ORIGINAL RESEARCH

УДК 616.24-002.5:616.24-036.12(571.13)

DOI: 10.20969/VSKM.2021.14(1).7-15

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УДК 616.831-005.1-036.11-085.814.1(470.67)

DOI: 10.20969/VSKM.2021.14(1).16-19

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УДК 616-053.32(470.57-25)

DOI: 10.20969/VSKM.2021.14(1).20-26

 HEALTH INDICATORS IN CHILDREN BORN THROUGH THE USE OF REPRODUCTIVE TECHNOLOGIES

DRUZHININA NATALIA A., ORCID ID: 0000-0002-1890-2470; D. Med. Sci., professor of the Department of pediatrics with the course of the Institute of higher professional education of Bashkir State Medical University, Russia, 450591, Ufa region, settl. Chesnokovka, Lesnaya str., 47, e-mail: druzh51@mail.ru

MERZLYAKOVA DINARA R., ORCID ID: 0000-0001-9037-7124; postgraduate student of the Department of pediatrics with the course of the Institute of higher professional education of Bashkir State Medical University, Russia, 450054, Ufa, Komsomolskaya str., 149/2-39, e-mail: Dinara-merzlykova@mail.ru

SHIRYAEVA GALINA P., ORCID ID: 0000-0002-8137-4463; D. Med. Sci., professor of the Department of pediatrics with the course of the Institute of higher professional education of Bashkir State Medical University, Russia, 450077, Ufa, Chernyshevsky str., 104-236, e-mail: GPShiryaeva@yandex.ru

VAKHITOVA GULNAZ A., ORCID ID: 0000-0001-9452-0901; C. Med. Sci., assistant of professor of the Department of pediatrics with the course of the Institute of higher professional education of Bashkir State Medical University, Russia, 450001, Ufa, Komsomolskaya str., 15-476, e-mail: vgafn@bk.ru

KHAFIZOVA NAILA R., ORCID ID: 0000-0002-1452-9998; C. Med. Sci., associate professor of the Department of pediatrics with the course of the Institute of higher professional education of Bashkir State Medical University, Russia, 450130, Ufa, Muksinov str., 1-132, e-mail: nailjak@yandex.ru

IMAEVA LILIYA R., ORCID ID: 0000-0002-6735-4896; C. Med. Sci., associate professor of the Department of pediatrics with the course of the Institute of higher professional education of Bashkir State Medical University, Russia, 450001, Ufa, Gagarin str., 68, bloc 2, e-mail: liliya@mail.ru

Abstract. Aim. The aim of the study was to examine the dynamics of health indicators in children who were born prematurely by in vitro fertilization technique during the rst 3 years of their life by means of a comprehensive clinical study. Material and methods. The study was carried out at the department of pathology of newborns and premature infants and the catamnesis of ce of the Children’s Republican Clinical Hospital of Ufa. The observation group consisted of 189 children who were born prematurely with a body weight of less than 1500 g. The following methods were used to achieve the goal of the study: continuous documentary, longitudinal, and prospective. Children conceived through in vitro fertilization (n=101) constituted the main observation group, while the control group consisted of those born naturally (n=88). The children were monitored from three months to three years of age on the basis of informed parental consent. In the course of a comprehensive clinical study we performed: assessment of the degree of physical development by the centile method, clinical examination, follow-up by a neurologist and neurosurgeon, instrumental and laboratory diagnostic methods, and analysis of primary medical records. Statistica 6 software was chosen to process the obtained data, correlation analysis was performed and Student’s coef cient was calculated. The differences were considered statistically signi cant at p<0,05. Results and discussion. The mothers of children conceived by in vitro fertilization, relative to the second group of mothers, at the time of childbirth predominantly belonged to the age group over 31 years old and were workers with higher education. Most mothers of children in the main group had a history of gynecological disorders. An analysis of neurological morbidity during the 3 years of life showed that children born prematurely, with very low and extremely low body weight had deviations from the normal range in 100% of cases; deviations of various kinds prevailed in those conceived by in vitro fertilization. The study of physical and psychomotor development revealed no differences between the observation groups. By the age of 3 years, premature infants in the main group predominantly had health group III (31,7%), children in the control group had health group II (37,5%). Group I healthy children predominated among those born naturally (14,7% vs. 11,8%). Conclusion. The health of premature infants born through in vitro fertilization depends on the severity of perinatal problems, prematurity, and a mother’s history of complications. This group of children had frequent respiratory diseases, allergic dermatitis and anemia. Healthy children born by in vitro fertilization were 11,8% by age 3.

Key words: reproductive technologies, IVF, extremely low body weight, very low body weight, children’s health.

For reference: Druzhinina NA, Merzlyakova DR, Shiryaeva GP, Vakhitova GA, Kha zova NR, Imaeva LR. Health indicators in children born through the use of reproductive technologies. The Bulletin of Contemporary Clinical Medicine. 2021; 14 (1): 20-26. DOI: 10.20969/VSKM.2021.14(1).20-26.

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УДК 616.24-002:612.015.39(470.43

DOI: 10.20969/VSKM.2021.14(1).27-31

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11. Almirall J, Bolibar I, Vidal J, Sauca G, Coll P, Niklasson B, Bartolome M, Balanzo X. Epidemiology of community– acquired pneumonia in adults: a population–based study. Eur Respir J. 2000; 15: 757–763.

12. Chien JW, Johnson JL. Viral pneumonias; Epidemic respiratory viruses. Postgrad Med. 2000; 107: 41–42, 45–47, 51–52.

 

УДК 616.5-082(470.41)

DOI: 10.20969/VSKM.2021.14(1).32-37

 MEDICAL AND PHARMACEUTICAL SERVICE PROVISION TO DERMATOLOGICAL PATIENTS FROM AMONG SUBSIDIZED BENEFICIARIES

LATYPOVA ALSINA F., postgraduate student of the Institute of pharmacy of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-927-427-69-19, e-mail: alsinaSagira@yandex.ru

YUSUPOVA LUIZA A., the Head of the Department of dermatology, venereology and cosmetology of Kazan State Medical Academy – the branch of Russian Medical Academy of Postgraduate Education, Russia, 420012, Kazan, Mushtari, 11, tel. +7-917-260-32-57, e-mail: luiza.yu157@gmail.com

TUKHBATULLINA RUZALIYA G., D. Pharm. Sci., professor of the Institute of pharmacy of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-917-266-45-66, e-mail: ruzaliyatuhbatullina@mail.ru

Abstract. The article is devoted to the research of medical and pharmaceutical services provided to the patients from among subsidized bene ciaries on the example of the State Autonomous Healthcare Institution «Republican Clinical Dermatological and Venereological Dispensary» (RCDVD), including patients with the diagnosis «common psoriasis» in the Republic of Tatarstan. Ensuring accessibility of pharmaceutical care for the patients at all stages of treatment is the most important task of the state and an important factor for social tension prevention. Aim. To study the range of medical products (MP) issued on preferential prescriptions to dermatological patients including those diagnosed with psoriasis vulgaris at the Federal and regional levels according to patient diagnoses, from the point of compliance with their approved lists, according to the pharmacological groups of the anatomical therapeutic and chemical (ATC) classi cation. Material and methods. statistical (tabular, graphical), retrospective, situational, marketing. Results and discussion. The results of the analysis will be used to determine the need for drugs in public procurement, as well as to plan budget funds. The study of the preferences of doctors in each pharmacy for the assortment will contribute to the timely provision of the patient with the drug. Conclusion. The study has shown that the organization of medical and pharmaceutical care for dermatological patients requires signi cant nancial resources. The provision of medications for the patients from among subsidized bene ciaries is almost entirely covered by federal funds.
Key words: patients from among subsidized bene ciaries, psoriasis, pharmaceutical service, medical supplies, list of medical products.

For reference: Latypova AF, Yusupova LА, Tukhbatullina RG. Medical and pharmaceutical service provision to dermatological patients from among subsidized bene ciaries. The Bulletin of Contemporary Clinical Medicine. 2021; 14 (1): 32-37. DOI: 10.20969/VSKM.2021.14(1).32-37.

References

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3. Postanovleniye Pravitel’stva RF No 1610 «O Programme gosudarstvennykh garantiy besplatnogo okazaniya grazhdanam meditsinskoy pomoshchi na 2020 god i na planovyy period 2021 i 2022 godov» ot 07/12/2019 [Resolution of the Government of the Russian Federation No 1610 «On the Program of state guarantees of free medical care for citizens for 2020 and for the planning period of 2021 and 2022» dated 07/12/2019].

4. Postanovleniye Kabineta Ministrov Respubliki Tatarstan No 4 «Perechen’ kategoriy zabolevaniy, pri ambulatornom lechenii kotorykh lekarstvennyye sredstva i izdeliya meditsinskogo naznacheniya otpuskayutsya po retseptam vrachey bezvozmezdno» ot 17/01/2005 goda [Resolution of the Cabinet of Ministers of the Republic of Tatarstan No 4 «List of categories of diseases for outpatient treatment of which medicines and medical devices are dispensed by doctors’ prescriptions free of charge» from 17/01/2005].

5. Postanovleniye Kabineta Ministrov Respubliki Tatarstan No 1258 ot 30/12/2019 «Ob utverzhdenii Programmy gosudarstvennykh garantiy besplatnogo okazaniya grazhdanam meditsinskoy pomoshchi na territorii Respubliki Tatarstan na 2020 god i na planovyy period 2021 i 2022 godov» [Resolution of the Cabinet of Ministers of the Republic of Tatarstan No 1258 dated 30/12/2019 «On approval of the Program of state guarantees of free medical care to citizens in the territory of the Republic of Tatarstan for 2020 and for the planning period of 2021 and 2022»].

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8. Wrone-Smith T, Jonson T, Nelson B. Discordant expression of Bcl-x und Bcl-2 by keratinocytes in vitro and psoriatic keratinocytes in vivo. Am J Pathol. 1995; 2: 1079-1088.

9. Gelfand JM, Weinstein R, Porter SB, Neiman AJ, Berlin JA, Morgolis DJ. Prevalence and treatment of psoriasis in the United Kinglom:a population – based study. Arch Dermatol. 2005; 3: 41.

10. Starodubov VI, Mishina OS, Dvornikov AS. Printsipy organizatsii meditsinskoy i sotsial’noy pomoshchi naseleniyu na osnove modeli «soprovozhdeniye khronicheskikh bol’nykh na protyazhenii vsey zhizni» (na primere bol’nykh psoriazom) [Principles of organizing medical and social assistance to the population on the basis of the model «support of chronic patients throughout life» (on the example of patients with psoriasis)]. Sotsial’nyye aspekty zdorov’ya naseleniya [Social aspects of population health]. 2015; 43 (3): 32.

11. Perechen’ zhiznenno neobkhodimykh i vazhneyshikh lekarstvennykh preparatov dlya meditsinskogo primeneniya na 2020 god, prilozheniye No 1 k rasporyazheniyu Pravitel’stva Rossiyskoy Federatsii ot 12 oktyabrya 2019 goda No 2406-r [The list of vital and essential medicines for medical use for 2020, Appendix No. 1 to the Order of the Government of the Russian Federation No 2406-r dated October 12, 2019].

12. Minimal’nyy assortiment lekarstvennykh preparatov, neobkhodimykh dlya okazaniya meditsinskoy pomoshchi, prilozheniye No 4 k rasporyazheniyu Pravitel’stva Rossiyskoy Federatsii ot 12 oktyabrya 2019 goda No 2406-r [The minimum range of drugs required for the provision of medical care, Appendix No 4 to the Order of the Government of the Russian Federation No 2406-r dated October 12, 2019].

13. Federal’nyye klinicheskiye rekomendatsii: Dermatovenerologiya 2015 [Federal clinical guidelines: Dermatovenereology 2015]. Psorias [Psoriasis]. 2015; 415. http://app.pharmprosvet.ru/wp-content/uploads/ bolezni_kozhi.pdf

14. Primernyy perechen’ osnovnykh lekarstvennykh sredstv, 21-y perechen’ [ Indicative List of Essential Medicines, List 21]. Kopengagen: Yevropeyskoye regional’noye byuro VOZ [Copenhagen: WHO Regional Of ce for Europe]. 2019.

 

УДК 616.61-006-072.1(470.41)

DOI: 10.20969/VSKM.2021.14(1).38-40

References

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6. Perlin DV, Aleksandrov IV, Zipunnikov VP, Kargin KA. Laparoskopicheskay resekzia pochki s primeneniem lokalinoy ishemii [Laparoscopic partial nephrectomy using local ischemia]. Urologia [Urology]. 2013; 4: 69 73.

7. Perlin DV, Dumkov IN, Zippunnikov VP, Shmanev AO, Biziev ShU. Laparoskopicheskaya radikalnay nefrektomia: sravnenie transperitonealnogo i retroperitonealnogo dostupov [Laparoscopic Radical Nephrectomy: Comparison of Transperial and Retroopineal Access]. Endoskopicheskay hirurgia [Endoskopic surgery]. 2019; 25 (4): 12-17.

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9. Safronova EA, Krashenninikov AA, Sergienko SA, Nushko KM, et al. Metody gemostaza pri reseczii pochki [Methods of hemostasis in kidney resection]. Onkologia, zurnal imeni GA Gerzena [Oncology, magazine named after GA Gerzen]. 2016; 5: 55-60.

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11. Gusev AA, Evseev SV, Kogan MI. Ozenka pochechnuh funkzii operativnoe lechenie pochechno-kletochnogo raka [Renal function evaluation and rapid treatment of renal-cell cancer]. Oncourologia [Oncourology]. 2013; 1: 17-23.

12. Krebs RK, Andreoni C, Ortiz V. Impact of radical and partial nephrectomy on renal function in patients with renal cancer. Urol Int. 2014; 92 (4): 449-454.

13. Liatsikos E, Kallidonis P, Do M, et al. Laparoscopic radical and partial nephrectomy: technical issues and outcome. World J Urol. 2013; 31 (4): 785-791.

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15. Mir MC, Campbell RA, Sharma N, et al. Parenchymal volume preservation and ischemia during partial nephrectomy: Functional and volumetric analysis. Urology. 2013; 82: 263-268.

16. Pignot G, Mejean A, Bernhard JC, et al. The use of partial nephrectomy: resuts from a contemporary national prospective multicenter study. World J Urol. 2015; 33 (1): 33-40.

17. Scosyrev E, Messing EM, Sylvester R, et al. Renal function after nephron-sparing surgery versus radical nephrectomy: Results from EORTC randomized trial 30904. Eur Urol. 2014; 65: 372-377.

 

УДК 616-036.12-02:616-056.257(470.41-25)

DOI: 10.20969/VSKM.2021.14(1).41-46

 RISK FACTOR PROFILE OF CHRONIC NON-COMMUNICABLE DISEASES IN DIFFERENT OBESITY PHENOTYPES

NURIEVA ALBINA R., ORCID ID: 0000-0001-7518-0964; postgraduate student of the Department of outpatient medicine and general medical practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-987-239-17-54, e-mail: albina-rashidovna@mail.ru

SINEGLAZOVA ALBINA V., ORCID ID: 0000-0002-7951-0040; D. Med. Sci., associate professor, the Head of the Department of outpatient medicine and general medical practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-952-041-10-01, e-mail: sineglazovaav@mail.ru

KIM TAISIYA YU., ORCID ID: 0000-0003-2370-2972; С. Med. Sci., assistant of professor of the Department of outpatient medicine and general medical practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-917-241-71-69, e-mail: tais_ariana@mail.ru

PARVE SWAPNIL, ORCID ID: 0000-0002-8069-4350; assistant of professor of the Department of outpatient medicine and general medical practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-987-414-92-28, e-mail: drswapnilparve@gmail.com

Abstract. Aim. To study the features of modi able biological and behavioral risk factors of chronic noncommunicable diseases in individuals with different metabolic phenotypes. Material and methods. The observation group consisted of 97 patients who underwent the rst stage of physical examination (age, Me 57,0 [42,0–66,0] years with a predominance of women – 80,4%). The examined patients were divided into 4 groups with metabolically healthy and unhealthy phenotypes depending on body mass index and presence of abdominal obesity. Biological and behavioral risk factors for chronic noncommunicable diseases were assessed in all patients based on the data obtained during the physical examination. Statistical processing was performed using IBM SPSS Statistics 20. Results and discussion. Unhealthy diet (78,4%), hypercholesterolemia (71,1%), abdominal obesity (64,9%) were the most frequent risk factors in the whole group of patients. Against the background of no signi cant differences in the frequency of behavioral risk factors of CNCD in the patients of the compared groups, signi cant differences in the features of biological risk factors were revealed. Individu- als with the metabolically unhealthy phenotype had arterial hypertension, hypercholesterolemia, fasting hyperglycemia, and diabetes mellitus more frequently. Those patients showed higher values of blood pressure, total cholesterol, and fasting glycemia. Conclusion. More than half of the total cohort had abdominal obesity, hypercholesterolemia, and an unhealthy diet. The presence of abdominal obesity was associated with a higher frequency and severity of biological risk factors for chronic noncommunicable diseases such as arterial hypertension, hypercholesterolemia, and hyperglycemia.

Key words: obesity, abdominal obesity, risk factors for chronic non-communicable diseases, metabolic phenotypes.

For reference: Nurieva AR, Sineglazova AV, Kim TYu, Parve S. The pro le of risk factors for chronic non-communicable diseases among distinct phenotypes of obesity. The Bulletin of Contemporary Clinical Medicine. 2021; 14 (1): 41-46. DOI: 10.20969/VSKM.2021.14(1).41-46.

References

1. Balanova YuA, Shalnova SA, Deev AD, et al. Ozhirenie v rossijskoj populyacii – rasprostranennost’ i associacii s faktorami riska hronicheskih neinfekcionnyh zabolevanij [Obesity in russian population – prevalence and association with the non-communicable diseases risk factors]. Rossijskij kardiologicheskij zhurnal [Russian Journal of Cardiology]. 2018; 6: 123-130.

2. World Health Organization. Obesity and overweight. [Internet]. 2020 Apr. Available from: https://www.who.int/ news-room/fact-sheets/detail/obesity-and-overweight.

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4. Rossijskoe kardiologicheskoe obshchestvo, Nacional’noe obshchestvo profilakticheskoj kardiologii, Rossijskoe obshchestvo profilaktiki neinfekcionnyh zabolevanij [Russian Society of Cardiology, National Society for Preventive Cardiology, Russian Society for the Prevention of Noncommunicable Diseases]. Kardiovaskulyarnaya profilaktika 2017 [Cardiovascular prevention, 2017]. 2017; 289 p. http://zdorovie29.ru/wp-content/uploads/ Kardiovaskulyarnaya-pro laktika-Novye-rekomendatsii. pdf

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6. Kuharchuk VV, Ezhov MV, Sergienko IV, et al. Diagnostika i korrekciya narushenij lipidnogo obmena s cel’yu pro laktiki i lecheniya ateroskleroza. Rossijskie rekomendacii, VII peresmotr [ Diagnostics and correction of lipid metabolism disorders in order to prevent and treat atherosclerosis. Russian recommendations VII revision]. Ateroskleroz i dislipidemii [Atherosclerosis and dyslipidemia ]. 2020; 1
(38): 7-40.

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15. Prikaz Ministerstva zdravoohraneniya RF ot 13/03/2019 No 124n «Ob utverzhdenii poryadka provedeniya pro lakticheskogo medicinskogo osmotra i dispanserizacii opredelennyh grupp vzroslogo naseleniya»: Registracionnyj N 54495 ot 24 aprelya 2019 goda [Order of the Ministry of Health of the Russian Federation of 13/03/2019 No 124n «On approval of the procedure for conducting preventive medical examination and medical examination of certain groups of the adult population»: Registration N 54495 of April 24, 2019 ]. 2019; 34 p.

16. Drapkina OM, Drozdova LYu, Kalinina AM, et al. Metodicheskie rekomendacii «Organizaciya provedeniya pro lakticheskogo medicinskogo osmotra i dispanserizacii opredelennyh grupp vzroslogo naseleniya» (Ministerstvom Zdravoohraneniya 22 oktyabrya 2019 goda) [Guidelines «Organization of preventive medical examination and clinical examination of certain groups of the adult population» (approved by the Ministry of Health October 22, 2019)]. 2019; 165 p. https://sudact. ru/law/organizatsiia-provedeniia-pro lakticheskogo-meditsinskogo-osmotra-i-dispanserizatsii/metodicheskie-rekomendatsii/

17. Bojcov SA, ed. Epidemiologicheskij monitoring faktorov riska hronicheskih neinfekcionnyh zabolevanij v prak-ticheskom zdravoohranenii na regional’nom urovne; Metodicheskie rekomendacii [Epidemiological monitoring of risk factors of chronic non-communicable diseases in public health practice at the regional level; Guidelines]. Moskva: Izdatel’stvo Media Sfera [Moscow: Media Sphere Publishing House]. 2016; 111 p. 

 

УДК 616.517-06:616.72-053.81/.85

DOI: 10.20969/VSKM.2021.14(1).47-52

 DIVERSITY OF COMORBID CONDITIONS IN YOUNG AND MIDDLE-AGED PATIENTS WITH PSORIATIC ARTHRITIS

FAIRUSHINA IRINA F., ORCID ID: 0000-0002-5975-4822; postgraduate student of the Department of advanced internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: sirenif@mail.ru

KIRILLOVA ELINA R., ORCID ID: 0000-0002-2152-7472; C. Med. Sci., associate professor of the Department of advanced internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: elinarin@mail.ru

MUKHAMETSHINA EMMA I., ORCID ID: 0000-0002-9778-8302; deputy chief physician for medical affairs of medical unit of Kazan Federal University, Russia, 420012, Kazan, Chekhov str., 1a, e-mail: emmaim@mail.ru

ABDULGANIEVA DIANA I., ORCID ID: 0000-0001-7069-2725; D. Med. Sci., рrofessor, the Head of the Department of advanced internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: diana-s@mail.ru

Abstract. Aim. The aim of the study was to investigate the prevalence of comorbid conditions in young and middle-aged patients with psoriatic arthritis. Material and methods. We analyzed data from the case reports of 84 patients with psoriatic arthritis for 2018–2020, among whom 39 (47,6%) were men and 45 (52,4%) were women, in a course of a cross-sectional observational study. The mean age of the patients was (42,8±10,1) years, DAPSA–18,1 (10,2; 26,7), PASI–5,3 (1,5; 10,8). Results and discussion. Comorbid conditions were observed in 68 (80,9%) patients; the mean number of comorbid conditions was 3 (1; 4). More than one comorbid condition was observed in 69% of the patients. Among transnosological conditions, cardiovascular diseases were the most frequent (40,5%), with high frequency of arterial hypertension (36,9%), atherosclerosis (20,2%), and combined cardiovascular diseases in 17,9% of patients. Osteoporosis and osteopenia (11,9%), obesity (26,2%) was also observed. Waist circumference was higher than normal values in 34,5% of patients, and waist-to-hip ratio was higher than normal in 57,1% of patients. Among the extra-articular manifestations, uveitis (1,2%) and Crohn’s disease (1,2%) were observed. Among chronic conditions there was a high frequency of gastrointestinal diseases (41,6%) – in ammatory diseases of upper gastrointestinal tract (27,4%), abnormality of gallbladder, biliary tract and pancreas (21,4%), alcoholic liver disease, toxic liver damage, nonalcoholic fatty liver disease (14,5%). Other musculoskeletal and connective tissue diseases unrelated to psoriasis were noted in 27,6% of patients (gout, osteoarthritis). Endocrine system diseases occurred in 19% of patients (type II diabetes mellitus, thyroid gland diseases). In 62,5% of the cases, type II diabetes mellitus was combined with increased body weight and obesity. Diseases of urogenital system were registered in 13,9% of patients, respiratory diseases such as chronic bronchitis, and bronchial asthma – in 3,6% of patients. Conclusion. A high incidence of combination of psoriatic arthritis with concomitant diseases, especially with lesions of the cardiovascular system and gastrointestinal tract diseases, has been revealed. This signi cantly aggravates the course of psoriatic arthritis, worsens the response to therapy, and in some cases (due to the existing contraindications) reduces the possibility of prescribing adequate therapy.

Key words: psoriatic arthritis, comorbidity.

For reference: Fairushina IF, Kirillova ER, Mukhametshina EI, Abdulganieva DI. Diversity of comorbid conditions in young and middle-aged patients with psoriatic arthritis. The Bulletin of Contemporary Clinical Medicine. 2021; 14 (1): 47-52. DOI: 10.20969/VSKM.2021.14(1).47-52.

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6. Oganov RG, Denisov IN, Simanenkov VI, et al. Komorbidnaya patologiya v klinicheskoy praktike; Klinicheskiye rekomendatsii [Comorbidities in practice; Clinical guidelines]. Kardiovaskulyarnaya terapiya i pro laktika [Cardiovascular Therapy and Prevention]. 2017; 16 (6): 5-56.

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8. Haddad A, Zisman D, et al. Comorbidities in Patients with Psoriatic Arthritis. Rambam Maimonides Medical Journal. 2017; 8: 1.

9. Salaf F, Carotti M, Gasparini S, et al. The health-related quality of life in rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis: a comparison with a selected sample of healthy people. Health Qual Life Outcomes. 2009; 7: 25.

10. Husted JA, Thavaneswaran A, Chandran V, et al. Incremental effects of comorbidity on quality of life in patients with psoriatic arthritis. J Rheumatol. 2013; 40 (8): 1349-1356.

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12. Edson-Heredia E, Zhu B, Lefevre C, et al. Prevalence and incidence rates of cardiovascular, autoimmune, and other diseases in patients with psoriatic or psoriatic arthritis: a retrospective study using Clinical practice research datalink. Journal of the European Academy of Dermatology and Venereology. 2014; 29 (5): 955-963.

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18. Li WQ, Han JL, Chan AT, et al. Psoriasis, psoriatic arthritis and increased risk of incident Crohn’s disease in US women. Ann Rheum Dis. 2013; 72 (7): 1200-1205.

19. Zeboulon N, Dougados M, Gossec L. Prevalence and characteristics of uveitis in the spondyloarthropathies: a systematic literature review. Ann Rheum Dis. 2008; 67 (7): 955-959.

20. Dreiher J, Freud T, Cohen AD. Psoriatic arthritis and diabetes: a population-based cross-sectional study. Dermatol Res Pract. 2013; 2013: 580404.

 

УДК 618.3-06:616.34-007.272-036.11

DOI: 10.20969/VSKM.2021.14(1).53-61

 PLACENTAL DYSFUNCTION AND METHOD OF ITS CORRECTION IN ACUTE INTESTINAL OBSTRUCTION IN PREGNANT

KHVOROSTUKHINA NATALIYA F., ORCID ID: 0000-0002-5864-3397; D. Med. Sci., associate professor, the Head of the Department of obstetrics and gynecology of Saratov State Medical University named after V.I. Razumovsky, Russia, 410012, Saratov, Bolshaya Kazachya str., 112, tel. +7-927-277-79-35, e-mail: Khvorostukhina-NF@yandex.ru

NOVICHKOV DENIS A., ORCID ID: 0000-0001-6945-835X, C. Med. Sci., associate professor of the Department of obstetrics and gynecology of Saratov State Medical University named after V.I. Razumovsky, Russia, 410012, Saratov, Bolshaya Kazachya str., 112, e-mail: dnovichkov@mail.ru

Abstract. Aim. To study the effect of plasmapheresis on the functional state of the uterine-placental complex in adhesive acute intestinal obstruction in pregnant. Material and methods. Patients with acute intestinal obstruction with gestational age from 15 to 36 weeks (n=81) and 35 healthy pregnant women (Group 3) participated in the study. In Group 1 (n=39), the conventional therapeutic measures additionally included discrete plasmapheresis on the 1st and the 3rd day after surgical treatment for acute intestinal obstruction. In Group 2 (n=42) pregnant women underwent standard postoperative therapy. The program of investigation consisted of an ultrasound examination with Doppler, calculation of the leukocytic intoxication index, determination of total endotoxin, trophoblastic beta-1-glycoprotein, placental speci c alpha-1-microglobulin in serum by enzyme immunoassay. For statistical analysis we used Excel MS Of ce and Statistica 6.0 programs. We considered statistically signi cant the differences in the values at p<0,05. Results and discussion. Occurrence of acute intestinal obstruction in pregnant women is accompanied by the development of endotoxemia and placental dysfunction, their manifestations are maladaptation of gravid proteins synthesis and uteroplacental blood ow disorders, which leads to the development of acute (28,6%) and chronic (71,4%) placental insuf ciency with high rate of fetal death (26,2%), spontaneous miscarriage (16,7%) and preterm birth (40,5%). Additional use of plasmapheresis can effectively level the effect of endotoxin aggression products on the function of the uteroplacental complex, contributing to the correction of hemodynamic disorders and preventing the progression of placental dysfunction. Conclusion. The use of plasmapheresis in the complex of standard therapeutic measures after surgical removal of adhesive acute intestinal obstruction reduces the frequency of threatening interruption of pregnancy by 3 times, premature birth – by 8 times, thereby increasing the proportion of favorable outcomes of gestation.

Key words: pregnancy, acute intestinal obstruction, placental dysfunction, plasmapheresis

For reference: Khvorostukhina NF, Novichkov DA. Placental dysfunction and method of its correction in acute intestinal obstruction in pregnant. The Bulletin of Contemporary Clinical Medicine. 2021; 14 (1): 53-61. DOI: 10.20969/VSKM.2021.14(1).53-61.

References

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12. Khvorostukhina NF, Salov IA, Rogozhina IE, Stolyarova UV. Faktory riska kishechnoj neprohodimosti u beremennyh [Risk factors of intestinal obstruction in pregnancy]. Saratovskij nauchno-medicinskij zhurnal
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13. Dibirov MD, Vasil’chenko MI, Sych TYu, Vuchenovich YuD. Provedenie simul’tannoj operacii po povodu ostroj spaechnoj kishechnoj neprohodimosti u beremennoj v III trimester beremennosti [Carrying out simultaneous operation because of acute adhesive obstruction in pregnant in III trimester of pregnancy]. Vestnik Rossijskoj voenno-medicinskoj akademii [Herald of the Russian Academy of Military Medicine]. 2016; 4 (56): 23-26.

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УДК 616.24-036.12:004.7(470.53)

DOI: 10.20969/VSKM.2021.14(1).62-68

 THE ELECTRONIC REGISTRY OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS: ANALYSIS OF FACTORS ASSOCIATED WITH MORTALITY

SHUBIN IGOR V., ORCID: 0000-0003-2393-4685; C. Med. Sci., Honored Doctor of the Russian Federation, deputy director
of the Center for the Introduction of Changes of the Ministry of Health of the Moscow Region, Russia, 143408, Moscow region, Krasnogorsk, Karbyshev str., 4, tel. 8-905-500-35-30, e-mail: shubin-igor@mail.ru

MISHLANOV VITALY YU., ORCID: 0000-0002-8428-6020; D. Med. Sci., professor, Corresponding Member of the Russian Academy of Sciences, Secretary of the Electronic and Mobile Medicine Group of the European Respiratory Society, the Head of the Department of introduction to internal medicine No 1 of Perm State Medical University named after acad. E.A. Vagner, Russia, 614990, Perm, Petropavlovskaya str., 26, tel. 8-950-467-76-96, e-mail: permmed@hotmail.com

KOSHURNIKOVA EKATERINA P., ORCID: 0000-0002-4889-9794; C. Med. Sci., associate professor of the Department of introduction to internal medicine No 1 of Perm State Medical University named after acad. E.A. Vagner, Russia, 614990, Perm, Petropavlovskaya str., 26, tel. 8-912-883-22-32, e-mail: ekaterina_koshur@mail.ru

Abstract. Aim. The aim of the study was to investigate clinical and phenotypic factors that in uence the increase in the mortality rate in patients with chronic obstructive pulmonary disease according to the electronic registry. Material and methods. Analysis of information about patients with chronic obstructive pulmonary disease included in the electronic clinical registry was carried out. The study was performed using telemedicine and e-medicine methods, including processing the data for 2017–2019 stored in the Uni ed Information and Analytical System. Statistical processing of the results was performed using Statistica 8.0 software. Results and discussions. Correlation analysis showed a pronounced in uence on the frequency of exacerbations of chronic obstructive pulmonary disease of such factors as the number of nocturnal attacks of dyspnea, dyspnea severity according to mMRC scale, number of daily episodes of dyspnea, frequency of application of short acting bronchodilators on demand, value of FEV1 and severity of respiratory failure. The frequency of nocturnal attacks, the need for emergency medications, daytime episodes of dyspnea associated with physical activity, and, to a lesser extent, the value of FEV1 had a signi cant in uence on the severity of dyspnea. Interdependence of the frequency of exacerbations of the disease and severity of dyspnea according to mMRC scale was revealed. Factors of maximal in uence on the lethal outcome of the disease were decrease of FEV1 below 50% of the normal value in the postbronchodilator test, age older than 65 years, and frequent exacerbations of chronic obstructive pulmonary disease. Analysis of symptoms and syndromes of the phenotypic structure in patients with chronic obstructive pulmonary disease, obtained by means of COPD patients survey using interactive questionnaire «Electronic clinic», showed signi cant prevalence of such symptoms as aspiration or mixed dyspnea; dyspnea, increasing with physical activity and not disappearing after its termination; productive cough with from 30 to 100 ml of sputum per day, which increased during exacerbation of the disease. Dyspnea prevailed in phenotypes B and D, severe dyspnea in group D. In the same group, dyspnea with impaired inhalation and exhalation or even with predominant impaired inhalation was detected. The equivalent of severe dyspnea was the frequency and effectiveness of bronchodilators for dyspnea control. Cough was distinctly different in group D patients, besides, in this group there was reliably more frequent increase in the amount of expectorated bronchial secretion up to 100 ml per day. Conclusion. The analysis of the electronic registry con rmed the data on the maximum in uence on the lethal outcomes of such factors as a decrease in FEV1 less than 50% of the normal value, age older than 65 years, the presence of frequent exacerbations and severe symptoms of the disease. Severe symptoms had an indirect effect through an increase in the frequency of exacerbations and were associated with a decrease in FEV1, and the frequency of exacerbations was directly proportional to the frequency of nocturnal symptoms of the disease.

Key words: COPD, mortality, risk factors, electronic patient registry, exacerbation, dyspnea.

For reference: Shubin IV, Mishlanov VJ, Koshurnikova EP. The electronic registry of chronic obstructive pulmonary disease (COPD) patients: analysis of factors associated with mortality. The Bulletin of Contemporary Clinical Medicine. 2021; 14 (1): 62-68. DOI: 10.20969/VSKM.2021.14(1).62-68.

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REVIEWS

УДК 616.98:578.834.1-06:616.127(048.8)

DOI: 10.20969/VSKM.2021.14(1).69-75

 CARDIOLOGICAL ASPECTS OF SARS-CoV-2 INFECTION

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

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

ABDRAKHMANOVA ALSU I., ORCID ID: 0000-0003-0769-3682; SCOPUS Author ID: 57192296744; C. Med. Sci., associate professor of the Department of clinical medicine fundamental basis of Institute of biology and fundamental medicine of Kazan Federal University, Russia, 420012, Kazan, Karl Marx str., 74; doctor of the Department of cardiology of Interregional Clinical Diagnostic Center, Russia, 420089, Kazan, Karbyshev str., 12а, e-mail: alsuchaa@mail.ru

ABDULYANOV ILDAR V., ORCID ID: orcid.org/0000-0003-2892-2827; C. Med. Sci., associate professor, the Head of the Department of cardiology, interventional cardiology and cardiovascular surgery of Kazan State Medical Academy – the branch of Russian Medical Academy of Postgraduate Education, Russia, 420012, Kazan, Butlerov str., 36; cardiovascular surgeon, Interregional Clinical Diagnostic Center, 420101, Kazan, Karbyshev str. 12a, tel. 8-987-421-90-09, e-mail: ildaruna@mail.ru

Abstract. Aim. The aim of the study was to analyze the scienti c medical literature on the cardiac manifestations of SARS-CoV-2 virus infection. Material and methods. A review and analysis of current scienti c data on cardiac complications combined with acute respiratory syndrome caused by this pathogen has been performed. Results and discussion. Infection caused by the SARS-CoV-2 virus is an urgent aspect of modern practical medicine. In a number of cases it manifests as a severe acute respiratory syndrome. Pulmonary lesion, which is primary, is accompanied by cardiovascular complications. Pulmonary and cardiovascular lesions are determined by the tropism of the virus to the protein, which is the enzyme angiotensin-convertase-2 that is widely expressed on cells of the respiratory and vascular systems, as well as in the myocardium. Thrombotic complications, including deep vein thrombosis of the lower extremities, thromboembolism and pulmonary artery thrombosis are very common. High mortality rate is noted among ICU patients on arti cial ventilation with multiple organ failure. Lungs are the main organ affected, but systemic lesions of other organs, such as vessels, heart, kidneys, are also possible. Cardiac damage affects the myocardium, resulting in increased levels of markers of myocardial damage, such as troponin I. Myocardial dysfunction in the background of infection worsens the patient’s condition and is associated with a poor prognosis. The data indicate the possibility of viral infection of the myocardium and direct cyto-pathogenic damage. In the absence of signs of coronary insuf ciency, elevated marker levels are considered as myocardial damage of nonischemic nature. Conclusion. An important factor in the pathogenesis of cardiac lesions is the aggravation of existing disorders due to additional activation of the reninangiotensin system. Systemic in ammatory changes can aggravate the severity of the course of infection in patients with metabolic syndrome.

Key words: infection SARS-CoV-2, cardiovascular system, myocardium.

For reference: Tsibulkin NA, Amirov NB, Abdrakhmanova AI, Abdulyanov IV. Cardiological aspects of SARS-CоV-2 infection. The Bulletin of Contemporary Clinical Medicine. 2021; 14 (1): 69-75. DOI: 10.20969/VSKM.2021.14(1).69-75.

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28. Liu J, Zheng X, Tong Q, et al. Overlapping and discrete aspects of the pathology and pathogenesis of the emerging human pathogenic coronaviruses SARS-CoV, MERS-CoV, and 2019-nCoV. J Med Virol. 2020; 92 (5): 491–494.

29. Xu Z, Shi L, Wang Y, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020; 8 (4): 420–422.

 

EXPERIMENTAL STUDIES – TO PRACTICAL MEDICINE

УДК 616.314-72:004.9

DOI: 10.20969/VSKM.2021.14(1).76-82

 COMPUTER MODELING AS THE MAIN STAGE OF ENDODONTIC ROOT NEEDLE REFINEMENT

KAZAKOVA LARISA N., ОRCID ID: 0000-0001-8060-1348; C. Med. Sci., associate prodessor of the Department of pediatric dentistry and orthodontics of Saratov State Medical University n.a. V.I. Razumovsky, Russia, 410012, Saratov, B. Kazachya str., 112

TERESHCHUK OKSANA S., ORCID ID: 0000-0002-4917-797X; аssistant of professor of the Department of emergency, anesthesiology, resuscitation and simulation technologies in medicine of Saratov State Medical University n.a. V.I. Razumovsky,Russia, 410012, Saratov, B. Kazachya str., 112, e-mail: kleo.ok@yandex.ru

NEBOGATIKOV ROMAN S., 1st year Master program student of Saratov State Technical University named after Y. Gagarin, Russia, Saratov, Polytechnicheskaya str., 77, e-mail: nebogatikov.r.@gmail.com

KULIGIN ALEXANDER V., ORCID ID: 0000-0001-5705-215Х; D. Med. Sci., professor, the Head of the Department of emergency, anesthesiology, resuscitation and simulation technologies of medicine of Saratov State Medical University n.a. V.I. Razumovsky, Russia, 410012, Saratov, B. Kazachya str., 112, e-mail: avkuligin@yandex.ru

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

PICHKHIDZE SERGEY YA., D. Tech. Sci., professor of the Department of materials science and biomedical engineering of Saratov State Technical University named after Y. Gagarin, Russia, Saratov, Polytechnicheskaya str., 77,e-mail: serg5761@yandex.ru

Abstract. The issue of high-quality root canal treatment in deciduous and permanent teeth is currently highly relevant. There is a huge variety of tools, devices, and medicines that can be used for working with the root canals. It is often the case that in the dental market medical products of various quality characteristics are being offered for a certain manipulation, leaving consumers face to face with a tough choice of what to buy to obtain good results. According to the English-language literature review, evaluation of the technical characteristics of endodontic needles and the results of their use in practice showed a rather large number of negative aspects, which outlines the need to nd the ways of endodontic needle re nement. Aim. This study aims to determine the optimal technical characteristics of endodontic root needles and to develop a new design of the endodontic needle to be applied for the uniform irrigation of the rootcanal delta with a minimum probability of damaging periapical tissues. Material and methods. Solid Works softwarepackage was selected as the primary working tool because it allows to build a 3D model of biological and technical models and offers the possibility to choose the material from the existing library or to create one’s own material. For the accuracy and clarity of the calculations, a biological model of the tooth and two needle models (a prototype and a modernized design) were built. Results and discussion. The result of the study is a new model of the endodontic rootneedle, which assures uniform irrigation of the entire surface of the root canal with minimal probability of damage to periodontal tissues. The technical solution was achieved by imparting to the design all the advantages of the analogues whilst eliminating their disadvantages. Conclusion. The technical solution proposed in our work is the new model of the endodontic needle, which enables uniform irrigation along the entire perimeter of the root canal surface and minimizes the likelihood of damaging periapical tissues even when the needle is inserted into the root canal at a maximum depth.

Key words: root canal, periapical tissues, endodontic needle, drug treatment.

For reference: Kazakova LN, Tereshchuk OS, Nebogatikov RS, Kuligin AV, Suetenkov DE, Pichkhidze SYa. Computer modeling as the main stage of endodontic root needle re nement. The Bulletin of Contemporary Clinical Medicine. 2021; 14 (1): 76-82. DOI: 10.20969/VSKM.2021.14(1).76-82.

References

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6. Boutsioukis C, Gogos C, Verhaagen B, Versluis M, Kastrinakis E, van der Sluis LWM. The effect of root canal taper on the irrigant ow: evaluation using an unsteady Computational Fluid Dynamics model. International Endodontic Journal. 2010; 43: 909–916.

7. Karpagam G Nithya, Raj James David. Types of needles used in the irrigation of root canal system – A review. Drug Invention Today. 2018; 10 (3): 234-237.

8. Li Ping, Zhang Di, Xie Yonghui, Lan Jibing. Numerical investigation of root canal irrigation adopting innovative needles with dimple and protrusion. Acta of Bioengineering and Biomechanics. 2013; 15 (1): 124-128.

9. Vivan RR, Bortolo MV, Duarte MA, Moraes IG, Tanomaru – Filho M, Bramante CM. Scanning electron microscopy analysis of rins endo system and conventional irrigation for debris removal. Brazilian Dental Journal. 2010; 21: 305-309.

10. Guerreiro-Tanomaru Juliane Maria, Loiola Lívia Etchebehere, Morgenta Renata Dornelles, Leonardo Renato de Toledo, Tanomaru-Filho Mario. Ef cacy of Four Irrigation Needles in Cleaning the Apical Third of Root Canals. Brazilian Dental Journal. 2013; 24 (1): 21-24.

11. Shen Y, Gao Y, Qian W, Ruse ND, Zhou X, Wu H. Three-dimensional numeric simulation of root canal irrigant ow with different irrigation needles. International Endodontic Journal. 2010; 36: 884-901.

12. Uzunoglu-Özyürek Emel, Karaaslan Hakan, Türker Sevinç Aktemur, Bahar Özçelik. In uence of size and insertion depth of irrigation needle on debris extrusion and sealer penetration. Restorative Dentistry and Endodontics. 2018; 43 (1), 2: 125-129.

13. Huang Qi, Barnes Jonathan B., Schoeffe G John, Fan Bing, Tay Candice, Bergeron Brian E, Susin Lisiane F, Junqi Ling, Lina Niu, Franklin RTay. Effect of Canal Anastomosis on Periapical Fluid Pressure Build-up during Needle Irrigation in Single Roots with Double Canals using a Polycarbonate Model. Scienti c Reports. 2017; 7: 1582.

14. Shalan Linz A, Alhuwaizi Hussain F, Fatalla Abdalbseet Ahmad, Hameed Ammar Saleem. Intra-canal Pressure Produced by Three Irrigation System: A Comparative Study. Journal of Research in Medical and Dental Science. 2018; 6 (5): 161-164.

15. Kazakova LN, Tereshchuk OS, Nebogatikov RS, Kuligin AV, Suetenkov DYe, Pichkhidze SYa. Patent na poleznyu model’ No 195903 Endodonticheskaya igla dlya provedeniya antisepticheskoj obrabotki kornevogo kanala [Utility Model Patent No 195903 «Endodontic needle for antiseptic root canal treatment»]. 

 

CLINICAL CASE

УДК 616.453-008.6-055.25(470.62)

DOI: 10.20969/VSKM.2021.14(1).83-90

 FAMILY CASE OF CONGENITAL ADRENAL CORTEX DYSFUNCTION (clinical case)

KOROL’ INNA V., ORCID ID: 0000-0002-3909-9007; C. Med. Sci., associate professor of the Department of endocrinology, faculty of advanced training and professional specialist retraining of Kuban State Medical University, Russia, 350063, Krasnodar, Sedin str., 4, tel. +7 (918)414-44-19, e-mail: innakorol1@mail.ru

IVANOVA LIUDMILA A., ORCID ID: 0000-0001-5302-3802; D. Med. Sci., professor, the Head of the Department of endocrinology, faculty of advanced training and professional specialist retraining of Kuban State Medical University, Russia, 350063, Krasnodar, Sedin str., 4, tel. +7 (988)242-13-90, e-mail: endocrinkgmu@mail.ru

KOVALENKO JULIYA S., ORCID ID: 0000-0002-7236-7341; С. Med. Sci., assistant of professor of the Department of endocrinology, faculty of advanced training and professional specialist retraining of Kuban State Medical University, Russia, 350063, Krasnodar, Sedin str., 4, tel. +7 (952)813-17-96, e-mail: julendo@mail.ru

MOSKVINA ANNA I., ORCID ID: 0000-0002-8298-1580; second year clinical resident of the Department of endocrinology, faculty of advanced training and professional specialist retraining of Kuban State Medical University, Russia, 350063, Krasnodar, Sedin str., 4, tel.+7 (918)233-06-67, e-mail: annamoskvina412@gmail.com

SHELUKHA ALEXANDRA A., ORCID ID: 0000-0002-8298-1580; second year clinical resident of the Department
of endocrinology, faculty of advanced training and professional specialist retraining of Kuban State Medical University, Russia, 350063, Krasnodar, Sedin str., 4, tel.+7 (909)459-37-65, e-mail: ashelukha@yandex.ru

RUZHITSKAYA LIDIYA V., ORCID ID: 0000-0002-8809-7008; senior laboratory of the Department of endocrinology, faculty of advanced training and professional specialist retraining of Kuban State Medical University, Russia, 350063, Krasnodar, Sedin str., 4, tel.+7 (918)671-56-05, e-mail: lida_ruz-7@mail.ru

TANIN IVAN YU., ORCID ID: 0000-0001-8883-3899; second year clinical resident of the Department of endocrinology, faculty of advanced training and professional specialist retraining of Kuban State Medical University, Russia, 350063, Krasnodar, Sedin str., 4, +7 (989)280-50-76, e-mail: Tanin2012ivan@mail.ru

Abstract. Aim. The aim of the study was to demonstrate the stages of diagnosis, differential diagnosis, and treatment of a virile form of congenital adrenal cortex dysfunction, and 21-hydroxylase de ciency in siblings. Material and methods. We present a clinical case of adrenogenital syndrome in siblings with a debut in preschool age. Results and discussion. The rst patient had debut of adrenogenital syndrome at the age of 6, but was not diagnosed until the age of 14, with permanent treatment beginning at age 18, when severe hyperandrogenism and stunting were already present. A family history check revealed that the patient’s 7-year-old younger sister began premature puberty and telarche at the age of 6. Genetic testing of this patient con rmed a virile form of congenital dysfunction of the adrenal cortex, and 21-hydroxylase de ciency. The patients were prescribed glucocorticoids, and compensation of the disease was achieved only one year after the initiation of the therapy due to the low compliance of the patients. Conclusion. In order to achieve the compensation of adrenogenital syndrome, a physician is required to strictly follow the clinical guidelines for the treatment of this disease, as well as patient motivation, regular clinical and laboratory monitoring, and the patient is required to strictly follow the recommendations not only for lifelong therapy, but also for the maintenance of a proper lifestyle. Only in this case it is possible to achieve stable compensation of the disease and to improve the quality of life in the patients.

Key words: congenital dysfunction of the adrenal cortex, viril form, 21-hydroxylase de ciency.

For reference: Korol’ IV, Ivanova LA, Kovalenko JuS, Moskvina AI, Shelukha AA, Ruzhitskaya LV, Tanin IYu. Family case of congenital adrenal cortex dysfunction (clinical case). The Bulletin of Contemporary Clinical Medicine. 2021; 14 (1): 83-90. DOI: 10.20969/VSKM.2021.14(1).83-90.

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