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ORIGINAL RESEARCH
Glutamic acid changes in plasma of critical patients with hypoxia. Alekseeva E.V. P.14
Globus pharyngeus – is it a symptom of the esophageal disease? Firsova L.D., Tunik N.V.49
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ANNIVERSARIES
CLINICAL CASE
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UDC [616.98:578.825.12]-078
DOI: 10.20969/VSKM.2016.9(5).7-14
AVDONINA ALEXANDRA S., postgraduate student of I.I. Mechnikov Scientific Research Institute of Vaccines and Serums of Russian Academy of Medical Sciences, Head of the Department of research and production of «HIV-Blot», deputy-head of the Department of advanced technology of Closed Joint Stock Company «EKOlab», Russia, Moscow region, 142530, Elektrogorsk, Budyonnyi str., 1, tel/fax: (49643) 3-13-74, 3-17-45, 3-35-29, e-mail: ekolab-avdonina@mail.ru
MARDANLY SEYFADDIN G., C. Med. Sci., president and director for science of Closed Joint Stock Company «EKOlab», Russia, Moscow region, 142530, Elektrogorsk, Budyonnyi str., 1
YUMINOVA NADEZHDA V., D. Biol. Sci., deputi-director for scientific activity of I.I. Mechnikov Scientific Research Institute of Vaccines and Serums, Russia, 105064, Moscow, Malyi Kazennyi lane, 5
Abstract. Aim. Development of Russian test kit for detecting IgM-antibodies to individual cytomegalovirus antigens by immunoblotting (Western blot). Material and methods. Cytomegalovirus strain AD-169 was cultured to obtain the lysate antigen. Lysate antigen was subjected to electrophoresis in polyacrylamide gel. Then separated proteins were transferred to nitrocellulose membrane to obtain immunosorbent. Selection of the composition of reagents for immune blotting and the time of incubation was performed. Sensitivity and specificity of the new test kit was evaluated by studying 21 samples of the mixed panel of serums «Anti-CMV Mixed Titer Performance Panel PT C203» (reference material) and 48 samples of human serum (clinical material). Results and discussion. Test kit «Blot-CMV-IgM» was designed. It has sensitivity and specificity not conceding one of its analogues, the «Anti-CMV (IgM) Westernblot» (EUROIMMUN AG, Germany). It demonstrates characteristics of more efficient use. Conclusion. The new test kit is intended for confirmation of positive screening results and for differentiation the stage of infection in the diagnosis of cytomegalovirus infection.
Key words: cytomegalovirus infection, IgM-antibodies, cytomegalovirus antigens, immunoblotting.
For reference: Avdonina AS, Mardanly SG, Yuminova NV. Development of a test kit for detection of IgM-antibodies to individual cytomegalovirus antigens by immunoblotting (Western blot). The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 7—14.
References
1. Karazhas NV ed. Sovremennye aspekty gerpesvirusnoj infekcii: epidemiologija, klinika, diagnostika, lechenie i profilaktika: metodicheskie rekomendacii [Modern aspects of herpesvirus infection: the epidemiology, clinical features, diagnosis, treatment and prevention: methodical recommendations]. Moscow: Speckniga [Moscow: Special book]. 2012; 128 p.
2. Germanenko IG. Cytomegalovirusnaja infekcija u detej: uchebno-metodicheskoe posobie [Cytomegalovirus infection in children: a teaching aid]. Minsk: BGMU [Minsk: Belarusian State Medical University]. 2009; 34 p.
3. Malyshev ON et al. Cytomegalovirusnaja infekcija: epidemiologija, klinika, diagnostika, lechenie i profilaktika: metodicheskoe posobie [Cytomegalovirus infection: the epidemiology, clinical features, diagnosis, treatment and prevention: methodical aid]. Government of Moscow, Health Committee. 2001; 44 p.
4. Mardanly SG, Kirpichnikova GI, Neverov VA. Cytomegalovirusnaja infekcija [Cytomegalovirus infection]. Elektrogorsk: ZAO «EKOlab». 2011; 32 p.
5. Mardanly SG. Epidemiologicheskij nadzor za infekcijami TORCH-gruppy na osnove sovremennyh tehnologij laboratornoj diagnostiki [Epidimiological surveillance of infections TORCH-group on the basis of modern technologies of laboratory diagnostics]. Avtoreferat dissertacii [Thesis of the PhD dissertation]. Moscow. 2016; 49 p.
6. Shahgil’djan VI et al. Problemy laboratornoj diagnostiki citomegalovirusnoj infekcii u VICh-inficirovannyh pacientov [The problems of laboratory diagnostics of cytomegalovirus infection in HIV-infected patients.]. URL: http://www.hivrussia.org/pub/2006/07.shtml
7. Citomegalovirusnaja infekcija u vzroslyh (iskljuchaja bol’nyh VICh-infekciej): klinicheskie rekomendacii [Cytomegalovirus infection in adults (excluding HIV-infected patients): clinical guidelines]. Moskva: Nacional’noe nauchnoe obshhestvo infekcionistov [ Moscow: National Scientific Society of infectious diseases]. Moscow. 2014; 74 p.
8. Dolgih TI. Strategija i metodicheskoe obespechenie diagnostiki infekcionnyh zabolevanij [Strategy and methodical support of diagnostics of infectious diseases]. Omsk. 2007; 57 p.
9. Markina MV, Romanov VV. Immunoblot v diagnostike infekcionnyh zabolevanij: novye vozmozhnosti (Prakticheskoe rukovodstvo po interpretacii poluchennyh rezul’tatov) [Immunoblot in the diagnosis of infectious diseases: new opportunities (Practical guidance on the interpretation of the results)]. URL: http://www.labdiagnostic.ru/docs/specialists/immunoblot_infect.shtml.
10. Tomtishen JP. Cytomegalovirus Tegument Proteins and the Development of Novel Antiviral Therapeutics, chapter 7 in book «Manifestations of Cytomegalovirus Infection» (Edited by Price P, Makwana N and Brunt S). InTech. 2013; 140 p.
11. Kalejta RF. Tegument Proteins of Human Cytomegalovirus. Microbiology and Molecular Biology Reviews. 2008; 72 (2): 249–265.
GLUTAMIC ACID CHANGES IN PLASMA OF CRITICAL PATIENTS WITH HYPOXIA
UDC 616-001.8-036.81-07:616.153.466.64-074
DOI: 10.20969/VSKM.2016.9(5).14-25
ALEKSEEVA ELENA V., С. Мed. Sci., anesthesiologist-resuscitator of the Department of intensive care unit of Central Clinical Hospital with Out-Patient service, 121359, Moscow, Marshal Timoshenko str., 15, tel. 8-910-442-11-37, e-mail: aev_69@mail.ru
Abstract. Aim. To study the main components of glutamatergic neurotransmitter system in plasma in critical patients with hypoxia. Material and methods. We have analyzed the data of examination and treatment of 2 groups of patients of Intensive Care Unit. Group I (n=19) patients presented hypoxia. Group II (n=9) — patients without hypoxia. Criteria of hypoxia were the following: reduced level of hemoglobin saturation with oxygen in the superior vena cava and increased lactate concentration in plasma. Amino acid content in was detected by the method of high performance liquid chromatography — mass-spectrometry. The groups were compared by the content of glutamic acid and glutamine. Statistical data processing was carried out using software Statistica 12. Results and discussion. The content of glutamic acid was lower in patients of group I (5-fold lower, r = 0,833) compared to those in group II. Intensity of multiple organ dysfunction and the incidence of adverse outcomes was higher in patients with reduced level of glutamic acid in the whole sample (р=0,0181, odds ratio = 5) and in group I (odds ratio = 4,4). Possible concomitant changes in the level of glutamic acid and glutamine in critical patients reflect the formation of hypofunction of the glutamatergic neurotransmitter system with an increasing severity of hypoxia. Conclusion. Development of hypoxia in critical patients is associated with hypofunction of glutamatergic neurotransmitter system. It is the most unfavorable condition in relation to the prognosis of pathological process. Emergent correction of hypofunction of glutamatergic neurotransmitter system is probably one of the ways to restore cellular mechanisms of adaptation in hypermetabolic patients in critical condition.
Key words: glutamic acid, hypoxia, critical patients.
For reference: Alekseeva EV. Glutamic acid changes in plasma of critical patients with hypoxia. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 14—25.
References
1. Rivers EP, Yataco AC, Jaehne AK et al. Oxygen extraction and perfusion markers in severe sepsis and septic shock: diagnostic, therapeutic and outcome implications. Curr Opin Crit Care. 2015; 21 (5): 381-387.
2. Zeitouni NE, Chotikatum S, von Köckritz-Blickwede M et al. The impact of hypoxia on intestinal epithelial cell functions: consequences for invasion by bacterial pathogens. Mol Cell Pediatr. 2016; 3 (1): 14.
3. Ryabov GA. Gipoksiya kriticheskikh sostoyaniy [ Hypoxia of critical states]. M.: Meditsina [Moscow: Medicine]; 1988: 288 p.
4. Kumar GK. Adapt or avoid. Elife. 2016; 5: 14345.
5. Pascual JM, Carceller F, Roda JM et al. Glutamate, glutamine, and GABA as substrates for the neuronal and glial compartments after focal cerebral ischemia in rats. Stroke. 1998; 29 (5): 1048-1056.
6. Pisarenko OI. Uchastie aminokislot v regulyatsii energeticheskogo obmena myshtsy serdtsa pri ishemii i gipoksii [Participation of amino acids in the regulation of the heart muscle energy metabolism during ischemia and hypoxia]. Avtoreferat dissertacii: Moskva [Abstract of dissertation: Moscow]; 1991; 37 р.
7. Wise DR, Ward PS, Shay JE et al. Hypoxia promotes isocitrate dehydrogenase-dependent carboxylation of α-ketoglutarate to citrate to support cell growth and viability. Proc Natl Acad Sci USA. 2011; 108 (49): 19611-19616.
8. Zielke HR, Zielke CL, Baab PJ. Direct measurement of oxidative metabolism in the living brain by microdialysis: a review. J Neurochem. 2009; 109 (1): 24-29.
9. Brose SA, Marquardt AL, Golovko MY. Fatty acid biosynthesis from glutamate and glutamine is specifically induced in neuronal cells under hypoxia. J Neurochem. 2014; 129 (3): 400-412.
10. Fan J, Kamphorst JJ, Rabinowitz JD et al. Fatty acid labeling from glutamine in h16-ypoxia can be explained by isotope exchange without net reductive isocitrate dehydrogenase (IDH) flux. J Biol Chem. 2013; 288 (43): 31363-31369.
11. Ashmarin IP, Stukalov VP, ed. Neyrokhimiya [Neurochemistry]. Moskva: Institut biomeditsinskoy khimii RAMN [Pub at the Institute of Biomedical Chemistry, Russian Academy of Medical Sciences]. 1996; 470 p.
12. Aleksandrova EV, Zaytsev OS, Potapov AA. Klinicheskie sindromy disfunktsii neyromediatornykh sistem pri tyazheloy travme mozga. [Clinical syndromes of neurotransmitter system dysfunction in case of severe brain injury] Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova [Journal of Neurology and Psychiatry named after S.S. Korsakov]. 2015; 7: 40-46.
13. Dhawan J, Benveniste H, Luo Z et al. A new look at glutamate and ischemia: NMDA agonist improves long-term functional outcome in a rat model of stroke. Future Neurol. 2011; 6 (6): 823-834.
14. Biegon A, Fry PA, Paden CM et al. Dynamic changes in N-methyl-D-aspartate receptors after closed head injury in mice: Implications for treatment of neurological and cognitive deficits. Proc Natl Acad Sci U S A. 2004; 101 (14): 5117-5122.
15. Du J, Li XH, Li YJ. Glutamate in peripheral organs: biology and pharmacology. Eur J Pharmacol. 2016; 784: 42–48.
16. Ferrario M, Cambiaghi A, Brunelli L et al. Mortality prediction in patients with severe septic shock: a pilot study using a target metabolomics approach. Sci Rep. 2016; 6: 20391.
17. Marx G, Reinhart K. Venous oximetry. Curr Opin Crit Care. 2006; 12 (3): 263-268.
18. Kulabukhov VV. Sistema transporta kisloroda u bol’nykh v kriticheskikh sostoyaniyakh (predposylki k prognozirovaniyu iskhoda bolezni): dissertacija [Oxygen transport system in critical patients (prerequisites for predicting outcomes of the disease): dissertation]. Moskva [Moscow]. 2006; 287 p.
19. al-Bekairi AM. Effect of hypoxia and/or cold stress on plasma and brain amino acids in rat. Res. Commun Chem Pathol Pharmacol. 1989; 64 (2): 287-297.
20. Tholey G, Copin JC, Ledig M. Hypoxia induced metabolism dysfunction of rat astrocytes in primary cell cultures. Neurochem Res. 1991; 16 (4): 423-428.
21. Wagenmakers AJ. Amino acid metabolism, muscular fatigue and muscle wasting. Speculations on adaptations at high altitude. Int J Sports Med. 1992; 13 (1): 110-113.
22. Kobayashi S, Millhorn DE. Hypoxia regulates glutamate metabolism and membrane transport in rat PC12 cells. J Neurochem. 2001; 76 (6): 1935-1948.
23. Wang YP, Guo CJ, Yang JJ et al. Effects of acute hypoxia on plasma metabolome in mice. Zhongguo Ying Yong Sheng Li Xue Za Zhi. 2009; 25 (2): 177-180.
24. Koundal S, Gandhi S, Kaur T et al. Neurometabolic and structural alterations in rat brain due to acute hypobaric hypoxia: in vivo 1H MRS at 7 T. NMR Biomed. 2014; 27 (3): 341-347.
25. Ding W, Yu P, Liu W et al. Buyang Huanwu decoction increases the expression of glutamate transporter-1 and glutamate synthetase in association with PACAP-38 following focal ischemia. Biomed Rep. 2015; 3 (5): 651-656.
26. Swamy M, Salleh MJ, Sirajudeen KN et al. Nitric oxide (no), citrulline — no cycle enzymes, glutamine synthetase and oxidative stress in anoxia (hypobaric hypoxia) and reperfusion in rat brain. Int J Med Sci. 2010; 7 (3): 147-154.
27. Soeters PB, Grecu I. Have we enough glutamine and how does it work? A clinician’s view. Ann Nutr Metab. 2012; 60 (1): 17-26.
28. Poeze M, Luiking YC, Breedveld P et al. Decreased plasma glutamate in early phases of septic shock with acute liver dysfunction is an independent predictor of survival. Clin Nutr. 2008; 27 (4): 523-530.
29. Stobart JL, Anderson CM. Multifunctional role of astrocytes as gatekeepers of neuronal energy supply. Front Cell Neurosci. 2013; 7: 38.
30. Burnham EL, Moss M, Ziegler TR. Myopathies in critical illness: characterization and nutritional aspects. J Nutr. 2005; 135 (7): 1818-1823.
31. Dao DN, Ahdab-Barmada M, Schor NF. Cerebellar glutamine synthetase in children after hypoxia or ischemia. Stroke. 1991; 22 (10): 1312-1316.
32. Aleksandrova EV. Sindromy disfunktsii neyromediatornykh sistem v protsesse vosstanovleniya soznaniya posle tyazheloy cherepno-mozgovoy travmy: dissertacija [Syndromes of neurotransmitter systems dysfunction in the process of recovery of consciousness after severe craniocerebral injury: dissertation]. Moskva [Moscow]. 2013; 207 p.
33. Obrenovitch TP, Urenjak J, Zilkha E. Effects of increased extracellular glutamate levels on the local field potential in the brain of anaesthetized rats. Br J Pharmacol. 1997; 122 (2): 372-378.
34. Obrenovitch TP, Urenjak J. Altered glutamatergic transmission in neurological disorders: from high extracellular glutamate to excessive synaptic efficacy. Prog Neurobiol. 1997; 51 (1): 39-87.
35. Obrenovitch TP, Urenjak J, Zilkha E et al. Excitotoxicity in neurological disorders--the glutamate paradox. Int J Dev Neurosci. 2000. 18 (2-3): 281-287.
36. Schober A, Warenits AM, Testori С et al. Microdialysis Assessment of Cerebral Perfusion during Cardiac Arrest, Extracorporeal Life Support and Cardiopulmonary Resuscitation in Rats — A Pilot Trial. PLoS One. 2016; 11 (5): 0155303.
37. Vestergaard MB, Lindberg U, Aachmann-Andersen NJ et al. Acute hypoxia increases the cerebral metabolic rate — a magnetic resonance imaging study. J Cereb Blood Flow Metab. 2016; 36 (6): 1046-1058.
38. Adeleye A, Shohami E, Nachman D et al. D-cycloserine improves functional outcome after traumatic brain injury with wide therapeutic window. Eur J Pharmacol. 2010; 629, (1-3): 25-30.
39. Ostapchenko DA, Vlasenko AV, Rylova AV. Kislorodnyy balans u bol’nykh s sepsisom i poliorgannoy nedostatochnost’yu [Oxygen Balance in Patients with Sepsis and Multiple Organ Dysfunction]. Obshchaya reanimatologiya [General Reanimatology]. 2007; 3 (2): 52-56.
THE ROLE OF MEDICAL TECHNOLOGIES IN INFANT MORTALITY REDUCTION IN SAMARA REGION
UDC 616-036.88-053.3(470.43)
DOI: 10.20969/VSKM.2016.9(5).25-29
KATKOVA LYUDMILA I., D. Med. Sci., Samara State Medical University, Russia, 443099, Samara, Chapaevskaya str., 89,
tel. +7 (846) 332-16-34, e-mail: info@samsmu.ru
MIKHALCHENKO SVETLANA V., D. Med. Sci., Head consultant for the organization of medical care for women and children of the Ministry of Health of Samara region, Russia, 443010, Samara, Lenin str., 73, tel. +7 (846) 332-95-32
Abstract. Aim. Evaluation of the significance of basic medical and organizational technologies in infant mortality reduction in obstetric and pediatric institutions. Material and methods. Analysis of infant mortality in Samara region for the period of 2012—2015 was performed. Analyzing performance data of Rosstat of the Russian Federation and of Samara region was used. Results and discussion. The efficiency of implementation of the three-level system of perinatal care for women and children, the use of high-tech medical care in nursing of preterm infants in accordance with the procedures and standards of care, contributing to the early detection of disease, optimal treatment and rehabilitation was shown. Higher mortality rates in rural areas of the region and the presence of mortality from controllable causes (infectious diseases and respiratory diseases) indicate the need to improve the health management aiming to reach availability and proper quality of care. Conclusion. Evaluation and implementation of medical and organizational technologies aiming to improve the availability and quality of health care for women and children is one of the main reserves in infant mortality reduction in the region.
Key words: infant mortality rate, three-level system of perinatal care, order and standards of care.
For reference: Katkova LI, Mihalchenko SV. The role of medical technologies in infant mortality reduction in Samara region. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 25—29.
References
1. Baranov AA. Smertnost’ detskogo naselenija v Rossii (tendencii, prichiny i puti snizhenija) [Child Mortality in Russia (trends, causes and ways to reduce)]. Moskva: Izd-vo Sojuza pediatrov Rossii [Moscow: Publishing House of the Union of pediatricians of Russia]. 2009; 387 p.
2. Terleckaja RN et al. Metody ocenki i koncepcija sokrashhenija predotvratimyh poter’ zdorov’ja detskogo naselenija [Methods of assessment and the concept of reduce avoidable losses of health of the child population]. Moskva: Pediatr# [Moscow: Pediatr]. 2013;
89 p.
3. Suhanova LP, Skljar MS. Detskaja i perinatal’naja smertnost’ v Rossii: tendencii, struktura, faktory riska [Children and perinatal mortality in Russia: trends, structure, risk factors]. Social’nye aspekty zdorov’ja naselenija [Social aspects of public health]. 2007; 4: 46.
4. Habriev RU, Jagudina RI, Pravdjuk NG. Ocenka tehnologij zdravoohranenija [Health technology assessment]. Moskva: Medicinskoe informacionnoe agentstvo [Moscow: Medical Information Agency]. 2013; 404 p.
WORKING CONDITIONS AND OCCUPATIONAL MORBIDITY IN AGRICULTURAL WORKERS OF THE REPUBLIC OF TATARSTAN
UDC 613.62:63(470.41)
DOI: 10.20969/VSKM.2016.9(5).29-34
OSIPOV SERGEY A., C. Med. Sci., Deputy Minister of health of the Republic of Tatarstan, Russia, Kazan, Ostrovsky str., 11/6, e-mail: minzdrav@tatar.ru
MALYSHEVA IRINA YU., Head of the Administration of medical and preventive care of Ministry of health of the Republic of Tatarstan, Russia, Kazan, Ostrovsky str., 11/6, e-mail: Irina.Malysheva@tatar.ru
BERKHEEVA ZUKHRA M., C. Med. Sci., associate professor of the Department of preventive medicine of Kazan State Medical University, Russia, Kazan, Butlerov str., 49, e-mail: kgmu_profpat@mail.ru
TROFIMOVA MARINA V., deputy head of the Administration of the Federal service for supervision of consumer rights protection and human well-being in the Republic of Tatarstan, Russia, Kazan, B. Krasnaya str., 30, е-mail: trofimova.mv@tatar.ru
GINIATOVA ALSU M., Head of the Department of supervision in occupational health, radiation hygiene and transport of the Administration of the Federal service for supervision of consumer rights protection and human well-being in the Republic of Tatarstan, Russia, Kazan, B. Krasnaya str., 30, e-mail: rpn.trud@tatar.ru
SAFINA KADRIYA R., Head of Republican Centre of occupational diseases of the Ministry of health in the Republic of Tatarstan, Russia, Kazan, Lechebnaya str., 7, е-mail: kadriya-safina@mail.ru
Abstract. Aim. The study of the dynamics and structure of occupational diseases in agricultural workers in the Republic of Tatarstan. Material and methods. A study was based on the register data of Republican Center of Occupational Diseases and of the Office of epidemiology in Tatarstan. Results and discussion. Working conditions remain harsh and even dangerous to workers health in 88% of agrarian objects. Employees of the agricultural sector of the Republic demonstrate consistently high levels of professional incidence considerably exceeding the Federal indicator for the industry. Analysis of occupational morbidity over the past 15 years revealed that occupational diseases were diagnosed in 224 stockbreeders and in 210 tractor drivers. Stockbreeders are usually diagnosed with musculo-tonic neck syndrome — 58% (130 people), upper extremities polyneuropathy — 54% (121 persons) and with other diseases of peripheral nervous system — 17% (38 persons). Tractor drivers tend to suffer from vibration disease — 76,7% (161 persons), bilateral sensorineural hearing loss — 71,9% (151 persons). Conclusion. There is a steady upward trend in the number of patients with newly identified occupational diseases. The presence of 2 or more diagnosis indicates the late diagnostics and the absence of periodic medical examinations of agricultural workers. The negative role in this process is played by the lack of the legal base. It is associated with the low social security of employees with initial forms of occupational diseases, for which there is no preventive treatment from social insurance funds.
Key words: occupational health, agricultural complex.
For reference: Osipov SA, Malysheva IYu, Berheeva ZM,Trofimova MV, Giniâtova AM, Safina KR. Working conditions and occupational morbidity in agricultural workers of the republic of Tatarstan. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 29—34.
References
1. Bezrukova GA, Shalashova ML, Spirin VF, Novikova TA. Struktura professional’noj zabolevaemosti mehanizatorov sel’skogo hozjajstva [Structure of occupational diseases in agriculture mechanics]. Materialy XII Vserossijskogo kongressa «Professija i zdorov’e» i V s’ezda profpatologov, Moskva, 27—30 nojabrja 2013 [Materials of XII all-Russian Congress «Profession and health» and the V Congress of profpatologov]. 2013; 103—105.
2. Bezrukova GA, Novikova TA, Shalashova ML, Rajkin SS. Zabolevanija perifericheskoj nervnoj sistemy, associirovannye s uslovijami truda, v professii traktorist-mashinist sel’skohozjajstvennogo proizvodstva [Diseases of peripheral nervous system, associated with the working conditions in the profession, the tractor driver-Machinist of an agricultural production]. Medicina truda i promyshlennaja jekologija [Occupational medicine and industrial ecology]. 2015; 9: 32.
3. Novikova TA, Mihajlova NA, Taranova VM et al. Planirovanie meroprijatij po upravleniju professional’nymi riskami zdorov’ju rabotnikov sel’skohozjajstvennogo proizvodstva [Planning for the management of occupational risks to health workers in agricultural production]. Materialy XI Vserossijskogo kongressa «Professija i zdorov’e», Moskva, 27—29 nojabrja 2012 [Materials of the XI all-Russian Congress «Profession and health»]. 2012; 341—343.
4. Spirin VF, Bujanov ES, Spirin AV et al. Rezul’taty monitoringa funkcional’nogo sostojanija organizma mehanizatorov sel’skogo hozjajstva [The results of monitoring the functional State of the body mechanics of the rural households]. Medicina truda i promyshlennaja jekologija [Occupational medicine and industrial ecology]. 2012; 5: 12—17.
5. O sostojanii sanitarno-jepidemiologicheskogo blagopoluchija naselenija v Respublike Tatarstan v 2014 godu: Gosudarstvennyj doklad [On the status of sanitary-epidemiological welfare of the population in the Republic of Tatarstan in the year 2014: State report]. Upravlenie Federal’noj sluzhby po nadzoru v sfere zashhity prav potrebitelej i blagopoluchija cheloveka [Department of the Federal service for supervision of consumer rights protection and human well-being]. 2015; 143—149.
6. O sostojanii sanitarno-jepidemiologicheskogo blagopoluchija naselenija v Rossijskoj Federacii v 2014 godu: Gosudarstvennyj doklad [On the status of sanitary-epidemiological welfare of the population in the Russian Federation in the year 2014: State report]. Federal’naja sluzhba po nadzoru v sfere zashhity prav potrebitelej i blagopoluchija cheloveka [Federal service for supervision of consumer rights protection and human well-being]. 2015; 74—91.
UDC 616.24-036.12-036.22(470.23-25)
DOI: 10.20969/VSKM.2016.9(5).35-40
POKHAZNIKOVA MARINA A., C. Med. Sci., associate professor of the Department of family medicine of I.I. Mechnikov North-Western State Medical University, Russia, 191015, St. Petersburg, Kirochnaya str., 41, tel. 8-905-212-20-24, e-mail: pokmar@mail.ru
LEBEDEV ANATOLIY K., C. Med. Sci., associate professor of the Department of family medicine of I.I. Mechnikov North-Western State Medical University, Russia, 191015, St. Petersburg, Kirochnaya str., 41, e-mail: lebedev_ak@mail.ru
ANDREEVA ELENA A., C. Med. Sci., associate professor of the Department of family medicine of Northern State Medical University, Russia, 163000, Arkhangelsk, Troitsky ave., 51, e-mail: klmn.69@mail.ru
OVAKIMYAN KARINA V., assistant of professor of the Department of family medicine of I.I. Mechnikov North-Western State Medical University, Russia, 191015, St. Petersburg, Kirochnaya str., 41, e-mail: ursa-alba@yandex.ru
TUR EKATERINA YU., postgraduate student of the Department of family medicine of I.I. Mechnikov North-Western State Medical University, Russia, 191015, St. Petersburg, Kirochnaya str., 41, e-mail: tur.e.y@yandex.ru
MOISEEVA IRINA E., C. Med. Sci., associate professor of the Department of family medicine of I.I. Mechnikov North-Western State Medical University, Russia, 191015, St. Petersburg, Kirochnaya str., 41, e-mail: dr-moiseeva@yandex.ru
KUZNETSOVA OLGA YU., D. Med. Sci., professor, Head of the Department of family medicine of I.I. Mechnikov North-Western State Medical University, Russia, 191015, St. Petersburg, Kirochnaya str., 41, tel. 8-921-935-70-34, e-mail: oukuznetsova@mail.ru
Abstract. Aim of the study is to assess the prevalence of chronic obstructive pulmonary disease (COPD) based on socio-demographic characteristics according to the GOLD criteria and to identify risk factor of airflow obstruction (AO) among the residents of St. Petersburg. Material and methods. The research was conducted in 2012—2013 as a part of RESPECT study done in St. Petersburg and Arkhangelsk. The RESPECT is a cross-sectional population based study. This article represents data analysis of St. Petersburg participants aged 35—70 years from 10 primary health care centers. COPD was defined as FEV1/FVC <0,7 (fixed cut-off) after bronchodilator (BD) administration. Results and discussion. 1446 respondents who filled all questionnaires and demonstrated satisfactory criteria on spirometry were assessed. The overall prevalence of AO after BD test was 7,6%; 15,7% among men and 4,1% among women (95% CI: 6,3—9,1, 12,4—19,5 and 2,9—5,5 respectively). 14,4% (95% CI: 11,3—17,9) smokers had post-BD AO. Participants with AO were more intense smokers and were more frequently exposed to dust and gas/fumes in comparison to those without AO. Age, male gender and smoking were the predictors for AO (OR — 1,7; 95% CI: 1,04—1,10; OR — 3,14; 95% CI: 2,04—4,85 and OR — 2,94; 95% CI: 1,77—4,86 respectively). Conclusion. The prevalence of COPD in St. Petersburg residents was higher in men and current smokers. The risk factors of AO are the age, male gender and smoking. Participants with AO were more frequently exposed to occupational hazards.
Key words: chronic obstructive pulmonary disease, epidemiological study, spirometry, obstructive ventilation disorders, prevalence.
For reference: Рokhaznikova MA, Lebedev AK, Andreeva EA, Ovakimyan KV, Tur EYu, Moiseeva IE, Kuznetsova OYu. Prevalence of chronic obstructive pulmonary disease according to spirometry in citizens of Saint Petersburg. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 35—40.
References
1. Global strategy for diagnosis, management and prevention of COPD. Available at: http://www.goldcopd.org. (last updated 2016; last accessed 27.06.2016)
2. Chuchalin AG, Avdeev SN, Ajsanov ZR et al. Rossijskoe respiratornoe obshhestvo: Federal’nye klinicheskie rekomendacii po diagnostike i lecheniju hronicheskoj obstruktivnoj bolezni legkih [Russian Respiratory Society: Federal clinical guidelines on diagnostic and treatement of Chronic Obstructive Pulmonary Disease]. Pul’monologija [Pulmonology]. 2014; 3: 15—36.
3. Vizel’ AA, Vizel’ IYu, Amirov NB. Hronicheskaya obstruktivnaya bolezn’ legkih (HOBL). Peremeny kak povod dlya obsuzhdeniya [Chronic obstructive pulmonary disease (COPD). Changes as a cause for discussion]. Vestnik sovremennoj klinicheskoj mediciny [The Bulletin of Contemporary Clinical Medcine]. 2015; 1 (8): 62—69.
4. Menezes AM, Perez-Padilla R, Jardim JR et al. Chronic obstructive pulmonary disease in fifive Latin American cities (the PLATINO study): a prevalence study. Lancet. 2005; 9500 (366): 1875—1881.
5. Buist SA, McBurnie M A, Vollmer W M, Gillespie S, Burney P, Mannino D M, Menezes AM, Sullivan SD, Lee TA, Weiss KB, Jensen RL, Marks GB, Gulsvik A, Nizankowska-Mogilnicka E. International variation in the prevalence of COPD (The BOLD Study): a population-based prevalence study. Lancet. 2007; 370: 741—750.
6. Chuchalin AG, Khaltaev N, Antonov NS, Galkin DV, Manakov LG et al. Chronic respiratory diseases and risk factors in 12 regions of the Russian Federation. Int J Chron Obstruct Pulmon Dis. 2014; 9: 963—974.
7. Gambaryan MG, Kalinin AM, SHal’nova SA, Smirnova MI, Deev AD. Izuchenie ehpidemiologicheskih osobennostej hronicheskih respiratornyh zabolevanij v zavisimosti ot regiona prozhivaniya v Rossii [The study of the epidemiological features of chronic respiratory diseases, depending on the region of residence in Russia]. Profilakticheskaya medicina [Preventive medicine]. 2015; 1: 14—20.
8. Andreeva E, Pokhaznikova M, Lebedev A, Moiseeva I, Kozlov A, Kuznetsova O, Degryse J.-M. The RESPECT study: RESearch on the PrEvalence and the diagnosis of COPD and its Tobacco-related etiology: a study protocol. BMC Public Health. 2015; doi:10.1186/s12889-015-2161-z.
9. Andreeva E, Pokhaznikova M, Lebedev A, Moiseeva I, Kozlov A, Kuznetsova O, Degryse J-M. The prevalence of airflow limitation in North-West Russia according to different cut-off values. Respiration. 2016; 91: 43—55.
10. Bridevaux PO, Probst-Hensch NM, Schindler C, Curjuric I, Felber Dierich D et al. Prevalence of airflow obstruction in smokers and never smokers in Switzerland. European Respiratory Journal. 2010; 36: 1259—1269.
11. Koval’kova NA, Logvinenko NI, Voevoda MI, Malyutina SK. Rasprostranennost’ bronhoobstruktivnogo sindroma v otkrytoj populyacii goroda Novosibirska [The prevalence of bronchial obstruction syndrome in the open population of Novosibirsk]. Yakutskij medicinskij zhurnal [Yakut Medical Journal]. 2013; 4: 22—24.
12. Lundbäck B, Lindberg A, Lindström M et al. Not 15 but 50% of smokers developed COPD?: Report from the obstructive lung disease in Northern Sweden studies. Respir Med. 2003; 97: 115—122.
PREDICTORS OF MORTALITY IN PEDIATRIC PATIENTS WITH DILATED INCOMPACT MYOCARDIUM PHENOTYPE
UDC 616.127-053.2-036.88-037
DOI: 10.20969/VSKM.2016.9(5).40-48
UMAROVA MALIKA K., graduate student of the Department of cardiology of Scientific Center of Children’s Health, Russia, 119991, Moscow, Lomonosovsky ave., 2, b.1, tel. +7(499)134-04-90, e-mail: u.malika@gmail.com
BASARGINA ELENA N., D. Med. Sci., professor, Head of the Department of cardiology of Scientific Center of Children’s Health, Russia, 119991, Moscow, Lomonosovsky ave., 2, b.1, tel. +7(499)134-04-90, e-mail: basargina@nczd.ru
SHULAEV ALEKSEY V., D. Med. Sci., professor, vice-rector for clinical work of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7(843)299-42-34, e-mail: shulaev8@gmail.com
MARAPOV DAMIR I., assistant of professor of the Department of public health and health management of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel.+7(987)288-00-20, e-mail: damirov@list.ru
Abstract. Aim. To determine the predictors of mortality in pediatric patients with left ventricle incompact myocardium dilated phenotype. Material and methods. 48 children (20 — female, 41,7%) with dilated incompact myocardium phenotype aged 2 moths — 17 years 7 months were surveyed. Clinical history was taken. Heart ultrasound and Holter electrocardiogram data were used in clinical trial. Results and discussion. According to the resulting model the risk of mortality in pediatric patients with dilated incompact myocardium phenotype increases by 1,9% at the older age of the onset of the disease with each month. Nonisolated form is accompanied by a risk of mortality 302,5% higher in comparison to the isolated form. Holter electrocardiogram data analysis revealed 2 clusters. 2nd cluster was characterized by a higher prevalence of ventricular arrhythmia. The cluster presented the increased risk of mortality by 143,6%. Thrombosis in patient history increased the risk of mortality by 173,3%. The factors excluded in regression model construction as insignificant were the following: gender, the origin of the disease (casual / heart failure), the age of the 1st hospitalization, the ratio of the thickness of non-compact and compact myocardial layers, the number of non-compact myocardial segments and heart ultrasound parameters. Conclusion. The factors affecting the possibility of mortality in pediatric patients with dilated incompact myocardium phenotype were revealed. Those are the age of the onset of the disease; associated congenital heart defects; ventricular arrhythmia and thrombotic complications in patient history.
Key words: incompact myocardium, dilated phenotype, predictors of mortality.
For reference: Umarova MK, Basargina EN, Shulaev AV, Marapov DI. Predictors of mortality in pediatric patients with dilated incompact myocardium phenotype. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 40—48.
References
1. Jefferies JL, Wilkinson JD, Sleeper LA, Colan SD, Lu M, Pahl E, Kantor PF, Everitt MD, Webber SA, Kaufman BD, Lamour JM, Canter CE, Hsu DT, Addonizio LJ, Lipshultz SE, Towbin JA. Pediatric Cardiomyopathy Registry Investigators: Cardiomyopathy Phenotypes and Outcomes for Children With Left Ventricular Myocardial Noncompaction: Results From the Pediatric Cardiomyopathy Registry. J Card Fail. 2015; 21(11): 877–884.
2. Lilje C, Razek V, Joyce JJ, Rau T, Finckh BF, Weiss F, Habermann CR, Rice JC, Weil J. Complications of noncompaction of the left ventricular myocardium in a paediatric population: a prospective study. Eur Heart J. 2006; 27 (15): 1855–1860.
3. Wald R, Veldtman G, Golding F, Kirsh J, McCrindle B, Benson L. Determinants of outcome in isolated ventricular noncompaction in childhood. Am J Cardiol. 2004; 94 (12): 1581–1584.
4. Pignatelli RH, McMahon CJ, Dreyer WJ, Denfield SW, Price J, Belmont JW, Craigen WJ, Wu J, El Said H, Bezold LI, Clunie S, Fernbach S, Bowles NE, Towbin JA. Clinical characterization of left ventricular noncompaction in children: a relatively common form of cardiomyopathy. Circulation. 2003; 25: 108(21): 2672–2678.
5. Brescia ST, Rossano JW, Pignatelli R, Jefferies JL, Price JF, Decker JA, Denfield SW, Dreyer WJ, Smith O, Towbin JA, Kim JJ. Mortality and sudden death in pediatric left ventricular noncompaction in a tertiary referral center. Circulation. 201; 127 (22): 2202–2208.
6. Engberding R, Stöllberger C, Ong P, Yelbuz TM, Gerecke BJ, Breithardt G. Isolated noncompaction cardiomyopathy. Dtsch Arztebl Int. 2010; 107 (12): 206–213.
7. McMahon CJ, Pignatelli RH, Nagueh SF, Lee VV, Vaughn W, Valdes SO, Kovalchin JP, Jefferies JL, Dreyer WJ, Denfield SW, Clunie S, Towbin JA, Eidem BW. Left ventricular non–compaction cardiomyopathy in children: characterisation of clinical status using tissue Doppler–derived indices of left ventricular diastolic relaxation. Heart. 2007; 93 (6): 676–681.
8. Punn R, Silverman NH. Cardiac segmental analysis in left ventricular noncompaction: experience in a pediatric population. J Am Soc Echocardiogr. 2010; 23 (1): 46–53.
9. Espinola–Zavaleta N, Soto ME, Castellanos LM, Játiva–Chávez S, Keirns C. Non–compacted cardiomyopathy: clinical–echocardiographic study. Cardiovasc Ultrasound. 2006; 26 (4): 35.
10. Amzulescu MS, Rousseau MF, Ahn S A, Boileau L, de Meester de Ravenstein C, Vancraeynest D, Pasquet A, Vanoverschelde JL, Pouleur AC, Gerber BL. Prognostic Impact of Hypertrabeculation and Noncompaction Phenotype in Dilated Cardiomyopathy: A CMR Study JACC. Cardiovasc Imaging. 2015; 8 (8): 934–
946.
11. Sil’nova IV. Ul’trazvukovaja diagnostika nekompaktnogo miokarda u detej [Ultrasound diagnostics in children with noncompaction myocardium]. Avtoref Dis Kand Med Nauk [Candidate of medical science dissertation’ abstract]. 2012: 23 p.
12. Steffel J, Hürlimann D, Namdar M, Despotovic D, Kobza R, Wolber T, Holzmeister J, Haegeli L, Brunckhorst C, Lüscher T F, Jenni R, Duru F. Long–term follow–up of patients with isolated left ventricular noncompaction: role of electrocardiography in predicting poor outcome. Circ J. 2011; 75 (7): 1728–1734.
13. Nugent AW, Daubeney PE, Chondros P, Carlin JB, Cheung M, Wilkinson LC, Davis AM, Kahler SG, Chow CW, Wilkinson JL, Weintraub RG. The epidemiology of childhood cardiomyopathy in Australia. N Engl J Med. 2003; 348 (17): 1639–1646.
14. Hussein A, Karimianpour A, Collier P, Krasuski RA. Isolated Noncompaction of the Left Ventricle in Adults. J Am Coll Cardiol. 2015; 66 (5): 578–585.
15. Oechslin EN, Attenhofer Jost CH, Rojas JR, Kaufmann PA, Jenni R. Long–term follow–up of 34 adults with isolated left ventricular noncompaction: a distinct cardiomyopathy with poor prognosis. J Am Coll Cardiol. 2000; 36 (2): 493–500.
16. Dotsenko O, Kakkar VV. Antithrombotic therapy in patients with chronic heart failure: rationale, clinical evidence and practical implications. J Thromb Haemost. 2007; 5 (2): 224–231.
GLOBUS PHARYNGEUS — IS IT A SYMPTOM OF THE ESOPHAGEAL DISEASE?
UDC 616.321:616.329
DOI: 10.20969/VSKM.2016.9(5).49-53
FIRSOVA LIUDMILA D., D. Med. Sci., Head of the laboratory of clinical psychology of Moscow Clinical Research Center, Russia, 111123, Moscow, Entuziast road, 86, tel. +7 (916) 043-36-55, e-mail firsovald@gmail.com
TUNIK NATALIA V., postgraduate student of Moscow Clinical Research Center, Russia, 111123, Moscow, Entuziast road, 86
Abstract. Aim. To present clinical description of the symptom «lump in the throat» and its relevance to the esophageal diseases. Material and methods. Clinical and instrumental examination according to the Standards, complemented by esophageal manometry and filling in clinical questionnaires regarding the «lump in the throat». Results and discussion. Analysis of the medical examination results of 94 patients with a feeling of a «ump in the throat» showed that the characteristic features include localization in the upper half of the neck; mild sensation in most cases worsening with swallowing; episodic advent with no connection to any external factors; the absence of symptoms in the night time. Gastro-esophageal reflux disease was diagnosed in 83 patients (88,3%) in accordance with the Montreal criteria. Manometry data has showed that 71 patients (75,5%) had esophagus dyskinesia; yet the symptoms of esophageal spasm have been present three times more often than malfunctioning inherent to ineffective esophageal motility (58,5 and 17,0% respectively). For the first time it was shown that the sensation of a lump in the throat may be the only manifestation of dyskinesia of the esophagus in majority of cases (38,0%). Conclusion. The study demonstrates the value of the clinical symptom in determining the statements for the further examination (esophageal manometry) and — depending on the results obtained — in determining the focus of the treatment.
Key words: lump in the throat, gastro-esophageal reflux disease, esophagus manometry, esophageal dyskinesia, esophageal spasm, ineffective esophageal motility.
For reference: Firsova LD, Tunik NV. Globus pharyngeus — is it a symptom of the esophageal disease? The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 49—53.
References
1. Berke, G.S. Educational and research horizons in laryngology / G.S. Berke // The Laryngoscope. — 2008. — Vol. 118, № 1. — P.181—184.
2. Combined Dual Channel Impedance/pH-metry in Patients With Suspected Laryngopharyngeal Reflux / B.E. Lee, G.H. Kim, D.Y. Ryu [et al.] // J. Neurogastroenterol Motil. — 2010. — Vol. 16. — Р.157–—165.
3. Poelmans, J.A. Chronic middle ear disease and gastroesophageal reflux disease: a causal relation? / J.A. Poelmans // Otol. Neurotol. — 2001. — Vol. 22. — P.447—450.
4. Reflux-associated diseases of the otorhinolaringology tract / F. Rosanowski, T. Rabenstein, E.G. Hahn, U. Eysholdt // Laringorhinootologie. — 2001. — Vol. 80, № 8. — P.487—496.
5. Jaspersen, D. Extraesophageal manifestation in GERD / D. Jaspersen // Minerva Gastroenterol. Dietol. — 2006. — Vol. 52, № 3. — P.269—274.
6. Postma, G.N. Ambulatory pH monitoring methodology/ G.N. Postma //Ann. Otol. Rhinol. Laryngol. — 2000. — Vol. 109. — P.10—14.
7. Vaezi, M.F. Atypical Manifestations of Gastroesophageal Reflux Disease / M.F. Vaezi // Мedscape. — 2005. — Vol. 27. — Р.25.
8. Night-Time and Daytime Atypical Manifestations of Gastro-Oesophageal Reflux Disease: Frequency, Severity and Impact on Health-Related Quality of Life / B.B. Dean, D. Aguilar, L.F. Johnson // Aliment. Pharmacol. Ther. — 2008. — Vol. 27, № 4. — Р.327—337.
9. Eslick, G.D. Dysphagia: Epidemiology, Risk Factors and Impact on Quality of Life — A Population-based Study / G.D. Eslick, N.J. Talley // Aliment. Pharmacol. Ther. — 2008. — Vol. 27, № 10. — Р.971—979.
10. Esophageal motor dysfunction plays a key role in GERD with globus sensation — analysis of factors promoting resistance to PPI therapy / H. Tsutsui, N. Manabe, M. Uno [et al.] // Scand. J. Gastroenterol. — 2012. — Vol. 47, № 8/9. — Р.893—899.
11. Globus sensation: pharyngoesophageal function, psychometric and psychiatric findings, and follow-up in 88 patients / G. Moser, T.A. Wenzel-Abatzi, M. Stelzeneder [et al.] // Arch. Intern. Med. — 1998. — Vol. 158, № 12. — Р.1365—1373.
12. Is ineffective esophageal motility associated with gastropharyngeal reflux disease? / Kyung Yup Kim, Gwang Ha Kim, Dong Uk Kim [et al.] // World J. Gastroenterol. — 2008. — Vol. 14, № 39. — Р.6030—6035.
13. Hyperdynamic upper esophageal sphincter pressure: a manometric observation in patients reporting globus sensation / M.A. Kwiatek, F. Mirza, P.J. Kahrilas, J.E. Pandolfino // Am. J. Gastroenterol. — 2009. — Vol. 104. — Р.289—298.
BIOFILM FORMATION OF LACTOBACILLUS FROM GENITAL TRACT OF WOMEN IN THE FIRST TRIMESTER OF PREGNANCY
UDC 618.215-008.87
DOI: 10.20969/VSKM.2016.9(5).53-56
SHISHKOVA JULIJA S., D. Med. Sci., professor of the Department of мicrobiology, virology, immunology and clinical laboratory diagnostics of South Ural State Medical University, Russia, 454092, Chelyabinsk, Vorovskiy str., 64
DOLGUSHINA VALENTINA F., D. Med. Sci., professor, Head of the Department of obstetrics and gynecology of South Ural State Medical University, Russia, 454092, Chelyabinsk, Vorovskiy str., 64
GRAFOVA ELENA D., postgraduate student of the Department of obstetrics and gynecology of South Ural State Medical University, Russia, 454092, Chelyabinsk, Vorovskiy str., 64, e-mail: AJLEHA@yandex.ru.
KOLESNIKOV OLEG L., D. Med. Sci., professor, Head of the Department of biology of South Ural State Medical University, Russia, 454092, Chelyabinsk, Vorovskit str., 64
LIPSKAJA ANASTASIJA D., research technician of the Department of microbiology, virology, immunology and clinical laboratory diagnostics of South Ural State Medical University Russia, 454092, Chelyabinsk, Vorovskiy str., 64
ZAVJALOVA SVETLANA A., Head of the women consultation of State Clinical Outpatient Clinic № 5, Russia, 454041, Chelyabinsk, Komsomolskiy ave., 36а
EVSTIGNEEVA NATALJA P., D. Med. Sci., Head of the Department of scientific experimental laboratory of Ural Research Institute of Dermatology, Venereology and Immunopathology, Russia, 620076, Ekaterinburg, Shcherbakov str., 8
AMINEVA POLINA G., junior research worker of the Department of laboratory medicine of Ural Research Institute of Dermatology, Venereology and Immunopathology, Russia, 620076, Sherbakov str., 8
Abstract. Aim. To study biological features of vaginal lactobacillus obtained from pregnant women. Material and methods. We definded 35 lactobacillus strains obtained from genital tract of women in the first trimester of pregnancy. We used mass spectrometry analysis to identify Lactobacilli and evaluated biofilm formation. All strains were divided into 3 groups depending on vaginal pathology (1 group — normal vaginal microbiota, 2 group — vaginal dysbiosis, 3 group — genital tract inflammation). Results and discussion. In our study we revealed the decrease of the lactobacillus titre in case of vaginal infection or dysbiosis. Lactobacillus were in titre lg(5,48±0,1) in pregnant women without genital infections and included mainly L. acidophilus, less L. helvet and L. plantarum. Lactobacillus defined in women with vaginal dysbiosis were: L. acidophillus and L. delbrueckii in equal amount, singular L. salvarius and L. paracaseisppparacasei. Women with vaginal infections had L. acidophilus at most: 30% — L. delbrueckiispplactis, less L. paracaseisppparacasei 1 and sporadic L. curvatussppcurvatus. We have also detected that biofilm activity of lactobacillus increases in case of genital infection (groups 2 and 3). Conclusion. The modification of vaginal microbiocenosis in trimester I of pregnancy may reflect on lactobacillus quality and quantity. Thus, genital infection leads to decrease of the amount of lactobacillus in 1 ml of vaginal fluid. It also expands the composition of species and notably increases biofilm formation.
Key words: biofilm formation, lactobacillus, genital infection of pregnant women
For reference: Shishkova JS, Dolgushina VF, Grafova ED, Kolesnikov OL, Lipskaja AD, Zav’jalova SA, Evstigneeva NP, Amineva PG. Biofilm formation of lactobacillus from genital tract of women in the first trimester of pregnancy. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 53—56.
References
1. Kiss H, Kogler B, Petricevic L et al. Vaginal Lactobacillus microbiota of healthy women in the late first trimester of pregnancy. BJOG. 2007; 114: 1402–1407.
2. Melkumyan AR, Priputnevitch TV, Ankirskaya AS et al. Vidovoj sostav laktobakterij pri razlichnom sostoyanii mikrobioty vlagalishcha u beremennyh [Lactobacilli Species Diversity in Different States of Vaginal Microbiota in Pregnant Women]. Klinicheskaya mikrobiologiya, antimikrobnaya himioterapiya [Clinical microbiology and Antimicrobal Chemotherapy]. 2013; 15 (1): 72–79.
3. Ventolini G. Update on Vaginal Lactobacilli and Biofilm Formation. J Bacteriol Mycol. 2014; 1 (1): 2.
4. Verstraelen H, Verhelst R, Claeys G et al. Longitudinal analysis of the vaginal microflora in pregnancy suggests that L crispatus promotes the stability of the normal vaginal microflora and that L gasseri and / or L iners are more conducive to the occurrence of abnormal vaginal microflora. BMC Microbiol. 2009; 9: 116.
5. Glushanova NA. Biologicheskie svojstva laktobacill [Biological properties of lactobacillus]. Byulleten’ sibirskoj mediciny [Bulletin of Siberian Medicine]. 2003; 2 (4): 50–58.
6. Leccesse Terraf MC, Juarez Tomas MS, Nader–Macias MEF, Silva C. Screening of biofilm formation by beneficial vaginal lactobacilli and influence of culture media components. Journal of Applied Microbiology. 2012; 113: 1517–1529.
7. Ventolini G. Vaginal Lactobacillus biofilm formation in vivo — clinical implications. International journal of women’s health. 2015; 7: 243–247.
8. Lamont RF et al. The vaginal microbiome: New information about genital tract flora using molecular based techniques. BJOG. 2011; 118 (5): 533–549.
THE DISTRIBUTION OF SOMATIC AND OCCUPATIONAL DISEASES IN COLLIERS OF KUZBASS
UDC 613.62:622.333(571.17)
DOI: 10.20969/VSKM.2016.9(5).56-60
KHANIN ARKADY L., professor, Head of the Department of phthisiopulmonology of Novokuznetsk Extension Course Institute for Medical Practitioners, Russia, Novokuznetsk, Stroitely str.,5, tel. +7-903-945-22-52, e-mail: prof.khanin@yandex.ru
ANDREYANOVA MARIA A., general practitioner of Central City Hospital, Russia, 652881, Mezhdurechensk, Berezovaja str., 3, tel. +7-923-470-13-41, e-mail: mawalusa@gmail.com
SHUTNIKOVA GALINA A., phthisiopneumologist, Head of the Department of diagnostic, Russia, 654055, Novokuznetsk, Klubnaya str., 60b, tel. +7-951-602-68-43, e-mail: mail@nvkd-tub.ru
Abstract. Aim. Assessment of the impact of the process on the prevalence of occupational and somatic diseases among workers of various coal mining enterprises in the city of Mezhdurechensk. Material and methods. Comparative analysis of the results of periodic medical examinations of colliers since 2013 till 2015. Results and discussion. The methods of primary and secondary prevention of somatic and occupational diseases among employees of the coal industry of the city were designed. Conclusion. The prevalence of heterogeneous diseases among workers of the coal industry is significantly higher than in general population. The need for outpatient, inpatient and sanatorium treatment is higher among miners than cut workers and conversely the need for medical check-up is lower. Effective measures of primary and secondary prevention are: annual medical check-ups, development of the Health Schools, the individual and group medical consultations, improving continuity between the department of medical examination and outpatient service, rehabilitation of the patients with chronic diseases on the job.
Key words: coal mining, prevention, annual medical check-up, somatic disease, professional disease.
For reference: Khanin AL, Andreyanova MA, Shutnikova GA. The distribution of somatic and occupational diseases in colliers of Kuzbass. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 56—60.
References
1. Khanin AL, Chernushenko TI, Kravchenko NI, Morozova GV. Problemi boleznei organov dihanija i vozmognie puti ih reshenija na urovne municipalnogo zdravoohranenija [Problems of respiratory diseases and their possible solutions at the level of municipal health]. Pulmonologija [Pulmonology]. 2011; 2: 115–118.
2. Chernushenko TI. Emidimiologija tabakokurenija i drugih faktorov riska hronicheskoi obstruktivnoy bolezni legkih v promishlennom gorode Kuzbassa [Epidemiology of smoking and other risk factors for chronic obstructive pulmonary disease in the industrial city of Kuzbass]. Tomsk. 2014; 26 p.
3. Carik GN, Shternis TA, Bogomolova ND. Problemi i perspective okazanija medicinskoi pomoshi rabotnikam ugledobivajushyh predpriatij [Problems and perspectives of health care workers of coal mines]. Medicina v Kuzbasse [Medicine in Kuzbass]. 2013, 3: 11–16.
4. Horuzaja OG, Gorbljanskiy UU, Piktushanskaja TE. Kriterii ocenki kachestva medicinskyh osmotrov rabotnikov [Criteria for assessing the quality of medical examinations of workers]. Medicina truda I promishlennaja ekologija [Occupational medicine and industrial ecology]. 2015; 11: 33-37.
5. Khanin AL, Chernushenko TI. Rasprostranennost respiratornih simptomov I vozmognosti vijavlenija hronicheskoj obstruktivnoi bolezni legkih v shahterskom gorode Kuzbassa [The prevalence of respiratory symptoms and the identification of chronic obstructive pulmonary disease in the mining town of Kuzbass]. Pulmonologija [Pulmonology]. 2012, 3: 59–62.
6. Petrov GP, Petrov AG, Semenihin VA. Metodicheskie podhodi k ocenke individualnogo kachestva gizni rabotajushih v ugolnoj otrasli [Methodological approaches to assessing the quality of life of an individual working in the coal industry]. Medicina truda I promishlennaja ekologija [Occupational medicine and industrial ecology]. 2015; 15: 22–25.
7. Chechenin GI. Sistemnij podhod i sistemnij analis v zdravoohranenii i medicine: uchebnoe posobie [The systems approach and systems analysis in health and medicine: schoolbook]. Novokuznetsk: МОU DPО IPK. 2002; 141 p.
UDC 617-002-036-037:616.153.963.32-074(048.8)
DOI: 10.20969/VSKM.2016.9(5).61-66
BAYMAKOV SAYFIDDIN R., C. Med. Sci., associate professor of the Department of surgery of Tashkent Medical Academy, Uzbekistan, 100109, Tashkent, Almazar region, Farabi str., 2, tel. +9 (9890)356-62-21, e-mail: bsayfiddin@yahoo.com
ASHURMETOV ABDURASHID KH., D. Med. Sci., professor, Head research worker of Scientific Research Institute of hematology and blood transfusion of the Republic of Uzbekistan, Uzbekistan, Tashkent, Yakkasaray region, Spitamen str., 26, tel. +9 (9871)250-89-57, e-mail: rrrh@mail.ru
Abstract. Aim. Analysis of modern data on investigation of informational and practical significance of qualitative and quantitative changes of cell-free DNA in blood. Material and methods. Review of publications of foreign authors, the data from randomized clinical and experimental studies was examined. Results and discussion. It was established, that the level of circulating DNA increases in numerous oncological diseases in different levets, which allows us to get data for monitoring of treatment effectiveness. Qualitative parameters of cell-free DNA are significantly dependent on methods of determination and on the reagents. The increase of the cell-free DNA level occurs in chronic to acute inflammation and further in severe infection and critical condition independently from used reagents. The levels of cell-free DNA correlate with such clinical parameters as mortality and severity of patient condition and can be used as a predictor. Conclusion. It is necessary to make further investigations in order to confirm these information, which should be performed in different populations and in other inflammatory conditions and diseases.
Key words: cell-free DNA, oncological diseases, chronic inflammation, acute inflammation, surgical diseases, severity of patient’s condition.
For references: Baymakov SR, Ashurmetov AKh. Cell free DNA as a feasible predictor of severity of patient’s condition in inflammatory surgical diseases. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 61—66.
References
1. Agassi R, Czeiger D, Shaked G et al. Measurement of circulating cell-free DNA levels by a simple fluorescent test in patients with breast cancer. Am J Clin Pathol. 2015; 143: 18-24.
2. Alfirevic Z, Sundberg K, Brigham S. Amniocentesis and chorionic villus sampling for prenatal diagnosis. Cochrane Database Syst Rev. 2003; 3: CD003252.
3. Altrichter J, Zedler S, Kraft R et al. Neutrophil-derived circulating free DNA (cf-DNA/NETs), a potential prognostic marker for mortality in patients with severe burn injury. European Journal of Trauma and Emergency Surgery. 2010; 36: 551–557.
4. Antonatos D, Patsilinakos S, Spanodimos S et al. Cell-free DNA levels as a prognostic marker in acute myocardial infarction. Ann N Y Acad Sci. 2006; 1075: 278–281.
5. Aung KL, Board RE, Ellison G et al. Current status and future potential of somatic mutation testing from circulating free DNA in patients with solid tumours. HUGO J. 2010; 4 (1–4): 11–21.
6. Avriel A, Paryente Wiessman M, Almog Y et al. Admission cell free DNA levels predict 28-day mortality in patients with severe sepsis in intensive care. PLoS One. 2014; 9: e100514.
7. Borissoff JI, Joosen IA, Versteylen MO et al. Elevated levels of circulating DNA and chromatin are independently associated with severe coronary atherosclerosis and a prothrombotic state. Arteriosclerosis, Thrombosis, and Vascular Biology, 2013; 33: 2032–2040.
8. Butt AN, Swaminathan R. Overview of circulating nucleic acids in plasma/serum. Ann N Y Acad Sci. 2008; 1137: 236–242.
9. Crowley E, Di Nicolantonio F, Loupakis F, Bardelli A. Liquid biopsy: monitoring cancer-genetics in the blood. Nat Rev Clin Oncol. 2013; 10 (8): 472–484.
10. Devonshire AS, Whale AS, Gutteridge A et al. Towards standardization of cell-free DNA measurement in plasma: controls for extraction efficiency, fragment size bias and quantification. Anal Bioanal Chem. 2014; 406: 6499–6512.
11. Dwivedi DJ, Toltl LJ, Swystun LL et al. Prognostic utility and characterization of cell-free DNA in patients with severe sepsis. Crit Care. 2012; 16: R151.
12. Francis G, Stein S. Circulating Cell-Free Tumour DNA in the Management of Cancer. Int J Mol Sci. 2015; 16, 14122-14142.
13. Frank MO. Circulating Cell-Free DNA Differentiates Severity of Inflammation. Biological Research for Nursing. 2016; sagepub.com/journals Permissions. nav DOI: 10.1177/1099800416642571
14. Forsblom E, Aittoniemi J, Ruotsalainen E et al. High cell-free DNA predicts fatal outcome among Staphylococcus aureus bacteremia patients with intensive care unit treatment. PLoS One. 2014; 9: e87741.
15. Fuchs TA, Brill A, Wagner DD. Neutrophil extracellular trap (NET) impact on deep vein thrombosis. Arterioscler Thromb Vasc Biol. 2012; 32: 1777–1783.
16. Hahn S, Jackson LG, Kolla V et al. Noninvasive prenatal diagnosis of fetal aneuploidies and Mendelian disorders: new innovative strategies. Expert Rev Mol Diagn. 2009; 9 (6): 613–621.
17. Huttunen R, Kuparinen T, Jylhava J. et al. Fatal outcome in bacteremia is characterized by high plasma cell free DNA concentration and apoptotic DNA fragmentation: a prospective cohort study. PLoS One. 2011; 6: e21700.
18. Jeune SL, Charue D, Baudry C et al. Increased levels of extracellular DNA in plasma are associated with diabetic microangiopathy. Abstract of poster presented at the Amer Heart Association’s Arteriosclerosis, Thrombosis and Vascular Biology Scientific Sessions, Toronto, Canada.Arteriosclerosis, Thrombosis, and Vascular Biology. 2014, May 34; A402.
19. Jylhava J, Lehtimaki T, Jula A et al. Circulating cell-free DNA is associated with cardiometabolic risk factors: The health 2000 survey. Atherosclerosis. 2014; 233: 268–271.
20. Kocsis AK, Szabolcs A, Hofner P et al. Plasma concentrations of high-mobility group box protein 1, soluble receptor for advanced glycation end-products and circulating DNA in patients with acute pancreatitis. Pancreatology. 2009; 9: 383-391.
21. Kyongchol Kim, Dong Gue Shin, Min Koo Park et al. Circulating cell-free DNA as a promising biomarker in patients with gastric cancer: diagnostic validity and significant reduction of cfDNA after surgical resection Ann Surg Treat Res. 2014; 86 (3): 136-142.
22. Margraf S, Logters T, Reipen J et al. Neutrophil-derived circulating free DNA (CF-DNA/NETs): A potential prognostic marker for posttraumatic development of inflammatory second hit and sepsis. Shock. 2008; 30: 352–358.
23. Mosca M, Giuliano T, Cuomo G et al. Cell-free DNA in the plasma of patients with systemic sclerosis. Clin Rheumatol. 2009; 28: 1437–1440.
24. Okkonen M, Lakkisto P, Korhonen1 A-M et al. Plasma cell-free DNA in patients needing mechanical ventilation. Critical Care. 2011; 15: R196.
25. Rainer TH, Lam NY, Man CY et al. Plasma beta-globin DNA as a prognostic marker in chest pain patients. Clin Chim Acta. 2006; 368: 110-113.
26. Saukkonen K, Lakkisto P, Pettila V et al. Cell-free plasma DNA as a predictor of outcome in severe sepsis and septic shock. Clin Chem. 2008; 54: 1000-1007.
27. Snyder TM, Khush KK, Valantine HA, Quake SR. Universal noninvasive detection of solid organ transplant rejection. Proc Natl Acad Sci U S A. 2011; 108 (15): 6229–6234.
28. Van der Vaart M, Pretorius PJ Is the role of circulating DNA as a biomarker of cancer being prematurely overrated? Clin Biochem. 2010; 43: 26-36.
29. Yipp BG, Kubes P. NETosis: how vital is it? Blood. 2013; 122: 2784–2794.
30. Zhong XY, Hahn S, Kiefer V, Holzgreve W. Is the quantity of circulatory cell-free DNA in human plasma and serum samples associated with gender, age and frequency of blood donations? Ann Hematol. 2007; 86: 139–143.
THE INFLUENCE OF METABOLIC SYNDROME AND PSYCHOEMOTIONAL TYPE OF THE PERSON ON QUALITY OF LIFE
UDC 616-008.9-052(048.8)
DOI: 10.20969/VSKM.2016.9(5).66-70
GORDEEVA ALLA YU., obstetrician-gynecologist of Clinic of obstetrics and gynecology of I.M. Sechenov the First Moscow State Medical University, obstetrician-gynecologist of V.F. Snegirev University clinic of obstetrics and gynecology, Russia, 119991, Moscow, Trubetskaya str., 8, b. 2, tel. +7-499-248-67-29, e-mail: ostalkaaa@gmail.com
TKACHYOVA MARIA V., endocrinologist, ultrasonographer of «Cecile’s Clinic» Ltd., Russia, 125047, Moscow, 1st Tverskaya-
Yamskaya lane, 13/5, e-mail: tkacheva_m@mail.ru
BELOSTOTSKY ANDREY V., D. Med. Sci., Director of Board of Directors for coordination of activities of medical organizations of the Department of health care of Moscow, Russia, 115280, Moscow, 2nd Avtozavodsky passage, 3, tel. +7-495-531-69-80 (ext. 100), +7-495-722-09-57, e-mail: belostotskyAV@zdrav.mos.ru
CHILOVA RAISA A., D. Med. Sci., professor of the Department of obstetrics and gynecology № 1 of I.M. Sechenov the First Moscow State Medical University, obstetrician-gynecologist of V.F. Snegirev University clinic of obstetrics and gynecology, Russia, 119991, Moscow, Trubetskaya str., 8, b. 2, tel. +7-985-761-91-35, е-mail: rtchilova@gmail.com
KOCHARIAN RENICK А., senior laboratory assistant of the Department of obstetrics and gynecology № 1 of I.M. Sechenov the First Moscow State Medical University, Russia, Moskow, tel. +7-985-423-32-23, e-mail: kocharyan.renik@yandex.ru
CHUSHKOV YURY V., C. Med. Sci., associate professor of the Department of obstetrics and gynecology № 1 of I.M. Sechenov, the First Moscow State Medical University, Russia, tel. +7-926-619-15-66, e-mail: yury-chushkov@rambler.ru
ZHUKOVA ELVIRA V., obstetrician-gynecologist, Head of the Department of medical-diagnostic № 1 of Clinic of obstetrics and gynecology of University Clinic of obstetrics and gynecology of I.M. Sechenov the First Moscow State Medical University, Russia, 119991, Moscow, Trubetskaya str., 8, b. 2, tel. +7-985-998-04-41, e-mail: zhukova.elvira@mail.ru
TRIFONOVA NATALYA S., C. Med. Sci., obstetrician-gynecologist of Clinic obstetrics and gynecology of the University hospital № 2 Medical University of I.M. Sechenov the First Moscow State Medical University, Russia, 119991, Moscow, Trubetskaya str., 8, b. 2, tel. +7-903-773-72-02, e-mail: trifonova.nataly@mail.ru
Abstract. Aim. Metabolic syndrome as a comorbid disease has a significant impact on quality of life and on psycho-emotional status of patients. The aim of the study is to assess the impact of metabolic syndrome on the quality of life and its dependence on psycho-emotional type of patient. Material and methods. Analysis of domestic and foreign literature on quality of life issues in metabolic syndrome. On the basis of analysis of recent studies we enlightened the impact of metabolic syndrome on the quality of life as well as the dependence of psycho-emotional type on perception of the disease. This review provides the rationale for the treatment of metabolic syndrome assessing the quality of life of patients with the help of validated questionnaires. In the course of therapy each doctor should take into account the psycho-emotional type of the patient. Conclusion. Modern medical community draws special attention to personalized medicine. In this regard a special place related to health is to be occupied by the quality of life. It is authentically proved that the evaluation of the quality of life during the course of treatment of metabolic syndrome helps to obtain the most favorable results.
Key words: metabolic syndrome, quality of life, obesity, psychological and emotional type of infertility.
For reference: Gordeeva AYu, Tkachyova MV, Belostotsky AV, Chilova RA, Kocharian RА, Chushkov YuV, Zhukova EV, Trifonova NS. Influence of the metabolic syndrome and psychoemotional type of the person on quality of life of the patient. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 66—70.
References
1. Novik AA, Ionova TI. Rukovodstvo po issledovaniyu kachestva jizni v meditcine [Guide to research of quality of life]. Moscow: ZAO “OLMA Media Grupp”. 2007; 2: 320 p.
2. Ahmedjanov NM, Buturova SA, Dedov II et al. Konsensus rossiyskih ekspertov po problem metabolicheskogo sindroma v Rossiyskoy Federatsii: opredeleniye, diagnosticheskiye kriterii, pervichnaya profilaktika, lecheniye [Consensus of the Russian experts in a problem of a metabolic syndrome in the Russian Federation: definition, diagnostic criteria, primary prophylaxis, treatment]. Consilium medicos kardiologiya [cardiology]. 2010; 12 (5): 12.
3. Alekseyeva NS. Vliyaniye komponentov metabolicheskogo sindroma na kachestvo jizni patsiyentov [Influence of components of a metabolic syndrome on quality of life of patients]. Novokuznetski gosudarstvenni institute usovershenstvovaniya vrachey — Byulleten VCNTS CO RAMN [Novokuznetsk state institute of improvement of doctors — The Bulletin]. 2014; 6: 5.
4. Demidova TY. Borba s ojireniyem — neobhodimoye zveno profilaktiki saharnogo diabeta II-tipa [Fight against an obesity — a neobkhokdimy link of prophylaxis of a diabetes mellitus II types]. Diabet: obraz jizni [Diabetes: way of life]. 2005; 6 (100): 55–56.
5. Krasilnikova EI, Baranova EI, Blagosklonnaya YV et al. Mehanizmi razvitiya arterialnoy gipertenzii u bolnih metabolicheskim sindromom [Mechanisms of development of arterial hypertension in patients with a metabolic syndrome]. Arterialnaya gipertenziya [Arterial hypertension]. 2011; 17 (5): 405–414.
6. Hohlov AL, Jilina AN, Buydina TA. Vzaimisvyaz pokazateley kachestva jizni I osobennostey psihologicheskogo statusa s klinicheskimi proyavleniyami metabolicheskogo sindroma [Interrelation of indicators of quality of life and features of the psychological status with clinical implications of a metabolic syndrome]. Kachestvennaya klinicheskaya praktika [Good clinical practice]. 2006; 2: 19-23.
7. Chazova IY, Michka VB. Metabolicheski sindrom, saharni diabet II-tipa I arterialnaya gipertenziya [Metabolic syndrome, diabetes mellitus II types and arterial hypertension]. Serdtse: jurnal dlya praktikuyushih vrachey [Heart: the magazine for the practicing doctors]. 2003; 2 (3): 102–104.
8. Lautatzis ME, Goulis DG, Vrontakis M. Efficacy and safety of metformin during pregnancy in women with gestational diabetes mellitus or polycystic ovary syndrome: a systematic review. Metabolism. 2013; 62: 1522-1534.
THE CHARACTERISTICS OF DRUG METABOLISM DURING PREGNANCY
UDC 615.015.4:618.2(048.8)
DOI: 10.20969/VSKM.2016.9(5).70-75
SOKOVA ELENA A., C. Med. Sci., associate professor, senior research officer of Center of clinical pharmacology of Scientific Center for expert evaluation of medical products, Russia, 127051, Moscow, Petrovsky ave., 8, b. 2, e-mail: sokova2@rambler.ru
CHILOVA RAISA A., D. Med. Sci, professor of the Department of obstetrics and gynecology № 1 of I.M. Sechenov the First Moscow State Medical University, Russia, 119991, Moscow, Pirogovskaya str. 2, b. 4
PROCLOVA GUZEL F., laboratory assistant of the Department of obstetrics and gynecology № 1 of I.M. Sechenov the First Moscow State Medical University, Russia, 119991, Moscow, Pirogovskaya str. 2, b. 4
MEKSHA YURY V., C. Med. Sci., Head of the Department of obstetrics of V.F. Snegirev Clinic of obstetrics and gynecology of I.M. Sechenov the First Moscow State Medical University, Russia, 119991, Moscow, Pirogovskaya str. 2, b. 4
DEMIDOVA OLGA A., C. Pharm. Sci., research worker of Center of clinical pharmacology of Scientific Center for expert evaluation of medical products, Russia, 127051, Moscow, Petrovsky ave., 8, b. 2
Abstract. Aim. The article highlights contemporary scientific issues concerning the effects of pregnancy on drug metabolism and its clinical implications for drug therapy. Material and methods. The search for information on contemporary scientific issues of drug metabolism during pregnancy was performed in MEDLINE and in other internet resources based on key words: pregnancy, drugs, safety, efficacy, drug metabolism, CYP-450; enzyme. Results and discussion. Pregnancy is associated with significant physiologic changes that determine clinical pharmacology of drugs in maternal-placental-fetus complex. Pregnancy appears to increase the activity of some enzymes (CYP3A, CYP2D6, CYP2C9 and UGT), while other ones seem to have decreased activity (CYP1A2 and CYP2C19). Conclusion. Learning the effects of pregnancy on total drug exposure is often the first step in understanding drug’s pharmacokinetics and the potential need in medication selection and dosage (for example of glyburide, fluoxetine, lamotrigene).
Key words: pregnancy, drugs, safety, efficacy, drug metabolism, CYP-450, enzyme.
For reference: Sokova EA, Chilova RA, Proclova GF, Demidova OA. The characteristics of drug metabolism during pregnancy. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 70—75.
References
1. Isoherranen N, Kenneth E. Drug Metabolism and Transport During Pregnancy: How Does Drug Disposition Change during Pregnancy and What Are the Mechanisms that Cause Such Changes? Drug Metab Dispos. 2013; 41: 256–262.
2. Feghali MN, Mattison DR. Clinical Therapeutics in Pregnancy (Review Article). Journal of Biomedicine and Biotechnology. 2011; 783528.
3. Tracy TS, Venkataramanan R, Glover DD, Caritis SN. Temporal changes in drug metabolism (CYP1A2, CYP2D6 and CYP3A Activity) during pregnancy. American Journal of Obstetrics and Gynecology. 2005; 192 (2): 633–639.
4. Hodge LS, Tracy TS. Alterations in drug disposition during pregnancy: implications for drug therapy. Expert Opinion on Drug Metabolism and Toxicology. 2007; 3 (4): 557–571.Hirt D, Treluyer JM, Jullien V et al. Pregnancy–related effects on nelfinavir–M8 pharmacokinetics: a population study with 133 women. Antimicrobial Agents and Chemotherapy. 2006; 50 (6): 2079–2086.
6. Villani P, Floridia M, Pirillo MF et al. Pharmacokinetics of nelfinavir in HIV–1–infected pregnant and nonpregnant women. British Journal of Clinical Pharmacolog. 2006; 62 (3): 309–315.
7. Pennell PB, Newport DJ, Stowe ZN, Helmers SL, Montgomery JQ, Henry TR. The impact of pregnancy and childbirth on the metabolism of lamotrigine. Neurology. 2004; 62 (2): 292–295.
8. Hebert MF, Easterling TR, Kirby B, Carr DB, Buchanan ML, Rutherford T et al. Effects of pregnancy on CYP3A and P–glycoprotein activities as measured by disposition of midazolam and digoxin: a University of Washington Specialized Center of Research Study. Clinical Pharmacology and Therapeutics. 2008; 84 (2): 248–253.
9. Tracy TS, Venkataramanan R, Glover DD, Caritis SN et al. Temporal changes in drug metabolism (CYP1A2, CYP2D6 and CYP3A Activity) during pregnancy. Am J Obstet Gynecol. 2005; 192 (2): 633–639.
10. Hebert MF, Easterling TR, Kirby B, Carr DB, Buchanan ML, Rutherford T et al. Impact of pregnancy on pharmacokinetics of medications. J Popul Ther Clin Pharmacol. 2013; 20(3): 350–357.
11. Yep T, Eyal S, Easterling TR, Shen DD, Kelly EJ, Hankins GDV et al. The pharmacokinetics of metoprolol during pregnancy. Abstract of Annual Meeting American College of Clinical Pharmacology, Pittsburg? PA. 2011; 106–107.
12. Buchanan ML, Easterling TR, Carr DB, Shen DD, Risler LJ et al. Clonidine pharmacokinetics in pregnanacy. Drug Metab Dispos. 2009; 37: 702–705.
13. Sim SC, Ingelman–Sundberg V. Pharmacogenomic biomarkers: new tools in current and future drug therapy. Trends Pharmacol Sci. 2011; 32: 72–81.
14. Yerby MS, Friel PN, McCormick K, Koerner M, Van Allen M., Leavitty AM et al. Pharmacokinetics of anticonvulsants in pregnancy: alterations in plasma protein binding. Epilepsy Res. 1990; 5: 223–228.
15. Hebert MF, Ma X, Naraharisetti SB, Krudys KM, Umans JG, Hankins GDV et al. Are we optimizing gestational diabetes treatment with glyburide? The pharmacologic basis for better clinical practice. Clin Pharmacol Ther. 2009; 85: 607–614.
16. Carter BL, Driscoll CE, Smith GD. Theophylline clearance during pregnancy. Obstetrics and Gynecology. 1986; 68 (4): 555–559.
17. McGready R, Stepniewska K, Seaton E, Cho T, Cho D, Ginsberg A et al. Pregnancy and use of oral contraceptives reduces the biotransformation of proguanil to cycloguanil. Eur J Clin Pharmacol. 2003; 59 (7): 553–537.
18. Tran TA, Leppik IE, Blesi K, Sathanandan ST, Remmel R. Lamotrigine clearance during pregnancy. Neurology. 2002; 23: 299–302.
ETIOLOGY AND PATHOGENESIS OF INFERTILITY IN OBESITY AS A COMPONENT OF METABOLIC SYNDROME
UDC 618.177:616-056.257:616-008.9(048.8)
DOI: 10.20969/VSKM.2016.9(4).75-79
TKACHEVA MARIA V., endocrinologist, ultrasonographer of «Cecil Clinic» Ltd., Russia, 125047, Moscow, 1st Tverskaya-Yamskaya, 13/5, e-mail: tkacheva_m@mail.ru
GORDEEVA ALLA YU., obstetrician-gynecologist of Clinic of obstetrics and gynecology of I.M. Sechenov the First Moscow State Medical University, obstetrician-gynecologist of V.F. Snegirev University clinic of obstetrics and gynecology, Russia, 119991, Moscow, Trubetskaya str., 8, b.2, e-mail: ostalkaaa@gmail.com
BELOSTOTSKY ANDREY V., D. Med. Sci., Director of Beard of Directors for coordination of activities of medical of organizations of the Department of health care of Moskow, Russia, 115280, Moscow, 2nd Avtozavodskii passage, 3, tel. +7-495-531-69-80 (ext. 100), +7-495-722-09-57, e-mail: belostotskyAV@zdrav.mos.ru
CHILOVA RAISA A., D. Med. Sci., professor of the Department of obstetrics and gynecology № 1 of I.M. Sechenov the First Moscow State Medical University, obstetrician-gynecologist of V.F. Snegirev University clinic of obstetrics and gynecology, Russia, 119991, Moscow, Trubetskaya str., 8, b.2, tel. +7-985-761-91-35, e-mail: rtchilova@gmail.com
KOCHARJAN RENIK A., senior laboratory assistant of the Department of obstetrics and gynecology № 1 of I.M. Sechenov the First Moscow State Medical University, Russia, Moskow, tel. +7-985-423-32-23, e-mail: kocharyan.renik@yandex.ru
ZHUKOVA ELVIRA V., obstetrician-gynecologist, Head of the Department of medical-diagnostic № 1 of Clinic of obstetrics and gynecology of University clinic of obstetrics and gynecology of I.M. Sechenov the First Moscow State Medical University, Russia, 119991, Moscow, Trubetskaya str., 8, b.2, tel. +7-985-998-04-41, e-mail: zhukova.elvira@mail.ru
TRIFONOVA NATALYA S., C. Med. Sci., obstetrician-gynecologist of Clinic obstetrics and gynecology of the University hospital № 2 Medical University of I.M. Sechenov the First Moscow State Medical University, Russia, 119991, Moscow, Trubetskaya str., 8, b.2, tel. +7-903-773-72-02, e-mail: trifonova.nataly@mail.ru
Abstract. Aim. Metabolic syndrome is a problem of social significance. However, this issue is twofold. On the one hand, all the processes and components of metabolic syndrome are reversible with timely initiated diagnosis and treatment. On the other hand, all of the components of metabolic syndrome lead to the diseases with extremely dangerous consequences and drastically impair quality of life. Material and Methods. Analysis of modern and relevant publications devoted to the problem of metabolic syndrome, obesity as an important component of the metabolic syndrome. Results and discussion. According to the analysis of the recent years of research there is a modern vision of etiology and pathogenesis of metabolic syndrome and obesity and on the impact of these conditions on the development of polycystic ovary syndrome and infertility. Early diagnosis and prevention of metabolic syndrome and obesity in childhood and adolescence are explained. The importance of early treatment of the metabolic syndrome, as a socially significant disease was indicated. Conclusion. The problem of timely diagnosis and treatment of metabolic syndrome is relevant for the whole medical community due to the avalanche-like increase of the metabolic syndrome in all countries.
Key words: obesity, infertility, polycystic ovarian syndrome, metabolic syndrome.
For reference: Tkacheva MV, Gordeeva AY, Belostotsky AV, Chilova RA, Kocharjan RA, Zhukova EV, Trifonova NS. Etiology and pathogenesis of infertility in obesity as a component of metabolic syndrome. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 75—79.
References
1. Butrova SA. Metabolicheski sindrom: patogenez, klinika, diagnostika, podhodi k lecheniyu [Metabolic syndrome: pathogenesis, clinic, diagnostics, approaches to treatment]. Endokrinologicheski nauchnii tsentr RAMN [Endocrinological Russian Academy of Medical Science scientific center]. 2012; 32: 24.
2. Dedov II, Melnichenko GA. Ojireniye: etiologiya, patogenez, klinicheskiye aspekti. [Obesity: etiology, pathogenesis, clinical aspects]. Moskva [Мoscow]: MIA. 2004; 449 p.
3. Podzolkova NM, Anshin MB, Shamugiya NL, Ablyaev ESh. Vliyanie massi tela na effektivnost program vspomogatelnih reproduktivnih tehnologi. [Influence of body weight on efficiency of programs of auxiliary reproductive technologies]. Mejdunarodni congress po reproduktivnoy meditsine «Reproduktivnoye zdorovye I planirovaniye semyi» [The international congress on reproductive medicine «Reproductive health and planning of a family»]. 2008; 366.
4. Dedov II, Andreyeva EN, Pishulin AA, Karpova EA. Sindrom giperandrogenii u jenshin [Giperandrogeniya syndrome at women]. Moskva [Мoskow]: MIA. 2006; 40.
5. Dedov II, Melnichenko GA. Sindrom polikistoznih yaichnikov [Syndrome of polycystous ovaries]. Moskva [Мoscow]: MIA. 2007; 242—272.
6. Krasnopolsky VI, Logutov LS, Serov OF, Tuanova VA, Zarochentseva NV, Pozdnyakov T.I. Sindrom polikistoznih yaichnikov [Syndrome of polycystous ovaries]. Мoskva [Moscow]: АdamantЪ. 2005; 40 p.
7. Evdokimova AG, Evdokimov VV. Vozmozhnosti primenenija preparatov ingibitorov angiotenzin-prevrashhajushhego fermenta u bol’nyh arterial’noj gipertoniej i ishemicheskoj bolezn’ju serdca [Possibilities of use of drugs of angiotensin-converting enzyme inhibitors in patients with arterial hypertension and ischemic heart disease]. Kardiovaskuljarnaja terapija i profilaktika [Cardiovascular therapy and prevention]. 2013; 1: 10-14.
8. Koluell DzhA. Saharni diabet: novoye v lecheniye I profilaktike [Diabetes: new in treatment and prevention]. BINOM: Laboratoriya znaniy [Laboratory of knowledge]. 2010; 288 p.
9. Makolkin VI. Metabolicheski sindrom [Metabolic syndrome]. OOO Meditsinskoye informatsionnoye agentstvo [LLC: Medical News Agency]. 2010; 144 p.
10. Pankrushina AN, Tolstykh KYu. Leptin: noviye perspektivi I podhodi k korrektsii ojireniya [Leptin: new prospects and approaches to obesity]. Vestnik TvGU: Serija «Biologija i jekologija [Bulletin tver: A series of «Biology and Ecology]. 2008; 10: 91-97.
11. Prilepskaya VN. Beremennost I ojireniye: vozmojnosti primeneniya Ksenikala [Pregnancy and obesity: possibilities of application of Ksenikal]. Farmateka. 2010; 9: 4-5.
12. Roytenberg G E. Metabolicheskij sindrom [Metabolic syndrome]. Moskva: Medpress inform [Moscow: Medical press inform]. 2007; 224 p.
13. Serov VN, Prilepskaya VN, Pshenichnikova TYa. Prakticheskoye rukovodstvo po ginekologicheskoy endokrinologii [Practical guidance on gynecologic endocrinology]. Moskva [Moscow]: Rusfarmmed. 1995; 95-101.
14. Tokareva ZN, Mamedov MN, Deyev AD. Rasprostranennost I osobennosti proyavleniy metabolicheskogo sindroma vo vzrosloy gorodskoy populyatsii [Prevalence and features of manifestations of a metabolic syndrome in adult city population] Kardiovaskuljarnaja terapija i profilaktika [Cardiovascular therapy and prevention]. 2012; 1: 3-6.
15. Brinkoetter M, Magkos F, Vamvini M, Mantzoros CS. Leptin treatment reduces body fat but does not affect lean body mass or themyostatin-follistatin-activin axis in lean hypoleptinemic women. Am J Physiol Endocrinol Metab. 2011; 301 (1): 99-104.
16. Kahn R. Metabolic syndrome — what is the clinical usefulness? Lancet. 2008; 7: 17.
UDC 618.33-037(048.8)
DOI: 10.20969/VSKM.2016.9(5).79-82
ULYANINA ELENA V., graduate student of the Department of obstetrics and gynecology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-903-306-44-25, e-mail: ualena87@yandex.ru
FATKHULLIN ILDAR F., D. Med. Sci., professor, Head of the Department of obstetrics and gynecology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-960-048-01-04, e-mail: Fatkullin@yandex.ru
KHAYRULLINA GUZYAL R., C. Med. Sci., associate professor of the Department of obstetrics and gynecology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-987-296-92-29, e-mail: bas.gulya@mail.ru
Abstract. Aim. To analyze the latest information on the role of growth factors and ultrasonic examination in the assessment of uteroplacental blood flow functioning in order to improve parental care for women suffering from severe fetal growth retardation syndrome. Material and methods. The literature dedicated to early prediction of fetal growth retardation syndrome through the identification of vascular endothelial growth factor in the blood and the increase of uterine artery pulsatility index via Doppler velocimetry was reviewed. Publications by Russian and foreign authors were considered to attention. Results and discussion. Identification of vascular endothelial growth factor in the blood of pregnant women and proved significant correlation between doppler velocimetry parameters at their critical values can be used as an indication for early delivery due to the high probability of antenatal fetal death in fetal growth retardation syndrome. Conclusion. In order to determine the optimal time for delivery in fetal growth retardation syndrome ultrasonic examination results and angiogenesis markers shall be considered.
Key words: angiogenic growth factor, vascular endothelial growth factor, fetal growth retardation syndrome, angiogenesis.
For reference: Ulyanina EV, Fatkhullin IF, Khayrullina GR. The markers of angiogenesis and ultrasonography in the assessment of severity of the fetal growth retardation syndrome. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 79—82.
References
1. Trishkin AG, Artymuk NV, Bikmetova ES. Taktika vedeniya beremennyh s zaderzhkoy rosta ploda [Tactics of antenatal care for women suffering from fetal growth retardation]. Doctor Ru, 2012; 7 (75): 69–73.
2. Makarov IO. Zaderzhka rosta ploda [Fetal Growth Retardation]. Vrachebnaya taktika: uchebnoe posobie [Medical tactics: Education Guidance]. M: MED-Press Inform. 2012; 56 p.
3. Strizhakov AN, Ignatko IV, Timoxina EV. Sindrom zaderzhki rosta ploda. Patogenez. Diagnostika. Lechenie. Akusherskaya taktika: monografiya [Fetal Growth Retardation Syndrome. Pathogenesis. Diagnosis. Treatment. Obstetrician tactics: monography]. M: GEOTAR-Media. 2013; 120 p.
4. Rogova EV, Barinov SV, Dolgih TI. Znachenie faktora rosta v geneze oslazhneniy pri mnogoplodnoy beremennosti [Influence of growth factors onthe origin of complications at multifetation]. Rossijskij vestnik akushera-ginekiologa [Russian bulletin of obstetrician-gynecologist]. 2012; 6: 7–9.
5. Volkova EV, Lysyuk LY, Jokhadze LS. Osobennosti izmenenij pro- i antiogennyh faktorov u beremennyh s hronicheskoj arterialnoy gipertenziej [Peculiarities of proangiogenic and antiangiogenic factor changesat pregnant women suffering from chronic arterial hypertension]. Rossijskij vestnik akushera-ginekiologa [Russian bulletin of obstetrician-gynecologist]. 2013; 3: 9–13.
6. Crispi F, Dominguez C, Llurba E. Placental angiogenic growth factors and uterine artery Doppler findings for characterization of different subsets in preeclampsia and in isolated intrauterine growth restriction. Am J Obstet Gynecol. 2006; 195: 201–207.
7. Lascowska M, Lascowska K, Oleszczuk J. aVEGF-A and its soluble receptor type-1 (sVEGFR-1, sFlt-1) concentracions in pregnancies with intrauterine growth restriction in the presence or absence of preeclampsia. Research Journal of Pharmaceutical, Biological and Chemical. 2015; 6 (2): 319–325.
8. Davydov AI, Agrba IB, Voloshchuk IN. Patogenez patologii prikrepleniya placenty: rol’ faktorov rosta I drugih immunogistohimicheskih markerov [Pathogenesis of placentation abnormalities: role of growth factors and other immunohistochemical markers]. Voprosy ginekologii, akusherstva I perinatologii [Matters of gynecology, obstetrics and perinatology]. 2012; 11 (1): 48–54.
9. Campbell S, Griffen DR, Pearce JM. New Doppler technique for assessing uteroplacental blood flow. The lancet. 1983; 321: 675–677.
10. Zamaleeva RS, Maltseva LI, Cherepanova NA. Sostoyaniya problemy lecheniya i prognozirovaniya zaderzhki razvitiya ploda [Problems of fetal growth retardationtreatment and prediction]. Prakticheskaya medicina [Practical Medicine]. 2016; 1 (93): 41–44.
11. Savelyeva GM, Bugerenko EY, Panina OB. Prognosticheskaya znachimost’ narusheniya matochno-placentarnogo krovoobrasheniya v I trimester beremennosti u pacientok s otyagoshennym akusherskim anamnezom [Predictive significance of uteroplacental blood circulation disturbance at the I trimester of pregnancy at patients with burdened obstetric anamnesis]. RAMN Vestnik [RAMS Bulletin]. 2013; 7: 4–8.
12. Kan NE, Amiraslanov EY, Tyutyunnik VL. Prognozirovanie zaderzhki rosta ploda u beremennyh s nedifferencirovannoy displaziey soedinitelnoy tkani [Prediction of fetal growth retardation at pregnant women suffering from undifferentiated connective tissue dysplasia]. Akusherstvo I ginekologiya [Obstetrics and gynecology]. 2014; 10: 22–26.
13. Gugushvili NA, Sichinava LG, Gankovskaya LV. Kliniko- patogeneticheskoe obosnovanie dosrochnogo rodorazresheniya pri zaderzhke rosta ploda [Clinico-pathogenetic justification of early delivery at Fetal Growth Retardation].Voprosy ginekologii, akusherstva I perinatologii [Matters of gynecology, obstetrics and perinatology]. 2013; 12 (2): 22–28.
14. Diab AE, El-Behery M, Mebrahiem MA. Angiogenic factors for the prediction of preeclampsia in women with abnormal midtrimester uterine artery Doppler velocimetry. J Gynaecol Obstet. 2008; 102 (2): 146–51.
15. Shibata E, Rajakumar A, Powers RW. Soluble fms-like tyrosine kinase-1 is increased in preeclampsia but not in normotensive pregnancies with small-for gestational-age neonates: relationship to circulating placental growth factor. J Clin Endocrinol Metab. 2005; 90 (8): 4895–903.
UDC 615.9(470.41)(091)
DOI: 10.20969/VSKM.2016.9(5).83-87
KHALITOV FARIT JA., C. Med. Sci., assistant of professor of the Department of general medicine of Kazan State Medical University, Russia, 424012, Kazan, Butlerov str., 49, e-mail: h_tox@mail.ru
BOMBINA LARISA K., C. Med. Sci., associate professor of the Department of general medicine of Kazan State Medical University, Russia, 424012, Kazan, Butlerov str., 49, tel. +7-960-039-47-13
ABDULGANIEVA DIANA I., D. Med. Sci., professor, Head of the Department of general medicine of Kazan State Medical University, Russia, 424012, Kazan, Butlerov, str., 49, tel. +7-987-296-27-68, e-mail: diana_s@mail.ru
Abstract. 19 June, 2016 is a 75-year anniversary since the birth of Ildar Gazimdzhanovich Salikhov — doctor of medical sciences, professor and corresponding member of the Academy of Sciences, Honored Worker of Science of the Republic of Tatarstan, Honored Doctor of the Republic of Tatarstan and of the Russian Federation. Aim. The study was conducted to establish the role of the professor I.G. Salikhov in organizing toxicological service in the Republic of Tatarstan. Material and methods. Analysis of archival materials, memoirs and publications of colegues, statistical information on the provision of toxicological assistance to the population in the Republic of Tatarstan. Results and discussion. The steps of creating toxicological service in Tatarstan were identified. The efficiency of organizational steps to create a service and research on diagnosis and treatment of acute poisoning, teaching students and training doctors undertaken by Professor I.G. Salikhov was estimated. Conclusion. Creating and improving toxicological assistance to the population, organization of scientific studies of acute poisoning as well as training of students and doctors in the Republic of Tatarstan in toxicology are resulting from activities of Professor I.G. Salikhov in the field of clinical toxicology.
Key words: Salikhov Ildar Gazimdzhanovich, toxicology, Kazan school of general medicine.
For reference: Khalitov FJa, Bombina LK, Abdulganieva DI. The role of Professor Ildar G. Salikhov in toxicologic assistance for the population of Tatartstan Republic (Dedicated to the 75th anniversary).The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 83—87.
References
1. Salikhov IG, Margolin ES, Khalitov FJa. Opyt intensivnoj terapii ostryh otravlenij FOI [Intensive therapy of acute toxicosis]. Moskva: sbornik trudov NII SP imeni NV Sklifosovskogo [Moscow: a collection of works of research Institute SP them Sklifosovsky NV]. 1984; 57: 127–131.
2. Salikhov IG, Margolin ES, Khalitov FJa. Klinicheskie osobennosti techenija ostryh otravlenij razlichnymi FOI i ih korrekcija [Clinical features of acute poisoning by various OIF and their correction]. Kazanskij medicinskij zhurnal [Kazan medical journal]. 1985; 4: 274-276.
3. Khalitov FJa, Maksimov ON, Salikhov IG. Ukusy zmej — klinika, lechenie: metod. rekomendacii [Bites of snakes — clinic, treatment : recommendations]. Kazan; 1988; 6 p.
4. Salikhov IG, Gashigullin RI, Maksimov ON et al. Diagnosticheskaja i lechebnaja taktika prikomatoznyh sostojanijah [Experience diagnosis of the aetiology of coma in acute poisoning]. Klinicheskaja medicina [Clinical medicin].1991; 12: 88-90.
5. Salikhov IG, Khalitov FJa, Maksimov ON et al. Opyt diagnostiki jetiologii komy pri ostryh otravlenijah [Experience diagnosis of the aetiology of coma in acute poisoning]. Diagnostika, klinika i lechenie kriticheskih sostoyanij pri ostryh otravleniyah i ehndotoksikozah: Moskva: sbornik trudov NII SP imeni NV Sklifosovskogo [Diagnosis, clinic and treatment of critical conditions in acute poisoning and endotoxemia: Moscow: a collection of works of research Institute SP them Sklifosovsky NV]. 1988; 74: 98-100.
6. Salikhov IG, Muhametzjanov ShA, Girfanov VS et al. Pokazanija k gemosorbcii [Indications hemosorption]. Kazanskij medicinskij zhurnal [Kazan medical journal].1983; 64 (2): 88-92.
7. Khalitov FJa, Salikhov IG. Diagnostika i lechenie otravlenij gribami [Diagnosis and treatment of mushroom poisoning: a method. benefit]. Kazan’: KGMU [Kazan: Kazan State Medical University], 2000; 26 p.
8. Khalitov FJa, Salikhov IG. Informacionnoe obespechenie vracha — opyt primenenija toksikologicheskih komp’juternyh trenazherov [Information support for doctor — experience with toxicology computer simulators].Salikhov IG, Margolin ES, Khalitov FJa. Opyt intensivnoj terapii ostryh otravlenij FOI [Intensive therapy of acute toxicosis]. Moskva: sbornik trudov NII SP imeni NV Sklifosovskogo [Moscow: a collection of works of research Institute SP them Sklifosovsky NV]. 1984; 57: 127–131.
9. Salikhov IG. Izbrannye lekcii [Selected lectures]. Kazan: KGMU [Kazan: Kazan State Medical University]. 1995; 319 p.
10. Salikhov IG, Ahmerov SF. Neotlozhnye sostojanija v praktike terapevta: uchebnoe posobie [Emergency conditions in the practice of the therapist: manual]. Kazan: KGMU [Kazan: Kazan State Medical University]. 2007; 375 p.
11. Salikhov IG, Akhmerov SF, Latfullin IA. Neotlozhnye sostojanija v praktike terapevta [Emergency conditions in the practice of the therapist: monographs]. Kazan: KGMU [Kazan: Kazan State Medical University]. 2000; 320 p.
UDC [616.98:579.873.21]-091(470.56)
DOI: 10.20969/VSKM.2016.9(5).88-93
MIKHAILOVSKY ALEXEY M., C. Med. Sci., Head of the Department of pathology of Orenburg Regional Clinical Tuberculosis Dispensary, assistant of proffesor of the Department of tuberculosis and pulmonology of Orenburg State Medical University, Russia, 460041, Orenburg, Nezhinsky highway, 6, tel. +7-922-627-75-22, e-mail: michailovsky2007@yandex.ru
CHURKIN SERGEY A., C. Med. Sci., Head of Orenburg Regional Clinical Tuberculosis Dispensary, Russia, 460041, Orenburg, Nezhinsky highway 6, tel. 8 (3532) 32-74-54, e-mail: oobo5@mail.ru
PASHKOVA NATALIA A., Head of the laboratory of Orenburg Regional Clinical Tuberculosis Dispensary, Russia, 460041, Orenburg, Nezhinsky shosse, 6, tel. +7-922-628-11-03, e-mail: pashkova.dom @ mail.ru
LEPEKHA LARISA N., D. Biol. Sci., professor, Head of the Department of pathology, cell biology and biochemistry of Central Research Institute of Tuberculosis, Russia, 107564, Moscow, Yauzskaya alley, 2, tel. (499) 785-91-79, e-mail: lep3@yandex.ru
Abstract. Aim. Description of clinical and morphological manifestations of the generalized case of nontuberculosis mycobacteriosis (NTMB) caused by Mycobacterium avium in a patient with terminal stage HIV infection diagnosed posthumously revealing the criteria of morphological diagnosis of nontuberculous mycobacteriosis. Material and methods. The study describes the clinical picture of the disease, using in-patient medical record data. Proprietary study included an autopsy with macroscopic description of inner organs, histological, bacteriological and molecular genetic studies of pathological material. After fixation in 10% neutral formalin the pieces of inner organs were embedded in paraffin. Prepared sections were stained with hematoxylin and eosin, Van Gieson, Ziehl-Nielsen reaction. The culture of Mycobacterium avium was identified in postmortem brain tissue of bone, lung, spleen and lymph nodes by real-time PCR followed by hybridization of amplification products on DNA strips. Results and discussion. We conducted a morphological and microbiological examination that revealed generalized mycobacterial infection caused by M. avium as the only type of the disease in the patient. Morphological features included subtotal dissemination of histiocytic macrophage granulomas with intracellular content of a large number of acid resistant bacteria, predominance of productive tissue reaction with a tendency to form sclerosis granulomas as well as fibrosis in the perifocal area in parenchymal organs. Conclusion. Our findings describe morphological features of the biopsy, surgical or autopsy material making it possible to suspect the presence of NTMB. It is necessary to conduct microbiological research on NTMB differentiation and molecular genetic identification of the species to confirm the diagnosis.
Key words: nontuberculous mycobacteriosis, respiratory insufficiency, HIV, mycobacterium avium.
For reference: Mikhailovsky AM, Churkin SA, Pashkova NA, Lepeha LN. The first case of post-mortem diagnosis of generalized non-tuberculosis mycobacteriosis in a patient at the late stage of HIV-infection in the Orenburg Region. The Bulletin of Contemporary Clinical Medicine. 2016; 9 (5): 88—93.
References
1. Mihajlovskij AM, Chepasov VI. Kachestvennye i kolichestvennye obuslovlennosti osnovnyh ehpidemiologicheskih pokazatelej po tuberkulezu v Orenburgskoj oblasti [Qualitative and quantitative conditionality of the main epidemiological indicators of tuberculosis in the Orenburg region]. Vestnik Orenburgskogo gosudarstvennogo universiteta [Bulletin of the Orenburg State University]. 2015; 1: 145-149.
2. Otten TF, Vasil’ev AV. Mikobakterioz [Mycobacteriosis]. SPb: Medicinskaya pressa [St Petersburg: Medical Press]. 2005; 224 p.
3. Berdnikov RB, Grinberg LM, Sorokina ND et al. VICH-infekciya i tuberkulez po dannym patologoanatomicheskih vskrytij [HIV and tuberculosis, according to autopsy]. Ural’skij medicinskij zhurnal [Ural Medical Journal]. 2011; 1: 67-72.
4. Farhi DC, Mason UD, Horsburg CR. Pathologic findings in disseminated Mycobacterium avium-intracellulart infection: а report of 11 cases. Amer J clin Path. 1986; 8: 67-72.
5. Piersimoni C, Daley C. Epidemiology of human pulmonary infection with nontuberculous mycobacteria. Clin Chest Med. 2002; 23: 553-567.
6. Litvinov VI, Makarova MV, Krasnova MA. Netuberkuleznye mikobakterii [Nontuberculous mycobacteria]. Moskva [Moscow]: MNPCBT. 2008; 256 p.
7. Parhomenko YG, Erohin VV, Zyuzya YR et al. Patomorfologicheskie izmeneniya v legkih pri tuberkuleze u umershih ot VICH-infekcii v stadii SPIDa [Changes in the lungs of tuberculosis have died of HIV- infection in the stage of AIDS]. Arhiv patologii [Archives of pathology]. 2007; 3: 26-28.
8. Al’vares Figeroa MV, Zyuzya YR, Prokopenko AV et al. Diagnostika sochetaniya tuberkuleza i mikobakterioza pri VICH-infekcii [Diagnosis combination of tuberculosis and mycobacteriosis in HIV infection]. Tuberkulez i social’no znachimye zabolevaniya [Tuberculosis and socially significant diseases]. 2015; 4: 50-57.