ORIGINAL RESEARCH

UDC 616.155.194.8-074:616.36-008.5-02:616.367-003.7

DOI: 10.20969/VSKM.2020.13(2).7-12

 HEPCIDIN AND ITS ASSOCIATION WITH INTERLEUKIN 6 IN THE DEVELOPMENT OF IRON DEFICIENCY OF PATIENTS WITH MECHANICAL JAUNDICE DUE TO CHOLEDOCHOLITHIASIS

ALEKBEROVA SEVDA A., senior laboratory assistant of the Department of surgical diseases No 3 of Azerbaijan Medical University, Azerbaijan, AZ 1007, Baku, E. Gasimzadeh, 14, e-mail: mic_amu@mail.ru

GAFAROV ISMAIL A., D. Sci. in Physics and Mathematics, senior lecturer of the Department of medical physics and informatics of Azerbaijan Medical University, Azerbaijan, AZ 1007, Baku, E. Gasimzadeh, 14, e-mail: mic_amu@mail.ru

Abstract. Aim. To study of the role of hepcidin and interleukin-6 in the development of iron de ciency, their informativeness and diagnostic value in predicting the development of anemia in patients with obstructive jaundice due to choledocholithiasis. Material and methods. In 50 patients aged 12–81 years with obstructive jaundice before the operation the concentration of interleukin 6 in blood serum using ELISA, in the blood plasma – hepcidin and serum iron (SI) were studied. Of the 50 patients with obstructive jaundice due to choledocholithiasis, 26 had anemia. Patients were divided into 2 groups: patients with anemia (n=26) and patients without anemia (n=24). In the statistical processing of digital material, we used the methods of variational statistic (U-Mann–Whitney), dispersion (F-Fisher, FS-Fisher-Snedecor), correlation (ρ-Spearman), discriminant (speci city, sensitivity) and ROC-analyzes (cut of point). The calculations were performed (USING) with the MS Excel-2016 and the IBM Statistics SPSS-22 statistical package. Results and discussion. In 26 patients with revealed anemia, the average hemoglobin was (9,7±0,3) g/dl, i.e. 31,0% (p˂0,001) below normal. In the same patients, upon admission, the concentration of interleukin-6 in serum averaged (43,9±2,1) ng/ml, which is 2,7 times (р˂0,001) more than a value of healthy individuals and 51,0% (p1˂0,001) is more signi cant than the value of patients with breast cancer without anemia. The patients with anemia in background of obstructive jaundice due to choledocholithiasis before surgery, the level of hepcidin was 4,3 times higher than the normal value and 19,4% (p1<0,001) higher than the average value of patients without anemia. The content of LF was 47,1% (p˂0,001) and 32,4% (p1˂0,001), respectively, below the norm and value in patients with obstructive jaundice without anemia. A signi cant positive relationship between hepcidin and IL-6, signi cant negative links between interleukin-6 and hemoglobin, and also between hepcidin and hemoglobin were found. Conclusion. Hepcidin, interleukin 6 as biomarkers has strong diagnostic and prognostic potentials, are one of the most sensitive and speci c markers of development of not only the in ammatory process, but also of anemia of patients with obstructive jaundice due to choledocholithiasis.

Key words: hepcidin, interleukin 6, iron de ciency, obstructive jaundice.

For reference: Alekberova SA, Gafarov IA. Hepcidin and its association with interleukin 6 in the development of iron de ciency of patients with mechanical jaundice due to choledocholithiasis. The Bulletin of  Contemporary Clinical Medicine. 2020; 13 (2): 7-12. DOI: 10.20969/VSKM.2020.13(2).7-12.

References

 

UDC 616.516.5-053.2-07:616.15-07

DOI: 10.20969/VSKM.2020.13(2).12-15

References

 

UDC 616-002.5-057.36-036.2(479.24)

DOI: 10.20969/VSKM.2020.13(2).16-22

 INCIDENCE OF CLINICAL FORMS OF TUBERCULOSIS IN THE MILITARY PERSONNEL OF THE REPUBLIC OF AZERBAIJAN

AKHMEDOV SALEKH B., medical service mayor of Military Academy of the Azerbaijan Armed Forces, Azerbaijan, AZ1065, Baku, Sh. Mehdiev str., 136, «Krasniy Vostok» military settlement, the Department of adjuncturgy and science, tel. +9(945)040-271-39, e-mail: saleh60@mail.ru, ehmedovsaleh86@gmail.com

BAYRAMOV RAFIK I., D. Med. Sci., associate professor, Head of the Department of pulmonary diseases of Azerbaijan Medical University, Scientific Research Institute of Pulmonary Diseases, Azerbaijan Republic, AZ1118, Baku, E. Suleymanov str., Nizaminskiy district, 2514th quarter, e-mail: rafiq-bayram@mail.ru, departm_ftiziatriya@amu.edu.az

Abstract. Aim. Study of epidemiological features of various clinical forms of tuberculosis, depending on the length of service, among members of the armed forces of the Republic of Azerbaijan was performed. Material and methods. A retrospective analysis of tuberculosis morbidity in the military personnel of the Republic of Azerbaijan was conducted for 10 years (2009-2018) on the basis of the medical records of patients treated at the Pulmonary Diseases Hospital of the Armed Forces of Azerbaijan and the Central Hospital of the Armed Forces of Azerbaijan. All servicemen were divided into 3 groups depending on their duration of service: those who fell ill during the rst 3 months of service – Group I, those who fell ill during the rst 3–6 months of service – Group II, and those who fell ill after 6 months of service – Group III. Epidemiological analysis covered the distribution of tuberculosis morbidity among the groups in dynamics over 10 years as well as different forms of tuberculosis. The obtained digital data were statistically processed using the Excell 2010 program and SPSS 13,0 package. Results and discussion. The distribution of the groups’ proportion by year was as follows: proportion of cases among Group III troops > proportion of cases among Group I troops > proportion of cases among Group II troops. In Group I, the highest number of cases was recorded in 2014 (34,2%), in Group II in 2010 (22,1%) and in Group III in 2018 (69,5%). The mean indicators of the percentage of the disease incidence by groups were as follows: Group I – pulmonary tuberculosis [(81,8±1,8)%], extrapulmonary tuberculosis [(16,2±1,7)%], generalized forms of tuberculosis [(1,9±0,6)%]; Group II – pulmonary tuberculosis [(69,6±2,5)%], extrapulmonary tuberculosis [(27,7±2,5)%], generalized forms of tuberculosis [(2,7±0,9)%]; Group III – pulmonary tuberculosis [(78,1±1,2)%], extrapulmonary tuberculosis [(20,3±1,2)%], generalized forms of tuberculosis [(1,6±0,4)%]; χ2 – 17,88 (p=0,001). The most frequent were focal and in ltration forms, which were registered mainly among the military personnel serving for more than 6 months. Conclusion. The duration of service in the armed forces has an important impact on the level of tuberculosis morbidity among servicemen of the Republic of Azerbaijan. When planning tuberculosis control measures, it is necessary to consider both the time of service in the armed forces and the speci cs of the distribution of various clinical forms of tuberculosis.

Key words: military personnel, clinical forms of tuberculosis, focal tuberculosis, infiltrative tuberculosis.

For reference: Akhmedov SB, Bayramov RI. Incidence of clinical forms of tuberculosis in the military personnel of the Republic of Azerbaijan. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (2): 16–22. DOI: 10.20969/VSKM.2020.13(2).16-22.

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UDC 615.234.032.23

DOI: 10.20969/VSKM.2020.13(2).22-30

 THE SEARCH OF THE «IDEAL» DRUG DELIVERY MEANS IN OBSTRUCTIVE RESPIRATORY DISEASES: AN OBSERVATIONAL STUDY IN COMPARISON WITH THE LITERATURE DATA

VIZEL ALEXANDER A., ORCID ID: 0000-0001-5028-5276; SPIN-kod: 5918-5465; Author ID: 195 447; D. Med. Sci., professor, Head of the Department of phthisiopulmonology of Kazan State Medical University, 420012, Kazan, Butlerov str., 49, tel. +7-987-296-25-99, e-mail: lordara@inbox.ru

REZYAPOVA ALINA I., clinical resident of the Department of phthisiopulmonology of Kazan State Medical University, 420012, Kazan, Butlerov str., 49, tel. +7-987-189-64-29, e-mail: rezyapovaai@mail.ru

VIZEL IRINA YU., D. Med. Sci., professor of RAE, associate professor of the Department of phthisiopulmonology of Kazan State Medical University, 420012, Kazan, Butlerov str., 49; researcher of Central Research Institute of Tuberculosis, 107564, Moscow, Yauzskaya alley, 2, tel. +7-917-903-91-13, e-mail: tatpulmo@mail.ru

AMIROV NAIL B., ORCID ID: 0000-0003-0009-9103; D. Med. Sci., academician of RAE, professor of the Department of outpatient medicine and general medical practice of Kazan State Medical University, 420012, Kazan, Butlerov str., 49, tel. +7-905-313-01-11, e-mail: namirov@mail.ru

Abstract. Aim. The aim of the study was to compare the accuracy of the use of 8 means, delivering drugs into lungs and to compare the data obtained with international studies. Material and methods. The accuracy of operation of 8 devices was studied intuitively (before reading the instructions), after reading the instructions and after training by a doctor – dosing aerosol inhaler, Respimat, Brizhaler, CDM Inhaler, Turbuchaler, Jenwayr, Spiromax and Ellipta, 10 5participants (53,3% men and 46,7% women), the mean age was (48,2±1,6) years (16,01), from 18 to 80 years, the median age of 50 years. 37,1 per cent of them were healthy, 44,8 per cent suffered from respiratory diseases (including 11 patients with chronic obstructive pulmonary disease and 27 with bronchial asthma), 18,1 per cent suffered from diseases of other organs and systems. The sequence of device evaluation was performed in random order by pulling out a note with the number of the device under study. SPSS-18 software in Windows-10 environment was applied for data gathering and processing. Results and discussion. Ellipta dosing powder inhaler was correctly used by 98,1% of the participants after the training, but only 4,8% of those surveyed called it the most convenient device (as well as Respimat). While the dosing aerosol inhaler was the second most frequently used by patients and the 4th most intuitively used, it was the last in terms of the nal result. Turbuchaler was ranked third by patient preference and fth by intuitive use. Brizhaler was ranked third in terms of intuitive use, but only 2,9% of those surveyed (as well as CDM and Jenwayr) preferred this dispensing powder inhaler. The Respimat was intuitively used by 4,8%, but after training 79% used it correctly. 29,5% of those surveyed thought Spiromax was the most convenient, 42,9% were able to use it without training and instruction, and after the training – 98,1% of participants. The data obtained and the literature data do not allow identifying the best device. Factors affecting the correctness of inhalation were age, level of education, different diseases and previous experience with inhalers. Conclusion. The study showed that training in the use of delivery means is a mandatory component in the appointment of inhalers.

Key words: inhalers, inhalation technique, intuitiveness, training, COPD, BA.

For reference: Vizel AA, Rezyapova AI, Vizel IYu, Amirov NB. The search of the «ideal» drug delivery means in obstructive respiratory diseases: an observational study in comparison with literature data. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (2): 22–30. DOI: 10.20969/VSKM.2020.13(2).22-30.

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2. Vizel AA, Vizel IYu, Salakhova IN, Va na AR. Priverzhennost’ pri bronkhial’noy astme i khronicheskoy obstruktivnoy bolezni logkikh: ot problemy k resheniyu [Adherence to bronchial asthma and chronic obstructive pulmonary disease: from problem to solution]. Farmateka [Farmateka]. 2019; 26 (5): 34-38. DOI: 10.18565/ pharmateca.2019.5.00-00.

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5. Azouz W, Chetcuti P, Hosker H, Saralaya D, Chrystyn H. Inhalation characteristics of asthma patients, COPD patients and healthy volunteers with the Spiromax® and Turbuhaler® devices: a randomised, cross-over study. BMC Pulm Med. 2015; 1 (15): 47.

6. O’Hagan P, Dederichs J, Viswanad B, Gasser M, Walda S. Patient preference for a maintenance inhaler in chronic obstructive pulmonary disease: a comparison of Breezhaler and Respimat. J Thorac Dis. 2018; 10 (10): 5727-5735.

7. Rönmark P, Jagorstrand B, Sa oti G, Menon S, Bjermer L. Comparison of correct technique and preference for Spiromax®, Easyhaler® and Turbuhaler®: a single-site, single-visit, crossover study in inhaler -naïve adult volunteers. Eur Clin Respir J. 2018; 5 (1): 1529536. doi: 10.1080/20018525.2018.1529536.

8. Nasledov AD. SPSS 15: professional’nyy statisticheskiy analiz dannykh [SPSS 15: professional statistical data analysis]. SPb: Piter [St Petersburg: Peter]. 2008; 416 p.

9. Vizel IU, Salakhova IN, Va na AR, Vizel AA, Rakhmatullina NM,KudryavtsevaEZ,ShakirovaGR.Klinicheskoye, instrumental’noye i farmakologicheskoye sopostavleniye bol’nykh khronicheskoy obstruktivnoy bolezn’yu legkikh i bronkhial’noy astmoy v usloviyakh real’noy klinicheskoy praktiki [Clinical, instrumental and pharmacological comparison of patients with chronic obstructive pulmonary disease and bronchial asthma in real clinical practice]. Pul’monologiya [Pulmonology]. 2019; 29 (4): 448–455. DOI: 10.18093/0869-0189-2019-29-4-448-455.

10. Ramadan WH, Sarkis AT. Patterns of use of dry powder inhalers versus pressurized metered-dose inhalers devices in adult patients with chronic obstructive pulmonary disease or asthma: An observational comparative study. Chron Respir Dis. 2017; 14 (3): 309-320. doi: 10.1177/1479972316687209.

11. Mannan H, Foo SW, Cochrane B. Does device matter for inhaled therapies in advanced chronic obstructive pulmonary disease (COPD)? A comparative trial of two devices. BMC Res Notes. 2019; 12 (1): 94. doi: 10.1186/ s13104-019-4123-5.

12. Pothirat C, Chaiwong W, Limsukon A, Phetsuk N, Chetsadaphan N, Choomuang W, Liwsrisakun C. Real-world observational study of the evaluation of inhaler techniques in asthma patients. Asian Pac J Allergy Immunol. 2019; http://apjai-journal.org/wp-content/uploads/2019/02/AP-210618-0348.pdf

13. Janežič A, Locatelli I, Kos M. Inhalation technique and asthma outcomes with different corticosteroid-containing inhaler devices. J Asthma. 2019; 2: 1-9. doi: 10.1080/02770903.2019.1591442.

14. Khurana AK, Dubey K, Goyal A, Pawar KS, Phulwaria C, Pakhare A. Correcting inhaler technique decreases se-verity of obstruction and improves quality of life among patients with obstructive airway disease. J Family Med Prim Care. 2019; 8 (1): 246-250. doi: 10.4103/jfmpc. jfmpc_259_18.

15. Ciciliani AM, Langguth P, Wachtel H. Handling forces for the use of different inhaler devices. Int J Pharm. 2019; 560: 315-321. doi: 10.1016/j.ijpharm.2019.01.05.053.

16. Larsson K, Bjermer L, Svartengren M. The importance of selecting the right type of inhaler for patients with asthma and chronic obstructive pulmonary disease (COPD). Lakartidningen. 2019; 116: FF76.

17. García-Río F, Soler-Cataluña JJ, Alcazar B, Viejo JL, Miravitlles M. Requirements, strengths and weaknesses of inhaler devices for COPD patients from the expert prescribers’ point of view: results of the EPOCA Delphi consensus. COPD. 2017; 14 (6): 573-580. doi: 10.1080/15412555.2017.1365120.

 

UDC 616.28-008.55

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12. Nedoluzhko IYu, Kazakova SS, Chernikova EN, Shishin KV, Kurushkina NA. Osobennosti perioperatsionnogo perioda pri endoskopicheskoy polipektomii i rezektsii slizistoy tolstoy kishki u patsiyentov pozhilogo i starcheskogo vozrasta [Features of the perioperative period with endoscopic polypectomy and resection of the colon mucosa in elderly and senile patients]. Doktor Ru [Doctor Ru]. 2015; 2 (103): 44.

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UDC 616.31-053.2-08:159.944.4

DOI:10.20969/VSKM.2020.13(2).41-45

 THE IMPACT OF PSYCHO-EMOTIONAL TENSION IN CHILDREN DURING A DENTAL INTERVENTION ON THE DISTRESS DEVELOPMENT IN DENTISTS

KAZAKOVA LARISA N., ORCID ID: 0000-0001-8060-1348; C. Med. Sci., associate professor of the Department of pediatric dentistry and orthodontics of Saratov State Medical University n.a. V.I. Razumovsky, Russia, Saratov, 410012, B. Kazachya str., 112, tel. 8-905-321-06-11, e-mail: avkuligin@yandex.ru

FIRSOVA IRINA V., C. Med. Sci., associate professor of the Department of pediatric dentistry and orthodontics of Saratov State Medical University n.a. V.I. Razumovsky, Russia, 410012, Saratov, B. Kazachya str., 112, tel. 8-937-966-70-72, e-mail: suetenkov@gmail.com

DAVYDOVA NATALIYA V., assistant of professor of the Department of pediatric dentistry and orthodontics of Saratov State Medical University n.a. V.I. Razumovsky, Russia, 410012, Saratov, B. Kazachya str., 112, tel. 8-903-386-30-12, e-mail: natdav13@yandex.ru

MAKHONOVA EKATERINA V., assistant of professor of the Department of pediatric dentistry and orthodontics of Saratov State Medical University n.a. V.I. Razumovsky, Russia, 410012, Saratov, B. Kazachya str., 112, tel. 8-917-210-24-09, e-mail: mahonova.ev@mail.ru

NARYZHNAYA ELENA V., assistant of professor of the Department of pediatric dentistry and orthodontics of Saratov State Medical University n.a. V.I. Razumovsky, Russia, 410012, Saratov, B. Kazachya str., 112, tel. 8-905-384-40-03, e-mail: eturusova@bk.ru

SAYUTINA LARISA V., resident of the Department of pediatric dentistry and orthodontics of Saratov State Medical University n.a. V.I. Razumovsky, Russia, 410012, Saratov, B. Kazachya str., 112, tel. 8-905-384-40-03, e-mail: larisochka00@rambler.ru

Abstract. The professional activity of a dentist is subject to many stress factors in rendering quality medical care to children. The increased level of psycho-emotional tension in children cannot but affect the emotional state of the dentist. In turn, accumulation of psychological tension leads to moral and physical exhaustion of the doctor. Aim. The aim of the study is to characterize the stress resistance in pediatric dentists working in practical health care during active labor activity, to identify symptoms of psycho-emotional tension and its impact on cardiovascular system indicators. Material and methods. A group of 30 doctors was examined, with a mean age of 38 years and an average duration of service of 14 years. In the course of the study they conducted a survey using the Akioshi Kitaioka method and monitored cardiovascular system activity during the working week. Conclusion. Low stress resistance in practicing pediatric dentists, does not provide optimal adaptation of the body in extreme conditions, which is con rmed by increasing fatigue, exhaustion, reduced attention levels, reduced ability to concentrate at the end of the work shift and of the working week. Prolonged negative emotional stress leads to the development of distress in practicing pediatric dentists, which is con rmed by insuf cient functionality of the cardiovascular system.

Key words: pediatric dentist, stress resistance, psycho emotional tension, stress, distress.

For reference: Kazakova LN, Firsova IV, Davydova NV, Makhonova EV, Naryzhnaya EV, Sayutina LV. The impact of psycho-emotional tension in children during a dental intervention on the distress development in dentists. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (2): 41-45. DOI: 10.20969/VSKM.2020.13(2).41-45.

References

1. Berezin V, Yanak A, ed. Mydroct` tysyacheletia [Wisdom of the millennium]. Moskva: OLMA-PRESS [Moscow: OLMA-PRESS]. 2006; 830 p.

2. Vinokurov VA. Professional`nyj stress u vrachej [ Professional stress among doctors]. Vestnik MAPO [Vestnik MAPO]. 2010; 8-9: 104-105.

3. Vodopianova NE, Starchenkova ES. Sindrom vygoranya: diagnostika i pro laktika [Burnout syndrome: diagnostics and prevention]. Sankt-Peterburg: Piter [St Petersburg: Piter]. 2008; 56 p.

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5. Subaev MN, Setko NP. Osobennosti professional`nogo stressa u detskih vracheiy stomatologov v usloviyah proizvodstvennoij sredy [Characteristics of professional stress among child dentists in the working environment]. Sovremennye problemy nauki i obrazovaniya [Modern problems science and education]. 2015; 1-1: 1288.

6. Larentseva LI, Rvacheva EA. Professional`nyij stress i sindrom emocional`nogo vygoraniya vrachei-stomatologov na detskom ambylatornom prieme [Professional stress and syndrome of emotional burnout among dentists conducting outpatient treatment of children]. Rossiiskii stomatologicheskii zhurnal [Rossiiskii Stomatological Jurnal]. 2010; 1: 36-37.

7. Kotova EV. Profilaktika sindroma emozional`nogo vygoraniya: ychebnoe posobie [Burnout syndrome prevention: training manual]. Krasnoyarsk: Krasnoyarskii gosudarstvennii pedagogicheskii universitet imeni VP Astafeva [Krasnoyarsk: Krasnoyarsk State Pedagogical University named after VP Asta eva]. 2013; 76 p.

8. Lozinskaya EI, Lutova NB. Sistemnyi index sindroma peregoraniya (na osnove testa MBI): metodicheskie rekomendazii [System index of burnout syndrome (based on MBI test): methodological recommendations]. Natsional’niy meditsinskiy issledovatel’skiy tsentr psikhiatrii i nevrologii imeni VM Bekhtereva [National Medical Research Center for Psychiatry and Neurology VM Bekhtereva]. 2007; 103 p.

9. Maslach Ch, Cooper L. Mnogomernaya teoriya vygoraniya; Teoriya organizacionnogo stressa. [A multidimensional Theory of Burnout; Theories of Organizational Strees Cary]. Oxford Univercity press. 1998; 66-85.

10. Yudina NA. Obosnovanie patogeneticheskih mehanizmov vzaimosvyazi stomatologicheskih i obshchih zabolevanij [The rationale for pathogenic mechanisms of relationship between dental and general diseases]. Stomatologicheskii Zhurnal [Stomatological Jurnal]. 2007; 2: 16-19.

 

UDC 616.36-004-07:616.12-073.97

DOI: 10.20969/VSKM.2020.13(2).46-49

 QT INTERVAL PROLONGATION AS A MARKER OF LIVER CIRRHOSIS SEVERITY

OKURLU ALFIYA F., ORCID ID: 0000-0001-8890-1468; C. Med. Sci., assistant of professor of the Department of internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-843-224-51-31, e-mail: alfiaf@yandex.ru

SALIMOVA LILIYA M., ORCID ID: 0000-0003-4186-6049; assistant of professor of the Department of internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-927-246-40-59, e-mail: calimova.lili@gmail.com

BAIMYASHKINA ANASTASIA A., 6th year student of the Pediatric Faculty of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str. 49, tel. +7-843-224-51-31, e-mail: nastyab28@bk.ru

Abstract. There are an increasing number of patients with chronic liver diseases of various etiologies in the population, which lead to the development of cirrhosis, which affects other organs and systems, particularly the cardiovascular. Aim. The aim of the study was to evaluate QT interval changes in patients with liver cirrhosis and to identify correlations with the severity of the liver process. Material and methods. The study group included 30 patients with liver cirrhosis of various etiologies hospitalized in the therapeutic department of the city hospital. The comparison group consisted of 30 patients without liver cirrhosis, hospitalized at the same time in the same department. The estimation of clinical, laboratory and instrumental data of patients was performed evaluating the duration of correlated QT interval using the Basett formula (QTc). Statistical processing with determination of mean, mean error, signi cance of differences by Student's criterion, and correlation analysis by means of Pearson's criterion r (Microsoft Excel, 2013) was performed. Results and discussion. A prolongation of the QT interval was found in patients with liver cirrhosis of different etiologies. A positive correlation between the severity of Child-Pugh class of liver cirrhosis and the QT interval value was found. Conclusion. Prolonged QT interval in patients with cirrhosis of the liver may lead to the development of life-threatening arrhythmias and be the cause of sudden death in patients, therefore, it is necessary to routinely monitor electrocardiographic data in this group of patients.

Key words: liver cirrhosis, QT interval, cirrhotic cardiomyopathy.

For reference: Okurlu AF, Salimova LM, Baimyashkina AA. QT interval prolongation as a marker of liver cirrhosis severity. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (2): 46-49. DOI: 10.20969/VSKM.2020.13(2).46-49.

References

1. Cheema E, Al-Aryan A, Al-Hamid A. Medicine use and medicine-related problems in patients with liver cirrhosis: a systematic review of quantitative and qualitative studies. Eur J Clin Pharmacol. 2019; 75 (8): 1047-1058. doi: 10.1007/s00228-019-02688-z

2. Asrani SK, Devarbhavi H, Eaton J, Kamath PS. Burden of liver diseases in the world. J Hepatol. 2019; 70 (1): 151-171. doi: 10.1016/j.jhep.2018.09.014

3. Solnyshkov SK. Cirroticheskaya kardiomiopatiya [Cirrhotic cardiomyopathy]. Vestnik Ivanovskoy meditsinskoy akademii [Bulletin of the Ivanovo Medical Academy]. 2017; 22 (3): 44-51.

4. Rodina AS. Diagnostika i klinicheskie proyavleniya cirroticheskoj kardiomiopatii [Diagnosis and clinical manifestations of cirrhotic cardiomyopathy]. Eksperimental’naya i klinicheskaya gastroenterologiya [Experimental and clinical gastroenterology]. 2015; 11: 34.

5. Malinovskaya YuO. Cirroticheskaya kardiomiopatiya i transplantaciya pecheni [Cirrhotic cardiomyopathy and liver transplantation]. Al’manakh klinicheskoy meditsiny [Almanac of clinical medicine]. 2016; 4 (6): 775-784.

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7. Fedos’ina EA. Nekotorye prakticheskie voprosy vedeniya bol’nyh s dekompensirovannym cirrozom pecheni [Some practical issues of managing patients with decompensated cirrhosis]. Terapevticheskiy arkhiv [Therapeutic Archive]. 2019;

8: 148-154. 8. Chistyakova MV. Serdechnye aritmii i kardiogemodinamicheskie rasstrojstva u bol’nyh virusnym cirrozom pecheni [Cardiac arrhythmias and cardiodynamic disorders in patients with viral cirrhosis]. Rossiyskiy kardiologicheskiy zhurnal [Russian Journal of Cardiology]. 2014; 12: 44-48.

9. Ostroumova OD. Lekarstvenno-inducirovannoe udlinenie intervala QT: rasprostranennost’, faktory riska, lechenie i pro laktika [Drug-induced lengthening of the QT interval: prevalence, risk factors, treatment and prevention]. Consilium Medicum. 2019; 21 (5): 62-67.

10. Rodionova ON. Cirroticheskaya kardiomiopatiya [Cirrhotic cardiomyopathy]. Vestnik Volgogradskogo gosudarstvennogo meditsinskogo universiteta [Bulletin of Volgograd State Medical University]. 2018; 2 (66): 10-13.

11. Galkina VV. Narusheniya ritma u pacientov s cirrozom pecheni [Rhythm disorders in patients with cirrhosis]. Simvol nauki [Symbol of science]. 2016; 44 (16): 116-121.

 

REVIEWS

UDC 616.12-005.4-039.56:616.72-002.77(048.8)

DOI: 10.20969/VSKM.2020.13(2).50-55

 PAINLESS MYOCARDIAL ISCHEMIA AS A MANIFESTATION OF CORONARY HEART DISEASE IN PATIENTS WITH RHEUMATOID ARTHRITIS

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 Institute of biology and fundamental medicine of Kazan Federal University, Russia, 420012, Kazan, Karl Marx str., 74; doctor of the Department of cardiology of Interregional Clinical Diagnostic Center, Russia, 420089, Kazan, Karbyshev str., 12а, 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

TSIBULKIN NIKOLAY A., ORCID ID: 0000-0002-1343-0478; C. Med. Sci., associate professor of the Department of cardiology, roentgen-endovascular and cardiovascular surgery of Kazan State Medical Academy – the branch of Russian Medical Academy of Postgraduate Education, Russia, 420012, Kazan, Butlerov str., 36

Abstract. Aim. The aim of the study is to analyze the medical literature on the features of coronary heart disease in patients with rheumatoid arthritis. Material and methods. The review and analysis of modern scienti c data on the features of the coronary heart disease, primarily painless myocardial ischemia, in patients with rheumatoid arthritis have been conducted. Results and discussion. The main cause of painless myocardial ischemia, as a special form of coronary heart disease, is coronary artery atherosclerosis. Due to the fact that rheumatoid arthritis is a chronic systemic disease, it increases the risk of atherosclerosis and its complications. It is manifested by a higher incidence of coronary heart disease in such patients compared to the general population. It is proved that atherosclerosis is caused by changes in lipid metabolism and in ammatory changes in the vascular wall, which is associated with autoimmune mechanisms. Hypercholesterolemia remains a signi cant cause of atherosclerosis and in patients with rheumatoid arthritis. Cardiovascular diseases and their complications are one of the main causes of death in patients with rheumatoid arthritis. In patients with rheumatoid arthritis the rst manifestation of coronary heart disease is often painless myocardial ischemia, which increases the risk of sudden cardiac death, heart rhythm disorders, myocardial infarction and congestive heart failure. Conclusion. Timely diagnosis and treatment of painless myocardial ischemia in patients with rheumatoid arthritis is an important issue in general clinical practice.

Key words: painless myocardial ischemia, rheumatoid arthritis.

For reference: Abdrakhmanova AI, Amirov NB, Tsibulkin NA. Рainless myocardial ischemia as a manifestation of coronary heart disease in patients with rheumatoid arthritis. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (2): 50-55. DOI: 10.20969/VSKM.2020.13(2).50-55.

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9. Kerola AM, Kauppi MJ, Kerola T, et al. How early in the course of rheumatoid arthritis does the excess cardiovascular risk appear? Ann Rheum Dis. 2012; 10 (71): 1606-1615.

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11. Kirillova IG, Novikova DS, Popkova TV, et al. Diastolicheskaya disfunkciya levogo i pravogo zheludochkov u bol’nyh rannim revmatoidnym artritom do naznacheniya bazisnoj protivovospalitel’noj terapii [Diastolic dysfunction of the left and right ventricles in patients with early rheumatoid arthritis before the appointment of basic anti-in ammatory therapy]. Terapevticheskij arhiv [Therapeutic Archive]. 2015; 5 (87): 16-23.

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17. Kitas GD, Erb N. Tackling ischaemic heart disease in rheumatoid arthritis. Rheumatology. 2003; 8 (42): 607-613.

18. Hramcova NA, Dzizinskij AA. Ishemicheskaya bolezn’ serdca pri revmatoidnom artrite: factory riska, osobennosti techeniya i kliniko-patogeneticheskie vzaimosvyazi s aktivnost’yu vospaleniya [Coronary heart disease with rheumatoid arthritis: risk factors, course features and clinical and pathogenetic relationships with in ammation activity]. Sibirskij medicinskij zhurnal [Siberian Medical Journal]. 2011; 6: 46-48.

19. Mazurov VI, Kol’cov AV, Toporkov MM, et al. Ocenka porazheniya miokarda pri razlichnyh variantah revmatoidnogo artrita na fone bazisnoj i biologicheskoj terapii (in iksimabom) [Assessment of myocardial damage in various variants of rheumatoid arthritan in the background of basic and biological therapy (in iximab)]. Nauchno-prakticheskaya revmatologiya [Scienti c and practical rheumatology]. 2010; 6 (25): 10-16.

20. Popkova TV, Novikova DS, Pisarev VV, et al. Faktory riska kardiovaskulyarnyh zabolevanij pri revmatoidnom artrite [Risk factors for cardiovascular disease in rheumatoid arthritis]. Nauchno – prakticheskaya revmatologiya [Scienti c and practical rheumatology]. 2009; 3 (25): 4–11.

21. Stryuk RI, Leonova EA, Tedikova NS, et al. Bezbolevaya ishemiya miokarda u bol’nyh revmatoidnym artritom [Painless myocardial ischemia in patients with rheumatoid arthritis]. Terapevticheskij arhiv [Therapeutic Archive]. 2008; 5 (80): 16-20.

22. Sineglazova AV. Determinanty stabil’noj stenokardii u zhenshchin s revmatoidnym artritom. Vestnik [Determinants of stable angina in women with rheumatoid arthritis]. Yuzhno – ural’skogo universiteta [Herald South Ural State university]. 2011; 39 (256): 103-106.

23. Cibul’kin NA, Abdrahmanova AI, Abdul’yanov IV, et al. Ostryj koronarnyj sindrom pri revmatoidnom artrite [Acute coronary syndrome with rheumatoid arthritis]. Prakticheskaya medicina [Practical medicine]. 2019; 17 (2): 32-36.

24. Mazurov VI, Stolov SV, Vorob’eva OA, et al. Kardio-vaskulyarnye problemy v revmatologii [Cardiovascular problems in rheumatology]. Medicinskij akademicheskij zhurnal [Medical academic journal]. 2009; 1 (9): 59–64.

25. Stryuk RI, Leonova EA, Chernuha TY, et al. Bezbolevaya ishemiya miokarda i lipidnyj obmen u bol’nyh revmatoidnym artritom pozhilogo vozrasta [Painless myocardial ischemia and lipid metabolism in elderly patients with rheumatoid arthritis]. Klinicheskaya gerontologiya [Clinical Gerontology].2008; 2: 10-14.

26. Sattar N, McCarey DW, Capell H, et al. Explaining how high-grade systemic in ammation accelerates vascular risk in rheumatoid arthritis. Circulation. 2003; 108: 2957–2963.

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28. Mazurov VI, Stolov SV, Vorob’eva OA, et al. Kardiovaskulyarnye problemy v revmatologii [Cardiovascular problems in rheumatology]. Medicinskij akademicheskij zhurnal [Medical academic journal]. 2009; 1: 59–64.

29. Leonova EA, Stryuk RI. Ocenka sutochnogo monitorirovaniya EKG u bol’nyh revmatoidnym artritom [Assessment of daily monitoring of ECG in patients with rheumatoid arthritis]. Voronezh: Tezisy II Vserossiiskoi konferencii revmatologov «Social’nye aspekty revmaticheskih zabolevanij» [Voronezh: Abstracts of the II All-Russian Conference of Rheumatologists “Social aspects of rheumatic diseases”]. 2006; 94.

30. Leonova EA. Osobennosti razvitiya i techeniya bezbolevoj ishemii miokarda u bol’nyh revmatoidnym artritom [Features of the development and course of painless myocardial ischemia in patients with rheumatoid arthritis]. Moskva: GOU VPO Moskovskiy gosudarstvennyy mediko-stomatologicheskiy universitet Roszdrava [Moscow: GOU VPO Moscow State Medical and Dental University of Roszdrav]. 2009; 124 p.

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UDC 616.127-007.61(048.8)

DOI: 10.20969/VSKM.2020.13(2).55-62

 OBSTRUCTIVE HYPERTROPHIC CARDIOMYOPATHY: HISTORICAL ASPECTS AND MODERN METHODS OF TREATMENT (review)

VELIEVA LEYLA M., ORCID ID: 0000-0002-7646-2661; postgraduate student of the Department of cardiovascular and endovascular surgery of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. 8-965-602-35-58, e-mail: velieva89@mail.ru

DZHORDZHYKIYA ROIN K., D. Med. Sci., professor, Head of the Department of cardiovascular and endovascular surgery of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49

Abstract. Hypertrophic cardiomyopathy is a disease in which myocardial mass increases without increasing the volume of the heart cavity. In the last decade, interest in this disease has increased signi cantly. Aim. To analyze scienti c publications on the issue of hypertrophic cardiomyopathy. Material and methods. Review of the domestic and foreign literature devoted to the problem of studying hypertrophic cardiomyopathy was conducted. Results and discussion. Hypertrophic cardiomyopathy is a hereditary myocardial disease resulting from a mutation of genes encoding sarcomer proteins, manifested by an increase in the left ventricular wall thickness with uncharacteristic pressure rise. Fatal outcome in hypertrophic cardiomyopathy depends on both the age of the patient and the form of the disease. One of the leading causes of disability and mortality in young working population is an obstructive form of hypertrophic cardiomyopathy. The obstruction of the left ventricular output department (tract) is being detected in 20–30% of patients with hypertrophic cardiomyopathy. At present the system of unfavorable outcome risk strati cation in hypertrophic cardiomyopathy has been developed, which allows to identify patients with high risk of sudden cardiac death with a certain degree of reliability. The algorithm of therapeutic and diagnostic measures for patients with hypertrophic cardiomyopathy includes: individual analysis of history, clinical data and strati cation of the risk of sudden cardiac death. Modern methods of surgical treatment in obstructive hypertrophic cardiomyopathy include: septal myoectomy, alcohol ablation, two-chamber electrocardiostimulation, and cardioverter de brillator implantation. Surgical elimination of obstruction in symptomatic and severe patients reduces long-term mortality and the incidence of sudden cardiac death. Conclusion. Hypertrophic cardiomyopathy can be detected at any age from the rst days to the last decade of life, regardless of gender and race, but most often the disease is being diagnosed in persons of young, working age, which determines the special social signi cance of the problem.

Key words: subaortic hypertrophic stenosis, surgical treatment, illness, heart.

For reference: Velieva LM, Dzhordzhykiya RK. Obstructive hypertrophic cardiomyopathy: historical aspects and modern methods of treatment (review). The Bulletin of Contemporary Clinical Medicine. 2020; 13 (2): 55-62. DOI: 10.20969/VSKM.2020.13(2).55-62.

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UDC 616.146.7-007.64-06:618.13-009.7-036.12(048.8)

DOI: 10.20969/VSKM.2020.13(2).62-69

 MODERN UNDERSTANDING OF PELVIC VARICOSE VEIN DISEASE IN THE STRUCTURE OF CHRONIC PELVIC PAIN SYNDROME: DIAGNOSIS AND TREATMENT (review)

MINULLINA NINA K., C. Med. Sci., associate professor of the Department of obstetrics and gynecology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: nina-constan@mail.ru

AKHMETOVA DINARA I., 6th year student of Faculty of general medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: dinara.akhmetova.2496@mail.ru

Abstract. Aim. The aim of the study was to investigate the problem of pelvic varicose vein disease in the structure of chronic pelvic pain syndrome, as well as the modern principles of diagnosis and treatment of this disease. Material and methods. Russian and foreign scienti c publications on this topic for the last 10 years have been studied. Results and discussion. This article presents a modern concept of basic etiopathogenetic mechanisms, diagnostic principles and treatment of pelvic varicose vein disease as one of the causes of chronic pelvic pain. Etiological factors can vary. It is both gynecological disease and vascular lesions due to systemic manifestations, hormonal imbalance, in ammatory processes, genetic predisposition, anatomical and physiological features, etc. Pathogenetic varicose vein transformation follows two basic principles: valve insuf ciency and development of obstructive disorders. This in turn leads to pathological re ux and stagnation in the pelvic venous system. The main reason for women’s approach to specialists is chronic pelvic pain, which is characterized as non-cyclical pain lasting more than 6 months, localized in the small pelvis, reducing the quality of life of the patient. The main dif culty lies precisely in differential diagnosis. Under the mask of pelvic pain syndrome may hide a huge number of both gynecological and non-gynecological diseases. Timely assumption and adequate diagnostic routing of the patient will allow establishing the correct diagnosis faster and reducing the risk of diagnostic, and as a consequence, therapeutic errors. Conclusion. Despite the fact that pelvic varicose vein disease is a known disease and has been studied for many years, there is still no clear idea about the nature of the disease. This disease is multi-disciplinary in nature, and requires a coordinated and continuous work of specialists. Due to the lack of speci city in the clinical picture and reliable markers of the disease, many women experience a long and dif cult journey from primary consultation to the nal diagnosis.

Key words: pelvic varicose vein disease, chronic pelvic pain syndrome.

For reference: Minullina NK, Akhmetova DI. Modern understanding of pelvic varicose vein disease in the structure of chronic pelvic pain syndrome: diagnosis and treatment (review).The Bulletin of Contemporary Clinical Medicine. 2020; 13 (2): 62-69. DOI: 10.20969/VSKM.2020.13(2).62-69.

References

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CLINICAL LECTURES

UDC 616-056.3 -02:678.061 

DOI: 10.20969/VSKM.2020.13(2).70-75

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12. Donald F. Latex Allergy. Allergy and Asthma: Practical Diagnosis and Management. 2016; 2: 397-405.

 

CLINICAL CASE

UDC 616.341-005.1-02:616.341-006.311

DOI: 10.20969/VSKM.2020.13(2).76-79

 DIFFICULTIES IN DIAGNOSING THE SOURCE OF AN INTESTINAL BLEEDING

KRASILNIKOV DMITRIY M., ORCID ID: 0000-0003-4973-4040; SCOPUS ID: 6508327107; D. Med. Sci., professor, the Head of the Department of surgical diseases of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: dmkras131@gmail.com

MIRGASIMOVA DZHAUKHARIYA M., C. Med. Sci., associate professor of the Department of surgical diseases of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: d.mirgasimova@yandex.ru

ABDULYANOV AIDAR V., C. Med. Sci., associate professor of the Department of surgical diseases of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: aabdulianov@mail.ru 

ZEFIROV RUSLAN A., C. Med. Sci., the Head of the Department of surgery No 1 of Republican Clinical Hospital, Russia, 420064, Kazan, Orenburgskiy highway, 138, e-mail: abdominalsurgery@mail.ru

ZAKHAROVA ANNA V., C. Med. Sci., assistant of professor of the Department of surgical diseases of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: zahanna83@yandex.ru

MATVEEV VALERY YU., C. Med. Sci., Head of the Department of thoracic surgery No 1 of Republican Clinical Hospital, Russia, 420064, Kazan, Orenburgskiy highway, 138, e-mail: lavmat@mail.ru

SEMENOVA IRINA I., graduate student of the Department of surgical diseases of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: irena.1981@mail.ru

Abstract. Aim. The aim of the study was to present a clinical case of a patient with a small-intestinal hemangioma complicated by recurrent bleeding. Material and methods. Complex examination was performed. The features of the clinical course and provision of medical care at Republican Clinical Hospital were revealed in a patient with recurrent small intestinal bleeding. Results and discussion. A 57-year-old patient was admitted to the clinic with complaints of weakness, dizziness, especially during exercise, rapid fatigue, and reduced appetite. It has been established from the history that for the last 6 years the patient has been annually experiencing severe gastrointestinal bleeding. The patient has repeatedly undergone conservative treatment and examination: esophagogastroduodenoscopy, colonoscopy, and video capsule endoscopy. However, the source of bleeding has not been identi ed. During his hospital treatment in Republican Clinical Hospital he has experienced an X-ray computer tomography, which revealed a tumor under the pancreas, sized 40×44×58 mm. During the surgical intervention, a tumor-shaped formation was detected in the area of transition of the duodenum into the jejunum, coming from the wall of the jejunum along the mesenteric edge, fused with mesenterial vessels, at a distance of 40 mm from the Traitz ligament. It was irregularly shaped, 50×50×58 mm in size, dark red, with a pronounced venous pattern, soft elastic consistency, easily traumatized and bleeds. The passage through the intestine was not impaired. The tumor was separated from the mesenterial vessels. Jejunum was mobilized for 25 cm. Resection of jejunum with the tumor was performed. 3 cm of the adducting department was left. «End to side» entero-enteroanastomosis was formed. Histological conclusion: there is more data for undifferentiated hemangiopericytoma. The postoperative period proceeded without complications; the patient was discharged on the 7th day in a satisfactory condition. Conclusion. Current clinical case shows that tumors of the small intestine complicated by bleeding are dif cult to diagnose. The discussion of this clinical case is driven by the need to analyze the mistakes made at the diagnostic stages.

Key words: sources of intestinal bleeding, hemangioma of intestine.

For reference: Krasilnikov DM, Mirgasimova DМ, Abdulyanov AV, Ze rov RA, Zakharova AV, Matveev VYu, Semenova II. Dif culties in diagnosing the source of an intestinal bleeding. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (2): 76–79. DOI: 10.20969/VSKM.2020.13(2).76-79.

References