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ORIGINAL RESEARCH
Glutamic acid changes in plasma of critical patients with hypoxia. Alekseeva E.V. P.14
Globus pharyngeus – is it a symptom of the esophageal disease? Firsova L.D., Tunik N.V.49
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ANNIVERSARIES
CLINICAL CASE
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UDC [616.98:578.825.12]-078
DOI: 10.20969/VSKM.2016.9(5).7-14
AVDONINA ALEXANDRA S., postgraduate student of I.I. Mechnikov Scientific Research Institute of Vaccines and Serums of Russian Academy of Medical Sciences, Head of the Department of research and production of «HIV-Blot», deputy-head of the Department of advanced technology of Closed Joint Stock Company «EKOlab», Russia, Moscow region, 142530, Elektrogorsk, Budyonnyi str., 1, tel/fax: (49643) 3-13-74, 3-17-45, 3-35-29, e-mail: ekolab-avdonina@mail.ru
MARDANLY SEYFADDIN G., C. Med. Sci., president and director for science of Closed Joint Stock Company «EKOlab», Russia, Moscow region, 142530, Elektrogorsk, Budyonnyi str., 1
YUMINOVA NADEZHDA V., D. Biol. Sci., deputi-director for scientific activity of I.I. Mechnikov Scientific Research Institute of Vaccines and Serums, Russia, 105064, Moscow, Malyi Kazennyi lane, 5
Abstract. Aim. Development of Russian test kit for detecting IgM-antibodies to individual cytomegalovirus antigens by immunoblotting (Western blot). Material and methods. Cytomegalovirus strain AD-169 was cultured to obtain the lysate antigen. Lysate antigen was subjected to electrophoresis in polyacrylamide gel. Then separated proteins were transferred to nitrocellulose membrane to obtain immunosorbent. Selection of the composition of reagents for immune blotting and the time of incubation was performed. Sensitivity and specificity of the new test kit was evaluated by studying 21 samples of the mixed panel of serums «Anti-CMV Mixed Titer Performance Panel PT C203» (reference material) and 48 samples of human serum (clinical material). Results and discussion. Test kit «Blot-CMV-IgM» was designed. It has sensitivity and specificity not conceding one of its analogues, the «Anti-CMV (IgM) Westernblot» (EUROIMMUN AG, Germany). It demonstrates characteristics of more efficient use. Conclusion. The new test kit is intended for confirmation of positive screening results and for differentiation the stage of infection in the diagnosis of cytomegalovirus infection.
Key words: cytomegalovirus infection, IgM-antibodies, cytomegalovirus antigens, immunoblotting.
For reference: Avdonina AS, Mardanly SG, Yuminova NV. Development of a test kit for detection of IgM-antibodies to individual cytomegalovirus antigens by immunoblotting (Western blot). The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 7—14.
References
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GLUTAMIC ACID CHANGES IN PLASMA OF CRITICAL PATIENTS WITH HYPOXIA
UDC 616-001.8-036.81-07:616.153.466.64-074
DOI: 10.20969/VSKM.2016.9(5).14-25
ALEKSEEVA ELENA V., С. Мed. Sci., anesthesiologist-resuscitator of the Department of intensive care unit of Central Clinical Hospital with Out-Patient service, 121359, Moscow, Marshal Timoshenko str., 15, tel. 8-910-442-11-37, e-mail: aev_69@mail.ru
Abstract. Aim. To study the main components of glutamatergic neurotransmitter system in plasma in critical patients with hypoxia. Material and methods. We have analyzed the data of examination and treatment of 2 groups of patients of Intensive Care Unit. Group I (n=19) patients presented hypoxia. Group II (n=9) — patients without hypoxia. Criteria of hypoxia were the following: reduced level of hemoglobin saturation with oxygen in the superior vena cava and increased lactate concentration in plasma. Amino acid content in was detected by the method of high performance liquid chromatography — mass-spectrometry. The groups were compared by the content of glutamic acid and glutamine. Statistical data processing was carried out using software Statistica 12. Results and discussion. The content of glutamic acid was lower in patients of group I (5-fold lower, r = 0,833) compared to those in group II. Intensity of multiple organ dysfunction and the incidence of adverse outcomes was higher in patients with reduced level of glutamic acid in the whole sample (р=0,0181, odds ratio = 5) and in group I (odds ratio = 4,4). Possible concomitant changes in the level of glutamic acid and glutamine in critical patients reflect the formation of hypofunction of the glutamatergic neurotransmitter system with an increasing severity of hypoxia. Conclusion. Development of hypoxia in critical patients is associated with hypofunction of glutamatergic neurotransmitter system. It is the most unfavorable condition in relation to the prognosis of pathological process. Emergent correction of hypofunction of glutamatergic neurotransmitter system is probably one of the ways to restore cellular mechanisms of adaptation in hypermetabolic patients in critical condition.
Key words: glutamic acid, hypoxia, critical patients.
For reference: Alekseeva EV. Glutamic acid changes in plasma of critical patients with hypoxia. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 14—25.
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THE ROLE OF MEDICAL TECHNOLOGIES IN INFANT MORTALITY REDUCTION IN SAMARA REGION
UDC 616-036.88-053.3(470.43)
DOI: 10.20969/VSKM.2016.9(5).25-29
KATKOVA LYUDMILA I., D. Med. Sci., Samara State Medical University, Russia, 443099, Samara, Chapaevskaya str., 89,
tel. +7 (846) 332-16-34, e-mail: info@samsmu.ru
MIKHALCHENKO SVETLANA V., D. Med. Sci., Head consultant for the organization of medical care for women and children of the Ministry of Health of Samara region, Russia, 443010, Samara, Lenin str., 73, tel. +7 (846) 332-95-32
Abstract. Aim. Evaluation of the significance of basic medical and organizational technologies in infant mortality reduction in obstetric and pediatric institutions. Material and methods. Analysis of infant mortality in Samara region for the period of 2012—2015 was performed. Analyzing performance data of Rosstat of the Russian Federation and of Samara region was used. Results and discussion. The efficiency of implementation of the three-level system of perinatal care for women and children, the use of high-tech medical care in nursing of preterm infants in accordance with the procedures and standards of care, contributing to the early detection of disease, optimal treatment and rehabilitation was shown. Higher mortality rates in rural areas of the region and the presence of mortality from controllable causes (infectious diseases and respiratory diseases) indicate the need to improve the health management aiming to reach availability and proper quality of care. Conclusion. Evaluation and implementation of medical and organizational technologies aiming to improve the availability and quality of health care for women and children is one of the main reserves in infant mortality reduction in the region.
Key words: infant mortality rate, three-level system of perinatal care, order and standards of care.
For reference: Katkova LI, Mihalchenko SV. The role of medical technologies in infant mortality reduction in Samara region. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 25—29.
References
1. Baranov AA. Smertnost’ detskogo naselenija v Rossii (tendencii, prichiny i puti snizhenija) [Child Mortality in Russia (trends, causes and ways to reduce)]. Moskva: Izd-vo Sojuza pediatrov Rossii [Moscow: Publishing House of the Union of pediatricians of Russia]. 2009; 387 p.
2. Terleckaja RN et al. Metody ocenki i koncepcija sokrashhenija predotvratimyh poter’ zdorov’ja detskogo naselenija [Methods of assessment and the concept of reduce avoidable losses of health of the child population]. Moskva: Pediatr# [Moscow: Pediatr]. 2013;
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3. Suhanova LP, Skljar MS. Detskaja i perinatal’naja smertnost’ v Rossii: tendencii, struktura, faktory riska [Children and perinatal mortality in Russia: trends, structure, risk factors]. Social’nye aspekty zdorov’ja naselenija [Social aspects of public health]. 2007; 4: 46.
4. Habriev RU, Jagudina RI, Pravdjuk NG. Ocenka tehnologij zdravoohranenija [Health technology assessment]. Moskva: Medicinskoe informacionnoe agentstvo [Moscow: Medical Information Agency]. 2013; 404 p.
WORKING CONDITIONS AND OCCUPATIONAL MORBIDITY IN AGRICULTURAL WORKERS OF THE REPUBLIC OF TATARSTAN
UDC 613.62:63(470.41)
DOI: 10.20969/VSKM.2016.9(5).29-34
OSIPOV SERGEY A., C. Med. Sci., Deputy Minister of health of the Republic of Tatarstan, Russia, Kazan, Ostrovsky str., 11/6, e-mail: minzdrav@tatar.ru
MALYSHEVA IRINA YU., Head of the Administration of medical and preventive care of Ministry of health of the Republic of Tatarstan, Russia, Kazan, Ostrovsky str., 11/6, e-mail: Irina.Malysheva@tatar.ru
BERKHEEVA ZUKHRA M., C. Med. Sci., associate professor of the Department of preventive medicine of Kazan State Medical University, Russia, Kazan, Butlerov str., 49, e-mail: kgmu_profpat@mail.ru
TROFIMOVA MARINA V., deputy head of the Administration of the Federal service for supervision of consumer rights protection and human well-being in the Republic of Tatarstan, Russia, Kazan, B. Krasnaya str., 30, е-mail: trofimova.mv@tatar.ru
GINIATOVA ALSU M., Head of the Department of supervision in occupational health, radiation hygiene and transport of the Administration of the Federal service for supervision of consumer rights protection and human well-being in the Republic of Tatarstan, Russia, Kazan, B. Krasnaya str., 30, e-mail: rpn.trud@tatar.ru
SAFINA KADRIYA R., Head of Republican Centre of occupational diseases of the Ministry of health in the Republic of Tatarstan, Russia, Kazan, Lechebnaya str., 7, е-mail: kadriya-safina@mail.ru
Abstract. Aim. The study of the dynamics and structure of occupational diseases in agricultural workers in the Republic of Tatarstan. Material and methods. A study was based on the register data of Republican Center of Occupational Diseases and of the Office of epidemiology in Tatarstan. Results and discussion. Working conditions remain harsh and even dangerous to workers health in 88% of agrarian objects. Employees of the agricultural sector of the Republic demonstrate consistently high levels of professional incidence considerably exceeding the Federal indicator for the industry. Analysis of occupational morbidity over the past 15 years revealed that occupational diseases were diagnosed in 224 stockbreeders and in 210 tractor drivers. Stockbreeders are usually diagnosed with musculo-tonic neck syndrome — 58% (130 people), upper extremities polyneuropathy — 54% (121 persons) and with other diseases of peripheral nervous system — 17% (38 persons). Tractor drivers tend to suffer from vibration disease — 76,7% (161 persons), bilateral sensorineural hearing loss — 71,9% (151 persons). Conclusion. There is a steady upward trend in the number of patients with newly identified occupational diseases. The presence of 2 or more diagnosis indicates the late diagnostics and the absence of periodic medical examinations of agricultural workers. The negative role in this process is played by the lack of the legal base. It is associated with the low social security of employees with initial forms of occupational diseases, for which there is no preventive treatment from social insurance funds.
Key words: occupational health, agricultural complex.
For reference: Osipov SA, Malysheva IYu, Berheeva ZM,Trofimova MV, Giniâtova AM, Safina KR. Working conditions and occupational morbidity in agricultural workers of the republic of Tatarstan. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 29—34.
References
1. Bezrukova GA, Shalashova ML, Spirin VF, Novikova TA. Struktura professional’noj zabolevaemosti mehanizatorov sel’skogo hozjajstva [Structure of occupational diseases in agriculture mechanics]. Materialy XII Vserossijskogo kongressa «Professija i zdorov’e» i V s’ezda profpatologov, Moskva, 27—30 nojabrja 2013 [Materials of XII all-Russian Congress «Profession and health» and the V Congress of profpatologov]. 2013; 103—105.
2. Bezrukova GA, Novikova TA, Shalashova ML, Rajkin SS. Zabolevanija perifericheskoj nervnoj sistemy, associirovannye s uslovijami truda, v professii traktorist-mashinist sel’skohozjajstvennogo proizvodstva [Diseases of peripheral nervous system, associated with the working conditions in the profession, the tractor driver-Machinist of an agricultural production]. Medicina truda i promyshlennaja jekologija [Occupational medicine and industrial ecology]. 2015; 9: 32.
3. Novikova TA, Mihajlova NA, Taranova VM et al. Planirovanie meroprijatij po upravleniju professional’nymi riskami zdorov’ju rabotnikov sel’skohozjajstvennogo proizvodstva [Planning for the management of occupational risks to health workers in agricultural production]. Materialy XI Vserossijskogo kongressa «Professija i zdorov’e», Moskva, 27—29 nojabrja 2012 [Materials of the XI all-Russian Congress «Profession and health»]. 2012; 341—343.
4. Spirin VF, Bujanov ES, Spirin AV et al. Rezul’taty monitoringa funkcional’nogo sostojanija organizma mehanizatorov sel’skogo hozjajstva [The results of monitoring the functional State of the body mechanics of the rural households]. Medicina truda i promyshlennaja jekologija [Occupational medicine and industrial ecology]. 2012; 5: 12—17.
5. O sostojanii sanitarno-jepidemiologicheskogo blagopoluchija naselenija v Respublike Tatarstan v 2014 godu: Gosudarstvennyj doklad [On the status of sanitary-epidemiological welfare of the population in the Republic of Tatarstan in the year 2014: State report]. Upravlenie Federal’noj sluzhby po nadzoru v sfere zashhity prav potrebitelej i blagopoluchija cheloveka [Department of the Federal service for supervision of consumer rights protection and human well-being]. 2015; 143—149.
6. O sostojanii sanitarno-jepidemiologicheskogo blagopoluchija naselenija v Rossijskoj Federacii v 2014 godu: Gosudarstvennyj doklad [On the status of sanitary-epidemiological welfare of the population in the Russian Federation in the year 2014: State report]. Federal’naja sluzhba po nadzoru v sfere zashhity prav potrebitelej i blagopoluchija cheloveka [Federal service for supervision of consumer rights protection and human well-being]. 2015; 74—91.
UDC 616.24-036.12-036.22(470.23-25)
DOI: 10.20969/VSKM.2016.9(5).35-40
POKHAZNIKOVA MARINA A., C. Med. Sci., associate professor of the Department of family medicine of I.I. Mechnikov North-Western State Medical University, Russia, 191015, St. Petersburg, Kirochnaya str., 41, tel. 8-905-212-20-24, e-mail: pokmar@mail.ru
LEBEDEV ANATOLIY K., C. Med. Sci., associate professor of the Department of family medicine of I.I. Mechnikov North-Western State Medical University, Russia, 191015, St. Petersburg, Kirochnaya str., 41, e-mail: lebedev_ak@mail.ru
ANDREEVA ELENA A., C. Med. Sci., associate professor of the Department of family medicine of Northern State Medical University, Russia, 163000, Arkhangelsk, Troitsky ave., 51, e-mail: klmn.69@mail.ru
OVAKIMYAN KARINA V., assistant of professor of the Department of family medicine of I.I. Mechnikov North-Western State Medical University, Russia, 191015, St. Petersburg, Kirochnaya str., 41, e-mail: ursa-alba@yandex.ru
TUR EKATERINA YU., postgraduate student of the Department of family medicine of I.I. Mechnikov North-Western State Medical University, Russia, 191015, St. Petersburg, Kirochnaya str., 41, e-mail: tur.e.y@yandex.ru
MOISEEVA IRINA E., C. Med. Sci., associate professor of the Department of family medicine of I.I. Mechnikov North-Western State Medical University, Russia, 191015, St. Petersburg, Kirochnaya str., 41, e-mail: dr-moiseeva@yandex.ru
KUZNETSOVA OLGA YU., D. Med. Sci., professor, Head of the Department of family medicine of I.I. Mechnikov North-Western State Medical University, Russia, 191015, St. Petersburg, Kirochnaya str., 41, tel. 8-921-935-70-34, e-mail: oukuznetsova@mail.ru
Abstract. Aim of the study is to assess the prevalence of chronic obstructive pulmonary disease (COPD) based on socio-demographic characteristics according to the GOLD criteria and to identify risk factor of airflow obstruction (AO) among the residents of St. Petersburg. Material and methods. The research was conducted in 2012—2013 as a part of RESPECT study done in St. Petersburg and Arkhangelsk. The RESPECT is a cross-sectional population based study. This article represents data analysis of St. Petersburg participants aged 35—70 years from 10 primary health care centers. COPD was defined as FEV1/FVC <0,7 (fixed cut-off) after bronchodilator (BD) administration. Results and discussion. 1446 respondents who filled all questionnaires and demonstrated satisfactory criteria on spirometry were assessed. The overall prevalence of AO after BD test was 7,6%; 15,7% among men and 4,1% among women (95% CI: 6,3—9,1, 12,4—19,5 and 2,9—5,5 respectively). 14,4% (95% CI: 11,3—17,9) smokers had post-BD AO. Participants with AO were more intense smokers and were more frequently exposed to dust and gas/fumes in comparison to those without AO. Age, male gender and smoking were the predictors for AO (OR — 1,7; 95% CI: 1,04—1,10; OR — 3,14; 95% CI: 2,04—4,85 and OR — 2,94; 95% CI: 1,77—4,86 respectively). Conclusion. The prevalence of COPD in St. Petersburg residents was higher in men and current smokers. The risk factors of AO are the age, male gender and smoking. Participants with AO were more frequently exposed to occupational hazards.
Key words: chronic obstructive pulmonary disease, epidemiological study, spirometry, obstructive ventilation disorders, prevalence.
For reference: Рokhaznikova MA, Lebedev AK, Andreeva EA, Ovakimyan KV, Tur EYu, Moiseeva IE, Kuznetsova OYu. Prevalence of chronic obstructive pulmonary disease according to spirometry in citizens of Saint Petersburg. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 35—40.
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PREDICTORS OF MORTALITY IN PEDIATRIC PATIENTS WITH DILATED INCOMPACT MYOCARDIUM PHENOTYPE
UDC 616.127-053.2-036.88-037
DOI: 10.20969/VSKM.2016.9(5).40-48
UMAROVA MALIKA K., graduate student of the Department of cardiology of Scientific Center of Children’s Health, Russia, 119991, Moscow, Lomonosovsky ave., 2, b.1, tel. +7(499)134-04-90, e-mail: u.malika@gmail.com
BASARGINA ELENA N., D. Med. Sci., professor, Head of the Department of cardiology of Scientific Center of Children’s Health, Russia, 119991, Moscow, Lomonosovsky ave., 2, b.1, tel. +7(499)134-04-90, e-mail: basargina@nczd.ru
SHULAEV ALEKSEY V., D. Med. Sci., professor, vice-rector for clinical work of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7(843)299-42-34, e-mail: shulaev8@gmail.com
MARAPOV DAMIR I., assistant of professor of the Department of public health and health management of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel.+7(987)288-00-20, e-mail: damirov@list.ru
Abstract. Aim. To determine the predictors of mortality in pediatric patients with left ventricle incompact myocardium dilated phenotype. Material and methods. 48 children (20 — female, 41,7%) with dilated incompact myocardium phenotype aged 2 moths — 17 years 7 months were surveyed. Clinical history was taken. Heart ultrasound and Holter electrocardiogram data were used in clinical trial. Results and discussion. According to the resulting model the risk of mortality in pediatric patients with dilated incompact myocardium phenotype increases by 1,9% at the older age of the onset of the disease with each month. Nonisolated form is accompanied by a risk of mortality 302,5% higher in comparison to the isolated form. Holter electrocardiogram data analysis revealed 2 clusters. 2nd cluster was characterized by a higher prevalence of ventricular arrhythmia. The cluster presented the increased risk of mortality by 143,6%. Thrombosis in patient history increased the risk of mortality by 173,3%. The factors excluded in regression model construction as insignificant were the following: gender, the origin of the disease (casual / heart failure), the age of the 1st hospitalization, the ratio of the thickness of non-compact and compact myocardial layers, the number of non-compact myocardial segments and heart ultrasound parameters. Conclusion. The factors affecting the possibility of mortality in pediatric patients with dilated incompact myocardium phenotype were revealed. Those are the age of the onset of the disease; associated congenital heart defects; ventricular arrhythmia and thrombotic complications in patient history.
Key words: incompact myocardium, dilated phenotype, predictors of mortality.
For reference: Umarova MK, Basargina EN, Shulaev AV, Marapov DI. Predictors of mortality in pediatric patients with dilated incompact myocardium phenotype. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 40—48.
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GLOBUS PHARYNGEUS — IS IT A SYMPTOM OF THE ESOPHAGEAL DISEASE?
UDC 616.321:616.329
DOI: 10.20969/VSKM.2016.9(5).49-53
FIRSOVA LIUDMILA D., D. Med. Sci., Head of the laboratory of clinical psychology of Moscow Clinical Research Center, Russia, 111123, Moscow, Entuziast road, 86, tel. +7 (916) 043-36-55, e-mail firsovald@gmail.com
TUNIK NATALIA V., postgraduate student of Moscow Clinical Research Center, Russia, 111123, Moscow, Entuziast road, 86
Abstract. Aim. To present clinical description of the symptom «lump in the throat» and its relevance to the esophageal diseases. Material and methods. Clinical and instrumental examination according to the Standards, complemented by esophageal manometry and filling in clinical questionnaires regarding the «lump in the throat». Results and discussion. Analysis of the medical examination results of 94 patients with a feeling of a «ump in the throat» showed that the characteristic features include localization in the upper half of the neck; mild sensation in most cases worsening with swallowing; episodic advent with no connection to any external factors; the absence of symptoms in the night time. Gastro-esophageal reflux disease was diagnosed in 83 patients (88,3%) in accordance with the Montreal criteria. Manometry data has showed that 71 patients (75,5%) had esophagus dyskinesia; yet the symptoms of esophageal spasm have been present three times more often than malfunctioning inherent to ineffective esophageal motility (58,5 and 17,0% respectively). For the first time it was shown that the sensation of a lump in the throat may be the only manifestation of dyskinesia of the esophagus in majority of cases (38,0%). Conclusion. The study demonstrates the value of the clinical symptom in determining the statements for the further examination (esophageal manometry) and — depending on the results obtained — in determining the focus of the treatment.
Key words: lump in the throat, gastro-esophageal reflux disease, esophagus manometry, esophageal dyskinesia, esophageal spasm, ineffective esophageal motility.
For reference: Firsova LD, Tunik NV. Globus pharyngeus — is it a symptom of the esophageal disease? The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 49—53.
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BIOFILM FORMATION OF LACTOBACILLUS FROM GENITAL TRACT OF WOMEN IN THE FIRST TRIMESTER OF PREGNANCY
UDC 618.215-008.87
DOI: 10.20969/VSKM.2016.9(5).53-56
SHISHKOVA JULIJA S., D. Med. Sci., professor of the Department of мicrobiology, virology, immunology and clinical laboratory diagnostics of South Ural State Medical University, Russia, 454092, Chelyabinsk, Vorovskiy str., 64
DOLGUSHINA VALENTINA F., D. Med. Sci., professor, Head of the Department of obstetrics and gynecology of South Ural State Medical University, Russia, 454092, Chelyabinsk, Vorovskiy str., 64
GRAFOVA ELENA D., postgraduate student of the Department of obstetrics and gynecology of South Ural State Medical University, Russia, 454092, Chelyabinsk, Vorovskiy str., 64, e-mail: AJLEHA@yandex.ru.
KOLESNIKOV OLEG L., D. Med. Sci., professor, Head of the Department of biology of South Ural State Medical University, Russia, 454092, Chelyabinsk, Vorovskit str., 64
LIPSKAJA ANASTASIJA D., research technician of the Department of microbiology, virology, immunology and clinical laboratory diagnostics of South Ural State Medical University Russia, 454092, Chelyabinsk, Vorovskiy str., 64
ZAVJALOVA SVETLANA A., Head of the women consultation of State Clinical Outpatient Clinic № 5, Russia, 454041, Chelyabinsk, Komsomolskiy ave., 36а
EVSTIGNEEVA NATALJA P., D. Med. Sci., Head of the Department of scientific experimental laboratory of Ural Research Institute of Dermatology, Venereology and Immunopathology, Russia, 620076, Ekaterinburg, Shcherbakov str., 8
AMINEVA POLINA G., junior research worker of the Department of laboratory medicine of Ural Research Institute of Dermatology, Venereology and Immunopathology, Russia, 620076, Sherbakov str., 8
Abstract. Aim. To study biological features of vaginal lactobacillus obtained from pregnant women. Material and methods. We definded 35 lactobacillus strains obtained from genital tract of women in the first trimester of pregnancy. We used mass spectrometry analysis to identify Lactobacilli and evaluated biofilm formation. All strains were divided into 3 groups depending on vaginal pathology (1 group — normal vaginal microbiota, 2 group — vaginal dysbiosis, 3 group — genital tract inflammation). Results and discussion. In our study we revealed the decrease of the lactobacillus titre in case of vaginal infection or dysbiosis. Lactobacillus were in titre lg(5,48±0,1) in pregnant women without genital infections and included mainly L. acidophilus, less L. helvet and L. plantarum. Lactobacillus defined in women with vaginal dysbiosis were: L. acidophillus and L. delbrueckii in equal amount, singular L. salvarius and L. paracaseisppparacasei. Women with vaginal infections had L. acidophilus at most: 30% — L. delbrueckiispplactis, less L. paracaseisppparacasei 1 and sporadic L. curvatussppcurvatus. We have also detected that biofilm activity of lactobacillus increases in case of genital infection (groups 2 and 3). Conclusion. The modification of vaginal microbiocenosis in trimester I of pregnancy may reflect on lactobacillus quality and quantity. Thus, genital infection leads to decrease of the amount of lactobacillus in 1 ml of vaginal fluid. It also expands the composition of species and notably increases biofilm formation.
Key words: biofilm formation, lactobacillus, genital infection of pregnant women
For reference: Shishkova JS, Dolgushina VF, Grafova ED, Kolesnikov OL, Lipskaja AD, Zav’jalova SA, Evstigneeva NP, Amineva PG. Biofilm formation of lactobacillus from genital tract of women in the first trimester of pregnancy. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 53—56.
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THE DISTRIBUTION OF SOMATIC AND OCCUPATIONAL DISEASES IN COLLIERS OF KUZBASS
UDC 613.62:622.333(571.17)
DOI: 10.20969/VSKM.2016.9(5).56-60
KHANIN ARKADY L., professor, Head of the Department of phthisiopulmonology of Novokuznetsk Extension Course Institute for Medical Practitioners, Russia, Novokuznetsk, Stroitely str.,5, tel. +7-903-945-22-52, e-mail: prof.khanin@yandex.ru
ANDREYANOVA MARIA A., general practitioner of Central City Hospital, Russia, 652881, Mezhdurechensk, Berezovaja str., 3, tel. +7-923-470-13-41, e-mail: mawalusa@gmail.com
SHUTNIKOVA GALINA A., phthisiopneumologist, Head of the Department of diagnostic, Russia, 654055, Novokuznetsk, Klubnaya str., 60b, tel. +7-951-602-68-43, e-mail: mail@nvkd-tub.ru
Abstract. Aim. Assessment of the impact of the process on the prevalence of occupational and somatic diseases among workers of various coal mining enterprises in the city of Mezhdurechensk. Material and methods. Comparative analysis of the results of periodic medical examinations of colliers since 2013 till 2015. Results and discussion. The methods of primary and secondary prevention of somatic and occupational diseases among employees of the coal industry of the city were designed. Conclusion. The prevalence of heterogeneous diseases among workers of the coal industry is significantly higher than in general population. The need for outpatient, inpatient and sanatorium treatment is higher among miners than cut workers and conversely the need for medical check-up is lower. Effective measures of primary and secondary prevention are: annual medical check-ups, development of the Health Schools, the individual and group medical consultations, improving continuity between the department of medical examination and outpatient service, rehabilitation of the patients with chronic diseases on the job.
Key words: coal mining, prevention, annual medical check-up, somatic disease, professional disease.
For reference: Khanin AL, Andreyanova MA, Shutnikova GA. The distribution of somatic and occupational diseases in colliers of Kuzbass. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 56—60.
References
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2. Chernushenko TI. Emidimiologija tabakokurenija i drugih faktorov riska hronicheskoi obstruktivnoy bolezni legkih v promishlennom gorode Kuzbassa [Epidemiology of smoking and other risk factors for chronic obstructive pulmonary disease in the industrial city of Kuzbass]. Tomsk. 2014; 26 p.
3. Carik GN, Shternis TA, Bogomolova ND. Problemi i perspective okazanija medicinskoi pomoshi rabotnikam ugledobivajushyh predpriatij [Problems and perspectives of health care workers of coal mines]. Medicina v Kuzbasse [Medicine in Kuzbass]. 2013, 3: 11–16.
4. Horuzaja OG, Gorbljanskiy UU, Piktushanskaja TE. Kriterii ocenki kachestva medicinskyh osmotrov rabotnikov [Criteria for assessing the quality of medical examinations of workers]. Medicina truda I promishlennaja ekologija [Occupational medicine and industrial ecology]. 2015; 11: 33-37.
5. Khanin AL, Chernushenko TI. Rasprostranennost respiratornih simptomov I vozmognosti vijavlenija hronicheskoj obstruktivnoi bolezni legkih v shahterskom gorode Kuzbassa [The prevalence of respiratory symptoms and the identification of chronic obstructive pulmonary disease in the mining town of Kuzbass]. Pulmonologija [Pulmonology]. 2012, 3: 59–62.
6. Petrov GP, Petrov AG, Semenihin VA. Metodicheskie podhodi k ocenke individualnogo kachestva gizni rabotajushih v ugolnoj otrasli [Methodological approaches to assessing the quality of life of an individual working in the coal industry]. Medicina truda I promishlennaja ekologija [Occupational medicine and industrial ecology]. 2015; 15: 22–25.
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UDC 617-002-036-037:616.153.963.32-074(048.8)
DOI: 10.20969/VSKM.2016.9(5).61-66
BAYMAKOV SAYFIDDIN R., C. Med. Sci., associate professor of the Department of surgery of Tashkent Medical Academy, Uzbekistan, 100109, Tashkent, Almazar region, Farabi str., 2, tel. +9 (9890)356-62-21, e-mail: bsayfiddin@yahoo.com
ASHURMETOV ABDURASHID KH., D. Med. Sci., professor, Head research worker of Scientific Research Institute of hematology and blood transfusion of the Republic of Uzbekistan, Uzbekistan, Tashkent, Yakkasaray region, Spitamen str., 26, tel. +9 (9871)250-89-57, e-mail: rrrh@mail.ru
Abstract. Aim. Analysis of modern data on investigation of informational and practical significance of qualitative and quantitative changes of cell-free DNA in blood. Material and methods. Review of publications of foreign authors, the data from randomized clinical and experimental studies was examined. Results and discussion. It was established, that the level of circulating DNA increases in numerous oncological diseases in different levets, which allows us to get data for monitoring of treatment effectiveness. Qualitative parameters of cell-free DNA are significantly dependent on methods of determination and on the reagents. The increase of the cell-free DNA level occurs in chronic to acute inflammation and further in severe infection and critical condition independently from used reagents. The levels of cell-free DNA correlate with such clinical parameters as mortality and severity of patient condition and can be used as a predictor. Conclusion. It is necessary to make further investigations in order to confirm these information, which should be performed in different populations and in other inflammatory conditions and diseases.
Key words: cell-free DNA, oncological diseases, chronic inflammation, acute inflammation, surgical diseases, severity of patient’s condition.
For references: Baymakov SR, Ashurmetov AKh. Cell free DNA as a feasible predictor of severity of patient’s condition in inflammatory surgical diseases. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 61—66.
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THE INFLUENCE OF METABOLIC SYNDROME AND PSYCHOEMOTIONAL TYPE OF THE PERSON ON QUALITY OF LIFE
UDC 616-008.9-052(048.8)
DOI: 10.20969/VSKM.2016.9(5).66-70
GORDEEVA ALLA YU., obstetrician-gynecologist of Clinic of obstetrics and gynecology of I.M. Sechenov the First Moscow State Medical University, obstetrician-gynecologist of V.F. Snegirev University clinic of obstetrics and gynecology, Russia, 119991, Moscow, Trubetskaya str., 8, b. 2, tel. +7-499-248-67-29, e-mail: ostalkaaa@gmail.com
TKACHYOVA MARIA V., endocrinologist, ultrasonographer of «Cecile’s Clinic» Ltd., Russia, 125047, Moscow, 1st Tverskaya-
Yamskaya lane, 13/5, e-mail: tkacheva_m@mail.ru
BELOSTOTSKY ANDREY V., D. Med. Sci., Director of Board of Directors for coordination of activities of medical organizations of the Department of health care of Moscow, Russia, 115280, Moscow, 2nd Avtozavodsky passage, 3, tel. +7-495-531-69-80 (ext. 100), +7-495-722-09-57, e-mail: belostotskyAV@zdrav.mos.ru
CHILOVA RAISA A., D. Med. Sci., professor of the Department of obstetrics and gynecology № 1 of I.M. Sechenov the First Moscow State Medical University, obstetrician-gynecologist of V.F. Snegirev University clinic of obstetrics and gynecology, Russia, 119991, Moscow, Trubetskaya str., 8, b. 2, tel. +7-985-761-91-35, е-mail: rtchilova@gmail.com
KOCHARIAN RENICK А., senior laboratory assistant of the Department of obstetrics and gynecology № 1 of I.M. Sechenov the First Moscow State Medical University, Russia, Moskow, tel. +7-985-423-32-23, e-mail: kocharyan.renik@yandex.ru
CHUSHKOV YURY V., C. Med. Sci., associate professor of the Department of obstetrics and gynecology № 1 of I.M. Sechenov, the First Moscow State Medical University, Russia, tel. +7-926-619-15-66, e-mail: yury-chushkov@rambler.ru
ZHUKOVA ELVIRA V., obstetrician-gynecologist, Head of the Department of medical-diagnostic № 1 of Clinic of obstetrics and gynecology of University Clinic of obstetrics and gynecology of I.M. Sechenov the First Moscow State Medical University, Russia, 119991, Moscow, Trubetskaya str., 8, b. 2, tel. +7-985-998-04-41, e-mail: zhukova.elvira@mail.ru
TRIFONOVA NATALYA S., C. Med. Sci., obstetrician-gynecologist of Clinic obstetrics and gynecology of the University hospital № 2 Medical University of I.M. Sechenov the First Moscow State Medical University, Russia, 119991, Moscow, Trubetskaya str., 8, b. 2, tel. +7-903-773-72-02, e-mail: trifonova.nataly@mail.ru
Abstract. Aim. Metabolic syndrome as a comorbid disease has a significant impact on quality of life and on psycho-emotional status of patients. The aim of the study is to assess the impact of metabolic syndrome on the quality of life and its dependence on psycho-emotional type of patient. Material and methods. Analysis of domestic and foreign literature on quality of life issues in metabolic syndrome. On the basis of analysis of recent studies we enlightened the impact of metabolic syndrome on the quality of life as well as the dependence of psycho-emotional type on perception of the disease. This review provides the rationale for the treatment of metabolic syndrome assessing the quality of life of patients with the help of validated questionnaires. In the course of therapy each doctor should take into account the psycho-emotional type of the patient. Conclusion. Modern medical community draws special attention to personalized medicine. In this regard a special place related to health is to be occupied by the quality of life. It is authentically proved that the evaluation of the quality of life during the course of treatment of metabolic syndrome helps to obtain the most favorable results.
Key words: metabolic syndrome, quality of life, obesity, psychological and emotional type of infertility.
For reference: Gordeeva AYu, Tkachyova MV, Belostotsky AV, Chilova RA, Kocharian RА, Chushkov YuV, Zhukova EV, Trifonova NS. Influence of the metabolic syndrome and psychoemotional type of the person on quality of life of the patient. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 66—70.
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THE CHARACTERISTICS OF DRUG METABOLISM DURING PREGNANCY
UDC 615.015.4:618.2(048.8)
DOI: 10.20969/VSKM.2016.9(5).70-75
SOKOVA ELENA A., C. Med. Sci., associate professor, senior research officer of Center of clinical pharmacology of Scientific Center for expert evaluation of medical products, Russia, 127051, Moscow, Petrovsky ave., 8, b. 2, e-mail: sokova2@rambler.ru
CHILOVA RAISA A., D. Med. Sci, professor of the Department of obstetrics and gynecology № 1 of I.M. Sechenov the First Moscow State Medical University, Russia, 119991, Moscow, Pirogovskaya str. 2, b. 4
PROCLOVA GUZEL F., laboratory assistant of the Department of obstetrics and gynecology № 1 of I.M. Sechenov the First Moscow State Medical University, Russia, 119991, Moscow, Pirogovskaya str. 2, b. 4
MEKSHA YURY V., C. Med. Sci., Head of the Department of obstetrics of V.F. Snegirev Clinic of obstetrics and gynecology of I.M. Sechenov the First Moscow State Medical University, Russia, 119991, Moscow, Pirogovskaya str. 2, b. 4
DEMIDOVA OLGA A., C. Pharm. Sci., research worker of Center of clinical pharmacology of Scientific Center for expert evaluation of medical products, Russia, 127051, Moscow, Petrovsky ave., 8, b. 2
Abstract. Aim. The article highlights contemporary scientific issues concerning the effects of pregnancy on drug metabolism and its clinical implications for drug therapy. Material and methods. The search for information on contemporary scientific issues of drug metabolism during pregnancy was performed in MEDLINE and in other internet resources based on key words: pregnancy, drugs, safety, efficacy, drug metabolism, CYP-450; enzyme. Results and discussion. Pregnancy is associated with significant physiologic changes that determine clinical pharmacology of drugs in maternal-placental-fetus complex. Pregnancy appears to increase the activity of some enzymes (CYP3A, CYP2D6, CYP2C9 and UGT), while other ones seem to have decreased activity (CYP1A2 and CYP2C19). Conclusion. Learning the effects of pregnancy on total drug exposure is often the first step in understanding drug’s pharmacokinetics and the potential need in medication selection and dosage (for example of glyburide, fluoxetine, lamotrigene).
Key words: pregnancy, drugs, safety, efficacy, drug metabolism, CYP-450, enzyme.
For reference: Sokova EA, Chilova RA, Proclova GF, Demidova OA. The characteristics of drug metabolism during pregnancy. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 70—75.
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ETIOLOGY AND PATHOGENESIS OF INFERTILITY IN OBESITY AS A COMPONENT OF METABOLIC SYNDROME
UDC 618.177:616-056.257:616-008.9(048.8)
DOI: 10.20969/VSKM.2016.9(4).75-79
TKACHEVA MARIA V., endocrinologist, ultrasonographer of «Cecil Clinic» Ltd., Russia, 125047, Moscow, 1st Tverskaya-Yamskaya, 13/5, e-mail: tkacheva_m@mail.ru
GORDEEVA ALLA YU., obstetrician-gynecologist of Clinic of obstetrics and gynecology of I.M. Sechenov the First Moscow State Medical University, obstetrician-gynecologist of V.F. Snegirev University clinic of obstetrics and gynecology, Russia, 119991, Moscow, Trubetskaya str., 8, b.2, e-mail: ostalkaaa@gmail.com
BELOSTOTSKY ANDREY V., D. Med. Sci., Director of Beard of Directors for coordination of activities of medical of organizations of the Department of health care of Moskow, Russia, 115280, Moscow, 2nd Avtozavodskii passage, 3, tel. +7-495-531-69-80 (ext. 100), +7-495-722-09-57, e-mail: belostotskyAV@zdrav.mos.ru
CHILOVA RAISA A., D. Med. Sci., professor of the Department of obstetrics and gynecology № 1 of I.M. Sechenov the First Moscow State Medical University, obstetrician-gynecologist of V.F. Snegirev University clinic of obstetrics and gynecology, Russia, 119991, Moscow, Trubetskaya str., 8, b.2, tel. +7-985-761-91-35, e-mail: rtchilova@gmail.com
KOCHARJAN RENIK A., senior laboratory assistant of the Department of obstetrics and gynecology № 1 of I.M. Sechenov the First Moscow State Medical University, Russia, Moskow, tel. +7-985-423-32-23, e-mail: kocharyan.renik@yandex.ru
ZHUKOVA ELVIRA V., obstetrician-gynecologist, Head of the Department of medical-diagnostic № 1 of Clinic of obstetrics and gynecology of University clinic of obstetrics and gynecology of I.M. Sechenov the First Moscow State Medical University, Russia, 119991, Moscow, Trubetskaya str., 8, b.2, tel. +7-985-998-04-41, e-mail: zhukova.elvira@mail.ru
TRIFONOVA NATALYA S., C. Med. Sci., obstetrician-gynecologist of Clinic obstetrics and gynecology of the University hospital № 2 Medical University of I.M. Sechenov the First Moscow State Medical University, Russia, 119991, Moscow, Trubetskaya str., 8, b.2, tel. +7-903-773-72-02, e-mail: trifonova.nataly@mail.ru
Abstract. Aim. Metabolic syndrome is a problem of social significance. However, this issue is twofold. On the one hand, all the processes and components of metabolic syndrome are reversible with timely initiated diagnosis and treatment. On the other hand, all of the components of metabolic syndrome lead to the diseases with extremely dangerous consequences and drastically impair quality of life. Material and Methods. Analysis of modern and relevant publications devoted to the problem of metabolic syndrome, obesity as an important component of the metabolic syndrome. Results and discussion. According to the analysis of the recent years of research there is a modern vision of etiology and pathogenesis of metabolic syndrome and obesity and on the impact of these conditions on the development of polycystic ovary syndrome and infertility. Early diagnosis and prevention of metabolic syndrome and obesity in childhood and adolescence are explained. The importance of early treatment of the metabolic syndrome, as a socially significant disease was indicated. Conclusion. The problem of timely diagnosis and treatment of metabolic syndrome is relevant for the whole medical community due to the avalanche-like increase of the metabolic syndrome in all countries.
Key words: obesity, infertility, polycystic ovarian syndrome, metabolic syndrome.
For reference: Tkacheva MV, Gordeeva AY, Belostotsky AV, Chilova RA, Kocharjan RA, Zhukova EV, Trifonova NS. Etiology and pathogenesis of infertility in obesity as a component of metabolic syndrome. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 75—79.
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UDC 618.33-037(048.8)
DOI: 10.20969/VSKM.2016.9(5).79-82
ULYANINA ELENA V., graduate student of the Department of obstetrics and gynecology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-903-306-44-25, e-mail: ualena87@yandex.ru
FATKHULLIN ILDAR F., D. Med. Sci., professor, Head of the Department of obstetrics and gynecology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-960-048-01-04, e-mail: Fatkullin@yandex.ru
KHAYRULLINA GUZYAL R., C. Med. Sci., associate professor of the Department of obstetrics and gynecology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-987-296-92-29, e-mail: bas.gulya@mail.ru
Abstract. Aim. To analyze the latest information on the role of growth factors and ultrasonic examination in the assessment of uteroplacental blood flow functioning in order to improve parental care for women suffering from severe fetal growth retardation syndrome. Material and methods. The literature dedicated to early prediction of fetal growth retardation syndrome through the identification of vascular endothelial growth factor in the blood and the increase of uterine artery pulsatility index via Doppler velocimetry was reviewed. Publications by Russian and foreign authors were considered to attention. Results and discussion. Identification of vascular endothelial growth factor in the blood of pregnant women and proved significant correlation between doppler velocimetry parameters at their critical values can be used as an indication for early delivery due to the high probability of antenatal fetal death in fetal growth retardation syndrome. Conclusion. In order to determine the optimal time for delivery in fetal growth retardation syndrome ultrasonic examination results and angiogenesis markers shall be considered.
Key words: angiogenic growth factor, vascular endothelial growth factor, fetal growth retardation syndrome, angiogenesis.
For reference: Ulyanina EV, Fatkhullin IF, Khayrullina GR. The markers of angiogenesis and ultrasonography in the assessment of severity of the fetal growth retardation syndrome. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 79—82.
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UDC 615.9(470.41)(091)
DOI: 10.20969/VSKM.2016.9(5).83-87
KHALITOV FARIT JA., C. Med. Sci., assistant of professor of the Department of general medicine of Kazan State Medical University, Russia, 424012, Kazan, Butlerov str., 49, e-mail: h_tox@mail.ru
BOMBINA LARISA K., C. Med. Sci., associate professor of the Department of general medicine of Kazan State Medical University, Russia, 424012, Kazan, Butlerov str., 49, tel. +7-960-039-47-13
ABDULGANIEVA DIANA I., D. Med. Sci., professor, Head of the Department of general medicine of Kazan State Medical University, Russia, 424012, Kazan, Butlerov, str., 49, tel. +7-987-296-27-68, e-mail: diana_s@mail.ru
Abstract. 19 June, 2016 is a 75-year anniversary since the birth of Ildar Gazimdzhanovich Salikhov — doctor of medical sciences, professor and corresponding member of the Academy of Sciences, Honored Worker of Science of the Republic of Tatarstan, Honored Doctor of the Republic of Tatarstan and of the Russian Federation. Aim. The study was conducted to establish the role of the professor I.G. Salikhov in organizing toxicological service in the Republic of Tatarstan. Material and methods. Analysis of archival materials, memoirs and publications of colegues, statistical information on the provision of toxicological assistance to the population in the Republic of Tatarstan. Results and discussion. The steps of creating toxicological service in Tatarstan were identified. The efficiency of organizational steps to create a service and research on diagnosis and treatment of acute poisoning, teaching students and training doctors undertaken by Professor I.G. Salikhov was estimated. Conclusion. Creating and improving toxicological assistance to the population, organization of scientific studies of acute poisoning as well as training of students and doctors in the Republic of Tatarstan in toxicology are resulting from activities of Professor I.G. Salikhov in the field of clinical toxicology.
Key words: Salikhov Ildar Gazimdzhanovich, toxicology, Kazan school of general medicine.
For reference: Khalitov FJa, Bombina LK, Abdulganieva DI. The role of Professor Ildar G. Salikhov in toxicologic assistance for the population of Tatartstan Republic (Dedicated to the 75th anniversary).The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 83—87.
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2. Salikhov IG, Margolin ES, Khalitov FJa. Klinicheskie osobennosti techenija ostryh otravlenij razlichnymi FOI i ih korrekcija [Clinical features of acute poisoning by various OIF and their correction]. Kazanskij medicinskij zhurnal [Kazan medical journal]. 1985; 4: 274-276.
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8. Khalitov FJa, Salikhov IG. Informacionnoe obespechenie vracha — opyt primenenija toksikologicheskih komp’juternyh trenazherov [Information support for doctor — experience with toxicology computer simulators].Salikhov IG, Margolin ES, Khalitov FJa. Opyt intensivnoj terapii ostryh otravlenij FOI [Intensive therapy of acute toxicosis]. Moskva: sbornik trudov NII SP imeni NV Sklifosovskogo [Moscow: a collection of works of research Institute SP them Sklifosovsky NV]. 1984; 57: 127–131.
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11. Salikhov IG, Akhmerov SF, Latfullin IA. Neotlozhnye sostojanija v praktike terapevta [Emergency conditions in the practice of the therapist: monographs]. Kazan: KGMU [Kazan: Kazan State Medical University]. 2000; 320 p.
UDC [616.98:579.873.21]-091(470.56)
DOI: 10.20969/VSKM.2016.9(5).88-93
MIKHAILOVSKY ALEXEY M., C. Med. Sci., Head of the Department of pathology of Orenburg Regional Clinical Tuberculosis Dispensary, assistant of proffesor of the Department of tuberculosis and pulmonology of Orenburg State Medical University, Russia, 460041, Orenburg, Nezhinsky highway, 6, tel. +7-922-627-75-22, e-mail: michailovsky2007@yandex.ru
CHURKIN SERGEY A., C. Med. Sci., Head of Orenburg Regional Clinical Tuberculosis Dispensary, Russia, 460041, Orenburg, Nezhinsky highway 6, tel. 8 (3532) 32-74-54, e-mail: oobo5@mail.ru
PASHKOVA NATALIA A., Head of the laboratory of Orenburg Regional Clinical Tuberculosis Dispensary, Russia, 460041, Orenburg, Nezhinsky shosse, 6, tel. +7-922-628-11-03, e-mail: pashkova.dom @ mail.ru
LEPEKHA LARISA N., D. Biol. Sci., professor, Head of the Department of pathology, cell biology and biochemistry of Central Research Institute of Tuberculosis, Russia, 107564, Moscow, Yauzskaya alley, 2, tel. (499) 785-91-79, e-mail: lep3@yandex.ru
Abstract. Aim. Description of clinical and morphological manifestations of the generalized case of nontuberculosis mycobacteriosis (NTMB) caused by Mycobacterium avium in a patient with terminal stage HIV infection diagnosed posthumously revealing the criteria of morphological diagnosis of nontuberculous mycobacteriosis. Material and methods. The study describes the clinical picture of the disease, using in-patient medical record data. Proprietary study included an autopsy with macroscopic description of inner organs, histological, bacteriological and molecular genetic studies of pathological material. After fixation in 10% neutral formalin the pieces of inner organs were embedded in paraffin. Prepared sections were stained with hematoxylin and eosin, Van Gieson, Ziehl-Nielsen reaction. The culture of Mycobacterium avium was identified in postmortem brain tissue of bone, lung, spleen and lymph nodes by real-time PCR followed by hybridization of amplification products on DNA strips. Results and discussion. We conducted a morphological and microbiological examination that revealed generalized mycobacterial infection caused by M. avium as the only type of the disease in the patient. Morphological features included subtotal dissemination of histiocytic macrophage granulomas with intracellular content of a large number of acid resistant bacteria, predominance of productive tissue reaction with a tendency to form sclerosis granulomas as well as fibrosis in the perifocal area in parenchymal organs. Conclusion. Our findings describe morphological features of the biopsy, surgical or autopsy material making it possible to suspect the presence of NTMB. It is necessary to conduct microbiological research on NTMB differentiation and molecular genetic identification of the species to confirm the diagnosis.
Key words: nontuberculous mycobacteriosis, respiratory insufficiency, HIV, mycobacterium avium.
For reference: Mikhailovsky AM, Churkin SA, Pashkova NA, Lepeha LN. The first case of post-mortem diagnosis of generalized non-tuberculosis mycobacteriosis in a patient at the late stage of HIV-infection in the Orenburg Region. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 88—93.
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