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Vol. 8 Issue 2 (2015)

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ORIGINAL ARTICLES

Effects of tobacco smoking on the quality of life in oil industry workers with chronic obstructive pul-monaty disease. A.Yu. Abdullaev

Assessment the probability of burnout syndrome formation in health care workers. R.V. Garipova, Z.M. Berkheeva, S.V. Kuzmina

Ramipril and amlodipin therapy effects on endothelial vasodilatation in women with postmenopausal metabolic syndrome. A.R. Ishmanova, I.E. Nikolaeva, A.N. Zakirova, S.M. Yanbaeva

Correlation of the clinical-immunological and neuro-imaging displays of activity of relapsing remitting multiple sclerosis progress. T.A. Kobys

Pneumocystis carinii in pattients with combined coinfection (HIV/tuberculosis) according to patomorfological researches. A.M. Mikhailovskiy, S.A. Churkin

Retrospective analysis of the results of selective portosystemic shunts in patients with portal hypertension. F.G. Nazyrov, A.V. Devyatov, A.Kh. Babadzhanov, S.A. Raimov, R.R. Baybekov, E.I. Nigmatullin

Endovascular revascularization of total renal artery occlusion in patients with ischemic kidney disease. A.Z. Sharafeev, A.F. Khalirakhmanov, A.V. Postnikov, B.M. Sharafutdinov, T.R. Khabibulayev, A.V. Bagautdinov

REVIEW

Epidemiological aspects of children bronchial tubes disease. A.V. Bogdanova, Ts.V. Zandakov, O.N. Titova, E.V. Bojtsova, M.M. Goloborod'ko

Duodenogastric reflux as a cause of reflux-gastritis. Sh.Z. Galiev, N.B. Amirov

Benefits and harm of electronic cigarettes through the prism of different therapeutic methodologies. V.D. Mendelevich

ORGANIZATION OF HEALTHCARE

Clinical and statistical analysis of morbidity with temporary disability of the economically active population of Kazan city. N.N. Shamsiyarov, A.N. Galiullin

HELP FOR PRACTITIONER

Treatment of allergic rhinitis in women during pregnancy. A.A. Vasiljeva, R.F. Khakimova

CLINICAL CASE

Free wall myocardium rupture and thrombolytic therapy. Clinical observation. N.A. Kosheleva, D.V. Krasikov, I.A. Morozov, A.P. Rebrov

 

ORIGINAL ARTICLES

PDF downloadEffects of tobacco smoking on the quality of life in oil industry workers with chronic obstructive pulmonaty disease

AdalYat Yu. Abdullaev, Head of Department of pulmonology Central Oil industry workers hospital, Azerbaijan, Baku, tel. +9-945-021-054-23, e-mail: dr_adalyat@adanet.az

Abstract. Aim. To compare the results of physical examination in patients with chronic obstructive pulmonary disease (COPD) with nicotine addiction to subjective indicators based on the quality of life questionnaire SF-36. Material and methods. We examined 255 patients with chronic obstructive pulmonary disease, with varying degrees of nicotine addiction. All of them were employees of the oil industry. The complex survey included methods of objective evaluation of respiratory function, and the results of a comparative study conducted using SF-36 quality of life in this group of patients. Results. Found that smoking affects not only the objective condition of the patient, but also on subjective health indicators included in the concept of quality of life. Conclusions. Tobacco smoking negatively affects both the physical and social activity in the patients with COPD, as well as their psychological and emotional sphere.

Key words: chronic obstructive pulmonary disease, quality of life, smoking.

 

References

  1. Amirov, N.B. Tabachnaya epidemiya: farmakologicheskie vozmozhnosti bor’by [Tobacco epidemic: pharmacological possibilities of struggle] / N.B. Amirov, T.I. Andreeva // Vestnik sovremennoi klinicheskoi mediciny [Bulletin of modern clinical medicine]. — 2011. — T. IV, vyp. 3. — S.28—33.
  2. Osobennosti formirovaniya bronhoobstruktivnogo sindroma u rabotnikov MVD i MCHS, rabotayuschih v avtoinspekcii i v pozharnoi sluzhbe [Peculiarities of bronchial obstruction in the Interior Ministry and the Emergencies Ministry workers working in the traffic police and fire service] / N.B. Amirov, A.A. Vizel’, M.V. Potapova [i dr.] // Vestnik sovremennoi klinicheskoi mediciny [Bulletin of modern clinical medicine]. — 2008. — T. I, vyp. 1. — S.95—98.
  3. Antonov, N.S. Hronicheskaya obstruktivnaya bolezn’ legkih u kuryaschih: rannyaya stadiya bolezni [Chronic obstructive pulmonary disease in smokers: the early stage of the disease] / N.S. Antonov, G.M. Saharova // Terapevticheskii arhiv [Therapeutic archive]. — 2009. — № 3. — S.82—84.
  4. Global’naya strategiya diagnostiki, lecheniya i profilaktiki 4. hronicheskoi obstruktivnoi bolezni legkih (peresmotr 2008 g.) [Global strategy for the diagnosis, treatment and prevention of chronic obstructive pulmonary disease (revision 2008)] / pod red. A.S. Belevskogo; per. s angl. — M.: Atmosfera, 2009. — 100 s.
  5. Dvoreckii, L.I. Kachestvo zhizni pozhilogo bol’nogo [Quality of life of elderly patients] / L.I. Dvoreckii // Consilium Medicum. — 2009. — № 11. — S.98—102.
  6. Il’kovich, M.M. Bor’ba s tabakokureniem, kak osnova profilaktiki hronicheskoi obstruktivnoi bolezni legkih [Tobacco control, as a basis for the prevention of chronic obstructive pulmonary disease] / M.M. Il’kovich, N.A. Kuzubova, E.A. Kisileva // Pul’monologiya [Pulmonology]. — 2010. — № 2. — S.37—39.
  7. Novik, A.A. Rukovodstvo po issledovaniyu kachestva zhizni v medicine [Guidelines for Quality of Life Research in Medicine]/ A.A. Novik, T.I. Ionova. — M., 2007. — 156 s.
  8. Rebrova, O.Yu. Statisticheskii analiz medicinskih dannyh. Primenenie paketa prikladnyh programm Statistica [Statistical analysis of medical data. Application software package Statistica] / O.Yu. Rebrova. — M., 2000. — 122 s.
  9. Sincova, S.V. Tabakokurenie — epidemiya HHI veka [Smoking — an epidemic of the XXI century] / S.V. Sincova, E.N. Chicherina // Tuberkulez i bolezni legkih [Tuberculosis and Lung Disease]. — 2011. — № 3. — S.23—26.
  10. Stasyuk, O.N. Ocenka kachestva zhizni u bol’nyh hronicheskoi obstruktivnoi bolezn’yu legkih [Quality of life in patients with chronic obstructive pulmonary disease] / O.N. Stasyuk, M.I. Ul’yanova // Nauchno-medicinskii vestnik Central’nogo CHernozem’ya [Scientific and Medical Bulletin of the Central Black Earth region]. — 2008. — № 32. — S.29—32.
  11. Chernyak, B.A. Kachestvo zhizni u bol’nyh hronicheskoi obstruktivnoi bolezni legkih [Quality of life in patients with chronic obstructive pulmonary disease] / B.A. Chernyak // Hronicheskaya obstruktivnaya bolezn’ legkih [Chronic obstructive pulmonary disease] / pod red. A.G. Chuchalina. — M.: Atmosfera, 2008. — S.322—338.
  12. Shmelev, E.I. Izmenenie parametrov spirometrii forsirovannogo vydoha u bol’nyh HOBL (rezul’taty dlitel’nogo nablyudeniya) [Change the settings for forced expiratory spirometry in patients with COPD (long-term monitoring results)] / E.I. Shmelev, I.Yu. Vizel’, A.A. Vizel’ // Tuberkulez i bolezni legkih [Tuberculosis and Lung Disease]. — 2010. — № 8. — S.50—56.
  13. Comparison of demographic data of patients with COPD treated in primary care by country in European Health-related Quality of Life in COPD study / P.W. Jones, G. Brusselle, T. van der Molen [et al.] // Eur. Resp. J. — 2010. — Vol.36, suppl. 54. — P. 4233.
  14. Primary care physician assessment of COPD severity: European Health-related Quality of Life in COPD study / P. Kardos, P.W. Jones, M.L. Levy [et al.] // Eur. Resp. J. — 2010. — Vol. 36, suppl. 54. — P.4228.

 

PDF downloadAssessment the probability of burnout syndrome formation in health care workers

Railya V. Garipova, C.Med.Sci., assistant of professor of Department of hygiene and occupational health of SBEI HPE «Kazan State Medical University» of Russian Ministry of Health, Kazan, Russia, tel. 8-917-255-38-44, е-mail: railyagaripova@mail.ru

Zukhra M. Berkheeva, C.Med.Sci., associate professor of Department of hygiene and occupational health of SBEI HPE «Kazan State Medical University» of Russian Ministry of Health, Kazan, Russia, tel. 8-905-310-74-46, е-mail: kgmu_profpat@mail.ru

Svetlana V. Kuzmina, C.Med.Sci., assistant of professor of Department of hygiene and occupational health of SBEI HPE «Kazan State Medical University» of Russian Ministry of Health, Kazan, Russia, tel. 8-987-296-22-49, е-mail: skouzmina21@list.ru

Abstract. Aim. To study the psychosocial risk factors in the of burnout syndrome formation. Material and methods. Based on a questionnaire developed by WHO experts for the European model of «health management, environment and security in the workplace», we conducted survey of 246 health care workers. The questionnaire presents questions that reflect social status, lifestyle, character and safety of employment, the presence of stress factors both production and non-production nature. Special attention was paid to health, physical activity and nutrition. Results. Survey conducted of the medical personnel showed high prevalence of psychophysical, social and psychological, behavioral symptoms among them that allows to think about the high probability of formation of a syndrome of professional burning out.

Key words: health care workers, occupational stress, burnout syndrome.

 

References

  1. Psihosocial’nye faktory truda, obraz zhizni i zdorov’e vrachei v sovremennyh usloviyah: posobie dlya vrachei [Psychosocial factors of work, lifestyle and health of doctors in modern conditions: а guide for doctors] / V.T. Kaibyshev, A.R. Galimov, N.I. Simonova [i dr.]. — M., 2007. — S.48.
  2. Garipova, R.V. Rol’ psihosocial’nyh faktorov v razvitii sindroma professional’nogo vygoraniya [The role of psychosocial factors in the development of burnout syndrome] / R.V. Garipova, I.R. Galieva // Svyaz’ zabolevaniya s professiei s pozicii dokazatel’noi mediciny: materialy Vseros. nauch.-prakt. konf. s mezhdunarodnym uchastiem [Communication of a disease with a profession from a position of evidential medicine: materials of All-Russian scientific and practical conference with the International participation]. — Kazan’, 2011. — S.243—245.
  3. Garipova, R.V. Osobennosti formirovaniya sindroma professional’nogo vygoraniya u predstavitelei medicinskih special’nostei, rabotayuschih v gorodskoi i sel’skoi mestnosti [Features of formation of professional burnout syndrome in the health care professions working in urban and rural areas] / R.V. Garipova, I.R. Galieva // Zdorov’e cheloveka v XXI veke: sb. nauch. st. IV Ros. nauch.-prakt. konf. [Human health in the XXI century: collection of scientific articles Russian scientific and practical conference]. — Kazan’, 2012. — S.513—517.
  4. Stress and Psychological Disorders in Great Britain 2013 [electronic resource]. — URL: http: //www.hse.gov.uk/statistics/causdis/stress/stress.pdf
  5. Tsai, Y.-C. Factors and symptoms associated with work stress and healthpromoting lifestyles among hospital staff: a pilot study in Taiwan / Y.-C. Tsai, С.-Н. Liu // BMC Health Serv. Res. — 2012. — Vol. 12. — Р.199.
  6. Tyssen, R. Health рroblems and the use of health services among physicians: a review article with particular emphasis on Norwegian studies / R. Tyssen // Industrial Health. — 2007. — Vol. 45. — Р.599—610.
  7. Work-related stress in nursing. — Geneva: ILO, 2000. — 52 p.

 

PDF downloadRamipril and amlodipin therapy effects on endothelial vasodilatation in women with postmenopausal metabolic syndrome

Aigul R. Ishmanova, C.Med.Sci., cardiologist of Republican Cardiology Center, Ufa, Russia, tel. 8-987-109-46-67, e-mail: ishmanova.2012@mail.ru

Irina E. NiKolaeva, C.Med.Sci., Chief of Republican Cardiology Center, Ufa, Russia, tel. 8-917-752-35-46

Alara N. Zakirova, D.Med.Sci., Heard of Department of сlinical сardiology of SBEI HPE «Bashkir State Medical University» Russian Ministry of Health, Ufa, Russia, tel. 8-917-345-99-23

Sakina M. Yanbaeva, C.Med.Sci., cardiologist of Republican Cardiology Center, Ufa, Russia, tel. 8-917-485-16-19

Abstract. Aim. To compare the effects of ramipril and amlodipin on the vasodilatation function of endothelium in arterial hypertension (AH) treatment in women with postmenopausal metabolic syndrome (MS). Material and methods. Study included 80 postmenopausal women with AH and MS. Control group consisted of 25 women without apparent disease. Duration of treatment was 24 weeks. Antihypertensive effect of these drug combinations and their effects on the endothelium-dependent vasodilatation were evaluated. Endothelial function was analyzed by the reactive hyperemia test using high-resolution ultrasound; nitric oxide metabolites were measured in blood serum by the method of Emchenco et. al. (1994). Results. It was shown that ramipril in combination with amlodipine more effectively controlled blood pressure in postmenopausal patients with AH and MS. This combination therapy had a more pronounced endothelium-protective effect characterized by recovering of endothelium-dependent vasodilatation (EDV) and increased production of nitric oxide metabolites. Conclusion. Therefore ramipril in combination with amlodipine can be recommended for the treatment of postmenopausal women with AH and MS.

Key words: arterial hypertension, metabolic syndrome, postmenopausal, endothelial dysfunction, ramipril, amlodipin.

 

References

  1. Bahshaliev, A.B. Sravnitel'naya effektivnost' moksonidina i prestariuma u zhenschin v postmenopauzal'nom periode s myagkoi i umerennoi arterial'noi gipertoniei [Comparative efficacy of moxonidine and prestarium in postmenopausal women with mild to moderate hypertension] / A.B. Bahshaliev, G.M. Sabzalieva // Obzory klinicheskoi kardiologii [Reviews Clinical Cardiology]. — 2007. — № 11. — C.35—39.
  2. Belenkov, Yu.N. Rezul'taty mnogocentrovogo randomizirovannogo otkrytogo issledovaniya po izucheniyu effektivnosti izmeneniya obraza zhizni i terapii ingibitorami APF u bol'nyh AG i MS [Results of a multicenter, randomized, open-label study to evaluate the efficacy of lifestyle changes and treatment with ACE inhibitors in patients with hypertension and MS] / Yu.N. Belenkov, I.E. Chazova, V.B. Mychka // Kardiologiya [Cardiology]. — 2004. — № 4. — C.14—17.
  3. Zadiochenko, V.S. Psihologicheskie osobennosti i kachestvo zhizni bol'nyh arterial'noi gipertenziei i metabolicheskimi faktorami riska [Psychological characteristics and quality of life in patients with hypertension and metabolic risk factors] / V.S. Zadiochenko, S.B. Hrulenko, T.V. Adasheva // Kardiologiya [Cardiology]. — 2000. — № 10. — C.38—41.
  4. Zateischikova, A.A. Endotelial'naya regulyaciya sosudistogo tonusa: metody issledovaniya i klinicheskoe znachenie [Endothelial regulation of vascular tone: research methods and clinical significance] / A.A. Zateischikova, D.A. Zateischikov // Kardiologiya [Cardiology]. — 1998. — № 9. — C.68—80.
  5. Kobalava, Zh.D. Klinicheskie osobennosti i lechenie arterial'noi gipertonii u zhenschin [Clinical features and treatment of hypertension in women] / Zh.D. Kobalava, V.V. Tolkacheva, O.N. Moryleva // Serdce [Heart]. — 2004. — № 6. — C.284—288.
  6. Kovaleva, I.B. Funkciya endoteliya u zhenschin s arterial'noi gipertenziei v postmenopauze [Endothelial function in women with hypertension in postmenopausal] / I.B. Kovaleva, S.E. Myasoedova, I.K. Bogatova // Kardivaskulyarnaya terapiya i profilaktika [Kardiovaskular therapy and prevention]. — 2004. — № 3. — C.4—8.
  7. Leonova, M.V. Sravnitel'naya effektivnost' i bezopasnost' sovremennyh ingibitorov angiotenzinprevraschayuschego fermenta moeksiprila i spiraprila u zhenschin s postmenopauzal'nym metabolicheskim sindromom [Comparative efficacy and safety of modern angiotensin converting enzyme inhibitor moexipril and spirapril in women with postmenopausal metabolic syndrome] / M.V. Leonova, M.A. Demidova, A.V. Tarasov // Kardiologiya [Cardiology]. — 2006. — № 5. — C.40—43.
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  9. Nibieridze, D.V. Metabolicheskie i sosudistye effekty antigipertenzivnoi terapii [Metabolic and vascular effects of antihypertensive therapy] / D.V. Nibieridze, R.G. Oganov. — M.: Universum Pablishing, 2005. — C.66—104.
  10. Ol'binskaya, L.I. Arterial'naya gipertoniya u zhenschin v prostmenopauze i ee lechenie enalaprilom [Hypertension in women prostmenopauze and its treatment with enalapril] / L.I. Ol'binskaya, B.A. Hapaev, S.A. Sayumakova // Konsilium medikum [Consilium Medicum]. — 2006. — № 5. — C.38—41.
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  12. Ostroumova, O.D. Disfunkciya endoteliya pri CCZ [Endothelial dysfunction with CVD] / O.D. Ostroumova, R.E. Dubinskaya // Kardiovaskulyarnaya terapiya i profilaktika [Cardiovascular therapy and prevention]. — 2004. — № 3. — C.83—85.
  13. Smetnik, V.P. Menopauza i serdechno-sosudistaya sistema [Menopause and cardiovascular system] / V.P. Smetnik, I.G. Shestakova // Terapevticheskii arhiv [Therapeutic archive]. — 1999. — № 10. — C.61—65.

 

PDF downloadCorrelation of the clinical-immunological and neuroimaging displays of activity of relapsing remitting multiple sclerosis progress

Tatiana A. Kobys, C.Med.Sci., candidate of a degree of Department of neurology of National Medical University n.a. o. Bogomolets, Kiev, ukraine, tel. +38 067 287-31-65, e-mail: tkobys@ukr.net

Abstract. Аim. The purpose to the study was to determine the correlation and prognostic values of clinical, immunological and neuroimaging signs of activity of relapsing-remitting multiple sclerosis (RRMS). Material and methods. We examined 72 patients with RRRS. We registered the nature of disease onset, relapse rate, and EDSS level. Neuroimaging was done using GE Signa Excite HD 1,5T scanner. We determined the number of T2- and T1-lesions and further conducted H1-MR spectroscopy in different areas. Synthesis and secretion of cytokines IL-1, IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ were studied in the culture of human mononuclear cells. Statistica 10.0 software was used for data processing. Results. The work presents the findings of the 9-year follow-up of RRMS patients. Signs of the CIS (mono- and polysymptomatic) had average correlation with the level of EDSS and weak correlation with relapse frequency in RRMS patients. Average correlation was found between the number of T1 and T2 lesions > 3 mm and EDSS level. Changes in the level of cerebral metabolites (NAA, Cho) were identified both in demyelination lesions and intact brain tissue. Prognostic value of the timing of the relapse development using the Kaplan — Meier was influenced by such factors as the size of lesions, number of T2 lesions on early stages of the disease and reduced NAA/Cr, Cho/Cr indices. Increased lactate levels in demyelinating lesions had a strong correlation with relapse frequency. We determined persistent elevation of proinflammatory cytokines in patients with active course of the disease and a strong positive correlation with the number of relapses per year. Conclusion. In assessing RRMS activity one should take into account clinical and neuroimaging methods of monitoring, which have varying degrees of relationship and prognostic significance.

Key words: relapsing-remitting multiple sclerosis, disease activity, disability progression, lesions, cerebral metabolytes, cytokines.

 

References

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PDF downloadPneumocystis carinii in pattients with combined coinfection (HIV/tuberculosis) according to patomorfological researches

Alexey M. MiKhailovskiy, C.Med.Sci., Head of Department of pathology of SAIH «Orenburg Regional TB Clinic», assistant of Department of phthisiology and pulmonology, Orenburg, Russia, tel. 8-922-627-75-22, e-mail: michailovsky2007@yandex.ru

Sergey A. Churkin, C.Med.Sci., Head of SAIH «Orenburg Regional TB Clinic», Orenburg, Russia, e-mail: oobo5@mail.ru

Abstract. Aim. The analysis of pathomorfological picture of combined infection: pneumonia induced by Pneumocystis carinii and progressing tuberculosis in patients with late stages of a HIV-infection. Material and methods. Pathomorfological research of 6 patients with multiple forms of tuberculosis inflammation, HIV-infection and Pneumocystis carinii pneumonia was conducted. The group of the investigated patients contained of 4 men and 2 women in an age interval from 20 to 37 years, with late stages of a HIV-infection and with level CD4 T-lymphocytes < 200 cells/µl. Results. Co infection of tuberculosis and HIV-infection does not exclude presence of other infectious diseases which sometimes play an important role in death. Conclusion. Patients at late stages of a HIV-infection can often have combined infectious diseases. It is revealed that patients at late stages of a HIV-infection may have combination of multiple infectious diseases which sometimes play an important role in death. It specifies a necessity of carrying out of additional methods of research to reveal all infection pathology in patient (morphological, bacteriological and genetic methods).

Key words: pneumocystosis, tuberculosis, HIV-infection, combined confection HIV—tuberculosis.

 

References

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  3. Kletochnaya biologiya legkih v norme i patologii: rukovodstvo dlya vrachei [Cellular biology of lungs in norm and a pathology] / pod red. V.V. Erohina, L.K. Romanovoi. — M.: Medicina, 2000. — 496 s.: il.
  4. Lepeha, L.N. Pnevmocistoz legkogo v eksperimente i klinike [Lung pneumocystosis in experiment and clinic] / L.N. Lepeha, T.G. Barhina, Yu.G. Parhomenko // Arhiv patologii. — 1998. — № 5. — S.46—52.
  5. Mihailovskii, A.M. Patomorfologiya tuberkuleza na pozdnih stadiyah VICH-infekcii (po dannym autopsii) [Pathology of Tuberculosis in the later stages of HIV infection (according to autopsy)] / A.M. Mihailovskii // Tuberkulez s lekarstvennoi ustoichivost'yu k MBT u bol'nyh VICH-infekciei: materialy III Vseros. nauch.-prakt. konf. — Tver': OOO «Izdatel'stvo «Triada», 2009. — S.68—69.
  6. Mihailovskii, A.M. Osobennosti kliniko-morfologicheskih proyavlenii tuberkuleza, sochetannogo s VICH-infekciei v Orenburgskoi oblasti [Features of kliniko-morphological displays of a tuberculosis, combined with a HIV-infection in the Orenburg region]: avtoref. dis. ... kand. med. nauk / Mihailovskii Aleksei Modestvovich. — M., 2011. — 27 s.
  7. Samitova, E.R. Sluchai sochetaniya pnevmocistnoi pnevmonii s disseminirovannym tuberkulezom legkih u bol'nogo VICH-infekciei [Combination case of P.C. pneumonia with a lung tuberculosis at sick of a HIV-infection] / E.R. Samitova, A.K. Tokmalaev, T.N. Ermak // Vestnik RUDN. — 2006. — № 1. — S.81—83.
  8. Current Epidemiology of Pneumonia / A. Morris, J.D. Lundren, H. Masur [et al.] // Emerg. Infect. Dis. — 2004. — Vol. 10(10). — P.1713—1720.

 

PDF downloadRetrospective analysis of the results of selective portosystemic shunts in patients with portal hypertension

Feruz G. Nazyrov, D.Med.Sci., Professor, Director of the Acad. V.Vakhidov republican Specialized center of Surgery, Tashkent, Uzbekistan, tel. 8-371-233-49-09, e-mail: cs75@mail.ru

Andrey V. Devyatov, D.Med.Sci., Professor, chief researcher at the Department of surgery of portal hypertension and pancreatoduodenal zone of the Acad. V.Vakhidov republican Specialized center of Surgery, tashkent, uzbekistan, tel. 8-371-277-06-17, e-mail: avdevyatov1777@gmail.com

Azam Kh. Babadzhanov, C.Med.Sci., senior research fellow at the Department of surgery of portal hypertension and pancreatoduodenal zone of the Acad. V.Vakhidov republican Specialized center of Surgery, tashkent, uzbekistan, tel. 8-371-277-06-17, e-mail: azam747@mail.ru

Salokhiddin A. Raimov, trainee researcher, applicant at the Department of surgery of portal hypertension and pancreatoduodenal zone of the Acad. V.Vakhidov republican Specialized center of Surgery, tashkent, uzbekistan, tel. 8-371-277-06-17, e-mail: cs75@mail.ru

Renat R. Baybekov, junior researcher at the Department of surgery of portal hypertension and pancreatoduodenal zone of the Acad. V.Vakhidov republican Specialized center of Surgery, tashkent, uzbekistan, tel. 8-371-277-06-17, e-mail: renat.baybekov@gmail.com

Elnar I. Nigmatullin, master of the second year of the Tashkent Medical Academy, Tashkent, Uzbekistan, tel. 8-371-277-06-17, e-mail: etoyaek@mail.ru

Abstract. Aim — to analyze the results of selective portosystemic shunt in patients with portal hypertension. Material and methods. Analysis is carried out in three study groups: the first group — the implementation phase, which covered the period from 1976 to 1992; the second group — a step of forming a specialized unit of surgery of PH in RSCS (1992—1998); the third group — stage of improvement techniques of DSRS and expanding indications for this type of bypass (1998—2014). The study included 396 patients with PH, whom were performed DSRS, for the periods indicated. Results and discussion. The incidence of hepatic failure and encephalopathy in the implementation phase of PSSH reached 25% and 33,3%, respectively, in the future, after standardization indications for DSRS its frequency decreased to 14,3% and 17,1%, while in the present period developed in 5,1% of cases and the clinical signs of encephalopathy in 10,9% of patients. The frequency of bleeding against the backdrop of a functioning DSRS established in 16 out of 23 of our patients with bleeding from esophageal varices. The growth of ascites averaged a total group of patients with DSRS — in 11,3% of cases. Depending on the chronological period, the frequency of this complication has decreased from 20,8% in the first period to 10,1% in the third period. Selective shunt thrombosis in the immediate postoperative period was 1,8%, bleeding from esophageal varices — 4,7% of cases. Conclusion. Depending on the characteristics of the vascular transformation of splenic vein DSRS in the present period is dominant and performed in more than 50% of cases, and for the older age group or a low compensatory allowance hepatocytes against a background of cirrhosis of the liver, this type of bypass surgery remains a priority, and sometimes and the only way to decompress of portal pool.

Key words: liver cirrhosis, portal hypertension, portosystemic shunts, the distal splenorenal shunt, bleeding from esophageal varices.

 

References

  1. Nazyrov, F.G. Otdalennye rezul'taty distal'nogo splenorenal'nogo anastomoza u bol'nyh cirrozom pecheni [Long-term results of distal splenorenal anastomosis in patients with cirrhosis] / F.G. Nazyrov, A.V. Devyatov, R.A. Ibadov // Annaly hirurgicheskoi gepatologii [Annals of Surgical Hepatology]. — 2007. — № 4. — S.36—41.
  2. Turakulov, A.B. Hirurgicheskie aspekty sindroma splenomegalii u bol'nyh cirrozom pecheni [Surgical aspects of the syndrome of splenomegaly in patients with cirrhosis]: dis. ... kand. med. nauk / A.B. Turakulov. — Tashkent, 2006. — 126 s.
  3. Regulyaciya cirkulyacii krovi pri hirurgicheskoi korrekcii portal'noi gipertenzii [Regulation of blood circulation in the surgical correction of portal hypertension] / Yu.N. Shanin, B.N. Kotiv, V.N. Cygan, V.I. Ioncev // Voennyi medicinskii zhurnal [Military Medical Journal]. — 2011. — № 332(3). — S.29—34.
  4. Warren—Zeppa distal splenorenal shunts: a 34-year experience / A.S. Livingstone, L.G. Koniaris, E.A. Perez [et al.] // Ann. Surg. — 2006. — Vol. 243(6). — P.884—892.
  5. Orloff, M.J. Fifty-three years' experience with randomized clinical trials of emergency portacaval shunt for bleeding esophageal varices in Cirrhosis: 1958—2011 / M.J. Orloff // JAMA Surg. — 2014. — Vol. 149(2). — P.155—69.
  6. Rare, spontaneous trans–splenic shunt and intra–splenic collaterals with attendant splenic artery aneurysms in an adult patient with compensated cirrhosis and portal hypertension / C.A. Philips, L. Anand, K.N. Kumar [et al.] // Gastroenterol Rep. (Oxf). — 2014. — Vol. 9. — pii: gou047.
  7. A 10 year experience of shunt surgery for esophagogastric varices in a single center in Japan / Y. Sato, H. Oya, S. Yamamoto [et al.] // Hepatogastroenterology. — 2011. — Vol. 58(106). — P.444—452.
  8. Sharma, N. Portal hypertension: A critical appraisal of shunt procedures with emphasis on distal splenorenal shunt in children / N. Sharma, M. Bajpai, A. Kumar [et al.] // J. Indian. Assoc. Pediatr Surg. — 2014. — Vol. 19(2). — P.80—84.
  9. Congenital hepatic fibrosis with extra-hepatic porto-systemic shunt and hepatopulmonary syndrome successfully managed with living related liver transplantation / S. Taneja, Manavwadhawan, S. Gupta [et al.] // Trop. Gastroenterol. — 2014. — Vol. 35(2). — P.116—118.
  10. Rationale for the potential use of mesenchymal stromal cells in liver transplantation / M. Vandermeulen, C. Grégoire, A. Briquet [et al.] // World J. Gastroenterol. — 2014. — Vol. 28, № 20(44). — P.16418—16432.
  11. Nonalcoholic Steatohepatitis is the Second Leading Etiology of Liver Disease Among Adults Awaiting Liver Transplantation in the U.S. / R.J. Wong, M. Aguilar, R. Cheung [et al.] // Gastroenterology. — 2014. — Vol. S0016—5085(14). — P.1474—1477.
  12. Effects of portaazygous disconnection, portocaval shunt and selective shunts on experimental ratliver cirrhosis / X.B. Xu, J.X. Cai, J.H. Dong [et al.] // Zhonghua Gan. Zang. Bing Za Zhi. — 2005. — Vol. 13(2). — P.113—116.

 

PDF downloadEndovascular revascularization of total renal artery occlusion in patients with ischemic kidney disease

Aydar Z. Sharafeev, D.Med.Sci., Head of Department of cardiology, endovascular and cardiovascular surgery of SBEI APE «Kazan State Medical Academy» of Russian Ministry of Health, Head of Department of angiografical and x-ray surgical studies of SAIH RCH № 2, e-mail: aidarch@mail.ru

Ayrat F. Khalirakhmanov, doctor of Department of angiografical and x-ray surgical studies of SAIH RCH № 2, tel. 8-929-722-33-34, e-mail: ai.bolit@mail.ru

Alexander V. Postnikov, doctor of Department of angiografical and x-ray surgical studies of SAIH RCH, tel. 8-960-048-11-98, e-mail: sasha-postnikov@mail.ru

Bulat M. Sharafutdinov, doctor of Department of angiografical and x-ray surgical studies of SAIH RCH № 2, tel. 8-927-404-24-99, e-mail: bulaty555@mail.ru

Timur R. Khabibulayev, doctor of Department of angiografical and x-ray surgical studies of SAIH RCH, tel. 89172553048, e-mail: tim3048@mail.ru

Aydar V. Bagautdinov, doctor of Department of MRT of SAIH RCH № 2, tel. 8-937-611-19-29, e-mail: mammolog1985@mail.ru

Abstract. Aim. To analyze the effect of endovascular revascularization of total occluded renal arteries in patients with IKD in immediate and postpone periods. Material and methods. It was a comprehensive examination of the 15 patients with total occlusions of RAs, which included a study of renal function according to GFR and nephroscintigraphy, daily monitoring of BP, ultrasound imaging of the RA. According to the results, 13 patients underwent recanalization with angioplasty and stenting of chronic occlusions of the RA. For two patients recanalization was not performed. Renal function (GFR), dynamics of blood pressure, the patency of the stents has been controlled at the 7-th day, 1 month, 6 and 12 months. Results. In this study we received immediate and long-term significant improvement in renal function and reducing class of hypertension in most patients. Only one patient was identified with hemodynamic significant restenosis, required balloon dilation. Conclusion. Endovascular revascularization of total renal artery occlusion is an effective and safe procedure in patient with preserved occluded kidney function. Given that, the restoration of blood flow in stenosis of the renal arteries is an independent predictor of improvement distant prediction of survival in patients with renovascular hypertension and impaired renal function, probably revascularization of the renal arteries will lead to improve survival in these patients. This aspect must be the subject of future research.

Key words: total occlusion of the renal artery, renal artery stenting.

 

References

  1. Karev, A.V. Dvuhetapnaya chreskozhnaya angioplastika v lechenii hronicheskih okklyuzii pochechnyh arterii [Two-stage percutaneous angioplasty in the treatment of chronic occlusions of the renal arteries] / A.V. Karev, G.B. Saraev, D.V. Semenov // Mezhdunarodnyi zhurnal intervencionnoi kardioangiologii [International Journal of interventional cardiology]. — 2010. — № 7. — S.23—26.
  2. Ishemicheskaya bolezn' pochek [Ischemic kidney disease] / N.A. Muhin [i dr.] // Consilium Medicum. — 2002. — T. 4, № 7. — S.334—337.
  3. Sharafeev, A.Z. Sovremennoe sostoyanie voprosa stentirovaniya pochechnyh arterii[The present state of renal artery stenting] / A.Z. Sharafeev, A.F. Halirahmanov, B.M. Sharafutdinov // Prakticheskaya medicina [The practice of medicine]. — 2014. — № 20. — S.24—32.
  4. Sluchai uspeshnogo lecheniya ateroskleroticheskoi bilateral'noi okklyuzii pochechnyh arterii [Successful Treatment of bilateral atherosclerotic renal artery occlusion] / H.A. Yaickii, A.M. Ignashov, A.V. Smirnov [i dr.] // Nefrologiya [Nephrology]. — 2005. — T. 9, № 2. — S.117—120.
  5. Alhadad, A. Percutaneous transluminal renal angioplasty and surgical revascularization in renovascular disease a retrospective comparison of results, complications and mortality / A. Alhadad, M. Ahle, K. Ivancev // Eur. J. Endovasc. Surg. — 2004. — № 27. — P.151—156.
  6. Gross, C. Ostial renal artery placement for atherosclerotic renal artery stenosis in patients with coronary artery disease / C. Gross, J. Kramer, J. Waigand // Cath. Cardiovasc. Diagn. — 1998. — № 45. — P.1—8.
  7. Lawrie, G. Long-term results of treatment of the totally occluded renal artery in forty patients with renovascular hypertension / G. Lawrie, G. Morris, M. DeBakey // Surgery. — 1980. — № 88. — P.753—759.
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  9. Sniderman, K. Percutaneous transluminal recanalization and dilatation of totally occluded renal arteries / K. Sniderman, T. Sos // Radiology. — 1982. — № 142. — P.603—610.
  10. Rastan, A. Improved renal function and blood pressure control following renal artery angioplasty: the renal artery angioplasty in patients with renal insufficiency and hypertension using a dedicated renal stent device study (PRECISION) / A. Rastan // Eurolntervention. — 2008. — Vol. 4, № 2. — P.208—213.

 

REVIEW

PDF downloadEpidemiological aspects of children bronchial tubes disease

Alevtina V. Bogdanova, D.Med.Sci., professor, leading researcher of COPD laboratory of Pulmonology Research Institute of Pavlov first Saint Petersburg State Medical university, tel. +7-911-298-93-82, email: AlevBogdanova@yandex.ru

Tsyrendorzhi V. Zandakov, graduate student of Pulmonology Research Institute of Pavlov First Saint Petersburg State Medical University, pediatrician at Federal State Budget Health Institution Central Health Care Department 38 of Russian Federal Medical and Biology Agency, tel. +7-952-249-82-58, email: docent_do@mail.ru

Olga N. Titova, D.Med.Sci., Director of Pulmonology Research Institute of Pavlov First Saint Petersburg State Medical University

Evgenija V. Bojtsova, D.Med.Sci., Head of the Pediatric Pulmonology Laboratory

Maria M. Goloborod'ko, С.Med.Sci., pulmonologist

Abstract. Aim. To review data on chronic diseases of bronchial tubes in children (asthma, bronchopulmonary dysplasia, obliterating bronchiolitis), its prevalence and quality of diagnosis. Material and methods. We reviewed recent publications on prevalence of chronic diseases of bronchial tubes in children. A comparison of the true prevalence of chronic diseases of bronchial tubes in children with official statistics was performed. The analysis of modern classification of bronchopulmonary diseases in children (2009) applying in practical medicine. Results and discussion. Our data suggest that these diseases are one of the most severe respiratory pathology and require significant financial costs to achieve control, and are predictors of pediatric chronic obstructive pulmonary disease (COPD). At the same time, we have late diagnosis in many patients for many years, as evidenced by a comparison of official statistics and epidemiological studies, conducted using a standardized method by questionnaire followed by in-depth survey. Conclusions. Creating a unified, automated forms of diagnosis can solve the problem of early detection of chronic diseases of bronchial tubes in children.

Key words: asthma, bronchopulmonary dysplasia, obliterating bronchiolitis, prevalence, quality of diagnostics.

 

References

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  4. Bogdanova, A.V. Diagnostika, klinicheskie osobennosti i lechenie bronholegochnoi displazii u detei [Diagnosis, clinical features and treatment of bronchopulmonary dysplasia in children] / A.V. Bogdanova // Bolezni organov dyhaniya. Klinika i lechenie bronholegochnoi displazii u detei [Diseases of the respiratory system. The symptoms and treatment of bronchopulmonary dysplasia in children] / pod red. A.N. Kokosova. — SPb.: Lan', 1999. — S.48—57.
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PDF downloadDuodenogastric reflux as a cause of reflux-gastritis

Shamil Z. Galiev, graduate student of Department of general practice of SBEI HPE «Kazan State Medical University», Kazan, Russia, tel. 8-927-421-03-08, e-mail: galis160@gmail.com

Nail B. Amirov, D.Med.Sci., professor of Department of general practice of SBEI HPE «Kazan State Medical University», Kazan, Russia, tel. 8-905-313-01-11

Abstract. Aim. The purpose of the study is to look into the problem of duodenogastric reflux (DGR) among different categories of patients. And also to identify consequences of the disease. Material and methods. The literature review shows different existing positions on pathophysiological mechanisms of the DGR and development of reflux gastritis. The main attention is paid on of the articles pointing on the link between DGR and the development of precancerous changes in the gastric mucosa. Comparison of different surveys on how biliary reflux affects H. Pylori displays controversy in their data. Results. Mainly it’s because the clinical picture of DGR has no specific symptoms, so generally the diagnosis is based on instrumental methods of research. Conclusion. It is known than different groups of drugs are used in the treatment of the DGR and reflux gastritis. Nevertheless their efficiency has not been studied uniformly. And the generally accepted regimen for this illness seems has not been found yet. It is shown the validity of UDCA prescription for DGR treatment.

Key words: duodenal reflux, reflux gastritis, intestinal metaplasia, UDCA.

 

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PDF downloadBenefits and harm of electronic cigarettes through the prism of different therapeutic methodologies

Vladimir D. Mendelevich, D.Med.Sci., Professor, Chair of Department of medical and general psychology of SBEI HPE «Kazan State Medical University», Kazan, Russia, tel. +7-843-238-60-74, e-mail: mend@tbit.ru

Abstract. Aim. The article provides an analytical overview of current research on the assessment of benefit and harm of using electronic cigarettes (ES) for nicotine addiction. Material and methods. Analyzed the results of a study of several dozen works carried out in the design of evidence-based research. Results. It is concluded that the evaluation of the effectiveness depends on what kind of therapeutic paradigm adheres the researcher — the strategy of «zero tolerance» or «harm reduction». In the first case, the positive impact is assessed solely on the basis of complete smoking cessation (both conventional and electronic cigarettes), the second — using criteria of reduced harmful effects of smoking. Attention is drawn to the fact that physicians have a relationship with real patients; most of them did not wish to give up smoking and will continue to smoke despite the obvious health risks. Conclusion. It is noted that nicotine addiction is one of the most severe and resistant to therapy, and on the severity of the addictive potential of nicotine is in third place out of fifteen drugs, second only to heroin and crack. This necessitates the use in evaluating the effectiveness of ES criteria of harm reduction strategies.

Key words: e-cigarettes, therapy, harm reduction.

 

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ORGANIZATION OF HEALTHCARE

PDF downloadClinical and statistical analysis of morbidity with temporary disability of the economically active population of Kazan city

NuriKhan N. Shamsiyarov, C.Med.Sci., Honored Doctor of the Republic of Tatarstan, Deputy Director of the organizational and methodical work of ICC, tel. 8-927-442-78-70, e-mail: kybm@mail.ru

Afgat N. Galiullin, D.Med.Sci., Professor of Department of health management of SBEI HPE «Kazan State Medical University», tel. 8-987-296-87-64, e-mail: kybm@mail.ru

Abstract. Aim. To analyze morbidity with temporary disability (MTD) by the clinical and statistical analysis of economically active population of Kazan city. To perform the analysis of MTD according to a form 16BH. Material and methods. We studied 1011 variables on 6 indicators for this purpose in 1995—2011 years. Results. MTD coefficient was decreased from 861,1 in days (on 100 cases of the working population) in 1995 to 495,0 in 2011. Thus the morbidity coefficient in cases for this period decreased on 8,1 case on 100 cases of the working population. We demonstrated structure of MTD. In this structure, in the prevailing diseases forming the MTD high level were respiratory diseases, traumas and poisoning, bone and muscular system diseases. Predicting of morbidity with temporary disability of the population of economically active age from 2012 to 2016 is carried out. Conclusion. The received results of Kazan city are yielded in comparison with coefficient of MTD of the Republic of Tatarstan.

Key words: MTD, morbidity, cases, days of morbidity, the working population.

 

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HELP FOR PRACTITIONER

PDF downloadTreatment of allergic rhinitis in women during pregnancy

Alla A. Vasiljeva, C.Med.Sci., associate professor of Department of clinical immunology and allergology of SBEI HPE «Kazan State Medical University», Kazan, Russia

Rezeda F. Khakimova, D.Med.Sci., Professor of Department of clinical immunology and allergology of SBei HPe «Kazan State Medical university», Kazan, russia, e-mail: khakimova@yandex.ru

Abstract. Aim. In this manuscript we show contemporary data on the diagnosis and treatment of allergic rhinitis in women during pregnancy. Material and methods. Pregnant women suffering from allergic rhinitis. The authors describe the choice of medications based on the evidence-based medicine, as well as also according to the toxicity of these medications to a pregnant woman and her future child. Results. Given that the organism of a pregnant woman undergoes specific physiological changes, many pathological conditions in this group of population present and run differently. It is known that allergic rhinitis in pregnants has more complicated course, оftenly, accompanying asthma gets worse. During allergic rhinitis in pregnancy it is important to do elimantion actions, as well as to use intranasal irrigation-elimination and barrier medications. Conclusion. Intranasal corticosteroids are the most effective drugs for basis therapy of allergic rhinitis in pregnant. Among those is Budesonide, that belongs to category B according to FDA.

Key words: allergic rhinitis, pregnancy, base therapy, symptomatic therapy.

 

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CLINICAL CASE

PDF downloadFree wall myocardium rupture and thrombolytic therapy. Clinical observation

Natalya A. Kosheleva, D.Med.Sci., associate professor of Depatment of hospital therapy of SBEI HPE «Saratov State Medical university n.a. V.i. razumovsky», Head of office of urgent cardiology of Saratov regional clinical Hospital, Saratov, Russia, e-mail: kosheleva2009@yandex.ru

Dmitry V. Krasikov, internship doctor of Department of hospital therapy general medicine faculty of SBEI HPE «Saratov State Medical university n.a. V.i. razumovskiy», Saratov, russia, e-mail: krasikovmd@gmail.com

Igor A. Morozov, C.Med.Sci., Deputy chief physician on the Regional vascular center of Saratov Regional Clinical Hospital, Saratov, Russia, e-mail: igormorozov@mac.com

Andrey P. Rebrov, D.Med.Sci., professor, Head of Depatment of hospital therapy of SBEI HPE «Saratov State Medical university n.a. V.i. razumovsky», Saratov, russia, e-mail: andreyrebrov@yandex.ru

Abstract. Aim — to show an effective option of thrombolysis in myocardial reinfarction, complicated by late rupture of the anterior wall of the left ventricle. Material and methods. Clinical observation. Results and discussion. Reperfusion strategy prevented the development of early complications of acute myocardial infarction, but showed its two-faced effect. The described pathogenetic expansion mechanism of the myocardial necrosis zone explains the connection of thrombolytic therapy with the subsequent development of cardiac rupture. Conclusions. This clinical observation shows that thrombolytic therapy, being the main focus in the treatment of patients with myocardial infarction and ST-segment elevation, may increase the number of cardiac ruptures. The predictor of the impending cardiac rupture is the appearance of idioventricular rhythm. If over the next 1,5—2,0 hours the primary PCI is possible, balloon angioplasty and stenting of coronary arteries are preferable.

Key words: myocardial infarction, cardiac ruptures, thrombolytic therapy.

 

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