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ORIGINAL ARTICLES
The efficiency of radiowave treatment of cervical pathology. Subkhankulova A.F. P.35-38
PRACTICAL EXPERIENCE
ORGANIZATION OF HEALTHCARE
SHORT MESSEGES
REVIEWS
Right ventricle myocardial infarction in medical practice. Abdrakhmanova A.I., Amirov N.B. P.62-69
Health status of medical professionals. Gatiya-tullina L.L. P.69-75
Genetic polymorphism and efficiency of lipid-lowering therapy. Kabakova A.V., Galyavich A.S. P.75-81
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PREDICTION OF VIRAL HEPATITIS CHRONICITY BASED ON A DYNAMIC ASSESSMENT OF SERUM IRON LEVEL
UDC 616.36-002-022.6-037:616.152.72-074
DOI: 10.20969/VSKM.2016.9(3).7-11
BELOKONOVA LYUDMILA V., C. Med. Sci., associate professor of the Department of infectious diseases and epidemiology of Kursk State Medical University, Russia, Kursk, Sumscaya str., 45g, e-mail: Ludmila2611@yandex.ru
ZAYTSEVA LYUDMILA YU., C. Med. Sci. associate professor of the Department pediatrics of Kursk State Medical University, Russia, Kursk, Koltsov str., 11
TITAREVA LYUDMILA V., C. Med. Sci. associate professor of the Department infectious diseases and epidemiology of Kursk State Medical University, Russia, Kursk, Sumscaya str., 45g
Abstract. Aim of our study was to improve the efficiency of predicting the risk of chronisation of acute viral hepatitis based on the study of serum iron level. Material and methods. There were 77 patients with viral hepatitis В and C under our observation. According to the basic clinical and laboratory criteria all patients had moderate disease. The serum iron concentration was studied in dynamics: at admission, during treatment and at discharge. During the dispensary observation, convalescent’s serum iron level was monitored after 1, 3, 6 and 12 months after discharge from the hospital. Results and discussion. It was established that increased levels of serum iron in patients with acute viral hepatitis is a poor prognostic factor in the risk of chronisation. Conclusion. Our data allow us to suspect that persistent hyperferremia is a criterion of chronicity of acute viral hepatitis B and C and include a serum iron test in the scheme of clinical examination of viral hepatitis convalescents.
Key words: viral hepatitis, serum iron, risk of chronisation.
For reference: Belokonova LV, Zaytceva LYu, Titareva LV. Prediction of viral hepatitis chronicity based on a dynamic assessment of serum iron level. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (3): 7—11.
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5. Ivashkin VT, Jushhuk ND, Maevskaja MV, Znojko OO, Dudina KR, Karetkina GN et al. Klinicheskie rekomendacii Rossijskoj gastrojenterologicheskoj associacii i Rossijskogo obshhestva po izucheniju pecheni po diagnostike i lecheniju vzroslyh bol’nyh gepatitom В [Clinical guidelines of the Russian gastroenterological Association and the Russian society on studying of liver diseases on diagnostics and treatment of adult patients with hepatitis B]. Rossijskij zhurnal gastrojenterologii, gepatologii, koloproktologii [Russian magazine of gastroenterology, Hepatology, Coloproctology]. 2014; 3: 58-88.
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7. Orlov JuP, Ivanov AV, Dolgih VT, Lukach VN, Chesnokova MV, Pritykina TV et al. Narushenija obmena zheleza v patogeneze kriticheskih sostojanij (jeksperimental’noe issledovanie) [A disorder of iron metabolism in the pathogenesis of critical conditions (experimental study)]. Toksikologicheskij vestnik [Toxicological Bulletin]. 2011; 2: 34—41.
8. Dudina KR, Caruk KA, Shut’ko SA, Bokova NO, Jushhuk ND. Faktory progressirujushhego techenija hronicheskogo gepatita S [Factors of progressive course of chronic hepatitis C]. Lechashhij vrach [Doctor]. 2013; 10: 36-39.
PROGNOSTIC VALUE OF CLINICAL AND NEUROIMAGING RISK FACTORS OF MULTIPLE SCLEROSIS ACTIVITY
UDC 616.832-004.2-036.1-073.756.8
DOI: 10.20969/VSKM.2016.9(3).12-18
KOBYS TATIANA A., C. Med. Sci., Head of Kyiv City Center of Multiple Sclerosis, Kyiv City Clinical Hospital №4, doctoral candidate of the Department of neurology of O.O. Bogomolets National Medical University, Ukraine, Kyiv, tel. +38-067-287-31-65, e-mail: tkobys@ukr.net
Abstract. Purpose of the study. To improve predictive assessment of multiple sclerosis (MS) activity on the basis of complex clinical-neurological and neuroimaging prospective study. Research methods. A prospective ten-year study of 180 patients with MS starting with the first clinical signs. MRI examination was performed on a GE unit Signa Excite HD 1,5T, determined by the number of T2 lesions including lesiona >3 mm, and T1 Gd + lesions. Results and discussion. We proved the effect of frequency of relapses in the beginning of the disease and the type of FS affected by CIS on the long-term prognosis of clinical activity. Based on the MRI monitoring we identified prognostic risk factors for the activity of the disease in different periods of the study — namely, the number of T2 lesions, their size and location. Conclusion. Prediction of the course of MS activity should be carried out taking into account the clinical and neuroimaging evidence of disease activity in different periods from its onset.
Key words: multiple sclerosis, clinical disease activity, lesions, disability progression.
For reference: Kobys TA. Prognostic value of clinical and neuroimaging risk factors of multiple sclerosis activity. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (3): 12—18.
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11. Scalfari A, Neuhaus A, Daumer M, Deluca G, Muraro P, Ebers G. Early relapses, onset of progression, and late outcome in multiple sclerosis. JAMA Neurol. 2013; 70 (2): 214—222.
12. Scalfari A, Neuhaus A, Degenhardt A et al. The natural history of multiple sclerosis, a geographically based study. Relapses and long-term disability. Brain; 2010; 133 (Pt 7): 1914-1929.
13. Tremlett H, Yousefi M, Devonshire V, Rieckmann P, Zhao Y. UBC Neurologists; Impact of multiple sclerosis relapses on progression diminishes with time. Neurology; 2009; 73 (20): 1616—1623.
14. Tremlett H, Zhao Y, Rieckmann P, Hutchinson M. New perspectives in the natural history of multiple sclerosis. Neurology. 2010; 74 (24): 2004—2015.
15. Ziemsenn T, Tintore M. A New Era in Multiple Sclerosis: New Consideration for Therapeutic Approaches. Elsevier. 2010; 94 p.
HOW THE GOLD 2014 GUIDELINES IS USED IN REAL-LIFE MEDICAL PRACTICE?
UDC 616.24-036.12-08
DOI: 10.20969/VSKM.2016.9(3).18-22
KUPAEV VITALII I., D. Med. Sci., professor, Head of the Department family medicine of Samara State Medical University,
Russia, Samara, tel.+7-927-256-09-27, e-mail: vk1964sam@rambler.ru
SHCHELKUNOVA LARISA A., pulmonologist of Siti Hospital № 15, Russia, Samara, e-mail: larisonn@rambler.ru
NAGOVSKAYA NATALIA G., Head of the Department of Siti Hospital № 4, Russia, Samara, e-mail: natalya.nagovskaya@mail.ru
GUSAROV KONSTANTIN V., graduate student of the Department of family medicine of Samara State Medical University, Russia, Samara, e-mail: dok_gus@mail.ru
Abstract. The aim was to evaluate the feasibility of GOLD 2014 new classification implementation in outpatient medical practice in Russian Federation. Material and methods. Data from Samara Polyclinic COPD patient’s electronic register was analyzed. In the cohort of 599, 76 cases were selected to assess how GOLD 2014 guidelines can be used in real-life medical practice. In order to achieve this goal, after the period of eight weeks outpatient care, patients answered COPD Assessment Test (CAT), modified Medical Research Council (mMRC) dyspnea scale, and undergone spirometry. Results. According to classification, 76 patients were distributed on four groups: (1) group A included 15,8% of patients; (2) group B — 38,15%; (3) group C — 2,5% and (4) group D — 40,8%. Structure of patients classified by GOLD 2014 criteria differed from pulmonologist and the general practitioner. After eight weeks of glycopyrronium therapy, the change from baseline in FEV1 was greater in 6 (5,0—9,0)% and the improvement of ΔCAT score value was 5,5 (2,0—7,0) points (p<0,01). As a result, the number of patients in Group A increased up to 36,4%, compared to 9,1% before the treatment, by switching patients from Group B. Group D decreased in 2 times by switching COPD patients in groups B and C. Conclusion. The analysis showed the possibility of COPD patients treatment in compliance with international initiatives in real-life medical practice.
Key words: chronic obstructive pulmonary disease, recommendations bronchodilators.
For reference: Kupaev VI, Shchelkunova LA, Nagovskaya NG, Gusarov KV. How the GOLD 2014 guidelines is used in real-life medical practice? The Bulletin of Contemporary Clinical Medicine. 2016; 9 (3): 18—22.
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5. Zhestkov AV, Kosarev VV, Babanov SA. Hronicheskaja obstruktivnaja bolezn’ u zhitelej krupnogo promyshlennogo centra: jepidemiologija i faktory riska [Chronic obstructive pulmonary disease among residents of large industrial center: epidemiology and risk factors]. Pul’monologija [Pulmonology]. 2009; 6: 53—58.
6. Altuhova JuV, Burlachuk VT, Tribunceva LV, Budnevskij AV. Rol’ komp’juternogo registra v ocenke jeffektivnosti upravlenija lechebno–diagnosticheskim processom u bol’nyh hronicheskoj obstruktivnoj bolezn’ju legkih [The role of the computer register in assessement of effectiveness of the management of medical-diagnostic process in patients with chronic obstructive pulmonary disease]. Sistemnyj analiz i upravlenie v biomedicinskih sistemah [System analysis and control in biomedical systems]. 2013; 12 (3): 618–621.
7. Chetta A, Olivieri D. The COPD Assessment Test in the Evaluation of Chronic Obstructive Pulmonary Disease Exacerbations. Expert Rev Resp Med. 2012; 6 (4): 373–374.
8. Haughney J, Gruffydd–Jones K, Roberts J et al. The distribution of COPD in UK general practice using the new GOLD classification. Eur Respir J. 2014; 43 (4): 993—1002.
9. Zykov KA, Ovcharenko SI. Podhody k lekarstvennoj terapii bol’nyh HOBL stabil’nogo techenija: predlagaemyj algoritm lechenija [Approaches to drug therapy in patients with stable COPD: A proposed treatment algorithm]. Medicinskij sovet [Medical advice]. 2015; 17: 78—85.
UDC 616.149-008.341.1-089:616.36-004
DOI: 10.20969/VSKM.2016.9(3).23-29
NAZYROV FERUZ G., D. Med. Sci., professor, Director of the acad. V. Vakhidov Republican Specialized Center of Surgery, Uzbekistan, Tashkent, tel. 8-371-233-49-09, e-mail: cs75@mail.ru
DEVYATOV ANDREY V., D. Med. Sci., professor, Head research worker of the acad. V. Vakhidov Republican Specialized Center of Surgery, Uzbekistan, Tashkent, tel. 8-371-277-06-17, e-mail: avdevyatov1777@gmail.com
URAKOV SHUKHRAT T., D. Med. Sci., professor of Bukhara State Medical Institute, Uzbekistan, Bukhara, tel. (99890)-718-10-40, e-mail: сs.75@mail.ru
NIGMATULLIN ELNAR I., resident of Tashkent Medical Academy, Uzbekistan, Tashkent, tel. (99890)-372-24-77, e-mail: etoyaek@mail.ru
ZUPAROV KAMOLIDDIN F., resident of Tashkent Medical Academy, Uzbekistan, Tashkent, tel. (99890)-346-51-42, e-mail: liddin89@mail.com
Abstract. Aim. To perform a comparative analysis of the results of portosystemic shunting with competitive methods in patients with liver cirrhosis. Material and methods. During the period from 1976 to 2015 in the department of surgery of portal hypertension and pancreatoduodenal zone of Academician V.Vahidova Republican Specialized Center of Surgery JSC, portosystemic shunt (PSSh) in the traditional version was performed to 925 patients with portal hypertension (PH). Etiological factor of PH in 867 (94,3%) cases was liver cirrhosis, in 58 patients (5,7%) — extrahepatic form of PH. Results. The results describe three study groups: the first group with PSSh implementation phase, period spanned 1976 to 1992. The second group consisted of patients on the stage of implementation of the partial shunts (1992—1998) and patients of the third group consisted of patients on modern stage with the introduction of portocaval reset restrictions by the original method and the implementation of the TIPS methodology (1998—2015). In the structure of mortality, main complication was fatal liver failure (over 70% of cases). Over the last follow-up on a background of prophylactic bypass, preserving hepatopetal flow, rate of mortality in the immediate postoperative period decreased to 2,7% at thecentral bypass and 3,9% in the selective decompression. Conclusion. For patients with functional classes «A» and «B», in the absence of immediate hepatotransplantation prospects, performing the traditional selective or partial central portosystemic shunting operations should be considered as an alternative to actual competition.
Key words: liver cirrhosis, portal hypertension syndrome, bleeding from esophageal and gastric varices, portosystemic shunting.
For reference: Nazyrov FG, Devyatov AV, Urakov ShT, Nigmatullin EI, Zuparov KF. Сompetitive prospects of portosystemic shunting in patients with liver cirrhosis and portal hypertension. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (3): 23—29.
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[Annals of surgical gastroenterology]. 2010; 15 (3): 36-41.
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20. Orloff MJ, Isenberg JI, Wheeler HO, Haynes KS, Jinich-Brook H, Rapier R, Vaida F, Hye RJ. Emergency Portacaval Shunt Versus Rescue Portacaval Shunt in a Randomized Controlled Trial of Emergency Treatment of Acutely Bleeding Esophageal Varices in Cirrhosis-Part 3. Gastrointestinal Surgery. 2010; 14: 1782–1795.
21. Henderson M, Boyer TD, Kutner MH et al. Distal Splenorenal Shunt Versus Transjugular Intrahepatic Portal Systematic Shunt for Variceal Bleeding: A Randomized Trial. Gastroenterology. 2006; 130 (6): 1643-1651.
THE RESULTS OF PROGRAM MANAGEMENT OF THE REGISTER OF PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE
UDC 616.12-005.4-036.12-052:004.4(571.150)
DOI: 10.20969/VSKM.2016.9(3).30-35
NOMOKONOVA EVGENIYA A., candidate of a degree of the Department of therapy and general medical practice of Altai
State Medical University, Russia, Regional Clinical Hospital, 656024, Altai, Barnaul, Lyapidevsky str., 1, tel. (8-3852) 689-852,
e-mail: nomokonova-81@mail.ru
ELYKOMOV VALERIY A., D. Med. Sci., professor, Head of the Department of therapy and general medical practice of Altai State Medical University, Russia, Head physician of Regional Clinical Hospital, 656024, Altai, Barnaul, Lenin ave., 40, tel. (3852) 689-645
EFREMUSHKINA ANNA A., D. Med. Sci., professor of the Department of therapy and general medical practice of Altai State Medical University, Russia, Head cardiologist of the Altai, 656038, Barnaul, Lenin ave., 40, tel. (3852) 592-284
NEDOSEKO KOSTANTIN V., Head of the Department of clinical and expert work of Regional Clinical Hospital, Russia, 656024, Altai, Barnaul, Lyapidevsky str., 1, tel. (3852) 689-737
Abstract. Aim. To evaluate results of chronic ischemic heart disease patients (CIHD) register management for 2011—2015 in the Altai Krai. Material and methods. Current system (Register) was developed and implemented in 2011. Register was tested originally in Regional Clinical Hospital and Altay Krai Cardiology Clinic. The Register was completed permanently, according to the examination of eligible patients. Statistical analysis was performed using the statistical software Statistica version 6.0. Results and discussion. A total of 12886 patients diagnosed with IHD aged (65,1±9,9) years of age were included in Registed during 2011—2015 year. In the cohort, there were 35,5% citizens of Barnaul and 64,5% patients were from Altai Krai. Two-thirds of registered patients were men. It has been found significantly more patients with myocardial infarction in past history — 7094 (p<0,01) in the Registry. High-technology ‘Cardiovascular Surgery’ care was provided to 6115 (47,4%) patients. Drug treatment of patients was carried out according to the recommendations and standards of management of patients with IHD. Introduction of the register, improved the accessibility of cardiac care for the villagers: the levels of specialized outpatient cardiac care increased in 3 times, the levels of cardiovascular surgery increased in 1,8 times. The dynamics of mortality from cardiovascular diseases for the past five years showed a decline of 19,6%. Conclusion. A universal approach to the creation of a unified database for patients suffering from ICH was formed. CIHD Register allows to analyze the work of cardiology services and to influence the qualitative and quantitative work indicators. The necessity of the monitoring systems development in all health care clinics of the region is shown for accessible high-tech cardiac care of patients.
Key words: register, coronary heart disease, high-tech medical care, specialized cardiac care.
For reference: Nomokonova EA, Elykomov VA, Efremushkina AA, Nedoseko KV. The results of program management of the register of patients with chronic ischemic heart disease. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (3): 30—35.
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9. Nomokonova EA, Elykomov VA, Efremuhkina AA. Pervye rezul’taty vnedrenija registra hronicheskoj ishemicheskoj bolezni serdca v Altajskom kraj [First results of the introduction of the register of chronic ischemic heart diseases in Altai Krai]. Kardiovaskuljarnaja terapija i profilaktika [Cardiovascular Therapy And Prevention]. 2015; 1: 63–69.
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12. Rabochaja gruppa po lecheniju stabil’noj ishemicheskoj bolezni serdca Evropejskogo obshhestva kardiologov (ESC) [Working group on treatment of stable coronary heart disease of the European society of cardiology (ESC)]. Rekomendacii po lecheniju stabil’noj ishemicheskoj bolezni serdca ESC 2013 [Treatment recommendations on stable coronary heart disease ESC 2013]. Rossijskij kardiologicheskij zhurnal [Russian of Cardiology J]. 2014; 7 (111): 44–50.
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14. Dimov AS, Maksimov NI. K obosnovaniju sistemnogo podhoda v prevencii vnezapnoj serdechnoj smerti kak vozmozhnogo puti reshenija problemy sverhsmertnosti v Rossii, chast’ I: kardiovaskuljarnye aspekty sverhsmertnosti v Rossii: analiz situacii i vozmozhnosti profilaktiki. [The rationale of the system approach in the prevention of sudden cardiac death as a possible way of solving the problem of high mortality in Russia, part 1: cardiovascular aspects of high mortality in Russia: analysis of the situation and the possibility of prevention]. Kardiovaskuljarnaja terapija i profilaktika [Cardiovascular therapy and prevention]. 2013. 12 (2): 98–104.
THE EFFICIENCY OF RADIOWAVE TREATMENT OF CERVICAL PATHOLOGY
UDC 618.146-089
DOI: 10.20969/VSKM.2016.9(3).35-38
SUBKHANKULOVA ASIA F., C. Med. Sci., associate professor of the Department of obstetrics and gynaecology №2 of Kazan State Medical University, Russia, Kazan, Butlerov str., 49, e-mail: asia-sf@mail.ru
Abstract. Аim — of this study was to assess the efficacy of radiowave treatment of cervical pathology and the external genitalia in female patients with genital warts, ectropion, nabothian cysts and leukoplakia. The paper based on evaluation the clinical effect of treatment, the severity of pain during the procedure and the healing time of the wound surface. Material and methods. The study involved 62 patients with various pathologies of the cervix. Diagnoses were confirmed by clinical, instrumental and laboratory research methods (colposcopy, histological examination of the biopsy results, ELISA and PCR diagnostics). Patients underwent lesions destruction by radio-wave method with apparatus «Surgitron» in the I phase of the menstrual cycle. Results and discussion. The group that underwent radiosurgical destruction showed low trauma: there were no intra- and postoperative bleeding, there were no burn eschar and abundant purulent discharge. Patients emphasized the painlessness of the procedure. Conclusion. Summing up the results, it can be concluded that radiowave treatment demonstrated high efficacy, safety, and good cosmetic effect in the treatment of various pathologies of the cervix.
Key words: genital warts, ectropion of cervix, leukoplakia, radiowave surgery.
For reference: Subkhankulova AF. The efficiency of radiowave treatment of cervical pathology. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (3): 35—38.
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ANALYSIS OF DEATHS OF PATIENTS WITH BRONCHIAL ASTHMA IN THE PERM REGION
UDC 616.248-036.88:314.14(470.53)
DOI: 10.20969/VSKM.2016.9(3).39-42
ZHADOVA TAISIYA A., C. Med. Sci., Perm Regional Clinical Hospital, Russia, Perm, Pushkin str., 85
ZAIKINA MARIYA V., graduate student of Perm State Medical University, Russia, Perm, tel. 8(342)239-30-88, 8-908-274-20-11, e-mail: mariya_zaikina_mz@mail.ru
KARPUNINA NATALIA S., D. Med. Sci., associate professor of Perm State Medical University, Russia, Perm
AGAFONOV ALEXANDER V., D. Med. Sci., professor of Perm State Medical University, Russia, Perm
Abstract. Aim of the study was to analyze lethal cases of bronchial asthma in Perm region in 2014. Material and methods. The analysis of medical records, charts, case histories of patients with asthma from Perm region who have died within 2008—2014 was carried out. Results. We have analyzed 29 cases of total of 32. The study population comprised of 16 (55,1%) men and 13 (44,9%) women aged 45 to 88 years (mean 71,6). Three patients were identified as able-bodied population (10,3%), 20 had moderate disability (69%), one patient had severe disability (4,5%) and one patient had mild degree (4,5%) disability. The mean disease duration gained was 13.8 years. There were 24 cases of endogenous asthma (82,7%), one case — exogenous (3,4%), four patients had both (13,8%). Disease severity and control were as follows: severe — 21 (72,4%), moderate — 8 (27,6%); uncontrolled 22 (75,8%), partially controlled — 7 (24,2%). Revealed complications were respiratory failure — 17 (58,6%) and pulmonary heart signs — 12 (41,3%). Four patients did not receive basic anti-inflammatory therapy (13,8%). The most frequent concomitant diseases were: hypertension — 23 cases (79,3 percent), chronic obstructive pulmonary disease — 17 (58,6%) and ischemic heart disease — 14 (48,2%). The causes of deterioration focused on 4 apects: (1) progressive pulmonary heart failure in 15 (51,7%) patients, (2) acute cerebrovascular disease — 3 (10,3%), (4) acute viral respiratory infection — 1 (3,4%), (5) acute heart (left ventricle) failure — 1 (3,4%). Signs of asthma exacerbation, including status asthmaticus, were recorded in four patients (13,8%) only. Autopsy was performed in four cases (13,8%). Conclusions. Patients with asthma who have died during year 2014 in Perm region were predominantly males (55,1%) of mean age of 71,6 years with symptoms of chronic severe irreversible bronchial obstruction, more than mildly disabled (69%), with severe (72,4%), poor controlled (75,8%) asthma. Severe exacerbation of asthma as the cause of death was recorded only in 4 cases, in other 25 cases the cause of death was extrapulmonary.
Key words: asthma, mortality, comorbidity.
For reference: Zhadova TA, Zaikina MV, Karpunina NS, Agafonov AV. Analysis of deaths patients with bronchial asthma in the Perm region. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (3): 39—42.
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THE EVOLUTION OF THE CENTRAL PUBLIC HEALTH ADMINISTRATION IN PREREVOLUTIONARY RUSSIA
UDC 614.2(091)(470+571)
DOI: 10.20969/VSKM.2016.9(3).43-48
EGORYSHEVA IRINA V., C. Hist. Sci., leading research worker of the Department of history of medicine and health care of N.A. Semashko National Scientific Research Institute of Public Health, Russia, Moscow, e-mail: egorysheva@rambler.ru
MOROZOV ALEXEY V., C. Med. Sci., senior research worker of the Department of history of medicine and health care of N.A. Semashko National Scientific Research Institute of Public Health, Russia, Moscow, e-mail: А0067138@yandex.ru
Abstract. Aim. The purpose of the study is to show the development of health care management in Russia in pre-Soviet period, and central and local authorities relations. Material and methods. The study used the general methodological approaches to historical and medical researches — the historical, comparative, and chronological with comparative and systemic analysis. Results and discussion. The main concern of the paper was to research the government’s attempts to reform health care. It has been founded that the creation of the orders for public charity, whose functions included the device workhouses, orphanages, urban elementary schools, alms-houses, and hospitals, initiated the development of civilian health care in Russia. In order to combat quackery and prescription drug fraud, the Ministry of internal Affairs from 1809 initiated publishing a «list of Russian Physicians» based of information submitted to provincial medical councils. We have also considered the creation of the first in history Ministry of Health. Conclusion. Analysis of health development in prerevolutionary Russia helped to identify issues existing in different historical periods and to assess the effectiveness of measures aimed at its solution.
Key words: Medical board, Medical department, Ministry of interior, General directorate of public health, G.E. Raine.
For reference: Egorysheva IV, Morozov AV. The evolution of the central public health administration in prerevolutionary Russia. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (3): 43—48.
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POSSIBILITY OF QUALITY MANAGEMENT HEALTH CARE IN THE PRACTICE OF THE HEAD OF REGIONAL ENDOCRINOLOGY SERVICE (for example late complications of diabetes mellitus)
UDC 616.379-008.64-06-082
DOI: 10.20969/VSKM.2016.9(3).49-58
UDOVICHENKO OLEG V., C. Med. Sci., endocrinologist of Municipal Polyclinic № 22 of the Department of health care of Moscow, Russia, 125581, Moscow, tel. +7(926)-711-29-16, e-mail: ovu2003@mail.ru
NIMAEVA DARIMA E., C. Med. Sci., Head of Еndocrinological centre of N.A. Semashko Republican Clinical Hospital, Russia, 670031, Ulan-Ude, e-mail: darima_nim@mail.ru
BERSENEVA EVGENIA A., D. Med. Sci., N.A. Semashko National Research Institute of Public Health, Russia, 105064, Moscow, e-mail: eaberseneva@gmail.com
MESHKOV DMITRY O., D. Med. Sci., N.A. Semashko National Research Institute of Public Health, Russia, Moscow, e-mail: meshkovdo@nriph.ru
Abstract. Control and management of medical care quality (MCQ) become an integral part of everyday work of local endocrinology service administrators. Aim. Was to elaborate tools allowing effectively, not formally and with reasonable labor costs to carry out MCQ assessment in prevention and treatment of late complications of diabetes mellitus (DM). Material and methods. We used analysis of daily clinical practice, epidemiological data and expert recommendations concerning diagnosis and treatment of late complications of diabetes. Results. Authors developed a set of indicators for MCQ assessment concerning prevention and treatment of diabetic retinopathy, nephropathy and diabetic foot in outpatient setting. Conclusions. Despite of high importance of MCQ assessment and management, there is a lack of tools for assessment the complications of diabetes. Our system is an effective way to analyze three aspects of quality of diagnostics and treatment of late DM complications, which helps to plan actions for improvement of a situation, to estimate changes of MCQ upon time and to compare several regions.
Key words: diabetes, diabetic retinopathy, diabetic nephropathy, diabetic foot, outpatient treatment organization, quality of medical care.
For reference: Udovichenko OV, Nimaeva DE, Berseneva EA, Meshkov DO. Possibility of quality management health care in the practice of the head of regional endocrinology service (for example late complications of diabetes mellitus). The Bulletin of Contemporary Clinical Medicine. 2016; 9 (3): 49—58.
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38. Dedov II, Shestakova MV, Suntsov YuI et al. Rezul’taty realizatsii federal’noy tselevoy programmy «Sakharnyy diabet» Federal’noy tselevoy programmy «Preduprezhdenie i bor’ba s sotsial’no znachimymi zabolevaniyami 2007-2012 gg» [Results of implementation of the federal target program “Diabetes” of the Federal target program “Prevention and reduction of Socially Significant Diseases 2007-2012”]. Sakharnyy diabet [Diabetes mellitus]. 2013; 2: 1-48.
39. Kalashnikova MF, Suntsov YuI, Belousov DYu et al. Analiz epidemiologicheskikh pokazateley sakharnogo diabeta 2 tipa sredi vzroslogo naseleniya goroda Moskvy [Analysis of epidemiological indicators of diabetes type 2 among adult population of Moscow.]. Sakharnyy diabet [Diabetes mellitus]. 2014; (3): 5-16.
40. Dedov II, Shestakova MV, Vikulova OK. Gosudarstvennyy registr sakharnogo diabeta v Rossiyskoy Federatsii: status 2014 g. i perspektivy razvitiya [National Registry of diabetes in Russian Federation: 2014 status and perspectives of development]. Sakharnyy diabet [Diabetes mellitus]. 2015; (3): 5-22.
UDC 616.147.17-007.64-089-06
DOI: 10.20969/VSKM.2016.9(3).59-61
FATKHUTDINOV ILSUR M., С. Med. Sci., associate professor of the Department of surgical disease № 1 of Kazan State Medical University, Russia, Kazan, Butlerov str., 49, e-mail: ilsur1801@mail.ru
Abstract. Aim. The aim of the research was to analyze the early postoperative complications after transanal hemorrhoidal dearterialization with mucopexy, and rectum mucosa lifting in patients with III and IV stage of hemorrhoidal disease and in patients with combined pathology of the anal canal. The paper presents the ways of its prevention and treatment. Material and methods. The study included 96 patients with chronic hemorrhoids of stages III—IV, 25 patients had combined pathology of the anal canal. All patients underwent transanal hemorrhoidal dearterialization with mucopexy, and lifting the mucosa of the rectum. In cases of anal canal combined pathology, simultaneous operations were performed. Results and discussion. The following complications were observed in the early postoperative period: eight patients had bleeding, acute hemorrhoidal thrombosis occurred in three patients, the expressed painful syndrome was observed in two cases. Two patients with bleeding had second operation — hemorrhoidectomy, other patients had haemostatic therapy with final hemostasis. A blockade of the anal sphincter procedure was performed in patients with expressed pain syndrome. Conservative therapy for acute hemorrhoidal thrombosis allowed stopping the inflammation. Conclusion. To prevent early complications after transanal hemorrhoidal dearterialization with mucopexy, and lifting the mucosa of the rectum it is necessary to upgrade the operating techniques. Patients should thoroughly fulfill postoperative doctor’s advice. Occurrence of bleeding requires an integrated treatment approach.
Key words: transanal hemorrhoidal dearterialization with mucopexy, lifting the mucosa of the rectum.
For reference: Fatkhutdinov IM. Early complications after transanal of the hemorrhoids dezarterization with mucopexy and lifting the mucosa of the rectum in patients with III and IV stage of hemorrhoidal disease and in patients with combined pathology of the anal canal. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (3): 59—61.
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RIGHT VENTRICLE MYOCARDIAL INFARCTION IN MEDICAL PRACTICE
UDC 616.127-005.8:616.124.3(048.8)
DOI: 10.20969/VSKM.2016.9(3).62-69
ABDRAKHMANOVA ALSU I., C. Med. Sci., associate professor of the Department of cardiology, X-ray-endovascular and cardiovascular surgery of Kazan State Medical Academy, Russia, 420012, Kazan, Mushtari str., 11, associate professor of the Department of clinical medicine fundamental basis of the Institute of Biology and Fundamental Medicine of Kazan Federal University, Russia, 420012, Kazan, Karl Marx str., 74, tel. 8-917-922-66-29, e-mail: alsuchaa@mail.ru
AMIROV NAIL B., ORCID ID : orcid.org/0000-0003-0009-9103, SCOPUS Author ID : 7005357664, D. Med. Sci, professor
of the Department of general medical practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49,
e-mail: namirov@mail.ru
Abstract. Aim. Analysis of recent publications devoted to prevalence, clinical course features, diagnostics and treatment of right ventricle myocardial infarction. Material and methods. We reviewed publications in scientific and medical literature on right ventricular myocardial infarction. Results and discussion. Isolated right ventricular myocardial infarction is a rare condition. The clinical triad of the right ventricle myocardial infarction consists of: hypotension; increased blood pressure in jugular veins and right atrium; the absence of wheezing during lungs auscultation. Right ventricle myocardial infarction is diagnosed by electrocardiography, echocardiography, coronary angiography. The management of patients with myocardial infarction of the right ventricle is directed to detection of myocardial infarction, reperfusion, load capacity, heart rate and rhythm control, inotropic support. The coronary angioplasty is indicated in case of drug effect absence. Right ventricle function abnormalities is a factor of unfavorable course of the disease and it is associated with a more than fourfold increase in hospital mortality, long-term mortality, regardless of age, the size of the myocardial infarction and left ventricular ejection fraction. Conclusion. The right ventricular failure after myocardial infarction leads to complications growth and ultimately increase mortality. Early diagnosis of right ventricular infarction is necessary due to the fact that right ventricular function abnormalities require correction treatment. The main treatment of patients with myocardial infarction involving the right ventricle is an early restoration of blood flow in the infarct artery.
Key words: myocardial infarction, right ventricle, coronary arteries, coronary angiography, electrocardiography.
For reference: Abdrahmanova AI, Amirov NB. Right ventricle myocardial infarction in medical practice. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (3): 62—69.
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31. Amirov NB ed. Ishemicheskaja bolezn’ serdca v obshhej vrachebnoj praktike: diagnostika, lechenie i profilaktika: monografija [Coronary heart disease in general practice: diagnosis, treatment and prevention: monograph]. Kazan’: Orange-K. 2011; 194 p.
HEALTH STATUS OF MEDICAL PROFESSIONALS
UDC 614.256.5(048.8)
DOI: 10.20969/VSKM.2016.9(3).69-75
GATIYATULLINA LILIA L., Head of the Department of internship of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. 8-917-242-17-80, e-mail: lilijaluk@yandex.ru
Abstract. Aim of the article is to analyze the publications dedicated to health study of medical specialists. Material and methods. Survey of publications from the scientific medical literature, dedicated to study sickness rate of medical professionals is presented. Results and discussions. The analysis of the present status of professional case rate of medical professionals is made. Conclusions. Nowadays it is proved that one of basic reasons of high sickness rate of health personnel is specificity of professional activity. The interest to interacting in professional activity, behavior of people and their health has considerably increased in domestic and foreign researches today. The health saving behavior of medical professionals is observed as capability of the organism to save and activate compensatory, protective, regulatory mechanisms providing working efficiency in all conditions of professional activity. Therefore questions of health promotion of physicians in the modern healthcare institutions emerge full blown.
Key words: sickness rate of medical professionals.
For reference: Gatiyatullina LL. Health status of medical professionals. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (3): 69—75.
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GENETIC POLYMORPHISM AND EFFICIENCY OF LIPID-LOWERING THERAPY
UDC 616.12-005.4-085.272.4:575.174.015.3 (048.8)
DOI: 10.20969/VSKM.2016.9(3).75-81
KABAKOVA ALINA V., postgraduate student of the Department of cardiology of TEF and PRS of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, Inter-regional Clinical and Diagnostic Centre, Russia, 420101, Kazan, Karbyshev str., 12a, tel. +7-927-240-14-12, e-mail: leagirl@mail.ru
GALYAVICH ALBERT S., ORCID ID : orcid.org/0000-0002-4510-6197, D. Med. Sci., professor, Head of the Department
of cardiology of TEF and PRS of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-987-296-16-43,
e-mail: agalyavich@mail.ru
Abstract. Aim. To analyze the published articles of SORT1/CELSR2/PSRC1 and SLCO1B1 genes polymorphism influence on statins tolerance in patients with ischemic heart disease (IHD). Material and methods. The paper presents the modern views on different statins effects manifestatative in the population in different ways. Results and arguing. One of the mechanisms regulating the peculiarities of drug effect providing individual response to therapy, is pharmacogenetic inhomogeneity of population. The literature data on the relatedness of polymorphism of genes SORT1/CELSR2/PSRC1and SLCO1B1with acceptability (origin of side effects) at patients with ischemic heart disease is presented. Current gene polymorphisms carriage encoding drug transport proteins can essentially change pharmacokinetic parameters of 3-hydroxy-3-methylglutaryl-coenzyme A reductaseinhibitors (statins). Conclusion. Genetic polymorphism underlies the pathophysiology of the disease and can influence therapy efficiency. Research of association of genetic polymorphism with medication efficiency is one of the ways of therapy strategy individualization.
Key words: ischemic heart disease, polymorphism of genes SORT1/CELSR2/PSRC1 and SLCO1B1, statins.
For reference: Kabakova AV, Galyavich AS. Genetic polymorphism and efficiency of lipid-lowering therapy. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (3): 75—81.
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UDC 616.24-036.12-08
DOI: 10.20969/VSKM.2016.9(3).82-89
SHMELEV EVGENY I., D. Med. Sci., professor, Head of the Department of differential diagnosis pulmonary tuberculosis and extracorporeal therapies of Central Research Institute of Tuberculosis, Russia, 107564, Moscow, Yauzskaya alley, 2, tel. +7-903-192-32-74, e-mail: eishmelev@mail.ru
ZHESTKOV ALEXANDER V., ORCID ID : orcid.org/0000-0002-3960-830X, D. Med. Sci., professor, Head of the Department of microbiology, immunology and allergology of Samara State Medical University, Russia, 443099, Samara, Chapaevskaya str., 89, tel. +7-846-260-33-61, e-mail: avzhestkov2015@yandex.ru
VIZEL ALEXANDER A., ORCID ID : orcid.org/0000-0001-5028-5276, D. Med. Sci., professor, Head of the Department of phthisiopulmonology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-987-296-25-99, e-mail: lordara@inbox.ru
ZAGIDULLIN SHMAMIL Z., D. Med. Sci., professor, Head of the Department of propedeutic internal diseases of Bashkir State Medical University, Russia, 450000, Ufa, Lenin str., 3, tel. +7-917-442-48-63, e-mail: zshamil@inbox.ru
KAROLI NINA A., D. Med. Sci., professor of the Department of hospital therapy of Saratov State Medical University, Russia, 410012, Saratov, Bolshaya Kazachya str., 112, tel. +7-845-249-14-37, e-mail: nina.karoli.73@gmail.com
MISHLANOV VITALIY YU., D. Med. Sci., professor, Head of the Department of propedeutic internal diseases № 1 of Perm State Medical University, Russia, 614990, Perm, Petropavlovskaya str., 26, tel. +7-950-467-76-96, e-mail: permmed@hotmail.com
FASSAKHOV RUSTEM S., SCOPUS Author ID : 6507842427, D. Med. Sci., professor of Kazan (Federal) State University, Russia, Kazan, Kremlevskaya str., 18, tel. +7- 987-296-19-28, e-mail: farrrus@mail.ru
KHAMITOV RUSTEM F., D. Med. Sci., professor, Head of the Department of internal diseases № 2 of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-917-272-96-72, e-mail: rhamitov@mail.ru
VAVASHKINA EKATERINA A., pulmonologist of Medical station № 1 of Ioshkar-Ola, Russia, 424000, Ioshkar-Ola, Vodoprovodnaya str., tel. +7-905-008-24-42, e-mail: pulmonolog.rme@yandex.ru
VIZEL IRINA YU., C. Med. Sci., assistant of professor of the Department of phthisiopulmonology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-903-388-71-64, e-mail: tatpulmo@mail.ru
VOROBIOVA NATALIYA B., pulmonologist of Medical center «Tanar», Russia, 423800, Nabereznie Chelni, Young Lenintsev ave., 3a (27/22a), tel. +7-917-294-73-15, e-mail: nataliavorobeva61@mail.ru
KULBAISOV AMIRZHAN M., C. Med. Sci., Head of the Department of pulmonology of Orenburg Regional Clinical Hospital № 2, Russia, 460000, Orenburg, Nevelskaya str., 24, tel. +7-903-360-89-74, e-mail: kul60@yandex.ru
KOSTINA ELENA M., D. Med. Sci., professor of the Department of allergology and immunology of Penza Medical Refresher Institute, Russia, 440060, Penza, Stasov str., 8a, tel. +7-905-367-58-14, e-mail: elena-kostina-br@rambler.ru
KUNYAEVA TATIANA A., C. Med. Sci., associate professor of the Department of outpatient therapy with the course of public health and health organization of National Research Ogarev Mordovia State University, Russia, 430005, Saransk, Bolshevistskaya str., 68, tel.+7-927-175-53-18, e-mail: kunya_eva@mail.ru
PAVLOV PETR I., Head of the Department of pulmonology of Republican Clinical Hospital of Ministry of Health of the Chuvash Republic, Russia, 428018, Cheboksari, Moskovskiy ave., 9, tel. +7-927-854-72-24, e-mail: pi_pavlov@mail.ru
PESKOV ANDREW B., D. Med. Sci., professor of the Department of postgraduate education and family medicine of Ulyanovsk State University, Russia, 432017, Ulyanovsk, Tolstoy str., 42, tel. +7-903-320-17-11, e-mail: abp_sim@mail.ru
POSTNIKOVA LARISA B., D. Med. Sci, associate professor, professor of the Department of internal diseases, Head of Municipal Pulmonology Advisory Center of City Hospital № 28, Russia, 426039, Nizhny Novgorod, Chaadaev str., 7, tel. 8-910-390-64-37, e-mail: plbreath@mail.ru
STARODUBTSEVA OKSANA I., С. Med. Sci, Head of the Department of pulmonology of the First Republic Clinical Hospital of Ministry of Health of Udmurtia, Russia, 426039, Izhevsk, Votkinskoe shosse, 57, tel. +7-912-458-70-56, e-mail: staroduboksan@mail.ru
SUSHENTSOV VADIM G., Head of the Department of pulmonology of Medical station № 1 of Ioshkar-Ola, Russia, 424000, Ioshkar-Ola, Vodoprovodnaya str., 83b, tel. +7-937-939-38-32, e-mail: vadiksushentsov@mail.ru
FARKHUTDINOV USMAN R., D. Med. Sci., professor of the Department of internal diseases of Bashkir State Medical University, Head of the Department of pulmonology of City Clinical Hospital № 21, Russia, 450000, Ufa, Lenin str., 3, tel. +7-917-431-00-66, e-mail: babe@bk.ru
Abstract. Aim. To summarize the opinions of experts in respiratory medicine on a new approach in COPD treatment using dual bronchodilation with LAMA/LABA fixed dose combination (FDC). Material and methods. A collaborative analysis of randomized clinical trials data and real practice experience has been performed. Results and conclusions. Based on discussion the consensus about LAMA/LABA FDC and tiotropium/olodaterol (T/O) FDC role in COPD treatment was developed by the experts. The role of tiotropium as a standard treatment for all the COPD patients’ categories has been endorsed. Based on existing data conclusion has been developed that T/O FDC reduce COPD exacerbation rate and have significant advantages in effects on bronchial obstruction, lung hyperinflation, dyspnea and quality of life in COPD patients stages II—IV. Pronounced clinical advantages of T/O in comparison with tiotropium can be observed form stage II of COPD. Conclusion. The T/O combination has comparable safety with tiotropium monotherapy and placebo. T/O is indicated for patients with low risk and higher symptom burden (category B), as well as for patients with a high risk of exacerbations (categories C and D).
Key words: COPD, double bronchodilation, tiotropium, olodaterol.
For reference: Shmelev EI, Zhestkov AV, Vizel AA et al. Optimization of chronic obstructive pulmonary disease treatment: the way to double bronchodilation (conclusion of the expert council of the Volga Federal District of Russia). The Bulletin of Contemporary Clinical Medicine. 2016; 9 (3): 82—89.
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