UDC [616.24+616.428]-002.282:616.12-005.4

DOI: 10.20969/VSKM.2019.12(3).7-15

 FEATURES OF SARCOIDOSIS OF THE LUNGS AND INTRATHORACIC LYMPH NODES, COMBINED WITH CORONARY HEART DISEASE

ABUBIKIROV ANVER F., C. Med. Sci., senior research worker of the Department of tuberculosis differential diagnosis and extracorporeal treatment of Central Tuberculosis Research Institute, Russia, 107564, Moscow, Yauzskaya alley, 2, tel. +7(499)785-90-31, e-mail: abubik_1@mail.ru

ZAITSEVA ANNA S., C. Med. Sci., senior research worker of the Department of tuberculosis differential diagnosis and extracorporeal treatment of Central Tuberculosis Research Institute, 107564, Russia, Moscow, Yauzskaya alley, 2, tel. +7(499)785-90-31, e-mail: anyasyls@yandex.ru

LEONOVA ELENA I., C. Med. Sci., research worker of the Department of tuberculosis differential diagnosis and extracorporeal treatment of Central Tuberculosis Research Institute, Russia, 107564, Moscow, Yauzskaya alley, 2, tel. +7(499)785-90-31, e-mail: zei86@mail.ru

MAZAEVA LARISA A., C. Med. Sci., research worker of the Department of tuberculosis differential diagnosis and extracorporeal treatment of Central Tuberculosis Research Institute, Russia, 107564, Moscow, Yauzskaya alley, 2, tel. +7(499)785-90-31, e-mail: lara.mazaeva@yandex.ru

MEDVEDEV ALEXANDER V., C. Med. Sci., senior research worker of the Department of tuberculosis differential diagnosis and extracorporeal treatment of Central Tuberculosis Research Institute, Russia, 107564, Moscow, Yauzskaya alley, 2, tel. +7(499)785-90-31, e-mail: alexmedved_1@mail.ru

SHMELEVA NATALIA M., C. Med. Sci., senior research worker of the Department of tuberculosis differential diagnosis and extracorporeal treatment of Central Tuberculosis Research Institute, Russia, 107564, Moscow, Yauzskaya alley, 2, tel. +7(499)785-90-31, e-mail: 09shmeleva@mail.ru

SHMELEV EVGENY I., D. Med. Sci., Head of the Department of tuberculosis differential diagnosis and extracorporeal treatment of Central Tuberculosis Research Institute, Russia, 107564, Moscow, Yauzskaya alley, 2, tel. +7(499)785-90-08, e-mail: eishmelev@mail.ru

Abstract. Aim. The aim of the research was to study clinical, radiological, and functional parameters in patients with lung and intrathoracic lymph node sarcoidosis in combination with coronary heart disease. The nature of lung sarcoidosis clinical, radiological and functional manifestations in the presence of comorbid heart disease was analyzed. Material and methods. The study involved patients with lung and intrathoracic lymph node sarcoidosis divided into two groups. The first main group consisted of patients with lung sarcoidosis and coronary heart disease as a concomitant pathology. The second comparison group was represented by patients with lung sarcoidosis without coronary heart disease. The diagnosis of pulmonary sarcoidosis was made based on clinical indicators, and the results of radiological studies (chest X-ray, chest computed tomography). Some patients had a morphological verification of the diagnosis. The presence of coronary heart disease was confirmed by typical clinical signs, electrocardiographic and echocardiographic changes. 6-minute walk test, spirometry, body plethysmography, and lung diffusion capacity evaluation was performed to assess the functional status. Results and discussion. Respiratory symptoms were more pronounced and they developed in ashorter time in patients with coronary heart disease. Physical exercise tolerance in this group was significantly lower than in the main group. Spirometry and body plethysmography indicators did not differ between the groups. Lung diffusivity was significantly lower in the group with coronary heart disease. This may be due to development of interstitial edema and microcirculatory disorders at alveolar-capillary membrane level. Moderate pulmonary hypertension was detected in both groups, with no significant difference between them. Conclusion. The presence of coronary heart disease inpatients with lung sarcoidosis worsens and accelerates respiratory symptom development. It leads to exercise tolerance significant reduction and causes more pronounced diffusion disorders.

Key words: lung sarcoidosis, ischemic heart disease, spirometry, lung diffusion capacity, pulmonary hypertension.For reference: Abubikirov AF, Zaitseva AS, Leonova EI, Mazaeva LA, Medvedev AV, Shmeleva NM, Shmelev EI. Features of sarcoidosis of the lungs and intrathoracic lymph nodes, combined with coronary heart disease. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (3): 7-15. DOI: 10.20969/VSKM.2019.12(3).7-15.

14. Dmitrieva L.I., Sigaev A.T., Romanov V.V. Luchevaya diagnostika sarkoidoza organov dyhaniya. [Radiodiagnosis of a sarcoidosis of a respiratory organs]. Problemy tuberkuleza [ Tuberculosis problems]. 2001; 2: 56-61.

DOI: 10.20969/VSKM.2019.12(3).15-20

 THE INFLUENCE OF INFORMATION DEVICES AND SOCIAL ENVIRONMENT FACTORS ON SPEECH DEVELOPMENT IN EARLY AGE CHILDREN

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, 420061, Kazan, Ershov str., 49, tel. (843)272-41-51, e-mail: belousova.marina@mail.ru

SHVETS ELIZAVETA V., associate researcher of laboratory of speech psychology and psycholinguistics of Institute of psychology of the Russian Academy of Sciences, Russia, Moscow, Yaroslavskaya str., 13, tel. 8-903-771-57-83, e-mail: ferly1995@mail.ru

Abstract. The article considers the impact of modern information technology world on speech development in early age children. The main component is the fact of using information devices, and gadgets, by children aged 1 to 3,5 years. Aim. The aim of the study was to analyze speech development in young children from perspective of the influence of information devices and certain social environment components. Material and methods. The study included families with children aged 1 to 3,5 years. Three psychological diagnostic tools were applied in the course of the study, those were Nancy Bayley’s scale of psychomotor development in children; Home scale, developed by Betty Caldwell and Robert Bradley, aiming for assessment of the impact of environment via watching at home; as well as «Your child and his free time» Questionnaire for interviewing parents. Results and discussion. Interrelation between child speech development and the use of information devices was revealed in two groups out of three studied, those were the group of children with a specified level of speech development and the one with low level speech development. There was also an interrelation between speech development and certain components of social environment and mother care indicators. Conclusion. Uncontrolled use of information devices by children does not contribute to active development of speech. Adequate parent demanding attitude to their children can be a factor that has a positive impact on speech development. The key factors that have a positive impact on the speech development in children are active position of the mother and diversity of educational environment.

Key words: speech, information devices (gadgets), social factors (components), speech development level.

For reference: Belousova MV, Shvets EV. The influence of information devices and social environment factors on speech development in early age children. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (3): 15-20. DOI: 10.20969/VSKM.2019.12(3).15-20.

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UDC 616.342-008.17-031:611.33

 THE IMPACT OF DUODENOGASTRIC REFLUX ON GASTRIN-PRODUCING CELL QUANTITY AND ON OTHER MORPHOLOGICAL FEATURES OF CHRONIC GASTRITIS

GALIEV SHAMIL Z., postgraduate student of the Department of general medical practice of Kazan State Medical University, Russia, Kazan, Butlerov str., 49, tel. 8-927-421-03-08, e-mail: galis160@gmail.com

AMIROV NAIL B., ORCID ID: 0000-0003-0009-9103; D. Мed. Sci., professor of the Department of general medical practice of Kazan State Medical University, Russia, Kazan, Butlerov str., 49, tel. 8-905-313-01-11, e-mail: namirov@mail.ru

AKHMETOV TIMUR R., C. Med. Sci., Republic Clinical Cancer Center, Russia, 420029, Kazan, Sibirskiy tract str., 29, e-mail: timur1111@mail.ru

PETROV SEMEN V., D. Мed. Sci., professor, Republic Clinical Cancer Center, Russia, 420029, Kazan, Sibirskiy tract str., 29, e-mail: semyonp@mail.ru

AMIROVA RENATA N., medical officer «SOGAZ» OJSC, Russia, Kazan, tel. + 7-903-307-99-47, e-mail: renata1980@mail.ru

Abstract. Aim. The aim of the study was to identify the nature of the impact of duodenogastric reflux and H. pylori on acidity level, gastrin-producing (G) cell quantitative indicators and other morphological changes in gastric mucosa in «primary» reflux gastritis. Material and methods. 66 patients with reflux gastritis were examined. 15 people were enrolled in control group. All patients underwent esophagogastroduodenoscopy with determination of acidity and bile acid concentration in the gastric content. Gastric mucosa biopsy material histological examination was performed in 55 cases. Additionally, histochemical (Schiff-iodic acid and alcian blue) staining and immunohistochemical studies (gastrin, cytokeratin 20, villin, MUC2, and cancer embryonic antigen expression determination) were carried out in 25 cases.Results and discussion. Acidity level was higher in patients with duodenogastric reflux (pH 3,47±2,37) comparing to control group (pH 5,73±1,91). As for the morphological features of duodenogastric reflux, mononuclear infiltration (p=0,001), foveolar hyperplasia (p=0,001) in all parts of the stomach, antral edema (p=0,022) and atrophy (p=0,02), intestinal metaplasia (p=0,022) at the level of the body of the stomach significantly differed from control group. G-cell hyperplasia in the antral mucous membrane was detected in patients with DGR (p=0,016). In patients with gastritis, caused jointly by duodenogastric reflux and H. pylori infection, the percentage of G-cells in gland epithelium did not differ from the control group (p=0,776). Conclusion. The mechanisms of morphological changes in duodenogastricreflux are associated with G-cell hyperplasia. Duodenogastric reflux contributes to the «acidification» of gastric content.Key words: duodenogastric reflux, gastrin-producing cells, acidity, chronic gastritis

For reference: Galiev ShZ, Amirov NB, Akhmetov TR, Petrov SV, Amirova RN. The impact of duodenogastric reflux on gastrin-producing cell quantity and on other morphological features of chronic gastritis. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (3): 20-28. DOI: 10.20969/VSKM.2019.12(3).20-28.

15. Bakurskaya ES, Dubrovin GM. Sposob izgotovleniya individual’noj ortopedicheskoj stel’ki pri plosko-val’gusnoj nefiksirovannoj deformacii stop [A method of manufacturing an individual orthopedic insole for flat-valgus unfixed deformation of the feet]. Zayavka na patent No 2017112463 RF,MKPA61F5/14A43B7/22–No2651701[Patent application No 2017112463 RF, MKP A 61 F 5/14 A 43 B 7/22 – No 2651701]. 2018; 12: 7 р.

16. Farzin Halabchi, Reza Mazaheri, Maryam Mirshahi, Ladan Abbasian. Pediatric Flexible Flatfoot; Clinical Aspects and Algorithmic. Iranian Journal of Pediatrics. 2013; 23 (3): 247–260.

DOI: 10.20969/VSKM.2019.12(3).33-39

 THE IMPACT OF THE SECOND BREAKFAST ON THE FREQUENCY OF HYPOGLYCEMIC STATES IN PATIENTS WITH TYPE II DIABETES MELLITUS AND ACUTE MYOCARDIAL INFARCTION WITH Q-WAVE, RECEIVING SULPHONYLUREA MEDICATIONS

IVANOVA LIUDMILA A., ORCID: 0000-0001-5302-3802; D. Med. Sci., professor, Head of the Department of endocrinology of faculty of advanced training and professional specialist retraining of Kuban State Medical University, Russia, 350063, Krasnodar, Sedin str., 4, tel. +7 (988)242-13-90, e-mail: endocrinkgmu@mail.ru

SOKUEVA KHEDA YU., postgraduate student of the Department of endocrinology of faculty of advanced training and professional specialist retraining of Kuban State Medical University, Russia, 350063, Krasnodar, Sedin str., 4, tel. +7 (928)738-38-82, e-mail: s.khaidi@yandex.ru

KOROL INNA V., ORCID: 0000-0002-3909-9007; C. Med. Sci., associate professor of the Department of endocrinology of faculty of advanced training and professional specialist retraining of Kuban State Medical University, Russia, 350063, Krasnodar, Sedin str., 4, tel. +7 (918)414-44-19, e-mail: innakorol1@mail.ru

Abstract. Aim. The aim of the study was to determine the frequency of hypoglycemic conditions in patients with type II diabetes and acute myocardial infarction with Q-wave receiving sulphonylurea medications, and to reduce their number by adding a second breakfast. Material and methods. The study included 90 patients [mean age (55±3,7) years] with type II diabetes mellitus and acute myocardial infarction with Q-wave. The patients were divided into 3 groups: patients of group 1 (n=30) were receiving gliclazide (mean daily dose 60 mg), group 2 (n=30) – micronized glybenclamide (mean daily dose 3,5 mg), group 3 (n=30) – glimepiride (mean daily dose 3 mg). At the first stage of the study the diet consisted of 3 main meals. At the second stage second breakfast was added 2 hours after morning sulphonylurea medication intake. Laboratory tests, electrocardiography and echocardiography were performed in all patients at both stages. Results and discussion. It was revealed that the frequency of hypoglycemic conditions is significantly higher in patients on three meals a day without snacking. Hypoglycemia occurred 2–2,5 hours after morning sulphonylurea drug intake. The highest frequency of hypoglycemia was observed in the group of patients receiving glybenclamide. After adding a second breakfast, hypoglycemia disappeared. Conclusion. Hypoglycemic condition frequency reduction in patients with type II diabetes and acute myocardial infarction with Q-wave receiving sulphonylurea medications is possible by adding a second breakfast, containing 12–15 grams of carbohydrates, at the drug action spike.

Key words: sulphonylurea medications, diabetes mellitus, hypoglycemic state.

For reference: Ivanova LA, Sokueva Khu, Korol IV. The impact of the second breakfast on the frequency of hypoglycemic states in patients with type 2 diabetes mellitus and acute myocardial infarction with Q-vawe, receiving sulphonylurea medications. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (3):33-39. DOI: 10.20969/ VSKM.2019.12(3).33-39.

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 NEURAL NETWORK APPLICATION FOR CEREBRAL PALSY PREDICTION IN CHILDREN BASED ON PERINATAL FACTOR INFLUENCE EVALUATION

ORLOVA ELENA V., Head of day care hospital for medical rehabilitation of Regional Pediatric Clinical Hospital, Russia, Rostov-on-Don, Strelcovaya Divizya 339 str., 14/168, e-mail: orlovae1@yandex.ru

DUDNIKOVA ELEONORA V., D. Med. Sci., professor, Head of the Department of pediatric diseases No 1 of Rostov State Medical University, Russia, Rostov-on-Don, Nakhichevan layn, 29, e-mail: kaf.det.bol.1@yandex.ru

VODOPYANOV ALEXEY S., C. Med. Sci., Rostov-on-Don Anti-Plague Institute of Federal Service on Surveillance for Consumer rights protection and human well-being, Russia, Rostov-on-Don, M. Gorky str., 117, e-mail: alexvod@gmail.com

CHERNOVA MARIA S., C. Med. Sci., assistant of professor of the Department of pediatric diseases No 1 of Rostov State Medical University, Russia, 101, Rostov-on-Don, Nakhichevan layn, 29, e-mail: marysia2005.87.11@mail.ru

Abstract. Aim. Development of a methodology and creation of a neural network software package for cerebral palsy risk prediction in children was the aim of the study. Material and methods. The study involved children with adiagnosis of cerebral palsy, confirmed by clinical, instrumental and laboratory study methods, as well as the children without diagnosed central nervous system diseases. In addition to primary medical documentation review, we surveyed mothers followed by filling out an individual card. Statistical data processing was carried out using Fisher’s exact test using StatisticaNeuralNetworks software package. The software was developed in Java programming language using the Encog 3.4 module. Results and discussion. Based on an artificial neural network, we developed a method assessing the influence of 20 perinatal factors on cerebral palsy development risk. The software package to be used in routine practice has been created in Java programming language, which allows quick cerebral palsy risk assessment.Conclusion. Statistically significant factors that influence cerebral palsy development risk in children were identified. We developed neural network classifier. Significance indicators of the parameters that had the greatest influence on the risk of cerebral palsy development in children were calculated. Test prediction of the developed expert system was also performed using control patient sample.

Key words: children, risk factors, cerebral palsy, artificial neural network.

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 THE IMPACT OF THE SECOND CLINICAL STAGE ON INEFFECTIVE PROSTHETIC TREATMENT IN FULL OVERDENTURE RESTORATION

PANAKHOV NAZIM A., D. Med. Sci., professor of the Department of prosthetic dentistry of Azerbaijan Medical University, Azerbaijan, AZ 1007, Baku, Gasymzade str., 14

BAYRAMOV YUNIS I., Ph. D. in Medicine, assistant of professor of the Department of prosthetic dentistry of Azerbaijan Medical University, Azerbaijan, AZ 1007, Baku, Gasymzade str., 14, e-mail: mic_amu@mail.ru

MUSAYEV EMIN R., Ph. D. in Medicine, assistant of professor of the Department of prosthetic dentistry of Azerbaijan Medical University, Azerbaijan, AZ 1007, Baku, Gasymzade str., 14

Abstract. Aim. Study of the influence of the second clinical stage of denture manufacture on ineffective prosthetic treatment in full overdenture restoration. Material and methods. A retrospective analysis of the results of treatment wasperformed in 1400 patients with complete secondary edentulous at the age of 34–69 years [mean age (56±6,3) years] who had received prosthetic treatment via complete overdenture restoration. Anatomical impressions were made with elastic impression mass (İpeen, Hydrocolor), functional impressions were obtained via crystallizing impression materials (repin, silicone-correction layer impression material). Chewing efficacy evaluation was performed by I.S. Rubinova method in 62 patients using denture for 2 years out of the total number, on the day of prostheses delivery, after 1 month, 12, and 24 months. The data obtained were processed by methods of variation statistics, including calculation of the mean and the error of the mean (M±m). Results and discussion. When analyzing the condition of patients after prosthetics, it was revealed that 58,9% of them had overdenture restoration fixation errors in the process of chewing food, 40,1% had various diseases of the mucous membrane. 39,1% of patients complained of impaired speech, 15% of aesthetic deficiencies and whistles when talking, 27,4% of food penetration under the denture, 10,4% of denture instability in the mouth when consuming liquid food, 28,6% – of nausea and urge to vomit. 25,6% of patients were not using overdenture restorations made for them. The best chewing efficacy indicators were recorded 12 months after the denture was delivered (p˂0,05). However, deterioration in performance was subsequently noted. Conclusion. Thus, in order to prevent complications during prosthetics at the second clinical stage, the pressure on prosthetic bed area applied by the dentist when taking a functional impression with an individual spoon until the impression mass hardens, while thepatient performs various functional movements has to comply with such in overdenture restorations on prosthetic bedsurface. However, the impression obtained with individual spoon was not functional.

1. Nespryad’ko VP, Baranovskij AV, Kisel’ ZF. Osobennosti ortopedicheskiogo lecheniya pacientov s polnym otsutstviem zubov na odnoj iz chelyustej [Features oforthopedic treatment of patients with complete absenceof teeth in one of the jaws]. Sovremennaya stomatologiya [Modern dentistry]. 2014; 1: 81–83.

2. Baradina IN, Gun’ko II, Lobko VA. Adaptaciya k s»emnym zubnym protezam [Adaptation to removable dentures]. Minsk: BelMAPO. 2012; 40 p.

3. Zholudev SE. Osobennosti protezirovaniya polnymi s»emnymi protezami i adaptacii k nim u lic pozhilogo i starcheskogo vozrasta [Features of prosthetics with fullremovable prostheses and adaptation to them in elderlyand senile persons]. Ural’skij medicinskij zhurnal [Ural Medical Journal]. 2012; 8: 31-35.

4. Zholudev SE, Gette SA. Reshenie problemy adaptacii k s»emnym konstrukciyam zubnyh protezov pri polnoj utrate zubov (klinicheskij sluchaj) [Solution of the problemof adaptation to the removable structures of dentureswith the complete loss of teeth (clinical case)]. Problemy stomatologii [Dental problems]. 2016; 12 (3): 46-51. DOI: 10.18481/2077-7566-2016-12-3-46-51

5. Shulyatnikova OA. Optimizaciya ortopedicheskogo etapa lecheniya v kompleksnoj specializirovannoj pomoshchi pacientam s defektami chelyustno-licevoj oblasti [Optimization of the orthopedic treatment in complex specialized care for patients with defects in the maxillofacial area]. Rossijskij stomatologicheskij zhurnal [Russian Dental Journal]. 2016; 20 (2): 38—41.

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7. Lobko VA, Pryalkin SV, Troyanovskaya MS. Sposob izgotovleniya polnogo s»emnogo proteza chelyusti [A method of fabricating a complete denture jaw]. Sovremennaya stomatologiya [Modern dentistry]. 2013; 2: 33–37.

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UDC 616.2-036.22:314.14(571.17)

DOI: 10.20969/VSKM.2019.12(3).47-53

 RESPIRATORY DISEASES IN INDUSTRIAL REGION OF SIBERIA: MORBIDITY ANALYSIS ON THE EXAMPLE OF THE KEMEROVO REGION

KHANIN ARKADIY L., professor, Head of the Department of phthisiopulmonology of Novokuznetsk State Institute for Advanced Physician training – the branch of Russian Medical Academy of Postgraduate Education, Russia, 654005, Novokuznetsk, Stroitely ave., 5, tel/fax 8(3843)45-42-19, e-mail: prof.khanin@yandex.ru

SHABINA OLESYA P., pulmonologist, Russia, 654007, Novokuznetsk, Kuznetskstroevskiy ave., 11, tel/fax 8(3843)99-40-40, e-mail: o.shabina@gm.clinic

VIKTOROVA IRINA B., С. Med. Sci., associate professor of the Department of phthisiopulmonology of Novokuznetsk State Institute for Advanced Physician training – the branch of Russian Medical Academy of Postgraduate Education, Russia, 654005, Novokuznetsk, Stroitely ave., 5, tel/fax 8(3843)45-42-19, e-mail: irinaviktoroff@mail.ru

Abstract. Aim. The aim of the research was to study the incidence of respiratory diseases in the region with highindustrial pollution of the environment (coal, metallurgical, chemical and construction industries) on the example of the Kemerovo region. Material and methods. Publication data and official statistical materials for the years 2015 and 2016 have been applied. Results and discussion. The incidence of respiratory diseases in Kuzbass is 2,4 times higher comparing to injuries, poisoning or other diseases caused by external causes, 5,4 times – diseases of the genitourinary system, 6,5 times – diseases of the musculoskeletal system, 7,25 times – diseases of the circulatory system and 8,5 times – diseases of the digestive system. The incidence of community-acquired pneumonia is higher by 25,9%, the one of bronchial asthma and other respiratory allergies is higher by 40,8%, and the one of chronic obstructive pulmonary disease is 2 times higher than in the Russian Federation. The incidence of tuberculosis, multidrug-resistant tuberculosis, tuberculosis with HIV infection was 2,0; 2,4 and 6,75 times, respectively, higher comparing to national indicators. The incidence of malignant respiratory diseases was 5,7% higher than the mean indicator for the Russian Federation. Conclusion. Respiratory diseases are the leading ones in Kuzbass, which is primarily associated with a high concentration of coal and metallurgical enterprises, creating an unfavorable ecological situation and, accordingly, a high load on the respiratory system of the population living in the region.

Key words: Kemerovo region, respiratory diseases, incidence.

For reference: Khanin AL, Shabina OP, Viktorova IB. Respiratory diseases in industrial region of Siberia: morbidity analysis on the example of the Kemerovo region. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (3): 47-53.DOI: 10.20969/VSKM.2019.12(3).47-53.

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12. Ekonomika Kemerovskoy oblasti [Economy of the Kemerovo region]. https://ru.wikipedia.org/wiki/ Ekonomika_Kemerovskoy_oblasti

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DOI: 10.20969/VSKM.2019.12(3).53-56

 GENDER IDENTIFICATION BY INDIVIDUAL BLADE BONE PARAMETERS

CHERTOVSKY ANDREY A., ORCID ID: orcid.org/ 0000-0003-1777-1752; C. Med. Sci., forensic doctor of Bureau of Forensic Medical Examination of the Department of Public Health of Moscow, Russia, 115516, Moscow, Tarny proezd, 3, e-mail: traumfilipp@mail.ru

TUCHIK EVGENIY S., ORCID ID: 0000-0003-4330-2327; D. Med. Sci., professor of the Department of forensic medicine of Russian National Research Medical University named after N.I. Pirogov, Russia, 117997, Moscow, Ostrovityanin str., 1, e-mail: rsmu@rsmu.ru

Abstract. Aim. The aim of the study was to determine blade bone individual parameters significant for gender identification applying blade bone morphometric study and to develop formulas that allow reliable gender determination using statistical methods. Material and methods. The study was based on the data from 108 acts (conclusions) of corpse forensic investigations and morphometric measurements of the blades obtained from them. Osteometric and morphological study methods, as well as mathematical method using applied programs for data statistical processing have been applied. Results and discussion. Certain blade parameters and the relationship of their absolute values with the gender have been studied. The most significant morphometric indicators showing the strongest correlation and accuracy were used to build the formulas, which allow determining the gender of a person with the highest accuracy and simplicity by using only this bone. Correction factors were calculated by statistical methods. Conclusion. The developed method of gender determination, that has a mathematical expression by means of a specific formula, provides extensive identification capabilities in the study of skeletal and strongly burned corpses of unknown persons. Simplicity of the practical application and proposed problem solving algorithm, minor cost of morphometric parameter determination allows significant reduction of the number of manipulations through targeted measurements, which makes it available at any stage of forensic medical corpse examination.

Key words: osteometry, blade bone, identification, statistics, gender.

For reference: Chertovsky AA, Tuchik ES. Gender identification by individual blade bone parameters. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (3): 53-56. DOI: 10.20969/VSKM.2019.12(3).53-56.

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UDC 616.153.915-008.61-08

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 LONG-TERM FEVER AS A MANIFESTATION OF DRUG INTOLERANCE IN PATIENTS WITH NONTUBERCULOUS PULMONARY MYCOBACTERIOSIS (clinical case)

DEGTYAREVA SVETLANA A., ORCID ID: 0000-0002-4541-056X; C. Med. Sci., senior researcher of the Department of tuberculosis differential diagnosis of Central Tuberculosis Research Institute, Russia, 107564, Moscow, Yauzskaya alley, 2, tel. +7(499)785-90-31, e-mail: bonita.lana@mail.ru

SHMELEV EVGENIY I., professor, Honored scientist of the Russian Federation, Head of the Department of tuberculosis differential diagnosis of Central Tuberculosis Research Institute, Russia, 107564, Moscow, Yauzskaya alley, 2, tel. +7(499)785-90-08, e-mail: ishmelev@mail.ru

STEPANYAN IGOR E., D. Med. Sci., professor, Honored doctor of the Russian Federation, leading researcher of the Department of tuberculosis differential diagnosis of Central Tuberculosis Research Institute, Russia, 107564, Moscow, Yauzskaya alley, 2, tel. +7(499)785-90-31, e-mail: drstepanyan@mail.ru

VLADIMIROVA ELENA B., C. Med. Sci., researcher of the Department of tuberculosis differential diagnosis of Central Tuberculosis Research Institute, Russia, 107564, Moscow, Yauzskaya alley, 2, tel. +7(499)785-90-31, e-mail: velebor@mail.ru

KOVALEVSKAYA MARINA N., C. Med. Sci., researcher of the Department of tuberculosis differential diagnosis of Central Tuberculosis Research Institute, Russia, 107564, Moscow, Yauzskaya alley, 2, tel. +7(499)785-90-31, e-mail: ya.kovmar60-dom@ya.ru

KASIMTSEVA SVETLANA A., C. Med. Sci., researcher of the Department of tuberculosis differential diagnosis of Central Tuberculosis Research Institute, Russia, 107564, Moscow, Yauzskaya alley, 2, tel. +7(499)785-90-31, e-mail: skasimtseva@mail.ru

HERGERT VLADISLAV YА., professor, Head of the Department of immunology of Central Tuberculosis Research Institute, Russia, 107564, Moscow, Yauzskaya alley, 2, tel. +7(499)785-90-72, e-mail:hergertv@mail.ru

Abstract. A clinical case of a 40-year-old patient with non-tuberculosis lung mycobacteriosis and chronic obstructive bronchitis with bronchiectasis is described. She has been receiving etiotropic chemotherapy for a year, taking intoaccount the sensitivity of the microorganism (M. avium). This led to side effect development presenting by a long lasting fever (three months), which required drug cancelling. A second attempt of prescribing antimicrobial therapy was unsuccessful. Patient monitoring continues at present. Aim. The aim of the study was to demonstrate the manifestationsof drug intolerance in a patient with non-tuberculosis mycobacteriosis with long-term medication. Material and methods.Lung mycobacteriosis diagnosis and treatment was performed in 40 year old patient. Physical examination, blood test, respiratory function evaluation, chest computed tomography and microbiological sputum examination were performed.Results and discussion. Long lasting fever developed as a result of long-term antimicrobial therapy, and this requiredtreatment cancellation in a patient with M. avium lung mycobacteriosis. Conclusion. The presented case demonstratesthe complexity of the long-term continuous non-tuberculosis mycobacteriosis treatment. Antibacterial therapy was canceled due to drug disease manifestations development.

Key words: lung mycobacteriosis, drug intolerance, chemotherapy, diagnostics, drug fever.

For reference: Degtyareva SA, Shmelev EI, Stepanyan IE, Vladimirova EB, Kovalevskaya MN, Kasimtseva SA., Hergert V.Ya. Long-term fever as a manifestation of drug intolerance in patients with nontuberculous pulmonary mycobacteriosis (clinical case). The Bulletin of Contemporary Clinical Medicine. 2019; 12 (3): 73-77. DOI: 10.20969/ VSKM.2019.12(3).73-77.

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UDC 616.728.48-001-089.844

DOI: 10.20969/VSKM.2019.12(3).78-82

 SURGICAL TREATMENT OF THE LEAK OF DISTAL TIBIOFIBULAR SYNDESMOSIS AFTER ANKLE FRACTURE (clinical case)

MIKHAILOV SERGEY V., ORCID ID: 0000-0002-3738-0639; C. Med. Sci., assistant of professor of the Department of military traumatology and orthopedics of Kirov Military Medical Academy, Russia, 194044, St. Petersburg, Botkin str., 13, tel. +7-911-004-68-04, e-mail: msv06@mail.ru

KHOMINETS VLADIMIR V., ORCID ID: 0000-0002-7000-6614; D. Med. Sci., professor, Head of the Department of military traumatology and orthopedics of Kirov Military Medical Academy, Russia, 194044, St. Petersburg, Botkin str., 13, tel. +7-921-941-64-16, e-mail: Khominets_62@mail.ru

SHAKUN DMITRY A., ORCID ID: 0000-0002-2723-3707; C. Med. Sci., teaching faculty of the Department of military traumatology and orthopedics of Kirov Military Medical Academy, Russia, 194044, St. Petersburg, Botkin str., 13, tel. +7-911-903-42-70, e-mail: dshakun72@gmail.ru

SHCHUKIN ALEXEY V., ORCID ID: 0000-0002-3423-8367; C. Med. Sci., Head of the Department of Clinic of military traumatology and orthopedics of Kirov Military Medical Academy, Russia, 194044, St. Petersburg, Botkin str., 13, tel. + 7-911-939-60-44, e-mail: ossa.76mail.ru

FOOS IVAN V., ORCID ID: 0000-0002-7845-2133; Head of the Department of Clinic of military traumatology and orthopedics of Kirov Military Medical Academy, Russia, 194044, St. Petersburg, Botkin str., 13,
tel. + 7-905-224-62-97, e-mail: foosiv@mail.ru

KOMAROV ARTEM V., ORCID ID: 0000-0002-8260-0311; chief resident of surgery department of Branch No 2 «425 VG» Clinic, Russia, 660017, Krasnoyarsk, Gorky str., 2, tel. +7-911-821-32-23, e-mail: ximikatu@mail.ru

Abstract. One of the causes of early deforming arthrosis after ankle joint injury is persistent subluxation of the foot outwards. The recurrence of subluxation with distal tibiofibular syndesmosis leak after ankle fracture treatment is about 4,7%. Aim. The aim of the study was to demonstrate the possibilities of shortening plastics in distal tibiofibular syndesmosis anterior portion in foot subluxation reccurence after surgical treatment of a patient with ankle fracture.Material and methods. The technique of distal intertibial syndesmosis anterior portion shortening plastics in foot subluxation recurrence is presented. Foot and ankle joint disease clinical evaluation scale of the American Orthopedic Foot Association (AOFAS) was applied to assess the outcomes of treatment. Results and discussion. The patient wasre-examined 4 months after the surgery. Ankle joint X-ray was performed. It showed no foot subluxation recurrence. The range of motion in the ankle joint: plantar flexion – 120°, dorsal flexion – 78°. The clinical outcome according to the AOFAS scale was 75 points. Thus, it is possible to consider the achieved outcome of treatment as good. Conclusion.Distal intertibial syndesmosis anterior portion shortening plastics in foot subluxation recurrence contributes to ankle joint fork width maintenance after removing the screws fixing the distal intertibial syndesmosis, which allows to improve long-term functional outcomes and to reduce the risk of deforming arthrosis.

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