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ORIGINAL RESEARCH
REVIEWS
ORGANIZATION OF HEALTHCARE
PRACTICAL EXPERIENCE
MEDICIN’S HISTORY
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ORIGINAL RESEARCH
УДК: 616-07:616-053.31:616.155.3
DOI: 10.20969/VSKM.2025.18(5).7-14
Clinical significance of determining the levels of iron, copper, cobalt, and zinc in the blood of neonates and their mothers, in case of hemolytic disease of the newborn
Abdurayim Sh. Arzikulov1, Gulazzam D. Abdullaeva1, Abdikadir G. Arzibekov1, Zemfira B. Khafizova1, Dilmurakhon A. Abdullaeva1, Sherzod O. Toshboev1, Maria A. Daminova2
1 Andijan State Medical Institute, 1 Atabekov str., 170100 Andijan, Uzbekistan
2 Institute of Biology and Fundamental Medicine, Kazan Federal University, 74 Karl Marx str., 420012 Kazan, Russia
Abstract. Introduction. Although the etiology and pathogenesis of hemolytic disease of the newborn are well-understood, the issue of metabolic processes in this disease has not received adequate attention. Trace elements and electrolytes are essential to the development of this pathology, especially to metabolic changes associated with erythrocyte damage. Thus, the pathogenesis of the disease is closely linked to disorders of trace element metabolism—trace element imbalances—which aff ects the specifi c features of the clinical course, severity, and development of complications. Aim. To determine the levels of iron, copper, cobalt, and zinc in the blood of newborns with hemolytic disease at various clinical forms and degrees of severity, as well as dynamically during the course of the disease. Materials and Methods. The subjects of the study were newborns with hemolytic disease and their mothers who were undergoing inpatient treatment at the perinatal center of Andijan State Medical Institute from September, 2022 to December, 2024. Trace elements, i.e. iron, copper, cobalt, and zinc, were determined in the blood of newborns with hemolytic disease (n=130) and their mothers (n=117). For control, the levels of these trace elements were determined in the cord blood of healthy newborns (n=85) born to mothers with Rh-negative blood type, and in the blood of their mothers (n=72). Anamnestic, general clinical, laboratory, instrumental, and biochemical investigation methods were used additionally. The obtained data were statistically processed using the variation statistics method with advanced computer software packages Statistica 6.0, using parametric and nonparametric statistical methods, correlation analysis, Student’s t-test, and chi-square test (Х2). Results and Discussion. Changes in the levels of iron, copper, cobalt, and zinc in the blood of newborns, which we have determined in various forms of and at diff erent stages of the course of hemolytic disease of the newborn indicate serious disturbances in the metabolism of these trace elements. The nature and extent of these changes are directly related to the severity of the pathological process in the child’s body. Conclusions. The contents of trace elements in the blood of newborns with hemolytic disease and of their mothers diff er from their normal contents and change dynamically during the course of the disease. It was noticed that there is a dependence of the levels of trace elements in the blood of newborns and their mothers on the clinical forms and severity of hemolytic disease. Thus, the determination of the iron, copper, cobalt, and zinc levels in the blood of newborns with hemolytic disease and of their mothers is a relevant research area that can improve the diagnosis, treatment, and prognosis of this disease.
Keywords: hemolytic disease, newborns, trace elements, iron, copper, cobalt, zinc.
For citation: Arzikulov, A. Sh.; Abdullaeva, G.D.; Arzibekov,A.G.; et al. Clinical signifi cance of determining the levels of iron, copper, cobalt, and zinc in the blood of neonates and their mothers, in case of hemolytic disease of the newborn. The Bulletin of Contemporary Clinical Medicine. 2025, 18(5), 7-14. DOI: 10.20969/VSKM.2025.18(5).7-14.
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15. Lewicka I, Kocyłowski R, Grzesiak M, Gaj Z, Oszukowski P, Suliburska J. Selected trace elements concentrations in pregnancy and their possible role - literature review. Ginekol Pol. 2017;88(9):509-514. DOI: 10.5603/GP.a2017.0093
УДК: 616-01.-07
DOI: 10.20969/VSKM.2025.18(5).15-22
Evaluation of the practice management of physicians who have newly diagnosed patients with sarcoidosis
Alexander A. Vizel1, Sergey N. Avdeev2,3, Irina Yu. Vizel1, Gulnaz R. Shakirova1,4, Nail B. Amirov1,5, Marina N. Zinovieva1, Anastasiya S. Semenova1, Leonid A. Vizel6
1 Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
2 I.M. Sechenov First Moscow State Medical University (Sechenov University), 8 Trubetskaya str, Bldg. 2, 119991 Moscow, Russia
3 Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia, 28 Orekhovyy Blvd., 115682 Moscow, Russia
4 Republican Clinical Hospital, 138 Orenburgsky Trakt str., 420064 Kazan, Russia
5 Medical Unit of the Ministry of Internal Affairs of the Russian Federation in the Republic of Tatarstan, 132 Orenburgsky Trakt str., 420059 Kazan, Russia
6 Kazan (Volga Region) Federal University, 18 Kremlevskaya str., 420008 Kazan, Russia
Abstract. Introduction. Sarcoidosis is a systemic granulomatosis of unknown etiology that is still diffi cult to diagnose at the primary health care stage, and initial prescriptions require knowledge of clinical guidelines. It is known that unreasonable practice management at the beginning of treatment signifi cantly worsens the disease prognosis. The aim of the study was to evaluate the actions of doctors and their initial prescriptions for their patients who were subsequently diagnosed with the biopsy-confi rmed sarcoidosis. Materials and Methods. We analyzed 1001 cases of histologically confirmed sarcoidosis: 634 (63.3%) women and 367 (36.7%) men who consulted a pulmonologist from 68 regions of Russia and neighboring countries. The methods of detection, primary diagnoses, and specialties of doctors who made initial prescriptions and conducted a diagnostic search were recorded, as well as the contents of such primary recommendations and prescriptions. Results and Discussion. The detection of sarcoidosis was associated with diagnostic investigations, the causes of which varied. Most often (in 417 cases, 41.74%), changes were detected during preventive fl uorography, 250 patients (25.03%) sought help with respiratory complaints, while the remaining reasons for visits accounted for less than 10% each. 87 diagnoses were preliminarily made, among which the most common were tuberculosis (in 297 cases, 29.7%), sarcoidosis (in 161 cases, 16.1%), pneumonia (in 105 cases, 10.5%), and tumors – (in 88 cases, 8.8%). Only 237 patients (23.68%) were left under observation without treatment, while 515 patients were recommended to take vitamin E (51.45%) and 241 (24.08%) pentoxifylline (236 of them together with vitamin E). 210 patients (20.98%) were immediately prescribed systemic glucocorticosteroids (SGCS), 56 (5.59%) antibiotics, 50 (4.99%) anti-tuberculosis drugs, while the remaining prescriptions were less frequent than in 5% of cases. Frequency of SGCS prescription upon detection was more frequent in Löfgren’s syndrome (34.5% of cases versus 18.7% without this syndrome), which cannot be considered reasonable practice management. Conclusions. Despite the fact that most physicians are familiar with the key issues of diagnosis and initial therapy of sarcoidosis, in every fourth patient the practice management does not comply with clinical recommendations. Excessive administration of glucocorticosteroids in Löfgren’s syndrome has been observed, which may adversely aff ect the subsequent disease course.
Keywords: sarcoidosis, detection, treatment, Löfgren’s syndrome.
For citation: Vizel, A.A.; Avdeev, S.N.; Vizel, I.Yu.; et al. Evaluation of the practice management of physicians who have newly diagnosed patients with sarcoidosis. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (5), 15-22. DOI: 10.20969/VSKM.2025.18(5).15-22.
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УДК 616.12-008.331.1
DOI: 10.20969/VSKM.2025.18(5).23-36
Predictors of the risk of arterial hypertension in young internal affairs officers
Madina T. Gabdullina 1, Nail B. Amirov 2,3, Aidar T. Beshimov 2
1Consulting and Diagnostic Center of the Aviastroitelny District,10 Lukin str.,420127 Kazan, Russia
2Medical Unit of the Ministry of Internal Affairs of the Russian Federation in the Republic of Tatarstan, 132 Orenburgsky Trakt str., 420059 Kazan, Russia
3Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
Abstract. Introduction. Arterial hypertension is the leading cause of the global disease burden, especially among young people, due to its high prevalence and numerous complications. Aim. To identify risk predictors of developing arterial hypertension and their prevalence among young internal aff airs offi cers. Materials and Methods. The study included 40 patients (80% men, 20% women) aged 18-44 years with arterial hypertension. In addition to standard methods, such as electrocardiogram, echocardiogram, and lipid profi le, a questionnaire was used to identify risk factors and psychological tests (HADS) and assessment of social aspects were performed. The fi ndings were processed statistically using the Statistica 6.0 software; the diff erences were considered signifi cant at p<0.05. Results and Discussion. This study revealed that the prevalence of arterial hypertension increases with age, reaching 87.5% in employees aged 35-44. Overweight, a history of smoking, and high sugar consumption are associated with increased blood pressure, as is alcohol consumption in military personnel. Emotional stress and job dissatisfaction aff ect blood pressure, as well. Conclusions. In order to reduce the incidence of arterial hypertension among internal aff airs offi cers, it is necessary to implement a comprehensive approach that includes early diagnosis, lifestyle changes, and improvement of working conditions. It is important to conduct regular health monitoring, ensure access to medical care, and develop individualized prevention and treatment programs, taking into account risk factors, such as weight, smoking, nutrition, alcohol consumption, and emotional states.
Keywords: arterial hypertension, predictors, military personnel.
For citation: Gabdullina, M.T; Amirov, N.B.; Beshimov, A.T. Predictors of the risk of arterial hypertension in young internal aff airs offi cers. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (5), 23-36. DOI: 10.20969/VSKM.2025.18(5).23-36.
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УДК 615.036.8. 616.379-008.64
DOI: 10.20969/VSKM.2025.18(5).37-46
Pharmacoeconomic evaluation of insulin therapy in children with type 1 diabetes mellitus, based on real-world clinical data
Alexandra A. Grazhdankina1, Elena V. Karakulova1, Marina V. Koshmeleva1, Yulia G. Samoylova1,2
1Siberian State Medical University, 2 Moskovsky Trakt str., 634050 Tomsk, Russian Federation
2Novosibirsk State University, 1 Pirogov str., 630090 Novosibirsk, Russian Federation
Abstract. Introduction. Use of insulin pumps and continuous glucose monitoring systems has been shown to improve the control of type 1 diabetes mellitus in children, but these technologies require signifi cant costs for the healthcare system. Aim. To assess the cost-eff ectiveness of various insulin therapy regimens in children with type 1 diabetes mellitus, based on real-world clinical data. Materials and Methods. Cost-eff ectiveness was analyzed using data from the Federal Register of Diabetes Mellitus in the Tomsk Region for the years 2022-2024 (328 children). Results and Discussion. Number of children receiving insulin pump therapy increased 2.5-fold during the study period, which led to an increase in the total treatment costs from 6 million to 15.3 million Russian rubles, primarily due to the increased costs in the Preferential Drug Provision System. At the same time, the target HbA1c level of <7.0% was achieved by only 9–15% of patients in both groups. Cost-eff ectiveness and sensitivity analyses revealed that the costs of achieving the result with insulin pump therapy were many times higher than with multiple daily injections, with the result critically dependent on achieving the target HbA1c level of <7.0%. Conclusions. The fi ndings emphasize the importance of evaluating the economic effi ciency when making decisions regarding public funding of modern diabetes management technologies.
Keywords: multiple daily injections, insulin pump, continuous glucose monitoring, cost-eff ectiveness analysis, modeling, sensitivity analysis
For citat ion: Grazhdankina, A.A.; Karakulova, E.V.; Koshmeleva, M.V.; Samoylova Yu.G. Pharmacoeconomic evaluation of insulin therapy in children with type 1 diabetes mellitus, based on real-world clinical data. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (5), 37-46. DOI: 10.20969/VSKM.2025.18(5).37-46.
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УДК: 615.1-012.8:547.918-001.
DOI: 10.20969/VSKM.2025.18(5).47-57
Marketing research in the pharmaceutical market of herbal medicines containing saponins
Naira A. Davitavyan1, Anastasia I. Shevchenko1, Christina V. Gorkovenko1, Vilena V. Burlakova1, Anastasia S. Dolgova1
1Kuban State Medical University, 4 M. Sedin str., 350063 Krasnodar, Russia
Abstract. Introduction. Currently, one of the main sources of obtaining natural medicines are medicinal plants providing a mild combined therapeutic eff ect. Pharmacotherapeutic potential of herbal medicines is based on groups of biologically active substances, such as fl avonoids, phenolcarboxylic acids, polysaccharides, alkaloids, and saponins. Saponins are one of the groups of biologically active substances of potential interest to pharmaceutical developers. They are characterized by structural diversity and a wide range of biological, pharmacological, and physicochemical properties, which ensures high demand for their use both in the pharmaceutical industry and in the cosmetic and food industries. Aim. To study the nomenclature of the domestic pharmaceutical market of herbal medicines containing saponins and to analyze the present-day data on promising sources of their manufacturing. Materials and Methods. Objects of the study include offi cial information presented in the State Register of Medicines of the Russian Federation for the years 2024-2025, the Vidal reference book, and data obtained from our own scientifi c research. Wholesale prices for herbal medicines containing saponins were analyzed using the electronic resource of North Caucasus Laboratory of Information Technologies (SKLIT). To evaluate the dynamics in retail prices of herbal medicines containing saponins, we used information from the unifi ed pharmacy reference system Pharmacies in Russia – www.apteki.su. The study used content analysis methods, as well as graphic and comparative analyses. Results and Discussion. The research conducted has determined 50 families and 149 genera are the sources of herbal medicines containing saponins. At the same time, medicinal plants of 37 genera are used to manufacture herbal medicinal products containing saponins. Marketing analysis of herbal medicines containing saponins has revealed that they are presented as 398 trade names and 100 international non-proprietary names. About 97 pharmaceutical companies manufacture herbal medicines, among which 67% of the nomenclature of medicinal products accrue to domestic manufacturers. It has been revealed that herbal medicines containing saponins are available to consumers in 30 diff erent dosage forms. The leaders among saponin-containing herbal medicines are preparations included in the following groups: Other Medicinal Products, Digestive Tract and Metabolism, and Respiratory System. We also structured the pharmaceutical market by price segments for saponin-containing herbal medicinal products sold by wholesale distributors and pharmacy organizations in the constituent entities of the Russian Federation. Conclusions. Marketing research was performed in the pharmaceutical market of herbal medicines containing saponins, including domestic and international manufacturing. We also studied the dynamics of structural price segments in Russian rubles for saponin-containing herbal medicines sold in the constituent entities of the Russian Federation.
Keywords: herbal medicinal products, saponins, pharmaceutical market, marketing research
For citation: Davitavyan, N.A.; Shevchenko, A.I.; Gorkovenko, K.V.; et al. Marketing research in the pharmaceutical market of herbal medicines containing saponins. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (5), 47-57. DOI: 10.20969/VSKM.2025.18(5).47-57.
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УДК 356.33:355.721
DOI: 10.20969/VSKM.2025.18(5).58-63
Analysis of human resource status in a public medical institution
Sergey A. Kuzmin1, Sergey A. Mendel2, Tatiana S. Kuzmina2, Lyubov K. Grigorieva1
1Orenburg State Medical University, 6 Sovetskaya str., 460014 Orenburg, Russian Federation
2Medical Unit of the Ministry of Internal Affairs of Russia for the City of Moscow, 3a Novaya Ipatovka str., 127299 Moscow, Russia
Abstract. Introduction. Healthcare human resource status, i. e., its size, structure, work motivation, and health status, determines the eff ectiveness of the operations of a medical institution. Being employed in a medical institution is often associated with a high labor intensity and with psychological stresses when working with patients and their relatives. Aforementioned factors often lead to emotional burnout among healthcare professionals. The aim of the study is to examine the medico-social characteristics of employees of a large, multidisciplinary medical institution providing inpatient medical care. Material and Methods. This study was conducted based on the clinical hospital of the Medical Unit of the Ministry of Internal Aff airs of the Russian Federation for the City of Moscow. The sociological study was concerned with the medical personnel of the hospital: 24 heads of its structural units, 182 medical specialists, and 389 nurses. Professional burnout was studied using the Russian-language version of the Maslach Burnout Inventory (MBI). Research methods used were sociological, statistical, and analytical. Results and Discussion. Anonymous questionnaires completed by all medical employees of the hospital, allowed us to create a medico-social profile of each group of healthcare professionals. A more pronounced level of overall professional burnout was revealed among the heads of the structural units of the hospital. The fi nal assessment showed a moderate level of emotional burnout among the heads of structural units. Conclusions. The results obtained regarding the medico-social characteristics of the medical personnel of the hospital suggest a team capable of performing the tasks assigned adequately.
Keywords: hospital, head, doctor, nurse, medical and social characteristics, professional burnout
For citation: Kuzmin, S.A.; Mendel, S.A.; Kuzmina, T.S.; Grigorieva, L.K. Analysis of human resource status in a public medical institution. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (5), 58-63. DOI: 10.20969/VSKM.2025.18(5).58-63.
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11. Хальфин Р.А., Смольникова П.С., Столкова А.С. Профессиональное выгорание у медицинских работников // Национальное здравоохранение. – 2023. – № 2. – С.40–46. Khalfi n RA, Smolnikova PS, Stolkova AS. Professionalnoe vygoranie u medicinskih rabotnikov [Professional burnout among medical workers]. Nacionalnoe zdravoohranenie [National Healthcare]. 2023; 2: 40–46. (In Russ.).
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УДК: 616-06
DOI: 10.20969/VSKM.2025.18(5 ).64-68
Clinical and functional stratification of older patients within the long-term care system
Dmitrii S. Medvedev1, Sergey B. Maltsev1, Dmitrii V. Dobrynin2, Dina V. Trotsyuk1, Mikhail A. Sevastyanov3, Viktoriya O. Polyakova1
1 St. Petersburg Medical and Social Institute, 72A Kondratievsky Ave., 195271 Saint Petersburg, Russian Federation
2 Medical and Sanitary Unit of the Ministry of Internal Affairs of the Russian Federation in St. Petersburg and the Leningrad Region,
7a Ochakovskaya str., 191015 St. Petersburg, Russian Federation
3 Residential Home No. 1 for the Disabled and Elderly, 52 Poklonnogorskaya str., 197341 Saint Petersburg, Russian Federation
Abstract. Introduction. Development of medical and social rehabilitation programs within the long-term care system for elderly and senile individuals requires a comprehensive approach, considering the progression of chronic diseases and geriatric syndromes, including cognitive and motor impairments. Eff ective interventions should be based on the patient’s individual characteristics. Clinical and functional stratifi cation proposed in this study allows a more precise determination of the level of need for assistance, risks of falls, and cognitive decline, forming the basis for a personalized care and rehabilitation pathway. Aim. To develop a model program of clinical and functional stratifi cation of elderly and senile patients for the long-term care system, using cognitive, somatic, and functional indicators. Materials and Methods. 150 elderly and senile patients were examined, residing in a long-term care facility. Average age of the patients was 74.2 ± 6.8 years. Characteristics were assessed using the MoCA scale, HADS-D, Barthel Index, gait parameters, stabilometry, cognitive-motor tests, and the ICF scale. Results and Discussion. Diff erences between the groups were analyzed statistically, confi rming the necessity of a stratifi ed approach to rehabilitation. Three clinical and functional groups were identifi ed. As we move from the group with minimal impairments, clinical and functional group 1, to pronounced cognitive-motor defi cits and complete dependence, clinical and functional group 3, there is a significant deterioration in cognitive (MoCA), emotional (HADS-D), and functional (Barthel Index) statuses. Postural instability and motor disintegration parameters, such as stabilometry area, step asymmetry, and number of errors in dual-task performance, also increase signifi cantly). The most pronounced limitations were recorded in clinical and functional group 3, where severe impairments are observed in the categories of the International Classifi cation of Functioning, Disability and Health, i.e., attention, mobility, strength, hygiene, and dressing. Conclusions. Stratifying patients into clinical and functional groups for the long-term care enables the formati on of individualized care pathways for elderly and senile patients, considering their cognitive and functional reserves.
Keywords: stratifi cation, old age, long-term care, rehabilitation, self-care, stabilometry.
For citation: Medvedev, D.S.; Maltsev,S.B.; Dobrynin, D.V.; et al. Clinical and functional stratification of older patients within the long-term care system. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (5), 64-68. DOI: 10.20969/VSKM.2025.18(5).64-68.
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УДК: 314.174:332.132
DOI: 10.20969/VSKM.2025.18(5).69-76
Characteristics of demographic processes in the arctic zone: The case of the Republic of Sakha (Yakutia)
Anatoly L. Sannikov1, Roman V. Kubasov1, Irina V. Vereshchagina1, Anastasia P. Kharkevich1, Elena D. Kubasova1, Valery V. Lupachev1, Zoya A. Goncharova2, Nikolay V. Kochubeynik2, Dmitry V. Shatov2, Dmitry V. Safonov3, Sergey G. Afendikov2, Galina S. Groshilina4, Vadim O. Krylov2, Victoria E. Miroshnikova2
1 Northern State Medical University, 51 Troitskiy ave, 163000 Arkhangelsk, Russia
2 Rostov State Medical University; 29 Nakhichevan lane, 344022 Rostov-on-Don, Russia
3 Taganrog Municipal Clinical Emergency Hospital; 16 Bolshoy Prospekt, 347930 Taganrog, Russia
4 1602 Military Clinical Hospital, 7/7 Mylnikova St., 344016 Rostov-on-Don, Russia
Abstract. Introduction. When developing new regions of strategic importance, such as, for example, the arctic zone, the state faces many problematic issues. Numerous diffi culties arising are caused by the uneven distribution of the population and insuffi cient economic infrastructure. In addition, the extremely harsh natural and climatic environment of the habitat makes its impact here. In this regard, there is a need to create favorable conditions for the population to live and work. Assessment of the standard of living includes a signifi cant number of criteria. Among them, special importance should be given to recording and constant monitoring of demographic indicators. The aim of the study is to analyze demographic processes in one of the territories of the arctic zone in the Russian Federation (Republic of Sakha, Yakutia) in order to develop further prospects for the socio-economic development of the region. Materials and Methods. The analysis was carried out on the basis of information materials from the database of the Federal State Statistics Service of the Russian Federation in the Republic of Sakha (Yakutia) and the Unifi ed Interdepartmental Information and Statistical System for the period from 2014 to 2024. Core demographic indicators were studied: Total population, amount of the able-bodied population, birth rate, mortality (total, infant), and population growth/decrease. Their changes over the period of time under study were compared with the all-Russian numbers. Results and Discussion. Positive dynamics were found regarding the total population of the region studied (a total increase of almost 5% over 10 years) and the working-age people. Despite the fact that it has decreased in recent years, the regional birth rate turned out to be 15-20% higher than the national average. At the same time, the death rate here is much lower than in throughout the country. In recent years, the infant mortality rate has been signifi cantly reduced. Over the years of the study, the population gain/loss has been positive in the region. Conclusions. Thus, Yakutia, as a region, is characterized by a territory with the positive natural increase rate due to the powerful migration fl ows of young able-bodi e d population.
Keywords: Republic of Sakha (Yakutia), arctic zone, birth rate, mortality, population gain/loss.
For citation: Sannikov, A.L.; Kubasov, R.V.; Vereshchagina, I.V.; et al. Characteristics of demographic processes in the arctic zone: The case of the Republic of Sakha (Yakutia). The Bulletin of Contemporary Clinical Medicine. 2025, 18 (5), 69-76. DOI: 10.20969/VSKM.2025.18(5).69-76
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REVIEWS
УДК 616-01
DOI: 10.20969/VSKM.2025.1 8(5).77-83
Trends in iron deficiency anemia research 2015-2024: A bibliometric analysis
Anna E. Bakirova1, Alexandr S. Parcernyak1
1 S. M. Kirov Military Medical Academy, 6 Akademika Lebedeva str., 194044 St. Petersburg, Russia
Abstract. Introduction. Iron defi ciency anemia is one of the most prevalent pathologies worldwide, aff ecting over 1.2 billion people. A bibliometric analysis of publications from the past 10 years demonstrates a high level of interest in this issue among physicians of various specialties. Key research areas include studying pathogenesis, early diagnosis, and the most optimal methods for iron delivery. Aim. To examine the main research trends in iron defi ciency anemia, based on estimating literature sources published between 2015 and 2024, with a particular focus on identifying the most often cited articles and authors publishing data in this area, as well as the most active collaborative research networks. Materials and Methods. The study was conducted using data obtained from the Web of Science Core Collection, a citation database, on the topic of “iron defi ciency anemia,” limited to document types (articles or reviews), the English language, and a time interval from 2015 to 2024. The following data were extracted from the articles: Publication year, journal, study design, the fi rst author’s country, and number of citations. The metadata obtained from the search were used to identify trends in iron defi ciency anemia research and their distribution across countries/regions and institutions. Networks were visualized using VOSviewer (Leiden University), a software program for constructing and visualizing bibliometric networks, to identify international research groups and pinpoint the hotspots. Results and Discussion. The search identifi ed 4,167 publications based on the query. Since 2021, there has been an almost two-fold increase in publication activity. The leading positions in terms of the number of publications are held by the USA, India, and China. Seven clusters of 36 countries were identifi ed for collaborative publications: USA, Great Britain, India, Germany, Italy, and other countries. Journals with the highest number of publications in the top ten are from the USA, Great Britain, and Switzerland. A total of 140 keywords was identifi ed, with a frequency of use greater than 35 times. Conclusions. Publication activity and high citation rates on iron defi ciency anemia have more than doubled since 2021. The largest number of studies were published in the USA, India, and China. Research predominantly focuses on studying pathogenesis, clinical presentation, and diagnosis of iron defi ciency anemia in women and children, as well as on methods for correction with parenteral iron preparations and dietary supplements.
Keywords: iron deficiency anemia, women, reproductive age, bibliometrics, VOSviewer, trends.
For citation: Bakirova, A.E.; Parcernyak, A.S. Trends in iron defi ciency anemia research 2015-2024: A bibliometric analysis. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (5), 77-83. DOI: 10.20969/VSKM.2025.18(5).77-83.
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УДК 616.379-008.64-052-07
DOI: 10.2 0969 /VSKM.2025.18(5).84-92
New approaches to stratification of patients with type 2 diabetes mellitus
Tatiana A. Kiseleva1, Farida V. Valeeva1, Diana R. Islamova1, Ildarija H. Valeeva1
1Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russian Federation
Abstract. Introduction. Type 2 diabetes mellitus represents one of the key medical and social problems of contemporary public health. It is predicted that the number of patients with this disease could reach 643 million by 2030 and increase to 783 million by 2045. Traditionally regarded as a diagnosis of exclusion, type 2 diabetes mellitus is characterized by marked clinical heterogeneity and involves a variety of pathophysiological mechanisms. In recent years, the focus has shifted towards personalized medicine, necessitating the development of new methods of patient stratifi cation. Aim. To study and systematize current data on stratifi cation of patients with type 2 diabetes mellitus. Materials and Methods. A systematic search in the PubMed, Scopus, Web of Science, and eLibrary databases was performed. Studies were included, which use simple and complex algorithms to stratify patients were included. Results and Discussion. Based on the results of the literature review, two key approaches to stratifi cation patients with type 2 diabetes mellitus can be distinguished: Analysis of simple parameters, including clinical characteristics and widely available laboratory tests, and the application of sophisticated methods using machine learning and genomics data. Sophisticated approaches have allowed the identifi cation of reproducible subclasses of type 2 diabetes mellitus in diff erent cohort studies: Severe insulin-defi cient diabetes, severe insulin-resistant diabetes, mild obesity-related diabetes, and mild age-related diabetes. A number of studies that included determination of autoantibody titers to glutamate decarboxylase identified a specifi c cluster labeled severe autoimmune diabetes. Each subclass is characterized by a unique clinical profile and diff erent trajectories of disease progression, as well as specifi c risks of developing diabetes-associated complications. Conclusions. Patient stratifi cation based on multivariate data opens new perspectives for the development of personalized approaches to prevention and treatment of type 2 diabetes mellitus. Simple methods are more convenient for routine clinical application, but complex algorithms demonstrate higher reproducibility of the subgroups identified. Further research should focus on validation of these approaches in diff erent pop ulations and fi nal evaluation of the effectiveness of applying the phenotype concept to clinical practice.
Keywords: type 2 diabetes mellitus clusters, stratifi cation, phenotypes.
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УДК: 616-008.64
DOI: 10. 2096 9/VSKM.2025.18(5).93-101
Chronic fatigue syndrome in clinical practice: Main approaches to diagnosis and treatment
Alsu F. Molostvova1, Liliya M. Salimova1, Inessa Z. Makarova 1, Svetlana V. Mullina 1
1Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russian Federation
Abstract. Introduction. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome is a complex, multi-systemic illness characterized by profound fatigue and symptom exacerbation following physical or cognitive exertion for at least six months. The aim of this study is to investigate, based on the existing global literature, the etiology, pathogenesis, and contemporary approaches to the diagnosis and treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Materials and Methods. A search for and subsequent analysis of scientifi c publications on “chronic fatigue syndrome” were conducted on PubMed, ResearchGate, eLibrary, and CyberLeninka databases, limited to open-access articles published within the last fi ve years. Based on the review of scientifi c publications, the main aspects were identified regarding the etiology and pathogenesis of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Various diagnostic algorithms relevant to clinical practice were analyzed, along with the current data on the pathogenetic and symptomatic treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Results and Discussion. Due to the absence of highly specific and readily available biomarkers, the diagnosis of the disease is based on a comprehensive assessment of clinical data by a multidisciplinary team, with emphasis on risk factors. Treatment should be based on the prevailing syndromes and must include non-pharmacological methods, including rehabilitation. Conclusions. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome is a multifactorial illness that cannot be eff ectively diagnosed or treated by considering it in isolation. Due to the lack of highly specifi c and accessible biomarkers, the diagnosis is based on a comprehensive assessment of clinical data. The following are recommended for use as diagnostic algorithms in clinical practice: The 1994 Fukuda Criteria, the 2003 Canadian Consensus Criteria, and the 2015 Institute of Medicine (IOM) Criteria. Because of the complexity of the illness, the management of patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome requires adherence to the principles of a personalized approach involving a multidisciplinary team, considering individual diff erences in the disease manifestation.
Keywords: chronic fatigue syndrome, risk factors, diagnosis and treatment.
For citation: Molostvova, A. F.; Salimova, L. M.; Makarova, I. Z.; Mullina, S.V. Chronic fatigue syndrome in clinical practice: Main approaches to diagnosis and treatment. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (5), 93-101. DOI: 10.20969/VSKM.2025.18(5).93-101.
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УДК: 616-003.821
DOI: 10.2096 9/VSKM.2025.18(5).102-110
Differential diagnosis of primary amyloidosis
Vladimir N. Oslopov1, Yuliana S. Mishanina1, Svetlana I. Safiullina2, Yulia V. Oslopova2, Elena V. Khazova1, Darya V. Oslopova3, Daria S. Makarova2, Anna A. Terekhova1
1Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russian Federation
2Institute of Biology and Fundamental Medicine, Kazan Federal University, 74 Karl Marx str., 420012 Kazan, Russian Federation
3Children’s City Polyclinic No. 9, 6 Adoratsky str., 420133 Kazan, Russian Federation
Abstract. Introduction. This article deals with the current topic: Diagnosis of a rather rare plasma cell dyscrasia, namely primary AL-amyloidosis. Aim. The study is aimed at reviewing the current information about clinical manifestations, methods of laboratory and instrumental diagnostics of AL-amyloidosis, and the diff erential diagnosis with rare forms of multiple myeloma. Material and Methods. While writing the material, we analyzed over 50 sources of Russian and foreign literature. The search was of unlimited depth, the absolute number of the papers found were published over the last 5 years. Results and Discussion. This article contains data on the clinical manifestations of primary idiopathic AL-amyloidosis and on modern laboratory tests allowing diff erential diagnosis between rare forms of multiple myeloma. Core criteria are presented for diff erential diagnosis of plasma cell dyscrasias. Importance of positron emission tomography/computed tomography studies is shown regarding confi rming or excluding the diagnosis. Modern approaches to choosing the treatment strategy are also highlighted. Conclusions. Primary idiopathic amyloidosis (AL-amyloidosis) is a rare disease belonging to plasma cell, paraproteinemic dyscrasias. Macroglossia is one of the pathognomonic symptoms of AL-amyloidosis. Criteria are presented that allow diff erential diagnosis between idiopathic amyloidosis and other paraproteinemic dyscrasias.
Keywords: macroglossia, amyloidosis, myeloma, immunoelectrophoresis, Bence Jones protein, κ light chains.
For citation: Oslopov, V.N.; Mishanina, Yu.S.; Safi ullina, S.I.; et al. Diff erential diagnosis of primary amyloidosis. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (5), 102-110. DOI: 10.20969/VSKM.2025.18(5).102-110.
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ORGANIZATION OF HEALTHCARE
УДК 616.31-08-039.57-053.88
DOI: 10.2096 9/VSKM.2025.18(5).111-118
Dental care quality provided to senior working-age individuals at the outpatient and polyclinic stage
Afgat N. Galiullin1, Yulia Yu. Yakimova1, Madina N. Khadyeva2,3, Anzhela I. Kashapova1
1 Kazan (Volga Region) Federal University, Institute of Fundamental Medicine and Biology, 74 Karl Marks str., 420012 Kazan, Russia
2 Kazan State Medical University, 49 Butlerov str., 420012, Kazan, Russia 3 UniDent – Dental Clinic Chain, 79 Chistopolskaya str., 420066 Kazan, 2 Orenburg Tract str., 420059 Kazan, Russia
Abstract. Introduction. It is understood that the aging of the body entails the progression of non-infectious diseases and affects the state of the oral cavity. This, in turn, requires the dentist to take into account the characteristics of the clinical course of dental diseases when providing medical and preventive care to older people and, therefore, studying the quality of dental care provided to older people is mandatory. The aim of the study is to identify crucial points in dental care for the senior generation and assess their satisfaction with the services of medical institutions in order to improve the quality of medical care provided to this subpopulation. Materials and Methods. We have done a survey among 305 various dental professionals in relevant outpatient polyclinics. Simultaneously, the opinion of 478 older people about satisfaction with dental care was assessed by means of a sociological survey. Results and Discussion. The findings of the research conducted show that dentists of diff erent specialties understand the importance of providing dental care to the older patients. Doctors also noted the need for organizing outpatient clinics for them. 71.6% of the surveyed older people believe it is necessary establish gerontological appointments with dentists in dental clinics. Conclusions . The fi ndings of our study showed suggest that the experience maturity of aged patients regarding their dental care interrelates with the patients’ age peculiarities, gender diff erences, and medical and social statuses, as well as with the places of their domicile and resources for providing gerontological dental care.
Keywords: gerontology, dental care, health care, elderly people.
For citation: Galiullin, A.N.; Yakimova, Yu.Yu.; Khadyeva, M.N.; Kashapova, A.I. Dental care quality for senior working-age people at the outpatient-polyclinic stage. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (5), 111-118. DOI: 10.20969/VSKM.2025.18(5).111-118.
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PRACTICAL EXPERIENCE
УДК 616.79-008.64-06-08
DOI: 10.20969/VSKM.2025 .18( 5).119-125
Development of a hyperosmolar condition associated with the combined use of sodium-glucose co-transporter-2 inhibitors and loop diuretics in the new onset diabetes mellitus (clinical case)
Liudmila A. Ivanova1, Yuliya S. Kovalenko1, Inna V. Korol1, Anna V. Mezinova1, Ivan Yu. Tanin1, Lidiya V. Ruzhitskaya1, Anna P. Khalimova1, Elizaveta S. Kumanina1
1Kuban State Medical University, 4 Mitrofan Sedin, 350063 Krasnodar, Russian Federation
Abstract. Introduction. Currently, little is known about the eff ects of combining sodium-glucose co-transporter-2 inhibitors with loop diuretics. There are only isolated safety studies of the combined use of loop diuretics and sodium-glucose co-transporter-2 inhibitors in real clinical practice. Aim. Тo show the possibility of developing a hyperosmolar condition a result of the combined use of sodium-glucose co-transporter-2 inhibitors and loop diuretics the new onset diabetes mellitus. Materials and Methods. The article describes a clinical case of female patient Yu., 38 years old, with the development of a hyperosmolar condition in the new onset diabetes mellitus associated with severe concomitant pathology. The stages of diagnosis and treatment are described, as well as possible causes that could lead to hyperosmolarity. Results and Discussion. Prolonged use of diuretics together with dapaglifl ozin led to body dehydration, increased natriuresis, a signifi cant increase in osmotic diuresis, and a decrease in circulating blood volume. Against the background of taking diuretics, there was a loss of the liquid part of the blood plasma, which led to blood clots. Development of hypervolemic hyponatremia in chronic heart failure is associated with bad prognosis in many cardiac patients. Administration of glucocorticoids increased hyperglycemia. Conclusions. With unstable hemodynamics, it is contraindicated to use sodium-glucose co-transporter-2 inhibitors with loop diuretics. When prescribing sodium-glucose co-transporter-2 inhibitors, it is necessary to assess hemodynamics and blood pressure levels, monitor glomerular filtration rate, measure glycemic levels in patients with diabetes mellitus, and follow a healthy water schedule.
Keywords: hyponatremia, sodium-glucose co-transporter-2 inhibitors, SGLT2, loop diuretics, diabetes mellitus, heart failure.
For citation: Ivanova, L.A.; Kovale nko, Yu.S.; Korol, I.V.; et al. Development of a hyperosmolar condition associated with the combined use of sodium-glucose co-transporter-2 inhibitors and loop diuretics in the new onset diabetes mellitus (clinical case). The Bulletin of Contemporary Clinical Medicine. 2025, 18 (5), 119-125. DOI: 10.20969/VSKM.2025.18(5).119-125.
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MEDICIN’S HISTORY
УДК: 61:351.74(091)(470.41)
DOI: 10.20969/VSKM .202 5.18(5).126-130
95 years safeguarding the health of police officers and veterans
Viktor V. Frolov1, Ruslan R. Zaripov1, Rashid I. Khalitov1, Nail B. Amirov1,2
1Medical Unit of the Ministry of Internal Affairs of the Russian Federation in the Republic of Tatarstan, 13 Lobachevsky str., 420111 Kazan, Russia
2Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
Abstract. Introduction. This article refl ects the stages of developing the medical service of the Ministry of Internal Aff airs of Russia in the Republic of Tatarstan. Structure of the medical unit is presented, the periodic improvement of the material and technical base is shown, and the experience is refl ected regarding the medical support for the internal aff airs employees involved in the protection of public order and ensuring public safety during large-scale sports and other international events in Kazan. Aim. The aim of the study is to show the formation path of departmental medicine of the law enforcement bodies of the Republic of Tatarstan, to share the experience of medical support for law enforcement employees who participated in the protection of public order and public safety during the preparation and holding of international sports and other events. Materials and Methods. Historical aspects of the development of departmental medicine were studied, and activities were analyzed in terms of medical support for sports and other international events. Results and Discussion. Medical service of the Ministry of Internal Aff airs in the Republic of Tatarstan has traveled a long way in its formation and development over its 95 years of existence. Continuing the glorious traditions of their predecessors, employees of departmental medicine worthily wear the banner of the most humane profession, continuing to work for the health of the employees of internal aff airs bodies, employees of other law enforcement agencies, veterans, and members of their families. Conclusions. Having gone all the development and transformation stages, undergoing reforms initiated by the government and by healthcare, departmental medicine faithfully stands guard over the health of employees of internal aff airs bodies, performing the tasks assigned to it at the highest level.
Keywords: departmental medicine, Ministry of Internal Aff airs for the Republic of Tatarstan, medical support.
For citation: Frolov,V.V.; Zaripov,R.R.; Khalitov,R.I.; Amirov,N.B. 95 years safeguarding the health of police officers and veterans. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (5), 126-130. DOI: 10.20969/VSKM.2025.18(5).126-130.
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