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ORIGINAL RESEARCH 

Functional state of endothelium in patients with psoriasis Arslanova R.M. (Russia, Sterlitamak), Mutalova E.G. (Russia, Ufa), Khismatullina Z.R. (Russia, Ufa), Nigmatullina A.E. (Russia, Ufa), Galyautdinova V.R. (Russia, Ufa), Kamaltdinova G.J. (Russia, Ufa), Asadullina G.V. (Russia, Ufa), Samigullina L.I. (Russia, Ufa), Rustyamova Z.Ya. (Russia, Ufa), Sadikova R.I. (Russia, Ufa), Frid S.A. (Russia, Ufa), Kamaltdinov E.R. (Russia, Ufa), Musina F.S. (Russia, Ufa) P.7

Impact of the previous 2019 novel coronavirus infection on the structural and functional parameters of the right heart and on pulmonary hemodynamics in patients with chronic obstructive pulmonary disease Kulik E.G. (Russia, Blagoveshchensk) Pavlenko V.I. (Russia, Blagoveshchensk) Bakina A.A. (Russia, Blagoveshchensk) Naryshkina S.V. (Russia, Blagoveshchensk) P.15 

Immune status characteristics of glomerulonephritis patients with refractory nephrotic syndrome Kudryashov S.I. (Russia, Cheboksary), Stenina M.A. (Russia, Moscow), Karzakova L.M. (Russia, Cheboksary), Sokolova E.V. (Russia, Moscow), Sidorov I.A.(Russia, Cheboksary), Borisova L.V. (Russia, Cheboksary), Vozyakova T.R. (Russia, Cheboksary) P.22

Relationship between the annexin А5 level and the regression of pulmonary complications in patients with SARS-COV-2-associated pneumonia at the outpatient stage Kurmaeva A.Sh. (Russia, Astrakhan), Bashkina O.A. (Russia, Astrakhan), Prokofyeva T.V. (Russia, Astrakhan), Polunina O.S. (Russia, Astrakhan), Polunina E.A. (Russia, Astrakhan) P.29

Characteristics of cardiovascular risk in patients with psoriatic arthritis Mutalova E.G. (Russia, Ufa), Arslanova R.M. (Russia, Sterlitamak), Khismatullina Z.R. (Russia, Ufa), Nigmatullina A.E. (Russia, Ufa), Galyautdinova V.R. (Russia, Ufa), Kamaltdinova G.J. (Russia, Ufa), Asadullina G.V. (Russia, Ufa), Samigullina L.I. (Russia, Ufa), Rustyamova Z.Ya. (Russia, Ufa), Sadikova R.I. (Russia, Ufa), Frid S.A. (Russia, Ufa), Kamaltdinov E.R. (Russia, Ufa), Musina F.S. (Russia, Ufa) P.35

Decompensated chronic heart failure management modifications for patients with frailty Podobed I.V. (Russia, Moscow), Lokinskaya L.S. (Russia, Belgorod), Alehina A.V. (Russia, Voronezh), Osipov K.V. (Russia, Moscow), Lenkin S.G. (Russia, Moscow), Ponomarev A.S. (Russia, Ekaterinburg), Fomchenkova N.V. (Russia, Vladimir) P.44

Characteristics of dental morbidity prevalence in preschool children living in nuclear and reconstituted families Khadyeva M.N. (Russia, Kazan), Galiullin A.N. (Russia, Kazan), Yakimova Ju.Yu. (Russia, Kazan) P.53

Premature rupture of membranes in full-term pregnancies as a risk factor of uterine cervix ruptures in childbirth Khvorostukhina N.F. (Russia, Saratov), Bakhmach V.O. (Russia, Saratov), Trushina O.V. (Russia, Saratov), Kolesnikova E.A. (Russia, Saratov), Odnokozova O.S. (Russia, Saratov), Chupakhin R.V. (Russia, Saratov) P.63

Prognostic significance of studying the levels of apoptosis markers, proteins P53 and BCL-2, in elderly patients with SARS-COV-2-caused viral pneumonia Khutaeva K.A. (Russia, Astrakhan), Demidov A.A. (Russia, Astrakhan) P.71

Interaction between inflammation markers and anxiety-depressive disorders in patients with acute myocardial infarction Shayakhmetova E.Sh. (Russia, Ufa), Mutalova E.G. (Russia, Ufa), Galyautdinova V.R. (Russia, Ufa), Frid S.A. (Russia, Ufa), Mingazetdinova L.N. (Russia, Ufa), Kamaltdinova G.J. (Russia, Ufa), Asadullina G.V. (Russia, Ufa), Rustyamova Z.Ya. (Russia, Ufa), Nigmatullina A.E. (Russia, Ufa), Samigullina L.I. (Russia, Ufa), Sadikova R.I. (Russia, Ufa), Musina F.S. (Russia, Ufa) P.78

Decision tree determining the probability of increased cardiovascular risk in patients with arterial hypertension after viral pneumonia caused by SARS-COV-2 Prokofyeva T.V. (Russia, Astrakhan), Shuvalova A.S. (Russia, Astrakhan), Polunina O.S. (Russia, Astrakhan), Polunina E.A. (Russia, Astrakhan) P.87

Prognostic model of the probability of an increase in the stage of arterial hypertension after viral pneumonia caused by SARS–COV–2 Shuvalova A.S. (Russia, Astrakhan), Prokofyeva T.V. (Russia, Astrakhan), Polunina O.S. (Russia, Astrakhan), Polunina E.A. (Russia, Astrakhan) P.94

REVIEWS 

Etiology of sinonasal inverted papilloma: a modern view on the problem Boiko N.V. (Russia, Rostov-on-Don), Stagnieva I.V. (Russia, Rostov-on-Don), Kiselev V.V. (Russia, Rostov-on-Don), Gukasyan E.L. (Russia, Rostov-on-Don), Stateshnaya P.A. (Russia, Rostov-on-Don), Lebedenko M.K. (Russia, Rostov-on-Don) P.101

Post-tuberculous obstructive pulmonary disease (review of foreign literature) Tlais H. (Russia, Moscow), Anaev E.Kh. (Russia, Moscow) P.107

Bioresorbable composites for osteosynthesis: a review of modern research Khisamieva D.R. (Russia, Kazan), Sharafiev I.A. (Russia, Kazan), Agatieva E.A. (Russia, Kazan), Nikiforov A.A. (Russia, Kazan), Galimzyanova R.Y. (Russia, Kazan), Ksembayev S.S. (Russia, Kazan), Khakimulin Yu.N. (Russia, Kazan), Wolfson S.I. (Russia, Kazan) P.119

EXPERIMENTAL STUDIES – TO PRACTICAL MEDICINE 

Morphological changes in the stria vascularis in experimental endolymphatic hydrops Kiselev V.V. (Russia, Rostov-on-Don), Boiko N.V. (Russia, Rostov-on-Don), Stagnieva I.V. (Russia, Rostov-on-Don), Alekseev V.V. (Russia, Rostov-on-Don), Gukasyan E.L. (Russia, Rostov-on-Don), Lebedenko M.K. (Russia, Rostov-on-Don) P.127

MEDICIN’S HISTORY 

In the memorial year of Stanislav I. Zalesky, ordinary professor, medical scientist, and russian statesman Perederina I.A. (Russia, Tomsk), Bakushina S.A. (Russia, Tomsk), Tveryakova E.N. (Russia, Tomsk), Miroshnichenko Yu.Yu. (Russia, Tomsk), Zykova M.V. (Russia, Tomsk) P.133

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ORIGINAL RESEARCH 

УДК 616.72-002.2, 616.517.8, 616.133.2 DOI: 10.20969/VSKM.2024.17(1).7-14

 FUNCTIONAL STATE OF ENDOTHELIUM IN PATIENTS WITH PSORIASIS

ARSLANOVA RENATA M., ORCID ID: 0009-0003-6477-753Х; Physician, Hippocrates Medical Center, 2B Lokomotivnaya str., 453115 Sterlitamak, Russia. Tel.: +7-927-935-99-11. E-mail: renatarslanova30@gmail.com 

MUTALOVA ELVIRA G., ORCID ID: 0000-0002-7454-9819; Dr. sc. med., Professor, Head of the Department of Hospital Therapy No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: emutalova@mail.ru 

KHISMATULLINA ZAREMA R. ORCID ID: 0000-0002-7454-9819; Dr. sc. med., Professor, Head of the Department of Dermatology & Venereology with Post-Graduate Courses in Dermatology, Venereology, and Cosmetology, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: hzr07@mail.ru 

NIGMATULLINA ALBINA E., ORCID ID: 0000-0002-3511-8477; Cand. sc. med., Associate Professor at the Department of Hospital Therapy No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: albanigma@mail.ru

GALYAUTDINOVA VELENA R., ORCID ID: 0000-0001-9715-6930; Assistant Professor at the Department of Hospital Therapy No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: velena.galyautdinova1704@gmail.com 

KAMALTDINOVA GULNARA J., ORCID ID: 0000-0002-1193-7240; Cand. Sc. Med., associate professor of the Department of Hospital Therapy No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: kgj69@mail.ru 

ASADULLINA GULNARA VENEROVNA, ORCID ID: 0000-0003-2736-0041; Cand. sc. med., Associate Professor at the Department of Hospital Therapy No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: asgulnara@rambler.ru 

SAMIGULLINA LIANA I., ORCID ID: 0000-0003-1876-7325; Cand. sc. med., Associate Professor at the Department of Hospital Therapy No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: liana_sam@inbox.ru 

RUSTYAMOVA ZULFIYA YAVDATOVNA, ORCID ID: 0000-0002-8353-0140; Cand. sc. med., Associate Professor at the Department of Hospital Therapy No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: rzulfiya@yandex.ru 

SADIKOVA REGINA I., ORCID ID: 0000-0002-6653-9194; ; Cand. sc. med., Assistant Professor at the Department of Hospital Therapy No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: regina281210@yandex.ru 

FRID SVETLANA A., ORCID ID: 000-0003-0131-4266; Cand. sc. med., Associate Professor at the Department of Hospital Therapy No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: valex69@mail.ru 

KAMALTDINOV ELDAR R., ORCID ID: 0009-0006-0068-2795; 5th-year student of the Faculty of General Medicine, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: 8-347-272-41-73 

MUSINA FLARISA S., ORCID ID: 0000-0002-0898-7052; Cand. sc. med., Associate Professor at the Department of Hospital Therapy No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: musinaflarisa@mail.ru 

Abstract. Introduction. Psoriasis is an independent risk factor for cardiovascular diseases, accompanied by an increased risk of mortality from cardiovascular diseases, as compared with the population, which is mainly associated with chronic systemic inflammation (increased levels of C-reactive protein, fibrinogen, and homocysteine) and with the accumulation of conventional cardiovascular risk factors, such as dyslipidemia, obesity, decreased physical activity, and arterial hypertension. There are only few studies evaluating the link between psoriasis, inflammation, and cardiovascular disease. Our aim was to study the relationship between pro-inflammatory mediators and the endothelium functional state indicators of the in patients with psoriasis. Materials and Methods. We examined 116 patients with verified psoriasis, aged 19-62 years. The control group consisted of 25 comparably aged and practically healthy individuals. The diagnosis was made considering the psoriasis clinical form, stage, seasonality, type, and severity. All patients underwent a standard laboratory and instrumental examination. The levels of pro-inflammatory markers (IL-6, VEGF, CRPvh) were determined by enzyme-linked immunosorbent assay using commercial ELISA-BEST kits manufactured by OOO Vector-Best, Novosibirsk, Russia. The endothelial function was assessed by using the Biomedical ENDOTELIN test system by BioKhimMak JSC to measure the quantitative content of endothelin-1, a characteristic of the vasomotor function of endothelium, determined by ultrasound according to the method proposed by Celermajer D. et al. Results and Discussion. The study revealed a high incidence of the disease in people of working age and a slight predominance among male patients. In 55.2% of patients, classic atherosclerosis risk factors were identified: Arterial hypertension, smoking, low physical activity, alcohol abuse, and improper nutrition. 33.6% of patients were overweight; 24.1% had obesity I-II degree, and 39.7% with abdominal obesity. According to the findings of the study of pro-inflammatory markers in the blood serum, there is a significant increase in their levels as compared with the control group indicators, which correlates with the severity of psoriasis and a decrease in the ratio of IL-6/CRPvh. Endothelial dysfunction was characterized by a statistically significant increase in endothelin-1 and a significant increase in the content of vascular endothelial growth factor (VEGF) in the blood serum of psoriasis patients. Percentage increase in the brachial artery diameter on the endothelium-dependent stimulus was reduced and averaged 9.14% in the group of patients with psoriasis. Conclusion. A high comorbidity of psoriasis and cardiovascular diseases has been established. A significant increase in the levels of systemic immune inflammation mediators IL-6 and C-RBhv and a decrease in the ratio of IL-6/C-RPhvh were identified, which correlates with the severity of the disease and the presence of cardiovascular diseases. Vascular endothelium dysfunction is characterized by an increase in the content of ET-1 and VEGF in the blood serum and a decrease in the flow-mediated dilatation of the brachial artery. 

Keywords: psoriasis, cardiovascular disease, endothelial dysfunction, inflammation. 

For reference: Arslanova RM, Mutalova EG, Khismatullina ZR, et al. Functional state of endothelium in patients with psoriasis. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (1): 7-14. DOI: 10.20969/VSKM.2024.17(1).7-14.

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УДК: 616-06: 616.24-036.12+578.834.11 DOI: 10.20969/VSKM.2024.17(1).15-21

 IMPACT OF THE PREVIOUS 2019 NOVEL CORONAVIRUS INFECTION ON THE STRUCTURAL AND FUNCTIONAL PARAMETERS OF THE RIGHT HEART AND ON PULMONARY HEMODYNAMICS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE 

KULIK EKATERINA G., ORCID ID: 0000-0002-6059-1813; Cand. sc. med., Associate Professor at the Department of Intermediate- and Advanced-Level Therapy, Amur State Medical Academy of the Ministry of Health of Russia, 95 Gorky Street, 675006 Blagoveshchensk, Amur Region, Russia. Е-mail: rybas_katya@mail.ru 

PAVLENKO VALENTINA I., ORCID ID: 0000-0001-8794-9929; Dr. sc. med., Professor at the Department of Intermediate-and Advanced-Level Therapy, Amur State Medical Academy of the Ministry of Health of Russia, 95 Gorky Street, 675006 Blagoveshchensk, Amur Region, Russia. Е-mail: agmapedfac@mail.ru

BAKINA ANASTASIA A., ORCID ID: 0000-0003-2653-8661; Cand. sc. med., Assistant Professor at the Department of Intermediate- and Advanced-Level Therapy, Amur State Medical Academy of the Ministry of Health of Russia, 95 Gorky Street, 675006 Blagoveshchensk, Amur Region, Russia. Е-mail: anastasia_darchi@mail.ru 

NARYSHKINA SVETLANA V., ORCID ID: 0000-0003-0587-456X; Dr. sc. med.., Professor, Head of the Department of Intermediate- and Advanced-Level Therapy, Amur State Medical Academy of the Ministry of Health of Russia, 95 Gorky Street, 675006 Blagoveshchensk, Amur Region, Russia. Е-mail: rybas_katya@mail.ru 

Abstract. Introduction. This paper presents the interim results of a prospective clinical study, in which we studied the long-term influence of 2019 novel coronavirus infection (2019-nCoV) on pulmonary-cardiac relationships in patients with chronic obstructive pulmonary disease. Aim: Studying the effect provided by the previous 2019-nCoV on the structural and functional parameters of the right ventricle of the heart and on pulmonary hemodynamics in patients with chronic obstructive pulmonary disease. Materials and Methods. Over the years 2021-2023, we examined 43 patients with stable chronic obstructive pulmonary disease, having a history of 2019-nCoV by transthoracic echocardiography. The study consisted of two control points: on day 8-12 in the hospital and the follow-up visit to the clinic 12 months after 2019-nCoV. The study included a control group of 30 stable chronic obstructive pulmonary disease patients having no 2019-nCoV history. Results and Discussion. We found that the structural and functional strains of the right heart are aggravated in the acute period of 2019-nCoV in patients with chronic obstructive pulmonary disease. Thus, as compared to the control group, the maximum right atrium width (p<0.05), right ventricle anterior wall thickness (p<0.05), and basal right ventricle diameter values were significantly higher. Echocardiographic signs of right ventricle diastolic dysfunction Type 1 were found in 36,3% of cases and Type 2 in 23.3%. Pulmonary artery diameter and mean pulmonary artery pressure were higher than in those of the control group, as well. In 44% of patients, the value of pulmonary artery acceleration time was less than 105 ms (χ2 = 4.59; p<0.05). Persistently high linear and volumetric right atrium and right ventricle indicators were registered in patients after 12 months of follow-up. Signs of the Type 1 diastolic dysfunction were found in 62.7% of patients. There was a tendency to decrease the mean pulmonary artery pressure and pulmonary artery acceleration time values. Conclusions. Thus, according to echocardiography, the combination of chronic obstructive pulmonary disease and 2019-nCoV leads to the aggravation of right ventricle diastolic dysfunction and the progression of pulmonary hypertension. These signs persisted for a long time (12 months). 

Keywords: COPD, novel coronavirus infection, echocardiography, diastolic dysfunction, right ventricle 

For reference: Kulik EG, Pavlenko VI, Bakina AA, Naryshkina SV. Impact of the previous 2019 novel coronavirus infection on the structural and functional parameters of the right heart and on pulmonary hemodynamics in patients with chronic obstructive pulmonary disease. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (1): 15-21. DOI: 10.20969/VSKM.2024.17(1).15-21.

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УДК. 616.61; 616-002.2 DOI: 10.20969/VSKM.2024.17(1).22-28 

 IMMUNE STATUS CHARACTERISTICS OF GLOMERULONEPHRITIS PATIENTS WITH REFRACTORY NEPHROTIC SYNDROME 

KUDRYASHOV SERGEY I., ORCID ID: 0000-0003-2277-9425; Cand. sc. med., Associate Professor at the Department of Internal Medicine, Chuvash State University, 15 Moskovskiiˋ Ave., 428015 Cheboksary, Russia. Tel.: +7 (917) 652-34-99. E-mail: medicpro21@mail.ru 

STENINA MARINA A. ORCID ID: 0009-0007-0488-9598; Dr. sc. med., Professor at the Department of Immunology of Pirogov Russian National Research Medical University, 1 Ostrovityanova str., 117997 Moscow, Russia. E-mail: stenina_ma@mail.ru 

KARZAKOVA LOUISE M., ORCID ID: 0000-0002-5899-6352; SCOPUS Author ID: 56916027300, Dr. sc. med., Head of the Department of Internal Medicine, Chuvash State University, 15 Moskovskiiˋ Ave., 428015 Cheboksary, Russia. E-mail: luizak58@mail.ru 

SOKOLOVA EVGENIYA V., ORCID ID: 0009-0009-5427-756X; Cand. sc. med., Associate Professor at the Department of Immunology of Pirogov Russian National Research Medical University, 1 Ostrovityanova str., 117997 Moscow, Russia. E-mail: ev.v.sokolova@yandex.ru 

SIDOROV IVAN A., ORCID ID: 0000-0003-3658-6579, Dr. sc. med., Professor at the Department of Internal Medicine, Chuvash State University, 15 Moskovskiiˋ Ave., 428015 Cheboksary, Russia. E-mail: ivansv68@yandex.ru 

BORISOVA LYUDMILA V., ORCID ID: 0000-0002-1245-3811; Cand. sc. med., Associate Professor at the Department of Internal Medicine, Chuvash State University, 15 Moskovskiiˋ Ave., 428015 Cheboksary, Russia. Tel.: +7 (917) 652-34-99. E-mail: lyudmilabor@mail.ru 

VOZYAKOVA TATYANA R., ORCID ID: 0009-0005-7588-1564; Cand. sc. med., Associate Professor at the Department of Internal Medicine, Chuvash State University, 15 Moskovskiiˋ Ave., 428015 Cheboksary, Russia. Tel.: +7 (903) 322-70-28. E-mail: trv5@mail.ru 

Abstract. Introduction. Research in the issues related to glomerulonephritis with nephrotic syndrome is an important problem of modern medicine due to their prevalence among the global population and mainly in the younger age group, with a significant proportion of patients with refractory nephrotic syndrome (frequent relapses, persistent course). Currently, there are no ways to predict the development of glomerulonephrites with refractory nephrotic syndrome. Due to the immunological nature of glomerulonephrites, it seems advisable to search for predictors of refractory nephrotic syndrome among the indicators characterizing the patient’s immune status. Aim of the study was to study the characteristic features of the immune status and their prognostic value in glomerulonephritis with refractory nephrotic syndrome. Materials and Methods. We examined 136 glomerulonephritis patients with active nephrotic syndrome, hospitalized in the nephrology department in 2015-2021. Along with conventional examinations, humoral and T-cell immunity indicators were tested in the patients. The end point of the study was in 2022 where the the clinical course of the disease was assessed in patients, and patients with nephrotic syndrome who showed refractory to steroid therapy were placed into one group, while those with non–refractory nephrotic syndrome were placed into another one. Within the selected groups of patients, we performed the comparative study of demographic, clinical and laboratory parameters, the indicators of humoral and T-cell immunity, and the ROC analysis of indicators correlating with the nephrotic syndrome recurrence frequency. Results and Discussion. In the group of patients with a refractory course of the disease, an increase was detected in the number of T helper phenotype cells and of the activated T cells carrying activation markers, HLA-DR and CD38, on their surfaces. At the same time, the relative content of regulatory T cells (Treg) among T helper cells decreased. The B system was characterized by an increase in the number of B lymphocytes, an increase in the levels of circulating immune complexes and IgM, and a decrease in IgG levels. The changes detected in the parameters of humoral and T-cell immunity may be essential to the development of refractory nephrotic syndrome. In the refractory nephrotic syndrome pathogenesis, the most important is the decrease in the number of Tregs, which correlated most closely with the nephrotic syndrome recurrence frequency. Conclusions. An association was found between refractory nephrotic syndrome and the pronounced activation of humoral immunity, and a significant imbalance was detected between various immunoregulatory and activated T-lymphocyte subpopulations. The Treg content in the blood can be a prognostic indicator: Treg content values of under 1.9% indicate a high probability of developing refractory nephrotic syndrome. 

Keywords: glomerulonephritis, refractory nephrotic syndrome, immune status. 

For reference: Kudryashov SI, Stenina MA, Karzakova LM, et al. Immune status characteristics of glomerulonephritis patients with refractory nephrotic syndrome. The Bulletin of Contemporary Clinical Medicine. 2024;17 (1): 22-28. DOI: 10.20969/VSKM.2024.17(1).22-28. 

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13. Kuroki A, Iyoda M, Shibata T, Sugisaki T. Th2 cytokines increase and stimulate B cells to produce IgG4 in idiopathic membranous nephropathy. Kidney Int. 2005; 68 (1): 302–310. DOI: 10.1111/j.1523-1755.2005.00415.x 
14. Motavalli R, Etemadi J, Kahroba H, et al. Immune system-mediated cellular and molecular mechanisms in idiopathic membranous nephropathy pathogenesis and possible therapeutic targets. Life Sci. 2019; 238: e116923. DOI: 10.1016/j.lfs.2019.116923 
15. Khandelwal P, Chaturvedi V, Owsley E, et al. CD38brightCD8+ T Cells Associated with the Development of Acute GVHD Are Activated, Proliferating, and Cytotoxic Trafficking Cells. Biol Blood Marrow Transplant. 2020; 26 (1): 1–6. DOI: 10.1016/j.bbmt.2019.08.008

 

УДК: 616.24-002-06-092.818-08:616.988 DOI: 10.20969/VSKM.2024.17(1).29-34 

 RELATIONSHIP BETWEEN THE ANNEXIN A5 LEVEL AND THE REGRESSION OF PULMONARY COMPLICATIONS IN PATIENTS WITH SARS-COV-2- ASSOCIATED PNEUMONIA AT THE OUTPATIENT STAGE 

KURMAEVA ASIA SH., ORCID ID: 0009-0008-4449-5275, Postgraduate Student at the Internal Medicine Department, Faculty of Pediatrics, Astrakhan State Medical University, 54-170 Pobedy str., 414040 Astrakhan, Russia. E-mail: asiy_92@mail.ru

BASHKINA OLGA A., ORCID ID: 0000-0003-4168-4851, Dr. sc. med., Professor, Rector, Head of the Department of Theoretical Pediatrics, Astrakhan State Medical University, 121 Bakinskaya str., 414000 Astrakhan, Russia. E-mail: post@astgmu.ru 

PROKOFYEVA TATIANA V., ORCID ID: 0000-0002-3260-2677; Cand. sc. med., Associate Professor at the Internal Medicine Department, Faculty of Pediatrics, Astrakhan State Medical University, 54-170 Pobedy str., 414040 Astrakhan, Russia. E-mail: prokofeva-73@inbox.ru 

POLUNINA OLGA S., ORCID ID: 0000-0001-8299-6582, Dr. sc. med., Professor, Head of the Internal Medicine Department, Faculty of Pediatrics, Astrakhan State Medical University, 121 Bakinskaya str., 414000 Astrakhan, Russia. E-mail: admed@yandex.ru 

POLUNINA EKATERINA A., ORCID ID: 0000-0002-3679-432X, Dr. sc. med., Associate Professor at the Internal Medicine Department of Pediatric Department, Astrakhan State Medical University, 121 Bakinskaya str., 414000 Astrakhan, Russia. E-mail: gilti2@yandex.ru 

Abstract. Introduction. To date, there are still some questions regarding the novel coronavirus infection. One of them concerns the long-term post-COVID-19 effects and the regression of complications that have developed during the acute period of this disease. Apoptosis is one of the universal mechanisms for maintaining the body homeostasis. Annexin A5 (ANXA5) is a calcium-containing protein indicative of early apoptosis. Aim: To determine the relationship between the annexin A5 levels and the regression of pulmonary complications in patients with SARS-CoV-2-associated pneumonia 6 months after being treated regarding COVID-19. Materials and Methods. We examined 90 residents of the Astrakhan region, diagnosed with the coronavirus infection COVID-19 (virus identified), aged 47 [39; 57] years. Pulmonary complications were detected in 46 patients using сomputed tomography at discharge: 30 (33.3 %) with diffuse pulmonary fibrosis, 3 (3.3 %) with exudative pleuritis, and 13 (11.1 %) with the combination of the two. After 6 months of outpatient follow-up, pulmonary complications were detected in 16 (17.8 %) patients: Diffuse pulmonary fibrosis in 7 (7.8 %), pleural adhesions in 5 (5.6%), and both complications 4 (4.5 %) patients. ANXA5 level (ng/ml) in blood serum was determined by enzyme immunoassay method using immune-enzyme reaction analyzer Uniplan AIFR-01 manufactured by Picon, Russia. The distribution of numerical scores was nonparametric. To determine the statistical significance of differences in quantitative characteristics, we used the Mann-Whitney test in two independent samples and the Wilcoxon test in dependent samples. Differences in qualitative characteristics in two independent groups were analyzed using contingency tables with subsequent calculation of Pearson’s χ2 criterion, odds ratio, and 95% confidence interval. Results and Discussion. Even after 6 months of follow-up the differences remained statistically significantly higher than in the control group. Number of patients with pulmonary complications on сomputed tomography 6 months after hospitalization decreased threefold, i. e., from 51.1% down to 17.8 %. ANXA5 level after 6 months of follow-up in patients with pulmonary complications on сomputed tomography was statistically significantly higher compared to the patients of this group without pulmonary complications (p<0.001). Conclusions. Probability of pulmonary complications on сomputed tomography after 6 months of follow-up was 10 times higher in patients with the insufficient dynamics of ANXA5 levels, as compared to those with the positive dynamics of this index level (OR 10.0, 95% CI 2.7-33.3). 

Keywords: annexin A5, ANXA5, hyperanexinemia, COVID-19, SARS-CoV-2-associated pneumonia, pulmonary complications. 

For reference: Kurmaeva ASh, Bashkina OA, Prokofieva TV, et al. Relationship between the annexin A5 level and the regression of pulmonary complications in patients with SARS-CoV-2-associated pneumonia at the outpatient stage. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (1): 29-34. DOI: 10.20969/VSKM.2024.17(1).29-34 

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УДК 616.72-002.2, 616.517.8, 616.133.2 DOI: 10.20969/VSKM.2024.17(1).35-43

 CHARACTERISTICS OF CARDIOVASCULAR RISK IN PATIENTS WITH PSORIATIC ARTHRITIS

MUTALOVA ELVIRA G., ORCID ID: 0000-0002-7454-9819; Dr. sc. med., Professor, Head of the Department of Advanced Internal Medicine No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: emutalova@mail.ru 

ARSLANOVA RENATA M., ORCID ID: 0009-0003-6477-753Х; Physician at the Hippocrates MC, 2B Lokomotivnaya str., 453115 Sterlitamak, Russia. Tel.: +7-927-935-99-11. Е-mail: renatarslanova30@gmail.com 

KHISMATULLINA ZAREMA R., ORCID ID: 0000-0002-7454-9819; Dr. sc. med., Professor, Head of the Department of Dermatology/Venereology with further-education courses in dermatology/venereology and cosmetology, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: hzr07@mail.ru 

NIGMATULLINA ALBINA E., ORCID ID: 0000-0002-3511-8477; Cand. sc. med., Associate Professor at the Department of Advanced Internal Medicine No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel. +7-347-272-41-73. E-mail: albanigma@mail.ru 

GALYAUTDINOVA VELENA R., ORCID ID: 0000-0001-9715-6930; Assistant Professor at the Department of Advanced Internal Medicine No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: velena.galyautdinova1704@gmail.com 

KAMALTDINOVA GULNARA J., ORCID ID: 0000-0002-1193-7240; Cand. sc. med., Associate Professor at the Department of Advanced Internal Medicine No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: kgj69@mail.ru 

ASADULLINA GULNARA V., ORCID ID: 0000-0003-2736-0041; Cand. sc. med., Associate Professor at the Department of Advanced Internal Medicine No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: asgulnara@rambler.ru 

SAMIGULLINA LIANA I., ORCID ID: 0000-0003-1876-7325; Cand. sc. med., Associate Professor at the Department of Advanced Internal Medicine No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: liana_sam@inbox.ru 

RUSTYAMOVA ZULFIYA YA., ORCID ID: 0000-0002-8353-0140; Cand. sc. med., Associate Professor at the Department of Advanced Internal Medicine No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: rzulfiya@yandex.ru 

SADIKOVA REGINA I., ORCID ID: 0000-0002-6653-9194; Cand. sc. med., Assistant Professor at the Department of Advanced Internal Medicine No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: regina281210@yandex.ru 

FRID SVETLANA A., ORCID ID: 000-0003-0131-4266; Cand. sc. med., Associate Professor at the Department of Advanced Internal Medicine No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: valex69@mail.ru 

KAMALTDINOV ELDAR R., ORCID ID: 0009-0006-0068-2795; 5th year student at the Faculty of General Medicine, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73 

MUSINA FLARISA S., ORCID ID: 0000-0002-0898-7052; Cand. sc. med., Associate Professor at the Department of Advanced Internal Medicine No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. Е-mail: musinaflarisa@mail.ru 

Abstract. Introduction. Patients with psoriatic arthritis are exposed to a higher risk of developing cardiovascular complications. Development and progression of these disorders are based on a complex of closely interrelated factors, such as traditional cardiovascular risk factors, cardiovascular toxicity of some antirheumatic drugs, primarily non-steroidal anti-inflammatory drugs and glucocorticoids, and chronic autoimmune inflammation, which, according to many researchers, is the leading pathogenetic mechanism of atherosclerotic vascular lesions. The aim of the study was to assess the prevalence of traditional risk factors, the state of the blood lipid spectrum, and atherosclerotic remodeling of peripheral arteries in patients with psoriatic arthritis. Materials and Methods. We examined 84 patients (41 women and 43 men) aged 20 to 65 years. Arthritis was diagnosed based on the CASPAR criteria. Patients were assessed regarding traditional risk factors, such as hypertension, obesity, smoking, aggravated family history of CVD, diabetes, physical inactivity, and dyslipidemia; ten-year total coronary risk was calculated using the SCORE scale. To diagnose subclinical atherosclerosis, the patients underwent Doppler ultrasound of the carotid arteries with an assessment of the intima-media complex thickness. Results and Discussion. Assessment of disease development risk factors showed that all patients with psoriatic arthritis had from one to five risk factors. More common risk factors were smoking in 50 (59.5 %) patients, AO in 44 (52.4 %), dyslipidemia in 48 (57.1 %), and arterial hypertension. Patients with a long history of the disease have a higher prevalence of risk factors. According to the results of calculating the ten-year total coronary risk (SCORE scale), most patients were in the group of low (46.4 %) and moderate (38 %) risk. An association was found between the level of total coronary risk and arthritis activity in groups of patients with low and moderate risk. The average intima-media complex thickness of the common carotid artery in the group of patients with psoriatic arthritis was statistically significantly higher than in those in the control group (p=0.0361).Conclusions. An increased risk of cardiovascular complications was found in patients with psoriatic arthritis, while most patients have several risk factors in various proportions. According to the risk assessment on the SCORE scale, it was found to be statistically significant in the group of patients with psoriatic arthritis, which correlates with disease activity. The presence of subclinical atherosclerosis was detected in form of a statistically significant increase in the intima-media complex thickness of the carotid arteries. All the above indicates the current problem of psoriasis comorbidity, which dictates a personalized comprehensive approach to therapy for the selection of safe and adequate therapy for all diseases diagnosed in an individual patient. 

Keywords: psoriatic arthritis, cardiovascular risk, subclinical atherosclerosis. 

For reference: Mutalova EG, Arslanova AM, Khismatullina ZR, et al. Characteristics of cardiovascular risk in patients with psoriatic arthritis. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (1): 35-43. DOI: 10.20969/VSKM.2024.17(1).35-43.

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УДК 616.12-008.44 DOI: 10.20969/VSKM.2024.17(1).44-52 

 DECOMPENSATED CHRONIC HEART FAILURE MANAGEMENT MODIFICATIONS FOR PATIENTS WITH FRAILTY 

PODOBED IVAN V., ORCID ID: 0000-0001-6644-6054; Researcher at the Department of Clinical Gerontology, ANCO Scientific Research Medical Center “Gerontologiya” (Gerontology), 116 Volokolamskoe highway, Bldg. 1, 125371 Moscow, Russia. Tel.: +7-969-086-86-87. E-mail: i89690868687@yandex.ru 

LOKINSKAYA LILIYA S., ORCID ID: 0000-0002-5179-70-86; Postgraduate Student at the Department of Healthcare Management and Public Health, Institute of Medicine, Belgorod State National Research University, 85 Pobedy str., 308015 Belgorod, Russia. Tel.: +7-910-361-95-15. E-mail: lokinskaya@rambler.ru 

ALEHINA ANNA V., ORCID ID: 0000-0002-6202-9525; Postgraduate Student at the Department of Physical and Rehabilitation Medicine & Geriatrics, Voronezh State Medical University named after N. N. Burdenko, 10 Studencheskaya str., 394036 Voronezh, Russia. Tel.: +7-473-722-25-73. E-mail: alechinaannaalex@gmail.com 

OSIPOV KIRILL V., ORCID ID: 0000-0002-5110-8009; the head of department day hospital at the complex medical health center III level, Federal Medical Biophysical Center named after A.I. Burnazyan, 15 Gamaleya street, 123098 Moscow, Russia. Tel.: +7-906-086-67-31. E-mail: dr-osi@yandex.ru

LENKIN SERGEY G., ORCID ID: 0000-0002-6094-9221; Cand. sc. med., Urologist and Dermatologist/Venereologist at Platny KVD (For-Profit Clinic for Dematology/Venereology), 8 Bolshoy Kazenny Lane, Bldg. 2, 105064 Moscow, Russia. Tel.: +7-919-771-07-09. E-mail: gippocratus@mail.ru 

PONOMAREV ALEXEY S., ORCID ID: 0000-0002-2830-0334; Cand. sc. med., Associate Professor at the Department of Anatomy, Ural State Medical University, 3 Repin str., 620028 Ekaterinburg, Russia. Tel.: +7-912-605-37-52. E-mail: alekseosokin@yandex.ru 

FOMCHENKOVA NATAL’YA V., ORCID ID: 0009-0003-0989-7686; Chief Physician, Clinic GEN87, 27 Gorkogo str., 600017 Vladimir, Russia. Tel.: +7-492-247-40-27. E-mail: foma.n1973@yandex.ru 

Abstract. Introduction. Frailty affects the prognosis of patients suffering from chronic heart failure. This syndrome increases the frequency of hospitalizations, complicates treatment, and increases the patients’ lethality. Managing patients with chronic heart failure requires some strategic modifications, namely, such management should be supplemented with the procedures aimed at correcting geriatric syndromes. Aim. Optimization of management tactics patients with chronic heart failure and frailty syndrome. Materials and Methods. The study included 52 patients with decompensated chronic heart failure and severe or terminal frailty. Patients were divided into 2 groups: 27 people in group 1, where patients were managed in a standard manner for 7 days, and 25 people in group 2 where integrated management was used. Results and Discussion. Patients of the two groups were comparable in lethality (p=0.17). By the 7th day of observation, the groups were comparable in terms of the number of persons with malnutrition syndrome (p=0.73). The patients were comparable in terms of the pressure ulcer stages and of the presence of infectious complications (p = 1.0). The frequency of thromboembolic complications in the study sample was 5.7%. Conclusions. Integrated management may be considered to improve long-term prognosis for the decompensated chronic heart failure patients with frailty, despite the lack of improvement in short-term outcomes. 

Keywords: frailty, chronic heart failure, integrated patient management, lethality. 

For reference: Podobed IV, Lokinskaya LS, Alehina AV, Osipov KV, Lenkin SG, Ponomarev AS, Fomchenkova NV. Decompensated chronic heart failure management modifications for patients with frailty. The Bulletin of Contemporary Clinical Medicine. 2024; 17(1): 44-52. DOI: 10.20969/VSKM.2024.17(1).44-52. 

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УДК 616.31-053.4:316.362.3 DOI: 10.20969/VSKM.2024.17(1).53-62 

 CHARACTERISTICS OF DENTAL MORBIDITY PREVALENCE IN PRESCHOOL CHILDREN LIVING IN NUCLEAR AND RECONSTITUTED FAMILIES 

KHADYEVA MADINA N., ORCID ID: 0009-0002-0643-0418; Cand. sc. med., Assistant Professor at the Therapeutic Dentistry Department, Kazan State Medical University, 49 Butlerova str., 420012 Kazan, Russia; Chief Physician and Director of the UniDent Dental Clinic Chain, 79 Chistopolskaya str. and 2 Orenburg Tract str., 420016 Kazan, Russia. Tel.: +79375202249. E-mail: madina-565@mail.ru 

GALIULLIN AFGAT N., ORCID ID: 0000-0002-1294-4055; Dr. sc. med., Professor, Department of Preventive Medicine, Institute of Fundamental Medicine and Biology, Center for Postgraduate Education, Kazan Federal University, 18 Kremlevskaya str., 420008 Kazan, Russia. Tel.: +79872968764. 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 (Volga Region) Federal University, 18 Kremlevskaya str., 420008 Kazan, Russia. Tel.: +79375218425. E-mail: optima00@list.ru 

Abstract. Introduction. Dental diseases in preschool children do not appear to tend downward. According to the literature, the prevalence of dental decay and its complications in preschool children reaches 70%, dental abnormalities more than 80%, and periodontal diseases and oral mucosa diseases up to 98%. There are some data described in literature, regarding how family types affect the overall incidence in children. At the same time, the impact of family type on the children dental health has not been studied a lot so far. Taking this into account, this paper provides data on dental morbidity in preschool children living in nuclear and reconstituted families. The aim of the study is to examine the pattern of prevalence of major dental diseases in preschool children living in nuclear or reconstituted families. Materials and Methods. Preschool children of different ages and their parents took part in this study. During the study, we identified reconstituted and nuclear families, the children from which families constituted the subject of the study. In total, the study examined 1,929 children from 1,842 nuclear families and 166 children from 146 reconstituted children. Results and Discussions. The study found that the most important dental diseases occur in children of the earliest age, before 1 year of life. With the passage of time and the child’s growth, their dental morbidity progresses and reaches its peak among preschool children aged 4.6-6 years. Children living in reconstituted families were significantly more susceptible to the onset and progression of major dental diseases than those from nuclear families. Conclusions. The impact of family type on dental morbidity in preschool children should be considered while planning the prevention and medical examination programs, which will help identify dental diseases at an early stage, prevent the development of complications, and optimize health care costs for the treatment and prevention of dental diseases in preschool children. 

Keywords: preschool children, dental decay, dentoalveolar abnormalities, nuclear family, reconstituted family, bite pathology, oral mucosa diseases, periodontal diseases, non-caries damage. 

For reference: Khadyeva MN, Galiullin AN. Yakimova JuYu. Characteristics of dental morbidity prevalence in preschool children living in nuclear and reconstituted families. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (1): 53-62. DOI: 10.20969/VSKM.2024.17(1).53-62.

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УДК: 618.544 DOI: 10.20969/VSKM.2024.17(1).63-70 

 PREMATURE RUPTURE OF MEMBRANES IN FULL-TERM PREGNANCIES AS A RISK FACTOR OF UTERINE CERVIX RUPTURES IN CHILDBIRTH 

KHVOROSTUKHINA NATALIA F., ORCID ID: 0000-0002-5864-3397, Scopus Author ID: 56801899300, SPIN code: 4804-8075, Author ID: 466181, Dr. sc. med., Professor, Head of the Department of Obstetrics and Gynecology, Faculty of Pediatrics, Saratov State Medical University named after V.I. Razumovsky, 112 Bolshaya Kazachya str., 410012 Saratov, Russia. Tel.: +7 927 277 79-35. E-mail: Khvorostukhina-NF@yandex.ru 

BAKHMACH VLADISLAV O., ORCID ID: 0000-0002-4644-0357, SPIN code: 4804-8075, Author ID: 466181, Assistant Professor at the Department of Obstetrics and Gynecology, Faculty of Pediatrics, Saratov State Medical University named after V.I. Razumovsky, 112 Bolshaya Kazachya str., 410012 Saratov, Russia. Tel.: +7 987 831 69 59. E-mail: bakchmach@mail.ru 

TRUSHINA OKSANA V., ORCID ID: 0000-0003-1019-1907, SPIN code: 4188-8722, Author ID: 890928, Cand. sc. med., Associate Professor at the Department of Obstetrics and Gynecology, Faculty of Pediatrics, Saratov State Medical University named after V.I. Razumovsky, 112 Bolshaya Kazachya str., 410012 Saratov, Russia. Tel.: +7 900 314 67 89. E-mail: pilot.med@mail.ru 

KOLESNIKOVA EKATERINA A., ORCID ID: 0000-0002-0816-0477, SPIN code: 1644-0270, Author ID: 989729, Cand. sc. med., Associate Professor at the Department of Obstetrics and Gynecology, Faculty of Pediatrics, Saratov State Medical University named after V.I. Razumovsky, 112 Bolshaya Kazachya str., 410012 Saratov, Russia. Tel.: +7 904 242 37 47. E-mail: kolesik06@yandex.ru 

ODNOKOZOVA OKSANA S., ORCID ID: 0000-0001-8092-020X, SPIN code: 5711-4577, Author ID: 567215, Cand. sc. med., Associate Professor at the Department of Obstetrics and Gynecology, Faculty of Pediatrics, Saratov State Medical University named after V.I. Razumovsky, 112 Bolshaya Kazachya str., 410012 Saratov, Russia. Tel.: +7 917 209 55 01. E-mail: oxano4ka5@mail.ru 

CHUPAKHIN RUSLAN V., ORCID ID: 0000-0001-7823-7508, SPIN code: 3450-8993, Author ID: 1133191, Assistant Professor at the Department of Obstetrics and Gynecology, Faculty of Pediatrics, Saratov State Medical University named after V.I. Razumovsky, 112 Bolshaya Kazachya str., 410012 Saratov, Russia. Tel.: +7 967 501 23 73. E-mail: chupahinrv13@gmail.com 

Abstract. Introduction. Premature rupture of membranes continues to be one of the urgent problems in modern obstetrics, since it is exactly the pathology a high frequency of unfavorable pregnancy outcomes is associated with. At the same time, an equally important task in obstetrics and gynecology remains the problem of maternal birth injuries, including cervical ruptures, the frequency of which ranges 6 to 15 %. Aim. To study how premature ruptures of membranes in full-term pregnancies affect the frequency of cervical ruptures in childbirth and to identify the risk factors of cervical injuries in at-term labor complicated by premature rupture of membranes. Materials and Methods. A retrospective analysis of birth histories for the years 2019-2020 was carried out according to the data of the perinatal center at Saratov City Clinical Hospital No. 8. The study group included 894 histories of single at-term vaginal deliveries complicated by premature rupture of membranes, while the control group included 6,735 birth histories of women whose vaginal deliveries were performed with timely ruptures of membranes. Later, we identified subgroups within the study group: Subgroup 1 (n=101) included patients with premature rupture of membranes at full-term gestation, whose at-term labors were complicated by uterine cervix ruptures, while Subgroup 2 (n=336) included women with premature ruptures of membranes during at-term labors without any maternal birth traumas. When analyzing medical records, special attention was paid to the anamnesis details and to the special aspects of birth courses and outcomes. Statistical data processing was performed using the MS Excel and Statistica 7.0 software programs. Differences in indications were considered statistically significant at p<0.05. Results and Discussion. Probability of premature ruptures of membranes during full-term pregnancy increases in patients expecting their first childbirth by 1.6 times (χ2 = 173.49; p <0.001), those with a burdened obstetric/gynecological history, such as abortions, miscarriages, and genital pathology, and those with concomitant extragenital diseases (85.9%). In the study group, we identified an increase in the incidence of labor anomalies (by 3 times) and acute fetal distress (by 1.9 times), which increased the proportion of using surgical aids in childbirth (by 2.7 times) and the risk of obstetric injuries to the mother (by up to 63.4%), including uterine cervix ruptures by up to 11.3%. Conclusions. Premature rupture of membranes at full-term gestation increases the risk of uterine cervix ruptures in childbirth by 10.3 times. In this obstetric context, the uterine cervix rupture risk factors should include the first birth (57.4%; p= 0.003) in the absence of biological readiness of the birth canal (“unripe” or “insufficiently ripe” uterine cervix, 76.2%), development of ineffective uterine contractions (12.9%), and the use of surgical aids in delivery (vacuum-assisted deliveries and episiotomies, 32.7%). 

Keywords: term birth, premature rupture of membranes, uterine cervix rupture, risk factor. 

For reference: Khvorostukhina NF, Bakhmach VO, Trushina OV, at all. Premature rupture of fetal membranes in full-term pregnancy as a risk factor for cervical rupture in childbirth. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (1): 63-70. DOI: 10.20969/VSKM.2024.17(1).63-70.

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УДК: 616.24-002-022.6-053.9-037:616.153.96 DOI: 10.20969/VSKM.2024.17(1).71-77

 PROGNOSTIC SIGNIFICANCE OF STUDYING THE LEVELS OF APOPTOSIS MARKERS, PROTEINS P53 AND BCL-2, IN ELDERLY PATIENTS WITH SARS-COV-2-CAUSED VIRAL PNEUMONIA 

KHUTAEVA KARINA A., ORCID ID 0009-0008-7886-514X; Post-graduate student at the Department of Hospital Therapy, Astrakhan State Medical University, 121 Bakinskaya str., 414000 Astrakhan, Russia. E-mail: khutaeva_karina@mail.ru 

DEMIDOV ALEXEY A., ORCID ID 0000-0001-7179-5101, Dr. sc. med., Professor, Head of the Department of Hospital Therapy, Astrakhan State Medical University, 121 Bakinskaya str., 414000 Astrakhan, Russia. E-mail: demidovfamily@rambler.ru 

Abstract. Introduction. Тo date, the prognostic value has been proven for some laboratory biomarkers and biomarker panels for risk stratification in patients with viral pneumonia caused by SARS-CoV-2. In studies related to the research in the leading pathogenetic mechanisms of COVID-19, much attention is paid to apoptosis and its markers, such as proteins P53 and BCL-2. Aim: To study the levels of P53 and Bcl-2 proteins and their prognostic significance in lethal outcomes among elderly patients with viral pneumonia caused by SARS-CoV-2, hospitalized in an infectious hospital. Materials and Methods. For the period December 2021 – February 2022, in accordance with the inclusion criteria, a sample of 67 patients was formed from elderly patients (60-74 years old) hospitalized in the hospital of infectious diseases. During the follow-up, 18 patients (26.9 %) had fatal outcomes and 49 patients (73.1 %) had favorable outcomes. Biochemical markers of apoptosis, P53 and BCL-2, were detected using the enzyme immunoassay method. Results and Discussion. The analysis showed the presence of statistically significant differences when comparing the levels of both proteins, P53 (p=0.001) and BCL-2 (p=0.002) in patients with favorable outcomes, compared to those with fatal outcomes. Threshold values of the P53 and BCL-2 proteins at the cut-off point in case of death of elderly patients with viral pneumonia caused by SARS-CoV-2 were 99.3 pg/ml and 78.9 IU/ml, respectively. The classification tree includes the following lethality predictors: Threshold levels of apoptosis markers, the number of comorbid diseases, and the respiratory failure degree. Five terminal nodes were identified. Terminal nodes 6 and 8 were classified as high risk of death. Lethal outcomes were observed in 75.0 % of patients at these nodes. At terminal node 3, fatal outcome was observed in 8.1 % of patients, while there were no fatal outcomes at terminal node 7; therefore, both were classified as low-risk ones in terms of a fatal outcome. The sensitivity of the resulting model was 66.7 %, while its specificity was 91.8%. The total share of correct predictions made 85.1% among the subjects of this sample (p=0.044). Conclusions. The data obtained indicate the prognostic significance of studying the apoptosis markers, i. e., proteins P53 and BCL-2, in elderly patients with viral pneumonia caused by SARS-CoV-2. The classification tree proposed can be used as an auxiliary algorithm to optimize the personalized stratification of the lethality risk in elderly patients with viral pneumonia caused by SARS-CoV-2. 

Keywords: apoptosis, SARS-COV-2, viral pneumonia, lethality outcome, prognosis. 

For reference: Khutaeva KA, Demidov AA. Prognostic significance of studying the levels of apoptosis markers, proteins P53 and BCL-2, in elderly patients with SARS-CoV-2-caused viral pneumonia. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (1): 71-77. DOI: 10.20969/VSKM.2024.17(1).71-77.

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УДК 616.127-005.8 DOI: 10.20969/VSKM.2024.17(1).78-86 

 INTERACTION BETWEEN INFLAMMATION MARKERS AND ANXIETY-DEPRESSIVE DISORDERS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION 

SHAYAKHMETOVA ELVIRA SH., ORCID ID: 0000-0001-592-7460; Dr. sc. med., Associate Professor, Head of the Department of Developmental and Social Psychology, Bashkir State Pedagogical University named after M. Akmulla, 3a October Revolution str., 450008 Ufa, Republic of Bashkortostan, Russia. Tel.: +7(347)287-99-91. E-mail: office@bspu.ru 

MUTALOVA ELVIRA G., ORCID ID: 0000-0002-7454-9819; Dr. sc. med., Professor, Head of the Department of Advanced Internal Medicine No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: emutalova@mail.ru 

GALYAUTDINOVA VELENA R., ORCID ID: 0000-0001-9715-6930; Assistant Professor at the Department of Advanced Internal Medicine No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: velena.galyautdinova1704@gmail.com 

FRID SVETLANA A., ORCID ID: 000-0003-0131-4266; Cand. sc. med., Associate Professor at the Department of Advanced Internal Medicine No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: valex69@mail.ru 

MINGAZETDINOVA LIRA N., ORCID ID: 0000-0002-0412-089X; Dr. sc. med., Professor at the Department of Advanced Internal Medicine No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: minln35@mail.ru 

KAMALTDINOVA GULNARA J., ORCID ID: 0000-0002-1193-7240; Cand. sc. med., Associate Professor at the Department of Advanced Internal Medicine No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: kgj69@mail.ru 

ASADULLINA GULNARA V., ORCID ID: 0000-0003-2736-0041; Cand. sc. med., Associate Professor at the Department of Advanced Internal Medicine No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: asgulnara@rambler.ru 

RUSTYAMOVA ZULFIYA YA., ORCID ID: 0000-0002-8353-0140; Cand. sc. med., Associate Professor at the Department of Advanced Internal Medicine No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: rzulfiya@yandex.ru 

NIGMATULLINA ALBINA E., ORCID ID: 0000-0002-3511-8477; Cand. sc. med., Associate Professor at the Department of Advanced Internal Medicine No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel. +7-347-272-41-73. E-mail: albanigma@mail.ru 

SAMIGULLINA LIANA I., ORCID ID: 0000-0003-1876-7325; Cand. sc. med., Associate Professor at the Department of Advanced Internal Medicine No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: liana_sam@inbox.ru 

SADIKOVA REGINA I., ORCID ID: 0000-0002-6653-9194; Cand. sc. med., Assistant Professor at the Department of Advanced Internal Medicine No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. E-mail: regina281210@yandex.ru 

MUSINA FLARISA S., ORCID ID: 0000-0002-0898-7052; Cand. sc. med., Associate Professor at the Department of Advanced Internal Medicine No. 1, Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia. Tel.: +7-347-272-41-73. Е-mail: musinaflarisa@mail.ru 

Abstract. Introduction. In recent years, the influence of anxiety and depressive disorders on the course of cardiovascular diseases has been increasingly discussed. The main psychosocial risk factors for the development of acute myocardial infarction include depression and anxiety (various anxiety syndromes and disorders). Currently, inflammation is considered as one of the leading links in myocardial infarction pathogenesis, course, and prognosis. Recent studies have linked the development of anxiety and depressive disorders with changes in the proinflammatory cytokine levels. Severity of immunoinflammatory reactions in patients with unstable forms of coronary heart disease is greater than in patients with a stable course of the disease. The aim of our investigation was to study the proinflammatory cytokine levels in patients with myocardial infarction depending on the presence of anxiety and depressive disorders. Materials and Methods. The study included 160 patients, averagely aged 56.2±1.4 years, who were admitted to the hospital with the ST-segment elevation myocardial infarction. The diagnosis of the said disease was set according to the generally accepted diagnostic criteria. In addition to the traditional clinical and instrumental studies, the patients of the groups under study underwent an assessment of the concentrations of inflammatory biomarkers in plasma and psychological tests using anxiety and depression rating scales, such as Zung Depression Scale and Spielberger-Khanin Anxiety Scale. Results and Discussion. Signs of depression were identified in 82 (51.25%) patients with acute myocardial infarction. Symptoms of mild depression were identified in 44 (53.7%) patients, moderate depression in 30 (36.6%) patients, and severe depression in 8 (9.7%) patients. It has been proven that the average depression score increases with the increase in the disease severity. The average score was 49.72+1.68 for personal anxiety in the group and 41.9±1.6 for reactive anxiety. As the class of infarction severity increased, a significant increase in anxiety levels was observed. An increase in the serum concentrations of CRP, IL-1β, IL-6, IL-8, and TNF-α was detected during the development of myocardial infarction, which was statistically significantly associated with the presence of anxiety-depressive disorders and some indicators of myocardial contractile function. Conclusions. Subclinical inflammation is one of the mechanisms of the negative impact of anxiety and depressive disorders on the prognosis for this category of patients. The presence of anxiety and depression symptoms is associated with higher levels of pro-inflammatory markers, i. e., CRP, IL-1β, IL-6, IL-8, and TNF-a. The degree of activation of proinflammatory markers depends on the severity of the myocardial damage signs and on the nature of complications. 

Keywords: myocardial infarction, depression, anxiety, inflammation. 

For reference: Shayakhmetova ESh, Mutalova EG, Galyautdinova VR, et al. Interaction between inflammation markers and anxiety-depressive disorders in patients with acute myocardial infarction. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (1): 78-86. DOI: 10.20969/VSKM.2024.17(1).78-86.

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УДК: 616.153.96:616.98+616.12–008.331.1 DOI: 10.20969/VSKM.2024.17(1).87-93 

 DECISION TREE DETERMINING THE PROBABILITY OF INCREASED CARDIOVASCULAR RISK IN PATIENTS WITH ARTERIAL HYPERTENSION AFTER VIRAL PNEUMONIA CAUSED BY SARS–COV–2 

PROKOFYEVA TATIANA V., ORCID ID: 0000–0002–3260–2677; Cand. sc. med., Associate Professor at the Department of Internal Medicine, Faculty of Pediatrics, Astrakhan State Medical University, 121 Bakinskaya str., 414000 Astrakhan, Russia. E-mail: prokofeva–73@inbox.ru 

SHUVALOVA ANNA S., ORCID ID: 0009–0003–1912–7300; Post–Graduate Student at the Department of Internal Medicine, Faculty of Pediatrics, Astrakhan State Medical University, 121 Bakinskaya str., 414000 Astrakhan, Russia. E-mail: pyatakova-anya@mail.ru

POLUNINA OLGA S., ORCID ID: 0000–0001–8299–6582, Dr. sc. med., Professor, Head of Department of Internal Medicine, Faculty of Pediatrics, Astrakhan State Medical University, 121 Bakinskaya str., 414000 Astrakhan, Russia. E-mail: admed@yandex.ru 

POLUNINA EKATERINA A., ORCID: 0000–0002–3679–432X, Dr. sc. med., Associate Professor at the Department of Internal Medicine, Faculty of Pediatrics, Astrakhan State Medical University, 121 Bakinskaya str., 414000 Astrakhan, Russia. E-mail: gilti2@yandex.ru 

Abstract. Introduction. Recent research results demonstrate the association of arterial hypertension with the risk of infection with SARS–CoV–2, as well as with high mortality in COVID–19. An actively debated problem is the search and study of a causal relationship between a more severe COVID–19 course and the background arterial hypertension in these patients. Aim. To predict the probability of an increase in cardiovascular risk in patients with arterial hypertension within 6 months after viral pneumonia caused by SARS–COV–2, who were treated in an infectious hospital, based on constructing a decision tree using the CHAID method. Materials and Methods. A sample was formed from persons hospitalized in 2021 in an infectious hospital deployed based on the regional clinical hospital, diagnosed with “COVID–19, virus identified” (n=45). The duration of inpatient treatment was 14 [10–16] days. Among the patients included in the study, there were 22 (48,9%) women and 23 (51,1%) men. Enzyme immunoassay was used to detect the level of endothelin–1 and the N–terminal precursor of natriuretic peptide C–type in blood serum samples. Statistical analysis was carried out using the IBM SPSS Statistics 26.0 program (USA). The decision tree was constructed using the CHAID method. Results and Discussion. According to the analysis results, a statistically significant decrease in the levels of both endothelin–1 and N–terminal precursor of natriuretic peptide C–type had been detected by the time of the patients’ discharge from the hospital, as compared with their levels at admission (p<0,001). The following predictors were selected for the model: Changes in the endothelin–1 levels during inpatient treatment (a decrease in the endothelin–1 level exceeding 10% was considered as positive change, while an increase in the endothelin–1 level, a retention at the same level and a decrease of less than 10% were considered as minor variation) and the level of N–terminal precursor of natriuretic peptide C–type at discharge (>17,6 pg/ml and ≤17,6 pg/ml). In the resulting decision tree, 3 terminal nodes were observed. The sensitivity of the resulting model was 86.7%, while its specificity was 86,7%. The total share of correct forecasts was 86,7%. Conclusions. Determination of the levels of endothelin–1 and N–terminal precursor of natriuretic peptide C–type in the blood serum makes it possible to adequately assess and personally predict the likelihood of an increase in cardiovascular risk in patients with arterial hypertension within 6 months after viral pneumonia caused by SARS–COV–2. 

Keywords: SARS–COV–2, endothelial dysfunction, N–terminal precursor of the C–type natriuretic peptide, endothelin-1. 

For reference: Prokofyeva TV, Shuvalova AS, Polunina OS, Polunina EA. Decision tree determining the probability of increased cardiovascular risk in patients with arterial hypertension after viral pneumonia caused by SARS–COV–2. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (1): 87-93. DOI: 10.20969/VSKM.2024.17(1).87-93. 

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УДК: 616.153.96:616.98+616.12-008.331.1 DOI: 10.20969/VSKM.2024.17(1).94-100

 PROGNOSTIC MODEL OF THE PROBABILITY OF AN INCREASE IN THE STAGE OF ARTERIAL HYPERTENSION AFTER VIRAL PNEUMONIA CAUSED BY SARS–COV–2 

SHUVALOVA ANNA S., ORCID ID: 0009-0003-1912-7300; Post-Graduate Student at the Department of Internal Medicine, Faculty of Pediatrics, Astrakhan State Medical University, 121 Bakinskaya str., 414000 Astrakhan, Russia. E-mail: pyatakova-anya@mail.ru 

PROKOFYEVA TATIANA V., ORCID ID: 0000-0002-3260-2677; Cand. sc. med., Associate Professor at the Department of Internal Medicine, Faculty of Pediatrics, Astrakhan State Medical University, 121 Bakinskaya str., 414000 Astrakhan, Russia. E-mail: prokofeva-73@inbox.ru 

POLUNINA OLGA S., ORCID ID: 0000-0001-8299-6582, Dr. sc. med., Professor, Head of Department of Internal Medicine, Faculty of Pediatrics, Astrakhan State Medical University, 121 Bakinskaya str., 414000 Astrakhan, Russia. E-mail: admed@yandex.ru

POLUNINA EKATERINA A., ORCID ID: 0000-0002-3679-432X, Dr. sc. med., Associate Professor at the Department of Internal Medicine, Faculty of Pediatrics, Astrakhan State Medical University, 121 Bakinskaya str., 414000 Astrakhan, Russia. E-mail: gilti2@yandex.ru 

Abstract. Introduction. An alarming aspect and area of study are represented by the COVID-19 consequences. Arterial hypertension is one of the most frequently reported comorbid pathologies in patients with severe-course COVID-19 requiring the patient’s hospitalization. Given the similarity of some pathogenetic mechanisms underlying arterial hypertension and COVID-19, there is no doubt about their interinfluence. One of the common pathogenetic links of arterial hypertension and COVID-19 is endothelial dysfunction. Objective: To develop a prognostic model of the probability of an increase in the stage of arterial hypertension in 6 months after viral pneumonia caused by SARS-COV-2. Material and Methods: The study included 45 patients with a confirmed diagnosis of COVID-19 (virus identified) with arterial hypertension. This group of patients was dynamically monitored for 6 months after discharge from the hospital. The duration of inpatient treatment was 14 [10-16] bed days. The level of biomarkers of endothelial dysfunction - endothelin-1 and the N-terminal precursor of natriuretic peptide C-type was determined in blood serum by enzyme immunoassay. The dynamics of the levels of these biomarkers during the hospital stay is regarded as positive with a decrease in the level of more than 10% and as insufficient – with an increase, unchanged values or a decrease to 10% inclusive. Results and discussion. The final prognostic model included: the level of the N-terminal precursor of natriuretic peptide C-type upon admission to the hospital and the dynamics of its level in the hospital. The model was statistically significant (p=0,028). Based on the values of regression coefficients, the level of the N-terminal precursor of natriuretic peptide C-type has a direct relationship with the probability of an increase in the stage of arterial hypertension after 6 months in patients with arterial hypertension after viral pneumonia caused by SARS-COV-2. An increase in the level of the N-terminal precursor of natriuretic peptide C-type by 1 pg/ml upon admission increases the risk of an increase in the stage of arterial hypertension by 1,3 times. The absence of positive dynamics of the level of the N-terminal precursor of natriuretic peptide C-type during inpatient treatment increases the likelihood of an increase in the stage of arterial hypertension by 19,6 times. The diagnostic sensitivity of the developed prognostic model was 86,7%, diagnostic specificity – 80,0%, diagnostic efficiency – 84,4%. Conclusions: The prognostic model developed by us, including as a predictor the level of the N-terminal precursor of natriuretic peptide C-type at admission and its dynamics in the hospital, can be used to individually predict an increase in the stage of arterial hypertension within 6 months after viral pneumonia caused by SARS-COV-2. 

Key words: COVID-19, endothelial dysfunction, N-terminal precursor of the C-type natriuretic peptide, endothelin-1 

For reference: Shuvalova AS, Prokofyeva TV, Polunina OS, Polunina EA. Prognostic model of the probability of an increase in the stage of arterial hypertension after viral pneumonia caused by SARS-COV-2. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (1): 94-100. DOI: 10.20969/VSKM.2024.17(1).94-100. 

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REVIEWS 

УДК: 616.216-006.52.02 DOI: 10.20969/VSKM.2024.17(1).101-106  

 ETIOLOGY OF SINONASAL INVERTED PAPILLOMA: A MODERN VIEW ON THE PROBLEM 

BOIKO NATALIA V., ORCID ID: 0000-0002-1316-5061, Scopus Author ID: 16681053200, Researcher ID: I-9086-2017; Dr. sc. med., Professor at the Department of Otorhinolaryngology, Rostov State Medical University, 29 Nakhichevansky per., 344022 Rostov-on-Don, Russia. E-mail: nvboiko@gmail.com; tel.: +79034334113 

STAGNIEVA IRINA V., ORCID ID: 0000-0002-2894-2062, Scopus Author ID: 37008481700; Dr. sc. med., Associate Professor, Head of Department of Otorhinolaryngology, Rostov State Medical University, 344022, Russia, Rostov-on-Don, Nakchichevanskiy, 29. E-mail: irinastagnieva@yandex.ru 

KISELEV VLADIMIR V., ORCID ID: 0000-0001-6008-4283; Scopus Author ID: 37008437500; Cand. sc. Med., assistant professor of Department of Otorhinolaryngology, Rostov State Medical University, 29 Nakhichevansky per., 344022 Rostov-on-Don, Russia. E-mail: vladkis2003@yandex.ru. 

GUKASYAN ELENA L., ORCID ID: 0000-0001-7401-0680, Scopus Author ID: 57384421800, Cand. sc. med., assistant professor of Department of Otorhinolaryngology, Rostov State Medical University, 344022, Russia, Rostov-on-Don, Nakchichevanskiy, 29. E-mail: elena.guckasyan@yandex.ru 

STATESHNAYA PAULA A., ORCID ID: 0000-0002-7035-4344, Scopus Author ID: 57384660800, Postgraduate Student, Department of Otorhinolaryngology, Rostov State Medical University, 29 Nakhichevansky per., 344022 Rostov-on-Don, Russia. E-mail: lula14@rambler.ru 

LEBEDENKO MARIA K., ORCID ID: 0009-0006-2281-5851, Student, Rostov State Medical University, 29 Nakhichevansky per., 344022 Rostov-on-Don, Russia. E-mail: marialebedenko1102@gmail.com 

Abstract. Introduction. Inverted papilloma is the most common type of sinonasal papilloma. It refers to benign tumors, but its clinical course is often associated with post-surgical recurrences and malignancy. Although the morphological characteristics and clinical features of inverted papilloma are well known, its etiology and risk factors remain a matter of debate. Aim. The aim of the study was to analyze the contemporary literature and summarize the data available regarding the significance of viral infection, cell cycle regulator proteins, angiogenesis, chronic inflammation, environmental influences, and other factors for the risk of inverted papilloma. Materials and Methods. A search was made in databases, such as SCOPUS, PubMed, Google Scholar, and RSCI, using the following keywords: Sinonasal papilloma, inverted nasal papilloma, Schneiderian papilloma. Results and Discussion. Human papillomavirus is considered the main growth trigger of inverted papilloma. Potential role of human papillomavirus in initiating the tumor growth is related to the presence in its genome of genes encoding the E6 and E7 proteins. Certain cell cycle regulatory factors and angiogenic proteins contribute to the dysregulation of proliferation and apoptosis and facilitate cell migration and tumor invasion. However, despite the frequent detection of human papillomavirus DNA and associated transcription factors in inverted papilloma tissues, significance of the papillomavirus infection in the occurrence of inverted papilloma or its transformation into malignant forms has not been proven reliably yet. It should be noted that human papillomavirus stimulates not only apoptosis inhibition and the uncontrolled division of epithelial cells, but also angiogenesis, which is also a tumor growth trigger. Among other pathogenic factors, we also discussed the importance of chronic inflammation, smoking, occupational hazards, and industrial environmental pollution. Conclusions. Though etiology of sinonasal inverted papilloma remains controversial, the studies reviewed here indicate the importance of viral infection, cell cycle and angiogenic factors, environmental and occupational exposure, and chronic inflammation. Further studies on etiologic factors are required to ensure better clinical guidance and therapeutic targets. 

Keywords: sinonasal papilloma, inverted nasal papilloma, Schneiderian papilloma, etiology. 

For reference: Boiko NV, Stagnieva IV, Kiselev VV, et al. Etiology of sinonasal inverted papilloma: A modern view on the problem. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (1): 101-106. DOI: 10.20969/VSKM.2024.17(1).101−106. 

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УДК: 616.24 DOI: 10.20969/VSKM.2024.17(1).107-118 

 POST-TUBERCULOSIS OBSTRUCTIVE PULMONARY DISEASE (review of foreign literature)

TLAIS HADI, ORCID ID: 0009-0008-1034-3724; Postgraduate Student of the Department of Pulmonology, Pirogov Russian National Research Medical University, 1 Ostrovityanov str., 117997 Moscow, Russia. Tel.: +7 495 965 45 20. E-mail: tlais88@mail.ru 

ANAEV ELDAR Kh., ORCID ID: 0000-0003-3672-9242, Scopus Author ID: 6507305976, Researcher ID: A-1304-2016, RSCI Author ID: 3542-3412, Dr. sc. med., Professor at the Department of Pulmonology, Pirogov Russian National Research Medical University, 1 Ostrovityanov str., 117997 Moscow, Russia. Tel.: +7 495 965 45 20. E-mail: el_anaev@hotmail.com 

Abstract. Introduction. Post-tuberculous obstructive pulmonary disease has been considered as a chronic disease for the last decade. Despite successful clinical cure of tuberculosis, up to 50% of patients have post-tuberculous obstructive pulmonary disease, defined as the “signs of chronic respiratory distress, with or without symptoms, at least partially attributable to prior pulmonary tuberculosis”. Aim. To consider the epidemiological and pathophysiological relationships between chronic airway obstruction in COPD and tuberculosis and to highlight the diagnostic and therapeutic approaches to managing patients with post-tuberculous obstructive pulmonary disease. Materials and Methods. We searched available information databases up to June 2023 using key terms, i.e. COPD, tuberculosis associated with COPD, post-tuberculous obstructive pulmonary disease. Results and Discussion. Post-tuberculous obstructive pulmonary disease is one of the many TB complications that significantly affects the economic, social, and psychological well-being of individuals, families, and communities. Post-tuberculous obstructive pulmonary disease includes a group of heterogeneous conditions affecting the large and small airways, such as bronchiectasis or obstructive airways; lung parenchyma, pleura, and/or pulmonary vasculature, and may present with symptoms partly associated with past pulmonary tuberculosis. Post-tuberculous obstructive pulmonary disease results from a complex interaction between human immune reactivity, pathogens, and environmental factors that affects long-term respiratory health. Major risk factors for post-tuberculous obstructive pulmonary disease include smoking, low socioeconomic status, vitamin D deficiency, and diabetes mellitus. People with post-tuberculous obstructive pulmonary disease have a reduced life expectancy and an increased risk of TB recurrence. Conclusions. Currently, due to the lack of controlled clinical trials, there are no generally accepted recommendations for the diagnosis and treatment of post-tuberculous obstructive pulmonary disease. The management of patients with post-tuberculous obstructive pulmonary disease mainly includes adjuvant therapy used in other chronic obstructive pulmonary diseases and in pulmonary rehabilitation. Early diagnosis and timely treatment are essential to limit lung damage. 

Keywords: chronic obstructive pulmonary disease, tuberculosis, post-tuberculous obstructive pulmonary disease, risk factors, diagnosis, treatment. 

For reference: Tlais H, Anaev EKh. Post-tuberculous obstructive pulmonary disease (review of foreign literature). The Bulletin of Contemporary Clinical Medicine. 2024; 17(1): 107-118. DOI: 10.20969/VSKM.2024.17(1).107-118.

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УДК 616.71 DOI: 10.20969/VSKM.2024/17(1).119-126 

 BIORESORBABLE COMPOSITES FOR OSTEOSYNTHESIS: A REVIEW OF MODERN RESEARCH 

KHISAMIEVA DILYARA R., ORCID ID: 0009-0003-5082-6468, Postgraduate Student, Department of Medical Engineering, Kazan National Research Technological University (KNRTU), 68 K. Marx str., 420015 Kazan, Russia; phone: +79172326089. E-mail: osenzima1811@gmail.com 

SHARAFIEV ILSUR A., ORCID ID: 0009-0008-5134-0597, Postgraduate Student, Department of Chemistry and Technology of Elastomer Processing, Kazan National Research Technological University (KNRTU), 68 K. Marx str., 420015 Kazan, Russia; phone: +79083397905. E-mail: ilsur.sharafiev@mail.ru 

AGATIEVA ELIMA A., ORCID ID: 0000-0002-2503-7622, Assistant Professor at the Department of Oral and Maxillofacial Surgery and Surgical Dentistry, Kazan State Medical University (KSMU); Maxillofacial Surgeon at City Clinical Hospital, 49 Butlerov str., 420012 Kazan, Russia; phone: +79061100865. E-mail: elly87@mail.ru

NIKIFOROV ANTON A., ORCID ID: 0000-0001-5783-0521, Cand. sc. Eng., Associate Professor at the Department of Chemistry and Technology of Elastomer Processing, Kazan National Research Technological University (KNRTU), 68 K. Marx str., 420015 Kazan, Russia; phone: +70172957466. E-mail: antonnikifor@gmail.com 

GALIMZYANOVA REZEDA Y., ORCID ID: 0000-0001-7059-1481, PhD in Engineering, Associate Professor at the Department of Medical Engineering, Kazan National Research Technological University (KNRTU), 68 K. Marx str., 420015 Kazan, Russia; phone: +79178912563. E-mail: galimzyanovar@gmail.com 

KSEMBAYEV SAID S., ORCID ID: 0000-0002-5712-9601, Dr. sc. med., Professor at the Department of Oral and Maxillofacial Surgery and Surgical Dentistry, Kazan State Medical University (KSMU); Maxillofacial Surgeon at City Clinical Hospital, 49 Butlerov str., 420012 Kazan, Russia; phone: +79050206886. E-mail: ksesa@mail.ru 

KHAKIMULIN YURI N., ORCID ID: 0000-0002-6919-7601, Dr. sc. Eng., Professor at the Department of Chemistry and Technology of Elastomer Processing, Federal State Budgetary Educational Institution of Higher Education “KNRTU”, 420015, Russia, Kazan, st. K.Marksa, 68, tel.: +79179192911. E-mail: hakim123@rambler.ru 

WOLFSON SVETOSLAV I., ORCID ID: 0000-0002-1465-4633, Dr. sc. Eng., Professor, Head of the Department of Chemistry and Technology of Elastomer Processing, Kazan National Research Technological University (KNRTU), 68 K. Marx str., 420015 Kazan, Russia; tel.: +79178912563. E-mail: svolfson@kstu.ru 

Abstract: At present, there is a trend towards an increase in fractures of facial bones. Fractures of the lower jaw are in the first place within the structure of maxillofacial traumatology. Numerous foreign studies consider the possibility of using bioresorbable plates and screws in the treatment of facial fractures. This technique has some undeniable advantages. When using bioresorbable plates, there is no need for a second surgery aimed at the preplanned metal structure removal, which significantly reduces costs and provides good effects on the optimization of domestic medicine. The aim of the study was to analyze the contemporary scientific literature dealing with the development and research of composites for osteosynthesis. Materials and Methods. More than 50 sources of contemporary publications over the past 20 years were analyzed based on the scientometric databases, such as Scopus, Web of Science, RSCI, and Google Scholar. We searched by the following keywords: bioresorbable polymers, implants, polylactic acid, composite materials, osteosynthesis, thermoplastic starch. Results and Discussion. It is noted that in recent years, composite polymers are being studied intensely, which contain the additives of thermoplastic starch for use in bone engineering. Such interest is due to the hydrophilic nature of starch since cells attach and proliferate more efficiently on hydrophilic surfaces. Conclusions. Despite the variety of developments currently underway, both in Russia and abroad, the search continues for a material that would meet all the physical, mechanical, physicochemical, and physiological requirements for recovering bone defects. The issues of the correct choice of bioresorbable material depending on the location, size and shape of the defect, as well as the issues of obtaining a single biomechanical system bone-implant, are still unresolved and require further research. 

Keywords: bioresorbable polymers, implants, polylactic acid, composites, osteosynthesis, thermoplastic starch 

For reference: Khisamieva DR, Sharafiev IA, Agatieva EA at al. Bioresorbable composites for osteosynthesis: A review of modern research. The Bulletin of the Modern Clinical Medicine. 2024; 17(1): 119-126. DOI: 10.20969/VSKM.2024/17(1).119-126.

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EXPERIMENTAL STUDIES – TO PRACTICAL MEDICINE 

УДК: 616.282-018-00.8 DOI: 10.20969/VSKM.2024.17(1).127-132 

 MORPHOLOGICAL CHANGES IN THE STRIA VASCULARIS IN EXPERIMENTAL ENDOLYMPHATIC HYDROPS 

KISELEV VLADIMIR V., ORCID ID: 0000-0001-6008-4283; Scopus Author ID: 37008437500; Cand. sc. med., Associate professor of Department of Otorhinolaryngology of Rostov State Medical University, 344022, Russia, Rostov-on-Don, Nakchichevanskiy, 29. Е-mail: vladkis2003@yandex.ru 

BOIKO NATALIA V., ORCID ID: 0000-0002-1316-5061, Scopus Author ID: 16681053200, Researcher ID: I-9086-2017; Dr. sc. med., professor of Department of Otorhinolaryngology of Rostov State Medical University, 344022, Russia, Rostov-on-Don, Nakchichevanskiy, 29. Е-mail: nvboiko@gmail.com. +79034334113 

STAGNIEVA IRINA V., ORCID ID: 0000-0002-2894-2062, Scopus Author ID: 37008481700; Dr. sc. med., Associate professor, head of Department of Otorhinolaryngology of Rostov State Medical University, 344022, Russia, Rostov-on-Don, Nakchichevanskiy, 29. Е-mail: irinastagnieva@yandex.ru 

ALEKSEEV VLADIMIR V., ORCID ID: 0000-0002-8055-2184; Scopus Author ID: 56677329900; Dr. sc. med., head of Department of histology, cytology and embryology of Rostov State Medical University, 344022, Russia, Rostov-on-Don, Nakchichevanskiy, 29. 

GUKASYAN ELENA L., ORCID ID: 0000-0001-7401-0680, Scopus Author ID: 57384421800, Cand. sc. med., assistant professor of Department of Otorhinolaryngology of Rostov State Medical University, 344022, Russia, Rostov-on-Don, Nakchichevanskiy, 29. Е-mail: elena.guckasyan@yandex.ru 

LEBEDENKO MARIA K., ORCID ID: 0009-0006-2281-5851, student of Rostov State Medical University, 344022, Russia, Rostov-on-Don, Nakchichevanskiy, 29. Е-mail: marialebedenko1102@gmail.com 

Abstract. Introduction. Etiopathogenesis of Ménière’s disease is still poorly understood, although the morphological substrate of this disease is known well: It is endolymphatic hydrops. Animal modeling of endolymphatic hydrops has traditionally been used to study the relationship between hydrops and changes in the inner ear. In recent years, the attention of researchers has been attracted by microcirculatory disorders in the stria vascularis during experimental endolymphatic hydrops, since the stria vascularis is essential to maintaining endolymph homeostasis, transporting ions, generating endocochlear potential, and supporting the function of the organ of Corti. Aim. This study was aimed at examining alterations in the stria vascularis in experimental endolymphatic hydrops. Materials and Methods. Endolymphatic hydrops was modeled in 90 rats by irrigating the lateral surface of the neck in the projection of the vertebral artery with chloroethyl to simulate vasomotor disorders. Animals were killed at different periods after exposure (1-8 days). In the 1st series of experiments (40 animals), we studied the dynamics of pathomorphological changes in the cochlea, while in the 2nd series (40 animals), we studied changes in the stria vascularis after intravital isolation of the cochlea. Results and Discussion. Local cooling of the lateral surface of the neck of rats led to forming the labyrinth hydrops on the affected side with the key morphological features: Edema of cellular elements, deformation of membranes (vestibular and tectorial), and vascular disorders (hyperemia of the vascular stria, venous congestion). Hydropic changes reached their maximum on the 4th day after exposure. In the capillaries of the stria vascularis, we observed an expansion of their diameters, sludge syndrome, and the edema of paravascular tissues. Microcirculatory changes correlated with the severity of EG signs, reaching their maximum on the 4th day after exposure with subsequent regression. Conclusions. Synchronous development of microcirculatory and hydropic changes in the inner ear indicates that the vascular factor is involved in forming the experimental endolymphatic hydrops. 

Keywords: Ménière’s disease, endolymphatic hydrops, animal model, stria vascularis, histological changes. 

For reference: Kiselev VV, Boiko NV, Stagnieva IV, at all. Morphological changes in the stria vascularis in experimental endolymphatic hydrops. The The Bulletin of Contemporary Clinical Medicine. 2024; 17(1): 127-132. DOI: 10.20969/VSKM.2024.17(1).127-132.

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MEDICIN’S HISTORY 

УДК 616-074 DOI: 10.20969/VSKM.2024.17(1).133-138 

 IN THE MEMORIAL YEAR OF STANISLAV I. ZALESKY, ORDINARY PROFESSOR, MEDICAL SCIENTIST, AND RUSSIAN STATESMAN 

PEREDERINA IRINA A., ORCID ID: 0000-0002-5882-7946; Scopus ID: 6508085700; Cand. sc. chem., Associate Professor, Department of Chemistry, Siberian State Medical University, 2 Moskovsky Trakt, 634050 Tomsk, Russia. E-mail: perederina.irina@yandex.ru 

BAKUSHINA SOFIA A., ORCID ID: 0009-0007-5416-5635; Student, Siberian State Medical University, 2 Moskovsky Trakt, 634050 Tomsk, Russia. E-mail: bakushina_sofiya@mail.ru 

TVERYAKOVA ELENA N., ORCID ID: 0000-0001-9268-0629; Scopus ID: 10045494100; Cand. sc. chem., Associate Professor at the Department of Chemistry, Siberian State Medical University, 2 Moskovsky Trakt, 634050 Tomsk, Russia. E-mail: e.tveryakova@mail.ru

 MIROSHNICHENKO YULIA YU., ORCID ID: 0000-0003-4208-0304; Scopus ID: 6507111324; Cand. sc. chem., Associate Professor, Department of Chemistry, Siberian State Medical University, 2 Moskovsky Trakt, 634050 Tomsk, Russia; Associate Professor, Department of Chemical Engineering, School of Natural Resources Engineering, Tomsk Polytechnic University, 30 Lenin Ave., 634050 Tomsk, Russia. E-mail: myy42@yandex.ru 

ZYKOVA MARIA V., ORCID ID: 0000-0002-1973-8983; Scopus ID: 56091887800; Dr. sc. pharm., Professor, Senior Researcher at the Central Research Laboratory and Head of the Department of Chemistry, Siberian State Medical University, 2 Moskovsky Trakt, 634050 Tomsk, Russia. E-mail: huminolog@mail.ru 

Abstract. Introduction. In the year of the 165th anniversary of Ordinary Professor Stanislav I. Zalesky, collecting and structuring the materials about his scientific discoveries and his public and social reforms allow us to thankfully and highly appreciate his contribution to the development of Siberia and the Russian state as whole. Aim of the study is to estimate S. I. Zalesky’s importance for the progress of the medicine, chemistry, balneology, hydrology, and public life of the state and for the development of new approaches in teaching chemistry. Materials and Methods. In preparing this paper, we used the theoretical text analysis of lectures, speeches, dissertations, historical articles, and publications in the album of biographies. We present the analysis of the professor’s activities within the period of 1850-1890s. Results and Discussion. Working with Professor S. I. Zalesky’s research materials allows us to evaluate his contribution to various areas of science. Having got medical background and achieved considerable successes in studying anatomy, he worked his scientific way from a physician through a chemical scientist and made a great progress in this area. His interdisciplinary activities allowed Zalesky to be first to isolate ferritin, to discover the linkage between the spread of cholera and the water supply to populated areas, and to make much more important conclusions. Организовывал научные экспедиции совместно со студентами, в ходе которых был проведен химико-геологический и климатический анализ местных озер. Being a scientist eternally committed to his native Polish land, he established the fundamentals of studying and teaching chemistry in Siberia, having proposed the principle of profiling. He defined the importance of physiological, pathological, pharmaceutical, and geological chemistry. He studied micro- and macro-chemical reactions to iron in biological media, contributed to opening forensic institutions in Tomsk, initiated the studies of physiography of Siberia in terms of balneology, hydrology, and chemistry. Together with his students, he arranged research expeditions where they performed the chemical, geological, and climatic analyses of local lakes. Conclusions. Based on the theoretical analysis and structurization of materials available, we could evaluate the special contributions made by Professor S. I. Zalesky to the development of various areas of science. 

Keywords: history of medicine, ferritin, balneology, geochemical analysis. 

For reference: Perederina IA, Bakushina SA, Tveryakova EN, at al. In the memorial year of Stanislav I. Zalesky, ordinary professor, medical scientist, and Russian statesman. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (1): 133-138. DOI: 10.20969/VSKM.2024.17(1).133-138.

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