bluuebunny/crossref_metadata_2025 huggingface dataset:
Original method of esophagojejunal anastomosis after gastrectomy for stomach cancer, allowing post-operative complications prevention
Authors: Akhmetzyanov F Sh , Borisov V P , Akhmetzyanova F F , Borisov S V
Published: November 2019

Aim. To perform the comparative assessment of postoperative complications and mortality rate associated with two types of cuff esophagojejunal anastomosis after gastrectomy. Methods. Follow-up data of short-term post-operative complications rate in two groups of patients who underwent gastrectomy for gastric cancer, are described. Comparative results are presented on after gastrectomy in two groups of patients with gastric cancer: 193 patients were operated using the original method - single-row esophageal-intestinal anastomosis (main group), and 164 patients - using a double-row anastomosis (comparison group). Results. Among the patients who underwent an operation, 229 (64.1%) were older 60 years of age. Post-operative complications were observed in 25.4% of cases in the main group and in 36.6% of cases - in comparison group, including complications leading to unfavorable outcome - in 8.3 and 16.5% of cases, respectively. Post-surgical mortality in non-combined interventions was 5.1% in the main group and 13.7% in comparison group. After combined gastrectomy, post-surgical mortality was assessed as 10.5 and 17.7%, respectively. Early post-operative complications were subdivided into 2 groups: (1) associated with the method of anastomosis and (2) not associated with the method of anastomosis. The first group consisted of anastomosis suture failure, esophagojejunal anastomosis afferent loop obstruction syndrome, pancreatitits. Those complications were combined in one group because of pathogenesis unity. The number of such complications was lower by 2.2 times in the main group, including those with fatal outcome - by 3.2 times. Conclusion. Early post-surgical complications and mortality rate in patients who underwent gastrectomy with original method of single-row esophageal-intestinal anastomosis (main group) was significantly lower compared to patients who underwent gastrectomy with double-row anastomosis. Good reliability of the method of single-row esophageal-intestinal anastomosis allows to recommend its wide use in daily practice by surgeons and oncologists.
Serum lipid profile in differential diagnosis of salmonellosis-associated and acute alcoholic gastroenteritis
Authors: Makarov V K , Starikov S V , Makarov P V
Published: November 2019

Aim. To assess serum lipid spectrum profile as a potential tool for differential diagnosis of gastroenteritis associated with salmonellosis and acute alcoholic gastroenteritis. Methods. Serum lipid profile was examined in 50 healthy volunteers, 50 patients with acute alcoholic gastroenteritis and 50 patients with gastroenteritis associated with salmonellosis of moderate severity. Lipids were extracted by Folch method and fractionated by a modified method; the percentage of separate lipid fractions was determined by densitometry using the «Shimadzu CS-9000» scanner. General lipid level was determined by Marsh method. Total serum lipid level and their fractions: phospholipids total level, free cholesterol, free fatty acids, triglycerides and cholesterol ethers levels were measured. Results. Total serum lipid level was almost 2 times higher in patients with acute alcoholic gastroenteritis compared to patients with gastroenteritis associated with salmonellosis. Relative total level of phospholipids was significantly higher in patients with gastroenteritis associated with salmonellosis compared to patients with acute alcoholic gastroenteritis. However, difference in absolute levels of phospholipids was not significant between the patients with gastroenteritis associated with salmonellosis and patients with acute alcoholic gastroenteritis. Absolute level of free cholesterol was significantly higher in patients with acute alcoholic gastroenteritis than in patients with gastroenteritis associated with salmonellosis. Free fatty acids levels in patients with gastroenteritis associated with salmonellosis did not differ from a respective parameter in patients with acute alcoholic gastroenteritis. Relative level of cholesterol ethers in patients with gastroenteritis associated with salmonellosis was significantly lower compared to patients with acute alcoholic gastroenteritis. Absolute and relative levels of triglycerides in patients with acute alcoholic gastroenteritis were significantly higher, compared to patients with gastroenteritis associated with salmonellosis. Conclusion. Lipid profile detection can be used as an additional test for differential diagnosis of gastroenteritis associated with salmonellosis and acute alcoholic gastroenteritis.
Antioxidant system blood enzymes activity in patients with echinococcosis
Authors: Maslennikova N A , Sergeeva E Yu , Tikhonova E P , Burakov A Yu , Titova N M , Fefelova Yu A , Ruksha T G
Published: November 2019

Aim. To study the activity of antioxidant enzymes and concentration of malondialdehyde - lipid peroxidation product - in patients with echinococcosis. Methods. 22 patients aged 32 to 74 years [females - 9 (40%), males - 13 (60%), mean age 37.6 years] with established diagnosis of liver echinococcosis confirmed by ELISA, were examined. Mean disease duration was 10 years. 12 patients, in whom the diagnosis of liver echinococcosis was excluded, were included in the control group. Superoxide dismutase activity was determined based on adrenaline auto-oxidation inhibition, as well as catalase activity and malondialdehyde level were determined. Results. Statistically significant decrease in the malondialdehyde concentration from 5.9 [5.6÷6.6] to 3.7 [3.3÷4.1] mmol/g of hemoglobin (p 0.001), superoxide dismutase activity - from 764 [744÷796] to 666 [627÷695] i.u./min.×g of hemoglobin (p 0.001) was revealed in patients with echinococcosis. Catalase activity did not change significantly (maintained at the level of control group), which may indicate a temporary activation of the compensatory abilities of the body. Conclusion. Revealed data suggest that gradual development of oxidative stress and decrease in body adaptive abilities play a significant role in the pathogenesis of liver echinococcosis which should be considered while working out the new treatment options for the disease.
Methods of improving treatment results for patients with postoperative ventral hernia
Authors: Malkov I S , Mukhtarov Z M , Malkova M I
Published: November 2019

Aim. To improve the results of surgical treatment for patients with postoperative ventral hernia by improving complex preoperative physical examination and better prevention of wound complications. Methods. Results of surgical treatment of 160 patients [mean age - 64 years, females - 120 (75%), males - 40 (25%)] with postoperative ventral hernia treated from 2003 to 2012 were analyzed. The surgeries were performed routinely. All patients were distributed to 2 groups depending on postoperative wound complications prevention. The main group included 60 patients who underwent a vacuum therapy (authors’ technology) during postoperative period for preventing wound complications. Perioperative management of patients with large and huge hernias in this group was performed according to recommendations of the European Society of Cardiologists and All-Russian Scientific Cardiologic Society for cardiovascular risk assessment at surgeries excluding heart surgery. Comparison group included 100 patients who underwent surgery for postoperative ventral hernias using a conventional vacuum drainage and common methods of patient examination according to recommended standards. Results. Using vacuum therapy in patients of the main group limited the number of Redon-drainage procedures, reduced the rate of local pyoinflammatory complications by 4.2 times (p 0.05). Cardiovascular risk identification and proper preoperative preparation allowed avoiding unfavorable outcomes associated with cardiovascular complications in patients with high cardiovascular risk. Conclusion. High efficiency of a complex approach in preventing postoperative complications after ventral hernias surgical treatment allows to recommend its use in clinical practice.
Prevalence of bronchial asthma in young people living in industrial city
Authors: Zakharova I A
Published: November 2019

Aim. To reveal the true prevalence of asthma in young people living in a large industrial city. Methods. 1518 young persons aged 18-44 years (males - 698, females - 820, mean age 30.34±5.7 years) who attended outpatient clinics of the Clinical Hospital №4 of Chelyabinsk (12.9% of the total population served by the hospital) were randomly picked out. Respondents surveys were conducted, the determination of total immunoglobulin E levels were measured, patients underwent spirometry and were consulted by pulmonologist. Results. Diagnosis of bronchial asthma has been previously confirmed in 2.8% of patients, while in accordance with the Global Initiative for Asthma (GINA) criteria (2013), the true prevalence is 7.8%. In patients with newly diagnosed bronchial asthma body mass index was 26.32±6.3 kg/m2 compared to 24.53±4.9 kg/m2 in patients without asthma; level of total immunoglobulin E was 259.6±16.5 ME/ml vs 47.8±12,6 ME/ml respectively. Not only a decrease in spirometric indices of respiratory function (forced expiratory volume in 1st second (FEV1) was 69.2±8.1% of the expected value vs 105.6±9.1% in the group of healthy individuals, FEV1/FVC (forced vital capacity) ratio - 75.62±13.7% vs 84.2±12.9% respectively), but also a significant increase in total lung capacity (up to 94.5±18,8% of the expected value compared to 78.1±14.1% in the group of healthy subjects) and the residual lung volume (up to 102.2±14.5% vs 79.5±5.9% respectively), was registered in newly diagnosed patients with bronchial asthma indicating pathological process in the small airways, even in patients with small term of the disease. Conclusion. The incidence of bronchial asthma is more than 3 times higher than the official statistics report; in individuals with newly diagnosed bronchial asthma higher body mass index and total immunoglobulin E levels were registered in comparison with the general population.
Protein oxidative modification and cathepsin H activity in rats’ thymocytes at nitrogen oxide (II) synthesis modulation in vitro
Authors: Abalenikhina Yu V , Fomina M A
Published: November 2019

Aim. To study the influence of substrate for nitrogen oxide (II) synthesis - L-arginine - and non-selective NO-synthase inhibitor - N-nitro-L-arginine-methyl ester - on protein oxidative modification in combination with rats’ thymocytes cathepsin H activity estimation in vitro. Methods. The study was performed on male Wistar rats with body weight of 280-320 g. Freshly-separated thymocytes were incubated in vitro in the full nutrient medium containing 5 мМ of N-nitro-L-arginine-methyl ester (n=8) or 5 мМ of L-arginine for 24 hours at the temperature of 37 °C (n=8). Control group consisted of thymocytes incubated in the same conditions in the full nutrient medium (n=8) for 24 hours. Nitric oxide metabolites levels were measured by spectrophotometry in the visible spectrum using the reaction with Griess reagent. Cathepsin H activity was estimated by BarrettKirschke spectrofluorimetry. Protein oxidative modification was measured by R.L. Levine method in E.E. Dubinina modification followed by carbonyl derivatives absorption spectrum quantitative analysis. Results. In nitrogen oxide (II) synthesis deficiency model, protein oxidative modification degree increased, mainly due to basic and neutral aldehyde- and ketone-dinitrophenylhydrazones level increase. Those changes were accompanied by increased activity of cathepsin H. In nitrogen oxide (II) synthesis stimulation model, level of oxidative-modified proteins decreased, mainly due to lower levels of neutral amino acid derivatives, cathepsin H activity didn’t change. Conclusion. In vitro nonselective inhibitor of inducible NO-synthase - N-nitro-L-arginine-methyl ester - stimulates protein oxidative modification and increases activity of cathepsin Н; substrate of NO synthesis - L-arginine - showes antioxidant effect.
Experimental study of hypoglycemic effect of medicago sativa leaves extract
Authors: Eremenko R F , Maloshtan L N , Yatsenko E Yu
Published: November 2019

Aim. To study the hypoglycemic effect of the Medicago Sativa leaves extract in intact rats and in rats with a glucose load. Methods. At the first stage, hypoglycemic effect of Medicago Sativa leaves extract was determined in intact rats. 50 mg/kg of metformin and 18 mg/kg of herbal anti-diabetic «Arfazetin» tea were used as comparator drugs. At the second stage, hypoglycemic effect of Medicago Sativa leaves extract was determined in rats with glucose load. Blood samples for glucose analysis were taken before and in 15, 30, 60 and 120 minutes after loading. Blood glucose level was determined by glucose oxidase method. Results. Medicago Sativa leaves extract showed hypoglycemic effect both in intact animals and in animals with glucose load. 25 mg/kg of Medicago Sativa leaves extract decreased blood glucose level in intact animals at 4, 6 and 8 hours by 1.04, 1.14 and 1.11 times compared to the baseline level; the effect was comparable with herbal anti-diabetic «Arfazetin» tea and was inferior to metformin. A single 25 mg/kg dose of Medicago Sativa leaves extract showed hypoglycemic effect in animals with glucose load and significantly reduced blood glucose level in 15, 30, 60 and 120 minutes compared to control. Conclusion. The findings suggest that 25 mg/kg of Medicago Sativa leaves extract can be used as a herbal medication in the complex treatment of type II diabetes mellitus for its hypoglycemic properties.
Changes in prevalence of diabetes mellitus in the Republic of Azerbaijan in 1994-2012 and prospects for 2030
Authors: Alieva T T
Published: November 2019

Aim. To study the changes in prevalence of diabetes mellitus in the Republic of Azerbaijan in 1994-2012 and to predict the changes by 2030. Methods. The data of the number of patients with diabetes mellitus in the Republic of Azerbaijan were gained by analyzing official statistics of Ministry of Healthcare of the Azerbaijan Republic. The population of Azerbaijan in 1994-2012 was also analyzed. Microsoft Excel software package was used for prognosis calculation and graphical representation. Results. In 1994 40 438 patients with diabetes mellitus were registered in the Republic of Azerbaijan, in 2003 - 49 083 pa-tients, and in 2012 the number of patients with diabetes mellitus has reached 151 667 which was 375.06% compared to 1994 and 309.00% compared to 2003. Mid-annual change of the country’s population was calculated, with the gained data used for population prediction for 2030. According to the calculations, the number of officially registered patients with diabetes mellitus should reach 3.73% of the Azerbaijan Republic population by 2030. Conclusion. Statistical data show considerable growth in diabetes mellitus prevalence in the Republic of Azerbaijan. The prediction based on the last 9 years data allows to predict the increase of the number of officially registered patients with diabetes mellitus up to 380 178 patients by 2030, which will make 3.73% of the country’s population.
Assessment of health damage due to exposure to mineral wool fine dusts
Authors: Kopytenkova O I , Levanchuk A V , Tursunov Z Sh
Published: November 2019

Aim. To develop the rapid method for cardiovascular diseases risk assessment among employees exposed to mineral wool fine dusts. Methods. Concentrations of particles smaller than 10 and 2.5 μm were measured in the air of mineral wools producing working area using «OMPN-10.0» dust meter. The mass fraction of heavy metals in mineral wools was calculated by atomic absorption method. Statistical analysis of 40 out-patient charts data and discharge summaries of occupational diseases department was performed. Cardiovascular risk mathematical model parameters were calculated using SPSS Statistica 17.0 software package. Results. Dust concentration in the air of working area where mineral wools are used was 8.2±1.3 mg/m3, including 1.8±0.4 mg/m3 of particles smaller than 10 μm and 1.25±0.3 mg/m3 of particles smaller than 2.5 μm. Heavy metal compounds, such as Cu, Zn, Pb, Cd, Ni, were revealed in the dust. Relation between the cardiovascular risk and duration of service in unfavorable environmental conditions and hygienic standards overage ratio was established. The risk for a disease for workers with term of service of 4 years was assessed as high, with term of service of 14 years - as extra-high. Conclusion. Results showing the dependence of cardiovascular risk on contact with mineral wool fine dust and length of service and hygienic standards overage ratio can be used as an express cardiovascular risk assessment method in employees exposed to mineral wool fine dusts with the particles size smaller than 10 and 2.5 μm.
Coronary artery disease involving left main coronary artery (diagnosis, main treatment approaches)
Authors: Khalimova G Z , Galyavich A S
Published: November 2019

The review analyzes diagnostic and treatment methods and controversies in coronary artery disease involving left coronary artery trunk. Significant occlusion of left main coronary artery is seen in 5-7% of patients with coronary artery disease and is associated with high risk, because this artery gives blood supply for 75-100% of left ventricle myocardium. Involvement of left main coronary artery is considered as an independent predictor for higher prevalence of coronary artery disease and mortality associated with coronary artery disease. Coronary angiography is an appropriate test for diagnosing it. Two types of left main coronary artery involvement are identified - «protected» and «non-protected». In patients on treatment with significant involvement of left main coronary artery, 3-year mortality rate is 50%. Currently a combination of drug treatment and interventional approaches is successfully used to treat coronary heart disease with significant left main coronary artery involvement. The rate of stent angioplasty for such stenosis is currently raising. However, bypass surgery remains to be the «gold standard» treatment in patients with «non-protected» left main coronary artery involvement, and the techniques are constantly improving. Bypass surgery is indicated in patients with left main coronary artery stenosis over 50% and signs of angina pectoris or silent myocardial ischemia. Urgent bypass surgery is preferred in cases of combination of acute coronary syndrome and marked stenosis of left main coronary artery. Presence of unstable angina is an independent predictor for severe concomitant cardiovascular events.
Results of combined anesthesia application with the usage of non-narcotic analgesics in the surgical oncology practice
Authors: Tanatarov S Z
Published: November 2019

Aim. To evaluate the effectiveness of pre-, intra- and postoperative intravenous administration of paracetamol in combined anesthesia in patients undergoing surgical interventions in the surgical oncology practice. Methods. Examined were 35 patients aged from 43 to 75 years, operated on under combined anesthesia. During the operation and after its completion an infusion of liquid paracetamol at a dose of 3.3 mg/h was performed. Cardiac monitoring was conducted, the content of cortisol in the blood and the Bispectral Index were determined. The pain indices measured by visual analogue and digital rating scales were determined in the postoperative period. The control group included 35 patients in whom anesthesia was performed without the use of paracetamol. Results. During the infusion of paracetamol an adequate level of analgesia was achieved without development of adverse reactions on the part of the vital systems. The use of paracetamol in the early postoperative period contributed to the reduction of pain on digital rating and visual analogue scales compared to the group with basic anesthesia. Conclusion. The use of liquid paracetamol is a promising and safe method of additional analgesia.
Ways of improving surgical tactics in the treatment of victims of motor vehicle accidents with combined mechanical trauma
Authors: Mustafin R R , Isaeva I V , Anisimov A Yu
Published: November 2019

Aim. To study the effectiveness of the surgical tactic «Damage control» in providing medical care to victims of motor vehicle accidents with associated mechanical injuries of various locations. Methods. 85 victims of motor vehicle accidents with associated mechanical injuries of various locations from 2006 to 2010 were the subjects of the clinical study. Depending on the surgical approach, which was chosen on the basis of assessment of the severity of the condition and injuries, the patients were divided into two groups. The first (main) group included 35 (41.2%) victims, in whom the stepwise tactic of trauma elimination «Damage control» was used. The second (comparison) group consisted of 50 (58.8%) patients, in whom the traditional tactic of simultaneous treatment of all lesions during the surgical intervention was applied. An analysis of the dynamics of clinical indicators, incidence of complication development and mortality was conducted depending on the chosen surgical treatment tactic. Results. The overall incidence of complications in the early postoperative period in the first group was lower by 38.0% and the mortality - by 7.7%. Conclusion. The use of the «Damage control» surgical tactic is effective in the complex treatment of victims of motor vehicle accidents with associated mechanical trauma.
Optimization of antifibrinolytic protection during neurosurgical operations
Authors: Sultanov L R
Published: November 2019

Aim. To conduct a retrospective analysis of intraoperative and postoperative blood loss during removal of brain tumors with the usage of tranexamic acid and infusion correction of hemodynamically significant blood losses. Methods. The study included 139 patients operated on for tumors of the brain and spinal cord, and treated with tranexamic acid. Distribution of patients according to the volume of blood loss was as follows: the first group - up to 500 ml of blood loss, 48 patients (34.5%); the second group - 500-1200 ml of blood loss, 72 patients (51.7%); the third group - more than 1200 ml of blood loss, 19 patients (13.9%). Results. The retrospective analysis has shown that 34.5% of patients (first group) were operated with the lowest blood loss - up to 10% of the circulating blood volume; 51.7% of patients (second group) - with a blood loss of 20 to 30% of the circulating blood volume. In the third group, which included 13.9% of patients, there was a blood loss of more than 30% of the circulating blood volume, which is defined as hemodynamically significant. It is in the third group, as shown by the analysis, that in addition a therapeutic dose of tranexamic acid 15-20 mg/kg was administered. The extent and intensity of intraoperative blood loss were dependent on many factors, mainly on the nature of the tumor process. Conclusion. It was established that the changes of the hemostatic system were depended on the degree of hemodilution; the use of tranexamic acid made it possible to reduce the amount of postoperative blood loss, despite the degree of intraoperative blood loss.
Evaluation of the effectiveness of the double indicator method of scintigraphy in the differential diagnosis of thyroid nodules
Authors: Timofeeva L A
Published: November 2019

Aim. To evaluate the effectiveness of double indicator scintigraphy in the differential diagnosis of thyroid nodules. Methods. Analyzed was the data of radionuclide investigations of 25 patients with thyroid disease at the age of 36 to 72 years, who were operated on in 2009-2011. The radioisotope study was conducted in two stages. Evaluation of the scintigraphic uptake pattern of the radiopharmaceutical in the studied areas was performed visually and quantitatively. Results. The scintigraphic results were compared with cytological and histological studies. In the diagnosis of papillary thyroid cancer the sensitivity of the radioisotope investigation was 95%, specificity - 92%, diagnostic accuracy - 94%. The method was less precise and specific in the diagnosis of follicular cancer and macro-micro follicular adenomas (it gave positive results in the cases of adenoma and negative results in cases of follicular thyroid cancer). On average, the specificity of the double-phase radioisotope scintigraphy method using 99mTc-pertechnetate and technetril (99mTc-MIBI) in our study was 69%, accuracy - 75%, sensitivity - 79%. Conclusion. Radionuclide double-phase scintigraphy with the usage of 99mTc-pertechnetate and technetril (99mTc-MIBI) - is a highly informative method for the differential diagnosis of thyroid nodules, which can be used during atypical sonographic patterns and in the absence of clear histological data.
Porphyrin metabolism in secondary hepatic porphyria in patients with hereditary deficiency of glucose-6-phosphate dehydrogenase
Authors: Baytaeva D A , Bessmel’tsev S S
Published: November 2019

Aim. The study the porphyrin metabolism during the development of secondary hepatic porphyria in patients with glucose-6-phosphate dehydrogenase deficiency. Methods. Examined were 148 male patients aged 5-19 years (median 12 years) with impaired activity of glucose-6-phosphate dehydrogenase in combination with β-thalassemia and without it. Qualitative and quantitative methods of examining the activity of this enzyme were used in order to verify the diagnosis. Taking into account the varying degree of glucose-6-phosphate dehydrogenase deficiency, the indices of metabolism of the enzyme and of the porphyrins were correlated with the severity of anemia, functional liver capacities, with parameters reflecting iron content in blood serum, bone marrow, liver and urine. The markers of intoxication were also taken into account in the development of secondary hepatic porphyria and endotoxemia. Therapeutic plasmapheresis was used to correct the revealed disorders. Results. The influence of glucose-6-phosphate dehydrogenase deficiency on the metabolism of porphyrins and liver functional status has been shown, which leads to the development of anemia and endogenous intoxication. With the help of parameters, which characterize the porphyrin metabolism in patients, secondary hepatic porphyria was revealed. It was established that determination of the content of glucose-6-phosphate dehydrogenase and porphyrins makes it possible to detect disturbances in heme synthesis at an early stage and to evaluate the compensatory abilities of the liver. An important diagnostic feature for glucose-6-phosphate dehydrogenase deficiency, regardless of severity, is the impaired synthesis of the end products of metabolism of porphyrins - uro-, copro- and protoporphyrin. The effectiveness of therapeutic plasmapheresis for hemolysis, secondary hepatic porphyria and endogenous intoxication has been shown. Conclusion. Increased excretion of uro-and coproporphyrin with urine reflects the severity of endotoxemia, and is an alternative to markers of intoxication; high concentration of free protoporphyrin and low concentration of uro- and coproporphyrin in erythrocytes is an important diagnostic sign of impaired activity of glucose-6-phosphate dehydrogenase in patients.
Adaptive changes of the indices of the cardiovascular system and serum content of a number of hormones under examination stress condition
Authors: Lavrov O V , Pyatin V F , Shirolapov I V
Published: November 2019

Aim. To study the features of the indices of the cardiovascular system and serum concentrations of several hormones and biogenic amines among the students under the impact of examination stress. Methods. The study was conducted on a group of young conditionally healthy volunteers. The starting group of study subjects consisted of 203 students who prior to participation in the study passed a medical examination, including medical history, calculation of body mass index, physical, instrumental and laboratory investigations. As a result, 93 students were selected; their own indicators outside the examination period were used as controls. The study individuals had an investigation of the state of autonomic reactions (measurement of systolic and diastolic blood pressure, heart rate, Kerdo autonomic index) conducted 1 hour before and within 1 hour after the examination. The hormonal status was investigated by enzyme immunoassay. The results of the study were verified using the software package «StatPlus». Results. Sympathicotonic nature of the vegetative response dominated, according to which two categories of students were allocated: with a steady and significant increase in Kerdo autonomic index (53%) and with the lack of such growth rate (47%). In the study of the hormonal profile a reduction in the serum concentrations of thyroid-stimulating hormone and cortisol levels, an increase in blood content of the tested biogenic amines - histamine, epinephrine (adrenaline), serotonin was revealed. Conclusion. The established changes in the indices of the cardiovascular and endocrine systems emphasize the individual nature of each subject’s reactions, and therefore require clustering of students into groups according to the characteristics of autonomic and hormonal responses to psychoemotional stress.
Features of etiopathogenesis of psychosomatic and somatoform disorders
Authors: Marincheva L P , Zlokazova M V , Solov’ev A G
Published: November 2019

Aim. To identify the features of etiopathogenesis of somatoform and psychosomatic disorders in adolescents. Methods. Examined were 426 adolescents and their families. The main group - 321 patients of the Kirov City Children’s Clinical Hospital, which included two subgroups: 117 adolescents with somatoform autonomic dysfunction, and 204 - with psychosomatic disorders; the mean age was 15.1±1 years. The control group consisted of 105 adolescents who were students of secondary schools in the city of Kirov with the first group of health; the mean age was 15.1±1 years. The clinical-psychopathological method of investigation, questionnaire surveys, and experimental psychological tests were used in order to perform the study. Results. The conducted study confirms the multifactor nature of the pathogenesis of psychosomatic disorders (identified was the importance of biological, psychological and social factors) and makes it possible to suggest that the onset of symptoms of psychosomatic disorders is formed according to the main stages of the nonspecific response to stress, from the autonomic neurotic reactions during somatoform autonomic dysfunction (at the stage of resistance) to the development of the psychosomatosis picture - during the development of psychosomatic disorders (at the exhaustion stage). The level of disease development is determined by both the individual predisposition and the spectrum of adaptive responses to stress. All this confirms the need for earliest detection of somatoform autonomic dysfunction in order to prevent the development into a chronic process and its progression. Conclusion. Complex treatment is of great importance, including the personal-oriented psychotherapy aimed at the development of adaptive mechanisms for coping with stress.
Features for the autonomic balance during tuberculin diagnosis in accordance with the mantoux method and using the skin prick test
Authors: Borodulina E A , Kozlova O S , Seredina Yu P , Korolev V V , Pyatin V F , Amosova E A
Published: November 2019

Aim. To evaluate the dynamics of the autonomic balance in children during tuberculin diagnosis (Mantoux test and skin prick test) by investigating the heart rate variability. Methods. In 30 children (14 boys and 16 girls) aged 7.5±0.54 years the parameters of heart rate variability were recorded before and during the Mantoux test and skin prick test. Results. The comparative analysis of the used diagnostic techniques revealed advantages of the prick test method: during the diagnostic testing procedure with the skin prick test the increase in the heart rate of all children was less by 53%, sympathetic activation of the regulation of cardiac activity according to the NN50 parameter (number of pairs of cardiac intervals, differing from the neighbouring ones by more than 50 ms) was lees by 35%, the activity of the sympathetic and parasympathetic tone was less by 32 and 15% compared to such during the Mantoux test. The index of tension of the regulatory systems during the skin prick test was 25% less than during the normal tuberculin test carried out with a syringe. Conclusion. During the performance of the skin prick test a general tendency of preservation of the vagal influence on the cardiac function in children was revealed in contrast to the Mantoux test; the technique of injecting tuberculin using the skin prick test is associated with development of less emotional stress in children.
Integrated ultrasound investigation and magnetic resonance tomography in the diagnosis of focal thyroid pathology
Authors: Timofeeva L A
Published: November 2019

Aim. To determine the features an integrated ultrasound investigation and magnetic resonance tomography in the diagnosis of focal thyroid pathology. Methods. Integrated ultrasound examination was conducted in 1440 patients with focal lesions of the thyroid gland at the age of 17-76 years, and magnetic resonance tomography was performed in 91 patients (65 females and 26 males). Results. It was established that the informativeness of the ultrasound investigation is characterized by the following parameters: sensitivity - 92.1%, specificity - 78.6%, and diagnostic accuracy - 90.3%; the informativeness of magnetic resonance tomography: sensitivity - 94.1%, specificity - 89.6 %, and diagnostic accuracy - 91.0%. Conclusion. Integrated use of ultrasound investigation and magnetic resonance tomography significantly increases the informativeness during primary diagnosis of focal thyroid diseases.
The state of the oxidation-reduction system in patients with primary open angle glaucoma
Authors: Gazizova I R
Published: November 2019

Aim. To study the state of the oxidation-reduction system in patients with primary open-angle glaucoma. Methods. Conducted were biochemical studies of the state of the oxidation-reduction system in 30 patients with primary open-angle glaucoma. The level of lipid peroxidation of cell membranes was determined in blood serum by the method of accumulation of malondialdehyde based on its interaction with thiobarbituric acid. The state of the antioxidant system was assessed according to the activity of superoxide dismutase, catalase, glutathione reductase and the content of thiol disulfide groups in the blood. The concentration of lactate in the blood serum was determined using an automated analyzer. Results. In patients with a chronic course of glaucoma elevated levels of oxidized thiol groups of proteins, increased activity of antioxidant enzymes, activation of lipid peroxidation processes, increased lactate content have been identified. Conclusion. Changes in the oxidation-reduction system in patients with primary open-angle glaucoma may be a sign of mitochondrial dysfunction.
The role of subvalvular structures in the development of mitral valve prolapse in children
Authors: Belozerov Yu M , Magomedova Sh M , Abakarova Z S , Osmanov I M
Published: November 2019

Aim. To assess the role of subvalvular structures in the development of mitral valve prolapse in children. Methods. Conducted was an echocardiography investigation with comparative analysis of structural and functional parameters of subvalvular structures in healthy children (50 individuals) and children with mitral valve prolapse divided in two groups: first group - without regurgitation (34 children), the second group - with regurgitation (16 children). Results. In healthy children identified were strong correlation links between echocardiographic indices of the subvalvular structures of the mitral valve and the functional parameters of the left ventricle. The diameter of the anterolateral group of papillary muscles directly correlated with the thickness of the interventricular septum, while the diastolic distance between the papillary muscles - with the end diastolic diameter of the left ventricle. It was established that the following factors may contribute to the pathogenesis of mitral valve prolapse: (1) long papillary muscles and the corresponding chords of the valve, (2) a weak (relative to the norm) contractile ability of the papillary muscles, (3) hyperkinesis of the left ventricular apex, and (4) no relationship between the apical and the global ejection fraction. These factors contribute to the fact that the papillary muscles and chords constrain the mitral valve cusps to a lesser extent during systole, which in turn easily bulge into the left atrium under the influence of systolic blood pressure. Apical hyperkinesis contributes to even closer approximation of the subvalvular structures with the cusps. Conclusion. Mitral valve prolapse is attributed to desynchronization of the function of papillary muscles and of the left ventricle; the development of functional mitral regurgitation during mitral valve prolapse is associated with dyssynchrony of the papillary muscles’ activity.
Functional status of neutrophils during carbon tetrachloride intoxication in rats
Authors: Alekhin E K , Mufazalova L F , Mufazalova N A
Published: November 2019

Aim. To study the damaging effect of acute carbon tetrachloride intoxication on the functional status of neutrophils in an experiment. Methods. The experiments were performed on 90 non-inbred white rats weighing 200-220 g; two groups were identified - experimental group and control group (45 animals in each). Carbon tetrachloride was administered intragastrically to the experimental group (1.25 ml/kg 50% solution in olive oil) for the duration of four days. Determined were the number of leukocytes, neutrophils and lymphocytes in the peripheral blood, the intensity of the oxygen-dependent metabolism (through spontaneous and induced nitro blue tetrazolium test), the absorption and antimicrobial activity, the content of myeloperoxidase and cationic proteins in neutrophils. The results were recorded on the 7th, 14th and 28th day from the end of the toxicant administration. Results. On the 7th day in rats of the experimental group leukopenia was registered in the form of reduction in the number of lymphocytes, the inactivation index decreased, which was confirmed by reduction of the number of myeloperoxidase-positive cells and of the mean cytochemical coefficient; noted was a decrease in the absorptive capacity of neutrophils. On the 14th day leukopenia persisted, which was now in the form of an even decrease in the number of neutrophils and lymphocytes; with the continued decrease in the phagocytic index an increase in the number of cells involved in phagocytosis was registered. By the 28th day the number of lymphocytes increased in the presence of neutropenia; the decrease in the number of myeloperoxidase-positive cells and of the mean cytochemical coefficient in the myeloperoxidase system, reduction of the indices of the induced test with nitro blue tetrazolium and of the proportion of cells positive for cationic proteins persisted. Conclusion. Acute intoxication with carbon tetrachloride leads to profound dysfunction of neutrophils (leukopenia, decreased absorption and microbicidal activity of neutrophils, reduced myeloperoxidase activity and the content of cationic proteins), which is not eliminated by the 28th day of observation.
Prospects for using agonists and antagonists of P2 receptors in clinical ophthalmology
Authors: Ziganshina A P , Ziganshin B A , Samoilov A N , Ziganshin A U
Published: November 2019

This literature review focuses on the role of purinergic P2-receptors in the physiology and pathophysiology of the eye, as well as on the possibilities of pharmacologic stimulation of these receptors. The most important studies from the clinical point of view on the involvement of purinergic neuronal transmission in the physiological processes have been analyzed, ranging from normal embryogenesis to cell apoptosis in age-related degenerative diseases of the eye. Data on the effect of agonists and antagonists of P2 receptors on corneal wound healing, lacrimal fluid production, regulation of intraocular pressure, neurotransmission, proliferation of glial tissue in the retina has been presented along with data on the possibilities of modulating these processes by using potential drugs acting via P2 receptors.
Prevalence of the metabolic syndrome in an unorganized population taking into account different criteria of its diagnosis
Authors: Isaeva E N
Published: November 2019

Aim. To study the prevalence of metabolic syndrome in an unorganized population of Orenburg city. Methods. The sample was formed by the method of random numbers. Examined were 301 people aged 25 to 75 years, of which 148 were males and 153 females. Studied were the socio-demographic characteristics and medical history (including filling out of a questionnaire), the clinical status of study participants (with the measurement of blood pressure, height, weight, waist and hip circumference, biochemical blood analysis to determine the concentration of glucose and lipid profile). In order to identify the metabolic syndrome the following diagnostic criteria were used: of the Work Group on the treatment of adults of the National Cholesterol Education Program of the U.S. (2001-2005), of the International Diabetes Federation (2005) and of the All-Russian Scientific Society of Cardiology (2009). Results. The prevalence of abdominal obesity was reduced by using less stringent thresholds for waist circumference. The most common variant of the metabolic syndrome was the combination of the following components: abdominal obesity, arterial hypertension and a low content of high-density lipoproteins. According to the criteria of the International Diabetes Federation such a combination occurred in 7.6%, while in accordance with the Criteria of the Work Group on for the treatment of adults of the National Cholesterol Education Program of the U.S. - it occurred in 4.3%. Conclusion. The frequency of registration of the metabolic syndrome depends on the criteria for its diagnosis.
The study of the prevalence of articular syndrome and pathology of the musculoskeletal system through a telephone questionnaire survey
Authors: Krechikova D G , Erdes Sh F , Milyagin V A
Published: November 2019

Aim. To establish the prevalence of complaints of joint swelling and arthralgia among the population of Smolensk city, to assess their correlation with the presence of rheumatic diseases. Methods. A cross-sectional telephone questionnaire survey of residents of six therapeutic districts of two municipal polyclinics of Smolensk city was conducted. Interviewed were 2737 people (64.8% females and 35.2% males). The average age of respondents was 49.1±17.6 years. Results. Swelling of the joints at the time of the survey was revealed in 665 (24.3%) of respondents, in the majority of which (583 people, 21.3%) the symptoms persisted for more than the last 12 months. Pain in the knee joints was observed in 1141 (41.7%) residents, including arthralgia lasting more than a year - in 1012 (37.0%) people. The relationship between both of the symptoms and the gender (the predominance of women) and age (an increasing linear nature of the frequency of complaints in males and non-linear with a peak in the group of 70-80-year-olds - in females) was revealed. It was established that only 41.3% of respondents with joints swelling and 30.9% with arthralgia had a previously established diagnosis of rheumatic disease. Conclusion. The study results suggest that there is high prevalence of rheumatic complaints among residents of Smolensk city with a predominance of articular disease in women and individuals of older age groups; revealed was the fact of low awareness of the population of the existing rheumatic disease.
On the prevalence of somatic pathology among patients with mental disorders
Authors: Mendelevich B D , Kuklina A M
Published: November 2019

Aim. To determine the medical and statistical features of somatic pathology in patients of a therapeutic district with severe mental disorders. Methods. Conducted was a comparative clinical statistical analysis of data on patients’ referral to outpatient psychiatric health services (924 people, the main group) and patients of one therapeutic district of Naberezhnye-Chelny city (2250 pe-ople, the comparison group) for the year 2010. The method of observation - comprehensive, obtaining the necessary medical and statistical information - copying of the data from the ambulatory patient records. Results. In the structure of the somatic pathology among patients of the therapeutic district (comparison group) according to the referral data the leading position is held by cardiovascular disease (32.2%), diseases of the nervous (24%) and respiratory (21.1%) systems. In the group of patients with mental disorders the leading nosological group were diseases of the nervous system (30.2%) and cardiovascular disease (28.2%). Patients of the main group rarely visited the district physician themselves, most often it occured after the referral of a psychiatrist in order to pass the medical and social assessment, or to obtain medications. Conclusion. Due to the lack of criticism for their own condition, the patients with chronic mental illnesses rarely come to visit physicians of the therapeutic service, thus greater attention to this on behalf of the psychiatrists and other specialists is needed, as well as of the relatives of patients.
Correction of stress urinary incontinence in women using a free suburethral loop
Authors: Neymark A I , Razdorskaya M V , Neymark B A
Published: November 2019

Aim. To evaluate the efficacy and safety of implantation of a free synthetic loop (Tension-free Vaginal Tape - TVT) in the treatment of stress urinary incontinence in women. Methods. Examined and operated were 80 patients suffering from stress urinary incontinence. Suburethral implantation of a free loop (sling) in 3 patients was performed using standard TVT kit, while in 77 - using the IVS kit (Intravagynal Sling), which has some design differences from the TVT kit. Results. The observation period ranged from 3 months to 5 years. According to a questionnaire survey designed by the authors, which includes 21 questions, the following results were obtained: good - in 72 (90%) patients, satisfactory - in 6 (7.5%), unsatisfactory - in 2 (2.5%) patients. According to uroflowmetry, after the conducted treatment the duration and volume of urination increased, the maximal urine flow rate decreased to the normal values. Conclusion. The operation of implantation of a free synthetic loop serves as a rational and effective treatment method for the correction of stress urinary incontinence in women without prolapse of the vaginal walls; the success of intervention largely depends on the proper selection of patients and on the surgical technique.
On providing the continuity of dynamic observation of students on the basis a medical institution of the university
Authors: Polovnikova A A , Ponomarev S B , Soboleva N P , Alekseenko S N , Ivanov E V , Aleksandrov A B
Published: November 2019

Aim. To improve measures aimed at ensuring the continuity of the dynamic health monitoring of students on the basis of medical institutions of the University. Methods. On the basis of the technology «client-server», which is oriented on the management system of the Firebird databases, developed was an information-analytical system of dynamic observation of the health of students. Results. This system presumes a specific algorithm for the medical examination, first of all the screening methods: psychological testing, measurement of anatomical and physiological parameters, obtaining of the medical history, physical examination, cardiorhythmography and routine clinical and laboratory tests. With the help of original methods the medical information system provides a complex report on the state of health of the student and on the risks of the most common diseases in this age group. Conclusion. Health care providers of medical institutions of a University can use the developed system for dynamic monitoring of the health of the students.