JUSTIFICATION OF METHODOLOGICAL APPROACHES TO STUDIES OF HEALTHY LIFE EXPECTANCY IN PERSONS OVER WORKING AGE

GALIULLIN DAMIR A., ORCID ID: 0000-0002-8878-2777; С. Med. Sci., the Head of the Medical department of NICF «Yardam», Russia, 420006, Kazan, Yutazinskaya str., 8, tel. +7 (917) 291-72-14, e-mail: gvkim68@mail.ru

SHAMSIYAROV NURIKHAN N., ORCID ID 0000-0003-2868-0629; D. Med. Sci., Deputy Head physician of the Medical Diagnostic Center, Russia, 420141, Kazan, Juliusa Fuchika str., 105a, building 1, tel. +7 (927) 498-78-40, 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, Butlerov str., 49, Russia, 420012, Kazan, tel. +7-927-033-78-41, e-mail: kitaevaenge@mail.ru

 DAMAGE TO THE THORAX AND THORACIC CAVITY ORGANS IN PEDESTRIANS INJURED IN MOTOR VEHICLE COLLISIONS

INDIAMINOV SAYIT I., ORCID ID: 0000-0001-9361-085X; D. 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

GAMIDOV SEYMUR SH., ORCID ID: 0000-0002-7842-4634; medical investigator of Republican Scientific and Practical Centre for forensic medicine at the Navoi branch, Uzbekistan, 210100, Navoi, tel. +9 (989)343-943-40, e-mail: seymur2662@mail.ru

Abstract. Background. Combined severe trauma due to road traf c injuries and falls from heights is a global medical, social, and economic problem all over the world. Aim. Identi cation of features of development of injuries of the thorax structure and thoracic cavity organs in pedestrians in their collisions with moving cars. Material and methods. A forensic medical examination was conducted on 215 corpses of people who died in collisions with moving cars. There were 173 men and 42 women among the dead. The age of the victims ranged from 14 to 75 years old. According to the materials of the preliminary inquiry (investigation), in most cases the collisions were front- and front-end type. Results and discussion. Combined severe trauma of two or more body parts with fractures of limb bones (120) – 55,8% and combined severe trauma of the head, chest, and abdomen (50) – 23,3% predominated on the bodies of deceased pedestrians. Rib fractures along different lines with injuries of intercostal muscles and parietal pleura were noted in 124 pedestrians (57,7%). The fractures were most frequently (59 of 124) bilateral, with right and left rib fractures occurring to the same degree (31 and 34, respectively). In 64 cases (29,8%), fractures in deceased pedestrians covered almost all ribs (ribs 1 to 11), and by localization, fractures along the midclavicular and axillary lines predominated, which were indirect in nature with signs of compression on the inner and extension on the outer plates. As for the thoracic cavity, the most pronounced hemorrhages were observed in the mediastinum, in the roots and other parts of the lungs, as well as in the heart cof n, in the heart muscles and in the walls of the main vessels, the intensity of hemorrhages prevailed in the lung tissues in 184 dead patients. Of these, in 36 cases there were ruptures of the lungs, heart, aorta, trachea and cardiac coxae. Damage to the lung, trachea and heart structure was the main cause of death in the victims on the pre-hospital stage due to the development of traumatic (hemorrhagic, pleuropulmonary) shock and hemopneumothorax.Conclusion. As part of the combined severe trauma, injuries to the structure of the chest and thoracic cavity organs were noted in 85,6% of cases. The nature of the injuries to the structure of the chest and thoracic cavity organs allowed us to establish the possibility of their development in the 3rd phase of automobile trauma as a result of the victims falling on the pavement. Traumatic (hemorrhagic, pleuropulmonary) shock and hemopneumothorax were the main causes of death in the victims at the pre-hospital stage.

 RISK ASSESSMENT OF CONTRAST-INDUCED NEPHROPATHY IN PATIENTS WITH ACUTE CORONARY SYNDROME

KIM ZULFIYA F., ORCID ID: 0000-0003-4240-3329; C. Med. Sci., Deputy Head physician on medical affairs of City Clinical Hospital No 7; Chief freelance cardiologist of the Ministry of Health of Republic of Tatarstan; associate professor of the Department of internal medicine No 2 of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. 8-917-255-55-74, e-mail: profz@yandex.ru

BUDEEVA DARINA V., ORCID ID: 0000-0002-7899-3984; post-graduate student of the Department of internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: darina88_88@mail.ru

NURIEVA LUIZA M., ORCID ID: 0000-0002-1762-9492; 1-year resident of the Department of cardiology, advanced training faculty and professional retraining of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: nurievaluiza@list.ru

Abstract. Aim. The aim of the study was to estimate the incidence and risk factors of contrast-induced nephropathy in patients with acute coronary syndrome hospitalized in Cardiology Department No 1 of the City Clinical Hospital No 7, Kazan. Material and methods. Clinical and laboratory parameters were assessed in 565 patients with acute coronary syndrome, patients’ age ranged from 30 to 95 years [mean age was 65,78±11,41]. All patients were assessed for their medical history, coronary angiography protocols, and the ndings of general and biochemical blood tests. All patients were calculated the glomerular ltration rate according to CKD-EPI formula and the risk of contrast-induced nephropathy according to Mehran scale (2004). Results and discussion. After coronary angiography, 89 (15,8%) patients developed contrast-induced nephropathy; The incidence of contrast-induced nephropathy in patients with acute coronary syndrome is rather high and, according to our data, reaches 15,75%. Conclusion. The most signi cant factors associated with the development of contrast-induced nephropathy in patients with acute coronary syndrome are: age (over 75 years), anemia, hypertension, history of chronic kidney disease, a history of myocardial infarction, reduced ejection fraction below 55%, early postinfarctional complications, and multivessel coronary lesions.

Key words: contrast-induced nephropathy, acute kidney injury, acute coronary syndrome.

For reference: Kim ZF, Budeeva DV, Nurieva LM. Risk assessment of contrast-induced nephropathy in patients with acute coronary syndrome. The Bulletin of Contemporary Clinical Medicine. 2021; 14 (3): 18-22.DOI: 10.20969/VSKM.2021.14(3).18-22.

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 EFFECTS OF RHYTHMIC TRANSCRANIAL AND MULTILEVEL MAGNETIC STIMULATION ON COGNITIVE IMPAIRMENT IN POST-STROKE PATIENTS

MAMEDOVA MARZIYA YU., ORCID ID: orcid.org/0000-0001-5976-6551; Jjunior research worker of Clinical neurophysiological laboratory of Scientific Research Institute of Medical Rehabilitation of Union of the Medical territorial unit management, Azerbaijan Republic, AZ1008, Baku, Khatai av., 3, tel. +9 (945)567-544-24, e-mail: mammadovamarziyya@gmail.com

Abstract. Background. Cognitive impairment in post-stroke patients is often a major cause of social limitations. They seem insigni cant and are masked by prominent post-stroke motor disorders, but negatively affect rehabilitation outcomes with loss of learning skills. Application of transcranial magnetic stimulation using multiple variations of schemes, its feature of noninvasive in uence on the central and peripheral nervous system and modi cation of plasticity processes, appears effective for therapy in post-stroke patients, both in the acute and recovery periods. Aim. The aim of the studywas to investigate the effect of the developed therapeutic techniques of rhythmic transcranial and multilevel magnetic stimulation on cognitive functions in post-stroke patients. Material and methods. An open placebo-controlled clinical trial of 102 post-stroke patients was conducted. Clinical data of patients, results of neuroimaging study, degree of paresis according to 6-point muscle strength rating scale, and level of cognitive impairment according to Mini-Mental State Examination-MMSE cognitive screening scale were analyzed. Two groups underwent multilevel and transcranial magnetic stimulation according to our developed methods, and the third group underwent false transcranial magnetic stimulation. Results and discussions. Evaluation of the MMSE scale scores after treatment revealed an increase in the mean scores on the items of orientation, perception, attention and calculation, memory, and speech in both treatment groups (p<0,05). There was a signi cant 17,8% increase in the cumulative mean score above 24 points in the group with multilevel magnetic stimulation, which was regarded as a signi cant positive effect in improving cognitive function. The distribution of the mean MMSE score by stroke recovery periods showed positive dynamics at all stages of the disease in the groups with multilevel and transcranial stimulation; no changes were detected in the placebo group.Conclusion. Application of therapeutic techniques of rhythmic transcranial and multilevel magnetic stimulation in post-stroke patients contributes to improvement of clinical course of the disease, regression of motor de ciency, contributes to reduction of cognitive disorders such as disorders of memory, attention, orientation, speech, reading, reduction of inadaptation and due to this increases the level of everyday activity.

УКД 616.61-073.432.-19:[616.379-008.64+616.12-008.331.1] DOI: 10.20969/VSKM.2021.14(3).33-37

 COMPARATIVE ASSESSMENT OF ULTRASOUND INDICATORS OF INTRARENAL BLOOD FLOW IN THE EARLY DIAGNOSIS OF RENAL LESIONS

NASRULLAYEV MAGOMED N., ORCID ID: 0000-0001-6176-9372; D. Med. Sci., professor of the Department of surgery of Kazan State Medical Academy – the branch of Russian Medical Academy of Postgraduate Education, Russia, 420012, Kazan, Mushtari str., 11, e-mail: msh.avia yandex.ru

Abstract. Aim. Study of the opportunities of ultrasound investigation methods in the early diagnosis of kidney lesions.Material and methods. The informative value of ultrasound methods in studying the hemodynamics of intrarenal blood ow in type II diabetes mellitus and arterial hypertension was evaluated. We examined 379 patients, including 139 patients with diabetes mellitus type II, 115 patients with arterial hypertension and 125 healthy individuals in the control group. Results and discussion. There was found an increase in the values of the mean indicators of linear size in the group of patients with diabetes mellitus type II, compared to the control group and almost equal to the indicators in the group of patients with arterial hypertension. The value of the mean kidney volume in the group of patients with diabetes mellitus type II was signi cantly higher compared to the control group, as well as compared to the patients with arterial hypertension. Increased hemodynamic indices of intrarenal blood ow and high intrarenal vascular resistance were revealed in patients with type II diabetes and arterial hypertension. The values of the pulsatility and resistance index in patients with type II diabetes mellitus were signi cantly higher than those in the control group, as well as in patients with arterial hypertension. The direct dependence of quantitative characteristics of intrarenal blood ow in patients with type II diabetes on the duration of the disease, and in patients with arterial hypertension on the age and blood pressure level was established. Conclusion. The obtained data allow us to recommend ultrasound examination with color mapping of blood ow and Doppler sonography of renal vessels to be included in the complex of clinical examination of patients with diabetes mellitus and arterial hypertension for detection of renal lesions at the initial stages.

Key words: intrarenal blood ow, diabetes mellitus, arterial hypertension, color Doppler mapping of blood ow.

For reference: Nasrullayev MN. Cоmparative assessment of ultrasound indicators of intrarenal blood flow in the early diagnosis of renal lesions. The Bulletin of Contemporary Clinical Medicine. 2021; 14 (3): 33-37.DOI: 10.20969/VSKM.2021.14(3).33-37.

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 ALGORITHM OF TREATMENT AND DIAGNOSIS IN RESISTANT FORMS OF COLONIC CONSTIPATION IN ADULTS

SAKULIN KIRILL A., ORCID ID: 0000-0002-7444-6617; assistant of professor of the Department of surgical diseases of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. 8(843) 269-00-53, e-mail: volgakir1@yandex.ru

KARPUKHIN OLEG YU., ORCID ID: 0000-0002-7479-4945; D. Med. Sci., professor of the Department of surgical diseases of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. 8(843) 269-00-53, e-mail: oleg_karpukhin@mail.ru

Abstract. Background. The variety of etiological causes of chronic constipation requires an individual approach to diagnosis and treatment. Outdated views do not consider a detailed examination of patients with long-term constipation. Today, surgical interventions for refractory colonic constipation are used more and more often and have begun to demonstrate positive outcomes. The choice of surgical intervention largely depends on the results of the detected abnormality of the structure and location of the colon, as well as on the functional state of its various parts.Aim. Improvement of diagnostic algorithm and treatment strategy in resistant forms of chronic colonic constipation.Material and methods. We analyzed the treatment of 502 patients hospitalized in coloproctology clinic for chronic constipation, 70 (13,9%) of them were operated on. OriginPro 2015 software was used for statistical processing, the reliability of differences was determined using Mann-Whitney test. Results and discussion. We developed a two-stage diagnostic algorithm using innovative diagnostic methods including three-dimensional multispiral computed tomographic colonography, as well as the passage of original X-ray contrast markers and radiopharmaceuticals along the gastrointestinal tract. Precise choice of surgical treatment was made based on the detected abnormality of structure and location of the colon and the place of marker deposition at distant terms from their intake. Sixty-two (88,6%) patients required signi cant reduction of the colon. Subtotal colectomy with ascendorectoanastomosis was the dominant type of surgery and it was performed in 21 (30,0%) cases. We considered the outcomes of surgical treatment to be positive with restoration of regular independent bowel movements, good general well-being and complete restoration of the ability to work in 77,5% of patients. All interviewed patients noted the restoration of regular defecation in the long term after surgery. However, 17,5% of the patients had to periodically use laxatives in case of dietary disturbances and decreased physical activity. Conclusion. The developed algorithm of treatment and diagnosis using new and original methods of investigation allowed the clinic to apply a precision approach to the choice of intervention scope, while the analysis of immediate and long-term outcomes of surgical treatment in patients with refractory forms of colonic constipation syndrome demonstrated good ef cacy.

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 OUTCOMES OF SURGICAL TREATMENT FOR PULMONARY EMBOLISM FOLLOWING PHLEBOLOGIC INTERVENTIONS

FEDOROV SERGEY A., ORCID ID: 0000-0002-5930-3941; C. Med. Sci., cardiovascular surgeon of Specialized heart surgery clinical hospital named after academician B.A. Korolev, Russia, 603950, Nizhny Novgorod, Vaneev str., 209, e-mail: Sergfedorov1991@yandex.ru

MEDVEDEV ALEXANDER P., ORCID ID: 0000-0003-1757-5962; D. Med. Sci., professor of the Department of advanced surgery named after B.A. Korolev of Volga Research Medical University, Russia, 603005, Nizhny Novgorod, Minin i Pozharsky sq., 10/1, e-mail: medvedev.map@yandex.ru

ZHURKO SERGEY A., ORCID ID: 0000-0002-5222-1329; C. Med. Sci., cardiovascular surgeon of Specialized heart surgery clinical hospital named after academician B.A. Korolev, Russia, 603950, Nizhny Novgorod, Vaneev str., 209, e-mail: zhurkoser@mail.ru

ABDULYANOV ILDAR V., ORCID ID: 0000-0003-2892-2827; C. Med. Sci., cardiovascular surgeon the Head 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, e-mail: ildaruna@mail.ru

CHIGINEV VLADIMIR A., ORCID ID: 0000-0001-8977-1968; D. Med. Sci., professor of the Department of advanced surgery named after B.A. Korolev of Volga Research Medical University, Russia, 603005, Nizhny Novgorod, Minin i Pozharsky sq., 10/1, e-mail: chiginevvladimir@yandex.ru

TSELOUSOVA LADA M., ORCID ID: 0000-0002-6005-2684; postgraduate student of the Department of advanced surgery named after B.A. Korolev of Volga Research Medical University, Russia, 603005, Nizhny Novgorod, Minin i Pozharsky sq., 10/1, e-mail: ladamc@rambler.ru

TROFIMOV NIKOLAY A., ORCID ID: 0000-0002-1975-5521; C. Med. Sci., cardiovascular surgeon of Republican cardiology dispensary of the Ministry of Health of the Chuvash Republic, Russia, 428020, Cheboksary, Fedor Gladkov str., 29a, e-mail: nikolai.trofimov@mail.ru

Abstract. Aim. The aim of the study was to analyze the outcomes of surgical treatment for pulmonary embolism in the group of patients previously operated on for varicose vein disease of the lower extremities. Material and methods. Ourstudy was based on the experience of surgical treatment for high-risk pulmonary embolism in a group of phlebologic patients who had previously undergone some type of surgical intervention for varicose vein disease of the lower extremities. The group of patients under investigation consisted of 9 patients, 7 (78%) of them were women. The mean age of the patients under investigation was (57,9±10,8) years (from 36 to 74 years). At the time of admission to the hospital, the patients’ condition was considered to be severe, determined by progressively increasing respiratory and cardiovascular insuf ciency. Borg index at the moment of hospitalization was > 10 points, which was a direct indication for highow noninvasive oxygen therapy. Patients’ APACHE II status corresponded to (10+2) points. In all cases patients underwent embolectomy from the trunk and lobe branches of the pulmonary artery against the background of parallel perfusion of the arti cial circulation, except for one patient, in whom the embolectomy stage preceded the stage of coronary artery bypass grafting, which was performed under pharmaco-cold cardioplegia. The duration of surgical intervention was (128±22,1) min. At the same time, the duration of parallel perfusion was (26,7±10,3) min. Aortic constriction, which was performed in one case during the coronary stage of the surgery, lasted 23 min. Results and discussion. The hospital survival rate of the patients was 100%. All patients were discharged from the hospital on (19,6±3,12) days (13 to 17 days) in a satisfactory condition, for subsequent outpatient treatment. Among non-lethal complications, cardiovascular and respiratory insuf ciency prevailed, which determined the duration of arti cial pulmonary ventilation up to (17,2±3,4) hours, as well as the use of a combined two-component scheme of inotropic myocardial stimulation, lasting up to (14±7,1) hours. The peak pulmonary artery pressure was (27,65±6,2) mmHg, whereas the mean was (18,4±3,1) mmHg. Conclusion. surgical treatment for varicose veins of the lower extremities is an independent risk factor for the development of VTE, which requires revision of risk strati cation and changes in approaches to anticoagulant prevention. Surgical treatment for pulmonary embolism is a reasonable and reliable method due to the presence of absolute contraindications to thrombolytic therapy, as well as due to unsatisfactory anticoagulant therapy. We consider it justi ed to perform open surgical intervention as early as possible, under conditions of parallel perfusion by arti cial circulation, without aortic clamping during the primary surgical phase.

Key words: pulmonary embolism, varicose veins of the lower extremities, venectomy.

For reference: Fedorov SA, Medvedev AP, Zhurko SA, Abdulyanov IV, Chiginev VA, Tselousova LM, Tro mov NA. Outcomes of surgical treatment for pulmonary embolism following phlebologic interventions. The Bulletin of Contemporary Clinical Medicine. 2021; 14(3): 50-57. DOI: 10.20969/VSKM.2021.14(3).50-57.

1. Claeys MJ, Vandekerckhove Y, Cosyns B, Van de Borne P, Lancellotti P. Summary of 2019 ESC Guidelines on chronic coronary syndromes, acute pulmonary embolism, supraventricular tachycardia and dislipidaemias. Acta Cardiologica. 2020; 10: 1-8. PMID: 31920149. https://doi. org/10.1080/00015385.2019.1699282.

2. Nikulina NN, Terekhovskaya YuV. Epidemiologiya tromboembolii legochnoj arterii v sovremennom mire: analiz zabolevaemosti, smertnosti i problem ih izucheniya [Epidemiology of pulmonary embolism in the modern world: analysis of morbidity, mortality and problems of their study]. Rossijskij kardiologicheskij zhurnal [Russian journal of cardiology]. 2019; (6): 103-108. https://doi. org/10.15829/1560-4071-2019-6-103-108

3. Jaff MR, McMurtry MS, Archer SL, Cushman M, Goldenberg N, Goldhaber SZ, Jenkins JS, et al. Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association. Circulation. 2011; 123 (16): 1788-1830. https://doi.org/10.1161/ CIR.0b013e318214914f.

UDC 616.839-053.6-085.217:796 DOI: 10.20969/VSKM.2021.14(3).58-62

 VEGETAL DISBALANCE AND PSYCHOLOGICAL STATUS IN CHILD ATHLETES AND ITS CORRECTION

YAKOVLEVA LYUDMILA V., ORCID ID: 0000-0001-7362-2685; D. Med. Sci., professor, the Head of the Department
of outpatient and emergency pediatrics with the course of the Institute of higher professional education of Bashkir State Medical University, Russia, 450000, Ufa, Lenin str., 3, e-mail: fock20051@mail.ru

SHANGAREEVA GUZEL N., ORCID ID: 0000-0002-4193-3531; C. Med. Sci., associate professor of the Department
of outpatient and emergency pediatrics with the course of the Institute of higher professional education of Bashkir State Medical University, Russia, 450000, Ufa, Lenin str., 3, e-mail: g89656633@yandex.ru

Abstract. Aim. The aim of the study was to evaluate the effect of nootropics on vegetal disbalance and psychological status in child athletes. Material and methods. We observed 50 boys [mean age 14,75 years (14,00–15,50)] with a high level of sportsmanship. Among them there were 10 children with signs of maladaptation and with an increased level of anxiety. The control group consisted of 30 healthy children of comparable age and gender, not involved in athletic activities, selected by random sampling. To correct the detected disorders, deanol aceglumate was administered in a dose of 2 g/day (1 teaspoon twice a day – morning and afternoon) for 1 month. Results and discussion. When analyzing the results of heart rhythm variability, sympathicotonic type of autonomic regulation was revealed in 11% of boy athletes. Analyzing the data of psychological tests, we found that child athletes had a statistically signi cant lower level of reactive anxiety compared to the control group. According to the results of psychological testing we found differently directed levels of reactive and personal anxiety. To correct the identi ed changes, 10 child athletes were prescribed nootropics for 1 month. After repeated study of the autonomic nervous system a shift to the parasympathicotonic side was revealed. Analysis of the results of control psychological testing showed stabilization of the condition and reduction of the level of anxiety. Conclusion. Children with high athletic performance have different types of autonomic regulation of heart rhythm. Sympathicotonic regulation is found in 11% of child athletes. It can be regarded as an early marker of disruption of adaptation processes. It was found that 3% of child athletes have a high level of reactive anxiety and 6% have a high level of personal anxiety. The results obtained justify the use of nootropics to correct the imbalance of autonomic regulation and elevated levels of anxiety.

Key words: child athletes, psychological status, heart rate variability, type of autonomic regulation.

For reference: Yakovleva LV, Shangareeva GN. Vegetal dysbalance and psychological status in child athletes and its correction. The Bulletin of Contemporary Clinical Medicine. 2021; 14 (3): 58-62. DOI: 10.20969/VSKM.2021.14(3).58-62.

1. Yakovleva LV, Shangareyeva GN. Variabel’nost’ serdechnogo ritma i osobennosti psikhologicheskogo statusa u yunykh khokkeistov [Heart rate variability and features of psychological status in young hockey players]. Kazanskiy meditsinskiy zhurnal [Kazan Medical Journal]. 2015; XCVI (4): 675-679.

2. Veyn AM. Vegetativnyye rasstroystva; Klinika, diagnostika, lecheniye [Vegetative disorders: Clinic, diagnostics, treatment]. Moskva: MIA [Moscow: MIA]. 2003; 749 p.

3. Rassel Dzhessi. Vegetativnaya nervnaya sistema [The autonomic nervous system]. Moskva: VSD [Moscow: VSD]. 2019; 952 p.

4. Gusev YeI, Konovalov AN, Skvortsova VI; Konovalova AN, Kozlova AV eds. Nevrologiya: uchebnik [Neurology: textbook]. Moskva: GEOTAR-Media [Moscow: GEOTAR-Media]. 2015; 4: 640 s.

5. Shangareyeva GN. Vzaimosvyaz’ variabel’nosti serdechnogo ritma, morfometricheskikh parametrov serdtsa i psikhologicheskikh osobennostey u detey v sporte vysokikh dostizheniy. [The relationship of heart rate variability, morphometric parameters of the heart and psychological characteristics in children in high-performance sports]. Ufa. 2017; 111 p.

6. Zagaynov RM. Psikhologiya sovremennogo sporta vysshikh dostizheniy [Psychology of modern sport of higher achievements]. Moskva: Sovetskiy sport [Moscow: Soviet sport]. 2019; 370 p.

UDC 616.24-036.12: 616.24-002.5 DOI: 10.20969/VSKM.2021.14(3).63-69

 COMPARATIVE STUDY OF THE IMPACT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE ON THE QUALITY OF LIFE OF PATIENTS WITH PULMONARY TUBERCULOSIS BASED ON THE MOS SF-36 QUESTIONNAIRE

YAUSHEV MARAT F., ORCID ID: 0000-0001-6485-3166; D. Med. Sci., professor of the Department of phthisiopulmonology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49a,
e-mail: umukgmu@rambler.ru

ALEXEEV ALEXEY P., ORCID ID: 0000-0001-5334-2133; chief physician of Republican Clinical Tuberculosis Dispensary of the Ministry of Health of Republic of Tatarstan, Russia, 420049, Kazan, Pribolnichnaya str., 1, e-mail: guz.rkpd@tatar.ru

MAKHMUTOV ILGIZYAR F., ORCID ID: 0000-0003-2924-030X; C. Med. Sci., phthisiologist of Republican Clinical Tuberculosis Dispensary of the Ministry of Health of Republic of Tatarstan, Russia, 420049, Kazan,
Pribolnichnaya str., 1, e-mail: ilfa1956@yandex.ru

PETROV BORIS M., ORCID ID: 0000-0002-7543-8803; resident of the Department of phthisiopulmonology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49a

Abstract. Pulmonary tuberculosis (TBL), as well as chronic obstructive pulmonary disease (COPD), have a diverse negative impact on the quality of life (QOL) of patients. In this regard, a detailed study of the quality of life of patients with pulmonary tuberculosis in combination with chronic obstructive pulmonary disease retains its importance and relevance.Aim. The aim of the study was to determine the orientation and degree of in uence of clinical and functional features of pulmonary tuberculosis and concomitant chronic obstructive pulmonary disease on patients’ quality of life and their interrelation with each other. Material and methods. Two groups of patients were studied: patients with pulmonary tuberculosis without chronic obstructive pulmonary disease (49 people), and pulmonary tuberculosis combined with chronic obstructive pulmonary disease (37 people), who were hospitalized at the tuberculosis dispensary. Male patients prevailed in both groups, in ltrative pulmonary tuberculosis was diagnosed more frequently, rst-time pulmonary tuberculosis was detected, and the mean age was over 45 years. Patients’ quality of life was assessed using the MOS SF-36 questionnaire. External respiratory function was examined by spirometry. Statistical analysis was performed using Statistica 10.0 package, variance and correlation analysis of the obtained data was performed. Results and discussion. In both groups, pulmonary tuberculosis with and without chronic obstructive pulmonary disease was associated with decreased physical activity (PF 63,91 and 67,55, respectively), and recurrence of chronic obstructive pulmonary disease was associated with decreased perception of general health (GH 53,0), and had a negative effect on daily activities (RP 48,64), including through impairment of the emotional sphere (RE 43,24). In the group of patients with pulmonary tuberculosis without chronic obstructive pulmonary disease compared to the general population in the Russian Federation, there was a decrease in social activity (SF 62,75) and physical activity (PF 67,55). Conclusion.The study showed that for the majority of domains, the decrease in quality of life in both groups - pulmonary tuberculosis with chronic obstructive pulmonary disease and pulmonary tuberculosis without chronic obstructive pulmonary disease – was noted in older age groups. The most signi cant decrease in the quality of life in both groups was in the domain of physical functioning (PF). In the group of patients with pulmonary tuberculosis with chronic obstructive pulmonary disease there was a more pronounced negative effect of emotional background (RE) on the performance of daily activities and a lower perception of the physical component of health (PH). In the group of patients with pulmonary tuberculosis without chronic obstructive pulmonary disease, social functioning (SF) was affected more frequently, and there was a more pronounced sensation of pain (BP).

Key words: lung tuberculosis, COPD, quality of life, SF-36.

For reference: Yaushev MF, Alexeev АP, Makhmutov IF, Petrov BM. Comparative study of the impact of chronic obstructive pulmonary disease on the quality of life of patients with pulmonary tuberculosis based on MOS SF-36 questionnaire. The Bulletin of Contemporary Clinical Medicine. 2021; 14 (3): 63-69. DOI: 10.20969/VSKM.2021.14(3).63-69.

2. Velikaya OV, Akulova AV. Ocenka kachestva zhizni zhenshchin, bol’nyh tuberkulyozom lyogkih, s ispol’zovaniem ankety SF-36 [Assessment of the quality of life of women with pulmonary tuberculosis using the SF-36 questionnaire]. Nauchnye vedomosti [Scienti c journal]. 2015; 16 (213): 110-115.

3. Chushkin MI. Kachestvo zhizni i respiratornaya funkciya u pacientov, izlechennyh ot tuberkuleza legkih [Quality of lifeand respiratory function in patients cured form pulmonarytuberculosis]. Moskva [Moscow]. 2015; 45 p.

4. Vizel’ AA, Alekseev AP, Shmelev EI, et al. Bronhoobstruktivnyj sindrom u bol’nyh tuberkulezom legkih (analiticheskij obzor literatury) [Broncho-obstructive syndrome in patients with pulmonary tuberculosis (analytical literature review)]. Prakticheskaya pul’monologiya [Practical pulmonology]. 2018; 1: 33–42.

5. Savinceva EV, Kozlova TP, Bitneva AM, et al. Ocenka kachestva zhizni bol’nyh tuberkulezom legkih [Assessment of the quality of life of patients with pulmonary tuberculosis]. Problemy nauki [Problems of science]. 2019; 2 (38): 75-77.

6. Chushkin MI, Smerdin SV, Ots ON, et al. Sravnitel’nyj analiz anket dlya ocenki kachestva zhizni bol’nyh tuberkulezom legkih v processe provodimogo lecheniya [Comparative analysis of questionnaires for assessing the quality of life of patients with pulmonary tuberculosis during treatment]. Zdravoohranenie Rossijskoj Federacii [Healthcare of Russia]. 2016; 60 (3): 133-137.

7. Chuchalin AG, Belevskij AS, Chernyak BA, et al. Kachestvo zhizni bol’nyh hronicheskoj obstruktivnoj bolezn’yu legkih v Rossii: rezul’taty mnogocentrovogo populyacionnogo issledovanie «IKAR-HOBL» [Quality of life of patients with chronic obstructive pulmonary disease in Russia: results of a multicenter population study “ICAR-COPD”]. Pul’monologiya [Pulmonology]. 2005; 1: 93–102.

8. Bagisheva NV, Moiseeva MV, Viktorova IA, et al. Kachestvo zhizni kak integral’nyj pokazatel’ effektivnosti terapii: v fokuse pacienty s hronicheskoj obstruktivnoj bolezn’yu legkih, tuberkulezom legkih i arterial’noj gipertenziej [Quality of life as an integral indicator of the effectiveness of therapy: focusing on patients with chronic obstructive pulmonary disease, pulmonary tuberculosis and arterial hypertension]. Medicinskij al’yans [Medical alliance]. 2020; 8 (3): 37-45.

9. Bagisheva NV, Neganova YuA, Neganova NA, et al. Hronicheskaya obstruktivnaya bolezn’ legkih i tuberkulez kak vzaimootyagoshchayushchie zabolevaniya [Chronic obstructive pulmonary disease and tuberculosis as mutually aggravating diseases]. Tuberkulez i bolezni legkih [Tuberculosis and lung diseases]. 2015; 6: 21-22.

10. Kazimirova NE, Amirova ZR, Fomin ON. Ispol’zovanie pokazatelej kachestva zhizni bol’nyh tuberkulezom legkih v prognozirovanii effektivnosti lecheniya [Using indicators of the quality of life of patients with pulmonary tuberculosis in predicting the effectiveness of treatment]. Tuberkulez i bolezni legkih [Tuberculosis and lung diseases]. 2015; 6: 68-69.

11. Danilov AN. Monitoring kachestva zhizni naseleniya s pomoshch’yu oprosnika SF-36 kak operezhayushchij indikator prognozirovaniya epidemiologicheskoj obstanovki po tuberkulez [Monitoring the quality of life of the population using the SF-36 questionnaire asa leading indicator of predicting the epidemiologicalsituation in tuberculosis]. Vestnik sovremennoj klinicheskoj mediciny [Bulletin of modern clinical medicine]. 2015; 8 (3): 15-20.

12. Ware JE, Snow KK, Kosinski M, et al. SF-36 Health Survey. Manual and interpretation guide. The Health Institute, New England Medical Center; Boston, Mass. 1993; 316 p.

13. Amirdzhanova VN, Goryachev DV, Korshunov NI, et al. Populyacionnye pokazateli kachestva zhizni po oprosniku SF-36 [Population indicators of quality of life according to the SF-36 questionnaire]. Nauchno-prakticheskaya revmatologiya [Scienti c and practical rheumatology]. 2008; 1: 36–42.

UDC 616.155.294:616.98:578.834.1(048.8) DOI: 10.20969/VSKM.2021.14(3).76-83

 THROMBOСYTOPENIA AND OTHER MANIFESTATIONS OF СOAGULOPATHY: DIAGNOSTIС AND TREATMENT OPTIONS FOR СOVID-19 NEW СORONAVIRUS INFEСTION

KHAMITOV RUSTEM F., ORСID ID: 0000-0001-8821-0421; D. Med. Sci., professor, the Head of the Department of internal medicine of Kazan State Medical University, Russia, 420012, Kazan, tel. 8-917-272-96-72, e-mail: rhamitov@mail.ru

MOLOSTVOVA ALSU F., ORСID ID: 0000-0001-6996-9985; assistant of professor of the Department of internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-904-672-81-19, e-mail: alsuvesna@mail.ruSALIMOVA LILIYA M., ORСID ID: 0000-0003-4186-6049; assistant of professor of the Department of internal medicine of Kazan State Medical University, Russia, 420012, Kazan, tel. 8-917-232-86-63, e-mail: calimova.lili@gmail.com

Abstraсt. An important role in the development of adverse outcomes of new coronavirus infection (COVID-19) is played by hemostasis disorders, one manifestation of which is thrombocytopenia. Often it is dif cult for the clinician to identify the underlying cause of thrombocytopenia: whether it is coronavirus-induced coagulopathy or whether thrombocytopenia was present in the patient before the disease. Aim. To study the most signi cant causes, methods of diagnosis and treatment of thrombocytopenias. Material and methods. A review of Russian and foreign scienti c publications devoted to the study of diagnosis and treatment of thrombocytopenic conditions in clinical practice has been performed. Results and discussion. Thrombocytopenia is a decrease in the platelet count below the reference values (150×109/l). The incidence of thrombocytopenia ranges from 10–130 to 200 per 1 million population. The key mechanisms of thrombocytopenia in coronavirus-induced coagulopathy are in ammation and hypercoagulation. The differential diagnosis of thrombocytopenias in coronavirus-induced coagulopathy should be made with hypoproductive thrombocytopenias due to reduced platelet production in bone marrow; with thrombocytopenias caused by increased platelet destruction or consumption; with distribution and hereditary thrombocytopenias. Conclusion. Further researchis needed to study the pathophysiological features of thrombocytopenias and other disorders of the hemostasis systemin СOVID-19, exploring the possibilities of prevention and correction, known since the pre-COVID era, development of optimal treatment approaches based on the ndings of clinical and experimental studies devoted to this new infection for mankind.

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