess the dynamics of endogenous intoxication.

Results. The course of the inpatient palliative treatment has showed its effectiveness by improving the category of clinical mobility on the Rivermid scale and the psychological condition of the patients with malignant neoplasms of II and IV clinical groups: there was a decrease in anxiety and depression, some decrease in the degree of pain syndrome. The Garkawi and Calf-Caliph indices were not effective tools for the assessment of the short treatment course.

Conclusion. Inpatient palliative care for patients with malignant neoplasms of II clinical group reduces undesirable effects of radical treatment, thus improving the quality of life, and it relieves the suffering in the patients of IV clinical group in whom the application of radical methods is not possible.
Prevalence of nontuberculous mycobacteria in Gomel region
Authors: Bujnevich I. V. , Ruzanov D. Yu. , Zolotuhina L. V. , Bondarenko V. N. , Majseenko V. I. , Zhuravleva N. Yu.
Published: November 2021

Objective: to assess the species diversity and frequency of detection of nontuberculous mycobacteria (NTM) in patients of antituberculous organizations in Gomel region. Material and methods. 1057 isolates of mycobacteria were analyzed. To identify the species of the mycobacteria, phenotypic and molecular genetic studies of the isolates were performed. Results. A total of 13 NTM types have been identified. The most common were M. avium and M. intracellulare (MAC complex) - 63.7 % (60.79-66.67), followed by M. gordonae and M. fortuitum (7.66 %; 6.13-9.43 and 7.57 %; 6.05-9.33, respectively). Multiple isolation of NTMs of one species (from 2 or more samples) was observed in 190 patients, which amounted to 37.4 % of all the patients. In 75.3 % of the cases, MAC was obtained (χ2 = 97.01; p <0.001). The second place in terms of etiological significance was occupied by M. xenopi (6.43 %), the third one - by M. gordonae (5.3 %). Conclusion. Out of 13 identified NTMs, the most common causes of the development of mycobacteriosis were MAС complex, M. xenopi , M. gordonae .
Experimental myocardial infarction in rats: features of modeling and course within the first 48 hours after ligation of the coronary artery
Authors: Nikulina N. A. , Dotsenko E. A. , Nerovnya A. M. , Salivonchik D. P. , Platoshkin E. N. , Nikolaeva N. V. , Tishkov S. P.
Published: November 2021

Objective: to identify the features of modeling and give a morphofunctional assessment of the course of experimental myocardial infarction (EMI) in rats within the first 48 hours after ligation of the left coronary artery (LCA). Material and methods. EMI was reproduced according to the method of H. Selye [1] in Jian Ye`s modification [2] by means of LCA ligation in 24 Wistar rats. Electrocardiographical, histological, biochemical studies were performed. The control group consisted of 7 falsely operated animals in which the chest had been opened without manipulation on the LCA. Results. 5-15 minutes after LCA ligation, an ischemic change in the (Q)RST complex was observed as a monophasic curve. The Q wave appeared on the EGG after 1 hour of EMI in 20% cases, after 7 hours in 88% cases, in 100% cases after 27 hours and remained by 48 hours of EMI. Histologically, within the first 7 hours there was acute alterative myocardial damage followed by a quantitative increase in diffusely located necrotic cardiomyocytes (CMC) by 27 hours and the appearance of a clear zone of coagulation necrosis by 48 hours; which was accompanied by corresponding changes in the level of troponin I. Conclusion. The course of EIM after LCA ligation is characterized by the staging of myocardial changes similar to that in humans, which provides a prerequisite for possible extrapolation of the results of the studies to humans.
Prevalence of non-conventional risk factors among patients with chronic obliterating diseases of lower limb arteries
Authors: Kulikovich Y. K. , Sharshakova T. M. , Lyzikov A. A. , Kulikovich D. B.
Published: November 2021

Objective: to study the prevalence of non-conventional risk factors among patients with chronic obliterating diseases of lower limb arteries.

Material and methods. To identify the non-conventional risk factors among patients, the Hospital Anxiety and Depression Scale (HADS), DS-14 questionnaire were used. The survey included 250 patients with chronic obliterating diseases of lower limb arteries (men - 192 patients (76.8 %), women - 58 (23.2 %). The statistical analysis of the data was carried out by means of the program «Statistica» 8.0. Differences between the groups were considered as statistically significant at p < 0.05.

Results. Anxiety symptoms were observed in 53.2 % of the patients. The average HADS-A subscale score was 8.0 (5.0; 9.0) points. Symptoms of hospital depression were observed in 38.4 % of the patients. The average HADS-D subscale score in all the patients was 6.0 (4.0; 9.0) points. Personality type D was detected in 51.2 % of the patients.
Advantages and disadvantages of the use of eHealth technologies during the COVID-19 pandemic
Authors: Semutenko K. M. , Sharshakova T. M.
Published: November 2021

Objective: to evaluate the experience and possibilities of the use of eHealth technologies during the pandemic.

Material and methods. A systematic review of literature containing information about the use of telemedicine, crowdsourcing monitoring and other eHealth resources during the COVID-19 pandemic was performed.

Results. The main advantages and disadvantages of the use of eHealth technologies have been highlighted, the main problems arising on the way of their implementation have been identified and options for their solution have been proposed.

Conclusion. In developed countries the COVID-19 pandemic has already accelerated the implementation of eHealth as a tool to combat the pandemic. But despite this, new laws and regulations governing liability in the field of remote treatment are needed, as well as guidelines regarding the use of crowdsourcing disease monitoring systems in addition to traditional epidemiological surveillance systems.
Burnout syndrome in the professional work of doctors
Authors: Murashkin M. S. , Sharshakova T. M.
Published: November 2021

Objective : to study the severity and analyze the causes of burnout syndrome in doctors of various specialties.

Material and methods . A survey of doctors in which 331 respondents took part was conducted in health care institutions of the Republic of Belarus. The validated method for burnout diagnosis - «Maslach Burnout Inventory» - was applied. The questionnaire includes a general part (questions regarding sex, length of service, place of work, and chosen specialization); 22 questions evaluate burnout syndrome according to 3 domains: «Emotional exhaustion», «Depersonalization», «Reduction of professional achievements»; 14 questions identify possible causes that contribute to the development of burnout syndrome. The study involved doctors of various specialties (obstetrician-gynecologist; anesthetist-resuscitator; general practitioner; pediatrician; ambulance doctor; surgeon). The sociological and statistical methods were used.

Results . The integral index of burnout syndrome for obstetrician-gynecologists (n = 50) was 65.3 points; for anesthetist-resuscitators (n = 46) - 83.1 points; for general practitioners (n = 74) - 71.8 points; for pediatricians (n = 66) - 62.5 points; for ambulance doctors (n = 42) - 86 points; for surgeons (n = 53) - 69.8 points.

Conclusion . Currently, there is a tendency towards an increase in the burnout syndrome rate among all the groups of specialists. The highest indices are observed in the groups of ambulance doctors and anesthetist-resuscitators. At the level of health care insitutions, in order to mitigate the burnout risk factors, the optimization of the organizational environment should include the following criteria: availability of prospects for financial and professional growth of doctors, corporate development and effective leadership; effective trade union management; professional, legal and administrative support of doctors.
Comparative description of "primary" bioethical notions of first-year and final-year medical students
Authors: Ostrovsky A. M. , Koliada I. N.
Published: November 2021

Objective:to conduct a sociological study aimed at identifying the «primary» bioethical notions of the first-year and six-year students of the Faculty of General Medicine of the educational institution «Gomel State Medical University».

Material and methods.The results of a survey of 115 first-year students and 114 six-year students of the Faculty of General Medicine were analyzed.

Results. The survey has revealed statistically significant differences in the responses of the first- and six-year students to questions regarding the use of the human body or its separate organs and tissues for purposes of practical medicine or biomedical research ( χ2= 5.27; p = 0.022), personal social status as the basis for making decisions about any medico-biological manipulation ( χ2= 9.33; p = 0.002), necessity of the present-day form of human biological existence in future ( χ2= 6.51; p = 0.011), acceptability of separating personal consciousness from the physical body for the human society in future ( χ2= 4.23; p = 0.04), necessity to take a special «oath» to perform professional activities in everyday medical practice ( χ2= 8.92; p = 0.003).

Conclusion. The results of the study have shown that the first-year students have no clearly formed system of bioethical notions of living beings and possibilities for medical manipulations with them due to the lack of essential relevant knowledge. The sixth year students demonstrate more conscious answers to the questionnaire questions, which indicates the presence of theoretical knowledge and formation of their bioethical outlook for the subsequent development of practical skills for making moral decisions on this basis.
Polymorphism of the glycerol-3-phosphate oxidase gene as one of the Mycoplasma Pneumoniae genetic features influencing the formation of pathogenicity factors
Authors: Kostiuk S. A. , Hlinkina T. V. , Poluyan O. S. , Rudenkova T. V.
Published: November 2021

Objective: to identify possible genetic variants of Mycoplasma pneumoniae in a glycerol-3-phosphate oxidase gene fragment corresponding to the FAD binding domain of the enzyme, and to study their pathogenic properties.

Material and methods: The material for the obtainment of Mycoplasma pneumoniae isolates was sputum, epithelial cell scrapings from the nasopharynx, tracheobronchial secretion from 85 children and adolescents diagnosed with bronchitis and pneumonia and detecting Mycoplasma pneumoniae DNA. The isolation of Mycoplasma pneumoniae from the clinical material was proceeded in a mycoplasma medium without an energy source. The DNA isolation from the biological material and from the culture fluid was performed by the method of sorption extraction. The sediment of the cellular elements of the sputum was used for the DNA extraction with the use of the CTAB reagent.

Results. Synonymous and non-synonymous nucleotide substitutions have been identified in 54 clinical isolates of Mycoplasma pneumoniae . It has been found that the amino acid substitutions His51Leu and Asp55His are essential for the realization of the pathogenic potential of the Mycoplasma pneumoniae isolates associated with the production of hydrogen peroxide.

Conclusion. The A152T (His51Leu) and G163C (Asp55His) substitutions were identified in the G3P oxidase gene of the Mycoplasma pneumonia clinical isolates, and their presence was associated with the variability in the activity of the enzyme. The Mycoplasma pneumoniae isolates carrying the A152T substitution (His51Leu) produced hydrogen peroxide in significantly lower amounts (5 mg/l) in comparison with the reference strain (10 mg/l) and had reduced cytotoxicity in relation to respiratory epithelial cells. The Mycoplasma pneumoniae isolates carrying the substitution G163C (Asp55His) were characterized by enhanced pathogenic properties, such as increased production of hydrogen peroxide (25 mg/l) and more pronounced cytotoxicity towards respiratory epithelial cells.
Analysis of clinico-morphological and molecular-genetic markers in patients with chronic dermatosis followed by face skin atrophy
Authors: Kostiuk S. A. , Shimanskaya I. G. , Rudenkova T. V. , Poluyan O. S. , Hlinkina T. V.
Published: November 2021

Objective: to identify associations between clinico-morphological and molecular-genetic markers in skin biopsy on the basis of a complex analysis.

Material and methods. Skin punch-biopsies with a diameter from 1 till 4 mm were used as a material for research. To assess the morphological charcateristis of the skin, the histological analysis was carried out; to assess the level of gene expression, real time PCR with reverse transcription was performed.

Results. It has been found that the presence of morphological alterations in the skin of patients with chronic dermatosis is associated with the levels of normalized expression of СOL1A1 gene less than 100 % and/or gene COL1A2 gene less than 200 % and/or gene LOX less than 50 %.

Conclusion. Real time PCR with reverse transcription can be used for objective assessment of the degree of skin alteration in patients with chronic dermatosis.
Study of the geometric and mechanical features of nanoparticles of various nature by atomic force microscopy in PeakForce QNM mode
Authors: Chelnokova I. A. , Ronishenko B. V. , Starodubtseva M. N.
Published: November 2021

Objective: to identify the difference of the numerical values of parameters characterizing the geometric and mechanical (adhesive) properties of inorganic nanosized particles and nanosized particles of biological origin by atomic force microscopy using the mode of the mapping of surface features at nanosized resolution.

Material and methods. Exosomes isolated from the blood of Af mice by the method of sequential ultracentrifugation were used as bionanoparticles. Silver nanoparticles were used as inorganic nanoparticles. The nanoparticles were scanned in air with the help of the BioScope Resolve (Bruker) atomic force microscope in the PeakForce QNM in Air mode with the recording of the maps of adhesion forces and imaging of the topography of the studied surfaces.

Results. The silver nanoparticles and exosomes had similar but statistically different diameters (45.59 ± 1.04 nm and 41.25 ± 0.91 nm, р < 0.001 t-test). Nevertheless, the silver nanoparticles were characterized by higher values of both height and free surface area in comparison with the corresponding values of the exosome parameters. This leads to a higher value of the spreading ration for exosomes (the average ratio of diameter to height (d/h) was 11.78 for exosomes and 6.67 for nanoparticles (p < 0.001, Mann-Whitney U test) due to greater adhesion properties of the exosome membranes compared to the silver nanoparticles and a lower value of the ratio of the particle volume to its surface area. Averaged over the nanoscale areas of the nanoparticle surface, the adhesion forces of exosomes were higher (3.2 ± 0.57 nN) compared to those of silver nanoparticles (2.2 ± 0.03 nN, p < 0.05, Mann-Whitney U test).

Conclusion. The differences in the parameters of the geometric (diameter, height, free surface area) and mechanical properties (adhesion forces) of the silver nanoparticles and exosomes have been revealed, which allows identifying and differentiating of these nanoparticles by the methods of atomic force microscopy during the study of complex biological fluids with possible content of both the types of nanoparticles.
Efficiency and safety of an anesthetic technique in surgical correction of congenital malformations of the lower parts of the urogenital system in children
Authors: Karamyshev A. M. , Ilukevich G. V. , Lyzikova T. V.
Published: November 2021

Objective: to assess the efficiency and safety of an anesthetic technique in surgical correction of congenital malformations of the lower parts of the urogenital system in children by means of the performance of the comparative analysis of perioperative adverse events and complications, consumption of the inhalation anesthetic sevoflurane and the cost of anesthesia, and also the course of the early postoperative period. Material and methods. Depending on the type of anesthesia, all patients (127 boys) were divided into 3 clinical groups: those operated under multicomponent balanced inhalation anesthesia (group 1, n = 37), under general laryngeal mask anesthesia in combination with caudal blockade with 0.25% bupivacaine solution (group 2, n = 45), under general laryngeal mask anesthesia with caudal blockade with the combination of 0.25% bupivacaine solution and adjuvant (group 3, n = 45). Results. The performed analysis has not revealed any statistically significant distinctions in the assessment of anesthesia complications but it has found some significant distinctions in the consumption of sevoflurane, depth of anesthesia and its cost, as well as the necessity for postoperative anesthesia and introduction of analgesics, which testifies to the efficiency and safety of combined anesthesia and its economic benefit. Conclusion. The most effective, safe, and economically reasonable is the technique of combined anesthesia with the application of caudal blockade with local anesthetic solution and 0.1% adjuvant of morphine solution during surgical correction of congenital malformations of the lower parts of the urogenital system in children.
Comorbid pathology of the cardiovascular system in patients suffering from morphea
Authors: Poroshina L. A. , Yurkovskiy A. M. , Bakalets N. F.
Published: November 2021

Objective: to assess the parameters of echocardiography, structure of cardiovascular pathology in patients suffering from morphea. Material and methods. The echocardiographic data and cardiovascular pathology were studied in 74 patients with morphea. Results. Diastolic dysfunction of the left ventricle was revealed in 37.5 % of the morphea patients, dilatation of the left atrium was found in 10.8% of the patients, pathological regurgitation on the aortic valve - in 21.62 %. 86.5 % of the patients had morphea combined with arterial hypertension. Conclusion: Such comorbid pathologies as arterial hypertension, dilatation of the left atrium, pathological regurgitation on the aortic valve and left ventricular diastolic dysfunction are common for patients with morphea.
Diagnostic blockade under sonographic control in patients with lumbosacral ligamentoses
Authors: Yurkovskiy A. M. , Nazarenko I. V. , Achinovich S. L.
Published: November 2021

Objective: to develop standardized methods for performing diagnostic blockades increasing their effectiveness in lumbosacral ligamentoses. Material and methods. The study included the results of sonographically controlled blockades of the iliolumbar (66 patients), posterior long sacroiliac (126 patients), and sacrotuberal ligaments (25 patients). All of the patients had manifestations of low back pain syndrome. Results. The use of the standardized method of therapeutic and diagnostic blockades in all the patients with ligament-induced low back pain syndrome led to a marked decrease in the intensity of the pain syndrome and allowed verification of its cause. Conclusion. Sonographically controlled blockade of the iliolumbar, posterior long sacroiliac, and sacrotuberal ligaments is an effective way to verify and treat low back pain syndrome in lumbosacral ligamentoses.
Dynamics of minor T-lymphocyte subpopulations in patients undergoing kidney transplantation
Authors: Zybleva S. V. , Zyblev S. L.
Published: November 2021

Objective: to study the dynamics of the indicators of CD3+CD4+CD8+double-positive and CD3+CD4-CD8- double-negative T-lymphocytes in patients who underwent kidney transplantation. Material and methods. Three groups were formed out of 197 allograft recipients. PGF group consisted of patients with primary satisfactory graft function. PGD group - with primary graft dysfunction. GR group - with primary graft dysfunction and histologically confirmed graft rejection. We studied the CD3+CD4+CD8+ (DP) and CD3+CD4-CD8- (DN) T-lymphocyte levels before the transplantation, and on the 1st, 3rd, 7th, 30th, and 90th days after the transplantation. Results. Within a month after the transplantation we noted a decrease in the relative DN T-lymphocyte level in the PGF group, while in the PGD and GR groups this indicator significantly increased. By the 90th day, the count of DN T-lymphocytes had remained unchanged in the PGD group, while there had been a statistically significant increase of this subpopulation in the PGF group. The absolute counts of DN T-lymphocytes in the PGF group on the 1st and 7th days were lower than in the GR group. On the 90th day, there was no statistically significant difference in the absolute number of DN T-lymphocytes in the recipient groups. In all the groups, there was a decrease in the number of DP T-lymphocytes on the 1st day, however, in the PGF group, the relative level was significantly higher. This tendency retained for 3 months. There were no statistically significant differences between the PGD and GR groups. The absolute number of DP T-lymphocytes in the PGF group during the entire observation period was significantly higher than in the PGD and GR groups. Conclusion. We noted a decrease in the indicators of DN T-lymphocytes in the PGF group associated with the increase in the DP T-lymphocyte level within the first three months. In the PGD and GR groups, an increase in the DN T-lymphocyte level was revealed due to a decrease in the indicators of DP T-lymphocytes within 90 days after transplantation.
Effect of intraarticular injection of chondroitin sulfate into synovial joint elements in an experiment
Authors: Nikolaev V. I. , Zinovkin D. A. , Tretyakov A. A.
Published: November 2021

Objective: to study morphological and morphometric changes in the epiphysis bone in a rat during the intra-articular injection of chondroitin sulfate (CS). Mаteriаl аnd methods. The object of the study was the knee joints of 36 Wistar rats. CS injections at a dose of 0.05 ml were performed once a week into one of the knee joints (experimental joint), and isotonic NaCl solution at the same volume was injected into the opposite joint (control joint). The animals in the number of 12 units were withdrawn from the experiment on the 7th, 14th, and 21st days, which corresponded to one week after one-, two-and three-fold intra-articular injections of HC and 0.9 % NaCl. The isolated knee joints were placed in a decalcifying liquid, then were fixed in 10% neutral buffered formalin. 4 micron histological sections were stained with hematoxylin and eosin. The morphometric analysis assessed the thickness of hyaline articular cartilage, the thickness of the epiphysis growth zone cartilage, and the cell content of the subchondral bone. Results. The study of the thickness of the articular cartilage, the growth zone of epiphyseal cartilage and the cellular composition of the subchondral bone has showed a statistically significant dynamic increase in these indicators after the 2nd and 3rd intra-articular injections of CS. The assessment of the thickness of the articular cartilage on the 21st day found some statistically significant differences between the experimental and control groups (p < 0.0001), the thickness of the epiphyseal cartilage had increased significantly by that time (p < 0.0001), and the cell content of bone marrow showed statistically significant differences (p = 0.002). Conclusion. The obtained data testify to a pronounced regenerative effect of CS, injected intra-articularly into articular cartilage.
Influence of the biomechanical parameters of movement on the ice-hockey player`s sitting position
Authors: Bondarenko K. K. , Novik G. V. , Bondarenko ALLA E.
Published: November 2021

Objective: to evaluate the effect of flexion and extension of the body units during ice-hockey players` movements in the sitting position on the location of the joints in relation to the general center of body mass. Material and methods. A group of 14 highly qualified ice-hockey players who performed running movements on skates and proprioceptive movements onto the strain platform in the ice-hockey player`s sitting position. The biomechanical analysis of the movements was conducted with the use of the methods of video analysis, strain gauge, and myometrial method . Results. The most optimal ranges of the articular angles of the knee and hip joints in the in the ice-hockey player`s sitting position have been identified. In particular, in the fixation of the angular position of the knee joint within the range of 80-90 degrees, there was a decrease in the strength of the muscle pull of the quadriceps femoris on the anterior cruciate ligament. The value of this decrease varied within the range of 17-22 % of the average values of the indicator that were obtained when the angular position of the knee joint was less than 80 or more than 90 degrees. Flexion in the hip joint over the range of 42-55 degrees with the optimal position of the knee joint contributed to increased balance in the given position. Conclusion. Flexion and extension of the torso lead to changes in the position of the joints associated with the general center of body mass (GCMB) and subsequent biomechanics of the sitting position. The deviation of the angular positions from the optimal ranges affects the trajectory of the GCMB with vertical vibrations, which, in its turn, negatively affects the speed of movement and stability of the ice-hockey player`s sitting position. Going beyond the boundaries of the postural position zone can lead to a more rigid sitting position, which increases the risk of injury of the anterior cruciate ligament.
The problem of adherence to treatment from the standpoint of the sociology of medicine
Authors: Boyko S. L.
Published: November 2021

Objective: to substantiate adherence to treatment as a form of social responsibility of citizens from the standpoint of the sociology of patients. Material and methods. The work uses the principles and methods of the sociology of medicine. A sociological survey of a representative sample of medical care consumers (880 people) on adherence to treatment was conducted, and a model of compliance ratio as a model for subsequent drug therapy was substantiated. Results and discussion. The performed survey has shown that every second patient learns about their rights from the mass media. Men are significantly less likely than women to follow medical prescriptions (p < 0.01). Women are significantly more likely to trust the doctor's opinion about treatment, if they disagree, they are more likely to turn to another specialist, while men are significantly more likely to simply refuse treatment and other recommendations from the attending doctor. The respondents called their own laziness and / or aversion to taking medications as the main reason for non-compliance with treatment. Conclusion. Low social responsibility of patients for compliance with the doctor's recommendations has been found. The concept «adherence to treatment» has been introduced into the problem field of the sociology of medicine.
A long anhydrous period — a possible outcome
Authors: Lashkevich E. L. , Voronovich G. V.
Published: November 2021

Preterm premature rupture of the fetal membranes is observed in 30-50 % of premature labors. The frequency of infectious maternal and neonatal complications increases аs a result of a long anhydrous period. The article presents a description of the course of pregnancy and its outcome in a patient with a long anhydrous period.
Idiopathic retroperitoneal fibrosis (Ormond's disease): clinical picture, diagnosis, and option of surgical treatment
Authors: Nechiporenko A. N.
Published: November 2021

The paper provides a brief review of literature on the problem of retroperitoneal fibrosis and the author`s own observation on the diagnosis and successful surgical treatment of idiopathic Ormond`s disease. Retroperitoneal fibrosis is the development of a nonspecific inflammatory process in the adipose tissue of the retroperitoneal space with the formation of a fibrous lesion around the aorta, vena cava inferior, iliac vessels. The focus of fibrosis can spread towards the ureters and compresses them. One- or two-sided hydrouretheronephrosis leads to a chronic kidney disease. The given observation presents the diagnosis and method of the surgical treatment of a patient with idiopathic retroperitoneal fibrosis with bilateral hydrouretheronephrosis and a chronic kidney disease.
Posterior reversible encephalopathy syndrome in the practice of obstetrics and gynecology
Authors: Korbut I. A. , Budyukhina O. A. , Zhelobkova T. I. , Baginsky F. V. , Voronovich G. V. , Dolzhevskaya E. S.
Published: November 2021

The article presents clinical cases of posterior reversible encephalopathy syndrome, which complicated pregnancy and childbirth, and describes the clinical course, features of diagnosis, and treatment.
Possibilities for prediction of congenital fetal malformations and chromosomal abnormalities based on the determination of the levels of free amino acids and their nitrogen-containing derivatives in blood plasma of pregnant women
Authors: Keda L. N. , Naumov A. V. , Smirnov V. YU.
Published: November 2021

Objective: to determine the possibilities for prediction and diagnosis of congenital fetal malformations and chromosomal abnormalities on the basis of the study of the levels of amino acids and their nitrogen-containing derivatives in blood plasma of pregnant women with pathological conditions requiring artificial termination of pregnancy. Material and methods. The content of free amino acids and their nitrogen-containing derivatives was studied in 104 pregnant women having congenital malformations and chromosomal abnormalities in their fetuses at 13-22 weeks` gestation (group I) and 25 women with physiological pregnancy (group II). The amino acid level was determined by the high-performance liquid chromatography method. Results. The levels of 14 out of the 26 studied amino acids in the blood plasma of the pregnant women of group I were statistically higher than those of the women in group II. ROC analysis was used to determine six amino acids (glycine, α-aminobutyric acid, hydroxylysine, glutamic acid, citrulline, serine) and their threshold values which with high accuracy (85.3 %) allow of predicting congenital fetal malformations and chromosomal abnormalities. A prognostic model making it possible to determine high probability of congenital fetal anomalies based on the determination of the concentration of 5-hydroxytryptophan, glycine, asparagine, and serine in blood plasma of pregnant women has been developed. Conclusion. The study of the levels of amino acids and their nitrogen-containing derivatives in plasma of pregnant women at 13-22 weeks` gestation can be used for prenatal diagnosis of congenital fetal malformations and chromosomal abnormalities, as well as used as an additional criterion for making the decision on the necessity for artificial termination of pregnancy upon fetal medical indications.