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ORIGINAL RESEARCH

The properties of Escherichia coli strains isolated in human inflammatory diseases. Godovalov A.P. (Russia, Perm),  Ozhgibesov G.P. (Russia, Perm), Nikulina E.A. (Russia, Perm) P. 7

Sleep apnea screening results in security agency and establishment employees. Golenkov A.V. (Russia, Cheboksary), Kurakina N.G. (Russia, Cheboksary),Naumova T.V. (Russia, Cheboksary), Vecherkina M.I. (Russia, Cheboksary) P.11

Pharmaceutical counseling in geriatric patients: study of retail pharmacist information needs. Grigorieva I.A. (Russia, Kazan), Egorova S.N. (Russia, Kazan), Akhmetova T.A. (Russia, Kazan), Bakaeva D.I.(Russia, Kazan) P.14

Assessment of the factors affecting the course of glomerulonephitis in hemorrhagic vasculitis. Zhitkova R.Sh. (Russia, Kazan) P.20

Anaphylaxis diagnosis and treatment issues in general medical practice. Kamasheva G.R. (Russia, Kazan), Sigitova O.N. (Russia, Kazan), Amirov N.B.(Russia, Kazan), Nadeeva R.А. (Russia, Kazan), Arkhipov E.V. (Russia, Kazan) P.24

Specificity of criteria for respiratory disease diagnosis applied for remote medical consultation problem solving. Katkova A.V. (Russia, Perm) P.30

Lifestyle and quality of life in firemen in udmurt republic. Kobylyatskaya I.A. (Russia, Izhevsk), Shkatova E.Y. (Russia, Izhevsk), Mokhova L.Ya. (Russia, Izhevsk), Filimonov A.M. (Russia, Izhevsk) P.35

Therapeutic comorbidity in men with acute coronary syndrome. Strelnikova M.V. (Russia, Chelyabinsk),Sineglazova A.V. (Russia, Kazan), Sigitova O.N. (Russia, Kazan) P.39

Lipoprotein metabolism indicators in young patients with arterial hypertension. Plekhova N.G. (Russia, Vladivostok), Nevzorova V.A. (Russia, Vladivostok),Rodionova L.V. (Russia, Vladivostok), Lagureva A.V.(Russia, Vladivostok), Maslennikova K.K. (Russia, Vladivostok), Tsygankov M.A. (Russia, Vladivostok), Dubov V.S. (Russia, Vladivostok) P.45

REVIEWS

Polysomnography diagnostic opportunities in general medical practice. Abdrakhmanova A.I. (Russia, Kazan), Tsibulkin N.A. (Russia, Kazan), Avdonina O.A.(Russia, Kazan), Shagiakhmetova L.Yа. (Russia, Kazan), Amirov N.B. (Russia, Kazan) P.52

Current issues of special emergency service operation in foreign countries. Kobylyatskaya I.A. (Russia, Izhevsk), Shkatova E.Yu. (Russia, Izhevsk), Mokhova L.Ya. (Russia, Izhevsk), Filimonov A.M. (Russia, Izhevsk), Medvedev M.S. (Russia, Izhevsk) P.60

New opportunities in achievement control over the course of severe bronchial asthma. Ovsyannikov N.V. (Russia, Omsk), Bilevich O.А. (Russia, Omsk), Zinchenko L.M. (Russia, Omsk), Kozlova E.A. (Russia, Omsk) P.63

Viral myocarditis in cardiologist practice. Oschepkova O.B. (Russia, Kazan), Tsybulkin N.A. (Russia, Kazan), Frolova E.B. (Russia, Kazan), Rudnitskaya L.A. (Russia, Kazan) P.69

Pathogenetic mechanisms of alcoholic cardiomyopathy development. Fadeev G.A. (Russia, Kazan),Tsibulkin N.A. (Russia, Kazan), Mikhoparova O.Y.(Russia, Kazan), Tukhvatullina G.V. (Russia, Kazan) P.75

Hypoalbuminemia and chronic heart failure. Khazova E.V. (Russia, Kazan), Bulashova O.V. (Russia, Kazan), Amirov N.B. (Russia, Kazan) P.81

SHORT MESSEGES

Early anastomositis after stomach resection. Illarionova I.N. (Russia, Cheboksary), Igonin Yu.A. (Russia, Cheboksary) P.86

ORGANIZATION OF HEALTHCARE

Morbidity analysis in internal affairs officers involved in civil order protection during the XXIX World winter universiade in Krasnoyarks in 2019 in terms of internal affairs officer team for Altai territory. Vyun O.G.(Russia, Barnaul), Antonov Yu.A. (Russia, Barnaul),Podzorova A.V. (Russia, Barnaul), Khoroshilov A.A.(Russia, Barnaul), Kochkina A.G. (Russia, Barnaul) P.90

The features of annual health examination organization in internal affairs bodies staff on a regional level on the territory of Sakha republic (Yakutia). Dolinskaya E.A. (Russia, Yakutsk), Gubko R.V. (Russia, Yakutsk) P.93

The role of routine medical examinations in occupational and corporal disease prevention. Fadeev G.A.(Russia, Kazan), Garipova R.V. (Russia, Kazan),Arkhipov E.V. (Russia, Kazan), Mikhoparova O.Yu. (Russia, Kazan), Berkheeva Z.M. (Russia, Kazan),Oshchepkova O.B. (Russia, Kazan), Safina K.R.(Russia, Kazan) P.100

EXPERIMENTAL STUDIES – TO PRACTICAL MEDICINE

Behavioral model factor analysis in experimental animals with different stress reactivity. Permyakov A.A. (Russia, Izhevsk), Isakova L.S. (Russia, Izhevsk), Mokhova L.Ya. (Russia, Izhevsk), Filimonov A.M. (Russia, Izhevsk) P.106

THESIS RESEARCHES

The role of laboratory parameters in a long-term prognosis in patients with myocardial infarction with different localization ST segment elevation. Kharisova E.Kh. (Russia, Kazan) P.110

Coronary artery restenosis risk factors in emergency or planned stenting. Shames D.V. (Russia, Kazan) P.116Coronary artery restenosis risk factors in emergency or planned stenting. Shames D.V. (Russia, Kazan) P.116

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ORIGINAL RESEARCH

UDC 579.842.11.083.1

DOI: 10.20969/VSKM.2019.12(4).7-10

PDF download THE PROPERTIES OF ESCHERICHIA COLI STRAINS ISOLATED IN HUMAN INFLAMMATORY DISEASES

GODOVALOV ANATOLIY P., ORCID ID: 0000-0002-5112-2003; SCOPUS Author ID: 57204065570; C. Med. Sci., leading researcher of the Central research laboratory, associate professor of the Department of microbiology and virology of Perm State Medical University named after acad. E.A. Wagner, Russia, 614990, Perm, Petropavlovskaya str., 26, tel. +7(342)236-44-85, e-mail: AGodovalov@gmail.com

OZHGIBESOV GEORGY P., the Head of Bacteriological laboratory of Center for State Sanitary and Epidemiological Surveillance of Medical Unit of the Ministry of Internal Affairs of Russia in the Perm region, Russia, 614990, Perm, Permskaya str., 128, tel. +7(342)264-22-55.

NIKULINA ELENA A., bacteriologist of Bacteriological laboratory of the Center for State Sanitary and Epidemiological Surveillance of Medical Unit of the Ministry of Internal Affairs of Russia in the Perm region, Russia, 614990, Perm, Permskaya str., 128, tel. +7(342)264-22-55

Abstract. Currently, we can see an increase in the incidence of infectious and inflammatory diseases caused by opportunistic pathogenic microorganisms. One of the leading positions among them belongs to Escherichia coli. Relatively little attention is paid to the study of individual properties of E. coli, as well as to the role of such atypical species in human disease development. Aim. The aim of the study was to assess the presence of E. coli in urogenital and respiratory tract inflammatory diseases, as well as the properties of the isolated strains. Material and methods. Microbiological study of urine, cervical discharge, upper respiratory tract, sputum of patients with inflammatory diseases, and intestinal discharge samples was carried out during the period of 2016–2018. The ability to move, lactose fermentation, citrate utilization as the sole carbon source, as well as urease and hemolytic activity was evaluated in the isolated E. coli strains. χ2 test was used for statistical data analysis. Differences were considered statistically significant at p<0,05. Results and discussion. Current study has shown that atypical E. coli strains are present in urogenital inflammatory diseases and in community-acquired pneumonia in more than a third of cases of E. coli recovery. The most common recorded colonies are represented by lactose-negative, hemolytic and immobile E. coli strains. Such findings may be related to the fact that the E. coli genome is characterized by high plasticity, which provides adaptation and «fitness» for the strains. It can be assumed that the loss of certain properties may be just necessary for successful unusual biotope colonization. On the other hand, urogenital and respiratory tract can be colonized only by those E. coli strains that are able to successfully rebuild their metabolism, for example, by reducing mobility and lactose utilization, but by retaining the ability to synthesize hemolysins. Conclusion. Thus, when conducting microbiological studies, it is necessary to take into account the atypical manifestations of E. coli properties, since such data may indicate additional factors that increase the virulence in the strains, allowing them more successful unusual biotope colonization.

Key words: Escherichia coli, lactose fermentation, motility, hemolytic activity, atypical strain, inflammation.

For reference: Godovalov AP, Ozhgibesov GP, Nikulina EA. The properties of Escherichia coli strains isolated in human inflammatory diseases. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 7-10. DOI: 10.20969/ VSKM.2019.12(4).7-10.

References

1. Stromberg ZR, Van Goor A, Redweik GAJ, Wymore Brand MJ, Wannemuehler MJ, Mellata M. Pathogenic and non-pathogenic Escherichia coli colonization and host inflammatory response in a defined microbiota mouse model. Dis Model Mech. 2018; 11 (11): dmm035063.

2. Mendoza-Palomar N, Balasch-Carulla M, González-Di Lauro S, Céspedes MC, Andreu A, Frick MA, Linde MÁ, Soler-Palacin P. Escherichia coli early-onset sepsis: trends over two decades. Eur J Pediatr. 2017; 176 (9): 1227- 1234.

3. Oppenheim B. Escherichia coli bacteraemia papers. J Hosp Infect. 2017; 95 (4): 363-364.

4. Vila J, Sáez-López E, Johnson JR, Römling U, Dobrindt U, Cantón R, Giske CG, Naas T, Carattoli A, Martínez-Medina M, Bosch J, Retamar P, Rodríguez-Baño J, Baquero F, Soto SM. Escherichia coli: an old friend with new tidings. FEMS Microbiol Rev. 2016; 40 (4): 437-463.

5. Guiral E, Bosch J, Vila J, Soto SM. Prevalence of Escherichia coli among samples collected from the genital tract in pregnant and non-pregnant women: relation- ship with virulence. FEMS Microbiol Lett. 2011; 314: 170-173.

6. Godovalov AP, Gushhin MO, Karpunina TI. Osobennosti mezhmikrobnyh otnoshenij v mikrobiote vlagalishha infertil’nyh zhenshhin [Features of intermicrobial relations in the microbiota of the vagina at infertile women]. Medicinskij vestnik Severnogo Kavkaza [Medical Bulletin of the North Caucasus]. 2019; 14 (1.1): 40-44.

7. Godovalov AP, Karpunina TI, Rakitina JuV. Sravnitel’nyj analiz rezul’tatov molekuljarno-geneticheskogo i kul’- tural’nogo issledovanija jejakuljata [Comparative analysis of the results of molecular-genetic and cultural studies of ejaculate]. Problemy medicinskoj mikologii [Medical Mycology Problems]. 2019; 21 (2): 57-58.

8. Sannes MR, Kuskowski MA, Owens K, et al. Virulence factor profiles and phylogenetic background of Escherichia coli isolates from veterans with bacteremia and uninfec- ted control subjects. J Infect Dis. 2004; 190: 2121- 2128.

9. Tenaillon O, Skurnik D, Picard B, Denamur E. The population genetics of commensal Escherichia coli. Nature Rev Microbiol. 2010; 8: 207-217.

10. Toussaint A, Chandler M. Prokaryote genome fluidity: toward a system approach of the mobilome. Methods Mol Biol. 2012; 804: 57-80.

11. Nowrouzian F, Adlerberth I, Wold AE. P fimbriae, capsule and aerobactin characterize colonic resident Escherichia coli. Epidemiol Infect. 2001; 126: 11-18.

12. Dale AP, Woodford N. Extra-intestinal pathogenic Escherichia coli (ExPEC): Disease, carriage and clones. J Infect. 2015; 71 (6): 615-626.

13. Pratt LA, Kolter R. Genetic analysis of Escherichia coli biofilm formation: roles of flagella, motility, chemotaxis and type I pili. Mol Microbiol. 1998; 30 (2): 285-293.

14. Magistro G, Magistro C, Stief CG, Schubert S. The high- pathogenicity island (HPI) promotes flagellum-mediated motility in extraintestinal pathogenic Escherichia coli. PLoS One. 2017; 12 (10): e0183950.

15. Ghazi A, Therisod H, Shechter E. Comparison of lactose uptake in resting and energized Escherichia coli cells: highrates of respiration inactivate the lac carrier. J Bacteriol.1983; 154 (1): 92-103.

 

UDC [616.24-008.444:616.8-009.836]-057.36-07

DOI: 10.20969/VSKM.2019.12(4).11-13

PDF download SLEEP APNEA SCREENING RESULTS IN SECURITY AGENCY AND ESTABLISHMENT EMPLOYEES

GOLENKOV ANDREI V., ORCID ID: 0000-0002-3799-0736; SCOPUS Author ID: 36096702300; D. Med. Sci., professor, the Head of the Department of psychiatry, medical psychology and neurology of Chuvash State University named after I.N. Ulyanov, Russia, 428015, Cheboksary, Moscovsky ave., 15, e-mail: golenkovav@inbox.ru

KURAKINA NADEZHDA G., psychiatrist, drugs counselor of Medical Unit of the Ministry of Internal Affairs of Russia for Chuvash Republic, Russia, 428000, Cheboksary, Yaroslavskaya str., 66, e-mail: msch21@mvd.ru

NAUMOVA TATYANA V., internist of Medical Unit of the Ministry of Internal Affairs of Russia for Chuvash Republic, Russia, 428000, Cheboksary, Yaroslavskaya str., 66, e-mail: msch21@mvd.ru

VECHERKINA MARINA I., occupational therapist of Medical Unit of the Ministry of Internal Affairs of Russia for Chuvash Republic, Russia, 428000, Cheboksary, Yaroslavskaya str., 66, e-mail: msch21@mvd.ru

Abstract. Aim. The aim of the research was to study the prevalence of sleep apnea in a representative sample of security forces and departments (from police officers and rescuers). Material and methods. 670 employees of security agencies and departments (Ministry of Internal Affairs and the Ministry of Emergency Situations) aged 21 to 54 years [mean age (34,4±6,2) years] were examined at the medical unit of the Ministry of Internal Affairs of Russia for Chuvash Republic in Cheboksary. 347 people belonged to the Ministry of Emergency Situations. 323 were the servants of the Ministry of Internal Affairs. 302 of them were not ranked officers (45,1%). 368 people were officers (54,9%). The questionnaire and Epworth’s drowsiness scale were used for screening. Results and discussion. The likelihood of sleep apnea was found in 18 (2,68%) employees of security agencies and departments, with no significant difference between the Ministry of Internal Affairs and the Ministry of Emergency Situations. Those who had apnea were significantly older; they had greater service experience, body mass index and neck circumference, as well as the total score according to the Epworth drowsiness scale. Despite the absence of significant difference in apnea prevalence in employees of the Ministry of Internal Affairs and the Ministry of Emergency Situations, the same mean age and sleepiness severity according to the Epworth scale, there were more people having risk factors, including a greater body mass index, among the servants of the 1st Ministry. The data on the prevalence of obstructive sleep apnea in law enforcement officers and departments correspond to the general population (1–3%), but the numbers are smaller comparing to those described in the publications, which may be related to the use of self-assessment based questionnaires. Law enforcement officers in Chuvashia smoked or consumed alcohol much less frequently; fewer of them were overweight or obese when compared with the data from the studies conducted in other regions. Conclusion. It is important to conduct screening for sleep apnea in security forces, especially in the older age group, in the servants who have officer rank and health risk factors, not only by using questionnaires and scales, but also applying instrumental study methods.

Key words: obstructive sleep apnea syndrome, prevalence, police, rescuers.

For reference: Golenkov AV, Kurakina NG, Naumova TV, Vecherkina VI. Sleep apnea screening results in security agency and establishment employees. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 11-13. DOI:10.20969/VSKM.2019.12(4).11-13.

References

1. Golenkov AV, Kurakina NG. Rasprostranennost’ faktorov riska zdorov’yu sredi sotrudnikov pravoohranitel’nyh organov [Prevalence of health risk factors among law enforcement officers]. Voprosy narkologii [Narcology questions]. 2013; 4: 73-81.

2. Golenkov AV, Kurakina NG, Prokop’eva EF, Golishnikova LI. Narusheniya sna u sotrudnikov organov vnutrennih del [Sleep disorders in the internal affairs bodies]. Medicinskij vestnik MVD [Medical Bulletin of the Ministry of Internal Affairs]. 2014; 2 (69): 68-71.

3. Mednov VN, Red’ko VV, Orlova OS, et al. Opyt vnedreniya v praktiku metodov diagnostiki i lecheniya sindroma obstruktivnogo apnoe sna (v MSCh MVD Rossii po Vologodskoj oblasti) [Experience of implementing methodsof diagnosing and treating obstructive sleep apnea inpractice (in the NFM and the Ministry of Internal Affairs of Russia in the Vologda region)]. Medicinskij vestnik MVD [Medical Bulletin of the Ministry of Internal Affairs]. 2017; 1 (86): 14-21.

4. Shogenov AG, El’garov AA, Makitova MP, et al. Dyhatel’nye rasstrojstva vo sne u policejskih: chastota, serdechno- sosudistye riski, professional’naya rabotosposobnost’ [Respiratory disorders in a dream at police officers: frequency, cardiovascular risks, professional performance]. Medicinskij vestnik MVD [Medical Bulletin of the Ministry of Internal Affairs]. 2017; 3 (88): 73-78.

5. Klawe JJ, Laudencka A, Miśkowiec I, Tafil-Klawe V.Occurrence of obstructive sleep apnea in a group of shiftworked police officers. J Physiol Pharmacol. 2005; 56, 4: 115-117.

6. Poluektova MG ed. Somnologiya i medicina sna: nacional’noe rukovodstvo pamyati AM Vejna i YaI Levina [Sleep Somnology and Medicine: A National Memory Guide AM Wayn and YaI Levin]. Moskva: Medforum [Moscow: Medforum]. 2016; 664 p.

 

UDC 615.15:616-053.9:378.046.4

DOI: 10.20969/VSKM.2019.12(4).14-19

PDF download PHARMACEUTICAL COUNSELING IN GERIATRIC PATIENTS: STUDY OF RETAIL PHARMACIST INFORMATION NEEDS

GRIGORIEVA IRAIDA A., postgraduate student of Institute of pharmacy of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49

EGOROVA SVETLANA N., ORCID ID: 0000-0002-3212-8282; SCOPUS Author ID: 7005682318; D. Pharm. Sci., professor, deputy director for education of Institute of pharmacy of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49

AKHMETOVA TATYANA A., С. Pharm. Sci., senior lecturer of Institute of pharmacy of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49

BAKAEVA DANIA I., deputy director for education of Medical Pharmaceutical College of Kazan State Medical University, Russia, 420021, Kazan, Tukay str., 73

Abstract. Aim. The aim of the study was to identify the information needs in pharmaceutical workers required for effective elderly patient counseling. Material and methods. A survey was conducted in retail pharmacists as well as in the ones undergoing continuous professional training in Kazan. The specialists were offered an original questionnaire «The features of counseling elderly patients». Results and discussion. 81,6% of pharmacy workers indicated that half or more pharmacy visitors are elderly persons. They are being advised on the use of prescription and over the counter medicines as well as the other groups of pharmaceutical products, but the pharmaceutical workers themselves are not educated on important signs of the diseases that require urgent referral to the doctor, and their self-assessment of medical knowledge is inadequate. It is alarming that no pharmaceutical worker has fully named all of the pharmacokinetic features in elderly patients. At the same time, only 69,44% of pharmaceutical chemists and 56,60% of pharmacists consider it necessary to increase the level of knowledge of geriatric patient counseling. The most common reasons for pharmacy visits in elderly patients have been identified. A negative trend has been revealed. Pharmaceutical workers are selling prescription drugs as over-the-counter and give recommendations on prescription drugs, as it was noted in the questionnaire by 9,43% of pharmaceutical chemists and 19,44% of pharmacists. Apparently, it might be related to the lack of control over the level of knowledge on the subject of pharmaceutical counseling in geriatric patients to be acquired during additional professional training, continuous medical and pharmaceutical education and to be evaluated on certification exam. It is necessary to develop educational materials on counseling elderly patients, taking into account the features of pharmacokinetics and pharmacodynamics in the elderly. Conclusion. The results of the survey showed that pharmaceutical workers are not sufficiently prepared to counsel geriatric patients visiting pharmacies. The necessity of developing the algorithms for pharmaceutical counseling in geriatric patients as well as the training on pharmacotherapy features in elderly for the system of additional professional education has been established.

Key words: elderly patients, geriatrics, pharmaceutical counseling, pharmacokinetics in elderly patients.

For reference: Grigorieva IA, Egorova SN, Akhmetova TA, Bakaeva DI. Pharmaceutical counseling in geriatric patients: study of retail pharmacist information needs. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 14-19. DOI: 10.20969/VSKM.2019.12(4).14-19.

References

1. Yarygin VN, Melent’ev AS. Rukovodstvo po gerontologii i geriatrii; Osnovy gerontologii; Obshchaya geriatriya [Manual on geriatric and gerontology; Basic gerontology; General geriatrics]. Moskva: GEOTAR-Media [Moscow: GEOTAR-Media]. 2010; 1 (4): http://www.rosmedlib.ru/book/ISBN9785970416877.html

2. Ushkalova EA, Tkacheva ON, Runihina NK, Chuhareva NA, Bevz AYu. Osobennosti farmakoterapii u pozhilyh pacientov; Vvedenie v problemu [Features of pharmacotherapy in the elderly patients; Introduction to

the problem]. Racional’naya farmakoterapiya v kardiologii [Rational Pharmacotherapy in Cardiology]. 2016; 1 (12): 94-100.

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5. Ushkalova EA. Polipragmaziya v geriatrii [Polypharmacy in geriatrics]. Voprosy organizacii i informatizacii zdravoohraneniya [Issues of Organization and Informatization of Healthcare]. 2018; 2 (95): 120-130.

6. Prikaz Ministerstva truda i social’noj zashchity RF ot 9 marta 2016 goda № 91n «Ob utverzhdenii professional’nogostandarta «Provizor» [Order of Ministry of Health Russian Federation from 9 March 2016 № 91 «On ratifi cation of new professional standard: Pharmacist»]. 2016.

7. Gabdrafikova YU.S, Kirshchina IA, Soloninina AV. Farmacevticheskaya pomoshch’ geriatricheskim pacientam: aktual’nost’, problemy, puti resheniya [Farmaceutical help for geriatric patients: vital problems and possible solutions]. Farmaciya [Pharmacy]. 2018; 5: 35-41.

8. Timofeeva TS. Vozrast kak integrativnyj pokazatel’ dlya izucheniya potrebitel’skogo povedeniya [Age as an Integrative Indicator for Studying Consumer Behaviour]. Mir nauki, kul’tury, obrazovaniya [World of Science, Culture, Education]. 2017; 2 (63): 282-285.

9. Bazeko NP, Alekseenko YuV. Vsemirnaya Organizaciya Zdravoohraneniya: Insul’t – programma vozvrata k aktivnoj zhizni [World Health Organization: Stroke – program of return to active life]. Moskva : Meditsinskaya literatura [Moscow: Medical literature]. 2004; 256 p.

10. Ryzhova OA, Moroz TL. Problemy konsul’tacionnogo soprovozhdeniya bezrecepturnogo otpuska lekarstvennyh preparatov [Problems of Consulting Support for Over-the-Counter Medicines]. Medicinskij vestnik Bashkortostana [Bashkortostan Medical Journal]. 2016; 5 (65): 49-53.

 

UDC 616.611-002-07:616.13/.14-002.151

PDF download ASSESSMENT OF THE FACTORS AFFECTING THE COURSE OF GLOMERULONEPHITIS IN HEMORRHAGIC VASCULITIS

ZHITKOVA RENATA SH., C. Med. Sci., associate professor of the Department of advanced internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49; cardiologist of outpatient clinic of Republic Clinical Hospital of the Ministry of Health of the Republic of Tatarstan, tel. 8-937-628-62-17, e-mail: stelsy@mail.ru

Abstract. Aim. The aim of the research was to study laboratory parameters that affect the course of glomerulonephritisin hemorrhagic vasculitis. Material and methods. 127 patients with hemorrhagic vasculitis aged between 15 and 72 years were under observation. Of these, 48,0% were men (61 person) and 52,0% – women (66 persons). Men and women with this disease belonged to the same age group. Duration of hemorrhagic vasculitis ranged from 1 month to 20 years. Indicators of proteinuria, β2-microglobulinuria, fibronectinuria, leukocyturia (including lymphocyturia), and erythrocyturia were assessed in patients with hemorrhagic vasculitis. Serum urea, albumin, globulin, immunoglobulins (Ig), circulating immune complexes (CIC), cryoglobulins, fibrinogen and electrolytes were determined. Creatinine, uric acid, oxypurinol, and electrolytes were counted in two biological fluids and their clearance was calculated. Moreover, the recruited patients were monitored for blood pressure changes. Results and discussion. β2-microglobulinuria urine level increases with the age of patients, but it shows inverse correlation relationship with glomerulonephritis development in hemorrhagic vasculitis. Attention is drawn to the fact that in patients with glomerulonephritis and hemorrhagic vasculitis β2-microglobulinuria does not depend on the presence of nephrotic syndrome or renal failure. In turn, these factors clearly affect proteinuria and fibronectinuria level. The presented data of fibronectinuria reflect the severity of glomerular changes in glomerulonephritis and hemorrhagic vasculitis. β2-microglobulinuria indicates tubulointerstitial damage even in patients with hemorrhagic vasculitis without glomerulonephritis. Conclusion. The degree of glomerular damage correlates with fibronectinuria, IgM levels and fibrinogen. Urine fibronectin levels > 0,64 μg/ml, IgM > 1,7 g/l and serum fibrinogen > 6,3 g/l indicate a severe course of glomerulonephritis with hemorrhagic vasculitis, and are unfavorable signs. Urine β2-microglobulin parameter characterizes the presence of tubular interstitial lesions even in the absence of glomerulonephritis withhemorrhagic vasculitis and it does not depend on the presence of nephrotic syndrome or renal failure. There is acorrelation of mean arterial pressure with proteinuria level.

Key words: hemorrhagic vasculitis, glomerulonephritis, fibronectinuria, ß2-microglobulinuria, nephrotic syndrome,arterial blood pressure.

For reference: Zhitkova RSh. Assessment of the factors affecting the course of glomerulonephritis in hemorrhagic vasculitis. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 19-23. DOI: 10.20969/VSKM.2019.12(4).19-23.

References

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  6. Vogt B. Nephrology update: glomerular disease in children. FP Essent. 2016; 444 (5): 30-40.

  7. Aggarwal R, Gupta A, Naru J, et al. HLA-DRB1 in Henoch- Schonlein purpura: A susceptibility study from North India. Hum Immunol. 2016; 77 (7): 555-558.

  1. Albaramki J. Henoch-Schonlein purpura in childhood a fifteen-year experience at a tertiary hospital. J Med Liban. 2016; 64 (1): 13-17.

  2. Zhao YL, Liu ZJ, Bai XM, et al. Obesity increases the risk of renal involvement in children with Henoch- Schönlein purpura. Eur J Pediatr. 2015; 174 (10): 1357- 1363.

  3. Nicoara O, Twombley K. Immunoglobulin A nephropathy and immunoglobulin A vasculitis. Pediatric Clinics of North America. 2019; 66 (1): 101-110.

  4. Kolesnik MO, Lapchinskaya II. Bolezn’ Berzhe – atipichnyy gemoragicheskiy vaskulit? [Berger disease – an atypical haemorrhagic vasculitis?]. Ukrainskiy revmatologicheskiy zhurnal [Ukrainian rheumatological journal]. 2001; 5 (3): 42-44.

  5. Соppo R, Mazucco S. Long term prognosis of Henoch – Schoenlein nephritis in adults and children. Nephrol Dial Transplant. 1997; 12: 2277-2283.

  6. Kulacova NV, Nevzorova VA, Lukjanova PA, Geltser BI. Biochimicheskie markeri vospolenia i obstructsii bronchov [Biochemical markers of inflammation and bronchial obstruction]. Klinicheskaya meditsina [Clinical medicine]. 2000; 78 (3): 36-39.

 

UDC 612.017.3+616-001.36-02:616-056.3

DOI: 10.20969/VSKM.2019.12(4).23-29

PDF download ANAPHYLAXIS DIAGNOSIS AND TREATMENT ISSUES IN GENERAL MEDICAL PRACTICE

KAMASHEVA GULNARA R., ORCID ID: 0000-0002-6811-4966; C. Med. Sci., associate professor of the Department of policlinical therapy and general medical practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: gulnara.kamasheva@mail.ru

SIGITOVA OLGA N., ORCID ID: 0000-0001-8983-245X; D. Med. Sci., professor of the Department of policlinical therapy and general medical practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49

AMIROV NAIL B., ORCID ID: 0000-0003-0009-9103; D. Med. Sci., professor of the Department of policlinical therapy and general medical practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49

NADEEVA ROZALIYA А., ORCID ID: 0000-0001-5881-5278; C. Med. Sci., associate professor of the Department of policlinical therapy and general medical practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49

ARKHIPOV EVGENIY V., ORCID ID: 0000-0003-0654-1046; C. Med. Sci., associate professor of the Department of policlinical therapy and general medical practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: jekaland@mail.ru

Abstract. The steady increase in anaphylactic reaction incidence and high mortality from them indicate the importance of the problem. Aim. The aim of the study was to analyze current clinical guidelines for anaphylaxis/anaphylactic shockdiagnosis and treatment and to assess the initial professional primary care physician training in terms of anaphylacticshock diagnosis and treatment. Material and methods. Analysis of modern clinical guidelines was carried out. Initial professional knowledge in diagnosing and providing emergency medical care in anaphylactic shock was assessed in 40 primary care physicians who were trained in advanced training courses in the field of «Internal medicine» and «General Medical Practice (Family Medicine)». Results and discussion. Current clinical guidelines on anaphylaxis/anaphylactic shock contain diagnostic and treatment algorithms that doctors of all specialties have to follow. A study in 40 primary care physicians suggests that the diagnosis of anaphylactic shock does not cause any particular difficulties. However, when analyzing measures to provide emergency medical care in anaphylactic shock, we revealed inconsistencies with theguidelines. Conclusion. In order to improve the knowledge in doctors, it is recommended to include practical training on anaphylaxis/anaphylactic shock diagnosis and treatment, based on the clinical guidelines in advanced training program.Key words: anaphylaxis, anaphylactic shock, epinephrine.

For reference: Kamasheva GR, Sigitova ON, Amirov NB, Nadeeva RА, Arkhipov EV. Anaphylaxis diagnosis and treatment issues in general medical practice. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 23-29. DOI:10.20969/VSKM.2019.12(4).23-29.

References

  1. Haitov RM, Il’ina NI, et al. Allergologija i klinicheskaja immunologija; Klinicheskie rekomendacii [Allergology and clinical immunology; Clinical guidelines]. Moskva: GJeOTAR-Media [Moscow: GEOTAR-Media]. 2019; 336 p.

  2. Haitov RM, Il’ina NI, et al. Allergologija i immunologija : nacional’noe rukovodstvo [Allergology and immunology: national leadership]. Moskva: GJeOTAR-Media [Moscow: GEOTAR-Media]. 2014; 656 p.

  3. Fomina DS, Gorjachkina LA. Anafilaksija – diagnostika i lechenie [Anaphylaxis – diagnosis and treatment]. Moskva: Rossiyskaya meditsinskaya akademiya nepreryvnogo professional’nogo obrazovaniya [Moscow: Russian Medical Academy of Continuing Professional Education]. 2017; 95 p.

  4. Panesar SS, Javad S, de Silva D, et al. The epidemiology of anaphylaxis in Europe: a systematic review. Allergy. 2013; 68 (11): 1353–1361.

  5. Astafeva NG Gamova IV, Gorjachkina LA, et al. Anafilaksija: kljuchevye aspekty diagnostiki, lechenija i profilaktiki v sovremennyh klinicheskih rukovodstvah [Anaphylaxia: key aspects of diagnostics, treatment and prevention in modern clinical manuals]. Farmateka [Pharmateca]. 2013; S1: 8–16.

  6. Astafeva NG, Gamova IV, Kobzev DJ, et al. Pishhevaja anafilaksija: problemy pacienta, vracha i obshhestva [Food anaphylaxis: problems of the patient, doctor and society]. Jeffektivnaja farmakoterapija [Effective pharmacoherapy]. 2016; 6: 38-49.

  7. Simons FE, Ardusso LR, Simons FE, et al. World Allergy Organization Anaphylaxis Guidelines: 2013 update of the evidence base. Int Arch Allergy Immunol. 2013; 162 (3): 193–204.

  8. Muraro A, Roberts G, Worm M, et al. Anaphylaxis: guidelines from the European Academy of Allergy and Clinical Immunology. Allergy. 2014; 69 (8): 1026– 1045.

  9. Prikaz Ministerstva zdravoohranenija RF ot 10 maja 2017 goda No 203n «Ob utverzhdenii kriteriev ocenki kachestva medicinskoj pomoshhi» [Order of the Ministry of health of the Russian Federation of May10, 2017 «On the approval of criteria for assessing the quality of medical care»]. 2017; https://www.garant.ru/products/ipo/prime/ doc/71575880/

 

UDC 616.2-07:004.9 616.2

DOI: 10.20969/VSKM.2019.12(4).29-35

PDF download SPECIFICITY OF CRITERIA FOR RESPIRATORY DISEASE DIAGNOSIS APPLIED FOR REMOTE MEDICAL CONSULTATION PROBLEM SOLVING

KATKOVA ANASTASIYA V., ORCID ID: 0000-0002-1496-0112; C. Med. Sci., associate professor of the Department of introduction into internal medicine No 1 of Perm State Medical University named after acad. E. Wagner, Russia, 614107, Perm, KIM str., 2, e-mail: avf0707@yandex.ru

Abstract. Aim. The aim of the study was to evaluate the effectiveness of the diagnostic criteria available for remote telemedicine technologies, for a number of bronchial obstructive diseases, lung parenchyma lesions (pneumonia), andlung cancer. Material and methods. Interactive survey was performed in 203 respondents using the respiratory module of the Electronic Clinic automated system. Among those there were 45 patients with bronchial obstructive diseases, 37 ones with community-acquired pneumonia, 31 patients with lung cancer and 90 healthy persons. Statistical data processing was performed using Statistica 10.0 software. Results and discussion. The use of a standard electronicquestionnaire revealed that of the 157 studied signs highly specific and sensitive bronchial obstructive disease symptoms are paroxysmal nature of shortness of breath in the early morning and night hours, and noisy wheezing; for community- acquired pneumonia – it is a fever. Hemoptysis, general weakness and decreased physical activity are of the greatestdiagnostic value for lung cancer diagnosis. The electronic standard scale for respiratory disease diagnosis via surveyfor counseling in remote access mode can contain no more than 15 questions, while it should be based on the most specific symptoms in relation to a particular respiratory disease. Conclusion. The results of the study made it possibleto create a scale of standard questions for respiratory disease diagnosis that can be limited to 15 questions.

Key words: complaint specification, respiratory symptom sensitivity and specificity, respiratory diseases.

For reference: Katkova AV. Specificity of criteria for respiratory disease diagnosis applied for remote medical consultation problem solving. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 29-35. DOI: 10.20969/ VSKM.2019.12(4).29-35.

References

  1. Muxin NA, Moiseev VS. Propedevtika vnutrennix boleznej [Propedeutics of internal diseases]. Moskva: GE`OTAR – Media [Moskva: GEOTAR – Media]. 2008; 58 p.
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  3. Mishlanov VYu, Mishlanov YaV, Katkova AV et al. Interaktivnoe anketirovanie bol`nogo i razvitie avtoma- tizirovanny`x sistem pomoshhi vrachu obshhej klinicheskoj praktiki v diagnostike respiratorny`x zabolevanij [Interactive questioning of the patient and the development ofautomated systems to help the general practitioner in thediagnosis of respiratory diseases]. Zhurnal neprery`vnogo medicinskogo obrazovaniya «Prakticheskaya pul`mono- logiya», Atmosfera [Journal of Continuing Medical Education «Practical Pulmonology», Atmosphere]. 2016; 1: 24-29.
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  1. Khronicheskaya obstruktivnaya bolezn` legkix [Chronic obstructive pulmonary disease]. Federal`ny`e klinicheskie rekomendacii Rossijskogo respiratornogo obshhestva [Federal clinical guidelines of the Russian Respiratory Society]. 2018; http://spulmo.ru/obrazovatelnye-resursy/ federalnye-klinicheskie-rekomendatsii/

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10. By`chkov MB. Melkokletochny`j rak legkogo [Small cell lung cancer]. Moskva: Farmarus Print Media [Moscow: Farmarus Print Media]. 2013; 263 p.

11. Traxtenberg AX, Kolbanov IK. Rak legkogo [Lung cancer]. AtmosferA: Pul`monologiya i allergologiya [AtmosphereA: Pulmonology and allergology]. 2008; (4): 3-9.

12. Demidchik YuE. Rak legkogo [Lung cancer]. Meditsin- skiy portal: Stat’i o zdorov’ye i meditsine: Onkologiya i gematologiya [Medical portal: Articles about health and medicine: Oncology and hematology]. 2011; https://www. medcentre.com.ua/articles/Rak-legkogo-28314

 

UDC 614.842.83.05(470.51)

DOI: 10.20969/VSKM.2019.12(4).35-38

PDF download LIFESTYLE AND QUALITY OF LIFE IN FIREMEN IN UDMURT REPUBLIC

KOBYLYATSKAYA IRINA A., ORCID ID: https://orcid.org/0000-0002-4104-1007; full-time postgraduate student of the Department of disaster medicine and life safety of the Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunar str., 281, e-mail: kolybri@gmail.com

SHKATOVA ELENA Y., ORCID ID: https://orcid.org/0000-0003-2027-6277; D. Med. Sci., professor, the Head of the Department of disaster medicine and life safety of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunar str., 281, e-mail: army@igma.udm.ru

MOKHOVA LUDMILA YA., ORCID ID: https://orcid.org/0000-0002-7121-1265; internal service colonel, the Head of Medical Unit of the Ministry of Internal Affairs of Russia for the Udmurt Republic, Russia, 426035, Izhevsk, Serov str., 69, e-mail: medic.18@mvd.ru

FILIMONOV ALEXANDER M., ORCID ID: https://orcid.org/0000-0003-3797-9526; C. Med. Sci., lieutenant colonel of internal service, the Head of the Hospital of Medical Unit of the Ministry of Internal Affairs of Russia for the Udmurt Republic, Russia, 426035, Izhevsk, Serov str., 69, e-mail: medic.18@mvd.ru 

Aim. The aim of the research was to study social and hygienic features and quality of life in firemen in the Udmurt Republic. Material and methods. Survey according to the method of continuous research was conducted in order to obtain information on social and hygienic factors that affect health in 169 male firemen using an original questionnaire «Social and hygienic characteristics of employee of the Ministry of Emergency Situations», which includes 68 questions. Analogue of the universal questionnaire «SF-36 Health status survey» in Russian language was used to assess the quality of life. The survey was conducted according to the principle of voluntary informed consent. Statistical data analysis was carried out. It included absolute and relative value calculation, indicator statistical significance and difference determination. Student criterion was applied in the course of the study with a probability of 95,0% for biomedical research. Results and discussion. Lifestyle analysis in firemen allowed us to present a social hygienic portrait: this is a man aged (30,7±6,2) years, who often has a secondary specialty (47,0%) or a higher education (35,3%), he is married (59,7%), keeps regular balanced diet with hot food consumption (85,3%), is engaged in physical training in his spare time. The adverse factors identified include non-compliance with the daily and rest regimen (75,3%), adherence to bad habits – smoking (34,7±5,8)% and drinking alcohol every weekend (24,3±3,2)%. Significant decrease (t=2,31, p<0,05) in integral quality of life indicator was revealed in 3,8% of the firemen with work experience of more than 5 years. Conclusion. Identified risk factors and features of the work of firefighters in the Udmurt Republic can lead to chronic disease exacerbation. Modern medical and preventive measures and commitment to a healthy lifestyle would help to preserve and strengthen the state of health and professional longevity.

Key words: firemen, lifestyle, quality of life.

For reference: Kobylyatskaya IA, Shkatova EY, Mokhova LYa, Filimonov AM. Lifestyle and quality of life in firemen in Udmurt Republic. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 35-38. DOI: 10.20969/ VSKM.2019.12(4).35-38.

References

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2. Golikova TD. Vvedenie edinyh standartov pozvolit upravlyat’ kachestvom okazaniya medicinskoj pomoshchi [The introduction of uniform standards will allow to manage the quality of medical care]. Glavnyj vrach [Head physician]. 2009; (1): 12.

3. Bullinger M, Blome C, Sommer R, Lohrberg D, Augustin M. Health-related quality of life: a pivotal endpoint in benefit assessment of medical procedures.Bundesgesundheitsblatt GesundheitsforschungGesundheitsschutz. 2015; 58 (3): 283-290. DOI: 10.1007/ s00103-014-2107-0.

4. Prigent A, Simon S, Durand-Zaleski I, Leboyer M, Chevreul K. Quality of life instruments used in mental health research: properties and utilization. Psychiatry Research. 2014; 30: 1–8.

5. Kydyrbaeva EO, Shomshekova BK. Konceptual’nye podhody k opredeleniyu ponyatij «blagosostoyanie», «kachestvo zhizni», «uroven’ zhizni» [Conceptual approaches to the definition of the concepts of «Welfare», «Quality of life», «Living Standard»]. Vestnik Kyrgyzsko- Rossijskogo Slavyanskogo universiteta [Bulletin of the Kyrgyz-Russian Slavic University]. 2017; 17 (11): 38-42.

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8. Poroshin AA, Harin VV, Bobrinev EV, Shavyrina TA. Analiz zabolevaemosti, travmatizma, gibeli, invalidnosti i smertnosti lichnogo sostava podrazdelenij MChS Rossii za 2010–2014 gg. [Analysis of morbidity, injuries, death, disability and mortality of personnel of units EMERCOM of Russia for 2010–2014]. Mediko-biologicheskie i social’no- psihologicheskie problemy bezopasnosti v chrezvychajnyh situa ciyah [Medical-biological and socio-psychological problems of security in emergency situations]. 2015; (4): 18-22.

9. Gorbach NA, Zharova AV, Lisnyak MA, Koloskova TP, Timofeeva TYu, Trepashko TV. Metodologiya izucheniya i sohraneniya zdorov’ya uchastnikov obrazovatel’nogo processa v VUZe [Methodology for studying andpreserving of the health of participants in educationalprocess at the university]. Krasnoyarsk: SibYUI FSKN Rossii [Krasnoyarsk: SibUI FSKN of Russia]. 2012; 248 p.

10. World Health Organization. Global status report on alcohol and health 2014. 2014; URL: https://apps.who.int/iris/ bitstream/handle/10665/112736/9789240692763_eng. pdf;jsessionid=E927DFCCFFF851ED07A2209ADAE1 3429?sequence=1

11. Goryaev DV, Tihonova IV, Dogadin FV. Rasprostranennost’ kureniya i risk utraty zdorov’ya naseleniya Krasnoyarskogo kraya [The prevalence of smoking and the risk of loss of the population`s health of the Krasnoyarsk Territory]. Gigiena i sanitariya [Hygiene and Sanitation]. 2015; 94 (2): 23-28.

12. Shkarin VV, Denisenko MK, Blagonravova AS. Epidemio- logicheskoe issledovanie osobennostej rasprostraneniya alkogolizma v Nizhegorodskoj oblasti [Epidemiologicalstudy of the distribution of alcoholism in the regionof Nizhny Novgorod]. Medicinskij al’manah [Medical Almanac]. 2016; 43 (3): 136-143.

 

UDC 616.132.2-036.11-055.1-06:616.1/.9

DOI: 10.20969/VSKM.2019.12(4).39-44

PDF download THERAPEUTIC COMORBIDITY IN MEN WITH ACUTE CORONARY SYNDROME

STRELNIKOVA MARIA V., a person assigned to prepare a thesis for a candidate of science degree without completion of postgraduate training program on research and teaching science, South Ural State Medical University, Russia, 454092, Chelyabinsk, Vorovsky str., 64; recourse teacher physician of the Department of quality control and safety of medical activities of Chelyabinsk Regional Clinical Hospital, Russia, 454076, Chelyabinsk, Vorovsky str., 70

SINEGLAZOVA ALBINA V., ORCID ID: 0000-0002-7951-0040; D. Med. Sci., the Head of the Department of policlinical therapy and general medical practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: sineglazovaav@mail.ru

SIGITOVA OLGA N., ORCID ID: 0000-0001-8983-245X; D. Med. Sci., professor of the Department of policlinical therapy and general medical practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: osigit@rambler.ru

Abstract. Aim. The aim of the study was to evaluate the features of therapeutic comorbidity in acute coronary syndromein men. Material and methods. A total of 98 men hospitalized for acute coronary syndrome were examined (74% with myocardial infarction and 26% with unstable angina). Therapeutic diseases were diagnosed based on the results of analysis of the data from questionnaire of the integrated program for chronic noncommunicable disease prevention (Countrywide integrated noncommunicable disease intervention (CINDI), 1996), medical documentation and laboratory diagnostic data. All patients underwent emergency coronary angiography. Results and discussion. Primary comorbid condition in men with acute coronary syndrome was represented by such diseases as arterial hypertension (n=80; 82%), lipid metabolism disorders (n=78; 80%), constitutional obesity (n=22; 22%), chronic kidney disease (n=14; 14%), peptic ulcer in the stomach and/or duodenum (n=11; 11%) and impaired fasting glycemia (n=10; 10%). Multiple disease incidence in men with acute coronary syndrome was 83,5% (n=81), while 1 and 2 disorders were seen in 16,5% (n=16). In case of multiple diseases, coronary artery stenosis ≥ 75% was diagnosed 3 times more often than in 1 and 2 disorders (CI 95% 1,022–9,772). Direct correlation was obtained between the number of coronary artery stenoses ≥ 75% and the number of internal organ diseases that are present simultaneously (rs=0,248; p=0,014). Conclusion. Multiple diseasesin acute coronary syndrome occur in 83,5% of men and they are represented by combination of coronary heart disease with arterial hypertension, obesity, gastric and/or duodenal ulcer, disorders of lipid and carbohydrate metabolism. The presence of multiple diseases in men with acute coronary syndrome is associated with severity and number of severecoronary stenosis.

Key words: therapeutic comorbidity, multiple diseases, acute coronary syndrome, coronary stenosis.

For reference: Strelnikova MV, Sineglazova AV, Sigitova ON. Therapeutic comorbidity in men with acute coronary syndrome. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 39-44. DOI: 10.20969/VSKM.2019.12(4).39-44.

References

  1. Oganov RG, Denisov IN, Simanenko VI, et al. Komorbidnaya patologiya v klinicheskoj praktike: Klinicheskie rekomendacii [Comorbid pathology in clinical practice: Clinical practice guidelines]. Kardiovaskulyarnaya terapiya i profilaktika [Cardiovascular Therapy and Prevention]. 2017; 16 (6): 5-56.

  2. Shamurova YY, Frolova ES, Shamaeva TN, et al. Sochetannye formy boleznej sistemy krovoobrashcheniya i drugih neinfekcionnyh zabolevanij u lic zheleznodorozhnyh professij [Combined forms of diseases of the circulatory system and other non-communicable diseases in railway occupations]. Ural’skij medicinskij zhurnal [Ural Medical Journal]. 2018; 10 (165): 39-42.

  3. Shal’nova SA, Oganov RG, Deev AD, et al. Sochetaniya ishemicheskoj bolezni serdca s drugimi neinfekcionnymi zabolevaniyami v populyacii vzroslogo naseleniya: associacii s vozrastom i faktorami riska [Combinations of ischemic heart disease with other non-communicable diseases in the adult population: associations with age and risk factors]. Kardiovaskulyarnaya terapiya i profilaktika [Cardiovascular therapy and prevention]. 2015; 14 (4): 44-51.

  4. Canivell S, Muller O, Gencer B, et al. Prognosis of cardiovascular and non-cardiovascular multimorbidity after acute coronarysyndrome. PLoS One. 2018; 13 (4): e0195174.

  5. Tisminetzky M, Nguyen HL, Gurwitz JH, et al. Magnitude and impact of multiple chronic conditions with advancing age in older adults hospitalized with acute myocardial infarction. Int J Cardiol. 2018; 1 (272): 341-345.

  6. Hall M, Dondo TB, Yan AT, et al. Multimorbidity and survival for patients with acute myocardial infarction in England and Wales: Latent class analysis of a nationwide population- based cohort. PLoS Med. 2018; 15 (3): e1002501.

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  8. Krapivina EV, Donchenko YK, Lapina VO, et al. Komor- bidnost’ pri ostrom koronarnom syndrome [Comorbidity in acute coronary syndrome]. Izvestiya vysshih uchebnyh zavedenij [News of higher educational institutions]. 2018; 1: 151-155.

  9. Marco Roffi, Carlo Patrono, Jean-Philippe Collet, et al. Rekomendacii ESC po vedeniyu pacientov s ostrym koronarnym sindromom bez stojkogo pod»ema segmenta ST [ESC recommendations for the management of patients with acute coronary syndrome without persistent ST segment elevation]. Rossijskij kardiologicheskij zhurnal [Russian Journal of Cardiology]. 2016; 3 (131): 9-63.

  10. Ibanez Borja, James Stefan, Agewall Stefan [et al.]. Rekomendacii EOK po vedeniyu pacientov s ostrym infarktom miokarda s pod»emom segmenta ST [EOK recommendations for the management of patients with acute myocardial infarction with ST-segment elevation]. Rossijskij kardiologicheskij zhurnal [Russian Journal of Cardiology]. 2018; 23 (5): 103-158.

  11. Boytsov SA, Pogosova NV, Bubnova MG, et al. Kardiovaskulyarnaya profilaktika 2017: Rossijskie nacional’nye rekomendacii [Cardiovascular prophylaxis 2017: Russian national recommendations]. Rossijskij kardiologicheskij zhurnal [Russian Journal of Cardiology]. 2018; 6: 7-122.

  12. Moiseyev VS, Mukhin NA, Smirnov AV, et al. Serdechno- sosudistyj risk i hronicheskaya bolezn’ pochek: strategii kardio-nefroprotekcii: Klinicheskie rekomendacii [Cardiovascular risk and chronic kidney disease: strategies for cardiac nephroprotection: Clinical guidelines]. Rossijskij kardiologicheskij zhurnal [Russian Journal of Cardiology]. 2014; 8 (112): 7-37.

  13. Kokov SL ed. Luchevaya diagnostika bolezni serdca i sosudov: nacional’noe rukovodstvo [Radiologicaldiagnosis of heart disease and blood vessels: a nationalguide]. Moskva: GEOTAR-Media [Moscow: GEOTAR- Media]. 2011; 688 p.

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  15. Zykov MV, Kashchtalap VV, Bykova IS, et al. Svyaz’ mul’timorbidnosti s riskom razvitiya serdechno-sosudistyh oslozhnenij u pacientov s ostrym koronarnym sindromom [Relationship of multimorbidity with the risk of cardiovascular complications in patients with acute coronary syndrome]. Kardiologicheskij vestnik [Cardiological Bulletin]. 2018; 2: 59-65.

 

UDC 616.12-008.331.1-053.81-07:616.153.915-074

DOI: 10.20969/VSKM.2019.12(4).44-51

PDF download LIPOPROTEIN METABOLISM INDICATORS IN YOUNG PATIENTS WITH ARTERIAL HYPERTENSION

PLEKHOVA NATALIA G., ORCID ID:0000-0002-8701-7213; SCOPUS Author ID: 6603245380; D. Bio. Sci., the Head of Central research laboratory of Pacific State Medical University, Russia, 690002, Vladivostok, Ostryakov ave., 2, tel. 8(423)242-97-78, e-mail: pl_nat@hotmail.com

NEVZOROVA VERA A., SCOPUS Author ID:6603425593; D. Med. Sci., professor, director of the Institute of therapy and instrumental diagnostics of Pacific State Medical University, Russia, 690002, Vladivostok, Ostryakov ave., 2, e-mail: nevzorova@inbox.ru

RODIONOVA LARISA V., postgraduate student of Institute of therapy and instrumental diagnostics of Pacific State Medical University, Russia, 690002, Vladivostok, Ostryakov ave., 2, tel. 8(423)242-97-78, e-mail: larisa_90.08@mail.ru

LAGUREVA ALEXANDRA V., junior researcher of Central research laboratory of Pacific State Medical University, Russia, 690002, Vladivostok, Ostryakov ave., 2, tel. 8(423)242-97-78, e-mail: sandy767@mail.ru

MASLENNIKOVA KSENIA K., student of faculty of public health of Pacific State Medical University, Russia, Vladivostok, 690002, Ostryakov ave., 2, tel. 8(423)242-97-78, e-mail: ksenia9299@gmail.com

TSYGANKOV MIKHAIL A., student of faculty of general medicine of Pacific State Medical University, Russia, 690002, Vladivostok, Ostryakov ave., 2, tel. 8(423)242-97-78, e-mail: mikhail.tsygankov@gmail.com

DUBOV VITALY S., student of faculty of general medicine of Pacific State Medical University, Russia, 690002, Vladivostok, Ostryakov ave., 2, tel. 8(423)242-97-78, e-mail: mikhail.tsygankov@gmail.com

Abstract. Aim. The aim of the study was to establish the significance of biochemical atherogenic indicators in hypertension risk identification. Material and methods. Serum lipoprotein spectrum was evaluated in participants of «Epidemiology of cardiovascular diseases in different regions of the Russian Federation (ESSE-RF)» multicenter observational study in Vladivostok. Among those there were healthy people (692 persons) and young patients with identified arterial hypertension (AH, 209 persons). Results and discussion. It was shown that cholesterol, high and low density lipoprotein values and apoprotein ratio (Kapo) of the examined patients did not significantly differ depending on the age or gender. Significant difference was revealed in relation to cholesterol coefficient indicator Kchol (F<0,05). In studied male group atherogenicity indicators can be considered as a diagnostic criterion for identifying the risk of hypertension, depending on age. In young women (20–30 years old) serum lipoprotein spectrum did not correlate with the risk of arterial hypertension. Whereas in older women, statistically significant disease development markers included cholesterol level (F=0,03), low-density lipoproteins (F=0,03), and Kchol (F=0,02). It has been established that there are no gender differences in arterial hypertension risk development markers in patients older than 40 years. Statistically significant indicators are cholesterol, low-density lipoprotein and Kchol. Conclusion. Thus, it is possible to use the following indicators as cardiovascular disease risk markers, respectively, according to the degree of importance. Those are cholesterol atherogenic coefficient (Kchol); low-density lipoprotein cholesterol and total cholesterol.

Key words: arterial hypertension, cholesterol, lipid profile, obesity, smoking.

For reference: Plekhova NG, NevzorovaVA, Rodionova LV, Lagureva AV, Maslennikova KK, Tsygankov MA, Dubov VS. Lipoprotein metabolism indicators in young patients with arterial hypertension.The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 44-51. DOI: 10.20969/VSKM.2019.12(4).44-51.

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2. Titov VN, Amelyushkina VA, Rozhkova TA. Inoj vzglyad na diagnostiku giperlipoproteinemii, holesterin lipoproteinov nizkoj plotnosti i dejstvie statinov (lekciya) [A different look at the diagnosis of hyperlipoproteinemia, low density lipoprotein cholesterol and the effect of statins (lecture)]. Klinicheskaya laboratornaya diagnostika [Clinical Laboratory Diagnostics]. 2015; 1: 27-38.

3. Scientific and Organizing Committee of the ESSE-RF project. Epidemiologiya serdechno-sosudistyh zabolevanij v razlichnyh regionah Rossii (ESSE-RF); Obosnovanie i dizajn issledovaniya [Epidemiology of cardiovascular diseases in various regions of Russia (ESSE-RF); Justification and design of the research]. Profilakticheskaya medicina [Preventive medicine]. 2013; 6: 25-34.

4. Ansell Benjamin J, Fonarow Gregg C, Fogelman Alan M. High-density lipoprotein: Is it always atheroprotective? Curr Atheroscler Reports. 2006; 8: 405-411.

5. Boytsov SA. Izuchenie patogeneza gipertonicheskoj bolezni prodolzhaetsya [The study of the pathogenesis of hypertension continues] Terapevticheskij arhiv [Therapeutic archive]. 2006; 78 (9): 5-12.

6. Metelskaya VA, Shalnova SA, Deev AD, et al. Analiz rasprostranennosti pokazatelej, harakterizuyushchih aterogennost’ spektra lipoproteinov, u zhitelej Rossijskoj Federacii (po dannym issledovaniya ESSE-RF) [Analysis of the prevalence of indicators characterizing theatherogenic spectrum of lipoproteins in residents of theRussian Federation (according to the ESSE-RF study)]. Kardiologiya i angiologiya [Cardiology and Angiology]. 2016; 19 (1): 15-23.

7. Chazova IE. Arterial’naya gipertenziya i dislipidemiya: osnovnye napravleniya strategii lecheniya bol’nyh vysokogo serdechno-sosudistogo riska [Arterial hypertension anddyslipidemia: the main directions of the treatment strategyfor patients with high cardiovascular risk]. Effektivnaya farmakoterapiya: kardiologiya i angiologiya [Effective pharmacotherapy: cardiology and angiology]. 2015; 3: 42-49.

8. Chazova IE. Arterial’naya gipertoniya v svete sovremennykh rekomendatsiy [Arterial hypertension in the light of current recommendations] Terapevticheskiy arkhiv [Therapeutic archive]. 2018; 9: 4-7.

9. Kukharchuk VV, Konovalov GA, Susekov AV, et al. Diagnostika i korrektsiya narusheniy lipidnogo obmena s tsel’yu profilaktiki i lecheniya ateroskleroza: rossiyskiye rekomendatsii: V peresmotr [Diagnosis and correction oflipid metabolism disorders for the prevention and treatmentof atherosclerosis: Russian recommendations: V revision]. Moskva: Rossiyskoye kardiologicheskoye obshchestvo (RKO) [Moscow: Russian Society of Cardiology (RKO)]. 2012; 50 p. https://scardio.ru/content/Guidelines/rek_ lipid_2012.pdf

10. Chazova IYe, Oshchepkova YeV, Zhernakova YuV. Diagnostika i lecheniye arterial’noy gipertonii: klinicheskiye rekomendatsii [Diagnosis and treatment of arterial hypertension: clinical guidelines]. Moskva: Ministerstvo zdravookhraneniya Rossiyskoy Federatsii [Moscow: Ministry of Health of the Russian Federation]. 2013; 64 p. https://minzdrav.med04.ru/Clinical_recommendations/ %D0%90%D1%80%D1%82%D0%B5%D1%80%D0% B8%D0%B0%D0%BB%D1%8C%D0%BD%D0%B0%D 1%8F%20%D0%B3%D0%B8%D0%BF%D0%B5%D1% 80%D1%82%D0%BE%D0%BD%D0%B8%D1%8F.pdf

11. Gruzdeva OV, Palicheva EI, Barabash OO, et al. Kliniko- laboratornaya otsenka lipidtransportnoy funktsii krovi u patsiyentov s ostrym infarktom miokarda s pod»yemom segmenta ST [Clinical and laboratory assessment of blood lipid-transport function in patients with acute myocardial infarction with ST-segment elevation]. Patologiya krovoobrashcheniya i kardiokhirurgiya [Pathology of blood circulation and heart surgery]. 2010; 4: 36-41.

  1. Velkov VV. Ateroskleroz: artilleriya b’yet po svoim [Atherosclerosis: artillery beats on his]. Khimiya i zhizn [Chemistry and life]. 2006; 12: 30-36.

  2. Lui GK, Rogers IS, Ding VY. Risk Estimates for Atherosclerotic Cardiovascular Disease in Adults With Congenital Heart Disease. Am J Cardiol. 2017; 119 (1): 112-118.

  3. Barter PJ, Ballantyne CM, Carmena R, et al. Apo B versus cholesterol in estimating cardiovascular risk and in guiding therapy: report of the thirty-person/ten-country panel. J Intern Med. 2006; 3: 247-258.

  4. Tvorogova MG. Apolipoproteiny – svoystva, metody opredeleniya, klinicheskaya znachimost’ [Apolipoproteins – properties, methods of determination, clinical significance].

Laboratornaya meditsina; Aktual’nyye problemy serdechno- sosudistoy patologii [Laboratory medicine; Actual problems of cardiovascular pathology]. 2005; 7: 29-37.

16. Nevzorov VA, Shumatov VB, Nastradin OV, et al. Sostoyanie funkcii sosudistogo endoteliya u lic s faktorami riska i bol’nyh ishemicheskoj bolezn’yu serdca [The state of the function of the vascular endothelium in people with risk factors and patients with coronary heart disease]. Tihookeanskij medicinskij zhurnal [Pacific Med J]. 2012; 2: 37-44.

17. Odden MC, Tager IB, Gansevoort RT, et al. Hypertension and low HDL cholesterol were associated with reduced kidney function across the age spectrum: a collaborative study. Annals of epidemiology. 2013; 23 (3): 106-111.

18. Al-Naamani N, Palevsky HI, Lederer DJ, et al. Prognostic Significance of Biomarkers in Pulmonary Arterial Hypertension. Ann Am Thorac Soc. 2016; 13 (1): 25-30.

 

REVIEWS

UDC [616.24-008.444:616.8-009.836]-07(048.8)

DOI: 10.20969/VSKM.2019.12(4).52-59

PDF download POLYSOMNOGRAPHY DIAGNOSTIC OPPORTUNITIES IN GENERAL MEDICAL PRACTICE

ABDRAKHMANOVA ALSU I., ORCID ID: orcid.org/0000-0003-0769-3682; SCOPUS Author ID: 57192296744; C. Med. Sci., associate professor of the Department of clinical medicine fundamental basis of Institute of biology and fundamental medicine of Kazan Federal University, Russia, 420012, Kazan, K. Marx str., 74, tel. 8-917-922-66-29, e-mail: alsuchaa@mail.ru

TSIBULKIN NIKOLAY A., ORCIDID: 0000-0002-1343-0478; C. Med. Sci., associate professor of the Department of cardiology, roentgen-endovascular and cardiovascular surgery of Kazan State Medical Academy – the branch of Russian Medical Academy of Postgraduate Education, Russia, 420012, Kazan, Butlerov str., 36

AVDONINA OLGA A., student of Institute of biology and fundamental medicine of Kazan Federal University, Russia, 420012, Kazan, K. Marx str., 74

SHAGIAKHMETOVA LILIА YA., specialist in functional diagnostics of Medical Unit of Kazan Federal University, 420012, Russia, Kazan, Chekhov str., 1

AMIROV NAIL B., ORCID ID: 0000-0003-0009-9103; SCOPUS Author ID: 7005357664; D. Med. Sci., professor of the Department of policlinical therapy and general medical practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: namirov@mail.ru

Abstract. Aim. The aim of the study was the analysis of medical publications on polysomnography diagnostic capabilities and personal data presentation. Material and methods. Medical research papers on the subject of respiratory disorders during sleep, their connection with cardiovascular disease development and the possibility of diagnosing such disorders. Retrospective data analysis of polysomnography studies performed over a period of seven years. Results and discussion. The features of cardiovascular system regulation form a direct link between the nature of the nervous system activity during sleep and such indicators as blood pressure and heart rate. Interruption of sleep or its disturbances can have a negative impact on the functional state of the heart and the vascular bed. The mechanisms of such influence can be related both to sleep cyclic phase disturbance and direct physiological function reduction, in particular, to hypoxia episode development. Significant correlation was revealed between obstructive sleep apnea and cardiovascular diseases. It has been established that the risk of cardiovascular disease is 2,4 times higher in patients with obstructive sleep apnea comparing to people without breathing disorders during sleep. Significantly higher body mass index values were seen in the groups of patients with obstructive sleep apnea. Conclusion. Repeated hypoxic conditions can cause persistent gas exchange disruption and further worsen sleep. The interdependence of sleep disorders and circulatory functions creates a vicious circle of pathogenetic influences, leading ultimately to an increased risk of cardiovascular disease and related mortality. Assessment of drowsiness as a screening method for obstructive sleep apnea diagnosis is required in patients with cardiovascular diseases, especially in ones having forms resistant to treatment. Polysomnographic study is required for diagnosis of obstructive sleep apnea.

Key words: cardiovascular diseases, diagnostics, polysomnography.

For reference: Abdrakhmanova AI, Tsibulkin NA, Avdonina OA, Shagiakhmetova LY, Amirov NB. Polysomnography diagnostic opportunities in general medical practice. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 52-59. DOI: 10.20969/VSKM.2019.12(4).52-59.

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UDC 614.8.084(1-87)(048.8)

DOI: 10.20969/VSKM.2019.12(4).59-63

PDF download CURRENT ISSUES OF SPECIAL EMERGENCY SERVICE OPERATION IN FOREIGN COUNTRIES

KOBYLYATSKAYA IRINA A., ORCID ID: 0000-0002-4104-1007; full-time postgraduate student of the Department of disaster medicine and life safety of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunar str., 281, e-mail: kolybri@gmail.com

SHKATOVA ELENA YU., ORCID ID: 0000-0003-2027-6277; D. Med. Sci., professor, the Head of the Department of disaster medicine and life safety of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunar str., 281, e-mail: army@igma.udm.ru

MOKHOVA LUDMILA YA., ORCID ID: 0000-0002-7121-1265; internal service colonel, the Head of Medical Unit of the Ministry of Internal Affairs of Russia for the Udmurt Republic, Russia, 426035, Izhevsk, Serov str., 69, e-mail: medic.18@mvd.ru

FILIMONOV ALEXANDER M., ORCID ID: 0000-0003-3797-9526; C. Med. Sci., lieutenant colonel of internal service, the Head of the Hospital of Medical Unit of the Ministry of Internal Affairs of Russia for the Udmurt Republic, Russia, 426035, Izhevsk, Serov str., 69, e-mail: medic.18@mvd.ru

MEDVEDEV MAKSIM S., ORCID ID: 0000-0002-8567-501X; 2nd year student of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunar str., 281, e-mail: mister.redspike47@yandex.ru

Abstract. There are two types of natural disasters: emergency situations and major natural disasters, which differ in theamount of assistance provided. There are special structural units for safeguarding interests and protecting the rights ofthe citizens and territories in all countries. Aim. The aim of the research was to study the principles of work organization in special emergency services in foreign countries as well as the current health related issues in professionals operatingin such services. Material and methods. The data was studied and the analysis of modern foreign research publications on special service management in emergency situations was carried out. Results and discussion. The Federal Emergency Management Agency is a division of the United States Department of Homeland Security that manages disaster response efforts that local governments are not able to cope with, acting as a coordinating and advisory structurethat regulates federal and municipal ministries and agencies to preserve economy and social structure of the state incase of emergency situations or disasters of peaceful time, as well as in martial law. The issue of the state of health in emergency response personnel is given special attention, since the quality of functional duty performance would depend on this. There is a significant increase in the incidence of the diseases of the musculoskeletal system and connective tissue, circulatory system and digestive organs, with age. The authors indicate the most common symptoms related to harmful factor exposure, such as runny nose, irritation in the eyes and throat, hoarseness, shortness of breath, and, as a consequence, development of acute and chronic sinusitis and chronic obstructive pulmonary disease. It was noted that the risk of respiratory diseases increases with duration of service, even several years after the emergency is eliminated. It was revealed that after elimination of the consequences of the terrorist attack from September 11, 2001 in the World Trade Center in New York, the number of retirements for disability increased by 47,0%. The most common causes leading to disability have been identified. Those are respiratory diseases, mental and behavioral disorders, as well as injuries, poisoning and other certain consequences of exposure to external factors. Negative social and economic consequences and professional longevity reduction require additional medical and preventive measures for specialservice employees. Conclusion. Thus, foreign countries have a developed emergency service system. In order to solve emerging problems when organizing assistance to the victims in our country, it is necessary to take international experience into account and, if appropriate, to consolidate the efforts in order to successfully resolve emerging issues taking the rights of the citizens of the affected party as a priority.

Key words: firemen, health, special emergency services in foreign countries.

For reference: Kobylyatskaya IA, Shkatova EY, Mokhova LYа, Filimonov AM, Medvedev MS. Current issues of special emergency service operation in foreign countries. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 59-63.DOI: 10.20969/VSKM.2019.12(4).59-63.

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1. Anda HH, Braithwaite S. EMS, Criteria For Disaster Declaration. StatPearls Publishing. 2019; https://www. ncbi.nlm.nih.gov/books/NBK539803/

2. Department of Homeland Security. «The Federal Emergency Management Agency». URL: https://www. fema.gov/media-library-data/20130726-1823-25045-8164/ pub_1_final.pdf

3. Department of Homeland Security. «Executive Order 12127-Federal Emergency Management Agency». 1979; URL: https://www.encyclopedia.com/social- sciences/applied-and-social-sciences-agazines/executive- order-12127.

4. Lyahovec TL, Sobakin FS, Prokopenkova AV, Kotoso- nov AS. Organizaciya upravleniya v chrezvychajnyh situaciyah v SShA [Organization of Emergency Mana- gement in the USA]. Tekhnologii grazhdanskoj bezopas- nosti [Civil Security Technologies]. 2010; 7 (1-2): 125-131.

5. Stewart A, Marlow R, Campeau D, Russell T, Ryan J.The evolution of response and management training atthe FEMA Center for Domestic Preparedness. Journal of Emergency Management. 2019; 17 (1): 53-60.

6. Cwiak CL. Framing higher education and disciplinary efforts through a professionalization lens. Journal of Emergency Management. 2019; 17 (1): 61-66.

7. Kommor MB, Hodge B, Ciottone G. Development and Implementation of a Disaster Medicine Certificate Series (DMCS) for Medical Students. Prehospital and Disaster Medicine. 2019; 34 (2): 197-202.

8. Baris D, Garrity TJ, Telles JL, Heineman EF, Olshan A, Hoar Zahm Sh. Cohort mortality study of Philadelphia firefighters. American Journal of Industrial Medicine. 2001; 39 (5): 463-476.

9. LeMasters GK, Genaidy AM, Succop P, Deddens J, Sobeih T, Barriera-Viruet H, Dunning K, Lockey J. Cancer risk among firefighters: a review and meta-analysis of 32 studies. Journal of Occupational and Environmental Medicine. 2006; 48 (11): 1189–1202. DOI: 10.1097/01. jom.0000246229.68697.90

10. Mustajbegovie J, Zuskin E, Schachter EN, Kern J, Vrcic M, Heimer S, Vitale K, Nada T. Respiratory function in active firefighters. American Journal of Industrial Medicine. 2001; 40 (1): 55-62. DOI: 10.1002/ajim.1071.

11. Weakley J, Webber MP, Gustave J. Trends in respiratory diagnoses and symptoms of firefighters exposed to the World Trade Center disaster: 2005-2010. Preventive Medicine. 2011; 53 (6): 364-369.

12. Niles JK, Webber MP, Gustave J, Zeig-Owens R, Lee R, Glass L, Weiden MD, Kelly KJ, Prezant DJ. The impact of the World Trade Center attack on FDNY firefighter retirement, disabilities, and pension benefits. American Journal of Industrial Medicine. 2011; 54 (9): 672- 680.

 

UDC 616.248-0.85.37(048.8)

DOI: 10.20969/VSKM.2019.12(4).63-68

PDF download NEW OPPORTUNITIES IN ACHIEVEMENT CONTROL OVER THE COURSE OF SEVERE BRONCHIAL ASTHMA

OVSYANNIKOV NIKOLAY V., SCOPUS Author ID: 36164474700; Honored Doctor of the Russian Federation, D. Med. Sci., the Head of the Department of introduction into internal medicine of Omsk State Medical University, Russia, 644099, Omsk, Lenin str., 12, e-mail: niklajjovs@rambler.ru

BILEVICH OLGA А., ORCID ID: 0000-0003-2583-5648; C. Med. Sci., associate professor of the Department of introduction into internal medicine of Omsk State Medical University, Russia, 644099, Omsk, Lenin str., 12, e-mail: bilewich@mail.ru

ZINCHENKO LUBOV M., student of Omsk State Medical University, Russia, 644099, Omsk, Lenin str., 12, tel. 8-905-098-74-26, e-mail: lyubov.zinchenko.1997@mail.ru

KOZLOVA EKATERINA A., student of Omsk State Medical University, Russia, 644099, Omsk, Lenin str., 12, tel. 8-950-792-47-43, e-mail: katya_kozlova_20@mail.ru

Abstract. Phenotypes and endotypes of severe refractory bronchial asthma have been actively studied in recent years. Biological medications have been created using the obtained data. Those are humanized and human monoclonal antibodies, the action of which is targeted to specific pathogenetic pathways of bronchial asthma. Aim. The aim of thestudy is analysis of publications devoted to pathogenesis, phenotypes, endotypes and modern methods of asthma management using biological drugs which are humanized and human anti-IgE and anti-type 2 IL-4, IL-5, IL-13 сytokine monoclonal antibodies, algorithm of severe asthma management based on clinical data and immune inflammation biomarker evaluation, suitable for application in real clinical practice. Material and methods. Review of research publications on severe bronchial asthma management by affecting the pathogenesis of the disease, taking into account the endotypes of bronchial asthma (T2 asthma and non-T2 asthma) and several phenotypes, has been carried out.Results and discussion. At present, drugs based on monoclonal antibodies have been developed and are being actively introduced into clinical practice, which allow influencing various pathways of bronchial asthma pathogenesis. The use of such drugs is based on bronchial asthma biophenotyping and assessing the level of such biomarkers as induced sputum eosinophils; serum eosinophils; exhaled air nitrous oxide; periostin and dipeptidyl peptidase 4. The Board of experts ofthe Russian association of allergists and clinical immunologists and the Russian respiratory society has developed an algorithm for severe bronchial asthma management using the drugs based on monoclonal antibodies. Counclusion.Modern diagnostic method application, step-by-step adherence to the patient management algorithm makes it possible to implement new technologies for severe bronchial asthma management and opens up new possibilities for achievingcontrol over the course of the disease.

Key words: asthma endotypes and phenotypes, biological therapy.

For reference: Ovsyannikov NV, Bileviсh OA, Zinchenko LM, Kozlova EA. New opportunities in achievement control over the course of severe bronchial asthma. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 63-68. DOI:10.20969/VSKM.2019.12(4).63-68.

References

1. Global Strategy for Asthma Management and Prevention. Revised 2017. www.ginasthma.com.

2. Rossijskoe respiratornoe obshchestvo, Rossijskaya associaciya allergologov i klinicheskih immunologov [Russian Respiratory Society, Russian Association of Allergists and Clinical Immunologists]. Bronhial’naya astma; Peresmotr 2018 [Bronchial asthma; Revision 2018]. http://webmed.irkutsk.ru/doc/pdf/asthmaru.pdf.

3. Arhipov VV, Grigor’eva EV, Gavrishina EV. Kontrol’ nad bronhial’noj astmoj v Rossii: rezul’taty mnogocentrovogo nablyudatel’nogo issledovaniya NIKA [Control of asthmain Russia: the results of a multicenter observational studyNIKA]. Pul’monologiya [Pulmonology]. 2011; 6: 87-93.

4. Bousqet J, et al. Uniform definition of asthma severity, control and exacerbations: document presented for the World Health Organization Consultation on Severe Asthma. J Allergy Clin Immunol. 2010; 126 (5): 926-928.

5. Il’ina NI, et al. Algoritm fenotipirovaniya i vybor targetnoj terapii tyazheloj nekontroliruemoj bronhial’noj astmy s eozinofil’nym tipom vospaleniya dyhatel’nyh putej [Phenotyping Algorithm and Choice of Targeted Therapy for Severe Uncontrolled Asthma with Eosinophilic Type of Airway Inflammation]. Rossijskij allergologicheskij zhurnal [Russian Journal of Allergy]. 2017; 14 (3): 5-18.

6. Hekking PP, et al. The prevalence of severe refractory asthma. J Allergy Clin Immunol. 2015; 135: 896-902.
7. Fedoseev GB. Bronhial’naya astma; Biblioteka vracha

obshchej praktiki [Bronchial asthma; Library of general practitioner]. Sankt-Peterburg: Medicinskoe informacionnoe agentstvo [St Petersburg: Medical information agency]. 1996; 2: 464 p.

8. Fedoseev GB, Trofimov VI. Bronhial’naya astma [Bronchial asthma]. Sankt-Peterburg: Nordmedizdat [St Petersburg: Nordmedizdat]. 2006; 308 p.

9. Wensel SE. Asthma phenotypes: the evolution from clinical to molecular approaches. Nat Med May. 2012; 18 (5): 716-725.

10. Wynn TA. Type 2 cytokines: mechanisms and therapeutic strategies. Nat Rev Immunol. 2015; 15 (5): 271-282.

11. Bal SM, et al. IL1β, IL-4 and IL-12 control the fate of group 2 innate lymphoid cells in human airway infl ammation in the lungs. Nat Immynol. 2016; 17 (6): 636-645.

12. Nenasheva NM. Tyazhelaya bronhial’naya astma: osobennosti techeniya i fenotipy [Severe bronchial asthma: course features and phenotypes]. Consilium Medicum: Bolezni organov dyhaniya [Consilium Medicum:

Respiratory diseases]. 2018; 1: 7-14.

13. Robinson D, et al. Revisiting Type 2-high and Type 2-low airway infl ammation in asthma: current knowledge and therapeutic implications. Clin Exp Allergy. 2017; 47 (2): 161-175.

14. Gandhi NA, et al. Targeting key proximal drivers of type 2 infl ammation in disease. Nat Rev Drug Giscov. 2016; 15 (1): 35-50.

15. Schleich F, et al. Heterogeneity of phenotypes in severe asthmatics. The Belgian Severe Asthma Registry (BSAR). Respiratory Medicine. 2014; 108 (12): 1723-1732.

16. Simpson JL, et al. Infl ammatory subtypes in asthma: assessment and identifi cation using induced sputum. Respirology. 2006; 11 (1): 54-61.

17. Kurbacheva OM, Pavlova KS. Fenotipy i endotipy bronhial’noj astmy: ot patogeneza i klinicheskoj kartiny k vyboru terapii [Phenotypes and endotypes of bronchial asthma: from pathogenesis and clinical picture to the choice of therapy]. Rossijskij allergologicheskij zhurnal [Russian Journal of Allergy]. 2013; 1: 15-24.

18. Alhossan A, et al. «Real-life» Effectiveness Studies of Omalizumab in Adult Patients with Severe Allergic Asthma: Meta-analysis. J Allerge Clin Immunol Pract. 2017; 5 (5): 1362-1370e2.

19. Ortega HG, et al. Mepolizumab Treatment in patients with severe eosinophilic asthma. N Engl J Med. 2014; 25, 371 (13): 1198-1207.

20. Lugogo N, et al. Long-term Efficacy and Safety of Mepolizumab in Patients With Severe Eosinophilic Asthma: A Multi-center, Open-label, Phase IIIb Study. Clinical Therapeutics. 2016; 38 (9): 2058-2071e1.

21. Bel EN, et al. Oral glucocorticoid-sparingeffect of mepolizumabin eosinophilic asthma. N Engl J Med. 2014; 371 (13): 1189-1197.

22. Castro M, et al. Reslizumab for inadequately controlled asthma with elevated blood eosinophil counts: results from two multicentre, parallel, double-blind, randomised, placebo-controlled, phase 3 trials. Lancet Respir Med. 2015; 3 (5): 355-366.

23. Bjermer L, et al. Reslizumab for Inadequately Controlled Asthma With Elevated Blood Eosinophil Levels: A Randomized Phase 3 Study. Chest. 2016; 150 (4): 789-798.

24. Bleecker ER, et al. Effi cacy and safety of benralizumab for patients with severe asthma uncontrolled with highdosage inhaled corticosteroids and long-acting β2-agonists (SIROCCO): a randomised, multicentre, placebo-controlled phase 3 trial. Lancet. 2016; 29, 388 (10056): 2115-2127.

25. FitzGerald JM, et al. Benralizumab, an anti-interleukin-5 receptor α monoclonal antibody, as add-on reatment for patients with severe, uncontrolled, eosinophilic asthma (CALIMA): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2016; 29, 388 (10056): 2128-2141.

26. Wenzel S, et al. Dupilumab effi cacy and safety in adults with uncontrolled persistent asthma despite use of medium-to-high-dose inhaled corticosteroids plus a longacting β2 agonist: a randomised double-blind placebocontrolled pivotal phase 2b dose-ranging trial. Lancet. 2016; 2, 388 (10039): 31-44.

27. Hanania NA, et al. Effi cacy and safety of lebrikizumab in patients with uncontrolled asthma (LAVOLTA I and LAVOLTA II): replicate, phase 3, randomised, doubleblind, placebo-controlled trials. Lancet Respir Med. 2016; 4 (10): 781-796.

28. Brightling CE, et al. Effi cacy and safety of tralokinumab in patients with severe uncontrolled asthma: a randomised, double-blind, placebo-controlled, phase 2b trial. Lancet Respir Med. 2015; 3 (9): 692-701.

 

UDC 616.127-002-022:578(048.8)

PDF download VIRAL MYOCARDITIS IN CARDIOLOGIST PRACTICE

OSCHEPKOVA OLGA B., ORCID ID: 0000-0002-9845-0266; the Head of the Department of cardiology of Clinical hospital of Medical Unit of the Ministry of Internal Affairs of Russia for Tatarstan Republic, Russia, 420059, Kazan, Orenburgskiy tract str., 132, e-mail: oschepkova.kazan@mail.ru

TSYBULKIN NIKOLAY A., ORCID ID: 0000-0002-1343-0478; C. Med. Sci., associate professor of the Department of cardiology, roentgen-endovascular and cardiovascular surgery of Kazan State Medical Academy – the branch of Russian Medical Academy of Postgraduate Education, Russia, 420012, Kazan, Butlerov str., 36, e-mail: kdkgma@mail.ru

FROLOVA ELVIRA B., ORCID ID 0000-0002-4653-1734; C. Med. Sci., Deputy Head for diagnostics of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuikov str., 54, e-mail: frolova.67@mail.ru

RUDNITSKAYA LILIYA A., ORCID ID: 0000-0002-5559-3722; student of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49

Abstract. Aim. The features of modern concepts related to epidemiology, etiology, pathogenesis and diagnosis ofviral myocarditis are presented from the perspective of practical medicine. Material and methods. Review of researchmedical articles on viral myocarditis. Results and discussion. Myocarditis is one of the most common types of non- coronary heart disease. It results from inflammatory changes in the myocardium, manifested by clinical symptoms,functional disorders and changes in the structure of heart tissue. The most common causes of myocarditis are viralinfections, autoimmune diseases, toxic and drug effects. The complexity of practical diagnosis of myocarditis does not allow obtaining accurate data on its prevalence. The pathogenesis of myocarditis is diverse and includes infections, physical factor effects, and hypersensitivity. A special feature of viral myocarditis is the possibility of combined direct lesion in the myocardium with an infectious agent leading to autoreactive state development. Viral infections can createmyocardial damage both in the course of the primary disease and as its complication. Conclusion. Viral myocarditis is a common complication of seasonal acute respiratory viral infection outbreaks and it remains a significant public health problem. The epidemic nature of such infections, wide coverage in the population, more severe course in young children and in elderly patients, requires timely diagnosis and treatment of a large number of such patients. Late detection of myocarditis can have adverse consequences and makes prognosis less favorable. The difficulties in diagnosis are related to low specificity of the most typical symptoms and to invasiveness of the studies that can ultimately solve thediagnostic dilemma. Biopsy is less preferred comparing to magnetic resonance imaging in the diagnosis of myocarditis.Key words: myocarditis, viral infection, pathogenesis, diagnostics.

For reference: Oschepkova OB, Tsybulkin NA, Frolova EB, Rudnitskaya LA. Viral myocarditis in cardiologist practice. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 68-74. DOI: 10.20969/VSKM.2019.12(4).68-74.

References 

  1. Hu J, Florido R, Lipson E, et al. Cardiovascular toxicities associated with immune checkpoint inhibitors. Cardiovasc Res. 2019; 115 (5): 854-868.

  2. Aretz H. Myocarditis: the Dallas criteria. Hum Pathol. 1987; 18 (6): 619-624

  3. Wakafuji S, Okada R. Twenty year autopsy statistics of myocarditis incidence in Japan. Jpn Circ J. 1986; 50: 1288–1293.

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  7. Liapounova N, Mouquet F, Ennezat P. Acute myocardialinfarction spurred by myopericarditis in a young femalepatient: Coxsackie B2 to blame. Acta Cardiol. 2011; 66 (1): 79–81.

  8. Chang L, Lu C, Shao P, Lee P, Lin M. Viral infections associated with Kawasaki disease. J Formos Med Assoc. 2014; 113 (3): 148-154.

  9. Lauer B, Niederau C, Kuhl U, et al. Cardiac troponin T in patients with clinically suspected myocarditis. J Am Coll Cardiol. 1997; 30: 1354–1359.

  10. Schultz J, Hilliard A, Cooper L, et al. Diagnosis and Treatment of Viral Myocarditis. Mayo Clin Proc. 2009; 84 (11): 1001–1009.

11. Kufukihara K, Watanabe Y, Inagaki T, et al. Cytometric cell- based assays for anti-striational antibodies in myasthenia gravis with myositis and/or myocarditis. Sci Rep. 2019; 9 (1): 5284.

12. Baughman K. Diagnosis of myocarditis: death of Dallas criteria. Circulation. 2006; 113 (4): 593-595.

13. Testolina M, Schiavo A, Marcolongo R, Iliceto S. Endomyocardial biopsy should be performed in every patient with suspected myocarditis. G Ital Cardiol (Rome). 2015; 16 (10): 533-538.

14. Friedrich M, Sechtem U, Schulz-Menger J, et al. Cardio-vascular magnetic resonance in myocarditis: a JACCwhite paper. J Am Coll Cardiol. 2009; 53 (17): 1475–1487.

15. Ziegler C, Painter D, Borawski J, Kim R, Kim H, Limka- keng A. Unexpected Cardiac MRI Findings in Patients Presenting to the Emergency Department for Possible Acute Coronary Syndrome. Crit Pathw Cardiol. 2018; 17 (3): 167-171.

16. Ntusi N. HIV and myocarditis. Curr Opin HIV AIDS. 2017; 12 (6): 561-565.

17. Huber SA. Viral Myocarditis and Dilated Cardiomyopathy: Etiology and Pathogenesis. Curr Pharm Des. 2016; 22 (4): 408-426.

18. Wright P, Strauss G, Langford M. Acute hemorrhagic conjunctivitis. Am Fam Physician. 1992; 45 (1): 173-178.

19. Maron B, Udelson J, Bonow R, Nishimura R, Ackerman M. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities. Circulation. 2015; 132 (22): e273-280.

20. Patrianakos A, Protonotarios N, Nyktari E, Pagonidis K. Arrhythmogenic right ventricular cardiomyopathy/dysplasia and troponin release; Myocarditis or the «hot phase» of the disease? Int J Cardiol. 2012; 157 (2): e26-28.

 

UDC 616.127-02:613.81(048.8)

DOI: 10.20969/VSKM.2019.12(4).74-80

PDF download PATHOGENETIC MECHANISMS OF ALCOHOLIC CARDIOMYOPATHY DEVELOPMENT

FADEEV GRIGORIY A., ORCID ID: 0000-0002-0213-8631; Deputy Head, physician of Clinical hospital of Medical Unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, Russia, 420059, Kazan, Orenburgskiy tract str., 132, e-mail: Dr.GrigoryFadeev@yandex.ru

TSIBULKIN NIKOLAY A., ORCID ID: 0000-0002-1343-0478; C. Med. Sci., associate professor of the Department of cardiology, roentgen-endovascular and cardiovascular surgery of Kazan State Medical Academy – the branch of Russian Medical Academy of Postgraduate Education, Russia, 420012, Kazan, Butlerov str., 36

MIKHOPAROVA OLGA Y., the Head of offic for functional diagnostics of Clinical hospital of Medical Unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, Russia, 420059, Kazan, Orenburgskiy tract str., 132, e-mail: olga-mihoparova@rambler.ru

TUKHVATULLINA GALINA V., ORCID ID: 0000-0002-7949-0457; the Head of Clinical diagnostic laboratory of Clinical hospital of Medical Unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, Russia, 420059, Kazan, Orenburgskiy tract str., 132

Abstract. Aim. The aim of the study was to characterize the modern concepts of alcoholic cardiomyopathy developmentpathogenetic mechanisms. Material and methods. Review of research medical publications on alcoholic cardiomyopathypathogenesis and clinical manifestations. Results and discussion. Long time alcohol abuse is one of the common causes of cardiovascular mortality, along with smoking, hyperlipidemia, and hypertension, which is associated with the prevalence of alcohol dependence. Every third adult had at least one period of excessive alcohol consumption during one’s lifetime. The treatment cost in such patients is ten times higher than such in ones with the heart failure. A common effect of alcohol on the cardiovascular system is alcoholic cardiomyopathy, which remains asymptomatic for a long time, but at the final stage of the disease it is manifested by progressive heart failure. Alcoholic cardiomyopathy is expressed in an increase in the heart chamber size, mainly in the left ventricle, diffuse myocardial hypokinesis development, and a decrease in its integral contractility. Complications of alcoholic cardiomyopathy can be heart rhythmdisturbances and thromboembolism. The leading causes of increased cardiovascular morbidity and mortality in peoplewho consume alcohol are the factors leading to heart failure development. The main ones are viable cardiomyocyte loss, common cardiosclerosis, and a decreased function in the remaining contractile elements. Conclusion. The maindamaging mechanism of alcohol exposure to the myocardium is metabolic disorders in the cardiomyocytes, leading to their irreversible dystrophic changes and cardiosclerosis. An increase in cell active oxygen radical amount not only destroys it chemically, but also initiates and completes apoptotic cell death process through intracellular signaling system modification.

Key words: alcoholic cardiomyopathy, pathogenesis, heart failure, apoptosis.

For reference: Fadeev GA, Tsybulkin NA, Mikhoparova OY, Tukhvatullina GV. Pathogenetic mechanisms of alcoholic cardiomyopathy development. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 74-80. DOI: 10.20969/ VSKM.2019.12(4).74-80.

References

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  2. Bui A, Horwich T, Fonarow G. Epidemiology and risk profile of heart failure. Nat Rev Cardiol. 2011; 8: 30–41.
  3. Bouchery E, Harwood H, Sacks J, et al. Economic costs of excessive alcohol consumption in the US, 2006. Am J Prev Med. 2011; 41: 516–524.
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  2. George A, Figueredo V. Alcoholic cardiomyopathy. J Card Fail. 2011; 17: 844–849.

  3. Ba A. Alcohol and thiamine deficiency trigger differentialmitochondrial transition pore opening mediating cellulardeath. Apoptosis. 2017; 22 (6): 741-752.

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  6. Khalil H, Peltzer N, Walicki J, et al. Caspase-3 protects stressed organs against cell death. Mol Cell Biol. 2012; 32: 4523–4533.

  7. Bodhinathan K, Slesinger P. Alcohol modulation of G-protein-gated inwardly rectifying potassium channels: from binding to therapeutics. Front Physiol. 2014; 25 (5): 76. doi: 10.3389/fphys.2014.00076.

  8. Aryal P, Dvir H, Choe S. A discrete alcohol pocket involved in GIRK channel activation. Nature Neuroscience. 2009; 12: 988–995.

  9. Dopico A, Bukiya A, Martin G. Ethanol modulation of mammalian BK channels in excitable tissues: molecular targets and their possible contribution to alcohol-induced altered behavior. Front Physiol. 2014; 5: 466. doi: 10.3389/ fphys.2014.00466.

    13. Bamji Z, Haddad G. Convergence of theories of alcoholadministration postanabolic stimulation on mTORsignaling: Lessons for exercise regimen. Alcohol Clin Exp Res. 2015; 39: 787–789.

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    15. Hers I, Vincent E, Tavare J. Akt signalling in health and disease. Cellular signaling. 2011; 23 (10): 1515-1527. 16. Umoh N, Walker R, Al-Rubaiee M, et al. Acute alcohol modulates cardiac function as PI3K/Akt regulates oxidative stress. Alcohol Clin Exp Res. 2014; 38: 1847–1864.

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UDC 616.12-008.46-036.12-07:616.153.96-008.64-074(048.8)

DOI: 10.20969/VSKM.2019.12(4).80-85

PDF download  HYPOALBUMINEMIA AND CHRONIC HEART FAILURE

KHAZOVA ELENA V., ORCID ID: 0000-0001-8050-2892; SCOPUS Author ID: 57205153574; C. Med. Sci., associate professor of the Department of introduction into internal medicine named after prof. S.S. Zimnitsky of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. 8-905-313-97-10, e-mail: hazova_elena@mail.ru

BULASHOVA OLGA V., ORCID ID: 0000-0002-7228-5848; SCOPUS Author ID: 6507198087; D. Med. Sci., professor of the Department of introduction into internal medicine named after prof. S.S. Zimnitsky of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. (843)296-14-03, e-mail: boulashova@yandex.ru

AMIROV NAIL B., ORCID ID: 0000-0003-0009-9103; SCOPUS Author ID: 7005357664; D. Med. Sci., professor of the Department of policlinical therapy and general medical practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49; Chief freelance internist of Clinical hospital of Medical Unit of the Ministry of Internal Affairs of Russia for the Republic of Tatarstan, e-mail: namirov@mail.ru

Abstract. Hypoalbuminemia is recognized as a significant adverse risk factor in relation to prediction of all-cause mortality, cardiovascular events, and frequent hospitalizations in cardiac patients. Aim. Serum protein spectrum was analyzed in patients with chronic heart failure. Material and methods. Review of publications on serum protein spectrum studies in patients with coronary heart disease, chronic heart failure, as well as on its value as adverse outcome predictor,has been performed. Results and discussion. The prevalence of hypoalbuminemia in patients with stable coronary heart disease is 13%, in ones with chronic heart failure is 25%, reaching 90% in elderly and senile patients with heart failure decompensation. It has been established that in the general population, individuals with hypoalbuminemia have a greater risk of developing coronary heart disease and chronic heart failure. It has been shown that serum albumin level in individuals having a number of risk factors (smoking, obesity, etc.) may predispose them to various inflammatory reactions. The review presents the data on the significance of hypoalbuminemia, along with other traditional risk factors, as a predictor of hospital and long-term mortality in patients with acute coronary syndrome, myocardial infarction, and chronic heart failure. Hypoalbuminemia (<3,4 g/dL) demonstrates high sensitivity (78,8%) and specificity (75%) in relation to the onset of hospital mortality in cases of chronic heart failure. According to Cox multivariate regression analysis after adjusting for significant predictors, albumin levels less than 3,8 g/dL in chronic heart failure appear associated with a fivefold increase in mortality compared to albumin levels of more than 4,2 g/dL (OR=5,74, 95% CI 4,08–8,07;p<0,001). Conclusion. The article presents the data indicating the significance of serum albumin determination in terms of possibility of adverse cardiovascular events in patients with chronic heart failure.

Key words: chronic heart failure, hypoalbuminemia, prognosis, hospital mortality.

For reference: Khazova EV, Bulashova OV, Amirov NB. Hypoalbuminemia and chronic heart failure. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 80-85. DOI: 10.20969/VSKM.2019.12(4).80-85.

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2. Nelson JJ, Liao D, Sharrett AR, et al. Serum albumin levelas a predictor of incident coronary heart disease: theAtherosclerosis Risk in Communities (ARIC) study. Am J Epidemiol. 2000; 151 (5): 468–477.

3. Shaper AG, Wannamethee SG, Whincup PH. Serum albumin and risk of stroke, coronary heart disease, and mortality: the role of cigarette smoking. J Clin Epidemiol. 2004; 57 (2): 195–202.

4. Djoussé L, Rothman KJ, Cupples LA, et al. Serum albumin and risk of myocardial infarction and all-cause mortality in the Framingham Offspring Study. Circulation. 2002; 106 (23): 2919–2924.

5. Yang Q, He YM, Cai DP, et al. Risk burdens of modifiable risk factors incorporating lipoprotein (a) and low serum albumin concentrations for first incident acute myocardial infarction. Sci Rep. 2016; 6: 35463.

6. Mukamal KJ, Tolstrup JS, Friberg J, et al. Fibrinogen and albumin levels and risk of atrial fibrillation in men and women (the Copenhagen City Heart Study). Am J Cardiol. 2006; 98 (1): 75–81.

7. Chien SC, Chen CY, Leu HB, et al Association of lowserum albumin concentration and adverse cardiovascularevents in stable coronary heart disease. Int J Cardiol. 2017; 241: 1–5.

8. González-Pacheco H, Amezcua-Guerra LM, Sandoval J, et al. Prognostic implications of serum albumin levels in patients with acute coronary syndromes. Am Cardiol. 2017; 119 (7): 951–958.

9. Oduncu V, Erkol A, Karabay CY, et al. The prognostic value of serum albumin levels on admission in patients with acute ST-segment elevation myocardial infarction undergoing a primary percutaneous coronary intervention. Coron Artery Dis. 2013; 24 (2): 88–94.

  1. Plakht Y, Gilutz H, Shiyovich A. Decreased admission serum albumin level is an independent predictor of long-term mortality in hospital survivors of acute myocardialinfarction. Soroka Acute Myocardial Infarction II (SAMI-II) project. Int J Cardiol. 2016; 219: 20–24.

  2. Arques S, Ambrosi P. Human serum albumin in the clinical syndrome of heart failure. J Card Fail. 2011; 17 (6): 451–458.

  3. Gotsman I, Shauer A, Zwas DR, et al. Low serum albumin: A significan predicto of reduced survival in patients with chronic heart failure. Clin Cardiol. 2019; 42 (3): 365-372.

  4. Gopal DM, Kalogeropoulos AP, Georgiopoulou VV, et al. Health ABC study; Serum albumin concentration and heart failure risk the health, aging, and body composition study. Am Heart J. 2010; 160 (2): 279–285.

14. Filippatos GS, Desai RV, Ahmed MI, et al. Hypoalbuminaemia and incident heart failure in older adults. Eur J Heart Fail. 2011; 13 (10): 1078–1086.

15. Wada H, Dohi T, Miyauchi K, et al. Impact of serum albumin levels on long-term outcomes in patients undergoing percutaneous coronary intervention. Heart Vessels. 2017; 32: 1085–1092.

16. Ancion A, Allepaerts S, Oury C, et al. Serum albumin level and hospital mortality in acute non-ischemic heart failure. ESC Heart Fail. 2017; 4 (2): 138–145.

17. Liu M, Chan CP, Yan BP, et al. Albumin levels predict survival in patients with heart failure and preserved ejection fraction. Eur J Heart Fail. 2012; 14 (1): 39–44.

18. Su W, An T, Zhou Q, et al. Serum albumin is a useful prognostic indicator and adds important information to NT- proBNP in a Chinese cohort of heart failure. Clin Biochem. 2012; 45 (7–8): 561–565.

 

SHORT MESSEGES

UDC 616.33-089.87-06

DOI: 10.20969/VSKM.2019.12(4).86-89

PDF download  EARLY ANASTOMOSITIS AFTER STOMACH RESECTION

ILLARIONOVA IRINA N., ORCID ID: orcid.org/0000-0002-8939-9980; postgraduate student of the Department of general surgery and oncology of Chuvash State University named after I.N. Ulyanov, Russia, 428034, Cheboksary, Moskovsky ave., 45, tel. 8-960-051-66-11, e-mail: isha53@mail.ru

IGONIN YUVENALY A., ORCID ID: orcid.org/0000-0001-6662-2900; C. Med. Sci., associate professor, the Head of the Department of general surgery and oncology of Chuvash State University named after I.N. Ulyanov, Russia, 428000, Cheboksary, Gladkov str., 23, tel. 8-987-670-39-72, e-mail: Yuvig54@gmail.ru

Abstract. Aim. The aim of the study was to analyze the published data on the subject of post-gastro-resectionanastomositis in gastric cancer. Material and methods. Analysis of current medical research articles devoted to theincidence, diagnosis and treatment of post-gastro-resection anastomositis was carried out. Results and discussion.According to various data sources the incidence of anastomositis after gastrectomy ranges from 5 to 61%. The factors related to anastomositis are narrow gastrojejunoanastomosis or coarse ligature anastomosis in the wound, multi-row suturing, and allergic inflammatory infiltration in the area of anastomosis. For the treatment of post-gastro- resection anastomositis in the postoperative period, adequate anesthesia is required to prevent catabolic processes and fluid-electrolyte imbalance, especially potassium loss. Enteral nutrition in the early postoperative period is difficultdue to depression digestive function resulting in indication for early intestinal tract stimulation. There is evidence of lymphostimulation effectiveness in the early postoperative period. Conclusion. Anastomositis in gastric cancer and itsinconsistency, being a multifactorial disease, requires development of new methods of surgical treatment, as well as local endoscopic types of treatment in order to minimize repeated surgical interventions. Early diagnosis of post-gastro- resection anastomositis contributes to quality of life improvement in patients and faster digestive function restoration.Key words: gastric cancer, gastrectomy, anastomositis.

For reference: Illarionova IN, Igonin YuA. Early anastomositis after stomach resection. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 86-89. DOI: 10.20969/VSKM.2019.12(4).86-89.

References

1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA A Cancer Journal for Clinicians. 2011; 61 (2): 69–90.

2. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Par- kin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. International Journal of Cancer. 2010; 127: 2893–2917.

3. Tran TB, Worhunsky DJ, Norton JA, et al. Multivisceral Resection for Gastric Cancer: Results from the US Gastric Cancer Collaborative. Ann Surg Oncol. 2015; 3: 840- 847.

4. Kaprin AD, Starinsky VV, Petrova GV. Zlokachestvennye novoobrazovaniya v Rossii v 2015 godu (zabolevaemost’ i smertnost’) [Malignant neoplasms in Russia in 2015 (morbidity and mortality)]. Moskovskiy nauchno- issledovatel’skiy onkologicheskiy institut (MNIOI) imeni PA Gertsena – filial FGBU «NMITS radiologii» Minzdrava Rossii [Moscow Research Institute of Oncology (Moscow), PA Herzen – branch of the Federal ResearchCenter of Radiology Research Center of the Ministry ofHealth of Russia]. 2017; 250 p.

5. Andreou A, Biebl M, Dadras M, Struecker B, Sauer IM, Thuss-Patience PC, Chopra S, Fikatas Р., Bahra M, Seehofer D, Pratschke J, Schmidt SC. Anastomotic leak predicts diminished long-term survival after resection for gastric and esophageal cancer. Surgery. 2016; 160 (1): 191-203.

6. Yoo HM, Lee HH, Shim JH, Jeon HM, Park CH, Song KY. Negative impact of leakage on survival of patientsundergoing curative resection for advanced gastric cancer.Journal of Surgical Oncology. 2011; 104: 734-740.

7. Sietses C, Beelen RH, Meijer S, Cuesta MA. Immunological consequences of laparoscopic surgery, speculations on the cause and clinical implications. Langenbecks Arch Surg. 1999; 384: 250-258.

  1. Goldfarb Y, Sorski L, Benish M, Levi B, Melamed R, BenEliyahu S. Improving postoperative immune status andresistance to cancer metastasis: a combined perioperative approach of immunostimulation and prevention ofexcesssive surgical stress responses. Ann Surg. 2011; 253: 798-810.

  2. Kim EH, Lee H, Chung H, Park JC, Shin SK, Lee SK, et al. Impact of metabolic syndrome on oncologic outcome after radical gastrectomy for gastric cancer. Clin Res Hepatol Gastroenterol. 2014; 38: 372–378.

  3. Lin XH, Luo JC. Metabolic syndrome and gastrointestinal- hepatobiliary diseases. J Chin Med Assoc. 2017; 80: 3–4.

  4. Lin XH, Huang KH, Chuang WH, Luo JC, Lin CC, Ting PH, Young SH, Fang WL, Hou MC, Lee FY. The long term effect of metabolic profile and microbiota status in early gastric cancer patients after subtotal gastrectomy. PLoS One. 2018; 13 (11): e0206930.

12. Diomidova VN, Vinogradova VS. Ul`trazvukovaya diagnostika patologii operirovannogo zheludka [Ultrasound diagnosis of pathology of the operated stomach]. Prakticheskaya medicina [Practical medicine.]. 2018; 1 (112): 86-89.

13. James MW, Hawkey СJ. Assessment of non-steroidal antiinflammatory drug (NSAID) damage in the human gastrointestinal tract. British Journal of Clinical Phar- macology. 2003; 56: 146-155.

14. LiTF,WuG,HanXW,ShuiSF,RenJZ,LiZ,RenKW. Application of Y-shaped, coated self-expandable metallicstents for anastomotic stenosis after gastrojejunostomy(Billroth II). Acta Radiologica. 2017; 58 (1): 41-45.

 

ORGANIZATION OF HEALTHCARE

UDC 616-057.36(571.150):796.093.444(571.51-25)«2019»

DOI: 10.20969/VSKM.2019.12(4).90-93

PDF download  MORBIDITY ANALYSIS IN INTERNAL AFFAIRS OFFICERS INVOLVED IN CIVIL ORDER PROTECTION DURING THE XXIX WORLD WINTER UNIVERSIADE IN KRASNOYARKS IN 2019 IN TERMS OF INTERNAL AFFAIRS OFFICER TEAM FOR ALTAI TERRITORY

VYUN OLEG G., ORCID ID: 0000-0003-1040-7552; the Head of the Center for psycho-physiological diagnostics of Medical Unit of the Ministry of Internal Affairs of Russia in Altai territory, Russia, 656056, Barnaul, Anatolia str., 66, e-mail: caducei_22@mail.ru

ANTONOV YURI A., the Head of Medical Unit of the Ministry of Internal Affairs of Russia in Altai territory, Russia, 656056, Barnaul, Anatolia str., 66

PODZOROVA ALINA V., the Head of organizational and methodical department of Medical Unit of the Ministry of Internal Affairs of Russia in Altai territory, Russia, 656056, Barnaul, Anatolia str., 66

KHOROSHILOV ALEXEY A., deputy Head of the State sanitary and epidemiological surveillance of Medical Unit of the Ministry of Internal Affairs of Russia in Altai territory, Russia, 656056, Barnaul, Anatolia str., 66

KOCHKINA ANASTASIA G., ophthalmologist of military physician board of Medical Unit of the Ministry of Internal Affairs of Russia in Altai territory, Russia, 656056, Barnaul, Anatolia str., 66 

Abstract. Aim. The aim of the study was to analyze the incidence in police officers who took part in ensuring civil order protection during the XXIX World Winter Universiade 2019 in Krasnoyarsk, formulating a proposal on medical care organization improvement during mass sporting events. Material and methods. The data of the journal of outpatientrequests and extracts from inpatient cards were studied. Analysis of the features of medical care organization and of the incidence in personnel according to the journal of outpatient applications was performed. Results and discussion.The first place in the morbidity structure belongs to respiratory diseases, the second – to the diseases of the oral cavity, salivary glands and jaws, the third – to musculoskeletal system diseases. Comparative analysis of the main incidence rates with the ones for the Ministry of Internal Affairs as a whole for 2018 has been carried out. The cases requiring inpatient treatment have been considered. When analyzing the incidence, the role of factors contributing to the morbidity in personnel (a high amplitude of daily air temperature, low air humidity in residential areas, and an intensive schedule of service) was noted. Conclusion. When planning a business trip, it is necessary to conduct timely vaccination, as well as thorough oral cavity sanitation in employees who leave for a business trip.

Key words: universiade, morbidity analysis.

For reference: Vyun OG, Antonov YuA, Podzorova AV, Khoroshilov AA, Kochkina AG. Morbidity analysis in internal affairs officers involved in civil order protection during the XXIX World Winter Universiade in Krasnoyarks in 2019 in terms of internal affairs officer team for Altai territory. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 90-93. DOI: 10.20969/VSKM.2019.12(4).90-93.

References

1. Ukaz Prezidenta Rossiyskoy Federatsii ot 20.02.2019 No 53 «Ob obespechenii bezopasnosti XXIX Vsemirnoy zimney universiady 2019 goda v gorode Krasnoyarske» [Decree of the President of the Russian Federation of February 20, 2019 No 53 «On ensuring the security of the XXIX World Winter Universiade 2019 in the city of Krasnoyarsk»]. 2019.

2. Prikaz MVD Rossii ot 08.11.2006 No 895 «Ob utverzhdenii Polozheniya ob organizatsii meditsinskogo obsluzhivaniya i sanatorno-kurortnogo lecheniya v meditsinskikh uchrezhdeniyakh sistemy MVD Rossii» [Order of the Ministry of Internal Affairs of Russia of November 8, 2006 No 895 «On Approval of the Regulations on the Organization of Medical Care and Sanatorium-Resort Treatment in Medical Institutions of the System of the Ministry of Internal Affairs of Russia»]. 2006.

3. Prikaz MVD Rossii ot 10.01.2012 No 9 «Ob organizatsii meditsinskogo obespecheniya sotrudnikov organov vnutrennikh del, komandiruyemykh dlya vypolneniya sluzhebno-boyevykh i operativno-sluzhebnykh zadach» [Order of the Ministry of Internal Affairs of Russia dated January 10, 2012 No 9 «On the organization of medical support for officers of the internal affairs agencies sent to carry out service-combat and operational-service tasks»]. 2012.

4. Veremchuk AT, Mineeva EE, Vitkina TI, Gvozdenko TA. Vliyaniye klimata na funktsiyu vneshnego dykhaniya zdorovogo naseleniya g. Vladivostoka i bol’nykh s bronkholegochnoy patologiyey [Climate influence on the function of external respiration of healthy population of Vladivostok and patients with bronchopulmonary pathology]. Gigiyena i sanitariya [Hygiene and sanitation]. 2018; 97 (5): 23-28.

5. Gilman A, Ayotte P, Berner J, Dewailly E, Dudarev AA, Bonefeld-Jorgensen EC. Public health and the effects of contaminants. In: Arctic Monitoring and Assessment Programme (AMAP). Human health in the Arctic. 2009; 6; 143–149.

6. Ovsyannikov VG, Sapronov S.V. Struktura obshchey zabolevayemosti kontingenta MVD i yeyo vozrastno-stazhevyye osobennosti [The structure of the overall incidence of the Ministry of Internal Affairs contingent and its age-specific features]. Fundamental’nyye issledovaniya [Basic research]. 2008; 9: 45-47.

7. Shostak NA. Lyumbalgiya: diagnostika, podkhody k terapii [Lumbodynia: diagnosis, approaches to therapy]. Klinitsist [Clinician]. 2007; 4: 29-34.

8. Lezhneva IYu, Balabina NM. Rasprostranennost’ i faktory riska khronicheskogo gastrita [The prevalence and risk factors of chronic gastritis]. Sibirskiy meditsinskiy zhurnal [Siberian Medical Journal]. 2011; 4: 31-32.

 

UDC 616-057.36-084.3(571.56)

DOI: 10.20969/VSKM.2019.12(4).93-99

PDF download  THE FEATURES OF ANNUAL HEALTH EXAMINATION ORGANIZATION IN INTERNAL AFFAIRS BODIES STAFF ON A REGIONAL LEVEL ON THE TERRITORY OF SAKHA REPUBLIC (YAKUTIA)

DOLINSKAYA ELVIRA A., the Head of Medical Unit of the Ministry of Internal Affairs of Russia for Sakha Republic (Yakutia), colonel of internal service, Russia, 677005, Yakutsk, Sverdlov str., 1/2, tel. 8-4112-454-098, e-mail: elvi.67@mail.ru

GUBKO ROMAN V., Deputy Head of the Hospital of Medical Unit of the Ministry of Internal Affairs of Russia for Sakha Republic (Yakutia), internal service major, Russia, 677005, Yakutsk, Sverdlov str., 1/2, tel. 8-4112-454-961, e-mail: gubkor@mail.ru

Abstract. Aim. The aim of the study was to analyze the results of preventive medical examinations in internal affairs bodies’ staff on the territory of the Republic of Sakha (Yakutia). Evaluation of preventive medical examination effectiveness was performed for remote and nearby areas. Incidence rate monitoring in internal affairs officers was carried out forisolated areas and in general. Material and methods. The materials rely on the regular number of internal affairs bodies’workers in the Republic of Sakha (Yakutia). The results of preventive medical examinations in employees of nearby internal affairs agencies and reports on morbidity established in accordance with the order of the Minister of Internal Affairs for the Republic of Sakha (Yakutia) were analyzed. Results and discussion. Monitoring the state of health in district policedepartment staff allows timely disease identification in the employees and casualty prevention in personnel. It appears to be more efficient and cost-effective to conduct medical examinations in remote bodies of internal affairs in the central district hospitals, which is less expensive in case of medical unit team attendance. Conclusion. Preventive medical examinations in internal affairs bodies’ staff remain one of the priority areas of departmental medicine. It is proposed that the internal affairs bodies’ staff incidence reports to be moved to the level of the Ministry of Internal Affairs of Russia.Key words: preventive medical examinations, internal affairs bodies’ staff, territorial internal affairs bodies.

For reference: Dolinskaya EA, Gubko RV. The features of annual health examination organization in internal affairs bodies staff on a regional level on the territory of Sakha republic (Yakutia). Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 93-99. DOI: 10.20969/VSKM.2019.12(4).93-99.

References

1. Prikaz Minzdravsocrazvitiya Rossii ot 12.04.2011 No 302n «Ob utverzhdenii perechnej vrednyh i (ili) opasnyh proizvodstvennyh faktorov i rabot, pri vypolnenii kotoryh provodyatsya obyazatel’nye predvaritel’nye i periodicheskie medicinskie osmotry (obsledovaniya), i Poryadka provedeniya obyazatel’nyh predvaritel’nyh i periodicheskih medicinskih osmotrov (obsledovanij) rabotnikov, zanyatyh na tyazhelyh rabotah i na rabotah s vrednymi i (ili) opasnymi usloviyami truda» [Order of the Ministry of Healthcare and Social Development of Russia of 12.04.2011 No 302n «On approval of the lists of harmful and (or) occupational hazards and works, during which mandatory preliminary and periodic medical examinations (examinations) are carried out, and theprocedure for mandatory preliminary and periodic medicalexaminations (examinations) of workers engaged in heavy work and work with harmful and (or) hazardous working conditions»]. 2011.

2. Samoylova GS, Goryachko MD. Fiziko-geograficheskiy ocherk [Physico-geographical sketch]. Bol’shaya Rossiyskaya entsiklopediya [Big Russian Encyclopedia]. www.bigenc.ru/geography/text/4925634

3. Yegorov YeG, Ponomareva GA, Fedorova YeN. Geograficheskoye polozheniye Respubliki Sakha (Yakutiya) i yego unikal’nost’ [The geographical position of the Republic of Sakha (Yakutia) and its uniqueness]. Strategiya razvitiya regiona [Regional development strategy]. 2009; 14 (107): 16–18.

4. Shtatnoye raspisaniye vnutrennikh del po Respublike Sakha (Yakutiya) na 2019 god [The staff list of the internal affairs body in the Republic of Sakha (Yakutia) for 2019].

5. Rasporyazheniye MVD Rossii ot 27.12.2018 No 1/4892 «O federal’nom byudzhete MVD RF na 2019 god i na planovyy period 2020 i 2021godov» [The order of the Ministry of Internal Affairs of Russia dated December 27, 2018 No 1/4892 «On the federal budget of the Ministry of Internal Affairs of the Russian Federation for 2019 and for the planning period 2020 and 2021»]

6. Postanovleniya Pravitel’stva RF ot 15.12.2018 No 1563 «O poryadke predostavleniya sotrudnikam organov vnutrennikh del Rossiyskoy Federatsii, v tom chisle grazhdanskim vlastyam, organam po kontrolyu za oborotom narkoticheskikh sredstv i psikhotropnykh veshchestv, ikh sem’yam i litsam, nakhodyashchimsya v ikh podchinenii, meditsinskoy pomoshchi i obespecheniya ikh sanatorno- kurortnym lecheniyem» [Decisions of the Government of the Russian Federation of December 15, 2018 No 1563«On the procedure for providing employees of the internalaffairs bodies of the Russian Federation, certain categories of citizens of the Russian Federation, discharged from service with the internal affairs bodies, bodies controlling the circulation of narcotic drugs and psychotropic substances, their family members and dependent persons, medical help and providing their spa treatment»].

7. Rezul’taty profilakticheskikh meditsinskikh osmotrov territorial’nykh organov vnutrennikh del po Respublike Sakha (Yakutiya) po itogam 2018 goda [The results of preventive medical examinations of the territorial internal affairs bodies in the Republic of Sakha (Yakutia) following the results of 2018].

 

UDC 616-057-084:331.483.2 

DOI: 10.20969/VSKM.2019.12(4).99-105

PDF download  THE ROLE OF ROUTINE MEDICAL EXAMINATIONS IN OCCUPATIONAL AND CORPORAL DISEASE PREVENTION

FADEEV GRIGORY A., ORCID ID: 0000-0002-0213-8631; Deputy Head of Clinical Hospital of Medical Unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, Russia, 420059, Kazan, Orenburgskiy tract str., 132, e-mail: Dr.GrigoryFadeev@yandex.ru

GARIPOVA RAILA V., ORCID ID: 0000-0001-8986-8030; SCOPUS Author ID: 54904191000; D. Med. Sci., associate professor of the Department of hygiene and occupational medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: railyagaripova@mail.ru

ARKHIPOV EVGENY V., ORCID ID: 0000-0003-0654-1046; SCOPUS Author ID: 56997299700; C. Med. Sci., associate professor of the Department of policlinical therapy and general medical practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: jekaland@mail.ru

MIKHOPAROVA OLGA YU., the Head of office for functional diagnostics of Clinical Hospital of Medical Unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, Russia, 420059, Kazan, Orenburgskiy tract str., 132, e-mail: olga-mihoparova@rambler.ru

BERKHEEVA ZUKHRA M., C. Med. Sci., associate professor of the Department of preventive medicine and human ecology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: kgmu_profpat@mail.ru

OSHCHEPKOVA OLGA B., the Head of the Department of cardiology of Clinical hospital of Medical Unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, Russia, 420059, Kazan, Orenburgskiy tract str., 132, e-mail: oschepkova.kazan@mail.ru

SAFINA KADRIYA R., the Head of Republican Center for Occupational Diseases, Russia, 420036, Kazan, Lechebnaya str., 7

Abstract. Aim. The aim of the study was to assess the effectiveness of routine medical examinations in the Republic of Tatarstan for 2016–2018 according to the final acts submitted to the Republican Center for Occupational Diseases of the Ministry of Health of the Republic of Tatarstan. Material and methods. Analysis of annual reports from 45 territories of the Republic of Tatarstan for 2016–2018 was performed. Results and discussion. Annually, 300 536 employees approximately undergo routine medical examinations in the Republic of Tatarstan. The average medical examination coverage is 97–98%. In 2018 not a single suspicion of occupational disease was detected in 34 municipalities of the Republic of Tatarstan (2016 – 21, 2017 – 22) during routine medical examinations. Private medical organizations practically do not detect occupational diseases. Suspicion of occupational disease was established in only one organization out of 12 that submitted the final acts to the center of occupational diseases. In 2018 the cases of occupational diseases were registered in 15 administrative territories (2016 – 24, 2017 – 22). Outpatient examination and treatment in 2018 was recommended in 17,8% of the examined workers (2016 – 16,2%, 2017 – 18,6%), inpatient examination and treatment – in 0,35% (in 2016 – 0,23%, in 2017 – 0,5%). Health resort treatment was indicated in 5,5% of examined workers (6,2% and 6,8%). Specialist follow up was recommended for 16,7% of workers (15,2% and 16,2%). Conclusion. At present, routine medical examinations neither reveal the early signs of occupational diseases, nor suspected ones that have been acquired. Among common diagnosed corporal diseases there are nutrition and metabolic disorders, diseases of the circulatory, blood, and urinary system. Thus, with a high degree of certainty, it can be concluded that it is necessary to change the approaches to routine medical examinations introducing more thorough quality control.

Key words: routine medical examinations, occupational diseases, occupational medical care.

For reference: Fadeev GA, Garipova RV, Arkhipov EV, Mikhoparova OY, Berkheeva ZM, Oshchepkova OB, Safina KR. The role of routine medical examinations in occupational and corporal disease prevention. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 99-105. DOI: 10.20969/VSKM.2019.12(4).99-105.

References

1. Prikaz Minzdravsocrazvitiya Rossii ot 12.04.2011 No 302n «Ob utverzhdenii perechnej vrednyh i (ili) opasnyh proizvodstvennyh faktorov i rabot, pri vypolnenii kotoryh provodyatsya obyazatel’nye predvaritel’nye i periodicheskie medicinskie osmotry (obsledovaniya), i Poryadka provedeniya obyazatel’nyh predvaritel’nyh i periodicheskih medicinskih osmotrov (obsledovanij) rabotnikov, zanyatyh na tyazhelyh rabotah i na rabotah s vrednymi i (ili) opasnymi usloviyami truda» [Order of the Ministry of Healthcare and Social Development of Russia of 12.04.2011 No 302n «On approval of the lists of harmful and (or) occupational hazards and works, during which mandatory preliminary and periodic medical examinations (examinations) are carried out, and theprocedure for mandatory preliminary and periodic medicalexaminations (examinations) of workers engaged in heavy work and work with harmful and (or) hazardous working conditions»]. 2011.

2. Amirov NKh, Berkheeva ZM, Yakupov EZ, et al. Sovre- mennye problemy medicinskogo nablyudeniya zarabotayushchimi v neblagopriyatnyh usloviyah truda[Current problems of medical observation of workers in unfavourable labour condition]. Kazanskij medicinskij zhurnal [Kazan medical journal]. 2003; 84 (5): 386-387.

3. Kretov AS, Bushmanov AY, Mamonova EY. Metodika ocenki riska razvitiya hronicheskogo professional’nogo zabolevaniya i medicinskih protivopokazanij [Method of chronic occupational disease development risks assessment, and medical contra-indication]. Medicina truda i promyshlennaya ekologiya [Russian Journal of Occupational Health and Industrial Ecology]. 2015; 9: 78-79.

4. Bushmanov AU, Kretov AS, Kasymova OA, et al. Formirovanie grupp riska razvitiya professional’nyh zabolevanij v hode predvaritel’nyh i periodicheskih medicinskih osmotrov dlya provedeniya vosstanovitel’nyh meropriyatij [The formation of risk groups for development of occupational diseases during the pre-employment and periodic medical examinations to conduct recreational activities]. Saratovskij nauchno-medicinskij zhurnal [Saratov Journal of Medical Scientific Research]. 2014; 10 (4): 754-758.

5. Gosudarstvennyy doklad [Governmental report]. O sostoyanii sanitarno-epidemiologicheskogo blagopolu- chiya naseleniya v Respublike Tatarstan v 2017 godu [On state of sanitary epidemiologic well-being of population in Republic of Tatarstan in 2017]. Kazan’: Upravleniye Federal’noy sluzhby po nadzoru v sfere zashchity prav potrebiteley i blagopoluchiya cheloveka [Kazan: Federal Service for Supervision of Consumer Rights Protection and Human Welfare]. 2018; 318 р.

6. Prikaz Minzdrava Rossii ot 13.11.2012 No 911n «Ob utverzh- denii poryadka okazaniya meditsinskoy pomoshchi pri ostrykh i khronicheskikh professional’nykh zabolevaniyakh» [Order of the Ministry of Health of the Russian Federation dated November 13, 2012 No 911n «On the approval of theprocedure for the provision of medical care for acute andchronic occupational diseases»].

 

EXPERIMENTAL STUDIES – TO PRACTICAL MEDICINE

UDC [616.45-092.19:616-001]-092.9

DOI: 10.20969/VSKM.2019.12(4).106-109

PDF download  BEHAVIORAL MODEL FACTOR ANALYSIS IN EXPERIMENTAL ANIMALS WITH DIFFERENT STRESS REACTIVITY

PERMYAKOV ALEKSANDR A., ORCID ID: 0000-0001-5196-0448; C. Med. Sci., associate professor of the Department of human physiology of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunar str., 281, e-mail: aa-permyakov@mail.ru

ISAKOVA LARISA S., ORCID ID: 0000-0003-4780-8720; D. Med. Sci., professor, the Head of the Department of human physiology of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunar str., 281, e-mail: lisakova18@mail.ru

MOKHOVA LUDMILA YA., ORCID ID: 0000-0002-7121-1265; internal service colonel, the Head of Medical Unit of the Ministry of Internal Affairs of Russia for the Udmurt Republic, Russia, 426035, Izhevsk, Serov str., 69, e-mail: medic.18@mvd.ru

FILIMONOV ALEXANDER M., ORCID ID: 0000-0003-3797-9526; C. Med. Sci., lieutenant colonel of internal service, the Head of the Hospital of Medical Unit of the Ministry of Internal Affairs of Russia for the Udmurt Republic, Russia, 426035, Izhevsk, Serov str., 69, e-mail: medic.18@mvd.ru

Abstract. Aim. The aim of the research was to study behavioral reactions in rats via «open field» test and to create various stress-reactivity group ethological models in animals using factor analysis method. Material and methods. Theexperiments were performed on 167 white outbred rats in the open field test. Factor analysis of behavioral indicators on the distribution of stress resistance degree in different groups of animals was applied. Results and discussion.Physiological behavior and motivation mechanisms of group and individual stress-resistance were investigated in rats in «the open field» test using integrated multiple statistical processing method application. Under conditions of minor stress, the functional value of search activity in «the open field» is being determined by dominant motivation, which is being developed according to the animal’s background emotional state, which is a balance of fear and anxiety. It is being realized as a search motor activity. Each of the four groups of animals different in terms of stress-resistance showed various numbers of factor connections and its own individual correlated set of behavioral traits, creating an ethological profile specific for every group. Conclusion. Comprehensive behavioral indicator assessment allows dividing experimental animals into groups according to degree of prognostic stress-resistance, forecasting individual stress- reactivity for every animal, and also identifying basic group and individual motivations that form stress-induced behavior.

Key words: behavior, motivation, stress-resistance, «open field» test, factor analysis.

For reference: Permyakov AA, Isakova LS, Mokhova LYa, Filimonov AM. Behavioral model factor analysis in experimental animals with different stress reactivity. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 106-109. DOI:10.20969/VSKM.2019.12(4).106-109.

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THESIS RESEARCHES

UDC 616.127-005.8-037:616.15-07

DOI: 10.20969/VSKM.2019.12(4).110-115

PDF download  THE ROLE OF LABORATORY PARAMETERS IN A LONG-TERM PROGNOSIS IN PATIENTS WITH MYOCARDIAL INFARCTION WITH DIFFERENT LOCALIZATION ST SEGMENT ELEVATION

KHARISOVA ENZHE КH., ORCID: 0000-0002-4890-4768; postgraduate student of the Department of сardiology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-950-946-80-89, e-mail: cardiorean@mail.ru

Abstract. Aim. The aim of the study was to evaluate the role of laboratory parameters in long term survival in patients with myocardial infarction with different localization ST segment elevation. Material and methods. The study included998 patients with myocardial infarction with ST segment elevation aged from 25 to 92 years. Mean duration of observation was (302,7±170) days. The patients were divided into 4 groups depending on the localization of myocardial damage. In the 1st group the patients had combined lesions of the lateral and upper parts of the left ventricular wall. In the 2nd group – left ventricle lower wall, in the 3rd group – left ventricle anterior wall, in the 4 group there was a circularmyocardial infarction. Results and discussion. Coronary artery stenosis according to Gensini scale in groups 1 and 2 (489 patients, left ventricle lower wall myocardial infarction) was Me 59 (26; 87,5) points and Me 66,5 (53; 91) points, respectively (p<0,001). After adjusting for gender, the differences resembled. Hospitalization duration in groups 1 to 4, was respectively (in days): Me 12 (9; 14), Me 12,04 (11; 12), Me 11,8 (11; 12), Me 12,7 (12; 14), p=0,29. High mortality rate was registered in group 1 – (4,8±2,1)%, compared with the other three (2,5±1,5)% group 2, (2,8±1,7)% group 3 and (3±1,7)% group 4, p=0,84. Survival was effected by an increase in creatinine, both upon admission (above 94,4 μmol/L,p=0,03; OR – 1,01; 95% CI 1,004–1,008) and repeatedly (above 96,8 μmol/l; p<0,001; OR – 1,01 95% CI 1,02–1,04), KSH (p<0,001; OR – 1,8; 95% CI 4,25–9,6). No statistically significant relationship of laboratory parameters and survival was seen in groups 1 and 4. In group 2 it was glucose over time (higher than 6,9 mmol/l; p=0,037, OR – 1,1; 95% CI 1,1–1,6), creatinine (higher than 97 μmol/l; p<0,001; OR – 1,01; 95% CI 1,02–1,03). In anterior myocardial infarction with ST-segment elevation group, cardiogenic shock upon admission 5 times increased the risk of death (p=0,005; OR – 1,67; 95% CI 5,7–19,6). After adjustment for age, the difference in overall survival remained statistically significant (p=0,052; OR – 0,99; CI 1,6–2,58). Conclusion. Age younger than 45 years and older than 75 years, a lesion in the left ventricle anterior wall, the history of diabetes mellitus, serum creatinine level above 97 μmol/l, blood glucose level above 7 mmol/l, natriuretic peptide level above 150 ng/ml were predictors of adverse outcomes in the long-term periodand after adjusting for gender.

Key words: myocardial infarction, ST-segment elevation, long-term prognosis, laboratory markers, Gensini.

For reference: Kharisova EH. The role of laboratory parameters in a long-term prognosis in patients with myocardial infarction with different localization ST-segment elevation. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 110-115. DOI: 10.20969/VSKM.2019.12(4).110-115.

References

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3. Smilowitz NR, Mahajan AM, et al. Mortality of Myocardial Infarction by Sex, Age, and Obstructive Coronary Artery Disease Status in the ACTION Registry-GWTG (Acute Coronary Treatment and Intervention Outcomes Network Registry-Get with the Guidelines). Circulation: Cardiovascular Quality and Outcomes. 2017; 10 (12): e003443. DOI: 10.1161/CIRCOUTCOMES.116.003443

4. Yamashita Y, Shiomi H, et al. Cardiac and Noncardiac Causes of Long-Term Mortality in ST-Segment-Elevation Acute Myocardial Infarction Patients Who Underwent Primary Percutaneous Coronary Intervention. Circulation: Cardiovascular Quality and Outcomes. 2017; 10 (1): e002790. DOI: 10.1161/CIRCOUTCOMES.116.002790

5. Aggarwal NR, Patel HN, et al. Sex Differences in Ischemic Heart Disease: Advances, Obstacles, and Next Steps. Circulation: Cardiovascular Quality and Outcomes. 2018; 11 (2): 1–15. DOI: 10.1161/CIRCOUTCOMES.117.004437

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9. Lew J, Sanghavi M, et al. Sex-Based Differences in Cardiometabolic Biomarkers. Circulation. 2017; 135 (6): 544–555. DOI: 10.1161/CIRCULATIONAHA.116.023005

10. Park Y, Tantry US, et al. Novel role of platelet reactivity in adverse left ventricular remodeling after ST-segment elevation myocardial infarction: The REMODELING trial. Thrombosis and Haemostasis. 2017; 117 (5): 911–922. DOI: 10.1160/TH16-10-0744

11. Piackova E, Jäger B, et al. Gender differences in short- and long-term mortality in the Vienna STEMI registry. International Journal of Cardiology. 2017; 244: 303–308. DOI: 10.1016/j.ijcard.2017.05.068

12. Erlih AD, Gracianskij NA. Ostryj koronarnyj sindrom u bol’nyh saharnym diabetom: Dannye registra REKORD [Acute coronary syndromes in hospitalized patients with diabetes: Data from the RECORD Registry]. Kardiologiya [Cardiology]. 2011; 11: 16-21.

 

UDC 616.132.2-089.819.5-06

DOI: 10.20969/VSKM.2019.12(4).116-123

PDF download  CORONARY ARTERY RESTENOSIS RISK FACTORS IN EMERGENCY OR PLANNED STENTING

SHAMES DENIS V., ORCID ID: orcid.org/0000-0002-7613-836X; postgraduate student of the Department of cardiology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: denshames@mail.ru

Abstract. Aim. The aim of the study was to assess the differences in in-stent restenosis predictors in emergency orplanned stenting. Material and methods. The study included 438 patients. Inclusion criteria were patient age 45–74 years, coronary angiography and native coronary artery emergency or planned stenting, repeated coronary angiography and restenosis. The patients were divided into two groups: the patients with acute CHD types and the patients with chronic CHD. Control group of patients who did not differ in diagnosis, but had no restenosis in a previously installed stent, was recruited for each study group. 73 patients were included in the studied group of patients who underwent emergency stenting. The control group with the absence of restenosis on repeated CAG consisted of 67 people. The study group with restenosis after planned stenting was 145 people; the control group of patients united 153 people. Results and discussion. Platelet-lymphocyte ratio (OR – 1,043), total cholesterol (OR – 1,016), coronary atherosclerosis index Gensini (OR – 1,06) and the number of simultaneously implanted stents (OR – 2,64) were predictors of restenosis inside the stent for emergency coronary artery stenting. The following restenosis predictors were found for the patients with planned stenting: diabetes mellitus (OR – 4,3), hyperlipidemia (OR – 2,5), RDW (OR – 1,9), Gensini index (OR – 1,1), fibrinogen (OR – 2,61), and simultaneously implanted stent number (OR – 1,58). Patient age groups did not demonstrate any significance, both in predictor analysis for emergency stenting, and in such for planned stenting. Conclusion. Risk factors for coronary artery restenosis after emergency stenting are platelet-lymphocyte ratio, total cholesterol, and severity of coronary atherosclerosis. Risk factors for coronary artery restenosis after planned stenting are the width of the red blood cell volume range, fibrinogen, coronary atherosclerosis severity, simultaneously implanted stent number, diabetes, and hyperlipidemia. When comparing the groups of patients who underwent emergency or planned stenting,the age of patients did not appear as a predictor of restenosis.

Key words: coronary heart disease, restenosis, bare metal stents, drug elusive stents, risk factors.

For reference: Shames DV. Coronary artery restenosis risk factors in emergency or planned stenting. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (4): 116-123. DOI: 10.20969/VSKM.2019.12(4).116-123.

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