Vol. 13 Issue 4 (2020)

VSKM 2020 N 4

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ORIGINAL RESEARCH

The effect of structured training on blood pressure indicators in type II diabetes mellitus patients having arterial hypertension Azizov V.A. (Azerbaijan, Baku), Mirzazade V.A. (Azerbaijan, Baku), Garibova C.A. (Azerbaijan, Baku) P.7

Effort angina after coronary stenting Akhtereev R.N. (Russia, Kazan), Galyvich A.S. (Russia, Kazan), Galeeva Z.M. (Russia, Kazan), Baleeva L.V. (Russia, Kazan) P.13

Practical aspects of the application of the retractor to perform surgeries on the cervical spine in ventral subaxial cervical spinal fusionVereshchako A.V. (Russia, St. Petersburg),Travkov D.A. (Russia, Lipetsk), Manukovsky V.A. (Russia, St. Petersburg), Kindyukhin Yu.Yu. (Russia, Lipetsk) P.17

Scientific justification of measures for medical and social prevention of arterial hypertension in persons older than working age Galiullin A.N. (Russia, Kazan), Kitaeva E.A. (Russia, Kazan), Zainullina D.R. (Russia, Kazan), Galiullin D.A. (Russia, Kazan), Sagitova I.I. (Russia, Kazan) P.26

Clinical and objective analysis of patients’ referrals to a multidisciplinary clinic Garipov R.Z. (Russia, Kazan), Shulaev A.V. (Russia, Kazan), Galimzyanov A.F. (Russia, Kazan), Teunova G.A. (Russia, Kazan), Kim I.V. (Russia, Kazan), Zaripova E.M. (Russia, Kazan), Mortazina R.M. (Russia, Kazan) P.32

Mutations in BRCA1 and BRCA2 genes as a cause of hereditary breast cancer Gimaeva R.R. (Russia, Kazan), Kupriyanova E.A. (Russia, Kazan), Gabelko D.I. (Russia, Kazan) P.39

The role of ultrasonic scanning in the diagnosis of lymphadenopathy of the neck Pulatova I.Z. (Uzbekistan, Tashkent) P.44

Comparative safety of antiepileptic drugs: gender aspects Shaimardanova R.M. (Russia, Kazan), Gamirova R.G. (Russia, Kazan) P.49

Bone mineral density and arterial stiffness in men with chronic obstructive pulmonary diseaseSchegortsova Ju.Yu. (Russia, Blagoveshchensk)Pavlenko V.I. (Russia, Blagoveshchensk) P.55

Dependence of cardiovascular mortality rate on helioseismic indicators in Lenkoransky district of Azerbaijan Republic Efendiyeva L.G. (Azerbaijan, Baku) P.62

REVIEWS

Organization of advanced physician training in pre-revolutionary Russia Egorysheva I.V. (Russia, Moscow) Morozov A.V. (Russia, Moscow) P.70

Modern methods of slowing down the progression of chronic kidney disease in type II diabetes mellitusMurkamilov I.T. (Kyrgyzstan, Bishkek), Sabirov I.S. (Kyrgyzstan, Bishkek), Fomin V.V. (Russia, Moscow)
Murkhamilova Z.A. (Kyrgyzstan, Bishkek), Yusupov F.A. (Kyrgyzstan, Osh), Rayimzhanov Z.R. (Kyrgyzstan, Bishkek) P.76

Rheumatoid arthritis and cardiovascular diseases Serdyuk I.L. (Russia, Kazan), Abdrakhmanova A.I. (Russia, Kazan), Amirov N.B. (Russia, Kazan), Nam T.O. (Russia, Kazan) P.86

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ORIGINAL RESEARCH

UDC 616.379-008.64-06:616.12-008.331.1

DOI: 10.20969/VSKM.2020.13(4).7-12

PDF download THE EFFECT OF STRUCTURED TRAINING ON BLOOD PRESSURE INDICATORS IN TYPE II DIABETES MELLITUS PATIENTS HAVING ARTERIAL HYPERTENSION

AZIZOV VASADAT A., D. Med. Sci., professor, the Head of the Department of internal medicine No 1 of Azerbaijan Medical University, Azerbaijan, AZ1007, Baku, Gasimzade str., 14, tel. (012)-597-43-23, e-mail: mic_amu@mail.ru

MIRZAZADE VALEKH A., D. Med. Sci., professor, the Head of the Department of internal medicine of Azerbaijan State Institute of Advanced Medical Training named after A. Aliyev, Azerbaijan, AZ1012, Baku, Tbilisski av., 3165, tel. (+99412)-431-40-33, е-mail: info@adhti.edu.az

GARIBOVA CUBRA A., senior laboratory assistant of the Department of internal medicine No 1 of Azerbaijan Medical University, Azerbaijan, AZ1007, Baku, Gasimzade str., 14, tel. (012)-597-43-23, e-mail: mic_amu@mail.ru

Abstract. Aim. Determination of the effect of structured training in type II diabetes mellitus patients having arterial hypertension on the ef ciency of arterial pressure management was the aim of our study. Material and methods. The study was conducted under the BADAM programme. The study included 224 patients who were initially divided into 2 groups: group 1 – patients who refused structured training but received partial training during doctor’s visit (n=54) and group 2 – patients who received structured training (n=170). Patients were monitored at the beginning of the study (control point 1), 6 months later (control point 2), 12 months later (control point 3), 18 months later (control point 4), 24 months later (control point 5), 30 months later (control point 6), and 36 months later (control point 7) at the end of the study. Statistical analysis of the data determined the minimum, maximum and mean sample sizes, standard deviation and error of the mean value. The statistical analysis was performed using a standard Microsoft Excel computer program. Results and discussion. In the course of the BADAM study, both during the passage of SE and in case of refusal, it was possible to reduce the level of SBP and DBP in patients with type II diabetes having hypertension. However, in group 1, the level of statistical signi cance was p<0,01, and in group 2, p<0,001. Upon subsequent observation, changes in SBP were observed in both groups, and the differences between groups 1 and 2 were not statistically signi cant at the beginning of the study (p>0,05) and were highly signi cant (p<0,001) at all other (2–7) CP. As for the DBP, the differences between groups 1 and 2 were not statistically signi cant at the beginning of the study (p>0,05) and were highly signi cant (p<0,001) at all other (2–7) study points. Conclusion. The data obtained indicate that structured training is a factor contributing to a signi cant decrease in SBP and DBP and can be considered as an important component of the complex impact in the management of diabetes and hypertension.

Key words: structured patient training, diabetes mellitus, arterial hypertension, systolic and diastolic blood pressure.

For reference: Azizov VA, Mirzazade VA, Garibova C. The effect of structured training on blood pressure indicators in type II diabetes mellitus patients having arterial hypertension. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (4): 7­12. DOI: 10.20969/VSKM.2020.13(4).7­12.

References

1. Azizov VA. Mirzazade VA, Askerov MM. Arterial’naya gipertenziya [Arterial hypertension]. Baku: AzerDiab [Baku: AzerDiab]. 2006; 168p.

2. Dedov II, Shestakova MV. Saharnyj diabet tipa 2; Ot teorii k praktike [Type 2 diabetes; From theory to practice]. Moskva: Medicinskoe Informacionnoe Agentstvo [Moscow: Medical Information Agency]. 2016; 576 p.

3. Pavlou DI, Paschou SA, Anagnostis P, Spartalis E et al. Hypertension in patients with type 2 diabetes mellitus: Targets and management. Maturitas. 2018; 112: 71­77.

4. Jani Y, Kamberi A, Lala D, Polisi G et al. Control of Arterial Hypertension among Type 2 Diabetics. International Journal of Bio Medicine. 2013; 3 (4): 232­239.

5. Saidova FX, Mirzazade VA. Vvedenie v endokrinologiyu [Introduction to endocrinology]. Baku: Tebib [Baku: Tebib]. 2016; 313 p.

6. Verdecchia P, Reboldi G, Angeli F, Borgioni C, Gattobi­ gio R, Filippucci L, et al. Adverse prognostic signi cance of new diabetes in treated hypertensive subjects. Hypertension. 2004; 43: 963–969.

7. Peberty V (IFPMA). Hypertension: Putting the Pressure on the Silent Killer. 2016; https://www.ifpma.org/wp­content/ uploads/2016/05/2016­Hypertension­putting­the­pres-sure­on­the­silent­killer.pdf

8. Williams B, Mancia G, Spiering W, Rosei EA et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension; The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). European Heart Journal. 2018; 00: 1–98.

9. American Diabetes Association. Standards of Medical Care in Diabetes – 2020. Diabetes Care. 2020; 43: 1­212. 10. Gæde P, Lund­Andersen H, Parving HH, Pedersen O. Effect of a Multifactorial Intervention on Mortality in Type 2 Diabetes. N Engl J Med. 2008; 358: 580­591.

11. UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood­glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet. 1998; 352: 854­865.

12. Turner R, UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ. 1998; 317: 703­713.

13. Patel A, MacMahon S, Chalmers J, et al. Effects of a xed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial. Lancet. 2007; 370 (9590): 829­840.

14. Zoungas S, de Galan BE, Ninomiya T, Grobbee D, et al. The combined effects of routine blood pressure lowering and intensive glucose control on macrovascular and microvascular outcomes in patients with type 2 diabetes; new results from advance. Diabetes Care. 2009; 32 (11): 2068­2074.

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  2. Vargas­Schaffer G, Cogan J. Patient therapeutic education. Placing the patient at the centre of the WHO analgesic ladder. Canadian Family Physician. 2014; 59: 235­241.

  3. Calle­Bustos A­M, Juan M­C, García­García I, Abad F. Anaugmented reality game to support therapeutic educationfor children with diabetes. An augmented reality game to support therapeutic education for children with diabetes. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0184645

18. Hopitaux Universitaries Geneve. Therapeutic Education for Chronic Diseases. 2018; https://www.hug­ge.ch/en/therapeutic-education-chronic-diseases

19. Excel 2016 – get it now with an Of ce 365 subscription. https://products.of ce.com/en­us/excel)

20. Med Calc. Easy­to­use statistical software. https://www. medcalc.org/calc/comparison_of_proportions.php

 

UDC 616.12-009.7-02:616.132.2-089.86-032:611.132

DOI: 10.20969/VSKM.2020.13(4).13-16

PDF download EFFORT ANGINA AFTER CORONARY STENTING

AKHTEREEV RAVIL N., ORCID ID: 0000-0002-1904-8632; physician of the Department of ultrasound diagnostics of Kazan City Hospital No 7, Russia, 420103, Kazan, Marshall Chuikov str., 54

GALYVICH ALBERT S., ORCID ID: 0000-0002-4510-6197; D. Med. Sci., professor, the Head of the Department of cardiology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: agalyavich@mail.ru

GALEEVA ZULFIA M., ORCID ID: 0000-0002-9580-3695; associate professor of the Department of cardiology advanced training faculty of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49

BALEEVA LARISA V., ORCID ID: 0000-0002-7974-5894; assistant of professor of the Department of cardiology of advanced training faculty of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49

Abstract. Aim. Evaluation of effort angina intensity changes in patients with concomitant arterial hypertension and type II diabetes mellitus in the long­term period after coronary stenting was the aim of our study. Material and methods. The study enrolled 401 patients aged 45 to 75 years. All patients underwent routine coronary angiography with subsequent stenting. Clinical outcomes were assessed on average after 44 months of outpatient observation. Patients were divided into two groups: Group 1 – 275 patients with functional class III effort angina combined with arterial hypertension; Group 2 – 126 patients with functional class III effort angina combined with arterial hypertension and type II diabetes mellitus. Results and discussion. During outpatient observation in the group of patients with effort angina and arterial hypertension, effort angina of functional class III transferred to functional class II in 22,2% of patients. It remained at the same level in 33,4% of patients. It transferred to functional class IV in 44,4% of patients. The systolic blood pressure decrease in this group was 24,8 mm Hg, 18 mm Hg and 14 mm Hg, respectively (p<0,001). Diastolic blood pressure decrease was 17,9 mm Hg, 14 mm Hg and 18 mm Hg, respectively. 146 patients (53,1%) experienced myocardial infarction during the observation period. In the group of patients with arterial hypertension and type II diabetes mellitus functional class III effort angina transferred to functional class II in 35,7% of patients. It remained at the same level in 47,6% of patients. It transferred to functional class IV in 16,7% of patients. Decrease in systolic blood pressure in this group was 21,4 mm Hg, 19,1 mm Hg and 18,6 mm Hg respectively (p<0,001). Decrease in diastolic blood pressure was 15,9 mm Hg, 12,2 mm Hg and 7,2 mm Hg respectively (p<0,001). The number of myocardial infarction cases in this group of patients was 81 (64,3%). Conclusion. The degree of functional class III effort angina severity in patients in the long­term period after coronary stenting is associated with adequate control of systolic blood pressure regardless of the presence of type II diabetes mellitus. Increase of effort angina severity up to functional class IV in patients with arterial hypertension and type II diabetes mellitus is associated with lethal outcome during 44 months.

Key words: arterial hypertension, effort angina, systolic blood pressure, myocardial infarction, diabetes mellitus, stenting.

For reference: Akhtereev RN, Galyavich AS, Galeeva ZM, Baleeva LV. Effort angina after coronary stenting. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (4): 13­16. DOI: 10.20969/VSKM.2020.13(4).13­16.

References

1. Knuuti J, Wijns W, Saraste A, et al. 2019 ESC Guidelinesfor the diagnosis and management of chronic coronarysyndromes. European Heart Journal. 2020; 41: 407­477.

2. Vidal­Petiot E, Ford I, Greenlaw N, et al. CLARIFY Investigators. Cardiovascular event rates and mortality according to achieved systolic and diastolic blood pressure in patients with stable coronary artery disease: an international cohort study. Lancet. 2016; 388: 2142–2152.

3. Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018; 39: 3021­3104.

4. Cosentino F, Grant P, Aboyans V, et al. 2019 ESC Guidelines on diabetes, pre­diabetes, and cardiovascular diseases developed in collaboration with the EASD. European Heart Journal 2020; 41: 255­323.

5. Chacko L, Howard J, Rajkuma C, et al. Circ Cardiovasc Qual Outcomes. 2020; 13: e006363.

6. Newman J, Alexander K, Gu X, et al. Baseline Predictors of Low­Density Lipoprotein Cholesterol and Systolic Blood Pressure Goal Attainment After 1 Year in the ISCHEMIA Trial. Circ Cardiovasc Qual Outcomes. 2019; 12: e006002.

7. Hochman J. International Study Of Comparative Health Effectiveness With Medical And Invasive Approaches (ISCHEMIA): Primary Report of Clinical Outcomes. 2019; https://www.acc.org/latest­in­cardiology/clinical­ trials/2019/11/15/17/27/ischemia

8. Steg P, Greenlaw N, Tendera M, et al. Prevalence of Anginal Symptoms and Myocardial Ischemia and Their Effect on Clinical Outcomes in Outpatients With Stable Coronary Artery Disease. Data From the International Observational CLARIFY Registry. JAMA Intern Med. 2014; 174: 1639­1651.

9. Grodzinsky A, Kosiborod M, Tang T, et al. Residual Angina After Elective Percutaneous Coronary Intervention in Patients With Diabetes Mellitus. Circ Cardiovasc Qual Outcomes. 2017; 10: e003553.

 

UDC 616-711.1-089-72

DOI: 10.20969/VSKM.2020.13(4).17-24

PDF download PRACTICAL ASPECTS OF THE APPLICATION OF THE RETRACTOR TO PERFORM SURGERIES ON THE CERVICAL SPINE IN VENTRAL SUBAXIAL CERVICAL SPINAL FUSION

VERESHCHAKO ANATOLY V., D. Med. Sci., professor of the Department of neurosurgery, of North-Western State Medical University named after I.I. Mechnikov, Russia, 191014, St. Petersburg, Mayakovskay str., 12, e-mail: vereshako@inbox.ru

TRAVKOV DMITRY A., ORCID ID: 0000-0003-4457-3911; neurosurgeon of Lipetsk Regional Clinical Hospital, Russia, 398055, Lipetsk, Moskovskaya str., 6a, e-mail: docdat@ro.ru

MANUKOVSKY VADIM A., D. Med. Sci., professor, the Head of the Department of neurosurgery of North-Western State Medical University named after I.I. Mechnikov, Russia, 191014, St. Petersburg, Mayakovskay str., 12, e-mail: manukovskiy@emergency. spb.ru

KINDYUKHIN YURY YU., ORCID ID: 0000-0002-2351-7948; Novolipetsk Steel, principal engineer, Russia, 398040, Lipetsk, Metallurg str., 2, e-mail: yurij-kindyukhin@yandex.ru

Abstract. Aim. Comparison of access instruments for ventral subaxial cervical spinal fusion performance in terms of duration of the surgery depending on the constitutional features of the patient’s neck, moisture content of tissues, re ectivity of separating elements and length of the incision was the aim of the study. Material and methods. The study covers 71 patients with injuries and degenerative dystrophic diseases, who were operated in 2018–2019 using the Cloward retractor. An experimental comparison of the instruments on the re ectivity of the surface of the separating elements and the moisture content of the tissues under them, the duration of surgeries depending on the constitutional features of the neck was performed. Statistical processing of the obtained data was conducted using the Microsoft Of ce Excel 2007 program. Results and discussion. Experiment to compare the re ectivity of the separating elements established such for the Cloward retractor 1,87 times higher than for the developed device, which creates advantages for the latter, providing better visualization and less stress for the eyes. The application of the developed device has allowed reducing somewhat the length of the incision to allow access in case of corporectomy, in case of both injury and the disease. The possibility of faster execution of disectomies with ventral cervical spinal fusion in case of trauma in patients with constitutionally more dif cult to access types of the neck has been established using the developed device. Comparison of the duration of such surgeries in case of the disease under the same conditions, as well as the duration of disectomy in ventral subaxial cervical spinal fusion in patients with constitutionally more accessible neck types, as in case of injuries and diseases, did not reveal any signi cant difference in the application of this or that device. Corporectomy with cervical spinal fusion shows better time results using the developed device in both trauma and the disease. Comparison of the wound moisturising under the separating elements revealed the advantages of the developed device. Conclusion. The developed device can be an addition to traditional Caspar and Cloward’s wound retractors in ventral subaxial cervical spinal fusion, allowing a certain reduction in the length of the incision in corporectomy both in case of trauma and the disease, the duration of the surgery in a more complex access due to constitutional features of the neck in case of disectomies in trauma, as well as in corporectomy in case of trauma and diseases. The application of the developed device has had a positive impact on the maintenance of moisture in the wound.

Key words: ventral subaxial cervical spinal fusion, re ectivity of separating elements, retractor for performing surgeries on the cervical spine.

For reference: Vereshchako AV, Travkov DA, Manukovsky VA, Kindyukhin YuYu. Practical aspects of the application of the retractor to perform surgeries on the cervical spine in ventral cervical spinal fusion. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (4):17­24. DOI: 10.20969/VSKM.2020.13(4).17­24.

References

1. Tighe SM. Instrumentation for the Operating Room: A Photographic Manual, 8th edition. Maryland Heights, Missoury, Mosby. 2011; 352 p.

2. Daniel Kim Alexander ed. Pozvonochnik. Hirurgicheskaya anatomiya i operativnaya tekhnika: perevod vtorogo izdaniya [Surgical Anatomy and Techniques to the Spine 2nd Edition]. Moskva : Izdatel’stvo Pan lova [Moscow: Pan lov Publishing House]. 2016; 829 p.

3. Baskov AV, Borshchenko IA. Tekhnika i principy hirurgicheskogo lecheniya zabolevanij i povrezhdenij pozvonochnika: prakticheskoe rukovodstvo [Technique and principles of surgical treatment of diseases and injuries of the spine: practical guide]. Moskva: GEOTAR­Media [Moscow: GEOTAR­Media]. 2008; 136 p.

4. Fountas KN, Kapsalaki EZ, Nikolakakos LG, et al. Anterior cervical discectomy and fusion associated complications. Spine (Phila Pa 1976). 2007; 32 (21): 2310­2317.

5. Bilbao G, Duart M, Aurrecoechea JJ, et al. Surgical results and complications in a series of 71 consecutive cervical spondylotic corpectomies. Acta Neurochir (Wien). 2010; 152: 1155­1163.

  1. Epstein NE. A Review of Complication Rates for Anterior Cervical Diskectomy and Fusion (ACDF). Surg Neurol Int. 2019; 10: 100.

  2. Sherris Devid A, Kern Yudzhin B. Bazovye hirurgicheskie navyki [Essential Surgical Skills]. Moskva: GEOTAR­Media [Moscow: GEOTAR­Media]. 2015; 217 p.

  3. Semenov GM. Sovremennye hirurgicheskie instrument; vtoroe izdanie [Modern surgical instruments; 2nd ed]. SPb: Piter [Saint Petersburg: Piter]. 2013; 347 p.

  4. Patent RF, No RU194741 U1,Application 2019119582, 2019­06­21, Publication 2019­12­23 bulletin No 36.

10. Maleev YuV. Hirurgicheskaya anatomiya shchitovidnoj zhelezy v svyazi s tipovymi osobennostyami shei: avtoreferat dis. kandidata medicinskih nauk [Surgical anatomy of the thyroid gland due to typical neck features: extendedabstract of candidate medical sciences dissertation]. Voronezh: Voronezhskaya gosudarstvennaya meditsinskaya akademiya imeni NN Burdenko [Voronezh: Voronezh State Medical Academy named after NN Burdenko]. 1999; 23 p.

11. GOST R 55710­2013 «Osveshchenie rabochih mest vnutri zdanij; Normy I metody izmerenij» [State Standard 55710­ 2013 «Lighting of workplaces inside buildings; Standards and measurement methods»]. Moskva: Standartinform [Moscow: Standartinforn]. 2014; 16 p.

 

UDC 616.12-008.331.1-053.9-084

DOI: 10.20969/VSKM.2020.13(4).25-31

PDF download SCIENTIFIC JUSTIFICATION OF MEASURES FOR MEDICAL AND SOCIAL PREVENTION OF ARTERIAL HYPERTENSION IN PERSONS OLDER THAN WORKING AGE

GALIULLIN AFGAT N., ORCID ID: 0000-0002-1294-4055; D. Med. Sci., professor of the Department of general hygiene, AC «Lean technologies in healthcare» of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7 (987)296-87-64, e-mail: kybm@mail.ru

KITAEVA ENDZHE A., ORCID ID: 0000-0003-2147-9025; С. Med. Sci., assistant of professor of the Department of general hygiene of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49; the Head of the Department of neurology of Certer District Hospital of Rybnaya Sloboda, Russia, Republic of Tatarstan, 422650, Rybno-Slobodsky district, urban settlement Rybnaya Sloboda, Sosnovaya str., 6, tel. +7-927-033-78-41, e-mail: kitaevaenge@mail.ru

ZAINULLINA DINARA R., bachelor of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. 8(929)723-73-80, e-mail: zainullina_dinara@mail.ru

GALIULLIN DAMIR A., ORCID ID: 0000-0002-8878-2777; С. Med. Sci., deputy chief physician of City Clinical Hospital No 16, Russia, 420039, Kazan, Gagarin str., 121, tel. 8(917)291-72-14, e-mail: kybm@mail.ru

SAGITOVA ILMIRA I., bachelor of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. 8 (927)432-52-51, e-mail: ilmira.sagitova.98@mail.ru

Abstract. Aim. The aim of the study was to determine the prevalence of social and behavioral factors, nutrition, lifestyle, de ciencies in medical care, the impact of these factors on the development of arterial hypertension in persons older than working age, as well as to develop measures for medical and social prevention of arterial hypertension. Material and methods. The prevalence of social and behavioral factors, nutrition, lifestyle and health care de ciencies was studied in 906 persons older than working age with arterial hypertension, of whom 48,0 per cent were men and 52,0 per cent women. To study risk factors for arterial hypertension, a special map was developed which consisted of 106 questions and 412 gradations. More than 24 000 pieces of information on gradation of arterial hypertension risk factors was analyzed. Arterial hypertension incidence was studied depending on age and gender. The in uence of risk factors on development was assessed by means of dispersion analysis. As a result of the conducted research 10 measures on medical and social prevention of arterial hypertension were developed. Results and discussion. Different stages of arterial hypertension have been detected in 74,5% of persons older than working age living in Kazan. The prevalence of arterial hypertension in men was 70,2%, while in women it was 78,5%. The highest prevalence of arterial hypertension risk factors is due to cardiovascular diseases (100,0%), irregular morning exercise (84,1%), rare consumption of fresh fruits and vegetables (71,4%), diabetes mellitus (60,6%), excess body weight (57,0%) and others. The conducted dispersion analysis has shown that the emergence and development of arterial hypertension in persons older than working age was most strongly in uenced by medical and biological factors (ɳ2=17,6%; p<0,001), the second place was occupied by the factors – shortcomings of medical service (ɳ2=8,5%; p<0,01), the third place was occupied by the factors of nutrition (ɳ2=7,8%; p<0,01) and the last place belonged to behavioral factors and lifestyle (ɳ2=6,3%; p<0,05). According to the study, 10 measures were developed for medical and social prevention of arterial hypertension in persons older than working age. Conclusion. The study showed that the prevalence of arterial hypertension among persons older than working age was 74,5%, while in women it was 8,3% higher than in men. The highest prevalence of risk factors was cardiovascular disease, irregular morning exercise, rare consumption of fruits and vegetables, overweight, abuse of sweets and salts, etc. A strong in uence on the occurrence and development of arterial hypertension in persons older than working age has been established for medical and biological factors (ɳ2=17,6%; p<0,001), medical service de ciencies (ɳ2=8,5%; p<0,01), nutritional factors (ɳ2=7,8%; p<0,01), behavioral factors and lifestyle (ɳ2=6,3%; p<0,05).

Key words: arterial hypertension, risk factors, medical and social prevention, variance analysis.

For reference: Galiullin AN, Kitaeva EA, Zainullina DR, Galiullin DA, Sagitova II. Scienti c justi cation of measures for medical and social prevention of arterial hypertension in persons older than working age. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (4): 25­31. DOI: 10.20969/VSKM.2020.13(4).25­31.

References

  1. Vorobyova NM, Tkacheva ON, Kotovskaya YuV. Kak uroven’ arterial’nogo davleniya vliyayet na 5­letnyuyu vyzhivayemost’ lits starcheskogo vozrasta i dolgozhiteley? [How does the level of blood pressure affect the 5­year survival of senile and long­lived individuals?]. Arterial’naya gipertenziya [Arterial hypertension]. 2019; 25 (3): 232­245. https://doi.org/10.18705/1607­419X­2019­25­3­232­245

  2. Ena LM, Akhaladze NG. Arterial’naya gipertenziya v starosti [Arterial hypertension in old age]. Arterial’naya gipertenziya [Arterial hypertension]. 2013; 3 (29): 21­25. https://cyberleninka.ru/article/n/arterialnaya­gipertenziya­ v­starosti

3. Klimov AV, Denisov EN, Ivanova OV. Arterial’naya gipertenziya i yeye rasprostranennost’ sredi naseleniya [Arterial hypertension and its prevalence among the population]. Molodoy uchenyy [Young scientist]. 2018; 50: 86­90. https://moluch.ru/archive/236/54737/

4. Raskina EA, Makeeva AV. Rasprostranennost’ faktorov riska serdechno­sosudistykh zabolevaniy u patsiyentov s arterial’noy gipertoniyey [Prevalence of risk factors for cardiovascular diseases in patients with arterial hypertension]. Mezhdunarodnyy studencheskiy nauchnyy vestnik [International student scienti c Bulletin]. 2016; 2­4: 163­164. https://www.elibrary.ru/item.asp?id=26245861

5. Karabayeva AI, et al. Etiologiya, patogenez, klinicheskaya kartina arterial’noy gipertenzii v pozhilom vozraste [Etiology, pathogenesis, clinical picture of arterial hypertension in old age]. Vestnik KazNMU [Bulletin of KazNMU]. 2013; 4 (1): 71­73.

 

UDC 614.2(470.41):616-082

DOI: 10.20969/VSKM.2020.13(4).32-38

PDF download CLINICAL AND OBJECTIVE ANALYSIS OF PATIENTS’ REFERRALS TO A MULTIDISCIPLINARY CLINIC

GARIPOV RUSLAN Z., the Head of the Department of admission of Interregional Clinical Diagnostic Center, Russia, 420101, Kazan, Karbyshev str., 12a, e-mail: garipov.ruslan@list.ru

SHULAEV ALEXEY V., D. Med. Sci., professor, vice-rector for regional healthcare development of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: shulaev8@gmail.com

GALIMZYANOV ADEL F., C. Med. Sci., deputy chief officer on general issues of Interregional Clinical Diagnostic Center, Russia, 420101, Kazan, Karbyshev str., 12a, e-mail: galiadel@yandex.ru

TEUNOVA GALINA A., internist of the Department admission of Interregional Clinical Diagnostic Center, Russia, 420101, Kazan, Karbyshev str., 12a

KIM IRINA V., internist of the Department admission of Interregional Clinical Diagnostic Center, Russia, 420101, Kazan, Karbyshev str., 12a

ZARIPOVA ELVIRA M., C. Med. Sci., associate professor of the Department of dentistry and implant dentistry of Institute of fundamental medicine and biology of Kazan (Volga region) Federal University, Russia, 420012, Kazan, Karl Marx str., 74

MORTAZINA RUZIYA M., statistician of the Department of statistical accounting of Interregional Clinical Diagnostic Center, Russia, 420101, Kazan, Karbyshev str., 12a

Abstract. Aim. The aim of the study was to investigate and evaluate the algorithm of referring patients to the admission­diagnostic department of a multidisciplinary clinic. Material and methods. 2492 applications of cardiac pro le patients to the admission and diagnostic department of the nterregional Clinical and Diagnostic Center for the period from 01.01.2019 to 31.12.2019 were analyzed. The obtained data were analyzed using methods of variation statistics (calculation of relative and mean values). Calculations were performed using the MS Excel­2016 spreadsheet and IBM Statistics SPSS­21 statistical package. Results and discussion. During the analyzed period 996 cases of cardiac patients’ appeal were registered in the admission and diagnostic department: 720 (72,3%) – by self­referral, 229 (23,0%) – were forwarded from the outpatient department of the Interregional Clinical and Diagnostic Center, 47 (4,7%) – from medical organizations of the Republic of Tatarstan. The majority of patients were aged 60 to 74 years (39,2%), the mean age was (65,7±3,7) years, no reliable differences between men and women were found (53,6% and 46,4% respectively; p>0,05). More than half of the patients who applied (51,4%) to the admission and diagnosis unit were referred under the supervision of a district therapist or a cardiologist to a territorial outpatient clinic at their place of residence with recommendations for examination and treatment because there was no life­threatening condition. 322 patients (32,3%) were hospitalized at the Interregional Clinical and Diagnostic Centre, of whom 158 were admitted to the intensive care unit. Of these, 158 (49,1%) were admitted to the intensive care unit and 164 (50,9%) to the cardiology unit. 76 (7,6%) patients were transferred to other specialized medical organizations of Kazan. By frequency of registration the largest numbers of patients were those with coronary heart disease (29,7%), hypertension (22,7%) and acute coronary syndrome (15,0%). Conclusion. In 72,3% of cases, patients applied directly to a multi­disciplinary hospital, which shows the insuf cient effectiveness of the system of routing patients from outpatient to inpatient level. All this points to the need for continuous evaluation of ef ciency and monitoring of continuity indicators between the outpatient department and inpatient unit.

Key words: outpatient unit, patient appealability, effectiveness.

For reference: Garipov RZ, Shulaev AV, Galimzyanov AF, Teunova GA, Kim IV, Zaripova EM, Mortazina RM. Clinical and objective analysis of patients’ referrals to a multidisciplinary clinic. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (4): 32­38. DOI: 10.20969/VSKM.2020.13(4).32­38.

References

1. Federal’nyy zakon ot 21 noyabrya 2011 goda No 323­FZ (izdanie 01/04/2020) «Ob osnovakh okhrany zdorov’ya grazhdan v Rossiyskoy Federatsii» (s izmeneniyami i dopolneniyami, vstupivshiy v silu 12 aprelya 2020 goda) [Federal Law of November 21, 2011 No 323­FZ

(edition from 01/04/2020) «On the Basics of Protecting the Health of Citizens in the Russian Federation» (as amended and supplemented, entered into force on April 12, 2020)]. 2020; URL: http: // www.consultant.ru/ document/cons_doc_LAW_121895/dd5b443a6d2c374d-c77998bcc6ccad68c593488e /

2. Agalarova LS. Sovershenstvovaniye tekhnologii raboty vrachey pervichnoy meditsinskoy pomoshchi gorodskikh poliklinik v usloviyakh modernizatsii zdravookhraneniya [Improving the technology of primary care physicians work city clinics in the modernization of health care]. Vestnik Dagestanskoy Gosudarstvennoy Meditsinskoy Akademii [Bulletin of the Dagestan State Medical Academy]. 2015; 1 (14): 41­46.

3. Emelyanov AO, Okulov VM, Rotar RY. Osnovnyye problemy organizatsii raboty vrachey­terapevtov rayonnykh militsionerov; Sbornik nauchnykh trudov pod redaktsiyey professora Vishnyakova NI. [Тhe major problems of the organization of work of doctors­therapists of district police of cers; Collection of scienti c papers edited by professor Vishnyakova NI]. Sankt­Peterburg: Pervyy Sankt­ Peterburgskiy gosudarstvennyy meditsinskiy universitet imeni akademika IP Pavlova [Saint Petersburg: First Saint Petersburg State Medical University named after IP Pavlova]. 2014; 93­97.

4. Prikaz Ministerstva zdravookhraneniya Respubliki Tatarstan ot 11/12/2017 goda No 2591 «O vnesenii izmeneniy v Prikaz Ministerstva zdravookhraneniya Respubliki Tatarstan» ot 23/04/15 goda No 735 «Ob organizatsii ekstrennoy meditsinskoy pomoshchi vzroslomu naseleniyu pri ostrom infarkte miokarde i nestabil’noi stenokardii v Respublike Tatarstan» [The order of Ministry of Health of Republic of Tatarstan from 11/12/2017 No 2591 «On amendments to order of Ministry of Health of Republic of Tatarstan 23/04/15 No 735 «On the organization ofemergency medical care to adult population in acutemyocardial infarction and unstable angina in the Republic of Tatarstan»]. 2017; https://base.garant.ru/22564502/

5. Prikaz Ministerstva zdravookhraneniya Respubliki Tatarstan ot 04/02/2019 No 172 «O sovershenstvovanii organizatsii kardiokhirurgicheskoy pomoshchi naseleniyu Respubliki Tatarstan» [The order of Ministry of Health of Republic of Tatarstan from 04/02/2019 No 172 «On improving the organization of cardiac surgery care to the population of the Republic of Tatarstan»]. 2019; http://docs. cntd.ru/document/561758916

6. Ilyasova UG, Asimov AA, Abdurachmanova SSh. Rol’ vrachey obshchey praktiki i uchastkovykh terapevtov v provedenii pro lakticheskoy sistemy gorodskogo naseleniya [The role of general practitioners and district therapentists in carried out of prophylactic system urban population]. Ural’skiy meditsinskiy zhurnal [Ural medical journal]. 2010; 1 (66): 12­15.

7. Shevsky VI, Sheiman IM. Problemy formirovaniya integrirovannoy sistemy zdravookhraneniya [Problems of forming an integrated health care system]. Voprosy gosudarstvennogo i munitsipal’nogo upravleniya [Issues of state and municipal government]. 2013; 3: 24­47.

8. Komarov YuM. Na nauchnoy osnove Semashkinskaya model’ zdravookhraneniya [On the scienti c basis of the Semashkinsky model of health care]. Organizatsionnoye zdorov’ye: novosti, mneniya, obucheniye [Organizational Health: news, opinions, training]. 2015; 1 (1): 120­127.

 

UDC 618.19-006.6-056.7:575.224(048.8)

DOI: 10.20969/VSKM.2020.13(4).39-43

PDF download MUTATIONS IN BRCA1 AND BRCA2 GENES AS A CAUSE OF HEREDITARY BREAST CANCER

GIMAEVA REGINA R., ORCID ID: 0000-0002-4906-166X; resident of Institute of biology and fundamental medicine of Kazan Federal University, Russia, 420012, Kazan, Karl Marx str., 74; laboratory and research assistant of OpenLab «Genetic and Cellular Technologies» research laboratory, Precision and Regenerative Medicine Сenter of Institute of biology and fundamental medicine, Russia, 420021, Kazan, Parizhskaja Kommuna str., 9, e-mail: gimaeva.regina2013@yandex.ru

KUPRIYANOVA ELENA A., ORCID ID: 0000-0002-9185-4217; junior researcher of OpenLab «Omics Technologies» research laboratoryof Institute of biology and fundamental medicine of Kazan Federal University, Russia, 420021, Kazan, Parizhskaja Kommuna str., 9, e-mail: fewrandomletters@gmail.com

GABELKO DENIS I., lecturer 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, e-mail: freeden777@mail.ru

Abstract. Aim. The aim of the study was to analyze the medical literature on mutations in BRCA1 and BRCA2 genes associated with breast cancer. Material and methods. The scienti c and medical literature on mutations of BRCA1/2 genes causing high risk of breast cancer was reviewed. Results and discussion. Breast cancer is one of the most common malignancies in women. According to statistics, breast cancer, which has a hereditary predisposition, accounts for 5–10% of the total disease burden. More than 1000 different gene mutations are known to be related to the emergence of breast cancer. Mutations in the BRCA1 and BRCA2 genes cause high risk of breast cancer, accounting for up to 30% of cases. Violation of the normal function of the BRCA1 and BRCA2 genes leads to DNA lament repair errors, which in turn causes further cell proliferation with mutations occurring in cells and inducing programmed cell death. Conclusion. Timely referral for medical and genetic counseling is an integral part of providing assistance to patients with cancer. Detection of an oncological disease transmitted by inheritance is of great importance, as it allows to change the tactics of treatment in time and to apply a personalized approach, as well as to assess the possibility of simultaneous use of surgical treatment and preventative contralateral mastectomy in each case. According to literature data, accurate genetic identi cation of the form of hereditary breast cancer with subsequent personalized therapy can reduce the mortality rate of patients by 90%. This allows us to consider genetic testing as one of the most important tools to improve the effectiveness of treatment in cancer patients.

Key words: mutations, BRCA1 and BRCA2 genes, hereditary cancer, breast cancer.

For reference: Gimaeva RR, Kupriyanova EA, Gabelko DI. Mutations in BRCA1 and BRCA2 genes as a cause of hereditary breast cancer. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (4): 39­43. DOI: 10.20969/ VSKM.2020.13(4).39­43.

References

  1. Laptiev SA, Korzhenevskaya MA, Imyanitov EN. Molekulyarno­geneticheskij «portret» raka molochnoj zhelezy [Molecular genetic «portrait» of breast cancer]. Uchenye zapiski SPbGMU imeni akademika IP Pavlova [Scienti c notes of St Petersburg State University named after IP Pavlova]. 2017; 2: 12­22.

  2. Snigireva GP, Rumyanceva VA, Novikova EI, et al. Algoritm molekulyarno­geneticheskogo obsledovaniya dlya vyyavleniya nasledstvennogo BRCA­associirovannogo raka molochnoj zhelezy [Molecular genetic screening algorithm for detecting hereditary BRCA­associated breast cancer]. Al’manah klinicheskoj mediciny [Clinical Medicine Almanac]. 2019; 47 (1): 54–65.

  3. Lyubchenko LN, Bateneva EI. Mediko­geneticheskoe konsul’tirovanie i DNK­diagnostika pri nasledstvennoj predraspolozhennosti k raku molochnoj zhelezy i raku yaichnikov [Genetic counseling and DNA diagnostics for an inherited predisposition to breast and ovarian cancer]. Moskva: IG RONC [Moscow: IG RONC]. 2014; 76 p.

4. Parkes A, Arun BK, Litton JK. Systemic treatment strategies for patients with hereditary breast cancer syndromes. Oncologist. 2017; 22 (6): 655–666.

5. Paul A, Paul S. The breast cancer susceptibility genes (BRCA) in breast and ovarian cancers. Front Biosci (Landmark Ed). 2014; 19: 605–618.

6. Brozek I, Cybulska C, Ratajska M, Piatkowska M, Kluska A, Balabas A, Dabrowska M, Nowakowska D, Niwinska A, Pamula­Pilat J, Tecza K, Pekala W, Rembowska J, Nowicka K, Mosor M, Januszkiewicz­Lewandowska D, Rachtan J, Grzybowska E, Nowak J, Steffen J, Limon J. Prevalence of the most frequent BRCA1 mutations in Polish population. J Appl Genet. 2011; 52 (3): 325–330.

7. Lyubchenko LN, Bateneva EI, et al. Nasledstvennyj rak molochnoj zhelezy i yaichnikov [Hereditary breast and ovarian cancer]. Zlokachestvennye opuholi [Malignant tumors]. 2013; 2: 53–61.

8. Shimelis H, LaDuca H, Hu C, Hart SN, Na J, Thomas A, Akinhanmi M, Moore RM, Brauch H, Cox A, Eccles DM, Ewart­Toland A, Fasching PA, Fostira F, Garber J, Godwin AK, Konstantopoulou I, Nevanlinna H, Sharma P, Yannoukakos D, Yao S, Feng BJ, Tippin Davis B, Lilyquist J, Pesaran T, Goldgar DE, Polley EC, Dolinsky JS, Couch FJ. Triple­negative breast cancer risk genes identi ed by multigene hereditary cancer panel testing. J Natl Cancer Inst. 2018; 110 (8): 855–862.

9. Van der Groep P, Van der Wall E, Van Diest PJ. Pathology of hereditary breast cancer. Cell Oncol (Dordr). 2011; 34 (2): 71–88.

10. Dmitriev VN, Suhoterin IV, et al. Mutacii genov BRCA1, BRCA2 – budushchee prediktivnoj onkologii: obzor literatury [Mutations of the BRCA1, BRCA2 genes – the future of predictive oncology: literature review]. Opuholi zhenskoj reproduktivnoj sistemy [Tumors of the female reproductive system]. 2012; 1: 13­16.

11. Bit­Sava EM, Belogurova MB. Nasledstvennyj rak molochnoj zhelezy [Hereditary Breast Cancer]. Sibirskij onkologicheskij zhurnal [Siberian Oncology Journal]. 2013; 1: 75­81.

12. Lyubchenko LN, Bateneva EI, et al. Nasledstvennyj rak molochnoj zhelezy: geneticheskaya i klinicheskaya geterogennost’, molekulyarnaya diagnostika, hirurgicheskaya pro laktika v gruppah riska [Hereditary breast cancer: genetic and clinical heterogeneity, molecular diagnostics, surgical prophylaxis at risk]. Uspekhi molekulyarnoj onkologii [Advances in Molecular Oncology]. 2014; 2: 16–25.

13. Yılmaz NK, Karagin PH, Terzi YK, Kahyaoğlu İ, Yılmaz S, Erkaya S, Şahin Fİ. BRCA1 and BRCA2 sequence variations detected with next­generation sequencing in patients with premature ovarian insuf ciency. J Turk Ger Gynecol Assoc. 2016; 17 (2): 77–82.

14. Winter C, Nilsson MP, Olsson E, George AM, Chen Y, Kvist A, Törngren T, Vallon­Christersson J, Hegardt C, Häkkinen J, Jönsson G, Grabau D, Malmberg M, Kristoffersson U, Rehn M, Gruvberger­Saal SK, Larsson C, Borg Å, Loman N, Saal LH. Targeted sequencing of BRCA1 and BRCA2 across a large unselected breast cancer cohort suggests that one­third of mutations are somatic. Ann Oncol. 2016; 27 (8): 1532–1538.

15. Chen S, Parmigiani G. Meta­analysis of BRCA1 and BRCA2 penetrance. J Clin Oncol. 2007; 25: 1329­1333.

16. Klinicheskie rekomendacii «Pro laktika raka molochnoj zhelezy i raka yaichnikov u nositelej mutacij genov BRCA1/ BRCA2» [Clinical guidelines «Prevention of breast cancer and ovarian cancer in carriers of mutations of the BRCA1/ BRCA2 gene mutations»]. 2020; https://promisan.ru/storage/uploads/ le/s/i/g/7frzhgbv/Protokol_BRCA.pdf

 

UDC 616.428-006-073.432.19

DOI: 10.20969/VSKM.2020.13(4).44-48

PDF download THE ROLE OF ULTRASONIC SCANNING IN THE DIAGNOSIS OF LYMPHADENOPATHY OF THE NECK

PULATOVA IRODA Z., ORCID ID: 0000-0003-4030-9486; PhD, associate professor of the Department of oncology with a course of ultrasound diagnostics of Tashkent Institute for Advanced Physician Training, Uzbekistan, 100007, Tashkent, Parkentskaya str., 51, e-mail: Iroda1979@mail.ru

Abstract. Aim. The aim of the study was to investigate differential­diagnostic criteria of lymph nodes of the neck using ultrasonic scanning in V­mode and via echo Doppler scanning. Material and methods. In the course of the study we examined neck lymph nodes in 53 patients with head and neck disorders. All patients were examined by ultrasound of neck lymphatic collectors in B­mode and by color mapping echo Doppler scanning, energy Doppler and spectral mode. Pre surgery puncture biopsy was performed along with the histological examination of remote lymphatic collectors in case of surgical intervention. Statistical processing of the obtained data was performed using Microsoft Excel 2007 and Statistica 10 software package. Results and discussion. The main differential-diagnostic criteria for metastaticallyaltered lymph nodes were an increase in size, mainly round shape, uneven clear contours, no clear differentiation of the cortical layer from the gate, hypoechogeneity and heterogeneity of the node structure. Color Doppler mapping allowed determining the presence of primarily perinodular blood ow in 74,5%. The rest of the lymph nodes showed single color signals in both center and cortical area. In the spectral mode, the blood ow rate in metastatic lymph nodes doubled against a decrease in the resistance index (RI) (p<0,05). Conclusion. Ultrasound examination in B­mode in combination with Doppler is a highly informative differential­diagnostic method for detection of peripheral lymph node disorders.

Key words: ultrasound diagnostics, B­mode, Doppler scanning, color Doppler mapping, lymphadenopathy, metastases.

For reference: Pulatova IZ. The role of ultrasonic scanning in the diagnosis of lymphadenopathies of the neck. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (4): 44­48. DOI: 10.20969/VSKM.2020.13(4).44­48.

References

  1. Melikyan AL, Kovrigina AM, Nikitin EA. Klinicheskie rekomendacii po diagnostike limfadenopatij [Clinicalrecommendations for the diagnosis of lymphadenopathy]. Moskva: FGBU «Gematologicheskij Nauchnyj centr» Minzdrava Rossii [Moscow: Federal State Budgetary Institution «Hematological Research Center» of the Ministry of Health of Russia]. 2014; 46 p.

  2. Abbasova EV. Rol’ ekhogra i v differencial’noj diagnostike zlokachestvennyh i dobrokachestvennyh limfadenopatij [The role of ultrasound in the differential diagnosis of malignant and benign lymphadenopathies]. Moskva: FGU «Rossiyskiy nauchnyy tsentr rentgenoradiologii» [Moscow: Federal State Institution «Russian Scienti c Center for X­ray Radiology»]. 2005; 32 p.

  3. Savel’eva NA. Kompleksnoe ul’trazvukovoe issledovanie s ispol’zovaniem kompressionnoj elastogra i v diagnostike lokal’nyh recidivov raka molochnoj zhelezy [Complex ultrasound study using compression elastography in the diagnosis of local relapse of breast cancer]. Kazanskij medicinskij zhurnal [Kazan Medical Journal]. 2017; 2 (98): 288­293.

4. Savel’eva NA. Ul’trazvukovaya diagnostika zloka­ chestvennogo porazheniya perifericheskih limfaticheskih uzlov [Ultrasound diagnosis of malignant lesions of the peripheral lymph nodes]. Prakticheskaya medicina [Practical medicine]. 2014; 3 (14): 135­138.

5. Gupta A, Rahman K, Shahid M, et al. Sonographic assessment of cervical lymphadenopathy: Role of high resolution and color doppler imaging. Head Neck. 2011; 33: 297­302.

6. Esen G. Ultrasound of super cial lymph nodes. Eur J Radiology. 2006; 58 (3): 345­359.

7. Ghafoori М, Azizian A, Pourrajabi Z, Vaseghi H. Sonographic Evaluation of Cervical Lymphadenopathy; Comparison of Metastatic and Reactive Lymph Nodes in Patients With Head and Neck Squamous Cell Carcinoma Using Gray Scale and Doppler Techniques. Iran J Radiol. 2015; 12 (3): e11044.

8. Allahverdieva GF, Sinyukova GT, Sholohov VN, et al. Vozmozhnosti kompleksnogo ul’trazvukovogo issle­ dovaniya v diagnostike metasticheskogo porazheniya limfouzlov shei [Possibilities of a complex ultrasoundexamination in the diagnosis of metastatic lesionsof the lymph nodes of the neck]. Ul’trazvukovaya i funkcional’naya diagnostika [Ultrasound and functional diagnostics]. 2005; 1: 18­22.

9. Allahverdyan GS, Chekalova MA. Vozmozhnosti ekhogra i v diagnostike patologii poverhnostnyh limfaticheskih uzlov [Possibilities of ultrasound in the diagnosis of pathology of super cial lymph nodes]. Ul’trazvukovaya i funkcional’naya diagnostika [Ultrasound and functional diagnostics]. 2012; 6: 88–95.

10. Ying M, Bhatiab KSS, Leeb YP, et al. Review of ultrasonography of malignant neck nodes: greyscale, Doppler, contrast enhancement and elastography. Cancer Imaging. 2013; 13 (4): 658­669.

 

UDC 615.213-065

DOI: 10.20969/VSKM.2020.13(4).49-54

PDF download COMPARATIVE SAFETY OF ANTIEPILEPTIC DRUGS: GENDER ASPECTS

SHAIMARDANOVA ROZA M., ORCID ID: 0000-0001-6287-8896; neurologist of Children’s City Hospital No 8, Russia, 420061, Kazan, Bari Galeev str., 11, e-mail: roza.shaimardanova@mail.ru

GAMIROVA RIMMA G., ORCID ID: 0000-0002-8582-592X; SCOPUS Author ID: 25422029100; C. Med. Sci., associate professor of the Department of pediatric neurology of Kazan State Medical Academy – the branch of Russian Medical Academy of Postgraduate Education, Russia, 420012, Kazan, Mushtari str., 11; associate professor of the Department of clinical medicine fundamental basis of Institute of biology and fundamental medicine of Kazan Federal University, senior researcher of Clinical linguistics research laboratory of Kazan Federal University, Russia, 420008, Kazan, Kremlevskaya str., 18, tel. +7-917-257-96-44, e-mail: r-gamirov@mail.ru

Abstract. Aim. The aim of the study was to compare gender­speci c adverse drug reactions in patients taking various antiepileptic drugs. Material and methods. Criteria for patient inclusion: 1) patients diagnosed with Idiopathic generalized epilepsy, Structural focal epilepsy or Focal epilepsy of unspeci ed etiology; 2) monotherapy with various antiepileptic agents. Comparative analysis of safety of antiepileptic agents was performed by the method of risk ratio calculation (RR). An adverse outcome – the presence of any undesirable drug reactions in a patient – was used as an indicator of safety of antiepileptic agents. Differences at p<0,05 were considered statistically signi cant. Results and discussion. The study enrolled 428 patients with idiopathic generalized and focal epilepsy. There were 302 (71%) patients under 18 years of age and 126 (29%) adult patients. The gender distribution of patients with focal and idiopathic generalized epilepsy was as follows: 235 (55%) female and 193 (45%) male patients. A total of 359 undesirable drug reactions were registered in 52% (in 223 out of 428) of patients who reported side effects. When analyzing treatment safety, regardless of the type of antiepileptic agent, the number of patients with adverse drug reactions was higher in 61% of women than in 39% of men (p=0,006). Comparative gender analysis of the frequency of certain types of undesirable drug reactions during valproic acid treatment showed that women were more likely to have an increase in body weight (18%) than men (6,6%), p=0,04. Hair loss was also more frequently noted by women (22%) than by men (3%), p=0,003. At the same time, men (20%) were signi cantly more frequent than women (6%), p=0,006. A comparative gender analysis of the frequency of individual side effects in carbamazepine treatment revealed that dizziness was more frequently observed in women than in men, p=0,03. No differences by gender in undesirable drug reactions were found in treatment with oxcarbazepine, levetiracetam, lamotrigine, ethosuximide, including individual variants of side effects. Conclusion. Gender differences were found in the incidence of undesirable drug reactions when taking antiepileptic drugs, predominantly in women. Side effects in treatment with carbamazepine and topiramate were more frequently detected in women than in men. Complaints about weight gain and hair loss during valproic acid intake, about dizziness during carbamazepine intake prevailed in women, while the increase of transaminase level was more often observed in men.

Key words: epilepsy, adverse drug reactions, gender differences in side effects, antiepileptic drugs.

For reference: Shaimardanova RM, Gamirova RG. Comparative safety of antiepileptic drugs: gender aspects. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (4):49­54. DOI: 10.20969/VSKM.2020.13(4).49­54.

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2. Muhin KYu, Mironov MB, Petruhin AS. Epilepticheskie sindromy; Diagnostika i terapiya; 3 izdanie [Epileptic syndromes; Diagnosis and therapy, 3 th ed]. M: OOO «Sistemnye resheniya» [Moscow: System solutions]. 2014; 353–364.

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  3. Lesik OO, Zhadnov VA. Sistemnyj podhod i gendernye aspekty epilepsii [Systemic approach and gender aspects of epilepsy]. Rossijskij mediko­biologicheskij vestnik imeni akademika IP Pavlova [IP Pavlov Russian Medical Biological Herald]. 2017; 25 (1): 122­123. doi: https://doi. org/10.23888/PAVLOVJ20171118­132.

  4. Zhidkova IA. Gendernye aspekty epilepsii [Gender aspects of epilepsy]. Vestnik epileptologii [Bulletin of Epileptology]. 2013; 1: 8.

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  7. Ziganshina LE, Gamirova R., Prohorova IV, et al. Farmako-epidemiologicheskie issledovaniya na sluzhbe optimizacii ispol’zovaniya lekarstv [Pharmacoepidemiological studies working to improve the use of medicines]. Kazanskij medicinskij zhurnal [Kazan medical ournal]. 2010; 91 (6): 721­723.

  8. Gómez­Arias B, Crail­Meléndez D, López­Zapata R, et al. Severity of anxiety and depression are related to a higher perception of adverse effects of antiepileptic drugs. Seizure. 2012; 21 (8): 588–594. doi: 10.1016/j. seizure.2012.06.003

  9. Roopa BS, Narayan SS, Sharma GR, et al. Pattern of adverse drug reactions to anti­epileptic drugs: a cross­ sectional one­year survey at a tertiary care hospital. Pharmacoepidemiol Drug Saf. 2008; 17: 807­812. doi: 10.1002/pds.1540.

12. Canevini MP, De Sarro G, Galimberti CA, et al. Relationship between adverse effects of antiepileptic drugs, number of coprescribed drugs, and drug load in a large cohort of consecutive patients with drug­refractory epilepsy. Epilepsia. 2010; 51: 797­804. doi: 10.1111/j.1528­ 1167.2010.02520.x.

13. Namazi S, Borhani­Haghighi A, Karimzadeh I. Adverse reactions to antiepileptic drugs in epileptic outpatients: a cross­sectional study in Iran. Clin Neuropharmacol. 2011; 32 (2): 79­83. doi: 10.1097/WNF.0b013e318210ece0.

14. Martins HH, Alonso NB, Vidal­Dourado M, et al. Af liations expand Are adverse effects of antiepileptic drugs different in symptomatic partial and idiopathic generalized epilepsies? The Portuguese–Brazilian validation of the Liverpool Adverse Events Pro le. Epilepsy Behav. 2011; 22: 511–517. doi: 10.1016/j.yebeh.2011.08.005.

15. Olusanya A, Ogunleye O, Godman B, et al. Adverse effects of carbamazepine monotherapy among patients in Nigeria: a pilot study and implications. J Comp Eff Res. 2017; 6(1): 33­42. doi: 10.2217/cer­2016­0057.

16. Biton V, Levisohn P, Hoyler S, et al. Hammer AE. Lamotrigine versus valproate monotherapy­associated weight change in adolescents with epilepsy: result from a post hoc analysis of a randomized, double­blind clinical trial. J Child Neurol. 2003; 18: 133–139. doi: 10.1177/08830738030180021701.

17. Pylvänen V, Knip M, Pakarinen A, et al. Serum insulin and leptin levels in valproate­associated obesity. Epilepsia. 2002; 43: 514–517. doi: 10.1046/j.1528­ 1157.2002.31501.x.

18. Elaine C, Wirrell MD. Valproic acid­associated weight gain in older children and teens with epilepsy. Pediatr Neurol. 2003; 28: 126–129. doi: https://doi.org/10.1016/S0887­ 8994 (02)00505­2.

19. Goldberg­Stern H, Itzhaki T, Landau Z, et al. Endocrine Effects of Valproate versus Carbamazepine in Males with Epilepsy: A Prospective Study. Horm Res Paediatr. 2015; 83 (5): 332­339. doi: 10.1159/000375374.

20. El­Khatib F, Rauchenzauner M, Lechleitner M, et al. Valproate, weight gain and carbohydrate craving: A gender study. Seizure. 2007; 16 (3): 226–232. doi: 10.1016/j. seizure.2006.12.009.

21. Yassa R, Ananth J. Hair loss in the course of lithium treatment: a report of two cases. Can J Psychiatry 1983; 28 (2): 132–133. doi: 10.1177/070674378302800211.

22. McKinney PA, Finkenbine RD, DeVane CL. Alopecia and mood stabilizer therapy. Ann Clin Psychiatry. 1996; 8 (3): 183–185. doi: 10.3109/10401239609147756.

 

UDC 616.24-036.12-055.1-07

DOI: 10.20969/VSKM.2020.13(4).55-61

PDF download BONE MINERAL DENSITY AND ARTERIAL STIFFNESS IN MEN WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

SCHEGORTSOVA JULIA YU., SPIN-code: 4505-8075; ORCID-ID: 0000-0001-9211-7174; graduate student of the Department of faculty and outpatient therapy of Amur Medical Academy, Russia, 675000, Blagoveshchensk, Gor’ky str., 95, e-mail: shchegortsova92@mail.ru

PAVLENKO VALENTINA I., SPIN-code: 1172-1390; ORCID-ID: 0000-0001-8794-9929; D. Med. Sci., professor of the Department of faculty and outpatient therapy of Amur Medical Academy, Russia, 675000, Blagoveshchensk, Gor’ky str., 95, e-mail: agmapedfac@mail.ru

Abstract. Aim. The aim of the study was to evaluate arterial stiffness (AS) indices in men with chronic obstructive pulmonary disease (COPD) having low and normal bone mass. Material and methods. We examined 100 male patients [mean age (57±0,6) years] with the veri ed diagnosis of COPD GOLD II­III, who were divided into 2 groups by densitometry examination results: Group 1 (n=34) – normal bone mass, Group 2 (n=66) – low bone mass. Mineral bone density (MBD) was assessed by double X­ray absorption. The lumbar spine at L1­L4 and femoral neck (FN) were scanned. The condition of the MBD was assessed using the T­criterion. AS indices, such as carotid­femoral pulse­wave velocity (cfSPW), right and left cardiovascular vascular index (R/L CAVI), augmentation index on the common carotid artery (C­AI) and right brachial artery (R­AI) were recorded by sphygmomanometry in the main mode using standard technique. Results and discussion. Patients of the 2nd group, in comparison with the 1st group, had higher values of cfSPV (p<0,05), R/L­CAVI (p<0,01), and C­AI (p<0,05). Moreover, signi cant differences in cfSPV and R­CAVI indices were registered only in patients with osteopenia, and C­AI and R­AI values were signi cantly higher both in the group of people with osteopenia and with osteoporosis, with predominance in the latter. In the 2nd group the incidence of individuals with cfSRPV values over 10 m/s (p<0,05) and R­CAVI values over 9 units was signi cantly higher (p<0,05), as well as the biological age of vessels (p<0,05). A moderate inverse relationship between the smallest T­criterion L1­L4 and femoral neck with cfPWV (p <0,05) and R­CAVI (p <0,05) was established. The attributive risk of increasing cfPWV > 10 m/s by 1,7 times and R­CAVI > 9 units was 2,2 times higher in the 2nd group than in the 1st group. The relative risk in the 1st group was 1,674, in the 2nd group it was 2,175. The chances of identifying patients with increased values of cfPWV and R­CAVI were 2,6 and 3,7 times higher in the 2nd group. Conclusion. In male patients with COPD GOLD II­III with low bone mass the stiffness of the vascular wall, endothelial dysfunction and vascular age of the main arteries are signi cantly higher than in patients with normal bone mass. Decrease of the MBD of the lumbar spine (L1­L4) and FN is associated with the increase of cfSPV and R­CAVI. Relative frequencies of increased cfSRPV and R­CAVI values above threshold values prevailed in men with low bone mass.

Key words: chronic obstructive pulmonary disease, bone mineral density, arterial stiffness.

For reference: Schegortsova JuYu, Pavlenko VI. Bone mineral density and arterial stiffness in men with chronic obstructive pulmonary disease. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (4): 55­61. DOI: 10.20969/ VSKM.2020.13(4). 55­61.

References

  1. Chuchalin AG, Khaltaev N, Antonov NS, et al. Chronic respiratory diseases and risk factors in 12 regions of the Russian Federation. Int J Chron Obstruct Pulmon Dis. 2014; 9: 963–974.

  2. Zhukovets IV, Zabolotskikh TV, Leshchenko TV, et al. Demograficheskiy potentsial Amurskoy oblasti [The demographic potential of the Amur region]. Byulleten’ ziologii i patologii dykhaniya [Bulletin of physiology and respiratory pathology]. 2019; 74: 78­85.

  3. Kulik EG, Pavlenko VI, Naryshkina SV. Assotsiatsiya arterial’noy rigidnosti s markerami disfunktsii sosudistogo endoteliya i sistemnogo vospaleniya pri khronicheskoy obstruktivnoy bolezni legkikh [Association of arterial stiffness with markers of vascular endothelial dysfunction and systemic in ammation in chronic obstructive pulmonary disease]. Byulleten’ ziologii i patologii dykhaniya [Bulletin of physiology and respiratory pathology]. 2018; 67: 31­36.

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  6. Shchegortsova YY, Pavlenko VI, Naryshkina SV. Sostoyaniye kostnoy sistemy u muzhchin s khronicheskoy obstruktivnoy bolezn’yu legkikh v zavisimosti ot kategorii riska obostreniy [The condition of the skeletal system in men with chronic obstructive pulmonary disease, depending on the risk category of exacerbations]. Ural’skiy meditsinskiy zhurnal [Ural Medical Journal]. 2020; 4: 160­164.

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  14.  Shirai K. Analysis of vascular function using the cardio­ ankle vascular index (CAVI). Hypertens Res. 2011; 34: 684–685.

  15. Tian G, Wei W, Zhang W, et al. Increasing age associated with elevated cardio­anklevascular index scores in patients with type 2 diabetes mellitus. J Int Med Res. 2013; 41: 435–444.

  16. Pavlenko VI, Naryshkina SV. Dopolnitel’nyye neinvazivnyye kriterii ranney diagnostiki arterioskleroza u bol’nykh khronicheskoy obstruktivnoy bolezn’yu legkikh [Additional non­invasive criteria for the early diagnosis of arteriosclerosis in patients with chronic obstructive pulmonary disease]. Byulleten’ fiziologii i patologii dykhaniya [Bulletin of Physiology and Respiratory Pathology]. 2010; 37: 33­36.

 

UDC 616-036.88-02:550.34(479.24)

DOI: 10.20969/VSKM.2020.13(4).62-69

PDF download DEPENDENCE OF CARDIOVASCULAR MORTALITY RATE ON HELIOSEISMIC INDICATORS IN LENKORANSKY DISTRICT OF AZERBAIJAN REPUBLIC

EFENDIYEVA LEYLA G., C. Med. Sci., associate professor of the Department of internal medicine of Azerbaijan Medical University, Azerbaijan, AZ 1007, Baku, Gasymzade str., 14. e-mail: mic_amu@mail.ru

Abstract. Aim. Study of the dependence of cardiovascular mortality on helioseismic indicators in Lenkoransky district of the Azerbaijan Republic was the aim of our research. Material and methods. In 2013, seismological information was obtained from 35 telemetric stations, which included an overview of the seismic regime of the Republic, the distribution of seismic waves, the dynamics of seismic processes, the intensity of the earthquake, the magnitude and other indicators. Based on the spatial distribution of focal zones identi ed by the weak seismicity and the magnitude values of the maximum possible earthquakes in them, a map of seismic hazard in Azerbaijan was drawn up. To analyze the connection with diseases in Lenkoransky district 822 case histories of patients who died in 2013 from various diseases were considered. Results and discussion. Among those who died from cardiovascular diseases, the main group was those with acute cerebral circulation disorder – 48,8%, of whom 55,8% were women and 41,9% men. Patients with acute coronary syndrome held second place in the number of deaths – 31,5%, of whom 38,6% were men and 24,3% women. The maximum number of deaths due to heart failure coincided with a magnitude of 1,42, acute coronary syndrome – with a magnitude of 1,41, acute cerebral circulation disorder – with a magnitude of 1,29. An age­related analysis revealed that the number of deaths due to vascular disasters has been increasing from the age of 30. Signi cantly (p=0,024) more deaths occurred at the deep focus (22,600 km), with the prevalence of patients with cerebral stroke. Conclusion. Thus, there is a close relationship between geomagnetic changes and mortality from cardiovascular diseases, which is realized in the form of increased incidence and mortality, with the number of such cases increasing as the age of patients grows.

Key words: helioseismic indicators, cardiovascular diseases, mortality, earthquake magnitude.

For reference: Efendiyeva LG. Dependence of cardiovascular mortality rate on helioseismic indicators in Lenkoransky district of Azerbaijan Republic. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (4): 62­69. DOI: 10.20969/ VSKM.2020.13(4).62­69.

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2. Grigor’ev YuG. Chelovek v elektromagnitnom pole [A man in an electromagnetic eld]. Radiatsionnaya biologiya, Radioekologiya [Radiation Biology, Radioecology]. 1997; 37 (4): 690­702.

3. Kuleshova VP, Sergeenko NP. Geliogeo zicheskie aspekty prognozirovaniya biotropnyh effektov [Heliogeophysical aspects of predicting biotropic effects]. Moskva: IZMIR AN [Moscow: IZMIR AN]. 1993; Preprint No 72 (1019): 18 p.

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10. Kushakovskij MS. Gipertonicheskaya bolezn’: (Es­ sentsianaya gipertenziya): Prichiny, mekhanizmy, klinika, lecheniye [Essential hypertension: (Essential Hypertension): Causes, mechanisms, clinic, treatment]. SPb: AO «Sotis» [SPb: JSC «Sotis»]. 1995; 4: 310 p.

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12. Alekseev VP, Ivanov KI, et al. Epidemiologiya IBS i osobennosti ateroskleroza u muzhchin Yakutska [Epidemiology of IHD and features of atherosclerosis in men of Yakutsk]. Terapevticheskiy arkhiv [Therapeutic archive]. 2001; 1: 12­17.

13. Oraevskij VN, et al. Mezhdunarodnaya programma po issledovaniyu Solnca [International Sun Research Program]. Novosti kosmonavtiki [Cosmonautics News].1998; 11 (178): 37-38.

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15. Rozhdestvenskaya ED. Sushchestvuet li zavisimost’ haraktera techeniya serdechno­sosudistyh zabolevanij ot kolebanij solnechnoj aktivnosti i geomagnitnyh vozdejstvij? [Is there a dependence of the nature of the course of cardiovascular diseases on uctuations in solar activity and geomagnetic effects?]. Ural’skij kardiologicheskij zhurnal [Ural Journal of Cardiology]. 2001; 1: 3­11.

16. Mammedli TYa. Vyyavlenie ochagovyh zon sil’nyh zem­ letryasenij Azerbajdzhana i opredelenie ih maksimal’nyh magnitud (Mmah) po slaboj sejsmichnosti [Identi cation 

of focal zones of strong earthquakes in Azerbaijan and determination of their maximum magnitudes (Mmah) by weak seismicity]. Izvestiya Nacional’noj Akademii Nauk Azerbajdzhana; Nauki o Zemle [News of the National Academy of Sciences of Azerbaijan; Earth sciences]. 2005; 4: 60­64.

17. Gurfinkel’ YuI, At’kov OYu, Sasonko ML, Sarimov RM. Novyj podhod k integral’noj ocenke sostoyaniya serdechno­sosudistoj sistemy u pacientov s arterial’noj gipertenziej [A new approach to the integral assessment

of the state of the cardiovascular system in patients with arterial hypertension]. Rossijskij kardiologicheskij zhurnal [Russian journal of cardiology]. 2014; 1 (105): 101­106.

18. Connie X Wang, Isaac A Hilburn, Daw­An Wu, Yuki Mizuhara, Christopher P Cousté, Jacob NH Abrahams, Sam E Bernstein, Ayumu Matani, Shinsuke Shimojo, Joseph L Kirschvink. Transduction of the Geomagnetic Field as Evidenced from Alpha­band Activity in the Human Brain. eNeuro. 2019; 6: 23 p. DOI: 10.1523/ ENEURO.0483­18.2019.

 

REVIEWS

UDC 61:378.046.4(47+57)(091)

DOI: 10.20969/VSKM.2020.13(4).70-75

PDF download ORGANIZATION OF ADVANCED PHYSICIAN TRAINING IN PRE-REVOLUTIONARY RUSSIA

EGORYSHEVA IRINA V., ORCID ID: 0000-0001-5936-8254; C. Hist. Sci., leading researcher of the Department of history of medicine and public health of N.A. Semashko National Scientific Research Institute of Public Health, Russia, 105064, Moscow, Vorontsovo Pole str., 12, bld. 1, e-mail: egorysheva@rambler.ru

MOROZOV ALEXEY V., ORCID ID: 0000-0001-7724-2735; SCOPUS Author ID: 8455076900; С. Med. Sci., associate professor of history of medicine course of Medical Institute of Peoples Friendship University of Russia (RUDN University), Russia, 117198, Moscow, Miklukho-Maklay str., 6, e-mail: А0067138@yandex.ru

Abstract. Aim. The aim of the study was to study the establishment of a system of development of medical personnel in pre­revolutionary Russia, the creation of the country’s rst specialized institution for advanced training of doctors – Elensky Clinical Institute in St. Petersburg, and the participation of the medical community in the organization of advanced training of medical personnel. Material and methods. The study applied general methodological approaches for historical and medical research. Results and discussion. Training of doctors in Russia began much later than in Western Europe. At the beginning of the XVIII century the primary concern of the government was to ensure the combat capability of the army, which was the basis for the organization of the rst hospital schools, which were taught by foreign doctors in German. In the analyzed historical period, the main form of medical training was a foreign internship. Later, in the second half of the XIX century, on the initiative of the medical community and with state support, the improvement of medical personnel at Russian universities and major medical institutions was widely developed. For secondary medical personnel, there was also professional development. In midwives’ schools, which were part of large hospitals, midwives were given higher­grade examinations. The examination programs were approved by the Medical Council of the Ministry of internal Affairs. Conclusion. Since the second half of the XIX century, on the initiative of the medical community and with state support, the development of medical personnel at Russian universities and at major medical institutions has been widely developed. For the rst time in the world, a special institution was created to improve the skills of doctors. It was Elensky clinical Institute.

Key words: hospital schools, Imperial medical and surgical Academy, doctor development, Clinical Institute for advanced physician training.

For reference: Yegorysheva IV, Morozov AV. Organization of advanced physician training in pre­revolutionary Russia. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (4): 70­75. DOI: 10.20969/VSKM.2020.13(4).70­75.

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  9. Egorysheva IV. Nikolaj Illarionovich Kozlov – uchenyj, vrach, vydayushchijsya organizator voennoj mediciny (K 200­letiyu so dnya rozhdeniya) [Nikolay Illarionovich Kozlov­scientist, doctor, outstanding organizer of military medicine (To the 200th anniversary of his birth)]. Voenno­ medicinskij zhurnal [Military medical journal]. 2014; 11: 71­75.

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UDC 616.61-036.12-084:616.379-008.64(048.8)

DOI: 10.20969/VSKM.2020.13(4).76-85

PDF download MODERN METHODS OF SLOWING DOWN THE PROGRESSION OF CHRONIC KIDNEY DISEASE IN TYPE II DIABETES MELLITUS

MURKAMILOV ILKHOM T., ORCID ID: 0000-0001-8513-9279; SPIN code: 4650-1168; Author ID: 752416; C. Med. Sci., nephrologist, аssociate рrofessor of the Department of internal medicine of Kyrgyz State Medical Academy named after I.K. Akhunbaev, Kyrgyzstan, 720020, Bishkek, Akhunbaev str., 92, e-mail: murkamilov.i@mail.ru

SABIROV IBRAGIM S., ORCID ID: 0000-0002-8387-5800; SPIN code: 2222-5544; Author ID: 847740; D. Med. Sci., professor, internist, the Head of the Department of internal medicine No 2 of medical faculty of Kyrgyz-Russian Slavic University, Kyrgyzstan, 720022, Bishkek, Kievskaya str., 44, e-mail: sabirov_is@mail.ru

FOMIN VIKTOR V., ORCID ID: 0000-0002-2682-4417; SPIN code: 8465-2747; Author ID: 230786; D. Med. Sci., professor, corresponding member of RAS, the Head of the Department of internal medicine No 1 of First Moscow State Medical University named after I.M. Sechenov (Sechenov University), Russia, 119991, Moscow, Bolshaya Pirogovskaya str., 2, e-mail: fomin_vic@mail.ru

MURKAMILOVA ZHAMILA A., ORCID ID: 0000-0002-7653-0433; SPIN code: 3574-1870; Author ID: 1037080; internist, correspondent post-graduate student of the Department of internal medicine No 2 of medical faculty of Kyrgyz-Russian Slavic University, Kyrgyzstan, 720022, Bishkek, Kievskaya str., 44, e-mail: murkamilovazh.t@mail.ru

YUSUPOV FURKAT A., ORCID ID: 0000-0003-0632-6653; SPIN code: 7415-1629; Author ID: 1047873; D. Med. Sci., professor, the Head of the Department of neurology, neurosurgery and psychiatry of faculty of medicine of Osh State University, Kyrgyzstan, 714000, Osh, Lenin str., 331, e-mail: furcat_y@mail.ru

RAYIMZHANOV ZAFARBEK R., ORCID ID: 0000-0001-5746-6731; SPIN code: 6061-6463; Author ID: 956672; correspondent postgraduate student of the Department of public health and healthcare of Kyrgyz State Medical Academy named after I.K. Akhunbaev, Kyrgyzstan, 720020, Bishkek, Akhunbaev str., 92, e-mail: rzrmam@mail.ru

Abstract. Aim. The aim is to highlight the issues of kidney protection in type II diabetes mellitus and to clarify the mechanisms of mutually bene cial effect and progression of carbohydrate metabolism disorders and chronic kidney disease. Material and methods. The review and analysis of modern publications devoted to the speci c features of chronic kidney disease development in patients with type II diabetes mellitus and the possibilities of kidney protection during the treatment of carbohydrate metabolism disorders have been conducted. Results and discussion. The main cause of chronic kidney disease in patients with type II diabetes mellitus is chronic hyperglycemia, lipid metabolism disorder, and endothelial dysfunction. Type II diabetes mellitus is a chronic systemic disease that increases the risk of arterial hypertension, kidney dysfunction and its complications. It is manifested by higher incidence of terminal stage of chronic kidney disease, cardiovascular and cerebrovascular diseases. Many studies have shown that blockers of rennin­angiotensin­aldosterone system, statins and slow calcium channel blockers contribute to inhibition of kidney damage in type II diabetes mellitus. New drugs such as type 2 sodium­glucose cotransporter inhibitors (and SGLT2) and type 4 highly selective dipeptidyldipethidase inhibitors have now appeared in the clinician’s arsenal and are widely used to treat type II diabetes. Along with glucose reduction, they have cardio­, nephro­ and cerebroprotective properties. In addition, SGLT2 have pleiotropic effects at an early stage of chronic kidney disease. Conclusion. Timely diagnosis and therapy of chronic kidney disease in patients with type II diabetes mellitus is an important challenge, and the use of both SGLT2 and vildaglyptin clearly delays the progression of kidney disease and reduces cardiovascular risks.

Key words: chronic kidney disease, type II diabetes mellitus, slowing the progression of renal failure, SGLT­2, vildagliptin.

For reference: Murkamilov IT, Sabirov IS, Fomin VV, Murkamilova ZhA, Yusupov FА, Rayimzhanov ZR. Modern methods of slowing down the progression of chronic kidney disease in type II diabetes mellitus. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (4): 76­85. DOI: 10.20969/VSKM.2020.13(4).76­85.

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UDC 616.72-002.77-06:616.1(048)

DOI: 10.20969/VSKM.2020.13(4).86-91

PDF download RHEUMATOID ARTHRITIS AND CARDIOVASCULAR DISEASES

SERDYUK IGOR L., rheumatologistof Medical center «Zvezda», Russia, 420012, Kazan, Karl Marx str., 46, e-mail: dr.serdyuc@mail.ru

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 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, 420012, Russia, Kazan, Butlerov str., 49, e-mail: namirov@mail.ru

NAM TATIANA O., student of Kazan Federal University, Russia, 420012, Kazan, Kremlevskaya str., 18, e-mail: tanyamoly@gmail.com

Abstract. Aim. The aim of the study was to analyze medical literature on the speci cs of cardiovascular disease in patients with rheumatoid arthritis. Material and methods. The review and analysis of modern scienti c data on the features of cardiovascular disease development in patients with rheumatoid arthritis were conducted. Results and discussion. Rheumatoid arthritis is a common and one of the most severe immune in ammatory diseases in humans, which determines the enormous medical and socio­economic importance of this disease. Patients with rheumatoid arthritis are 1,4–4 times more likely to develop angina and myocardial infarction. In addition to traditional risk factors, chronic in ammation/ autoimmune disorders and side effects of antirheumatic therapy are the causes of accelerated development of cardiovascular diseases in rheumatoid arthritis patients. One of the best known and most frequently used tools for the prognosis of individual risk of cardiovascular complications is the SCORE coronary risk scale. It has been proposed to multiply the cardiovascular risk calculated on the SCORE scale by 1,5 in all rheumatoid arthritis patients (mSCORE). Conclusion. Timely diagnosis and treatment of coronary heart disease in patients with rheumatoid arthritis is an important challenge in general clinical practice. It is necessary to modify the SCORE scale for comorbid rheumatoid arthritis patients with the inclusion of process activity indicators (ESR, C­reactive protein and interlekin­6, etc.) to better assess the risk of cardiovascular disease.

Key words: rheumatoid arthritis, cardiovascular disease.

For reference: Serdyuk IL, Abdrakhmanova AI, Amirov NB, Nam TO. Rheumatoid arthritis and cardiovascular diseases. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (4): 86­91. DOI: 10.20969/VSKM.2020.13(4).86­91.

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