Vol. 16 Issue 5 (2023)

VSKM 2023 N 5

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ORIGINAL RESEARCH

Systemic inflammation response findings in past-COVID-19 patients with newly diagnosed pulmonary tuberculosisAbdillaev R.Y. (Russia, Moscow), Shorokhova V.A. (Russia, Moscow), Komissarova O.G. (Russia, Moscow) P.7

Central sensitization in psoriatic arthritis Akulinushkina E.Y. (Russia, Kazan), Yakupova S.P. (Russia, Kazan), Yakupov E.Z. (Russia, Kazan), Ivanova L.V. (Russia, Izhevsk), Bragina T.A. (Russia, Izhevsk), Maksimov N.I. (Russia, Izhevsk) P.16

Features of the course of community-acquired pneumonia and evaluation of the effectiveness of complex therapy Gorbunov A.Y. (Russia, Izhevsk), Bobyleva E.S. (Russia, Izhevsk), Suchkova E.V. (Russia, Izhevsk), Filimonov A.M.(Russia, Izhevsk), Solovieva A.A. (Russia, Izhevsk), Ganzha T.V. (Russia, Izhevsk) P.22

Comparative evaluation of the effectiveness of wound pain treatment using transmembrane technologies after median laparotomy Kontorev K.V. (Russia, Krasnoyarsk), Zdzitovetsky D.E. (Russia, Krasnoyarsk), Borisov R.N. (Russia, Krasnoyarsk), Nikiforova E.D. (Russia, Krasnoyarsk), Gricenko D.A. (Russia, Krasnoyarsk), Ovsienko D.V. (Russia, Krasnoyarsk) P.30

Preschool children dentoalveolar deformities depending on family types and morphofunctional child development Khadyeva M.N. (Russia, Kazan), Galiullin A.N. (Russia, Kazan), Yakimova J.Y. (Russia, Kazan) P.35

Outcomes of chronic heart failure in patients with coronary heart disease: a prospective 5-year study Khazova E.V. (Russia, Kazan), Bulashova O.V. (Russia, Kazan), Amirov N.B. (Russia, Kazan) P.42

REVIEWS

Prospects for designing new, usnic acidbased innovator antiseptics Krylov I.A. (Russia, Arkhangelsk), Kubasova E.D. (Russia, Arkhangelsk), Korelskaya G.V. (Russia, Arkhangelsk), Kubasov R. V (Russia, Arkhangelsk) P.53

Contemporary view of the genetic aspects of ulcer disease development Kuramshina O.A. (Russia, Ufa), Batrakova K.V. (Russia, Ufa),Tuvaleva L.S. (Russia, Ufa), Shuvaeva L.G. (Russia, Ufa),Nigmatullin R.K. (Russia, Ufa), Kutuev Z.Z. (Russia, Ufa),Samsonova Y.E. (Russia, Ufa) P.59

Role of redox status changes in the pathogenesis of chronic lymphocytic leukemia Osikov M.V. (Russia, Chelyabinsk), Korobkin E.A. (Russia, Chelyabinsk), Fedosov A.A. (Russia, Moscow), Sineglazova A.V. (Russia, Kazan) P.65

Reconstruction of the transverse carpal ligament in the treatment of carpal tunnel syndrome. Literature review Pankratov A.S. (Russia, Samara), Knyazev N.A. (Russia, Samara), Klyuchnikov A.S. (Russia, Samara), Potapov A.N.(Russia, Samara), Openchenko K.A. (Russia, Samara) P.72

HEALTH ORGANIZATION

Special aspects of the occupational morbidity time profile and structure in the Republic of Tatarstan Berheeva Z.M. (Russia, Kazan), Imamov A.A. (Russia, Kazan), Ignatans E.V. (Russia, Kazan), Sabitova M.M. (Russia, Kazan) P.78

Epidemiological situation and detection of HIV infection in the Arkhangelsk region in 2012-2021 Kalinin A.G. (Russia, Arkhangelsk), Sannikov A.L. (Russia, Arkhangelsk), Kubasov R.V. (Russia, Arkhangelsk), Petrova T.E. (Russia, Arkhangelsk), Repina A.A. (Russia, Arkhangelsk),Yasak Alina S. (Russia, Arkhangelsk), Martynova N.A. (Russia, Arkhangelsk), Kubasova E.D. (Russia, Arkhangelsk) P.86

Analysis of pricing for drugs manufactured in the Ural Federal District Petrov A.L. (Russia, Ekaterinburg), Sharafieva E.R. (Russia, Ekaterinburg), Nuzhina M.P. (Russia, Ekaterinburg), Gavrilov A.S. (Russia, Ekaterinburg), Andrianova G.N. (Russia, Ekaterinburg) P.92

CLINICAL CASE

A clinical case of toxocariasis in an adult with laryngo- and angioedemas Motyreva A.I. (Russia, Izhevsk), Hrabrov I.S. (Russia, Izhevsk), Osipanova V.O. (Russia, Izhevsk), Fayzullina D.E. (Russia, Izhevsk) P.97

Clinical relevance of azygos anterior cerebral artery Shnyakin P.G. (Russia, Krasnoyarsk), Protopopov A.V. (Russia, Krasnoyarsk), Botov A.V. (Russia, Krasnoyarsk), Litvinyuk N.V. (Russia, Krasnoyarsk), Tyumentsev N.V. (Russia, Krasnoyarsk), Voronkovskiy I.I. (Russia, Krasnoyarsk) P.102

Brain abscess and subdural empyema within the complication of acute pyogenic sinusitis: a clinical case Shubin D.I. (Russia, Moscow), Karpova A.A. (Russia, Moscow), Nikitin P.A. (Russia, Moscow) P.107

WHEN THE NUMBER WAS MADE UP

Probability of changes in the respiratory function indicators in the development of COPD, depending on the number of cigarettes smoked and associated with pregnancy-related hormone fluctuations Dzyubailo A.V. (Russia, Samara), Lotkov V. S. (Russia, Samara) P.113

Thromboembolic risk factors in dialysis patients with end-stage chronic kidney disease and non-valvular atrial fibrillation by CHA2DS2VASc and D-dimer level Ketsko Y.L. (Russia, Togliatti), Zhestkov A.V. (Russia, Samara),Sukach G.A. (Russia, Togliatti), Sorokina N.I. (Russia, Togliatti),Yakubov L.Y. (Russia, Togliatti), Ivanov A.V. (Russia, Togliatti),Sukhov V. (Russia, Togliatti), Popov M.A. (Russia, Samara) P.120

Contemporary global trends in the development of higher medical education in the USA, Great Britain, France, and China Protasov A.D. (Russia, Moscow), Starodubtseva E.S. (Russia, Moscow), Moshlyak G.A. (Russia, Moscow), Zhestkov A.V. (Russia, Samara) P.127

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ORIGINAL RESEARCH

УДК: 616.24-002.5-006:616.379-008.64

DOI: 10.20969/VSKM.2023.16(5).7-15

PDF download SYSTEMIC INFLAMMATION RESPONSE FINDINGS IN PAST-COVID-19 PATIENTS WITH NEWLY DIAGNOSED PULMONARY TUBERCULOSIS

ABDULLAEV RIZVAN Y., ORCID ID: 0000-0002-9105-9264; Scopus Author ID: 15051804600; Researcher ID: R-1889-2018;SPIN-код: 4535-2302; D. Med. Sci., Professor, Head of the Department of Pathomorphology, Cell Biology and Biochemistry, Central TB Research Institute, Russia, 107564, Moscow, Yauzskaya alleya, 2; e-mail: rizvan0403@yandex.ru

SHOROKHOVA VIOLETTA A., ORCID ID: 0000-0002-7143-3204; Scopus Author ID: 55183564500; Researcher ID: IQX-1544-2023; SPIN-код: 8154-7188; С. Med. Sci, Junior Researcher, of the Department of Pathomorphology, Cell Biology and Biochemistry, Central TB Research Institute, Russia, 107564, Moscow, Yauzskaya alleya, 2; e-mail: shelakova.07@inbox.ru

KOMISSAROVA OKSANA G., ORCID ID: 0000-0003-4427-3804; Scopus Author ID: 15051823500; SPIN-код: 6006-6732; D. Med. Sci., Deputy Director for Scienti c and Medical Work, Central TB Research Institute, Russia, 107564, Moscow, Yauzskaya alleya, 2.; Professor of the Department of phthisiology of the Pirogov Russian National Research Medical University, Russia, 117997, Moscow, Ostrovityanova St., 1.; e-mail: oksana.komissarova.72@mail.ru

Abstract. Introduction. It is known that both tuberculosis patients and COVID-19 patients develop a systemic in ammatory response with changes in the indicators of acute phase reactants, clinical blood analysis and the hemostasis and brinolysis system. Aim. To study in a comparative aspect, the level of acute phase reactants, clinical blood counts and markers of the state of hemostasis and brinolysis systems in newly diagnosed patients with pulmonary tuberculosis who had and did not have an infection caused by SARS-CoV-2. Material and Methods. A retrospective study was conducted in 60 patients with newly diagnosed pulmonary tuberculosis who had an infection caused by SARS-CoV-2: 30 patients with mild severity and 30 patients with moderate and severe severity. The comparison group included 30 patients who had not su ered an infection caused by SARS-CoV-2. The control group consisted of 47 healthy volunteers. We studied the frequency of changes and the median of laboratory parameters upon admission to the hospital. Results and discussion. It was found that in the groups of patients who had an infection caused by SARS-CoV-2 of moderate and severe severity, the indicators of the systemic in ammatory response - C-reactive protein, brinogen and ESR were signi cantly higher compared to both the group of patients who had not undergone and who have had a mild infection with SARS-CoV-2. At the same time, a hypercoagulable shift was observed in the system of hemostasis and brinolysis, as evidenced by the highest values of D-dimer in these patients. Conclusion.The development of a new tuberculosis process in patients after an infection caused by SARS-CoV-2, of moderate and severe severity, is accompanied by a systemic in ammatory response with the simultaneous development of a hypercoagulation shift, the severity of which is higher compared to patients who have had an infection caused by SARS-CoV-2, of mild severity.

Key words: tuberculosis, SARS-CoV-2, systemic in ammatory response, acute phase reactants, hemostasis and brinolysis.

For reference: Abdillaev RU, Komissarova OG, Shorokhova VA. Systemic in ammation response ndings in past-COVID-19 patients with newly diagnosed pulmonary tuberculosis. The Bulletin of Contemporary Clinical Medicine. 2023; 16(5): 7-15.DOI: 10.20969/VSKM.2023.16(5).7-15.

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УДК 616.72-009.7

DOI: 10.20969/VSKM.2023.16(5).16-21

PDF download CENTRAL SENSITIZATION IN PSORIATIC ARTHRITIS

AKULINUSHKINA EKATERINA Y., ORCID ID: 0000-0002-9321-431X; Rheumatologist of Republican Clinical Diagnostic Center; Russia, 426000, Izhevsk, Lenina str., 87B, e-mail: katewenterly@gmail.com

YAKUPOVA SVETLANA P., ORCID ID: 0000-0002-8590-4839, Scopus Author ID 57188832953; Chief Freelance Specialist of Tatarstan Republic, C. Med. Sci., associate professor, Department of Advanced Internal Medicine, Kazan State Medical University; Russia, 420012, Kazan, Butlerov str., 49, e-mail: yakupovasp@mail.ru

YAKUPOV EDUARD Z., ORCID ID: 0000-0003-2965-1424, Scopus Author ID 36700882500; D. Med. Sci., professor, Head of «Research complex «Neuroclinika professora Yakupova»; Russia, 420097, Kazan, Dostoevskij str., 52, e-mail: ed_yakupov@mail.ru

IVANOVA LARISA V., ORCID ID: 0000-0003-0411-6118; Chief Freelance Specialist of Udmurt Republic, Head of Department of Rheumatology of Republican Clinical Diagnostic Center; Russia, 426000, Izhevsk, Lenina str., 87B, e-mail: loraivanova7@mail.ru

BRAGINA TATYANA A., ORCID ID: 0009-0009-0066-3537; Rheumatologist, Head of the Medical diagnostic Department of Republican Clinical Diagnostic Center; Russia, 426000, Izhevsk, Lenina str., 87B, e-mail: tatyana.brg@yandex.ruMAKSIMOV NIKOLAI I., ORCID ID: 0000-0001-6819-2633; D. Med. Sci., professor, Head of Department of Advanced Internal Medicine, Izhevsk State Medical Academy; Russia, 426034, Izhevsk, Kommunarov str., 281, e-mail: maxni@list.ru

Abstract. Introduction. Chronic pain consists of nociceptive, neuropathic and nociplastic components. Nociplastic pain based on central sensitization. Patients with central sensitization may experience severe pain even with no any signs of clinical and laboratory in ammation, and describe it in descriptors of neuropathic pain. The prevalence and in uence of central sensitization in clinical and laboratory activity, the development of mood disorders in patients with psoriatic arthritis are not explored well. Aim. To assess the prevalence of central sensitization in patients with psoriatic arthritis, to compare the parameters of patients with and without central sensitization. Materials and methods. We examined 107 patients with psoriatic arthritis: number of tender and swollen joints, severity of pain, patient global assessment, and C-reactive protein were determined. Activity of disease was assessed with Disease activity in psoriatic arthritis, Ankylosing Spondylitis Disease Activity Score. Central sensitization was determined with Central Sensitization Inventory, presence of anxiety and depression - with Hospital Anxiety and Depression Scale. Descriptors of neuropathic pain were determined with Pain Detect Questionnaire. Statistical processing was carried out with Statistics 26.0. Di erences were considered signi cant at p-value < 0.05. Results and discussion. Central sensitization was found in 46 (43%) patients – they had patient global assessment (p=0.004) and severity of pain (p=0.002) in higher values. The C-reactive protein (p=0.423), Disease activity in psoriatic arthritis (p=0.083) did not di er between groups, but the Ankylosing Spondylitis Disease Activity Score (p=0.002) was higher in patients with central sensitization. High prevalence of anxiety (25.2%) and depression (40.2%) was found; more often in patients with central sensitization (p=0.001 and p=0.004). Most of patients described the tactile allodynia, «electric shocks», and burning. Conclusion.Signi cant contribution of central sensitization to the persistence of pain in patients with psoriatic arthritis was found. The frequency of clinically signi cant anxiety and depression in patients with psoriatic arthritis was shown, as well as their higher prevalence among patients with central sensitization. Patients with psoriatic arthritis often described pain like neuropathic pain, which can indicate both local damage to the nervous system and the formation of pain sensitization without direct damage to peripheral nerve structures.

Keywords: psoriatic arthritis, chronic pain, central sensitization, neuropathic descriptors, anxiety, depression.

For reference: Akulinushkina EY, Yakupova SP, Yakupov EZ et al. Central sensitization in psoriatic arthritis. The Bulletin of Contemporary Clinical Medicine. 2023; 16(5): 16-21. DOI: 10.20969/VSKM.2023.16(5).16-21.

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7. Bellinato F, Gisondi P, Fassio A, et al. Central Pain Sensitization in Patients with Chronic Plaque Psoriasis. Dermatol Ther (Heidelb). 2023. DOI: 10.1007/s13555- 023-00917-z (Electonic resource.) URL: https://link. springer.com/article/10.1007/s13555-023-00917-z (access date: 10.04.2023).

8. Бoрисoвa A.Б., Лисицынa Т.A., Вельтищев Д.Ю., и др. Психические рaсстрoйствa и кoгнитивные нaру- шения у бoльных aнтифoсфoлипидным синдрoмoм // Терaпевтический aрхив. - 2020. - Т. 92. - No5. - C. 92-103. [Borisova AB, Lisitsyna TA et al. Psihicheskie rasstrojstva i kognitivnye narusheniya u bol’nyh antifosfolipidnym sindromom [Mental disorders and cognitive impairment in patients with antiphospholipid syndrome]. Terapevticheskii arkhiv [Therapeutic Archive]. 2020; 92 (5): 92-103. (In Russi.)]. DOI: 10.26 442/00403660.2020.05.000625

9. Yue T, Li Q, Wang R, et al. Comparison of Hospital Anxiety and Depression Scale (HADS) and Zung Self-Rating Anxiety/Depression Scale (SAS/SDS) in Evaluating Anxiety and Depression in Patients with Psoriatic Arthritis. Dermatology. 2020; 236 (2):170-178. DOI: 10.1159/000498848

10. Trouvin AP, Perrot S. New concepts of pain. Best Pract Res Clin Rheumatol. 2019; 33 (3): 101415. DOI: 10.1016/j.berh.2019.04.007

11. Ramiro S, Nikiphorou E, Sepriano A, et al. ASAS- EULAR recommendations for the management of axial spondyloarthritis: 2022 update. Annals of the Rheumatic Diseases. 2023; 82: 19-34. DOI: 10.1136/ ard-2022-223296

12. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983; 67(6) :361-70. DOI: 10.1111/j.1600-0447.1983.tb09716.x

13. Есин O.Р., Гoрoбец Е.A., Хaйруллин И.Х., и др. Oпрoсник центральной сенситизации — русскoя- зычнaя версия. Журнaл неврoлoгии и психиaтрии им. С.С. Кoрсaкoвa. – 2020. – Т. 120, вып. 6. – С. 51–56. [Esin OR, Gorobets EA, Khairullin IKh, et al. Oprosnik central’noj sensitizacii — russkoyazychnaya versiya. [Central Sensitization Inventory — a Russian version]. Zhurnal nevrologii i psihiatrii im. S.S. Korsakova [J of Neurology and Psychiatry in honor of S.S. Korsakov]. 2020; 120 (6): 51–56. (In Russ.). DOI: 10.17116/jnevro202012006151

14. Rutter-Locher Z, Arumalla N, Norton S, et al. A systematic review and meta-analysis of questionnaires to screen for pain sensitisation and neuropathic like pain in in ammatory arthritis. Semin Arthritis Rheum. 2023; 61: 152207. DOI: 10.1016/j.semarthrit.2023.152207

15. Skougaard M, Schjødt Jørgensen T, Rifbjerg- Madsen S, et al. Relationship Between Fatigue and In ammation, Disease Duration, and Chronic Pain in Psoriatic Arthritis: An Observational DANBIO Registry Study. The Journal of Rheumatology.2020; 47 (4): 548- 552. DOI: https://doi.org/10.3899/jrheum.181412

16. Heisler AC, Song J, Dunlop DD, et al. Association of Pain Centralization and Patient-Reported Pain in Active Rheumatoid Arthritis. Arthritis Care Res (Hoboken). 2020; 72 (8): 1122-1129. DOI: 10.1002/acr.23994

17. Gløersen M, Steen Pettersen P, Neogi T, et al. Associations between pain sensitization and measures of physical function in people with hand osteoarthritis: Results from the Nor-Hand study. Osteoarthritis Cartilage. 2023; 31 (10): 1388-1395. DOI: 10.1016/j.joca.2023.07.005

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УДК 616.24-002-036-08

DOI: 10.20969/VSKM.2023.16(5).22-29

PDF download FEATURES OF THE COURSE OF COMMUNITY-ACQUIRED PNEUMONIA AND EVALUATION OF THE EFFECTIVENESS OF COMPLEX THERAPY

GORBUNOV ALEXANDER Y., ORCID ID: 0000-0001-9940-5259; D. Med. Sci., Associate Professor, Professor of the Department of Propaedeutics of Internal Diseases of the Izhevsk State Medical Academy of the Ministry of Health of the Russian Federation, Russia, 426000, Izhevsk Kommunarov str. 281, e-mail: gor-a1976@yandex.ru

BOBYLEVA ELENA S., ORCID ID: 0000-0001-9195-0711; Doctor of the pulmonological department of First Republican Clinical Hospital, Russia, 426039, Udmurt Republic, Izhevsk Votikinsk hidhway 57, e-mail: lena.bobyleva2017@ yandex.ru

SUCHKOVA ELENA V., ORCID ID: 0000-0001-7968-4916; D. Med. Sci., Associate Professor, Associate Professor of the Department of Propaedeutics of Internal Diseases, Izhevsk State Medical Academy of the Ministry of Health of the Russian Federation, Russia, 426000, Izhevsk, Kommunarov str., 281, e-mail: e_suchkova@mail.ru

FILIMONOV ALEXANDER M., ORCID ID: 0000-0003-3797-9526; C. Med.Sci., Head of the Medical Unit of the Ministry of Internal A airs, Russia, 426035, Izhevsk, Serova str., 69, e-mail: a limonov76@mail.ru

SOLOVIEVA ANGELICA A., ORCID ID: 0009-0007-9769-4940, Deputy Chief Phisician of the Medical Unit of the Ministry of Internal A airs, Russia, 426035, Izhevsk, Serova str., 69, e-mail: a limonov76@mail.ru

GANZHA TATYANA V., ORCID ID: 0009-0007-2984-1707, Deputy Head of the Hospital of the Medical Unit of the Ministry of Internal A airs, Russia, 426035, Izhevsk, Serova str., 69, e-mail: a limonov76@mail.ru

Abstract. Introduction. Community-acquired pneumonia is an urgent problem of our time due to its high prevalence, increasing resistance of micro ora to antibacterial therapy, a large number of complications and high mortality. Aim.The aim of the study was features of the course of community-acquired pneumonia and evaluation of the e ectiveness of complex therapy. Material and methods. A survey of 120 patients was conducted, with a diagnosis of moderate and severe pneumonia. The patients were divided into 2 groups: group 1 (70 patients), in which, along with the standard therapy of pneumonia, the drug meglumine sodium succinate was included, and group 2 (50 patients), which received standard therapy of pneumonia. In addition to the standard clinical examination of patients with pneumonia, concomitant pathology from other organs and systems was studied. In addition to anamnesis and objective research methods, laboratory and instrumental methods of studying the respiratory and hepatobiliary systems were used. Additionally, procalcitonin was determined in blood serum by immunochromatography, and hepatocyte growth factor and endothelin-1 were determined by enzyme-linked immunosorbent assay. Statistical processing of the results of the study was carried out using parametric and nonparametric methods. Results and discussion. Community- acquired pneumonia is characterized by a moderate course, segmental or lobular lung damage, and the development of a number of complications. With community-acquired pneumonia, the hepatobiliary system is a ected and often community-acquired pneumonia occurs against the background of cardiovascular pathology. Conclusion. When meglumine sodium succinate was included in the complex therapy of community-acquired pneumonia, in addition to the positive dynamics of the clinical and laboratory picture of the underlying disease, and a signi cant reduction in the average duration of hospitalization. In the course of therapy of patients with community-acquired pneumonia with meglumine sodium succinate, a signi cant decrease in in ammation indicators and an increase in hepatocyte growth factor concentration were observed. When meglumine sodium succinate was included in the therapy of patients with pneumonia, there was a tendency to increase the number of endotheliocytes and a signi cant increase in the content of endothelin-1, which may re ect an increase in the sanogenetic ability of the body to systemic in ammation in community-acquired pneumonia.

Key words: community-acquired pneumonia; systemic in ammation; meglumine sodium succinate; endothelin.

For reference: Gorbunov AYu, Bobyleva ES, Suchkova ES et al. Features of the course of community-acquired pneumonia and evaluation of the e ectiveness of complex therapy. The Bulletin of Contemporary Clinical Medicine. 2023; 16(5): 22-29. DOI: 10.20969/VSKM.2023.16(5).22-29.

REFERENCES

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2. Горбунов А.Ю., Бобылева Е.С., Стародубцева О.И. и др. Медико-статистическая характеристика заболеваемости пневмонией в Удмуртской Республике // Архивъ внутренней медицины. – 2018. - № 6. – С. 438 – 443. [Gorbunov AYu, Bobyleva ES, Starodubtseva OI i dr. Mediko-statisticheskaya kharakteristika zabolevayemosti pnevmoniyey d Udmurtskoy Respublike [Medical and statistical characteristics of the incidence of pneumonia in the Udmurt Republic]. Arkhiv vnutrenney meditsiny [Archive of Internal Medicine]. 2018; 6: 488 – 443. (In Russ.)]. DOI: 10.20514/2226-6704-2018-8-6-438-443

3. Серов В.А., Гноевых В.В., Серова Д.В. и др. Внебольничная пневмония – актуальная проблема современного общества // Ульяновский медико-биологический журнал. – 2021. - № 1. – С. 54 – 70. [Serov VA, Gnoyevykh VV, Serova DV i dr. Vnebol`nichnaya pnevmoniya – actual`naya problema sovremennogo obschestva [Community–acquired pneumonia is an urgent problem of modern society]. Ul`yanovskiy mediko-biologicheskiy jurnal [Ulyanovsk Medical and Biological Journal]. 2021; 1: 54 – 70. (In Russ.)]. DOI 10.34014/2227-1848-2021-1-57-70

4. Viasus D, Garcia-Vidal C, Manresa F et al. Risk stratification and prognosis of acute cardiac events in hospitalized adults with community-acquired pneumonia. J Infect. 2013; 66(1): 27-33. DOI 10.1016/j.jinf.2012.09.003

5. Woodward RN, Finn AV, Dichek DA. Identification of intracellular pathways through which TGF- beta1 upregulates PAI-1 expression in endothelial cells. Atherosclerosis. 2006; 186: 92–100. DOI: 10.1016/j.atherosclerosis.2005.07.026

6. Чазова И.Е., Мартынюк Т.В., Мазенко И.П. Роль легких в метаболизме некоторых маркеров эндотелиального повреждения при нормальном состоянии и при первичной легочной гипертензии // Кардиология. – 2000. - № 8. – С. 13-15. [Chazova IYe, Martyn`uk TV, Mazenko IP. Rol` l`ogkikh v metabolizme nekotorykh mark`orov endoteliak`nogo povrejdeniya pri normal`nom sostoyanii i pri pervichnoy l`ogochnoy gipertenzii [The role of the lungs in the metabolism of some markers of endothelial damage in normal condition and in primary pulmonary hypertension]. Kardiologiya [Cardiology]. 2000; 8:13-15. (In Russ.)]. DOI: 10.24411/2076-4766-2020-10002

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13. Dai W, Sato S, Asano G. The protective effect of hepatocyte growth-promoting factor (pHGF) against carbon tetrachlorideinduced acute liver injury in rats. II. Protective effects on cell membrane injury. J. Nippon Med. Sch. 2001; 68(2):154–164. DOI:10.1007/s007950050026

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УДК: 616.381-089.85-009.7-08

DOI: 10.20969/VSKM.2023.16(5).30-34

PDF download COMPARATIVE EVALUATION OF THE EFFECTIVENESS OF WOUND PAIN TREATMENT USING TRANSMEMBRANE TECHNOLOGIES AFTER MEDIAN LAPAROTOMY

KONTOREV KONSTANTIN V., ORCID ID: 0000-0002-0641-5720; postgraduate student of the Department of faculty surgery named after professor Yu.M.Lubensky, «Krasnoyarsk State Medical University named after professor V.F. Voino- Yasenetsky», Russian Federation, 660022, Krasnoyarsk, Partizana Zheleznyaka St., 1, e-mail: kkontorev@mail.ru

ZDZITOVETSKY DMITRII E., ORCID ID: 0000-0002-2498-3844; D.M.Sc., Associate Professor, Head of the Department of faculty surgery named after professor Yu.M.Lubensky, «Krasnoyarsk State Medical University named after professor V.F. Voino-Yasenetsky», Russian Federation, 660022, Krasnoyarsk, Partizana Zheleznyaka St., 1, e-mail: zdz64@mail.ru

BORISOV ROMAN N., ORCID ID: 0000-0001-9670-9476; PhD, Associate Professor of the Department of faculty surgery named after professor Yu.M.Lubensky, «Krasnoyarsk State Medical University named after professor V.F. Voino- Yasenetsky», Russian Federation, 660022, Krasnoyarsk, Partizana Zheleznyaka St., 1, e-mail: boron-5@yandex.ru

NIKIFOROVA EKATERINA D., ORCID ID: 0000-0003-2957-887X, student of the medical faculty, «Krasnoyarsk State Medical University named after professor V.F. Voino-Yasenetsky», Russian Federarion, 660022, Krasnoyarsk, Partizana Zheleznyaka St., 1, e-mail: 89831533916@mail.ru

GRICENKO DMITRII A., ORCID ID: 0000-0002-4826-2398; student of the medical faculty, «Krasnoyarsk State Medical University named after professor V.F. Voino-Yasenetsky», Russian Federarion, 660022, Krasnoyarsk, Partizana Zheleznyaka St., 1, e-mail:

OVSIENKO DARIA V., ORCID ID: 0000-0003-2760-3568; a student of the medical faculty, «Krasnoyarsk State Medical University named after professor V.F. Voino-Yasenetsky», Russian Federarion, 660022, Krasnoyarsk, Partizana Zheleznyaka St., 1, e-mail: ovsienko.d01@mail.ru

Abstract. Introduction. Pain syndrome remains an urgent problem for patients who have undergone median laparotomy in the early postoperative period. The use of modern opioid analgesics, in addition to e ectively combating postoperative pain, has a number of negative systemic e ects on the body, which requires the search for new methods of analgesia. Aim. To determine the e ectiveness of the author’s device using semipermeable membranes for anesthesia of the median laparotomy wound in relation to the relief of pain syndrome in patients who have undergone abdominal surgery, in comparison with classical parenteral analgesia. Materials and methods. We analyzed the intensity of wound pain syndrome in 70 patients underwent a median laparotomy surgery for injuries and acute abdominal surgical diseases. A control group included 35 people. An experimental group had the similar number of patients. The control group received pain relief in the early postoperative period with systemic analgesics – opioid and non-steroidal anti- in ammatory drugs. In the study group, during the operation, the device was implanted in patients retromuscularly according to the author’s method using a semipermeable membrane, through which a transmembrane blockade of the sheaths of the rectus abdominis muscles was carried out with local anesthetics. Results and discussion. Opioid analgesics were not administered to all patients of the study group in the postoperative period due to a mild pain syndrome. Conclusion. The device for analgesia of the median laparotomy wound with the use of a semipermeable membrane provides relief of pain syndrome, which allows abandoning opioids and limiting the use of non-steroidal anti-inflammatory drugs signi cantly.

Key words: midline laparotomy, semi-permeable membrane, postoperative pain, opioid analgesics.

For reference: Kontorev KV, Zdzitovetsky DE, Borisov RN. et al. Comparative evaluation of the e ectiveness of wound pain treatment using transmembrane technologies after median laparotomy. The Bulletin of Contemporary Clinical Medicine. 2023; 16(5): 30-34. DOI: 10.20969/VSKM.2023.16(5).30-34.

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  2. Zhang B, Wang G, Liu X et al. The opioid-sparing e ect of perioperative dexmedetomidine combined with oxycodone infusion during open hepatectomy: a randomized controlled trial. Front Pharmacol. 2017; 8: 940. DOI: 10.3389/fphar.2017.00940

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4. Rudd RA, Seth P, David F, et al. Increases in drug and opioid-involved overdose deaths—United States, 2010– 2015. MMWR Morb Mortal Wkly Rep. 2016; 65 (50-51): 1445-1452. DOI: 10.15585/mmwr.mm655051e1

5. Centers for Disease Control and Prevention. Pocket guide: tapering opioids for chronic pain. Available at: https://www.cdc.gov/drugoverdose/pdf/clinical_pocket_guide_tapering-a.pdf. Accessed January 15, 2018.

6. Dowell D, Arias E, Kochanek K, et al. Contribution of opioid-involved poisoning to the change in life expectancy in the United States, 2000–2015. JAMA. 2017; 318 (11): 1065-1067. DOI: 10.1001/jama.2017.9308

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16. Beaussier M, White P F, Raeder J. Is a negative meta- analyses consisting of heterogenic studies on wound catheters su cient to conclude that no additional studies are needed? Acta Anaesthesiol Scand. 2012; 56 (3): 396–397. DOI: 10.1111/j.1399-6576.2011.02604.x.

17. Sherwinter DA, Ghaznavi AM, Spinner D, et al. Continuous infusion of intraperitoneal bupivacaine after laparoscopic surgery: a randomized controlled trial. Obes Surg. 2008; 18 (12): 1581–1586. DOI: 10.1007/511695- 008-9628-2

 

УДК616.314-007-053.4:612.06+316.362.3

DOI: 10.20969/VSKM.2023.16(5).35-41

PDF download PRESCHOOL CHILDREN DENTOALVEOLAR DEFORMITIES DEPENDING ON FAMILY TYPES AND MORPHOFUNCTIONAL CHILD DEVELOPMENT

KHADYEVA MADINA N., ORCID ID: 0009-0002-0643-0418; Cand. sc. med., Head Physician and Director of UniDent, a network of dental clinics, 79 Chistopolskaya str. and 2 Orenburg tract, 420016 Kazan, Russia, e-mail: madina-565@mail.ru

GALIULLIN AFGAT N., ORCID ID: 0000-0002-1294-4055; Dr. sc. med., Professor of at the Department of General Hygiene, UMC Lean Technologies in Healthcare, Kazan State Medical University, 49 Butlerova, 420012 Kazan, Russia, e-mail: kybm@mail.ru.

YAKIMOVA JULIA YU., ORCID ID: 0009-0003-5231-7755; Cand. sc. med., Associate Professor at the Department of Dentistry and Implantology, Institute of Fundamental Medicine and Biology, Kazan Federal University, 18 Kremlevskaya str., 420021 Kazan, Russia, e-mail: optima00@list.ru

Abstract. Introduction. Dentоfacial deformities in preschool children do not show any downtrend. Studying how various factors a ect their occurrence and development is of undoubted interest. Our aim was to study the impact of family types on the prevalence and nosology of dental system diseases. Materials and Methods. 2,556 children were examined, aged one to six years, of both genders, and from families of di erent types. To statistically process the study ndings, descriptive statistics methods were used. Integrity was assessed in the compared groups by averaging and computing error in mean, using Student’s t-test. Results and Discussion. Prevalence of dental abnormalities among preschool children was higher among boys of all ages (63.6±1.353%), as compared to girls (57.5± 1.376%). It was found that children from substitute families were most susceptible to dental abnormalities. Prevalence of dentoalveolar deformities was in 100% of cases in all age groups in children from adoptive families. High prevalence of dentoalveolar anomalies was also recorded in preschool children living in incomplete families, i.e., in 82±2.78% of cases. The lowest prevalence of dentoalveolar deformities was found in children living in full families, i.e., in 56.1±1.129% of cases, and in extended families, i.e., in 59.2±3.367% of cases. In children living in reconstituted families, dentoalveolar abnormalities are found less frequently (78.9±3.167%) than in children living in substitute and one-parent families, but more frequently than in children living in nuclear and extended families. When analyzing the structure of dentoalveolar anomalies, it was found that most often there were bite pathologies (prognatic and deep bites), as well as abnormalities of dental arches. The least common pathology of the jawbone system in the examined children turned out to be the cross-bite pathology. Older age group children (aged 4.6-6 years) are most susceptible to dentoalveolar abnormalities as compared to other ages of preschool children. Conclusions. Data presented in this article are of practical importance for implementing and developing preventive measures, considering the type of family and the morphofunctional development of the child.Keywords: preschool children, dentoalveolar deformities, family types, bite pathology, milk bite, replaceable bite.

For reference: Khadyeva MN, Galiullin AN, Yakimova JY. Preschool children dentoalveolar deformities depending on family types and morphofunctional child development. The Bulletin of Contemporary Clinical Medicine. 2023; 16(5): 35-41. DOI: 10.20969/VSKM.2023.16(5).35-41.

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УДК 616.12-008.46:616-005.4-071

DOI: 10.20969/VSKM.2023.16(5).42-52

PDF download OUTCOMES OF CHRONIC HEART FAILURE IN PATIENTS WITH CORONARY HEART DISEASE: A PROSPECTIVE 5-YEAR STUDY

KHAZOVA ELENA V., ORCID ID: 0000-0001-8050-2892; Scopus Author ID: 57205153574, Resercher ID O-2336- 2016, RSCI Author ID 639552; C. Med. Sci, associate professor of the department of propaedeutics of internal diseases named after Professor SS. Zimnitsky Kazan State Medical University, 420012, Russia, Kazan, Butlerov str., 49, research of the UNIL «New Professional Competences in Health Preservation» of the institute of fundamental medicine and biology, Kazan Federal University, Russia, 42008, Kazan, Kremlevskaya, str., 18, e-mail: hazova_elena@mail.ru

BULASHOVA OLGA V., ORCID ID: 0000-0002-7228-5848; Scopus Author ID: 6507198087, RSCI Author ID 46110692, D. Med. Sci, Professor of the department of propaedeutics of internal diseases named after Professor SS. Zimnitsky Kazan State Medical University, 420012, Russia, Kazan, Butlerov str. 49, e-mail: boulashova@yandex.ru

AMIROV NAIL B., ORCID ID: 0000-0003-0009-9103; Scopus Author ID: 7005357664, Resercher ID E-3177-2016, RSCI Author ID 259320, D. Med. Sci, professor of Department of polyclinic therapy and general medical practice of Kazan State Medical University, 420012 Russia, Kazan, Butlerov str., 49, Head of science, Medical Unit of the Ministry of Internal A airs of Russia for the Republic of Tatarstan, e-mail: namirov@mail.ru

Abstract. Introduction. Epidemiology and trends in survival of patients with chronic heart failure have changed over the past decades. As an important reason for prognostic deviations is recognized, among other things, the steady worldwide increase in the prevalence of obesity and concomitant conditions associated with it, such as diabetes mellitus, arterial hypertension, and atrial brillation, especially in young patients with chronic heart failure, which creates the so- called survival paradox. The aim of the study is to assess the structure of 5-year outcomes in patients with ischemic heart failure and identify some new long-term prognosis markers (mortality and cardiovascular events). Materials and Methods. 313 patients with ischemic heart failure of functional class I-IV were examined. A clinical study was conducted, and 5-year prognosis endpoints were assessed (all-cause mortality, cardiovascular mortality, and non-fatal cardiovascular events). The composite endpoint included cardiovascular mortality and nonfatal cardiovascular events.Results. All-cause 5-year mortality was 28.1%, including the cardiovascular mortality of 24.6%. In patients of functional class III-IV chronic heart failure, the 5-year risk of death from any cause and cardiovascular death was higher than in class I-II patients. All-cause death, cardiovascular mortality, and the composite endpoint risks were higher in patients with reduced ejection fraction than in those with moderately reduced or reduced left ventricular ejection fraction. The risk of death within 5 years from all causes and cardiovascular death was higher in women with a body mass index of <25 kg/m2 and >30 kg/m2 than in those who were moderately overweight. Mortality from all causes was lower in functional class III-IV patients with some overweight than in those with a body mass index of <25 kg/m2 (p=0.03). With moderately reduced and reduced left ventricular ejection fraction, all-cause mortality and cardiovascular mortality were lower in overweight patients than in those with a body mass index of <25 kg/m2 (p=0.009 and p=0.022). In patients with heart failure with reduced left ventricular ejection fraction, their overweight was a protective factor for all-cause mortality (OR=0.07, CI: 0.001-0.76) as compared to those with a body mass index of <25 kg/m2.

Key words: chronic heart failure, coronary heart disease, nutritional status, 5-year prognosis.

For reference: Khazova EV, Bulashova OV, Amirov NB. Outcomes of chronic heart failure in patients with coronary heart disease: a prospective 5-year study. The Bulletin of Contemporary Clinical Medicine. 2023; 16(5): 42-52. DOI: 10.20969/VSKM.2023.16(5).42-52.

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УДК 615.322:615.28

DOI: 10.20969/VSKM.2023.16(5).53-58

PDF download PROSPECTS FOR DESIGNING NEW, USNIC ACID-BASED INNOVATOR ANTISEPTICS

KRYLOV ILYA A., ORCID ID: 0000-0003-3042-4229; Doctor of Medical Sciences, Director of the Institute of Pharmacology and Pharmacy, Northern State Medical University, 51 Troitsky Ave., 163000 Arkhangelsk, Russia; e-mail: krylov.ilya@mail.ru

KUBASOVA ELENA D., ORCID ID: 0000-0001-9683-7814; Cand. Sc. Biology, Dean of the Faculty of Pharmacy, Associate Professor at the Department of Pharmacology and Pharmacy, Northern State Medical University, 51 Troitsky Ave., 163000 Arkhangelsk, Russia; e-mail: lapkino@mail.ru

KORELSKAYA GALINA V., ORCID ID: 0000-0003-4236-1966; Senior Lecturer at the Department of Pharmacology and Pharmacy, Northern State Medical University, 51 Troitsky Ave., 163000 Arkhangelsk, Russia; e-mail: galyusha12@ yandex.ru

KUBASOV ROMAN V., ORCID ID: 0000-0003-1698-6479; Cand. Sc. Biology, Associate Professor at the Department of Mobilization Preparation of Public Health and Accident Medicine, Northern State Medical University, 51 Troitsky Ave., 163000 Arkhangelsk, Russia; e-mail: romanas2001@gmail.com

Abstract. Introduction. Environment changing not least because of human activities determines the appearance of modi ed microorganisms. Many pathogens have enhanced their pathogenic properties. Their increasing drug resistance represents quite a serious problem. Among potentially e cient antiseptic substances, usnic acid and its derivatives are greatly emphasized on. Aim of our study was to conduct a narrative review of the prospects for the practical (pharmaceutical) use of usnic acid as an antiseptic. Research Materials. To perform the literature analysis, we used sources from international databases, such as Web of Science, Scopus, and PubMed, as well as from the domestic library system, eLibrary. Results. Usnic acid is found in large amounts in various lichen species. It has quite a broad spectrum of antimicrobial action. Its anti-in ammatory e ects and enhancement of tissue regeneration was proven both experimentally and clinically. The operation of usnic acid and its derivatives is determined by inhibiting the synthesis of ribonucleic acid and breaking the deoxyribonucleic acid replication. Moreover, it has a cytotoxic e ect and destroys the membranes of microorganisms. In pharmaceutical industry, usnic acid is produced in many forms, such as powders, capsules, antiseptic gels, creams, and protective tapes. They are used in combined treatment of infectious diseases, in general therapy, in post-burn wound healing procedures, and in dentistry. We have concluded that lichens are very promising as raw materials for isolating usnic acid. It is necessary to search for new highly e cient methods to manufacture and use it in various farmaceutical forms.

Keywords: usnic acid, lichen, bioactivity, antiseptic properties.

For reference: Krylov IA, Kubasova ED, Korelskaya GV, Kubasov RV. Prospects for designing new, usnic acid-based innovator antiseptics.The Bulletin of Contemporary Clinical Medicine. 2023; 16(5): 53-58.
DOI: 10.20969/VSKM.2023.16(5).53-58.

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УДК: 616-021.3

DOI: 10.20969/VSKM.2023.16(5).59-64

PDF download CONTEMPORARY VIEW OF THE GENETIC ASPECTS OF ULCER DISEASE DEVELOPMENT

KURAMSHINA OLGA A., ORCID ID: 0000-0001-6032-9156, Dr. sc. med., Professor at the Department of Outpatient Therapy (with a course at the Institute of Additional Vocational Education), Bashkir State Medical University, Ufa, Russia, е-mail: kuramshina_olga@mail.ru

BATRAKOVA KSENIA V., ORCID ID: 0000-0002-7644-0331, Assistant Professor at the Department of Pharmacology (with a course of Clinical Pharmacology), Bashkir State Medical University, Ufa, Russia, е-mail: xenya.batrakova@yandex.ru

TUVALEVA LIA S., ORCID ID: 0000-0001-5477-8975, Cand. sc. med., Associate Professor at the Department of Outpatient Therapy (with a course at the Institute of Additional Vocational Education), Bashkir State Medical University, Ufa, Russia, е-mail: liyatuvaleva@mail.ru

SHUVAEVA LILIA G., ORCID ID: 0000-0001-7331-5298, Assistant Professor at the Department of Therapy and Nursing with Patient Care, Bashkir State Medical University, Ufa, Russia, е-mail: lgshuvaeva@mail.ru

NIGMATULLIN RUSTEM K., ORCID ID: 0009-0003-4383-8217, Cand. sc. med., Deputy Head of the Primary Healthcare Unit of the Ministry of Internal Affairs of Russia in the Republic of Bashkortostan, Ufa, Russia, е-mail: nigrustem@yandex.ru

KUTUEV ZEMFIR Z., ORCID ID: 0009-0005-2125-141Х, Cand. sc. med., Head of the Primary Healthcare Unit of the Ministry of Internal Affairs of Russia in the Republic of Bashkortostan, Ufa, Russia, е-mail: doczem@mail.ru

SAMSONOVA YANNA E., ORCID ID: 0000-0002-5870-8031, Biologist of clinical laboratory medicine at Ufa City Hospital 13, Ufa, Russia, е-mail: optimizm2007@rambler.ru

Abstract. Introduction. Despite a considerable quantity of studies focused on the etiology and pathogenesis of ulcer disease, this condition continues to be one of the most relevant in the modern gastroenterology due to its prevalence, relapse rates, and the development of ulcerative-destructive complications. This article deals with the in uence level of the genetic predisposition to forming gastric and duodenal ulcers, including from the standpoint of the interrelation between the candidate gene and the disease pattern, considering various ethnic groups. Aim. Based on the analysis of scienti c medical literature, we are aiming at describing the current data on the molecular genetic basis of gastric and duodenal ulcers, given its wide prevalence among the population and its great medical and social signi cance.Materials and Methods. We analyzed publications in databases, such as eLibrary, Scopus, and Pubmed, as well as in science search engines, such as Google Scolar and Web of Science. Over 150 sources were studied in total, of which the most signi cant ones are included in our references herein. Results and Discussion. The article re ects a contemporary view of the epidemiological and etiopathogenetic aspects of developing gastric and duodenal ulcers with a focus on the role of polymorphism of candidate genes in forming such pathology. Conclusion. The analysis of this literature review showed the importance of how genetic factors a ect the risk of developing gastric and duodenal ulcers, as well as the relevance of further studies thereof followed by potentially developing some programs aimed at the primary prevention of ulcer disease and a personalized approach to health care delivery.

Keywords: ulcer disease, developmental factors, genetic markers, gene polymorphism.

For reference: Kuramshina OA, Batrakova KV, Tuvaleva LS et al. Contemporary view of the genetic aspects of ulcer disease development. The Bulletin of Contemporary Clinical Medicine. 2023; 16(5): 59-64.
DOI: 10.20969/VSKM.2023.16(5).59-64.

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УДК 616.155.392-036.12-008.922.1

DOI: 10.20969/VSKM.2023.16(5).65-71

PDF download ROLE OF REDOX STATUS CHANGES IN THE PATHOGENESIS OF CHRONIC LYMPHOCYTIC LEUKEMIA

OSIKOV MIKHAIL V., ORCID ID: 0000-0001-6487-9083, Scopus Author ID: 16040195100, Resercher ID: DWQ- 4192-2022, RSCI Author ID: 156113, D. Med. Sci., Professor, Head of Pathophysiology Department, South State Medical University, Russia, 454092, Chelyabinsk, Russia. 64 Vorovsky St., Head of scientific department in Chelyabinsk Regional Clinical Hospital, Chelyabinsk, Russia, 454048, 70 Vorovsky St., e-mail: prof.osikov @yandex.ru

KOROBKIN EGOR A., ORCID ID: 0000-0001-7241-1325, Resercher ID: HZK-1427-2023, RSCI AuthorID: 1193419, Assistant Professor of Pathophysiology Department, South State Medical University, Russia, 454092, Chelyabinsk, Russia. 64 Vorovsky St., Hematologist in Chelyabinsk Regional Clinical Hospital, Chelyabinsk, Russia, 454048, 70 Vorovsky St., e-mail: doktore77@yandex.ru

FEDOSOV ALEKSEY A., ORCID ID: 0000-0003-2224-5175, RSCI Author ID: 649871, C. Med. Sci, Associate Professor at the Department of Human Anatomy, Pirogov Russian National Research Medical University, Moscow, Associate Professor at the Department of Histology, Cytology and Embryology, Peoples’ Friendship University of Russia named after Patrice Lumumba, Moscow, e-mail: fedosov.76@mail.ru

SINEGLAZOVA ALBINA V., ORCID ID: 0000-0002-7951-0040; Scopus Author ID: 55001894700, RSCI Author ID: 629346, D. Med. Sci., Associate Professor, Head of the Department of Outpatient Therapy and General Medical Practice, Kazan State Medical University, Kazan, e-mail: sineglazovaav@mail.ru

Abstract. Introduction. Chronic lymphocytic leukemia is a hemoblastosis of CD5+ B lymphocytes characterized by lymphocytosis and damages to lymphatic organs and occurring in the older age group. Its etiology and pathogenesis have not been fully understood as of today. Oxidative stress is an important factor in the regulating the hemostasis of hemopoietic stem cells and in activating intracellular survival signaling pathways in chronic lymphocytic leukemia cells. Aim. This study is aimed at analyzing the current data on the role of redox status changes in the pathogenesis of chronic lymphocytic leukemia. Materials and Methods. We reviewed relevant studies published in 2018-2023 and research articles collected in scienti c electronic bibliographic databases PubMed and Social Sciences Citation Index, dealing with the pathogenesis of chronic lymphocytic leukemia and the role of free-radical oxidation processes in it. Results and Discussion. In chronic lymphocytic leukemia, oxidative stress with a systemic excess of reactive oxygen species, an imbalance in the e ectiveness of antioxidant defense is caused mainly by activation of oxidative phosphorylation in mitochondria, low levels of NADPH-oxidase type 2, increased expression of hemoxygenase-1, glutathione peroxidase and glutathione recycling enzymes, superoxide dismutase-2, thioredoxins, and decreased expression of catalase. Oxidative stress subsequences in the chronic lymphocytic leukemia cells include the activation of transcription factors related to erythroid nuclear factor, nuclear kappa B factor, and FOXO family transcription factors. One of the mechanisms of resistance to drug therapy and oxidative stress of chronic lymphocytic leukemia cells is the intracellular signaling pathway dependent on erythroid nuclear factor-2, due to the activation of expression in cells of superoxide dismutase-2, catalase, glutathione peroxidase, peroxiredoxin-3 and -5, heme oxygenase-1, thioredoxin-1 and -2, reduced glutathione, natural killer cell activity, which is associated with lifespan, chemotaxis, proliferation and survival. FOXO family proteins are believed to suppress carcinogenesis. FOXO3a increases the expression of superoxide dismutase-2, catalase, glutathione peroxidase, peroxiredoxin-3 and -5, and the activity of natural killer cells, which promotes the survival of tumor cells. Conclusion. The development of new targeted pharmacological agents that are capable of accumulating reactive oxygen species and reducing antioxidant protection due to the degradation of erythroid nuclear factor-2 and activation of NADPH-quinone oxidoreductase-1 is underway, which modernizes the therapy of chronic lymphocytic leukemia.

Keywords: redox status, oxidative stress, pathogenesis, chronic lymphocytic leukemia.

For reference: Osikov MV, Korobkin EA, Fedosov AA, Sineglazova AV. Role of redox status changes in the pathogenesis of chronic lymphocytic leukemia. The Bulletin of Contemporary Clinical Medicine. 2023; 16(5): 65-71.DOI: 10.20969/VSKM.2023.16(5).65-71.

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УДК 616.833-001.35

DOI: 10.20969/VSKM.2023.16(5).72-77

PDF download RECONSTRUCTION OF THE TRANSVERSE CARPAL LIGAMENT IN THE TREATMENT OF CARPAL TUNNEL SYNDROME. LITERATURE REVIEW

PANKRATOV ALEKSANDR S., ORCID: 0000-0002-6031-4824; C. Med. Sci., Associate Professor of the Department of Traumatology, Orthopedics and Extreme Surgery named after Academician of the Russian Academy of Sciences A.F. Krasnov FGBOU VO SamSMU of the Ministry of Health of Russia, 443099, Samara region, Samara city, Karl Marx Avenue, house 165b, e-mail: pas76@mail.ru

KNYAZEV NIKITA A., ORCID ID: 0000-0003-1770-965X; Assistant of the Department of Traumatology, Orthopedics and Extreme Surgery named after Academician of the Russian Academy of Sciences A.F. Krasnov FGBOU VO SamSMU of the Ministry of Health of Russia, 443099, Samara region, Samara city, Karl Marx Avenue, house 165b, e-mail: n.knyazev.bass@gmail.com

KLYUCHNIKOV ALEXEY S., ORCID ID: 0009-0009-5320-5142; clinical resident of the Department of Traumatology, Orthopedics and Extreme Surgery named after Academician of the Russian Academy of Sciences A.F. Krasnov FGBOU VO SamSMU of the Ministry of Health of Russia, 443099, Samara region, Samara city, Karl Marx Avenue, house 165b, e-mail: zif1111111@yandex.ru

POTAPOV ALEXANDER N., ORCID ID: 0009-0000-4681-8199; student of the Institute of Clinical Medicine, FGBOU VO SamSMU of the Ministry of Health of Russia, 443099, Russia, Samara region, Samara, Chapaevskaya str., house 89, e-mail: alex-p278@rambler.ru

OPENCHENKO KRISTINA A., ORCID ID: 0009-0000-0287-6223; student of the Institute of Clinical Medicine, Federal State Budgetary Educational Institution of the Ministry of Health of Russia, 443099, Samara region, Samara, Chapaevskaya str., 89, e-mail: openchenkokristina@yandex.ru

Abstract. Introduction. Carpal tunnel syndrome is a compression of the median nerve at the wrist, a common compression neuropathy of the upper extremities in medical practice. The most e ective treatment for this condition is considered to be surgical and the most common approach is either dissecting the carpal ligament without subsequent stitching or reconstructing it. A study of the e cacy of transverse carpal ligament reconstruction approaches helps in the search for treatment improvement. The aim of the study is to compare the e ectiveness and safety of di erent surgical techniques according to Russian and foreign literature sources containing information on the immediate and long-term results of treatment of patients with carpal tunnel syndrome using the transverse carpal ligament reconstruction method.Materials and methods. Scienti c publications on the topic for 2013-2023 were studied. Results and discussion. It was found out that reconstruction of the transverse carpal ligament contributes not only to the increase of carpal tunnel volume, but also to normalization of biomechanics of carpal movements after the operation. Conclusion. Currently, there is no unequivocal evidence of signi cant advantages of reconstructing the transverse carpal ligament. The majority of authors consider reconstructive surgery e ective in conditions of morphologically distorted median nerve or carpal tunnel as well as peculiarities of the patient history, which may require earlier restoration of the upper extremity functional state and ability to work.

Key words: carpal tunnel syndrome, neuropathy, carpal tunnel release, reconstruction of the transverse carpal ligament.

For reference: Pankratov AS, Knyazev NA, Klyuchnikov AS еt al. Reconstruction of the transverse carpal ligament in the treatment of carpal tunnel syndrome. Literature review. The Bulletin of Contemporary Clinical Medicine. 2023; 16(5): 72-77. DOI: 10.20969/VSKM.2023.16(5).72-77.

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HEALTH ORGANIZATION

УДК 613.62+614.2

DOI: 10.20969/VSKM.2023.16(5).78-85

PDF download SPECIAL ASPECTS OF THE OCCUPATIONAL MORBIDITY TIME PROFILE AND STRUCTURE IN THE REPUBLIC OF TATARSTAN

BERHEEVA ZUKHRA M., ORCID ID: 0000-0003-3224-4184, Cand. Sc. Med., Associate Professor at the Preventive Medicine and Human Ecology Department, Kazan State Medical University, 49 Butlerov Str., 420012 Kazan, Russia, e-mail: kgmu_profpat@mail.ru

IMAMOV ALMAS A., ORCID ID: 0000-0003-2608-0179, Dr. Sc. Med., Associate Professor, Head of the Preventive Medicine and Human Ecology Department, Kazan State Medical University, 49 Butlerov Str., 420012 Kazan, Russia, e-mail: profmed_kgmu@mail.ru

IGNATANS ELENA V., ORCID ID: 0000-0002-5051-0258, Cand. Sc. Med., MD-PhD, Senior Lecturer at the Preventive Medicine and Human Ecology Department, Kazan State Medical University, 49 Butlerov Str., 420012 Kazan, Russia, e-mail: diamond-vita@mail.ru

SABITOVA MINZILYA M., ORCID ID: 0000-0003-1843-9225, Assistant Professor at the General Hygiene Department, Kazan State Medical University, 49 Butlerov Str., 420012 Kazan, Russia, e-mail: mms80@bk.ru

Abstract. Introduction. In their labor activities, employees are exposed to some hazardous and harmful factors of the working environment, of which the key ones are physical factors, such as noise or local/general vibration; physical and functional overloads of the musculoskeletal system; aerosols of predominantly brogenic action; and dust. The core indicator characterizing the occupational risk of a health problems is occupational morbidity. Aim. Studying the time pro le and structure of occupational morbidity in employees of the Republic of Tatarstan. Material and methods.Occupational morbidity over the years 2007-2021 was analyzed. Over the period under research, occupational illnesses were diagnosed in 2,546 employees of 130 occupational categories. Results and discussion. The highest rates of occupational morbidity were recorded among employees of agricultural and mechanical engineering enterprises and companies. About 60% of occupational diseases were diagnosed in those pursuing 7 professions. What stands out is the similarity of occupational pathologies in assembly workers and riveters, fettlers, and farm-machine operators, who were diagnosed with vibration syndrome and occupational deafness. Occupational diseases of respiratory and musculoskeletal systems were additionally diagnosed in fettlers. In milkmaids, the occupational diseases of musculoskeletal system take the leading place. Polymorbidity of occupational pathology is most pronounced in machine milking operators followed by tractor drivers and fettlers. Conclusion. It is necessary to ensure early occupational pathology diagnoses in routine health screenings and timely referrals to the occupational pathology center in order to perform causal relationship assessments between disease and occupation.

Keywords: occupational morbidity, professions, branches of the economy, employees.

For reference: Berheeva ZM, Imamov AA, Ignatans EV, Sabitova MM. Special aspects of the occupational morbidity time pro le and structure in the Republic of Tatarstan. The Bulletin of Contemporary Clinical Medicine. 2023; 16(5): 78- 85. DOI: 10.20969/VSKM.2023.16(5).78-85.

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10. О состоянии санитарно-эпидемиологического бла- гополучия населения в Российской Федерации в 2021 году. Государственный доклад. – Москва: Фе- деральная служба по надзору в сфере защиты прав потребителей и благополучия человека, 2022. – 340 с. [O sostojanii sanitarno-jepidemiologicheskogo blagopoluchija naselenija v Rossijskoj Federacii v 2021 godu. Gosudarstvennyj doklad [On the state of sanitary and epidemiological welfare of the population in the Russian Federation in 2021. State Report]. Moskva: Federal’naja sluzhba po nadzoru v sfere zashhity prav potrebitelej i blagopoluchija cheloveka [Moscow: Federal Service for Supervision of Consumer Rights Protection and Human Well–Being]. 2022; 340 p. (In Russ.)]. https://rospotrebnadzor.ru/upload/iblock/594/ sqywwl4tg5arq 6xvl5dss0l7vvuank/Gosudarstvennyy- doklad.-O-sostoyanii-sanitarno_epidemiologicheskogo- blagopoluchiya-naseleniya-v-Rossiyskoy-Federatsii-v- 2021-godu.pdf

11. О состоянии санитарно-эпидемиологического бла- гополучия в Республике Татарстан в 2021 году. Го- сударственный доклад. – Казань: Управление Ро- спотребнадзора по Республике Татарстан, 2022. – 359 с. [O sostojanii sanitarno-jepidemiologicheskogo blagopoluchija v Respublike Tatarstan v 2021 godu. Gosudarstvennyj doklad [On the state of sanitary and epidemiological welfare in the Republic of Tatarstan in 2021. State report]. Kazan’: Upravlenie Rospotrebnadzora po Respublike Tatarstan [Kazan: Department of Rospotrebnadzor for the Republic of Tatarstan]. 2022; 359 р. (In Russ.)]. https://16.rospotrebnadzor.ru/c/ document_library/get_ le?uuid=4720046a-525f-428c- 9066-d073ce90a5be&groupId=10156

12. Сюрин С.А., Полякова Е.М. К вопросу профессио- нальной полиморбидности (на примере Российской Арктики) // Медицина труда и промышленная эколо- гия. – 2022. – No 7. – С. 459-465. [Syurin SA, Polyakova EM. K voprosu professional’noj polimorbidnosti (na primere Rossijskoj Arktiki) [On the issue of professional polymorphism (on the example of the Russian Arctic)]. Medicina truda i promyshlennaja jekologija [Occupational medicine and industrial ecology]. 2022; (7): 459-465. (In Russ.)]. DOI: 10.31089/1026-2022-62-7=459-465

13. Головкова Н.П., Хелковский-Сергеев Н.А., Котова Н.И., Николаев С.П. Оценка профессионально- го риска развития хронических заболеваний кост- но-мышечной системы и соединительной ткани у металлургов // Актуальные проблемы медицины тру- да: сборник трудов. – Саратов: ООО Амирет, 2018. – С. 351-358. [Golovkova NP, Helkovskij-Sergeev NA, Kotova NI, Nikolaev SP. Ocenka professional’nogo riska razvitija hronicheskih zabolevanij kostno-myshechnoj sistemy i soedinitel’noj tkani u metallurgov [Assessment of occupational risk of developing chronic diseases of the musculoskeletal system and connective tissue in metallurgists]. Aktual’nye problemy mediciny truda : sbornik trudov [Actual problems of occupational medicine: a collection of works]. Saratov: OOO Amirit [Saratov: Amirit LLC]. 2018; 351-358. (in Russ.)].

14. Широков В.А., Терехов Н.Л., Потатурко А.В. К вопро- су об эпидемиологической оценке производствен- ных факторов риска развития нижнепоясничного болевого синдрома // Материалы 16-го Российского Национального Конгресса с международным уча- стием «Профессия и здоровье». – Владивосток: НКО Ассоциация врачей и специалистов медици- ны труда, 2021. – С. 579-583. [Shirokov VA, Terekhov NL, Potaturko AV. K voprosu ob jepidemiologicheskoj ocenke proizvodstvennyh faktorov riska razvitija nizhnepojasnichnogo bolevogo sindroma [On the issue of epidemiological assessment of occupational risk factors for the development of lower lumbar pain syndrome]. Materialy 16-go Rossijskogo Nacional’nogo Kongressa s mezhdunarodnym uchastiem «Professija i zdorov’e» [Materials of the 16th Russian National Congress with international participation «Profession and Health»]. Vladivostok: NKO Associacija vrachej i specialistov mediciny truda [Vladivostok: NGO Association of Doctors and Specialists of Occupational Medicine]. 2021; 579- 583. (In Russ.)]. DOI: 10.31089/978-5-6042929-2-1- 2021-1-579-583

15. Лескина Л.М., Головкова Н.П., Котова Н.И. Значе- ние стажа и возраста работников при установлении диагноза хронического заболевания для профи- лактики профессионального нарушения здоровья // Медицина труда и промышленная экология. – 2019. – No 9. – С. 679. [Leskina LM, Golovkova NP, Kotova NI. Znachenie stazha i vozrasta rabotnikov pri ustanovlenii diagnoza hronicheskogo zabolevanija dlja pro laktiki professional’nogo narushenija zdorov’ja [The importance of the length of service and age of employees in establishing the diagnosis of a chronic disease for the prevention of occupational health disorders]. Medicina truda i promyshlennaja jekologija [Occupational medicine and industrial ecology]. 2019; (9): 679. (In Russ.)]. DOI: 10.31089/1026-9428-2019-59-9-679-680

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17. Серебряков П.В., Федина И.Н., Шиган Е.Е. Регио- нальные особенности выявления профессиональ- ных заболеваний от воздействия биологического фактора в Российской Федерации в 2020 г. // Мате- риалы 16-го Российского Национального Конгрес- са с международным участием «Профессия и здо- ровье». – Владивосток: НКО Ассоциация врачей и специалистов медицины труда, 2021. – С. 464-467. [Serebrjakov PV, Fedina IN, Shigan EE. Regional’nye osobennosti vyjavlenija professional’nyh zabolevanij ot vozdejstvija biologicheskogo faktora v Rossijskoj Federacii v 2020 g. [Regional features of the detection of occupational diseases from the effects of a biological factor in the Russian Federation in 2020]. Materialy 16-go Rossijskogo Nacional’nogo Kongressa s mezhdunarodnym uchastiem «Professija i zdorov’e» [Materials of the 16th Russian National Congress with international participation «Profession and Health»]. Vladivostok: NKO Associacija vrachej i specialistov mediciny truda [Vladivostok: NGO Association of Doctors and Specialists of Occupational Medicine]. 2021; 464-467. (In Russ.)]. DOI: 10.31089/978-5- 6042929-2-1-2021-1-464-467

 

УДК 314.44: 614.446.3

DOI: 10.20969/VSKM.2023.16(5).86-91

PDF download EPIDEMIOLOGICAL SITUATION AND DETECTION OF HIV INFECTION IN THE ARKHANGELSK REGION IN 2012-2021

KALININ ALEXEY G., ORCID ID: 0000-0002-0425-6359; Dr. sc. Med., Professor at the Department of Public Health and Social Work, Northern State Medical University, 51 Troitsky Ave., 163000 Arkhangelsk, Russia; e-mail: aleksei. kalinin1959@mail.ru

SANNIKOV ANATOLY L., ORCID ID: 0000-0003-0405-659X; Dr. sc. Med., Professor, Deputy Director of the Institute of Public Health and Social Work, Northern State Medical University, 51 Troitsky Ave., 163000 Arkhangelsk, Russia; e-mail: jsannikov@yandex.ru

KUBASOV ROMAN V., ORCID ID: 0000-0003-1698-6479; Cand. Sc. Biology, Associate Professor at the Department of Mobilization Preparation of Public Health and Accident Medicine, Northern State Medical University, 51 Troitsky Ave., 163000 Arkhangelsk, Russia; e-mail: romanas2001@gmail.com

PETROVA TATIANA E., ORCID ID: 0000-0002-1812-2677; student at the Northern State Medical University, 51 Troitsky Ave., 163000 Arkhangelsk, Russia; e-mail: aleksei.kalinin1959@mail.ru

REPINA ANASTASIA A., ORCID ID: 0000-0003-2821-1371; student at the Northern State Medical University, 51 Troitsky Ave., 163000 Arkhangelsk, Russia; e-mail: aleksei.kalinin1959@mail.ru

YASAK ALINA S., ORCID ID: 0000-0001-5049-2793; student at the Northern State Medical University, 51 Troitsky Ave., 163000 Arkhangelsk, Russia; e-mail: aleksei.kalinin1959@mail.ru

MARTYNOVA NATALIA A., ORCID ID: 0000-0001-9581-379X; Dr. sc. med., Professor at the Department of Human Anatomy and Operative Surgery, Northern State Medical University, 51 Troitsky Ave., 163000 Arkhangelsk, Russia; e-mail: mativala@mail.ru

KUBASOVA ELENA D., ORCID ID: 0000-0001-9683-7814; Cand. Sc. Biology, Dean of the Faculty of Pharmacy, Associate Professor at the Department of Pharmacology and Pharmacy, Northern State Medical University, 163000, Russia, Arkhangelsk, Troitskiy Ave., 51; e-mail: lapkino@mail.ru

Abstract. Introduction. JHistory of the emergence, spread and control of the acquired immunode ciency syndrome (AIDS) worldwide dates back over four decades. At the same time, the problem of AIDS morbidity is still relevant. It is determined by the inability to perform speci c prophylaxis. Therefore, one of the leading methods of preventing the spread of this infection is to identify its source as early as possible. Aim of this study was to assess the ten- year changes in the detectability of the immunode ciency virus in those infected in Arkhangelsk Oblast and perform its comparative analysis with other territories, i.e., Northwestern Federal District and throughout Russia. Materials and Methods. The analysis was performed based on informational materials from medical institutions responsible for controlling the immunode ciency virus. We studied the core morbidity indicators and the frequency of detecting positive samples both in general and in the population groups most vulnerable to infection over the past 10 years.Results. Acquired immunode ciency syndrome incidence is lower in Arkhangelsk Oblast than in most other regions of Russia. The situation with detectability, especially in high-risk groups, has improved signi cantly over the recent years. A conclusion is made about the role of special measures taken by regional executive authorities to prevent the occurrence and spread of the disease. The importance of community outreach was particularly emphasized regarding the issues of sanitary and hygienic epidemiological awareness, as well as control over persons in risk groups.Keywords: acquired immunode ciency syndrome, morbidity, prevalence, detectability, Arkhangelsk Oblast.

For reference: Kalinin AG, Sannikov AL, Kubasov RV et al. Epidemiological situation and detection of HIV infection in the Arkhangelsk region in 2012-2021. The Bulletin of Contemporary Clinical Medicine. 2023; 16(5): 86-91. DOI: 10.20969/VSKM.2023.16(5).86-91.

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УДК: 615.12

DOI: 10.20969/VSKM.2023.16(5).92-96

PDF download ANALYSIS OF PRICING FOR DRUGS MANUFACTURED IN THE URAL FEDERAL DISTRICT

PETROV ALEXEY L., ORCID ID: 0000-0002-1684-0480; C. Pharm. Sci., Associate Professor of the Department of management and economics of pharmacy and pharmacognosy, Ural State Medical University, 620028, Russia, Ekaterinburg, Repina str., 3, e-mail: palexlv5@mail.ru

SHARAFIEVA ELVIRA. R., ORCID ID: 0000-0003-1650-4863, student of Ural State Medical University, 620028, Russia, Ekaterinburg, Repina str., 3, 620028, e-mail: elvira408@yandex.ru

NUZHINA MARIA P. ORCID ID: 0000-0001-6669-7347, student of Ural State Medical University, 620028, Russia, Ekaterinburg, Repina str., 3, e-mail: msinicyna608@gmail.com

GAVRILOV ANDREY S., ORCID ID: 0000-0002-2737-3072 D. Pharm. Sci., Professor of the Department of Pharmacy and Chemistry, of Ural State Medical University, 620028, Russia, Ekaterinburg, Repina str., 3, e-mail: gavrilov.usma@mail.ru

ANDRIANOVA GALINA N., ORCID ID: 0000-0002-8008-9994 D. Pharm. Sci., the Head of Department of management and economics of pharmacy and pharmacognosy of Ural State Medical University, 620028, Russia, Ekaterinburg, Repina str., 3, e-mail: kuef@usma.ru

Abstract. Introduction. A ordability of drugs is a determining factor of transiting to new price regulation mechanisms in the pharmaceutical market, such as reference pricing. Studying the social and economic determinants of wholesale and retail pricing in the pharmaceutical markets of various regions is of additional interest within the context of long- term transition to pharmaceutical insurance. Aim: To identify the signs of price discrimination, exempli ed by some administrative-territorial entities of the Ural Federal District. Materials and Methods. A content analysis was performed regarding the aggregated o ers available on the nation-wide pharmaceutical marketplace in the context of 10 drug manufacturers located in the Urals Federal District, and an assortment matrix was compiled (n=115). The assortment was analyzed using matrix-based and categorical methods of analysis, while pricing data were collected using the methods of descriptive statistics. Results and Discussion. Using the Sturges formula, interval series of prices were identi ed, and the variation coe cient was calculated for 115 trade names of drugs. The least variable were the lowest and highest price segments with high and low share of medicines included in the List of Vital and Essential Drugs, respectively. Two synthetic metrics were used to analyze the regional pricing features. Overall price variation was 14.6%, which suggests the presence of discriminatory pricing elements. The riskiest price segment is the range of RUB 100-200 per pack. Conclusions. Based on the ndings of the pricing analysis for drugs manufactured in the regions of the Ural Federal District, the discriminatory pricing elements were found in the medium-low price segment.

Keywords: pricing, pharmaceutical market, pharmaceutical logistics, drug production.

For reference: Petrov AL, Shara eva ER, Nuzhina MP, Andrianova GN. Analysis of pricing for drugs manufactured in the Ural Federal District. The Bulletin of Contemporary Clinical Medicine. 2023; 16(5): 92-96.
DOI: 10.20969/VSKM.2023.16(5).92-96.

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  9. Грентикова И.Г., Гришаева О.В., Большаков В.В., Мальцева Е.М. Современные методы фармацевти- ческого ценообразования // Фундаментальные ис- следования. – 2022. – No 5. – С. 35-39; URL: https:// fundamental-research.ru/ru/article/view?id=43250 (дата обращения: 19.09.2023). [Grentikova IG, Grishaeva OV, Bol’shakov VV, Mal’ceva EM. Sovremennye metody farmacevticheskogo cenoobrazovaniya [Modern methods of pharmaceutical pricing]. Fundamental’nye issledovaniya [Fundamental research]. 2022; No5: 35- 39. (In Russ.)].

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CLINICAL CASE

УДК 616.995.1-08

DOI: 10.20969/VSKM.2023.16(5).97-101

PDF download A CLINICAL CASE OF TOXOCARIASIS IN AN ADULT WITH LARYNGO- AND ANGIOEDEMAS

MOTYREVA ANTONINA I., ORCID ID: 0009-0005-2962-3134, Cand. sc. med., Assistant Professor at the Department of Infectious Diseases, Izhevsk State Medical Academy, 281 Kommunarov str., 426034 Izhevsk, Udmurt Republic, е-mail: Antonina.44@mail.ru

HRABROV IVAN S., ORCID ID: 0000-0003-2829-7355, Student at the Department of General Medicine, Izhevsk State Medical Academy, 281 Kommunarov str., 426034 Izhevsk, Udmurt Republic, е-mail: iv.hrabrov@yadenx.ru

OSIPANOVA VICTORIA O., ORCID ID: 0009-0006-3371-5514, Student at the Department of General Medicine, Izhevsk State Medical Academy, 281 Kommunarov str., 426034 Izhevsk, Udmurt Republic, е-mail: osipanova.v@ yandex.ru

FAYZULLINA DINARA E., ORCID ID: 0009-0004-7472-9491, Student at the Department of General Medicine, Izhevsk State Medical Academy, 281 Kommunarov str., 426034 Izhevsk, Udmurt Republic, е-mail: fayzullina. dinara@mail.ru

Abstract. Introduction. Toxocariasis is a parasitic disease caused by the migration of the larvae of canids roundworm (T. canis). It is characterized by a long-term relapsing course and multiple organ lesions of an immunological nature. The core pathogenetic factor is sensitizing the body by Toxocara exo- and endoantigens formed after the larvae are destructed, which leads to the development of immediate and delayed allergic reactions. The aim of study was to review the scienti c literature on toxocariasis, and to present a clinical case report of cutaneous form of toxocariasis in a 36-year-old man complicated by angioedema. Material and Methods. Review of foreign publications on this helminthiasis in the PubMed databases. Clinical case of patient E., 36 years old, with the development of a complicated cutaneous form of toxocariasis of the angioedema type. Results and Discussion. During the instrumental and laboratory studies, antibodies to Toxocara canis were detected (titer in dynamics 1:6400 and 1:400) in the patient. Noteworthy was a severe allergic reaction, which manifested itself as itching maculopapular con uent rash resembling angioedema. A peculiarity of the course of the disease was the manifestation of rash and swelling of the larynx with each meal, which required calling emergency medical help. Laboratory testing of the patient’s blood did not show eosinophilia or any other deviations of the core blood parameters in the general blood test from the reference values.Conclusions. Toxocariasis often imitates the clinical manifestations of various diseases, such as ARVI, eye damage, neurological disorders (eosinophilic meningoencephalitis), enlargement of peripheral lymph nodes, liver and spleen, and allergic reactions in form of urticaria and angioedema, which causes di culties diagnosing it correctly. Lack of physicians’ alertness regarding allergic reactions in adults accompanied by skin manifestations may lead to an incorrect etiological diagnosis. Thus, we remind clinicians that this helminthiasis may occur in adults in cutaneous form with the development of angioedema.

Keywords: toxocariasis, allergic reaction, cutaneous form of parasitosis, T. сanis.

For reference: Motyreva AI, Hrabrov IS, Osipanova VO, Fayzullina DE. А сlinical case of toxocariasis in an adult with laryngo- and angio edemas. The Вulletin of Contemporary Clinical Medicine. 2023. 16(5): 97-101.
DOI: 10.20969/VSKM.2023.16(5).97-101.

REFERENCES

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16. Magnaval JF, Fillaux J, Cassaing S, et al. Human toxocariasis and atopy. Parasite. 2020; 27: 32. DOI: 10.1051/parasite/2020029

 

УДК: 611.133.33

DOI: 10.20969/VSKM.2023.16(5).102-106

PDF download CLINICAL RELEVANCE OF AZYGOS ANTERIOR CEREBRAL ARTERY

SHNYAKIN PAVEL G., ORCID ID: 0000-0001-6321-4557; Dr. sc. med., Associate Professor, Head of the Department of Neurosurgery, Traumatology, and Orthopedics, Krasnoyarsk State Medical University named after Prof. V.F. Voyno-Yasenetsky, 1 Partizan Zheleznyak str., Bldg. 3, Krasnoyarsk, Russia. Neurosurgeon at the Department of Neurosurgery No. 1, RCH 1, 3a Partizan Zheleznyak str., Krasnoyarsk, Russia. Deputy Head of the Regional Vascular Center at RCH 1, 3a Partizan Zheleznyak str., Krasnoyarsk, Russia. E-mail: shnyakinpavel@mail.ru

PROTOPOPOV ALEXEY V., ORCID ID: 0000-0001-5387-6944; Dr. sc. med., Professor, Rector of Krasnoyarsk State Medical University named after Prof. V.F. Voyno-Yasenetsky, 1 Partizan Zheleznyak str., Bldg. 3, Krasnoyarsk, Russia. Head of the Department of Radiological Diagnostics at Krasnoyarsk State Medical University named after Prof. V.F. Voyno-Yasenetsky, 1 Partizan Zheleznyak str., Bldg. 3, Krasnoyarsk, Russia. Physician for interventional radiology and treatment at RCH 1, 3a Partizan Zheleznyak str., Krasnoyarsk, Russia. E-mail: rector@krasgmu.ru

BOTOV ANTON V., ORCID ID: 0000-0001-6393-0430; Cand. sc. med., Assistant Professor at the Department of Neurosurgery, Traumatology, and Orthopedics, Krasnoyarsk State Medical University named after Prof. V.F. Voyno- Yasenetsky, 1 Partizan Zheleznyak str., Bldg. 3, Krasnoyarsk, Russia. Head of the Department of Neurosurgery No. 2, RCH 1, 3a Partizan Zheleznyak str., Krasnoyarsk, Russia. E-mail: doktor_anton@rambler.ru

LITVINYUK NIKITA V., ORCID ID: 0000-0002-0630-7244; Head of the Department of Interventional Radiology and Treatment at RCH 1, 3a Partizan Zheleznyak str., Krasnoyarsk, Russia. Assistant Professor at the Department of Diagnostic Radiology, Krasnoyarsk State Medical University named after Prof. V.F. Voyno-Yasenetsky, 1 Partizan Zheleznyak str., Bldg. 3, Krasnoyarsk, Russia. E-mail: nikita.litvinyuk@list.ru

TYUMENTSEV NIKOLAY V., ORCID ID: 0000-0003-4478-3599; Assistant Professor at the Department of Diagnostic Radiology, Krasnoyarsk State Medical University named after Prof. V.F. Voyno-Yasenetsky, 1 Partizan Zheleznyak str., Bldg. 3, Krasnoyarsk, Russia. Radiologist at RCH 1, 3a Partizan Zheleznyak str., Krasnoyarsk, Russia. E-mail: niktum@mail.ru

VORONKOVSKIY IVAN I., ORCID ID: 0000-0003-1241-9207; Resident physician at the Department of Neurosurgery, Traumatology, and Orthopedics, Krasnoyarsk State Medical University named after Prof. V.F. Voyno-Yasenetsky, 1 Partizan Zheleznyak str., Bldg. 3, Krasnoyarsk, Russia. E-mail: ivoronkovskiy@bk.ru

Abstract. Introduction. Vascular variations in the Circle of Willis occur rather frequently and, according to some observations, are often associated with some cerebrovascular diseases. A single azygos anterior cerebral artery is characteristic of mammals but rare in humans. Increased hemodynamic loads due to the blood supply of both hemispheres by a single azygos anterior cerebral artery can lead to the formation of aneurysms in it. Aim. This study is aimed at assessing the incidence of the azygos anterior cerebral artery and its association with cerebrovascular pathology. Materials and Methods. We analyzed Russian and foreign publications on the structural variants of anterior cerebral arteries over the years 2000-2022. This period was selected due to the wide implementation of cerebral angiographic studies in those years. We also presented two cases of our clinical patients having an azygos anterior cerebral artery. Results and Discussion. According to the literature review, an azygos anterior cerebral artery occurs in 0.3-4% of cases. Azygos anterior cerebral artery is most frequently associated with the development of distal aneurysms. Thrombosis of this artery leads to bilateral ischemic foci in the medial parts of the frontal and parietal lobes. We present clinical cases of a single azygos anterior cerebral artery in patients with distal aneurysms and arteriovenous malformation. Conclusions. A single azygos anterior cerebral artery is a rare variant of the Circle of Willis structure and may predispose to the development of cerebrovascular pathology.

Keywords: Circle of Willis, stroke, aneurysm, anterior cerebral artery, azygos anterior cerebral artery, variant anatomy.

For reference: Shnyakin PG, Protopopov AV, Botov AV et al. Clinical relevance of azygos anterior cerebral artery. The Вulletin of Contemporary Clinical Medicine. 2023. 16(5): 102-106. DOI: 10.20969/VSKM.2023.16(5).102-106.

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УДК: 616.216-002

DOI: 10.20969/VSKM.2023.16(5).107-112

PDF download BRAIN ABSCESS AND SUBDURAL EMPYEMA WITHIN THE COMPLICATION OF ACUTE PYOGENIC SINUSITIS: A CLINICAL CASE

SHUBIN DMITRIY I., ORCID ID: 0000-0002-5139-4922, Otolaryngologist at Clinical Research Center No. 2 of the Russian National Center of Surgery named after Acad. Prof. B.V. Petrovsky, 1A Litovsky Blvd., 117593 Moscow, Russia. E-mail: dimashubin@mail.ru

KARPOVA ANASTASIYA A., ORCID ID: 0000-0002-0251-254X; Radiologist at Clinical Research Center No. 2 of the Russian National Center of Surgery named after Acad. Prof. B.V. Petrovsky, 1A Litovsky Blvd., 117593 Moscow, Russia. E-mail: karpovaaadoc@yandex.ru

NIKITIN PAVEL A., ORCID ID: 0000-0003-1809-6330, Cand. sc. med., Radiologist at the Research Institute for Pulmonology under the Federal Medico-Biological Agency of Russia, 28 Orekhovy Blvd., 115682 Moscow, Russia. E-mail: paul2003@mail.ru

Abstract. Introduction. Diagnosing and treating acute pyogenic sinusitis represent a di cult issue of otorhinolaryngology, which has not been solved completely yet. According to statistics, 5 to 10 % of adults su er from one form of sinusitis or another. The most life-threatening type of this pathology manifestation is the development of intracranial and orbital complications that occur in 1 % of patients. These types of complications are an absolute surgical indication. Aim. To demonstrate a rare case of patient with acute pyogenic sinusitis complication. Material and Methods - This article describes a unique clinical case of a 50-year-old patient with the development of a brain abscess in combination with subdural empyema against the background of complications of the course of acute pyogenic sinusitis. Results and Discussion. The clinical case presented clearly demonstrated the need for correctly choosing and timely using advanced radiological methods to identify, assess the prevalence of the disease, and further determine the treatment strategy, both for the most acute pyogenic sinusitis manifestations and their intracranial and orbital complications. Conclusions.In connection with the results obtained, based on this clinical case, it can be concluded that a multidisciplinary approach to the assessment and treatment of acute purulent sinusitis and the active interaction among doctors majoring in various medical professions are the key to the successful treatment of patients and timely diagnosis of complications of the disease.

Keywords: pyogenic sinusitis, brain abscess, subdural empyema, computed tomography.

For reference: Shubin DI, Karpova AA, Nikitina PA. Brain abscess and subdural empyema within the complication of acute pyogenic sinusitis: а clinical case. The Вulletin of Contemporary Clinical Medicine. 2023. 16(5): 107-112. DOI:10.20969/VSKM.2023.16(5).107-112.

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WHEN THE NUMBER WAS MADE UP

УДК 616.24-008.46:613.84:618.2

DOI: 10.20969/VSKM.2023.16(5).113-119

PDF download PROBABILITY OF CHANGES IN THE RESPIRATORY FUNCTION INDICATORS IN THE DEVELOPMENT OF COPD, DEPENDING ON THE NUMBER OF CIGARETTES SMOKED AND ASSOCIATED WITH PREGNANCY-RELATED HORMONE FLUCTUATIONS

DZYUBAILO ANNA V., ORCID ID: 0000-0001-6908-4829, C. Med. Sci., associate professor, Head of the Department of Internal Medicine with a course of Outpatient Medicine and Hemotransfusiology of Samara State Medical University, Russia, 443099, Samara, Chapaevskaya St., 89, e-mail: adzyubajlo@yandex.ru

LOTKOV VYACHESLAV S., ORCID ID: 0000-0002-3995-6988, D. Med. Sci,.professor of the Department of Occupational Diseases and Clinical Pharmacology named after professor V.V. Kosarev of Samara State Medical University, Russia, 443099, Samara, Chapaevskaya str., 89, e-mail: v.s.lotkov@gmail.com

Abstract. Introduction. This is a study of possible changes in the respiration function indicators in the development of chronic obstructive pulmonary disease (COPD), depending on the number of cigarettes smoked and associated with pregnancy-related hormone uctuations. Aim. Our study aimed to determine the dependence of changes in rst- second forced expiratory volume upon the level of anti-in ammatory hormones cortisol and progesterone in female smokers with di erent number of cigarettes smoked. Materials and Methods. The study is based on the ndings of the analysis of changes in the level of hormones cortisol and progesterone in 243 pregnant women in antenatal care and on how such changes a ect the rst-second forced exhalation volume. The control group consisted of healthy non-smoking female patients. 4 groups were formed. For each group, the expected values of the rst-second forced exhalation volume were calculated, in parallel with changes in the cortisol and progesterone pro le and with forming the relevant statistical data matrices. Results and Discussion. With an increase in cortisol and progesterone levels, there is an increase in the rst-second of forced exhalation volume, which indicates an increase in the lung tissue elasticity and in the air ow rate in the rst second under the in uence of hormones that have a pronounced anti-in ammatory e ect. Conclusion. Pregnancy progress in smokers consuming di erent amounts of cigarettes is accompanied by an increase in the cortisol and progesterone levels. Hormone uctuations improve the functional state of external respiration in pregnant smokers with COPD, creating the illusion of preserving the physiological capabilities of lungs regardless of the number of cigarettes smoked. With this variant of the COPD developing during pregnancy, a temporary physiological increase in the anti-in ammatory hormonal pro le masks the extent, to which the number of cigarettes smoked a ects the COPD severity.

Keywords: pregnancy, smoking, FEV1, cortisol, progesterone.

For reference: Dzyubailo AV, Lotkov VS. Probability of changes in the respiratory function indicators in the development of COPD, depending on the number of cigarettes smoked and associated with pregnancy-related hormone uctuations. The Bulletin of Contemporary Clinical Medicine. 2023; 16(5): 113-119. DOI: 10.20969/VSKM.2023.16(5).113-119.

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Rossiiskoi Federatsii [Healthcare of the Russian Federation]. 2015; 3:43-46. (In Russ.)].

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4. Пестрикова Т.Ю., Юрасова Е.А., Юрасов И.В. Опти- мальный метод контрацепции для курящих женщин (обзор литературы). Проблемы репродукции. — 2016. — Т. 5. — С. 123-128. [Pestrikova TYU, YUrasova EA, YUrasov IV. Optimal’nyj metod kontracepcii dlya kuryashchih zhenshchin (obzor literatury). [The optimal method of contraception for women who smoke [literature review]. Problemy reproduktsii. [Reproduction problems]. 2016; 5:123-128. (In Russ.)]. DOI: 10.17116/ repro2016225123-128.

5. Дикке Г.Б. Курение табака среди женщин и страте- гия успешного отказа от табакокурения во время беременности. Фарматека. — 2014. Т. 4. — С. 76-79. [Dikke GB. Kurenie tabaka sredi zhenshchin i strategiya uspeshnogo otkaza ot tabakokureniya vo vremya beremennosti [Tobacco smoking among women and the strategy to successfully quit smoking during pregnancy]. Farmateka [Pharmateca]. 2014; 76-79. (In Russ.)].

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12. Павлова О.В. Особенности функционального со- стояния коры надпочечников у больных хрониче- ской обструктивной болезнью легких. Автореферат дис.Канд.мед. наук / Российский национальный ис- следовательский медицинский университет имени Н.И. Пирогова. — 2016. [Pavlova OV. Osobennosti funkcional’nogo sostoyaniya kory nadpochechnikov u bol’nyh hronicheskoj obstruktivnoj bolezn’yu legkih [Features of the functional state of the adrenal cortex in patients with chronic obstructive pulmonary disease]. Avtoreferat dis.Kand.Med.nauk / Rossijskij nacional’nyj issledovatel’skij medicinskij universitet imeni N.I. Pirogova [Abstract of the diss. of the Cand.Med.Sc. / Russian National Research Medical University named after N.I. Pirogov]. 2016. (In Russ.)].

 

УДК 616.61-036.12-073.27:616.125-008.313.2]-06-005.6

DOI: 10.20969/VSKM.2023.16(5).120-126

PDF download THROMBOEMBOLIC RISK FACTORS IN DIALYSIS PATIENTS WITH END-STAGE CHRONIC KIDNEY DISEASE AND NON-VALVULAR ATRIAL FIBRILLATION BY CHA2DS2-VASc AND D-DIMER LEVEL

KETSKO YURIY L., ORCID ID: 0000-0002-2749-8692; SCOPUS Author ID: 56896002800; Dr. sc. med., Associate Professor at the Department of Surgical Conditions, Medical University Reaviz, 227 Chapaevskaya str., 443001 Samara, Russia. Nephrologist at the Center of Nephrology and Dialysis, MSC LLC, 25 Zdorovya Blvd., Bldg. 10, 445039 Togliatti, Russia. E-mail: kezko-motor@mail.ru

ZHESTKOV ALEXANDER V., ORCID ID: 0000-0002-3960-830X; SCOPUS Author ID: 25935582600; Dr. sc. med., Honored Scientist of the Russian Federation, Head of the Department of General & Clinical Microbiology, Immunology and Allergology, Samara State Medical University, Ministry of Health of Russia, 89 Chapaevskaya str., 443099 Samara, Russia. E-mail: avzhestkov2015@yandex.ru

SUKACH GALINA A., ORCID ID: 0009-0007-6406-6913; Highest-Category Nephrologist, Deputy Chief Physician for Organizing Medical Activities and Controlling the Medical Care Quality at the Center of Nephrology and Dialysis, MSC LLC, 25 Zdorovya Blvd., Bldg. 10, 445039 Togliatti, Russia. E-mail: surka4@yandex.ru

SOROKINA NATALIA I., ORCID ID: 0009-0009-1757-8697; Nephrologist at the Center of Nephrology and Dialysis, MSC LLC, 25 Zdorovya Blvd., Bldg. 10, 445039 Togliatti, Russia. E-mail: nata_vot_123@mail.ru

YAKUBOV LEONID Y., ORCID ID: 0009-0005-1872-2874; Highest-Category Nephrologist and the Head of the Dialysis Department at the Center of Nephrology and Dialysis, MSC LLC, 25 Zdorovya Blvd., Bldg. 10, 445039 Togliatti, Russia. E-mail: leonid.yakubov2011@yandex.ru

IVANOV ANDREY V., ORCID ID: 0009-0008-0132-6009; Nephrologist at the Center of Nephrology and Dialysis, MSC LLC, 25 Zdorovya Blvd., Bldg. 10, 445039 Togliatti, Russia. E-mail: aivsam@rambler.ru

SUKHOV VLADISLAV Y., ORCID ID: 0009-0002-3166-0872; Nephrologist at the Center of Nephrology and Dialysis, MSC LLC, 25 Zdorovya Blvd., Bldg. 10, 445039 Togliatti, Russia. E-mail: gvin11@yandex.ru

POPOV MIKHAIL A., ORCID ID: 0000-0002-0087-1557; Doctoral Student at the Department of Intermediate Level Therapy, Samara State Medical University, Ministry of Health of Russia, 89 Chapaevskaya str., 443099 Samara, Russia. E-mail: ewok63@yandex.ru

Abstract. Introduction. Patients su ering from end-stage chronic kidney disease have a high risk of developing rhythm disorders, such as atrial brillation, and variations in the hemostatic system. There are only limited options to use the drug-based prophylaxis of thromboembolic complications in patients of this category. Aim. Our study aimed to compare the risk factors of developing thromboembolic complications in end-stage chronic kidney disease (CKD) patients with non-valvular atrial brillation, receiving renal replacement therapy, by their CHA2DS2-VASc and D-dimer levels. Materials and Methods. A prospective study was conducted on 143 end-stage CKD patients receiving extracorporeal renal replacement therapy in a single dialysis center. In patients with a high risk of thromboembolic complications, the most common signs were found according to the CHA2DS2-VASc scale. After examining hemostasis parameters, patients were divided into groups with normal and high D-dimer levels. Logistic and correlation analyses were performed according to the signi cantly di erent characteristics studied. Results and Discussion. Non-valvular atrial brillation was detected in 36 patients (25.17%), of which a high risk of thromboembolic complications was identi ed in 15 patients (41.7%). Risk of thromboembolic complications in combination with the high D-dimer level was observed in 7 patients (19.4%). Conclusions. Signs of high thromboembolic risk at the CHA2DS2-VASc scale were as follows: Arterial hypertension, vascular diseases, age, and female gender. A high level of D-dimer was closely associated with “dialysis experience,” C-reactive protein and ferritin levels, the primary nosology nature, and the fact of vascular access thrombosis. Assessment level using the CHA2DS2-VASc scale did not signi cantly correlate with an increased level of D-dimer.

Keywords: end-stage chronic kidney disease, renal replacement therapy, atrial brillation, CHA2DS2-VASc score, D-dimer, thromboembolic risk factors.

For reference: Ketsko YuL, Zhestkov AV, Sukach GA et al. Thromboembolic risk factors in dialysis patients with end- stage chronic kidney disease and non-valvular atrial brillation by CHA2DS2-VASc and D-dimer level. The Bulletin of Contemporary Clinical Medicine. 2023; 16(5): 120-126. DOI: 10.20969/VSKM.2023.16(5).120-126.

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4. Ananthapanyasut W, Napan S, Rudolph EH, et al. Prevalence of atrial brillation and its predictors in nondialysis patients with chronic kidney disease. Clin J Am Soc Nephrol. 2010; 5: 173–181. DOI: 10.2215/ CJN.03170509

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УДК 378:61(73+410+44+510)

DOI: 10.20969/VSKM.2023.16(5).127-135

PDF download CONTEMPORARY GLOBAL TRENDS IN THE DEVELOPMENT OF HIGHER MEDICAL EDUCATION IN THE USA, GREAT BRITAIN, FRANCE, AND CHINA

PROTASOV ANDREI D., ORCID ID: 0000-0001-8452-5776, Scopus Author ID: 0000-0001-8452-5776, Researcher ID: H-5971-2017; M.D., PhD, Professor at the Department of General & Clinical Microbiology, Immunology and Allergology; Associate Professor; Head of International Collaboration and Education at the Department of International Relations, Samara State Medical University, Ministry of Health of Russia, 89 Chapaevskaya str., 443099 Samara, Russia; 3rd year Master’s student majoring in the Management of International Education at the People’s Friendship University of Russia, 6 Miklukho-Maklaya str., 117198 Moscow, Russia. E-mail: a.d.protasov@ samsmu.ru

STARODUBTSEVA ELENA S., ORCID ID: 0009-0008-4903-9607; International Activities Expert at the International Affairs Department, Kirov State Medical University, 112 Karl Marx str., 610998 Kirov, Russia; 3rd year Master’s student majoring in the Management of International Education at the People’s Friendship University of Russia, 6 Miklukho-Maklaya str., 117198 Moscow, Russia. E-mail: 1132210293@rudn.ru

MOSHLYAK GABRIEL A., ORCID ID: 0000-0001-7450-1244; Associate Professor at the Educational and Scientific Institute of Comparative Educational Policy at the People’s Friendship University of Russia, Cand. Sc. History, Miklukho-Maklaya str. 6, Moscow, Russia, 117198, E-mail: moshlyak-gal@rudn.ru

ZHESTKOV ALEXANDER V., ORCID ID: 0000-0002-3960-830X; SCOPUS Author ID: 25935582600; Dr. sc. med., Honored Scientist of the Russian Federation, Head of the Department of General & Clinical Microbiology, Immunology and Allergology, Samara State Medical University, Ministry of Health of Russia, 89 Chapaevskaya str., 443099 Samara, Russia. E-mail: avzhestkov2015@yandex.ru

Abstract. Introduction. Higher medical education is one of the most sought-after and elite degrees worldwide. Systems of higher medical education di er from country to country, although they have certain features in common. Core di erences are as follows: Training duration at various stages, contents of educational programs, learning technologies, etc. Much attention is paid to physicians training, which is determined by the high social signi cance of medical education. Aim:To provide an overview of the contemporary global trends in the development of higher medical education in the USA, Great Britain, France, and China. Materials and Methods. World literature was analyzed on trends in the development of higher medical education. Results and Discussion. Development of the healthcare system in the UK requires an integrated approach that considers various aspects in higher medical education, personnel policy, and workplace management. French healthcare system is experiencing various problems, such as the a ordability of medical services and sta ng shortages in remote regions. The Government of France shall continue to invest in healthcare and address the challenges to ensure universal access to quality medical services, including through its higher education system. US medical education keeps pace with the challenges healthcare systems are facing in the 21st century. To address today’s challenges, US medical education is taking a more interdisciplinary and inclusive approach, focusing on public health, interdisciplinary teamwork, and community-based training. Chinese medical universities pay more attention to practical skills and to integrating various disciplines in training, which allows graduates to be the best medical experts able to solve complex practical problems. Conclusions. Global trends identi ed herein in the development of higher medical education in the USA, Great Britain, France, and China require re ection, while the best practices should be introduced into the Russian system of higher education. However, approaches to be implemented should be rst adapted to the historical, cultural, social, geographical, political, and other realities of Russia.

Keywords: global trends, higher medical education, China, France, UK, USA.

For reference: Protasov AD., Starodubtseva ES., Moshlyak GA., Zhestkov AV. Contemporary global trends in the development of higher medical education in the USA, Great Britain, France, and China. The Bulletin of Contemporary Clinical Medicine. 2023; 16(5): 127-135. DOI: 10.20969/VSKM.2023.16(5).127-135.

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