ORIGINAL RESEARCH

UDC 616.24-036.12-07:616.15-074

DOI: 10.20969/VSKM.2020.13(1).10-16

 COMPLEX ANALYSIS OF THE ACID-BASIC STATE, GAS AND ELECTROLYTE COMPOSITION OF THE VENOUS BLOOD IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH DIFFERENT EXACERBATION RISKS

BAKINA ANASTASIA A., ORCID ID: 0000-0003-2653-8661; postgraduate student of the Department of faculty and outpatient therapy of Amur State Medical Academy, Russia, 675000, Blagoveshchensk, Gorky str., 95, tel. 8-924-446-50-08, e-mail: anastasia_darchi@mail.ru

PAVLENKO VALENTINA I., D. Med. Sci., professor of the Department of faculty and outpatient therapy of Amur State Medical Academy, Russia, 675000, Blagoveshchensk, Gorky str., 95, e-mail: agmapedfac@mail.ru

Abstract. The aim of the study was to comprehensively analyze the acid-base state, gas and electrolyte composition of venous blood in patients su ering from chronic obstructive pulmonary disease (COPD) with various exacerbation risk. Material and methods. The study included 59 patients with a con rmed diagnosis of COPD who received treatment for their exacerbation episodes at inpatient department. All participants were divided in 2 groups: patients with low exacerbation risk and patients with high risk. They underwent a comprehensive assessment of complaints and medical history, laboratory and instrumental research according to COPD examination standard, including clinical and biochemical blood tests, general urine analysis, electrocardiography, computed tomography of chest organs, spirometry, pulse oximetry (saturation rate at rest without oxygen support was taken into account), the investigation of the acid-base state, electrolyte and gas composition of the venous blood. We used Microsoft O ce Excel 2007 and Statistica 10 software package for statistical processing of data. Results and discussion. We revealed a statistically signi cant di erence between the partial pressure of blood oxygen, standard bicarbonate and potassium levels in groups of patients. II degree respiratory failure was signi cantly more likely to occur in patients with high exacerbation risk. The correlation between hemoglobin concentrations and postbronchodilation numbers of almost all spirometric indicators takes place. Conclusions. Revealed patterns may indicate the e ect of COPD exacerbations frequency on the occurrence of imbalance in acid-base state, gas and electrolyte blood composition. Evaluation of blood gas parameters, acid-base state and balance of electrolytes should be considered as an integral part of the diagnostic process and management in patients with COPD, especially in those with high risk of exacerbations.

Key words: chronic obstructive pulmonary disease, exacerbation, acid-base condition, electrolytes, gas composition.

For reference: Bakina AA, Pavlenko VI. Complex analysis of the acid-basic state, gas and electrolyte composition of the venous blood in patients with chronic obstructive pulmonary disease with di erent exacerbation risks. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (1): 10-16. DOI: 10.20969/VSKM.2020.13(1).10-16.

References

 

UDC 616.831-001-085.272.032.14

DOI: 10.20969/VSKM.2020.13(1).17-21

References

 

UDC 616.314-007.21-031.84:316.344/.346

DOI: 10.20969/VSKM.2020.13(1).22-26

 SOCIO-DEMOGRAPHIC STATUS OF PATIENT WITH SECONDARY PARTIAL EDENTULISM

JALILOVA GONCHA I., Department of orthopedic stomatology of Azerbaijan Medical University, Azerbaijan, AZ 1007, Baku, Gasymzade str., 14, e-mail: mic_amu@mail.ru

Abstract. The aim of the study was to investigate the socio-demographic status of patients with secondary partial edentulism in the rst and second periods of the middle age. Material and methods. We observed 72 individuals (36 men and 36 women) from 22 to 55 years old who applied for orthopedic treatment with xed prosthetic construction due to secondary partial edentulism. Basic and auxiliary examination methods were used in patients. Participants were divided into four subgroups for the analysis of their medical and social characteristics by means of social survey questionnaire. Results and discussion. 60% of patients have higher education and 40% have secondary education according to the results of the study. Working hours of 80% of patients are longer than 8–10 hours. The income level has been de ned as medium-satisfactory in 60%, low in 20%, upper-middle in 18% and extremely low in 2%. The vast majority (90%) of patients noted the fact of living in an independent housing, 10% – other living conditions. When analyzing the marital status, most patients (82%) of both sexes were married. Food ration consisted of various products in 90%, soft food was preferred in 8% and especially hard food in 2%. 60% of examined don’t have bad habits (alcohol consumption or smoking), but 40% of them do. 20% of patients apply for medical assistance regularly, 63% only in case of acute pain, 17% undergo the examination on preventive purpose. Conclusion. Results of the research con rm that the occurrence and orthopedic treatment of secondary partial edentulism depend on socio-demographic status of the patient.

Key words: secondary partial edentulism, orthopedic treatment, non-removable dental bridge, socio-demographic status. For reference: Jalilova GI. Socio-demographic status of patient with secondary partial edentulism. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (1): 22-26. DOI: 10.20969/VSKM.2020.13(1).22-26.

References

 

UDC 616.24-006.6-033.2-073.756.8

DOI: 10.20969/VSKM.2020.13(1).26-31

References

 

UDC 616.12-008.46-036.12-07:616.36-07

DOI: 10.20969/VSKM.2020.13(1).31-36

 LIVER FUNCTION INDICATORS IN HOSPITALIZED PATIENTS WITH CHRONIC HEART FAILURE

MINGALIMOVA ILVERA M., ORCID ID: 0000-0002-7081-6211; cardiologist of Interregional Clinical Diagnostic Center, Russia, 420101, Kazan, Karbyshev str., 12a, tel. +7-987-297-16-00, e-mail: ilvera.maratovna@list.ru

GALEYEVA ZULFIUA M., С. Med. Sci., associate professor of the Department of cardiology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-917-265-85-64, e-mail: maktub29@mail.ru

BALEYEVA LARISA V., С. Med. Sci., assistant of professor of the Department of cardiology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-905-314-35-45, e-mail: smir151@yandex.ru

GALYAVICH ALBERT S., D. Med. Sci., professor, Head of the Department of cardiology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: agalyavich@mail.ru

Abstract. The aim of our study was to investigate the dynamics of liver function indicators during inpatient treatment in patients with severe heart insu ciency. Material and methods. The study included 196 patients with ischemic chronic heart failure. All patients underwent a laboratory examination (general blood tests, liver tests: aspartic transaminase (AcT), alanine transaminase (Alt), bilirubin, alkaline phosphatase) and instrumental examination (ECG, echocardiography). Medical treatment of patients in the hospital was carried out in accordance with the OSCH recommendations, 2017. The average duration of treatment in a hospital was (12±3,53) days. We analyzed the dynamics of liver samples before and after treatment, depending on patients’ gender and the presence of diabetes mellitus type 2. Statistical analysis was performed using the IBM SPSS Statistics v.23 program. We used Shapiro-Wilk, Kolmogorov-Smirnov, student and U-test Man on Whitney criteria. All patients were divided into subgroups according to gender and the presence of diabetes mellitus (DM) type 2: men with heart failure (63 pers), men with chronic heart failure and type 2 diabetes (37 pers), women with heart failure (44 pers) and women with heart failure and type 2 diabetes (52 pers). Results and discussion. We have studied the functional parameters of the liver depending on the gender of patients and the presence of type 2 diabetes. Drug therapy in patients with chronic heart failure in hospital leads to a signi cant improvement in liver function indices: an AcT decrease (by 17,4%; p=0,002) in men with heart failure with diabetes mellitus 2, a decrease in ALT (by 40,1%; p=0,001), AcT (by 75%; p=0,002), total bilirubin (by 50,5%; p=0,001) , direct bilirubin (by 62%; p=0,001) in men with heart failure. The presence of a long-existing excessively large blood volume in liver leads to the expansion of sinusoids and perivenous brosis. This process can further extend to the periphery, connecting one central vein to another, which, ultimately, leads to cirrhosis. The presence of functional and morphological changes in the liver a ects the metabolism of drugs used in the treatment of heart failure. After eliminating (decreasing) stagnation in the liver, the metabolism of drugs in the liver can improve. Conclusions. Based on these facts, we came to the conclusion that liver function can be improved signi cantly by adequate inpatient drug treatment for heart failure. In turn, improved liver function can signi cantly improve the metabolism of drugs used.

Key words: chronic heart failure, liver function.

For reference: Mingalimova IM, Galeyeva ZM, Baleyeva LV, Galyavich AS. Liver function indicators in hospitalized patients with chronic heart failure. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (1): 31-36. DOI: 10.20969/ VSKM.2020.13(1).31-36.

References

 

UDC [616.12-009.7-02:616.127-005.8]-08-07

References

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UDC 616.72-002.77-053.2/.6-07:616.15-07

References

 

UDC 616.33/.342-085.281.9-06:616.345-008.87-07

DOI: 10.20969/VSKM.2020.13(1).46-53

 HELICOBACTER PYLORI ERADICATION THERAPY AND GUT MICROBIOTA COMPOSITION IN PATIENTS WITH VARIOUS DISEASES OF UPPER GASTROINTESTINAL TRACT

SAFINA DILYARA D., ORCID ID: 0000-0002-5985-3089; SCOPUS Author ID: 56290414000; junior researcher of «Gene and Cell Technologies» OpenLab of Institute of fundamental medicine and biology of Kazan (Volga region) Federal University, Russia, 420008, Kazan, Kremlevskaya str., 18, e-mail: diliarik@yandex.ru

ABDULKHAKOV SAYAR R., ORCID ID: 0000-0001-9542-3580; SCOPUS Author ID: 8042571200; C. Med. Sci., associate professor, senior researcher of «Gene and Cell Technologies» OpenLab, Head of the Department of fundamentals of clinical medicine of Institute of fundamental medicine and biology of Kazan (Volga region) Federal University, Russia, 420008, Kazan, Kremlevskaya str., 18; assistant of professor of the Department of general medical practice and outpatient therapy of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: sayarabdul@yandex.ru

MARKELOVA MARIA I., ORCID ID: 0000-0001-7445-2091; SCOPUS Author ID: 57188689882; junior researcher of «Omics Technologies» OpenLab og Institute of fundamental medicine and biology of Kazan (Volga region) Federal University, Russia, 420008, Kazan, Kremlevskaya str., 18, e-mail: mimarkelova@gmail.com

GRIGORYEVA TATIANA V., ORCID ID: 0000-0001-5314-7012; SCOPUS Author ID: 56310630200; C. Biol. Sci., senior researcher of «Omics Technologies» OpenLab of Institute of fundamental medicine and biology of Kazan (Volga region) Federal University, Russia, 420008, Kazan, Kremlevskaya str., 18, e-mail: tatabio@inbox.ru

KHUSNUTDINOVA DILYARA R., ORCID ID: 0000-0002-9982-9059; SCOPUS Author ID: 57188680130; Head project engineer of Interdisciplinary center for proteomic research of Institute of fundamental medicine and biology of Kazan (Volga region) Federal University, Russia, 420008, Kazan, Kremlevskaya str., 18, e-mail: dilyahusn@gmail.com

BULYGINA EUGENIA A., ORCID ID: 0000-0003-3458-1176; SCOPUS Author ID: 55933685100; researcher of «Omics Technologies» OpenLab of Institute of fundamental medicine and biology of Kazan (Volga region) Federal University, Russia, 420008, Kazan, Kremlevskaya str., 18, e-mail: boulygina@gmail.com

MALANIN SERGEY YU., ORCID ID: 0000-0002-3343-4441; SCOPUS Author ID: 36020345300; C. Biol. Sci., Head project engineer of Interdisciplinary center for proteomic research of Institute of fundamental medicine and biology of Kazan (Volga region) Federal University, Russia, 420008, Kazan, Kremlevskaya str., 18, e-mail: sergen83@mail.ru

VASILYEV ILYA YU., ORCID ID: 0000-0001-7799-1728; SCOPUS Author ID: 39360974315; junior researcher of «Omics Technologies» OpenLab of Institute of fundamental medicine and biology of Kazan (Volga region) Federal University, Russia, 420008, Kazan, Kremlevskaya, 18, e-mail: u0412u0418u042e@gmail.com

SINIAGINA MARIA N., ORCID ID: 0000-0002-8138-9235; SCOPUS Author ID: 57192356666; detailer of Interdisciplinary center for proteomic research of Institute of fundamental medicine and biology of Kazan (Volga region) Federal University, Russia, 420008, Kazan, Kremlevskaya str., 18, e-mail: marias25@mail.ru

ABDULKHAKOV RUSTAM A., ORCID ID: 0000-0002-1509-6776; SCOPUS Author ID: 6506615710; D. Med. Sci., professor of the Department of hospital therapy of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: rustemabdul@mail.ru

Abstract. Aim of the study was to determine initial gut microbiota composition, as well as assess e ect of Helicobacter pylori (H.pylori) eradication on the gut microbiota composition in H.pylori-positive patients with various diseases of the upper gastrointestinal tract. Material and methods. One hundred and two 102 H.pylori-positive patients were included into the study. Stool samples before eradication (102 samples), immediately after (102 samples) and one month after eradication (29 samples) therapy were collected. Gut microbiota composition was analyzed using shotgun metagenomic sequencing (SOLiD 5500 Wild re platform). Results and discussion. Most widely represented bacterial phyla in the gut microbiota of H.pylori-positive patients before eradication therapy were Firmicutes – (58,52±21,48)%, Bacteroide­ tes – (33,49±23,51)%, Actinobacteria – (3,08±6,34)%, Proteobacteria – (2,33±6,70)%, Verrucomicrobia – (0,89±2,43)%, and Euryarchaeota archaeal phyla – (0,76±2,16)%. The gut microbiota composition was similar in case of most bacterial phyla, viruses, archaea, and eukaryotes in H.pylori-positive patients with various diseases of the upper gastrointestinal tract. Analysis of gut microbiota composition changes depending on diseases of the upper gastrointestinal tract revealed that in patients with ulcer (Ul), chronic H.pylori-associated gastritis (with clinical manifestations of dyspepsia) (ChG), gastroesophageal re ux disease (GERD) and those in whom eradication was performed for the prevention of gastric cancer the most pronounced changes were observed in abundance of Actinobacteria, Verrucomicrobia (patients with Ul, ChG, GERD) and Firmicutes (patients with Ul), which relative representation decreased immediately after treatment (p<0,05). Four weeks after eradication therapy abundance of most bacterial phyla almost completely returned to the initial level in case of most diseases, except the ulcer disease patients with Ul who still had a decreased representation of Actinobacteria (p=0,001). Conclusion. Thus, H.pylori eradication therapy causes signi cant changes of the gut microbiota composition. Some changes persist even one month after completion of eradication therapy.

Key words: gut microbiota, H.pylori, H.pylori eradication therapy, shotgun sequencing.

For reference: Safina DD, Abdulhakov SR, Markelova MI, Grigoryeva TV, Khusnutdinova DR, Bulygina EA, Malanin SYu, Vasilyev IYu, Siniagina MN, Abdulhakov RA. Helicobacter pylori eradication therapy and gut microbiota composition in patients with various diseases of upper gastrointestinal tract. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (1): 46-53. DOI: 10.20969/VSKM.2020.13(1).46-53.

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2. Sugano K, Tack J, Kuipers EJ, et al. Kyoto global consensus report on Helicobacter pylori gastritis. Gut. 2015; 64 (9): 1353-1367.

3. Ivashkin VT, Maev IV, Lapina TL. Klinicheskie rekomendacii Rossijskoj gastroenterologicheskoj associacii po diagnostike i lecheniyu infekcii Helicobacter pylori u vzroslyh [Clinical recommendations of the Russian Gastroenterological Association for the diagnosis and treatment of Helicobacter pylori infection in adults]. Rossijskij zhurnal gastroenterologii, gepatologii, koloproktologii [Russian Journal of Gastroenterology, Hepatology, Coloproctology]. 2018; 1 (28): 55-70.
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6. Ivashkin VT, Maev IV, Lapina TL. Klinicheskie rekomendacii rossijskoj gastroenterologicheskoj associacii po diagnostike i lecheniyu yazvennoj bolezni [Clinical recommendations of the Russian gastroenterological association for the diagnosis and treatment of peptic ulcer]. Rossijskij zhurnal gastroenterologii, gepatologii, koloproktologii [Russian Journal of Gastroenterology, Hepatology, Coloproctology]. 2016; 26 (6): 40-54.
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REVIEWS

UDC 616.127-005.4-039.55-07:616.127-073.916.3(048.8)

DOI: 10.20969/VSKM.2020.13(1).54-61

 MYOCARDIAL PERFUSION TOMOSCINTIGRAPHY INDICATORS IN SILENT MYOCARDIAL ISCHEMIA

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; doctor of Interregional Clinical Diagnostic Center, Russia, 420089, Kazan, Karbyshev str., 12а, e-mail: alsuchaa@mail.ru

SAIFULLINA GUSALIA B., doctor of Interregional Clinical Diagnostic Center, Russia, 420089, Kazan, Karbyshev str., 12а 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

KHUSAINOVA AIDA K., student of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: aida.husainowa@yandex.ru

KHASANOVA ADELIA G., student of Kazan Federal University, Russia, 420008, Kazan, Kremlevskaya str., 18, e-mail: wedance.wesing@gmail.com

Abstract. Aim. The purpose of the study was to analyze the medical literature on the use of single-photon emission computed tomography in diagnosis and to present the results of this research method in patients with silent myocardial ischemia. Material and methods. We analyzed the medical literature and presented our own investigation results. The study included patients who underwent single-photon emission computed tomography from January 2013 to December 2017 at Interregional Clinical Diagnostic Center on a MILLENIUM MPR / GE Medical Systems / gamma-ray tomograph according to a two-day protocol. Results and discussion. Impaired myocardial perfusion at rest was revealed in all patients. The exercise test provoked an increase in the number of segments with hypoperfusion from 10,6±3,53 to 11,06±3,13, signi cant di erences (p<0,05) for segments 11, 12, 16, 17, 19, for segments 16 and 18 in patients with a history of myocardial infarction (p<0,05), for segment 12 – among patients without myocardial infarction. 88,24% of patients had a high risk of coronary complications. High-risk scintigrams: multiple (more than 1 coronary artery pool) transient stress-induced perfusion defects were found in 82,5% of patients. Conclusion. The method of myocardial perfusion tomoscintigraphy allows to obtain a three-dimensional image of the left ventricle with information about the distribution of perfusion volume in myocardium and makes it possible to di erentiate silent myocardial ischemia more accurately. The obtained data set the task of further studying of silent ischemia diagnosis by means of perfusion tomoscintigraphy and comparative analysis of indicators depending on the type of silent myocardial ischemia, comorbidities, age and sex.

Key words: silent myocardial ischemia, perfusion scintigraphy.

For reference: Abdrakhmanova AI, Saifullina GB, Amirov NB, Khusainova AK, Khasanova AG. Myocardial perfusion tomoscintigraphy indicators in silent myocardial ischemia.The Bulletin of Contemporary Clinical Medicine. 2020; 13 (1): 54-61. DOI: 10.20969/VSKM.2020.13(1).54-61.

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UDC 616.72-002.77-06:[616.891.6+616.89-008.454](048.8)

DOI: 10.20969/VSKM.2020.13(1).61-65

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UDC 616.127-089:[616.12-005.4-06:616.379-008.64] (048.6)

DOI: 10.20969/VSKM.2020.13(1).65-76

 MYOCARDIAL REVASCULARIZATION IN PATIENTS WITH ISCHEMIC HEART DISEASE AND DIABETES MELLITUS

SHARAFEEV AIDAR Z., ORCID ID 0000-0002-3483-7103; SCOPUS Author ID 57193997123; D. Med. Sci., associate professor, professor of the Department of hospital surgery of Chechen State University, Russia, 364030, Grozny, A. Sheripov, str., 32; Head of the Department of cardiology, endovascular and cardiovascular surgery of Republican Clinical Hospital named after Sh.Sh. Ependieva, Russia, 364030, Grozny, Khvoynaya str., 5, tel. +7-927-410-93-89, e-mail: aidarch@mail.ru

INDERBIEV TIMUR S., ORCID ID: 0000-0001-5798-1880; C. Med. Sci., Chief physician of Republican Clinical Hospital for War Veterans, Russia, 364095, Grozny, Zhdanov str., 18, tel. +7-963-587-55-66, e-mail: inderbiev@gmail.com

KHALIRAKHMANOV AIRAT F., ORCID ID 0000-0001-7758-3935; D. Med. Sci., doctor of the Department of X-ray diagnostic methods and treatment of Medical Care unit of Kazan (Volga region) Federal University, Russia, 420043, Kazan, Chekhov str., 1a; Senior teacher of the Department of surgery, obstetrics and gynecology of Institute of fundamental medicine and biology of Kazan (Volga region) Federal University, Russia, 420012, Kazan, Karl Marx str., 74, tel. +7-929-722-33-34, e-mail: ai.bolit@mail.ru

Abstract. The aim of the study was to compare the e cacy of stenting and coronary artery bypass grafting in patients with diabetes mellitus. Material and methods. Based on a study of 45 literary sources of 2015–2019 years, we analyzed the e ectiveness of revascularization in patients with diabetes. Results and discussion. The three-year primary endpoint was signi cantly higher in patients with diabetes mellitus (20% versus 12,9%; p<0,001). Within 1–5 years after revascularization mortality in patients with diabetes after shunting did not di er from mortality after stenting (RR – 0,90; 95% CI 0,61–1,31; p=0,57). The stroke rate was also the same in both groups (RR – 1,24; 95% CI 0,78–1,99; p=0,36). However, the level of cardiovascular events was higher in the stenting group (RR – 0,63; 95% CI 0,48–0,82; p=0,0006). The frequency of repeated revascularization and myocardial infarction was signi cantly lower after stenting (RR – 0,27; 95% CI 0,24–0,30; p=0,00001 and RR – 0,40; 95% CI 0,35–0,47; p=0,00001). Revascularization in patients with left coronary artery lesions and SYNTAX score of ≤32 have similar primary endpoints (death, stroke, heart attack in 3 years under observation), although less side e ects occurred 30 days after stenting. The use of polymer-free 3rd generation drug-eluting stents reduces the frequency of re-revascularization (5% vs 13%; p=0,002 and 4% vs 9%; p=0,019) compared to 2nd generation biolimus-eluting stents. The statistical superiority of 3rd generation stents compared to 2nd generation stents in patient with diabetes was expressed at HbA1c >7,3% (p=0,02). Conclusions. After performing the planned myocardial revascularization in patients with type II diabetes mellitus the frequency of all adverse events is higher than in patients without diabetes in the long-term period (1–5 years). Cardiovascular mortality is higher in stenting group; the level of cardiac mortality and stroke does not signi cantly di er; the incidence of other serious adverse events is higher in the coronary artery bypass grafting group. Aortocoronary bypass surgery is the method of choice in patients with type II diabetes and SYNTAX score ≥22. The use of the 3rd generation polymer-free stents with an abluminal eluting made of bioresorbable polymer reduces the frequency of repeated revascularization compared to 2nd generation biolimus-eluting stents.

Key words: coronary heart disease, diabetes mellitus, CABG, PCI.

For reference: Sharafeev AZ, Inderbiev TS, Khalirakhmanov AF. Myocardial revascularization in patients with ischemic heart disease and diabetes mellitus. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (1): 65-76. DOI: 10.20969/VSKM.2020.13(1).65-76.

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CLINICAL CASE

UDC 616.24-002.5-07:616.379-008.64

DOI: 10.20969/VSKM.2020.13(1).77-79

 DIAGNOSIS OF TUBERCULOSIS IN A PATIENT WITH DIABETES MELLITUS IN THE ABSENCE OF BACTERIAL EXCRETION (clinical case)

RUSSKIKH OLEG E., ORCID ID: 0000-0001-7163-640X; D. Med. Sci., associate professor, Head of the Department of phthisiology of Izhevsk State Medical Academy, Republican Clinical Tuberculosis Hospital of Izhevsk, Russia, 426039, Izhevsk, Slavyansk highway str., 0/1, e-mail: olegr22@mail.ru

SYSOEV PAVEL G., С. Med. Sci., associate professor of the Department of phthisiology of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunar str., 281, e-mail: docspg@yandex.ru

AFANASIEV EFIM I., postgraduate student of the Department of phthisiology of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunar str., 281, e-mail: ya.afanasev-efim@yandex.ru

ALEXANDROV VLADIMIR A., thoracic surgeon of the Department of surgery of Republican Clinical Tuberculosis Hospital of Izhevsk, Russia, 426039, Izhevsk, Slavyansk highway str., 0/1, e-mail: Volodddka@mail.ru

VOLKOVA ANASTASIA G., student of the Department of general medicine of Izhevsk State Medical Academy, Russia, 426034, Izhevsk, Kommunar str., 281, e-mail: mlepra@mail.ru

KAVUNENKO ANDREY A., student of the Department of general medicine of Izhevsk State Medical Academy», Russia, 426034, Izhevsk, Kommunar str., 281, e-mail: kav.mailbox@mail.ru

Abstract. The aim of the study was to show the di culty in diagnosis of pulmonary tuberculosis in patient with type I diabetes mellitus without pathognomonic clinical laboratory data. Material and methods. The article presents a clinical case of a multimorbid patient with pulmonary tuberculosis in combination with type I diabetes mellitus (target HbA1c level <7,0%) with X-ray signs of changes in the left lung. Results and discussion. The patient with the rst identi ed changes in S1-S2 of the left lung was admitted to the Republican Clinical Tuberculosis Hospital for further examination to con rm the diagnosis. During the examination we found that bacteriological, immunological and molecular genetic methods showed negative results. These data could indicate morphologically similar lung tumor. Comorbid background of the patient was a contraindication for surgical intervention. The medical commission suggested anti-tuberculosis test therapy as a therapeutic tactic. During antituberculosis chemotherapy the patient showed positive X-ray dynamics in the form of regression of the detected focus in the left lung. After 3 months of therapy the patient was discharged with complete regression of the pathological process. Conclusion. In conditions of severe comorbid background, which acts as contraindication for surgical treatment, and absent pathognomonic clinical laboratory data, the anti-tuberculosis test therapy with X-ray assessment of changes in dynamics should be considered as an option.

Key words: tuberculosis, diabetes mellitus type I, comorbid pathology.

For reference: Russkikh OE, Sysoev PG, Afanasiev EI, Alexandrov VA, Volkova AG, Kavunenko AA. Diagnosis of tuberculosis in a patient with diabetes mellitus in the absence of bacterial excretion (clinical case). The Bulletin of Contemporary Clinical Medicine. 2020; 13 (1): 77-79. DOI: 10.20969/VSKM.2020.13(1).77-79.

References