THE EFFECT OF OBESITY AND LONG-TERM CHONDROPROTECTIVE THERAPY ON THE VALUE OF HYALINE CARTILAGE OF THE KNEE JOINTS IN PATIENTS WITH EARLY GONARTHROSIS WITHOUT X-RAY CHANGES

ARSHIN EVGENY V., D. Med. Sci., professor of the Department of advanced internal medicine and cardiology of Academician E.A. Wagner Perm State Medical University, Russia, 614000, Perm, Petropavlovskaya str., 26, tel. 8-929-234-05-89, e-mail: 1ewa1@mail.ru

RADOSHCHEKIN MIKHAIL A., ORCID ID 0000-0001-7746-4602; candidate of a degree of the Department of advanced internal medicine and cardiology of Academician E.A. Wagner Perm State Medical University, Russia, 614000, Perm, Petropavlovskaya str., 26; internist, cardiologist, rheumatologist of «Vita-D» medical center, Russia, 617763, Perm region, Chaikovsky, Dekabrist str., 23, build. 3, tel. 8-929-234-05-89, e-mail: radoshchekin87@mail.ru

GORSHKOV DANIL A., post-graduate student of the Department of advanced internal medicine and cardiology of Academician E.A. Wagner Perm State Medical University, Russia, 614000, Perm, Petropavlovskaya str., 26, tel. 8-995-09З-55-77, e-mail: danilgorshcov@yandex.ru

KHLYNOVA OLGA V., D. Med. Sci., professor, corresponding member of the Russian Academy of Sciences, high level certificate internist and gastroenterologist, the Head of the Department of advanced internal medicine and cardiology of Academician E.A. Wagner Perm State Medical University, Russia, 614000, Perm, Petropavlovskaya str., 26, tel. 8-902-478-34-82, e-mail: olgakhlynova@mail.ru

ARSHIN ROMAN Е., 4th year student of Academician E.A. Wagner Perm State Medical University, Russia, 614000, Perm, Petropavlovskaya str., 26, tel. 8-929-234-05-89, e-mail: 1ewa1@mail.ru

TUEV ALEXANDER V., D. Med. Sci., professor, Honored scientist of the Russian Federation, Academician of the Russian Academy of Sciences, high level certificate physician, Russia, 614000, Perm, Petropavlovskaya str., 26, tel. 8-34-22-239-31-88, e-mail: rector@psma.ru

Abstract. Aim. Study the effect of obesity on the size of hyaline cartilage and the effectiveness of long­term chondroprotective therapy in patients with early gonarthrosis without radiological changes. Material and methods.We examined 819 patients with early gonarthrosis. Patients were without radiological signs of gonarthrosis, having clinical and ultrasonographic manifestations of the disease. Two groups comparable by gender and age were singled out: the rst group – patients with body mass index <30, and the second – ≥30. Each group included two subgroups: rst one – patients receiving combined chondroprotective therapy during 2 years, and second one – were receiving only symptomatic drugs from the group of non­steroidal anti­in ammatory drugs occasionally. Initially, and two years later, everyone was examined by ultrasound of knee joints. The dynamics of the minimum thickness of hyaline cartilage was analyzed. Results and discussion. In patients with obesity, hyaline cartilage of knee joints signi cantly decreased by (0,23±0,14) mm over 2 years, while in patients with body mass index <30, hyaline cartilage decreased only by 0,10±0,10 (p<0,05). Patients with obesity, who regularly received chondroprotectors, had better parameters after two years of therapy than patients on symptomatic therapy (0,17±0,12) mm and (0,28±0,13) mm; p<0,05. A distinct cartilage­ saving effect on chondroprotective therapy was also determined in patients without obesity. Against the background of chondroprotective therapy in two years the cartilage size decreased by (0,06±0,08) mm, while in the group without chondroprotectors the cartilage loss was (0,16±0,10) mm. Regardless of the body mass index, the reception of CP slowed down the decrease in the height of articular cartilage by an average of 5,26% of the original value. In obese patients, despite the positive effect of chondroprotectors on joint cartilage structure, indicators such as pain on the visual analogue scale, Leken and WOMAC index changed slightly in contrast to patients with body mass index <30. In obese patients receiving chondroprotectors, VAS index decreased by (3,42±10,61) mm, Leken index by 0,61±1,0; WOMAC index by 27,56±93,80. At the same time, in obese patients, receiving chondroprotectors, the indices were 3–4 times better (VAS decreased by 13,64±8,06; p<0,05; Leken index by 1,95±3,43; p<0,05; WOMAC by 119,40±103,63; p<0,05).Conclusion. Obesity is an important factor in the progression of gonarthrosis. The application of chondroprotective drugs at the early preradiological stage of gonarthrosis allows slowing down the decrease in the height of hyaline cartilage of knee joints and reduces the clinical manifestations of gonarthrosis both in patients with normal body weight and, to a lesser extent, obesity. To obtain a structural cartilage saving effect, chondroprotective drugs should be administered at an early preradiological stage.

Key words: оsteoarthritis, gonarthritis, obesity, overweight, chondroprotectors, chondroitin sulfate, glucosamine hydrochloride.

For reference: Arshin EV, Radoschekin MA, Gorshkov DA, Khlynova OV, Arshin RE, Tuyev AV. The effect of obesity and long­term chondroprotective therapy on the size of the hyaline cartilage of the knee joints in patients with early gonarthrosis without X­ray changes. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (5): 7­14. DOI: 10.20969/ VSKM.2020.13(5).7­14.

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 INJURIES IN DRIVERS CAUSED BY AN IN-VEHICLE CAR TRAUMA

INDIAMINOV SAYIT I., ORCID ID: 0000-0001-9361-085X; C. Med. Sci., professor, the Head of the Department of forensic medicine of Samarkand State Medical Institute, Uzbekistan, 140100, Samarkand, A. Motrudiy str., 26, e-mail: antonina_amurovna@mail.ru

ISMAILOV RAVSHONBEK A., ORCID ID: 0000-0002-8224-3545; lecturer of the Department of forensic medicine of Samarkand State Medical Institute, Uzbekistan, 140100, Samarkand, A. Motrudiy str., 26

BAKHTIYOROV BAKHODIR B., ORCID ID: 0000-0002-7851-4728; forensic physician of Republican Scientific and Practical Center for Forensic Expert Service, Uzbekistan, Tashkent

Abstract. Aim. The aim of the study was to investigate the nature and the features of an injury development in drivers in case of an in­vehicle car trauma. Material and methods. Forensic medical examination of 61 corpses of 55 «Daewoo­ Uz» car drivers and of 6 domestic brand car drivers, who died as a result of in­vehicle car trauma, was conducted. Among the dead drivers 60 were men and there was 1 woman. The age of the victims was from 21 to 59 years. Circumstances of the intra­cabin injury were as follows: frontal collisions with other moving vehicles – 35, road­side collisions with subsequent overturning of cars – 19, and collisions of moving cars with xed obstacles (trees, poles, fences) – 7 cases.Results and discussion. Head, chest and chest organs, as well as abdominal organs were the ones most commonly damaged in drivers. Skull injuries in drivers were often accompanied by the fractures of the bones of the vault and base of the skull, as well as the fractures of the skull facial bones: nasal, cheekbone and jaw. Damage to the chest and chest organs were characterized by fractures of the ribs, sternum, and collarbone, ruptures of the walls of the heart left ventricle and lung parenchyma. Rib fractures in drivers were more often double­sided, with predominantly upper rib fractures – from 2 to 8 ribs, mainly along the parasternal, midclavicular and axillary lines. Parenchyma ruptures of a large proportion of the liver (mainly along the diaphragmatic surface), as well as the ruptures of the spleen and intestines, were often observed among the abdominal organ trauma. Damages to bones of upper and lower extremities in drivers were observed to a much lower degree. Spinal and spinal cord injury were also less common, as well as the damage to pelvic organ structures. Conclusion. The complex of injuries in passenger car drivers in case of an in­vehicle car trauma is distinguished by the severity of the injury and is characterized by development of the most common combined injuries of two or more body parts.

Key words: in­vehicle car trauma, driver, injuries.

For reference: Indiaminov SI, Ismailov RA, Bakhtiyorov BB. Injuries in drivers caused by an in­vehicle car trauma. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (5): 20­25. DOI: 10.20969/VSKM.2020.13(5).20­25.

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УДК 616.832-004.2 -07:616.747/.748-009.12-073.97

DOI: 10.20969/VSKM.2020.13(5).46-56

 THE FEATURES OF THE FUNCTIONAL STATE OF MUSCLE FIBERS IN PATIENTS WITH MULTIPLE SCLEROSIS WITH SPASTICITY ACCORDING TO THE RESULTS OF ELECTRONEUROMYOGRAPHY

DOMRES NATALIYA V., neurologist of the Department of demyelinating diseases of the nervous system of Kiev City Clinical Hospital No 4; doctoral student of the Department of neurology of A.A. Bogomolets National Medical University, Ukraine, 03110, Kiev, Solomenskaya str., 17, tel. +38-093-745-66-39, e-mail: nata003@ukr.net

Abstract. Aim. The aim of the study was to assess the functional state of muscle bers in spasticity in patients with multiple sclerosis (MS) according to the results of electroneuromyography. Material and methods. The study of elec­ troneuromyography indices was performed on 51 MS patients with spasticity (26 women and 25 men aged 24 to 71, mean age 43,8±1,6). The study was conducted via application of a stimulation non­invasive technique using a Nihon Kohden apparatus (motor bers of n. medianus, n. tibialis, and sensory bers of n. medianus, F­wave n. medianus,n. tibialis, and H­re ex). Spasticity of the upper and lower extremities was assessed using the Modi ed Ashworth Scale.Results and discussion. Signi cant decrease in the amplitude of the M­response was revealed when examining both the upper and lower extremities in MS patients with minimal clinical signs of spasticity. Indicators of late electro­ physiological phenomena (F­amplitude mean) changed only in the lower extremities, where the level of spasticity was higher. Threshold levels of the M­amplitude were identi ed in order to assess the risk of a high total score of spasticity >12. Conclusion. The results of the study revealed the main electrophysiological indicators of early manifestations of spasticity in MS patients. The main electrophysiological indicator of the early manifestations of spasticity in patients with multiple sclerosis is a decrease in the amplitude of M­response. The mean F­amplitude decreases according to the increase in spasticity in the lower extremities in patients with multiple sclerosis having different levels of spasticity.

Key words: spasticity, multiple sclerosis, М­amplitude, electrophysiologic phenomena.

For reference: Domres NV. The features of the functional state of muscle bers in patients with multiple sclerosis with spasticity according to the results of electroneuromyography. The Bulletin of Contemporary Clinical Medicine. 2020; 13 (5): 46­56. DOI: 10.20969/VSKM.2020.13(5).46­56.

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УДК 616.98:578.834.1

DOI: 10.20969/VSKM.2020.13(5).62-75

 COMMUNICATION ON THE PREVENTION AND TREATMENT OF COVID-19 EPIDEMIC BETWEEN ANHUI PROVINCE OF CHINA AND FEDERAL DISTRICTS ALONG THE VOLGA RIVER IN RUSSIA

CUI WANG, the First Affiliated Hospital of Anhui Medical University, Shushan Qu, Hefei Shi, Anhui Sheng, China

MIN SHAO, the First Affiliated Hospital of Anhui Medical University, Shushan Qu, Hefei Shi, Anhui Sheng, China

NIAN LIU, the First Affiliated Hospital of Anhui Medical University, Shushan Qu, Hefei Shi, Anhui Sheng, China

YUFENG GAO, the First Affiliated Hospital of Anhui Medical University, Shushan Qu, Hefei Shi, Anhui Sheng, China

CHANGHUI WANG, the First Affiliated Hospital of Anhui Medical University, Shushan Qu, Hefei Shi, Anhui Sheng, China

YUANYUAN YANG, the First Affiliated Hospital of Anhui Medical University, Shushan Qu, Hefei Shi, Anhui Sheng, China

MAOHONG BIAN, the First Affiliated Hospital of Anhui Medical University, Shushan Qu, Hefei Shi, Anhui Sheng, China

XINGWANG WU, the First Affiliated Hospital of Anhui Medical University, Shushan Qu, Hefei Shi, Anhui Sheng, China

PING DING, the First Affiliated Hospital of Anhui Medical University, Shushan Qu, Hefei Shi, Anhui Sheng, China

XIAOHU WANG, the First Affiliated Hospital of Anhui Medical University, Shushan Qu, Hefei Shi, Anhui Sheng, China

RUI LI, the First Affiliated Hospital of Anhui Medical University, Shushan Qu, Hefei Shi, Anhui Sheng, China

GUANGHE FEI, the First Affiliated Hospital of Anhui Medical University, Shushan Qu, Hefei Shi, Anhui Sheng, China, e-mail: verarus@foxmail.com

CHAOZHAO LIANG, the First Affiliated Hospital of Anhui Medical University, Shushan Qu, Hefei Shi, Anhui Sheng, China, e-mail: verarus@foxmail.com

Abstract. The ongoing coronavirus infection (COVID­19) pandemic is associated with high rates of morbidity and mortality. Russia, as a transport hub between Europe and Asia, has been hit hard by COVID­19. The aim of this publication is topresent the materials of a teleconference held between experts from Anhui province in China and experts from the federal districts of Russia. Material and methods. Discussion of methods of prevention and treatment of the new coronavirus infection COVID­19, as well as issues affecting the immune aspects of the disease, complications and possible long­term follow­up for patients after a new coronavirus infection. Results and discussion. The situation was especially dif cult for the federal district along the Volga River, so we shared and discussed questions on the prevention and treatment of the COVID­19 epidemic, which were asked by the experts of the region. Conclusion. The presented article is theresult of an online meeting of the doctors from the Volga region of Russia with experts from Anhui province in China.

Key words: new coronavirus infection, COVID­19.

For reference: Cui Wang, Min Shao, Nian Liu, Yufeng Gao, Changhui Wang, Yuanyuan Yang, Maohong Bian, Xingwang Wu, Ping Ding, Xiaohu Wang, Rui Li, Guanghe Fei, Chaozhao Liang. Communication on the prevention and treatment of COVID­19 epidemic between Anhui province of China and Federal districts along the Volga river in Russia. The Bulletinof Contemporary Clinical Medicine. 2020; 13 (5): 62­75. DOI: 10.20969/VSKM.2020.13(5).62­75.

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 ACUTE CEREBRAL INSUFFICIENCY DURING PERCUTANEOUS CORONARY SURGERY IN A PATIENT WITH ACUTE CORONARY SYNDROME (clinical case)

SHARAFUTDINOV BULAT M., ORCID ID: 0000-0002-4149-118; C. Med. Sci., the Head of the Department of X-ray surgical methods of diagnostics and treatment of Medical Unit of Kazan Federal University, Russia, 420012, Kazan, Chekhov str., 1, e-mail: bulaty555@mail.ru

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