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The state of health of adolescents studying in institutions of primary vocational education. Balayeva ShM (Azerbaijan, Baku) P. 15

Compliance and subjective symptoms of chronic obstructive pulmonary disease in patients with concomitant alcohol disease. Ivanova MA (Russia, Smolensk), Punin AA (Russia, Smolensk), Vaulin SV (Russia, Smolensk) P. 22

Analysis of the long-term dynamics of the general morbidity among rural residents living in region specializing in horticultural and cotton growing. Kamilov OА (Russia, Moscow), Kamilova RT (Uzbekistan, Tashkent), Navruzov EB. (Uzbekistan, Tashkent) P. 29

The quality of life of families with children with autism spectrum disorders in comparison with the quality of life of families with neurotypical children: survey results and interviews. Kuznetsova IB (United Kingdom, Birmingham),Mukharyamova LM (Russia, Kazan), Savelyeva JV (Russia, Kazan), Garapshina LR (Russia, Kazan), Kuznetsov MS (Russia, Kazan) P. 36

Comprehensive diagnosis of prostate cancer. Nasrullaev MN (Russia, Kazan), Nasrullaev MM (Russia, Kazan), Khasanov MZ (Russia, Kazan), Nasrullaev MM (Russia, Kazan), Fassakhova AA. (Russia, Санкт-Петербург) P. 44

Levels of medium- and low-molecular-weight substances and oligopeptides in patients with myocardial infarction against chronic obstructive pulmonary disease with single- and multivessel coronary artery disease. Prokofyeva TV (Russia, Astrakhan), Bashkina OA (Russia, Astrakhan), Polunina OS (Russia, Astrakhan), Voronina LP (Russia, Astrakhan), Sevostyanova IV (Russia, Astrakhan), Polunina EA (Russia, Astrakhan) P. 49

Application of organic compounds in therapeutic practice for liver function disturbances. Sorokina TV (Russia, Tomsk), Davydova VV (Russia, Tomsk), Kolesnik NYu. (Russia, Tomsk), Bolvantseva AI (Russia, Tomsk), Samoilova YuG (Russia, Tomsk), Oleynik OA (Russia, Tomsk), Tolmachev IV (Russia, Tomsk) P. 60

Parents’ assessment of medical care for their children with bronchial asthma and comorbid pathology. Ulishchenko IA (Russia, Moscow), Shulaev AV (Russia, Kazan), Konovalov OE (Russia, Moscow), Pak VI (Russia, Moscow), Yakhyaeva SA (Russia, Moscow) P. 76

Results of the use of combined probiotic therapy for the correction of intestinal microbiocenosis disorders in patients with multidrug-resistant tuberculosis. Kholodov EO (Russia, Кемерово), Bryukhacheva LYu (Russia, Кемерово), Otdushkina AA (Russia, Кемерово), Zakharova YuV (Russia, Кемерово), Primkulova MV (Russia, Кемерово), Pyanzova TV (Russia, Кемерово) P. 81


Inhibition of sodium glucose transport protein 2: clinical and pharmacological effects in chronic heart failure. Galyautdinov GS (Russia, Kazan), Zhidyaevskij A (Russia, Kazan), Nesterina MK (Russia, Kazan), Minnegalimova KR (Russia, Kazan) P. 89

Morphofunctional aspects of aging that determine the course of respiratory diseases in old and senile age. Kamasheva GR (Russia, Kazan), Sineglazova AV (Russia, Kazan), Arkhipov EV (Russia, Kazan) P. 95


Special aspects of giant renal angiomyolipoma diagnosis and treatment (clinical case). Styazhkina SN (Russia, Izhevsk), Khuzina LF (Russia, Izhevsk), Mullakhmetov BA (Russia, Izhevsk), Kiryanov NA (Russia, Izhevsk), Kuklin DN (Russia, Izhevsk), Erokhin OA (Russia, Izhevsk) P. 110


Features of the topographic and anatomical structure of the pterygo-mandibular space, affecting the effectiveness of nerve blocks and other surgical interventions: сlinical lectures. Kushta AA (Ukraine, Vinnytsia), Shuvalov SM (Ukraine, Vinnytsia) P. 117


The use of endonasal electrophoresis with Mexidol in combination with acupuncture in the treatment of patients with post-covid anosmia. Al-Zamil MH (Russia, Moscow), Puzin MN (Russia, Moscow), Shulaev AV (Russia, Kazan), Kiparisova ES (Russia, Moscow), Lyubimov AV (Russia, Moscow), Shilova TY (Russia, Moscow), Ramazanova LSh (Russia, Moscow), Makkaeva SM (Russia, Moscow), Skorokhodov AP (Russia, Moscow), Gunter NA (Russia, Moscow) P. 124






BAGISHEVA NATALIA V., ORCID ID: 0000-0003-3668-1023; C. Med. Sci., associate professor of the Department of Primary Care and Internal Medicine, Omsk State Medical University, Russia, 644099, Omsk, Lenin str., 12, e-mail: ppi100@mail.ru

MORDYK ANNA V., ORCID ID: 0000-0001-6196-7256; D. Med. Sci., professor of the Department of Phthisiology, Pulmonology and Infectious Diseases, Omsk State Medical University, Russia, 644099, Omsk, Lenin str., 12, e-mail: amordik@mail.ru

MOISEEVA MARINA V., ORCID ID: 0000-0003-3458-9346; C. Med. Sci., associate professor of the Department of Primary Care and Internal Medicine, Omsk State Medical University, Russia, 644099, Omsk, Lenin str., 12, e-mail: lisnyak80@mail.ru

NESTEROVA KLIMENTINA I., ORCID ID: 0000-0002-9793-7179; D. Med. Sci., professor of the Department of Otorhinolaryngology, Omsk State Medical University, Russia, 644099, Omsk, Lenin str., 12, e-mail: loromsk14@mail.ru

NEBESNAYA EKATERINA YU., ORCID ID: 0000-0001-6177-2889; Resident of the Department of Internal Medicine, Omsk State Medical University, Russia, 644099, Omsk, Lenin str., 12, e-mail: nebesnay_katya97@mail.ru

SITNIKOVA SVETLANA V., ORCID ID: 0000-0001-5071-8887; C. Med. Sci., Deputy Chief Physician, Clinical Tuberculosis dispensary No. 4, Russia, 644050, Omsk, Chemists str., 8a, e-mail: phtisiatria-omsk@mail.ru

Abstract. Introduction. The problem of treating tuberculosis (TB) remains relevant, due to the growth of drug-resistant forms of mycobacterium tuberculosis and an increase in the incidence of TB in persons with comorbid bronchopulmonary pathology, which requires comprehensive management of this category of patients, with mandatory drug correction of concomitant pathology. Aim. The aim of this study was to assess the effect of inhaled glucocorticosteroids (budesonide / formoterol 160 / 4.5 in an Inhaler device) on the ef cacy of TB therapy in patients with newly diagnosed multidrug-resistant tuberculosis (MDR) who developed in the presence of chronic obstructive pulmonary disease (COPD). Material and methods. A simple, prospective, comparative study in accordance with the inclusion criteria included 40 patients admitted to an anti-tuberculosis dispensary with newly diagnosed MDR tuberculosis with COPD. The diagnosis of TB and COPD was con rmed using radiographic, functional and laboratory research methods. Group 1, age Me (25; 75) 55.5 (46; 58) years - 22 patients with MDR + COPD tuberculosis who, simultaneously with TB chemotherapy, received a short-acting M-anticholinergic blocker, 2 inhalations 4 times a day, group 2, age 54.5 (51; 58) years - 18 patients with MDR + COPD tuberculosis, simultaneously with TB chemotherapy received a combination of ICS with a long-acting bronchodilator (beta-2-agonist (LABA)), budesonide + formoterol 160 / 4.5 μg dose - 2 inhalations 2 times a day (in an inhaler device). Duration of observation is 9 months. Results and discussion. After 9 months of observation, closure of decay cavities in 63.6% in group 1 and 83.3% in group 2 (χ2 = 0.3; p = 0.581), smear negativity in 90.9% of cases in group 1 and in 100, 0% in group 2, respectively (χ2 = 0.04 p = 0.834), abacillated 63.3% and 100.0% in groups 1 and 2, respectively (χ2 = 0.46; p = 0.496). Against the background of the use of ICS in the intensive phase of TB chemotherapy simultaneously with antibiotic therapy, there was a decrease in the time of abacillation and closure of decay cavities in comparison with the group that did not receive ICS. At the same time in broncholics, the use of ICS made it possible to quickly stop the broncho-obstructive syndrome, improve the quality of life and compliance with long-term anti-tuberculosis therapy. An additional nonspeci c anti-in ammatory effect of ICS promoted the active resorption of in ltrative changes and the cure of a speci c process, reducing the duration of the main course of treatment, including in patients with MDR. Conclusion. Patients of the anti-tuberculosis dispensary with concomitant bronchopulmonary pathology need complex treatment aimed at correcting comorbid conditions, simultaneously with chemotherapy for tuberculosis. The use of ICS in addition to long-acting bronchodilators (LABA, LDAH) in patients with COPD for the correction of broncho-obstructive syndrome in the intensive phase of TB treatment can reduce the time of smear negativity, abacillation and closure of decay cavities.

Key words: tuberculosis, multidrug resistance, chronic lung disease, treatment, inhaled glucocorticosteroids, long-acting β2-agonists.

For reference: Bagisheva NV, Mordyk AV, Moiseeva MV, Nebesnaya EYu, Sitnikova SV. Selected aspects of treatment of patients with newly diagnosed pulmonary tuberculosis with multidrug-resistant combination and chronic obstructive pulmonary disease: in the focus of inhaled glucocorticosteroids. The Bulletin of Contemporary Clinical Medicine. 2022; 15 (2): 7—14. DOI:10.20969/VSKM.2022.15(2). 7-14


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BALAYEVA SHAKHLA M. – ORCID ID: 0000-0003-3224-4184, Doctor of Philosophy in Medicine, Associate Professor, Head of the Department of Hygiene of children and adolescents, and occupational health, Azerbaijan Medical University, Baku, Azerbaijan, AZ 1078, E. Gasimzade str., 14; tel (+99412) 597-38-98; e-mail: mic_amu@mail.ru

Abstract. Introduction. Vocational education institutions are characterized by the impact of a set of diverse risk factors that are potentially dangerous to the health of student adolescents and can lead to illness. And this raises questions of preserving the health of the future labor potential as a priority task and requires the development and implementation of new methodological approaches to improve and organize medical care. Aim. The aim was to study the morbidity of students to assess the dynamics of changes in the state of health of students during the period of initial vocational training with further development of preventive measures. Material and methods. The data of a comprehensive medical examination, questionnaires on the identi cation and prevalence of complaints about the state of health, indicators of chronic morbidity in students of primary vocational education institutions have been analyzed. Results and discussion. In comparison with the rst year of study, the incidence of diseases of the nervous system increases by 43,8%, diseases of the digestive system – 41,7%, diseases of the musculoskeletal system and connective tissue – 29,5%, diseases of the eye and its accessory apparatus – 13,4% and for diseases of the genitourinary system - by 12,8%. In adolescents studying in different working conditions, there is a repeated frequency of complaints of a different nature. Among the trainees of the oil and gas production operator and carpenter, a high frequency of complaints was noted from the urinary system, skin and allergic reactions; carpet weaver - from the nervous, musculoskeletal system, skin and vision; in adolescent seamstresses - from the nervous, cardiovascular system with frequent allergic reactions; adolescents who are trained as chefs have a higher prevalence of complaints related to the cardiovascular system and allergic reactions. Conclusion. Despite the short contact of students with various production factors during labor training, unfavorable occupational and production risk factors can cause disruption of the regulatory mechanisms of physiological adaptation in adolescents.

Key words: primary vocational education, adolescent health, health care of students, occupational risk factors

For references: Balayeva ShM. The state of health of adolescents studying in institutions of primary vocational education. The Bulletin of Contemporary Clinical Medicine. 2022; 15 (2): 15—21. DOI: 10.20969/VSKM.2022.15(2).15-21


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18. Кучма В.Р., Шубочкина Е.И., Янушанец О.И., и др. Оценка рисков здоровью учащихся профессиональных колледжей в зависимости от характера осваиваемых профессий // Гигиена и санитария. - 2019. - Т. 98. - No 11. - С.1257–1261. [Kuchma VR, Shubochkina EI, Yanushanec OI, et al. Ocenka riskov zdorov’yu uchashchihsya professional’nyh kolledzhej v zavisimosti ot haraktera osvaivaemyh professij [Assessment of health risks of students of vocational colleges depending on the nature of the professions being mastered]. Gigiena i sanitariya [Hygiene and Sanitation]. 2019; 98 (11): 1257–1261. (In Russ.)]. DOİ: 10.18821/0016-9900-2019-98-11-1257-1261

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UDC 616.24+613.81



IVANOVA MARINA A., ORCID ID: 0000-0002-2388-4174; pulmonologist of the center of respiratory medicine «State clinical hospital No1», 214006, Russia, Smolensk, Frunze Str., 40,
e-mail: zamedikus@yandex.ru

PUNIN ALEKSANDR A., ORCID ID: 0000-0001-9883-8378, D. Med. Sci., Professor, Head of the Department of Internal Medicine, Smolensk State Medical University, 214019, Russia, Smolensk, Krupskay Str., 28, e-mail: 001e316@mail.ru

VAULIN SERGEY V., ORCID ID: 0000-0002-6944-6372; D. Med. Sci, professor of the Department of Psychiatry, Narcology and Psychotherapy of the Faculty of Additional Professional Education of Smolensk State Medical University, 214019, Russia, Smolensk, Krupskay Str., 28, e-mail: sv_vaulin@mail.ru

Abstract. Introduction. Chronic obstructive pulmonary disease (COPD) and alcohol disease submit a serious health-care problem due to their wide distribution and medical and social burden. Aim. The aim of the study was to reveal the impact of alcoholism on the level of COPD subjective symptoms in patients with different compliance. Material and methods. 147 men with COPD in the age of 40 – 88 years were examined. Spirometry criteria, mMRC, CAT, domestic questionnaire of adherence to therapy, 6-minutes walking tests were performed. The stage of alcohol disease was established. Results and discussion. We observed the trend to subjective COPD symptoms underestimation in patients with the II, III stages of alcohol disease. Alcohol disease performed no impact on subjective symptoms in patients with stages III, IV of COPD. The compliance level and subjective symptoms severity showed no interrelation in patients suffering from alcoholism. This emphasized the absent association between the high level of compliance and critical self-state perception in patients with concomitant diseases. Conclusion. The poor informativity of mMRC dyspnea scale and CAT-test was demonstrated in patients with mild and moderate COPD and severe alcoholism. The high level of compliance showed no impact on this tendency.

Key words: compliance, COPD, alcohol disease, dyspnea, CAT-test.

For reference: Ivanova MA, Punin AA, Vaulin SV. Compliance and subjective symptoms of chronic obstructive pulmonary disease in patients with concomitant alcohol disease. The Bulletin of Contemporary Clinical Medicine. 2022; 15 (2): 22—27. DOI: 10.20969/VSKM.2022.15(2). 22-27


1. Khaltaev N. GARD, a new way to battle with chronic respiratory diseases, from disease oriented programmes to global partnership. J Thorac Dis. 2017; 9 (11): 4676-4689. DOI:10.21037/jtd.2017.11.91

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The physical, mental, and social impact of COPD in a population-based sample: results from the Longitudinal Aging Study Amsterdam. NPJ Prim Care Respir Med. 2018; 28 (1): 30. DOI: 10.1038/s41533-018-0097-3

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17. Tanabe J, Yamamoto DJ, Sutton B, Brown MS et al. Effects of alcohol and acetate on cerebral blood ow: a pilot study. Clin Exp Res. 2019; 43 (10): 2070-2078. DOI: 10.1111/acer.14173


UDC 614.1:314.14(575.111-22):005.521



KAMILOV OYBEK А., ORCID ID: 0000-0003-3909-6700; postgraduate student of the Department of dermatology and venerology of Peoples’ Friendship University of Russia, Russia, 117198, Moscow, Miklukho-Maklay str.,6, e-mail: kamilov_oybek@mail.ru

KAMILOVA ROZA T., ORCID ID: 0000-0002-0397-8261; D. Med. Sci., professor, Deputy Director for research of the Institute of Sanitation of Hygiene and Occupational Diseases of the Ministry of Health of the Republic of Uzbekistan, Uzbekistan, Tashkent, 100050, Oltintepa str., 325, e-mail: rozakamilova@mail.ru

NAVRUZOV ERNAZAR B., ORCID ID: 0000-0002-3926-4471; C. Med. Sci., Senior research worker for research of the Institute of Sanitation of Hygiene and Occupational Diseases of the Ministry of Health of the Republic of Uzbekistan, Uzbekistan, Tashkent, 100050, Oltintepa str., 325, e-mail: navruzovernazar@mail.ru

Abstract. Introduction. The trends study of morbidity allows to develop the strategies to eliminate inequalities in health between residents of rural areas, specialized on different sectors of agriculture. Aim. Comparative assessment and analysis of long-term dynamics of general morbidity among rural residents of horticultural and cotton-growing regions.Material and methods. We conducted analysis the data of statistical reporting of two ve-year periods (2007-2011 and 2014-2018). Systematically evaluated database of Sanitation, Epidemiology and Health care Departments of Tashkent Province included the morbidity of adult residents living in Bostanlyk (horticultural) and Chinaz (cotton growing) regions. The analysis of the general morbidity was carried out according to ICD-10. Results and discussion. Dynamic observations shown an increase of 6 leading classes of diseases (III, IV, IX, X, XI and XIV) in the cotton-growing region in 2014-2018 compared to 2007-2011 (78,3 ± 0,15 against 86,4 ± 0,12%; р < 0,001). The morbidity rates of the 14 classes of diseases out of 17 registered were almost 2 times higher in the cotton growing region than in the horticultural region (р < 0,05-0,001). Comparative analysis of the results in long-term dynamics show to a decrease in the general morbidity which is more pronounced in the horticultural region. The revealed correlation between the general morbidity in 15 classes of diseases with the volume of mineral fertilizers and pesticides used had a high level in the cotton-growing region. Conclusion. The results of this kind of research make it possible to timely identify trends in the spread of diseases, the reasons for the prevalence of certain classes of diseases and develop preventive measures. In our opinion the decrease of morbidity rate in the studied regions - is the result of the ongoing large-scale reforms in the health care system in the rural areas including a program to reduce the use of pesticides and fertilizers.

Key words: morbidity, statistical reporting, long-term dynamics, rural residents.

For reference: Kamilov OА, Kamilova RT, Navruzov EB. Analysis of the long-term dynamics of the general morbidity among rural residents living in region specializing in horticultural and cotton growing. The Bulletin of Contemporary Clinical Medicine. 2022; 15 (2): 28—35. DOI: 10.20969/VSKM.2022.15(2). 28-35


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KUZNETSOVA IRINA B., ORCID ID: 0000-0002-1553-7746 C. Soc. Sci., School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham B15 2TT, UK, e-mail: .kuznetsova@bham.ac.uk

MUKHARYAMOVA LAISAN M., ORCID ID: 0000-0002-5016-6928, D. Polit. Sci., Professor, the Head of Department of History, Philosophy and Sociology of Kazan State Medical University, 420012 Russia, Kazan, Butlerova Str., 49, e-mail: edu-prorector@kazangmu.ru

SAVELEVA ZHANNA V., ORCID ID: 0000-0003-1465-0664, D. Soc. Sci., Associate Professor, Department of General and Ethnic Sociology of Kazan Federal University, 420008, Russia, Kazan, Kremlyovskaya street, 18 e-mail: gedier@mail.ru

GARAPSHINA LEYLYA R., ORCID ID: 0000-0002-4935-0808, C. Soc. Sci., Assistant Professor, Department of History, Philosophy and Sociology of Kazan State Medical University, 420012 Russia, Kazan, Butlerova Str., 49, e-mail: miftahova89@mail.ru

KUZNETSOV MAXIM S., ORCID ID: 0000-0002-4891-9169 Assistant Professor, Department of epidemiology and evidence-based medicine of Kazan State Medical University, 420012 Russia, Kazan, Butlerova Str., 49, e-mail: qmaxksmu@yandex.ru

Abstract. Introduction. The signi cant increase in the number of people with autism spectrum disorders (ASD) today makes it relevant to study the quality of life of families raising children with ASD compared to families of neurotypical children. Aim. The aim of the study was to identify the quality of life of families with children with ASD and to compare it with the quality of life of families with neurotypical children to determine the level of deprivation.Material and Methods. The study involved: 1. А survey of parents of neurotypical children and children with autism, based on The Beach Center on Disability at the University of Kansas «Concepts and Methods for Measuring Family Quality of Life» questionnaire. Veri cation of this instrument was ensured by double translating the questionnaire (English-Russian-English), and a pilot survey of parents (N=112) was conducted. One hundred and nine parents of neurotypical children in 19 Russian cities were interviewed. 2. Semi-structured interviews with parents of children with ASD (N=40). We performed a standardization procedure in which the responses of the participants were converted into scores for each subscale by calculating the average score. Results and discussion. The survey showed a set of problems in the accessibility of social and medical care, education, and safety concerns that were signi cantly lower compared to the results of the survey of parents of neurotypical children. Comparison of the survey data with the results of parent interviews revealed detailed experiences of daily life for families with children with ASD. There were signi cant differences in seeking medical care: 82.5% of parents with neurotypical children are satis ed with the medical care they receive, while for parents of children with ASD, this gure is much lower - 64.3%. Slightly more than half are satis ed with home, work, school and neighborhood safety (42.9% satis ed, 9.8% completely satis ed). The proportion of parents of neurotypical children who are completely satis ed with safety is 28.4% and 42.2% who are satis ed. Most parents support inclusive or integrative education (they could choose more than one answer). 72.3% considered the most effective education for children with autism in classes with children without disabilities, a little more than half (54.5%) supported inclusive education. They also consider education in special classes in general schools to be effective. 8.9% of parents support home schooling. Conclusion. The ndings reveal dangerous trends in the marginalization of families with children with ASD compared to families with neurotypical children. The solution to the problems of social integration must consider the indicators of these inequalities, both in terms of the quality of life of both the child and his/her immediate family.

Keywords. Autism spectrum disorder, autism, quality of life, inclusive education, safety.

For reference: Kuznetsova IB, Mukharyamova LM, Savelyeva JV, Garapshina LR, Kuznetsov MS. The quality of life of families with children with autism spectrum disorders in comparison with the quality of life of families with neurotypical children: survey results and interviews. The Bulletin of Contemporary Clinical Medicine. 2022; 15 (2): 36—43. DOI: 10.20969/VSKM.2022.15(2). 36-43


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NASRULLAYEV MAGOMED N., ORCID ID: 0000-0001-6176-9372; D. Med. Sci., Professor of the Department of Surgery of the Kazan State Medical Academy- branch of the Russian Medical Academy of Continuous Professional Education, 420012, Russia, Kazan, Mushtaristr., 11, e-mail: msh.aviayandex.ru

NASRULLAYEV MARAT M., C. Med. Sci., Head of the Oncology Department 6, Republican Clinical Oncology Dispensary, 400029, Russia, Kazan, ul. Siberian Tract, d. 23

KHASANOV MARAT Z., ORCID ID: 0000-0001-5164-4648; аssistant professor of the Department of Ultrasound Diagnostics of the Kazan State Medical Academy- branch of the Russian Medical Academy of Continuous Professional Education, 420012, Russia, Kazan, Mushtari str., 11

NASRULLAYEV MURAD M., C. Med. Sci., Doctor of Oncological Department 2, Republican Clinical Oncological Dispensary, 400029, Russia, Kazan, ul. Siberian Tract, d. 23

FASSAKHOVA ADELINA А., 6th year student, St. Petersburg State Medical University named after Academician I.P. Pavlov, 197022, Russia, St. Petersburg, L. Tolstogo str., 6/8 k3

Abstract. Aim. The purpose of the study is to study the possibility of clinical, laboratory and instrumental diagnostics in the combination in the diagnosis of prostate cancer. Material and methods. 147 patients were examined, the middle age of which was 69.5 ± 6.7 years. All patients underwent examination: identi cation of the level of prostate-speci c antigen (PSA) in blood serum, ultrasound transabdominal and transrectal examination in B mode, followed by the use of color Doppler mapping of blood ow, 3-dimensional Dopplerography, elastography and intravenous contrast enhancement. All patients underwent multifocal transrectal biopsy under ultrasound control followed by morphological examination of the obtained material. Results and discussion. The digital rectal examination found an increase of the prostate’s size at 115 patients, increase of the prostate’s density – at 69 patient, the high density’s existence of separate nodes - at 59 patients. The median level of prostate-speci c antigen in the blood serum of the surveyed patients was 16,5±6,7 ng / ml. Under transrectal ultrasound at 88 patients the hypoechogenicity center, at 34 – isoechogenicity and at the 22 th center – the mixed echogenic was revealed. We identi ed 111 patients with abnormal vascularity in disintegration and deformation of vascular pattern. Hyperintensive contrast in 59.0% of cases, rapid accumulation of the contrast agent in 56.0% and rapid leaching of the drug in 59.0% of cases were characteristic of prostate cancer. Comparison of data obtained at transrectal ultrasound with indicators of the Gleeson’s scale was carried out. It was established that hypoechogenic focus is more common in the total score 5-7, and less than 5 points, isoechogenic tumor often with a score 5-7. The pathological vascularization was more often diagnosed in the group of patients with a score 5-7. Conclusion. The use of clinical laboratory and modern methods of ultrasound examination in a complex allows to increase the effectiveness of prostate cancer diagnosis, which undoubtedly contributes to the choice of rational treatment tactics.

Key words: prostate’s cancer, ultrasound dopplerography, the pathological vascularization, the Gleeson’s scale.

For reference: Nasrullaev MN, Nasrullaev MM, Khasanov MZ, Nasrullaev MM, Fassakhova AA. Comprehensive diagnosis of prostate cancer. The Bulletin of Contemporary Clinical Medicine. 2022; 15 (2): 44—48.DOI: 10.20969/VSKM.2022.15(2). 44-48


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PROKOFYEVA TATIANA V., ORCID ID: 0000-0002-3260-2677; C. Med. Sci., associate professor of the Internal Medicine Department of Pediatric Department, Astrakhan State Medical University, Astrakhan, 54-170 Pobedy St., 414040, Russia, Astrakhan, e-mail: prokofeva-73@inbox.ru.

BASHKINA OLGA A., ORCID ID: 0000-0003-4168-4851, D. Med. Sci., Professor, Rector, Head of Department of Pediatrics, Astrakhan State Medical University, 414000, Astrakhan, Russia, Bakinskaya str.

POLUNINA OLGA S., ORCID ID: 0000-0001-8299-6582, D. Med. Sci., Professor, Head of Internal Medicine Department of Pediatric Department, Astrakhan State Medical University, 414000, Russia, Astrakhan, Bakinskaya str. 121, e-mail: admed@yandex.ru

VORONINA LUDMILA P., ORCID ID: 0000-0002-2395-745X, D. Med. Sci., professor of the Internal Medicine Department of Pediatric Department, Astrakhan State Medical University, Astrakhan, 414000, Russia, Astrakhan, Bakinskaya str. 121, e-mail: voroninaluda74@mail.ru

SEVOSTYANOVA IRINA V., ORCID ID: 0000-0002-3679-432X, C. Med. Sci., associate professor of the Internal Medicine Department of Pediatric Department, Astrakhan State Medical University, 414040, Russia, Astrakhan, Bakinskaya str. 121, e-mail: irina-nurzhanova@yandex.ru

POLUNINA EKATERINA A., ORCID ID: 0000-0002-3679-432X, D. Med. Sci., associate professor of the Internal Medicine Department of Pediatric Department, Astrakhan State Medical University, Astrakhan, 414000, Russia, Astrakhan, Bakinskaya str. 121, e-mail: gilti2@yandex.ru

Abstract. Introduction. The presence of endogenous intoxication syndrome in somatic pathology worsens the course and prognosis of diseases. It is especially urgent to study this syndrome in comorbid pathology, in particular, in myocardial infarction development in patients with chronic obstructive pulmonary disease. The objective markers of endogenous intoxication are medium and low molecular weight substances and oligopeptides. Aim. The aim is to estimate the severity of endogenous intoxication syndrome by studying the levels of medium and low molecular weight substances and oligopeptides in patients with myocardial infarction developed against the background of chronic obstructive pulmonary disease depending on the number of coronary arteries affected. Material and methods. 225 patients with myocardial infarction were examined. In 130 of them the infarction developed as monosomal disease, and in 195 - against the background of previously documented chronic obstructive pulmonary disease. Among patients with myocardial infarction as monoin ammation, 71 (64.5%) had a single-vessel lesion and 59 (35.5%) had a multivessel lesion. Among patients with myocardial infarction against chronic obstructive pulmonary disease, lesion of the 1st coronary artery was found in 50 patients (25.6%), and multivessel lesion was found in 145 (74.4%). The comparison group included 110 somatically healthy subjects. We used direct spectrometry (according to M.Y. Malakhova, 1995) to determine the levels of medium and low molecular weight substances and oligopeptides. Statistical data processing was carried out using software package SPSS 26.0. Results and discussion.In the group of patients with myocardial infarction the levels of medium and low molecular weight substances and oligopeptides and calculated indices showed signi cant differences in single- and multivessel lesions. In the 1st coronary artery lesion, the indices in most cases were comparable with the values in the control group. In the group of myocardial infarction patients with multivessel lesions, the values of medium and low molecular weight substances and oligopeptides increased signi cantly. In patients with myocardial infarction against the background of chronic obstructive pulmonary disease, all intoxication parameters were signi cantly higher compared not only with the control, but also with patients with myocardial infarction as monoin ammation. However, the values in the subgroups with single and multivessel lesions did not demonstrate statistical reliability. Conclusion. The number of affected vessels, and hence the volume of ischemic myocardium, affects the severity of endogenous intoxication in patients with myocardial infarction as mononasal. In this case, the elimination function of the excretory organs is not impaired, which means that the level of intoxication is due to the production of toxins in conditions of ischemia and myocardial necrosis. In conditions of cardiorespiratory comorbidity chronic obstructive pulmonary disease contributes signi cantly to the development of endogenous intoxication, aggravating it and levelling the differences occurring in monosensing.

Key words: myocardial infarction, chronic obstructive pulmonary disease, cardiorespiratory comorbidity, medium and low molecular weight substances, oligopeptides, endogenous intoxication syndrome.

For reference: Prokofyeva TV, Bashkina OA, Polunina OS, Voronina LP, Sevostyanova IV, Polunina EA. Levels of medium- and low-molecular-weight substances and oligopeptides in patients with myocardial infarction against chronic obstructive pulmonary disease with single- and multivessel coronary artery disease. The Bulletin of Contemporary Clinical Medicine. 2022; 15 (2): 49—59. DOI: 10.20969/VSKM.2022.15(2). 49-59


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SOROKINA TATIANA V., ORCID ID: 0000-0002-6264-4632; Candidate of Medical Sciences, Head of the Internal medicine department of the Hospital of Internal medicine, Assistant professor of the Department of Propaedeutic of  Internal Diseases with a course of therapy of the Pediatric Faculty of the Siberian State Medical University, 634050, Tomsk, Moskovsky Tract, 2, tel. +79138160744, e-mail: gbsmp.sorokinatatyana@mail.ru

DAVYDOVA VALENTINA V., ORCID ID: 0000-0002-2292-5974; internist, gastroenterologist of the Internal medicine department of the Hospital of Internal medicine of the Siberian State Medical University, 634050, Tomsk, Moskovsky Tract, 2, tel. (3822) 901101 ext.1313, e-mail: davydova_val_val@mail.ru

KOLESNIK NATALIA Yu., ORCID ID: 0000-0003-4213-2389; internist, cardiologist of the Internal medicine department of the Hospital of Internal medicine of the Siberian State Medical University, 634050, Tomsk, Moskovsky Tract, 2, tel. (3822) 901101 ext.1313, e-mail: nataliyakolesnik70@gmail.com

BOLVANTSEVA ALYONA I., ORCID ID: 0000-0001-6095-6598; internist in the Hospital of Internal medicine of the Siberian State Medical University, 634050, Tomsk, Moskovsky Tract, 2, tel. (3822) 901101 ext.1313, e-mail: abolvanceva@gmail.com

SAMOYLOVA YULIA G., ORCID ID: 0000-0002-2667-4842 - Doctor of Medical Sciences, Professor, Professor of the Department of Internal Medicine with a course in Clinical Pharmacology, Head of the Clinical Research Center of the Siberian State Medical University, Chief Specialist of the Tomsk Region Department of Health for Medical Prevention, 634050, Tomsk, Moskovsky Tract, 2, tel. +79138267424, e-mail: samoilova_y@inbox.ru

OLEYNIK OXANA A., ORCID ID: 0000-0002-2915-384X - Candidate of Medical Sciences, Associate Professor, Associate Professor of the Department of Internal Medicine with a course of Clinical Pharmacology, expert of the Center for Clinical Research of the Siberian State Medical University, 634050, Tomsk, Moskovsky Tract, 2, tel. +79138503840, e-mail: oleynikoa@mail.ru

TOLMACHEV IVAN V., ORCID ID: 0000-0002-2888-5539, Candidate of Medical Sciences, head of Target Search Laboratory of Medical Engineering Technologies of the Foundation for Advanced Research, Assoc. Professor of the Department of Medical and Biological Cybernetics of the Siberian State Medical University, 634050, Tomsk, Moskovsky Tract 2, tel. +79095419329, e-mail: ivantolm@mail.ru

Abstract. Introduction. The nonspeci city of the clinical manifestations of the initial stage of non-alcoholic fatty liver disease (NAFLD) - the stage of steatosis, is the reason for the untimely correction and progression of this disease. Aim.The aim of the study was to conduct a randomized open comparative study to determine the effectiveness of the use of the food supplement FanDetox as a source of organic compounds in liver function disorders. Material and methods. This study was a single-center randomized open one and included the study of the possibility of using the herbal product FanDetox in the complex therapy of NAFLD in patients aged 18 to 75 years with a veri ed diagnosis of obesity and the presence of signs of steatohepatosis, against the background of basic therapy with Carsil Forte. The study was conducted with the involvement of 68 people matched by sex and age, 34 of whom made up the main observation group, whose participants took the study product 1 sachet 2 times a day after meals, in the form of a suspension obtained after mixing the powder in 100 ml of water. The rest 34 patients made up the comparison group. Carsil Forte was chosen as a background drug for both groups. The duration of therapy for each study participant was 3 months. The follow-up process included patient visits with a detailed medical history, therapeutic examination, and laboratory and instrumental examinations. Statistical analysis was carried out using the IBM SPSS Statistics 23 program. Results and discussion. As a result, an improvement in the subjective well-being of patients, a decrease in the echoscopic manifestations of fatty hepatosis, a decrease in the longitudinal size of the liver, a decrease in the manifestations of the cytolysis syndrome and bilirubin levels, as well as a signi cant positive dynamics of the lipid spectrum in the blood of patients who received complex therapy, including the use of the FanDetox biologically active additive, compared with the comparison group undergoing therapy with the background drug Carsil Forte, were shown. Conclusion. It has been established that taking the food supplement FanDetox helps to reduce the manifestations of fatty hepatosis, reduce the longitudinal size of the liver, blood biochemistry indicators and the general well-being of patients.

Keywords: non-alcoholic fatty liver disease, dietary supplement, lipid spectrum

For reference: Sorokina TV, Davydova VV, Kolesnik NYu, Bolvantseva AI, Samoilova YuG, Oleynik OA, Tolmachev IV. Application of organic compounds in therapeutic practice for liver function disturbances. The Bulletin of Contemporary Clinical Medicine. 2022; 15 (2): 60—66. DOI: 10.20969/VSKM.2022.15(2). 60-66


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UDC 616-08-039.73



YABLONSKY PIOTR K., – ORCID ID: 0000-0003-4385-9643, Doctor of Medical Sciences, Professor, Director of the St. Petersburg Research Institute of Phthisiopulmonology, Professor of the Department of General Surgery of the Medical Faculty of St. Petersburg State University; Russia, St. Petersburg, Ligovsky pr., 2-4. 191036, e-mail: piotr_yablonskii@mail.ru.

STARSHINOVA ANNA A., – ORCID ID: 0000-0002-9023-6986. Doctor of Medical Sciences, Professor of the Department of Internal Medicine, Head of the Scientific Research Department of the V.A. Almazov National Medical Research Center; Russia, St. Petersburg, st. Akkuratova d.2, 197341; mob. +79052043861; e-mail: starshinova_777@mail.ru, starshinova_aa@almazovcentre.ru.

NAZARENKO MIKHAIL M., – ORCID ID: 0000-0002-6681-6411, Head of the medical unit of the St. Petersburg State Budgetary Institution of Health «Pushkin Tuberculosis Dispensary», junior researcher of the St. Petersburg Research Institute of Phthisiopulmonology, St. Petersburg, Pavlovskoye sh., 14, 196602; mol. +79643894778, e-mail: drpulmone@yandex.ru.

BELYAEVA EKATERINA N., - Head of the Department for the Treatment of Patients with Multidrug and Extensively Drug-Resistant Tuberculosis, St. Petersburg City Tuberculosis Hospital No. 2; Russia, St. Petersburg, Torez Ave., 93, 194214, mob. +7(931)3031760, ekaterina_83@bk.ru.

CHUZHOV ALEXANDER L., – ORCID ID: 0000-0002-7023-8984, C. Med. Sci., Head of the Department of St. Petersburg “Interdistrict Petrograd-Primorsky Tuberculosis Dispensary No.3”, Russia, St. Petersburg, Studencheskaya st., 16, 197343; e-mail: chuzhov@mail.ru.

ALEKSEEV DMITRY Y., – ORCID ID: 0000-0002-6303-4430, C. Med. Sci., Head of Phthisiopulmonology of St. Petersburg «Interdistrict Petrograd-Primorsky Tuberculosis Dispensary No.3»; Russia, St. Petersburg, Studencheskaya st, 16, 197343; e-mail: Alexeev466@yandex.ru.

PAVLOVA MARIA V., – ORCID ID: 0000-0002-9472-8136, Doctor of Medical Sciences, Professor, Leading Researcher, Head of the Phthisiopulmonology Department of the St. Petersburg Research Institute of Phthisiopulmonology; Russia, St. Petersburg, Ligovsky pr., 2–4, 191036; e-mail: mv@spbniif.ru.

Abstract. Introduction: Improving the effectiveness of treatment of the most dif cult category of patients with extensively drug-resistant tuberculosis is still relevant in the present circumstances. Ef cacy of therapy is not higher than 35,7%. New therapy regimes with the use of bedaquiline and pyridinium perchlorate were recommended for extended drug resistance treatment. Aim. Aim of the study is to compare ef cacy of new regimes of treatment with the use of bedaquiline and pyridinium perchlorate in patients with extended drug resistance of mycobacterium. Material and methods. Retrospective study with analysis of therapy in 150 patients with extended drug resistance tuberculosis, who were treated in the period from 2016 till 2019, divided into three groups: (I-st group, n=80) – standard therapy; (II-nd group, n=47) – regime with pyridinium perchlorate; and III-rd group (n=23) – regime with bedaquiline. Analysis was performed for clinical, laboratory, and radiology assessments. Evaluation of treatment ef cacy was done based on criteria de ned in the international guidance. Results and discussions. To the end of hospitalization stage of therapy, in the group with bedaquivilin cessation of bacterial excretion in extended drug resistance tuberculosis patients was observed signi cantly more frequent than in the group of standard therapy without Bq (60,8% (III) vs 30,0% (I), p˂0,01). In the II group of cessation was also signi cantly more frequent than in the group of standard therapy without pyridinium perchlorate (57,8% (III) vs 30,0% (I), p˂0,01). Ef cacy to the end of treatment assessed by positive roentgenologic dynamic was 78,2% и 57,8% (p˂0,0001) for 6-8 months of treatment by bedaquiline and pyridinium perchlorate correspondently, that was signi cantly more frequent than in the I-st group (25%). Based on performed analysis inclusion of this antituberculosis drugs in therapy of extended drug resistance tuberculosis patients is associated with increase of its ef cacy ((р=0,0046, ОР=0,7325, 95%Сl 0,3 – 1,65%, PPV=0,6140, NPV=0,1618). Comparison of general parameters of ef cacy demonstrates signi cantly high percent of treatment ef cacy in extended drug resistance tuberculosis patients while addition into therapy new antituberculosis drugs. Signi cant difference between groups for surveillance, while addition of new antituberculosis drugs, was not observed. Conclusion. Results of the study demonstrate opportunities to increase treatment ef cacy with addition of new antituberculosis drugs. Nevertheless, ef cacy of treatment limited by 6-8 months, that allows to recommend extension of treatment duration by new antituberculosis drugs, and as well to implement other methods to increase its ef cacy.

Key words: tuberculosis, treatment, extended drug resistance, bedaquivilin, tioureidoiminometylpiridinia perchlorate.

For reference: Yablonskiy PK, Starshinova АА, Nazarenko ММ, Beliaeva ЕN, Chuzhov АL, Alekseev DY, Pavlova МV. Increasing the ef ciency of patients pulmonary tuberculosis treatment with the use of new therapy regimens. The Bulletin of Contemporary Clinical Medicine. 2022; 15 (2): 67—75. DOI: 10.20969/VSKM.2022.15(2). 67-75


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ULISHCHENKO ILIYA A., ORCID ID: 0000-0001-5654-307X; Chief Executive Officer of LLC “International Academy of Faceplasty and Osteopathy”, Russia, Moscow, Alabyana street, 13, bldg. 2, tel. +7 (968) 737-89-98, e-mail: ilyaulish@gmail.com

SHULAEV ALEXEY V., ORCID ID: 0000-0002-2073-2538; Doctor of Medical Sciences, Professor, Vice-Rector for Clinical Work, Head of the Department of General Hygiene of Kazan State Medical University, Russia, Kazan, st. Butlerova, 49, tel. +7 (987) 213-67-12, e-mail: alexs_shu@mail.ru

KONOVALOV OLEG E., ORCID ID: 0000-0003-1974-9882; Doctor of Medical Sciences, Professor of the Department of Public Health, Healthcare and Hygiene of the Peoples’ Friendship University of Russia, Russia, Moscow, st. Miklukho-Maclay, 10, bldg. 2, tel. +7 (910) 508-10-45, e-mail: konovalov_oe@mail.ru

PAK VITALIY I., ORCID ID: 0000-0002-6941-9745; Post-graduate student of the Department of Public Health, Health Care and Hygiene, Peoples’ Friendship University of Russia, Russia, Moscow, st. Miklukho-Maclay, 10, bldg. 2, tel. +7 (916) 056-56-92, e-mail: pakvan@bk.ru

YAKHYAEVA SABIYAT A., ORCID ID: 0000-0002-4177-5078; 6th year student of the Medical Institute of the Peoples’ Friendship University of Russia, Russia, Moscow, st. Miklukho-Maclay, 10, bldg. 2, tel. +7 (988) 276-81-00, e-mail: Sabiyat30@mail.ru

Abstract. Currently, there is a steady increase in the number of children suffering from two or more diseases simultaneously occurring. In this regard, the assessment by parents of the medical care received by children with concomitant diseases is highly relevant. Aim. The aim of the study is to study the satisfaction of parents with medical care provided to patients with bronchial asthma and children with comorbid pathology. Material and methods. On the basis of the regional children’s clinical hospital, a selective sociological study was carried out, in which 368 parents of children aged 7 to 14 years old, patients with bronchial asthma with concomitant pathology, took part. Study design: single-center, non-randomized, uncontrolled study. Results and discussion. In the opinion of only 36.4% of the parents surveyed, inpatient medical care provided to their children is always available. The availability of outpatient care was positively assessed by only 29.5% of the respondents. In this case, the main reasons for dissatisfaction were called insuf cient provision of the speci ed specialists and a long wait for the day of admission. The majority (81.8%) of the respondents would like to receive consultations from specialists of other pro les, taking into account concomitant diseases, when the child is in the pulmonary department of the hospital. At the same time, according to almost every second parent, the level of consultation of various specialists is higher in hospitals than in children’s polyclinics. Among the respondents, 69.3% considered themselves suf ciently informed on the issues of bronchial asthma in children. However, the results of the survey showed that only 69% of parents always follow medical recommendations. Conclusion. The presence of concomitant pathology in childhood, including with such a fairly common chronic disease such as bronchial asthma, requires special medical and organizational approaches to treatment. At the same time, it is necessary to take into account the opinion of the legal representatives of children on the availability and quality of medical care provided.

Key words: children, bronchial asthma, medical care, parental assessment

For reference: Ulishchenko IA, Shulaev AV, Konovalov OE, Pak VI, Yakhyaeva SA. Parents’ assessment of medical care for their children with bronchial asthma and comorbid pathology. The Bulletin of Contemporary Clinical Medicine. 2022; 15 (2): 76—80. DOI: 10.20969/VSKM.2022.15(2). 76-80.


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8. Овсянников Д.Ю. Трудности и ошибки диагностики и терапии бронхиальной астмы у детей // Медицинский совет. 2017.- No1.- С. 100-106. [Ovsjannikov DJu. Trudnosti i oshibki diagnostiki i terapii bronxial`noj astmy` u detej [Challenges and errors in the diagnosis and treatment of asthma in children]. Medicinskij sovet [Medical advice]. 2017; 1: 100-106. (In Russ.)]. DOI: 10.21518/2079-701X-2017-1-100-106

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UDC 616.24-002.5-052-085-06:616.34-008.87

DOI: 10.20969/VSKM.2022.15(2).81-88


KHOLODOV ARTYOM A., ORCID ID: 0000-0001-5249-8822; Clinical Resident of the Department of Phthisiology, Kemerovo State Medical University, Russia, 650029, Kemerovo, Voroshilova Street 22 A,
tel .: 8-384-2-54-56-51, e-mail: artyomkass96@gmail.com

BRYUKHACHEVA EKATERINA O., ORCID ID: 0000-0001-5212-9234; Assistant of the Department of Phthisiology, Federal State Budgetary Educational Institution of Higher Education “Kemerovo State Medical University” of the Ministry of Health of Russia, Russia, 650029, Kemerovo, Voroshilova Street 22 A, Department of Phthisiology

OTDUSHKINA LARISA Y., ORCID ID: 0000-0003-4126-4312; Assistant Professor of the Department of Microbiology, Immunology and Virology of the Kemerovo State Medical University, Russia, 650029, Kemerovo, Voroshilova Street 22 A

ZAKHAROVA YULIA V., ORCID ID: 0000-0002-3475-9125; Doctor of Medical Sciences, Associate Professor, Associate Professor of the Department of Microbiology, Immunology and Virology of the Kemerovo State Medical University, Russia, 650029, Kemerovo, Voroshilova Street 22 A

PRIMKULOVA MARINA V., ORCID ID: 0000-0003-1776-2098; Assistant Professor of the Department of Phthisiology, Kemerovo State Medical University, Russia, 650029, Kemerovo, Voroshilova Street 22 A

PYANZOVA TATYANA V., ORCID ID: 0000-0002-4854-5734; Vice-rector for scientific, medical work and the development of regional health care, Doctor of Medical Sciences, Associate Professor, Head of the Department of Phthisiology of the Kemerovo State Medical University, Russia, 650029, Kemerovo, Voroshilova Street 22 A

Abstract. Introduction. About 90% of TB patients have side effects of anti-TB therapy in the form of gastrointestinal disorders. Currently, the role of disorders of the intestinal microbiocenosis in the formation of dyspepsia has been proven. In turn, dyspeptic syndrome leads to a decrease in patient adherence to treatment, which affects the effectiveness of tuberculosis treatment. The most dangerous in this regard are second-line anti-tuberculosis drugs used in the treatment of drug-resistant tuberculosis. Long-term use of these drugs requires the development and implementation of algorithms for the correction of microecological disorders of the intestine. The aim of the study was to evaluate the microbiological results of using a combined probiotic in persons with tuberculosis and multidrug-resistant pathogen in the course of anti-tuberculosis therapy. Material and methods. A prospective linear study included 30 patients with respiratory tuberculosis and multidrug-resistant pathogen. The study consisted in a two-stage study of the microbiocenosis of the intestinal biotope of these patients by a quantitative bacteriological method before and after combined probiotic therapy with a further comparison of the number of microorganisms. Statistical data processing was performed using the IBM SPSS program. Qualitative signs are represented by absolute and relative frequencies, expressed as a percentage, with 95% con dence intervals calculated for them by the Wilson method (rel.% [95% CI]). Quantitative data are presented in the work in the format of the median and interquartile range (Me (25th; 75th). For variables related to the ordinal scale and nonparametric quantitative variables, the Mann-Whitney U test was used to compare the two groups of observations. the compared groups were considered statistically signi cant with a statistical signi cance of less than 0.05. Results and discussion. The use of combined probiotic therapy in patients with multidrug-resistant tuberculosis did not compensate for the de ciency of obligate microorganisms - Bi dobacterium spp., Lactobacillus spp. However, in the process of probiotic therapy noted a decrease in the concentration of Enterococcus spp., E. Coli lac-, E. Coli hly +, Streptococcus spp., as well as a decrease in the titers and species structure of fungi of the genus Candida. A clinical example showing the microbiological and clinical ef cacy of probiotic therapy in a patient with co-infection TB / HIV. Despite the changes received, the average population indicators for the region have not been achieved. Conclusion. It was found that the use of combined probiotic therapy in patients with multidrug-resistant tuberculosis led to a decrease in the pool of opportunistic microorganisms in the intestinal lumen and had a positive clinical effect in a patient with TB / HIV co-infection.

Key words: correction of intestinal micro ora, microbiocenosis, dyspeptic syndrome, tuberculosis, multidrug resistance

For reference: Kholodov EO, Bryukhacheva LYu, Otdushkina AA, Zakharova YuV, Primkulova MV, Pyanzova TV. Results of the use of combined probiotic therapy for the correction of intestinal microbiocenosis disorders in patients with multidrug-resistant tuberculosis. The Bulletin of Contemporary Clinical Medicine. 2022; 15 (2): 81—88. DOI:10.20969/VSKM.2022.15(2). 81-88


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UDC 616.12-008.46:615.03



GALYAUTDINOV GENSHAT S., ORCID ID: 0000-0001-7403-0200; D. Med. Sci., professor of the Department of Advanced Internal Medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7 (843) 236-04-11, e-mail: galgen077@mail.ru

ZHIDYAEVSKIJ ALEXANDER G., ORCID ID: 0000-0002-4245-5201; assistant professor of the Department of Psychiatry and Medical psychology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7 (843) 236-05-63, e-mail: zhidyaevskij@mail.ru

NESTERINA MARIA K., 5th year student of the Faculty of General medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7 (906) 130-33-66, e-mail: mari.nesterina@mail.ru

MINNEGALIMOVA KARINA R., 5th year student of the Faculty of General medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7 (927) 447-44-73, e-mail: minnegalimova.karina@yandex.ru

Abstract. Introduction. This article provides information of sodium-glucose co-transporter-2. Aim. The aim of the study was to review the current information on the positive effect of drugs from the sodium-glucose co-transporter-2 on the cardiovascular system of patients with chronic heart failure. Material and methods. A review of current published studies of sodium-glucose co-transporter-2 is provided. Results and discussion. In 2015, for the rst time, there was a mention of the positive effect of sodium-glucose co-transporter-2 on the cardiovascular system of patients with type 2 diabetes mellitus. There was a decrease in the risk of death from cardiovascular diseases, non-fatal myocardial infarction, acute cerebrovascular accident, as well as a decrease in the frequency of hospitalizations for exacerbation of chronic heart failure. In 2020, information was obtained on the isolated effect of this group on chronic heart failure, regardless of the presence of type 2 diabetes. When studying the drugs, it was found that their cardioprotective effect is due to a decrease in blood pressure by increasing osmotic diuresis, partial suppression of the activity of the renin-angiotensin-aldosterone system due to an increase in sodium concentration in the area of the dense spot of the distal convoluted tubule, increased oxygen delivery to the heart muscle by stimulating erythropoiesis. Conclusion. It is reasonable to use drugs that belong to the group of inhibitors of sodium-glucose co-transporter-2 in clinical practice for the treatment of patients with chronic heart failure, regardless of whether they have type 2 diabetes mellitus.

Key words: chronic heart failure, diabetes mellitus, sodium-glucose co-transporter-2 inhibitors.

For reference. Galyautdinov GS, Zhidyaevskij AG, Nesterina MK, Minnegalimova KR. Inhibition of sodium glucose transport protein 2: clinical and pharmacological effects in chronic heart failure. The Bulletin of Contemporary Clinical Medicine. 2022; 15 (2): 89—94. DOI: 10.20969/VSKM.2022.15(2). 89-94


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UDC 616.2:616-053.9



KAMASHEVA GULNARA R., ORCID ID: 0000-0002-6811-4966; SCOPUS Author ID: 57212348954; C. Med. Sci., associate professor of the Department of general practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: kamasheva73@rambler.ru

SINEGLAZOVA ALBINA V., ORCID ID: 0000-0002-7951-0040; SCOPUS Author ID: 55001894700 D. Med. Sci., associate professor, the Head of the Department of outpatient medicine and general medical practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: sineglazovaav@mail.ru

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

Abstract. Aim. Based on an analysis of the medical literature, describe the key features of age-related organic and functional changes that potentially affect the course and therapy of respiratory diseases in elderly and senile people. Material andmethods. A review of publications in the scienti c and methodological literature on the problems of physiological and pathological aging, the epidemiology of somatic pathology and the peculiarities of its clinical manifestations and outcomes in the age aspect, including the relationship with the course of non-infectious and infectious respiratory diseases in elderly and senile people, is carried out. Results and discussion. The article provides relevant data on morbidity and mortality from respiratory pathology in old and senile age. A description is given of the mechanisms of aging of organs and systems, changes in the regulation of their functions, including changes in immunoreactivity from the standpoint of in uence on the occurrence and course of respiratory diseases. Conclusion. When managing elderly and senile patients, it is necessary to take into account the age-related characteristics of the aging organism, the existing comorbid pathology and its therapy, take a differentiated approach to the assessment of the clinic, taking into account the direct signs of age-associated symptoms and manifestations of the «pharmacological cascade».

Key words: aging, elderly and senile age, age-related morphological and functional changes, respiratory diseases, immune system.

For reference: Kamasheva GR, Sineglazova AV, Arkhipov EV. Morphofunctional aspects of aging that determine the course of respiratory diseases in old and senile age. The Bulletin of Contemporary Clinical Medicine. 2022; 15 (2): 95—102. DOI: 10.20969/VSKM.2022.15(2).95-102


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UDC: 615.357:616.98



TANIN IVAN YU., ORCID ID: 0000-0001-8883-3899; assistant professor of the Department of endocrinology of faculty of advanced training and professional specialist retraining of Kuban State Medical University, Russia, 350063, Krasnodar, Sedin str., 4, tel. +7(989)280-50-76, e-mail: Tanin2012ivan@mail.ru

IVANOVA LIUDMILA A., ORCID ID: 0000-0001-5302-3802; D. Med. Sci., professor, the Head of the Department of endocrinology of faculty of advanced training and professional specialist retraining of Kuban State Medical University, Russia, 350063, Krasnodar, Sedin str., 4, tel. +7(988)242-13-90, e-mail: endocrinkgmu@mail.ru

KOROL’ INNA V., ORCID ID: 0000-0002-3909-9007; C. Med. Sci., associate professor of the Department of endocrinology of faculty of advanced training and professional specialist retraining of Kuban State Medical University, Russia, 350063, Krasnodar, Sedin str., 4, tel. +7(918)414-44-19, e-mail: innakorol1@mail.ru

KOVALENKO YULIYA S., ORCID ID: 0000-0002-7236-7341; С. Med. Sci., associate professor of the Department of endocrinology of faculty of advanced training and professional specialist retraining of Kuban State Medical University, Russia, 350063, Krasnodar, Sedin str., 4, tel. +7(952)813-17-96, e-mail: julendo@mail.ru

RUZHITSKAYA LIDIYA V., ORCID ID: 0000-0002-8809-7008; assistant of professor of the Department of endocrinology of faculty of advanced training and professional specialist retraining of Kuban State Medical University, Russia, 350063, Krasnodar, Sedin str., 4, tel. +7(918)671-56-05, e-mail: lida_ruz-7@mail.ru

KONDRATENKO ANZHELIKA S., ORCID ID: 0000-0003-3045-7952; Second year clinical resident of the Department of endocrinology of faculty of advanced training and professional specialist retraining of Kuban State Medical University, Russia, 350063, Krasnodar, Sedin str., 4, tel. +7(964)911-95-79, e-mail: Anzhelikakondra@mail.ru

BANDURA KAPITOLINA A., ORCID ID: 0000-0002-8979-2571; Second year clinical resident of the Department of endocrinology of faculty of advanced training and professional specialist retraining of Kuban State Medical University, Russia, 350063, Krasnodar, Sedin str., 4, tel. +7(918)663-08-08, e-mail: kapitolina_b_a@mail.ru

Abstract. Introduction. This article discusses the treatment of coronavirus infection (COVID-19) with glucocorticosteroid drugs (GCS), side effects of drugs and their prevention, transfer from intravenous to intramuscular and then to oral administration, and the development of withdrawal syndrome. The article describes the conditions under which antibiotic therapy is prescribed, as well as the conditions under which the combined use of corticosteroids and antibiotics is necessary. Aim. The aim to analyze the basic principles of corticosteroids prescribing in the treatment of COVID-19: indications for corticosteroids administration, administration regimens and required dosages, side effects of corticosteroids administration. Material and methods. The article uses data from the Interim Guidelines for the Prevention, Diagnosis and Treatment of New Coronavirus Infection (COVID-19), the Federal Clinical Guidelines for the Specialty “Rheumatology”, as well as using the literature on basic and clinical endocrinology, cardiology and pharmacology. The work was written using a systems approach, methods of analysis, induction and observation. Results and discussion. Systemic corticosteroids are used in cases of severe and critical course of the disease COVID-19 (con rmation may be an increase in ferritin, procalcitonin, C-reactive protein (CRP), decreased cognitive functions, development of sopor). Their appointment is also justi ed when the initial course of the disease was not diagnosed as severe, but suddenly the patient’s condition deteriorated. The use of antibiotic therapy is advisable when a bacterial infection is attached - (procalcitonin (PCT)> 0.5 ng / ml, purulent sputum, leukocytosis> 12 × 109 / L (in the absence of previous use of glucocorticoids), an increase in band neutrophils of more than 10%). In the presence of chronic infectious diseases in patients with COVID-19 (for example, chronic obstructive pulmonary disease-COPD, chronic pyelonephritis, etc.), antibiotics are prescribed to prevent exacerbations of these diseases. Conclusion. In the course of the study, the authors of the article formulated the following principles of glucocorticoid therapy: drugs should be prescribed according to strict indications; maximum doses are applied in a short course; when the patient’s condition is stabilized, it is necessary to reduce the dose in a timely manner and gradually to complete withdrawal to prevent the development of “withdrawal” syndrome, adrenal insuf ciency of central genesis, sympathoadrenal crises; during and after treatment, prevention of complications of glucocorticoid therapy (hyperglycemia, hypocalcemia, osteopenia, in ammatory diseases of the urinary system) is recommended; collegial management of patients by infectious diseases and endocrinologists is mandatory.

Key words: glucocorticosteroids, antibiotics, coronavirus infection (COVID-19), withdrawal syndrome.

For reference: Tanin IY, Ivanova LA, Korol IV, Kovalenko YuS, Ruzhitskaya LV, Kondratenko AS, Bandura KA. Principles of glucocorticosteroid administration in patients with COVID-19. The Bulletin of Contemporary Clinical Medicine. 2022; 15 (2): 103—109. DOI: 10.20969/VSKM.2022.15(2). 103-109


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SVETLANA N. STYAZHKINA, ORCID ID: 0000-0001-5787-8269; D. Med. Sci., professor of the Department of surgery of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunarov str., 281, tel. +7-950-820-51-10, e-mail: sstazkina064@gmail.com

LILIYA F. KHUZINA, ORCID ID: 0000-0001-5025-2343; 6th year student of faculty of general medicine of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunarov str., 281, tel. +7-922-502-36-32, e-mail: khuzina-l2013@yandex.ru

BULAT A. MULLAKHMETOV, ORCID ID: 0000-0001-5393-2213; 6th year student of faculty of general medicine of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunarov str., 281, tel. +7-987-067-36-78, e-mail:Butatik@mail.ru

NIKOLAY A. KIRYANOV, D. Med. Sci., professor, Head of the Department of pathological anatomy of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunarov str., 281, tel. +7-912-850-25-89, e-mail: kirnik@list.ru

DMITRY N. KUKLIN, urologist, First Republic Clinical Hospital, Russia, 426039, Izhevsk, Votkinskoye Shosse St., 57, tel. +7-912-456-80-78, e-mail: kukdn@yandex.ru

OLEG A. EROKHIN, oncologist, First Republic Clinical Hospital, Russia, 426039, Izhevsk, Votkinskoye Shosse St., 57, tel. +7-922-525-90-00, e-mail: erochin06@mail.ru

Abstract. Introduction. One of the rare complex diseases in clinical practice is Bourneville-Pringle disease (tuberous sclerosis). It is a genetically determined polysystemic disease with an autosomal dominant type of inheritance, one of the manifestations of which are renal angiomyolipomas. Angiomyolipoma is a benign kidney tumor. It consists of epithelioid, smooth muscle cells and adipose tissue and has abundant abnormal vascularization. Aim. We analyze a complex clinical case in a patient with a giant angiomyolipoma of a single kidney. Material and methods. Patient S., 58 years old, was urgently admitted to the urology department. The patient complained of pain in the left lumbar region, in the left half of the abdomen, blood impurities in the urine. General clinical, laboratory and instrumental research tools were conducted.Results and discussion. According to the spiral CT of the kidneys with contrasting, in the left kidney a giant mass with a violation of its architectonics, with signs of hemorrhage and a formed hematoma in the upper third of the mass and hemorrhagic impregnation of its lower half was found. Surgical treatment was prescribed, during which embolization of the segmental arteries of the left kidney, selective angiography of the left renal artery, total nephrectomy on the left with a successful outcome were performed. Conclusion. On the basis of the given clinical case, it should be concluded that despite the benign nature of the renal angiomyolipoma, the tumor has reached gigantic sizes due to the late treatment of the patient caused by concomitant oligophrenia. In this regard, the late diagnosis has led to life-threatening complications that required immediate decision-making. The given clinical observation shows the success of the chosen surgical tactics in the form of a radical operation that allowed saving the life of the patient with a rare disease. The patient was discharged from the hospital for outpatient follow-up by an urologist and a nephrologist. Regular hemodialysis, monitoring with the help of laboratory and instrumental research tools are prescribed. The patient was put on the waiting list for renal transplantation in specialized centers in Russia.

Keywords: giant angiomyolipoma of the kidney, Bourneville-Pringle disease.

For reference: Styazhkina SN, Khuzina LF, Mullakhmetov BA, Kiryanov NA, Kuklin DN, Erokhin OA. Special aspects of giant renal angiomyolipoma diagnosis and treatment (clinical case). The Bulletin of Contemporary Clinical Medicine. 2022; 15 (2): 110—116. DOI: 10.20969/VSKM.2022.15(2). 110-116


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UDC: 611.714.3:611.831.55



KUSHTA ANNA O., ORCID ID: 0000-0001-8994-2560 PhD, Associate Professor of the Departmen of surgical dentistry and maxillofacial surgery, National Pirogov Memorial Medical University, Vinnytsia, Ukraine.

SHUVALOV SERGII M., ORCID ID: 0000-0001-5052-680xMD, Professor, Head of surgical dentistry and maxillofacial surgery, National Pirogov Memorial Medical University, Vinnytsia, Ukraine.

Abstract. Introduction. The region of the pterygo-mandibular space is an anatomical formation that is quite often subjected to surgical interventions (blockade of the mandibular nerve and its branches, operations for purulent processes, injuries). Among the complications of these surgical interventions, there are contractures of the lower jaw, neuritis of the lower alveolar and lingual nerves, and failure of anesthesia during blockades of these nerves. The purpose of the study was to analyze literature data and anatomical preparations of the pterygo-mandibular space, to take into account different options for the location of nerves and blood vessels during blockades and operations. Material and methods.The analysis of the literature and our own anatomical studies of 8 preparations of the deep parts of the human head was carried out. Results and discussion. The pterygo-mandibular space has a rather complex topographic and anatomical structure. Its anatomical structures are mobile along with the lower jaw and, accordingly, are adapted to these conditions in the form of a tortuous course of nerves and blood vessels, which prevents their stretching, tension, and injury. These features must be taken into account when performing surgical interventions, blockades of sensory and motor nerves in this area. Spatial perception of the location of the anatomical structures of the pterygo-mandibular space is facilitated by describing them relative to the lateral and medial muscles. Conclusions: The topographic and anatomical structure of the pterygo-mandibular space is variable and complex, which must be taken into account when performing nerve blocks, diagnostics, operations for purulent processes and traumatic injuries. The pterygo-mandibular space, connected directly with the peripharyngeal, should also be considered as part of the oral pharynx communicating with the base of the skull and neck.

Keywords: pterygo-mandibular space, nerves, muscles, anesthesia, operations.

For reference: Kushta AA, Shuvalov SM. Features of the topographic and anatomical structure of the pterygo-mandibular space, affecting the effectiveness of nerve blocks and other surgical interventions: сlinical lectures. The Bulletin of Contemporary Clinical Medicine. 2022; 15 (2): 117—123. DOI: 10.20969/VSKM.2022.15(2).117-123


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AL-ZAMIL MUSTAFA KH., ORCID ID: 0000-0002-3643-982X; Scopus Author ID 57313158200, Resercher ID ABC-4735-2021, SPIN-код: 3434-9150, AuthorID: 961632, Doctor of Medical Sciences, Professor of the Department of Physiotherapy, Faculty of Continuing Medical Education, Peoples’ Friendship University of Russia, 117198, st. Miklukho-Maclay 10, bldg. 2, Moscow, Russia, tel. +7(926)289-38-10, e-mail: alzamil@mail.ru

PUZIN MIKHAIL N., ORCID ID: 0000-0003-1823-1715; SPIN-код: 4336-9134, AuthorID: 416520, Doctor of Medical Sciences, Professor, Head of the Department of Nervous Diseases and Neurodentistry of a non-state educational private institution of additional professional education. Medical Dental Institute, 127253, Russia, Moscow, st. Pskovskaya, 9, building 1., tel. +7(499)504-54-76, e-mail: medinstmcu@inbox.ru

SHULAEV ALEXEY V., ORCID ID: 0000-0002-2073-2538; Scopus Author ID 57313158200, SPIN-код: 3229-1913, AuthorID: 210271, Doctor of Medical Sciences, Professor, Vice-Rector for Clinical Work, Head of the Department of General Hygiene of Kazan State Medical University, Russia, Kazan, st. Butlerova, 49, tel. +7 (987)213-67-12, e-mail: alexs_shu@mail.ru

KIPARISOVA ELENA S., ORCID ID: 0000-0001-6141-2971; Scopus Author ID 6701717574, Resercher ID ABS-9388-2022, SPIN-код: 2841-9154, AuthorID: 1077240, Doctor of Medical Sciences, Professor of the Department of Nervous Diseases of the Federal State Budgetary Institution Federal Scientific and Practical Center of the Federal Medical and Biological Agency of Russia, 125371, Russia, Moscow, Volokolamskoe shosse, 91, tel. +7(926)226-92-22, e-mail: kiparisova-es@yandex.ru

LUBIMOV ALEXANDER V., ORCID ID: 0000-0002-4573-2980; SPIN-код: 3623-2144, AuthorID: 883137, Doctor of Medical Sciences, Associate Professor of the Department of Nervous Diseases and Neurodentistry of a non-state educational private institution of additional professional education. Medical Dental Institute. 127253, Russia, Moscow, st. Pskovskaya, 9, building 1, tel. +7(499)504-54-76, email: lubalexan@mail.ru

SHILOVA TATYANA Y., ORCID ID: 0000-0002-4209-4370; Resercher ID A-5424-2014, Doctor of Medical Sciences, Associate Professor of the Department of Nervous Diseases and Neurodentistry of a non-state educational private institution of additional professional education. Medical Dental Institute, 127253, Russia, Moscow, st. Pskovskaya, 9, building 1, tel. +7(499)504-54-76, email: alexey.schilov@gmail.com

RAMAZANOVA LIA SH., ORCID ID: 0000-0001-5301-9299; SPIN-код: 5179-9515, AuthorID: 696274, Doctor of Medical Sciences, Associate Professor of the Department of Nervous Diseases and Neurodentistry of a Non-Governmental Private Educational Institution of Additional Professional Education. Medical Dental Institute. 127253, Russia, Moscow, st. Pskovskaya, 9, building 1, tel. +7(499)504-54-76, email: kmp4967@mail.ru

MAKKAEVA SAKINAT M., ORCID ID: 0000-0003-1313-9039; Doctor of Medical Sciences, Associate Professor of the Department of Nervous Diseases and Neurodentistry of a non-state educational private institution of additional professional education. Medical Dental Institute. 127253, Russia, Moscow, st. Pskovskaya, 9/1, tel. +7(985)774-45-41, email: medinstmcu@inbox.ru

SKOROKHODOV ALEXANDER P., ORCID ID: 0000-0002-3618-2964; SPIN-код: 1337-1897, AuthorID: 437272, Doctor of Medical Sciences, Professor of the Department of Nervous Diseases and Neurodentistry of a non-state educational private institution of additional professional education. Medical Dental Institute. 127253, Russia, Moscow, st. Pskovskaya, 9, building 1, tel. +7(909)232-20-63, email: scorohod-al@yandex.ru

GUNTER NINA A., ORCID ID: 0000-0002-7886-0938; SPIN-код: 9286-3586, AuthorID: 01715, Doctor of Medical Sciences, Associate Professor of the Department of Nervous Diseases and Neurodentistry of a non-state educational private institution of additional professional education. Medical Dental Institute. 127253, Moscow, st. Pskovskaya, 9/1, tel. +7(910)450-35-95, email: gutner2027@gmail.com

Abstract. Introduction. A change or lack of odor in patients after suffering from Covid-19 caused the development of serious disturbances in appetite and nutrition, which led to a decrease in body weight and a deterioration in the function of the digestive system as a whole, followed by alimentary damage to internal organs. Aim. To study the effectiveness of the combined use of endonasal electrophoresis and acupuncture in the treatment of patients with post-covid anosmia.Materials and methods: 30 patients with a con rmed diagnosis of COVID-19 were under our supervision. All patients suffered from post-covid anosmia. 15 patients underwent exclusively drug therapy (control group) and 15 patients, in addition to drug therapy, underwent a course of endonasal electrophoresis of 5% Mexidol solution and acupuncture. All patients underwent testing of olfactory nerve function with the Snif n ‘Sticks test before and after treatment. Results and its discussions: it was found that the use of endonasal electrophoresis in combination with acupuncture signi cantly enhances the effectiveness of drug therapy in improving the parameters of the olfactory nerve in the threshold test by 143.5% (p <0.01), the discriminatory test by 129.5% (p <0, 01), the identi cation test by 184.5% (p <0.01) and by the total number of points by 148.7% (p <0.01). Conclusion: High ef ciency of combined use of endonasal electrophoresis of 5% Mexidol solution and acupuncture in the treatment of patients with post-covid anosmia was detected. This method of treatment increases the effectiveness of drug therapy by 1.5 times.

Keywords: Covid-19, anosmia, hyposmia, Snif n ‘Sticks test, threshold test, discrimination test, identification test.

For reference: Al-Zamil MH, Puzin MN, Shulaev AV, Kiparisova ES, Lyubimov AV, Shilova TY, Ramazanova LSh, Makkaeva SM, Skorokhodov AP, Gunter NA. The use of endonasal electrophoresis with Mexidol in combination with acupuncture in the treatment of patients with post-covid anosmia. The Bulletin of Contemporary Clinical Medicine. 2022; 15 (2): 124—130. DOI: 10.20969/VSKM.2022.15(2). 124-130


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