Vol. 7 Issue 3 (2014)

Обложка журнала

PDF downloadDownload the whole Issue

СONTENTS

ORIGINALSTUDIES

Speleotherapy in the medical rehabilitation of chronic obstrustive pulmonary diseases patients. A.Yu. Abdullayev, R.S. Fassakhov

Gender differences in indices of functional methods in patients with ischemic heart disease. N.B. Amirov, O.Ju. Mikhoparova, N.A. Tsibulkin, E.B. Frolova, O.B. Oschepkova, A.A. Morozova

The prevalence rate and etiologic spectrum of pollen allergy in the Komi Republic. O.A. Vakhnina, R.S. Fassakhov

Electroencephalographic features in children with speech impairment. R.G. Gamirova, M.V. Belousova, M.A. Utkuzova, F.M. Zaikova

Diastolic dysfunctions and remodeling of left ventricular in patients with type II diabetes mellitus with co-morbidity obesity and essential arterial hypertension. E.V. Koroleva, A.E. Kratnov, E.V. Timganova

Genetic markers of carbohydrates methabolism dissfunction in adult cystic fibrosis patients and their influence on cystic fibrosis disease progression. V.A. Samoylenko, G.Y. Babadjanova, A.B. Nagorniy, S.A. Krasovskiy, S.Y. Chikina

Comparative analysis specialized outpatient and inpatient medical care for children with urticaria and angioedema. R.F. Khakimova, G.R. Kamasheva, G.A. Shamsutdinova, A.A. Vasileva, G.R. Davletbaeva, M.N. Tukhbatullina

Gender difference of arterial rigidity in patients with the arterial hypertensions and high total cardiovascular risk. I.I. Chukayeva, N.V. Orlova, A.I. Khachirova, I.V. Komarova, S.V. Goryaynova, N.D. Karseladze

Causes of non-responding to inhaled nitric oxide for respiratory distress-syndrome. V.A. Shtabnitskiy, A.G. Chuchalin

Comparative analysis of functional state of human body at application of biological medicine in yugra. O.A. Bondarenko, A.G. Danilov, V.V. Eskov, A. Mononov, R.N. Zhivoglyad

CASE FROM PRACTICE

New technologies in diagnostic untypical case of coronary artery disease. N.A. Mukhametzyanova, N.B. Amirov, G.B. Sayfullina

EXPERIMENTAL STUDIES TO PRACTICAL MEDICINE

Postoperative endothelial dysfunction of peritoneal vessels and its effect of peritoneal function. S.V. Poroyskiy, A.v. Poroyskaya

Impact of chronic psychosocial stress on retinal and plasma sphingolipids of rats with different stress resistance. E.A. Gizzatullina, I.G. Bryndina

REVIEWS

Various approaches to the estimation of the patient’s health damage. V.A. Shcherbakov

IN PRESS
Distance learning of doctors in the Kazan state medical university: experience of scientific library in its organization. O.I. Seregina

 

ORIGINALSTUDIES

PDF downloadSpeleotherapy in the medical rehabilitation of chronic obstrustive pulmonary diseases patients

Adalat Yu. Abdullaev, Head of the Division of Pulmonology Central Oil industry workers Hospital, Baku, Azerbaijan, tel. 9-945-021-054-23, e-mail: dr.adalat@arc.az

Rustem S. Fassakhov, Head of FBIS «Kazan SIIEM» of Rospotrebnadzor, Kazan, Russia, tel. (843) 236-67-21, e-mail: farrus@mail.ru

Abstract. Aim. The purpose of the investigation — to study the influence of speleotherapy on the clinical laboratory and functional features in patients with COPD. Material and мethods. We observed 78 patients with COPD stage I—II, receiving rehabilitation treatment — speleotherapy. Procedures were carried out in galotherapy speleokamera of natural salts. The course of treatment consisted of 10—25 procedures that were performed in the first half of the day, lasting 45—60 minutes. The study of pulmonary ventilation function performed by spirometry. Rating spirometry performed in relation to the proper values depending on the age, height, sex, and expressed as a percentage. All patients underwent clinical definition (complete blood count, white blood cells), blood biochemical parameters (sialic acid, CRP) and cellular composition of sputum (cell count, the percentage of lymphocytes, alveolar macrophages, neutrophils). Results and discussion. It was shown that the use of speleotherapy in treatment of COPD contributes expressed relief of broncho-pulmonary manifestations of the disease leads to improve airflow ventilation. Conclusion. Speleotherapy is an effective method of medical rehabilitation of patients with COPD.

Key words: chronic obstructive pulmonary disease, speleotherapy, rehabilitation.

 

References

  1. Abdullaev, A.A. Effektivnost’ speleoterapii u detei s bronhial’noi astmoi v solyanyh shahtah po dannym neposredstvennyh i otdalennyh nablyudenii [Efficiency Speleotherapy in children with asthma in the salt mines according to the immediate and remote observations] / A.A. Abdullaev, K.M. Gadzhiev, A.A. Eyubova // Voprosy kurortologii, fizioterapii i lechebnoi fizicheskoi kul’tury [Questions Balneology, physiotherapy and medical physical culture]. — 1993. — № 5. — S.25—28.
  2. Abdumalikova, I.A. Vysokogornaya speleoterapiya [Alpine speleoterapija] / I.A. Abdumalikova, Yu.H. Shidakov. — Bishkek, 2009. — 276 s.
  3. Belevskii, A.S. Reabilitaciya bol’nyh HOBL. Klinicheskie rekomendacii [Rehabilitation of patients with COPD. Clinical recommendations] / A.S. Belevskii, N.N. Mescheryakova. — M.: Atmosfera, 2007. — S.221—230.
  4. Global’naya strategiya diagnostiki, lecheniya i profilaktiki hronicheskoi obstruktivnoi bolezni legkih (GOLD) (peresmotr 2007 g.): per. s angl. — M.: Atmosfera, 2008. — 100 c.
  5. Malyavin, A.G. Reabilitaciya bol’nyh s porazheniem bronholegochnoi sistemy [Rehabilitation of patients with lesions of the bronchopulmonary system] / A.G. Malyavin // Medicinskaya reabilitaciya (rukovodstvo) [Medical rehabilitation]. — M.: Medicina, 2007. — T. 3. — S.217—278.
  6. Rassulova, M.A. Razrabotka programm vosstanovitel’nogo lecheniya bol’nyh hronicheskoi obstruktivnoi bolezn’yu legkih [Development of programs of rehabilitation treatment of patients with chronic obstructive pulmonary disease] Actual problems of regenerative medicine, health resorts and physiotherapy] / M.A. Rassulova, A.N. Razumov // Aktual’nye problemy vosstanovitel’noi mediciny, kurortologii i fizioterapii [Actual problems of regenerative medicine, health resorts and physiotherapy]. — M.: Medicina, 2007. — C.180.
  7. Rebrova, O.Yu. Statisticheskii analiz medicinskih dan-nyh. Primenenie paketa prikladnyh programm Statistica [Statistical analysis of medical data. Application software package Statistica] / O.Yu. Rebrova. — M.: Mediasfera, 2002. — 312 c.
  8. Salikova, N.M. Sovremennye tehnologii vosstanovitel’noi mediciny u bol’nyh hronicheskoi obstruktivnoi bolezn’yu legkih [Modern technologies of regenerative medicine in patients with chronic obstructive pulmonary disease] / N.M. Salikova // Materialy VII Mezhdunar. kongr. po vosstanovitel’noi medicine i reabilitacii [Proceedings of the VII International Congress on regenerative medicine and rehabilitation]. — M., 2010. — S.108.
  9. Ambrosino, N. Pulmonary rehabilitation: a year in review / N. Ambrosino, M. Serradore // Breathe. — 2006. — № 2(3). — P.236—244.

 

PDF downloadGender differences in indices of functional methods in patients with ischemic heart disease

N.B. Amirov, O.Ju. Mikhoparova, N.A. Tsibulkin, E.B. Frolova, O.B. Oschepkova, A.A. Morozova

Abstract. Research objective — to reveal and describe gender distinctions during the chronic ischemic heart disease on indexes of the main functional diagnostic methods, including holter monitoring of electrocardiogram, echocardiography and doppler. Material and methods. Research was conducted in groups of male and female patients with different forms of chronic ischemic heart disease. Diagnostic methods included: assessment of character and level of arrhythmia, dynamics of segment ST according to holter monitoring; assessment of heart and functions of left ventricle and doppler indexes according to echocardiography. Results. In patients with chronic ischemic heart disease gender distinctions in disease and indexes of functional diagnostic methods, shown by earlier start and more progressing course of disease, and also more expressed defeat of left ventricle at men, and dominance of arrhythmia at women is revealed.

Key words: gender differences, ischemic heart disease, holter monitoring ECG, echocardiography, Doppler.

 

References

  1. Culter, D. The determinants of mortality / D. Culter, A. Deaton, A. Lleras-Muney // Journal of economic perspectives. — 2006. — Vol. 20(3). — P.97—120.
  2. Gosudarstvennyi doklad o sostoyanii zdorov’ya naseleniya Rossiiskoi Federacii v 2002 godu // Zdravoohranenie RF. — 2004. — № 1. — S.3—18.
  3. Kardiologiya. Rukovodstvo dlya vrachei / pod red. R.G. Oganova, I.G. Fominoi. — M.: Medicina, 2004. — 852 s.
  4. Amirov, N.B. Ishemicheskaya bolezn’ serdca v obschei vrachebnoi praktike: diagnostika, lechenie i profilaktika: monografiya / N.B. Amirova, A.A. Vizel’, B.N. Oslopov [i dr.]; pod red. N.B. Amirova. — Kazan’: «Orange-k», 2011. — 194 s.
  5. Dudko, V.A. Ateroskleroz sosudov serdca i golovnogo mozga / V.A. Dudko, R.S. Karpov. — Tomsk: STT, 2003. — 416 s.
  6. Grischenko, M.Yu. Dinamika faktorov riska serdechno—sosudistyh zabolevanii po dannym monitoringa 2002— 2007 gg. / M.Yu. Grischenko, E.G. Volkova, S.Yu. Levashov // Poslediplomnoe obrazovanie i nauka. — 2009. — № 1. — C.21—27.
  7. Makarov, L. Holterovskoe monitorirovanie / L. Makarov. — M.: Medpraktika-M, 2008. — 456 s.
  8. Rybakova, M. Prakticheskoe rukovodstvo po ul’trazvukovoi diagnostike. Ehokardiografiya / M. Rybakova, M. Alehin, V. Mit’kov. — M.: Vidar-M, 2008. — 544 s.
  9. Amirov, N.B. Variabel’nost’ serdechnogo ritma. Metod i klinicheskoe primenenie / N.B. Amirov, E.V. Chuhnin // Vestnik sovremennoi klinicheskoi mediciny. — 2008. —T. I, vyp. 1. — S.72—78.

 

PDF downloadThe prevalence rate and etiologic spectrum of pollen allergy in the Komi Republic

Olga A. Vakhnina, allergist-immunologist of Diagnostic center, Komi republic, Syktyvkar, russia tel. 8-909-12-000-66, e-mail: voall@yandex.ru

Rustem S. Fassakhov, MD, professor, Head of fBiS «Kazan Siiem» of rospotrebnadzor, tel. (843)236-67-21, e-mail: kniem@mail.ru

Abstract. Pollen allergy is one of the most common allergic diseases, which necessitates the study of the true frequency of the PA and the spectrum of cause significant allergens. The purpose of the study — to examine the frequency of occurrence and etiologic spectrum of Palestinian residents of the Republic of Komi. Material and Methods. Studied blooming calendar major allergenic plants in the Republic of Komi. Randomly conducted surveys of residents Syktyvkar and countryside in age from 14 to 70 years in the international program GA2LEN, collected 2002 questionnaires. 1038 respondents who reported symptoms of pollen allergy conducted allergy testing. Results. It was shown that the incidence of pollen allergy among residents aged 14 to 70 years is 14,6%, which is significantly higher than official statistics . Among the etiological factors predominate pollen pollen allergens trees (35%) and grasses (45%).

Key words: pollen allergy, the prevalence rate, etiological spectrum of allergens.

 

References

  1. Astaf’eva, N.G. Pollinoz — pyl’cevaya allergiya / N.G. Astaf’eva, L.A. Goryachkina // Allergologiya. — 1998. — № 2. — S.34—40.
  2. Bondarenko, A.L. Rol’ glavnogo kompleksa gistosovmes- timosti v razvitii allergicheskih zabolevanii v koreiskoi populyacii / A.L. Bondarenko, L.D. Serova, V.N. Shabalin // Sovetskaya medicina. — 1991. — № 4. — S.26—28.
  3. Chernyak, B.A. Allergicheskie rinity v Vostochnoi Sibiri: rasprostranennost’, etiologicheskaya harakteristika i vzaimosvyaz’ s bronhial’noi astmoi v razlichnyh vozrastnyh gruppah / B.A. Chernyak, S.V. Tyarenkova, S.N. Buinova // Allergologiya. — 2002. — № 2. — S.3—9.
  4. Il’ina, N.I. Epidemiologiya allergicheskogo rinita / N.I. Il’ina // Rossiiskaya rinologiya. — 1999. — № 1. — S.23—24.
  5. Zavgorodnyaya, E.G. Nekotorye aspekty epidemiologii, patogeneza i konservativnogo lecheniya allergicheskogo rinita / E.G. Zavgorodnyaya, K.N. Prozorovskaya, N.D. Che- lidze // Vestnik otorinolaringologii. — 2000. — № 5. — S.73—75.

 

PDF downloadElectroencephalographic features in children with speech impairment

Rimma G. Gamirova, MD, PhD, assistant professor, department of pediatric neurology SBEI APE «Kazan State Medical Academy» of Russian Мinistry of Health, Kazan, Russia, tel. 8-917-257-96-44, e-mail: r-gamirov@mail.ru

Marina V. Belousova, MD, PhD, associate professor, department of pediatric neurology SBEI APE «Kazan State Medical Academy» of Russian Мinistry of Health, Kazan, Russia, e-mail: belousova.marina@mail.ru

Marina A. Utkuzova, MD, PhD, associate professor, department of pediatric neurology SBEI APE «Kazan State Medical Academy» of Russian Мinistry of Health, Kazan, Russia, e-mail: utkuzova.marina@gmail.com

Faniya M. Zaikova, MD, PhD, assistant professor, department of pediatric neurology SBEI APE «Kazan State Medical Academy» of Russian Мinistry of Health, Kazan, Russia, e-mail: detbol8@mail.ru

Abstract. Aim. To study electroencephalographic changes in children with speech impairment. Matherial and methods. We compared the electroencephalographic changes in children (n=251) with different forms and degrees of speech disorders. I group — children with autism spectrum disorders (n=56), II group — children with organic mental retardation and severe speech disorders (n=45), III group — children with motor and sensorimotor alalia (n=59), IV group — children with mild speech disorders and dysarthria (n=49), V group (control group) — children with mild delay of speech development without organic brain damage (n=42). Results. We found a high frequency of epileptiform changes and non-epileptiform EEG-abnormalities in I (19%) and II (20%) groups vs the control group (2%). Conclusion. The high frequency of detection of epileptiform changes in children with speech disorders makes it necessary conducting of EEG monitoring of sleep for the planning of treatment.

Key words: speech disorders, autism spectrum disorders, severe speech impairment, electroencephalogram, EEG-monitoring, epileptiform disorders.

 

References

  1. Aleksandrova, N.Sh. Detskie afazii i sindrom LandauKleffnera v svete plastichnosti mozga [Children’s aphasias and Landau—Kleffner syndrome in the light of brain plasticity] / N.Sh. Aleksandrova // Zhurnal nevrologii i psihiatrii [Journal of Neurology and Psychiatry]. — 2004. — T. 104, № 6. — C.54—58.
  2. Zavadenko, N.N. Trudnosti shkol’nogo obucheniya: giper- aktivnoe rasstroistvo s deficitom vnimaniya i disleksiya [Learning Difficulties: Attention deficit hyperactivity disorder and dyslexia] / N.N. Zavadenko, N.Yu. Suvorinova, M.V. Rumyanceva // Pediatriya (prilozhenie k Consilium medicum) [Supplements (Consilium Medicum Pediatrics)]. — 2006. — T. 8, № 2. — S.47—52.
  3. Zenkov, L.R. Narusheniya kognitivnyh funkcii: vozmozhnosti farmakoterapii [Cognitive impairment: possibilities of pharmacotherapy] / L.R. Zenkov // Lechaschii vrach. Psihonevrologiya [Аttending physician Psychoneurology]. — 2011. — № 9. — S.50—54.
  4. Zenkov, L.R. Neparoksizmal’nye epilepticheskie rasstroistva (rukovodstvo dlya vrachei) [Nonparoxysmal epileptic disorders: Сlinical Guidelines] / L.R. Zenkov. — M.: MEDpress-inform, 2013. — 278 s.
  5. Zenkov, L.R. Neiropatofiziologiya epilepticheskih ence- falopatii i neparoksizmal’nyh epilepticheskih rasstroistv i principy ih lecheniya [Neuro Pathophysiology of epileptic encephalopathies and epileptic nonparoxismal disorders, principles of their treatment] / L.R. Zenkov // Nevrologiya, neiropsihiatriya, psihosomatika [Neurology, neuropsychiatry, psychosomatics]. — 2010. — № 2. — S.26—33.
  6. Muhin, K.Yu. Epilepsiya. Atlas elektroklinicheskoi diagnostiki [The atlas of electro-clinical diagnosis] / K.Yu. Muhin, A.S. Petruhin, L.Yu. Gluhova. — M.: Al’vares Pablishing, 2004. — 440 s.
  7. Muhin, K.Yu. Kognitivnaya epileptiformnaya dezintegraciya i shozhie sindromy [Cognitive epileptiform disintegration and similar syndromes] / K.Yu. Muhin, A.S. Petruhin, A.A. Holin. — M.: ArtServis Ltd, 2011. — 680 s.
  8. Nogovicyn, V.Yu. Polimorfizm elektroencefalograficheskogo patterna dobrokachestvennyh epileptiformnyh narushenii v detstve [Polymorphism electroencephalographic pattern of benign epileptiform disorders in childhood] / V.Yu. Nogovicyn, Yu.E. Nesterovskii, G.N. Osipova [i dr.] // Zhurnal nevrologii i psihiatrii [Journal of Neurology and Psychiatry]. — 2004. — T. 104, № 10. — S.48—56.
  9. Pleshkova, E.V. Narusheniya rechevoi funkcii u detei s epilep- siei [Disturbances of speech function in children with epilepsy] / E.V. Pleshkova // Izvestiya Rossiiskogo gosudarstvennogo pedagogicheskogo universiteta im. A.I. Gercena [Proceedings of A.I.Herzen State Pedagogical University]. — 2007. — T. 16, № 40. — S.493—497.
  10. Cavazzuti, G.B. Longitudinal study of epileptiform EEG patterns in normal children / G.B. Cavazzuti, L. Capella, F. Nalin // Epilepsia. — 1980. — Vol. 21 — P.43— 55.
  11. Doose, H. EEG in childhood epilepsy / Н. Doose. — Hamburg: John libbey, 2003. — P.191—243.
  12. Kagan-Kushnir, T. Screening electroencephalograms in autism spectrum disorders: evidence-based guideline / T. Kagan-Kushnir, S.W. Roberts, O.C. Snead // J. Child Neurok. — 2005. — Vol. 20, № 3. — P.240.
  13. Luders, H.O. Atlas and classification of electroencephalo- graphy / H.O. Luders, S. Noachtar. — Philadelphia: W.B. Saunders, 2000. — 280 p.
  14. Spence, S.J. The Role of Epilepsy and Epileptiform EEGs in Autism Spectrum Disorders / S.J. Spence, M.T. Schnei- der // Pediatric Research. — 2009. — Vol. 65. — Р.599—606.

 

PDF downloadDiastolic dysfunctions and remodeling of left ventricular in patients with type II diabetes mellitus with comorbidity obesity and essential arterial hypertension

E.V. Koroleva, graduate student of the Department of Therapy of the Paediatric Faculty of SBei Hpe «Yaroslavl State medical academy» of russian ministry of Health, Yaroslavl, russia, tel. (4852)64-58-63, e-mail: elena-korol2014@yandex.ru

Andrey E. Kratnov, MD, Head of the Department of Therapy of the Paediatric Faculty оf SBei Hpe «Yaroslavl State medical academy» of russian ministry of Health, Yaroslavl, russia, tel. (4852)64-58-63, e-mail: kratnov@mail.ru

E.V. Timganova, intern of the Department of Therapy of the Paediatric Faculty of SBEI HPE «Yaroslavl State Medical Academy» of Russian Ministry of Health, Yaroslavl, Russia, tel. (4852)64-58-63, e-mail: timgsam@mail.ru

Abstract. Aim. To study of obesity and essential arterial hypertension on development of diastolic dysfunctions and remodeling of left ventricular in patients with type II diabetes mellitus without coronary heart disease. Material and мethods. The echocardiography with estimation of diastolic properties and diagnostics remodeling of left ventricular in 134 patients with type II diabetes aged 26 to 66 years has been investigated. Results. The greatest contribution to development of diastolic dysfunctions and remodeling of left ventricular at combination of obesity and arterial hypertension with type II diabetes brings increase of arterial pressure. The increase in degree of obesity in patients with type II diabetes and arterial hypertension promotes more often development of concentric hypertrophy of myocardium of left ventricular. Conclusion. Comorbidity of arterial hypertension and adiposity in patients with type II diabetes mellitus are accompanied with increase in frequency of diastolic dysfunctions and remodeling of myocardium left ventricular that can promote fast development of heart failure.

Key words: type II diabetes mellitus, diastolic dysfunctions, remodeling of the left ventricular.

 

References

  1. Gaasch, W. Diagnosis and treatment of heart failure based on left ventricular systolic or diastolic dysfunction / W. Gaasch // JAMA. — 1994. — № 271. — P.1276—1280.
  2. Vakili, B.A. Prognostic implications of ventricular hypertrophy / B.A. Vakili, P.M. Okin, R.B. Devereux // Am. Heart J. — 2001. — Vol. 141. — P.334—341.
  3. Kelly, D.J. Tranilast attenuates diastolic dysfunction and structural injury in experimental diabetic cardiomyopathy / D.J. Kelly, Y. Zhang, K. Connelly [et al.] // Am. J. Physiol. Heart Circ. Physiol. — 2007. — Vol. 293. — P.2860—2869.
  4. Devereux, R.B. Impact of diabetes on cardiac structure and function: the Strong Heart Study / R.B. Devereux, M.J. Roman, M. Paranicas [et al.] // Circulation. — 2000. — Vol. 101. — P.2271—2276.
  5. Dedov, I.I. Serdce i ozhirenie / I.I. Dedov, A.A. Aleksandrov, S.S. Kuharenko // Ozhirenie i metabolizm. — 2006. — № 1. — S.14—20.
  6. Shlyahto, E.V. Remodelirovanie serdca pri gipertoniches- koi bolezni / E.V. Shlyahto, A.O. Konradi // Serdce: zhurnal dlya praktikuyuschih vrachei. — 2002. — № 5. — S.232—238.
  7. Kratnov, A.E. Svyaz' diastolicheskoi disfunkcii levogo zheludochka s razvitiem neiropatii u bol'nyh saharnym diabetom II tipa / A.E. Kratnov, O.E. Sergeeva // Klinicheskaya medicina. — 2011. — № 5. — S.41—43.
  8. Nagueh, S.F. Recommendations for the evaluation of left ventricular diastolic function by echocardiography / S.F. Nagueh, C.P. Appleton, T.C. Gillebert [et al.] // European Journal of Echocardiography. — 2009. — Vol. 10, № 2. — P.165—193.
  9. Mareev, V.Yu. Nacional'nye rekomendacii OSSN, RKO i RNMOT po diagnostike i lecheniyu HSN (chetvertyi peresmotr) / V.Yu. Mareev, F.T. Ageev, G.P. Arutyunov [i dr.] // Zhurnal serdechnaya nedostatochnost'. — 2013. — № 7. — S.379—472.
  10. Lang, R.M. Recommendations for chamber quantification / R.M. Lang, M. Bierig, R.B. Devereux [et al.] // European Journal of Echocardiography. — 2006. — Vol. 7. — P.79—108.
  11. Ganau, A. Patterns of left ventricular hypertrophy and geometric remodeling in essential hypertension / A. Ganau, R.B. Devereux, M.J. Roman [et al.] // J. Am. Coll. Cadiol. — 1992. — Vol. 19. — P.1550—1558.
  12. Vasyuk, Yu.A. Osobennosti sistolicheskoi funkcii i remodelirovaniya levogo zheludochka u bol'nyh arterial'noi gipertenziei i ishemicheskoi bolezn'yu serdca / Yu.A. Vasyuk, A.A. Kozina, E.N. Yuschuk [i dr.] // Zhurnal serdechnaya nedostatochnost'. — 2002. — № 2. — S.79—80.
  13. Mychka, V.B. Saharnyi diabet II tipa i arterial'naya giperto- niya / V.B. Mychka, I.E. Chazova // Serdce: zhurnal dlya praktikuyuschih vrachei. — 2004. — T. 1, № 13. — P.13—16.
  14. Dedov, I.I. Diabeticheskoe serdce: Causa Magna / I.I. Dedov, A.A. Aleksandrov // Serdce: zhurnal dlya praktikuyuschih vrachei. — 2004. — № 1. — S.5—8.
  15. Fein, F.S. Diabetic cardiomyopathy / F.S. Fein, E.H. Sonnenblick // Cardiovascular Drugs and Therapy. — 1994. — Vol. 8. — P.65—73.

 

PDF downloadGenetic markers of carbohydrates methabolism dissfunction in adult cystic fibrosis patients and their influence on cystic fibrosis disease progression

Viktor A. Samoylenko, research officer, cystic fibrosis laboratory, FSBI «Pulmonology Research institute» FMBA Russia, Moscow, tel. +7-495-465-52-64, e-mail: samoilenkov@mail.ru

Gulnara Y. Babadjanova, PhD MD, head of genetics and multifactorial diseases laboratory, FSBI «Pulmonology Research institute» FMBA Russia, Moscow, tel. +7-495-465-52-64, e-mail: babadjanova@rambler.ru

Alexander B. Nagorniy, PhD, research officer, genetics and multifactorial diseases laboratory, FSBI «Pulmonology Research institute» FMBA Russia, Moscow, tel. +7-495-465-52-64, e-mail: alnagor@mail.ru

Stanislav A. Krasovskiy, PhD, research officer, cystic fibrosis laboratory, FSBI «Pulmonology Research institute» FMBA Russia, Moscow, tel. +7-495-465-52-64, e-mail: sa_krasovsky@mail.ru

Svetlana Ju. Chikina, PhD, research officer, functional and ultrasound diagnostics laboratory, FSBI «Pulmonology Research institute» FMBA Russia, Moscow, tel. +7-495-465-52-64, e-mail: svch@list.ru

Abstract. The role of genetic markers of carbohydrate metabolism dysfunction (CMD) in cystic fibrosis (CF), and their influence on main clinical and functional parameters of CF disease course, is not studied well. Thus study of CMD in adult CF patients is actual research problem. The aim of our study was to determine the frequency of alleles and genotypes of three polymorphism (rs12255372, rs7903146, rs11196205) in TCF7L2 gene (transcription factor 7-like 2) in adult CF patients with CMD, and CF patients without CMD, in type II diabetes mellitus (DM type II) patients and in control group. Also we aimed to study clinical features of CF course in adults with CMD. We have shown that polymorphism rs12255372 of TCF7L2 gene is linked with increased risk of DM type II in Russian population, we didn’t find significant differences in polymorphism rs7903146 alleles frequenses distribution and genotypes in studied groups. Rs11196205 polymorhism with C allele lowers risk of CFDM (cystic fibrosis dependent diabetes mellitus) in CF patients (plays a protective role), and rs11196205 polymorphism with G allele increases risk of CFDM in CF patients in more than 2 times. We have shown that with active CMD screening in CF (n=154) with oral glucose tolerance test (OGTT), normal glucose metabolism is found in 92 CF patients (59,7%), impaired glucose tolerance (IGT) — in 44 CF patients (28,6%), CFDM in 18 patients (11,7%). During further clinical and functional study, it was shown that in 3 groups of patients (92 without CMD, 44 with IGT and 55 with CFDM) CFDM had a lower height, body weight, and pulmonary function, lower rate of S. aureus colonization with tendency to B. cepacia colonization, comparing with patients without CMD. Patients with CMD had a higher rate of «severe» mutations when comparing to a group without CMD; we didn’t find «light» mutations in patients with CFDM.

Key words: Cystic fibrosis, diabetes mellitus, glucose metabolism dysfunction, cystic fibrosis dependent diabetes mellitus, alleles, genotypes, TCF7L2 gene, polymorphisms [IVS3 C-T (rs7903146), IVS4 G-T (rs12255372), IVS3, G-C (rs11196205)].

 

References

  1. Kapranov, N.I. Mukoviscidoz: mediko-social’noe znachenie, diagnostika, vozmozhnosti terapii / N.I. Kapranov // Vrach. — 2006. — № 4. — S.12—16.
  2. Chuchalin, A.G. Mukoviscidoz u vzroslyh: etiologiya, patogenez, perspektivy lecheniya / A.G. Chuchalin, L.M. Voronina, L.A. Kronina, M.V. Samsonova // Pul’monologiya. — 1994. — № 3. — S.17—22.
  3. No relationship between mean plasma glucose and glycated haemoglobin in patients with cystic fibrosis-related diabetes / A. Godbout, I. Hammana, S. Potvin [et al.] // Diabetes Metab. — 2008. — № 34 (6, pt 1). — P.568—573.
  4. Living with cystic fibrosis-related diabetes or type 1 diabetes mellitus: a comparative study exploring health-related quality of life and patients’ reported experiences of hypoglycaemia / S. Tierney, K. Webb, A. Jones [et al.] // Chronic Illn. — 2008. — № 4(4). — P.278—288.
  5. Genetic modifiers play a substantial role in diabetes complicating cystic fibrosis / S.M. Blackman, S. Hsu, L.L. Vanscoy [et al.] // J. Clin. Endocrinol. Metab. — 2009. — Vol. 94(4). — P.1302—1309.
  6. Association between TCF7L2 gene polymorphisms and susceptibility to type 2 diabetes mellitus: a large Human Genome Epidemiology (HuGE) review and meta-analysis / Y. Tong, Y. Lin, Y. Zhang [et al.] // BMC Med. Genet. — 2009. — Feb 19. — P.10—15.
  7. The rs12255372(G/T) and rs7903146(C/T) polymorphisms of the TCF7L2 gene are associated with type 2 diabetes mellitus in Asian Indians / D. Bodhini, V. Radha, M. Dhar [et al.] // Metabolism. — 2007. — Vol. 56(9). — P.1174—1178.
  8. Cystic fibrosis-related diabetes mellitus: etiology, evaluation, and management / D. Fischman, V.K. Nookala // Endocr. Pract. — 2008. — Vol. 14(9). — P.1169—1179.
  9. Latyshev, O.Yu. Narusheniya uglevodnogo obmena pri mukoviscidoze / O.Yu. Latyshev // Diabet. Obraz zhizni. — 2008. — № 4. — S.3—5.
  10. European Community for Steel and Coal: standardised lung function testing: lung volumes and forced ventilatory flows // Eur. Respir. J. — 1993. — Vol. 6 (suppl. 16). — P.5—40.
  11. Is cystic fibrosis-related diabetes an apoptotic consequence of ER stress in pancreatic cells? / B.R. Ali // Med. Hypotheses. — 2009. — Vol. 72(1). — P.55—57.
  12. Samoilenko, V.A. Klinicheskie osobennosti techeniya mukoviscidoza u vzroslyh bol’nyh s narusheniem uglevodnogo obmena / V.A. Samoilenko, S.A. Krasovskii, Ya.V. Marchenkov [i dr.] // Terapevticheskii arhiv. — 2013. — № 3. — S.32—37.
  13. Association of variants of transcription factor 7-like 2 (TCF7L2) with susceptibility to type II diabetes in the Dutch Breda cohort / J.V. Van Vliet-Ostaptchouk [et al.] // Diabetologia. — 2007. — Vol. 50, № 1. — P.59—62.
  14. Common variants in the TCF7L2 gene are strongly associated with type II diabetes mellitus in the Indian population / G.R. Chandak [et al.] // Diabetologia. — 2007. — Vol. 50, № 1. — P.63—67.
  15. Variant of transcription factor 7-like 2 (TCF7L2) gene confers risk of type II diabetes / S.F. Grant [et al.] // Nat. Genet. — 2006. — № 38. — P.320—323.
  16. Canadian Cystic Fibrosis Patient Data Registry Report 2009. — URL: www.cysticfibrosis.ca
  17. CF Registry Cystic fibrosis Trust. UK CF Registry Annual Data Report 2009. — URL: www.cftrust.org.uk
  18. Cystic Fibrosis Foundation, Patient Registry 2009 Annual Report, Cystic Fibrosis Foundation, Bethesda, Md. — USA, 2011. — P.65.
  19. Consensus on the use and interpretation of cystic fibrosis mutation analysis in clinical practice / C. Castellani, H. Cuppens, M. Macek Jr. [et al.] // Journal of Cystic Fibrosis. — 2008. — Vol. 7. — P.179—196.

 

PDF downloadComparative analysis specialized outpatient and inpatient medical care for children with urticaria and angioedema

Rezeda F. Khakimova, MD, Department of Clinical Immunology and Allergology of Kazan State Medical University, Kazan, Russia, e-mail: khakimova@yandex.ru

Gulnara R. Kamasheva, PhD, assistant professor, Department of General practice Kazan State medical university, Kazan¸ Russia

Galina A. Shamsutdinova, allergologist, Children’s Republican Clinical Hospital, Kazan, Russia

Alla A. Vasileva, PhD, Assistant Professor, Department of Clinical Immunology and Allergology of Kazan State Medical University, Kazan, Russia

Guzel R. Davletbaeva, nephrologist, Children’s Republican Clinical Hospital, Kazan, Russia

Maryana N. Tukhbatullina, dermatologist, Dermatological and STD Hospital, Nijnekamsk, Russia

Abstract. Purpose. We analyzed the quality of specialized outpatient and inpatient medical care of children with urticarial/angioedema. Material and methods. 198 children aged 7 months to 17 years were followed up by dermatologist, allergologist and pediatrician. In our work we utilized clinical and allergological diagnostic methods, analytical and statistical methods. Results. Acute utricaria is more prevalent in children. We established the differences in diagnostic algorithm and treatment of children based on the level of medical care, including primary and specialized outpatient and inpatient service. We found that doctors at the ambulatory level and dermatologists do not always abide by the diagnostic standards and treatment of urticarial/angioedema. Conclusion. The more complete diagnostic approach of urticarial/angioedema in children is carried by allergologist both in the outpatient and in the inpatient settings.

Key words: specialized medical care, urticaria, angioedema, children.

 

References

  1. Allergologiya i immunologiya: nacional'noe rukovodstvo [Allergology and immunology national guide] / pod red. R.M. Haitova, N.I. Il’inoi. — M.: GEOTAR-Media, 2009. — 656 c.
  2. Vasil’eva, A.A. Ostraya krapivnica i angiootek v praktike semeinogo vracha [Acute urticarial and angioedema in general practicionery’s practice] / A.A. Vasil’eva, R.F. Hakimova // Vestnik sovremennoi klinicheskoi mediciny. — 2011. — T. 4, vyp. 4. — S.54—59.
  3. Klinicheskaya allergologiya detskogo vozrasta s neotlozhnymi sostoyaniyami [Clinical Allergy in children with emergency conditions] / pod red. I.I. Balabolkina, V.A. Bulgakovoi. — M.: Izd-vo «MIA», 2011. — 264 s.
  4. Kolhir, P.V. Krapivnica i angiootek [Urticarial/angioedema] / P.V. Kolhir. — M.: Prakticheskaya medicina, 2012. — 364 s.
  5. Krapivnica. Klinicheskie rekomendacii [Urticaria. Clinical guidelines] / pod red. A.A. Kubanovoi. — M.: Rossiiskoe obschestvo dermatovenerologov, 2007. — 36 s.
  6. Pampura, A.N. Spektr hronicheskih krapivnic u detei [Range of chronic urticaria in children] / A.N. Pampura, T.N. Solovei // Sovremennye tehnologii v pediatrii i detskoi hirurgii: materialy VI Ros. kongr. — M., 2007. — S.43—44.
  7. Racional’naya farmakoterapiya allergicheskih zabolevanii: rukovodstvo dlya praktikuyuschih vrachei [Rational pharmacotherapy of allergic diseases] / R.M. Haitov, N.I. Il’ina, T.V. Latysheva [i dr.]. — M.: Litterra, 2007. — 504 s.
  8. Rossiiskii nacional’nyi soglasitel’nyi dokument «Krapivnica i angiootek». Rekomendacii dlya prakticheskih vrachei [Russian national conciliation document «Urticaria and angioedema»] / pod red. I.S. Guschina, N.I. Il’inoi. — M.: FarmarusPrint Medi, 2007. — 128 s.
  9. Kozel, М. Chronic Urticaria. Aetiology, management and current and future treatment options / М. Kozel, R. Sabroe // Drug. — 2004. — Vol. 64. — P.2516—2536.
  10. Sackesen, C. The etiology of different forms of urticaria in childhood / C. Sackesen, F. Orhan, C. Kosatas [et al.] // Pediatr. Dermatol. — 2004. — Vol. 21. — P.102.
  11. Sánchez-Borges, М. Diagnosis and treatment of urticaria and angioedema: a World Perspective / M. Sánchez-Borges, R. Asero, I.J Ansotegui [et al.] / World Allergy Organ J. — 2012. — Vol. 5(11). — Р.125—147.
  12. Simons, F. Prevention of acute urticaria in young children with atopic dermatitis / F. Simons // J. Allergy Clin. Immunol. — 2001. — Vol. 107. — P.703—706.
  13. Zuberbier, T. EAACI/GA2.LЕN/EDF guideline: management of urticarial (2006) / Т. Zuberbier, J.С. Bindslev, W. Canonica [et al.] // Allergy. — 2006. — Vol. 61. — P.321—331.

 

PDF downloadGender difference of arterial rigidity in patients with the arterial hypertensions and high total cardiovascular risk

Irina I. Chukayeva, MD, professor, Head of department chair of polyclinic therapy № 2 of Medical faculty of pirogov russian national research medical university, moscow, russia, tel. 8-916-933-87-29, e-mail: chukaeva@mail.ru

Natalya V. Oriova, MD, professor of chair of polyclinic therapy № 2 of Medical faculty of Pirogov Russian National research medical university, moscow, russia, tel. 8-916-990-25-47, e-mail: vrach315@yandex.ru

Asiyat I. Khachirova, the graduate student of chair of polyclinic therapy No. 2 of Medical faculty of Pirogov Russian national research medical university, moscow, russia, tel. 8-926-878-88-87, e-mail: asiyat-h@mail.ru

Irina V. Komarova, the assistant to chair of polyclinic therapy № 2 of Medical faculty of Pirogov Russian National research medical university, moscow, russia, tel. 8-910-418-95-17, e-mail: irka.komarova@gmail.com

Svetlana V. Goryaynova, the graduate student of chair of polyclinic therapy № 2 of Medical faculty of Pirogov russian national research medical university, moscow, russia, tel. 8-926-942-59-07, e-mail: mihalkova777@mail.ru

Nataliya D. Karseladze, cardiologist central clinical Hospital № 1 of jSc «russian railways», moscow, russia, tel. 8-915-342-95-42, e-mail: karseladze@yandex.ru

Abstract. The aim. Assessment of a pulse wave velocity in men and postmenopausal women with arterial hypertension and high total cardiovascular risk. Material and methods. We surveyed 50 patients aged from 50 till 68 years [30 women — average age 59,43 (56—62) years (menopause duration more than 3 years) and 20 men — average age of 57,7 (55—62) years], with arterial hypertension, without coronary heart disease, with total SCORE cardiovascular risk 5% and above. Pulse wave velocity (PWV)was evaluated in all patients with the device Tonokard. Results and discussions. The analysis of the obtained data based on results of statistical processing of a material, allowed to reveal the speed distribution distinction of PWV between men and women in a post menopause. Also was found reliable positive correlation between PWV and blood plasma CRP level in postmenopausal women. Conclusion. Proceeding from the data obtained in research, it is possible to assume that decrease of a protective role of an estrogen background in women occurs gradually, with preservation preventive action on a vascular wall during the first years of a post menopause. Also, received by us results allow to suggest about the higher predictive role of CRP level in postmenopausal women in comparison with men of the same age.

Key words: arterial hypertension, pulse wave velocity, postmenopausal women.

 

References

  1. Gurfinkel’, Yu.I. Osobennosti mikrocirkulyacii, endotelial’noi funkcii i skorosti rasprostraneniya pul’sovoi volny u pacientov s nachal’nymi stadiyami arterial’noi gipertenzii / Yu.I. Gurfinkel’, O.V. Makeeva, V.A. Ostrozhinskii // Funkcional’naya diagnostika. — 2010. — № 2. — S.18—24.
  2. Isakova, A.V. Osobennosti provospalitel’nyh i prokoagulyantnyh narushenii, associirovannyh s metabolicheskim sindromom, u zhenschin v postmenopauze / A.V.Isakova // Byulleten’ medicinskih internet-konferencii. — 2013. — Vol. 3, issue 3. — R.665—665
  3. Kardiovaskulyarnaya profilaktika. Nacional’nye rekomendacii // Kardiovaskulyarnaya terapiya i profilaktika (pril. 2). — 2011. — № 10(6). — 64 s.
  4. Katel’nickaya, L.I. Gendernye osobennosti klinicheskogo techeniya i lecheniya bol’nyh arterial’noi gipertenziei / L.I. Katel’nickaya, L.A. Haisheva // Racional’naya farma- koterapiya v kardiologii. — 2008. — № 1. — S.76—80.
  5. Malichenko, S.B. Osobennosti arterial’noi gipertonii v postmenopauze / S.B. Malichenko, K.K. Halidova // Kardiologiya. — 2002. — № 2. — S.31—34.
  6. Patent 2343826. Rossiiskaya Federaciya, MPK A61B 5/022, A61B 5/0285. Ustroistvo dlya opredeleniya parametrov serdechno-sosudistoi sistemy / Yu.I. Gurfinkel’; zayavitel’ i patentoobladatel’ OOO «Aktual’nye medicinskie diagnosticheskie tehnologii» — № 2007121004/14, zayavl. 06.06.2007; opubl. 20.01.2009, Byul. № 2.
  7. Smetnik, V.P. Zhenskie polovye gormony i serdechno-sosudistaya sistema / V.P. Smetnik, A.A. Smetnik // Medicinskii sovet. — 2011. — № 3/4. — S.40—45.
  8. 2013 ESH/ESC Guidelines for the management of arterial hypertension. // J. Hypertens. — 2013. — Vol. 31(7). — Р.1281—1357.
  9. Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients / J. Blacher, R. Asmar, S. Djane [et al.] // Hypertension. — 1999. — Vol. 33(5). — Р.1111—1117.
  10. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients / R. Asmar, S. Laurent, P. Boutouyrie [et al.] // Hypertension. — 2001. — Vol. 37(5). — Р.1236—1241.
  11. Cardiovascular risk assessment beyond systemic coronary risk estimation: a role for organ damage markers / M. Volpe, A. Battistoni, G. Tocci [et al.] // J. Hypertens. — 2012. — Vol. 30. — Р.1056—1064.
  12. Compliance and diameter in the human abdominal aorta the influence of age and sex / B. Sonesson, F. Hansen, H. Stale [et al.] // Eur. J. Vasc. Surg. — 1993. — Vol. 7 (6). — Р.690—697.
  13. C-reactive protein is associated with aortic stiffness in a cohort of African American and white women transitioning through menopause / G.A. Woodard, V.G. Mehta, R.H. Mackey [et al.] // Menopause (New York, N.Y.). — 2011. — Vol. 18(12). — Р.1291—1297.
  14. Gomez-Marcos, M.A. Relationships between high-sensitive C-reactive protein and markers of arterial stiffness in hypertensive patients. Differences by sex / M.A. Gomez-Marcos, J.I. Recio-Rodríguez, M.C. Patino-Alonso // BMC Cardiovascular Disorders. — 2012. — Jun. 7, 12. — Р.37.
  15. Influence of sex on the relation between heart rate and aortic stiffness / A. Benetos, P. Albaladejo, P. Laurent [et al.] // J. Hypertens. — 2003. — Mar. 21(3). — P.555—562.
  16. Mendelsohn, M.E. Molecular and cellular basis of cardiovascular gender differences / M.E. Mendelsohn, R.H. Karas // Science. — 2005. — Vol. 308, № 5728. — P.1583—1577.
  17. Risk prediction is improved by adding markers of subclinical organ damage to SCORE / T. Sehestedt, J. Jeppesen, T.W. Hansen [et al.] // Eur. Heart J. — 2010. — Vol. 31. — Р.883—891.
  18. Thresholds for pulse wave velocity, urine albumin creatinine ratio and left ventricular mass index using SCORE, Framingham and ESH/ESC risk charts / T. Sehestedt, J. Jeppesen, T.W. Hansen [et al.] // J. Hypertens. — 2012. — Vol. 30. — Р.1928—1936.

 

PDF downloadCauses of non-responding to inhaled nitric oxide for respiratory distress-syndrome

Vasiliy A. Shtabnitskiy, research officer in clinical pharmacology laboratory FGBU «Pulmonology research institute» fmBa of russia, moscow, russia, tel. +7-495-465-52-64, e-mail: vashtab@rambler.ru

Alexander G. Chuchalin, PhD, MD, professor, Academic RAS, Director of FGBU «Pulmonology research institute» FMBA of Russia, Moscow, Russia, tel. +7-495-465-52-64

Abstract. Acute respiratory distress syndrome (ARDS) is actual problem on the edge of modern pulmonology and intensive care medicine. Despite current progress in ARDS pathology and management, mortality continues to be high, and physicians still need to apply respiratory support with traumatic ventilation parameters. There are several methods of additional oxygenation improvement, inhaled nitric oxide is one of them. Still there is no clear explanation of different response rates to iNO therapy. We planned and conducted non-randomized open label prospective observational study, one of the aims was to determine the cause of non-responding to iNO therapy. All patients included in the study, according to 2012 criteria were treated with iNO (n=30). After dividing patients to responders and non-responders group, different parameters of severity, oxygenation and hemodynamic parameters and inflammatory response were assessed. Responders had a higher level of cardiac output — 6,8 (±2,2) vs 4,9 (±0,7); p=0,006, also there was non-significant differences in oxygenation and inflammatory response. There was a negative correlation with oxygenation improvement and baseline PaO2/FiO2 level. iNO was not linked with ARDS etiology, and mortality probability.

Key words: ARDS, Invasive ventilation, respiratory failure, nitric oxide.

 

References

  1. Ranieri, V.M. Acute respiratory distress syndrome: the Berlin Definition / V.M. Ranieri, G.D. Rubenfeld [et al.] // JAMA. — 2012. — Vol. 307, № 23. — P.2526—2533.
  2. Webster, N.R. Adult respiratory distress syndrome — how many cases in the UK? / N.R. Webster, A.T. Cohen, J.F. Nunn // Anaesthesia. — 1988. — Vol. 43. — P.923—926.
  3. Villar, J. The incidence of the adult respiratory distress syndrome / J. Villar, A.S. Slutsky // Am. Rev. Respir. Dis. — 1989. — Vol. 140. — P.814—816.
  4. Thomsen, G.E. Incidence of the the adult respiratory distress syndrome in the state of Utah / G.E. Thomsen, A.H. Morris // Am. J. Respir. Crit. Care Med. — 1995. — Vol. 152. — P.965—971.
  5. Luhr, O.R. Incidence and mortality after acute respiratory failure and acute respiratory distress syndrome in Sweden, Denmark, and Iceland / O.R. Luhr, K. Antonsen, M. Karlsson [et al.] // Am. J. Respir. Crit. Care Med. — 1999. — Vol. 159. — P.1849—1861.
  6. Fowler, A.A. Adult respiratory distress syndrome: risk with common predispositions / A.A. F owler, R.F. Hamman, J.T. Good [et al.] // Ann. Intern. Med. — 1983. — Vol. 98. — P.593—597.
  7. Bell, R.C. Multiple organ system failure and infection in adult respiratory distress syndrome / R.C. Bell, J.J. Coalson, J.D. Smith, W.G. Jr. Johanson // Ann. Intern. Med. — 1983. — Vol. 99. — P.293—298.
  8. Spragg, R.G. Beyond mortality: future clinical research in acute lung injury / R.G. Spragg, G.R. Bernard, W. Checkley [et al.] // Am. J. Respir. Crit. Care Med. — 2010. — Vol. 181. — P.1121—1127.
  9. Jackson, R.M. Molecular, pharmacologic, and clinical aspects of oxygen-induced lung injury / R.M. Jackson // Clin. Chest. Med. — 1990. — Vol. 11, № 1. — P.73—86 (Review).
  10. Jackson, R.M. Pulmonary oxygen toxicity / R.M. Jackson // Chest. — 1985. — Vol. 88, № 6. — P.900—905 (Review).
  11. Kassil’, V.L. Iskusstvennaya i vspomogatel’naya ventilyaciya legkih: rukovodstvo dlya vrachei / V.L. Kassil’, M.A. Vyzhgina, G.S. Leskin. — M.: Medicina, 2004. — S.377—388.
  12. The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome // N. Engl. J. Med. — 2000. — Vol. 342. — P.1301—1308.
  13. Rossaint, R. Inhalation of nitric oxide —a new approach in severe ARDS / R. Rossaint, H. Gerlach, K.J. Falke // Eur. J. Anaesthesiol. — 1994. — Vol. 11, № 1. — P.43—51 (Review).
  14. Bigatello, L.M. Prolonged inhalation of low concentrations of nitric oxide in patients with severe adult respiratory distress syndrome. Effects on pulmonary hemodynamics and oxygenation / L.M. Bigatello, W.E. Hurford, R.M. Kacmarek [et al.] // Anesthesiology. — 1994. — Vol. 80, № 4. — P.761—770.
  15. Taylor, R.W. Inhaled Nitric Oxide in ARDS Study Group. Low-doseinhaled nitric oxide in patients with acute lung injury: a randomized controlled trial / R.W. Taylor, J.L. Zimmerman, R.P. Dellinger [et al.] // JAMA. — 2004. — Vol. 291, № 13. — P.1603—1609.
  16. Mourgeon, E. Inhaled nitric oxide in acute respiratory distress syndrome with and without septic shock requiring norepinephrine administration: a dose-response study / E. Mourgeon, L. Puybasset, J.D. Law-Koune [et al.] // Crit Care. — 1997. — Vol. 1, № 1. — P.25—39.
  17. Johannigman, J.A. Positive end-expiratory pressure and response to inhaled nitric oxide: changing non responders to responders / J.A. Johannigman, K. Jr. Davis, R.S. Campbell [et al.] // Surgery. — 2000. — Vol. 127, № 4. — P.390—394.

 

PDF downloadComparative analysis of functional state of human body at application of biological medicine in Yugra.

O.A. Bondarenko, A.G. Danilov, V.V. Eskov, A. Mononov, R.N. Zhivoglyad

Abstract. The aim of research was to make bioinformating analysis of two biotherapy methods and research of functional status of organism of patients with sick of musculoskeletal system on the basis of studying autonomic nervous system (ANS ), and human adaptation reserves in the North with analysis of pain syndrome. Material and methods. We made inspection and rehabilitating treatment of patients with degenerative diseases of the spine , I—III severety, of the two groups:1 — the first group was treated apitherapy (92 patients — 53 male, 39 — female). 2 — the second group ws treated with hirudoreflexotherapy (92 patients, including her husband — 50 and wives — 42). On the research indicators were fixed before treatment and after 10 sessions. In research’s method of pulse oximetry. Each method also analyzed pain syndrome before and after treatment to control therapy efficiency by means of interrogation scale by multimeasured semantic pain description. 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 12-measured phase space was made. Results and discussion. Results and discussion. While analyzing the function indicators of patients' state quasi-attractors volume decrease was noted with asymmetry indicators decrease more expressed is more in hirudoreflexotherapy, that proves more rapid start of clinical effect. Equal decrease of pain indicators interrogation scale after treatment in both groups is marked, that confirms analgesic effect usage of both methods. Conclusion. Confirmation of analgesic effect after treatment in both groups allows to consider methods of biological medicine to be effectted. Bioinformating analysis proves negektropic effect, causing sanogenesis as in hirudoreflexotherapy, and in apitherapy, that can interest doctors usage biotherapy.

Key words: hirudoreflexotherapy, apitherapy, biological medicine, vector of the human's body state, bioinformatic analysis.

 

References

  1. Luvsan, G. Tradicionnye i sovremennye aspekty vostochnoi refleksoterapii / G. Luvsan. — M.: Nauka, 1990. — 576 s.
  2. Tabeeva, D.M. Prakticheskoe rukovodstvo po igloreflekso- terapii / D.M. Tabeeva. — M.: MEDpress-inform, 2004. — 440 s.
  3. Rakita, D.R. Teoreticheskie i prakticheskie osnovy apiterapii: monografiya / D.R. Rakita, D.G. Krivcov; GOU VPO RyazGMU Roszdrava. — Ryazan’, 2010. — 332 s.
  4. Goloschapov, V.M. Apiterapiya / V.M. Goloschapov. — M.: Timoshka, 2005. — 30 s.
  5. Vein, A.M. Vegetososudistaya distoniya / A.M. Vein, A.D. Solov’eva, O.A. Kolosova. — M., 1981. — 275 s.
  6. Hadarcev, A.A. Vosstanovitel’naya medicina: monografiya / A.A. Hadarcev, B.L. Vinokurov, S.N. Gontarev. — Tula-Belgorod, 2010. — T. III. — 296 s.
  7. 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.
  8. Zhivoglyad, R.N. Girudoterapiya i vosstanovitel’naya medicina: monografiya / R.N. Zhivoglyad. — Surgut, 2012. — 235 s.
  9. 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. — M.: ROSPATENT, 2009.
  10. Hasnulin, V.I. Formirovanie zdorov’ya gorodskogo naseleniya i ego social’no-trudovogo potenciala v ekstremal’nyh klimatogeograficheskih usloviyah. Urboekologiya / V.I. Has- nulin. — M.: Nauka, 1990. — S.174—181.

 

CASE FROM PRACTICE

PDF downloadNew technologies in diagnostic untypical case of coronary artery disease

Naila A. Mukhametzyanova, PhD , doctor of functional Diagnostic FKUZ «Health Part of the Interior Ministry in the Republic of Tatarstan», Kazan, tel. 8-917-887-22-61

Nail B. Amirov, MD, professor of General practice medical university of Kazan State medical university, tel. 8-905-313-01-11, e-mail: namirov@mail.ru

Guzalija B. Sayfullina, doctor of Interregional Clinical Diagnostic Cеnter, Kazan, tel. 8-917-395-10-51

Abstract. Purpose. To create wider doctors about atypical variants of CHD show atypical variant of acute myocardial infarction and the role of modern methods of diagnostic search to determine the correct diagnosis, localization of myocardial infarction and to determine subsequent treatment. Material and methods. The results of the survey, observation and treatment of a patient with an atypical course of coronary heart disease. A clinical case of atypical course of acute myocardial infarction. Shows diagnostic algorithm using all modern methods of diagnosis . Shows the steps of treating a patient and dynamics of postinfarction period. Results and discussion. The case study allows doctors to expand the representation of the possible variants of acute myocardial infarction and optimize diagnostic tactics. Conclusions. For suspected acute coronary syndrome development requires an integrated approach from all available diagnostic capabilities , including coronary angiography and perfusion tomostsintigrafiyu infarction.

Key words: ischemic heart disease, diagnostics, treatment.

 

References

  1. Nacional’nye rekomendacii po lecheniyu ostrogo koronarnogo sindroma bez stoikogo pod’ema ST na EKG // Kardiovaskulyarnaya terapiya i profilaktika. — 2006. — № 5. — (Pril. 1).
  2. Amirov, N.B. Bezbolevaya ishemiya miokarda kak variant klinicheskogo techeniya ishemicheskoi bolezni serdca / N.B. Amirov, R.A. Galyavi, L.I. Gornaeva // Vestnik sovremennoi klinicheskoi mediciny. — 2011. — T. IV, vyp. 2. — S.8—10.
  3. Ishemicheskaya bolezn’ serdca v obschei vrachebnoi praktike: diagnostika, lechenie i profilaktika / pod red. prof. N.B. Amirova. — Kazan’, 2011. — 194 s.

 

EXPERIMENTAL STUDIES TO PRACTICAL MEDICINE

PDF downloadPostoperative endothelial dysfunction of peritoneal vesseles and its effect of peritoneal function

Sergey V. Poroyskiy, MD, head of Emergency Medicine Chair at Volgograd State Medical University under Ministry for Public Health of Russian Federation, Volgograd, Russia, tel. 8-905-396-59-13, e-mail: poroyskiy@mail.ru

Anna V. Poroyskaya, PhD, assistant professor at Morbid Anatomy Chair at Volgograd State Medical University under Ministry for Public Health of Russian Federation, Volgograd, Russia, tel. 8-906-406-07-01, e-mail: poroiskaja@rambler.ru

Abstract. Aim. Objective of the study is to determine the condition of vasodilating function of peritoneal vessels, and resorption function of the peritoneum after infliction of a surgical wound on varying extent, and in the postoperative period. Materials and methods. An experimental study involved 390 mature Wistar rats weighing 250—300 g: group 1 included animals with a standard surgical wound; group 2 — a standard surgical wound accompanied by hysterectomywith intact appendages; group 3 — a standard surgical wound accompanied by hysteron-oophorectomy. Results. We revealed a development of peritoneal endothelial dysfunction and its association with decreased resorption activity of the peritoneum of varying intensity depending on the extent of the surgical wound. Conclusion. The observed changes in peritoneal function associated with postoperative endothelial dysfunction of peritoneal vessels are an important link in the pathogenetic chain of a number of postoperative complications, postoperative adhesion formation in particular.

Key words: endothelial dysfunction, peritoneum, adhesive process, peritoneal resorptive function, endothelium.

 

References

  1. Bezhenar', V.F. Etiologiya, patogenez i profilaktika spaiko- obrazovaniya pri operaciyah na organah malogo taza [Etiology, pathogeny and prevention of adhesion formation in small pelvis surgery] / V.F. Bezhenar’, E.K. Ailamazyan, A.A. Cypurdeeva [i dr.] // Rossiiskii vestnik akushera-ginekologa. — 2011. — № 2. — S.90—101.
  2. Petrischev, N.N. Patogeneticheskoe znachenie disfunkcii endoteliya [Pathogenetic importance of endothelial function] / N.N. Petrischev // Omskii nauchnyi vestnik. — 2005. — № 1. — S.20—22.
  3. Petuhov, V.A. Endotelial’naya disfunkciya: sovremennoe sostoyanie voprosa (po materialam nauchnogo simpoziuma) [Endothelial dysfunction: uptodate views on the question] / V.A. Petuhov // Hirurgiya. Prilozhenie «Sonsiliun medicum». — 2008. — № 1. — S.3—11.
  4. Poroiskii, S.V. Eksperimental’noe, morfologicheskoe i klinicheskoe obosnovanie patogeneza, diagnostiki i profilaktiki posleoperacionnogo spaikoobrazovaniya [Experimental, morphological and clinical substantiation of pathogeny, diagnostics and prevention of postoperative adhesion formation]: dis. ... d-ra med. nauk / S.V. Poroiskii. — Volgograd, 2012. — 420 s.
  5. Poroiskii, S.V. Sposob modelirovaniya posleoperacion- nogo spaechnogo processa bryushnoi polosti na fone nedostatochnosti polovyh gormonov [A way of modeling postoperative adhesion formation in the abdomen in patients with sex hormone insufficiency] / S.V. Poroiskii, A.A. Vorob’ev, A.V. Voronkov [i dr.]. — Patent RF na izobretenie № 2374699 ot 27.11.2009.
  6. Poroiskii, S.V. Sposob eksperimental’noi ocenki rezorbcionnoi funkcii bryushiny / S.V. Poroiskii, A.A. Vorob’ev, Yu.A. Dvoreckaya, I.A. Grechkina. — Patent RF na izobretenie № 2400821 ot 27.09.2010.
  7. Di Zerega, G.S. Prevention of intra-abdominal adhesions in gynaecological surgery / G.S. Di Zerega, T. Tulandi // Reprod Biomed Online. — 2008. — Vol. 17, № 3. — P.6.

 

PDF downloadImpact of chronic psychosocial stress on retinal and plasma sphingolipids of rats with different stress resistance

Ekaterina A. Gizzatullina, assistant professor, Department of ophthalmology SBei Hpe «izhevsk State Medical Academy» of Russian Ministry of Health, Izhevsk, Russia, tel. 8-904-275-84-90, e-mail: pinport@mail.ru

Irina G. Bryndina, DmSc, professor, Head of the Department of pathophysiology, SBei Hpe «izhevsk State Medical Academy» of Russian Ministry of Health, Izhevsk, Russia, tel. 8-912-465-75-80, e-mail: i_bryndina@mail.ru

Abstract. Aim. To study the effect of chronic psychosocial stress on sphingolipids content in the eye and blood plasma of rats resistant and susceptible to stress. Material and methods. On the group of 20 male albino rats the 10-day and 18-day psychosocial stress was simulated. The content of ceramide and sphingomyelin was studied in tissues by TLC in comparison with the control group (10 rats). Results and discussion. Stress caused more pronounced accumulation of ceramide in the eye and plasma of stress susceptible animals compared to resistant ones.

Key word: sphingolipids, stress resistance, psychosocial stress.

 

References

  1. Bryndina, I.G. Ceramidy skeletnyh myshc, pecheni i legkih gryzunov pri hronicheskom emocional'nom stresse i modelirovannoi nevesomosti / I.G. Bryndina, M.R. Bagautdinov, N.N. Vasil'eva [i dr.] // Vestnik Ural'skoi medicinskoi akademicheskoi nauki. — 2012. — № 2(39). — S.108—109.
  2. Velichkovskii, B.B. Mnogomernaya ocenka individual'noi ustoichivosti k stressu: dis. ... kand. psihol. nauk / B.B. Velichkovskii. — Moskva: RGB, 2007. — 195 s.
  3. Pogosova, G.V. Priznanie znachimosti psihoemocional'nogo stressa v kachestve serdechno-sosudistogo faktora riska pervogo poryadka / G.V. Pogosova // Kardiologiya. — 2007. — № 2. — S.65—73.
  4. Sudakov, K.V. Individual'nost' emocional'nogo stressa / K.V. Sudakov // Zhurnal nevrologii i psihologii. — 2005. — T. 105, № 2. — S.4—12.
  5. Chida, Y. A bidirectional relationship between psychosocial factors and atopic disorders: A systematic review and meta-analysis / Y. Chida, M. Hamer, A. Steptoe // Psychosom Med. — 2008. — Vol. 70. — P.102—116.
  6. Sanvicens, N. Ceramide is the key mediator of oxidative stress-induced apoptosis in retinal photoreceptor cells / N. Sanvicens, T.G. Cotter // J. Neurochem. — 2006. — Vol. 98. — P.1432—1444.
  7. Schenck, M. Ceramide: Physiological and pathophysiological aspects / M. Schenck [et al.] // Arch Biochem Biophys. — 2007. — Vol. 462. — P.171—175.
  8. Spiegel, S. Sphingosine 1-phosphate, a key cell signaling molecule / S. Spiegel, S. Milstein // J. Biol. Chem. — 2002. — Vol. 277. — P.25851—25854.

 

REVIEWS

PDF downloadVarious approaches to the estimation of the patient’s health damage

Vladimir A. Shcherbakov, graduate student of biomedical ethics, medical law and history of medicine SBEI HPE «Kazan State medical university» of russian ministry of Health, Kazan, russia, e-mail: vladimir.shcherbakov@inbox.ru

Abstract. Aim. The purpose of the research is to study the various approaches to the estimation of the patient’s health damage. Matherial and method. Abstract, analytical and retrospective research methods of Russian and foreign literature. Results. It is revealed that at present there are no common approaches to the estimation of the patient’s health damage. It is confirmed by numerous definitions of the terms relating to the problem and absence of them in the legislation. There are over 65 definitions of the term «medical error». At the same time, in the currently valid codes, laws and other legal acts the term is absent. This term is unreasonably expanded by some authors, who include in it the elements of criminal acts of a doctor. There are also different approaches to such definitions as «defect of medical care», «iatrogenic diseases», «medical accident», «professional medical offense». Conclusion. Currently, there exists uncertainty regarding the estimation of the patient’s health damage during the medical intervention in medical, legal and social spheres. The problem of the common approach development is not yet solved, so it is not possible to analyze and design effective interventions to prevent harm from medical care.

Key words: patient’s health damage; defect of medical care; medical error; medical accident; professional medical offenses.

 

References

  1. Bedrin, L.M. Psihologiya i deontologiya v rabote vracha: ucheb.-metod. rekomendacii dlya studentov, subordinatorov i vrachei [Psychology and deonthology in the work of the doctor: Educational and guidelines for students, subordinators, doctors] / L.M. Bedrin. — Yaroslavl’, 1988. — 156 s.
  2. Bolotovskii, I.S. Vrachebnye oshibki: lekciya dlya vrachei- slushatelei [Medical errors. Lecture for doctors] / I.S. Bolo- tovskii. — L., 1986. — 32 s.
  3. Viter, V.I. Ekspertnaya i yuridicheskaya ocenka neblagopriyat- nyh ishodov pri rassledovanii professional’nyh pravonarushenii medicinskih rabotnikov [Expert and legal assessment of adverse outcomes in the investigation of crimes of professional health workers] / V.I. Viter, A.R. Pozdeev, I.V. Gecmanova; pod red. G.A. Pashinyana. — Izhevsk, 2007. — 380 s.
  4. Vrachebnoe prestuplenie [Physician crime] // Medicinskaya enciklopediya i spravochnik medicinskih terminov [Medical Encyclopedia & directory of Medical Terms]. — URL: http://gipocrat.ru/medicencd_c2_88.phtml
  5. Davydovskii, I.V. Vrachebnye oshibki [Medical errors] / I.V. Davydovskii // Sovetskaya medicina [Soviet Medicine]. — 1941. — № 3. — S.3—18.
  6. Kassirskii, I.A. O vrachevanii [About the healing] / I.A. Kassir- skii. — M.: Medicina, 1970. — 271 s.
  7. Korotkih, R.V. Strahovanie professional’noi otvetstvennosti kak forma social’noi zaschity medicinskih rabotnikov rabot- nikov [Professional liability insurance as a form of social protection of medical workers] / R.V. Korotkih, E.V. Zhilin- skaya, N.V. Simakova, N.H. Lukova // Zdravoohranenie (Moskva) [Public health (Moscow)]. — 2000. — № 7. — S.49—65.
  8. Mezhdunarodnaya statisticheskaya klassifikaciya boleznei i problem, svyazannyh so zdorov’em. 10-i peresmotr. Special’nye perechni dlya statisticheskoi razrabotki [International Statistical Classification of Diseases and Related Health Problems. Special lists for statistical development]. — M.: Medicina, 1998. — T. 1, ch. 1. — 741 s.
  9. Pirogov, N.I. Annaly hirurgicheskogo otdeleniya kliniki Imperatorskogo universiteta v Derpte (god 1-go izdaniya c 1 aprelya 1836 g. po 1 aprelya 1837 g.) [Annals of the surgical department of the Imperial University Hospital in Dorpat (with year of publication I April 1, 1836 to April 1, 1837)] / N.I. Pirogov // Sobr. soch. v 8 t. — M: Gosizdatmedlit. — 1959. —T. 2. — S.9—273.
  10. Ponkina, A.A. Vrachebnaya oshibka v kontekste zaschity prav pacienta [Medical error in the context of the protection of patients’ rights] / A.A. Ponkina. — M.: Konsorcium specialistov po zaschite prav pacientov [Consortium of experts to protect the rights of patients], 2012. — 200 s.
  11. Popov, A.P. Sudebnaya medicina. Kratkii terminologicheskii i ponyatiinyi slovar’ [Forensic medicine. Short terminological and conceptual dictionary] / A.P. Popov. — Volgograd, 2003. — 28 s.
  12. Proekt Federal’nogo zakona «Ob obyazatel’nom strahovanii pacientov pri okazanii medicinskoi pomoschi» [Draft Federal Law «On obligatory insurance patients in health care»] // Ministerstvo zdravoohraneniya Rossiiskoi Federacii. — URL: http://www.rosminzdrav.ru/open/discuss/projects/39
  13. Rusakov, V.I. K probleme yatrogenii [On the problem of iatrogeny] / V.I. Rusakov // Hirurgiya [Surgery]. — 1998. — № 8. — S.45—48.
  14. Timofeev, I.V. Medicinskaya oshibka. Mediko-organizacionnye i pravovye aspekty [Medical error. Medical, organisational and legal aspects] / I.V. Timofeev, O.V. Leont’ev. — SPb., 2002. — 80 c.
  15. Tihomilov, S. Ugolovnaya otvetstvennost’ za vrachebnye prestupleniya [Criminal liability for medical offenses] / S. Tihomilov // Medicinskii zhurnal [Medical journal]. — URL: http://prizvanie.su/?p=8857
  16. Ugolovnyi kodeks Rossiiskoi Federacii (s izm. ot 02.11.2013) [The Criminal Code of the Russian Federation with changes on 2.11.2013]. — URL: http://www.consultant.ru/popular/ukrf/
  17. Shamov, I.A. Iskusstvo vrachevaniya [Art of healing] / I.A. SHamov. — Rostov n/D.: izd-vo Rostovskogo un-ta, 1982. — 176 s.
  18. El’shtein, N.V. Sovremennyi vzglyad na vrachebnye oshibki [Modern view on medical errors] / N.V. El’shtein. — Terapevticheskii arhiv. — 2005. — № 8. — S.66—92.
  19. Enciklopedicheskii slovar’ medicinskih terminov: v 3 t. (okolo 60 000 terminov) [Encyclopedic Dictionary of Medical Terms: In 3 volumes. About 60 000 terms] / gl. red. B.V. Pokrovskii. — M.: Sovetskaya enciklopediya. — 1982. — T.1. A-Ioresa sposob. — 464 s.
  20. Bumke, O. Der Arzt als Ursache seelischer Störungen / O. Bumke // Deutsche Medizinische Wochenschrift. — 1925. — В. 51(1). — S. 3.
  21. Kohn, L.T. To Err is Human: Building a safer health system / L.T. Kohn, J.M. Corrigan, M.S. Donaldson // Committee on Quality of Health Care in America. — Washington (DC, USA): National Academy Press, 2000. — P.170.
  22. Lester, H. Medical error: a discussion of the medical construction of error and suggestions for reforms of medical education to decrease error / H. Lester, J.Q. Tritter // Medical education (Blackwell Science Ltd.). — 2001. — № 35. — P.855—861.
  23. Liang, B.A. A system of medical error disclosure / B.A. Liang // Quality & safety in health care. — 2002. — № 11. — Р.64—68.
  24. Liebman, C.B. Medical error disclosure, mediation skills, and malpractice litigation. A Demonstration project in Pennsylvania / C.B. Liebman, C.S. Hyman // The Project «Medical Liability in Pennsylvania». — Washington, 2005. — P.12.

 

IN PRESS

PDF downloadDistance learning of doctors in the Kazan state medical university: experience of scientific library in its organization.

Olga I. Seregina, the head of the introduction of new information technology Scientific Library SBEI HPE «Kazan State medical university» Health ministry, tel. 8-987-421-86-59, e-mail: v.olya8@inbox.ru

Abstract. The purpose of research — to analyze the experience of Scientific Library of the Kazan State Medical University in distance education. Material and methods. Sociological poll conducted among students about the availability of educational and research resources located in the electronic library, document analysis. Results and discussion. Directions activities of the library associated with the introduction of new forms of service and further forming the fund to be used in higher professional and continuing medical education of doctors in the form of distance learning was determined according to the poll. Software and hardware services electronic library system of Kazan State Medical University was improved and updated. Notification listeners and authors of distance learning courses on advances of medicine, scientific research, domestic and foreign electronic information and educational resources using services provided by system Moodle was organized.

Key words: distance learning, doctors, continuing medical education, Scientific Library, electronic library system.

 

References

  1. Demin, V.Yu. Razvitie sistem distancionnogo obucheniya v vuzah (obobschenie opyta i uchebnye rekomendacii): uchebnoe posobie [The development of e-learning in universities (the generalization of experience and training advice): textbook] / V. Yu. Demin, V.A. Trainev, O.V. Trainev [i dr.]; pod obsch. red. V.A. Traineva. — M.: MGIU, 2010. — 288 s.
  2. Shapoval, S.D. Distancionnoe obuchenie kak organizacion- naya forma nepreryvnogo professional’nogo razvitiya vrachei [Distance learning as an organizational form of continuous professional development of doctors] / S.D. Shapoval, S.N. Dmitrieva, Yu.I. Reshetilov // Psihologo-pedagogicheskii zhurnal gaudeamus [Psychological and pedagogical journal Gaudeamus]. — 2010. — T. 2, № 16. — S.92—93.
  3. Agranovich, N.V. Vozmozhnosti i effektivnost’ distancionnogo obucheniya v medicine [Opportunities and effectiveness of distance learning in medicine] / N.V. Agranovich, A.B. Hodzhayan // Fundamental’nye issledovaniya [Funda-mental research]. — 2012. — № 3-3. — S.545—547.
  4. Proekt koncepcii razvitiya nepreryvnogo medicinskogo obrazovaniya (NMO) s uchastiem professional’nyh medicinskih organizacii v RF [Project development concept of continuing medical education (CME) with the participation of professional medical organizations in the Russian Federation]. — URL: http://www.msmsu.ru/userdata/manual/doc/pro.pdf