ORIGINAL RESEARCH

UDC 616.61-008.64-036.12-085.2/.3

DOI: 10.20969/VSKM.2019.12(6).7-12

 EFFECT OF COMBINATION THERAPY ON ENDOTHELIUM AND RENAL FUNCTION IN DIFFERENT STAGES OF CHRONIC KIDNEY DISEASE

AGAYEV MEKHMAN M., D. Med. Sci., professor of the Department of therapeutic and pediatric propedeutics of Azerbaijan Medical University, Azerbaijan, AZ 1078, Baku, Mardanov gardashlar str., 100

ISMAYILOVA SHALALA G., assistant of professor of the Department of therapeutic and pediatric propedeutics of Azerbaijan Medical University, Azerbaijan, AZ 1078, Baku, Mardanov gardashlary str., 100, e-mail: ismailovashalala@mail.ru

MAMEDOVA IRADA M., PhD, assistant of professor of the Department of therapeutic and pediatric propedeutics of Azerbaijan Medical University, Azerbaijan, AZ 1078, Baku, Mardanov gardashlary str., 100

NOVRUZOVA MANZAR S., PhD, assistant of professor of the Department of therapeutic and pediatric propedeutics of Azerbaijan Medical University, Azerbaijan, AZ 1078, Baku, Mardanov gardashlary str., 100

Abstract. Aim. To study ramipril (ACE inhibitor), atorvastatin (HMG-CoA reductase) and nebivalol (β-adrenoblocker) combined treatment effect on endothelium and kidney functional state in the different stages of CKD. Material and methods. The study involved patients with CKD (Stages 1–4). In our patients, the causes of CKD were as follows: chronic glomerulonephritis; and diabetic nephropathy due to type 2 diabetes. Patients were divided into 4 groups based on the level of GFR. In turn, each group, was divided into 2 subgroups depending on the cause of CKD: A – patients with chronic glomerulonephritis and B – type 2 diabetes. During the study, the effect of the combined treatment of ramipril, atorvastatin and nebivalol was studied in all groups. Variation statistics was used to evaluate the renoprotective effect and endothelial function during 3 months treatment. Results and discussion. Starting from stage 2 of CKD, despite a decrease in its level in both subgroups in patients with DM, its decrease was statistically insignificant. Despite the fact that at the 3 stages of CKD in both subgroups reliable results were obtained, at the 4 stages no positive results were achieved in any of the subgroups. Thus, in both subgroups of this group, the level of creatinine did not differ from its level before treatment and remained high. In the 2–3rd stage of CKD, there was an increase in the degree of endothelium-related vasodilation. In the 2A subgroup, this indicator averaged 12%, and in the 3A subgroup it was 10,2%. In subgroup 4A, the treatment performed did not have any effect on the endothelium function. Conclusion. 3-month treatment of patients with an improvement in the functional state of the kidneys, as well as positive changes in the vasodilating reaction of the vascular endothelium.

Key words: endothelial dysfunction, chronic kidney disease, chronic glomerulonephritis, diabetic nephropathy.

For reference: Agayev MM, Ismayilova ShG, Mamedova IM, Novruzova MS. Effect of combination therapy on endothelium and renal function in different stages of chronic kidney disease. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (6): 7-12. DOI: 10.20969/VSKM.2019.12(6).7-12.

References

1. Romanovskaya GA, Akatova EV, Gorohovskaya GN. Perspektivy medikamentoznogo lecheniya endotelial’noj disfunkcii. [Prospects for medical treatment of endothelial dysfunction]. Farmateka [Pharmateca]. 2005; 9: 31-37.
2. Vlasova SP, Il’chenko MYu, Kazakova EB. Endotelial’naya disfunkciya i arterial’naya gipertenziya [Endothelial dysfunction and hypertension]. Samara: OOO «Ofort». 2010: 192 p.
3. Galyavich AS. Sovremennaya farmakoterapiya pacientov s arterial’noj gipertenziej i vysokim riskom serdechnososudistyh oslozhnenij: v fokuse ingibitory angiotenzinprevrashchayushchego fermenta [Modern pharmacotherapy of patients with arterial hypertension and high risk of cardiovascular complications: angiotensin-converting enzyme inhibitors are in focus]. Medicinskij sovet [ Medical Council]. 2012; 12: 10-17.
4. Demin AA, Shulyat’eva OYu. Novye vozmozhnosti blokatora receptov angiotenzina II telmisartana v lechenii arterial’noj gipertenzii s metabolicheskimi narusheniyami [New features of the angiotensin II prescription blocker telmisartan in the treatment of hypertension with metabolic disorders]. Klinicheskaya medicina [Clinical medicine]. 2012; 1: 32-34.
5. Martynov AI, Gorohovskaya GN. Perspektivy medikamentoznogo lecheniya endotelial’noj disfunkcii [Prospects for the medical treatment of endothelial dysfunction]. Farmateka [Pharmateca]. 2005; 9: 31-40.
6. Tan K, Chow W, Ai V. Effects of angiotensin II reseptor antagonists on endothelial vasomotor function and urinary albumin excretion in type 2diabetic patients with microalbuminuria. Diabetic Metabolism Research and Reviews. 2002; 18 (1): 71-76.
7. Markova LI, Radzevich AE, Lazarev AV. Optimizaciya kombinirovannoj terapii pri trudnokontroliremoj arterial’noj gipertenzii [Optimization of combination therapy for difficult-to-control arterial hypertension]. Zhurnal Lechashchij vrach [Journal Physician]. 2012; 7: 4-8.
8. Fedoseev AN, Kudryakova AS, Smirnov VV. Primenenie ingibitorov APF s cel’yu korrekcii endotelial’noj disfunkcii u pacientov na raznoj stadii hronicheskoj bolezni pochek [The use of ACE inhibitors to correct endothelial dysfunction in patients at different stages of chronic kidney disease]. Klinicheskaya nefrologiya [Clinical Nephrology]. 2012; 4: 10-15.
9. Nebieridze DV. Disfunkciya endoteliya i ee korrekciya pri arterial’noj gipertonii [Endothelial dysfunction and its correction in arterial hypertension]. Russkij medicinskij zhurnal [Russian Medical Journal]. 2006; 14 (2): 34-38.
10. Baigent C, Landray M, Reith C et al. The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease (Study of Heart and Renal Protection): a randomised placebo–controlled trial. Lancet. 2011; 377: 2181–2192.
11. Mel’nik AA. Narushenie lipidnogo obmena i ego korrekciya pri hronicheskoj bolezni pochek [Disruption of lipid metabolism and its correction in chronic kidney disease]. Pochki [Kidneys]. 2016; 2 (16): 85-95.
12. Menshutina MA, Panina IYu, Smirnov AV. Endotelial’naya disfunkciya u bol’nyh hronicheskoj bolezn’yu pochek [Endothelial dysfunction in patients with chronic kidney disease]. Nefrologiya [Nephrology]. 2004; 3 (2): 48-54.
13. Kolina IB. Giperlipidemii pri hronicheskoj bolezni pochek: osobennosti i podhody k lecheniyu [Hyperlipidemia in chronic kidney disease: features and approaches to treatment]. Lechashchij vrach [Physician]. 2012; 1: 23-25.
14. Daweas M, Brett S, Chowienczyk P et al. The vasodilatator action of nebivalol in forearm vasculature of subjects with essential hypertension. Br J Clin Pharmacol. 1994; l48: 460-463.

 

UDC 616.28-008.1-057:613.693

DOI: 10.20969/VSKM.2019.12(6).12-18

 

UDC 618.13-002-008.87-07:616.153.96-074

DOI: 10.20969/VSKM.2019.12(6).18-22

References 

1. Serov VN, Sukhikh GT. Akusherstvo i ginekologiya; Klinicheskie recomendacii [Obstetrics and gynecology; Clinical guidelines]. Moskva [Moscow]: GEOTAR-Media. 2014; 4: 1011 p.
2. Serov VN, Dubnitskaya LV, Tyutyunnik VL. Vospalitelnye zabolevaniya organov malogo taza: diagnosticheskie kriterii i princhipy lecheniya [Pelvic inflammatory diseases: diagnostic criteria and treatment principles]. Rossiyskiy meditsinskiy zhurnal [Russian medical journal]. 2011; 19: 46-50.
3. Dikke GB. Polimikrobnye associacii v etiologii vospalitelnyh zabolevanii polovyh organov u genshchin [Polymicrobial associations in the etiology of inflammatory diseases of the genital organs in women]. Akusherstvo i ginekologiya [Obstetrics and Gynecology]. 2017; 6: 151-158.
4. Kolesnichenko AA. Vospalitelnye zabolevaniya pridatkov matki: chno novogo? [Inflammatory diseases of the uterine appendages: what’s new?]. Molodoy uchenyy [The young scientist]. 2016; 22 (1): 4-17.
5. Murashko AV, Murashko AA. Sovremennye podhody k terapii VZOMT [Modern approaches to the therapy of PID]. Meditsinskiy sovet [Medical advice]. 2014; 9: 103-105.
6. Pitirimova LN, Zagorodneva EA, Gumilevsky BYu. Osobennosti allelnogo polymorfizma genov interleikinov i citokinovyi balans genshchin s nevynashivaniemberemennosti [Features of allelic polymorphism of genes of interleukins and cytokine balance of women with miscarriages]. Akusherstvo i ginekologiya [Obstetrics and gynecology]. 2014; 3: 33-38.
7. Prilepskaya VN, Bebneva TN. Effektivnost immunomodulyatora Galavita v lechenii vospalitelnyh zabolevanii organov malogo taza [The effectiveness of Galovit immunomodulator in the treatment of inflammatory diseases of the pelvic organs]. Rossiyskiy meditsinskiy zhurnal [Russian medical journal]. 2013; 1: 31.
8. Tetelyutina FK, Kopieva OV. Vozmognosti immunnoi korrekcii pri hronicheskih vospalitelnyh zabolevaniyah organov malogo taza [Possibilities of immune correction in chronic inflammatory diseases of pelvic organs]. Sovremennyye problemy nauki i obrazovaniya [Modern problems of science and education]. 2015; 1 (1): 1370-1371.
9. Ali AS, Townes CL, Hall J, Pickard RS. Maintaining a sterile urinary tract: the role of antimicrobial peptides. J Urol. 2009; 182: 21–28.
10. Zasloff M. Antimicrobial peptides, innate immunity, and the normally sterile urinary tract. J Am Soc Nephrol. 2007; 18: 2810–2816.
11. Agier J, Brzezinska-Blaszczyk E. Cathelicidins and defensins regulate mast cell antimicrobial activity. Postepy Hig Med Dosw (Online). 2016; 70: 618–636.
12. Witkowska D, Bartys A, Gamian A. Defensins and cathelicidins as natural peptide antibiotics. Postepy Hig Med Dosw (Online). 2008; 22: 694–707.
13. Aleshina GM, Kokryakov VN, Shamova OV, Orlov DS, Andreeva YuV. Sovremennaya koncepciya ob antimikrobnyh peptidah kak molekulyarnyh faktorah immuniteta [The modern concept of antimicrobial peptides as molecular factors of immunity]. Meditsinskiy akademicheskiy zhurnal [Medical Academic Journal]. 2010; 4: 149–160.
14. Budikhina AS, Pinegin BV. A-defenziny – antimikrobnye peptidy neytrofilov: svoystva i funkcii [А-defensins – antimicrobial peptides of neutrophils: properties and functions]. Immunologiya [Immunology]. 2008; 5: 317-320.
15. Rathinakumar R, Walkenhorst WF, Wimley WC. Broad-spectrum antimicrobial peptides by rational combinatorial design and high-throughput screening: the importance of interfacial activity. J Am Chem Soc. 2009; 131: 7609–7617.
16. Zharkova MS, Orlov DS, Kokryakov VN, Shamova OV. Antimikrobnye peptidy mlekopitayushchih: klassifikaciya, biologicheskaya rol, perspektivy prakticheskogo primeneniya [Mammalian antimicrobial peptides: classification, biological role, practical application prospects]. Vestnik Sankt-Peterburgskogo universiteta, Seriya 3 – Biologiya [Bulletin of St Petersburg University, series 3 – Biology]. 2014; 1: 98-114.
17. Schindlbeck C, Schindlbeck D, Dziura D, Mylonas I. Diagnosis of pelvic inflammatory disease (PID): intraoperative findings and comparison of vaginal and intra-abdominal cultures. Arch Gynecol Obstet. 2014; 289 (6): 1263-1269.
18. 2018 European (IUSTI/WHO) Guideline on the Management of Vaginal Discharge. 2018; https://www.iusti.org/ regions/Europe/pdf/2019/Vagdx2018.pdf

 

References

1. Semple PL, Binder AB, Davids M, Mavedza A, Van Zyl-Smit RN, Dheda K. Regulatory T cells attemate mycobacterial stasis in alveolar and blood derived macrophages from patients with tuberculosis. Am J Respir Crit Care Med. 2013; 187: 1249-1258.
2. Plessis N, Locbenberg L, Kriel M, von Groote-Bidingmaier F, Ribechini E, Loxton AG, Van Helden PD, Lutz MB, Walze G. Increased frequency of myeloid derived suppressor cells during active tuberculosis and after recent mycobacterium tuberculosis infection suppresses T-cell function. Am J Respir Crit Care Med. 2013; 188: 724-732.
3. Gopai R Monin L, Torres D, Slight S, Mehra S, Mc Kenna KC, Fallert Junesko BA, Reinhart TA, Kolls J, BaezSaldana R, et al. S100 A8/A9 proteins mediate neutrophilic inflammation and lung pathology during tuberculosis. Am J Respir Crit Care Med. 2013; 118: 1137-1146.
4. Comstock GW, Edwards LB, Livesay VT. Tuberculosis morbidity in the US Navy: its distribution and decline. Am Rev Respir Dis. 1974; 110: 572-580.
5. Sester M Bumbacea D, Duarte R, Lange C. Tuberculosis in the immunocompromised host. Eur Respir Monogr. 2012; 58: 230-241.
6. Seeger W, Adir Y, Barbera JA, Champion H, Coghlan JG, Cottin V, De Marco T, Galie N, Ghio S, Gibbs S, et al. Pulmonary hypertension in chronic lung diseases. J An Coll Cardiol. 2013; 62 (25 suppl): 109-116.
7. Wrobel JP, Tompson BR, Williams TJ. Mechanisms of pulmonary hypertension in chronic obstructive pulmonary disease: a pathophysiologic review. J Heart lung Transplant. 2012; 31: 557-564.
8. Chaovat A, Savale L, Chovaid C Til, Srtrymf B, Canvet M, Maitre B, Housset B, Brandt L, le Corvoisier P, et al. Role for interleukin-6 in COPD – related pulmonary hypertension. Chest. 2009; 136: 678-687.
9. Nakomo Y, Wong JC de Jong PA, Buzatu L, Nagao T, Coxson HO, Elliott WM, Hogg JS, Pare PD. The prediction of small airway dimensions using computed tomography. Am J Respir Crit Care Med. 2005; 171: 142-146.
10. Iyer AS, Wells JM, Vishin S, Bhatt SP, Wille KM, Drans Field MT. CT-scan-measured pulmonary artery to aorta ratio and echocardiography for detecting pulmonary hypertension in severe COPD. Chest. 2014; 145: 824-832.
11. O’Shaughnessy TC, Ansavi TW, Barnes NC, Jeffery PK. Inflammation in bronchial biopsies of subjects with chronic bronchitis: inverse relationship of CD 8+ T lymphocytes with FEV1. Am J Respir Crit Care Med. 1997; 155: 852-857.
12. Kamazawa A, Asai K, Nonuva S. Vascular endothelial growth factor as a noninvasive marker of pulmonary vascular remodeling in patients with bronchitis – type of COPD. Respir Res. 2007; 8: 22.
13. Rahagi FN, Van Beek EJ, Washko GR. Cardiopulmonary coupling in chronic obstructive pulmonary disease: the role of imaging. J Thorac imaging. 2014; 29: 80-91.

 

UDC 616.441-006.5-089.87(575.1)

DOI: 10.20969/VSKM.2019.12(6).28-33

References

1. Ismailov SI, Rashitov MM, Alimdzhanov NA, Karimova MM, Kayumova NL, Khamidov FSh. Prostoy uzlovoy zob, diagnostika i lecheniye [Simple nodular goiter, diagnosis and treatment]. Tashkent: TPMI [Tashkent: TPMI]. 2007; 30 p.
2. Dedov II, Troshina YeA, Yushkov PV, Aleksandrova GA. Diagnostika i lecheniye uzlovogo zoba [Diagnosis and treatment of nodular goiter]. Petrozavodsk: IntelTek [Petrozavodsk: IntelTech]. 2003; 64 p.
3. Zayrat’yants OV. Epidemiologiya i etiologicheskaya struktura uzlovogo zoba po dannym autopsiy Moskovskiy gorodskoy Tsentr patologoanatomicheskikh issledovaniy [pidemiology and etiological structure of nodular goiter according to autopsy Moscow City Center for Pathological Research]. Tironet [Tyrone]. 2002; 5-6. http://thyronet. rusmedserv.com/spetsialistam/zhurnal/archiv/2002g/5-6/ Epidemiologiya_i_etiologicheskaya_struktura_uzlovogo_ zoba_po_dannym_autopsii.html
4. Dedov II, Mel’nichenko GA, Fadeyev VV, et al. Klinicheskiye rekomendatsii Rossiyskoy Assotsiatsii Endokrinologov (RAE) po diagnostike i lecheniyu uzlovogo zoba [Clinical recommendations of the Russian Association of Endocrinologists (RAE) for the diagnosis and treatment of nodular goiter]. Tironet [Tyrone]. 2004; 1-2. http://thyronet. rusmedserv.com/spetsialistam/zhurnal/archiv/2004g/1-2/ Klinicheskie_rekomendacii_Rossiiskoi_Associacii_Endokrinologov_po_diagnostike_i_lecheniyu_uzlovogo_ zoba.html
5. Laszlo Hegedüs et al. Management of Simple Nodular Goiter: Current Status and Future Perspectives. Endocrine Reviews. 2000; 24 (1): 102-132.
6. Bonnema SJ, Bennedbæk FN, Ladenson PW, Hegedüs LJ. Management of the nontoxic multinodular goiter: a North American survey. J Clin Endocrinol Metab. 2002; 87: 112–117.
7. Knudsen N, Bülow I, Laurberg P, Perrild H, Ovesen L, Jоrgensen T. Alcohol consumption is associated with reduced prevalence of goitre and solitary thyroid nodules. Clin Endocrinol (Oxf). 2001; 55: 41–46.
8. Knudsen N, Perrild H, Christiansen E, Rasmussen S, DigePetersen H, Jоrgensen T. Thyroid structure and size and two-year follow-up of solitary cold thyroid nodules in an unselected population with borderline iodine deficiency. Eur J Endocrinol. 2000; 142: 224–230.
9. Hegedüs L. Clinical practice. The thyroid nodule. N Engl J Med. 2004; 351: 1764-1771.
10. Ross DS. Diagnostic approach to and treatment of thyroid nodules. In: Rose BD, ed. MA: UpToDate. 2008; 21 p.
11. Gharib H, Papini E. Thyroid nodules: Clinical importance, assessment, and treatment. Endocrinol Metab Clin North Am. 2007; 36: 707-735.
12. Punales MK, da Rocha AP, Meotti C, Gross JL, Maia AL. Clinical and oncological features of children and young adults with multiple endocrine neoplasia type 2A. Thyroid.
2008; 18: 1261-1268.
13. Rosenbaum MA, McHenry CR. Contemporary management of papillary carcinoma of the thyroid gland. Expert Rev Anticancer Ther. 2009; 9: 317-329.
14. Gough J, Scott-Coombes D, Fausto Palazzo F. Thyroid incidentaloma: An evidence-based assessment of management strategy. World J Surg. 2008; 32: 1264-1268.
15. Papini E. The dilemma of non-palpable thyroid nodules. J Endocrinol Invest. 2003; 26: 3-4.
16. Papini E, Guglielmi R, Bianchini A, et al. Risk of malig-nancy in nonpalpable thyroid nodules: Predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab. 2002; 87: 1941-1946.
17. Boelaert K, Horacek J, Holder RL, Watkinson JC, Sheppard MC, Franklyn JA. Serum thyrotropin concentration as a novel predictor of malignancy in thyroid nodules investigated by fine-needle aspiration. J Clin Endocrinol Metab. 2006; 91: 4295-4301.
18. Yano Y, Shibuya H, Kitagawa W, et al. Recent outcome of Graves’ disease patients with papillary thyroid cancer. Eur J Endocrinol. 2007; 157: 325-329.
19. Shetty SK, Maher MM, Hahn PF, Halpern EF, Aquino SL. Significance of incidental thyroid lesions detected on CT: Correlation among CT, sonography, and pathology. AJR Am J Roentgenol. 2006; 187: 1349-1356.
20. Razek AA, Sadek AG, Kombar OR, Elmahdy TE, Nada N. Role of apparent diffusion coefficient values in differentiation between malignant and benign solitary thyroid nodules. AJNR Am J Neuroradiol. 2008; 29: 563-568.

 

UDC 616.151.511-06:616-009.7

DOI: 10.20969/VSKM.2019.12(6).33-37

References

1. Vorob’ev AI, Vasil’ev SA, Gorodeckij VM, SHevelev AA, Gorgidze LA, Kremeneckaya OS, SHklovskij-Kordi NЕ. Giperkoagulyacionnyj sindrom: klassifikaciya, patogenez, diagnostika, terapiya [Hypercoagulative syndrome: classification, pathogenesis, diagnosis, therapy]. Gematologiya i transfuziologiya [Hematology and transfusiology]. 2016; 3: 116-122.
2. Salvagno GL, Pavan C, Lippi G. Rare thrombophilic conditions. Ann Transl Med. 2018; 6(17):342.
3. Momot AP, Cyvkina LP, Taranenko IA, t al. [Sovremennye metody raspoznavaniya sostoyaniya tromboticheskoj gotovnosti]. Modern methods of recognition of the state of thrombotic readiness. Barnaul: AGU [Barnaul: ASU]. 2011; 138 p.
4. Tadtaeva ZG, Skoromec AA, Kacadze YuL. Geneticheskie polimorfizmy sistemy gemostaza pri migreni s auroj u detej [Genetic polymorphisms of the hemostatic system in migraine with aura in children]. Uchenye zapiski SPb-GMU imeni IP Pavlova [Scientific notes SPbGMU them IP Pavlova]. 2009; 2: 48-51.
5. Van Stralen KJ, Rosendaal FR, Doggen CJM. Minor Injuries as a Risk Factor for Venous Thrombosis. Arch Intern Med. 2008; 168 (1): 21–26.6. Momot AP. Problema trombofilii v klinicheskoj praktike [The problem of thrombophilia in clinical practice]. Rosssijskij zhurnal detskoj gematologii i onkologii [Russian Journal of Pediatric Hematology and Oncology]. 2015; 2 (1): 36-48.
7. Ahmad A. Genetics of cerebral venous thrombosis. J Pak Med Assoc. 2006; 56 (11): 488-90.
8. Pai N, Ghosh K, Shetty S. Hereditary thrombophilia in cerebral venous thrombosis: a study from India. Blood Coagul Fibrinolysis. 2013; 24 (5): 540-543.
9. Tadtaeva ZG, Dzanagova PO. Molekulyarnaya genetika migreni [Molecular genetics of migraine]. Roscijskij nejro-hirurgicheskij zhurnal [Russian Neurosurgical]. 2012; 4: 394.
10. Marcus J, Sarnak MJ, Menon V. Homocysteine lowering and cardiovascular disease risk: lost in translation. Can J Cardiol. 2007; 23 (9):707-710.
11. Tadtaeva ZG. Gipergomocisteinemiya (GGc) pri migreni u detej (obzor) [Hyperhomocysteinemia (GHz) in children with migraine (review)]. Zdorov’ye – osnova chelovecheskogo potentsiala: problemy i puti ikh resheniya [Health is the basis of human potential: problems and their solutions]. 2012; 2: 721-730.
12. Tietjen GE, Al-Qasmi MM, Athanas K, Utley C, Herial NA. Altered hemostasis in migraineurs studied with a dynamic flow system. Thromb Res. 2007; 119 (2): 217-222.
13. Bianchi A, Salomone S, Caraci F, Pizza V, Bernardini R, D’Amato CC. Role of magnesium, coenzyme Q10, riboflavin, and vitamin B12 in migraine prophylaxis. Vitam Horm. 2004; 69: 297-312.
14. Reshetnyak TM ed. Klinicheskie rekomendacii po lecheniyu antifosfolipidnogo sindroma. [Clinical recommendations for the treatment of antiphospholipid syndrome]. Obshcherossijskaya obshchestvennaya organizaciya «Associaciya revmatologov Rossii» [All-Russian public organization «Association of Rheumatology of Russia»]. Moscow; 2013: https://mzur.ru/ upload/%D0%90%D0%A4%D0%A1.pdf

 

UDC 616.36-008.5-072.1

DOI: 10.20969/VSKM.2019.12(6).37-41

References

1. Vetshev PS. Mekhanicheskaya zheltukha: prichiny i diagnosticheskiye podkhody (lektsiya) [Mechanical jaundice: causes and diagnostic approaches (lecture)]. Annaly khirurgicheskoy gepatologii [Annals of surgical hepatology]. 2011; 16 (3): 50-57.
2. Galperin EI, Vetshev PS. Rukovodstvo po khirurgii zhelchnykh putey [A guide to biliary tract surgery]. Moskva: Vidar-M [Moscow: Vidar-M]. 2009; 568 p.
3. Williams EJ, Taylor S, Fairclough P, et al. Risk factors for com plication following ERCP; results of a large-scale, prospective multicenter study. Endoscopy. 2007; 39 (9): 793-801.
4. Akhaladze GG. Pаtоgеnеtechеskiе аspеkty gnоinоgо hоlаngita, pochemu net sistemnoy vospalitelnoy reaktsii pri mekhanicheskoy zheltukhe? [Pathogenetic aspects of purulent cholangitis, why there is no systemic inflammatory reaction in mechanical jaundice]. Annaly khirurgicheskoy gepatologii [Annals of surgical hepatology]. 2009; 14 (2): 9-15.
5. Pautkin YuF, Klimov АЕ. Mekhanicheskaya neprokhodimost zhelchnykh putey (mekhanicheskaya zheltukha) [Mechanical obstruction of the biliary tract (mechanical jaundice)]. Moskva: Profil [Moscow: Profile]. 2010; 224 p.
6. Malkov IS, Shaymardanov RSh, Korobkov VN, Filippov VА. Metody intensivnoy terapii v lechenii pechenochnoy nedostatochnosti pri mekhanicheskoy zheltukhe [Intensive therapy in the treatment of hepatic insufficiency with mechanical jaundice]. Kazan: Materialy Respublikanskoy nauchno-prakticheskoy konferentsii «Mekhanicheskaya zheltukha – aktualnaya problema abdominalnoy khirurgii [Kazan: Materials of the Republican scientific-practical conference «Mechanical jaundice – an urgent problem of abdominal surgery»]. 2014; 23-28.
7. Malkov IS, Shaymardanov RSh, Korobkov VN, Filippov VА. Infuzionnaya terapiya pri mekhanicheskoy zheltukhe [Infusion therapy with mechanical jaundice]. Kazan: Materialy Respublikanskoy nauchno-prakticheskoy konferentsii «Mekhanicheskaya zheltukha – aktualnaya problema abdominalnoy khirurgii [Kazan: Materials of the Republican scientific-practical conference «Mechanical jaundice – an urgent problem of abdominal surgery»]. 2014; 21-23.
8. Malkov IS. Izbrannyye razdely neotlozhnoy abdominalnoy khirurgii [Selected sections of emergency abdominal surgery]. Izdatel’stvo kazanskogo gosudarstvennogo tekhnologicheskogo universiteta [Publishing House of Kazan State Technological University]. 2013; 408 p.
9. Bekbauov SA, Glebov KG, Kotovsky АЕ. Endoskopicheskiye transpapillyarnyye vmeshatelstva v lechenii bolnykh s sindromom mekhanicheskoy zheltukhi [Endoscopic transpapillary interventions in the treatment of patients with mechanical jaundice syndrome]. Endoskopichskaya khirurgiya [Endoscopic surgery]. 2013; 4: 36–39.
10. Glebov KG, Kotovsky АЕ, Dyuzheva TG. Kriterii vybora konstruktsii endoproteza dlya endoskopicheskogo stentirovaniya zhelchnykh protokov [Criteria for selecting the endoprosthesis design for endoscopic stenting of the bile ducts]. Annaly khirurgicheskoy gepatologii [Annals of surgical hepatology]. 2014; 19 (2): 55-65.
11. Glebov KG, Dyuzheva TG, Petrova NА, Bekbauov SA, Kotovsky АЕ. Endoskopicheskoye transpapillyarnoye stentirovaniye zhelchnykh protokov metallicheskimi samoraskryvayushchimisya endoprotezami [Endoscopic transpastillation of the bile ducts by metal self-opening endoprostheses]. Annaly khirurgicheskoy gepatologii [Annals of surgical hepatology]. 2012; 17 (3): 65–74.
12. Kotovsky АЕ, Urzhumtseva GА, Glebov KG, Petrova NА. Endoskopicheskiye tekhnologii v lechenii zabolevaniy organov gepatopankreatoduodenalnoy zony [Endoscopic technologies in the treatment of diseases of the hepatopan-creatoduodenal zone]. Annaly khirurgicheskoy gepatologii [Annals of surgical hepatology]. 2010; 15 (1): 9–21.
13. Deryabina EA, Bratnikova GI, Vasiliev АV, Bratnikova GI, Vasilyev AV. Povysheniye bezopasnosti lechebnykh endoskopicheskikh retrogradnykh kholangiopankreatografiy u bolnykh s dobrokachestvennymi obstruktivnymi zabolevaniyami zhelchevyvodyashchikh putey [Increasing the safety of therapeutic endoscopic retrograde cholangiopancreatography in patients with benign obstructive diseases of the biliary tract]. Meditsinskaya vizualizatsiya [Medical Visualization]. 2010; 2: 73-80.
14. Malkov IS, Zakirova GR, Korobkov VN, Nasrullayev MN. Endoskopicheskiye vmeshatelstva i korrektsiya narusheniy gomeostaza u patsiyentov s mekhanicheskoy zheltukhoy [Endoscopic interventions and correction of homeostatic disorders in patients with mechanical jaundice]. Kazanskiy meditsinskiy zhurnal [Kazan Medical Journal]. 2015; XCVI (3): 444-447.
15. Nasrullayev MN, Zakirova GR, Khamzin II. Vozmozhnosti endoskopicheskikh metodov v optimizatsii lecheniya bolnykh s mekhanicheskoy zheltukhoy [Possibilities of endoscopic methods in optimizing the treatment of patients with mechanical jaundice]. Materialy mezhregionalnoy nauchno – prakticheskoy konferentsii «Aktualnyye voprosy khirurgii» [Materials of the interregional scientific and practical conference «Actual problems of surgery»]. 2018; 70-73.
16. Schneider L, Büchler MW, Werner J. Acute pancreatitis with an emphasis on infection. Infect Dis Clin North Am. 2010; 24: 921-941.
17. Werner J, Hartwig W, Hackert T, et al. Multidrug strategies are effective in the treatment of severe experimental pancreatitis. Surgery. 2012; 151 (3): 372-381.
18. Chandrashekhara SH, Singh А, Bhatnagar S. Current status of percutaneous transhepatic biliary drainage in palliation of malignant obstructive jaudice: a review. Indian J Palliat Care. 2016; 20 (4): 378-387.
19. Moole H, Bechtold М, Puli SR. Effcacy biliary drainage in malignant obstructive jaundice: a meta-analysis and systematic review. World J SusgOncol. 2016; 14 (1): 182.

 

UDC 616.8-053.32-036.8

References

1. Demyanova TG, Grigoryanc LY, et al. Nablyudenie za gluboko nedonoshennymi detmi na pervom godu zhizni [Observation of deeply premature babies in their first year of life]. Moskva: Medpraktika-M [Moscow: Medpraktika-M]. 2006; 148 p.
2. Cabral TI, Pereira LG, Silva CM, et al. Analysis of sensory processing in preterm infants. Early Human Development. 2016; 103: 77-81.
3. Benassi E, Savini S, Iverson JM, et al. Early communicative behaviors and their relationship to motor skills in extremely preterm infants. Research in Developmental Disabilities. 2016; 48: 132-144.
4. He L, Parikh NA. Brain functional network connectivity development in very preterm infants the first six months. Early Human Development. 2016; 98: 29-35.
5. Ionio C, Riboni E, Confalonieri E, et al. Paths of cognitive and language development in healthy preterm infants. Infant Behavior and Development. 2016; 44: 199-207.
6. Beaulieu-Poulin C, Simard MN, Babakissa H, et al. Validity of the language development survey in infants born preterm. Early Human Development. 2016; 98: 11-16.
7. Wessels, Z, Lubbe W, Minnie K. Components of a tool for early detection of developmental delays in preterm infants: an integrative literature review. New born an dinfant nursing reviews. 2016; 16 (4): 327-339.
8. Belousova M, Utkuzova M, Nefedieva D. Ontogenetic conditional technologies of early habilitation of children with perinatal brain pathology. Journal of Development Research. 2018; 08 (10): 23377-23380.
9. Neroeva VV ed. Izbrannye lekcii po detskoj oftal’mologii [Selected Lectures on Pediatric Ophthalmology]. Moskva: GEHOTAR-Media [Mosow: GEOTAR-Media]. 2009; 184 p.
10. Koroleva IV. Kohlearnaya implantaciya gluhih detej i vzroslyh (ehlektrodnoe protezirovanie sluha) [Cochlear implantation of deaf children and adults (electrode prosthetics of hearing)]. SPb: KARO [St Petersburg: KARO]. 2008; 752 p.
11. Skvorcov IA. Nevrologiya razvitiya: rukovodstvo dlya vrachej [Development Neurology: A Guide for Physicians]. Moskva: Litterra [Moscow: Litterra]. 2008; 544 p. 12. Lekskulchai R, Cole J. Effect of a developmental program on motor performance in infants born preterm. Australian Journal of Physiotherapy. 2001; 47 (3): 169-176.
13. Maitra K, Park HY, Eggenberger J, et al. Difficulty in mental, neuromusculoskeletal, and movement-related scoll functions associated with low birthweght or pretermbirth: a meta-analysis. Am J Occup Ther. 2014; 68: 140-148.
14. Di Rosa G, Cavallaro T, Alibrandi A, et al. Predictive role of early milestones-related psychomotor profiles and long-term neurodevelopmental pitfalls in preterm infants. Early Human Development. 2016; 101: 49-55.
15. Adams-Chapman I, Bann CM, Vaucher YE, Stoll BJ. Association between feeding difficulties and language delay in preterm infants using Bayley scales of infant development – third edition. The Journal of Pediatrics. 2013; 163
(3): 680-685.
16. Capilouto GJ, Cunningham T, Frederick E, et al. Comparison of tongue muscle characteristics of preterm and full term infants during nutritive and nonnutritive sucking. Infant Behavior and Development. 2014; 37 (3): 435-445.
17. Natarajan G, Pappas A, Shankaran S, et al. Outcoms of extremilylow birth weight infants with bronchopulmonary dysplasia: impact of the physiologic definition. Early Human Development. 2012; 88: 509-515.
18. Alderliesten T, van Bell F, van der Aa N, et al. Low cerebral oxygenation preterm infants is associated with adverse neurodevelopmental outcome. The Journal of Pediatrics. 2019; 207: 109-116.

 

References

1. Parshall MB, Schwartzstein RM, Adams L, Banzett RB, Manning HL, Bourbeau J, Calverley PM, Gift AG, Harver A, Lareau SC, Mahler DA, Meek PM, O’Donnell DE. American Thoracic Society Committee on Dyspnea; An official American Thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea. Am J Respir Crit Care Med. 2012; 185 (4): 435
2. Abrosimov VN. Odyshka [Dyspnoe]; Respiratory medicine [Respiratory medicine]. Moskva [Moscow]: GEOTAR-Media. 2007; 407–418.
3. Sidorenko GI, Komisarova SM. Diskussionnye aspecty v probleme serdechnoy nedostatocynosty [Controversial Aspects problem in heart failure]. Kardiologiya [Cardiology]. 2009; 5: 61-63.
4. Kessler R, Partridge MR, Miravitlles M, et al. Symptom variability in patients with severe COPD: a pan European cross sectional study. Eur Respir J. 2011; 37: 264–272.
5. Miravitlles M, Worth H, Soler Cataluña JJ, et al. Observational study to characterise 24hour COPD symptoms and their relationship with patient reported outcomes: results from the ASSESS study. Respir Res. 2014; 15: 122.
6. Chuchalin AG, Khaltaev NG, Abrosimov VN, Kotlyarov SN, Martynov AV. Ocenka rasprostranennosty respiratornyh simptomov i vozmozhnosty skrininga spirometrii v diagnostike hronicheskih legochnyh zabolevanii
[Assessing the prevalence of respiratory symptoms and the possibility of screening spirometry in the diagnosis of chronic lung disease]. Pulmonologiya [Pulmonology]. 2010; 2: 56–61.
7. Hurst JR, Vestbo J, Anzueto A, et al. Susceptibility to exacerbation in chronic obstructive pulmonary disease. N Engl J Med. 2010; 363: 1128–1138.
8. Nishimura K, Izumi T, Tsukino M, Oga T. Dyspnea is a better predictor of 5 year survival than airway obstruction in patients with COPD. Chest. 2002; 121: 1434–1340.
9. Steer J, Norman EM, Afolabi OA, et al. Dyspnoea severity and pneumonia as predictors of in hospital mortality and early readmission in acute exacerbations of COPD. Thorax. 2012; 67: 117–121.
10. Kroenke K, Arrington ME, Mangelsdorff AD. The prevalence of symptoms in medical outpatients and the adequacy of therapy. Arch Intern Med. 1990; 150: 1685–1689.
11. Avdeev SN. Dyspnoe: mehanizmy, ocenka, terapiya [Dyspnea: mechanisms, assessment, therapy]. Konsilium medikum [Consilium medicum]. 2004; 6 (4): 228-232.
12. Karoli NA, Tsybulina AV, Rebrov AP. Kachestvennayi i kolichestvennaya ocenka odyshki u bolnyh s respiratornymi zabolevaniyami [Qualitative and quantitative evaluation of dyspnea in patients with respiratory diseases]. Dyhanie; Pulmonologiya i otolaringologiya [Breathing; Pulmonology and otolaryngology]. 2013; 3: 4-7.
13. Chikina SYu, Trushenko NV. Kak ponyat «yazyk odyshki»? [How to understand «language of dyspnea?»]. Atmosphera; Pulmonologiya i allergologiya [Atmosphere; Pulmonology and Allergology]. 2012; 4: 35-37.
14. Simon PM, Schwartzstein RM, Weiss JW, et al. Distinguishable types of dyspnea in patients with shortness of breath. Am Rev Respir Dis. 1990; 142: 1009–1014.
15. Martynenko TI, Paraeva OS, Dronov SV, Shoykhet YN. Yazyk odyshki kak instrument pervichnoi dypherenciacii legochnoi i serdechnoi patologii [The language of breathlessness as the primary tool of differentiation of lung and heart disease]. Problemy klinicheskoi medyciny [Problems of clinical medicine]. 2013; 30: 86-95.
16. Dronov SV. Mnogomernyi statysticheskii analiz [Multivariate statistical analysis]. Barnaul: ASU [Barnaul: Altai State University]. 2006; 220 p.

 

UDC 616.24-036.12-07

DOI: 10.20969/VSKM.2019.12(6).54-59

References

1. Hu J, Meek P. Health-related quality of life in individuals with chronic obstructive pulmonary disease. Heart Lung. 2005; 34 (6): 415-422. doi:10.1016/j.hrtlng.2005.03.008
2. Okutan O, Tas D, Demirer E, Kartaloglu Z. Evaluation of quality of life with the chronic obstructive pulmonary disease assessment test in chronic obstructive pulmonary disease and the effect of dyspnea on disease-specific quality of life in these patients. Yonsei Med J. 2013; 54 (5): 1214–1219. doi:10.3349/ymj.2013.54.5.1214
3. Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline: Global Strategy for the Diagnosis, management and Prevention of Chronic Obstructive Pulmonary Disease 2019. 2019; http://www.goldcopd.com.
4. Huang WC, Wu MF, Chen HC, Hsu JY; TOLD Group. Features of COPD patients by comparing CAT with mMRC: a retrospective, cross-sectional study. NPJ Prim Care Respir
Med. 2015; 25: 15063. doi:10.1038/npjpcrm.2015.63
5. Hajiro T, Nishimura K, Tsukino M, Ikeda A, Koyama H, Izumi T. Analysis of Clinical Methods Used to Evaluate Dyspnea in Patients with Chronic Obstructive Pulmonary Disease. AM J Respiratory Critical Care Medicine. 1998;
158 (4): 1185-1189. doi:10.1164/ajrccm.158.4.9802091 6. Ozaveli S, Ucan ES. The comparison of different dyspnoea scales in patients with COPD. J Eval Clin Pract. 2006; 12
(5): 532-538. doi:10.1111/j.1365-2753.2006.00658.x
7. Mahler DA, Harver A. A Factor Analysis of Dyspnea Ratings, Respiratory Muscle Strength, and Lung Function in Patients with Chronic Obstructive Pulmonary Disease. Am Rev Respir Dis. 1992; 145 (2 Pt 1): 467-470. doi:10.1164/ajrccm/145.2_Pt_1.467
8. Zhang Y, Tu YH, Fei GH. The COPD assessment test correlates well with the computed tomography measurements in COPD patients in China. Int J Chron Obstruct Pulmon Dis. 2015; 10: 507–514. doi:10.2147/COPD.S77257
9. Savushkina OI, Chernyak AV. Legochnye funkcional’nye testy: ot teorii k praktike; Rukovodstvo dlya vrachej [Pulmonary function tests: from theory to practice; A guide for doctors]. Moskva: «Firma STROM» Ltd [Moscow: LLC STROM]. 2017; 192 p.
10. O’Donnell DE, Laveneziana P. Dyspnea and Activity Limitation in COPD: Mechanical Factors. COPD: Journal of Chronic Obstructive Pulmonary Disease. 2007; 4 (3): 225-236. doi: 10.1080/15412550701480455
11. Taube C, Lehnigk B, Paasch K, Kirsten DK, Jorres RA, Magnussen H. Factor Analysis of Changes in Dyspnea and Lung Function Parameters after Bronchodilation in Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med. 2000; 162 (1): 216-220. doi:10.1164/ ajrccm.162.1.9909054
12. Marsh S, Guck TP. Anxiety and depression: easing the burden in COPD patients. J Fam Pract. 2016; 65 (4): 246-256.

 

UDC 614.256.5:616.9(470.313)

DOI: 10.20969/VSKM.2019.12(6).59-65

 HEALTH CARE-ASSOCIATED INFECTIONS IN HEALTHCARE WORKERS

SMETANIN VIKTOR N., C. Med. Sci., associate professor of the Department of epidemiology of Ryazan State Medical University, Russia, 390026, Ryazan, Vysokovoltnaya str., 9, e-mail: smetvn@rambler.ru

Abstract. The study aimed to identify health care-associated infections (HCAIs) in healthcare workers; to analyze the infection rate and structure of acute and chronic infectious diseases; to determine the structure and number of infectious diseases while provision of medical care. To diagnose the frequency of skin injuries of medical workers contacted with HIV-infected blood recalculated to 100 units of medical instruments. Material and methods. We performed a questionnaire survey of medical workers and epidemiology data analysis in of Ryazan and the Ryazan region. Results and discussion. It was revealed that HCAIs were presented predominantly in pediatricians – 37,6%, and infectionists (5,3%) (surgeons – 42 respondents, gynecologists – 46, pediatricians – 108, infectionists – 56, dentists – 24). Most infections were airborne infections – 83,3%, intestinal infections – 15,6%, and other infections (bites, etc.) – 1,1%. Two health workers (0,72%) (pediatrician and dentist) had tuberculosis; taxoplasmosis was found in one surgeon (0,36%); viral hepatitis in two (0,72%) (infectionist and dentist); skin mycoses in five (1,8%) (surgeon – 3; gynecologist – 2) subjects; HIV infection in one pediatrician (0,36%). In general, 3,9% of respondents had infectious diseases associated with medical care provision. One case of HIV infection after contact with HIV-infected blood was recorded. Conclusion. The conducted research raises the question of the development and empirical verification of the system for improving the working conditions of medical workers, which will be carried out at the next stages of our work.

Key words: infections, medical worker, medical care, infection.

For reference: Smetanin VN. Health care-associated infections in healthcare workers. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (6): 59-65. DOI: 10.20969/VSKM.2019.12(6).59-65.

References

1. Polyakov IV. Ocenka sostoyaniya zdorov’ya medicinskih rabotnikov skoroj medicinskoj pomoshchi i vliyayushchih na nego faktorov [Assessment of the health status of emergency medical personnel and factors affecting it]. Problemy social’noj gigieny, zdravoohraneniya i istorii mediciny [Problems of social hygiene, health and medical history]. 2012; 1: 25-28.
2. Amirov NH. Ocenka professional’nogo riska narushenij zdorov’ya medicinskih rabotnikov po rezul’tatam periodicheskogo medicinskogo osmotra [Occupational risk assessment of health disorders of medical workers based on the results of periodic medical examination]. Vestnik sovremennoj klinicheskoj mediciny [Bulletin of modern clinical medicine]. 2014; 7 (2): 10-14.
3. Yermolina TA, Martynova NA, Kalinin AG, Krasil’nikov SV. Sostoyanie zdorov’ya medicinskih rabotnikov: obzor literatury [The health status of health workers: a review of the literature]. Vestnik novyh medicinskih tekhnologij [Bulletin of new medical technologies]. 2012; 3: 197-200.
4. Hrapunova IA. Sanitarno-epidemiologicheskij nadzor za vnutribol’nichnymi infekciyami medicinskogo personala [Sanitary and Epidemiological Surveillance of Nosocomial Infections of Medical Personnel]. Moskva: TSNII epidemiologii [Moscow: Central Research Institute of Epidemiology]. 2004; 222 p.
5. Medvedeva OV. Sohranenie zdorov’ya srednih medicinskih rabotnikov v usloviyah standartizacii medicinskoj deyatel’nosti [Preserving the health of nurses in the standardization of medical practice]. Problemy standartizacii v zdravoohranenii [Problems of standardization in health care]. 2012; 3/4: 56-58.
6. Maksimov IL. Sostoyanie zdorov’ya vrachej mnogoprofil’noj bol’nicy [The health of doctors of a multidisciplinary hospital]. Zdravoohranenie RF [Healthcare of the Russian Federation]. 2003; 3: 38–39.
7. Faktory bezopasnosti medrabotnikov i laborantov. 2019; sente-lab.com/novinki-iz-laboratornogo-mira/svetya-drugim-sgorayusam-etot-starinnyij-vrachebnyij-lozung-v-nashi-dniobretaet-osobyij-smyisl.-spas.htm
8. Sergeeva IV, Tihonova EP, Andronova NV, Kuz’mina TYu, Zotina GP. Zabolevaemost’ medicinskih rabotnikov infekcionnymi boleznyami,svyazano li eto s professional’noj deyatel’nost’yu [The incidence of health care workers of infectious diseases, whether it is connected with the professional activity]. Sovremennye problemy nauki i obrazovaniya [Modern problems of science and education]. 2015; 6: http://www.science-education.ru/ru/article/ view?id=22914
9. Garipova RV. Sovershenstvovanie sistemy monitoringa za sostoyaniem zdorov’ya medicinskih rabotnikov [Improving the system of monitoring the health of medical workers]. Kazanskij medicinskij zhurnal [Kazan Medical Journal]. 2011; 1: 78-82.
10. Kosarev VV. Professional’nye zabolevaniya medicinskih rabotnikov [Occupational diseases of health workers]. Samara: Ofort [Samara: Etching]. 2009; 232 p.
11. Minakov VF. Nekotorye osobennosti truda vrachej [Some features of doctors’ labor]. Trud i zdorov’e medicinskih rabotnikov [Labor and Health of Medical Workers]. 1985; 7–18.
12. Bolekhan VN, et al. Infekcii, svyazannye s okazaniem medicinskoj pomoshchi: sovremennoe sostoyanie problemy [Infections associated with the provision of medical care: the current state of the problem]. Voenno-medicinskij zhurnal [Military Medical Journal]. 2014; 7: 48-50.
13. Babanov SA. Faktory riska zdorov’ya medicinskih rabotnikov [Health risk factors for health workers]. Terapevt [Therapist]. 2010; 8: 18-21.
14. Baks MYa, Luss IYu, Sprudzha DR, et al. Faktory riska zdorov’ya medicinskih rabotnikov [Health risk factors for health workers]. Medicina truda i promyshlennaya ekologiya [Occupational Medicine and Industrial Ecology]. 2002; 3: 28–33.
15. Kosarev VV. Gemokontaktnye infekcii u medicinskih rabotnikov: faktory riska inficirovaniya, diagnostika, profilaktika [Hemocontact infections in health care workers: risk factors for infection, diagnosis, prevention]. Terapevt [Therapist]. 2010; 7: 31-37.
16. Kucenko GI. Psihofiziologicheskie aspekty trudovoj deyatel’nosti vrachej [Psychophysiological aspects of the labor activity of doctors]. Trud i zdorov’e medicinskih rabotnikov [Labor and health of medical workers]. 1985; 55–69.
17. Natarova AA. Ocenka urovnya i faktorov riska professional’noj zabolevaemosti medicinskih rabotnikov [Assessment of the level and risk factors of occupational morbidity of medical workers]. Fundamental’nye issledovaniya [Fundamental research]. 2015; 1 (9): 1873-1874.

 

UDC 616.65-091.8:616.65-006.6-089.87

DOI: 10.20969/VSKM.2019.12(6).66-71

 INTRAOPERATIVE HISTOLOGICAL FROZEN-SECTION EXAMINATION OF PROSTATE REGIONS ADJACENT TO NEUROVASCULAR BUNDLE: INITIAL IMPLEMENTATION EXPERIENCE DURING ROBOTIC-ASSISTED RADICAL PROSTATECTOMY

SOKOLOV EGOR A., ORCID ID: 0000-0002-8887-5789; С. Med. Sci., assistant of professor of the Department of urology and surgical andrology of Russian Medical Academy of Continuous Professional Education, Russia, 125993, Moscow, Barrikadnaya str., 2/1, bld. 1, tel. +7-916-475-11-33, e-mail: sokolov.yegor@yandex.ru

VELIEV EVGENY I., ORCID ID: 0000-0002-1249-7224; D. Med. Sci., professor of the Department of urology and surgical andrology of Russian Medical Academy of Continuous Professional Education, Russia, 125993, Moscow, Barrikadnaya st, 2/1, bld. 1, e-mail: veliev@urotop.ru

PAKLINA OXANA V., ORCID ID: 0000-0001-6373-1888; D. Med. Sci., Head of the Department of pathology of S.P. Botkin’s Moscow State Hospital, Russia, 125284, Moscow, 2nd Botkin passage, 5, e-mail: botkinhospital@zdrav.mos.ru

KNYSHINSKY GRIGORY V., pathologist of the Department of pathology of S.P. Botkin’s Moscow State Hospital, Russia, 125284, Moscow, 2nd Botkin passage, 5, e-mail: botkinhospital@zdrav.mos.ru

Abstract. Aim. The main objective of this study was to develop and initially assess the effectiveness of our technique of intraoperative histological frozen-section examination of prostate regions adjacent to neurovascular bundle during nerve-sparing robot-assisted radical prostatectomy (RP). Material and methods. The prospective study group included prostate cancer (PC) patients with preserved preoperative erectile function who underwent nerve-sparing robot-assisted RP from March to May 2019. The control group comprised patients with PC who underwent nerve-sparing robot-assisted RP without intraoperative histological examination from January to May 2019. The presence of tumor tissue in the stained margin of the resection was determined as a positive surgical margin. For all types of statistical analysis, p<0,05 was taken as a statistical significant threshold. GraphPad Prism 8 software was used for statistical data processing. Results and discussion. The study groups were comparable in terms of the prostate specific antigen level, prostate volume, and body mass index. The median time to complete intraoperative histological examination technique was 26 minutes, while the total operative time was almost equal in both groups. Despite the higher prevalence of extracapsular extension in the study group (30 and 5,5%), there were no positive surgical margins identified using the methodology of intraoperative histological examination, and in all cases the subsequent final histological examination confirmed intraoperative data. At the same time, the positive status of the surgical margins in the case of nerve-sparing RP without intraoperative frozen-section examination were found in 7,41%. Conclusion. An initial assessment of the results of intraoperative histological frozen-section examination of prostate regions adjacent to neurovascular bundle showed a decrease in the frequency of positive surgical margins. This indicates the potential feasibility of further clinical application of the technique. Subsequent analysis will evaluate its effectiveness in relation to cancer outcomes and the recovery of erectile function after surgery.

Key words: prostate cancer; radical prostatectomy; surgical margin; intraoperative histological examination; nerve-sparing technique.

For reference: Sokolov EA, Veliev EI, Paklina OV, Knyshinsky GV. Intraoperative histological frozen-section examination of prostate regions adjacent to neurovascular bundle: initial implementation experience during robotic-assisted radical prostatectomy. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (6): 66-71. DOI: 10.20969/ VSKM.2019.12(6).66-71.

References

1. Rawla P. Epidemiology of prostate cancer. World J Oncol. 2019; 10 (2): 63-89.
2. Bekelman JE, Rumble RB, Chen RC, et al. Clinically Localized Prostate Cancer: ASCO Clinical Practice Guideline Endorsement of an American Urological Association/
American Society for Radiation Oncology/Society of Urologic Oncology Guideline. J Clin Oncol. 2018; 36 (32): 3251-3258.
3. Shpot EV, Chinenov DV, Amosov AV, et al. Erektilnaya disfunktsiya, associirovannaya s radikalnoi prostatektomiei: celesoobraznost I sposobi sohraneniya potencii [Erectile dysfunction associated with radical prostatectomy: appropriateness and methods to preserve potency]. Urologiia. 2018; 2: 75-82.
4. Mottet N, Bellmunt J, Bolla M, et al. EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent. Eur Urol. 2017; 71 (4): 618-629.
5. Nguyen LN, Head L, Witiuk K, et al. The Risks and Benefits of Cavernous Neurovascular Bundle Sparing during Radical Prostatectomy: A Systematic Review and Meta-Analysis. J Urol. 2017; 198 (4): 760-769.
6. Schiavina R, Bianchi L, Borghesi M, et al. MRI Displays the Prostatic Cancer Anatomy and Improves the Bundles Management Before Robot-Assisted Radical Prostatectomy. J Endourol. 2018; 32 (4): 315-321.
7. Schlomm T, Tennstedt P, Huxhold C, et al. Neurovascular structure-adjacent frozen-section examination (Neuro-SAFE) increases nerve-sparing frequency and reduces positive surgical margins in open and robot-assisted laparoscopic radical prostatectomy: experience after 11,069 consecutive patients. Eur Urol. 2012; 62 (2): 333-340.
8. Beyer B, Schlomm T, Tennstedt P, et al. A feasible and time-efficient adaptation of NeuroSAFE for da Vinci robot-assisted radical prostatectomy. Eur Urol. 2014; 66 (1): 138-144.
9. Walz J, Epstein JI, Ganzer R, et al. A critical analysis of the current knowledge of surgical anatomy related to optimization of cancer control and preservation of continence and erection in candidates for radical prostatectomy. Eur Urol. 2016; 70 (2): 301-311.
10. Medvedev AV, Kogan MI, Medvedeva LA. Intraoperacionnaya immunomorfologicheskaya ocenka hirurgicheskih kraev rezekcii pri radikalnoi prostatektomii po povodu raka predstatelnoi zhelezi [Intraoperative immunomorphological estimation of surgical resection margins at radical prostatectomy for prostate cancer]. Onkourologiya [Oncourology]. 2001; 2: 60-64.
11. Keller EX, Bachofner J, Britschgi AJ, et al. Prognostic value of unifocal and multifocal positive surgical margins in a large series of robot-assisted radical prostatectomy for prostate cancer. World J Urol. 2019; 37 (9): 1837–1844. DOI: 10.1007/s00345-018-2578-y
12. Sighinolfi MC, Sandri M, Torricelli P, et al. External validation of a novel side-specific, multiparametric magnetic resonance imaging-based nomogram for the prediction of extracapsular extension of prostate cancer: preliminary outcomes on a series diagnosed with multiparametric magnetic resonance imaging-targeted plus systematic saturation biopsy. BJU Int. 2019; 124 (2): 192-194.
13. Preiser F, Theissen L, Wild P, et al. Implementation of intraoperative frozen section during radical prostatectomy: short-term results from a German tertiary-care center. Eur Urol Focus. 2019; https://www.eu-focus.europeanurology.com/article/S2405-4569(19)30082-3/fulltext . DOI: 10.1016/j.euf.2019.03.007
14. Panarello D, Compérat E, Seyde O, et al. Atlas of Ex Vivo Prostate Tissue and Cancer Images Using Confocal Laser Endomicroscopy: A Project for Intraoperative Positive Surgical Margin Detection During Radical Prostatectomy. Eur Urol Focus. 2019; https://www.eu-focus.europeanurology.com/article/S2405-4569(19)30004-5/fulltext . DOI: 10.1016/j.euf.2019.01.004

 

UDC 616-002-031.81-074

DOI: 10.20969/VSKM.2019.12(6).72-76

 METHOD OF LABORATORY DIAGNOSTICS OF SYSTEMIC INFLAMMATORY REACTION

KHALIMOV EDUARD V., D. Med. Sci., professor of the Department of general surgery of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunar str., 231

MIKHAILOV ALEXANDER YU., C. Med. Sci., assistant of professor of the Department of general surgery of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunar str., 231

ZHUIKOVA ALINA A., student of group 318 of the Department of general medicine of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunar str., 231

DAVTYAN MARAT B., student of group 321 of the Department of general medicine of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunar str., 231, tel. +7(919)912-24-49, e-mail: ob.hirurgiy@mail.ru

Abstract. The aim of the study was to study the plasma level of non-cleaved native fibronectin (PNNF) in surgical patients with systemic inflammatory reaction (SIR). Materials and methods. The analysis of clinical and laboratory data of patients treated in the Department of purulent surgery of City clinical hospital No 6 in 2016 was performed. Patients were divided into 2 groups: the main group with SIR and the comparison group with trophic ulcers of the lower extremities, without the phenomen of toxemia. The dynamics and compliance of PNNF with clinical and laboratory symptoms of SIR, hematological leukocyte indices (HLI) in the treatment of both groups were analyzed. Results and discussion. The main group of patients had pronounced signs of SIR: leukocytosis, LII to 4,0, shift of HLI towards the indicators of inflammatory changes, fever. All patients of the main group showed a decrease in PNNF from (53,5±17,2) μg/ml to (29,5±9,4) μg/ml. With a decrease in clinical and laboratory parameters of SIR, positive dynamics of HLI, in the main group, an increase in PNNF to (55,8±13,5) μg/ml was noted. There were no changes in PNNF in the comparison group during the treatment. Conclusion. Surgical diseases with signs of SIR have the diminishing of PNNF level. When improving the condition of patients, clinical and laboratory parameters, HLI increases the content of PNNF. The study of the level of PNNF can be a reliable and affordable diagnostic marker of septicemic condition.

Key words: plasma native fibronectin, marker, systemic inflammatory reaction.

For reference: Khalimov EV, Mikhailov AYu, Zhuikova AA, Davtyan MB. Method of laboratory diagnostics of systemic inflammatory reaction. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (6): 72-76. DOI: 10.20969/ VSKM.2019.12(6).72-76.

References

1. Savel’eva VS, Gel’fanda BR, ed. Sepsis: klassifikaciya, kliniko-diagnosticheskaya koncepciya i lechenie [Sepsis: classification, clinical diagnostic concept and treatment]. Moskva: Medicinskoe informacionnoe agentstvo [Moscow: Medical Information Agency]. 2010; 2: 352 p.
2. Svetuhin AM. Klinika, diagnostika i lechenie hirurgicheskogo sepsisa [Clinic, diagnosis and treatment of surgical sepsis]. Moskva: AMN SSSR, Institut khirurgii imeni AV Vishnevskogo [Moscow AMN of the USSR, Institute of Surgery named after AV Višnevskogo]. 1988; 36 p.
3. Beloborodov VB. Sepsis: chto delat’? [Sepsis: what to do?]. Medicina dlya vsekh [Medicine for all]. 1998; 5: 10-11.
4. Shabalov NP, Ivanov DS. Neonatal’nyj sepsis; klinika, diagnostika, lechenie [Neonatal sepsis; clinic, diagnosis, treatment]. Akademicheskij medicinskij zhurnal [Academy
Medical Journal]. 2001; 3: 81-88.
5. Rudnov VA, Kulabuhov VV. Sepsis-3; Obnovlennye klyuchevye polozheniya, potencial’nye problemy i dal’nejshie prakticheskie shagi [Sepsis -3; Updated key points, potential problems and further practical steps]. Vestnik anesteziologii i reanimatologii [Bulletin of anesthesiology and resuscitation]. 2016; 13 (4): 4-10.
6. Jean-Marc Cavaillon. New Approaches to Treat Sepsis: Animal Models «Do Not Work». General Reanimatology. 2018; 14 (3): 46-52.
7. Bolotskih VM. Soderzhanie plazmennogo fibronektina i S-reaktivnogo belka pri provedenii aktivno-vyzhidatel’noj taktiki u beremennyh s prezhdevremennym izlitiem okoloplodnyh vod [The content of plasma fibronectin and C-reactive protein when conducting active-waiting tactics in pregnant women with premature rupture of amniotic fluid]. Zhurnal Akusherstva i zhenskih boleznej [Journal of Obstetrics and Women’s Diseases]. 2011; LX (3): 56-62.
8. Savel’ev VS. Peritonit i endotoksicheskaya agressiya [Peritonitis and endotoxic aggression]. Moskva: GEOTAR-Media [Moscow: GEOTAR-Media]. 2012; 243 p.
9. Chebotkevich VN, Kajtandzhan EI, Burylev VV, Shchetinkina EE. Sovremennye metody laboratornoj diagnostiki sepsisа [Modern methods of laboratory diagnosis of sepsis]. Laboratornaya diagnostika [Laboratory diagnostics]. 2013; 15 (4): 295-300.
10. Gel’fand BR, Filimonov MI, Brazhnik TB, Sergeeva NA, Burnevich SZ. Prokal’ciotonin: novyj laboratornyj diagnosticheskij marker sepsisa i gnojno-septicheskih oslozhnenij v hirurgii [Procaltsiotonin: a new laboratory diagnostic marker for sepsis and septic complications in surgery]. Vestnik intensivnoj terapii [Intensive Care Bulletin]. 2003; 1: 12-16.
11. Kachalov SN. Fibronektin plazmy kak pokazatel’ blokady retikulo – endotelial’noj sistemy – effektivnost’ eyo korrekcii u bol’nyh s ostrymi pankreatitami [Plasma fibronectin as an indicator of reticulo – endothelial system blockade – its effectiveness in patients with acute pancreatitis]. Khabarovsk. 1990; 21 p.
12. Stevens L, Clemmer T, Laub R, Miya F, Robbins L. Fibrontin in severe sepsis. Surg Gynec Obstet. 1986; 162: 222-228.
13. Hogstrom H, Borgstrom A, Haglund U. Plasma fibronectin in relation to surgical trauma. Scand J Clin Lab Invest. 1985; 45: 87-90.
14. Levitan BN, Perova NYu, Astahin AV, Trubnikov GA. Plazmennyj fibronektin pri yazvennoj bolezni zheludka i dvenadcatiperstnoj kishki [Plasma fibronectin in gastric ulcer and duodenal ulcer]. Klinicheskaya medicina [Clinical medicine]. 1999; 9: 31-33.
15. Levitan BN, Astahin AV. Diagnosticheskoe i prognosticheskoe znachenie plazmennogo fibronektina pri hronicheskih diffuznyh zabolevaniyah pecheni [Diagnostic and prognostic value of plasma fibronectin in chronic diffuse liver diseases]. Rossijskij Gastroenterologicheskij zhurnal [Russian Gastroenterological Journal]. 2012; 3: 1-6.
16. Vasil’ev SA, Dzhumabaeva BT. Plazmennyj geparinovyj precipitat kak istochnik fibronektina dlya lecheniya bol’nyh s troficheskimi porazheniyami kozhi [Plasma heparin precipitate is as a source of fibronectin for the treatment of patients with trophic skin lesions]. Terapevticheskij arhiv [Therapeutic archive]. 1987; 6: 127-130.
17. Ermolin GA, Azova EA, et al. Soderzhanie plamennogo fibronektina u novorozhdennyh detej s gnojno – vospalitel’nymi zabolevaniyami [Content of plasma fibronectin in newborns with purulent – inflammatory diseases]. Terapevticheskij arhiv [Therapeutic archive]. 1986; 3: 102-104.
18. Litvinov RI. Perspektivy lechebnogo primeneniya preparatov fibronektina [Prospects for the therapeutic use of drugs fibronectin]. Kazanskij medicipskij zhurnal [Kazan Medical Journal]. 1986; 5: 391-396.
19. Belousov YuB, Shishkin AV, Panchenko EP. Fibronektin i ego klinicheskoe znachenie [Fibronectin and its clinical significance]. Kardiologiya [Cardiology]. 1987; 15: 100-104.
20. Forner L, Larsen T, Kilian M, Holmstrup P. Incidence of bacteremia after chewing, tooth brushing and scaling in individuals with periodontal inflammation. J Clin Periodontol. 2006; 33 (6): 401-407.

 

REVIEWS

UDC 616.12-005.4-085.849.19(048.8)

DOI: 10.20969/VSKM.2019.12(6).77-82

 LASER THERAPY IN ISCHEMIC HEART DISEASE TREATMENT

ABDRAKHMANOVA ALSU I., ORCID ID: 0000-0003-0769-3682; SCOPUS Author ID: 57192296744; C. Med. Sci., associate professor of the Department of clinical medicine fundamental basis of the Institute of biology and fundamental medicine of Kazan Federal University, Russia, 420012, Kazan, Karl Marx str., 74, e-mail: alsuchaa@mail.ru

AMIROV NAIL B., ORCID ID: 0000-0003-0009-9103; SCOPUS Author ID: 7005357664; D. Med. Sci., professor of the Department of general medical practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: namirov@mail.ru

Abstract. Aim. To analyze the latest publications of laser radiation in coronary heart disease treatment. Material and methods. Recent publications in scientific and medical literature devoted to the use of laser radiation in the treatment of coronary heart disease were reviewed. Results and discussion. Standard drug therapy for coronary heart disease, is characterized by the presence of adverse effects, allergic reactions, lack of symptoms control and quality of life decrease, and drug resistance. For this reason, the attention of researchers is attracted by laser therapy. The effectiveness of laser radiation has been confirmed in a number of clinical trials, with a high level of evidence. Indications for laser therapy are: stable angina II–III functional classes; unstable angina pectoris; myocardial infarction; chronic heart failure, a combination of coronary heart disease with hypertension; refractoriness to antianginal drugs. Conclusion. Inclusion in the combine treatment of patients with ischemic heart disease laser therapy effectively, significantly optimizes traditional treatment, which determines the appropriateness of its use in the treatment of these patients.

Key words: laser radiation, ischemic heart disease.

For reference: Abdrakhmanova AI, Amirov NB. Laser therapy in ischemic heart disease treatment. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (6): 77-82. DOI: 10.20969/VSKM.2019.12(6).77-82.

References

1. VOZ [WHO]. Serdechno-sosudistye zabolevanija; Informacionnyj bjulleten’ N°317 [Cardiovascular diseases; Newsletter N ° 317]. 2015; 317. URL: http://www.who.int/ mediacentre/factsheets/fs317/ru/
2. Minzdrav Rossii [Ministry of Health of Russia.]. Mediko-demograficheskie pokazateli Rossijskoj Federacii v 2013 godu: Statisticheskiy Spravochnik [Medical and demographic indicators of the Russian Federation in 2013: Statistical Handbook]. Moskva [Moscow]. 2013; 59 р.
3. Babushkina GV, Kartelishev AV. Jetapnaja kombinirovannaja lazernaja terapija pri razlichnyh klinicheskih variantah ishemicheskoj bolezni serdca [Stage combined laser therapy for various clinical variants of coronary heart disease]. Moskva: Tehnika [Moscow: Technique]. 2003; 115 р.
4. Bezrukavnikov JuA. Primenenie nizkointensivnogo lazernogo izluchenija pri nestabil’noj stenokardii; Sovremennye dostizhenija lazernoj mediciny i ih primenenie v prakticheskom zdravoohranenii [Application of low-intensity laser radiation in unstable angina; Modern achievements of laser medicine and their application in practical public health services]. Moskva [Moscow]. 2006; 110 p.
5. Nikitin AV, Jel’zhurkaev AA. Nadvennoe nizkointensivnoe lazernoe izluchenie v kompleksnom lechenii ishemicheskoj bolezni serdca [Advanced low-intensity laser radiation in the complex treatment of coronary heart disease]. Vestnik novyh medicinskih tehnologij: Jelektronnoe izdani [Bulletin of new medical technologies: Electronic edition]. 2013; 1: 88.
6. Moskvin SV. Osnovy lazernoj terapii [Fundamentals of laser therapy]. Moskva–Tver’: Triada [Moscow – Tver: Triad]. 2016; 896 р.
7. Moskvin SV. Jeffektivnost’ lazernoj terapii [The effectiveness of laser therapy]. Moskva: Triada [Moscow: Triad]. 2014; 256 р.
8. Nechipurenko NI, Pashkovskaja ID, Stepanova JuI, et al. Mehanizmy dejstvija i biologicheskie jeffekty nizkointen-sivnogo lazernogo izluchenija [Mechanisms of action and biological effects of low level laser radiation]. Medicinskie novosti [Medical News]. 2008; 12: 17-21.
9. Moskvin SV. K voprosu o mehanizmah terapevticheskogo dejstvija nizkointensivnogo lazernogo izluchenija [To the question about the mechanisms of therapeutic action of low-intensity laser radiation]. Vestnik novyh medicinskih tehnologij [Bulletin of new medical technologies]. 2008; 1: 167-172.
10. Abdrahmanova AI, Amirov NB. Sovremennye predstavlenija o mehanizmah lazernogo vozdejstvija [Modern ideas about the mechanisms of laser action]. Vestnik sovremennoj klinicheskoj mediciny [Herald of modern clinical medicine]. 2015; 5: 7–12.
11. Gazdanova AA. Vlijanie lazernoj terapii na funkciju jendotelija, mikrocirkuljaciju i nekotorye pokazateli gemoreologii u bol’nyh stabil’noj stenokardiej [The effect of laser therapy on endothelial function, microcirculation and some parameters of hemorheology in patients with stable angina].
Vladikavkaz [Vladikavkaz]. 2009; 21 p.
12. Gireeva EJu. Dinamika pokazatelej gomocisteina, funkcii jendotelija, processov perekisnogo okislenija lipidov i gemostaza u bol’nyh stabil’noj stenokardiej pod vlijaniem nizkointensivnogo lazernogo izluchenija [Dynamics of homocysteine parameters, endothelial function, processes of lipid peroxidation and hemostasis in patients with stable angina under the influence of low-intensity laser radiation]. Vladikavkaz [Vladikavkaz]. 2010; 25 р.
13. Kehoeva AJu. Vlijanie nizkointensivnogo lazernogo izluchenija na funkciju jendotelii, mikrocirkuljaciju i nekotorye pokazateli gemoreologii u bol’nyh ishemicheskoj bolezn’ju serdca s soputstvujushhim saharnym diabetom 2 tipa [Influence of low-intensity laser radiation on endothelial function, microcirculation and some parameters of hemorheology in patients with coronary heart disease with concomitant type 2 diabetes mellitus]. Vladikavkaz [Vladikavkaz]. 2010; 24 р.
14. Krjuchkova AV, Poletaeva IA, Grosheva ES. Izmenenie klinicheskih i laboratornyh pokazatelej pod vozdejstviem lazeroterapii u bol’nyh ishemicheskoj bolezn’ju serdca s soputstvujushhej bronhial’noj astmoj [Changes in clinical and laboratory parameters under the influence of laser therapy in patients with coronary heart disease with concomitant bronchial asthma]. Vestnik novyh medicinskih tehnologij [Bulletin of new medical technologies]. 2013; 2: 243–246.
15. Abdrahmanova AI. Primenenie nizkointensivnogo lazernogo izluchenija v lechenii stabil’noj stenokardii naprjazhenija v sochetanii s razlichnymi kombinacijami lekarstvennyh sredstv [The use of low-intensity laser radiation in the treatment of stable angina pectoris in combination with various combinations of drugs]. Izhevsk [Izhevsk]. 2004; 24 р.
16. Elizarov NA. Adaptacionnaja kardioprotekcija fizicheskimi faktorami v lechenii i profilaktike ishemicheskoj bolezni serdca [Adaptive cardioprotection by physical factors in the treatment and prevention of coronary heart disease]. Moskva [Moscow]. 2007; 44 р.
17. Marcijash AA. Nizkointensivnaja lazernaja terapija v kompleksnom vosstanovitel’nom lechenii bol’nyh, perenesshih infarkt miokarda na sanatornom i poliklinicheskom jetapah reabilitacii [Low-intensity laser therapy in complex restorative treatment of patients who underwent myocardial infarction at the sanatorium and polyclinic stages of rehabilitation]. Tomsk [Tomsk]. 2005; 39 р.
18. Stupnickij AA. Magnitolazernaja terapija v kompleksnom lechenii bol’nyh gipertonicheskoj bolezn’ju [Magnitolazernaya therapy in the complex treatment of patients with essential hypertension]. Sankt – Peterburg [St Petersburg]. 2004; 24 р.
19. Moskvin SV. Jeffektivnye metodiki lazernoj [Effective laser techniques]. Moskva: Triada [Moscow: Triad]. 2016; 80 р.
20. Amirov NB, Abdrahmanova AI. Dinamika kliniko-laboratornyh pokazatelej u bol’nyh IBS pri vkljuchenii v kompleks lechenija lazernoj terapii [Dynamics of clinical and laboratory indicators in patients with ischemic heart disease when included in the complex treatment of laser therapy]. Lazernaja medicina [Laser Medicine]. 2003; 2: 4-7.
21. Amirov NB, Abdrahmanova AI. Primenenie nizkointensivnogo lazernogo izluchenija v kompleksnom lechenii ishemicheskoj bolezni serdca [The use of low-intensity laser radiation in complex treatment of coronary heart disease]. Rossijskij kardiologicheskij zhurnal [Russian Cardiology Journal]. 2002; 5: 24-27.
22. Il’ina OV. Jeffektivnost’ kompleksnoj terapii s ispol’zovaniem lazeropunktury pri serdechno-sosudistyh zabolevanijah [Effectiveness of complex therapy using laser puncture in cardiovascular diseases]. Vestnik novyh medicinskih tehnologij [Bulletin of new medical technologies]. 2012; 4: 36–40.
23. Solov’eva EL. Optimizacija konservativnogo lechenija ishemicheskoj bolezni serdca s pomoshh’ju lazernoj terapii [Optimization of conservative treatment of coronary heart disease with the help of laser therapy]. Cheboksary [Cheboksary]. 2006; 24 р.
24. Aleksandrova OM. Vlijanie vnutrivennogo lazernogo obluchenija krovi na funkciju jendotelija, mikrocirkuljatornye rasstrojstva i nekotorye pokazateli sistemy gemostaza u bol’nyh gipertonicheskoj bolezn’ju [Influence of intravenous laser irradiation of blood on the function of the endothelium, microcirculatory disorders and some indicators of the system of hemostasis in patients with essential hypertension]. Vladikavkaz [Vladikavkaz]. 2008; 22 р.
25. Belov JuV, Harlamova UV. Ocenka faktorov jeffektivnosti nizkointensivnogo lazernogo izluchenija u bol’nyh nestabil’noj stenokardiej [Evaluation of the factors of effectiveness of low-intensity laser radiation in patients with unstable angina]. Rossijskij kardiologicheskij zhurnal [Russian Cardiology Journal]. 2008; 4 (72): 16-19.
26. Doncov AV. Nizkointensivnoe lazernoe izluchenie v lechenii bol’nyh ishemicheskoj bolezn’ju serdca c metabolicheskim sindromom (obzor literatury) [Low-intensity laser radiation in the treatment of patients with ischemic heart disease with metabolic syndrome (literature review)]. Vestnik novyh medicinskih tehnologij [Bulletin of new medical technolo-gies]. 2012; 4: 144-147.
27. Bezrukavnikov YUA. Primenenie nizkointensivnogo lazernogo izlucheniya dlya korrekcii narushenij lipidnogo obmena u bol’nyh nestabil’noj stenokardiej [The use of low-intensity laser radiation for the correction of lipid metabolism disorders in patients with unstable angina pectoris]. Voronezh [Voronezh]. 2007; 24 р.
28. Belov VV, Volchegorskij IA, Lozovaya LP. Dinamika kliniko-funkcional’nyh i biohimicheskih pokazatelej u bol’nyh infarktom miokarda pri lazeroterapii [The dynamics of clinical, functional and biochemical parameters in patients with myocardial infarction during laser therapy]. Kardiovaskulyarnaya terapiya i profilaktika [Cardiovascular therapy and prevention]. 2004; 3: 63–66.
29. Knyazeva TA, Badtieva VA. Fiziobal’neoterapiya serdechno-sosudistyh zabolevanij: prakticheskoe rukovodstvo [Physio-balneotherapy of cardiovascular diseases: a practical guide]. Moskva: MEDpress-inform [Moscow: MEDpress-inform]. 2008; 272 р.
30. Solov’eva EL. Optimizaciya konservativnogo lecheniya ishemicheskoj bolezni serdca s pomoshch’yu lazernoj terapii [Optimization of conservative treatment of coronary heart disease using laser therapy]. Kazan’ [Kazan]. 2006; 26 р.
31. Kul’chickaya D.B. Optimizaciya fizioterapevticheskih vozdejstvij s ispol’zovaniem impul’snogo i nepreryvnogo infrakrasnogo lazernogo izlucheniya pri ateroskleroticheskih porazheniyah sosudov nizhnih konechnostej [Optimization of physiotherapeutic effects using pulsed and continuous infrared laser radiation for atherosclerotic lesions of the vessels of the lower extremities]. Moskva [Moscow]. 1996; 17 р.
32. Kul’chickaya DB, Konchugova TV, Minenkov AA. Vliyanie optimal’nyh chastotnyh harakteristik impul’snyh lazernyh vozdejstvij pri ateroskleroticheskom porazhenii arterij nog [The influence of the optimal frequency characteristics of pulsed laser effects in atherosclerotic lesions of the arteries of the legs]. Voprosy kurortologii, fizioterapii i LFK [Questions of balneology, physiotherapy and exercise therapy].1994; 5: 11-15.

 

ORGANIZATION OF HEALTHCARE

UDC 614.2(470.57):616-057.36-082

DOI: 10.20969/VSKM.2019.12(6).83-88

References

1. Federal’nyj zakon ot 19/11/2010 No326-FZ «Ob obyazatel’nom medicinskom strahovanii v Rossijskoj Federacii» [On compulsory medical insurance in the Russian Federation]. Sobranie zakonodatel’stva Rossijskoj Federacii [Meeting of the legislation of the Russian Federation]. 2010; 49: st 6422.
2. Federal’nyj zakon ot 21/11/2011 No323-FZ «Ob osnovah ohrany zdorov’ya grazhdan Rossijskoj Federacii» [About bases of health protection of citizens of the Russian Federation]. Sobranie zakonodatel’stva Rossijskoj Federacii [Meeting of the legislation of the Russian Federation]. 2011; 48: st 6724.
3. Postanovlenie Pravitel’stva Rossijskoj Federacii ot 30/12/2011 No 1232 «O poryadke okazaniya sotrudnikam organov vnutrennih del Rossijskoj Federacii, otdel’nym kategoriyam grazhdan Rossijskoj Federacii, uvolennyh so sluzhby v organah vnutrennih del, i chlenam ih semej medicinskoj pomoshchi i ih sanatorno-kurortnogo obespecheniya» [On the procedure of providing officers of the internal Affairs of the Russian Federation separate categories of citizens of the Russian Federation dismissed from service in bodies of internal Affairs, and members of their families medical care and sanatorium-resort support]. Sobranie zakonodatel’stva Rossijskoj Federacii [Meeting of the legislation of the Russian Federation]. 2012; 3: st 432.
4. Gurov SP, Vasilevskaya SB, Sidorov AG. Opyt vzaimodejstviya FKUZ «MSCH MVD Rossii po Orlovskoj oblasti» s departamentom zdravoohraneniya, territorial’nym fondom obyazatel’nogo medicinskogo strahovaniya i medicinskimi strahovymi kompaniyami v usloviyah «odnokanal’nogo» finansirovaniya [Experience of interaction of Federal state healthcare institution «Medical sanitary unit of Ministry of internal Affairs of Russia across the Oryol region» with the Department of health, territorial Fund of obligatory medical insurance and medical insurance companies in a «single-channel» funding]. Medicinskij vestnik MVD [Medical Bulletin of the Ministry of internal Affairs]. 2016; 2: 14-17.
5. Sidorenko VA. Medicinskoj sluzhbe MVD Rossii – 95 let! Vedomstvennoe zdravoohranenie: istoriya, sostoyanie i perspektivy [The medical service of the Ministry of Internal Affairs of Russia is 95 years old! Departmental health care: history, condition and prospects]. Medicinskij vestnik MVD [Medical Bulletin of the Ministry of Internal Affairs]. 2016; 6 (LXXXV): 2-8.
6. Sidorenko VA, Kon’kov AV, Morozov AV. Opyt organizacii vedomstvennogo kontrolya kachestva medicinskoj deyatel’nosti v medicinskih organizaciyah sistemy Ministerstva vnutrennih del Rossijskoj Federacii [The experience of organizing departmental quality control of medical activity in medical organizations of the Ministry of the Interior of the Russian Federation]. Vestnik sovremennoj klinicheskoj mediciny [The Bulletin of Contemporary Clinical Medicine]. 2018; 11 (4): 7-11.

 

UDC 614.25:349.2(470+571)

DOI: 10.20969/VSKM.2019.12(6).88-95

 MODERN LEGAL FRAMEWORK FOR LABOUR: ANALYSIS AND PERSPECTIVES

SHIPOVA VALENTINA M., ORCID ID: 0000-0002-8957-921X; D. Med. Sci., Head researcher of N.A. Semashko National Research Institute of Public Health, Russia, 105064, Moscow

BERSENEVA EVGENIYA A., ORCID ID: 0000-0003-3481-6190; SCOPUS Author ID 55554758300; D. Med. Sci., Head of the Center of higher and complimentary professional training Federal Scientific State Budgetary Institution «N.A. Semashko National Research Institute of Public Health», Russia 105064, Moscow, tel. +7(916)216-84-59, e-mail: eaberseneva@gmail.com

KIRILLOV KIRILL V., ORCID ID: 0000-0003-1838-5386; postqraduate student of N.A. Semashko National Research Institute of Public Health, Russia, Moscow, tel. +7(967)(039)33-13, e-mail: kirillov5000@gmail.com

KUDENTSOVA EVGENIYA A., ORCID ID: 0000-0003-3828-7425; postqraduate student of N.A. Semashko National Research Institute of Public Health, Russia, Moscow, tel. +7(985)172-48-22, e-mail: velvets@list.ru

Abstract. Labour standards are used in drawing up the staff table of medical organizations, determining the burden of medical workers, economic analysis of their activities, in pricing. These documents contain a lot of wealth in terms of labour standards, which are both editorial and meaningful. The purpose of the study is to assess the effectiveness and constructivity of the existing orders regulating the staffing table. Material and methods. The relevance, adequacy of regulatory documentation for the work of various medical institutions was assessed. Results and their discussion. The publication presents an analysis of the modern legal framework on work, shows systemic erroneous provisions. The systemic erroneous provisions of these legal instruments can be grouped as follows: unjustified changes in the presentation of labour standards; Violation of the nomenclature of medical organizations, specialties and positions of medical workers, knee fund; Erroneous number of posts to ensure 24-hour work; Unwarranted introduction of new indicators for labour standards; Lack of normative support of a number of LCP divisions, individual positions; Inconsistency of labour standards values in different, simultaneously operating documents; The uncertainty of the population and its population; Absence of differentiation of labour standards by types of medical organizations. It was concluded that the documents should be revised and the main directions for improving the system of labour standards in health care were identified. Conclusions. Labour standards contained in the Orders on Medical Care Procedures should be revised. The basis for the revision is the erroneous provisions of these documents, which have reached a critical mass, as well as the recommendations of the Ministry of Labour of the Russian Federation on the revision of standard sectoral labour standards every 5 years from the date of their approval.

Key words: labor standards, procedures for providing medical care, erroneous provisions of regulatory documents on labor.

For reference: Shipova VM, Berseneva EA, Kirillov KV, Kudentsova EA. Modern legal framework for labor: analysis and perspectives. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (6): 88-95. DOI: 10.20969/VSKM.2019.12(6).88-95.

References

 1. Habriev RU, SHipova VM, Gadzhieva SM. Kommentarii k normam truda v zdravoohranenii [Comments on labor standards in healthcare]. Moskva: GEOTAR-Media [Moscow: GEOTAR-Media]. 2017; 144 p.
2. Shipova VM, Habriev RU, ed. Organizaciya i tekhnologiya normirovaniya truda v zdravoohranenii [Organization and technology of labor standards in healthcare]. Moskva: GEOTAR-Media [Moscow: GEOTAR-Media]. 2018; 320 p.
3. Habriev RU, Shipova VM, Berseneva ЕA. Kommentarii k normam truda v zdravoohranenii; Novye prikazy – starye problem [Comments on labor standards in healthcare; New orders, old problems]. Moskva: GEOTAR-Media [Moscow: GEOTAR-Media]. 2019; 144 p.
4. Pis’mo Minzdrava Rossii, FFOMS ot 21/11/2018 No 117/10/2-7543, 14525/26-1i «O metodicheskih rekomendaciyah po sposobam oplaty medicinskoj pomoshchi za schet sredstv obyazatel’nogo medicinskogo strahovaniya» [Letter of the Ministry of Health of Russia, FFOMS dated 11/21/2018 No. 11-7 / 10 / 2-7543, 14525 / 26-1i “On Methodological Recommendations on Methods of Paying for Medical Care at the Cost of Mandatory Medical Insurance”]. 2018.
5. Prikaz Minzdrava Rossii ot 16/10/2016 No 708 «O priznanii ne dejstvuyushchimi na territorii Rossijskoj Federacii prikazov Ministerstva zdravoohraneniya SSSR i priznanii utrativshim silu prikaza Ministerstva zdravoohraneniya RSFSR ot 4 yanvarya 1988 No 2 «O sostoyanii i perspektivah razvitiya patologoanatomicheskoj sluzhby v RSFSR» [The order of the Ministry of Health of Russia dated 10.16.2016 No 708 «On the recognition of the orders of the USSR Ministry of Health and the invalidation of the order of the Ministry of Health of the RSFSR of January 4, 1988 No 2 «On the status and prospects of the development of the pathoanatomical service in the RSFSR»]. 2016.
6. Prikaz Ministerstva truda i social’noj zashchity Rossijskoj Federacii ot 31/05/2012 No 235 «Ob utverzhdenii metodicheskih rekomendacij dlya federal’nyh organov ispolnitel’noj vlasti po razrabotke tipovyh otraslevyh norm truda» [Order of the Ministry of Labor and Social Protection of the Russian Federation from 31.05. 2012 No. 235 “On approval of guidelines for federal executive bodies on the development of model industry labor standards”]. 2012.

 

PRACTICAL EXPERIENCE

UDC 616.248-085.234.032.23-07(470.341)

DOI: 10.20969/VSKM.2019.12(6).96-100

 EVALUATING THE TECHNIQUE OF USING INHALATION DEVICE IN BRONCHIAL ASTHMA PATIENTS. THE EXPERIENCE OF NIZHNY NOVGOROD REGION

FEDOTOV VASILIY D., C. Med. Sci., assistant of professor of the Department of hospital therapy and general medical practice of Privolzhsky Research Medical University, Russia, 603005, Nizhny Novgorod, Minin
and Pozharsky sq., 10/1; senior research fellow of Nizhny Novgorod Research Institute of hygiene and occupational pathology, Russia, 603950, Nizhny Novgorod, Semashko str., 20, e-mail: basil11@yandex.ru

MILYUTINA MARINA YU., assistant of professor of the Department of propaedeutics of internal diseases of Privolzhsky Research Medical University, Russia, 603005, Nizhny Novgorod, Minin and Pozharsky sq., 10/1; junior research fellow of Nizhny Novgorod Research Institute of hygiene and occupational pathology, Russia, 603950, Nizhny Novgorod, Semashko str., 20

RAEVA TATYANA S., student of the Departmen of medical of Federal State Budgetary Educational Institution of Higher Education «Privolzhsky Research Medical University», Russia, 603005, Nizhny Novgorod, Minin
and Pozharsky sq., 10/1

KLYUSHINA EKATERINA A., student of the Departmen of medical of Privolzhsky Research Medical University, Russia, 603005, Nizhny Novgorod, Minin and Pozharsky sq., 10/1

NIKOLAEV DENIS V., student of the Departmen of medical of Privolzhsky Research Medical University, Russia, 603005, Nizhny Novgorod, Minin and Pozharsky sq., 10/1

SHMONIN DMITRY O., student of the Departmen of medical of Privolzhsky Research Medical University, Russia, 603005, Nizhny Novgorod, Minin and Pozharsky sq., 10/1

KOVALENKO VIKTORYA E., student of the Departmen of medical of Privolzhsky Research Medical University, Russia, 603005, Nizhny Novgorod, Minin and Pozharsky sq., 10/1

KALININA ALEXANDRA A., student of the Departmen of medical of Privolzhsky Research Medical University, Russia, 603005, Nizhny Novgorod, Minin and Pozharsky sq., 10/1

Abstract. The aim of the study was to evaluate the inhalation technique of patients with uncontrolled asthma after teaching and controlling the correct use of inhalation devices and to improve the effectiveness of bronchial asthma therapy in the region. Material and methods. Patients asthma exacerbation were included, a total of 73 people (28 men and 45 women), aged (59,5±11,0) years. The ACT questionnaire was used to evaluate asthma control. Patients were interviewed about what inhalers they use, in what dose they use basic therapy and how many times per day they use short-acting β2-agonists. Results and discussion. Demonstrated, that every tenth patient does not receive basic therapy for bronchial asthma. About 15% of patients were not trained in the use of inhalers. Every third patient reported that their inhaler technique had not been checked during their admission. Conclusion. The study showed that the training and control of inhalation techniques in patients with acute bronchial asthma are not effective enough. Most patients prefer the use of short-acting β2-agonists instead of basic therapy dose escalation.

Key words: bronchial asthma, inhalation technique, bronchial asthma control.

For reference: Fedotov VD, Milyutina MYu, Raeva TS, Klyushina EA, Nikolaev DV, Shmonin DO, Kovalenko VE, Kalinina AA. Evaluating the technique of using inhalation device in Bronchial Asthma patients. The experience of Nizhny Novgorod region. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (6): 96-100. DOI: 10.20969/ VSKM.2019.12(6).96-100.

References

1. Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012; 380: 2163–2196.
2. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention (Updated 2018). 2018; http:// ginasthma.org/
3. Price D, Fletcher M, van der Molen T. Asthma control and management in 8,000 European patients: the REcognise Asthma and LInk to Symptoms and Experience (REALISE) survey. NPJ Prim Care Respir Med. 2014; 24: 14009.
4. Arhipov VV, Grigor’eva EV, Gavrishina EV. Kontrol’ nad bronhial’noj astmoj v Rossii: rezul’taty mnogocentrovogo nablyudatel’nogo issledovaniya NIKA [Asthma control in Russia: results of multicenter observational study NIKA]. Pul’monologiya [Pulmonology]. 2011; 6: 87-93.
5. Olaguibel JM, Quirce S, Julia B, et al. Measurement of asthma control according to Global Initiative for Asthma guidelines: a comparison with the Asthma Control Questionnaire. Respir Res. 2012; 13: 50.
6. Bateman ED, Hurd SS, Barnes PJ, et al. Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J. 2008; 31: 143-178.
7. Partridge MR, Molen T, Myrseth SE, Busse WW. Attitudes and actions of asthma patients on regular maintenance therapy: the INSPIRE study. BMC Pulm Med. 2006; 6: 13.
8. Rabe KF, Vermeire PA, Soriano JB, Maier WC. Clinical management of asthma in 1999: the Asthma Insights and Reality in Europe. Eur Respir J. 2000; 16: 802–807.
9. Fong PM, Sinclair DE. Inhalation devices for asthma. Choosing the right one could make all the difference. Can Fam Physician. 1993; 39: 2377–2382.
10. Bjermer L. The importance of continuity in inhaler device choice for asthma and chronic obstructive pulmonary disease. Respiration. 2014; 88 (4): 346-352.
11. Vizel’ AA, Salahova IN, Vizel’ IYu, Vafina AR, Shakirova GR, Kudryavceva EZ. Bol’nye hronicheskoj obstruktivnoj bolezn’yu legkih: analiz real’noj klinicheskoj praktiki [Patients with chronic obstructive pulmonary disease: analysis of real clinical practice]. Consilium medicum. 2018; 20 (3): 35-39.
12. Ludwikowski R, Płusa T, Bijos P. Rating criteria for selection of an inhaler and instructing its use in patients with asthma and COPD. Pol Merkur Lekarski. 2016; 41 (246): 279-282.
13. Leshchenko IV. Pharmacy reimbursement and pharmacoeconomic aspects of therapy of bronchial asthma. Pharmacoeconomics: theory and practice. 2018; 6 (1): 21-25.
14. Bjermer L. The importance of continuity in inhaler device choice for asthma and chronic obstructive pulmonary disease. Respiration. 2014; 88 (4): 346-352.

 

CLINICAL CASE

UDC 616.441-006.6-033.2:616.24

DOI: 10.20969/VSKM.2019.12(6).101-104

 LUNG METASTATIC PAPILLARY THYROID CARCINOMA WITH ABSENCE OF METASTASES IN REGIONAL LYMPH NODES

IDIATULLIN RAVIL M., ORCID ID: 0000-0003-0645-7864; postqraduate student of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunar str., 281, e-mail: radg-radg@mail.ru

STYAZHKINA SVETLANA N., D. Med. Sci., professor of the Department of faculty surgery of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunar str., 281

Abstract. Thyroid cancer (thyroid gland) is the most common malignant tumor of the endocrine system. In the structure of all malignant tumors, thyroid cancer accounts for approximately 3%. The annual incidence of thyroid cancer in the world is estimated to be 0,8–9,4 and 0,6–2,6 cases per 100 thousand population for women and men respectfully. The incidence of thyroid cancer as the most common endocrine malignancy has been increasing constantly in Russian Federation. The purpose of the study is to present a case of lung metastatic papillary thyroid carcinoma with absence of metastases in regional lymph nodes. Material and methods. Patient was admitted to Republican Clinical Oncological Dispensary named after Sergey Primushko in Izhevsk. Primary medical documentation was studied: outpatient card, inpatient case history, operation protocols, laboratory, instrumental and histological findings. Results and discussion. This clinical example demonstrates a rare case of aggressive course of papillary thyroid cancer, with metastatic lung lesions, but no metastases in regional lymph nodes. Conclusion. It is necessary to study and introduce into clinical practice molecular genetics and histological markers to predict such cases of the course of papillary thyroid cancer.

Key words: thyroid cancer, metastatic lesion, clinical case.

For reference: Idiatullin RM, Styazhkina SN. Lung metastatic papillary thyroid carcinoma with absence of metastases in regional lymph nodes. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (6): 101-104. DOI: 10.20969/ VSKM.2019.12(6).101-104.

References

1. Bershtein LM. Rak shchitovidnoj zhelezy: epidemiologiya, endokrinologiya, faktory i mekhanizmy kancerogeneza [Thyroid cancer: epidemiology, endocrinology, factors and mechanisms of carcinogenesis]. Practicheskaja onkologija [Practical oncology]. 2007; 8 (1): 1-8.
2. Rumyantsev PO, Ilyin AA, Rumyantseva UV, Saenko VA. Rak shchitovidnoj zhelezy; Sovremennye podhody k diagnostike i lecheniyu [Thyroid cancer; Modern approaches to diagnosis and treatment]. Moskva: Geotar-Media [Moscow: Geotar-Media]. 2009; 448 p.
3. Mikhnin AE. Rak shchitovidnoj zhelezy: diagnostika, klassifikaciya, stadirovanie [Cancer of the thyroid gland: diagnosis, classification, staging]. Practicheskaja onkologija [Practical oncology]. 2007; 8 (1): 17-18.
4. Kaprina AD, Starinsky VV, Petrova GV, ed. Zlokachestvennye novoobrazovaniya v Rossii v 2017 godu [Malignant neoplasms in Russia in 2017]. MNIOI imeni PA Gercena filial FGBU «NMIC radiologii» Minzdrava Rossii [MNIOI them PA Herzen branch of the Federal Research Center of Radiology Research Center, Ministry of Health of Russia]. 2018; 250 p.
5. Valdina EA. Zabolevaniya shchitovidnoj zhelezy: Rukovodstvo [Diseases of the thyroid gland: Leadership]. SPb: Peter [St Petersburg: Peter]. 2005; 368 p.
6. Styazhkina SN, Chernyshova TE, Idiatullin RM, Akimov AA, Valinurov AA, Varenik EYu. Klinicheskij sluchaj oslozhneniya pri tireoidektomii po povodu raka shchitovidnoj zhelezy [Clinical case of complication with thyroidectomy for thyroid cancer]. Zdorov’e i obrazovanie v XXI veke [Health and Education Millennium]. 2018; 20 (4): 124-127.
7. Zarivchatsky MF, Styazhkina SN, Chernyshov IE. Izbrannye stranicy hirurgicheskoj tireoidologii: monografija [Selected pages of surgical thyroidology: monograph]. Izhevsk. 2011; 42 p.
8. Popova YuV, Romanchishen AF. Posleoperacionnye oslozhneniya v hirurgii shchitovidnoj zhelezy [Postoperative complications in thyroid surgery]. Materialy 15 Rossijskogo simpoziuma po hirurgicheskoj endokrinologii [Materials of the 15th Russian Symposium on Surgical Endocrinology]. 2005; 265-269.
9. Denisova LB, Vorontsova SV, Yaurova NV. Vozmozhnosti novyh luchevyh tekhnologij (UZI, KT, MRT) v diagnostike endokrinnoj patologii [Possibilities of new radiation technologies (ultrasound, CT, MRI) in the diagnosis of endocrine pathology]. 0Vestnik rentgenologii i radiologii [Herald of radiology and radiology]. 2006; 1: 29–43.
10. Serov AS, Popova NA, Zhogova LN. Znachenie tonkoigol’noj aspiracionnoj punkcionnoj biopsii pod kontrolem UZI v diagnostike ochagovyh obrazovanij shchitovidnoj zhelezy [The value of fine-needle aspiration puncture biopsy under the control of ultrasound in the diagnosis of focal lesions of the thyroid gland]. Lipeck: Materialy XXI mezhregionalnoy nauchno-prakticheskoy konferencii [Lipetsk: Materials of the XXI interregional scientific and practical conference]. 2008; 158–160.
11. Kononenko SN. Rannyaya diagnostika i differencirovannoe lechenie raka shchitovidnoj zhelezy [Early diagnosis and differential treatment of thyroid cancer]. Hirurgiya [Surgery]. 2000; 3: 38–41.

 

UDC 616.11-002-02:616-073.75

DOI: 10.20969/VSKM.2019.12(6).104-107

 RADIATION-INDUCED PERICARDITIS AFTER DIAGNOSTIC RADIATION EXPOSURE

CHEPURNENKO SVETLANA A., ORCID ID: 0000-0002-3834-4699; D. Med. Sci., associate professor of the Department of general practice (family medicine) with courses of geriatrics and physiotherapy
of Rostov State Medical University, Russia, 344022, Rostov-on-Don, Nakhichevan lane, 29; cardiologist of the Department of cardiology outpatient of Cardiosurgery Center Rostov Regional Clinical Hospital, Russia, 344015, Rostov-on-Don, Blagodatnaya str., 170, tel. 8(918)507-28-93, e-mail: ch.svet2013@yandex.ru

SHAVKUTA GALINA V., ORCID ID: 0000-0003-4160-8154; D. Med. Sci., professor of the Department of general practice (family medicine) with courses of geriatrics and physiotherapy of Rostov State Medical University, Russia, 344022, Rostov-on-Don, Nakhichevan lane, 29

BULGAKOVA NATALIA M., ORCID ID: 0000-0001-6638-3698; C. Med. Sci., сardiologist of the Department of сardiology outpatient Cardiosurgery Center of Rostov Regional Clinical Hospital, Russia, 344015, Rostov-on-Don, Blagodatnaya str., 170

NASYTKO ALINA D., ORCID ID: 0000-0001-6341-6749; laboratory assistant of the Department of general medical practice (family medicine) of Rostov State Medical University, Russia, 344022, Rostov-on-Don, Nakhichevan lane, 29, tel. 8(960)442-49-98, e-mail: rainbow98al@gmail.com

Abstract. Radiation therapy is a very important part of combine therapy for many cancers, improving survival, but also have well-known side effects. Aim. We present a clinical case of radiation-induced heart disease – exudative pericarditis after diagnostic radiation exposure. Material and methods. The article discusses the development of acute pericarditis in a patient underwent surgery for ovarian cancer stage 3, clinical group 2, T3 N0 M0. Results and discussion. After the surgery, the patient received 6 courses of chemotherapy with carboplatin 600 mg, paclitaxel 300 mg during the maintenance therapy: chloropyramine, latran, dexamethasone, quamel. In order to search for possible metastases for 6 months, the patient underwent 3 spiral chest computed tomographies (CT), 2 spiral abdominal and pelvical CTs, and whole-body position-emission computed tomography (PET-CT). The total radiation exposure was 75,9 mSv. Hypothyroidism, systemic diseases, nephrotic syndrome were excluded with the help of additional studies. This allowed us to suggest radiation genesis of pericardial effusion. As a result of treatment with ibuprofen 600 mg every 8 hours with colchicine at a dose of 0,5 mg 2 times a day with a 20 mg of pantoprazole once daily after 1 month of treatment, exudative pericarditis resolved. Conclusion. It is necessary to evaluate the total dose of radiation received earlier to prevent radiation-induced damage. It is necessary to use the most informative research methods to avoid repeated spiral CT.

Key words: radiation pericardial effusion, spiral computed tomography, total radiation dose, colchicine, ibuprofen.

For reference: Chepurnenko SA, Shavkuta GV, Bulgakova NM, Nasytko AD. Radiation-induced pericarditis after diagnostic radiation exposure. The Bulletin of Contemporary Clinical Medicine. 2019; 12 (6): 104-107. DOI: 10.20969/ VSKM.2019.12(6).104-107.

References

1. Silverman SG, Tuncali K, Adams DF. CT Fluoroscopyguided Abdominal Interventions: Techniques, Results, and Radiation Exposure. Radiology. 1999; 3: 201-207. DOI:10.1148/radiology.212.3.r99se36673.
2. Stewart JR, Fajardo MD. Radiation injury to the heart. International Journal of Radiation Oncology. 1995; 31: 1205-1211. DOI: 10.1016/0360-3016(94)00656-6
3. Schultz-Hector S, Klaus-Rüdiger TP. Radiation-induced cardiovascular diseases: Is the epidemiologic evidence compatible with the radiobiologic data. Radiation and Environmental Biophysics. 2008; 47: 189-193. DOI:10.1016/j. ijrobp.2006.08.071.
4. Morton L, Glancy DL, Paul WL. Management of Patients with Radiation-Induced Pericarditis with Effusion: A Note on the Development of Aortic Regurgitation in Two of Them. Cleveland Clinic Journal of Medicine. 1973; 64: 291-297. DOI: 10.1378/chest.64.3.291.
5. Posner MR, Cohen GI. Pericardial disease in patients with cancer: The differentiation of malignant from idiopathic and radiation-induced pericarditis. The American Journal of Medicine. 1981; 71: 407-413. DOI: 10.1016/0002-9343(81)90168-6.
6. Cameron J, Oesterle N. The etiologic spectrum of constrictive pericarditis. American Heart Journal. 1987; 113: 354-360. DOI:10.1016/0002-8703(87)90278-X.
7. Taunk NK, Haffty BG. Radiation-induced heart disease: pathologic abnormalities and putative mechanisms. Front Oncol. 2015; 27: 1-5. DOI:10.3389/fonc.2015.00039.
8. Marmagkiolis K, Despina F. Radiation Toxicity to the Cardiovascular System. Current oncology reports. 2016; 18: 193-194. DOI:10.1007/s11912-016-0502-4.
9. Razumova YeT, Kharchenko MS, Litvinova IS. Opukholevyye porazheniya perikarda v klinike vnutrennikh bolezney [Tumor lesions of the pericardium in the clinic of internal diseases]. Rossiyskiy kardiologicheskiy zhurnal [Russian Journal of Cardiology]. 2006; 5: 106-116.
10. Adler Y, Charron P, Imazio M. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases. European Heart Journal. 2015; 36: 2921-2694. DOI:10.1093/eurheartj/ehv319