MEDICAL ACTIVITY DEPARTMENTAL QUALITY CONTROL ORGANIZATION EXPERIENCE IN MEDICAL INSTITUTIONS OF THE MINISTRY OF INTERNAL AFFAIRS OF RUSSIA

SIDORENKO VITALII A., ORCID ID:0000-0003-3328-4567; major general of internal service, С. Med. Sci., associate professor, Honored doctor of the Russian Federation, deputy head of the Department of material, technical and medical support of the Ministry of Internal Affairs of Russia, Head of the Department of medical service, Russia, 119049, Moscow, Raspletin str., 26

KONKOV ALEXANDER V., colonel of internal service, D. Med. Sci., professor, Honored doctor of the Russian Federation, deputy head of the Department of medical service of the Department of material, technical and medical support of the Ministry of Internal Affairs of Russia, Russia, 119049, Moscow, Raspletin str., 26; Head of the Department of internal medicine (with the course of pediatrics) of Institute of medical and social technologies of Moscow State University of Food Production, Russia, 125080, Moscow, Volokolamskoe highway, 11

MOROZOV ALEXEY V., ORCID ID: 0000-0001-7724-2735, SCOPUS Author ID: 8455076900; colonel of internal service, С. Med. Sci., Head of the Department of departmental quality control management and safety of medical activities of the Department of medical service of the Department of material, technical and medical support of the Ministry of Internal Affairs of Russia, Russia, 119049, Moscow, Raspletin str., 26; senior researcher of N.A. Semashko National Scientific Research Institute of Public Health, Russia, 1050641, Moscow, Vorontsovo Pole str., 12, 1 bld.; associate professor of Medical institute of Russian University of People’s Friendship, Russia, 117198, Moscow, Miklukho-Maklay str., 6, e-mail: А0067138@yandex.ru

Abstract. Aim. The study was performed aiming to identify the main typical de ciencies in activity management at the medical organizations of the Ministry of Internal Affairs of Russia, and to create management tools to prevent them.Material and methods. Materials from the reviews conducted by the medical service department of the Department of material, technical and medical support of the Ministry of Internal Affairs of Russia, analytical references (reviews) prepared at the Department of Medical service, and materials of Federal Service on Surveillance in Healthcare and Social Development of Russian Federation were studied. Results and discussion. The quality of medical care is a featurethat reflects providing a complex of preventive, diagnostic and therapeutic care to the patient that allows one to obtain the optimal result for one’s health in accordance with the level of medical science. Medical service can be considered qualitative if the following basic principles are observed: safety, adequacy, high scienti c, technical and professional level, economy and ef ciency. Comparison was made between the results of medical care departmental quality control in medical organizations of the Ministry of Internal Affairs of Russia and similar veri cation indicators and the results of state control conducted by the Federal Service on Surveillance in Healthcare and Social Development of Russian Federation. Appeals incoming to the Ministry of Internal Affairs of Russia and to the Federal Service on Surveillance in Healthcare and Social Development of Russian Federation, related to the quality of medical care, were confronted.Conclusion. Systematic reporting the de ciencies identi ed during the reviews, as well as the personal responsibility of the heads of medical organizations of the Ministry of Internal Affairs of Russia and their deputies, allows to signi cantly reduce the number of violations detected, as well as to prevent possible penalties following the results of reviews by the Federal Service on Surveillance in Healthcare and Social Development of Russian Federation.

Key words: medical activity departmental quality control, assessment of activities in medical organizations.

For reference: Sidorenko VA, Konkov AV, Morozov AV. Medical activity departmental quality control organization experience in medical institutions of the Ministry of Internal Affairs of Russia. The Bulletin of Contemporary Clinical Medicine. 2018; 11 (4): 7–11. DOI: 10.20969/VSKM.2018.11(4).7-11.

REFERENCES

 STRUCTURAL ANALYSIS OF THE MARKET RANGE OF MEDICATIONS FOR SYMPTOMATIC MULTIPLE SCLEROSIS TREATMENT AT THE FEDERAL AND REGIONAL LEVELS

AKHMEDOVA GUSEL M., ORCID ID: orcid.org/0000-0003-0857-8934, SCOPUS Author ID: 55674079300; C. Med. Sci., associate professor of the Department of neurology and manual therapy of Kazan State Medical Academy – the branch of Russian Medical Academy of Postgraduate Education, Russia, 420012, Kazan,
Butlerov str., 36, e-mail: guzel29@mail.ru

KHABIROV FARIT A., D. Med. Sci., professor, Head of the Department of neurology and manual therapy of Kazan State Medical Academy – the branch of Russian Medical Academy of Postgraduate Education, Russia, 420012, Kazan, Butlerov str., 36

SHAKIROVA DILIARA KH., D. Pharm. Sci., professor of the Institute of pharmacy of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49

KHAYBULLIN TIMUR I., C. Med. Sci., associate professor of the Department of neurology and manual therapy of Kazan State Medical Academy – the branch of Russian Medical Academy of Postgraduate Education, Russia, 420012, Kazan, Butlerov str., 36

Abstract. Aim. Structural analysis of the market range of the drugs for symptomatic multiple sclerosis treatment atthe Federal and regional levels has been performed in terms of the study. Material and methods. The objects of the study were the modern legal framework for drug provision to the patients with multiple sclerosis, price lists of wholesale pharmaceutical organizations of the Republic of Tatarstan, State register of medicines of the Russian Federation, 2293 medical records of patients on hospital treatment at Republic Clinical Neurology Center. Correlation and regression methods, mathematical and statistical analysis, the method of structural analysis of the range and content analysis have been applied. Results and discussion. There are 1896 names of medications for symptomatic treatment of multiple sclerosis on the Federal market taking into account the dosages and forms of release. The studied drugs belong to 20 pharmacological groups. The most widely available among them are nootropic drugs – more than 20%, antidepressants and proton pump inhibitors – about 9%. At the federal level the market is represented by 36 producer countries. It should be noted that almost half of them are domestic production. Signi cant proportion of drugs is manufactured in India (more than 10%). At the regional level, the market is represented by 23 producing countries, with a predominance of Russian-made products in the assortment. Italy takes the rst place (13,16%) in the foreign countries ranking, followed by Germany (12,28%) and India 9,65%). An important component of the clinical effect in the symptomatic treatment of multiple sclerosis patients is the correct choice of dosage form. It has been established that 82,63% of solid dosage forms occupy the largest number in the State Register of the Russian Federation for symptomatic treatment of multiple sclerosis, among which 27,46% are the leaders in the number of tablets. The share of liquid dosage forms is 17,37%, which is related to the painful injection, compulsory participation of medical personnel, laboriousness of the technological process and to the danger of infecting the body. At the regional market, solid forms also prevail among various dosage forms – 77,53%, in particular tablets – 27,54%. The speci c gravity of liquid dosage forms, which are most often used for exacerbations of the disease, is 22,47%. Conclusion. The results of marketing research conducted to study thepharmaceutical market of medicines for the symptomatic treatment of multiple sclerosis indicate a wide variety of synonyms and analogues, high renewability and prevalence of drugs of domestic production.

Key words: multiple sclerosis, dosage forms, drugs, treatment, symptomatic therapy.

For reference: Akhmedova GM, Khabirov FA, Shakirova DKh, Khaibullin TI. Structural analysis of the market range of medications for symptomatic multiple sclerosis treatment at the Federal and regional levels. The Bulletin of Contemporary Clinical Medicine. 2018; 11 (4): 12–18. DOI: 10.20969/VSKM.2018.11(4).12-18.

UDC 613.81/.83-057.36(470.51)

1. Alekseev LG. Problema social’nyh posledstvij zloupot- rebleniya psihoaktivnymi veshchestvami i mery pro laktiki [The problem of the social consequences of substance abuse and prevention measures]. Rossijskij poligraf [Russian Polygraph]. 2012; 7: 40-43.

2. Bogatyreva NL. K voprosu o medicinskoj profilaktike addiktivnogo povedeniya sredi sotrudnikov organov vnutrennih del [On the issue of medical prevention of addictive behavior among employees of law enforcement agencies]. Sovremennye nauchnye issledovaniya i innovacii [Modern scienti c research and innovation]. 2015; 3 (5): URL: web.snauka.ru/issues/2015/03/46443

3. Kubyshko VL ed. Osnovy raboty po ukrepleniyu sluzhebnoj discipliny i zakonnosti v organah vnutrennih del: uchebnoe posobie [Fundamentals of work to strengthen service discipline and the rule of law in the bodies of internal affairs: textbook]. Moskva: COKR MVD Rossii [Moscow: TsOCK Ministry of Internal Affairs of Russia]. 2008; 80: 36-47.

4. Saranchin YuK, Bannyh SG, Zarubina EV et al. Professional’naya ehtika sotrudnikov organov vnutrennih del: kurs lekcij [Professional Ethics of Internal Affairs Officers: Lecture Course]. Ekaterinburg: izdateltsvo Ural’skogo yuridicheskogo instituta MVD Rossii [Ekaterinburg: publishing house of the Ural law institute of the Ministry of Internal Affairs of Russia]. 2001; 174 p.

5. Ivanov AS, Lekomcev VT, Ibragimov VR, Uvarov IA. EHpidemiologicheskaya harakteristika upotrebleniya alkogol’nyh napitkov i narkotikov sredi studentov v Udmurtii [Epidemiological characteristics of drinking alcohol and drugs among students in Udmurtia]. Aktual’nye voprosy psihonevrologii: sbornik trudov mezhregional’noj nauchno-prakticheskoj konferencii; pod redakciey NS Osetrova [Actual questions of psychoneurology: sb.trudov interregional scienti c-practical conference; NS Osetrov ed.]. Izhevsk [Izhevsk]. 2005; 16-17.

6. Vovk EI. Diagnostika i lechenie neotlozhnyh sostoyanij, associirovannyh so zloupotrebleniem alkogolem [Diagnosis and treatment of emergency conditions associated with alcohol abuse]. Lechashchij vrach [The attending physician]. 2005; 2: URL: https://www.lvrach. ru/2005/02/4532148/

7. Leont’eva MV. Monitoring deviantnogo povedeniya uchashchihsya i studentov Arhangel’ska [Monitoring the deviant behavior of students and students of Arkhangelsk]. Sociologicheskie issledovaniya [Sociological research]. 2007; 12: 104-107.

8. Otchet ICAP No14 [ICAP Report No14]. Mezhdunarodnye rekomenduemye normy v otnoshenii potrebleniya alkogolya [International Recommended Standards for Alcohol Consumption]. Mezhdunarodnyj centr alkogol’noj politiki [International Center for Alcohol Policy]. 2003; URL: http://www.icap.org/LinkClick.aspx? leticket=1PHcRYow8 aM%3d&tabid=75

UDC 616.329-006.6-036.3-057.36(571.56)

DOI: 10.20969/VSKM.2018.11(4).21-25

 BARRETT ESOPHAGUS AND ANTI-HELICOBACTER PYLORI ANTIBODIES

VERCHOTUROVA ELENA N., ORCID: 0000-0002-3430-88-69; junior researcher of Yakutsk Scientific Center of Complex Medical Problems, Russia, 677010, Yakutsk, Sergelyakhskoye higway, 4; endoscopist, gastroenterologist of Medical Care unit of the Ministry of Internal Affairs of the Russian Federation for the Republic of Sakha, Russia, 677005, Yakutsk, Sverdlov str., 1/2, tel. 8-914-238-40-46, e-mail: elenaverchoturova@gmail.com

GOLDEROVA AITALINA S., ORCID: 0000-0002-3430-88-69; D. Med. Sci., professor of the Department of general and experimental physics of Physical technical institute of M.K. Ammosov North-Eastern Federal University, Russia, 677007, Yakutsk, Kulakovsky str., 48, tel. 8-914-821-59-98, e-mail: hoto68@mail.ru

OKHLOPKOVA ELENA D., C. Biol. Sci., leading researcher, Head of the laboratory of immunology of Yakutsk Scientific Center of Complex Medical Problems, Russia, 677010, Yakutsk, Sergelyakhskoye higway, 4, tel. 8-914-267-97-91, e-mail: elenaohlopkova@mail.ru

EFREMOVA SVETLANA D., junior researcher of Yakutsk Scientific Center of Complex Medical Problems, Russia, 677010, Yakutsk, Sergelyakhskoye higway, 4, tel. 8-924-171-58-80, e-mail: esd64@mail.ru

DOLINSKAYA ELVIRA A., colonel of internal service, Head of Medical Care unit of the Ministry of Internal Affairs of the Russian Federation for the Republic of Sakha, Russia, 677005, Yakutsk, Sverdlov str., 1/2, tel. 8-924-170-95-55, e-mail: elvi.67@mail.ru

Abstract. Aim. The aim of the study was to evaluate the risk factors and the role of Helicobacter pylori in development of Barrett esophagus in patients with gastroesophageal reflux disease, who work as police of cers in Yakutia. Materials and methods. 78 male police of cers with gastroesophageal reflux disease, including erosive and non-erosive types, being on examination and treatment at the Medical department of the Interior Ministry of the Russian Federation for the Republic of Sakha in 2017–2018 have been examined. The diagnosis was based on ndings of classical clinical, endoscopic, morphological and immunological methods of investigation. Fibroesophagogastroduodenoscopy was performed for clinical diagnosis and for obtaining biopsies in accordance with the standards. Barrett esophagus was veri ed in esophagus biopsy samples as incomplete intestinal metaplasia. Anti-Helicobacter pylori IgA, IgM and IgG antibodies were determined by ELISA method (BCM Diagnostics). Results and discussion. The results indicate a highprevalence of Barrett esophagus in male police of cers with gastroesophageal reflux disease in Yakutia. According to our study signi cant risk factors for Barrett esophagus development are Caucasian race, leading position at work, the natives of Yakutia, as well as the hiatal hernia and erosive gastroesophageal reflux. Conclusion. A negative correlation was revealed (r=-0,319 at p=0,002) between the degree of mucosa affection at the distal part of the esophagus and the level of IgA speci c anti-Helicobacter pylori antibodies.

Key words: gastroesophageal reflux disease, Barrett esophagus, Helicobacter pylori.

For reference: Verchoturova EN, Golderova AS, Ochlopkova ED, Efremova SD, Dolinskaya EA. Barrett esophagus and anti-Helicobacter pylori antibodies. The Bulletin of Contemporary Clinical Medicine. 2018; 11 (4): 21–25. DOI:10.20969/VSKM.2018.11(4).21-25.

1. Schneider JL, Corley DA. The Troublesome Epidemiology of Barrett’s Esophagus and Esophageal Adenocarcinoma. Gastrointest Endosc Clin N Am. 2017; 27 (3): 353-364. doi:10.1016/j.giec.2017.03.002.

2. Bichurina TB, Vasyutin AV, Butorin NN. Osobennosti rasprostranennosti pishchevoda Barretta [Features of the prevalence of Barrett’s esophagus]. Zabajkal’skij medicinskij vestnik [Zabaikalsky Medical Herald]. 2014; 3: 156-159.

3. Insrukcya po primeneniu nabora reagentov dlja immunofermentnogo opredelenija IgG antitel k antigenam Helicobacter pylori v syvorotke (plazme) krovi «Helicobacter pylori IgG-IFA» [Instructions on the use of a reagent kit forthe immunoenzymatic determination of IgG antibodiesagainst Helicobacter pylori antigens in blood serum (plasma) «Helicobacter pylori IgG-IFA»]. Moskva: Khema [Moscow: Khema]. 2012; 12 p.: https://xema-medica.com/ japan/sets/immuns/K119.pdf

4. Modiano N, Gerson LB. Barrett’s esophagus: Incidence, etiology, pathophysiology, prevention and treatment. Therapeutics and Clinical Risk Management. 2007; 3 (6): 1035-1045.

5. Shahabi S, Rasmi Y, Jazani NH, Hassan ZM. Protective effects of Helicobacter pylori against gastroesophageal reflux disease may be due to a neuroimmunological anti- inflammatory mechanism. Immunology and cell biology. 2008; 86 (2): 175–178. doi:10.1038/sj.icb.7100119.

6. Blaser MJ. Disappearing microbiota: Helicobacter pylori protection against esophageal adenocarcinoma. Cancer prevention research (Philadelphia, Pa.). 2008; 1 (5): 308–311. doi:10.1158/1940-6207.CAPR-08-0170.

7. Mastykova EK. Pishchevod Barretta v structure gastro- ezofagalnoyreflucnoy bolezni: sovremennye predstavienia [Barrett’s esophagus in the structure of gastroesophageal reflux disease: modern representations].VestnicVitebskogo gosudarstvennogo universiteta [Vestnik of the Vitebsk State University]. 2010; 9 (4): 65-74.

DOI: 10.20969/VSKM.2018.10(4).25-28

 ENDOGENIC INTOXICATION EVALUATION IN SUBFERTILE WOMEN WITH CHRONIC ENDOMETRITIS

GODOVALOV ANATOLIY P., ORCID ID: orcid.org/0000-0002-5112-2003; C. Med. Sci., associate professor of the Department of immunology of acad. E.A. Wagner Perm State Medical University, Russia, 614990, Perm, Ekaterininskaya str., 85, e-mail: AGodovalov@gmail.com

KARPUNINA TAMARA I., ORCID ID: orcid.org/0000-0003-2511-4656; D. Bio. Sci., professor of the Department microbiology and virology with a course of clinical laboratory diagnostics of acad. E.A. Wagner Perm State Medical University, Russia, 614990, Perm, Ekaterininskaya str., 85, e-mail: karpuninapsma@mail.ru

Abstract. Aim. Intensity of endogenic intoxication in afetal women with chronic endometritis, including the cases of comorbidity with extragenital inflammatory diseases, has been evaluated. Material and methods. Retrospective analysis of clinical blood tests has been performed in 45 patients with chronic endometritis and in 26 healthy people comparable in gender and age. Inclusion criteria for the rst group (n=20) were the presence of subclinical chronic endometritis, con rmed by histological data, and the absence of concomitant extragenital inflammatory diseases. The second group (n=25) consisted of patients in whom chronic endometritis has been diagnosed in comorbidity with chronic pyelonephritis, bronchitis and other extragenital inflammatory diseases. Peripheral blood leukocyte formula, body resistance index, leukocyte intoxication index and intoxication severity index have been studied. Statistical processingof the data has been performed using Student’s t-test. Results and discussion. It was shown that chronic endometritisis associated with an imperceptible increase of neutrophilic leukocyte count with a decrease of monocyte count. Thechanges in leukocyte population structure are more apparent in case when endometritis occurs against the backgroundof chronic inflammatory processes of other localization. The leukocyte intoxication index in patients of the rst group was 0,5±0,1, in the second group – 1,3±0,2, and in control group – 0,6±0,04 (p<0,05). The possibility of infectious complication development in patients with chronic endometritis combined with extragenital inflammatory diseases was shown. Conclusion. Thus, in all cases chronic endometritis is associated with development of endogenous intoxication development, that requires medical correction.

Key words: chronic endometritis, endogenic intoxication, leukocytes, infertility.

For reference: Godovalov AP, Karpunina TI. Endogenic intoxication evaluation in subfertile women with chronic endometritis. The Bulletin of Contemporary Clinical Medicine. 2018; 10 (4): 25–28. DOI: 10.20969/VSKM.2018.10(4).25- 28.

1. Osipovich OA, Godovalov AP. K voprosu o roli vospalitel’nyh zabolevanij v razvitii besplodija u zhenshhin [On the role of inflammatory diseases in the development of infertility in women]. Medicinskij al’manah [Medical Almanac]. 2016; 5 (45): 85-87.

2. Wu D, Kimura F, Zheng L, Ishida M, Niwa Y, Hirata K, Takebayashi A, Takashima A, Takahashi K, Kushima R, Zhang G, Murakami T. Chronic endometritis modi es decidualization in human endometrial stromal cells. Reprod Biol Endocrinol. 2017; 15 (1): 16.

3. Godovalov AP, Karpunina NS, Karpunina TI. Mikrobiota kishechnika i vlagalishha zhenshhin so vtorichnym besplodiem i zabolevanijami zheludochno-kishechnogo trakta [Microbiota of the intestine and vagina of women withsecondary infertility and diseases of the gastrointestinaltract]. Jeksperimental’naja i klinicheskaja gastrojenterologija [Experimental and clinical gastroenterology]. 2016; 6 (130): 109-113.

4. Park HJ, Kim YS, Yoon TK, Lee WS. Chronic endometritis and infertility. Clin Exp Reprod Med. 2016; 43 (4): 185-192. 5. Ostrovskij VK, Mashhenko AV, Jangolenko DV, Makarov SV. Pokazateli krovi i lejkocitarnogo indeksa intoksikacii v ocenke tjazhesti i opredelenii prognoza pri vospalitel’nyh, gnojnyh i gnojno-destruktivnyh zabolevanijah [Blood and leukocyte index of intoxication in assessing severity and determining the prognosis for inflammatory, purulent and purulent-destructive diseases]. Klinicheskaja laboratornaja diagnostika [Clinical laboratory diagnostics]. 2006; 6: 50-53. 6. Godovalov AP. Kompleksnaja ocenka mikroflory kishech- nika, vlagalishha i gormonal’nogo fona u zhenshhin s vtorichnym besplodiem [Complex assessment of the microflora of the intestine, vagina and hormonal background in women with secondary infertility]. Jeksperimental’naja i klinicheskaja gastrojenterologija [Experimental and clinical gastroenterology]. 2016; 3 (127): 58-59.

7. Kushnir VA, Solouki S, Sarig-Meth T, Vega MG, Albertini DF, Darmon SK, Deligdisch L, Barad DH, Gleicher N. Systemic Inflammation and Autoimmunity in Women with Chronic Endometritis. Am J Reprod Immunol. 2016; 75 (6): 672-677.

DOI: 10.20969/VSKM.2018.11(4).28-33

 COMPREHENSIVE ASSESSMENT OF THE EFFICACY AND SAFETY OF SYSTEMIC THROMBOLYTIC THERAPY FOR MYOCARDIAL INFARCTION WITH ST-SEGMENT ELEVATION ON THE PREHOSPITAL PHASE

DANKÓ VIKTOR A., senior physician of the Department medical of Military unit No 35690, Russia, 143905, Moscow region, Balashikha, Trubetskaya str., 116, e-mail: doctor-victor@mail.ru

Abstract. Аim. Complex assessment of ef ciency and safety of systemic thrombolytic therapy for myocardial infarctionwith ST-segment elevation at prehospital phase depending on the time of its initiation has been performed. Material and methods. The study was performed in the setting of intensive care team at emergency medical care station named after A.S. Puchkov in Moscow (personal participation of the author) according to subsequent follow up of the patients managed by the author at the prehospital phase in different hospitals of Moscow. 509 patients aged 39 to 83 years have been enrolled in the study. Results and discussion. Systemic thrombolytic therapy was started at the prehospitalphase: at home, at work, and it was continued during transportation to the hospital, as well as in the hospital in most patients. Scoring scale was developed for comprehensive assessment of the effectiveness of thrombolytic therapy. Theproposed methodology will allow medical personnel to make a balanced decision to conduct or abstain from thrombolytictherapy at the prehospital phase, and also to understand how safe this method is in each particular case, and what factors can influence the number of complications of this procedure. When performing systemic thrombolytic therapyat the prehospital phase in patients with myocardial infarction with ST-segment elevation, the greatest effectiveness was observed during the rst 180 minutes. Minimal number of life-threatening complications was observed during the time of procedure. Conclusion. The new method for assessment of the effectiveness of thrombolytic therapy allows one to evaluate it quantitatively. According to the results of the study, the use of systemic thrombolytic therapy at the prehospital phase is justi ed during the rst 3 hours. The effectiveness progressively decreases and the risk of life- threatening complications increases.

Key words: myocardial infarction, alteplase, thrombolytic therapy.

For reference: Dankó VA. Comprehensive assessment of the ef ciency and safety of systemic thrombolytic therapy for myocardial infarction with ST-segment elevation at prehospital phase. The Bulletin of Contemporary Clinical Medicine. 2018; 11 (4): 28–33. DOI: 10.20969/VSKM.2018.11(4).28-33.

1. Amirov NB ed. Diagnostika i lechenie neotlognich cardiologicheskich sostoyanii: monographi [Diagnosis and treatment of urgent cardiological conditions: monograph]. Kazan’: KGMU [Kazan: KSMU]. 2015; 194 p.

2. Ioseliani DG, El’kis IS. Kombinatsiya ehndovaskulyarnykh protseduri dogospital’noj sistemnoj tromboliticheskojterapii pri lechenii bol’nykh ostrym infarktom miokarda[The combination of endovascular procedures andprehospital systemic thrombolytic therapy in the treatmentof patients with acute myocardial infarction]. Kardiologiya [Cardiology]. 2005; 3: 4-9.

3. Kent DM et al. Comparison of mortality benefit of immediate trombolytic therapy versus delayed primary angioplasty for acute myocardial infarction. Am J Cardiol. 2016; 99: 1384-1388.

4. Oganov RG, Maslennikova GY. Znachenie serdechno- sosudistykh i drugikh neinfektsionnykh zabolevanij dlya zdorov’ya naseleniya Rossii [The importance of cardiovascular and other non-infectious diseases for the health of the population of Russia]. Pro laktika zabolevanij i ukreplenie zdorov’ya [Disease prevention and health promotion]. 2014; 2: 2-3.

5. ACC/AHA Guidelines for the Management of Patients With ST–Elevation Myocardial Infarction. Circulation. 2010; 110: 82–292.

6. Amirov NB ed. Ishemicheskaya bolezn’ serdtsa v obshei’ vrachebnoi’ practike: diagnostika, lechenie i pro laktika: monograph [Ischemic heart disease in general medical practice: diagnosis, treatment and prevention: monograph]. Kazan’: Orange-K [Kazan: Orange-K]. 2011; 194 p.

7. Aglullina EI. Ostrii coronarnii sindrom: ot diagnostiki k optimizacii lecheniya [Acute coronary syndrome: from diagnosis to treatment optimization]. Vestnik sovremennoj klinicheskoj mediciny [The Bulletin of Contemporary Clinical Medicine]. 2013; 6 (5): 91-94.

8. Roger VL, Go AS, Lloyd-Jones DM et al. Heart disease and stroke statistics — 2011 Update: A report from the American Heart Association. Circulation. 2011; 123: 18- 209.

9. Mille F, Shkol’nikov VM. Sovremennye tendentsii smertnosti poprichinam smerti v Rossii 1965-1994 [Current mortality trends for causes of death in Russia 1965- 1994]. Parizh: Natsional’nyj institute demogra cheskikh issledovanij [Paris: National Institute of Demographic Research]. 2009: 140 p.

10. Tsedenova EА, Volov NА, Lebedeva АY, Gordeev IG. Otsenka ehffektivnosti khirurgicheskogo i konservativnogo metodov lecheniya bol’nykh infarktom miokarda, poluchavshikh tromboliticheskuyu terapiyu [Estimation of the effectiveness of surgical and conservative methods of treatment of patients with myocardial infarction receiving thrombolytic therapy]. Rossijskij kardiologicheskij zhurnal [Journal of Russian Cardiology]. 2015; 12 (1): 24–25.

DOI: 10.20969/VSKM.2018.11(4).33-38

1. Medvedeva MV ed. Algoritmy prenatal’noy diagnostiki: uchebnoye posobiye [Algorithms of prenatal diagnostics: textbook]. Moskva: Real Taym [Moscow: Real Time]. 2011; 4; 40 p.

2. Nekrasova YeS, Nikolayeva YuA, Kashcheyeva TK et al. Vnedreniye algoritma kombinirovannogo skrininga khromosomnoy patologii ploda v I trimestre beremennosti; opyt raboty za 4 goda [Introduction of the algorithm forcombined screening of chromosomal pathology of thefetus in the rst trimester of pregnancy; work experience for 4 years]. Zhurnal akusherstva i zhenskikh bolezney [Journal of Obstetrics and Women’s Diseases]. 2007; 56 (1): 28—34.

3. Yudina YeV, Medvedeva MV ed. Osnovy prenatal’noy diagnostiki [Fundamentals of prenatal diagnosis]. Moskva: RAVUZDPG, Real’noye vremya [Moscow: Real time]. 2002; 184 p.

4. Aylamazyana EK, Baranova VS ed. Prenatal’naya diagnostika nasledstvennykh i vrozhdennykh bolezney [Prenatal diagnosis of hereditary and congenital diseases]. Triada-KH [Triad-X]. 2006; 111-148.

5. Pustotina OA. Al’fa-fetoprotein: znacheniye v razvitii beremennosti i prognozirovanii oslozhneniy u novo- rozhdennogo [Alpha-Fetoprotein: Significance in the development of pregnancy and the prediction of complications in the newborn]. Akusherstvo i ginekologiya [Obstetrics and Gynecology]. 2006; 3: 15-17.

6. Deborah A, Driscoll MD, Susan J, Gross MD. Screening for fetal aneuploidy and neural tube defects. Genet Med. 2009; 11 (11): 818–821.

7. Chudinova MI, Asymbekova GU, Sarymsakova TA, Dalbayeva BZh. Prenatal’naya diagnostika v praktike akushera-ginekologa [Prenatal diagnosis in the practice of an obstetrician-gynecologist]. Vestnik KRSU [Herald of the KRSU]. 2017; 17 (7): 80-87.

8. Trubnikova LI, Azizova RR, Tadzhiyeva VD et al. Diagnosticheskaya tsennost’ kompleksnogo issledovaniya vrozhdennykh porokov razvitiya tsentral’noy nervnoy sistemy ploda [Diagnostic value of the complex study of congenital malformations of the fetal central nervous system]. Ul’yanovskiy med biol zhurnal [Ulyanovsk med biol journal]. 2012; 3: 55-58.

9. Bahado-Singh RO, Sutton-Riley J. Biochemical screening for congenital defects. Obstet Gynecol Clin North Am. 2004; 31 (4): 857-872.

10. Chasen ST. Maternal serum analyte screening for fetal aneuploidy. Clin Obstet Gynecol. 2014; 57 (1): 182-188.

11. Spencer K, Crossley JA, Aitken DA et al. Temporal changes in maternal serum biochemical markers of trisomy 21 across the rst and second trimester of pregnancy. Ann Clin Biochem. 2002; 39: 567- 576.

12. Shabaldin AV, Simonova TA, Lisachenko GV. Rol’ al’fa- fetoproteina v patogeneze vrozhdennykh porokov razvitiya ploda [The role of alpha-fetoprotein in the pathogenesis of congenital malformations of the fetus]. Mat’ i ditya v Kuzbasse [Mother and child in the Kuzbass]. 2007; 3: 16-19.

DOI: 10.20969/VSKM.2018.11(4).38-43

1. Ichitovkina EG, Zlokazova MV, Soloviev AG. Ef cacy of medical-psychological rehabilitation of combatants; Neuroscience and behavioral physiology. Springer: New York Consultants Bureau. 2014; 44 (8): 933–938.

2. Mediko-sanitarnye chasti MVD Rossii po sub#ektam Rossijskoj Federacii [Medical and sanitary units of the Ministry of internal Affairs of Russia on subjects of the Russian Federation]. Analiticheskij obzor dejatel’nosti Centrov psihofiziologicheskoj diagnostiki Federal’nyh kazjonnyh uchrezhdenij [Analytical review of the activities Of the centers for psychophysiological diagnostics of Federal state institutions]. Moskva [Moscow]. 2018; 73.

3. Hisamiev RSh, Ginjatullina LR, Amirov NB. Dostizhenija i perspektivy vedomstvennoj medicinskoj sluzhby MVD po respublike Tatarstan [Achievements and prospects of the departmental medical service of the MIA for the Republic of Tatarstan]. Vestnik sovremennoj klinicheskoj mediciny [The Bulletin of Contemporary Clinical Medicine]. 2016; 9 (6): 13-15.

4. Korehova MV, Solov’ev AG, Novikova IA. Psihicheskaja dezadaptacija specialistov v jekstremal’nyh uslovijah dejatel’nosti [Psychological disadaptation of specialists in extreme conditions of activity]. Arhangel’sk: izdatel’stvo SGMU [Arkhangelsk: publishing House of Northern state medical University]. 2014; 139 p.

5. Marchenko AA, Goncharenko AYu, Krasnov AA, Lobachev AV. Osobennosti diagnostiki nevroticheskih rasstrojstv u voennosluzhashchih [Features of diagnosis of neurotic disorders in military personnel]. Vestnik Rossiiskoi voenno-meditsinskoi akademii [Herald of the Russian Military Medical Academy]. 2015; 1 (49): 48- 53.

6. Soldatkin VA, Sukiasjan SG, Galkin KJ. Posttravmaticheskoe stressovoe rasstrojstvo: kto na pricele? [Post-traumatic stress disorder: who is on the sight?]. Nauchno-metodicheskij jelektronnyj zhurnal «Koncept» [Scienti c and Methodical Electronic Journal «Concept»]. 2014; 20: 511–515.

7. Koncepcija razvitija psihiatricheskoj sluzhby MVD Rossii [Concept of development of psychiatric service of the Ministry of internal Affairs of Russia]. Pis’mo DT MVD Rossii 10.04.2018 No29/CCh/9-2098 [A letter DT of the MIA of Russia 10.04.2018 No. 29/TSCH/9-2098]. Moskva [Moscow]. 2018; 12 p.

8. Ichitovkina EG, Solov’ev AG, Zlokazova MV, Shut- ko GV, Har’kova OA. Prognozirovanie vozniknovenija of mental health of the combatants – police of cers]. Arhangel’sk: izdatel’stvo SGMU [Arkhangelsk: publishing House of Northern state medical University]. 2017; 205 р.

10. Burlachuk LF, Morozov SM. Slovar’-spravochnik po psihodiagnostike [Dictionary of Psychodiagnostics]. Sankt – Peterburg [St. Petersburg]: Piter. 2002; 528 p. donozologicheskih psihicheskih rasstrojstv u kombatantov [Predicting the emergence of donor psychological disorders in combatants]. Jekologija cheloveka [Human Ecology]. 2016; 10: 47-50.

1. Alyayev YuG et al. Mochekamennaya bolezn’: sovre- mennyye metody diagnostiki i lecheniya: rukovodstvo [Urolithiasis: modern methods of diagnosis and treatment: management]. Moskva: GEOTAR Media [Moscow: GEOTAR Media]. 2010; 224 p.

2. Alferov SM, Grishin MA. Endoskopicheskoye lecheniye urolitiaza [Endoscopic treatment of urolithiasis]. Moskva: Materialy pervogo Rossiyskogo kongressa po endourologii [Moscow: Materials of the first Russian congress on endourology]. 2008; 329-332.

3. Dutov VV. Sovremennyye aspekty lecheniya nekotorykh form mochekamennoy bolezni [Modern aspects of the treatment of certain forms of urolithiasis]. Moskva: MONIKI [Moscow: MONIKI]. 2000; 38 p.

4. Zhuravlev OV. Maloinvazivnaya retroperitoneoskopi- cheskaya ureterolitotomiya [Minimally invasive retroperitoneoscopic ureterolithotomy]. Moskva: Nauchno- issledovatel’skiy institut urologii [Moscow: Scientific Research Institute of Urology]. 2003; 111 p.

 EFFECTIVENESS OF HEPATOPROTECTORS IN COMPLEX THERAPY IN PSORIASIS PATIENTS

MILOV VASILY E., C. Med. Sci., lieutenant-colonel of internal service, Head of Outpatient clinic No 2 of Medical Care unit of the Ministry of Internal Affairs of Russia in Moscow, Russia, 115054, Moscow, Zatsepa str., 38, tel. +7-499-236-04-56, e-mail: 2360456@mail.ru

DMITRIKOVA TATIANA L., deputy head of Outpatient clinic No 2 of Medical Care unit of the Ministry of Internal Affairs of Russia in Moscow, Russia, 115054, Moscow, Zatsepa str., 38, tel. +7-499-236-04-56, e-mail: 2360456@mail.ru

MARTYNYUK GALINA V., Head of the Department of dermatology and sexually transmitted diseases of Outpatient clinic No 2 of Medical Care unit of the Ministry of Internal Affairs of Russia in Moscow, Russia, 115054, Moscow, Zatsepa str., 38, tel. +7-499-236-04-56, e-mail: 2360456@mail.ru

GARBUZOVA OLGA A., Head of the Department of internal medicine No 1 of Outpatient clinic No 2 of Medical Care unit of the Ministry of Internal Affairs of Russia in Moscow, Russia, 115054, Moscow, Zatsepa str., 38, tel. +7-499-236-04-56, e-mail: 2360456@mail.ru

BUZINA ANNA B., gastroenterologist of Outpatient clinic No 2 of Medical Care unit of the Ministry of Internal Affairs of Russia in Moscow, Russia, 115054, Moscow, Zatsepa str., 38, tel. +7-499-236-04-56, e-mail: 2360456@mail.ru

KUZNETSOVA BIRNAIS P., Head of the Department of clinical diagnostics of Outpatient clinic No 2 of Medical Care unit of the Ministry of Internal Affairs of Russia in Moscow, Russia, 115054, Moscow, Zatsepa str., 38, tel. +7-499-236-04-56, e-mail: 2360456@mail.ru

SELIVANOVA GALINA B., D. Med. Sci., professor of the Department of general medicine of N. Pirogov Russian National Research Medical University, Russia, 115054, Moscow, Zatsepa str., 38, tel. +7-499-236-04-56, e-mail: 2360456@mail.ru

Abstract. Psoriasis is one of the most common skin diseases. Among others, hepatoprotectors are the drugs of the rst choice for the treatment of this disease. Aim. The aim of the study was to perform a comparative evaluation of the effectiveness of hepatoprotectors, which are the drugs based on phosphatidylcholine and trisodium salt of glycerisic acid and essential phospholipids, in the treatment of patients with psoriasis. Criteria for the effectiveness of this category of drugs are a decrease both in clinical and biochemical activity and in intensity of inflammatory changes in the hepatic tissue, cholestasis and brogenesis activity reduction. Material and methods. In terms of the results of the clinicalresearch 2 groups of patients were under observation, 20 people each (12 men and 8 women). The age of the patients ranged from 22 to 58 years. Duration of the disease was from 1 to 18 years. The duration of the last relapse in 7 patients did not exceed 1 month, in 3 patients it was up to 3 months, in 10 patients it was up to 6 months. Pathological process was in progression phase in all patients. The area of skin lesions, the quality of life of patients, PASI indices (Psoriatic Area and Severity Index), BSA (Body Surface Area) and DLQI (Dermatology Life Quality Index) were calculated to assess the severity of psoriasis. In our study PASI index ranged from 10,5 to 14,5 (an average of 12,5). The duration of the study was 4 weeks (28 days). Results and discussion. The data obtained indicate a greater ef cacy of the drugs based on phosphatidylcholine and trisodium salt of glycerisic acid in comparison with essential phospholipids. They provide more rapid and persistent symptom elimination, which improves the adherence to therapy in 100% of patients.Conclusion. The drug based on phosphatidylcholine and trisodium salt glycerisic acid in a dose of 2 tablets 3 times a day for 30 days promotes more rapid relief of the skin process and improves the quality of life of the patients, especially in case of total adherence to recommendations on lifestyle, habit and diet change (which is especially important in metabolic syndrome). Good tolerability of the 4-week course of therapy with the drug based on phosphatidylcholine and trisodium salt of glycerisic acid has been established.

Key words: the agent based on phosphatidylcholine and trisodium salt glycerisic acid, PASI (Psoriatic Area and Severity Index), BSA (Body Surface Area) и DLQI (Dermatology Life Quality Index).

For reference: Milov VE, Dmitrikova TL, Martynyuk GV, Garbuzova OA, Buzina AB, Kuznetsova BP, Selivanova GB. Effectiveness of hepatoprotectors in complex therapy of psoriasis patients. The Bulletin of Contemporary Clinical Medicine. 2018; 11 (4): 51–57. DOI: 10.20969/VSKM.2018.11(4).51-57.

1. Butov YS, Mordovtseva VV, Vasenova VY, Shmako- va АS ed. Dermatovenerologiya; nacional`noe rukovodst- vo; kratkoe izdanie [Dermotovenereology: national manual; executive summary]. Moskva: GEHOTAR-Media [Moscow: GEOTAR-Media]. 2013; 896 p.

2. Bolevich SB, Urazalina AA. Psoriaz: sovremennyj vzglyad na ehtiopa-togenez [Psoriasis: a modern view of etiopathogenesis]. Vestnik Rossijskoj voenno-medicinskoj akademii [Bulletin of the Russian Military Medical Academy]. 2013; 2 (42): 202–206.

3. Kochergin NG, Smirnova LM. Poslednie trendy` v lechenii psoriaza [Recent trends in the treatment of psoriasis]. Lechaschiy vrach [The attending physician]. 2011; 5: https://www.lvrach.ru/2011/05/15435190/

4. Olisova OY, Teplyuk NP, Pinegin VB, Sovremenny`e metody` lecheniya psoriaza [Modern methods of psoriasis treatment]. Rossijskij medicinskij zhurnal [Russian Medical Journal]. 2017; 9: 483.

5. Jankovic S, Raznatovic M, Marinkovic J, Jankovic J, Kocev N, Tomic-Spiric V, Vasiljevic N. Health-related quality of life in patients with psoriasis. J Cutan Med Surg. 2011; 15(1): 29–36.

6. Azarova VN, Hamaganova IV, Polyakov AV, Natarova EhV. Poisk associacij s psoriazom v lokuse PSORS1 [Search for associations with psoriasis at the PSORS1 locus]. Medicinskaya genetika [Medical Genetics]. 2003; 2 (8): 370—380.

7. Kungurov NV, Philimonkova NN, Berdnikova ER, Chuverova KA. Osobennosti nasledovaniya psoriaticheskoi bolezni na osnove analiza rodoslovny`x [Aspects of Psoriasis Inheritance Based on Genealogy Analysis]. Sovremenny`e problem` dermatovenerologii immunalogii I vrachebnoi kosmetologii [Modern problems of dermatology, venerology, immunology and medical cosmetology]. 2009; 3 (3): 67–73.

8. González-Lara L, Coto-Segura P, Penedo A, Eiris N, Díaz M, Santos-Juanes J, Queiro R, Coto E. SNP rs11652075 in the CARD14 gene as a risk factor for psoriasis (PSORS2) in a Spanish cohort. DNA Cell Biol. 2013; 32 (10): 601–614.

9. Enamandram M, Kimball AB. Psoriasis epidemiology: the interplay of genes and the environment. J Invest Dermatol. 2013; 133 (2): 287–289.

10. Zhu KJ, Zhu CY, Fan YM. Alcohol consumption and psoriasis: a systematic literature review. J Eur Acad Dermatol Venereol. 2013; 27 (3): 30–35.

11. Tobin AM, Ahern T, Rogers S, Collins P, O’Shea D, Kirby B. The dermatological consequences of obesity. Int J Dermatol 2013; 52 (8): 927–932.

12. Meier M, Sheth PB. Clinical spectrum and severity of psoriasis. Curr Probl Dermatol. 2009; 38: 1–20.

13. Guenther L, Gulliver W. Psoriasis comorbidities. J CutanMed Surg. 2009; 13 (2): 77–87.

14. Farley E, Menter A. Psoriasis: comorbidities and associations. G Ital Dermatol Venereol. 2011; 146 (1): 9–15. 15. Gisondi P, Girolomoni G. Psoriasis and atherothrom- boticdiseases: disease-speci c and non-disease-speci c risk factors. Semin Thromb Hemost. 2009; 35 (3): 313–324. 16. Johnsson H, McInnes IB, Sattar N. Cardiovascular and metabolic risks in psoriasis and psoriatic arthritis: pragmatic clinical management based on available evidence. Ann Rheum Dis. 2012; 71 (4): 480–483.

 MODERN APPROACHES AND PERSPECTIVES OF REHABILITATION IN INTERNAL AFFAIRS BODIES OFFICERS WITH COMORBID PSYCHOSOMATIC DISORDERS

MURTAZOV ALBERT M., C. Med. Sci., Head of the Center of psychophysiological diagnostics of Medical Care unit of the Ministry of Internal Affairs of Russia for the Kabardino-Balkaria Republic, lieutenant colonel of internal service, Russia, 360000, Nalchik, M. Gorky str., 7, tel. 8-928-711-44-10

SHOGENOV AKHMED G., C. Med. Sci., Head of Medical Care unit of the Ministry of Internal Affairs of Russia for the Kabardino-Balkaria Republic, colonel of internal service, Russia, 360000, Nalchik, M. Gorky str., 7, tel. (8662) 44-28-11

ELGAROV ANATOLY A., D. Med. Sci., professor, general practitioner of Clinic of the outpatient of Medical Care unit of the Ministry of Internal Affairs of Russia for the Kabardino-Balkaria Republic, colonel of internal service, Russia, 360000, Nalchik, M. Gorky str., 7, tel. 8-928-589-58-58

KRAVTSOV ALEXANDER V., C. Psych. Sci., deputy Head of the Center of psychophysiological diagnostics of Medical Care unit of the Ministry of Internal Affairs of Russia for the Kabardino-Balkaria Republic, major of internal service, Russia, 360000, Nalchik, M. Gorky str., 7, tel. 8-928-913-57-82

MAKITOVA MARIANNA P., deputy head of Medical Care unit of the Ministry of Internal Affairs of Russia for the Kabardino- Balkaria Republic, senior lieutenant of internal service, Russia, 360000, Nalchik, M. Gorky str., 7, tel. 8-928-700-27-27

ASHKHOTOV ELBERD R., C. Med. Sci., Head of the Hospital of Medical Care unit of the Ministry of Internal Affairs of Russia for the Kabardino-Balkaria Republic, major of internal service, Russia, 360000, Nalchik, M. Gorky str., 7, tel. 8-928-709-20-76

Abstract. Current issues of rendering medical and psychological service for the employees of Internal affairs bodies are considered. Aim. The aim of the study was to establish the effectiveness of diagnostics and pharmacotherapy in Internal affairs bodies employees with borderline neuropsychic disorders and arterial hypertension, as well as to assess its impact on the level of professional performance. Material and methods. Clinical examination of 604 employees of law enforcement bodies of the 1st, 2nd, 3rd target groups aged 23–55 years with service experience of 2 years and more before and after preventive and individual rehabilitation activities was carried out. Results and discussion.Police of cers with stress-induced adaptation disorders and arterial hypertension demonstrate positive dynamics of signi cant psychophysiological parameters, clinical and dynamic health indicators against the background of integrated pharmacotherapy due to the staged implementation at the Medical Unit of the Ministry of Internal Affairs of Russia for the Kabardino-Balkaria Republic. According to the analysis of the obtained results, there is a possibility of expanding the level of implementation and active use of modern technologies in assessment of the effectiveness of therapeutic, diagnostic and rehabilitation measures (integrated pharmacotherapy, Health School of Medical Unit) in departmental health care at the Center for Psychophysiological Diagnostics. Conclusion. The system complex of measures for the implementation of medical and psychological rehabilitation should be considered an effective rehabilitation program within the framework of medical and psychological service organization that ensures professional longevity in employees of law enforcement bodies.

Key words: modern approaches and prospects of rehabilitation, monitoring, integrated pharmacotherapy, professional working capacity, professional longevity, police of cers.

For reference: Murtazov AM, Shogenov AG, Elgarov AA, Kravtsov AV, Makitova MP, Ashkhotov ER. Modern approachesand perspectives of rehabilitation in internal affairs bodies of cers with comorbid psychosomatic disorders. The Bulletin of Contemporary Clinical Medicine. 2018; 11 (4): 57–62. DOI: 10.20969/VSKM.2018.11(4).57-62.

1. Sidorenko VA. Modernizaciya zdravoohraneniya MVD Rossii [Modernization of the health of the Ministry of the Interior of Russia]. Medicinskij vestnik MVD [The Medical bulletin of the Ministry of Internal Affairs]. 2015; 1: 2-6.

2. Federal’nyj zakon «O social’nyh garantiyah sotrudnikam organov vnutrennih del Rossijskoj Federacii i vnesenii izmenenij v otdel’nye zakonodatel’nye akty Rossijskoj Federacii» ot 19.07.2011 No 247-FZ [The Federal Law «On Social Guarantees for Employees of the Internal Affairs Bodies of the Russian Federation and Amendments to Certain Legislative Acts of the Russian Federation» of 19.07.2011 No 247-FZ]. 2011; http://www.consultant.ru/ document/cons_doc_LAW_116988/

3. Prikaz MVD Rossii ot 10/01/2012 No 5 «O medico- psihologicheskoj reabilitacii sotrudnikov organov vnutrennih del Rossijskoj Federacii» [Order of the Ministry of Internal Affairs of Russia of 10.01.2012 No 5 (Edited on August 20, 2014) «On medical and psychological rehabilitation of of cers of the internal affairs of the Russian Federation»]. 2012; http://www.consultant.ru/document/ cons_doc_LAW_127140/

4. Murtazov AM, SHogenov AG. Professional’nyj stress i psihosomaticheskie zabolevaniya u sotrudnikov pravoohranitel’nyh organov [Professional stress and psychosomatic diseases among law enforcement of cers]. Medicina truda i promyshlennaya ehkologiya [Occupational medicine and industrial ecology]. 2014; 8: 34-38.

5. Petrov VE, Shutko GV. Organizaciya professional’nogo otbora v organy vnutrennih del [Organization of professional selection in the bodies of internal affairs]. Domodedovo: VIPK MVD Rossii; Sbornik materialov nauchno- prakticheskoj konferencii, posvyashchyonnoj 40-letiyusozdaniya sistemy professional’nogo psihologicheskogootbora v OVD [Domodedovo: VIPK of the Ministry of Internal Affairs of Russia; Collected materials of the scienti c and practical conference dedicated to the 40th anniversary of the creation of a system of professional psychological selection in the Internal Affairs Directorate]. 2013; 266 p.

6. Shogenov AG, Murtazov AM, Ashkhotov EhR et al. Vliyanie prolongirovannyh ehkstremal’nyh situacij na ehpidemiologiyu i kliniku yazvennoj bolezni zheludka i dvenadcatiperstnoj kishki sredi sotrudnikov policii [The influence of prolonged extreme situations on theepidemiology and the clinic of peptic ulcer of the stomachand duodenum among police of cers]. Medicinskij vestnik MVD [The Medical bulletin of the Ministry of Internal Affairs]. 2012; 2 ( LVII): 30-36.

7. Murtazov AM, Shogenov AG, Elgarov AA [et al]. Dvadcatiletnij opyt raboty po mediko-psihologicheskomu obespecheniyu deyatel’nosti sotrudnikov organov vnutrennih del [Twenty-year experience in the medical andpsychological support of the employees of law enforcementagencies]. Vestnik sovremennoj klinicheskoj mediciny [Bulletin of modern clinical medicine]. 2016; 9 (6): 72- 76.

8. Statisticheskij sbornik «Osnovnye pokazateli sostoyaniya zdorov’ya sotrudnikov organov vnutrennih del i deyatel’nosti medicinskih uchrezhdenij sistemy MVD Rossii za 2015 god» [Statistical compilation «Basic indicators of thestate of health of employees of internal affairs agenciesand the activities of medical institutions of the system of the Ministry of Internal Affairs of Russia for 2015»]. Moskva: MVD [Moscow: Ministry of Internal Affairs]. 2016; 350 p.

 CLINICAL AND FUNCTIONAL STATE OF KIDNEYS IN MIDDLE AGE PATIENTS WITH ARTERIAL HYPERTENSION

OSHCHEPKOVA OLGA B., Head of the Department of cardiology of Clinical hospital of the Medical Care unit
of the Ministry of Internal Affairs of Russia for the Republic of Tatarstan, Russia, 420059, Kazan, Orenburgskiy trakt str., 132, e-mail: oschepkova.kazan@mail.ru

ARKHIPOV EVGENII V., C. Med. Sci., associate professor of the Department of general medical practice No 1 of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: jekaland@mail.ru

MIKHOPAROVA OLGA YU., Head of the Department of functional diagnostics of Clinical hospital of the Medical Care unit of the Ministry of Internal Affairs of Russia for the Republic of Tatarstan, Russia, 420059, Kazan, Orenburgskiy trakt str., 132, e-mail: olga-mihoparova@rambler.ru

KAMASHEVA GULNARA R., C. Med. Sci., associate professor of the Department of general medical practice No 1 of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: kamasheva73@rambler.ru

Abstract. Aim. Kidney functional state and chronic kidney disease development have been assessed in middle age patients with arterial hypertension without associated diseases. Material and methods. 58 patients with essential hypertension aged from 38 to 60 years were examined. Diagnostic examination in the hospital was suf cient and included physical examination and history taking, complete blood count and biochemistry, common urine analysis, glomerular ltration rate calculation, functional diagnostic examination, monitoring of clinical state and test results during inpatient stay, after 3 and 6 months. The patients with associated cardiovascular disorders or serious inner organ diseases have not been enrolled to the study. Results and discussion. Smoking, obesity, dyslipidemia and arterial hypertension are the main factors that influence renal dysfunction development, manifested by hyposthenuria, albuminuria and proteinuria, in patients with essential hypertension without associated cardiovascular diseases. Hypertensive nephropathy and chronic kidney disease were diagnosed in 67% of cases with duration of arterial hypertension of more than 10 years. Conclusion. The results ofthe study con rm that smoking, obesity, dyslipidemia and arterial hypertension influence renal dysfunction development, manifested by albuminuria/proteinuria. The risk of hypertensive nephropathy development is 13 times higher in duration of essential hypertension of more than 10 years comparing to the duration of less than 5 years (RR=13,3, CI 95% 1,92–92,61;p<0,001). Antihypertensive nephroprotective therapy contributes to regression of albuminuria.

1. Arutyunov GP, Sokolova AV, Oganezova LG. Ekspe- rimental’nye modeli porazheniya tubulointersticial’noj tkani pochek pri arterial’noj gipertenzii [Experimental models of the behavior of tubulointerference tissue in hypertension]. Klinicheskaya nefrologiya [Clinical Nephrology]. 2011; 2: 75-78.

2. 2013 ESH/ESC: guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013; 34: 2159-219.

3. K/DOQI: Klinicheskie prakticheskie rekomendacii po Hronicheskomu Zabolevaniyu Pochek: Ocenka, Klassi kaciya i Strati kaciya [Clinical Practical Guidelines for Chronic Kidney Disease: Assessment, Classi cation and Stratification]. 2017; http://kdigo.org/wp-content/ uploads/2017/02/Russian_KDIGO-CKD-Guideline.pdf

4. Smirnov AV, Shilov EM, Dobronravov VA, et al. Nacional’nye rekomendacii. Hronicheskaya bolezn’ pochek: osnovnye principy skrininga, diagnostiki, pro laktiki i podhody k lecheniyu [National recommendations. Chronic kidney disease: the basic principles of screening, diagnosis, prevention and approaches to treatment]. Sankt-Peterburg: Levsha [Saint-Petersburg: Left-handed]. 2013; 54 p.

5. Sigitova ON, Bogdanova AR, Arkhipov EV, Saubanova EI. Ocenka vliyaniya arterial’noj gipertonii, giperlipidemii na formirovanie nefropatii pri ishemicheskoj bolezni serdca [Assessment of the effect of arterial hypertension,hyperlipidemia on the formation of nephropathy in coronaryheart disease]. Prakticheskaya medicina [Practical medicine]. 2012; 8 (64): 157-160.

6. Shilov ЕМ, Shvetsov MYu, Bobkova IYu, et al. Hro- nicheskaya bolezn’ pochek: metodicheskoe rukovodstvo dlya vrachej [Chronic kidney disease: a methodical guide for doctors]. Moskva [Moscow]. 2012; 83 p. http://ru.b-ok. org/ireader/2522501

7. Li W, Gu H, Teo K, et al. Hypertension prevalence, awareness, treatment, and control in 115 rural and urban communities involving 47 000 people from China. J Hypertens. 2016; 34: 39-46.

8. Yacoub R, Habib H, Lahdo A, et al. Association between smoking and chronic kidney disease: a case control study. BMC Public Health. 2010; 10: 731.

9. Kidney Disease: Improving Global Outcomes (KDIGO) Lipid Work Group. KDIGO Clinical Practice Guideline for Lipid Management in Chronic Kidney Disease. Kidney Int Suppl. 2013; 3: 259-305.

10. Kutyrina IM, Shvecov MYu, Fomin VV, et al. Diagnostika i lechenie arterial’noj gipertenzii pri hronicheskoj bolezni pochek [Diagnosis and treatment of arterial hypertension in chronic kidney disease]. Klinicheskaya nefrologiya [Clinical Nephrology]. 2015; 4: 4-29.

UDC 616-054.72(47+57)

DOI: 10.20969/VSKM.2018.11(4).67-72

 THE INCIDENCE OF NON-COMMUNICABLE DISEASES IN MIGRANT WORKERS AND THE CHALLENGES OF ITS ASSESMENT

PRISHCHEPOV IGOR A., ORCID ID: orcid.org/ 0000-0002-0466-1928, Researcher ID: L-4683-2018; C. Med. Sci., Head
of the Medical Care unit of the Ministry of Internal Affairs of Russia in Moscow, high level certificate physician, Russia, 127521, Moscow, Vetkin str., 9, bld. 1, tel.+7 (999) 010-41-89, e-mail: iaprishepov@bk.ru

MENDEL SERGEY A., ORCID ID: orcid.org/ 0000-0001-7679-7106, Researcher ID: D-2425-2018; C. Med. Sci., Head of Clinical hospital of the Medical Care unit of the Ministry of Internal Affairs of Russia in Moscow, high level certificate physician, Russia, 127299, Moscow, Novaya Ipatovka str., 3а, tel. +7 (916) 076-46-41, е-mail: 89160764641@mail.ru

NOVOZHILOVA OLGA L., ORCID ID: 0000-0003-2897-3798, Researcher ID: L-3666-2018; deputy chief physician for organizational and methodological work of Moscow research and practical center of Dermatology, venerology and cosmetology of Department Moscow of health, Russia, 119071, Moscow, Seleznevskaya str., 20, tel. +7 (910) 460-57-88, e-mail: Novozhilova.o@mail.ru

SHKARIN VLADIMIR V., ORCID ID: 0000-0002-4009-9733, Researcher ID D-6143-2018; C. Med. Sci., Head of the Department of public health and health management of faculty of physician postgraduate training of Volgograd State Medical University, Russia, 400131, Volgograd, Pavshih bortsov square, 1, tel. +7 (902) 311-83-66, e-mail: vlshkarin@mail.ru

BERSENEVA EVGENIA A., ID: orcid.org/0000-0003-3481-6190, SCOPUS Author ID 55554758300; D. Med. Sci., Head of the Center of the higher and additional professional education of N.A. Semashko National Research Institute of Public Health, Russia, Moscow, 105064, Vorontsovo Pole str., 12, bld. 1, tel. +7 (916) 216-84-59, e-mail: eaberseneva@gmail.com

KURAKOV DMITRY A., ORCID ID: 0000-0002-7753-2537, ResearcherIDD-4740-2018; Head of the Department of demographic policy of the Committee of health for the Volgograd region, Russia, 400001, Volgograd, Raboche-Krestyanskaya str., 16, tel. +7 (927) 252-52-31, e-mail: dkurakov@yandex.ru

SAVOSTINA ELENA A., ORCIDID: orcid.org/0000-0002-2039-4639, Researcher ID: D-3882-2018; D. Med. Sci., associate professor of the Department of medical statistics and informatics of Russian Medical Academy of Postgraduate Education, Russia, 123242, Moscow, Barrikadnaya str., 12, bld. 1, tel. +7 (916) 486-50-50, е-mail: eas-m@mail.ru

TAIROVA RAISA T., ORCID ID: orcid.org/0000-0002-4174-7114; C. Med. Sci., senior researcher of Research Institute of cerebrovascular diseases and stroke of N.I. Pirogov Russian National Research Medical University, Russia, 117997, Moscow, Ostrovitianov str., 1, tel. +7 (926) 226-59-88, e-mail: tairova-r@mail.ru

Abstract. Aim. The aim of the study is the analysis of non-communicable morbidity in labor migrants in the Russian Federation, development of strategic solutions to improve the management of the data on non-communicable morbidity in migrants, and creation of optimal data sources. Material and methods. Monitoring and expert activity of temporary detention centers for foreign citizens and stateless persons subject to administrative deportation or readmission from the Russian Federation of the Russian Ministry of Internal Affairs has been analyzed in the course of the study. Results and discussion. The study suggests optimal data sources for the analysis of non-communicable morbidity in labor migrants. The highest incidence rates belong to the groups of diseases of the cardiovascular system, gastrointestinal tract, nervous system, musculoskeletal system, and connective tissue. More than half of the revealed cases of infectious and parasitic diseases in 2016 and 2017 belong to tuberculosis (A15-A19) with the number of cases revealed during examinations at the Center for temporary detention of foreign citizens (per 10 000 people examined) is 60,5 in 2016 and 59,8 in 2017. The analysis of the highest need for inpatient treatment of migrants with speci c diseases was carried out. Conclusion. The results of control and expert analysis justify the urgent need to create an objective source of data on non-communicable diseases in migrants lled on an ongoing basis with the obligatory use of medical record lexical analysis tools in order to ensure the reliability of the original data.

Key words: migrants, non-communicable disease incidence, quality of medical care, lexical control.

For reference: Prishepov IA, Mendel SA, Novozhilova OL, Shkarin VV, Berseneva EA, Kurakov DA, Savostina EA, Tairova RT. The incidence of non-communicable diseases in migrant workers and the challenges of its assesment. The Bulletin of Contemporary Clinical Medicine. 2018; 11 (4): 67–72. DOI: 10.20969/VSKM.2018.11(4).67-72.

1. Kontseptsiya gosudarstvennoy migratsionnoy politiki Rossiyskoy Federatsii na period do 2025 goda [Theconcept of the state migration policy of the RussianFederation for the period until 2025]. 2018; https://www. garant.ru/products/ipo/prime/doc/70088244/

2. Prikaz Minzdrava Rossii ot 29 iyunya 2015 goda N 384n «Ob utverzhdenii perechnya infektsionnykh zabolevaniy, predstavlyayushchikh opasnost’ dlya okruzhayushchikh i yavlyayushchikhsya osnovaniyem dlya otkaza v vydache libo annulirovaniya razresheniya na vremennoye prozhivaniye inostrannykh grazhdan i lits bez grazhdanstva, ili vida na zhitel’stvo, ili patenta, ili razresheniya na rabotu v Rossiyskoy Federatsii, a takzhe poryadka podtverzhdeniya ikh nalichiya ili otsutstviya, a takzhe formy meditsinskogo zaklyucheniya o nalichii (ob otsutstvii) ukazannykh zabolevaniy» [Order No. 384н of the Ministry of Health of the Russian Federation of June 29, 2015 «On approving the list of infectious diseases thatpose a danger to others and are grounds for refusing to issue or cancel a temporary residence permit for foreign citizens and stateless persons or residence permits or apatent , or work permits in the Russian Federation, as well as the procedure for con rming their presence or absence,as well as the form of a medical report on the presence(on the absence) of these diseases»]. 2015.

3. VOZ [WHO]. Migratsiya i zdorov’ye: klyuchevyye voprosy [Migration and health: key issues]. Yevropeyskoye regional’noye byuro [European Regional Office]. 2018; http://www.euro.who.int/ru/health-topics/health- determinants/migration-and-health/migrant-health-in-the- european-region/migration-and-health-key-issues

4. Redaktsionnaya stat’ya [Editorial]. Tema nomera: zdorov’ye trudovykh migrantov [Theme of the issue: health of labor migrants]. Informatsionnyy byulleten’ [Newsletter]. 2013; 4: 75-81. https://cyberleninka.ru/article/n/tema- nomera-zdorovie-trudovyh-migrantov;

5. Ivakhnenko GA. Zdorov’ye trudovykh migrantov v Rossii [Health of labor migrants in Russia]. Sotsiologiya meditsiny [Sociology of Medicine]. 2013; 2: 48-51.

6. Chislennost’ i migratsiya naseleniya Rossiyskoy Federatsii v 2015 godu (byulleten’) [The number and migration of the population of the Russian Federation in 2015 (bulletin).]. 2018; http://www.gks.ru/bgd/regl/b16_107/Main.htm

7. Chislennost’ i migratsiya naseleniya Rossiyskoy Federatsii v 2016 godu (byulleten’) [Number and migration of the population of the Russian Federation in 2016 (bulletin)]. 2018; http://www.gks.ru/bgd/regl/b17_107/Main.htm

8. Kuznetsova IB, Mukharyamova LM, Va na GG. Zdorov’ye migrantov kak sotsial’naya problema [Health of migrants as a social problem]. Kazanskiy meditsinskiy zhurnal [Kazan Medical Journal]. 2013; 94 (3): 367-372.

9. O tsial’nyy sayt Yevropeyskogo regional’nogo byuro VOZ [Of cial website of the WHO Regional Of ce for Europe]. Strany [Countries]. http://www.euro.who.int/ru/countries

10. Kislitsyna OA. Razlichiya v sostoyanii zdorov’ya migrantov i korennogo naseleniya v Rossii i drugikh stranakh Yevropeyskogo regiona [Differences in health statusof migrants and indigenous populations in Russia andother countries of the European Region]. Sotsial’nyye aspekty zdorov’ya naseleniya [Social aspects of public health]. 2013; 3 (31): 2. http://vestnik.mednet.ru/content/ view/478/30/lang,ru/

11. Ivanova MV. Psikhicheskoye zdorov’ye migrantov : klinicheskiy, sotsial’no-psikhologicheskiy i reabilitatsionnyy aspekty [Mental health of migrants: clinical, socio- psychological and rehabilitation aspects]. Tomsk. 2007; 24 p.

12. Kurkina LV. Mediko-sotsial’nyye i gigiyenicheskiye aspekty adaptatsii migrantov k novym usloviyam zhizni v krupnom promyshlennom regione Sibiri [Mediko-social and hygienic aspects of adaptation of migrants to new living conditions in a large industrial region of Siberia]. Zdorov’ye i obrazovaniye v XXI veke [Health and education in the 21st century]. 2011; 8 (13): 400-401.

13. Myakisheva TV, Avdeyeva TG, Dragunova NYu. Sostoyaniye zdorov’ya detey-migrantov iz Ukrainy i detey, postoyanno prozhivayushchikh v gorode Smolenske [State of health of migrant children from Ukraine and children permanently residing in the city of Smolensk]. Vestnik Smolenskoy gosudarstvennoy meditsinskoy akademii [Bulletin of the Smolensk State Medical Academy]. 2016; 2 (15): 120-126.

DOI: 10.20969/VSKM.2018.11(4).72-78

1. Rosa Zampino, Adriana Boemio, Caterina Sagnelli, Loredana Alessio, Luigi Elio Adinolfi, Evangelista Sagnelli, and Nicola Coppola. Hepatitis B virus burden in developing countries. World J Gastroenterol. 2015; 21 (42): 11941–11953.

DOI: 10.20969/VSKM.2018.11(4).78-87

1. Tareeva IE ed. Nefrologiya, rukovodstvo dlya vrachej [Nephrology – guidelines for doctors]. Moskva: Medicina [Moscow: Medicine]. 2000: 215–216.

2. Shilov EM, Smirnov AV, Kozlovskaya NL. Nefrologiya: klinicheskie rekomendacii [Clinical guidelines]. Moskva: GJeOTAR-Media [Moscow: GEOTAR-Media]. 2016; 816 p.

3. Shilov EM, Ivanov AA, Troepol’skaya OV, Krasnova TN. Techenie i prognoz mezangioproliferativnogo glomerulonefrita [The course and prognosis of mesangial proliferative glomerulonephritis]. Uspekhi nefrologii: sbornik nauchnih trudov [Successes of nephrology collection of scientific works]. Moskva: MMA imeni Sechenova [Moscow: ММA Sechenov]. 2001: 165–183.

4. Ryabov SI. Nefrologiya: rukovodstvo dlya vrachej [Nephrology – guidelines for doctors]. Sankt- Peterburg: SpecLit [Saint Petersburg: Special Literature]. 2000; 672 p.

5. Shulutko BI, Makarenko SV, Shumilkin VR. Glomerulonefrity [Glomerulonephritis]. Sankt- Peterburg [Saint Petersburg]. 2001; 214 p.

6. Usha, Kumar S, Singh RG, et al. Mesangioproliferative glomerulonephritis: An important glomerulonephritis in nephrotic syndrome of young adult. Indian J Pathol Microbiol. 2008; 51 (3): 337–341.

7. Varshavskij VA, Proskurneva EP, Gasanov AB, et al. Ob utochnenii kliniko-morfologicheskoj klassifikacii hronicheskogo glomerulonefrita [On the clari cation of the clinical and morphological classi cation of chronic glomerulonephritis]. Nefrologiya i dializ [Nephrology and dialysis]. 1999; 1 (2–3): 99–102.

8. Tareeva IE, Serov VV, Varshavskij VA., Kaliev R. Osobennosti techeniya i prognoz razlichnyh morfo- logicheskih form hronicheskogo glomerulonefrita [Flow features and prognosis of various morphological forms of chronic glomerulonephritis]. Тerapevticheskij Arhiv [Therapeutic Archive]. 1981; 53 (6): 10–14.

9. Tareeva IE ed. Klinicheskie osobennosti otdel’nyh morfologicheskih form glomerulonefrita [Clinical features of individual morphological forms of glomerulonephritis] Nefrologiya – rukovodstvo dlya vrachej [Nephrology – guidelines for doctors]. Moskva: Medicina [Moscow: Medicine]. 2000; 239–246.

10. Shulutko BI. Patologiya pochek: kliniko – morfologicheskoe issledovanie [Kidney pathology: clinical and morphological study]. Leningrad: Medicina [Leningrad: Medicine]. 1983; 296 p.

11. Ratner MYa, Stenina II, Fedorova ND. Prognozirovanie uskorennogo progressirovaniya hronicheskoy pochech- noy nedostatochnosi na osnovanii klinicheskih i gisto- morfologichekih dannyh [Predicting the accelerated progression of CRF on the basis of clinical and histo- morphological data]. Тerapevticheskij Arhiv [Therapeutic Archive]. 1999; 6: 27–30.

12. Tomino Y. IgA nephropathy: lessons from an animal model, the ddY mouse. J Nephrol. 2008; 21 (4): 463–467.

13. Mubarak M, Naqvi R, Kazi JI, et al. Immunoglobulin M nephropathy in adults a clinicopathological study. IJKD. 2013; 7: 214–219.

14. Schena FP. Survey of the Italian Registry of Renal Biopsies. Frequency of the renal diseases for 7 consecutive years. The Italian Group of Renal Immunopathology. Nephrol Dial Transplant. 1997; 12 (3): 418–426.

15. Singhai AM, Vanikar AV, Goplani KR, et al. Immunoglobulin M nephropathy in adults and adolescents in India: a single- center study of natural history. Indian J Pathol Microbiol. 2011; 54 (1): 3–6.

16. Jalalah SM. IgG glomerulonephritis: a morphologic study of a rare entity. Saudi J Kidney Dis Transpl. 2009; 20 (5): 798–801.

17. Sato M, Kojima H, Nabeshima K, et al. Primary glo- merulonephritis with predominant mesangial immu- noglobulin G deposits: A distinct entity? Nephron. 1993; 64 (1): 122–128.

18. Yoshikawa N, Iijima K, Shimomura M, et al. IgG–associated primary glomerulonephritis in children. Clin Nephrol. 1994; 42 (5): 281–287.

19. Hotta O, Miyazaki M, Furuta T, et al. Tonsillectomy andsteroid pulse therapy significantly impact on clinicalremission in patients with IgA nephropathy. Am J Kidney Dis. 2001; 38 (4): 736-743.

20. Kartamysheva NN, Chumakova OV, Kucherenko AG, et al. Progressirovanie hronicheskogo glomerulonefrita: kliniko-morfologicheskie vzaimosvyazi [Progression of chronic glomerulonephritis: clinical and morphological interrelations]. Nefrologiya i dializ [Nephrology and dialysis]. 2003; 5 (4): 395–398.

21. Barbour SJ, Reich HN. Risk strati cation of patients with IgA nephropathy. Am J Kidney Dis. 2012; 59 (6): 865–873. 22. Reich HN, Troyanov S, Scholey JW, et al. Remission of proteinuria improves prognosis in IgA nephropathy. J Am Soc Nephrol. 2007; 18 (12): 3177–3183.

23. Franceschini N, Deng Y, Flessner MF, et al. Smoking patters and chronic kidney disease in US Hispanics: Hispanic Community Health Study. Nephrol Dial Transplant. 2016; 31 (10): 1670–1676.

24. Caliskan Y, Ozluk Y, Celik D, et al. The clinical signi cance of uric acid and complement activation in the progression of IgA nephropathy. Kidney Blood Press Res. 2016; 41 (2): 148-157.

25. Kulikova EV, Kuhtevich AV, Zinov’ev VG. Konstitucional’nayaharakteristika i techenie hronicheskogo glomerulonefrita[Constitutional characteristics and course of chronic glomerulonephritis]. Nefrologiya i dializ [Nephrology and dialysis]. 2003; 5 (2): 148–152.

26. Ignatova MS, Prihodina LS, Golicyna EP, et al. Yavlyaetsya libolezn’ tonkih bazal’nyh membran predraspolagayushchimfaktorom k razvitiyu drugoj nefrologicheskoj patologii? [Isthe disease of thin basal membranes a predisposing factorto the development of another nephrologic pathology]. Nefrologiya i dializ [Nephrology and dialysis]. 2007; 9 (2): 186–191.

27. Berg UB. Long-term follow up of renal function in IgA nephropathy. Arch Dis Child. 1991; 66 (5): 588–592. 

28. Lettgen B, Rascher W. Acute reversible kidney failure in IgA nephritis. Klin Padiatr. 1991; 203 (2): 124–128.

29. Shilov EM, Tareeva IE, Ivanov AA, et al. Techenie i prognoz mezangioproliferativnogo glomerulonefrita [The course and prognosis of mesangial proliferative

glomerulonephritis]. Тerapevticheskij Arhiv [Therapeutic Archive]. 2002; 7 (6): 11–18.

30. O’ Donoghue DJ, Lawler VV, Hunt LP, et al. IgM – associated primary diffuse mesangial proliferative glomerulonephritis: Natural history and prognostic indicators. Q J Med. 1991; 79 (288): 333–350. 

31. Sobarzo Toro M, Vilches A. Membranous kidney diseases in adults. Medicina (B Aires). 2004; 64 (1): 59–65.

32. Shiiki H, Saito T, Nishitani Y, et al. Prognosis and risk factors for idiopathic membranous nephropathy with nephrotic syndrome in Japan. Kidney Int. 2004; 65 (4): 1400–1407.

DOI: 10.20969/VSKM.2018.11(4).87-91

1. Barinov Ekh, Shcherbakov VV, Fedulova MV, Goncharo- va NN. Identifikatsiya lichnosti pri chrezvychaynykh proisshestviyakh s massovymi chelovecheskimi zhertvami [Identification of the person in emergency incidents with mass human victims]. Kirov-Moskva: KOGUZ «Meditsinskiy informatsionno-analiticheskiy tsentr» [Kirov-Moscow: KOGUZ «Medical Information-Analytical Center»]. 2008; 235 p.

2. Osipenkova-Vichtomova TK. Gistomorfologicheskaya ekspertiza kostey [Histomorphological examination of bones]. Moskva: Meditsina [Moscow: Medicine]. 2009; 152 p.

3. Alekseev VP. Osteometriya; Metodika antropologicheskikh issledovaniy [Osteometry; Methodology of anthropological research]. Moskva: Nauka [Moscow: Science]. 1966; 251 p.

4. Alekseev VP, Debets GF. Kraniometriya; Metodika antropologicheskikh issledovaniy [Craniometry; Metho- dology of anthropological research]. Moskva: Nauka [Moscow: Science]. 1964; 128 p.

5. Zel’tser A. Prichiny i formy proyavleniya uskorennogo rosta detey [Causes and forms of manifestation of accelerated growth of children]. Moskva: Meditsina [Moscow: Medicine]. 1968; 235 p.

6. Markosyan AA. Voprosy vozrastnoy ziologii [Questions of age physiology]. Moskva: Prosveshchenie [Moscow: Enlightenment]. 1974; 223 p.

7. Miklashevskaya NN. Rost i razvitie rebenka [Growth and development of the child]. Moskva: Izdatel’stvo Moskovskogo universiteta [Moscow: Publishing House of Moscow University]. 1973; 220 p.

8. Roginskiy YaYa, Levin MG. Osnovy antropologii [Fundamentals of Anthropology]. Moskva: Izdatel’stvo Moskovskogo universiteta [Moscow: Publishing House of Moscow University]. 1955; 502 p.

9. Zvyagin VN, Zamyatina AO, Galitskaya OI. Diagnostika massivnosti skeleta i somatotipa cheloveka po kostyam kisti [Diagnosis of the massiveness of the skeleton and somatotype of man on the bones of the hand]. Sudebno- meditsinskaya ekspertiza [Forensic medical examination]. 2003; 6: 19-25.

10. Pigolkin YuI, Fedulova MV, Zolotenkova GV. Opredelenie vozrasta cheloveka po kostnoy tkani [Determination of human age by bone tissue]. Sudebno-meditsinskaya ekspertiza [Forensic medical examination]. 2012; 1: 49-51.

11. Naynis IV. Identifikatsiya lichnosti po proksimal’nym kostyam konechnostey [Identi cation of personality by proximal limb bones]. Vil’nyus: Izdatel’stvo «Mintis» [Vilnius: Publishing house «Mintis»]. 1972; 158 p.

12. Koshelev LA. O polovom dimorfizme lopatok [On sexual dimorphism of scapula]. Sudebno-meditsinskaya ekspertiza [Forensic medical examination]. 1971; 4: 22-23.

13. Laptev ZL. Opredelenie pola i dliny tela po parametram lopatok [Determination of sex and body length according to blade parameters]. Sudebno-meditsinskaya ekspertiza [Forensic medical examination]. 1978; 3: 7-11.

14. Gurova NI. Vozrastnaya morfologiya grudnoy kletki cheloveka [Age morphology of the human chest]. Moskva: Prosveshchenie [Moscow: Enlightenment]. 1965; 216 p.

DOI: 10.20969/VSKM.2018.11(4).91-95

 VENA CAVA FILTER APPLICATION FOR PREVENTION OF THROMBOEMBOLIC COMPLICATIONS: EXPECTATIONS AND REALITIES

SHARAFEEV AIDAR Z., D. Med. Sci., associate professor, Head of the Department of cardiology, endovascular and cardiovascular surgery of Kazan State Medical Academy – the branch of Russian Medical Academy of Postgraduate Education, Russia, 420012, Kazan, Butlerov str., 36, tel. +7-927-410-93-89, e-mail: cardiokgma@mail.ru

GLUSHCHENKO LEONID V., specialist on endovascular diagnostics and treatment of the Department of angiographic diagnostics and interventional surgery of Ulyanovsk Regional Clinical Hospital, postgraduate student of the Department of cardiology, endovascular and cardiovascular surgery of Kazan State Medical Academy – the branch of Russian Medical Academy of Postgraduate Education, Russia, 432048, Ulyanovsk, Trety Internatsional str., 7, tel. +7(8422)32-61-51, e-mail: ileo.glu@gmail.com

AMIROV NAIL B., ORCID ID: 0000-0003-0009- 9103; SCOPUS Authоr ID: 7005357664; D. Med. Sci, professor of the Department of general medical practice No 1 of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: namirov@mail.ru

MUKHAMETSHINA GUZEL A., C. Med. Sci., cardiologist of the Department of cardiology of Medical Care unit of the Ministry of Internal Affairs of Russia for the Republic of Tatarstan, Russia, 420000, Kazan, Orenburgsky tract str., 132, tel. +7-929-723-12-91, e-mail: guzel.muhametshina.71@mail.ru

Abstract. Aim. The aim of the study was to perform a remote retrospective analysis of the ef cacy and safety of secondary thromboembolic complication prevention in patients with deep vein thrombosis of tre lower extremities.Material and methods. 226 patients with deep vein thrombosis of the lower extremities were examined and managed. Patients were divided into 2 main groups (91 patients were prescribed a vena cava lter, 135 patients were prescribed anticoagulant therapy). Indications for implantation of the vena cava lter were determined in accordance with the current Russian clinical guidelines for the diagnosis, treatment and prevention of venous thromboembolic complications, such as recurrent thromboembolism of the pulmonary arteries – in 3 cases (3%), pulmonary embolism and deep vein thrombosis with the signs of floating thrombus – in 12 cases (13%), the presence of deep vein thrombosis only with the signs of floating thrombus – in 46 cases (51%) and low ef cacy of anticoagulant therapy – in 30 (33%) cases. The study was approved by the ethical committee. The patients enrolled in the study signed informed consent form. Results and discussion. Pulmonary artery thromboembolism recurrence was observed in 5 patients with implanted vena cava lter (10%) (with relapse of pulmonary artery thromboembolism, which was not lethal). In the long-term perspective (1,5 years after implantation) vena cava lter thrombosis was revealed in 5 (10%) cases, which was due to the lack of compliance with anticoagulant therapy. Conclusions. The effectiveness of vena cava lters in secondary prevention of thromboembolic complications raises certain doubts. Despite the effectiveness of anticoagulant therapy, the patients showed a high incidence of thrombotic complications compared to the ones treated conservatively, ex. the frequency of recurrent deep vein thrombosis (20% vs 0,7%), recurrent pulmonary artery thromboembolism (5,5% vs 0%) and vena cava lter thrombosis (5,5%).

Key words: vena cava lter, pulmonary embolism, floating deep vein thrombosis of the lower limbs.

For reference: Sharafeev AZ, Glushchenko LV, Amirov NB, Muhametshina GA. Vena cava lter application for prevention of thromboembolic complications: expectations and realities. The Bulletin of Contemporary Clinical Medicine. 2018; 11 (4): 91–95. DOI: 10.20969/VSKM.2018.11(4).91-95.

1. Sharafeev, AZ, Zyatdinov KSh, Akberov RF. Otdalennie rezultati endovaskularnogo lechenya bolnih multifocalnim aterosklerozom [Long-term results of endovascular treatment of patients with multifocal atherosclerosis]. Obchestvennoe zdorovye i zdravoohranenie [Public Health and Public Health]. 2011; 3: 39-44.

2. Yablokov EG. Legochnaya gipertenzia embolicheskogo geneza [Lung hyperemia of embolic liver]. Legochnaya gipertenzia pri hronicheskih nespeci cheskih zabolevaniah legkih [Lung hypersensia in chronic non-speci c lung diseases]. Sankt-Petepbupg: VNII pul’monologii [St. Peterburg: All-Russian Research Institute of Pulmonology]. 2010; 59- 66.

3. Sharafeev AZ, Glushchenko LV. Sovremennie podhodi k implantacii kava- ltrov pri ugroze tromboembolii legochnih arterj [Modern Approaches of Implantation of IVC Filters in the Threat of Pulmonary embolism]. Novosti hirurgii [News of Surgery]. 2016; 24 (2): 177-184.

4. Reekers JA. Mechanical thrombectomy and vena cava lters. Cardiovasc Intervent Radiol. 2000; 23 (1): 54-55.

5. Dinglasan LA, Oh JC, Schmitt JE, Trerotola SO, Shlansky- Goldberg RD, Stavropoulos SW. Complicated Inferior Vena Cava Filter Retrievals: Associated Factors Identi ed at Preretrieval CT. Radiology. 2012; 9: http://www. biomedsearch.com/nih/Complicated-Inferior-Vena-Cava- Filter/23047840.html

6. Bokeria LA, Zatevakhin II, Kirienko AI. Rossijskie klinicheskie rekomendatsii po diagnostike, lecheniu I profilaktike venoznih tromboembolicheskih oslojnenij [Russian clinical recommendations of diagnosis, treatment and prophylactic venous thromboembolic events]. Flebologiya [Flebology]. 2015; 9 (4): 42.

 CLINICAL AND PATHOGENETIC ASPECTS OF IDIOPATHIC CARDIOMYOPATHY

AMIROV NAIL B., ORCID ID: 0000-0003-0009- 9103, SCOPUS Authоr ID: 7005357664; D. Med. Sci., professor of the Department of general medical practice No 1 of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: namirov@mail.ru

TSYBULKIN NIKOLAY A., C. Med. Sci., associate professor of the Department of cardiology, x-ray endovascular and cardiovascular surgery of Kazan State Medical Academy – the branch of Russian Medical Academy of Postgraduate Education, Russia, 420012, Kazan, Butlerov str., 36, e-mail: kdkgma@mail.ru

FROLOVA ELVIRA B., C. Med. Sci., deputy head of the City Clinical Hospital No 7, Russia, 420103, Kazan, Chuykov str., 54, е-mail: frolova.67@mail.ru

MIKHOPAROVA OLGA YU., Head of the Department of functional diagnostics of Clinical Hospital of the Ministry of Internal Affairs of Russia for the Republic of Tatarstan, Russia, 420059, Kazan, Orenburgskiy tract str., 132, tel. 8-937-525-5-261, e-mail: Olga-mihoparova@rambler.ru

TUKHVATULLINA GALINA V., Head of the laboratory of clinical and diagnostics of Clinical Hospital of the Ministry of Internal Affairs of Russia for the Republic of Tatarstan, Russia, 420059, Kazan, Orenburgskiy tract str., 132

OSHCHEPKOVA OLGA B., Head of the Department of cardiology of Clinical hospital of the Ministry of Internal Affairs of Russia for the Republic of Tatarstan, Russia, 420059, Kazan, Orenburgskiy tract str., 132

ABDRAKHMANOVA ALSU I., C. Med. Sci., associate professor of the Department of clinical medicine fundamental basis of Institute of biology and fundamental medicine of Kazan Federal University, Russia, 420012, Kazan, K. Marx str., 74, e-mail: alsuchaa@mail.ru

Abstract. Aim. The aim of the study is to characterize the modern perception of idiopathic cardiomyopathy as agenetically determined disease as well as its practical aspects. Material and methods. Review of scienti c medical literature on the subject of idiopathic cardiomyopathy was performed. Results and discussion. Cardiomyopathiesrepresent a group of heart diseases of non-ischemic nature, associated with a violation in the myocardial contractile protein structure and function. The main diagnostic features of the disease are structural changes in the heart chambers of particular nature. Classi cation that divided cardiomyopathies into 3 main types: dilated, hypertrophic and restrictive, was based on such changes. The classi cation has recently been expanded in order to include the cases of noncompact myocardium and arrhythmogenic right ventricular dysplasia. The classi cation of the heart diseases, based on the structural changes, was further expanded due to conditions with identi ed origin, having the same typical external signs. Thus, the classi cation of cardiomyopathies includes speci c forms, for example, ischemic, valvular and hypertonic. At the same time, cardiomyopathies underlying the initial classi cation are referred to as idiopathic. This name does not fully correspond to the nature of these diseases that have de nite causes such as genetically determined alteration of contractile protein structure or the accumulation of metabolic products in the myocardium. Conclusion. The modern concept of idiopathic cardiomyopathy includes the characteristics of the structural and functional features of the heartchambers, primary causes of the typical changes due to congenital dysfunction of myocardium contractile proteins, the structure of the endocardium, or the accumulation of the products of altered metabolism.

1. Tang X, Yu S, Yin L, Gong L. Two Patients with Coincident Noncompacted Myocardium and Hypertrophic Cardiomyopathy. Int Heart J. 2018; 59 (2): 424-426.

2. Arbustini E, Narula N, Dec G, et al. The MOGE(S) classi cation for a phenotype-genotype nomenclature of cardiomyopathy: endorsed by the World Heart Federation. J Am Coll Cardiol. 2013; 62 (22): 2046-2072.

3. Ingles J, Bagnall RD, Semsarian C. Genetic Testing for Cardiomyopathies in Clinical Practice. Heart Fail Clin. 2018; 14 (2): 129-137.

4. Deo R. Alternative splicing, internal promoter, nonsen- semediated decay, or all three; Explaining the distribution of truncation variants in titin. Circ Cardiovasc Genet. 2016; 9: 419–425.

5. Garfinkel AC, Seidman JG, Seidman CE. Genetic Pathogenesis of Hypertrophic and Dilated Cardiomyo- pathy. Heart Fail Clin. 2018; 14 (2): 139-146.

6. McNally EM, Mestroni L. Dilated Cardiomyopathy: Genetic Determinants and Mechanisms. Circ Res. 2017; 121 (7): 731-748.

7. Yoshihisa A, Suzuki S, Sato Y, et al. Relation of Testostero- ne Levels to Mortality in Men With Heart Failure. Am J Cardiol. 2018; 1-25. doi: 10.1016/j.amjcard.2018.01.052.

8. Peterson DF, Siebert DM, Kucera KL, et al. Etiology of Sudden Cardiac Arrest and Death in US Competitive Athletes: A 2-Year Prospective Surveillance Study. Clin J Sport Med. 2018. – Vol.o. – P.1–10. Режим доступа: https://doi.org/10.1097/JSM.0000000000000598.

9. Atteya G, Lampert R. Sudden Cardiac Death in Genetic Cardiomyopathies. Card Electrophysiol Clin. 2017; 9 (4): 581-603.

10. Razuin R, Nurquin F, Shahidan MN, Julina MN. Sudden cardiac death with triple pathologies: A case report. Egypt Heart J. 2017; 69 (2): 157-160.

11. Chervinsky E, Khayat M, Soltsman S, et al. A homozygous TTN gene variant associated with lethal congenital contracture syndrome. Am J Med Genet A. 2018; 176 (4): 1001-1005.

12. Ponikowski P, Voors A, Anker S, et al. 2016 ESC Guidelinesfor the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC); Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. European Heart Journal. 2016; 37 (27): 2129–2200.

13. Maisel AS, Daniels LB, Anand IS, McCullough PA, Chow SL. Utility of natriuretic peptides to assess and manage patients with heart failure receiving angiotensin receptor blocker/neprilysin inhibitor therapy. Postgrad Med. 2018; 130 (3): 299-307.

14. Sobrino-Márquez JM, Grande-Trillo A, Cantero-Pérez EM, et al. Prognostic Value of Blood Panel Parameters in Patients With Dilated Cardiomyopathy and Advanced Heart Failure. Transplant Proc. 2018; 50 (2): 650-652.

15. Inciardi RM, Galderisi M, Nistri S, et al. Echocardiographic advances in hypertrophic cardiomyopathy: Three- dimensional and strain imaging echocardiography. Echocardiography. 2018. – P.1-11. DOI: 10.1111/ echo.13878

16. Delekta J, Hansen SM, AlZuhairi KS, Bork CS, Joensen AM. The validity of the diagnosis of heart failure (I50.0-I50.9) in the Danish National Patient Register. Dan Med J. 2018; 65(4): A5470.

17. Grosman-Rimon L, Lalonde SD, Sieh N, et al. Exercise rehabilitation in ventricular assist device recipients: a meta-analysis of effects on physiological and clinical outcomes. Heart Fail Rev. 2018; 1-13. doi: 10.1007/ s10741-018-9695-y.

18. Gomes Neto M, Durães AR, Conceição LSR, et al. High intensity interval training versus moderate intensity continuous training on exercise capacity and quality of life in patients with heart failure with reduced ejection fraction: A systematic review and meta-analysis. Int J Cardiol. 2018; 1-36. doi:10.1016/j.ijcard.2018.02.076

19. Prabhu S, Voskoboinik A, McLellan AJA, et al. Biatrial Electrical and Structural Atrial Changes in Heart Failure: Electroanatomic Mapping in Persistent Atrial Fibrillation in Humans. JACC Clin Electrophysiol. 2018; 4 (1): 87-96.

20. Li Y, Xue Y, Yu J, Jiang C, Wang Z, et al. Electrophysiolo-gical characteristics and radiofrequency ablation ofsustained monomorphic ventricular tachycardia in adult patients with isolated ventricular noncompaction. J Interv Card Electrophysiol. 2018; 52: 117–125. https://doi. org/10.1007/s10840-018-0347-x.

 ACHIEVEMENTS AND DEVELOPMENT PROSPECTS OF DEPARTAMENTAL MEDICAL SERVICE OF THE MINISTRY OF INTERNAL AFFAIRS IN TATARSTAN REPUBLIC IN 2013–2017

KHISAMIEV RUSTEM SH., major of internal service, Head of the Medical Care unit of the Ministry of Internal Affairs of Russia for the Republic of Tatarstan, Russia, 420111, Kazan, Lobachevsky str., 13, tel. 8-843-291-24-58, e-mail: msch_16mvd.gov.ru

Abstract. The article reflects the activities of the Medical Care unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan over a 5-year period and the prospects for its development in the future. The quality and availability of medical care, quali ed personnel, the use of modern methods of diagnosis and treatment are an indisputable guarantee of strengthening and preserving health of employees of law enforcement bodies. Aim. Patient flow in interregional clinical and diagnostic center was assessed in the framework of interregional interaction on rendering medical service to the employees of law enforcement bodies. Material and methods. Comparative analysis of expenses on rendering medical service to the employees of the internal affairs bodies of the Republic of Tatarstan in state and municipal health organizations was carried out within the framework of Decree of the Government of the Russian Federation No 1232 from 30.12.2011, with the expenses of neighboring subjects of the Russian Federation bordering the Republic of Tatarstan. The main indicators of effectiveness of creation of Interregional Clinical Diagnostic Center were determined. Results and discussion. Analysis of the expenses on treatment and diagnostic service, forecasting of the patient flow for the diagnostic center, analysis of the effectiveness of its creation and the performance indicators fully justify the need for a clinical diagnostic center in the city of Kazan, where the largest patient flow is expected. Conclusion. Introductionof modern diagnostic methods based on the use of modern equipment and technologies will assure comprehensive patient examination, improvement of the level and quality of medical care, timely diagnosis at early stages and risk reduction for many diseases. Thus, creation of a diagnostic center will become a reference point for initiating positive changes in departmental health care.

3. Khisamiyev RSh, Amirov NB, Ginyatullina LR et al. Sravnitel’nyy analiz zabolevayemosti arterial’noy gipertenziyey i rasprostranennosti faktorov riska sredi sotrudnikov organov vnutrennikh del Kazanskogo garnizona [Comparative analysis of the incidence of arterial hypertension and the prevalence of risk factors among employees of internal affairs of the Kazan garrison]. Vestnik sovremennoy klinicheskoy meditsiny [The Bulletin of Contemporary Clinical Medicine]. 2016; 9 (6): 89—95.

4. Khisamiyev RSh, Ginyatullina LR, Amirov NB. Dostizheniya i perspektivy razvitiya vedomstvennoy meditsinskoy sluzhby MVD po respublike Tatarstan [Achievements and prospects of development of the departmental medical service of the Ministry of Internal Affairs in the Republic of Tatarstan]. Vestnik sovremennoy klinicheskoy meditsiny [The Bulletin of Contemporary Clinical Medicine]. 2016; 9 (6): 13-15.

5. Khisamiyev RSh, Ginyatullina LR, Amirov NB. Pi- lotnyy proyekt mezhregional’nogo vzaimodeystviya meditsinskogo obespecheniya na baze FKUZ «Mediko- sanitarnaya chast’ Ministerstva vnutrennikh del Rossii po Respublike Tatarstan» [Pilot project of interregionalinteraction of medical support on the basis of theFKUZ «Medical-sanitary part of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan»]. Vestnik sovremennoy klinicheskoy meditsiny [The Bulletin of Contemporary Clinical Medicine]. 2017; 10 (4): 7—11.

6. Khisamiyev RSh, Ginyatullina LR, Amirov NB. Opyt organizatsii deyatel’nosti mediko-sanitarnoy chasti v period provedeniya krupnykh mezhdunarodnykh i massovykh sportivnykh meropriyatiy (na primere FKUZ «MSCH MVD Rossi po respublike Tatarstan» v period podgotovki i provedeniya KHKHVII vsemirnoy letney universiady 2013 goda v g. Kazani» [Experience in organizing the activities of the medical and sanitary unit in the period of major international and mass sports events (on the example of the FKUZ «MSh Ministry of the Interior of Russia in theRepublic of Tatarstan» during the preparation and conductof the XXVII World Summer Universiade 2013 in Kazan»]. Vestnik sovremennoy klinicheskoy meditsiny [The Bulletin of Contemporary Clinical Medicine]. 2013; 6 (sup.1): 4-9.

 DILATED CARDIOMYOPATHY: MODERN PERCEPTION AND CLINICAL CASE

MUKHAMETGALIEVA GULNAZ M., cardiologist of the Department of cardiology of Clinical Hospital of the Ministry of Internal Affairs of Russia for the Republic of Tatarsan, Russia, 420059, Kazan, Orenburgskiy tract str., 132

OSHCHEPKOVA OLGA B., Head of the Department of cardiology of Clinical Hospital of the Ministry of Internal Affairs of Russia for the Republic of Tatarsan, Russia, 420059, Kazan, Orenburgskiy tract str., 132

TSYBULKIN NIKOLAY A., C. Med. Sci., associate professor of the Department of cardiology, x-ray endovascular and cardiovascular surgery of Kazan State Medical Academy – the branch of Russian Medical Academy of Postgraduate Education, Russia, 420012, Kazan, Butlerov str., 36, e-mail: kdkgma@mail.ru

TUKHVATULLINA GALINA V., Head of laboratory of clinical diagnostics of Clinical Hospital of the Ministry of Internal Affairs of Russia for the Republic of Tatarsan, Russia, 420059, Kazan, Orenburgskiy tract str., 132

MIKHOPAROVA OLGA YU., Head of the Department of functional diagnostic of Clinical Hospital of the Ministry of Internal Affairs of Russia for the Republic of Tatarsan, Russia, 420059, Kazan, Orenburgskiy tract str., 132

Abstract. Aim. The aim of the study was to analyze the modern perception of dilated cardiomyopathy in everyday clinical practice of a cardiologist and to provide a clinical example. Material and methods. Review of scienti c medical literature on the topic of dilated cardiomyopathy was conducted. The results of observation and clinical examination of a patient with a diagnosis of dilated cardiomyopathy are presented. Results and discussion. Dilated cardiomyopathy is a disease of the myocardium of multiple origins, characterized by a marked expansion of the left ventricular cavity and a decrease in global contractility in the absence of a major cardiac disease. Such patients are characterized by progressive heart failure development, heart rhythm and conduction disorders, thromboembolism and sudden death. The criterion of the disease is the decrease in the left ventricle ejection fracture and a pronounced increase in its cavity size. Patients with dilated cardiomyopathy occupy from a quarter to half among all cases of cardiomyopathies. The interaction of such factors as genetic predisposition, exposure to exogenous factors and autoimmune disorders is important for the initiation of the disease. In most cases, the cause of the disease is the structural and functional inadequacy of contractile or structural proteins in cardiomyocytes. Just over half of the patients admitted to the hospital with the symptoms of progressive chronic heart failure have ischemic origin of the disease, while the diagnosis of the idiopathic type requires additional investigation. Conclusion. The modern understanding of dilated cardiomyopathy includes the de nition of primary causes of the characteristic changes in the heart due to the underlying disease, identi cation of speci c cardiomyopathies, as well as assessment of the role of hereditary factor in the initiation of the disease.

1. Losurdo P, Stolfo D, Merlo M, et al. Early Arrhythmic Events in Idiopathic Dilated Cardiomyopathy. JACC Clin Electrophysiol. 2016; 2 (5): 535-543.

2. Kadish AH, Jacobson JT. Early Arrhythmic Risk Assessment in Idiopathic Cardiomyopathy: A Tincture of Time Can Be the Wrong Medicine. JACC Clin Electrophysiol. 2016; 2 (5): 544-545.

3. Piano MR. Alcoholic Cardiomyopathy: Is it Time for Genetic Testing? J Am Coll Cardiol. 2018; 71 (20): 2303-2305. 

4. Wilcox JE, Hershberger RE. Genetic cardiomyopathies. Curr Opin Cardiol. 2018; 33 (3): 354-362.

5. Deo R. Alternative splicing, internal promoter, nonsensemediated decay, or all three; Explaining the distribution of truncation variants in titin. Circ Cardiovasc Genet. 2016; 9: 419–425.

6. Elliott P, Andersson B, Arbustini E, et al. Classifi cation of the cardiomyopathies: a position statement from the European Society Of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2008; 29: 270–276.

7. Arbustini E, Narula N, Dec G, et al. The MOGE(S) classifi cation for a phenotype-genotype nomenclature of cardiomyopathy: endorsed by the World Heart Federation. J Am Coll Cardiol. 2013; 62 (22): 2046-2072.

8. Akinrinade O, Ollila L, Vattulainen S, et al. Genetics and genotype–phenotype correlations in Finnish patients with dilated cardiomyopathy. Eur Heart J. 2015; 36: 2327–2337.

9. Waseem M, Yaqoob N, Tariq MI, et al. Effects of Lower Limb Cycle Training on Echocardiographic Parameters of Left Ventricle in Dilated Cardiomyopathy Patients. J Coll Physicians Surg Pak. 2018; 28 (5): 370-373.

10. Yancy C, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013; 128: 1810–1852.

11. Ehlert F, Cannom D, Renfroe E, et al. Comparison of dilated cardiomyopathy and coronary artery disease in patients with life-threatening ventricular rrhythmias:

differences in presentation and outcome in the AVID registry. Am Heart J. 2001; 142: 816–822. 

12. Ingles J, Bagnall RD, Semsarian C. Genetic Testing for Cardiomyopathies in Clinical Practice. Heart Fail Clin. 2018; 14 (2): 129-137.

13. Ware JS, Amor-Salamanca A, Tayal U, et al. Genetic Etiology for Alcohol-Induced Cardiac Toxicity. J Am Coll Cardiol. 2018; 71 (20): 2293-2302.

14. Arbustini E, Narula N, Tavazzi L, et al. The MOGE(S) Classifi cation of Cardiomyopathy for Clinicians. J Am Coll Cardiol. 2014; 64: 304–318.

15. Masarone D, Kaski JP, Pacileo G, et al. Epidemiology and Clinical Aspects of Genetic Cardiomyopathies. Heart Fail Clin. 2018; 14 (2): 119-128.

 THE CHALLENGES IN ACUTE MYOCARDIAL INFARCTION DIAGNOSIS IN A PATIENT WITH ACUTE PANCREATITIS

MUKHAMETSHINA GUZEL A., C. Med. Sci., cardiologist of the Department of cardiology of Medical Care unit of the Ministry of Internal Affairs of Russia for the Republic of Tatarstan, Russia, 420000, Kazan, Orenburgsky tract str., 132, tel. +7-929-723-12-91, e-mail: guzel.muhametshina.71@mail.ru

GIMALETDINOVA IRINA A., gastroenterologist of the Department of gastroenterology of Clinical Hospital of Medical Care unit of the Ministry of Internal Affairs of Russia for the Republic of Tatarstan, Russia, 420000, Kazan, Orenburgsky tract str., 132, tel. 8-903-313-12-27, e-mail: iren-kaz@mail.ru.

AMIROV NAIL B., ORCID ID: 0000-0003-0009- 9103, SCOPUS Authоr ID: 7005357664; D. Med. Sci., professor of the Department of general medical practice No 1 of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: namirov@mail.ru

ABSALYAMOVA LYEILYE R., Head of the Department of gastroenterology of Clinical Hospital of Medical Care unit of the Ministry of Internal Affairs of Russia for the Republic of Tatarstan, Russia, 420000, Kazan, Orenburgsky tract str., 132, tel. 8-965-608-72-73, e-mail: absalyamova1609@mail.ru

MIKHOPAROVA OLGA YU., Head of the Department of functional diagnostics of Clinical Hospital of Medical Care unit of the Ministry of Internal Affairs of Russia for the Republic of Tatarsan, Russia, 420059, Kazan, Orenburgskiy tract str., 132, tel. 8-937-525-5-261, e-mail: Olga-mihoparova@rambler.ru

ARSLANOVA ALINA R., resident of the Department of cardiology, roentgenendovascular and cardiovascular surgery of Kazan State Medical Academy – the branch of Russian Medical Academy of Postgraduate Education, Russia, 420012, Kazan, Mushtari str., 11, tel. 8-937-773-02-45, e-mail: arslanovalina@yandex.ru

Abstract. Aim. The aim of the study was to share the experience of the differential diagnosis of acute myocardial infarction in a patient with acute pancreatitis. Material and methods. A clinical case demonstrating atypical development and course of acute myocardial infarction in a patient with exacerbation of chronic pancreatitis from hypertension and diabetes mellitus hospitalized in the clinical hospital of the Medical Unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan suffering is presented. Results and discussion. Depending on the clinical manifestations, myocardial infarction can be classi ed as asthmatic, cerebrovascular, arrhythmic or gastralgic. In particular, clinical manifestation of the gastralgic type is pain in the epigastric region, accompanied by various dyspeptic symptoms (heartburn, vomiting). In 5% of cases, clinical manifestations of acute myocardial infarction and acute pancreatitis can be similar, which makes diagnosis dif cult. In acute pancreatitis pain is localized in the upper abdomen, it can irradiate to the left arm, shoulder and interscapular area, which may be also the features of acute myocardial infarction. However, the duration of the pain syndrome in acute myocardial infarction is several hours, while in acute pancreatitis, pain can last several days. Approximately 8% of observed cases of acute myocardial infarction are characterized by single vomiting, while in acute pancreatitis it can be multiple and it is usually accompanied by flatulence and altered defecation pattern. The absence of a Q wave on the electrocardiogram and a typical rise of the ST interval (only diffuse changes on the electrocardiogram can be detected, such as a shift of the ST interval below the isoline and an inverted T wave), a high level of α-amylase and diastase in the urine. Shock may develop in either case. Conclusion. In a number ofcases, acute myocardial infarction occurs under the mask of other diseases. Sometimes both diseases can develop simultaneously, which requires from doctor to correctly assess the patient’s condition in the absence of laboratory tests and instrumental studies and to determine correct strategy for diagnosis and treatment. Coronary syndrome in acutepancreatitis can be considered only for those disorders that appear at the height of the disease and disappear alongwith the improvement of the patient’s condition.

Key words: acute myocardial infarction, pancreatitis, diabetes mellitus, pain.

For reference: Muhametshina GA, Gimaletdinova IA, Amirov NB, Absalyamova LR, Mikhoparova OYu, Arslanova AR. The challenges in acute myocardial infarction diagnosis in a patient with acute pancreatitis. The Bulletin of Contemporary Clinical Medicine. 2018; 11 (4): 119–124. DOI: 10.20969/VSKM.2018.11(4).119-124.

1. Oganov RG. Serdechno-sosudistyye zabolevaniya v Rossiyskoy Federatsii [Cardiovascular diseases in Russian Federation]. Kardiologiya [Cardiology]. 2001; 4: 8-11.

2. Amirov NB ed. Ishemicheskaja bolezn’ serdca v obshhej vrachebnoj praktike: diagnostika, lechenie i pro laktika monografiya [Ischemic heart disease in general medical practice: diagnosis, treatment and prevention: monograph]. Kazan’: KGMU [Kazan: KSMU]. 2011; 193 p.

3. Kornienko EA, O’notkinova OSch, Baranov AP, Goncharo- va EI, Ivanov DV. Sovremennyye vzglyady na etiopatoge- nez infarkta miokarda pri sakharnom diabete 2 tipa i metody lecheniya (obzor literatury) [Modern views onthe etiopethogenesis of myocardial infarction in diabetesmellitus type 2 and methods of treatment (literature review)]. Vestnik novykh meditsinskikh tekhnologiy: elektronnoye izdaniye [New Medical Technologies: Electronicedition]. 2015; 2: 3-8.

4. Dedov II, Alexandrov AA. Problemy ostrogo infarkta miokarda u bol’nykh sakharnym diabetom: ekho Myunkhena [Problems of acute myocardial infarction in patients with diabetes mellitus: echo of Munich]. Kardiologiya [Cardiology]. 2008; 1: 4-10.

5. Panova YeI, Kruglova NYe, Strongin LG, Kache- nyuk OA. Osobennosti i prognosticheskaya znachimost’ simpatoadrenalovoy aktivnosti u bol’nykh infarktom miokarda i sakharnym diabetom 2 tipa [Features and prognostic signi cance of sympathoadrenal activity inpatients with myocardial infarction and diabetes mellitustype 2]. Klinicheskaya meditsina [Clinical medicine]. 2011; 2: 81-84.

6. Stryuk RI, Dlusskiy IG. Adrenoreaktivnost’ i serdechno- sosudistaya sistema [Adrenoreactivity and the car- diovascular system]. Moskva: Meditsina [Moscow: Medicine]. 2003; 160 p.

7. Braunwald E, Isselbacher KG, Petersdorf RG et al. Vnutrenniye bolezni [Internalmedicine]. Moskva: Meditsina [Moscow: Medicine]. 1995; 10 (5): 284 p.

8. Vinogradov AV. Differentsial’nyy diagnoz vnutrennikh bolezney [Differential diagnosis of internal diseases]. Moskva: Meditsina [Moscow: Medicine]. 1987; 161, 162- 163.

9. Azarov AA, Yevtushenko SA, Tavlueva YeV, Barba- rash OL. Otdalennyye rezul’taty endovaskulyarnykh vmeshatel’stv u patsiyentov s ostrym infarktom miokarda v sochetanii s sakharnym diabetom 2 tipa [Long-term results of endovascular interventions in patients withacute myocardial infarction combined with diabetesmellitus type 2]. Kemerovo: Materialy vserossiyskoy nauchno-prakticheskoy konferentsii «Obliteriruyushchiye zabolevaniya sosudov: problemy i perspentivy» [Kemerovo: Materials of all-Russian scientific-practical conference «Obliterating diseases of vessels:problems and prospects»]. 2009; 20-21.

10. Kuzheleva YeA, Okrugin SA, ParshinYeA, Garganeeva AA.Atipichnaya klinicheskaya kartina ostrogo infarkta miokardakak prediktor otdalennoy letal’nosti (po dannym «Registra ostrogo infarkta miokarda») [Atypical clinical pictureof acute myocardial infarction as a predictor of distantlethality ( according to «The register of acute myocardial infarction»)]. Tomsk: Tezisy VIII Vserossiyskogo foruma «Voprosy neotlozhnoy kardiologii 2015» [Tomsk: Theses of the VIII all-Russian forum «Emergency cardiology issues 2015»]. 2015; 6.

11. Nicolaeva LF, Aronov DM. Reabilitatsiya bol’nykh ishemicheskoy bolezn’yu serdtsa [Rehabilitation of patients with coronary heart disease]. Moskva: Meditsina [Moscow: Medicine]. 2003; 160 p.

12. Boqueria LA, Buziashvili YuI, Rabotnikov VS. Ostryy koronarnyy sindrom [Acute coronary syndrome]. Moskva: izdatel’stvo NTSSSKH imeni AN Bakuleva RAMN [Moscow: The AN Bakoulev Scientific Center for Cardiovascular Surgery of Russian Academy of Medical Sciences]. 2004; 78-99.

13. Petrosyan YuS, Ioseliani DG. O summarnoy otsenkesostoyaniya koronarnogo rusla u bol’nykh ishemicheskoybolezn’yu serdtsa [On cumulative assessment of coronary arteries in patients with coronary heart disease]. Kardiologiya [Cardiology]. 1976; 12,16, 41-46.

DOI: 10.20969/VSKM.2018.11(4).124-129

REFERENCES

1. Khisamiyev RSh, Ginyatullina LR, Amirov NB. Opyt organizatsii deyatel’nosti mediko-sanitarnoy chasti v period provedeniya krupnykh mezhdunarodnykh i massovykh sportivnykh meropriyatiy (na primere FKUZ «MSCH MVD Rossi po respublike Tatarstan» v period podgotovki i provedeniya KHKHVII vsemirnoy letney universiady 2013 goda v g. Kazani» [Experience in organizing the activities of the medical and sanitary unit in the period of major international and mass sports events (on the example of the FKUZ «MSh Ministry of the Interior of Russia in theRepublic of Tatarstan» during the preparation and conductof the XXVII World Summer Universiade 2013 in Kazan»]. Vestnik sovremennoy klinicheskoy meditsiny [The Bulletin of Contemporary Clinical Medicine]. 2013; 6 (sup1): 4-9.

2. Sabirov LF, Spiridonov AV, Smirnov AO. Organizatsiya statsionarnogo zvena meditsinskogo obespecheniya sotrudnikov MVD v period provedeniya Universiady – 2013 [Organization of inpatient medical support for the Ministry of Internal Affairs staff during the Universiade – 2013]. Vestnik sovremennoy klinicheskoy meditsiny [The Bulletin of Contemporary Clinical Medicine]. 2013; 6 (sup1): 38-39.

3. Sakhibullin RF, Ageyev AG, Gimadiyev YuF, Stroitelev IA. Mediko – sanitarnoye soprovozhdeniye pridannykh sil MVD v period provedeniya XXVII Universiady 2013 goda v Kazani; Vzglyad vracha mobil’noy meditsinskoy brigady [Medical and sanitary support of the forces attached to the Ministry of Internal Affairs during the XXVII Universiade 2013 in Kazan; The view of the doctor of the mobile medical team]. Vestnik sovremennoy klinicheskoy meditsiny [The Bulletin of Contemporary Clinical Medicine]. 2013; 6 (sup1): 39-41.

4. Khisamiyev RSh, Ginyatullina LR, Amirov NB. Vedomstvennoye zdravookhraneniye MVD po Respublike Tatarstan: realii i perspektivy [Ministry of Internal Affairs of the Republic of Tatarstan: realities and prospects]. Vestnik sovremennoy klinicheskoy meditsiny [The Bulletin of Contemporary Clinical Medicine]. 2014; 7 (sup1): 11-15.

5. Sabirov LF, Spiridonov AV, Khisamiyev RSh, Amirov NB. Effektivnost’ menedzhmenta vedomstvennogo uchrezhdeniya zdravookhraneniya v svete 30-letnego yubileya otkrytiya novogo statsionara – Klinicheskogo gospitalya mediko-sanitarnoy chasti MVD Rossii po RT [The effectiveness of the management of the departmental health care establishment in the light of the 30th anniversary of the opening of a new hospital – the Clinical Hospital of the Ministry of the Interior of Russia for RT]. Vestnik sovremennoy klinicheskoy meditsiny [The Bulletin of Contemporary Clinical Medicine]. 2014; 7 (sup1): 15-20.

DOI: 10.20969/VSKM.2018.11(4).129-135

1. Brodie BC. Pathological and Surgical Observations on Diseases of the Joints. London: Longman. 1818; 54 p.

2. Fiessinger N, Leroy E. Contribution à l’étude d’une épidémie de dysenterie dans la Somme. Bull Soc Med Hôp Paris. 1916; 40: 2030-2069.

3. Reiter H. Über eine bisher unerkannte Spirochäteninfektion (Spirochaetosis arthritica). Deutsche Medizinische Wochenschrift. 1916; 42: 1535-1536.

4. Wright V, Reed WB. The Link between Reiter’s Syndrome and Psoriatic Arthritis. Ann Rheum Dis. 1964; 23 (1): 12–21.

5. Ahvonen P, Sievers K, Aho K. Arthritis associated with Yersinia enterocolitica infection. Acta Rheum Scand. 1969; 15: 232-253.

6. Thorsby E. A short history of HLA. Tissue Antigens. 2009; 74 (2): 101-116.

7. Bowness P. HLA-B27. Annu Rev Immunol. 2015; 33: 29–48.

8. Iglesias-Gammara A, Restrepo JF, Valle R and Matteson LM. A Brief History of Stoll-Brodie-Fiessinger-Leroy Syndrome (Reiter’s Syndrome) and Reactive Arthritis with a Translation of Reiter’s Original 1916 Article into English. Current Rheumatology Reviews. 2005; 1: 71-79.

9. Cheeti A, Ramphul K. Reactive Arthritis (Reiter Syndrome). Treasure Island (FL): StatPearls Publishing. 2018.

10. Nidavani RB, Mahalakshmi AM, Krishna K. Update on the diagnosis and management of Reactive arthritis (Reiter’s syndrome). Der Pharmacia Sinica. 2015; 6 (2): 12-18.

11. Nasonov EL, Nasonova VA. Revmatologiya. Natsional’noye rukovodstvo [Reumatology. National Guideline]. Moskva: GEOTAR-Media [Moscow: GEOTAR-Media]. 2010; 720 p.

12. Belov BS, Shubin SV, Balabanova RM, Erdes ShF. Reaktivnyye artrity [Reactive arthritis]. Nauchno- prakticheskaya revmatologiya [Scienti c and practical rheumatology]. 2015; 4: 414-459.

13. Kazakova TV, Rashid MA, Shostak NA, Karpova NYu. Reaktivnyy artrit: klinika, diagnostika i lecheniye [Reactive arthritis: clinic, diagnosis and treatment]. Lechebnoye delo [Therapeutics]. 2010; 1: 11-22.

14. Fedotov VP. Bolezn’ Reytera (istoriya, etiologiya, epidemiologiya, patogenez, klinika i techeniye, porazheniye kozhi, glaz, oporno-dvigatel’nogo apparata i drugikh organov): Klinicheskaya lektsiya [Reiter’s disease (history, etiology, epidemiology, pathogenesis, clinic and management, skin, eye, musculoskeletal and other organs impair): Clinical lecture] Dermatovenerologiya; Kosmetologiya; Seksopatologiya [Dermatovenerology; Cosmetology; Sexopathology]. 2016; 1: 83-106.

15. Vähämiko S, Penttinen MA, Granfors K. Aetiology and pathogenesis of reactive arthritis: role of non-antigen- presenting effects of HLA-B27. Arthritis Res Ther. 2005; 7 (4): 136-141.

16. Colmegna I, Cuchacovich R, Espinoza LR. HLA-B27- Associated Reactive Arthritis: Pathogenetic and Clinical Considerations. Clinical Microbiology Reviews. 2004; 17 (2): 348-369.

17. Kunder EV. Reaktivnyy artrit [Reactive Arthritis]. Meditsinskiye novosti [Medical News], 2015; 11: 8-13.

 EVGENIY VENTSESLAVOVICH PELIKAN – AN OUTSTANDING RESEARCHER AND HEALTH MANAGER

EGORYSHEVA IRINA V., C. Hist. Sci., leading researcher of the Department of history of medicine and public health of N.A. Semashko National Scientific Research Institute of Public Health, Russia, 105064, Moscow, Vorontsovo Pole str., 12, bld. 1, e-mail: egorysheva@rambler.ru

MOROZOV ALEXEY V., C. Med. Sci., senior researcher of the Department of history of medicine and public health of N.A. Semashko National Scientific Research Institute of Public Health, Russia, 105064, Moscow, Vorontsovo Pole str., 12, bld. 1; associate professor of history of medicine course of medical institute of Peoples’ Friendship University of Russia, Russia, 117198, Moscow, Miklukho-Maklay str., 6, e-mail: А0067138@yandex.ru

Abstract. Aim. Analysis of the activities of Evgeniy Ventseslavovich Pelikan (1824–1884) – forensic physician, toxicologist, one of the founders of forensic medicine in Russia and talented administrator, the founder of the rst Russian journals on forensic and veterinary medicine, has been performed. Material and methods. Common methodologicalapproaches for historical medical research have been applied. Results and discussion. Evgeniy Ventseslasovich Pelikan entered the history of Russian medicine as a researcher and leading statesman of the era of great reforms of the 60–70s in the 19th century and as the Head of Medical Department of the Ministry of Internal Affairs. Evgeniy Ventseslavovich was one of the initiators of creation of the rst hygienic society in Russia – Russian Society for Public Health Safety, that has united the representatives of clerisy of various specialties (doctors, lawyers, teachers, engineers) expressing progressive tendencies of their time. Evgeniy Ventseslasovich was also an honorary member of a number of Russian universities, Medical Surgical Academy and Imperial Free Economic Society. Conclusion. Evgeniy Ventseslasovich Pelikan signi cantly contributed to development of county medicine. He managed to achieve an increase in the level of medical education. The service and nancial position of the doctors who served in the Ministry of Internal Affairs have signi cantly improved on the initiative of E.V. Pelikan. Commission that regulates medical work has been created.

Key words: E.V. Pelican, Medical Department of the Ministry of Internal Affairs, health care, forensic medicine, experimental toxicology.

For reference: Egorysheva IV, Morozov AV. Evgeniy Ventseslavovich Pelikan – an outstanding researcher and health manager. The Bulletin of Contemporary Clinical Medicine. 2018; 11 (4): 136–139. DOI: 10.20969/VSKM.2018.11(4).136-139.

1. Egorysheva IV. Upravlenie zdravookhraneniem v pervoj polovine ХIX veka [Management in the rst half of the ХIX century]. Problemy sotsial’noj gigieny, zdravookhraneniya i istorii meditsiny [Problems of social hygiene, health and the history of medicine]. 2003; 6: 46-51.

2. Torzhestvo v chest’ Evgeniya Ventseslavovicha Pelikana [Celebration in honor of Eugene Ventseslavovich Pelican]. Sbornik sochinenij po sudebnoj meditsine [Collection of works on forensic medicine]. 1875; 1 (2): 56-64.

3. Nikolaev VR. Voprosy zdravookhraneniya i gigieny v trudakh EV Pelikana (1824-1884) [Health and hygiene Issues in the works of EV Pelican (1824-1884)]. Sovetskoe zdravookhranenie [Soviet health care]. 1960; 5; 53-57.

4. Sechenov IM. Аvtobiogra cheskie zapiski [Autobiographical notes]. Moskva [Moscow]. 1952; 164-165.

5. Diatroptov PN. EV Pelikan. Vestnik sudebnoj meditsiny i obshhestvennoj gigieny [Bulletin of forensic medicine and public hygiene]. 1884; 2 (6): 1-4.

6. Nazarov VY. EV Pelikan (K 150-letiyu zhurnala «Аrkhiv sudebnoj meditsiny i obshhestvennoj gigieny») [EV Pelican (to the 150th anniversary of the journal «Archive of forensic medicine and public hygiene»)]. Sudebno-meditsinskaya ehkspertiza [Forensic medical examination]. 2015; 1: 60-64.

7. Tajnyj sovetnik EV Pelikan, upravlyayushhij Meditsinskim departamentom MVD [He secret adviser EV Pelican, managing Medical Department of the Ministry of internal Affairs]. Vsemirnaya illyustratsiya [World illustration]. 1884; 363; 466-467.

8. Urusov VP. Sbornik tsirkulyarov i rasporyazhenij Ministerstva vnutrennikh del s 1858 po 1896 god [Collection of Circulars and orders of the Ministry of internal Affairs from 1858 to 1896]. Moskva [Moscow]. 1896; 388.

9. Sbornik Tsirkulyarov i rasporyazhenij Ministerstva vnutrennikh del za 1862-1864 goda [Collection of Circulars and orders of the Ministry of internal Affairs for 1862-1864]. Sankt-Peterburg [Saint Petersburg]. 1873; 373.

 X-RAY MORPHOLOGICAL CHARACTERISTICS OF THE CONSOLIDATION REGION OF THE TUBULAR BONE FRACTURE UNDER EXPERIMENTAL OSTEOPOROSIS USING MODIFIED IMPLANTS

KOSTIV ROMAN E., C. Med. Sci., associate professor of the Institute of surgery of Pacific State Medical University, Russia, 690002, Vladivostok, Ostryakov ave., 2, e-mail: kostiv2@rambler.ru

KABALYK MAXIM A., C. Med. Sci., associate professor of the Institute of internal medicine and instrumental diagnostics of Pacific State Medical University, Russia, 690002, Vladivostok, Ostryakov ave., 2, e-mail: maxi_maxim@mail.ru

NEVZOROVA VERA A., D. Med. Sci., professor, Head of the Institute of internal medicine and instrumental diagnostics of Pacific State Medical University, Russia, 690002, Vladivostok, Ostryakov ave., 2; senior researcher of Institute of сhemistry of Far Eastern District, Russia, 690022, Vladivostok, 100-letiye Vladivostoka ave., 159, e-mail: nevzorova@inbox.ru

MAYSTROVSKAYA JULIA V., C. Med. Sci., associate professor of the Institute of internal medicine and instrumental diagnostics of Pacific State Medical University, Russia, 690002, Vladivostok, Ostryakov ave., 2, e-mail: maistr30175@mail.ru

POGORELYI MAXIM A., 6th year student of the faculty of general medicine of Pacific State Medical University, Russia, 690002, Vladivostok, Ostryakov ave., 2, e-mail: maxibon94@mail.ru 

MASLYANTSEV EVGENY V., 6th year student of the faculty of general medicine of Pacific State Medical University, Russia, 690002, Vladivostok, Ostryakov аve., 2, e-mail: masl.e@gmail.com

MASHTALYAR DMITRY V., C. Tech. Sci., senior researcher of the Department of electrochemical systems and surface modification processes of Institute of сhemistry of Far Eastern District, Russia, 690022, Vladivostok, 100-letiye Vladivostoka ave., 159, e-mail: madiva@inbox.ru

KOCHETKOVA ELENA A., C. Med. Sci., associate professor of the Institute of internal medicine and instrumental diagnostics of Pacific State Medical University, Russia, 690002, Vladivostok, Ostryakov ave., 2, e-mail: kochetkovaEA@bk.ru

Abstract. Aim. X-ray morphological features of consolidation of the fracture of the tubular bone diaphysis in experimentalosteoporosis against intramedullary osteosynthesis with titanium implants with and without calcium phosphate coatingand magnesium implants were studied. Material and methods. The study was performed on 24 mature male Wistar rats weighing 200–250 g. A model of osteoporosis was reproduced in all animals, after which a closed fracture of the right femur diaphysis was modeled. In the rst, second and third groups the fragments were xed by closed intramedullary retrograde osteosynthesis. In the rst group the implants were manufactured in standard factory conditions using the grade of titanium BT-6 without coating. In the second one there was calcium-phosphate coating, in the third one – they were made from magnesium alloy. X-ray examination of the fracture consolidation region was performed on the 30th and 60th days. Evaluation of the results was carried out using traditional descriptive approach and morphometric analysis. Results and discussion. The study of the x-ray morphological features of consolidation of the femoral diaphysis fracture in experimental osteoporosis model against intramedullary osteosynthesis using titanium, calcium-phosphate and magnesium implants showed that the highest rates and simultaneously balanced processes of bonetissue regeneration are observed in osteosynthesis using magnesium implants and structures covered with bioactive hydroxyapatite. The application of magnesium and hydroxyapatite implants contributes to signi cant increase in bone density in experimental osteoporosis, not accompanied by inflammatory non-adaptive response of the cortical bone.Conclusion. Magnesium and hydroxyapatite implants have osteo-integrative and osteoregenerative properties. The results of the study con rm the general concept of using implants with bioactive properties for wide application in osteoporotic fractures of tubular bones.

Key words: osteosynthesis, osteoporosis, fracture, magnesium, hydroxyapatite, titanium/

For reference: Kostiv RE, Kabalyk MA, Nevzorova VA, Maistrovskaya JuV, Pogorelyi MA, Maslyantsev EV, Mashtalyar DV, Kochetkova YeA. X-ray morphological characteristics of the consolidation region of the tubular bone fracture under experimental osteoporosis using modi ed implants. The Bulletin of Contemporary Clinical Medicine. 2018; 11 (4): 140–149. DOI: 10.20969/VSKM.2018.11(4).140-149.

1. Nevzorova VA, Kochetkova EA, Ugay LG, Maistrovskaya YV, Khludeeva EA. Rol` markerov remodelirovaniya sosudov v formirovanii osteoporoza pri idiopaticheskoj legochnoj arterial`noj gipertonii [Role of vascular remodeling markers in the development of osteoporosis in idiopathic pulmonary arterial hypertension]. Terapevticheskij arxiv [Ter Arkh]. 2016; 88 (9): 65-70. doi: 10.17116/terarkh201688965-70.

2. Zhang Y, Xu J, Ruan YC, et al. Implant-derived magnesium induces local neuronal production of CGRP to improve bone-fracture healing in rats. Nat Med. 2016; 22 (10): 1160-1169. doi: 10.1038/nm.4162.

3. Axtyamov IF, Shakirova FV, Klyushkina YuA, et al. Analiz regenerativnogo processa v oblasti pereloma bol`sheberczovoj kosti (e`ksperimental`noe issledovanie) [Analysis of the regenerative process in the area of fracture of the tibia (experimental study)]. Travmatologiya i ortopediya Rossii [Traumatology and orthopedics of Russia]. 2016; 1: 100-107.

4. Cuijpers VM, Alghamdi HS, van Dijk NW. Osteogenesis around CaP-coated titanium implants visualized using 3D histology and micro-computed tomography. Journal of Biomedical Materials Research. 2015; 103 (11): 3463–3473.

5. Fini M, Giavaresi G, Toriccelli P. Osteoporosis and biomaterial osteointegration. Biomedicine and Pharmacotherapy. 2014; 58 (9): 487–493.

6. Surmeneva MA, Surmeniev RA, Khlusov IA. Calcium phosphate coatings, created by the HF magnetron sputtering method of hydroxyapatite: osteogenic potential in vitro and in vivo [Calcium phosphate coatings, created by the HF magnetron sputtering method of hydroxyapatite: osteogenic potential in vitro and in vivo]. Proceedings of Tomsk Polytechnic University [Proceedings of Tomsk Polytechnic University]. 2010; 317 (2): 101-106.

7. Maystrovskaya SE, Gnedenkov SV, Kostiev RE, et al. Sostoyanie kostnoj tkani pri e`ksperimental`nom osteoporoze s perelomom dia za bedrennoj kosti pri ispol`zovanii razlichny`x titanovy`x implantatov [The condition of bone tissue in experimental osteoporosiswith a fracture of the femoral bone diaphysis with the useof various titanium implants]. Tixookeanskij medicinskij zhurnal [Paci c Medical Journal]. 2017; 4: 60-64. doi: 10.17238/PmJ1609-1175.2017.4.60-65.

8. Wang J, Tang J, Zhang P, et al. Surface modi cation of magnesium alloys developed for bioabsorbable orthopedic implants: a general review. J Biomed Mater Res B Appl Biomater. 2012; 100 (6): 1691-1701. doi: 10.1002/ jbm.b.32707.

9. Rude RK, Singer FR, Gruber HE. Skeletal and hormonal effects of magnesium de ciency. J Am Coll Nutr. 2009; 28 (2): 131-141.

10. Yoshizawa S, Brown A, Barchowsky A, Sfeir C. Role ofmagnesium ions on osteogenic response in bone marrowstromal cells. Connect Tissue Res. 2014; 55 (1): 155-159. doi: 10.3109/03008207.2014.923877.

11. Liao Y, Xu Q, Zhang J, et al. Cellular response ofchondrocytes to magnesium alloys for orthopedicapplications. Int J Mol Med. 2015; 36 (1): 73-82. doi: 10.3892/ijmm.2015.2211.

12. Zhao N, Zhu D. Collagen self-assembly on orthopedicmagnesium biomaterials surface and subsequent bonecell attachment. PLoS One. 2014; 9 (10): e110420. doi: 10.1371/journal.pone.0110420.

13. Kazanin KS, Basov AV, Shpakovsky MS, et al. Sravnitel`noe issledovanie kostnogo regenerata posle osteosinteza perelomov shejki bedrennoj kosti bioinertny`mi i bioaktivny`mi implantatami s kal`cijfosfatny`m pokry`tiem (e`ksperimental`noe issledovanie) [Comparative studyof bone regenerate after osteosynthesis of femoral neckfractures with bioinert and bioactive implants with calcium phosphate coating (experimental study)]. [Traumatology and orthopedics of Russia]. 2015; 3: 51-60.

14. He H, Yu J, Liu Y, et al. Effects of FGF2 and TGFbeta1on the differentiation of human dental pulp stem cells invitro. Cell Biol Int. 2008; 32: 827–834. https://doi: 10.1016/j. cellbi.2008.03.013.

15. Padilla A, Keating P, Hartmann JX, Marí F. Effects of α-conotoxin ImI on TNF-α, IL-8 and TGF-β expression by human macrophage-like cells derived from THP-1 pre- monocytic leukemic cells. Sci Rep. 2017; 7 (1): 12742. https://doi: 10.1038/s41598-017-11586-2.

16. Courtois A, Andujar P, Ladeiro Y, et al. Impairment of NO- dependent relaxation in intralobar pulmonary arteries:comparison of urban particulate matter and manufacturednanoparticles. Environ Health Perspect. 2008; 116 (10): 1294-1299. doi: 10.1289/ehp.11021.

17. Zhou C, Lei F, Chodosh J, Paschalis EI. The Role of Titanium Surface Microtopography on Adhesion, Proliferation, Transformation, and Matrix Deposition of Corneal Cells. Invest Ophthalmol Vis Sci. 2016; 57 (4): 1927-1938. https://doi: 10.1167/iovs.15-18406.