ORIGINAL RESEARCH

УДК 616.441-006-073.432.19

DOI: 10.20969/VSKM.2019.12(1).7-11

 INVESTIGATION OF DOPPLER SONOGRAPHIC FEATURES OF THE BLOOD SUPPLY IN THYROID NODULES

AGABEYLY LALA Z., senior laboratory technician of the Department of radiology of Azerbaijan Medical University, Republic of Azerbaijan, AZ 1007, Baku, Gasymzade str., 14, e-mail: mic_amu@mail.ru

IBRAGIMOV ALI Z., Ph. D. in medicine, associate professor of the Department of internal medicine III of Azerbaijan Medical University, Republic of Azerbaijan, AZ 1007, Baku, Gasymzade str., 14, e-mail: mic_amu@mail.ru

ASKEROVA KHIZHRAN E., Ph. D. in medicine, assistant of professor of the Department of radiology of Azerbaijan Medical University, Republic of Azerbaijan, AZ1007, Baku, Gasymzade str., 14, e-mail: mic_amu@mail.ru

PANAKHOVA MATANAT S., Ph. D. in medicine, associate professor of the Department of radiology of Azerbaijan Medical University, Republic of Azerbaijan, AZ 1007, Baku, Gasymzade str., 14, e-mail: mic_amu@mail.ru

ISMAYILOVA FATMA Z., senior laboratory technician of the Department of internal medicine III of Azerbaijan Medical University, Republic of Azerbaijan, AZ 1007, Baku, Gasymzade str., 14, e-mail: mic_amu@mail.ru

KERIMOVA RUKHIYA F., senior laboratory technician of the Department of radiology of Azerbaijan Medical University, Republic of Azerbaijan, AZ 1007, Baku, Gasymzade str., 14, e-mail: mic_amu@mail.ru

Abstract. Aim. The aim of the study was to investigate the features of the blood supply in thyroid nodules and to assess the capabilities of doppler sonography in for the means of thyroid cancer differential diagnosis. Material and methods. We examined 178 nodules in 166 patients. The patients underwent an ultrasound examination and a fine-needle aspiration biopsy. The patients were divided into 3 groups. Group I was socalled «benign» (nodes of the I and II categories according to Bethesda scale, nI = 126). Group II was named «suspicious» (III and IV categories, nII = 23), group III was considered «malignant» (V and VI categories, nIII = 29). Doppler sonography and fine-needle aspiration biopsy were performed in all patients. The features related to the studies (sensitivity, specificity, accuracy, predictive value of a positive result, predictive value of a negative result) were evaluated. Results and discussion. Hypervascular nodules were more common in the «malignant» group (pI–III<0,001; pII–III<0,001, specificity is 98,4%, sensitivity is 17,4%). Nodules with a central type of blood circulation were found only in group III, socalled «malignant» group [(13,0±2,52)%]. Avascular nodules with peripheral blood supply were more common in groups I and II. Mixed type was seen in group III (pI–III<0,05; pII–III<0,05). The specificity of the central and mixed type of blood supply was 81,7%, sensitivity – 43,5%. Conclusion. Hypervascular nodes with central or mixed type of blood supply are associated with an increased risk of malignancy. Therefore, it is recommended to conduct a biopsy for such types of nodules.

Key words: doppler ultrasound examination, thyroid nodules, hypervascularity.

For reference: Agabeyly LZ, Ibragimov AZ, Askerova KhE, Panakhova MS, Ismayilova FZ, Kerimova RF. Investigation of Doppler sonographic features of the blood supply in thyroid nodules. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (1): 7-11. DOI: 10.20969/VSKM.2019.12(1).7-11.

УДК 616.72-002.772

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DOI: 10.20969/VSKM.2019.12(1).30-36

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УДК 616-057.36:314.14(470+571)

DOI: 10.20969/VSKM.2019.12(1).36-41

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УДК 614.77:579.63(470.23-25:210.5)

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УДК 616.153.922-06:616.1/.9(479.24-25)

DOI: 10.20969/VSKM.2019.12(1).45-49

 THE ROLE OF HYPERCHOLESTEROLEMIA IN POPULATION MORBIDITY NOSOLOGICAL STRUCTURE DEVELOPMENT

GAZHIEVA YAGUT G.A., Ph.D. in medicine, senior teacher of the Department of public health and its management of Azerbaijan Medical University, Azerbaijan, AZ 1022, Baku, Gasimzade str., 14, e-mail: mic_amu@mail.ru

Abstract. Aim. The aim of the research was to study the role of hypercholesterolemia (HCE) in morbidity nosological structure development. Material and methods. Survey of 2013 Baku residents was performed using Azerbaijani version of the international SF-36 questionnaire. Finger blood cholesterol was simultaneously measured using «Accutrendplus» portable device (test system). The results were handed to the participants in 1–2 minutes. Based on the questionnaire analysis, morbidity nosological structure was revealed and further compared to the outpatient card records from the clinics. The quality of life was also assessed in the participants. Results and discussion. Morbidity rates consistently increase against the background of increasing cholesterol levels in the body. So, when cholesterol level is less than 5,0 mmol/l (normal) the mean incidence rate is (53,5±2,4)%. In case of cholesterol level of 5,0–6,4 mmol/l this indicator reaches (54,5±2,1)% (p>0,05). At cholesterol level of >6,5–7,0 mmol/l – (60,6±1,8)% (p<0,05), at cholesterol level >7,8 mmol/l (hypercholesterolemia) – (68,5±2,3)% (p<0,01). Revealed cholesterol levels were corresponding to the following quality of life indicators respectively (70,6±2,29) points (satisfactory level is more than 70 points), (67,8±2,07) points (p>0,05), (57,7±1,83) points (p<0,001) and (49,3±2,61) points (p<0,01). Conclusion. Increasing body cholesterol level contributes to morbidity with different nosological entities and reduces the quality of life in urban residents. In this regard, it is necessary to implement the measures aiming to modify the lifestyle in the residents and to apply cholesterol-lowering drugs in them when indicated.

Key words: cholesterol, morbidity, quality of life.

For reference: Gazhieva Yagut G.A. The role of hypercholesterolemia in population morbidity nosological structure development. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (1): 45–49. DOI: 10.20969/VSKM.2019.12(1). 45-49.

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УДК 616.831-005.4-085.273.55-037

DOI: 10.20969/VSKM.2019.12(1).54-60

 ADVERSE OUTCOME RISK ASSESSMENT AFTER THROMBOLYSIS FOR ISCHEMIC STROKE USING PROGNOSTIC SCORE

DEOMIN TIMUR V., ORCID ID: orcid.org/0000-0002-0029-8113; Head of the Department of neurology for stroke patients of Interregional Clinical Diagnostic Center, Russia, 420101, Kazan, Karbyshev str., 12a, e-mail: tdiemin@gmail.com

NEFEDYEVA DARIA L., C. Med. Sci., Head of the Department of rehabilitation of Children’s Republic Clinical Hospital; assistant of professor of the Department of rehabilitation and sports medicine of Kazan State Medical Academy – the branch of Russian Medical Academy of Postgraduate Education, Russia, 420138, Kazan, Orenburgsky tract str., 140, tel. +7(843)229-06-31, e-mail: DLN-2006@yandex.ru

VOLODYUKHIN MIKHAIL YU., ORCID ID: orcid.org/0000-0001-8245-1996; C. Med. Sci., Head of the Department of radiologic surgery, diagnosis and treatment of Interregional Clinical Diagnostic Center, Russia, 420101, Kazan, Karbyshev str., 12a, tel. +7(843)291-10-88, e-mail: voloduckin@mail.ru

KHASANOVA DINA R., ORCID ID: orcid.org/0000-0002-8825-2346; D. Med. Sci., professor of the Department of neurology and neurosurgery of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7(843)291-10-88, e-mail: dhasanova@mail.ru

MUKHARLYAMOVA ELVIRA M., analyst, management and analysis unit of Interregional Clinical Diagnostic Center, Russia, 420101, Kazan, Karbyshev str., 12a, tel. +7(843)291-10-88, e-mail: rcssz@mail.ru

Abstract. Aim. The aim of the study was to assess the validity of the scores for predicting the efficacy and safety of thrombolytic therapy in patients with ischemic stroke. Material and methods. Evaluation of DRAGON, SEDAN, GRASPS and PREVIZ scores efficiency for prediction of the outcomes and symptomatic hemorrhagic transformation after thrombolysis was performed using the data from the stroke register of the Tatarstan Republic. The retrospective study included 192 patients with moderate and severe ischemic stroke treated with thrombolytic therapy. Assessment was performed according to the specified score at the time of admission to the hospital. The efficiency of treatment was determined by modified Rankin scale on the 30th day after stroke episode. We considered development of symptomatic hemorrhagic transformation associated with reperfusion therapy. Mathematical processing was carried out using variation statistical methods. Results and discussion. Our study confirms prognostic value of DRAGON score [estimates significantly correlated with the outcomes on the 30th day according to modified Rankin scale (r=0,42; p<0,001)], as well as of SEDAN score [this scale significantly correlated with the development of symptomatic hemorrhagic transformation (r=0,53; p<0,001) and with the outcomes after 30 days according to modified Rankin scale (r=0,82; p<0,001)], as well as PREVIZ score [the score of this scale significantly correlated with the outcomes on day 30 according to the modified Rankin scale (r=0,57; p<0,001)]. No correlation was found between the GRASPS score and the development of symptomatic hemorrhagic transformation. Conclusion. The predictive value of the easy-to-use DRAGON, SEDAN and PREVIZ scales, confirmed in our study, allows suggesting their use in the routine practice of the doctors of the vascular centers in deciding whether to conduct reperfusion therapy.

Key words: stroke, thrombolysis, outcome, prognosis.

For reference: Deоmin TV, Nefedyeva DL, Volodukhin MYu, Khasanova DR, Mukharlyamova EM. Adverse outcome risk assessment after thrombolysis for ischemic stroke using prognostic score. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (1): 54–60. DOI: 10.20969/VSKM.2019.12(1).54-60.

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УДК 612-097(470.43)

DOI: 10.20969/VSKM.2019.12(1).61-64

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DOI: 10.20969/VSKM.2019.12(1).64-69

 TRANSCRANIAL MICROPOLARIZATION APPLICATION IN COMPLEX REHABILITATION IN CHILDREN WITH EXPRESSIVE SPEECH DISORDER

KNYAZEVA OLESYA V., C. Med. Sci., associate professor of the Department of pediatric neurology of Kazan State Medical Academy – the branch of Russian Medical Academy of Postgraduate Education, Russia, 420012, Kazan, Galeev str., 11, tel. (843)273–49-09, e-mail: knyazeva.dnevr@mail.ru

BELOUSOVA MARINA V., C. Med. Sci., associate professor of the Department of psychotherapy and addictions of Kazan State Medical Academy – the branch of Russian Medical Academy of Postgraduate Education, Russia, 420012, Kazan, N. Ershov str., 49, tel. (843)272–41–51, e-mail: belousova.marina@mail.ru

PRUSAKOV VLADIMIR F., D. Med. Sci., professor, Head of the Department of pediatric neurology of Kazan State Medical Academy – the branch of Russian Medical Academy of Postgraduate Education, Russia, 420012, Kazan, Mushtari str., 11, tel. (843)273–49-09, e-mail: kaz.dnevr@mail.ru

ZAIKOVA FANIYA M., C. Med. Sci., assistant of professor of the Department of pediatric neurology of Kazan State Medical Academy – the branch of Russian Medical Academy of Postgraduate Education, Russia, 420012, Kazan, Mushtari str., 11, tel. (843)273–49-09, e-mail: detbol8@mail.ru

Abstract. The article provides information on transcranial micropolarization application in complex rehabilitation in children with expressive speech disorders. This method of restoration of the central regulation of child’s speech functions was optimally combined with corrective-speech therapy sessions and with a course assignment of nootropic, neurotrophic and vascular therapy. Аim. The aim of the study was to evaluate the outcomes of transcranial micropolarization application in complex rehabilitation in children with expressive speech disorder. Material and methods. The outcomes of transcranial micropolarization application in complex rehabilitation in children with expressive speech disorder were studied. The study involved 60 children with expressive speech disorder aged from 2,5 to 4,5 years. Results and discussion. The methods for early diagnosis and rehabilitation in children with expressive speech disorder were proposed. Case follow-up leaded to revealing persistent long-lasting effect of transcranial micropolarization in relation not only to speech nominative function or active vocabulary, but also to the pronunciation component of the speech. Conclusion. An integrated approach to the treatment of expressive speech disorders and transcranial micropolarization application will allow speech development acceleration.

Key words: perinatal brain trauma, expressive speech disorder, transcranial micropolarization, algorithm of observation, rehabilitation.

For references: Knyazeva OV, Belousova MV, Prusakov VF, Zaikova FM. Transcranial micropolarization application in complex rehabilitation in children with expressive speech disorder. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (1): 64–69. DOI: 10.20969/VSKM.2019.12(1).64-69.

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УДК 616.24-036.12-057-07:613.632.4(571.14-25)

DOI: 10.20969/VSKM.2019.12(1).69-78

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REVIEWS

УДК 616.132.2-008.6-07:616.153.96-074(048.8)

DOI: 10.20969/VSKM.2019.12(1).79-85

 C-REACTIVE PROTEIN IN ACUTE CORONARY SYNDROME: CONTENT IN BLOOD PLASMA AND PROGNOSTIC VALUE

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

AMIROV NAIL B., ORCID ID: orcid.org/0000-0003-0009-9103; SCOPUS Author 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

KIM ZULFIYA F., C. Med. Sci., associate professor of the Department of internal medicine No 2 of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49

GAIFULLINA RAUSHANIYA F., C. Med. Sci., associate professor of the Department of fundamental basis of clinical medicine of Institute of biology and fundamental medicine of Kazan Federal University, Russia, 420012, Kazan, K. Marx str., 74, e-mail: rushana78@mail.ru

Abstract. Aim. The latest publications devoted to the study of C-reactive protein level dynamics in patients with acute coronary syndrome and on its prognostic value have been analyzed. Material and methods. Review of publications devoted to the study of C-reactive protein level dynamics in patients with acute coronary syndrome and to its prognostic value was carried out in scientific and medical literature. Results and discussion. C-reactive protein concentration increases in acute coronary syndrome. Its maximal values in myocardial infarction are higher than in patients with unstable angina. Correlation is revealed between its level and the area of necrosis. It was explored that increased C-reactive protein concentration during hospital stay may be a predictor of poor prognosis. Its elevated basal levels serve as independent prognostic signs of short-and long-term risks of recurrent myocardial infarction or death. C-reactive protein level at discharge from the hospital has a greater prognostic value in patients than the one measured upon admission. Conclusion. Adding the study of C-reactive protein plasma level to the existing standard models of risk assessment allows one to predict the probability of acute coronary syndrome development and the prognosis more accurately.

Key words: C-reactive protein, acute coronary syndrome, prognosis.

For reference: Abdrahmanova AI, Amirov NB, Kim ZF, Gaifullina RF. C-reactive protein in acute coronary syndrome: content in blood plasma and prognostic value. The Bulletin of Contemporary Clinical Medicine. 2018; 11 (5): 79–85. DOI: 10.20969/VSKM.2019.12(1).79-85.

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EXPERIMENTAL STUDIES – TO PRACTICAL MEDICINE

УДК 616.381-002-092.9-71

DOI: 10.20969/VSKM.2019.12(1).99-102

 MODERN DEVICE FOR PERITONITIS REPRODUCTION IN RATS

MOROZOV ARTEM M., assistant of professor of the Department of general surgery of Tver State Medical University, Russia, 170100, Tver, Sovetskaya str., 4, e-mail: ammorozovv@gmail.com

MOKHOV EVGENIY M., D. Med. Sci., professor, professor of the Department of general surgery of Tver State Medical University, Russia, 170100, Tver, Sovetskaya str., 4, e-mail: ammorozovv@gmail.com

KADYKOV VICTOR A., C. Med. Sci., associate professor of the Department of general surgery of Tver State Medical University, Russia, 170100, Tver, Sovetskaya str., 4, e-mail: ammorozovv@gmail.com

ZHUKOV SERGEY V., D. Med. Sci., professor of the Department of public health with a course of health management of Tver State Medical University, Russia, 170100, Tver, Sovetskaya str., 4, e-mail: ammorozovv@gmail.com

ASKEROV ELSHAD M., C. Med. Sci., associate professor of the Department of general surgery of Tver State Medical University, Russia, 170100, Tver, Sovetskaya str., 4, e-mail: ammorozovv@gmail.com

PELTIKHINA OLGA V., student of the рediatric faculty of Tver State Medical University, Russia, 170100, Tver, Sovetskaya str., 4, e-mail: cola1072008@yandex.ru

KHORAK KONSTANTIN I., student of the Faculty of general medicine of Tver State Medical University, Russia, 170100, Tver, Sovetskaya str., 4, e-mail: ammorozovv@gmail.com

Abstract. Aim. The aim of the study was to develop a device for peritonitis reproduction in rats. Material and methods. We conducted two series of experiments on peritonitis reproduction in rats with the use of developed device and Е. Coli 2592210 strain. Results and discussion. Device for peritonitis reproduction in rats, which is a laparoscope consisting a handle and a tube with optical and manipulation channels was developed. Additional channel that runs parallel to diagnostic and manipulation channels was placed in the tube of the device. It has a circular section. One of the sides of the channel is open to the outside for 1/4 of the diameter. Movable rod was placed inside the channel, in which there is a recess for securing the carrier of the infectious material. The technical outcome of using the proposed device is providing an accurate simulation of abdominal cavity infection in rats in impaired sterilization of the laparoscope both in case of infection due to external contamination of the tube and in case of infection due to the use of contaminated manipulators. Conclusion. The proposed method for diffuse purulent peritonitis modeling assures reliable development of purulent process in the abdominal cavity. Such model can be recommended for future application in development of the new methods of treatment.

Key words: effective model, peritonitis, laparoscope.

For reference: Morozov AM, Mokhov EM, Kadykov VA, Zhukov SV, Askerov EM, Peltykhina OV, Khorak KI. Modern device for peritonitis reproduction in rats. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (1): 99–102. DOI: 10.20969/VSKM.2019.12(1).99-102.

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CLINICAL CASE

УДК 616.24-036.12-085.276

DOI: 10.20969/VSKM.2019.12(1).103-106

 CLINICAL EXPERIENCE OF SELECTIVE PHOSPHODYESTERASE-4 INHIBITOR ADMINISTRATION IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE

KULIK EKATERINA G., assistant of professor of the Department of internal medicine of Amur State Medical Academy, Russia, 675000, Blagoveshchensk, Gor’ky str., 95, e-mail: rybas_katya@mail.ru

PAVLENKO VALENTINA I., D. Med. Sci., professor of the Department of internal medicine of Amur State Medical Academy, Russia, 675000, Blagoveshchensk, Gor’ky str., 95, e-mail: amurvip@front.ru

NARYSHKINA SVETLANA V., D. Med. Sci., professor of the Department of internal medicine of Amur State Medical Academy, Russia, 675000, Blagoveshchensk, Gor’ky str., 95, e-mail: kaf_fakult_terapii@amursma.su

Abstract. Aim. The aim of our study was to analyze the course of chronic obstructive pulmonary disease in conditions of administration of selective phosphodiesterase-4 inhibitor – roflumilast. Material and methods. The article describes the clinical case of a patient with severe chronic obstructive pulmonary disease with the signs of systemic inflammation and vascular dysfunction treated with selective phosphodiesterase-4 inhibitor for 3 months. In addition to the studies included in the standard diagnostic protocol, serum markers of systemic inflammation were assessed using ELISA. Sphygmography and sphygmomanometry were performed on «Vasera-1000» machine (Fucuda Denshi, Japan). The control points of monitoring were: primary examination, examinations after 1st and 3rd months. Results and discussion. Based on the results of the examination, in accordance with international (GOLD, 2016) and federal guidelines, the patient was diagnosed with chronic obstructive pulmonary disease, group D (mMRC 3, high risk), degree according to GOLD III (severe). Respiratory failure of the 1st degree. The treatment prescribed to the patient had a positive effect in terms of clinical symptoms, parameters of respiratory function, and quality of life according to the assessment test results. Within 3 months of drug treatment, the patient did not have a single exacerbation. Despite the downward trend, the markers of endothelial dysfunction and arterial stiffness remained high against the background of the therapy. Conclusion. Thus, short-term roflumilast administration as a component of combined treatment for a patient with chronic obstructive pulmonary disease category D with the signs of systemic inflammation had a positive effect on the course of the disease. Taking into account the persistence of vascular dysfunction, the patient was advised to continue taking roflumilast for up to 12 months.

Key words: chronic obstructive pulmonary disease, roflumilast, arterial stiffness, endothelial dysfunction, inflammation.

For reference: Kulik EG, Pavlenko VI, Naryshkina SV. Clinical experience of selective phosphodyesterase-4 inhibitor administration in chronic obstructive pulmonary disease. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (1): 103–106. DOI: 10.20969/VSKM.2019.12(1).103-106.

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