COMPARATIVE STUDY OF THE EFFECT OF INSULIN-DEPENDENT DIABETES MELLITUS TYPE 2, HEREDITY AND SMOKING ON THE SEVERITY OF CORONARY HEART DISEASE

ALEKBEROV ELMAN Z., ORCID ID: 0000-0003-0565-4153; D. Med. Sci., senior researcher, the Head of the Department of coronary heart disease of Azerbaijan Research Institute of cardiology named after J.M. Abdullayev of TABIB Association, Azerbaijan, AZ1072, Baku, F. Khoyski str., 101a, tel. +994-50-328-24-56, +994-12-561-64-51, e-mail: azelman56@mail.ru

MAMEDRZAYEVA VAFA M., ORCID ID: 0000-0003-1792-2901; junior researcher of the Departmen rehabilitation of Azerbaijan Research Institute of cardiology named after J.M. Abdullayev of TABIB Association, Azerbaijan, AZ1072, Baku, F. Khoyski str., 101a, tel. +994-50-528-65-55, e-mail: vefaturan3@mail.ru

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 SPECIFICS OF PSYCHOLOGICAL STATUS OF LOCOMOTIVE CREW WORKERS WITH ARTERIAL HYPERTENSION

ALFUKAKHA MAKHMUD M.M., full-time postgraduate student of the Department of advanced internal medicine No 1
of Bashkir State Medical University, Russia, 450000, Ufa, Lenin str., 3

MUTALOVA ELVIRA G., ORCID ID: 0000-0002-7454-9819; D. Med. Sci., professor, the Head of the Department of advanced internal medicine No 1 of Bashkir State Medical University, Russia, 450000, Ufa, Lenin str., 3, e-mail: emutalova@mail.ru

Abstract. Introduction. Arterial hypertension is one of the most important problems of modern cardiology. Recently, special attention has been paid to the problem of early diagnosis and prevention of treatment of arterial hypertension in workers whose working conditions are associated with a stress-inducing factor causing psycho-emotional tension.Aim. Evaluation of psychological status in employees of locomotive crews with arterial hypertension was the aim of our study. Material and methods. 152 men working in the locomotive crews [mean age (43,2±5,1) years], including 88 patients with hypertension (main group) and 64 persons with normal blood pressure (comparison group) were examined. We performed anthropometric study with assessment of such parameters as waist circumference (cm), hip circumference (cm), calculated the ratio of body fat/hip, determined the parameters of lipidogram, blood insulin concentration, immunoreactive insulin, uric acid, and calculated the NOMA-IR index of insulin resistance. We used Spielberger–Hanin Scale, PSM 25 psychological stress scale, Internal Minute test, Reeder Scale of Psychological Stress, and DS-14 personality type diagnostic questionnaire to evaluate psycho-emotional status. The data were processed using standard statistical methods with Statistica 10 program, Microsoft Excel 2010. The differences were considered statistically significant at p<0,05. Results and its discussion. Changes in the indicators of psychological status, indicating a decrease in stress resistance and the development of stress reactivity, were revealed. Among patients with arterial hypertension there was a significantly higher proportion of individuals with a high level of personal anxiety, with a higher level of stress compared to the group of individuals without arterial hypertension. Conclusion. Patients with arterial hypertension working in locomotive crews are characterized by the presence of psychological status disorders, which are manifested by a high level of personal anxiety, stress, the development of «distressor» personality type D, and reduced stress tolerance. The degree of psychological disorders correlates with increased blood pressure level, age, and duration of stress factor exposure.

1. Strizhakov LA, et al. Arterial’naya gipertenziya na rabochem meste: faktory riska i populyacionnoe znachenie [Arterial hypertension in the workplace: risk factors and population significance]. Terapevticheskij arhiv [Therapeutic archive]. 2018; 9: 138-143. DOI: 10.26442/ terarkh2018909138-143.

2. Telegina AI, et al. Rasprostranyonnost’ faktorov riska u lyudej s arterial’noj gipertenziej, podverzhennyh professional’noj stressogennoj nagruzke [Prevalence of risk factors in people with arterial hypertension exposed to occupational stressful stress]. Klinicheskaya medicina [Clinical Medicine]. 2017; 95 (6): 535-544. DOI: 10.18821/0023-2149-2017-95-6-535-544.

3. Antropova ON, Osipova IV. Reaktivnost’ na psihoemocional’nyj stress: klinicheskie aspekty pri arterial’noj gipertenzii [Reactivity to psychoemotional stress: clinical aspects in arterial hypertension]. Arterial’naya gipertenziya [Arterial hypertension]. 2018; 2 (24): 145-150. DOI: 10.18705/1607-419X-2018-24-2-145-150

 EFFICACY OF RESLIZUMAB IN THE TREATMENT OF ASTHMA AND COMORBID CHRONIC RHINOSINUSITIS WITH POLYPS

BOIKO NATALIA V., ORCID ID: 0000-0002-1316-5061; SCOPUS Author ID: 16681053200; Researcher ID: I-9086-2017;
D. Med. Sci., professor of the Department of otorhinolaryngology of Rostov State Medical University, Russia, 344022, Rostov-on-Don, Nakhichevanskiy lane, 29, tel. +7-903-433-41-13, e-mail: nvboiko@gmail.com

STAGNIEVA IRINA V., ORCID ID: 0000-0002-2894-2062; SCOPUS Author ID: 37008481700; D. Med. Sci., associate professor, the Head of the Department of otorhinolaryngology of Rostov State Medical University, Russia, 344022, Rostov-on-Don, Nakhichevanskiy lane, 29, tel. +7-903-401-69-08, e-mail: irinastagnieva@yandex.ru

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19. Weinstein SF, Katial RK, Bardin P, et al. Effects of Reslizumab on Asthma Outcomes in a Subgroup of Eosinophilic Asthma Patients with Self-Reported Chronic Rhinosinusitis with Nasal Polyps. J Allergy Clin Immunol Pract. 2019; 7 (2): 589-596.

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 MECHANIZED CLEANING AND DISINFECTION OF SECTIONAL INSTRUMENTS USING ULTRASOUND AS ONE OF THE STAGES OF IMPROVING ANTI-EPIDEMIC MEASURES IN THE BUREAU OF FORENSIC MEDICINE

VASILIEV DENIS E. ORCID ID: 0000-0002-6205-3760; C. Med. Sci., teacher of the Department of preventive medicine of Institute of fundamental medicine and biology of Kazan (Volga Region) Federal University, Russia, 420012, Kazan, Karl Marx str., 76, tel. 8 (843) 236-78-92, e-mail: medbiol@kpfu.ru

Abstract. Introduction. An analysis of the most time-consuming and dangerous tasks for medical personnel shows that one of them is the cleaning of medical instruments from contamination. The same applies to sectional instruments used in the operations of the Bureau of Forensic Medicine during autopsy of corpses. To solve this problem, mechanized cleaning through the use of ultrasonic cleaners is increasingly applied in global practice. Aim. The aim of the work was to organize the washing and disinfection of sectional instruments by mechanized method using ultrasonic washers and to evaluate the efficiency and quality of instrument cleaning. Material and methods. We analyzed the experience of the Republican Bureau of Forensic Medicine of the Ministry of Health of the Republic of Tatarstan in the organization and provision of washing and disinfection of sectional instruments. We developed basic principles of operation and standard operating procedures for the personnel of thanatology department with regard to mechanized washing and disinfection of sectional instruments in ultrasonic washing. We evaluated the effectiveness of the implemented measures by conducting sanitary and bacteriological examination and by testing the effectiveness of ultrasound treatment of instruments. Results and discussion. Ensuring the safety of personnel working in the expert institution dictates the necessity of mechanization and automation of production processes in the area of cleaning and disinfection of metal instruments. In this regard, standard operating procedures for personnel based on the current regulatory documents were developed and implemented. The effectiveness of the implemented measures was further evaluated. Sanitary and bacteriological studies in the control group (before the implementation of standard operating procedures) revealed E. coli bacteria in 15% of the samples. Staphylococcus aureus was not detected in any of the samples. All samples containing E. coli group bacteria were in the washes taken from the scissors. In the experimental group (after implementation of standard operating procedures), E. coli and Staphylococcus aureus bacteria were not detected in all samples. When evaluating the efficiency of instrument washing in an ultrasonic washer, 98,33% of SteriTEC indicators for instrument cleaning reached the optimal variant. Conclusion. Thus, the introduction of modern, mechanized methods of instrument processing into the activities of medical and preventive treatment institutions, in particular forensic medicine bureaus, can significantly improve the quality of cleaning and disinfection of metal instruments involved in the performance of examinations. Such innovations must be accompanied by a comprehensive approach in solving sanitary and hygienic problems and be supported by clear guidelines and standard operating procedures for personnel.

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8. Timerzyanov MI, Gazizyanova RM, Nizamov AKh, Minaeva PV. Vozmognosti sovershenstvovaniya protivoepidemicheskih meropriyati v byuro sudebno-medicinskoi expertizi na osnove podhodov menedgmenta kachestva [Possibilities of improvement of anti-epidemic events at forensic medical institution on the basis of quality management approaches]. Sudebno-medicinskaya expertiza [Sudebno-meditsinskaya ekspertiza]. 2020; 63 (3): 40-44. DOI: 10.17116/sudmed20206303140.

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 CHANGES OF FACTORS OF NON-SPECIFIC PROTECTION OF THE ORAL CAVITY IN CHILDREN WITH GINGIVITIS AGAINST THE BACKGROUND OF THE USE OF ESSENTIAL OILS AND BENTONITE CLAY

DOVBNYA ZHANNA A., ORCID ID: 0000-0002-1544-2384; С. Med. Sci., associate professor of the Department of dentistry of V.I. Vernadsky Crimean Federal University, Medical Academy named after S.I. Georgievsky, Russia, 295006, Republic of Crimea, Simferopol, Lenin av., 5/7, e-mail: zhannulka1@mail.ru

GOLOVSKAYA GALINA G., ORCID ID: 0000-0001-7060-9581; С. Bio. Sci., senior lecturer of the Department of biochemistry of V.I. Vernadsky Crimean Federal University, Medical Academy named after S.I. Georgievsky, Russia, 295006, Republic of Crimea, Simferopol, Lenin av., 5/7

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10. Kaladze NN, Galkina OP, Bezrukov SG, et al. Terapevticheskaya cennost biorezonansnoj stimulyacii i «maloj» bal’neoterapii v okazanii stomatologicheskoj pomoshchi bol’nym yuvenil’nym revmatoidnym artritom na etape reabilitacii [Therapeutic value of bioresonance stimulation and “small” balneotherapy in providing dental care to patients with juvenile rheumatoid arthritis at the rehabilitation stage]. Vestnik fizioterapii i kurortologii [Bulletin of Physiotherapy and Balneology]. 2018; 24 (1): 14-19.

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 THE RATE OF INCREASE AND PREDICTION OF GENERAL MORBIDITY IN RURAL AREAS

KAMILOV OYBEK А., ORCID ID: 0000-0003-3909-6700; postgraduate student of the Department of dermatology and venerology of Peoples’ Friendship University of Russia (RUDN University), Russia, 117198, Moscow, Miklukho-Maklay str., 6, e-mail: kamilov_oybek@mail.ru

KAMILOVA ROZA T., ORCID ID: 0000-0002-0397-8261; D. Med. Sci., professor, Deputy Director for research of the Institute of Sanitation of Hygiene and Occupational Diseases of the Ministry of Health of the Republic of Uzbekistan, Uzbekistan, Tashkent, 100050, Oltintepa str., 325, e-mail: rozakamilova@mail.ru

Abstract. Introduction. It is necessary to forecast the development of population morbidity, based on the processing and analysis of accumulated reliable information to provide timely high-quality medical service, and to develop a set of targeted therapeutic and preventive measures. Aim. The aim of the study was to assess the features of the growth rate and to forecast general morbidity of the adult population in rural areas focused on different branches of agriculture.Material and methods. The processing and analysis of data from annual statistical reports of the Sanitary-Epidemiological Welfare and Public Health Service of Tashkent region on morbidity of adult population (18 years and older) living in Bostanlyk (fruit and vegetable) and Chinaz (cotton growing) districts were performed. Indicators of general morbidity of rural population in dynamics were studied for the period 2007–2018 by classes of diseases according to ICD-10. Comparative analysis of general morbidity was performed for two 5-year periods (2007–2011 and 2014–2018). Statistical analysis was performed using Microsoft Excel 2016 and Statistica 10.0 software packages. Student’s t-test was used to determine the significance of differences in mean values. Differences of arithmetic mean values were considered reliable at p < 0,05. Results and discussion. In the period from 2007 to 2018, the dynamic changes in the general morbidity of the adult population in the cotton-growing and, to a greater extent, in the fruit-and-vegetable districts of Tashkent province were characterized by a negative average growth rate (-6,8 vs. -66,5%). As a result of analysis of statistical data for 2014–2018, in comparison with 2007–2011, decrease of general morbidity of population in fruit and vegetable growing district by 39,5%, and on the contrary, in cotton-growing district there was increase by 9,6%. Forecasting indicates a further decrease in the general morbidity of population in rural areas of Tashkent region in the coming years. At the same time, the tendency to further increase of respiratory diseases - in the fruit and vegetable growing district and respiratory, digestive and circulatory diseases – in the cotton-growing district is outlined. Conclusion. The observed decrease in the general morbidity of the rural population, apparently, is associated with the implementation in Uzbekistan of crop diversification policy since 2010, based on reducing the use of pesticides and mineral fertilizers. Significant prevalence of general morbidity of six leading classes of diseases, characteristics of growth rate and medium-term forecast create the need for monitoring and contribute to establishment of a set of measures for prevention, early detection of diseases and pathological conditions, taking into account the contributing risk factors.

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 SNORING AND OBSTRUCTIVE SLEEP APNEA SYNDROME AS POSSIBLE CAUSES OF AUDITORY AND TUBAL DISORDERS

MIROSHNICHENKO NINA A., ORCID ID: 0000-0003-4213-6435; D. Med. Sci., associate professor, professor of the Department of otorhinolaryngology of Moscow State Medical and Dental University named after A. I. Evdokimov, Russia, 127473, Moscow, Delegatskaya str., 20, bld. 1, e-mail: mirnino@yandex.ru

PIKHTILEVA NATALIA A., ORCID ID: 0000-0003-1253-9719; assistant of professor of the Department of surgical dentistry and maxillofacial surgery with the course of otorhinolaryngology of Ryazan State Medical University named after I.P Pavlov, Russia, 39000, Ryazan, Vysokovoltnaya str., 9, tel. +7-920-961-60-78, e-mail: pixtileva@gmail.com

Abstract. Introduction. Snoring occurs in 20,5% of the population, and obstructive sleep apnea syndrome occurs in 5–7% of the population. Primary snoring and obstructive sleep apnea syndrome contribute to the development of a number of diseases of internal organs, among which impairment of auditory and tubal function seems to be understudied. Aim.The aim of the study was to determine the effect of obstructive sleep apnea syndrome and primary snoring on auditory and tubal functions. Material and methods. The study was conducted in two groups: the first group consisted of 30 patients with obstructive sleep apnea syndrome, and the second group consisted of 50 patients with primary snoring. The control group consisted of 50 observed patients without primary snoring and obstructive sleep apnea syndrome. The study protocol included patient questionnaires, examination of oropharyngeal structures, evaluation of auditory function with tonal threshold audiometry and tympanometry. Subgroup assignment was performed after registration of an apnea index of more than 5 episodes per hour. Identified forms of auditory impairment in patients of the study and control groups were processed using StatTech online software with a 95% confidence interval. Results and discussion. The results of the study revealed a statistically significant association between the risk factor (snoring) and the development of tubal dysfunction in both study groups. It was also determined that there were no significant differences in the frequency of hearing loss in the primary snoring and obstructive sleep apnea groups, but when comparing with the control group, it was found that the proportion of patients with reduced hearing in the study group was significantly higher. Correlation data were obtained between the duration of snoring and the occurrence of auditory and tubal dysfunction, due to which it can be argued that the form and severity of auditory dysfunction is influenced by the duration of snoring, the time of snoring during the sleep period, and the intensity (loudness) of snoring. The results obtained can be explained by long-term combined effects of noise and hypoxia in sleep in this category of patients, as well as by morphological and functional changes in oropharyngeal structures occurring in primary snoring and obstructive sleep apnea syndrome.Conclusion. In all cases of chronic tubal dysfunction, especially those accompanied by hearing loss, it is advisable to examine the patient for the presence of snoring and apnea.

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2. World Health Organization. Deafness and Hearing Loss (online) 2019. Accessed February 18, 2021. URL: https:// www.who.int/news-room/fact-sheets/detail/deafness-and-hearing-loss

3. Passali D, Passali GC, Cianfrone F, Passali FM, Bellussi LM. Hearing loss: a social problem. Analysis and consideration. Experimental and clinical Оtorhinolaryngology. 2020; 1 (02): 42-47. https://med122.com/news/1/Magazin_ OTORINO_01_2020_web.pdf4.

4. Vladimirova TYu, Martynova AB. Kachestvo zhizni i komorbidnyy status u lits starshey vozrastnoy gruppy s khronicheskoy sensonevral’noy tugoukhost’yu [Quality of life and comorbid status in persons of the older age group with chronic sensorineural hearing loss]. Rossiiskaya otorinolaringologiya [Russian otorhinolaryngology]. 2020; 19 (5): 36–43. DOI: 10.18692/1810-4800-2020-5-36-43

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11. Pihteleva NA, Starkova LN. Vliyaniye khrapa na sostoyaniye tubarnoy funktsii u bol’nykh pervichnym khrapom i sindromom obstruktivnogo sonnogo apnoe [Influence of snoring on the state of tubar function in patients with primary snoring and obstructive sleep apnea syndrome]. Fundamental’nyye aspekty psikhicheskogo zdorov’ya [Fundamental aspects of mental health]. 2019; 1: 38-41.

12. Starkova LN, Pihteleva NA. Anatomo-fiziologicheskiye osobennosti stroyeniya myagkogo neba v svete khirurgicheskogo lecheniya khrapa i sindroma obstruktivnogo apnoe sna [Anatomical and physiological features of the structure of the soft palate in the light of surgical treatment of snoring and obstructive sleep apnea syndrome]. Ural’skiy meditsinskiy zhurnal [Ural Medical Journal]. 2020; 8 (191): 75-80.

13. Belskikh ES, Uryazyev OM, Zvyagina VI, Faletrova SV. Issledovaniye okislitel’nogo stressa i funktsii mitokhondriy v mononukleanykh leykotsitakhkrovi u bol’nykh s khronicheskim bronkhitom i s khronicheskoy obstruktivnoy bolezn’yu legkikh [Investigation of oxidative stress and mitochondrial function in mononuclean blood leukocytes in patients with chronic bronchitis and chronic obstructive pulmonary disease]. Nauka molodykh (Eruditio Juvenium) [The Science of the Young (Eruditio Juvenium)]. 2018; 6 (2): 203-210.

УДК 616.12-008.331.1-057-07:616.15-074

DOI: 10.20969/VSKM.2021.14(6).51-57

 SPECIFICS OF THE STATE OF MYOCARDIUM AND PROFIBROTIC FACTORS IN THE DEVELOPMENT OF HYPERTENSIVE HEART

MUTALOVA ELVIRA G., ORCID ID: 0000-0002-7454-9819; D. Med. Sci., professor, the Head of the Department of advanced internal medicine No 1 of Bashkir State Medical University, Russia, 450000, Ufa, Lenin str., 3, e-mail: emutalova@mail.ru

ALFUKAKHA MAKHMUD M. M., full-time postgraduate student of the Department of advanced internal medicine No 1 of Bashkir State Medical University, Russia, 450000, Ufa, Lenin str., 3

Abstract. Introduction. Myocardial damage caused by arterial hypertension is manifested by changes in myocardial geometry and mass, as well as increased content of collagen and fibrous tissue in the myocardium. Excessive accumulation of collagen in myocardium is the result of imbalance between proteolytic enzymes such as matrix metalloproteinases 1 (MMP-1) and tissue inhibitors of matrix metalloproteinase 1 (TIMMP-1), high content of transforming growth factorβ1 (TFG-β1), which was found in fibroblasts and macrophages. Aim. The aim of the study was to investigate the role of MMP-1 activation, its tissue inhibitor TIMMP-1 and TGF-β1 in blood in the development of myocardial fibrosis in locomotive train workers with arterial hypertension. Material and methods. 82 patients with arterial hypertension and 20 virtually healthy control subjects were examined. The patients of the analyzed groups underwent evaluation of the data of daily blood pressure monitoring, echocardiographic examination, based on which the types of left ventricular remodeling, the content of matrix metalloproteinase 1 and its tissue inhibitor activity, the level of transforming growth factorβ1 in blood serum were identified. Calculation of the volume fraction of interstitial collagen was performed. Results and discussion. The study established statistically significant signs of structural changes in the left ventricular myocardium, which primarily indicated its marked left ventricular hypertrophy against the background of arterial hypertension due to chronic pressure overload. Statistically significant increase of all levels of serum markers of collagen metabolism was revealed in patients with arterial hypertension in comparison with the control group. Patients with arterial hypertension have a restructuring of the intercellular matrix components and imbalance in the MMP-1/TIMMP-1 system characterized by a shift of the collagen balance towards fibrosis (increase of THF-β1, TIMMP-1 level, decrease of MMP-1/TIMMP-1 ratio and increase of interstitial collagen volume fraction). Significant increase of interstitial collagen volume fraction index in the group of patients with arterial hypertension comparing to the control group also indirectly indicates high intensity of interstitial collagen genesis in myocardium of these patients. Conclusion. In arterial hypertension, serum levels of THF-β1, MMP-1, and TIMMP-1 increase, which indirectly indicates an increase in myocardial collagen content.

Key words: arterial hypertension, heart remodeling, myocardial fibrosis, biomarkers of myocardial fibrosis, matrix metalloproteinase, tissue matrix metalloproteinase inhibitor, transforming growth factor β1.

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 SELECTION OF THE OPTIMAL ENDOSCOPIC TREATMENT OPTION FOR PATIENTS WITH CHOLEDOCHOLITHIASIS

SAYFUTDINOV ILYAS M., ORCID ID: 0000-0002-5768-6096; C. Med. Sci., the Head of endoscopy of the Department of Interregional Clinic and Diagnostic Center, Russia, 420101, Kazan, Karbyshev str., 12а, e-mail: ISayfutdinov@mail.ru

KRASILNIKOV DMITRIY M., ORCID ID: 0000-0003-4973-4040; D. Med. Sci., professor, the Head of the Department of surgical diseases of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: dmkras131@gmail.com

SLAVIN LEV E., ORCID ID: 0000-0002-4121-4545; D. Med. Sci., professor of the Department of endoscopy, general and endoscopic surgery of Kazan State Medical Academy – the branch of Russian Medical Academy of Continuons Professional; Chief specialist for surgery of Interregional Clinic and Diagnostic Center, Russia, 420101, Kazan, Karbyshev str., 12а

KHAYRULLIN RUSTEM N., ORCID ID: 0000-0002-0006-1386; D. Med. Sci., General Manager of Interregional Clinical Diagnostic Center; Honored doctor of the Republic of Tatarstan, Russia, 420101, Kazan, Karbyshev str., 12а

ZIMAGULOV RUSTEM T., ORCID ID: 0000-0002-7250-0528; C. Med. Sci., the Head of the Department of surgery of Interregional Clinic and Diagnostic Center, Russia, 420101, Kazan, Karbyshev str., 12а

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SKOROKHODKINA OLESYA V., ORCID ID: 0000-0001-5793-5753; D. Med. Sci., professor, the Head of the Department of clinical immunology and allergology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: olesya-27@rambler.ru

KHAKIMOVA MILYAUSHA R., ORCID ID: 0000-0002-3533-2596; postgraduate student of the Department of clinical immunology and allergology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: mileushe7@gmail.com

TIMERBULATOVA GUZEL A., ORCID ID: 0000-0002-2479-2474; assistant of professor of the Department of hygiene and occupational medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: ragura@mail.com

FATKHUTDINOVA LILIYA M., ORCID ID: 0000-0001-9506-563X; D. Med. Sci., professor, the Head of the Department of hygiene and occupational medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: liliya.fatkhutdinova@gmail.com

Abstract. Introduction. The study of pathogenetic mechanisms of eosinophilic inflammation development in bronchial asthma is the basis for the development of an individual approach to the therapy of the disease. Aim. The aim of our research was to study the levels of individual cytokines: TSLP, IL-25, IL-33, IL-4, IL-5, IL-13 in patients with T2-endotype bronchial asthma and to conduct a comparative assessment of these parameters in allergic and non-allergic phenotype of the disease. Material and methods. We examined 53 patients with bronchial asthma (18–65 years old; mean age, 41,6 years), including 25 with allergic (group 1) and 28 with nonallergic phenotype of the disease (group 2). The levels of TSLP, IL-25, IL-33, IL-4, IL-5, IL-13 in serum were investigated in 30 patients by multiplex analysis. Statistical processing was performed using Microsoft Office Excel software package (2019). Results and discussion. The clinical features of the course of bronchial asthma in the patients of the studied groups are presented. High level of absolute eosinophil count in peripheral blood was registered in both groups of patients [(572,83±174,96) cells/μL and (470,32±131,73) cells/μL]. At the same time, a direct correlation between the absolute number of eosinophils and IL-5 level was observed primarily in group 1 patients (rxy=+0,74). Only patients with allergic bronchial asthma had an elevated level of total serum IgE [(274,55±53,90) IU/ml; p<0,01) and a significantly higher level of IL-4 (344 pg/ml; p<0,05). A direct correlation (rxy=+0,52) was detected between the above indices. IL-13 values did not differ significantly in both groups. The level of TSLP and IL-25 was significantly higher in the patients of the 1st group, while the IL-33 values did not differ significantly. At the same time a direct correlation between IL-33 and IL-13 levels (rxy=+0,53), IL-33 and IL-5 (rxy=+0,65) in group 1 patients, and between IL-33 and IL-5 levels (rxy=+0,43) in group 2 patients was found. Conclusion. Differences in the secretion of the studied cytokines with regard to the clinical picture of the disease allow to make a differential diagnosis of different phenotypes of bronchial asthma belonging to the T2-endotype of the disease and to provide a personalized approach to the choice of therapy.

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 SPECIFICS OF THE COURSE OF POSTTHROMBOTIC DISEASE IN PATIENTS WITH CONNECTIVE TISSUE DYSPLASIA

STYAZHKINA SVETLANA N., ORCID ID: 0000-0001-5787-8269; D. Med. Sci., professor of the Department of surgery of Izhevsk State Medical Academy, Russia, 426039, Izhevsk, Kommunarov str., 281, tel. +7-950-820-51-10, e-mail: sstazkina064@gmail.com

KIRSHIN ANDREY A., ORCID ID: 0000-0003-4525-0647; cardiovascular surgeon of the Department of vascular surgery of Republican Clinical and Diagnostic Center of the Ministry of Health of Udmurt Republic, Russia, 426009, Izhevsk, Lenin str., 87б, tel. +7-906-819-83-85, e-mail: aakirshin@gmail.com

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2. Nechaeva GI, Viktorova IA. Displaziya soedinitel’noj tkani: terminologiya, diagnostika, taktika vedeniya pacientov [Connective tissue dysplasia: terminology, diagnostics, patient management tactics]. Omsk: Tipografiya BLANKOM [Omsk: Printing house BLANKOM]. 2007; 188 p.

3. Nechaeva GI, Martynov AI. Displaziya soedinitel’noj tkani: serdechno-sosudistye izmeneniya, sovremennye podhody k diagnostike i lecheniyu [Connective tissue dysplasia: cardiovascular changes, modern approaches to diagnosis and treatment]. Moskva: OOO «Izdatel’stvo «Meditsinskoye informatsionnoye agentstvo» [Moscow: LLC «Publishing House» Medical Information Agency»]. 2017; 400 p.

4. Nechaeva GI, Drokina OV, Martynov AI, et al. Osnovy kuracii pacientov s displaziej soedinitel’noj tkani v pervichnom zvene zdravoohraneniya [Vtrshinina Fundametals of treatment patients with connective tissue dysplasia in primary care]. Terapiya [Therapy]. 2015; 1: https://therapy-journal.ru/ru/archive/article/31356

 CLINICAL AND STATISTICAL ANALYSIS OF THE INCIDENCE OF ENDOCRINE SYSTEM DISEASES, EATING AND METABOLIC DISORDERS AMONG CHILDREN AND ADOLESCENTS IN THE REPUBLIC OF TATARSTAN

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, Vice-Rector of Kazan State Medical University, Russia, 420012, Kazan, Butlerov, str., 49, tel. +7-987-213-67-12, e-mail: shulaev8@gmail.com

SHAIDULLINA MARIA R., ORCID ID: 0000-0002-2783-5759; SPIN 9051-2570; C. Med. Sci., associate professor of the Department of endocrinology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: zizi97@mail.ru

VALEEVA FARIDA V., ORCID ID: 0000-0001-6000-8002; SPIN-code 2082-3980; Author ID: 784269; D. Med. Sci., professor, the Head of the Department of endocrinology of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: val-farida@yandex.ru

1. Rukovodstvo po detskomu pitaniju i fizicheskoj̆ aktivnosti dlja roditelej i ljudej, rabotajushhih s det’mi 6-10 let [A guide to baby nutrition and physical activity for parents and people working with children 6-10 years old]. Kopengagen: Evropejskoe regional’noe bjuro VOZ [Copenhagen: WHO Regional Office for Europe]. 2020; 129 p.

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6. Zyjatdinov KSh, Gil’manov AA, Glushakov AN. Statistika zdorov’ja naselenija i zdravoohranenija (po materialam Respubliki Tatarstan za 2001-2004 gody): uchebno-metodicheskoe posobie [Population health and health care statistics (based on materials of the Republic of Tatarstan for 2001-2004: training manual)]. Kazan’ [Kazan]. 2006; 276 p.

7. Farrahov AZ, Gil’manov AA, Sherputovskij VG. Statistika zdorov’ja naselenija i zdravoohranenija (po materialam Respubliki Tatarstan za 2004-2008 gody): uchebno-metodicheskoe posobie [Population health and health care statistics (based on materials of the Republic of Tatarstan for 2004-2008: training manual)]. Kazan’ [Kazan]. 2009; 261 p.

8. Farrahov AZ, Gil’manov AA, Sherputovskij VG, Molokovich NI. Statistika zdorov’ja naselenija i zdravoohranenija (po materialam Respubliki Tatarstan za 2008-2012 gody): uchebno-metodicheskoe posobie [Population health and health care statistics (based on materials of the Republic of Tatarstan for 2008-2012: training manual)]. Kazan’ [Kazan]. 2013; 264 p.

9. Vafin AJu, Garipov RR, Shishmareva EI, Molokovich NI. Statistika zdorov’ja naselenija i zdravoohranenija (po materialam Respubliki Tatarstan za 2012-2016 gody): uchebno-metodicheskoe posobie [Population health and health care statistics (based on materials of the Republic of Tatarstan for 2012-2016: training manual)]. Kazan’ [Kazan]. 2017; 264 p.

10. Sadykov MN, Gajnutdinov AR, Husnullina GR. Statistika zdorov’ja naselenija i zdravoohranenija (po materialam Respubliki Tatarstan za 2015-2019 goda): uchebno-metodicheskoe posobie [Population health and health care statistics (based on materials of the Republic of Tatarstan for 2015-2019: training manual)]. Kazan’ [Kazan]. 2020; 267 p.

11. Federal’naya sluzhba gosudarstvennoy statistiki [Federal State Statistics Service]. Rossiyskaya gosudarstvennaya statistika i vyzovy XXI veka: materialy mezhdunarodnoy nauchno-prakticheskoy konferentsii, posvyashchennoy 200-letiyu obrazovaniya rossiyskoy statisticheskoy sluzhby (Moskva, 23-24 iyunya 2011 gоda) [Russian state statistics and the challenges of the XXI century: materials of the international scientific-practical conference devoted to the 200th anniversary of the Russian statistical service (Moscow, June 23-24, 2011). Moskva [Moscow]. 2011; 283 p.

12. Dedov II, Mel’nichenko GA, Platonova NM, Troshina EA, Abdulhabirova FM. Rezul’taty monitoringa jododeficitnyh zabolevanij v Rossijskoj Federacii (2000 –2005 gg); rukovodstvo dlja vrachej [Results of monitoring of iodine deficiency diseases in the Russian Federation (2000-2005); A guide for doctors]. Moskva [Moscow]. 2005; 124 p.

13. Ministerstvo zdravoohranenija Rossijskoj Federacii [The Ministry of Health of the Russian Federation]. Differencirovannyj rak shhitovidnoj zhelezy; Klinicheskie rekomendacii [Differentiated thyroid cancer; Clinical Recommendations]. Moskva [Moscow]. 2020; 47 p. https://www.endocrincentr.ru/sites/default/files/specialists/ science/clinic-recomendations/differencirovannyy_rak_ shchitovidnoy_zhelezy.pdf

14. Nagaeva EV, Shirjaeva TJu, Peterkova VA. Diagnostika i lechenie gipopituitarizma u detej i podrostkov [Diagnosis and treatment of hypopituitarism in children and adolescents]. Rossijskij nacional’nyj consensus: Problemy Jendokrinologii [Russian National Consensus: Problems of Endocrinology]. 2018; 64 (6): 402-411.

 POSTCOVID SYNDROME: MULTISYSTEM «DEFICITS»

AMIROV NAIL B., ORCID ID: 0000-0003-0009-9103; 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, tel. +7(843)291-26-76, e-mail: namirov@mail.ru

DAVLETSHINA ELZA I., ORCID ID: 0000-0001-6195-3428; 6th year student of Faculty of general medicine of the Department of outpatient medicine and general medical practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-996-952-51-22, e-mail: elz.ok@mail.ru

VASILIEVA ANNA G., ORCID ID: 0000-0002-8825-1554; 6th year student of Faculty of general medicine of the Department of outpatient medicine and general medical practice of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-999-156-65-34, e-mail: vasilevaag98@gmail.com

FATYKHOV RENAT G., ORCID ID: 0000-0001-5651-8341; the Head of the Clinical Hospital of 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

Abstract. Background. The emergence of new symptoms associated with SARS-CoV-2 infection and their persistence over a long period of time is an increasing problem for the population and its health care system. Although respiratory changes are the most common, extrapulmonary manifestations are also numerous. Aim. The aim of the study was to review current information on the epidemiology, clinical features, and possible pathogenetic mechanisms of the development of long-term effects of coronavirus infection. Material and methods. The aim of the study was to review current information on the epidemiology, clinical features, and possible pathogenetic mechanisms of the development of long-term effects of coronavirus infection. Results and discussion. Fatigue, insomnia, anxiety and depression, cognitive impairment, anosmia and dysgeusia are the most common symptoms seen after COVID-19. Conclusion. The wide range of symptoms that can occur in patients with post covid syndrome is now a major health concern worldwide. A proper clinical evaluation will help determine the etiology and build a treatment plan. Longer studies aimed at identifying the effects of COVID-19, possible risk factors for their development, a detailed study of the pathogenetic mechanisms of SARS-CoV-2, and the development of treatment and rehabilitation methods to improve the mental and physical health of surviving patients are relevant elements of study for the foreseeable future.

 THE EFFECTS OF IRON CONTENT IN THE BODY ON GUT MICROBIOTA (review)

BALASHOVA ELENA A., ORCID ID: 0000-0001-5766-6741; SCOPUS Author ID 57193901582; Researcher ID H-9863-2015; RSCI Author ID 249117; D. Med. Sci., associate professor of the Department of advanced pediatrics of Samara State Medical University, Russia, 443099, Samara, Chapayevskaya str., 89, tel.: 8 (846) 374-10-04, 8-927-603-22-98, e-mail: mine22@yandex.ru

KONDRATENKO OLGA V., ORCID ID: 0000-0002-7750-9468; D. Med. Sci., associate professor of the Department of general and clinical microbiology, immunology and allergology of Samara State Medical University, Russia, 443099, Samara, Chapayevskaya str., 89, tel.: 8(846)374-10-04, 8-927-200-55-00, e-mail: o.v.kondratenko@samsmu.ru

SHADRINA INNA L., ORCID ID: 0000-0002-6000-1959; Deputy Chief physician for childhood and maternity care of Samara City Hospital No 7, Russia, 443112, Samara, Upravlencheskij village, Krajnjaja str., 17; assistant of professor of the Department of advanced pediatrics of Samara State Medical University, Russia, 443099, Samara, Chapayevskaya str., 89, tel. 8-927-707-24-74, e-mail: 7gbshadrina@mail.ru

POGODINA ALEXANDRA A., ORCID ID: 0000-0001-9954-5729; pediatrician of Samara City Clinical and Diagnostic Outpatient Clinic No 14, Russia, 443124, Samara, Novo-Sadovaya str., 200a, e-mail: erisova63@gmail.com

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 A CURRENT PERSPECTIVE ON PRIMARY PREVENTION OF CARDIOVASCULAR DISEASES (review of current guidelines)

CHULKOV VASILIY S., ORCID ID: 0000-0002-0952-6856; SCOPUS Author ID: 55246314800; D. Med. Sci., associate professor, professor of the Department of internal medicine of South-Ural State Medical University, Russia, 454092, Chelyabinsk, Vorovsky str., 64, e-mail: vschulkov@rambler.ru

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

KONASHOV VLADISLAV A., ORCID ID: 0000-0002-1905-9155; 4-th year student of Faculty of general medicine of South-Ural State Medical University, Russia, 454092, Chelyabinsk, Vorovsky str., 64, e-mail: konashov74@bk.ru

SEDOVA ANASTASIA D., ORCID ID: 0000-0002-0253-5231; 4-th year student of Faculty of general medicine of South-Ural State Medical University, Russia, 454092, Chelyabinsk, Vorovsky str., 64, e-mail: nastushasedova1999@yandex.ru

FINK ARTUR E., ORCID ID: 0000-0002-9776-0166; 4-th year student of Faculty of general medicine of South-Ural State Medical University, Russia, 454092, Chelyabinsk, Vorovsky str., 64, e-mail: finkartur@icloud.com

Abstract. Aim. The aim of the study was to analyze current guidelines and studies on primary prevention of cardiovascular diseases. Material and methods. A review of current seminal work on primary prevention of cardiovascular disease, including discussion of unresolved issues, new approaches, and the added benefits of correcting risk factors through lifestyle changes and the use of medications, including aspirin, was conducted. Results and discussion. The burden of cardiovascular diseases can be reduced by primary prevention, which is an important public health priority. The effectiveness of interventions is determined by the rationality of modifying risk factors, which is constantly improving with the changing profile of the world’s population and the emergence of new evidence-based approaches to risk assessment and prevention, particularly in elderly patients. Analysis of international and national recommendations shows a unified position of experts on the need for smoking cessation and the importance of exercise. At the same time, the cardiovascular effects of different diets, management of patients with excessive weight, arterial hypertension and dyslipidemia, including comorbidity and age, are being actively studied. There are differences in the U.S. and European guidelines regarding the correction of the latter factors, as well as the prescription of aspirin. Conclusion. Primary prevention continues to be actively studied. With the emergence of new large studies, there is a better understanding of the tools with which we can assess and reduce cardiovascular risk. A personalized approach, the use of new relevant cardiovascular risk stratification scales, nonmedicinal correction, and evidence-based pharmacotherapy underlie effective primary prevention of cardiovascular diseases.

 SURGICAL TREATMENT OF RECURRENT CYSTIC LIVER ECHINOCOCCOSIS

ANISIMOV ANDREY YU., ORCID ID: 0000-0003-4156-434X; D. Med. Sci., professor, the Head of the Department of emergency medical care and simulation medicine of Institute of fundamental medicine and biology of Kazan (Volga Region) Federal University, Chief freelance specialist for surgery of the Ministry of Health of the Republic of Tatarstan, surgeon of Medical Unit of Kazan Federal University and Medical Care unit of the Ministry of Internal Affairs of Russia for RT, Russia, 420012, Kazan, Karl Marx str., 76, tel. 8-843-236-68-02, e-mail: aanisimovbsmp@yandex.ru

MOKHAMMED ALAN O., ORCID ID: 0000-0002-7895-9540; surgeon of the Department of surgery No 2 of Medical Unit of Kazan Federal University, Russia, 420055, Kazan, N. Ershov str., 2, tel. 8-900-314-99-29, e-mail: alan.muhammed@hotmail.com

OSPENNIKOV IGOR M., ORCID ID: 0000-0001-8347-4372; surgeon of the Department of surgery No 2 of Medical Unit of Kazan Federal University, Russia, 420055, Kazan, N. Ershova str., 2, tel. 8-917-272-52-90, e-mail: Ospennikov65@inbox.ru

MINABUTDINOV RAFAEL M., ORCID ID: 0000-0001-6598-7123; the Head of the Department of surgery No 2 of Medical Unit of Kazan Federal University, Russia, 420055, Kazan, N. Ershov str., 2, tel. 8-987-296-10-49, e-mail: Minabutdinov.rafael@bk.ru

Abstract. Aim. The aim of the study was to evaluate the effectiveness of the original surgical strategy in the treatment of patients with recurrent cystic echinococcosis of the liver. Material and methods. We retrospectively evaluated inpatient medical records of 9 patients with previously surgically treated echinococcal cysts, who were subsequently referred to the clinic for treatment of recurrence in the liver. In 7 patients, recurrence manifested as the reappearance of living cysts in place of previously treated liver cysts, whereas in 2 patients new cysts in the liver developed at a distance from the primary foci. The period of recurrence development ranged from 8 months to 7 years. All nine patients underwent an operative strategy consisting in total removal of the cyst contents with physical sterilization of the cyst cavity and subsequent drainage of the bed of the removed cyst. Results and discussion. Satisfactory long-term palliation was achieved in all nine clinical observations, which is preferable to the likelihood of death after overly enthusiastic attempts at complete cure with radical excisions. A clinical observation is presented. Conclusion. The management of patients with recurrent cystic echinococcosis of the liver is difficult and should be performed in specialized hepatosurgical centers with a full range of high-tech surgeries on the liver. Total removal of the cyst contents with physical sterilization of the cystic cavity and subsequent drainage of the removed cyst bed has proved to be good practice in the clinical practice of surgical treatment of recurrent cystic echinococcosis of the liver. To prevent recurrence of the disease along with compliance with the rules of surgery, antihelminthic therapy with albendazole in the postoperative period is necessary.

Key words: recurrent cystic liver echinococcosis, surgical treatment.

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