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ORIGINAL RESEARCH

Systemic immunotherapy with recombinant IL-2 in a complex treatment of abdominal sepsis. Anisimov A.Yu.(Russia, Kazan), Andreev A.I. (Russia, Kazan), Ibragimov R.A. (Russia, Kazan), Loginov A.V. (Russia, Kazan), Galeev B.R. (Russia, Kazan), Kalimullin I.A.(Russia, Kazan) P. 8

Prognosis in patients with heart failure and concomitant chronic obstructive pulmonary disease. Gazizyanova V.M. (Russia, Kazan), Bulashova O.V. (Russia, Kazan), Shaikhutdinova Z.A. (Russia, Kazan), Yafarova R.A. (Russia, Kazan) P.15

Risk factors of ischemic cardioembolic stroke. Ibragimova G.Z. (Russia, Kazan), Sabirova A.R. (Russia, Kazan), Bilalova R.R. (Russia, Kazan), Akhtereev R.N.(Russia, Kazan) P.20

Patient selection for anterior abdominal wall hernias surgery with postoperative wound complications prevention. Izmailov A.G. (Russia, Kazan), Dobrokvashin S.V. (Russia, Kazan), Volkov D.E. (Russia, Kazan), Pyrkov V.A. (Russia, Kazan), Zakirov R.F. (Russia, Kazan), Davlet-Kildeev Sh.A. (Russia, Kazan), Akhmetzyanov R.F. (Russia, Kazan) P.30

Patient selection for anterior abdominal wall hernias surgery with postoperative wound complications prevention. Izmailov A.G. (Russia, Kazan), Dobrokvashin S.V. (Russia, Kazan), Volkov D.E. (Russia, Kazan), Pyrkov V.A. (Russia, Kazan), Zakirov R.F. (Russia, Kazan), Davlet-Kildeev Sh.A. (Russia, Kazan), Akhmetzyanov R.F. (Russia, Kazan) P.30

Destructive forms of diabetic osteoarthropathy. Surgical aspects. Korejba K.A. (Russia, Kazan) P.35

The role of hospital nurses in training and rehabilitation patients with bronchial asthma. Palmova L.Yu. (Russia, Kazan), Ishmurzin G.P. (Russia, Kazan), Podolskaya A.A. (Russia, Kazan) P.41

Chronic heart failure in real clinical practice. Podolskaya A.A. (Russia, Kazan), Palmova L.Yu. (Russia, Kazan), Shaikhutdinova Z.A. (Russia, Kazan) P.46

Influence of the history of gestational hypertension on total cardiovascular risk in menopausal women. Sadykova A.R. (Russia, Kazan), Shamkina A.R. (Russia, Kazan), Sadykova A.M. (Russia, Kazan), Sadykova D.R. (Russia, Kazan) P.50

Change in memory disorders and compliance in patients with anemia. Salimova L.M. (Russia, Kazan), Okurlu A.F. (Russia, Kazan), Khamitov R.F. (Russia, Kazan), Molostvova A.F. (Russia, Kazan), Zakharova I.A. (Russia, Kazan) P.55

Coronary computed tomography angiography in patients with ischemic heart disease. Frolova E.B. (Russia, Kazan), Kurochkin S.V. (Russia, Kazan), Tsybulkin N.A. (Russia, Kazan), Gaynutdinova L.I. (Russia, Kazan), Rychkova V.S. (Russia, Kazan) P.59

Factors associated with contrast-induced acute kidney injure after endovascular intervention on the coronary arteries in patients with myocardial infarction. Yakupov I.F. (Russia, Kazan), Melnichuk M.A. (Russia, Kazan), Samsonova D.S. (Russia, Kazan), Khastieva D.R. (Russia, Kazan), Shamsutdinova D.M. (Russia, Kazan), Khasanov N.R. (Russia, Kazan) P.64

REVIEWS

Exercises in the management of rheumatoid arthritis.Abdrahmanova A.I. (Russia, Kazan), Ustinova S.M.(Russia, Kazan), Amirov N.B. (Russia, Kazan).68 Pectinate muscles of the right atrium. Ibragimova G.Z. (Russia, Kazan), Bilalova R.R. (Russia, Kazan), Shaykhutdinova Z.A. (Russia, Kazan) P.73

«The red flags» of vertigo. Kazantsev A.Yu. (Russia, Kazan), Yakupov E.Z. (Russia, Kazan) P.77

Pharmacological treatment of chronic pain in geriatric patients (a review). Pasynkova O.O. (Russia, Yoshkar-Ola), Krasilnikov A.V. (Russia, Yoshkar-Ola),Klyushkin I.V. (Russia, Kazan), Pasynkov D.V. (Russia, Yoshkar-Ola) P.81

Dyspnea in patients of therapeutic profile: issues of terminology, pathogenesis, assessment prognosis.Khazova E.V. (Russia, Kazan), Bulashova O.V. (Russia, Kazan), Frolova E.B. (Russia, Kazan), Malkova M.I. (Russia, Kazan), Zaynullina Ju.I. (Russia, Kazan)  P.93(Russia, Kazan), Frolova E.B. (Russia, Kazan), Malkova M.I. (Russia, Kazan), Zaynullina Ju.I. (Russia, Kazan)  P.93

ORGANIZATION OF HEALTHCARE

The role of a nurse of management patients with polytrauma in emeregency department in a multidisciplinary hospital. Chikaev V.F. (Russia, Kazan), Klyushkin I.V. (Russia, Kazan), Melnikov E.A. (Russia, Kazan), Sadriev R.R. (Russia, Kazan), Zinatullina N.Ya. (Russia, Kazan) P.101

PRACTICAL EXPERIENCE

Coronary, but not ischemic anemia masks. Oslopov V.N. (Russia, Kazan), Khazova E.V. (Russia, Kazan), Khabibullina R.T. (Russia, Kazan), Oslopova D.V. (Russia, Kazan), Khanaphieva A.L. (Russia, Kazan), Oslopova Ju.V. (Russia, Kazan),Malkova M.I. (Russia, Kazan), Delian A.M. (Russia, Kazan) P.105

CLINICAL CASE

Type 2B multiple endocrine neoplasia syndrome (clinical case). Valeeva F.V. (Russia, Kazan), Yilmaz T.S.(Russia, Kazan), Ibragimova S.R. (Russia, Kazan), Khuseyeva P.A. (Russia, Kazan), Shaydullina M.R.(Russia, Kazan), Petrova T.A. (Russia, Kazan) P.119

Combined disturbances of heart rhythm in cardiology department. Frolova E.B. (Russia, Kazan), Tsybulkin N.A. (Russia, Kazan), Slepukha E.G. (Russia, Kazan), Gaynutdinova L.I. (Russia, Kazan) P.122

Clinical case of acute complication in patient with chronic obstructive pulmonary disease. Khamitov R.F.(Russia, Kazan), Salimova L.M. (Russia, Kazan), Mingaleeva G.F. (Russia, Kazan), Zinnatullina A.R.(Russia, Kazan), Fatykhova K.R. (Russia, Kazan),Molostvova A.F. (Russia, Kazan), Khairullina A.R.(Russia, Kazan), Zakirova A.K. (Russia, Kazan) P.129

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ORIGINAL RESEARCH

UDC [616.94-02:616.381-002.3]-085.37

DOI: 10.20969/VSKM.2019.12(5).7-14

PDF download SYSTEMIC IMMUNOTHERAPY WITH RECOMBINANT IL-2 IN A COMPLEX TREATMENT OF ABDOMINAL SEPSIS

ANISIMOV ANDREI YU., ORCID: 0000-0003-4156-434X; D. Med. Sci., professor, Head of the Department of emergency medical care of Kazan State Medical Academy – branch of Russian Medical Academy of Continuing Professional Education; Chief freelance specialist surgeon and transplant surgeon of the Ministry of Health of Tatarstan Republic; Chief specialist in surgery of City Clinical Hospital No 7, Russia, 420012, Kazan, Butlerov str., 36, tel. +7-987-297-16-54, e-mail: aanisimovbsmp@yandex.ru

ANDREEV ANDREI I., ORCID: 0000-0003-0788-9845; C. Med. Sci., Head of the Department of surgery No 4 of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuikov str., 54, e-mail: aandreyi@yandex.ru

IBRAGIMOV RINAT A., ORCID: 0000-0003-0788-9845; C. Med. Sci., surgeon of the Department of surgery No 4 of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuikov str., 54, e-mail: rinatibr@mail.ru

LOGINOV ALEXANDER V., ORCID: 0000-0002-0999-5943; C. Med. Sci., emergency department surgeon of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuikov str., 54, e-mail: 613310@bk.ru

GALEEV BULAT R., ORCID: 0000-0002-3470-9603; surgeon of the Department of surgery No 4 of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuikov str., 54, e-mail: krankel@mail.ru

KALIMULLIN IREK A., ORCID: 0000-0002-8519-8700; surgeon of the Department of surgery No 4 of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuikov str., 54, e-mail: dr.kia@bk.ru

Abstract. Aim. Тo study the clinical efficacy of recombinant human IL-2 in complex treatment of diffuse peritonitis complicated by abdominal sepsis. Material and methods. In accordance with evidence-based medicine recommendations, a single blind, randomized, controlled study of 64 patients with secondary advanced purulent peritonitis complicated by sepsis defined by ACCP/SCCM classification was performed. Subjects were placed into two groups: study group (20 patients) in a comprehensive treatment program with recombinant human IL-2 injection and control group (44 patients) who underwent traditional intensive therapy. The effects of the two treatment regimens on outcome such as clinical effect, predicted and actual mortality, number and nature of immediate postoperative period complications, the detoxification and immunocorrective effect were investigated. Results and discussion.Patients received recombinant human IL-2 in two doses of 500 000 ED every 48 hours by intravenous injections had decrease APACHE II score from 21,3+0,6 to 10,1+0,4; reduced the number of complications in the immediate postoperative period, from 68,2 to 35,0%; reduced fatality rate from 22,7 to 15,0%; reduces length of hospitalization in patients with a favorable outcome from (29,4±4,6) to (19,7±3,7) days. No serious side effects have been reported when using recombinant human IL-2. The drug was well tolerated by patients with abdominal sepsis and was convenient in emergency abdominal surgery practice. Conclusion. Systemic immunotherapy with recombinant human IL-2 showed not only detoxifying, but also immunocorrecting effect, and possibly provided gastrointestinal tract motility stimulation. Systemic immunotherapy recombinant human IL-2 is not a single method of treatment. It should be combined with the rest of the routine treatment complex.

Key words: peritonitis, abdominal sepsis, systemic immunotherapy, recombinant IL-2.

For reference: Anisimov AYu, Andreev AI, Ibragimov RA, Loginov AV, Galeev BR, Kalimullin IA. Systemic immunotherapy with recombinant il-2 in a complex treatment of abdominal sepsis. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (5): 7-14. DOI: 10.20969/VSKM.2019.12(5).7-14.

References

1. Malangoni M.A. Current Concepts in Peritonitis. Current Gastroenterology Reports. 2003, 5 (4): 295–301. DOI: 10.1007/s11894-003-0066-y.

2. Mazuski JE, Solomkin JS. Intra-abdominal infections. Surg Clin North Am. 2009, 89 (2): 421-437. PMID: 19281892. DOI: 10.1016/j.suc.2008.12.001.

 3. Atema JJ, Gans SL, Boermeester MA. Systematic review and meta-analysis of the open abdomen and temporary abdominal closure techniques in non-trauma patients. World Journal of Surgery. 2015; 39 (4): 912-925. DOI: 10.1007/s00268-014-2883-6.

 4. Sartelli M, Chichom-Mefire A, Labricciosa FM, et al. The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intraabdominal Infections. World Journal of Emergency Surgery. 2017; 12: 29-63. DOI: 10.1186/s13017-017-0141-6.

5. Rossiiskoe obshestvo hirurgov [Russian society of surgeons]. Klinicheskie rekomendacii Ostrii peritonit [Clinical guidelines Acute peritonitis]. 2017; 91 p. http:// xn-9sbdbejx7bdduahou3a5d.xn--p1ai/upload/nkr_peritonit_ ispr_1-3.pdf

6. Chernish ER, Leplina OY, Tishonova MA et al. Zitokinovii balans v patogeneze sistemnogo vospalitelnogo otveta: novaya mishen immunoterapevticheskish vozdeistvii pri lechenii sepsisa [Cytokine balance in the pathogenesis of systemic inflammatory response: a new target of immunotherapeutic effects in the treatment of sepsis]. Med Immunologiya [Medical immunology]. 2001; 3 (3): 415-429.

7. Kozlov VK. Immunopatogenez I zitokinoterapiya shirurgicheskogo sepsisa [Immunopathogenesis and cytokine therapy of surgical sepsis]. Posobie dlya vrachei [Manual for doctors]. SPb: Yasnii Svet [Clear Light]. 2002; 48 p.

8. Ostanin AA, Chernish ER. Effektivnost zitokinoterapii ronkoleikinom v kompleksnom lechenii shirurgicheskish infekzii [Tsitokininami the effectiveness of Roncoleukin in the complex treatment of surgical infections]. Posobie dlya vrachei [Manual for doctors]. SPb: Izdatelstvo S-Peterburgskogo universiteta [St Petersburg University Press]. 2002; 28 p.

9. Еryshin IA, Bagnenko SF, Grigoriev EG, et al. Аbdominalnaya shirurgicheskaya infekziya: sovremennoe sostoyanie I blighaishee budushee v reshenii aktualnoi klinicheskoi problemi [Abdominal surgical infection: current state and near future in solving the actual clinical problem]. Infekcii v shirurgii [Infections in surgery]. 2007; 5 (1): 6-11.

10. Ward NS, Levy MM. Sepsis; Definitions, Pathophysiology and the Challenge of Bedside Management. Springer International Publishing AG. 2017; 271 p. DOI: 10.1007/978-3-319-48470-9.

11. Anisimov AY. Immunoterapiya Ronkoleikinom v kompleksnom lechenii bolnish abdominalnim sepsisom [Roncoleukin immunotherapy in the complex treatment of patients with abdominal sepsis]. Posobie dlya vrachei [Manual for doctors]. Kazan. 2004; 28 p.

12. Sartelli M, Abu-Zidan FM, Labricciosa FM, et al. Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) Study: a WSES observational study. World Journal of Emergency Surgery. 2019; 14: 34-45. DOI: 10.1186/s13017-019-0253-2.

13. Fletcher R, Fletcher S, Vagner E. Klinicheskaya epidemiologiya; Osnovi dokazatelnoi medicine [Clinical epidemiology; Fundamentals of evidence-based medicine]. Moskva: Media Sphera [Moscow: Media Sphere]. 1998; 347 p.

14. Lebedev VF, Kozlov VK, Gavrilin SV, et al. Immunoterapiya rekombinantnim interleikinom-2 tyaghelish ranenii I travm [Immunotherapy with recombinant interleukin-2 severe wounds and injuries]. SPb: Izdatelstvo S-Peterburgskogo universiteta [St Petersburg University Press]. 2002; 72 p.

15. Fedorov VD, Gostishev VK, Ermolov AS, Bognitskaya TN. Sovremennie predstavleniya o klassifikazii peritonita I sistemash ocenki tyagesti sostiyaniya bolnish [Modern concepts of classification of peritonitis and systems for assessing the severity of patients]. Shirurgiya [Surgery]. 2000; 4: 58-62.

16. Rebrova OY. Statisticheskii analiz medicinskish dannish; Primenenie paketa prikladnish program STATISTICA [Statistical analysis of medical data. Application of the STATISTICA application package]. Мoskva: Меdia Sfera [Moscow: Media Sphere]. 2006; 305.

 

UDC 616.12-008.46-036.12-06:616.24-036.12

DOI: 10.20969/VSKM.2019.12(5).15-19

PDF download PROGNOSIS IN PATIENTS WITH HEART FAILURE AND CONCOMITANT CHRONIC OBSTRUCTIVE PULMONARY DISEASE

GAZIZYANOVA VIOLETTA M., ORCID ID: 0000-0002-5601-8360; C. Med. Sci., assistant of professor of the Department of propedeutic internal disease of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: sunnу.gazizyanova@list.ru

BULASHOVA OLGA V., ORCID ID: 0000-0002-7228-5848; D. Med. Sci., professor of the Departmen of propedeutic internal disease of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: boulashova@yandex.ru

SHAIKHUTDINOVA ZULFIA A., deputy Head physician of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuykov str., 54

YAFAROVA RUMIA A., Head of the Department of therapy No 2 of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuykov str., 54

Abstract. Multimorbidity is a specific characteristic of the modern patient with chronic heart failure (CHF) which significantly changes clinical course, prognosis, leads to socio-economic losses. The goal is to study the clinical featuresand prognosis of patients with CHF in combination with chronic obstructive pulmonary disease (COPD). Material and methods. The study included 183 patients with stable CHF, including 105 with CHF combined with COPD. The clinical phenotype evaluated by 6-minute walk test (6-MWT), spirometry, echocardioscopy, clinical condition scale and quality of life assessment. The end points during the year were the following: all-cause mortality, cardiovascular mortality, myocardial infarction, stroke, pulmonary embolism, and hospitalization rates due to acute decompensation of CHF.Results and discussion.The clinical phenotype of CHF combined with COPD was characterized by a high frequency of smoking, low quality of life and poor exercise tolerance. Cardiovascular mortality in comorbid pathology was 4,0%, in CHF without COPD – 4,6%; myocardial infarction was observed 1,7 times more often with lung disease than in patients with CHF only (16,8 and 10,8%); stroke was observed exclusively in comorbid pathology (8,9%). The combined endpoint (all cardiovascular events) with CHF in combination with COPD was achieved 2,3 times more often in comparison with patients with CHF only (29,7 and 15,4%; p<0,05). Hospitalization due to acute decompensation of CHF occurred 2 times more often with CHF in combination with COPD than without it (32,7 and 15,4%). Conclusion. The results ofthe study demonstrate that COPD contributes to the formation of the clinical phenotype of CHF from the standpoint of the mutual influence of the characteristics of the cardiovascular and respiratory systems, and also aggravates the prognosis that requires an integrated approach to the differential diagnosis and individualization of pharmacotherapy.

Key words: prognosis, chronic heart failure, chronic obstructive pulmonary disease.

For reference: Gazizyanova VM, Bulashova OV, Shaikhutdinova ZA, Yafarova RA. Prognosis in patients with heart failure and concomitant chronic obstructive pulmonary disease. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (5): 15-19. DOI: 10.20969/VSKM.2019.12(5).15-19.

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2. Chen W, Thomas J, Sadatsafavi M. Risk of cardiovascular comorbidity in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. Lancet Respiratory Medicine. 2015; 3 (8): 631–639.

3. Rutten FH, Cramer MJ, Grobbee DE. Unrecognized heart failure in elderly patients with stable chronic obstructive pulmonary disease. European Heart Journal. 2005; 26 (18): 1887-1894.

4. Melenovsky V, Andersen MJ, Andress K. Lung congestion in chronic heart failure: haemodynamic, clinical, and prognostic implications. European journal of heart failure. 2015; 17: 1161-1171.

5. Polikutina OM, Slepyunina YuS, Bazdyurev ED. COPD ‒ marker neblagopriyatnogo otdalyennogo prognoza infarcta myocarda [COPD ‒ marker of unfavorable prognosis in myocardial infarction patients]. Sibirskoye medicinskoye obozrenie [Siberian medical review]. 2016; 1: 48-55.

6. Schwab P, Dhamane AD, Hopson SD. Impact of comorbid conditions in COPD patients on health care resource utilization and costs in a predominantly Medicare population. International Journal of COPD. 2017; 12: 735–744.

7. Hawkins NM, Huang Z, Pieper KS. Chronic obstructivepulmonary disease is an independent predictor of deathbut not atherosclerotic events in patients with myocardial infarction: analysis of the Valsartan in Acute Myocardial Infarction trial (VALIANT). European Journal of heart failure. 2009; 11: 292-298.

8. Lahousse L, Niemeijer MN, van den Berg ME. Chronic obstructive pulmonary disease and sudden cardiac death: the Rotterdam study. European Heart Journal. 2015; 36: 1754–1761.

9. Iversen KK, Kjaergaard J, Akkan D. The prognostic importance of lung function in patients admitted with heart failure. European journal of heart failure. 2010; 12: 685-691.

10. Agarwal SK, Heiss G, Barr RG. Airflow obstruction, lung function, and risk of incident heart failure: Atherosclerosis Risk in communities (ARIC) study. European journal of heart failure. 2012; 14: 414-422.

11. Plesner LL, Dalsgaard M, Schou M. The prognosticsignificance of lung function in stable heart failureoutpatients. Clinical Cardiology. 2017; 1-7.

12. Karoli NA, Borodkin AV, Rebrov AP. Chronizheskaya serdechnaya nedostatochnost razlichnogo geneza u bolnyh chronicheskoy obstructivnoi bolezhnu lyegkih [Chronic heart failure different ethyology in COPD patients]. Pulmonologiya [Pulmonology]. 2016; 26 (1): 38-45.

13. Canepa M, Migaj ES, Drozdz J. Characteristics, treatments and 1-year prognosis of hospitalized and ambulatory heart failure patients with chronic obstructive pulmonary disease in the European Society of Cardiology Heart Failure Long-Term Registry. European Journal of Heart Failure. 2018; 20: 100–110.

14. Eriksson B, Wandell P, Dahlstrom U. Comorbidities, risk factors and outcomes in patients with heart failure and an ejection fraction of more than or equal to 40% in primary care- and hospital care-based outpatient clinics. Scandinavian journal of primary health care. 2018; 36 (2): 207–215.

 

UDC 616.831-005-02

DOI: 10.20969/VSKM.2019.12(5).20-24

PDF download RISK FACTORS OF ISCHEMIC CARDIOEMBOLIC STROKE

IBRAGIMOVA GULNARA Z., doctor of ultrasonic diagnostics of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuykov str., 54, tel. +7-937-282-48-51, e-mail: morgens_vesna@mail.ru

SABIROVA AIGUL R., doctor of ultrasonic diagnostics of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuykov str., 54

BILALOVA RESEDA R., doctor of functional diagnostics of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuykov str., 54

AKHTEREEV RAVIL N., cardiologist and ultrasound diagnostics of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuykov str., 54

Abstract. Cardioembolic stroke is very heterogeneous in etiology, pathogenesis, course, and prognosis. It’s often associated with severe residual motor, speech, coordination disorders, high risk of relapse and a significant decrease in the quality of life. Timely recognition of the cardiac cause of stroke and optimal prevention strategy determination is extremely important. The purpose of the study was to identify significance of cardioembolic stroke risk factors in patients admitted to neurological department. Material and methods. In a retrospective study conducted in regional hospital No 7, data were collected on 100 cardioembolic stroke cases admitted in 2019. Anamnesis, neurological examination, neuroimaging (brain CT scan), extracranial sonography (ECS), transcranial Doppler sonography (TCDS), echocardiography (ECHO), electrocardiography (ECG), laboratory tests (lipid profile, glucose) were retrieved for analysis. Results and discussion. Recurrent cardioembolic stroke occurred in more than 50%. The median age was 74 years. The main risk factors were: atrial fibrillation, arterial hypertension, hyperglycemia. Persistent form of fibrillation dominated, which proves its high prevalence in patients with cardioembolism. According to the ultrasound examination, more than 80% had atherosclerotic changes of extracranial vessels, but the average percentage of stenosis was 36%. That proves the low value of atherosclerotic plaques in extracranial vessels in the development of cardioembolic stroke. On ECHO, more than 80% had hypertrophy of the walls and calcification of the valves. Conclusion. Cardiac pathology in the development of stroke is of key importance and requires a focused cardiac examination, a comprehensive approach to the treatment and prevention of cardioembolism.

Key words: cardioembolic stroke, risk factors, atrial fibrillation (AF), ischemic stroke (AI).

For reference: Ibragimova GZ, Sabirova RA, Bilalova RR. Akhtеreev RN. Risk factors of ischemic cardioembolic stroke. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (5): 20-24. DOI: 10.20969/VSKM.2019.12(5).20-24.

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13. Damulin IV, Andreev DA, Salpagarova ZK. Kardioembolicheskiy insul’t [Cardioembolic stroke]. Nevrologiya, neyropsikhiatriya, psikhosomatika [Neurology, neuropsychiatry, psychosomatic medicine]. 2015; 1: 80-86.

14. Parfenov A. Faktory riska povtornogo ishemicheskogo insul’tai yego profilaktika [Risk factors for recurrent ischemic stroke and its prevention]. Nevrologiya, neyropsikhiatriya, psikhosomatika [Neurology,neuropsychiatry, psychosomatic medicine]. 2010; 2 (3): 40-46.

15. Danilov VI, Hasanova E. Insul’t. Sovremennyye podkhody diagnostiki, lecheniya i profilaktiki: metodicheskiye rekomendatsii [Stroke; Modern approaches to the diagnosis, treatment and prevention: methodical recommendations]. Moskva: GEOTAR-Media [Moscow: GEOTAR-Media]. 2014; 248 p.

16. Damulin IV, Andreev DA. Fibrillyatsiya predserdiy i insul’t [Atrial fibrillation and stroke]. Rossiyskiy meditsinskiy zhurnal [Russian medical journal]. 2015; 21 (6): 41–45.

17. Tibekina LM, Dorofeeva MS, Sherbak YA. Kardioembolicheskiy insul’t: etiologiya, patogenez, faktory riska gemorragicheskoy transformatsii [Cardioembolic stroke: etiology, pathogenesis, risk factors of hemorrhagic transformation]. Vestnik Sankt-Peterburgskogo Universiteta [Bulletin of St Petersburg University]. 2014; 1 (1): 104-117.

 

UDC 616.132.2-085.2/.3-07

DOI: 10.20969/VSKM.2019.12(5).25-29

PDF download THE FREQUENCY OF CARDIOVASCULAR EVENTS AFTER ACS IN PATIENTS WITH DIFFERENT ADHERENCE TO THERAPY (data from a prospective study)

IVANTSOV EVGENIY N., postgraduate student of the Department of propedeutics internal diseases of Kazan State Medical University, Russia, Kazan, Butlerov str., 49, tel. +7-958-620-44-86, e-mail: zhenia.iva91@gmail.com

KIM ZULFIYA F., C. Med. Sci., associate professor of the Department of internal diseases of Kazan State Medical University, Russia, Kazan, Butlerov str., 49; deputy Head physician for the medical part of City Clinical Hospital No7, tel. +7-917-255-55-74, e-mail: profz@gmail.com

MAGAMEDKERIMOVA FERIDA A., postgraduate student of the Department of propaedeutics internal diseases of Kazan State Medical University, Russia, Kazan, Butlerov str., 49, tel. +7-937-771-40-64, e-mail: ferida_oradro.92@mail.ru KHASANOV NIYAZ R., D. Med. Sci., Head of the Department of propedeutics internal diseases of Kazan State Medical University, Russia, Kazan, Butlerov, 49, tel. +7-987-290-60-21, e-mail: ybzp@mail.ru

ZATEYSHCHIKOV DMITRIY A., D. Med. Sci., Head of the Department of therapy, cardiology and functional diagnostics with a course of nephrology of Central State Medical Academy of Presidential affairs office of the Russian Federation; Head of the Vascular Center of Clinical Hospital No 51 of the Moscow Health Department, Russia, Moscow, e-mail: dz@bk.ru Abstract. Aim. To study the frequency of cardiovascular events during the first year after acute coronary syndrome in patients with different adherence to therapy. Material and methods. This was a prospective observational study in acute coronary syndrome patients followed-up with phone calls at 1, 3, 6 and 12 months over 12 months after discharge. During telephone conversations with patients (and/or their relatives) adherence to the treatment and cardiovascular events (cardiovascular death, non-fatal myocardial infarction and stroke) were evaluated. Results and its discussion. It was found, that most of (92,3%) the major adverse cardiovascular events were observed in the first 6 months, and large part (61,5%) in the first 3 months after discharge. Discontinuing prescribed medicines for acute coronary syndrome was associated with an increase in major adverse cardiovascular events risk by 8,5 times, and cardiovascular death by 34,4 times during the first year after discharge. Conclusion. This findings emphasize the importance of dynamic surveillance of patients afeter acute coronary syndrome and increase patients’ adherence to recommended therapy.

Key words: acute coronary syndrome, adverse cardiovascular events, treatment compliance.

For reference: Ivantsov EN, Kim ZF, Magamedkerimova FA, Khasanov NR, Zateyshchikov DA. The frequency of cardiovascular events after ACS in patients with different adherence to therapy (data from a prospective study). The Bulletin of Contemporary Clinical Medicine. 2019; 12 (5): 25-29. DOI: 10.20969/VSKM.2019.12(5).25-29.

References

1. Khasanova LB et al. Dinamika letal’nosti patsiyentov s infarktom miokarda za pyat’ let (s 2011 po 2015 gg.) vzavisimosti ot izmeneniy taktiki khirurgicheskogo i medikamentoznogo lecheniyav GKB imeni SS Yudina [The dynamics of the lethality of patients with myocardase infarction for five years (from 2011 to 2015), dependingon changes in the tactics of surgical and drug treatmentat the City Clinical Hospital named after SS Yudina]. Sovremennyye problemy nauki i obrazovaniya (nauchnyy zhurnal) [Modern problems of science and education (scientific journal)] [Electronic resource]. URL: https://www. science-education.ru/ru/article/view?id=28557 (accessed: 07/19/2019).

2. McMillan MT, et al. Incorporation of Procedure-specific Risk Into the ACS-NSQIP Surgical Risk Calculator Improves the Prediction of Morbidity and Mortality After Pancreatoduodenectomy. Ann Surg. 2017; 265 (5): 978–986.

3. Sanchis-Gomar F, et al. Epidemiology of coronary heart disease and acute coronary syndrome. Ann Transl Med. 2016; 4 (13): 256–258.

4. Rosstat [Rosstat]. Rossiyskiy statisticheskiy yezhegodnik [Russian Statistical Yearbook]. Moskva [Moscow]. 2018; P76 M: 694 p.

5. Research Institute of Complex Problems of Cardiovascular Diseases et al. Results of 5-year monitoring of patients after myocardial infarction. Sib Med Rev. 2018; 3: 51–58.

6. Ho PM. Incidence of Death and Acute Myocardial Infarction Associated With Stopping ClopidogrelAfter Acute Coronary Syndrome. JAMA. 2008; 299 (5): 532.

7. Swieczkowski D, et al. Medication adherence in patients after percutaneous coronary intervention due to acute myocardial infarction: From research to clinical implications. Cardiol J. 2016; 23 (5): 483-490.

8. Kereiakes DJ, et al. DAPT Score Utility for Risk Prediction in Patients With or Without Previous Myocardial Infarction. J Am Coll Cardiol. 2016; 67 (21): 2492–2502.

9. Erlich AD. Shestimesyachnyye iskhody u patsiyentov s ostrym koronarnym sindromom, vklyuchennykh v Rossiyskiy registr REKORD-3 [Six-month outcomes in patients with acute coronary syndrome included in the Russian RECORD-3 registry]. Rossiyskiy kardiologicheskiy zhurnal [Russian Cardiology Journal]. 2017; 11 (151): 8-14.

10. Erlich AD. 12-month outcomes in patients with acute coronary syndrome included in the Russian RECORD-3 registry [12-mesyachnyyeiskhodyupatsiyentov s ostrym koronarnym sindromom, vklyuchennykh v Rossiyskiy registr REKORD-3]. Rossiyskiy kardiologicheskiy zhurnal [Russian Journal of Cardiology]. 2018; 3 (155): 23–30.

11. Aldrovandi A, et al. Major Adverse Cardiac Events and the Severity of Coronary Atherosclerosis Assessed by Computed Tomography Coronary Angiography in an Outpatient Population With Suspected or Known Coronary Artery Disease. J Thorac Imaging. 2012; 27 (1): 23–28.

12. Heianza Y, et al. Gut Microbiota Metabolites and Risk of Major Adverse Cardiovascular Disease Events and Death: A Systematic Review and Meta-аnalysis of Prospective Studies. J Am Heart Assoc. 2017; 6 (7): e004947.

 

UDC 616.34-07.43-089-06-084

DOI: 10.20969/VSKM.2019.12(5).30-34

PDF download PATIENT SELECTION FOR ANTERIOR ABDOMINAL WALL HERNIAS SURGERY WITH POSTOPERATIVE WOUND COMPLICATIONS PREVENTION

IZMAILOV ALEXANDER G., C. Med. Sci., associate professor of the Department of general surgery of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. 8-927-412-73-46, e-mail: izmailov_alex@mail.ru

DOBROKVASHIN SERGEY V., D. Med. Sci., professor, the Head of the Department of general surgery of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. 557-39-46, e-mail: gsurgery1@yandex.ru

VOLKOV DMITRY E., C. Med. Sci., associate professor of the Department of general surgery of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. (843) 557-39-26, e-mail: gsurgery1@yandex.ru

PYRKOV VYACHESLAV A., the Head of the Department of surgical of Hospital for veterans of wars in Kazan, Russia, 420039, Kazan, Isaev str., 5, tel. (843) 557-39-26, e-mail: pyrkovgvv@rambler.ru

ZAKIROV RUSTEM F., C. Med. Sci., doctor in the surgical department of Hospital for veterans of wars in Kazan, Russia, 420039, Kazan, Isaev str., 5, tel. (843) 557-39-26, e-mail: zakmurat@yandex.ru

DAVLET-KILDEEV SHAMIL A., doctor of surgical department of Hospital for veterans of wars in Kazan, Russia, 420039, Kazan, Isaev str., 5, tel. (843) 556-29-26, e-mail: i.fydfhsx51@yadex.ru

AKHMETZYANOV RADIK F., doctor of surgical department of Hospital for veterans of wars in Kazan, Russia, 420039, Kazan, Isaev str., 5, tel. (843) 556-29-26, e-mail: gsurgery1@yandex.ru 

Abstract. Hernias of the anterior abdominal wall observed in 5–7% of the total population, and about 70% of cases are inguinal hernias. The aim of the study was to improve the results of treatment of patients with anterior abdominal wall hernias by developing and implementing instrumental methods of surgical wound complications prevention. Material and methods. A study involved 509 patients aged 29 to 86 years, underwent surgical treatment for anterior abdominal wall hernias from 2013 to 2018 in the surgical department at the Hospital for war veterans in Kazan. An intra-abdominal pressure was measured before and after surgery of patients with large postoperative ventral hernias and inguinal-scrotal hernias. In the main group, in order to reduce the hollow-organ abdominal injuries risc, reduce tissue injury during allocation of the hernial sac and formation of a site for a synthetic endoprosthesis, a device for wound surface treating was used. When suturing the postoperative wound, a modified surgical needle was used. In the postoperative period for postoperative wounds cavity formations puncture, according to indications, a device made of a needle and a container of 15 ml with an antiseptic solution, forming a single sealed complex was used. Results and discussion. In 289 patients of the comparison group, seromas found, respectively, in 17 (5,9%), infiltrates, in 5 (1,7%) patients and 2 (0,7%) cases of hematoma. In 220 patients of the main group seroma was noted in 6 cases (2,7%), the presence of infiltration in 2 (0,9%) patients. Conclusion. We developed complex instrumental technology in surgical operations for hernias of the anterior abdominal wall, allowed to reduce the time of surgery, trauma to the tissues, hollow-organ abdominal injuries risc, and reduced the number of wound complications to 3,6%.

Key words: hernial protrusion, seroma, device for puncture, device for treatment of the wound surface, surgical needle.

For reference: Izmailov AG, Dobrokvashina SV, Volkov DE, Pyrkov VA, Zakirov RF, Davlet-Kildeev ShA, Akhmetzyanov RF. Patient selection for anterior abdominal wall hernias surgery with postoperative wound complications prevention. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (5): 30-34. DOI: 10.20969/VSKM.2019.12(5).30-34.

References

  1. Kirienko AI, Shevcov YuN, Nikishov AS, et al. Rasprostranennost’ gryzh perednej bryushnoj stenki: rezul’taty populyacionnogo issledovaniya [Prevalence of the anterior abdominal wall hernias: results from a population-based study]. Hirurgiya [Surgery]. 2016; 6: 61-66.

  2. Lavreshin PM, Efimov AV, Gobejishvili VK, et al. Posleoperatsionnyye ventral’nyye gryzhi: vybor plastiki gryzhevykh vorot [Postoperative ventral hernia: hernial ring selection plastics]. Vestnik Natsional’nogo mediko – khirurgicheskogo tsentra imeni NI Pirogova [Journal of the National Medical – Surgical Center named NI Pirogov]. 2015; 2: 61-64.

  3. Abbaszade TN, Andreev AI, Anisimov AY. Profilaktika rannikh posleoperatsionnykh ranevykh oslozhneniy pri gernioplastiki bol’shikh ventral’nykh gryzh [The prevention of early postoperative wound complications at large hernia repair ventral hernias]. Vestnik sovremennoy klinicheckoy meditsiny [Bulletin of modern clinical medicinec]. 2015; 8 (1): 11-18.

  4. Mukhtarov ZM, Malkov IS, Alishev OT. Profilaktika ranevykh posleoperatsionnykh oslozhneniy u bol’nykh s posleoperatsionnymi ventral’nymi gryzhami [The prevention of postoperative wound complications in patients with postoperative ventral hernias]. Prakticheskaya meditsina [Practical Medicine]. 2014; 5 (81): 106-109.

5. Belokonev VI, Pushkin SYu, Kovaleva ZV. Perednyaya proteziruyushchaya gernioplastika kombinirovannym sposobom pri bol’shih i gigantskih ventral’nyh gryzhah [Anterior prosthetic hernioplasty by combined method in large and giant ventral hernias]. Hirurgiya; Zhurnal imeni NI Pirogova [Surgery; Journal named by NI Pirogova]. 2018; 5: 45–50.

6. Belokonev VI. Patogenez i hirurgicheskoe lechenie posleoperacionnyh ventral’nyh gryzh. [Pathogenesis and surgical treatment of postoperative ventral hernias]. Samara: Perspektiva, [Perspective]. 2005; 208 p.

7. Trushin SN, Romanov AN, Polyakov AV. Problema ranevyh oslozhnenij v hirurgii incizionnyh ventral’nyh gryzh [Problem of wound complications in the surgery of incisional ventral hernias]. Zhurnal Zemskij vrach; Al’manah [Zemsky vrach (the Journal); Almanac]. 2017; 63-66.

8. Sonis AG, Grachev BD, Stolyarov EA, et al. Profilaktika i lechenie infekcionnyh ranevyh oslozhnenij pri proteziruyushchih gryzhesecheniyah [Prevention and treatment of infectious wound complications in prosthetic hernias]. Zhurnal imeni professora BM Kostyuchenka; Rany i ranevye infekcii (original’nye stat’i)[ Journal them Professor BM Kostyuchenko; Wounds and wound infections]. 2014; 1: 16–23.

9. Krasil’nikov DM, Minnullin MM, Zajnullin IV, Tolstikov AP. Hirurgicheskaya taktika pri ushchemlennyh posleoperacionnyh ventral’nyh gryzhah, oslozhnennyh kishechnoj neprohodimost’yu [Surgical tactics in treatment of strangulated postoperative ventral hernias complicated by bowel obstruction]. Prakticheskaya medicina [Practical medicine]. 2016; 4, 1(96): 130-133.

10. Samarcev VA, Gavrilov VA, Parshakov AA, et al. Zadnyaya separacionnaya gernioplastika TAR pri posleoperacionnyh ventral’nyh gryzhahW3 [Rear TAR separation hernia repair with postoperative ventral hernias W3]. Permskij medicinskij zhurnal [Perm medical journal]. 2017; 34 (1): 35–42.

11. Izmaylov SG, Lukoyanychev EE, Svetozarskiy NL, Butkevich ATs, Izmaylov AG, Kiselev MN, Semenov AG, Avdeev AS, Vorontsov AYu. Instrument dlya obrabotki ranevoy polosti [A tool for processing a wound cavity]. Patent RF No2565832//BI [Patent for utility model of the Russian Federation No2565832//BI]. 2015; 29.

12. Izmajlov AG, Dobrokvashin SV, et al. Ustrojstvo dlya mekhanicheskoj zatochki trekhgrannyh hirurgicheskih igl [Device for mechanical sharpening of trihedral surgical needles]. Patent na poleznuyu model’ RF No183422 [Patent for utility model of the Russian Federation RF No183422]. 21/09/2018.

13. Lukoyanychev EE, Izmailov SG, Izmailov AG, Sinyagina VG. Ustroystvo dlya vskrytiya polostnykh obrazovaniy [The device for opening the abdominal structures]. Patent na izobreteniya RF No2526246 [Patent for inventions of the Russian Federation No2526246]. 26/06/2014.

14. Degovcev EN, Kolyadko PV. Diagnostika i lechenie seromy posle gernioplastiki perednej bryushnoj stenki s ispol’zovaniem setchatogo implantata [Diagnosis andtreatment of seroma after hernioplasty of the anteriorabdominal wall using a mesh implant]. Hirurgiya [Surgery]. 2018; 1: 99.

15. Dobrokvashin SV, Izmajlov AG, Volkov DE, et al. Kliniko – instrumental’nyj kontrol’ za techeniem ranevogo processa pri urgentnyh zabolevaniyah organov bryushnoj polosti [Clinical and instrumental control over the course of the wound process in urgent diseases of abdominal cavity organs]. Prakticheskaya medicina [Practical medicine]. 2014; 5 (81): 38-41.

 

UDC [617.586-002.44-06:616.379-008.64]-089

DOI: 10.20969/VSKM.2019.12(5).35-40

PDF download DESTRUCTIVE FORMS OF DIABETIC OSTEOARTHROPATHY. SURGICAL ASPECTS

KOREJBA KONSTANTIN A., ORCID ID 0000-0002-0821-2249; C. Med. Sci., associate professor of the Department
of surgical diseases of Kazan State Medical University; Head manager of center «Diabetic foot», Russia, 420012, Kazan, Butlerov str., 49, tel. 8-917-259-47-47, e-mail: konkor038@gmail.com

Abstract. The purpose of the study was to evaluate the effectiveness surgical treatment of tissue defects in diabetic foot syndrome, based on the principles of evidence-based medicine and considering clinically significant phenomena – outcomes, based on a mathematical model for evaluating effectiveness. Material and methods. The study included25 patients treated from diabetic foot syndrome with bone structure abnormalities at «Diabetic Foot» center in Kazan and in the department of purulent surgery at the Clinic of the Medical University of Kazan in 2018–2019. According to the Wagner classification patients had grade 3, and 2–3 degree of arterial disease of the lower limbs of chronic arterial obstruction, according to the Fontein–Larissa–Pokrovsky classification. These patients were managed according to the method of treatment of the defect. Results and discussion. We evaluated clinically significant outcomes for patients: favorable and unfavorable, and various indicators of relative and absolute risks when using various treatment methods. We used mathematical formulas developed and adapted according to the principles of evidence-based medicine for data analysis. Conclusion. Treatment of bone and articular structures in diabetic foot syndrome with bioplastic material based on 15% of the gel form of native type 1 collagen and autologous growth factors is most justified decision. Tissue repair and relief of clinical manifestations of the disease, leaded to favorable outcomes in 90% of cases. In the treatment of bone and articular without the use of this technology, the adverse clinical outcome was 86%.

Key words: diabetic neuroosteoarthropathy, autologous growth factors, bioplastic materials, evaluation of the effectiveness of treatment of defects.

For reference: Korejba KA. Destructive forms of diabetic osteoarthropathy. Surgical aspects. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (5): 35-40. DOI: 10.20969/VSKM.2019.12(5).35-40.

References

  1. Mazovetskiy AG. Sakharnyy diabet [Diabetes]. Moskva: Meditsina [Moscow: Medicine]. 1987; 287 p.

  2. Bradshaw TV. Aetiopathogenesis in the Charcot foot: an overview. Practical Diabetes International. 1998; 15 (1): 22-24.

  3. Yefimov AS. Diabeticheskiye angiopatii [Diabetic angiopathy]. Moskva: Meditsina [Moscow: Medicine]. 1989; 287 p.

  4. Levin ME, O’Neal LW. The Diabetic Foot. London : Books oth Edition. 2001; 828 p.

  5. Gur’yeva IV. Profilaktika, lecheniye, mediko-sotsial’naya reabilitatsiya i organizatsiya mezhdistsiplinarnoy pomoshchi bol’nym s sindromom diabeticheskoy stopy: Avtoreferat dissertatsii [Prevention, treatment, medical and social rehabilitation and organization of interdisciplinary care for patients with diabetic foot syndrome: Abstract of the dissertation]. Moskva: Federal’nyy nauchno-prakticheskiy tsentr mediko-sotsial’noy ekspertizy i reabilitatsii invalidov i v Rossiyskoy meditsinskoy akademii poslediplomnogo obrazovaniya [Moscow: Federal Scientific and Practical Center for Medical and Social Expertise and Rehabilitation of Persons with Disabilities and at the Russian Medical Academy of Postgraduate Education]. 2001; 40 p.

6. Bensman VM. Khirurgiya gnoyno-nekroticheskikh oslozhneniy diabeticheskoy stopy [Surgery of purulentnecrotic complications of the diabetic foot]. Moskva: ID «Medpraktika-M» [Moscow: Publishing House Medpraktika-M]. 2015; 496 p.

7. Dedova II, Shestakovoy MV, Mayorova AYu, ed. Algoritmy spetsializirovannoy meditsinskoy pomoshchi bol’nym sakharnym diabetom, 9 vypusk [Algorithms for specialized medical care for patients with diabetes mellitus, 9th edition]. Moskva: UP PRINT [Moscow: UP PRINT]. 2019; 212 p.

8. Bensman VM, Savchenko YuV, Triandafilov KG. Funktsional’naya klassifikatsiya sindroma diabeticheskoy stopy i yeye prikladnoye znacheniye [Functional classification of diabetic foot syndrome and its applied value]. Vestnik sovremennoy klinicheskoy meditsiny [Bulletin of modern clinical medicine]. 2018; 11 (5): 12-16.

9. Zaytseva YeL. Klinicheskiye, morfologicheskiye i immunogistokhimicheskiye osobennosti reparatsii myagkikh tkaney nizhnikh konechnostey u bol’nykh s sindromom diabetichsekoy stopy na fone razlichnykh metodov mestnogo lecheniya: avtoreferat dissertatsii [Clinical, morphological and immunohistochemical features of the repair of soft tissues of the lower extremities in patients with diabetic foot syndrome against the background of various methods of local treatment: abstract of the thesis]. Moskva: Endokrinologicheskiy nauchnyy tsentr Minzdrava Rossii [Moscow: Endocrinological Research Center of the Ministry of Health of Russia]. 2015; 41 p.

10. Koreyba KA, Fatikhov IR, Gaziyev AR, Gaziyeva EG, Koreyba YeA. Sistema pomoshchi bol’nym s sindromom diabeticheskoy stopy: patent 2506894 RF, MPK 51 A61B5/00 [Assistance system for patients with diabetic foot syndrome: patent 2506894 Ros. Federation: IPC 51 A61B5/00]. Gosudarstvennoye Byudzhetnoye Obrazovatel’noye Uchrezhdeniye Vysshego Professional’nogo Obrazovaniya «Kazanskiy Gosudarstvennyy Meditsinskiy Universitet» Ministerstva zdravookhraneniya i sotsial’nogo razvitiya Rossiyskoy Federatsii [State Budgetary Educational Institution of Higher Professional Education «Kazan State Medical University» of the Ministry of Health and Social Development of the Russian Federation]. 2012135893, 21/08/2012; 20/02/2014.

11. Kotel’nikov GP, Shpigel’ AS. Dokazatel’naya meditsina; Nauchno-obosnovannaya meditsinskaya praktika: Monografiya [Evidence based medicine; EvidenceBased Medical Practice: Monograph]. Samara; SamGMU [Samara Samara State Medical University]. 2000; 19-24.

12. Voronin AS. Razrabotka i eksperimental’no-klinicheskoye obosnovaniye ispol’zovaniya fitoterapevticheskikh ranevykh pokrytiy v mestnom lechenii ran i ranevoy infektsii kozhi i myagkikh tkaney : avtoreferat dissertatsii [Development and experimental-clinical substantiation of the use of phytotherapeutic wound dressings in the local treatment of wounds and wound infections of the skin and soft tissues: abstract of the dissertation]. Volgograd: Volgogradskiy gosudarstvennyy meditsinskiy universitet [Volgograd: Volgograd State Medical University]. 2012; 22 p.

 

UDC 616.248-051:614.253.5

DOI: 10.20969/VSKM.2019.12(5).41-45

PDF download THE ROLE OF HOSPITAL NURSES IN TRAINING AND REHABILITATION PATIENTS WITH BRONCHIAL ASTHMA

PALMOVA LYUBOV YU., C. Med. Sci., assiociate professor of the Department of internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: palmova@bk.ru

ISHMURZIN GENNADY P., C. Med. Sci., assiociate professor of the Department of internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49

PODOLSKAYA ALLA A., C. Med. Sci., the Head of the Department therapeutic of City Clinical Hospital No 7 of Kazan; associate professor of the Department of internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49

Abstract. The aim of the research was to study satisfaction of patients with bronchial asthma with the educational role of nurses in therapeutic practice. Material and methods. A survey of 30 bronchial asthma (BA) patients was carried out in Therapeutic Department of Kazan Hospital with a 18 questions form. 10 nurses of the same Therapeutic Department were surveyed at the 2nd stage of the study. The questionnaire was anonymous and contained 10 closedended questions. The average age of patients was (60,5±3,07) years, among them were 18 women and 12 men.Results and discussion. The volume and quality of prescribed pharmacotherapy do not only determine BA course and control of asthma achievement, but also a various of non-drug factors. In achieving the necessary level of awareness, a significant role is given to nurses. The correctness of their actions directly determines the effectiveness of training, medical rehabilitation, and secondary prevention in patients with bronchial asthma. This study demonstrated an insufficient visiting of educational Asthma-schools (33%) by patients with BA, a low adherence of peak flow measurements, keeping a self-control diary (50%), nor doing physical exercise and breathing exercises (30%). Conclusions. Most patients with BA satisfied with educational activities carried out by nurses, but more than the half of them do not attend Asthma-schools (67%). Adherence to the implementation of the peak flow measurements and keeping a diary of self-control was also poor. These methods do not need large financial investments and should be close to 100% coverage of patients of this group. For higher efficiency of medical rehabilitation, it is necessary to systematize short-term recommendations and tips in specially developed programs of training schools by nurses.

Key words: bronchial asthma, nurse, training, rehabilitation.

For reference: Palmova LYu, Ishmurzin GP, Podolskaya AA. The Role of hospital nurses in training and rehabilitation patients with bronchial asthma. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (5): 41-45. DOI: 10.20969/ VSKM.2019.12(5).41-45.

References

  1. Ponomarenko GN. Medicinskaya reabilitaciya [Medical rehabilitation]. Moskva: GEOTAR-Media [Moscow: GEOTAR-Media]. 2014; 360 p.

  2. Nenasheva NM. Obostrenie bronhial’noj astmy: lechenie i profilaktika [Exacerbation of bronchial asthma: treatment and prevention]. Russkij medicinskij zhurnal [Russian medical journal]. 2013; 21 (29): 1490-1495. Islamova DA. Lechebnaya fizkul’tura kak element lecheniya i profilaktiki bronhial’noj astmy [Physical therapy as an element of treatment and prevention of bronchial asthma]. Voprosy nauki i obrazovaniya [Science and education]. 2017; 1: 107-109.

  3. Belevskij AS. Vzaimodejstvie vracha i medicinskoj sestry pri vedenii bol’nogo bronhial’noj astmoj [Interaction ofa doctor and a nurse in the management of a patientwith bronchial asthma]. Atmosfera; Pul’monologiya i allergologiya [Atmosphere; Pulmonology and Allergology]. 2008; 2: 60-62.

  4. Global’naya strategiya lecheniya i profilaktiki bronhial’noj astmy (peresmotr 2014) [Global strategy for the treatment and prevention of bronchial asthma (revision 2014)]. Perevod s angliiskogo AS Belevskogo [Translation from English AS Belevsky]. Moskva: Rossijskoe respiratornoe obshchestvo [Moscow: Russian respiratory society]. 2015; 148 p.

  5. Rogachikov AI. Tekhnika ingalyacii lekarstvennyh sredstv i kontrol’ nad bronhial’noj astmoj [Technique of inhalation medicines and the control over bronchial asthma]. Rossijskij mediko-biologicheskij vestnik imeni akademika IP Pavlova [Russian medical and biological Bulletin named by academician IP Pavlov]. 2016; 24 (3): 86-91.

 

UDC 616.12-008.46-036.12

PDF download CHRONIC HEART FAILURE IN REAL CLINICAL PRACTICE

PODOLSKAYA ALLA A., C. Med. Sci., Head of the Department of therapeutic of City Clinical Hospital No 7; associate professor of the Department of internal diseases of Kazan State Medical University, Russia, 420103, Kazan, Chuikov str., 54

PALMOVA LYUBOV YU., C. Med. Sci., associate professor of the Department of internal diseases of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: palmova@bk.ru

SHAIKHUTDINOVA ZULFIYA A., deputy Head physician for the medical part of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuikov str., 54

Abstract. Aim. The aim of the study was to analyze the cases of decompensation of chronic heart failure (CHF), NYHA III-IV functional class, requiring hospitalization in the therapeutic Department of a multidisciplinary hospital. Materialand methods. 422 medical histories of patients with decompensated CHF (31,3%) from 1345 (100%) hospitalized patients per year were analyzed. Mathematical analysis of the data was carried out using a computer-based Student’s t-test with cutoffs at p value less than 0,05. Results and discussion. Тhere were significantly more hospitalized women admitted for CHF decompensation (58%) than men (42%). The mean age of patients was (74,9±10,5) years [men – (69,6±10,2) years, women – (75,6±8,8) years; p<0,0001]. Mortality from CHF was 7,4%, 54 patients (mean age – 69,2 years; 16 men and 38 women) died during the reporting period (12 months). Repeated hospitalizations for CHF were 7,1% (30 patients). Retrospectively, according to clinical recommendations, only 18,5% of hospitalized patients received continuous therapy during the last year. The remaining 81,5% of patients did not receive complex therapy for CHF at the outpatient stage. Conclusions. the main etiological causes of decompensation of CHF in patients with NYHA III-IV functional class are postinfarction cardiosclerosis, chronic atrial fibrillation associated with ineffective heart rate and blood pressure control. Hospital mortality from CHF was 7,4%, an unfavorable prognosis was associated with a low use of a combination of essential drugs in the treatment of CHF, its insufficient dose, frequent interruption of treatment at the prehospital stage. To improve the prognosis and quality of life in patients with CHF, it is necessary to conduct CHF schools for patients and their relatives in the hospital, in the polyclinic to obtain information about the disease, acquire self-control skills related to dietary recommendations, physical activity, strict adherence to drug therapy, monitoring the symptoms of heart failure and seeking medical care in case of their strengthening.

Key words: chronic heart failure, causes, decompensation.

For reference: Podolskaya AA, Palmova LYu, Shaikhutdinova ZA. Chronic heart failure in real clinical practice. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (5): 45-49. DOI: 10.20969/VSKM.2019.12(5).45-49.

References

 1. Fomin IV. Hronicheskaya serdechnaya nedostatochnost’ v Rossijskoj Federacii: chto segodnya my znaem i chto dolzhny delat’. [Chronic heart failure in the Russian Federation: what we know today and what we should do]. Rossijskij kardiologicheskij zhurnal [Russian journal of cardiology]. 2016; 8 (136): 7–13.

  1. Belenkov YuN, Fomin IV, Mareev VYu, et al. Rasprostranennost xronicheskoj serdechnoj nedostatochnosti v Evropejskoj chasti Rossijskoj Federaczii dannye EPOXA– XSN (chast 2) [Prevalence of chronic heart failure in the European part of the Russian Federation – Data of AGE-CHF (part II)]. ZHurnal Serdechnaya Nedostatochnost’ [Russian Heart Failure Journal]. 2016; 7 (3): 3–7.

  2. Fomin IV. Epidemiologiya hronicheskoj serdechnoj nedostatochnosti v Rossijskoj Federacii V: Hronicheskaya serdechnaya nedostatochnost’ [Epidemiology of chronic heart failure in the Russian Federation B:Chronic heart failure]. Moskva: GEOTAR-Media [Moscow: GEOTAR-Media]. 2010; 7-77.

  3. Polyakov DS, Fomin IV, Valikulova FYu, Weisberg AR, Kraiem N, badin YuV, et al. Epidemiologicheskaya programma EPOHA–HSN: dekompensaciya hronicheskoj serdechnoj nedostatochnosti v real’noj klinicheskoj praktike (EPOHA–D–HSN)] [Epidemiological program EPOCH-CHF: decompensation of chronic heart failure in real clinical practice (EPOCH-D-CHF)]. ZHurnal Serdechnaya Nedostatochnost’ [Russian Heart Failure Journal]. 2016; 17 (6): 299– 305.

  4. Koziolova NA, Nikonova YuN, Shilova YaE, Agafonov AV, Polyanskaya EA. Harakteristika hronicheskoj serdechnoj nedostatochnosti na fone permanentnoj formy fibrillyacii predserdij [Characteristics of chronic heart failure on the background of permanent atrial fibrillation]. ZHurnal Serdechnaya Nedostatochnost’ [Russian Heart Failure Journal]. 2013; 14 (1): 14–21.

  5. Mareev VYu, Fomin IV, Ageev FT, et al. Klinicheskie rekomendacii OSSN-RKO – RNMOT. Serdechnaya nedostatochnost’: hronicheskaya (HSN) i ostraya dekompensirovannaya (ODSN); Diagnostika, profilaktika i lechenie [Russian Heart Failure Society, Russian Society of Cardiology; Russian Scientific Medical Society of Internal Medicine; Guidelines for Heart failure:chronic (CHF) and acute decompensated (ADHF); Diagnosis, prevention and treatment]. Cardiology [Kardiologiya]. 2018; 58 (6S): 8-164.

7. Dickstein K, Cohen-Solal A, Filippatos G, et al. ESCguidelines for the diagnosis and treatment of acute andchronic heart failure 2008: the Task Force for the diagnosis and treatment of acute and chronic heart failure 2008 of the European Society of Cardiology; Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur J Heart Fail. 2008; 10: 933–989.

8. Rekomendacii ESC po diagnostike i lecheniyu ostroj i hronicheskoj serdechnoj nedostatochnosti 2016 [ESCguidelines for the diagnosis and treatment of acute andchronic heart failure 2016]. Rossijskij kardiologicheskij zhurnal [Russian journal of cardiology]. 2016; 1 (141): 7–81.

9. Kirichenko AA, Ebzeeva EYu. Hronicheskaya serdechnaya nedostatochnost’ v praktike terapevta: trudno li ee raspoznat’? [Chronic heart failure in the practice of the therapist: is it difficult to recognize it?]. Consilium medicum [Consilium medicum]. 2019; 21 (1): 46-49.

10. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology; Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2012; 33: 1787–1847.

11. Galyavich AS. [Diagnostika i lechenie hronicheskoj serdechnoj nedostatochnosti segodnya [Diagnosis and treatment of chronic heart failure today]. Rusckij medicinskij zhurnal [Russian medical journal]. 2014; 12: 867-873.

 

UDC 618.3-06:616.12-008.331.1+616.1-055.2-053.81+618.173-06:616.1

DOI: 10.20969/VSKM.2019.12(5).49-54

PDF download INFLUENCE OF THE HISTORY OF GESTATIONAL HYPERTENSION ON TOTAL CARDIOVASCULAR RISK IN MENOPAUSAL WOMEN

SADYKOVA AIDA R., ORCID ID: 0000-0001-8324-2424; C. Med. Sci., associate professor of the Department of introduction to internal diseases of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: aidasad@mail.ru

SHAMKINA AYGUL R., C. Med. Sci., assistant of professor of the Department of introduction to internal diseases of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: schamkina.aigul@yandex.ru

SADYKOVA ALSU M., ultrasound diagnostic doctor of the Department of ultrasound diagnostics of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuykov str., 54, e-mail: alsiwise@gmail.com

SADYKOVA DIANA R., 5th year student of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: radiana2007@yandex.ru

Abstract. Aim – to evaluate total cardiovascular risk (CVR) in menopausal women depending on the history of gestational hypertension (HGH). Material and methods. 167 menopausal women aged 42–59; 22 normotensives (NT), 25 with high normal blood pressure (HNBP) and 120 hypertensives (HT) with average duration of hypertension (15,8±10,3) years were considered in the present analysis. Mean age of HT was (51,5±4,2) years. Patients with secondary hypertension were excluded. All the participants underwent questioning, complete physical examination, biochemical blood and urine investigation, standard ECG and echocardiography (standard protocol). All surveyed have been divided into 2 groups depending on presence of HGH. CVR was stratified according to ESC-ESH 2018 guidelines. Statistical analysis was performed using the «Statistica 13.0» software package. Results and discussion. No significant difference was found in frequency and mean number of risk factors in the HNBP and HT groups depending on presence of HGH. Significantly higher frequency (p<0,05 according Fisher exact method) of subclinical organ damage, established CVD and of very high risk was found (100% versus 16,7%; p<0,001; 19% versus 0%; p<0,05; 56,6% versus 0%; p<0,001 respectively) in HT with HGH comparing with HNBP without HGH. Significantly higher CVR was found in HT with and without HGH comparing with HNBP without HGH (3,3±0,9 versus 1,5±1,0; p<0,001 according Mann – Whitney U-test). Conclusion.HGH is associated with significantly higher (p<0,05) frequency of subclinical organ damage, established CVD and of very high risk and also higher values of total CVR in menopausal women.

Key words: gestational hypertension, cardiovascular risk, women, menopause.

For reference: Sadykova AR, Shamkina AR, Sadykova AM, Sadykova DR. Influence of the history of gestational hypertension on total cardiovascular risk in menopausal women. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (5): 49-54. DOI: 10.20969/VSKM.2019.12(5).49-54.

References

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  2. Profilaktika, diagnostika i lechenie pervichnoj arterial’noj gipertonii v Rossijskoj Federacii; Pervyj doklad ekspertov nauchnogo obshchestva po izucheniyu arterial’noj gipertonii Vserossijskogo nauchnogo obshchestva kardiologov i Mezhvedomstvennogo soveta po serdechno-sosudistym zabolevaniyam [Prevention, diagnostics and treatment of primary arterial hypertension in Russian Federation; The first expert’ report of scientific society on the research of arterial hypertension of the Russian scientific cardiologists society and Interdisciplinary Council on cardiovascular diseases]. Klinicheskaya farmakologiya i terapiya [Clinical pharmacology and therapy]. 2000; 3: 1–22.

  3. Yusuf S, Hawken S, Ounpu S, et al. On behalf of the INTERHEART Study Investigators. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART Study): case-control study. 2004. www.thelancet.com.

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  11. Chazova IE, Zhernakova YuV. Klinicheskie rekomendacii; Diagnostika i lechenie arterial’noj gipertonii [Clinical recommendations; Diagnostics and treatment of arterial hypertension]. Sistemnye gipertenzii [Systemic hypertensions]. 2019; 16 (1): 6–31.

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  13. Profilaktika, diagnostika i lechenie arterial’noj gipertenzii. Rossijskie rekomendacii (vtoroj peresmotr); VNOK 2004 [Prevention, diagnostics and treatment of arterial hypertension. Russian recommendations (the second revision). RSCS 2004]. 2004; 18 p.

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kardiologov (EOK, ESC) i Evropejskogo obshchestva po arterial’noj gipertenzii (EOAG, ESH) [Guideline on treatment of patients with arterial hypertension; Work group on treatment of arterial hypertension of the European society of cardiology (ESC) and European society of hypertension (ESH)]. Rossijskij kardiologicheskij zhurnal [Russian cardiologic journal]. 2018; 23 (12): 143-228.

17. Sadykova AR, Shamkina AR, Gizyatullova RI, Mustafina GR. Raspredelenie porazhenij organov-mishenej u zhenshchin klimaktericheskogo perioda v zavisimosti ot nalichiya gestacionnoj gipertenzii v anamneze [Distribution of target organs damage in menopausal women in dependence on history of gestational hypertension]. Tezisy Rossijskogo nacional’nogo kongressa kardiologov, gorod Ekaterinburg, 20−23 sentyabrya 2016 [Abstracts of Russian national congress of cardiologists, Ekaterinburg city, September, 20-23, 2016]. 2016: 184.

18. Shamkina AR, Sadykova AR, Mustafina GR. Gestacionnaya arterial’naya gipertenziya v anamneze i porazheniya organov-mishenej u zhenshchin [History of gestational hypertension and target organs damage in women]. VIII Rossijskaya nauchno-prakticheskaya konferenciya «Zdorov’e cheloveka v XXI veke»: Sbornik nauchnyh statej; Kazan’, 31 marta−1 aprelya [VIII Russian scientific practical conference “Health of human being in XXI century”: Collected scientific articl; s. Kazan, March, 31-April, 1]. 2016: 42−47.

19. Sadykova AR, Shamkina AR. Serdechno-sosudistyj risk i perenesennaya gestacionnaya arterial’naya gipertenziya u zhenshchin reproduktivnogo vozrasta [Cardiovascular risk and history of gestational hypertension in reproductive age women]. Kazanskij medicinskij zhurnal [Kazan medical journal]. 2017; 98 (1): 85–91.

20. Sadykova AR, Shamkina AR, Gizyatullova RI. Associaciya abdominal’nogo ozhireniya u zhenshchin s nekotorymi dannymi ginekologicheskogo anamneza [Association of abdominal obesity with some data of gynecologic history]. Kazanskij medicinskij zhurnal [Kazan medical journal]. 2013; 94 (3): 294−300.

21. Shamkina AR, Sadykova AR. Associaciya gestacionnoj gipertenzii v anamneze s serdechno-sosudistym riskom u zhenshchin reproduktivnogo vozrasta: monografiya [Association of history of gestational hypertension with cardiovascular risk in reproductive age women: monograph]. Kazan’: Ihlas [Kazan: Ihlas]. 2013:103 p.

22. Sadykova AR, Gizyatullova RI, Shamkina AR. Rasprostranyonnost’ faktorov riska serdechno-sosudistyh zabolevanij u zhenshchin klimaktericheskogo perioda s arterial’noj gipertenziej v zavisimosti ot nalichiya gestacionnoj gipertenzii v anamneze [Incidence of cardiovascular risk factors in menopausal women with arterial hypertension in dependence on history of gestational hypertension]. Materialy IV Rossijskoj nauchno-prakticheskoj konferencii «Zdorov’e cheloveka v XXI veke»: sbornik statej [Data of the IV Russian scientific practical conference “Health of human being in XXI century”: Collected scientific articles]. Kazan’ [Kazan]. 2012; 221−225.

23. Shamkina AR, Sadykova AR, Mustafina GR. Rasprostranyonnost’ faktorov riska serdechno-sosudistyh zabolevanij u zhenshchin reproduktivnogo vozrasta g. Kazani v zavisimosti ot gestacionnoj gipertenzii v anamneze [Incidence of cardiovascular risk factors in reproductive age women with arterial hypertension in dependence on history of gestational hypertension]. Vserossijskaya nauchno-prakticheskaya konferenciya «Zdorov’e cheloveka v XXI veke» (oktyabr’ 2008 g.): tezisy dokladov [Russian scientific practical conference “Health of human being in XXI century” (October, 2008): abstracts]. Kazan’ [Kazan]. 2008: 43-44.

 

UDC 616.155.194-06:616.89-008.46

DOI: 10.20969/VSKM.2019.12(5).55-58

PDF download CHANGE IN MEMORY DISORDERS AND COMPLIANCE IN PATIENTS WITH ANEMIA

SALIMOVA LILIYA M., ORCID ID: 0000-0003-4186-6049; assistant of professor of the Department of internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-927-246-40-59, e-mail: calimova.lili@gmail.com

OKURLU ALFIYA F., ORCID ID: 0000-0001-8890-1468; C. Med. Sci., assistant of professor of the Department of internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-432-245-13, e-mail: alfiaf@yandex.ru

KHAMITOV RUSTEM F., ORCID ID: 0000-0001-8821-0421; D. Med. Sci., professor, Head of the Department of internal diseases of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-917-272-96-72, e-mail: rhamitov@mail.ruMOLOSTVOVA ALSU F., ORCID ID: 0000-0001-6996-9985; assistant of professor of the Department of internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-904-672-81-19, e-mail: alsuvesna@mail.ru

ZAKHAROVA IRINA A., ORCID ID: 0000-0002-8678-9780; 5th year student of the pediatric faculty of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-960-056-44-16, e-mail: 79600564416@yandex.ru

Abstract. Aim. To identify the presence of memory disorders and cognitive impairements in patients with various types of anemia compared with healthy individuals. Material and methods. A total of 72 people, 36 of whom had various severity anemia (15 men and 21 women) participated in this study. The comparison group consisted of 36 people without anemia. The exclusion criteria were oncological diseases, acute purulent-inflammatory diseases, an acute period of myocardial infarction and cerebrovascular accident. The average age of participants was 55 years. The study used McNair and Kahn validated memory self-assessment questionnaires and Moriski – Green test for treatment compliance assessing in patients with anemia. Results and discussion. In patients with anemia, a memory loss was detected compared with the control group, which suggests casual relationships between memory safety and blood counts. Conclusion. In case of anemia, it is necessary to identify memory disorders, which can affect the course of treatment. Anemia management features and adherence to therapy should be discussed with patients.

Key words: memory, compliance, anemia.

For reference: Salimova LM, Okurlu AF, Khamitov RF, Molostvova AF, Zakharova IA. Changes in memory and compliance in patients with anemia. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (5): 55-58. DOI: 10.20969/ VSKM.2019.12(5).55-58.

References

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  3. YuNISEF, Universitet Organizacii Obʹedinennyh Nacij, VOZ. Zhelezodeficitnaya anemiya: ocenka, profilaktika i control’: rukovodstvo dlya rukovoditelej program [Iron deficiency anemia: assessment, prevention and control: program Manager Guide]. Zheneva: Vsemirnaya organizaciya zdravoohraneniya [Geneva: World Health Organization]. 2001; 114 p.

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6. Shostka GD. Deficit zheleza: principy diagnostiki i lecheniya [Iron deficiency: principles of diagnosis and treatment]. Anemiya; Zhurnal rabochej gruppy po anemii [Anemia; Journal of the working group on anemia]. 2004; 1: 11-18.

7. Levin OS. Diagnostika i lechenie demencii v klinicheskoj praktike [Diagnosis and treatment of dementia in clinical practice]. Moskva: MEDpressinform [Moscow: MEDpressinform]. 2014; 4: 256 p.

 

UDC 616.12-005.4-07:616.132.2-073.756.8

DOI: 10.20969/VSKM.2019.12(5).58-63

PDF download CORONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY IN PATIENTS WITH ISCHEMIC HEART DISEASE

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

KUROCHKIN SERGEY V., ORCIDID 0000-0002-8043-3871; C. Med. Sci., Head of the Department of X-ray of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuikov str., 54, e-mail: kurochkin.70@bk.ru

TSYBULKIN NIKOLAY A., ORCIDID 0000-0002-1343-0478; C. Med. Sci., associate professor of the Department of cardiology, rentgenendovascular and cardiovascular surgery of Kazan State Medical Academy – brauch of Russian Medical Academy of Continuing Professional Education, Russia, 420012, Kazan, Butlerov str., 36, e-mail: kdkgma@mail.ru

GAYNUTDINOVA LEYSAN I., ORCIDID 0000-0002-5859-8776; C. Med. Sci., Head of the Department of HMT of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuikov str., 54, e-mail: orgmetod.rkb3@mail.ru

RYCHKOVA VERONIKA S., ORCIDID 0000-0002-8523-1056; biophysicist of Institute of fundamental medicine and biology of Kazan Federal University, Russia, 420008, Kazan, Kremlevskaya str., 18, e-mail: roniveroni22@gmail.com

Abstract. Aim. To present an overview of the current state of coronary computed tomography angiography (CCTA). To compare coronary computed tomography angiography (CCTA) and coronary angiography in diagnostics of atherosclerosis and congenital coronary arteries anomalies in patients with ischemic heart disease (IHD). Material and methods.Scientific medical literature searched for articles with clinical relevance on CCTA in diagnostics of coronary artery disease and retrospective study 162 patients with chronic IHD was performed. Results and discussion. CCTA allows to visualize heart vascular network structure, coronary arteries distribution pattern, define congenital heart diseases, and atherosclerotic coronary walls impairment. CCTA is used for visualization of coronary arteries stenosis, restenosis after previous coronary interventions, shunts patency, and coronary wall calcium accumulation. In 93% of cases CCTA findings were as follows: absence of stenosis in 16% of cases, hemodynamically insignificant stenosis in 24%, and hemodynamically significant stenosis in 60% of cases. Conclusion. CCTA is useful not only planning patients for coronary angiography (CAG), but also in an exclusion from CAG.

Key words: coronary computed tomography angiography, coronary atherosclerosis, diagnostics.

For reference: Frolova EB, Kurochkin SV, Tsybulkin NA, Gaynutdinova LI, Rychkova VS. Coronary computed tomography angiography in patients with ischemic heart disease. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (5): 58-63. DOI: 10.20969/VSKM.2019.12(5).58-63.

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  5. Kutkiene S, Petrulioniene Z, Laucevicius A, et al. Is the coronary artery calcium score the first-line tool for investigating patients with severe hypercholesterolemia? Lipids Health Dis. 2019; 18 (1): 149.

  6. Van Diemen P, Driessen R, Stuijfzand W, et al. Impact of scan quality on the diagnostic performance of CCTA, SPECT, and PET for diagnosing myocardial ischemia defined by fractional flow reserve. J Cardiovasc Comput Tomogr. 2019; https://www.journalofcardiovascularct. com/article/S1934-5925(19)30029-2/fulltext . pii: S1934-5925(19)30029-2, doi: 10.1016/j.jcct.2019.06.007.

7. JiaY,ZhaiB,HeT,YuY,YuN,DuanH,YangC,ZhangX. Influence of virtual monochromatic spectral image at different energy levels on motion artifact correction in dual-energy spectral coronary CT angiography. Jpn J Radiol. 2019 ; 37 (9): 636-641. doi: 10.1007/s11604-019-00852-0.

8. Markham R, Murdoch D, Walters D, Hamilton-Craig C.Coronary computed tomography angiography and itsincreasing application in day to day cardiology practice. Intern Med J. 2016 ; 46 (1): 29-34.

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UDC 616.127-005.8-073.755.4-06:616.61-008.64-036.11

DOI: 10.20969/VSKM.2019.12(5).63-67

PDF download FACTORS ASSOCIATED WITH CONTRAST-INDUCED ACUTE KIDNEY INJURE AFTER ENDOVASCULAR INTERVENTION ON THE CORONARY ARTERIES

IN PATIENTS WITH MYOCARDIAL INFARCTION

YAKUPOV ISKANDER F., C. Med. Sci., Head of the Department of intensive care unit of City Clinical Hospital No 7, Russia, 420103, Kazan, Chyikov str., 54, tel. 8-937-615-35-68, e-mail: isyakup2000@mail.ru

MELNICHUK MARINA A., resident of the Department of introduction into internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: melmarimel@yandex.ru

SAMSONOVA DARIA S., resident of the Department of introduction into internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: darya.sergeevna.26@mail.ru

KHASTIEVA DILYARA R., resident of the Department of introduction into internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: dilyara_khastieva@mail.ru

SHAMSUTDINOVA DILYARA M., resident of the Department of introduction into internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: polka8aclass@yandex.ru

KHASANOV NIYAZ R., D. Med. Sci., Head of the Department of introduction into internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: ybzp@mail.ru

Abstract. Aim. The aim of the study was to determine the factors associated with contrast-induced acute kidney injury (AKI) after coronary arteries endovascular intervention in patients with myocardial infarction in clinical practice. Material and methods. The study included 311 patients with myocardial infarction treated in City Hospital No 7 in 2018–2019. All patients underwent coronary angiography and percutaneous coronary intervention. We selected data from general clinical examination, left ventricular ejection fraction measured by echocardiography, blood plasma creatinine, glomerular filtration rate calculated with CKD-EPI equation. Results and its discussion. Contrast volume increase in coronary angiography and transcutaneous coronary intervention was associated with contrast-induced AKI. Contrast volume was inversely correlated with the left ventricular ejection fraction. Conclusions. Our data supports the presumptionthat contrast-induced AKI in coronary angiography and transcutaneous coronary intervention is predicted by contrast volume. We suggest to perform the ventricular ejection fraction assessement by echocardiography in patients with myocardial infarction prior to coronary angiography and transcutaneous coronary intervention

Key words: myocardial infarction, contrast-induced acute kidney injury, left ventricular ejection fraction.

For reference: Yakupov IF, Melnichuk MA, Samsonova DS, Khastieva DR, Shamsutdinova DM, Khasanov NR. Factors associated with contrast-induced acute kidney injure after endovascular intervention on the coronary arteries in patients with myocardial infarction. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (5): 63-67. DOI: 10.20969/ VSKM.2019.12(5).63-67.

References

1. Belopuhov VM, Jakupov IF, Ajnutdinova IA, Ivanova AJu. Narushenie funkcii pochek u bol′nyh s infarktom miokarda i chreskozhnymi koronarnymi vmeshatel′stvami v do- i posleoperacionnom periode [Renal dysfunction in patients with myocardial infarction and percutaneous coronary interventions in the pre- and postoperative period]. Medicinskij al′manah [Medical almanac]. 2013; 28 (4): 55–56.

2. Solomon R, Dauerman HL. Contrast induced acute kidney injury. Circulation. 2010; 122: 2451–2455.

3. Tsai TT, Patel UD, Chang TI, Kennedy KF, Masoudi FA, Matheny ME, Kosiborod M, Amin AP, Messenger JC, Rumsfeld JS, Spertus JA. Contemporary incidence, predictors, and outcomes of acute kidney injury in patients undergoing percutaneous coronary interventions: insights from the NCDR Cath-PCI registry. J Am Coll Card Cardiovasc Interv. 2014; 7 (1): 1-9.

4. Watabe H, Sato A, Hoshi T, Takeyasu N, Abe D, Akiyama D, Kakefuda Y, Nishina H, Noguchi Y, Aonuma K. Association of contrast-induced acute kidney injury with long-term cardiovascular events in acute coronary syndrome patients with chronic kidney disease undergoing emergent percutaneous coronary intervention. Int J Cardiol. 2014; 174 (1): 57-63.

5. Akrawinthawong K, Ricci J, Cannon L, Dixon S, Kupfer K, Stivers D, Patrick A, Shukri D, McCullough PA. Subclinical and clinical contrast-induced acute kidney injury: data from a novel blood marker for determining the risk of developing 

contrast-induced nephropathy (ENCINO), a prospective study. Renal Fail. 2014; 12: Early Online:1-5.

Loh JP, Pendyala LK, Kitabata H. Comparison of outcomes after percutaneous coronary intervention among different coronary subsets (stable and unstable angina pectoris and ST-segment and non-ST-segment myocardial infarction). Am J Cardiol. 2014; 113 (11): 1794-1801.

Meinel FG, Cecco CN, Schoepf UJ, Katzberg R. Contrast-induced acute kidney injury: definition, epidemiology, and outcome. BioMed Research International. 2014; ID 859328: 6 p. http://www.hindawi.com/journals/ bmri/2014/859328/

8. Menzorov MV, Shutov AM, Makeeva ER, Serov VA, Saenko YV, Strakhov AA. Ostroye povrezhdeniye pochek i vnutrigospital’naya letal’nost’ u bol’nykh ostrym infarktom miokarda s pod»yemom segmenta ST [Acute kidney injury and in-hospital mortality in patients with acute myocardial infarction with elevation ST]. Fundamental’nyye issledovaniya [Fundamental research]. 2012; 12: 100-103

9. Levey AS. Measurement of renal function in chronic renal disease. Kinney Int. 1990; 38: 167-184.

10. KDIGO Clinical practice guideline for acute kidney injury. Kidney Int. 2012; 2(1): 141 p. https://kdigo.org/wp-content/ uploads/2016/10/KDIGO-2012-AKI-Guideline-English.pdf

 

REVIEWS

UDC 616.72-002.7-085.825.1(048.8)

DOI: 10.20969/VSKM.2019.12(5).68-72

PDF download EXERCISES IN THE MANAGEMENT OF RHEUMATOID ARTHRITIS

ABDRAKHMANOVA ALSU I., ORCID ID: 0000-0003-0769-3682; SCOPUS Author ID: 57192296744; C. Med. Sci., associate professor of the Department of clinical medicine fundamental basis of the Institute of biology and fundamental medicine of Kazan Federal University, Russia, 420008, Kazan, Karl Marx str., 74, e-mail: alsuchaa@mail.ru

USTINOVA SOPHIA M., student of the Department of clinical medicine fundamental basis of the Institute of biology and fundamental medicine of Kazan Federal University, Russia, 420008, Kazan, Karl Marx str., 74, e-mail: sonyaustinova31@gmail.com

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. Rheumatoid arthritis (RA) is a chronic, inflammatory, autoimmune disease that primarily affects the joints and is one of the leading causes of early disability. RA has a substantial impact on quality of life, with decrease in psychological and social adaptation, which is typical for people with chronic pain syndrome. Aim. The purpose of our study was to analyze recent data on various types of exercises in the management of RA. Material and methods. We performed a review of scientific medical literature on the role of exercise in the management of RA. Results and discussion. Various types of physical exercises in the complex treatment of RA has a general health-improving effect, shows increase of patient’s self-esteem, reduces fatigue and pain perception, improves the quality of life of patients. Increasing physical activity sessions reduce the intensity of chronic pain syndrome, reduce the duration of morning stiffness, reduce the frequency of exacerbation, improve joints function (increasing mobility), reduce the activity of the disease, have a trophic effect on the affected area, prevent contractures, increase bone mineral density, slowing the progression of the disease and atherosclerosis. Conclusion. Physical activity provides sufficient benefits in patients with RA and should be widely used in treatment. The use of exercise complexes should be one of the goals of therapeutic training of patients with RA.

Key words: exercises, rheumatoid arthritis, treatment.

For reference: Abdrahmanova AI., Ustinova SM., Amirov NB. Exercises in the management of rheumatoid arthritis. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (5): 67-72. DOI: 10.20969/VSKM.2019.12(5).67-72.

References

  1. Lööf H, Johansson U-B. «A body in transformation» – An empirical phenomenological study about fear-avoidance beliefs towards physical activity among persons experiencing moderate-to-severe rheumatic pain. J Clin Nurs. 2019; 28: 321–329.

  2. Smolen JS, Aletaha D, McInnes IB. Rheumatoid arthritis. Lancet. 2016; 10055: 2023–2038.

  3. Galushko EA, Nasonov EL. Rasprostranennost’ revmaticheskih zabolevanij v Rossii [The prevalence of rheumatic diseases in Russia]. Al’manah klinicheskoj mediciny [Almanac of clinical medicine]. 2018; 46 (1): 32–39.

  4. Nerurkar L, Siebert S. Rheumatoid arthritis and depression: an inflammatory perspective. The Lancet, Psychiatry. 2019; 2: 164-173.

  5. Bas DB, Jie Su, Gustaf Wigerblad, et al. Pain in rheumatoid arthritis: models and mechanisms. Pain Manag. 2016; 6 (3): 265-284.

  6. McWilliams DF, Walsh DA Pain mechanisms in rheumatoid arthritis. Clin Exp Rheumatol. 2017; 107 (5): 94-101.

  7. Walsh DA, McWilliams DF. Mechanisms, impact and management of pain in rheumatoid arthritis. Nat Rev Rheumatol. 2014; 10 (10): 581-592.

  8. Breivik H, Borchgrevink C, Allen SM, et al. Assessment of pain. Br J Anaesth. 2008; 101 (1): 17–24.

  9. Geneen LJ. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2017; 4: CD011279. https://con-med. ru/news/fizicheskaya-aktivnost-i-fizicheskie-uprazhneniya-pri-khronicheskoy-boli-u-vzroslykh-obzor-kokreynov/

  10. Robert S Porter. The Merck Manual; Rukovodstvo po medicine: Diagnostika i lechenie [The Merck Manual; Guide to medicine: Diagnosis and treatment]. Moskva: OOO «GRUPPA REMEDIUM» [Moscow: LLC «Group Remedium»]. 2015: 4640 p.

  11. Siqueira US, Orsini Valente LG, de Mello MT, et al. Effectiveness of aquatic exercises in women with rheumatoid arthritis: a rando-mized, controlled, 16-week

intervention-the HydRA trial. Am J Phys Med Rehabil. 2017; 96 (3): 167-175.

12. Wang L, Gao C, Zhu. Effect of functional exercises on patients with rheumatoid arthritis: a meta-analysis. Journal of Peking University (Health Sciences). 2018; 50 (6): 991-997.

13. Bullo V, Gobbo S. Nordic Walking Can Be Incorporated in the Exercise Prescription to Increase Aerobic Capacity, Strength, and Quality of Life for Elderly: A Systematic Review and Meta-Analysis, Rejuvenation Res. 2018; 21 (2): 141-161.

14. Adlan AM, Veldhuijzen van Zanten JJ. Cardiovascular autonomic regulation, inflammation and pain in rheumatoid arthritis. Auton Neurosci. 2017; 208: 137-145.

15. Janse van Rensburg , JA Ker , CC Grant, et al. Effect of exercise on cardiac autonomic function in females with rheumatoid arthritis. Clin Rheumatol. 2012; 31: 1155-1162.

16. Swärdh E, Brodin N. Effects of aerobic and muscle strengthening exercise in adults with rheumatoid arthritis: a narrative review summarising a chapter in Physical activity in the prevention and treatment of disease (FYSS 2016). Br J Sports Med. 2016; 50 (6): 362-367.

17. Baillet A, Vaillant M, Guinot M, et al. Efficacy of resistance exercises in rheumatoid arthritis: meta-analysis of randomized controlled trials. Rheumatology (Oxford). 2012; 51 (3): 519-527.

18. Baillet A, Zeboulon N, Gossec L, et al. Efficacy of cardiorespiratory aerobic exercise in rheumatoid arthritis: meta-analysis of randomized controlled trials. Arthritis Care Res (Hoboken). 2010; 62: 984 – 999.

19. Strasser B, Leeb G, Strehblow C, et al. The effects of strength and endurance training in patients with rheumatoid arthritis. ClinRheumatol. 2011; 30: 623 – 632.

20. Evans S, Moieni M, Lung K, et al. Impact of iyengar yoga on quality of life in young women with rheumatoid arthritis. Clin J Pain. 2013; 29: 988 – 997.

21. Ehrlich-Jones L, Lee J, Semanik P, et al. Relationship between beliefs, motivation, and worries about physical activity and physical activity participation in persons with rheumatoid arthritis. Arthritis Care Res. 2011; 63: 1700 – 1705.

22. Law R-J, Breslin A, Oliver EJ, et al. Perceptions of the effects of exercise on joint health in rheumatoid arthritis patients. Rheumatology (Oxford). 2010; 49: 2444 – 2451.

23. Hernández-Hernández M-V, Díaz-González F. Role of physical activity in the management and assessment of rheumatoid arthritis patients. Reumatología Clínica (English Edition). 2017; 13 (4): 214-220.

24. Verhoeven F, Tordi N, et al. Physical activity in patients with rheumatoid arthritis. JointBoneSpine. 2016; 83 (3): 265-270.

25. John H, Hale ED, Treharne GJ, et al. A randomized controlled trial of a cognitive behavioural patient education intervention vs a traditional information leaflet to address the cardiovascular aspects of rheumatoid disease. Rheumatology (Oxford). 2013; 52: 81 – 90.

26. Perdriger A, Michinov E. Therapeutic patient education: From infantilization to critical thinking. Joint Bone Spine. 2015; 82: 299 – 301.

27. Thomsen T, Esbensen BA, Hetland ML, Aadahl M. Motivational Counseling and Text Message Reminders: For Reduction of Daily Sitting Time and Promotion of Everyday Physical Activity in People with Rheumatoid Arthritis Rheumatic Disease Clinics of North America. 2019; 45: 231-244.

28. McWilliams DF, Dawson O, Young A, et al. Discrete trajectories of resolving and persistent pain in people with rheumatoid arthritis despite undergoing treatment for inflammation: Results from three UK cohorts. J Pain. 2019; 15: 1526-1559.

 

UDC 616.125.3-073.432.19(048.8)

DOI: 10.20969/VSKM.2019.12(5).73-76

PDF download PECTINATE MUSCLES OF THE RIGHT ATRIUM

IBRAGIMOVA GULNARA Z., doctor of ultrasonic diagnostics of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuikov str., 54, e-mail: morgens_vesna@mail.ru

BILALOVA RESEDA R., doctor of functional diagnostics of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuikov str., 54

SHAYKHUTDINOVA ZULFIYA A., C. Med. Sci., Honored Doctor of the Republic of Tatarstan, deputy Head physician for medical section of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuikov str., 54

Abstract. With the most widespread use, ultrasound is not only a control study of pathology, but also a method of mandatory research in complex clinical cases. In terms of sensitivity and specificity, echocardiography is a well-researched method, for investigation the morphological and functional changes in the heart and its valvular apparatus. Small heart anomalies differ from the normal morphology do not violate hemodynamics. One of the methods of differential diagnosis of small anomalies and formations of the right atrium is echocardiography. The aim of the study was to study the anatomy and structure of the right atrium, the right atrium pectinate muscles and its differential from thrombus and tumor.Material and method. A review of the literature on anatomy, ultrasound diagnosis of right atrium structure, right atrial pectinate muscles, right atrial hypertrophy was conducted. Results and discussion. Hypertrophied pectinate muscles can imitate hyperechogenic thrombus or tumor metastasis. One of the main features in the diagnosis of pectinate muscles abnormalities is its structure in echo apical four-chamber position. Differentiating hypertrophy of pectinate muscles in the right atrium from thrombus or metastasis is one of the urgent tasks. Conclusion. Pectinate muscles hypertrophy is a small anomaly, and a thrombus or tumor in the cavity is a pathology. Therefore, during ultrasound investigation it’s important to perform an integrated approach in differential diagnosis using not only transthoracic echocardiography, but also transesophageal diagnostic method, the class of ultrasound diagnostics, as well as the skills and experience of the doctor.

Key words: pectinate muscle, right atrium, echocardiography.

For reference: Ibragimova GZ, Bilalova RR, Shaikhutdinova ZA. Pectinate muscles of the right atrium. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (5): 73-76. DOI: 10.20969/VSKM.2019.12(5).73-76.

References

1. Rybakov MK, Alekhin MN, Mit’kov VV. Prakticheskoye rukovodstvo po ul’trazvukovoy diagnostike: Ekhokardiografiya, Izdaniye 2 [A Practical Guide to Ultrasound Diagnostics: Echocardiography, Edition 2]. Moskva: Izdatel’skiy dom Vidar-M [Moscow: Publishing House Vidar-M]. 2008; 544 p.
2. Stepanchuk AP. Ustroystvo predserdnykh polostey serdtsa cheloveka [The device of the atrial cavities of the human heart]. Svit meditsini ta biologii [Light of medicine and biology]. 2011; 2: 51-54.
3. Stepanchuk AP, Tikhonova OA, Soldatov AK. Stroyeniye ushek serdtsa v norme i pri kombinirovannom mitral’nom poroke [The structure of the ears of the heart is normal and with combined mitral defect]. Vistnik problem biologii i meditsini [Bulletin of problems biology and medicine]. 2012; 2 (1): 149–153.
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7. Bokeriya LA, Mashina TV, Golukhova YeZ. Trekhmernaya ekhokardiografiya [Three-dimensional echocardiography]. Moskva: Izdatel’stvovo NTSSSKH imeni AN Bakuleva RAMN [Moscow: Publishing House NTSSSH AN Bakuleva RAMS]. 2002; 90 p.
8. Bokeriya LA, Revishvili ASH, Golukhova YeZ, et al. Trekhmernaya komp’yuternaya model’ v izuchenii anatomii predserdiy [Three-dimensional computer model in the study of the anatomy of the atria]. Annaly aritmologii [Annals of arrhythmology]. 2005; 2: 29–35.
9. Shiler N, Osipov MA. Klinicheskaya ekhokardiografiya, vtoroye izdaniye [Clinical echocardiography, second edition]. Moskva: Medpress [Moscow: Medpress]. 2018; 344 p.
10. Feygenbaum, KH. Ekhokardiografiya, perevod s angliyskogo pod redaktsiyey VV Mit’kova, 5 izdaniye [Echocardiography, translation from English edited by VV Mitkov, 5th edition]. Moskva: Vidar [Moscow: Vidar]. 1999; 296 p.
11. Rybakova MK, Mit’kov VV. Differentsial’naya diagnostika v ekhokardiografii; 2 izdaniye [Differential diagnosis in echocardiography; 2nd edition]. Moskva: Vidar [Moscow: Vidar]. 2017; 248 p.
12. Vinkenskhof U, Kruk I. Spravochnik po ekhokardiografii [Handbook of echocardiography]. Moskva: Meditsinskaya literatura [Moscow: Medical literature]. 2014; 304 p.

 

UDC 616.28-008.55-07(048.8)

DOI: 10.20969/VSKM.2019.12(5).76-80

PDF download «THE RED FLAGS» OF VERTIGO

KAZANTSEV ALEXANDER YU., postgraduate student of the Department of neurology, neurosurgery and medical genetics of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: engine90@bk.ru

YAKUPOV EDUARD Z., D. Med. Sci., professor, Head of the Department of neurology, neurosurgery and medical genetics of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: ed_yakupov@mail.ru

Abstract. Aim The aim of the study was to present a simple and effective algorithm to diagnose acute vertigo in primary care unit (PCU). Material and methods. A review of scientific medical literature with relevance on topics concerning differential diagnosis of vertigo in PCU was performed. Results and discussion. Vertigo is one of the most common causes of urgent admission to PCU. The majority vertigo cases are benign thought it often presented with acute symptomatology. But also vertigo can be potentially a life threatening condition and doctor must stay on alert. Another important question is an economical aspect. There are a lot of expensive additional investigations used in PCU (MRI, CT, angiography), but only clinical data and physical examination of the patient are usually enough for the diagnosis. That’s why we recommend using the system of red flags. Similar system is used successfully in headache and spinal neurology for long time but haven’t adapt yet for vertigo. We determine 9 red flags that’s must know doctor in PCU.Conclusion. On the basis of this article the doctor in PCU will be able to timely diagnose the patient and prescribe the correct treatment. Competent measures can significantly reduce the number of admissions and hospitalizations, reduce the number of expensive additional examinations and thereby reduce economic costs.

Key words: vertigo, «red flags», stroke, peripheral vestibulopathy, BPPV.

For reference: Kazantsev AYu, Yakupov EZ. «The red flags» of vertigo. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (5): 76-80. DOI: 10.20969/VSKM.2019.12(5).76-80.

References

1. Brandt T, Diterikh M, Shtrupp M. Golovokruzheniyev [Vertigo]. Moskva: Praktika [Moscow: Practice]. 2009; 200 p.

2. Strupp M, Dieterich M, Brandt T. The Treatment and Natural Course of Peripheral and Central Vertigo. Deutsches Ärzteblatt International. 2013; 110 (29-30): 505–516. http://doi.org/10.3238/arztebl.2013.0505

3. Zamergrad MV. Kak raspoznat’ insul’t u bol’nogo s ostrym golovokruzheniyem? [How to recognize a stroke in a patient with acute dizziness? «]. «Sovremennaya terapiya v psikhiatrii i nevrologii» [Modern therapy in psychiatry and neurology ]. 2016; 1: 8-12.

4. Lee SH, Choi SK, Lim YJ, et al. Otologic manifestations of acoustic neuroma. Acta Otolaryngol. 2015; 135 (2): 140-146.

5. Foley RW, Shirazi S, Maweni RM, et al. Signs and Symptoms of Acoustic Neuroma at Initial Presentation: An Exploratory Analysis. Cureus. 2017; 9 (11): e1846. doi:10.7759/cureus.1846.

6. Matveyeva TV. Spravochnik nevrologa po sindromologii i topicheskoy diagnostike [Handbook of a neurologist in syndromology and topical diagnosis]. Izdatel’stvo: Kazan’ [Kazan Publishing House]. 2017; 609 p.

7. Klyushnikov SA, Aziatskaya GA. Glazodvigatel’nyye rasstroystva v praktike nevrologa [Oculomotor disorders in the practice of a neurologist]. Nervnyye bolezni [Nervous diseases]. 2015; 4: 41-46.

8. Lee H, Sohn SI, Cho YW, Lee SR, Ahn BH, Park BR. Cerebellar infarction presenting isolated vertigo: frequency and vascular topographical patterns. Neurology. 2006; 67 (7): 1178-1183. DOI: 10.1212/01.wnl.0000238500.02302.b4

9. Kase CS, Norrving B, Levine SR. Cerebellar infarction – clinical and anatomic observations in 66 cases. Stroke. 1993; 24 (1): 76-83.

10. Kattah JC, Talkad AV, Wang DZ, Hsieh YH, Newman-Toker DE. HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging. Stroke. 2009; 40: 3504–3510. DOI:10.1161/ STROKEAHA.109.551234

11. Jens Witsch, Monica Ferrer, Dhasakumar Navaratnam. Teaching Video NeuroImages: Vestibulo-ocular reflex defect in cerebellar stroke. Neurology. 2018; 91 (9): e888-e889. DOI: 10.1212/WNL.0000000000006087

12. Kazantsev AYu, Yakupov EZ. Defitsit vitamina D, kak vozmozhnyy faktor riska dobrokachestvennogo paroksizmal’nogo pozitsionnogo golovokruzheniya: obzor literatury [Vitamin D deficiency as a possible risk factor for benign paroxysmal positional vertigo: literature review]. Nevrologicheskiy vestnik [Neurological Bulletin]. 2017; 3: 60-63.

13. Shin DH, Kim BR, Shin JE, Kim CH. Clinical manifestations in patients with herpes zoster oticus. Eur Arch Otorhinolaryngol. 2016; 273 (7): 1739-1743. doi: 10.1007/ s00405-015-3756-9

14. Anderson WE. Herpes simplex encephalitis. 2018; http:// emedicine. medscape.com/article/1165183-overview
15. Hyung Lee. Isolated Vascular Vertigo. J Stroke; 2014: 16 (3): 124–130. doi: 10.5853/jos.2014.16.3.124

 

UDC 616-009.7-036.12-053-9(048.8)

DOI: 10.20969/VSKM.2019.12(5).81-92

PDF download PHARMACOLOGICAL TREATMENT OF CHRONIC PAIN IN GERIATRIC PATIENTS (a review)

PASYNKOVA OLGA O., C. Med. Sci., associate professor of the Department of fundamental medicine of Mari State University; clinical pharmacologist of Republican Clinical Hospital for veterans of wars, Russia, 424037, Yoshkar-Ola, Osipenko str., 24, e-mail: olgaved@inbox.ru

KRASILNIKOV ALEXEY V., deputy Head physician for a medical part of Republican Clinical Hospital for veterans of wars, Russia, 424037, Yoshkar-Ola, Osipenko str., 24, e-mail: krasdoc@yandex.ru

KLYUSHKIN IVAN V., D. Med. Sci., professor of the Department of the general surgery of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: hirurgivan@rambler.ru

PASYNKOV DMITRY V., C. Med. Sci., Head of the Department of radiodiagnosis of Republican Onkological Dispanser, Russia, 424037, Yoshkar-Ola, Osipenko str., 24, e-mail: passynkov@mail.ru

Abstract. Analgesics have become more widely accepted for treating older adults with chronic pain. Clinical guidelines of chronic pain in geriatric patients are focused on comorbidities, pharmacokinetic and pharmacodynamic changes of aging. STOPP-START criteria showed an efficiency in quality of anesthetizing therapy assessment, risk of falling reduction and costs of medical care in elderly patients. Aim. To decrease rate of irrational analgesics and adjuvants administration, and to exclude medicines with the highest side effect profile by STOPP-START criteria implementation. Material and methods. STOPP-START criteria analyzed and PubMed, Medline, EMBASE were searched for articles devoted to pain management in the elderly population. Results and discussion. For rational chronic pain syndrome management, neuropathic pain assessment is required. Secondly, pain intensity should be assessed by using a visually analog scale (VAS). Thirdly, it is necessary to use the principle of step therapy that means use of various algorithm of treatment depending on severity of pain and respond to previous step. Fourthly, it is necessary to avoid prescription of medicines, adverse events with risks for elderlies. Conclusion. The developed algorithm corresponds to the principles stated in criteria of STOPP-START, the regulating documents and modern scientific data. Use of this algorithm will increase quality of medical appointments at treatment of a chronic pain syndrome in elderlies and will decrease possible adverse events.

Key words: geriatrics, analgesics, pain, medicine selection.

For reference: Pasynkova ОО, Krasilnikov AV, Klyushkin IV, Pasynkov DV. Pharmacological treatment of chronic pain in geriatric patients (a review). The Bulletin of Contemporary Clinical Medicine. 2019; 12 (5): 81-92. DOI: 10.20969/ VSKM.2019.12(5).81-92.

References

1. Patel KV, Guralnik JM, Dansie EJ, Turk DC. Prevalence and impact of pain among older adults in the United States: findings from the 2011 National Health and Aging Trends Study. Pain. 2013; 154 (12): 2649–2657. DOI:10.1016/j. pain.2013.07.029.
2. Naumov AV, Moroz V I, Khovasova NO, Manevich TM, Balaeva MM-B, Demenok DV, Tkacheva O N. Hronitsceskaja bol v pozhilom vozraste: focus na sarkopeniyu [Chronic pain in older people: focus on sarcopenia]. Medicinski Sovet [Medical Council]. 2019; 12: 106-114. https://doi. org/10.21518/2079-701X-2019-12-106-114.
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UDC 616.24-008.47(048.8)

DOI: 10.20969/VSKM.2019.12(5).92-99

PDF download DYSPNEA IN PATIENTS OF THERAPEUTIC PROFILE: ISSUES OF TERMINOLOGY, PATHOGENESIS, ASSESSMENT PROGNOSIS

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

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

FROLOVA ELVIRA B., C. Med. Sci., deputy Head physician or diagnostics of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuikov str., 54, tel. 8-917-267-73-25, e-mail: frolova.67@mail.ru

MALKOVA MARIA I., C. Med. Sci., assistant of professor of the Department of propaedeutics of internal diseases named after professor S.S. Zimnitsky of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49; Head of the Department of functional diagnostics of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuikov str., 54, tel. 8-960-051-61-16, e-mail: marimalk@yandex.ru

ZAYNULLINA JULIANA I., ORCID ID: 0000-0002-0932-3987; student of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. 8-987-237-94-58, e-mail: zaynullina_yuliana@mail.ru

Abstract. Despite the successes of modern medicine, it is often difficult to find the causes of chronic shortness of breath in the practical work of a doctor. Dyspnea is one of the main reasons limiting physical activity and deteriorating quality of life for patients. The severity of this symptom varies, does not always correspond to the objective data of pulmonary or cardiac pathology and is associated with an unfavorable outcome. The low specificity and etiology of chronic dyspnea factors leads to difficulties in diagnosing its causes and often require detailed, long-term examination. Aim. To review aspects of terminology, mechanisms of development, evaluation of dyspnea of various etiology. Material and methods. To review the publications of the etiology, pathogenesis, and methods of diagnosing dyspnea. Results and discussion. Complaintsof shortness of breath make every second patient admitted to the hospital on an emergency basis and every fourth who needed an outpatient care. Dyspnea, as a patient’s subjective feeling, may vary due to the presence of depression, increased fatigue, as well as a general perception of health. The prevalence of dyspnea on the MRC scale (3–5 points) in the general population of elderly patients is (8,2–32,3)%, reaching 45,3% in men aged 80 and over, and 43% in women. The mean value of dyspnea in patients with chronic obstructive pulmonary disease (COPD) on a MRC scale was (3,33±0,16) points, with chronic heart failure (CHF) – (3,30±0,17) points, and in obesity – (1,55±0,25) points (p<0,001). It has been established that patients with shortness of breath, regardless of the presence of coronary heart disease (CHD) in history, have an increased risk of cardiovascular mortality HR=1,9 (with 95% CI 1,5–2,4) for patients with CHD and HR=2,9 (with 95% CI 1,7–5,1) for patients without a history of CHD. Conclusion. The epidemiological, pathophysiological aspects of dyspnea, its prognostic significance according to the data of clinical studies is considered in this article. The significance of the quantitative and qualitative determination of dyspnea in patients is highlighted.

Key words: dyspnoea, MRC, the language of dyspnoea, congestive heart failure, chronic obstructive pulmonary disease.

For reference: Khazova EV, Bulashova OV, Frolova EB, Malkova MI, Zaynullina JI. Dyspnea in patients of therapeutic profile: issues of terminology, pathogenesis, assessment prognosis. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (5): 92-99. DOI: 10.20969/VSKM.2019.12(5).92-99.

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ORGANIZATION OF HEALTHCARE

UDC 616-001.36-083.98:614.253.5

DOI: 10.20969/VSKM.2019.12(5).100-103

PDF download THE ROLE OF A NURSE OF MANAGEMENT PATIENTS WITH POLYTRAUMA IN EMEREGENCY DEPARTMENT IN A MULTIDISCIPLINARY HOSPITAL

CHIKAEV VYACHESLAV F., D. Med. Sci., professor of the Department of traumatology, orthopedics and emergencysurgery of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: prof.chikaev@gmail.com

KLYUSHKIN IVAN V., D. Med. Sci., professor of the Department of general surgery of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: hirurgivan@rambler.ru

MELNIKOV EVGENIY A., D. Med. Sci., deputy Head physician for surgery of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuykov str., 54

SADRIEV RAFAT R., D. Med. Sci., main specialist in anesthesiology and resuscitation of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuykov str., 54

ZINATULLINA NADYIA YA., Head nurse of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuykov str., 54

Abstract. Aim. To evaluate the role of paramedics in managing patients with polytrauma in emergency department in multidisciplinary hospitals. Material and methods. We performed a retrospective analysis of work organization in ED and nurses role in diagnostic and treatment of patients in a multidisciplinary City Clinical Hospital No 7 in Kazan. We evaluated the features of diagnosis and treatment of 343 patients with combined trauma selected from the entire cohort of patients. Results and discussion. All patients with combined trauma were immediately hospitalized in ED. The delivery time by the ambulance crew ranged from 10 to 40 min and averaged (31±8) min. It is also very important to clearly implement the standards of diagnostic and therapeutic procedures at all levels. An important role in the readiness of anti-shock plays paramedics. There were 2 steps of preparation. At the first step, the responsible nurse with head of ED prepares surgical kits and medicines kits for all cases: surgical, neurosurgical, traumatological, reanimation. At the second step, upon receipt of the information, the responsible nurse informs the head of the ED or the responsible surgeon about the transportation of severe patient. Adopted Clinic Protocol defines a clear consistent implementation of standards of professional activity at all levels – both doctors and nurses. In patients with combined trauma, one of the emergencies is blood loss. 45% of patients who died for the first 72 hours died from hemorrhagic shock. To reduce the blood group determining time, on admission enters we do this immediately in ED ward using two-way pneumatic tube system MVX Medic. Blood delivery time to the laboratory averages (1,5±0,5) min. Determination of blood group with phenotype averages (40±2) min. The standard diagnostic examination of patients with combined trauma and stable hemodynamics is whole body CT-scan. Time of preparation for blood components transfusion is (30±2,0) min. Conclusions. In the work of ED, an important role is played by personnel action algorithm adopted in the clinic, based on current guidelines and recommendations. Nurses play an important role in the preparation of ED and patients admission.

Key words: combined trauma, injury, nurse, emergency department.

For reference: Chikaev VF, Klyushkin IV, Melnikov EA, Sadriev RR, Zinatullina NYa. The role of a nurse of management patients with polytrauma in emeregency department in a multidisciplinary hospital. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (5): 100-103. DOI: 10.20969/VSKM.2019.12(5).100-103.

References

1. Agadzhanyan VV, Kravtsov SA, Shatalin AV, Levchenko TV. Gospital’naya letal’nost’ pri politravme i osnovnyye napravleniya yeyo snizheniya [In-hospital mortality in polytrauma and main areas of decrease]. Politravma [Polytrauma]. 2015; 1: 6‒15.

2. Bugaev DA. Zarubezhnyy i rossiyskiy opyt organizatsii spetsializirovannoy meditsinskoy pomoshchi postradavshim v dorozhno – transportnykh proishestviyakh [Russian and Foreign experience of organization of specialized medical care to victims of road traffic accidents]. Kazanskiy Meditsinskiy zhurna [Kazan Medical journal]. 2019; 3 (100): 464-467.

3. Bulanov AYu, Gorodetskii VM, Shulutko EM, et al. Vliyaniye razlichnykh tipov kolloidnykh ob»yemozameshchayushchikh rastvorov na izmenennuyu sistemu gemostaza [The effect of different types of colloidal objemozameshchati solutions to the modified system of hemostasis]. Anesetziologiya i reanimatologiya [Anesetziology and resuscitation]. 2004; 2: 25-29.

4. Vyatkina PA. Spravochnik meditsinskoy sestry [Directory of nurses]. Moskva: Eksmo [Moscow: Eksmo]. 2012; 608 p. 5. Rusakov AA, Salimzoda NF, Kurbanov SH, et al. Rukovodstvo po organizatsii meditsinskoy pomoshchi, diagnostike i lecheniyu ostrogo perioda sochetannoy i mnozhestvennoy travmy [Manual of medical care,diagnosis and treatment of the acute period of combinedand multiple trauma]. Dushanbe «Maorif» [Dushanbe: «Maarif»]. 2016; 628 p.

6. Chikaev VF, Akhtyamov IF, Ziatdinov BG, Galyautdinov FS. Organizatsionnyye aspekty raboty protivoshokovoy paty priyemnogo otdeleniya pri gospitalizatsii postradavshikh s politravmoy [Organisational aspects of the anti-shock opening in the admissions Department at admission of patients with polytrauma]. Politravma [Polytrauma]. 2017; 3: http://poly-trauma.ru/index.php/pt/article/view/39/113

7. Strelchenko OV, Orlova EY, Kashuba GP. Standarty i tekhnologii prakticheskoy deyatel’nosti meditsinskikh sester; Metodicheskiye rekomendatsii professional’noy deyatel’nosti operatsionnoy meditsinskoy sestry [Standards and technologies of practical activity of nurses; guidelines professional activities of operating nurses]. Novosibirsk [Novosibirsk]. 2013; 46 p.

 

PRACTICAL EXPERIENCE

UDC 616.155.194-039:616.12-005.4

DOI: 10.20969/VSKM.2019.12(5).104-118

PDF download CORONARY, BUT NOT ISCHEMIC ANEMIA MASKS

OSLOPOV VLADIMIR N., ORCID ID: 0000-0003-2901-0694; SCOPUS Author ID: 6602523658; D. Med. Sci., professor of the Department of propaedeutics of internal diseases named after professor S.S. Zimnitsky of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, 8-905-316-25-35, e-mail: kpvbol@yandex.ru

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

KHABIBULLINA RAMZIYА T., deputy Head physician of City Clinical Hospital No 11, Russia, 420127, Kazan, Maksimov str., 34/24, tel. 8-843-571-42-81, e-mail: gb11Kazan@mail.ru

OSLOPOVA DARYA V., student of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, тел. 8-965-597-77-66, e-mail: dasha.xexe@mail.ru

KHANAPHIEVA ALBINA L., ORCID ID: 0000-0003-4964-4432; student of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. 8-908-335-55-02, e-mail: hhllaa@bk.ru

OSLOPOVA JULIA V., ORCID ID: 0000-0002-9752-8703; C. Med. Sci., associate professor of the Department of the fundamentals of clinical medicine of Institute of fundamental medicine and biology of Kazan Federal University, Russia, 420008, Kazan, Kremlovskaya str., 18, tel. 8-917-287-94-56, e-mail: oslopovajul@mail.ru

MALKOVA MARIA I., C. Med. Sci., assistant of professor of the Department of propaedeutics of internal diseases named after professor S.S. Zimnitsky of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49; Head of the Department of functional diagnostics of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuikov str., 54, tel. 8-960-051-61-16, e-mail: marimalk@yandex.ru

DELIAN ARTHUR M., Head physician оf City Clinical Hospital No 7, Russia, 420103, Kazan, Chuikov str., 54, tel. (843) 237-91-78, e-mail: gkb7@bk.ru

Abstract. The question of the relationship between anemia and IHD is still relevant. A various severity anemia can cause clinical and electrocardiographic changes, similar to findings in case of coronary artery disease exacerbation. The literature data considers the relationship of these 2 diseases, and shows the complexity of diagnostic search, especially if it happens in urgent situation. Cardiac and ECG changes in anemia per se, mainly represented in the publications of South-East Asia and based on pediatric trials. South-Eastern data shows that severe anemia in malaria causeschanges in the ST segment and lengthens the QTc interval, which indicates the threat of arrhythmia. A 2-fold increase in troponin T levels was found in children who died of anemia, suggesting that severe anemia causes myocardial damage (injury). Aim. This publication presents our own interesting case of clinical and electrocardiographic findings in patient A., who suffered from iron deficiency anemia for many years. Results and discussion. Exacerbations of anemia were treated as manifestations of CHD – first as angina pectoris, then as a myocardial infarction until coronary angiography was done, with intact («clean») coronary arteries. Diagnoses of CHD exacerbations were revised and treatment was changed. An enhanced iron supplementation, improved patient’s condition, and the angina disappeared. ECG changes that misleaded doctors also disappeared. Conclusion. Thus, in clinical practice, it is necessary to allow the existence of «coronary masks» of anemia and to search for the true face of the pathology.

Key words: anemia, hemoglobin, hemic hypoxia, myocardial ischemia, angina pectoris, electrocardiographic changes.

For reference: Oslopov VN, Khazova EV, Khabibullina RT, Oslopova DV, Khanaphieva AL, Oslopova YuV, Malkova MI, Delian AM. Coronary, but not ischemic anemia masks. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (5): 104-118. DOI: 10.20969/VSKM.2019.12(5).104-118.

References

  1. Rojtberg GE, Strutynskij AV. Vnutrennie bolezni : Serdechno-sosudistaya sistema [Internal Diseases: Cardiovascular System. Moskva: MEDpress-inform [Moscow: MEDpress-inform]. 2019; 6: 903 p.

  2. Dvoreckij LI. Klinicheskie rekomendacii po lecheniyu bol’nyh zhelezodeficitnoj anemii [Clinical guidelines for the treatment of patients with iron deficiency anemia]. Russkij medicinskij zhurnal [Russian Medical Journal]. 2004; 12 (14): 893-897.

  3. Ettinger OA, Uskova OV, Gendlin GYe, Storozhakov GI. Anemiya s khronicheskoy serdechnoy nedostatochnost’yu: rol’ defitsita zheleza i yego korrektsiya [Anemia with chronic heart failure: the role of iron deficiency and its correction]. Consilium medicum (kardiologiya) [Consilium medicum (cardiology)]. 2011; 13 (5): 121-127.

  4. Groenveld HF, Januzzi JL, Damman K, et al. Anemia and mortality in heart failure patients a systematic review and meta-analysis. J Am Coll Cardiol. 2008; 52 (10): 818-827.

  5. Kaldara-Papatheodorou EE, Terrovitis JV, Nanas JN. Anemia in heart failure: should we supplement iron in patients with chronic heart failure? Pol Arch Med Weum. 2010; 120 (9): 354-360.

  6. Levina AA, Kazyukova TV, Tsvetayeva NV, et al. Gepsidin kak regulyator gemostaza zheleza [Hepsidin as a regulator of hemostasis of iron]. Pediatriya [Pediatrics]. 2008; 87 (1): 67-74.

  7. Danlay SM, Weston SA, Redfield MS, et al. Anеmia and heart failure: A community study. Am J Mtd. 2008; 121 (8): 726-732.

  8. He SW, Wang LX. The impact of anemia on the prognosis chronic heart failure: a meta-analysis and systemic revieu. Congest Heart Fail. 2009; 15 (3): 123-130.

  9. Jankowska EA, Rozentryt P, Witkowska A, et al. Iron deficiency: an ominous sing in patients with systolic chronic heart failure. Eur Heart J. 2010; 31 (15): 1872-1880.

10. Opasich C, Cazzola M, Scelsi L, et al. Blanted erythropoietin production and defective iron supply for erythropoiesis as major causes of anaemia in patients with chronic heart failure. Europ Heart J. 2005; 26: 2232-2237.

11. Wu WC, Rathore SS, Wang Y, et al. Blood transfusion in elderly patients with acute myocardial infarction. N Engl J M. 2001; 345: 1230-1236.

12. Shilov AM, Osiya AO. Osobennosti lecheniya ishemicheskoj bolezni serdca na fone anemii razlichnogo geneza [Features of the treatment of coronary heart disease on the background of anemia of various origin]. Trudnyj pacient [Difficult patient]. 2011; 9 (12): 10-14.

13. Kirichenko AA, Shatalova NO, Grishin GP, Fadeev AM. Ishemicheskaya bolezn’ serdca i anemiya [Ischemic heart disease and anemia]. Russkij medicinskij zhurnal [Russian Medical Journal]. 2015; 23 (5): 300-303.

14. Bokarev IN. Vnutrennie bolezni: differencial’naya diagnostika i lechenie: Uchebnik [Internal Diseases: Differential Diagnosis and Treatment: Tutorial]. Moskva: OOO «Izdatel’stvo «Medicinskoe informacionnoe agentstvo» [Moscow: Publishing House Medical Information Agency LLC]. 2009; 1004 p.

15. Sadoh WE, Uduebor JO. Electrocardiographic changes and troponin T levels in children with severe malaria anemia and heart failure. Niger J Clin Pract. 2017; 20 (5): 552-556. doi: 10.4103/1119-3077.187313.

16. Lagunju IA, Omokhodion SI. Childhood heart failure in Ibadan. West Afr J Med. 2003; 22: 42-45.

17. Sadoh WE, Akinsete AM. Epidemiology of childhood heart failure in Benin City. Niger J Cardiol. 2006; 3: 12-15.
18. Anah MU, Antia-Obong OE, Odigwe CO, Ansa VO. Heart failure among paediatric emergencies in Calabar, South Eastern Nigeria. Mary Slessor J Med. 2004; 4: 58-62. 19. Okafor HU, Nwaiwu O. Anemia of persistent malarial parasitemia in Nigerian children. J Trop Pediatr. 2001; 47: 271-275.

20. Mani A, Singh T, Calton R, Chacko B, Cherian B. Cardiovascular response in anemia. Indian J Pediatr. 2005; 72: 297-300.

21. Aksel’rod AS, Chomakhidze PSh, Syrkin AL. Nagruzochnyye EKG – testy: 10 shagov k praktike: uchebnoye posobiye [Stress ECG tests: 10 steps to practice: study guide]. Moskva: MEDpress-inform [Moscow: MEDpress-inform]. 2008; 208 p.

22. Fletcher G, et al. Exercise Standart for Testing and Training; AHA Scientific Statement. Circulation. 2001; 104: 1694-1698.

23. Orlova AF, Leytes IV, Chernikova IV. Proby s fizicheskoy nagruzkoy: metodicheskoye posobiye po veloergometrii [Samples with physical activity; methodological manual on bicycle ergometry]. Barnaul: AGMU [Barnaul: ASMU]. 2019; 37 p.

24. Rukavitsina OA ed. «Anemii»: kratkoye rukovodstvo dlya prakticheskikh vrachey vsekh spetsial’nostey [“Anemias”: A quick guide for practical doctors of all specialties]. Moskva: GEOTAR-Media [Moscow: GEOTAR-Media]. 2018; 176 p.

25. Kolokolov GR, et al. Analizy; Polnyy spravochnik [Analyzes; Complete reference]. Moskva: Eksmo [Moscow: Eksmo Publishing House]. 2006; 768 p.

26. Kamyshnikov VS. Karmannyy spravochnik vracha po laboratornoy diagnostike [Pocket guide of the doctor on laboratory diagnostics]. Moskva: MEDpress-inform [Moscow: MEDpress-inform]. 2007; 2: 400 p.

27. Fedotov VD. Bol’shoy slovar’ meditsinskikh terminov [Large dictionary of medical terms]. Moskva: ZAO Tsentrpoligraf [Moscow: CJSC Centerpolygraph]. 2007; 959 p.

 

CLINICAL CASE

UDC 616.43-006-031.14:616.441-006.6

DOI: 10.20969/VSKM.2019.12(5).119-121

PDF download TYPE 2B MULTIPLE ENDOCRINE NEOPLASIA SYNDROME (clinical case)

VALEEVA FARIDA V., D. Med. Sci., professor, Head of the Department of endocrinology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-917-255-55-79, e-mail: farida_val@yandex.ru

YILMAZ TATIANA S., C. Med. Sci., associate professor of the Department of endocrinology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-917-399-84-89, e-mail: tsmetannikova@yandex.ru

IBRAGIMOVA SUSANNA R., clinical resident of the Department of endocrinology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-919-699-70-71, e-mail: susannin_95@inbox.ru

KHUSEYEVA PETIMAT A., clinical resident of the Department of endocrinology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-905-377-51-95, e-mail: petiska94@mail.ru

SHAYDULLINA MARIA R., C. Med. Sci., associate professor of the Department of endocrinology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel.+7-960-045-67-79, e-mail: zizi97@mail.ru

PETROVA TATYANA A., doctor of the highest category, Head of the Department of endocrinology of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuikov str., 54, tel. +7-953-11-21-86, e-mail: tanuha1976@bk.ru

Abstract. Multiple endocrine neoplasia syndrome combines a group of inherited diseases characterized by tumor development and/or neuroectodermal origin cells hyperplasia (diffuse, nodular) in two or more endocrine organs. Аim. To present a clinical case of patient with type 2B multiple endocrine neoplasia syndrome as the rarest and most aggressive form of multiple endocrine neoplasia. Material and methods. We analyzed all medical documentation of a patient with type 2B multiple endocrine neoplasia syndrome from 2011 to 2019. Results and discussion. Medullary thyroid cancer occurs not only in sporadic forms, but also in 20–25% as a component of multiple endocrine neoplasia syndrome. Diagnostic search performed after total thyroidectomy made it possible to correctly diagnose (syndrome of multiple endocrine neoplasia of type 2B) and to develop further tactics of patient management. Due to this, pheochromocytoma was diagnosed and timely surgical treatment was performed. Conclusion. Thus, the clinical case described by us demonstrated how important is the cautiousness of endocrinologists regarding multiple endocrine neoplasia syndrome in medullary thyroid cancer. Timely surgical treatment and dynamic monitoring can prevent serious complications, making the prognosis of this disease as favorable as possible.

Key words: multiple endocrine neoplasia syndrome, medullary thyroid cancer, pheochromocytoma.

For reference: Valeeva FV, Yilmaz TS, Ibragimova SR, Huseyeva PA, Shaydullina MR, Petrova TA. Type 2B multiple endocrine neoplasia syndrome (clinical case). The Bulletin of Contemporary Clinical Medicine. 2019; 12 (5): 119-121. DOI: 10.20969/VSKM.2019.12(5).119-121.

References

1. Dedov II. Endokrinologiya [Endocrinology]. Moskva: «GEOTAR-Media» [Мoscow: «GEOTAR-Мedia»]. 2019; 1112 p.

2. Orlova EМ, Kareva МА. Karni-kompleks – sindrom mnozhestvennykh endokrinnykh neoplaziy [Carney-cоmplex – multiple endocrine neoplasia syndrome]. Problemy endokrinologii [Endocrinology problems]. 2012; 58 (3): 22–30.

3. White ML, Doherty GM. Multiple endocrine neoplasia. Surgical Oncology Clinics of North America. 2008; 17: 439–459.

4. Brandi ML, Gagel RF, Angeli A, Bilezikian JP, Beck-Peccoz P, Bordi C, ConteDevolx, Falchetti BA, Gheri RG, Libroia A, Lips CJ, Lombardi G, Mannelli M, Pacini F, Ponder BA, Raue F, Skogseid B, Tamburrano G, Thakker RV, Thompson NW, Tomassetti P, Tonelli F, Wells SAJr, Marx SJ. Guidelines for diagnosis and therapy of MEN type 1 and type 2. J Clin Endocrinol Metab. 2001; 86: 5658–5671.

 

UDC 616.12-008.318

DOI: 10.20969/VSKM.2019.12(5).122-128

PDF download COMBINED DISTURBANCES OF HEART RHYTHM IN CARDIOLOGY DEPARTMENT

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

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

SLEPUKHA ELENA G., ORCID ID: 0000-0002-5122-7235; Head of the Department of cardiology No 3 of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuikov str., 54, tel. +7(843)237-91-76, e-mail: slepuha_elena@mail.ru

GAYNUTDINOVA LEYSAN I., ORCID ID: 0000-0002-5859-8776; C. Med. Sci., Head of the Department of HMT of City Clinical Hospital No 7, Russia, 420103, Kazan, Chuikov str., 54, e-mail: orgmetod.rkb3@mail.ru

Abstract. Aim. To review the modern ideas of the combined heart rhythm disturbances in patients with cardiovascular disease. Material and methods. The purpose of this article is to explore modern ideas of combined heart rhythm disturbances in patients with cardiovascular disease and to demonstrate a clinical case. Results and discussion.Cardiac arrhythmias are one of the most common symptoms in practice of cardiologist. Arrhythmias caused by heart diseases, including an ischemic heart disease. The origins of arrhythmias underlie in disturbances of various electrophysiological properties and conduction disorders. Heart rhythm disturbances continue to be the most common causes of mortality in cardiovascular diseases. Heart diseases can lead to development of various arrhythmias based on different pathophysiological processes. Heart rhythm disturbances management can be medical or preventive. Treatment is based on medicinal therapy, invasive procedures, and pacemakers implantation. Preventive methods also include cardioverter defibrillators installation. Conclusion. Demonstrated clinical case shows a combination of various rhythm and conductivity disturbances in patient with absence of convincing evidence of cardiovascular disease. Thirddegree atrioventricular block followed by increased arrhythmic activity of a right ventricle developed. The myocardial infarction, myocarditis and an ischemic syndrome due to block of distal subdivisions of small branches of coronary arteries are probable causes. Perhaps, a combination of different factors, including of genetic predisposition led to the development of arrhythmia.

Key words: cardiac arrhythmia, electrocardiography, diagnostics.

For reference: Frolova EB, Tsybulkin NA, Slepukha EG, Gaynutdinova LI. Combined disturbances of heart rhythmin cardiology department. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (5): 122-128. DOI: 10.20969/ VSKM.2019.12(5).122-128.

References

1. Rudy Y, Lindsay BD. Electrocardiographic imaging of heart rhythm disorders: From bench to bedside. Card Electrophysiol Clin. 2015; 7: 17–35.
2. Fu D. Cardiac Arrhythmias: Diagnosis, Symptoms, and Treatments. Cell Biochem Biophys. 2015; 73 (2): 291-296. 3. Frommeyer G, Fischer C, Ellermann C, et al. Additive Proarrhythmic Effect of Combined Treatment with QT-Prolonging Agents. Cardiovasc Toxicol. 2018; 18 (1): 84-90. 4. Tanaka H, Matsuyama TA, Takamatsu T. Towards an integrated understanding of cardiac arrhythmogenesis.
Pathol Int. 2017; 67 (1): 8-16.
5. Aguiar R, Timoteo A, Ferreira L, et al. Complete atrioventricular block in acute coronary syndrome: prevalence, characterisation and implication on outcome. Eur Heart J Acute Cardiovasc Care. 2018; 7 (3): 218-223.
6. Themudo R, Johansson L, Ebeling-Barbier C, et al. The number of unrecognized myocardial infarction scars detected at DE-MRI increases during a 5-year follow-up. Eur Radiol. 2017; 27 (2): 715-722.
7. Krumm P, Zitzelsberger T, Weinmann M, et al. Cardiac MRI left ventricular global function index and quantitative late gadolinium enhancement in unrecognized myocardial infarction. Eur J Radiol. 2017; 92: 11-16.
8. Yamada T, Lloyd SG, Yoshida N, Kay GN. Double-Layer
Separate Ventricular Activation Patterns During Ventricular Tachycardia Associated With Myocarditis. Circ Arrhythm Electrophysiol. 2016; 9 (10): e004345.
9. Wan D, Blakely C, Branscombe P, et al. Lyme Carditis and High-Degree Atrioventricular Block. Am J Cardiol. 2018; 121 (9): 1102-1104.
10. Sacher F, Lim H, Derval N, et al. Substrate mapping and ablation for ventricular tachycardia: the LAVA approach. J Cardiovasc Electrophysiol. 2015; 26 (4): 464-471.
11. Sasaki K, Sasaki S, Kimura M, et al. Catheter ablation of ventricular arrhythmias arising from the basal septum of the right ventricle: characteristics and significance of junctional rhythm appearing during ablation. J Interv Card Electrophysiol. 2016; 45 (2): 159-167.
12. Yokokawa M, Good E, Crawford T, et al. Value of right ventricular mapping in patients with postinfarction ventricular tachycardia. Heart Rhythm. 2012; 9 (6): 938-942.
13. Zareba W. Should we consider the next implantable cardioverter-defibrillator trial in patients with acute coronary syndrome and monomorphic ventricular tachycardia? Heart Rhythm. 2018; 15 (6): 830-831.
14. Baritussio A, Ghosh Dastidar A, Frontera A, et al. Diagnostic yield of cardiovascular magnetic resonance in young-middle aged patients with high-grade atrioventricular block. Int J Cardiol. 2017; 244: 335-339. 

15. Roston T, Petegem F, Sanatani S. Catecholaminergic polymorphic ventricular tachycardia: a model for genotype-specific therapy. Curr Opin Cardiol. 2017; 32 (1): 78-85.

16. Kumar S, Barbhaiya C, Nagashima K, et al. Ventricular tachycardia in cardiac sarcoidosis: characterization of ventricular substrate and outcomes of catheter ablation. Circ Arrhythm Electrophysiol. 2015; 8 (1): 87-93.
17. Zhang D, Tu H, Wadman MC, Li YL. Substrates and potential therapeutics of ventricular arrhythmias in heart failure. Eur J Pharmacol. 2018; 833: 349-356.
18. Corrado D, Link MS, Calkins H. Arrhythmogenic Right Ventricular Cardiomyopathy. N Engl J Med. 2017; 376 (1): 61-72.

 

616.24-036.12-06:616.24-007.63

DOI: 10.20969/VSKM.2019.12(5).128-134

PDF download CLINICAL CASE OF ACUTE COMPLICATION IN PATIENT WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

KHAMITOV RUSTEM F., ORCID ID: 0000-0001-8821-0421; D. Med. Sci., professor, Head of the Department of internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. 8-917-272-96-72, e-mail: rhamitov@mail.ru

SALIMOVA LILIA M., assistant of professor of the Department of internal diseases of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. 8-917-232-86-63, e-mail: calimova.lili@gmail.com

MINGALEEVA GULNAZ F., assistant of professor of the Department of internal diseases of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. 8-987-292-55-37, e-mail: m.gulnaz.f@mail.ru

ZINNATULLINA AIGUL R., assistant of professor of the Department of internal diseases of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. 8-905-039-35-57, e-mail: aigoul-zinnatullina.rust@mail.ru

FATYKHOVA KIRA R., assistant of professor of the Department of internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. 8-987-221-83-50, e-mail: kira_sulbaeva@mail.ru

MOLOSTVOVA ALSU F., assistant of professor of the Department of internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. 8-904-672-81-19, e-mail: alsuvesna@mail.ru

KHAIRULLINA ADELYA R., assistant of professor of the Department of internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. 8-917-911-22-23, e-mail: adelyminsafy@gmail.com

ZAKIROVA ALFIA K., Head of the Department of internal diseases of Central City Clinical Hospital No 18, Russia, 420107, Kazan, Mavliutov str., 2, tel. 8-917-883-99-49

Abstract. Aim. To show the possible impact of minimally invasive thoracic procedures on the survival rate in patients with severe chronic obstructive pulmonary disease COPD. Material and methods. A clinical case of complicated course of COPD, required readmission and additional minimally invasive endoscopic manipulations is reviewed. Results and discussion. A patient with emphysema phenotype of very severe COPD had sudden breathlessness on the day of discharge. Spontaneous pneumothorax was considered as a possible cause of respiratory failure progression. During the diagnostic search, a giant bulla of the left lung with a mediastinal shift was founded. The bulla was formed by the merge of small upper lobe bullae. Due to comorbidity and morpho-functional state of the lungs open thoracotomy was a great risk. A bronchoscopic valvular bronchial blocker installed in left proximal bronchus. This minimally invasive manipulation was crucial for the survival of the patient. Conclusion. In cases of severe and very severe complicated course of COPD in patients with significant comorbidities the selection of adequate medical and oxygen therapy, must be accompanied with the opportunities of pulmonologists and thoracic surgeons cooperation.

Key words: COPD, complication, valvular bronchial blocker.

For reference: Khamitov RF, Salimova LM, Mingaleeva GF, Zinnatullina AR, Fatykhova KR, Molostvova AF, Khairullina AR, Zakirova AK. Clinical case of acute complication in patient with chronic obstructive pulmonary disease. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (5): 128-134. DOI: 10.20969/VSKM.2019.12(5).128-134.

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