Vol. 7 Issue 1 (2014)

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ORIGINAL ARTICLES

The influence of CPAP-therapy on system inflamma-tion in patients with obstructive sleep apnea. A.V. Markin, I.Ya. Tseymakh, V.M. Nagaytsev

Predictors of cardiovascular events in patients with chronic heart failure. E.V. Khazova, O.V. Bulashova, V.N. Оslopov, M. Ig. Malkova

Current approaches to the treatment of benign prostatic hyperplasia large. R.Kh. Galeev, S.V. Atriaskin, Sh.R. Galeev

Role of stiffness of arterial system and hemodynamic indicators in an assessment of endothelial function. Yu.E. Teregulov, D.K. Khusainova, F.N. Mukha-metshina, D.I. Abdulganiyeva, M.M. Mangusheva

Syndrome of multiple organ dysfunction during the isolated craniocerebral trauma at patients in a critical condition. E.V. Kiseleva, A.V. Kuligin, Ya.A. Osyko

Analysis of activity of the autonomic nervous system in patients with Parkinson’s disease at regenerative treatment by hirudoreflexotherapy. O.A. Bondaren-ko, A.G. Danilov, R.N. Zhivoglyad

Immune modulator «imunofan» efficiency in com-bination therapy of zoonotic trichophytosis. O.R. Mukhamadeeva, Z.R. Khismatullina, Yu.A. Medvedev

Results of survey respondents outpatient young to early detection chronic bronchitis. G.L. Ignatova, I.A. Zakharova, I.V. Drozdov

The challenges of surgical treatment of drug resis-tant tuberculosis. A.I. Gordon, I.B. Viktorova

ORGANIZATION OF HEALTHCARE

Sick, patient, client: the positions of labor migrants in the russian health care system (evidence from the Republic of Tatarstan). L.M. Mukharyamova, I.B. Kuznetsova, G.G. Vafina

HELP FOR PRACTITIONER

Mycobacterium tuberculosis drug resistance for-ming during the course of TB treatment. Realities of domestic TB management program and medical aspects of drug resistant TB epidemic prevention. A.L. Khanin, S.A. Dolgikh, I.B. Viktorova

Nonalcoholic fatty liver disease and atherogenic dyslipidemia. What problems cardiologist? Z.M. Galeeva, I.A. Gimaletdinova, N.B. Amirov

CLINICAL CASE

Pulmonary embolism in patient with giganticmyoma of the uterus. V.N. Oslopov, A.R. Sadykova, E.F. Akhmetzyanova, S.Sh. Krivonosova

HISTORY OF MEDICINE

Heads of the faculty... R.L. Kerzhenevich

CONGRESSES, CONFERENCES

Topical questions of diagnostic's treatment and preventive measures in medical practice. N.B. Ami-rov, L.R. Ginyatullina, R.Sh. Khisamiev P.74

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ORIGINAL ARTICLES

PDF downloadThe influence of cpap-therapy on system inflammation in patients with obstructive sleep apnea

Aleksey V. Markin, Irina Ya. Tseymakh, Vladimir M. Nagaytsev, Barnaul, Russia

Abstract. In order to assess the impact of the course CPAP therapy on the activity of systemic inflammation with patients with the obstructive sleep apnea syndrome (OSAS) there were examined 33 men from 38 to 68 years with a body mass index (BMI) (37,7±6,20 kg/m². The index of apnea / hypopnea index (AHI) with the observed patients was 57,5±24,0. As a result of the course of CPAP treatment within 6 weeks the concentration of pro-inflammatory mediators decreased from baseline: TNF-α — by 26%, IL-6 — by 34%, IL-8 — by 38%, CRP — 25% of endothelin — by 23%. CPAP therapy was effective in reducing the activity of systemic inflammation and can be an important method of preventing myocarial infarktion, stroke and sudden death while asleep.

Key words: sleep apnea, system inflammation, CPAP-therapy.

 

References

  1. Marin, J.M. Long-term cardiovascular outcomes in men with obstructive sleep apnoea/hypopnoea with or without treatment with continuous positive airway pressure: an observational study / J.M. Marin, S.J. Carrizo, E. Vicente [et al.] // Lancet. — 2005. — Vol. 365. — P.1046—1053.
  2. McNicholas, W.T. Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities / W.T. McNicholas, M.R. Bonsigore // Eur. Respir. J. — 2007. — Vol. 29. — P.156—178.
  3. Zimin, Yu.V. Serdechno-sosudistye narusheniya pri sindrome obstruktivnogo apnoe: deistvitel’no li oni yavlyayutsya samostoyatel’nym faktorom riska smertnosti bol’nyh s etim zabolevaniem? / Yu.V. Zimin, R.V. Buzunov // Kardiologiya. — 1997. — № 9. — S.85—97.
  4. Oliver, K.M. Hypoxia activates NF-kB-dependent gene expression through the canonical signaling pathway / K.M. Oliver, J.F. Garvey, C.T. Ng [et al.] // Antioxid Redox Signal. — 2009. — Vol. 11. — P.2057—2064.
  5. Minoguchi, K. Elevated production of tumor necrosis factor-a by monocytes in patients with obstructive sleep apnea syndrome / K. Minoguchi, T. Tazaki, T. Yokoe [et al.] // Chest. — 2004. — Vol. 126. — P.1473—1479.
  6. El Solh, A.A. Endothelial cell apoptosis in obstructive sleep apnea: a link to endothelial dysfunction / A.A. El Solh, M.E. Akinnusi, F.H. Baddoura [et al.] // Am. J. Respir. Crit. Care Med. — 2007. — Vol. 175. — P.1186—1191.
  7. Jelic, S. Inflammation, oxidative stress, and repair capacity of the vascular endothelium in obstructive sleep apnea / S. Jelic, M. Padeletti, S.M. Kawut [et al.] // Circulation. — 2008. — Vol. 117. — P.2270—2278.
  8. Institute for Clinical Systems Improvement (ICSI). Diagnosis and treatment of obstructive sleep apnea in adults. Blooming- ton (MN): Institute for Clinical Systems Improvement (ICSI), 2008. — Jun.
  9. Minoguchi, K. Elevated production of tumor necrosis factor-alpha by monocytes in patients with obstructive sleep apnea syndrome / K. Minoguchi, T. Tazaki, T. Yokoe [et al.] // Chest. — 2008. — Vol. 126 (5). — P.1473—1479.
  10. Ryan, S. Predictors of elevated tumour necrosis factor ? level in obstructive sleep apnoea syndrome / S. Ryan, T. Taylor, W. McNicholas // Eur. Respir. Rev. — 2006. — Vol. 15, № 101. — P.221—223.
  11. Steiropoulos, P. Effect of continuous positive airway pressure treatment on serum cardiovascular risk factors in patients with obstructive sleep apnea-hypopnea syndrome / P. Steiropoulos, V. Tsara, E. Nena [et al.] // Chest. — 2007. — Vol. 132 (3). — P.843—851.
  12. Grimpen, F. Endothelin-1 plasma levels are not elevated in patients with obstructive sleep apnoea / F. Grimpen, P. Kanne, E. Schulz // Eur. Respir. J. — 2000. — Vol. 15. — P.320—325.

 

PDF downloadPredictors of cardiovascular events in patients with chronic heart failure

Elena V. Khazova, graduate student of Internal Medicine Propaedeutics GBOU VPO «Kazan State Medical University» Russian Ministry of Health, Kazan, Russia, tel. 8-905-313-97-10, e-mail: hazova_elena@mail.ru

Olga V. Bulashova, MD, Professor of Internal Medicine Propaedeutics GBOU VPO «Kazan State Medical University» Russian Ministry of Health, Kazan, Russia, tel. 8-987-296-14-03, e-mail: boulashova@yandex.ru

Vladimir N. Оslopov, MD, Professor , Heard of Internal Medicine Propaedeutics GBOU VPO «Kazan State Medical University» Russian Ministry of Health, Kazan, Russia, tel. 8-905-316-25-35, e-mail: kpvbol@yandex.ru

Maria Ig. Malkova, PhD, head of the department of functional diagnostics GAUZ «City Clinical Hospital № 7», Kazan, Russia, tel. 8-960-051-61-16, e-mail: marimalk@yandex.ru

Abstract. The purpose of the study — to identify new prognostic markers of adverse long-term prognosis (mortality and cardiovascular events), chronic heart failure. Material and methods. The study was conducted on 150 patients (79 women and 71 men) with chronic heart failure hospital registers FC I—IV CHF. We evaluated the clinical condition, a 6-minute walk test, ECG and echocardioscopy. The functional condition of the cell membrane was assessed by the velocity Na+/Li+- countertransport erythrocyte membrane by the method of M. Canessa (1980). Results. The factors which have an adverse effect on cardiovascular mortality and achievement of non-fatal cardiovascular events in patients with CHF. A mathematical model allowing to predict cardiovascular event in CHF.

Key words: chronic heart failure, prognosis, velocity of Na+/Li+-countertransport.

 

References

  1. The prognosis in the presence of coronary artery disease / R. Califf, P. Bounous, F. Harrell [et al.] // Congestive heart failure / ed. by E. Braunwald, B. Mock, J. Watson. — New York: Grune and Stratton, 1982. — P.31—40.
  2. For the Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study With Tolvaptan (EVEREST) Investigators. Clinical Implications of QRS Duration in Patients Hospitalized With Worsening Heart Failure and Reduced Left Ventricular Ejection Fraction / N.C. Wang, A.P. Maggioni, M.A. Konstam [et al.] // JAMA. — 2008. — Vol. 299, № 22. — P.2656—2666.
  3. Ambrosy, A. Clinical course and predictive value of congestion during hospitalization in patients admitted for worsening signs and symptoms of heart failure with reduced ejection fraction: findings from the EVEREST trial / A. Ambrosy, P. Pang, S. Khan // Eur. Heart J. — 2013. — Vol. 34(11). — P.835—843.
  4. Dunlay, S.M. Critical elements of clinical follow-up after hospital discharge for heart failure: insights from the EVEREST trial / S.M. Dunlay, M. Gheorghiade, K.J. Reid // Eur. J. Heart Fail. — 2010. — Vol. 12. — P.367—374.
  5. Cohn, J.N. Prognostic factors in heart failure: poverty amidst a wealth of variables / J.N. Cohn// J. Am. Coll. Cardiol. — 1989. — № 14. — R.571—573.
  6. Belenkov, Yu.N. Znakom’tes’: diastolicheskaya serdechnaya nedostatochnost’ / Yu.N. Belenkov, F.T. Ageev, V.Yu. Mareev // Zhurnal Serdechnaya nedostatochnost’. — 2000. — № 1(2). — S.40—44.
  7. How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology / W.J. Paulus, T. Carsten, J.E. Sanderson [et al.] // Eur. Heart J. — 2007. — Vol. 28. — P.2539—2550.
  8. Long term outcome in heart failure: do patients with reduced and preserved ejection fraction differ?/ R. Singh, J.J. Murphy, G. Brennan [et al.] // European Heart Journal. — 2012. — Vol. 33. — P.517—518.
  9. Braunwald's Heart Disease. A Textbook of Cardiovascular Medicine / P. Libby, R.O. Bonow, D. Mann, D.P. Zipes; ed. E. Braunwald. — 8th еd. — Elsevier Saunders, 2008. — P.1167—1318.
  10. Left Ventricular Systolic Dysfunction, Heart Failure and the Risk of Stroke and Systemic Embolism in Patients with Atrial Fibrillation: Insights from the Aristotle Trial / J.J. McMurray, J.A. Ezekowitz, B.S. Lewis [et al.] // Circ. Heart Fail. — 2013. — Vol. 6(3). — P.451—460.
  11. Risk stratification for 1 year mortality in patients with heart failure and normal ejection fraction / M. Liu, A.P. Lee, J.P. Sun [et al.] // European Heart Journal. — 2012. — Suppl. 33. — P.518—519.
  12. Oslopov, V.N. Znachenie membrannyh narushenii v razvitii gipertonicheskoi bolezni: avtoref. dis. ... d-ra med. nauk / V.N. Oslopov. — Kazan’, 1995. — 78 s.
  13. Na+/N+-obmen v eritrocitah zdorovyh i bol’nyh serdechnoi nedostatochnost’yu / A.B. Gadzhiev, V.G. Naumov, A.A. Kuba- tiev, Yu.N. Belenkov // Terapevticheskii arhiv. — 1995. — № 12. — S.28.
  14. Bulashova, O.V. Klinicheskoe znachenie opredeleniya skorosti Na+/Li+-protivotransporta u bol’nyh s hronicheskoi serdechnoi nedostatochnost’yu / O.V. Bulashova, V.N. Oslopov, T.V. Matveeva // Kazanskii medicinskii zhurnal. — 2003. — T. 84, № 6. — S.409—413.
  15. Slepuha, E.G. Klinicheskoe i prognosticheskoe znachenie opredeleniya iontrasportnyh funkcii kletochnyh membran pri hronicheskoi serdechnoi nedostatochnosti: avtoref. dis. ... kand. med. nauk / E.G. Slepuha. — Kazan’, 2010. — 23 s.
  16. Sitnikova, M.Yu. Hronicheskaya serdechnaya nedostatochnost’: epidemiologiya i perspektivy planirovaniya / M.Yu. Sitnikova, E.A. Lyasnikova, M.A. Trukshina // Zhurnal Serdechnaya nedostatochnost’. — 2012. — T. 13, № 6(74). — S.372—376.
  17. Characteristics, treatments, and outcomes of patients with preserved systolic function hospitalized for heart failure: a report from the OPTIMIZE-HF Registry / G.C. Fonarow, W.G. Stough , W.T. Abraham [et al.] // J. Am. Coll. Cardiol. — 2007. — Vol. 50(8). — R.768—777.
  18. Differences in the incidence of congestive heart failure by ethnicity: the multi-ethnic study of atherosclerosis / H. Bahrami, R. Kronmal, D.A. Bluemke [et al.] // Arch. Intern. Med. — 2008. — Vol. 168(19). — R.2138—2145.
  19. Mareev, V.Yu. Nacional’nye rekomendacii VNOK i OSSN po diagnostike i lecheniyu HSN (III peresmotr) / V.Yu. Ma- reev, F.T. Ageev, G.P. Arutyunov [i dr.] // Zhurnal Serdech- naya nedostatochnost’. — 2010 — № 1(57). — S.3—62.

 

PDF downloadCurrent approaches to the treatment of benign prostatic hyperplasia large

Rinat kh. Galeev, Sergey V. Atriaskin, Shamil R. Galeev, Kazan, Russia

Abstract. The study evaluated the effectiveness of surgical treatment of patients with benign prostatic hyperplasia, in order to improve the technique of open transactions for the sizes and locations of adenomatous nodes. After the study was designed and implemented an operation. The purpose of the research. The aim — to evaluate the effectiveness of surgical treatment of patients with BPH with aim to improve the methods of opened operations with regard to the size and locations adenomatous nodes. Material and methods. The main research methods used for the diagnosis of BPH were transrectal ultrasound, exkrethornaya urografia down cystography and magnetic resonance imaging. Results and their discussion. After the research was developed and implemented operation: «retropubic prostatectomy extracystic». Conclusion. The proposed method of open retropubic prostatectomy uretrosberegayuschey in patients with large prostate can reduce postoperative complications by 19%. Retropubic access to the prostate gland can detect cancer of the prostate during surgery and go to Step prostatectomy.

Key words: prostate, benign prostatic hyperplasia, adenoma, adenomatous node retropubic access.

 

References

  1. Loran, O.B. Diagnostika i differencial’naya diagnos- tika dobrokachestvennoi giperplazii predstatel’noi zhe- lezy / O.B. Loran // Dobrokachestvennaya giperplaziya predstatel’noi zhelezy / red. N.A. Lopatkin. — M., 1999. — S.56—69.
  2. Mazo, E.B. Operativnoe lechenie DGPZH / E.B. Mazo // Dobrokachestvennaya giperplaziya predstatel’noi zhelezy / red. N.A. Lopatkin. — M., 1999. — S.184—192.
  3. Martov, A.G. Maloinvazivnye endoskopicheskie metody lecheniya dobrokachestvennoi giperplazii predstatel’noi zhelezy / A.G. Martov, A.A. Kamalov // Dobrokachestvennaya giperplaziya predstatel’noi zhelezy / red. N.A. Lopatkin. — M., 1999. — S.150—159.
  4. Pushkar’, D.Yu. Sovremennyi algoritm obsledovaniya i lecheniya bol’nyh adenomoi predstatel’noi zhelezy / D.Yu. Pushkar’, P.I. Rasner // Urologiya. — 2007. — № 3. — S.87—94.
  5. Gorilovskii, L.M. Epidemiologiya, faktory riska razvitiya i biologicheskoe techenie dobrokachestvennoi giperplazii predstatel’noi zhelezy / L.M. Gorilovskii // Dobrokachestven- naya giperplaziya predstatel’noi zhelezy / red. N.A. Lopatkin. — M., 1999. — S.12—20.
  6. Tubaro, A. Invasive and minimally invasive treatment modalities for lower urinary tract symptoms: What are the relevant differences in randomized controlled trials? / A. Tubaro, C. Vicentini, R.L. Miano // Eur. Urol. — 2000. — Vol. 38, suppl. 1. — P.7—17.

 

PDF downloadRole of stiffness of arterial system and hemodynamic indicators in an assessment of endothelial function

Yury E. Teregulov, PhD, associate professor of the chair of hospital therapy of GOU VPO «Kazan State Medical University», Kazan, chief of Department of functional diagnostics of GAUZ «RKB MZ RT», Kazan, Russia, tel. 8-917-264-70-04, e-mail: tereg2@mail.ru

Dina K. Khusainova, PhD, assistant of the chair of hospital therapy of GOU VPO «Kazan State Medical University», deputy chief physician of GAUZ «MZ RT Republican Clinical Hospital», Kazan, Russia, tel. 8-987-287-69-68

Farida N. MuКhametshina, assistant to chair of hospital therapy of GOU VPO «Kazan State Medical University», doctor of office of functional diagnostics of GAUZ «MZ RT Republican Clinical Hospital», Kazan, Russia, tel. 8-843-264-64-42

Diana I. Abdulganiyeva, MD, the manager of chair of hospital therapy of GOU VPO «Kazan State Medical University», Kazan, Russia, tel. 8-987-296-27-68

Marziyа M. Mangusheva, PhD, associate professor of hospital therapy of Public Educational Institution of Higher Professional Training Kazan State Medical University, Kazan, Russia, tel. 8-917-297-56-06

Abstract. The purpose of тне work was to study significance of indicators of stiffness of arterial system and the central hemodynamic in dilatation of arterial vessels at the test of reactive hyperemia at healthy persons. Materials and methods. 32 healthy volunteers, aged from 20 till 29 years, middle age of (24,0±3,94) years are surveyed. For an assessment of endothelial function used the ultrasonic D. Celermajer method in our modification. For definition of indicators of the central hemodynamic an echocardiography was used, arterial pressure was measured by N. Korotkov method. The model of the cardiovascular system of A.E. Teregulov was used to calculate the modulus of volume elasticity (MVE), mean arterial pressure (avg BP), and total peripheral vascular resistance (TPVR). Results. On degree of a dilatation of a humeral artery all surveyed persons were divided into two groups: I group — 22 patients with dilatation more than 10% from an initial lumen of the artery, II group — 9 patients with dilatation less than 10%. Persons of the II group in comparison with the I group had higher values of HR, SV, CO, MVE/TPVR and lower values of index local rigidity artery. At healthy persons in time of carrying out test with reactive hyperemia there was revealed negative correlative connection of extent of expansion of a vessel from HR and MVE/TPVR whereas with increase in SV, BPpuls and index local rigidity artery the vasodilatation increased. Conclusions:1. At healthy persons a various degree of a dilatation of humeral artery was found in the test of the reactive hyperemia for an assessment of endothelial function. 2. Degree of a dilatation had positive correlative relationship on indicators of the central hemodynamic (SV, BPpuls) and the negative correlative relationship on index local rigidity artery, MVE / TPVR , HR.

Key words: endothelial function, arterial stiffness, central hemodynamic.

 

References

  1. Petrischev, N.N. Fiziologiya i patofiziologiya endoteliya. Disfunkciya endoteliya. Prichiny, mehanizm, farmako- logicheskaya korrekciya / N.N. Petrischev, T.D. Vlasov. — SPb.: SPbGMU, 2003. — 184 s.
  2. Celermajer, D.S. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis / D.S. Celermajer, K.E. Sorensen, V.M. Cooch [et al.] // Lancet. — 1992. — Vol. 340. — P.1111—1115.
  3. Tayanovskaya, V.Yu. Metodologiya i prikladnoe znachenie issledovaniya funkcii endoteliya v obscheklinicheskoi praktike i klinike radiacionnoi mediciny / V.Yu. Tayanovskaya, V.G. Lelyuk, A.B. Kutuzova [i dr.] // Ehografiya. — 2001. — T. 2, № 4. — S.384—396.
  4. Balahonova, T.V. Neinvazivnoe opredelenie funkcii endoteliya u bol’nyh gipertonicheskoi bolezn’yu v sochetanii s giperholesterinemiei / T.V. Balahonova, O.A. Pogorelova, H.G. Alidzhanova [i dr.] // Terapevticheskii arhiv. — 1998. — № 4. — S.15—19.
  5. Mel’kumyanc, A.M. Rol’ deformiruemosti endotelial’nyh kletok v reakciyah arterii na izmenenie napryazheniya sdviga / A.M. Mel’kumyanc, S.A. Balashov // Rossiiskii fiziologicheskii zhurnal im. I.M. Sechenova. — 1999. — № 7.— S.910—917.
  6. Dvoreckii, D.P. Mehanogennaya regulyaciya tonusa i reaktivnosti krovenosnyh sosudov / D.P. Dvoreckii // Rossiiskii fiziologicheskii zhurnal im. I.M. Sechenova. — 1999. — T. 85, № 9/10. — S.1267—1277.
  7. Teregulov, Yu.E. K metodologii provedeniya proby i ocenki endoteliizavisimoi dilatacii plechevoi arterii / Yu.E. Teregulov, D.K. Husainova, I.G. Salihov [i dr.] // Ehografiya. — 2004. — T. 5, № 3. — S.217—221.
  8. Teregulov, Yu.E. ZHestkost’ arterial’noi sistemy kak faktor riska serdechno-sosudistyh oslozhnenii: metody ocenki / Yu.E. Teregulov, A.E. Teregulov // Prakticheskaya medicina. — 2011. — T. 52. — S.133—137.
  9. Savickii, N.N. Biofizicheskie osnovy krovoobrascheniya i klinicheskie metody izucheniya gemodinamiki / N.N. Savickii. — M.: Medicina, 1974. — 307 s.

 

PDF downloadSyndrome of multiple organ dysfunction during the isolated craniocerebral trauma at patients in a critical condition

Evgeniya V. Kiseleva, physician anesthesiologist the Saratov Regional Hospital, Saratov, Russia, tel. 8-906-313-78-58, e-mail: kiss.hi-hi @ mail.ru

Alexander V. Kuligin, doctor of medical science, Professor, Department of emergency and anesthesiology-resuscitation help, Saratov medical university V.i. razumovsky ministry of health of russia; Saratov, tel. 8-903-328-79-37, e-mail: avkuligin@yandex.ru

Yana A. Osyko, ordinator Department of emergency and anesthesiology-resuscitation help, Saratov medical university V.i. razumovsky ministry of health of russia; Saratov, tel. 8-905-324-34-53, e-mail: yana_osyko@mail.ru

Abstract. Specific weight of the closed craniocereberal trauma at patients takes the 3rd place in structure of a lethality of the population. High frequency of occurrence of a craniocereberal trauma, lethality, development of polysystem dysfunction at this pathology defined the purpose of the real research. Studying of degree of expressiveness and influence on an outcome of a disease of a syndrome of multiple organ dysfunction at patients with the isolated craniocereberal trauma was carried out. 30 clinical records of patients with the isolated closed craniocereberal trauma, aged from 18 till 50 years, without accompanying pathology are retrospectively studied. The assessment of cerebral insufficiency, external breath, gas transmission function of blood, liver function, condition of proteinaceous and carbohydrate exchanges, functions of kidneys, a gastrointestinal path was carried out. Quantitative indices of the central haemo dynamics, level of endogenous intoxication were studied. Researches were conducted in the first, third, seventh and tenth days. The obtained data were processed by the main methods of variation statistics with calculation of the following criteria: selective average, average error of a selective average. Formation fact in evidence a syndrome of multiple organ dysfunction at patients with the isolated closed craniocereberal trauma. Various degree of expressiveness of dysfunctions of studied systems on different terms of the closed craniocereberal trauma is revealed. The interrelation between expressiveness of dysfunction, number of the involved systems and an outcome of studied pathology is found. Involvement in the syndrome of multiple organ dysfunction functional systems is carried out by a mixed way. When the comparison between the groups of patients with different outcome degree of dysfunction of each of the systems in the group of patients with fatal outcome in average 30%higher.

Key words: multiple organ dysfunction syndrome, traumatic brain injury, polysystem dysfunction.

 

References

  1. Bone, I. Neurology in practice: sleep and coma / I. Bone, G.N. Fuller // Journal of neurology, neurosurgery and Psychiatry. — 2001. — Vol. 71, № 1. — P.1—2.
  2. Vilenskii, B.S. Neotlozhnaya nevrologiya / B.S. Vilenskii. — SPb.: Foliant, 2006. — 512 s.
  3. Savin, I.A. Rekomendacii po intensivnoi terapii u pacientov s neirohirurgicheskoi patologiei: posobie / I.A. Savin, M.S. Fo- kin. — M.: NII neirohirurgii im. akad. N.N. Burdenko RAMN / OOO «IPK «Indigo», 2013. — 168 s.
  4. Carenko, S.V. Neiroreanimatologiya. Intensivnaya terapiya cherepno-mozgovoi travmy / S.V. Carenko. — M.: Medicina, 2009. — 384 s.

 

PDF downloadAnalysis of activity of the autonomic nervous system in patients with parkinson’s disease at regenerative treatment by hirudoreflexotherapy

Olga A. Bondarenko, post-graduate student of Surgut State University, Yugra, Surgut, Russia, tel. 8-904-880-50-91, e-mail: bondolaa@mail.ru

Alexey G. Danilov, post-graduate student of Surgut State University, Yugra, Surgut, Russia, 8-982-564-58-24, e-mail: danilovalexey88@mail.ru

Raise N. Zhivoglyad, MD, professor, Surgut State university, Yugra, Surgut, russia, tel. 8-904-880-50-91

Abstract. The aim of research is to examine autonomic nervous system parameters of patients sick by Parkinson’s disease based on given rehabilitating treatment by hirudoreflexotherapy. Material and methods. We treated by hirudotherapy male patients as the age of 50—63 years old with diagnosis Parkinson’s disease, trembling form , of the 2—3 severit by Hyun-Yar , slowly developing current , with mild cognitive infraction . In research’s method of pulse oximetry, pulse ox meter ELOKS-01SZ designed and manufactured by JSC IMC «New Apparats», Samara. Received data were treated by method of variation statistics till believable interval by means of software package (PPP) Statistica 6,0 and comparative analysis of parameters of vector state of quasi-attractors in 9-measured phase space was made. Results and discussion. Analysis of autonomic nervous system in patients with Parkinson’s disease after hirudoreflexotherapy showed a decrease of activity of mechanisms influence suprasegmentar ergotropic on heart rhythm, with simultaneous increase of activity of segmentary influences, that is regarded as the neurovegetative balance with increasing of adaptive capacity of organism. The calculation of attractor’s parameters on the background of hirudoreflexotherapy leads to decrease of asymmetry with simultaneous increase of attractor volume of testing people, that is should be seen as a favorable trend behavior VHBS confirming sanogenetic action at hirudoreflexotherapy. Conclusion. Analysis of heart rate variability parameters of patients with Parkinson’s disease confirms impact of method of regenerative medicine — hirudoreflexotherapy as active factor of external influence on functional state of organism with changes in autonomic balance from absolute sympathotony in vegetative equilibrium with significant clinical effect. Bioinformatic analysis of parameters VHBS of patients with Parkinson's disease allows to determine change of measures of chaos after treatment and select the most informative indicators for assess effectiveness of treatment.

Key words: hirudoreflexotherapy, autonomic balance, vector of the human's body state, bioinformatic analysis.

 

References

  1. Vein, A.M. Vegetososudistaya distoniya / A.M. Vein, A.D. Solov’eva, O.A. Kolosova. —M., 1981. — 275 s.
  2. Golubev, V.L. Bolezn’ Parkinsona i sindrom parkinsonizma / V.L. Golubev, Ya.I. Levin, A.M. Vein. — M.: MEDрress, 2000. — 415 s.
  3. Es’kov, V.M. Sistemnyi analiz, upravlenie i obrabotka v biologii i klinicheskoi kibernetike / V.M. Es’kov; pod red. V.M. Es’kova, A.A. Hadarceva. — Samara, 2008. — 198 s.
  4. Zhivoglyad, R.N. Girudoterapiya i vosstanovitel’naya medicina: monografiya / R.N. Zhivoglyad. — Surgut, 2012. — 235 s.
  5. Levin, O.S. Nedvigatel’nye (nemotornye) proyavleniya BP / O.S. Levin // Bolezn’ Parkinsona i rasstroistva dvizhenii: I Nacional’nyi kongress, Moskva, 22—23 sent. — M., 2008. — S.94—96.
  6. Es’kov, V.M. Predstavlenie attraktora povedeniya vektora sostoyaniya dinamicheskih sistem v t-mernom fazovom prostranstve / V.M. Es’kov, M.Ya. Braginskii [i dr.] // Svidetel’stvo ob oficial’noi registracii programmy dlya EVM № 2009616012. — Rospatent, 2009.

 

PDF downloadImmune modulator «Imunofan» efficiency in combination therapy of zoonotic trichophytosis

Olga R. Mukhamadeeva, assistant of chair of Dermatovenereology Bashkortostan State medical university, phD, Ufa, Russia, e-mail: mukhamadeevs@gmail.com

Zarema R. KHismatullina, Head of chair of Dermatovenereology Bashkortostan State medical university, DSc., prof., Ufa, Russia, e-mail: hzr07@mail.ru

Yuri A. Medvedev, Senior researcher of Scientific-Research Technological Institute of Herbicides and Plant Growth Regulators Republic Bashkortostan Academy of Sciences, DSc., Prof., Ufa, Russia, e-mail: mukhamadeevs@gmail.com

Abstract. Aim. To improve the effectiveness of the therapy in patients with infiltrative and suppurative forms of zoonotic trichophytosis (ZT) immune modulator «Imunofan» was used. Matherial and method. Changes in levels of main lymphocyte subpopulations and the accumulation in blood cell cultures stimulated with pathogen antigens of cytokines — Interleukin 2 (IL-2) and Interferon gamma (IFN-γ) — have been studied. Results. There have been changes of lymphocyte subpopulations that are typical for the formation of cell-mediated immunity to dermatophytes (CMID) with concomitant stimulation of IL-2 and IFN-γ synthesis. In the course of treatment IL-2 production after short increase reduces, and IFN-γ production grows until the convalescence and CMID formation. Conclusion. Combined treatment of ZT with «Imunofan» intensifies signs of CMID with increasing IL-2 and IFN-γ production. At once the regression of inflammation symptoms in the foci occurs earlier than in control groups.

Key words: zooanthroponotic trichophytosis, lymphocytes, cytokines, imunofan.

 

References

  1. Kashkin, P.N. Rukovodstvo po medicinskoi mikologii / P.N. Kash- kin, N.D. Sheklakov. — M.: Medicina, 1978. — 325 s.
  2. Medvedev, Yu.A. Osnovy immunnyh i immunonapravlennyh metodov terapii i profilaktiki / Yu.A. Medvedev, M.M. Alsyn- baev. — Ufa: RIO GUP «Immunopreparat», 2000. — 81 s.
  3. Sergeev, Yu.V. Farmakoterapiya mikozov / Yu.V. Sergeev, B.I. SHpigel’, A.Yu. Sergeev. — M.: Medicina dlya vseh, 2003. — 199 s.
  4. Stepanova, Zh.V. Gribkovye zabolevaniya / Zh.V. Stepanova. — M.: Miklom, 2005. — 124 s.
  5. Hismatullina, Z.R. Zooantroponoznaya trihofitiya u detei: aspekty immunomoduliruyuschei terapii / Z.R. Hismatullina, Yu.A. Medvedev. — Ufa, 2005. — 100 s.
  6. Hismatullina, Z.R. Zooantroponoznaya trihofitiya / Z.R. His- matullina, Yu.A. Medvedev. — Ufa: GUP IPK MVD po RB «TiD», 2013. — 112 s.
  7. Hismatullina, Z.R. Funkcional’naya aktivnost’ neitrofilov u detei, bol’nyh zooantroponoznoi trihofitiei, pri kompleksnom lechenii s ispol’zovaniem preparata «Imunofan» / Z.R. His- matullina, O.R. Muhamadeeva // Prakticheskaya medicina. — 2012. — № 5 (60). — S.205—207.

 

PDF downloadResults of survey respondents outpatient young to early detection chronic bronchitis

Galina l. Ignatova, Inna A. Zakharova, Igor V. Drozdov, Cheljabinsk, Russia

Abstract. WHO estimates that by 2020, COPD prevalence and damage will from 12th to 5th place, and cause of death moves from 6th to 3rd place . The article analyzes the effectiveness of patient survey of respondents of younger age for early detection of chronic bronchitis. The purpose of the study — to investigate the prevalence of respiratory symptoms among young people, to identify the most important risk factors and assess the effectiveness of the survey to identify chronic bronchitis in young people. It was examed 140 people, average age (25,5±8,3) years. Signs of chronic bronchitis were showed in 16% of patients, among which 68% were current smokers (versus 30% in the group of healthy). In both groups, parameters FEV1 were within normal limits, but in individuals with chronic bronchitis showed significantly lower value (96,3%) compared to respondents who do not have respiratory complaints (102,3%).

Key words: chronic bronchitis, early detection.

 

Referenses

  1. Lopez, A.D. The global burden of disease, 1990—2020 / A.D. Lopez, C.C. Murray // Nat. Med. — 1998. — Vol. 4(11). — P.1241—1243.
  2. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease (revised 2013).
  3. Guerra, S. Chronic bronchitis before age 50 years predicts incident airflow limitation and mortality risk / S. Guerra, D.L. Sherrill, C. Venker [et al.] // Thorax. — 2009. — Vol. 64. — P.894—900.
  4. De Marco, R. Incidence of chronic obstructive pulmonary disease in a cohort of young adults according to the presence of chronic cough and phlegm / R. de Marco, S. Accordini, I. Cerveri [et al.] // Am. J. Respir. Crit. Care Med. — 2007. — Vol. 175. — P.32—39.
  5. Onischenko, G.G. Gorodskaya sreda i zdorov’e cheloveka / G.G. Onischenko // Gigiena i sanitariya. — 2007. — № 5. — S.3—4.
  6. Tzortzaki, E.G. A hypothesis for the initiation of COPD / E.G. Tzortzaki, N.M. Siafakas // Eur. Respir. J. — 2009. — Vol. 34. — P.310—315.
  7. Gerasimenko, N.F. Zdorov’e ili tabak: cifry i fakty / N.F. Gerasimenko, D.G. Zaridze, G.M. Saharova. — M., 2007. — S.21.
  8. Global’nyi opros vzroslogo naseleniya o potreblenii tabaka. Rossiiskaya Federaciya, 2009, stranovoi otchet. — M., 2009.
  9. Batozhargalova, B.C. Vliyanie ekspozicii k tabachnomu dymu na respiratornoe zdorov’e podrostkov / B.C. Batozhargalova, Yu.L. Mizernickii // Vestnik NGU. — 2012. — E. 10, vyp. 3. — S.112—121. — (Ser. biologiya, klinicheskaya medicina).

 

PDF downloadThe challenges of surgical treatment of drug resistant tuberculosis

Alla I. Gordon, phD, Head of the department for drug-resistant tuberculosis treatment, GKuz Ko «novokuznetsk clinical tB Dispensary», novokuznetsk, russia, тel. 8-384-337-83-05, e-mail: irinaviktoroff@mail.ru

Irina B. Viktorova, PhD, Associate Professor, Phthisiopulmonary Department, GBOU DPO «Sate Medical Institute for postgraduate training» russian ministry of Health, novokuznetsk, russia, тel. 8-384-345-42-19, e-mail: irinaviktoroff@mail.ru

Abstract. Aim — to explore the challenges of surgical treatment of drug resistant tuberculosis. Material and method. An analysis of 720 cases of drug resistant and MDR tuberculosis (TB) over a 5-year period (2008—2012) was made; 141 of all patients (19,6%) underwent surgical treatment of pulmonary TB. Results. Among all these patients the majority were new TB cases (n=86; 75,4%), persons with MDR (n=66; 57,9%), surgical treatment more often was performed in patients with tuberculomas (n=88; 73,7% ) and fibrous cavernous TB (n=19; 16,7%). In a 5-year period 24,8% of cavities were closed due to surgery. The causes of comprehensive treatment failure (n=8) were defaults (n=2; 25%) and the presence of drug resistance to injectables and/or fluoroquinolones (n=6; 75%). Conclusion. Surgical treatment of MDR tuberculosis without adequate chemotherapy is unable to cure TB; persistent positive smear/culture during chemotherapy can be regarded to be a contraindication to the elective surgical treatment of MDR TB, because it indicates the effectiveness of chemotherapy.

Key words: tuberculosis, MDR, XDR, surgical treatment of tuberculosis.

 

References

  1. Krasnov, D.V. Kollapsohirurgiya v lechenii bol'nyh destruktivnym tuberkulezom legkih s mnozhestvennoi lekarstvennoi ustoichivost'yu vozbuditelya: avtoref. dis. ... kand. med. nauk / D.V. Krasnov. — Novosibirsk, 2006. — 25 s.
  2. Strelis, A.A. Hirurgicheskoe lechenie lekarstvenno-ustoichivogo tuberkuleza legkih i klinicheskaya reabilitaciya bol'nyh: avtoref. dis. ... d-ra med. nauk / A.A. Strelis. — Tomsk, 2005. — 48 s.
  3. Effektivnost' hirurgicheskogo lecheniya tuberkuleza legkih s mnozhestvennoi lekarstvennoi ustoichivost'yu v usloviyah programmy DOTS-PLUS / A.K. Strelis, A.A. Strelis, O.V. Anastasov [i dr.] // Byulleten' sibirskoi mediciny. — 2009. — № 1. — S.85—93.
  4. Adjunctive surgery improves treatment outcomes among patients with multidrug-resistant and extensively drug-resistant tuberculosis. / M. Gegia, I. Kalandadze, R.R. Kempker [et al.] //Int. J. Infect. Dis. — 2012. — № 16(5). — P.e391—396.
  5. Dewan, R.K. Surgical interventions in multidrug-resistant tuberculosis: Retrospective analysis of 74 patients treated at a tertiary level care centre/ R.K. Dewan, Н. Pratap // Ind. J. Thorac. Cardiovas. Surg. — 2006. — № 22. — P.15—18.
  6. Gimferrer, J.M. Role of surgery in drug-resistant pulmonary tuberculosis/ J.M. Gimferrer, C.A. Mestres // Asian Cardiovasc. Thorac. Ann. — 2005. — № 13. — P.201—202.
  7. Ormerod, L.P. Role of surgery in pulmonary multidrug-resistant tuberculosis / L.P. Ormerod // Thorax. — 2007. — № 62. — P.377.
  8. Prognostic factors for surgical resection in patients with multidrug-resistant tuberculosis / H.J. Kim, C.H. Kang, Y.T. Kim [et al.] // Eur. Respir. J. — 2006. — № 28(3). — P.576—580.
  9. Pulmonary resection for extensively drug resistant tuberculosis in Kwazulu-Natal, South Africa / A. Iddriss, N. Padayatchi, D. Reddy [et al.] // Ann. Thorac. Surg. — 2012. — № 94(2). — P.381—386.
  10. Role and outcome of surgery for pulmonary tuberculosis / А. Olcmen, М.Z. Gunluoglu, A. Demir [et al.] // Asian. Cardiovasc. Thorac. Ann. — 2006. — № 14. — P.363—366.
  11. Role of surgery in pulmonary tuberculosis / J.G. Freixinet, J.J. Rivas, F. Rodríguez De Castro [et al.] // Med. Sci. Monit. — 2002. — № 8(12). — P.782—786.
  12. Surgical treatment for multidrug-resistant and extensive drug-resistant tuberculosis / M.W. Kang, H.K. Kim, Y.S. Choi [et al.] // Ann. Thorac. Surg. — 2010. — № 89(5). — P.1597—1602.

 

ORGANIZATION OF HEALTHCARE

PDF downloadSick, patient, client: the positions of labor migrants in the russian health care system (evidence from the Republic of Tatarstan)

Laysan M. Mukharyamova, phD, professor, chief of the Department of History, philosophy, Sociology of Kazan State Medical University, Kazan, Russia, tel. 8-843-236-09-92, e-mail: l.mukharyamova@yandex.ru

Irina B. Kuznetsova, PhD, director of the institute for the comparative Studies of modernity, Kazan (Volga region) Federal University, Kazan, Russia, tel. 8-843-233-70-21, e-mail: irina.b.kuznetsova@gmail.com

Gusel G. Vafina, deputy director of the Skin and Venereal Diseases Hospital of Republic of Tatarstan of the Ministry of Health Care of Republic of Tatarstan, tel. 8-843-238-89-84, e-mail: kazankvd@mail.ru

Abstract. Aim. To analyze a status of labor migrants in Russian health care system, reveal evaluation of their health in a context of social security, consider a potential influence of health of migrants to public health and health care system in general. Material and method. The article is based on the research conducted in 2012—2013 in Republic of Tatarstan, Russia (survey of 339 labor migrants, expert interviews, analysis of documents) and addresses the issues of health of migrants, the impact of migrants on public health and healthcare system. Results. The survey results show no significant difference in the self-assessment of health among labor migrants and permanent residents. The level of some dangerous diseases is higher among migrants but it does affect public health in general. Only about 27% of foreign workers have health insurance policies, and only a third of them are insured with the assistance of the employer. In the event of illness 40% of labor migrants seek medical advice, 48% — self-medicate, 12% — do not do anything. Free emergency medical care received slightly more than 0,2% of the total number of migrants working in the region. Conclusion. Labor migrants in the Russian health care system are a vulnerable group because their rights are unclear and they often find themselves as involuntary clients. This limits their possibilities to access to clinics and free medical care and therefore they turn to private doctors «specializing» on migrants. Thus the development of optimal models of medical evaluation and medical care for labor migrants is an important social, economic and humanitarian issue.

Key words: health of migrants, medical insurance, medical care of foreign citizens, public health.

 

References

  1. Vestnik rossiiskogo monitoringa ekonomicheskogo polozheniya i zdorov’ya naseleniya NIU VSHE (RLMS-HSE) [elektronnyi resurs]: sb. nauch. st. / otv. red. P.M. Kozyreva. — M.: Vysshaya shkola ekonomiki, 2012. — Vyp. 2. — S.172.
  2. Valieva, A.Z. Medicinskie aspekty vneshnei migracii na primere Respubliki Tatarstan / A.Z. Valieva // Kazanskii medicinskii zhurnal. — 2013. — № 3. — S.373—376.
  3. Gricyuk, M. Kto vylechit gostya? / M. Gricyuk // Rossiiskaya gazeta. — 2013. — 27 sent.
  4. Zaklyuchenie ob ocenke reguliruyuschego vozdeistviya na proekt Federal’nogo zakona «O vnesenii izmenenii v Trudovoi kodeks Rossiiskoi Federacii, svyazannyh s osobennostyami osuschestvleniya trudovoi deyatel’nosti inostrannymi grazhdanami» i na proekt Postanovleniya Pravitel’stva Rossiiskoi Federacii «Ob utverzhdenii trebovanii k dogovoru (polisu) medicinskogo strahovaniya i dogovoru s medicinskoi organizaciei na poluchenie pervichnoi mediko—sanitarnoi pomoschi i specializirovannoi medicinskoi pomoschi (za isklyucheniem vysokotehnologichnoi medicinskoi pomoschi) inostrannym grazhdaninom ili licom bez grazhdanstva» [elektronnyi resurs]. — URL: http://www.economy.gov.ru/wps/wcm/connect/economylib4/mer/about/structure/depregulatinginfluence/doc20130718_05
  5. Kislicina, O.A. Razlichiya v sostoyanii zdorov’ya migrantov i korennogo naseleniya v Rossii i drugih stranah evropeiskogo regiona / O.A. Kislicina // Social’nye aspekty zdorov’ya naseleniya. Elektronnyi nauchnyi zhurnal. — URL: http://vestnik.mednet.ru/content/view/478/30/lang,ru/
  6. Kuznecova, I.B. Zdorov’e migrantov kak social’naya problema / I.B. Kuznecova, L.M. Muharyamova, G.G. Vafina // Kazanskii medicinskii zhurnal. — 2013. — № 3. — S.367—372.
  7. Migrantov perestali testirovat’ na narkotiki i alkogol’ // Izvestiya. —2013. — 27 avg.
  8. Minzdrav podderzhal vizy dlya gastarbaiterov: migranty ugrozhayut zdorov’yu rossiyan [elektronnyi resurs]. — URL: http://www.newsru.com/russia/27may2013/visa.html
  9. Federal’nyi zakon № 323-FZ «Ob osnovah ohrany zdorov’ya grazhdan v Rossiiskoi Federacii» [elektronnyi resurs]. — URL: http://ivo.garant.ru/SESSION/PILOT/main.htm
  10. Bopp, M. Health risk or resource? Gradual and independent association between self-rated health and mortality persists over 30 years / M. Bopp [et al.] // PloS one. — 2012. — Vol. 7, № 2. — P.e30795.
  11. Cuadra, C.B. Right of access to health care for undocumented migrants in EU: a comparative study of national policies / C.B. Cuadra // The European Journal of Public Health. — 2012. — Vol. 22, № 2. — P.267—271.
  12. Gavin, B.E. The mental health of migrants / B.E. Gavin [et al.] // Instructions for Authors. — 2013. — Vol. 106, № 5.
  13. Hansen, E. Health issues of migrant and seasonal farm- workers / E. Hansen, M. Donohoe, // Journal of Health care for the Poor and Underserved. — 2003. — Vol. 14, № 2. — P.153—164.
  14. Lassetter, J.H. The Impact of Migration on the Health of Voluntary Migrants in Western Societies A Review of the Literature / J.H. Lassetter, L.C. Callister, // Journal of Transcultural Nursing. — 2009. — Vol. 20, № 1. — P.93—104.
  15. Nielsen, S.S. Poorer self-perceived health among migrants and ethnic minorities versus the majority population in Europe: a systematic review / S.S. Nielsen, A. Krasnik // International journal of public health. — 2010. — Vol. 55, № 5. — P.357—371.
  16. O’Donnell, C. Health-care access for migrants in Europe / C. O’Donnell [et al.] // The Lancet. — 2013. — Vol. 382, № 9890. — P.393.
  17. Rechel, B. Monitoring migrant health in Europe: A narrative review of data collection practices / B. Rechel, P. Mladovsky, W. Devillé // Health policy. — 2012. — Vol. 1. — P.10—16.
  18. Rechel, B. Migration and health in an increasingly diverse Europe / B. Rechel, P. Mladovsky, D. Ingleby [et al.] // Lancet. — 2013. — Vol. 381. — P.1235—1245.

 

HELP FOR PRACTITIONER

PDF downloadMycobacterium tuberculosis drug resistance forming during the course of TB treatment. Realities of domestic TB management program and medical aspects of drug resistant TB epidemic prevention

Arkadyi L. Khanin, Sergey A. Dolgikh, Irina B. Viktorova, Novokuznetsk, Russia

Abstract. In Russia, patients with MDR-TB more than 50% of the newly diagnosed smear-positive cases, and the proportion of MDR-TB patients from 8 to 25%. MDR-TB is diagnosed in 16,4% of adolescents with PTB, consisting at a dispensary. All this testifies to the ineffectiveness of TB control activities. In current conditions of high level of primary and secondary drug resistance to I and II line drugs and high rates of treatment defaults, the empirical treatment with combination of first and second line drugs (in cases of unknown drug susceptibility test) is a risk factor for amplification and formation XDR TB. Prevention of resistance amplification by using of adequate chemotherapy regimens and minimizing of treatment defaults should be a priority of TB control activities.

Key words: drug-resistant tuberculosis; treatment organization.

 

References

  1. Bogorodskaya, E.M. Organizacionnye aspekty lecheniya bol’nyh tuberkulezom v sovremennyh social’no-ekonomicheskih usloviyah / E.M. Bogorodskaya, S.V. Smerdin, S.A. Sterlikov. — M.: N’yu-Terra, 2011. — 216 s.
  2. Borisov, S.E. Etiotropnoe lechenie tuberkuleza pri lekarstvennoi ustoichivosti MBT. Vzglyady i rekomendacii mezhdunarodnyh organizacii / S.E. Borisov, G.B. Sokolova // Consilium medicum. — 2001. — T. 3, № 12. — S.595—602.
  3. Dolgih, S.A. Lekarstvennaya ustoichivost’ k preparatam II ryada — novoe kachestvo epidemii tuberkuleza v RF / S.A. Dolgih, A.L. Hanin // Sb. tr. HH Nacional’nogo kongressa po boleznyam organov dyhaniya. — M., 2010. — S.345.
  4. Dosrochnoe prekraschenie lecheniya v protivotuberkuleznyh stacionarah / S.E. Borisov, E.M. Belilovskii, F. Kuk [i dr.] // Problemy tuberkuleza. — 2007. — № 7. — S.17—25.
  5. Ispol’zovanie ftorhinolonov v intensivnoi faze lecheniya vpervye vyyavlennyh bol’nyh destruktivnym tuberkulezom legkih / E.V. Vaniev, I.A. Vasil’eva, R.Yu. Abdullaev [i dr.] // Problemy tuberkuleza. — 2008. — № 10. — S.54—58.
  6. Mishin, V.I. Effektivnost’ lecheniya tuberkuleza legkih, vyzvannogo mikobakteriyami s mnozhestvennoi lekarstvennoi ustoichivost’yu / V.I. Mishin, V.I. Chukanov, I.A. Vasil’eva // Problemy tuberkuleza. — 2002. — № 12. — S.18—23.
  7. Osobennosti techeniya processa i effektivnost’ lecheniya bol’nyh tuberkulezom legkih, vydelyayuschih mikobakterii tuberkuleza s obshirnoi lekarstvennoi ustoichivost’yu k protivotuberkuleznym preparatam / M.Yu. Mishin, O.G. Komissarova, V.I. Chukanov [i dr.] // Problemy tuberkuleza. — 2009. — № 2. — S.50—52.
  8. Prikaz MZ RF ot 21.03.03 № 109 «O sovershenstvovanii protivotuberkuleznyh meropriyatii v Rossiiskoi Federacii».
  9. Prichiny neeffektivnosti lecheniya bol’nyh tuberkulezom s mnozhestvennoi lekarstvennoi ustoichivost’yu/ I.M. Astahova, T.N. Astahova, N.V. Emec [i dr.] // Medicina v Kuzbasse. Special’nyi vypusk. — 2008. — № 8. — S.84—87.
  10. Rol’ i mesto ftorhinolonov v lechenii bol’nyh tuberkulezom: rabochee soveschanie veduschih ftiziatrov Rossii // Problemy tuberkuleza. — 2008. — № 8. — S.38—42.
  11. Rider, G.L. Epidemiologicheskie osnovy bor’by s tuberkulezom / G.L. Rider; per. s angl. — M., 2001. — 192 s.
  12. Sravnitel’naya effektivnost’ IIb i I rezhimov himioterapii u  vpervye vyyavlennyh bol’nyh tuberkulezom legkih s vysokim riskom razvitiya pervichnoi lekarstvennoi ustoichivosti s pozicii mediciny dokazatel’stv / V.Yu. Mishin, Yu.G. Grigor’ev, S.P. Zavrazhnov [i dr.] // Tuberkulez i bolezni legkih. — 2011. — № 5. — S.50—51.
  13. Tuberkulez s mnozhestvennoi lekarstvennoi ustoichivost’yu / pod red. I. Bastiana, F. Portals. — M.: Medicina i zhizn’, 2003. — 368 s.
  14. Hanin, A.L. Organizaciya i rezul’taty lecheniya bol’nyh lekarstvenno—ustoichivym tuberkulezom v krupnom promyshlennom centre Sibiri / A.L. Hanin, S.A. Dolgih, I.B. Viktorova // Medicina v Kuzbasse. — 2010. — № 4. — S.29—37.
  15. Hanin, A.L. Problema lekarstvenno-ustoichivogo tuber- kuleza. Vozmozhnye puti resheniya na primere krupnogo promyshlennogo goroda Sibiri / A.L. Hanin, S.A. Dolgih, I.B. Viktorova // Vestnik sovremennoi klinicheskoi mediciny. — 2011. — № 1. — S.9—17.
  16. Shilova, M.V. Epidemicheskaya obstanovka po tuberkulezu v Rossiiskoi Federacii k nachalu 2009 g. / M.V. Shilova // Problemy tuberkuleza. — 2010. — № 5. — S.14—21.
  17. Towards universal access to diagnosis and treatment of multidrug-resistant and extensively drug-resistant tuberculosis by 2015: WHO progress report 2011. — WHO/HTM/TB/2011.3. — 119 p. — URL: http://whqlibdoc.who.int/publications/2011/9789241501330_eng.pdf

 

PDF downloadNonalcoholic fatty liver disease and atherogenic dyslipidemia. What's problems cardiologist?

Zarina M. Galeeva, Irina A. Gimaletdinova, Nail B. Amirov, Kazan, Russia

Abstract. The article examines the modern concepts of non-alcoholic fatty liver disease as a component of metabolic syndrome, as well as the experience of studying lipid-lowering effect of the drug ursodeoxycholic acid (drug «Ursodez» manufacturer JSC «Northern Star», Russia) as monotherapy and in combination with statins. Materials and Methods. On the basis of clinical gastroenterology department of the hospital FKUZ NFM Russian Ministry of Internal Affairs in the Republic of Tatarstan was a clinical study, the effectiveness of combination therapy with a statin drug and ursodeoxycholic acid («Ursodez» manufacturer JSC «Northern Star», Russia) and monotherapy with ursodeoxycholic acid («Ursodez» manufacturer JSC «Northern Star», Russia), including 45 patients with metabolic syndrome and signs of NAFLD by ultrasound. Patients were divided into 3 groups. Patients of Group 1 (n — 15) received a standard dose of a statin 20 mg/day ( from this group of patients was excluded from the active stage to steatohepatitis or increase of transaminases more than 3 times the upper limit of normal) . The second group consisted of patients with elevated transaminases more than 3 times and have contraindications to statins , they received ursodez a daily dose of 10 mg / kg for 3 months. The third group of patients were classified with atherogenic dyslipidemia , syndrome cytolysis taking statins in doses of 10 mg per day in combination with ursodezom 10 mg/kg per day. Results. In one group of patients treated with statins, total cholesterol decreased by 1,4% in a month, by 2,9% in 2 months and 5,8% by the end of the third month of treatment, LDL cholesterol decreased by 2,1—6,4% by the end of the third month on 17%, triglycerides decreased after 3 months to 10,5 %, the ratio decreased by atherogenic 14, 25, 38%, respectively. HDL cholesterol increased by 37,5% by the end of the third month . In the group of patients receiving ursodez percentage reduction of triglycerides and LDL cholesterol was lower than in patients taking statins. Increasing HDL in both groups comparable In the third group of patients had greater significant reduction in total cholesterol, LDL cholesterol, triglycerides, atherogenic factor, increase HDL cholesterol compared to patients receiving monotherapy with statins or Ursodez.

Key words: atherosclerosis, non-alcoholic fatty liver disease, transaminase, hypercholesterolemia, ursodeoxycholic acid, statins.

 

Referenses

  1. Amirov, N.B. Issledovanie effektivnosti atorvastatina dlya korrekcii dislipidemii / N.B. Amirov, S.N. Orehova // Vestnik sovremennoi klinicheskoi mediciny. — 2008. — T. I, vyp. 1. — S.42—44.
  2. Drapkina, O.M. Nealkogol’naya zhirovaya bolezn’ pecheni kak komponent metabolicheskogo sindroma / O.M. Drapkina, D.S. Gacolaeva, V.T. Ivashkin // Rossiiskie medicinskie vesti. — 2010.
  3. Drapkina, O.M. Statiny i pechen’: tupik ili novye gorizonty? / O.M. Drapkina, Yu.V. Dubolazova // Rossiiskii medicinskii zhurnal. — 2009.
  4. Zvenigorodskaya, L.A. Gipolipidemicheskaya terapiya u bol’nyh s nealkogol’noi zhirovoi bolezn’yu pecheni: mesto gepatoprotektorov / L.A. Zvenigorodskaya, N.V. Mel’nikova // Gastroenterologiya. — 2009. — Prilozhenie k zhurnalu Consillium Medicum.
  5. Zvenigorodskaya, L.A. Statinovyi gepatit / L.A. Zvenigorodskaya, L.B. Lazebnik, E.A. Cherkashova, L.I. Efremov // Trudnyi pacient. — 2009.
  6. Klimenko, E.D. Rol’ dislipoproteidemii v geneze hronicheskogo gepatita / E.D. Klimenko, O.M. Pozdnyakov // BEBM. — 1992. — T. 114, № 10. — S.473—438.
  7. Klimenko, E.D. Giperlipoproteidogennaya mikroangiopatiya v geneze organnoi patologii i patogeneticheskie podhody k ee korrekcii: avtoref. dis. ... d-ra med. nauk / E.D. Klimenko. — M., 1994.
  8. Korneeva, O.N. Ursodezoksiholevaya kislota i statiny v lechenii metabolicheskogo sindroma / O.N. Korneeva, O.M. Drapkina // Rossiiskie medicinskie vesti. — 2007. — № 3.
  9. Korneeva, O.N. Nealkogol’naya zhirovaya bolezn’ pecheni kak proyavlenie metabolicheskogo sindroma / O.N. Korneeva, O.M. Drapkina, A.O. Bueverov, V.T. Ivashkin // Klinicheskie perspektivy gastroenterologii, gepatologii. — 2005. — № 4.
  10. Polunina, T.E. Nealkogol’nyi steatoz pecheni v praktike internista / T.E. Polunina, I.V. Maev // Effektivnaya farmakoterapiya v gastroenterologii. — 2009. — № 1.
  11. Bellentani, S. Epidemiology of non-alcoholic fatty liver disease / S. Bellentani, F. Scaglioli, M. Marino, G. Bedogni // Dig Dis. — 2010.
  12. Dunn, W. Suspected nonalcoholic fatty liver disease and mortality risk in a population-based cohort study / W. Dunn, R. Xu, D.L. Wingard [et al.] // Am. J. Gastroenterol. — 2008.
  13. Gastaldelli, A. Fatty Liver Is Associated with Insulin Resistance, Risk of Coronary Heart Disease, and Early Atherosclerosis in a Large European Population // A. Gastaldelli, M. Kozakova, K. Hojlund // Hepatology. — 2009.
  14. Georgescu, E.F. Therapeutic options is non-alcoholic stestohepatitis (NASH). Are all agents alike? Results of a preliminary study / E.F. Georgescu, M. Georgescu // J. Gastrointest Liver Dis. — 2007. — Vol. 16(1). — P.39—46.
  15. Kiyici, M. Ursodeoxycholic acid and atorvastatin in the treatment of nonalcoholic steatohepatitis / M. Kiyici, M. Gulten, S. Gurel [et al.] // Can. J. Gastroenterol. — 2003. — Vol. 17(12). — P.713—718.
  16. Loria, P. Non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease: an open question / P. Loria, A. Lonardo, S. Bellentani [et al.] // Nutrition, Metabolism and Cardiovascular Diseases. — 2007.
  17. Schwimmer, J. Fatty liver as a determinant of atherosclerosis / J. Schwimmer, R. Deutsch, C. Behling, J. Lavine // Hepatology. — 2005. — Vol. 42. — P.610А.
  18. Solis Herruzo, J.A. Non-alcoholic fatty liver disease. From insulin resistance to mitochondrial dysfunction / J.A. Solis Herruzo, R.I. Garcia, M. Perez Carreras, M.T. Munoz Yague // Rev. Esp. Enferm. Dig. — 2006. — Vol. 98, № 11.
  19. Targher, G. Non-alcoholic fatty liver disease and increased risk of cardiovascular disease // G. Targher, G. Arcaro // Atherosclerosis. — 2007.
  20. Toledo, G.S.F. Influence of Hepatic Steatosis (Fatty Liver) on Severity and Composition of Dyslipidemia in Type 2 Diabetes / G.S.F. Toledo, D.A. Sniderman, E.D. Kelley // Diabetes Care. — 2006. — № 29.
  21. Targher, G. Relations between carotid artery wall thickness and liver histology in subjects with nonalcoholic fatty liver disease / G. Targher, L. Bertolini, R. Padovani [et al.] // Diabetes Care. — 2006. — Vol. 29.
  22. Targer, G. Risk of Cardiovascular Disease in Patients with Nonalcoholic Fatty Liver Disease / G. Targer, P.D. Day, E.N. Bonora // Engl. J. Med. — 2010.

 

CLINICAL CASE

PDF downloadPulmonary embolism in patient with giganticmyoma of the uterus

Vladimir N. Oslopov, MD, Head of the Department of Introduction to Internal Diseases GBOU VPO «Kazan State Medical university» russian ministry of Healthcare, Kazan city, russia, tel. 8-905-316-25-35, e-mail: KPVBol@yandex.ru

Aida R. Sadykova, PhD, Associate Professor of the Department of Introduction to Internal Diseases GBOU VPO «Kazan State medical university» russian ministry of Healthcare, Kazan city, russia, tel. 8-960-032-55-49, e-mail: KPVBol@yandex.ru

Elena F. Akhmetzyanova, Deputy Chief Doctor on Medical Service of GAUZ «SCH № 7», Kazan city, Russia, tel. 8-905-314-14-48, e-mail: gkb9@mail.ru

Svetlana Sh. Krivonosova, Head of Therapeutical Department of GAUZ «SCH № 7», Kazan city, Russia, tel. 8-905-377-18-48, e-mail: gkb9@mail.ru

Abstract. The article describes dynamic in condition of diagnosed and successfully treated patient with acute recurrent pulmonary embolism on the background of gigantic myoma of uterus.

Key words: pulmonary embolism, myoma of uterus, uterine arteries embolization.

 

References

  1. Mazur, N.A. Prakticheskaya kardiologiya / N.A. Mazur. — M.: ID «Medpraktika-M», 2009. — 616 s.
  2. Shpektor, A.V. Kardiologiya. Klinicheskie lekcii / A.V. Shpektor, E.Yu. Vasil’eva. — M.: AST; Astrel’. — 2008. — S.688—700.
  3. Torbicki, A. Guidelines on the diagnosis and management of acute pulmonary embolism. The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC) / A. Torbicki, A. Perrier, S. Konstantinides [et al.] // European Heart Journal. —2008. — Vol. 29. — P.2276—2315.
  4. Goldhaber, S.Z. Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER) / S.Z. Goldhaber, L. Visani, M. De Rosa // Lancet. — 1999. — Vol. 24, № 353. — P.1386—1389.
  5. Embolizaciya matochnyh arterii (EMA). — URL: http://www.mioma.ru/3.html
  6. Oslopov, V.N. Trudnosti diagnostiki tromboembolii legochnoi arterii u pacientki s gigantskoi miomoi matki / V.N. Oslopov, A.R. Sadykova, E.F. Ahmetzyanova, [i dr.] // Prakticheskaya medicina. — 2010. — № 5(44). — S.136—138.
  7. Oslopov, V.N. Sluchai plnogo vyzdorovleniya pacientki s tromboemboliei obeih vevtvei legochnoi arterii, obuslovlennoi gigantskoi miomoi matki // V.N. Oslopov, A.R. Sadykova, A.A. Gil’manov, M.G. Tregubova // Prakticheskaya medicina. — 2012. — № 9(44). — S.136—138.

 

HISTORY OF MEDICINE

PDF downloadProfessor Semen Semenovich Zimnickij (k 140-letiju so dnja rozhdenija)

Professor Semen Semenovich Zimnickij (to the 140-th anniversary)

UDK 61(092)Zimnickij

V.N.Oslopov, V.F.Bogojavlenskij, O.V.Bogojavlenskaja, V.A.Shherbakov

GBOU VPO «Kazanskij gosudarstvennyj medicinskij universitet» Minzdrava RF

 

References

  1. Bogoyavlenskii, V.F.1. Professor Semen Semenovich Zimnic- kii — vrach, uchenyi, patriot / V.F. Bogoyavlenskii. — Kazan’: Tatarskoe knizhnoe izdatel’stvo, 1970. — 98 s.
  2. Bogoyavlenskaya, O.V.2. Uchenye-terapevty kafedry pro- pedevtiki vnutrennih boleznei Kazanskogo Imperatorskogo universiteta, Kazanskogo medicinskogo instituta, Kazanskogo medicinskogo universiteta — gordost’ otechestvennoi medi- ciny / O.V. Bogoyavlenskaya, V.N. Oslopov, V.A. Scherbakov // Zdorov’e cheloveka v XXI veke: V Ros. nauch.-prakt. konf.: sb. nauch. st; Kazan’, 5—6 aprelya 2013 g. / pod obsch. red. prof. S.S. Ksembaeva. — Kazan’: Izd-vo «Otechestvo», 2013. — S.33—39.
  3. Bogoyavlenskii, V.F.3. S.S. Zimnickii — osnovatel’ kafedry propedevtiki vnutrennih boleznei Kazanskogo medicinskogo universiteta / V.F. Bogoyavlenskii, V.N. Oslopov, O.V. Bo- goyavlenskaya // Dnevnik kazanskoi medicinskoi shkoly. — 2013. — № 1. — S.84—85.
  4. Oslopov, V.N.4. S.S. Zimnickii — vrach, uchenyi, pedagog / V.N. Oslopov, O.V. Bogoyavlenskaya // Medicinskaya professura Rossiiskoi imperii: tez. dokl. nauch. konf. — 2005. — S.124—126.
  5. Teregulov, A.G.5. K harakteristike tvorcheskogo oblika professora S.S. Zimnickogo / A.G. Teregulov // Kazanskii medicinskii zhurnal. — 1958. — № 2. — S.5—10.
  6. Yakobson, L.6. Pamyati Semena Semenovich Zimnickogo / L. Yakobson // Klinicheskaya medicina. — 1928. — № 1. — S.5—7.

 

PDF downloadHeads of the faculty...

Rozana L. Kerzhenevich, Kazan, Russia

Abstract. Article consists of general reviewed data about deans of Emperor's Kazan University (Kazan State University since 1918, named after V.I. Lenin since 1924). Data collected from the period of medical faculty establishment in May 1814 to the period of reorganization into Medical Institute in December 1930. Ph.Kh. Erdmahn as the first dean, T.I.Yudin was the last. The total number of deans was 30 during 116 year history of Medical faculty existing. All deans were representatives of allmost all fields of medicine: 5 internists, 4 pharmacologists, 4 physiologists, 4 surgeons, 3 obstetricians, 2 psychiatrists, 1 anatomist, 1 biochemist and 1 forensic medicine specialist. Data presented according University Charter of 1804, 1835, 1863 and 1884.

Key words: history of medicine, higher medical education, universities, medical faculties, deans.

 

References

  1. Al’bickii, V.Yu. Istoriya Kazanskogo gosudarstvennogo medicinskogo universiteta: ucheb.-metod. posobie dlya studentov / V.Yu. Al’bickii, M.E. Guryleva, A.S. Sozinov. — Kazan’: Medicina, 2011. — 136 s.
  2. Biograficheskii slovar’ professorov i prepodavatelei Imperаtorskogo Kazanskogo universiteta za sto let (1804—1904): v 2 ch. / pod red. N.P. Zagoskina. — Ch. 2: Fakul’tety yuridicheskii i medicinskii, prepodavateli iskusstv i dobavleniya spravochnogo haraktera. — Kazan’: Tipo-lit. Imp. un-ta, 1904. — 455 s.
  3. Dekany Kazanskogo medicinskogo universiteta (ot medicinskogo fakul’teta do medicinskogo universiteta): biogr. slovar’ dekanov Kazan. gos. med. un-ta / Kazan. gos. med. un-t; pod red. A.L. Zefirova, V.Yu. Al’bickogo. — Kazan’: Medicina, 1997. — 64 s.
  4. Istoriya Kazanskogo gosudarstvennogo medicinskogo universiteta / V.Yu. Al’bickii [i dr.]. — Kazan’: Magarif, 2006. — 376 s.
  5. Kazanskii gosudarstvennyi medicinskii universitet (1804—2004 gg.): zaveduyuschie kafedrami i professora: biogr. slovar’ / M-vo zdravoohraneniya Ros. Federacii; V.Yu. Al’bickii [i dr.]; pod red. V.Yu. Al’bickogo, N.H. Amirova. — Kazan’: Magarif, 2004. — 472 s.
  6. Rektory Kazanskogo universiteta, 1804—2004 gg.: ocherki zhizni i deyatel’nosti / sost. i nauch. red. V.S. Korolev. — Kazan’: Izd-vo Kazan. un-ta, 2004. — 360 s.

 

CONGRESSES, CONFERENCES

PDF downloadTopical questions of diagnostic's treatment and preventive measures in medical practice

N.B. Amirov, L.R. Ginyatullina, R.Sh. Khisamiev