DEPARTMENTAL MEDICAL SERVICE OF THE MINISTRY OF INTERNAL AFFAIRS OF THE RUSSIAN FEDERATION IS 100 YEARS OLD

KHISAMIEV RUSTEM SH., Lieutenant Colonel of the Internal Service, the Head of the Medical Care unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, Russia, 420111, Kazan, Lobachevsky str., 13, tel. 8(843)291-24-58, e-mail: msch_16mvd.gov.ru

SULTANOVA DILYA R., Colonel of the Internal Service, Deputy Head of the Medical Care unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, Russia, 420111, Kazan, Lobachevsky str., 13, tel. 8(843)291-32-14

1. Khisamiev RSh, Ginyatullina LR, Amirov NB. Dostizheniya i perspektivy razvitiya vedomstvennoy meditsinskoy sluzhby MVD po Respublike Tatarstan [Achievements and development prospects of the departmental medical service of the Ministry of Internal Affairs in the Republic of Tatarstan]. Vestnik sovremennoy klinicheskoy meditsiny [Bulletin of contemporary clinical medicine]. 2016; 9 (6): 13-15.

2. Amirov NB, Vizel AA, Sabirov LF. II Vserossiyskaya konferentsiya vrachey mediko-sanitarnykh chastey MVD i vrachey Respubliki Tatarstan [II All-Russian conferenceof doctors of medical and sanitary units of the Ministry ofInternal Affairs and doctors of the Republic of Tatarstan]. Vestnik sovremennoy klinicheskoy meditsiny [Bulletin of contemporary clinical medicine]. 2009; 2 (4): 67-72.

3. Khisamiev RSh, Ginyatullina LR, Amirov NB. Opyt organizatsii deyatel’nosti mediko-sanitarnoy chasti v period provedeniya krupnykh mezhdunarodnykh i massovykh sportivnykh meropriyatiy na primere FKUZ «MSCH MVD Rossii po Respublike Tatarstan» v period podgotovki i provedeniya XXVII Vsemirnoy letney universiady [The experience of organizing the activitiesof the medical and sanitary unit during the period ofmajor international and mass sports events on the example of the FKUZ «Medical unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan» during the preparation and holding of the XXVII World Summer Universiade]. Vestnik sovremennoy klinicheskoy meditsiny [Bulletin of contemporary clinical medicine]. 2013; 6 (1): 4-9.

4. COMTO «Meditsina» Podsistema «Meditsina» servisa obespecheniya deyatel’nosti podrazdeleniy material’notekhnicheskogo obespecheniya organov vnutrennikh del Rossiyskoy Federatsii; Dannyy servis vveden v ekspluatatsiyu s 01/09./2016 goda soglasno prikaza MVD Rossii ot 24/03/2016 No 133 «Voprosy organizatsii raboty servisa obespecheniya deyatel’nosti podrazdeleniy material’no-tekhnicheskogo obespecheniya organov vnutrennikh del Rossiyskoy Federatsii» [SOMTO “Medicine” Subsystem «Medicine» of the service for the activities of the subdivisions of the material and technicalsupport of the internal affairs bodies of the RussianFederation; This service was put into operation from 01/09/2016 according to the order of the Ministry of Internal Affairs of Russia dated 24/03/2016 No 133 “Issues of organizing the work of the service to support the activitiesof the logistics departments of the internal affairs bodiesof the Russian Federation”].

5. Khisamiev RSh, Ginyatullina LR, Amirov NB. Vedomstvennoye zdravookhraneniye MVD po Respublike Tatarstan: realii i perspektivy [Departmental health care of the Ministry of Internal Affairs in the Republic of Tatarstan: realities and prospects]. Vestnik sovremennoy klinicheskoy meditsiny [Bulletin of contemporary clinical medicine]. 2014; 7 (1): 11-15.

6. Vremennyye metodicheskiye rekomendatsii: Pro laktika, diagnostika i lecheniye novoy koronavirusnoy infektsii (Covid-19) [Temporary guidelines: Prevention, diagnosis and treatment of new coronavirus infection (Covid-19)]. 05/07/2021; Version 11.

7. Rasporyazheniye ministra vnutrennikh del Rossiyskoy Federatsii, generala politsii VA Kolokol’tseva ot 31/01/2020 No1/984 «O komplekse mer po preduprezhdeniyu rasprostraneniya koronavirusnoy infektsii» [Order of the Minister of Internal Affairs of the Russian Federation, Police General VA Kolokoltsev dated 31/01/2020 No 1/984 «On a set of measures to prevent the spread of coronavirus infection»].

8. Postanovleniye Glavnogo gosudarstvennogo sanitarnogo vracha Rossiyskoy Federatsii AYU Popovoy ot 24/01/2020 No2 «O dopolnitel’nykh meropriyatiyakh po nedopushcheniyu zavoza i rasprostraneniya novoy koronavirusnoy infektsii, vyzvannoy 2019-nCoV» [Resolution of the Chief State Sanitary Doctor of the Russian Federation AYu Popova dated January 24, 2020 No 2 «On additional measures to prevent the import and spread of the new coronavirus infection caused by 2019-nCoV»].

 THE INFORMATIVE VALUE OF PELVIC ULTRASONOGRAPHY IN RECURRENT EXTERNAL GENITAL ENDOMETRIOSIS

ALIEVA FARAKH T., ORCID ID: 0000-0001-5505-0433; postgraduate student of the Department of obstetrics and gynecology of I.M. Sechenov First Moscow State Medical University (Sechenov University), Russia, 1119991, Moscow, Trubetskaya str., 8/2, e-mail: mic_amu@mail.ru

BRYUNIN DMITRY V., ORCID ID: 0000-0002-5969-4217; D. Med. Sci., professor, the Head of the Department of gynecology of Clinic of obstetrics and gynecology named after V.F. Snegirev, Russia, Moscow, Elansky str., 2, build. 1, tel. +7(499)450-88-89, e-mail: mic_amu@mail.ru

ALIEVA FIDAN T., ORCID ID: 0000-0001-5555-3022; postgraduate student of the Department of obstetrics and gynecology of I.M. Sechenov First Moscow State Medical University (Sechenov University), Russia, 1119991, Moscow, Trubetskaya str., 8/2, e-mail: mic_amu@mail.ru

1. Barto RA, Chechneva MA. Ul’trazvukovaya diagnostika retrocervikal’nogo endometrioza [Ultrasound diagnostics of retrocervical endometriosis]. Al’manah klinicheskoj mediciny [Almanac of Clinical Medicine]. 2015; 37: 93-99.

2. Borisova AV, Kozachenko AV. Faktory riska razvitiya recidiva naruzhnogo genital’nogo endometrioza [Risk factors for the development of recurrence of external genital endometriosis] Medicinskij sovet [Medical Council]. 2018; 7: 32-38. DOI: 10.21518/2079-701X-2018-7-32-38

3. Rusina EI, Yarmolinskaya MI, Ivanova AO. Sovremennye podhody pri luchevoj diagnostike endometrioza [Modern approaches to radiation diagnosis of endometriosis]. Akusherstva i zhenskih boleznej [Obstetrics and female diseases]. 2020; 69 (2): 59-72.

4. Yarmolinskaya MI, Rusina EI, Hachaturyan AR, Frolova MS. Klinika i diagnostika genital’nogo endometrioza [Clinic and diagnosis of genital endometriosis]. Aktual’nye problemy zdravoohraneniya [Actual problems of health care]. 2016; 65 (5): 4-21. DOI: 10.3109/00016349.2010.512061

5. Alborzi S, Keramati P, Youncsi M. The impact of laparoscope cysteotomy on ovarian reserve in patients with unilareral and bilateral endometriomas. Fertil Steril. 2014; 101: 427-434.

6. Alborzi S, Rasekhi A, Shomali Z, Madadi G. Diagnostic accuracy of magnetic resonance imaging, transvaginal,and transrectal ultrasonography in deep infiltratingendometriosis. Medicine. 2018; 97 (8): 1-8.

7. Scioscia M, Virgilio BA, Laganà AS, et al. Differential Diagnosis of Endometriosis by Ultrasound: A Rising Challenge. Diagnostics (Basel). 2020; 10 (10): 848. DOI: 10.3390/diagnostics10100848

8. Benacerraf BR, Groszmann Y, Hornstein MD. Deep in ltrating endometriosis of the bowel wall: the comet sign. Am J Ultrasound Med. 2015; 34: 537-542.

9. Fuldeore MJ, Soliman AM. Prevance and symptomatic durden of diagnosed andometriosis in the united states: national estimates from a cross-sectional survery of 59411 women. Am J Gynecol Obstet Invest. 2017; 82: 453-461.

10. Nisenblat V, Bossuyt PM, Farquhar C. Imaging modilities for the non-invasive diagnosis of endometriosis. Cochrane Database Syst Rev. 2016; 2 (2): CD009591. DOI: 10.1002/14651858.CD009591

 HORMONE LEVEL CHANGES IN ENDOMETRIAL ABNORMALITIES IN THE POSTMENOPAUSAL PERIOD

ALIEVA FIDAN T., ORCID ID: 0000-0001-5555-3022; postgraduate student of the Department of obstetrics and gynecology of I.M. Sechenov First Moscow State Medical University (Sechenov University), Russia, 1119991, Moscow, Trubetskaya str., 8/2, e-mail: mic_amu@mail.ru

BRYUNIN DMITRY V., ORCID ID: 0000-0002-5969-4217; D. Med. Sci., professor, the Head of the Department of gynecology of Clinic of obstetrics and gynecology named after V.F. Snegirev, Russia, Moscow, Elansky str., 2, build. 1, tel. +7(499)450-88-89, e-mail: mic_amu@mail.ru

ALIEVA FARAKH T., ORCID ID: 0000-0001-5505-0433; postgraduate student of the Department of obstetrics and gynecology of I.M. Sechenov First Moscow State Medical University (Sechenov University), Russia, 1119991, Moscow, Trubetskaya str., 8/2, e-mail: mic_amu@mail.ru

Abstract. Background. In recent decades, the increase in life expectancy has led to a signi cant increase in the duration of the postmenopausal period. Prolonged estrogen de ciency contributes to an increase in the incidence of chronic somatic diseases, including neurovegetative, metabolic-endocrine, and psycho-emotional disorders that de ne the menopausal syndrome. Aim. To study the prognostic and diagnostic signi cance of hormone parameters in endometrial abnormalities in the postmenopausal period. Material and methods. Forty-seven women with various clinical manifestations of endometrial pathology in the postmenopausal period were examined. The mean age of the examined women was (58,43±1,1) years. All the patients had luteinizing hormone, follicle-stimulating hormone, progesterone, testosterone, estradiol, dehydroepiandrosterone sulfate, and serum sex hormone-binding globulin measured by enzyme immunoassay. The results obtained were subjected to statistical processing using standard computer programs «Statgraph» designed for parametric and nonparametric methods of calculating mean values. We calculated mean and standard deviation (M±Se), as well as minimum-maximum values for the sample. Differences were considered significant at p<0,05. Results and discussion. As a result of the study the abnormality of the endometrium in thepostmenopausal period was determined. Endometritis was observed in 4 (8,5%) of 47 patients, atrophic endometrium in 7 (14,9%) patients, diffuse endometrial hyperplasia in 3 (6,4%) cases, endometrial polyp in 29 (61,7%) cases, and endometrial carcinoma in 3 (6,4%) cases. A signi cant increase in follicle-stimulating hormone [(65,39±1,27) mmE/ mL], luteinizing hormone [(34,85±0,15] mmE/mL), estradiol [(88,73±2,1) pg/mL], and testosterone [(2,29±0,08) ng/mL] values was registered in the postmenopausal patients, which is an important prognostic and diagnostic criterion in this patient population. Conclusion. The study of hormone parameters in the postmenopausal period is one of the most important methods of early detection of various endometrial abnormalities, allowing timely implementation of appropriate therapeutic and preventive measures.

1. Ahundova NE. Osobennosti endokrinnyh i metabolicheskihizmenenij u zhenshchin s giperandrogeniej razlichnogogeneza v reproduktivnom periode [Features of endocrineand metabolic changes in women with hyperandrogenismof various origins in the reproductive period]. Vestnik Rossijskoj voenno-medicinskoj akademii [Bulletin of the Russian Military Medical Academy]. 2016; 4 (56): 32-35.

2. Buyanova SN, Gitinov EM, Yudina NV, Rizhinashvili ID. Optimizaciya diagnostiki i lecheniya u bol’nyh s giperplaziej endometriya v postmenopauze pri sochetannoj ginekologicheskoj patologii [Optimization of diagnosis andtreatment in postmenopausal patients with endometrialhyperplasia with combined gynecological pathology]. Rossijskij vestnik akushera-ginekologa [Russian Bulletin of Obstetrician-Gynecologist]. 2013; 4: 58-62.

3. Kogan EA, Satarov ShN, Sarkisov SE. Strukturno-molekulyarnye perestrojki v polipah i okruzhayushchem endometrii v postmenopauze: processy proliferacii, neoangiogeneza, stareniya i apoptoza [Structural andmolecular rearrangements in polyps and the surroundingendometrium in postmenopausal women: the processes of proliferation, neoangiogenesis, aging and apoptosis]. Akusherstvo i ginekologiya [Obstetrics and gynecology]. 2014; 1: 46-53.

4. Kogan EA, Satarov ShN, Sarkisov SE, Bojko MA. Receptornyj status polipov endometriya u zhenshchin v postmenopauze [Receptor status of endometrial polyps in postmenopausal women]. Akusherstvo i ginekologiya [Obstetrics and gynecology]. 2014; 2: 60-66.

5. Savel’eva GM, Breusenko VG, Karaeva EN, Golova YuA. Patоgenez polipov endometriya u pacientok v pre- i postmenopauze; Ekspressiya genov receptorov estradiola i progesterona v ih tkani [Pathоgenesis of endometrial polyps in pre- and postmenopausal patients; Expressionof genes for estradiol and progesterone receptors in theirtissues]. Akusherstvo i Ginekologiya [Obstetrics and Gynecology]. 2015; 4: 33-39.

6. Chestnova GP, Kulyushina EA, Abashin VG, E menko NA. Osobennosti diagnostiki giperplasticheskih processov v endometrii u zhenshchin v period dlitel’noj postmenopauzy [Features of diagnostics of hyperplastic processes in the endometrium in women during prolonged postmenopause]. Klinicheskaya Medicina [Clinical Medicine]. 2013; 9: 46-47.

7. Guidelines on Clinical Management of Endometrial Hyperplasia. HKCOG Guidelines, 2015; 16: 1-14.

8. Hartman A, Wolfman W, Nayot D, Hartman M. Endometrial thickness in 1500 asymptomatic postmenopausal women not on hormone replacement therapy. Am J Gynecol Obstet Invest. 2013; 75: 191-195.

9. Mac Bride MB, Rhodes DJ, Shuster LT. Vulvovaginal atrophy. Mayo Clin Proc. 2010; 85 (1): 87-94.

10. Mamedova SM, Garashova MA, Alieva EM. Osobennosti rasprostraneniya dobrokachestvennyh, preinvazivnyh i invazivnyh processov v organah reproduktivnoj sistemy v postmenopauzal’nom periode [Features of the spread of benign, pre-invasive and invasive processes in the organs of the reproductive system in the postmenopausal period]. Medicinskie novosti [Medical News]. 2018; 11 (290): 33-35.

11. Elkholi DGE, Nagy HM. Unexplained postmenopausal uterine bleeding from atrophic endometrium: Histopathological and hormonal studies. Middle East Fertility Society Journal. 2015; 20: 262-270.

12. Ahundova NE, Alieva EM, Mamedgasanov RM, Garashova MA. Kliniko-diagnosticheskie osobennosti sindroma giperandrogenii v razlichnye periody zhizni zhenskogo organizma [Clinical and diagnostic features of thesyndrome of hyperandrogenism in different periods ofthe life of the female body]. Medicinskie novosti, [Medical News]. 2018; 11 (290): 40-42.

BABAKHANOV ISBI S., ORCID ID: 0000-0002-5303-439X; PhD in medicine, doctoral student of the Department of epidemiology of Azerbaijan Medical University; the Head of the Republican Hospital of the Medical Service of the Ministry of Internal Affairs of the Republic of Azerbaijan, Azerbaijan, AZ1069, Baku, Ziya Buniyadov str., 36, tel. +994(050)252-92-22, e-mail: mic_amu@mail.ru

Abstract. Background. Stroke is the second leading cause of death worldwide and the third leading cause of long-term disability in adults. In law enforcement of cers, stress may contribute to the development of cardiovascular disease, exacerbating a number of stroke risk factors. Aim. Study of prevalence and identi cation of leading risk factors for ischemic stroke in law enforcement workers. Material and methods. A retrospective analysis of case records of patients diagnosed with atrial brillation, acute insuf ciency of cerebral circulation and transient ischemic attack who received treatment in the Republican Hospital of the Ministry of Internal Affairs of Azerbaijan from 2016 to 2020 (n=1864) was performed. Of these, 225 case records of patients with a concomitant diagnosis of ischemic stroke [(12,07±2,2)%] were selected. We studied such pathological conditions as transient ischemic attack, hypertensive cerebral crisis and chronic forms of cerebrovascular disease as risk factors for stroke. Results and discussion. We found that there were 81 [(36,0±3,2)%] cases of cerebrovascular disease among the 225 examinees, including 64 [(28,44±2,9)%] established and 17 [(7,56±3,6)%] probable cases of cerebrovascular disease. Acute forms of cerebrovascular disease often occurred together with chronic forms. (6,98±3,2)% of patients aged 40–54 years (n=129) and (17,70±3,9)% of patients aged 55–65 years (n=96) had discirculatory encephalopathy. There was a total of 6 cases of transient ischemic attack [(2,67±1,4)%] in the patients examined, of which 2 cases [(0,89±1,2)%] were «de nite» and 4 cases [(1,78±0,9)%] were «possible». The overall prevalence of transient ischemic attack in patients was (2,67±1,4)%. In 75,0% of the cases detected, transient ischemic attacks were registered predominantly once. Out of the total number of all detected cases of transient ischemic attack, 4 (66,67%) cases were registered for the rst time upon history taking. Arterial hypertension was registered in 198 of 225 [(88,0±2,1)%] patients examined. Hypertensive crisis during ischemic stroke was detected in 14 of 225 patients (6,22% of all patients examined) and in (17,68±2,7)% of patients with arterial hypertension (34 patients). Additionally, there were 15 [(6,67±3,83)%] cases of hypertensive cerebral crisis: 5 (2,22%) established cases of hypertensive cerebral crisis and 10 [(4,44±2,80)%] «possible» cases. Conclusion. A comprehensive study of the clinical features, course, and complications of ischemic stroke will allow us to develop new approaches to solve the urgent research problem, which is the management strategy to be applied to patients in the acute period of ischemic stroke.

1. Roger VL, Go AS, Lloyd-Jones DM, et al; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Executive summary: heart disease and stroke statistics–2012 update: a report from the American Heart Association. Circulation. 2012; 125: 188–197. doi: 10.1161/CIR.0b013e3182456d46.

2. Mozzafarian D, Benjamin EJ, Go AS, et al, on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics–2016 update: a report from the American Heart Association. Circulation. 2016; 133: e38–e360.

3. Isakova EV, Ryabceva AA, Kotov SV. Sostoyanie mikrocirkulyatornogo rusla u bol’nyh, perenesshih ishemicheskij insul’t [The state of the microvasculature in patients with ischemic stroke]. Russkiy meditsinskiy zhurnal; Aktual’naya problema [Russian medical journal; Actual problem]. 2015; 12: 680-682.

4. Levin OS, Bril’ EV. Pervichnaya i vtorichnaya pro laktika insul’ta [Primary and secondary prevention of stroke]. Sovremennaya terapiya v psihiatrii i nevrologii [Modern therapy in psychiatry and neurology]. 2016; 1: 4-7.

5. Fonyakin AV, Geraskina LA. Pro laktika ishemicheskogo insul’ta; Rekomendacii po antitromboticheskoj terapii; pod redakciej SA Suslinoj]. [Prevention of ischemic stroke; Recommendations for antithrombotic therapy, ed ZA Suslina]. Moskva [Moscow]: IMA-PRESS. 2014; 72 p.

6. Agarwal SK, Heiss G, Rautaharju PM, et al. Premature ventricular complexes and the risk of incident stroke. Stroke. 2010; 41: 588-593.

7. Dirnagl U, Simon RP, Hallenbeck JM. Ischemic tolerance and endogenous neuroprotection. Trends Neurosci. 2017; 6: 248-254.

8. Kochhauser S, Dechering DG, Dittrich R, et al. Supraventricular premature beats and short atrial runs predict atrial brillation in continuously monitored patients with cryptogenic stroke. Stroke. 2014; 45: 884-886.

9. Lee S, Kim H. Clopidogrel and Aspirin versus Aspirin Alone for Prevention of Recurrent Ischemic Lesion in Acute Atherothrombotic Stroke: A Randomized, Double-Blind, Placebo-Controlled Trial. Stroke. 2014; 45: 334.

10. Chimowitz MI. The Feinberg award lecture 2013; Treatment of intracranial atherosclerosis: from the past and planning for the future. Stroke. 2013; 44: 2664–2669.

11. Davhale R, Potapova MV, Amirov NB. Rasprostranennost’ arterial’noj gipertenzii sredi sotrudnikov pravoohranitel’nyh organov [Prevalence аrтеrial hipertension among the employees of law-enforcement bodies]. Vestniksovremennoi klinicheskoi mediciny [The bulletin of contemporary clinical medicine]. 2013; 6 (2): 66-72.

12. Amirov NB, Vizel’AA, Potapova MV, et al. Chastota i osobennosti formirovaniya giper-tenzivnogo sindroma i faktorov riska SSZ u rabotnikov MVD i MCHS, rabotayuschih v avtoinspekcii i v pozharnoi sluzhbe [Frequency and features of the formation of hypertensive syndrome and risk factors for CCP in employees of the Ministry of Internal Affairs and the Ministry of Emergency Situations working in the traf c police and in the re service]. Vestnik sovremennoi klinicheskoi mediciny [The bulletin of contemporary clinical medicine]. 2008; 1 (1): 93–95.

13. Amirov NB, Andreeva TI. Tabachnaya epidemiya: farmakologicheskie vozmozhnosti bor’by [Tobacco epidemic: pharmacological control options]. Vestnik sovremennoi klinicheskoi mediciny [The bulletin of contemporary clinical medicine]. 2011; 4 (3): 28–33.

 COMPARISON OF THE STATE OF THE MAXILLARY SINUSES IN A NEW CORONAVIRUS INFECTION COVID-19 AND ACUTE RESPIRATORY VIRAL INFECTION

KOLSANOV ALEXANDER V., ORCIDID: 0000-0002-4144-7090; D. Med. Sci., professor, the Head of the Department of operative surgery and clinical anatomy with the course of innovative technologies of Samara State Medical University, Russia, 443099, Samara, Chapaevskaya str., 89, tel. 8-927-202-71-15, e-mail: a.v.kolsanov@samsmu.ru

VLADIMIROVA TATYANA JU., ORCID ID: 0000-0003-1221-5589; C. Med. Sci., associate professor, the Head of the Department named after academician of the Russian Academy of Sciences I.B. Soldatov of Samara State Medical University, Russia, 443099, Samara, Chapaevskaya str., 89, tel. 8-927-004-20-33, e-mail: vladimirovalor@yandex.ru

ZELTER PAVEL V., ORCID ID: 0000-0003-1346-5942; C. Med. Sci., the Head of the Department of X-ray of Samara State Medical University, Russia, 443099, Samara, Karl Marx str., 165b, tel. 8-917-942-12-34, e-mail: pzelter@mail.ru

ZELYOVA OLESYA V., ORCID ID: 0000-0003-0143-4655; otorhinolaryngologist, Samara State Medical University, Russia, 443099, Samara, Karl Marx str., 165b, tel. 8-929-707-19-77, e-mail: olesyalorik@gmail.com

Abstract. Aim. The aim of the study was to identify possible changes in the maxillary sinuses during new coronavirusinfection in comparison with the changes in the sinuses occurring during acute respiratory infections and to correlate the gender structure of the study groups. Material and methods. The study included 40 patients (18 women and 22 men) with a con rmed new coronavirus infection, hospitalized at the Covid Hospital Clinics of Samara State Medical University in 2020. All patients underwent multispiral computed tomography of the paranasal sinuses on a Ge revolution Evo 128 tomograph on the 10th day after the appearance of the rst clinical symptoms. We also examined a control group of patients with acute respiratory infections with similar complaints of impaired sense of smell, rhinorrhea, and upper maxillary sinus discomfort. This group also included 40 people (24 women and 16 men). Statistical processing of the study results was performed using Microsoft Excel software package, the Mann – Whitney method of statistical signi cance calculation was used. Results and discussions. In 18 (45%) patients with a con rmed new coronavirus infection, a slight mucosal thickening along the lower wall of the maxillary sinuses was found symmetrically on both sides. Six (15%) of them were women and 12 (30%) were men. The age of the examined patients ranged from 31 to 83 years. Chronic sinusitis was noted in the history of 8 (20%) of the examined patients. In 6 (15%) patients with chronic sinusitis no abnormalities were detected in the maxillary sinuses at the time of examination. Two of them had parietal thickening of the mucous membrane along the lower wall of the maxillary sinuses. In the control group, there was signi cant symmetric parietal thickening of the mucous membrane of the paranasal sinuses in 24 (60%) examined patients (14 women and 10 men). There were no statistically signi cant differences in the prevalence of changes in the studied and control groups. Conclusion. According to the results of this study, there were no data on the pattern of occurrence of changes in the mucosa of the maxillary sinuses in new coronavirus infection with gender background or the presence of chronic in ammation of the maxillary sinuses in the history compared with the control group of examined patients after acute respiratory infections.

1. Assuncao Santos RE, Giselda da Silva M, Barbosa do Monte Silva MC, Mendes Barbosa DA, do Vale Gomes Al, Monteiro Galindo LG, Raquel da Silva Aragao, Ferraz-Pereira KN. Onset and duration of symptoms of loss of smell/taste in patients with COVID-19: A systematic review. American Journal of Otorlaryngology – Head and Neck Medicine and Surgery. 2021; 42: 4-6.

2. Tong JY, Wong A, Zhu D, Fastenberg JH, Tham T. The prevalence of olfactory and gustatory dysfunction in COVID-19 patients: a systematic review and meta-analysis. Otolaryngol – Head Neck Surg (United States) 2020; 163 (1): 3-11. DOI: 10.1177/0194599820926473.

3. Jotz GP, Voegels RL, Bento RF. Otorhinolaryngologists and coronavirus disease 2019 COVID-19. Int Arch Otorhinolaryngol. 2020; 24 (2): 125–128. DOI: 10.1055/s-0040-1709724.

4. Vargas-Gandica J, Winter D, Schnippe R, Rodriguez-Morales AG, Mondragon J. Escalera-Antezana JP, et al. Ageusia and anosmia, a common sign of COVID-19? A case series from four countries. J Neurovirol. 2020; 26: 785–789. DOI: 10.1007/s13365-020-00875-8.

5. Kryukov AI, Kazakova AA, Geht AB. Narusheniye obonyaniya u bol’nykh COVID-19: mekhanizmy i klinicheskoye znacheniye [Olfactory impairment in patients with COVID-19: mechanisms and clinical significance]. Vestnik otorinolarinogologii [Bulletin of Otorhinolaryngology]. 2020; 85 (5): 93-97. DOI: 10.17116/ otorino20208505193

6. Lechien JR, Chiesa-Estomba CM, De Siati DR, Horoi M, Le Bon SD, Rodriguez A, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-tomoderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch Oto-Rhino-Laryngology. 2020; 277 (8): 2251-2261. DOI:10.1007/s00405-020-05965-1

7. Gane SB, Kelly C, Hopkins C. Isolated sudden onset anosmia in COVID-19 infection. A novel syndrome? Rhinology. 2020; 58 (3): 4-8. DOI: 10.4193/Rhin20.114

8. Rocke J, Hopkins C, Philpott C, Kumar BN. Isn\ loss of sense of smell as a diagnostic marker in COVID-19: A Systematic Review and Meta-analysis. Clinical  otolaryngology. 2020; 45 (6): 914-922. DOI: 10.22541/

 QUALITATIVE AND QUANTITATIVE FEATURES OF DYSPNEA IN PATIENTS WITH THE PROGRESSIVE FIBROTIC PHENOTYPE OF INTERSTITIAL LUNG DISEASE ASSOCIATED WITH CARDIOVASCULAR DISEASE

MEDVEDEV ALEXANDER V., C. Med. Sci., Senior research worker of the Department of tuberculosis differential diagnosis and extracorporeal treatment of Central Tuberculosis Research Institute, Russia, 107564, Moscow, Yauzskaya alley, 2, tel. +7(499)785-90-08; +7(909)691-41-54, e-mail: alexmedved_1@mail.ru

1. Lutz Wollin , Jörg H W Distler, Elizabeth F Redente, David W H Riches, Susanne Stowasser, Rozsa Schlenker-Herceg , Toby M Maher, Martin Kolb. Potential of nintedanibin treatment of progressive fibrosing interstitial lung diseases. Eur Respir J. 2019; 54 (3): 1900161. DOI: 10.1183/13993003.00161-2019.

2. George PM, Spagnolo P, Kreuter M, Altinisik G, Bonifazi M, Martinez FJ, Molyneaux PL, Renzoni EA, Richeldi L, Tomassetti S, Valenzuela C, Vancheri C, Varone F, Cottin V, Costabel U. Progressive brosing interstitial lungdisease: clinical uncertainties, consensus recommendations, and research priorities. Lancet Respir Med. 2020; 8 (9): 925-934. DOI: 10.1016/S2213-2600(20)30355-6

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7. Nasser M, Larrieu S, Si-Mohamed S, Ahmad K, Boussel L, Brevet M, Chalabreysse L, Fabre C, Marque S, Revel D, Thivolet-Bejui F, Traclet J, Zeghmar S, Maucort-Boulch D, Cottin V, Nasser M, et al. Progressive brosing interstitial lung disease: a clinical cohort (the PROGRESS study). Eur Respir J. 2021; 57 (2): 2002718. DOI: 10.1183/13993003.02718-2020

8. Nathan D Wong. Epidemiological studies of CHD and the evolution of preventive cardiology. Nat Rev Cardiol. 2014; 11 (5): 276-289. DOI: 10.1038/nrcardio.2014.26

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11. Gauthier JM, Bierhals AJ, Liu J, Balsara KR, Frederiksen C, Gremminger E, et al. Chest computed tomography imaging improves potential lung donor assessment. J Thorac Cardiovasc Surg. 2019; 157 (4): 1711-1718. DOI: 10.1016/j.jtcvs.2018.11.038

12. Steven A Wahls. Causes and evaluation of chronic dyspnea. Am Fam Physician. 2005; 71 (8): 1529-1537.

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15. Masa JF, Pépin JL, Borel JC, Mokhlesi B, Murphy PB, Sánchez-Quiroga MÁ. Masa JF, et al. Obesity hypoventilation syndrome. Eur Respir Rev. 2019 Mar 14; 28 (151): 180097.

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17. Yvette N Lamb. Nintedanib: A Review in Fibrotic Interstitial Lung Diseases. Drugs. 2021; 81 (5): 575 – 586. DOI: 10.1007/s40265-021-01487-0

18. Niedermeyer J. Dyspnea in airway and pulmonary diseases. Internist (Berl). 2015; 56 (8): 882-889. DOI: 10.1007/s00108-015-3692-1

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 DEVELOPMENT OF ANTIBIOTIC RESISTANCE IN THE ASPECT OF OUTPATIENT SERVICES

MOROZOV ARTEM M., ORCID ID: 0000-0003-4213-5379; C. Med. Sci., associate professor of the Department of general surgery of Tver State Medical University, Russia, 170100, Tver, Sovetskaya str., 4, e-mail: ammorozovv@gmail.com

SERGEEV ALEXEY N., ORCID ID: 0000-0002-9657-8063; D. Med. Sci., associate professor, the Head of the Department of general surgery of Tver State Medical University, Russia, 170100, Tver, Sovetskaya str., 4, e-mail: ammorozovv@gmail.com

KADYKOV VICTOR A., ORCID ID: 0000-0002-7516-3467; C. Med. Sci., associate professor of the Department of general surgery of Tver State Medical University, Russia, 170100, Tver, Sovetskaya str., 4, e-mail: ammorozovv@gmail.com

1. Lysenko VA, Orlova EV, Litvinova TI, Babich MV. Prakticheskoe znachenie issledovaniya antibiotiko-rezistentnosti [Practical significance of the study of antibiotic resistance]. Byulleten fiziologii i patologii dykhaniya [Bulletin of physiology and pathology of respiration]. 2004; 18: 17-20.

2. Morozov AM, Sergeev AN, Askerov EM, et al. Sovremennyj podhod k antibakterial’noj terapii v praktike hirurga [Modern approach to antibiotic therapy in the practice of a surgeon]. Vestnik medicinskogo instituta “REAVIZ”: reabilitaciya, vrach i zdorov’e [Bulletin of the medical institute “REAVIZ”: rehabilitation, doctor and health]. 2021; 2 (50): 79-86. DOI 10.20340/vmirvz.2021.2.CLIN.6.

3. Frolova AV. Antibiotikorezistentnost; Alternativnye podkhody k resheniyu problem [Antibiotic resistance; Alternative approaches to solving the problem]. Vesczi naczyyanalnaj akademii navuk belarusi; Seryya biyalagichnykh nauk [News of the National Academy of Sciences of Belarus; Series of biological sciences]. 2015; 1: 82-88.

4. Sergeev AN, Morozov AM, Askerov EM. Metody lokal’noj antimikrobnoj pro laktiki infekcii oblasti hirurgicheskogo vmeshatel’stva [Methods of local antimicrobial prevention of infection in the eld of surgical intervention]. Kazanskij medicinskij zhurnal [Kazan Medical Journal]. 2020; 2: 243-248.

5. Golubovskaya OA. Problema antibiotikorezistentnosti i mezhdunarodnye usiliya po ee preodoleniyu [Theproblem of antibiotic resistance and international efforts toovercome it]. Klinicheskaya infektologiya i parazitologiya [Clinical infectology and parasitology]. 2015; 1 (12): 6-11.

6. Rozin AV, Sergeev AN. Vozbuditeli infekcii oblasti hirurgicheskogo vmeshatel’stva u pacientov obshche-khirurgicheskogo stacionara [Pathogens of infection in the eld of surgical intervention in patients of a general surgical hospital]. Tverskoj medicinskij zhurnal [Tver Medical Journal]. 2019; 1: 57-59.

7. Matievskaya V. Invazivnaya Infekciya, Vyzvannaya β-Gemoliticheskim Streptokokkom Gruppy A: Etiologiya, Epidemiologiya, Klinika, Diagnostika, Lechenie [Invasive Infection Caused By beta-Hemolytic Streptococcus Of Group A: Etiology, Epidemiology, Clinic, Diagnosis, Treatment]. Medicinskie novosti [Medical News]. 2017; 9: 21-25.

8. Palagin IS, Sukhorukova MV, Dekhnich AV, Eidelstein MV, Shevelev AN, Grinev AV, Perepanova TS, Kozlov RS, Kogan MI. Sovremennoe sostoyanie antibiotikorezistentnosti vozbuditelej vnebol’nichnyh infekcij mochevyh putej v Rossii: rezul’taty issledovaniya “DARMIS” (2010–2011) [The current state of antibiotic resistance of pathogens of community-acquired urinary tract infections in Russia: results of the DARMIS study (2010-2011)]. Klinicheskaya mikrobiologiya i antimikrobnaya himioterapiya [Clinical microbiology and antimicrobial chemotherapy]. 2012; 14 (4): 280-302.

9. Beloborodov VB, Briko NI, Brusina EB, Gusarov VG, Eliseeva EV, Zhuravleva MV, Zamyatin MN, Zyryanov SK, Kukes VG, Popov DA, Protsenko DN, Sidorenko SV, Suvorova MP, Yakovlev SP. Programma SKAT (Strategiya Kontrolya Antimikrobnoj Terapii) pri okazanii stacionarnoj medicinskoj pomoshchi; Metodicheskie rekomendacii dlya lechebno-pro lakticheskih uchrezhdenij Moskvy [The SCAT program (Antimicrobial Therapy Control Strategy) in the provision of inpatient medical care; Methodological recommendations for medical and preventive institutions in Moscow]. Consilium Medicum [Consilium Medicum]. 2017; 7-1: 15-51.

10. Belevsky AS, Zaitsev AA. Zashchishchennye aminopenicilliny: 35 let klinicheskogo primeneniya v terapii infekcij nizhnih dyhatel’nyh putej [Protected aminopenicillins: 35 years of clinical application in the treatment of lower respiratory tract infections]. Prakticheskaya pul’monologiya [Practical pulmonology]. 2015; 3: 43-48.

11. EUCAST guidelines for detection of resistance mecha-nisms and specific resistances of clinical and / orepidemiological importance Version 2.0.

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13. Lagun LV. Beta-laktamazy rasshirennogo spektra i ih znachenie v formirovanii ustojchivosti vozbuditelej infekcij mochevyvodyashchih putej k antibakterial’nym preparatam [Beta-lactamases of the extended spectrum and their signi cance in the formation of resistance of pathogens of urinary tract infections to antibacterial drugs]. Problemy zdorov’ya i ekologii [Problems of health and ecology]. 2012; 3 (33): 82-88.

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16. Dovnar AG, Nosova ES. Harakteristika mnozhestvennoj rezistentnosti klinicheskih shtammov enterobakterij, acinetobakter i kandid [Characteristics of multiple resistance of clinical strains of Enterobacteria, Acinetobacter and candide]. Zhurnal GrGMU [Journal of GrSMU]. 2011; 4 (36): 53-54.

 ANALYSIS OF THE SPECIFIC FEATURES OF THE USE OF PHYSIOTHERAPEUTIC METHODS IN PATIENTS WHO UNDERWENT ARTHROSCOPIC OPERATIONS ON THE KNEE JOINT IN 2018–2019 AT THE MEDICAL UNIT OF THE MINISTRY OF INTERNAL AFFAIRS OF RUSSIA IN THE REPUBLIC OF TATARSTAN

SAKOVETS TATIANA G., ORCID ID: 0000-0002-0713-9836; C. Med. Sci., associate professor of the Department of neurology and rehabilitation of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: tsakovets@yandex.ru

1. Orlyanskij V, Golovaha M. Rukovodstvo po artroskopii kolennogo sustava [Knee arthroscopy manual]. Izdatel’stvo Fintreks [Publisher Fintreks]. 2016; 264 p.

2. Hodarev SV, Fabrikant MG, Prohorskij DA, Ivanov DV, Sklyarov VYu. Artroskopicheskie operacii v usloviyah lechebno-reabilitacionnogo centra [Arthroscopic surgery in a treatment and rehabilitation center]. Glavnyj vrach Yuga Rossii [Chief Physician of the South of Russia]. 2016; 49 (2): 23-27.

3. Sakovets TG. Osobennosti nejropaticheskoj boli pri porazhenii sustavov [Features of neuropathic pain with joint damage]. Prakticheskaya medicina [Practical medicine]. 2014; 4: 14.

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7. Gulbani RSh, Pakulya NV. Fizicheskaya reabilitaciya posle artroskopii kolennogo sustava pri povrezhdenii meniskov [Physical rehabilitation after knee arthroscopy with meniscus damage]. Pedagogika, psihologiya i mediko-biologicheskie problemy zicheskogo vospitaniya i sporta [Pedagogy, psychology and medico-biological problems of physical education and sports]. 2010; 5: 43-46.

8. Bolotov DD, Starikov SM. Primenenie gidrokinezioterapii v reabilitacii bol’nyh s travmami oporno-dvigatel’nogo apparata [The use of hydrokinesiotherapy in the rehabilitation of patients with injuries of the musculoskeletal system]. Vestnik vosstanovitel’noj mediciny [Bulletin of regenerative medicine]. 2014; 3: 75-79.

9. Cikunov MB. Programma reabilitacii pri povrezhdzhenii hryashchevyh i kapsul’no-svyazochnyh struktur kolennogo sustava; Metodicheskie rekomendacii [Rehabilitation program for damage to the cartilaginous and capsularligamentous structures of the knee joint; Guidelines]. Vestnik vosstanovitel’noj mediciny [Bulletin of regenerative medicine]. 2014; 3: 110-114.

10. Merkulov VN, Eremushkin M, El’cin AG, Dovluru RK. Reabilitaciya detej i podrostkov s povrezhdeniyami perednej krestoobraznoj svyazki kolennogo sustava [Rehabilitation of children and adolescents with injuries of the anterior cruciate ligament of the knee joint]. Vestnik vosstanovitel’noj mediciny [Bulletin of regenerative medicine]. 2015; 3: 7-14.

11. Ilfeld BM, Gilmore CA, Grant SA, Bolognesi MP, Del Gaizo DJ, Wongsarnpigoon A, Boggs JW. Ultrasound-guided percutaneous peripheral nerve stimulation for analgesia following total knee arthroplasty: a prospective feasibility study. J Orthop Surg Res. 2017; 12 (1): 4.

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 SCREENING FOR COLORECTAL CANCER IN THE EMPLOYEES OF THE MINISTRY OF INTERNAL AFFAIRS OF RUSSIA IN THE REPUBLIC OF TATARSTAN. FIRST RESULTS AND PROSPECTS FOR DEVELOPMENT

SAKHIBULLIN RAMIL F., ORCID ID: 0000-0003-1015-7872; the Head of endoscopy office of Clinical Hospital of the Medical Care unit of the Ministry of Internal Affairs of Russian in the Republic of Tatarstan, Russia, 420059, Kazan, Orenburgskiy tract str., 132, tel. +7(843)291-26-98, e-mail: sahibullin@mail.ru

AMIROV NAIL B., ORCID ID: 0000-0003-0009-9103; SCOPUS Author ID: 7005357664; D. Med. Sci., academician of RAE, professor of the Department of outpatient therapy and general medical practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7(905)313-01-11, e-mail: namirov@mail.ru

FATYKHOV RENAT G., ORCID ID: 0000-0001-5651-8341; the Head of the Clinical Hospital of the Medical Care unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, Russia, 420000, Kazan, Orenburgskiy tract str., 132, tel. +7(843)291-26-84, e-mail: fatyhov.renat2011@yandex.ru

FADEEV GRIGORIY A., ORCID ID: 0000-0002-0213-8631; deputy Head on medical affairs of the Clinical Hospital of the Medical Care unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, Russia, 420000, Kazan, Orenburgskiy tract str., 132, tel. +7(843)291-26-82, e-mail: dr.grigoryfadeev@yandex.ru 

1. Informatsionnyy byulleten’ VOZ [WHO Newsletter]. 30/04/2021. https://www.who.int/ru/news-room/fact-sheets/detail/cancer. Accessed

2. Kaprin AD, Starinsky VV, Shakhzadova AO ed. Zlokachestvennyye novoobrazovaniya v Rossii v 2019 godu (zabolevayemost’ i smertnost’) [Malignant neoplasms in Russia in 2019 (morbidity and mortality)]. Moskva: MNIOI imeni PA Gertsena – lial FGBU «NMITS radiologii» Minzdrava Rossii [Moscow: PA Herzen Moscow State Medical Research Institute-branch of the Federal State Budgetary Institution “NMIC of Radiology” of the Ministry of Health of Russia]. 2020; 252 p.

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4. Prakticheskoye rukovodstvo Vsemirnogo gastroentero-logicheskogo obshchestva i Mezhdunarodnogo soyuza po pro laktike raka pishchevaritel’noy sistemy: Skrining kolorektal’nogo raka. [Practical guide of the World Gastroenterological Society and the International Union for the Prevention of Cancer of the Digestive System: Screening for colorectal cancer]. 2008. https://www.worldgastroen-terology.org/UserFiles/ le/guidelines/colorectal-cancer-screening-russian-2008.pdf

5. Skrining kolorektal’nogo raka [Colorectal cancer screening]. Kazakhskiy nauchno-issledovatel’skiy institut onkologii i radiologii [Kazakh Research Institute of Oncology and Radiology]. https://onco.kz/skrining-na-rannee-vyyavlenie-kolorektalnogo-raka/

6. Kolorektal’nyy rak: rukovodstvo dlya patsiyentov – informatsiya, osnovannaya na Rukovodstve po klinicheskoy praktike ESMO [Colorectal Cancer: A Patient Guide-information based on the ESMO Clinical Practice Guide]. 2016. https://www.esmo.org/content/download/92556/1706367/ le/ESMO-ACF-Colorectal-Cancer-Guide-for-Patients-Russian.pdf

7. Nowakowska-Duława E, Reguła J, Szczepanek M. Rola endoskopii w badaniach przesiewowych w kierunku nowotworów przewodu pokarmowego i trzustki w Europie; Omówienie stanowiska European Society of Gastrointestinal Endoscopy 2020. Med Prakt. 2021; 3: 62–75.

8. Prikaz Ministerstva zdravookhraneniya RF ot 13 marta 2019 g. N 124n “Ob utverzhdenii poryadka provedeniya pro lakticheskogo meditsinskogo osmotra i dispanserizatsii opredelennykh grupp vzroslogo naseleniya” (s izmeneniyami i dopolneniyami) [Order of the Ministry of Health of the Russian Federation of March 13, 2019 No 124n “On approval of the procedure for conducting preventive medical examinations and medical examinations of certain groups of the adult population” (with amendments and additions)]. 2019.

9. Nikonov EL, Galkova ZV, Kashin SV, Gorelov MV, Zharova MЕ. Podgotovka k sozdaniyu natsional’noy programmy skrininga kolorektal’nogo raka [Preparation for the creation of a national colorectal cancer screening program]. Doctor ru. 2019; 10 (165): 23-30. DOI: 10.31550/1727-2378-2019-165-10-23-30

10. Desyatov EN, Aliev FSh, Zuev VYu, Kiryanova AS, Kuznetsov VYu, Shchepkin KV. Kolorektal’nyy skrining. Pervyye rezul’taty [Colorectal screening; First results]. Tazovaya khirurgiya i onkologiya [Pelvic surgery and oncology]. 2017; 7 (4): 31-37. DOI: 10.17650/2220-3478-2017-7-4-31-37

11. Nesterov PV, Ukharskiy AV, Kislov NV. Regional’naya kliniko-ekonomicheskaya model’ skrininga kolorektal’nogo raka [Regional clinical and economic model of colorectal cancer screening]. Issledovaniya i praktika v meditsine [Research and Practical Medicine Journal]. 2020; 7 (3): 146-159. DOI: 10.17709/2409-2231-2020-7-3-15

UDC 616.12-008.318-073.97

DOI: 10.20969/VSKM.2021.14(5).62-67

 HEART RATE TURBULENCE INDICATORS IN CLINICAL PRACTICE

FADEEV GRIGORIY A., ORCID ID: 0000-0002-0213-8631; deputy head of Clinical Hospital of the Medical Care unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, Russia, 420059, Kazan, Orenburgskiy trakt str., 132, e-mail: vazax@bk.ru

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

MIKHOPAROVA OLGA YU., ORCID ID: 0000-0002-5592-8450; the Head of the Department of functional diagnostics of the Medical Care unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, Russia, Kazan, 420059, Orenburgskiy tract str., 132, tel. 8-937-525-53-61, e-mail: Olga-mihoparova@rambler.ru

BATYRSHIN GRIGORIY G., ORCID ID: 0000-0002-2763-4367; physician of the Department of functional diagnostics of the Medical Care unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, Russia, 420059, Kazan, Orenburgskiy trakt str., 132

12. Gatzoulis K, Tsiachris D, Arsenos P, Antoniou CK, Dilaveris P, Sideris S, Kanoupakis E, Simantirakis E, Korantzopoulos P, Goudevenos I, Flevari P, Iliodromitis E, Sideris A, Vassilikos V, Fragakis N, Trachanas K, Vernardos M, Konstantinou I, Tsimos K, Xenogiannis I, Vlachos K, Saplaouras A, Triantafyllou K, Kallikazaros I, Tousoulis D. Arrhythmic risk strati cation in post-myocardial infarction patients with preserved ejection fraction: the PRESERVE EF study. Eur Heart J. 2019; 40 (35): 2940-2949. DOI: 10.1093/eurheartj/ehz260

13. Kusumoto FM, Bailey KR, Chaouki AS, Deshmukh AJ, Gautam S, Kim RJ, Kramer DB, Lambrakos LK, Nasser NH, Sorajja D. Systematic review for the 2017 AHA/ ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Heart Rhythm. 2018; 15 (10): e253-e274. DOI: 10.1016/j. hrthm.2017.10.037

14. Blesius V, Scholzel C, Ernst G, Dominik A. HRT assessment reviewed: a systematic review of heart rate turbulence methodology. Physiol Meas. 2020; 41 (8): 08TR01. DOI:10.1088/1361-6579/ab98b3

15. Cygankiewicz I. Heart rate turbulence. Prog Cardiovasc Dis. 2013; 56 (2): 160-71. DOI:10.1016/j. pcad.2013.08.002

16. Huikuri HV, Stein PK. Heart rate variability in risk strati cation of cardiac patients. Prog Cardiovasc Dis. 2013; 56 (2): 153-159. DOI:10.1016/j.pcad.2013.07.003

17. Catai A, Pastre C, Godoy M, Silva E, Takahashi A, Vanderlei L. Heart rate variability: are you using it properly? Standardisation checklist of procedures. Braz J Phys Ther. 2020; 24 (2): 91-102. DOI:10.1016/j. bjpt.2019.02.006

 EVALUATION OF EFFICIENCY AND THE DEGREE OF DEPENDENCE OF HEALTH INSTITUTION PERFORMANCE INDICATORS ON THE LEVEL OF ADMINISTRATIVE COMPETENCE OF THE MANAGER

SHULAEV ALEXEY V., ORCID ID: 0000-0002-2073-2538; SPIN-код 3229-1913; Author ID: 210271; D. Med. Sci., professor, the Head of the Department of general hygiene of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. 8-987-213-67-12, e-mail: shulaev8@gmail.com

KHISAMIEV RUSTEM SH., the Head of the Medical Care unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, Russia, 420111, Kazan, Lobachevsky str., 13, tel. 8(843)291-24-58, e-mail: msch_16mvd.gov.ru

ZINOVIEV PAVEL V., ORCID ID: 0000-0003-1305-0843; assistant of professor of the Department of general hygiene of Kazan State Medical University, Russia, 420012, Kazan, Butlerov, 49, tel. 8-905-315-08-00, e-mail: pavel.zinovyev@gmail.com

Abstract. Aim. The aim of the study was to develop proposals for improving the administrative competencies in managers of health institutions. Material and methods. The main data for the study were obtained by questioning a group ofmanagers of health institutions, namely state autonomous health care institutions of the Republic of Tatarstan. In total the questionnaire survey covered 31 health institutions. A total of 73 persons, including 31 heads of health institutions of the Republic of Tatarstan and 42 specialists from among the heads of departments and deputy chief physicians, who are the members of reserve of management personnel, participated in the questionnaire survey. Results and discussion.According to the data obtained, the group of heads of health institutions with the highest rating score differed from the representatives of health institutions with fewer rating scores by higher values of anticipatory statefulness. Among the heads of health institutions with the highest rating score, a higher level of overall anticipation competence was revealed, which allows us to conclude about the application of the algorithm of psychological tests for determining the level of anticipation competence to predict the effectiveness of the head when considering candidates for the appointment to the position of the head of a health institution. Conclusion. The developed algorithm of using the parameters of psychological tests to assess and predict the effectiveness of the respondent can be applied in the practice of the Ministry of Health, as a tool for human resource activities.

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 SPECIFICS OF THERAPY FOR BACK PAIN IN PATIENTS WITH FACET SYNDROME

SAKOVETS TATIANA G., ORCID ID: 0000-0002-0713-9836; C. Med. Sci., associate professor of the Department of neurology and rehabilitation of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: tsakovets@yandex.ru

KHUZINA GULNARA R., ORCID ID: https://orcid.org/0000-0002-6991-4906; C. Med. Sci., associate professor of the Department of neurology and rehabilitation of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7(987)296-43-86, e-mail: gkhuzina@yandex.ru

BARYSHEVA ELENA N., ORCID ID: 0000-0001-8740-4275; the Head of the Department of physiotherapy of Clinical Hospital of Medical Care unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, Russia, 420012, Kazan, Orenburgskiy trakt str., 132, e-mail: e.barysheva@mail.ru

Abstract. Background. Back and neck pain are among the most common medical complaints in developed countries, with up to 66% of the population suffering from acute nonspeci c back pain. As early as 1911, Goldthwaite J.E. proved that the articular joints of the spine can serve as a source of pain impulsation, with the proportion of facet syndrome increasing in older age groups, which can cause a clinical dilemma in identifying causes of back pain in the elderly. Like other synovial joints, the bicuspid joints, which are richly innervated by nociceptors, are also at risk of developing dystrophic changes with destruction of articular cartilage and, accordingly, the development of pain, which is provoked by stretching of the bicuspid joint capsule against the background of in ammatory modulators activation. Aim. The aimof the study was to investigate the eficacy of different methods of treatment of facet syndrome. Material and methods.An analytical review of publications in the scienti c medical literature was performed. Results and discussion. In facet syndrome, both local injection therapy with glucocorticosteroids, hyaluronic acid, local anesthetics, mesenchymal stem cells, and platelet-derived autoplasma are effective. Additional application of non-pharmacological treatments such as therapeutic gymnastics, physiotherapy, and therapeutic massage potentiates the effects of conventional conservative therapy. Radiofrequency laser neurotomy has been recognized as an alternative effective treatment for facet syndrome with a long-term positive effect. The choice of drugs and cellular substances for therapeutic blocks is wide enough and provides an adequate therapeutic approach to the treatment of nonspeci c back pain caused by articular joint lesions.Conclusion. The diagnosis of facet syndrome is a diagnosis of exclusion, which requires a thorough differential diagnosis to choose further adequate treatment strategy.

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 GUT MICROBIOTA AND ITS IMPORTANCE FOR HUMAN HEALTH

SAFINA DILYARA D., ORCID ID: 0000-0003-0769-8176; C. Med. Sci., junior researcher of the Institute of fundamental medicine and biology of Kazan (Volga region) Federal University, Russia, 420008, Kazan, Kremlevskaya str., 18, e-mail: dilyara-sd@yandex.ru

ABDULKHAKOV SAYAR R., ORCID ID: 0000-0003-0769-8176; C. Med. Sci., associate professor, the Head of the Department of internal medicine, senior researcher of Institute of fundamental medicine and biology of Kazan (Volga region) Federal University, Russia, 420008, Kazan, Kremlevskaya str., 18; associate professor of the Department of outpatient medicine and general medical practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: sayarabdul@yandex.ru

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

Abstract. Background. In recent years, much attention has been paid to the importance and role of the gut microbiota in human health maintaining and its composition violations in various diseases. Aim. The aim of the study was to analyzethe up-to-date literature on the intestinal microbiota, its composition, role and functions in maintaining human health, as well as on the factors affecting the composition of the intestinal microbiota. Material and methods. An analyticalreview of published studies on the intestinal microbiota was conducted. Results and discussion. The development of new metagenomic methods for studying the microbiota has led to a fundamental breakthrough in the advancement of ideas about its role, composition and functions in the human body. Despite signi cant differences in the composition of the gut microbiota in healthy people, the microbiota of a healthy person remains relatively stable throughout life; its composition is in uenced by a number of factors: mode of delivery, age, geographic area of residence, genetic characteristics of the person, consumption of related drugs, diet, and others. Treatment with antibiotics may also lead to pronounced changes in the composition of the intestinal microbiota. Other adverse events of antibiotic therapy may include the development of antibiotic-resistant strains of bacteria; resistance may be due to the presence of genes encoding resistance factors to antibacterial drugs. Conclusion. Thus, the gut microbiota plays a tremendous role in maintaining human health and the development of a number of diseases.

Key words: gut microbiota, antibiotic resistance, antibacterial drugs.

For reference: Safina DD, Abdulkhakov SR, Amirov NB. Gut microbiota and its importance for human health. The Bulletin of Contemporary Clinical Medicine. 2021; 14 (5): 81-94. DOI: 10.20969/VSKM.2021.14(5).81-94.

 MINIMAL CHANGE DISEASE IN THERAPEUTIC PRACTICE

SIGITOVA OLGA N., ORCID ID: 0000-0001-8983-245X; Web of Science Researcher ID AAV-1365-2021; SCOPUS Auhtor ID 527686; D. Med. Sci., professor, the Head of the Department of outpatient medicine and general practice of Kazan State Medical University, 420012, Russia, Kazan, Butlerov str., 49, tel. +7-917-396-24-17, e-mail: osigit@rambler.ru

SHAYMURATOV RUSTEM I., ORCID ID: 0000-0002-5940-1656; Web of Science Researcher ID Q-3122-2019; C. Med. Sci., assistant of professor of the Department of phthisiopulmonology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: russtem@gmail.com

SHARIPOVA ROZALIA R., ORCID ID: 0000-0002-7281-1000; physician of the Department of internal medicine of Clinical Hospital of the Medical Care unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, Russia, 420059, Kazan, Orenburgskiy tract str., 132, e-mail: sharipova.7@mail.ru

SAFARGALIYEVA LILYA KH., the Head of the Department of internal medicine of Clinical Hospital of Medical Care unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, Russia, 420059, Kazan, Orenburgskiy tract str., 132, e-mail: Safargalieva.lilia@mail.ru

YAGFAROVA RITA R., physician of the Department of internal medicine of Clinical Hospital of Medical Care unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, Russia, 420059, Kazan, Orenburgskiy tract str., 132

Abstract. Background. The disease of minimal changes occurs in 10–15% of adult patients with idiopathic nephrotic syndrome, it often has a relapsing course. Glucocorticoids are effective in achieving remission, but in some patients steroid resistance and progressive course of the disease are observed. Recent studies have investigated the mechanisms of minimal change disease development for the purpose of estimating the prognosis of the disease and the ef cacy of immunosuppressive therapy. Aim. The aim of the present study was to review current data on the diagnosis, pathogenetic therapy of minimal change disease, and to demonstrate the clinical case of a relapsed disease in steroid resistant patient. Material and methods. A review of original research in the foreign and domestic literature on the subject over the past 5 years was conducted. Results and discussion. Minimal change disease is clinically manifested by rapid, almost sudden development of nephrotic syndrome (proteinuria, hypoalbuminemia, marked hypercholesterolemia, and massive generalized edema). Arterial hypertension and microhematuria occur occasionally. Glucocorticoids are being prescribed to achieve early remission even before morphological veri cation of the diagnosis. The course of the disease is mostly benign. The majority of patients with steroid sensitivity have long-term preserved renal function, while steroid resistance is associated with a progressive course leading to terminal renal failure. The presented clinical case is interesting because the unfolded picture of the disease of minimal changes including severe nephrotic syndrome and steroid-resistance, appeared in the patient a year after the disease debut. After receiving combined immunosuppressive therapy for 16 weeks incomplete remission was achieved. Conclusion. Unfortunately, at present, there are no available reliable methods to predict the development of steroid resistance and there are no effective therapies guaranteeing the achievement of remission in such cases.

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2. Smirnov AV, Trofimenko II, Sipovskiy VG Bolezn’ minimal’nykh izmeneniy u vzroslykh [Minimal change disease in adults]. Nefrologiya [Russian Nephrology, Saint-Petersburg]. 2013;17(6):9-36. DOI: 10.24884/1561-6274-2013-17-6-9-36.

3. Smirnov AV, Dobronravov VA, Sipovskij VG, Tro menko II, Pirozhkov IA, Kayukov IG, Lebedev KI Klinicheskiye rekomendatsii po diagnostike, lecheniyu i prognozu bolezni minimal’nykh izmeneniy u vzroslykh [Clinical practice guidelines for diagnosis, treatment and prognosis of the minimal change disease in adults]. Nefrologiya [Russian Nephrology, Saint-Petersburg]. 2014; 18 (4): 68-92.

4. Vivarelli M, Massella L, Ruggiero B, Emma F. Minimal Change Disease. Clin J Am Soc Nephrol. 2017; 12 (2): 332-345. DOI:10.2215/CJN.05000516.

5. Szeto CC, Lai FM, Chow KM, Kwan BC, Kwong VW, Leung CB, Li PK. Long-term outcome of biopsy-proven minimal change nephropathy in Chinese adults. Am J Kidney Dis. 2015; 65 (5): 710-718. DOI: 10.1053/j. ajkd.2014.09.022.

6. Mak SK, Short CD, Mallick NP. Long-term outcome of adult-onset minimal-change nephropathy. Nephrol Dial Transplant. 1996; 11 (11): 2192-201. DOI: 10.1093/ oxfordjournals.ndt.a027136.

7. Fenton A, Smith SW, Hewins P. Adult minimal-change disease: observational data from a UK centre on patient characteristics, therapies, and outcomes. BMC Nephrol. 2018; 19 (1): 207. DOI: 10.1186/s12882-018-0999-x

8. Futrakul N, Yenrudi S, Sensirivatana R, Watana D, Laohapaibul A, Watanapenphaibul K, Kingwatanakul P, Futrakul P, Futrakul S. Peritubular capillary flow determines tubulointerstitial disease in idiopathic nephrotic syndrome. Ren Fail. 2000; 22 (3): 329-335. DOI: 10.1081/ jdi-100100876.

 COVID-19 OUTCOMES: DRUG TREATMENT OPTIONS

KHAMITOV RUSTEM F., ORCID ID: 0000-0001-8821-0421; Author ID: 56195558300; SPIN: 5362-0356; D. Med. Sci., professor, the Head of the Department of internal medicine of Kazan State Medical University; Chief freelance pulmonologist of Kazan Health Department of the Republic of Tatarstan, Russia, Kazan, 420012, Butlerov str., 49, tel. +7-917-272-96-72,
e-mail: rhamitov@mail.ru

ZHESTKOV ALEXANDER V., ORCID ID: 0000-0002-3960-830; D. Med. Sci., professor, the Head of the Department of microbiology, immunology and allergology of Samara State Medical University; Chief freelance pulmonologist of the Volga Federal District, Russia, 443099, Samara, Chapaevskaya str., 89, tel. +7-987-445-14-90, e-mail: avzhestkov2015@yandex.ru

VIZEL ALEXANDER A., ORCID ID: 0000-0001-5028-5276; D. Med. Sci., professor, the Head of the Department of phthisiopulmonology of Kazan State Medical University; Chief freelance pulmonologist of the Ministry of Health of the Republic of Tatarstan, Russia, 420012, Kazan, Butlerov str., 49, e-mail: lordara@inbox.ru

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3. Gebru AA, Birhanu T, Wendimu E, Ayalew AF, Mulat S, Abasimel HZ, Kazemi A, Tadesse BA, Gebru BA, Deriba BS, Zeleke NS, Girma AG, Munkhbat B, Yusuf QK, Luke AO, Hailu D. Global burden of COVID-19: Situational analysis and review. Hum Antibodies. 2021;29(2):139-148. doi: 10.3233/HAB-200420.

4. Khamitov R.F., Molostvova A.F., Salimova L.M. Trombo-citopenii i drugie proyavleniya koagulopatii: vozmozhnosti diagnostiki i lecheniya pri novoj koronavirusnoj infekcii COVID-19. [Thromboсytopenia and other manifestations of coagulopathy: diagnostic and treatment options for СOVID-19 new сoronavirus infection]. Vestnik sovremennoj klinicheskoj mediciny. [The Bulletin of Contemporary Clinical Medicine]. 2021;14(3):76-83. doi: 10.20969/VSKM.2021.14(3).76-83.

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 ADAPTIVE CAPACITY IMPAIRMENT IN CHILDREN WITH INSULIN-DEPENDENT DIABETES MELLITUS AS SHOWN BY TIME INTERVAL ASSESSMENT

BYKOV YURI V., ORCID ID: 0000-0003-4705-3823; C. Med. Sci., assistant of professor of the Department of anesthesiology, resuscitation and emergency medicine of Stavropol State Medical University, Russia, 355017, Stavropol, Mir str., 310, tel. +7-962-443-04-92, e-mail: yubykov@gmail.com

BATURIN VLADIMIR A., ORCID ID: 0000-0003-4705-3823; D. Med. Sci., professor, the Head of the Department of clinical pharmacology of Stavropol State Medical University, Russia, 355000, Stavropol, Mir str., 310, e-mail: prof.baturin@gmail.com

Abstract. Aim. The aim of the study was to diagnose and study the severity of impaired adaptive capacity in children with insulin-dependent diabetes mellitus using the method of assessment of time intervals. Material and methods. Thestudy included 54 adolescents, aged 14 to 18 years. 27 adolescents with type I diabetes mellitus, who were urgently hospitalized in the intensive care unit in a serious condition, constituted the study group, the other 27 adolescents who were hospitalized for planned surgical intervention constituted the control group (conditionally healthy children). The diagnosis of type I diabetes mellitus was con rmed by clinical and laboratory data (hyperglycemia, ketoacidosis, impaired level of consciousness (deafening-sore). Study protocol: psychophysiological testing in adolescents was performed using the original «Rhythm» program, which presented patients with a reference sequence of sound signals and pauses between them, after which the patients played back the sound sequence using a personal computer. Adolescents in the study group were tested after diabetic ketoacidosis had subsided, glycemia had stabilized, and the level of consciousness had normalized (3–5 days after admission). The control group was tested upon admission to the hospital for planned treatment. Signi cance of the total index of deviations from the speci ed reference was determined using Student’s t-criterion. Results and discussion. Signi cant adaptation disorders were detected both in the study group and in the control group. However, in children with diabetes mellitus these disorders were more pronounced due to a greater shortening of the total duration of the cycle, as well as a greater aggregate index of deviations from the duration of set signals and pauses as compared to the «reference standard». Conclusion. The ndings support the hypothesis that impaired adaptation mechanisms as a manifestation of desynchronization of biological rhythms may lie in the mechanism of insulin-dependent diabetes mellitus development.

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11. Baturin VA, Gubareva LI, Voronenko IN, Baturin MV. Metod komp’yuternoj ocenki ritmicheskogo vosproizvedeniya zadannyh vremennyh otrezkov [Method of computer assessment of rhythmic reproduction of speci ed time intervals]. Metodicheskie rekomendacii [Guidelines]. 2005: 8 p.

 THE HISTORY OF ESTABLISHMENT AND DEVELOPMENT OF MEDICAL CARE FOR CUSTOMS OFFICIALS IN THE XIX–XX CENTURIES

MOROZOV ALEXEY V., ORCID ID: 0000-0001-7724-2735; SCOPUS Author ID: 8455076900; Web of Science Researcher ID: AAI-7096–2021; deputy head of the Medical Department of the FCS of Russia of Federal Customs Service, Russia, 107842, Moscow, Novozavodskaya str., 11/5; С. Med. Sci., associate professor of the Department of history of medicine of the Medical institute of Peoples Friendship University of Russia (RUDN University) of the Ministry of Science and Higher Education of the Russian Federation, Russia, 117198, Moscow, Miklukho-Maklay str., 6, tel. +7(916)495-49-07, e-mail: a0067138@yandex.ru

SHISHKINA NATALIA V., deputy head of Museum and Exhibition Activities Department of Federal Customs Service of Russia (Central Museum of the Customs Service), Russia, 107140, Moscow, Komsomolskaya sq., 1a, tel. +7(495)275-38-81, e-mail: shishkinanv@ca.customs.gov.ru

Abstract. Aim. The article considers materials that allow evaluating the way of establishment of medical service for customs authorities during the XIX–XX centuries. Material and methods. The study was conducted in a combination of the main methodological principles – historicism, objectivity, and comprehensiveness of the research. Materials stored in the funds of the Central Museum of the Federal Customs Service, electronic resources allowing access to the Full Collection of laws of the Russian Federation were considered. Results and discussion. Before the beginning of the 19th century there was virtually no medical care for customs of cials. The key role in the establishment of medical service provision was played by the «Charter of frontier and port quarantines», which determined the presence of doctors or staff-medics in the staff of Quarantine Of ces, who were supposed to provide free of charge assistance to quarantined and quarantine survivors. Later, the emphasis in providing medical care for customs of cials shifted to hospitals and military hospitals. Most likely, it was due to the huge length of the Russian Empire borders, along which the customs houses, customs outposts and posts were located. The changes in socio-political system in 1917 had their effect on the processes occurring with the provision of medical services in the country and in the customs of ce. In the period after the Great Patriotic War, medical services to employees of the department began to be provided in the outpatient clinic created under the USSR Ministry of Foreign Trade, and since 1957 – in the outpatient clinics of the USSR State Committee on Foreign Economic Relations, as well as in the inpatient clinics which were part of the structure of the USSR Ministry of Health. Conclusion. In the Russian Empire, customs houses, customs outposts and posts were located on the border, designed to solve a complex of problems in the border areas. The study of the historical experience of their medical service allows us to make more rational managerial decisions at the level of the Federal Customs Service in the future.

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