RISK FACTORS OF RESISTANCE IN JUVENILE MYOCLONIC EPILEPSY

GAMIROVA RIMMA G., ORCID ID: 0000-0002-8582-592X; Scopus Author ID 25422029100; Researcher ID N-6910-2013; RSCI Author ID 641154; PhD, Associate Professor, Head of the Department of Neurology with courses in Psychiatry, Clinical Psychology and Medical Genetics; Senior Researcher at the Neurocognitive Research Laboratory of Kazan Federal University, 18 Kremlyovskaya str., 420008 Kazan, Russia. E-mail: r-gamirov@mail.ru

SOKOLOVA ALINA A., ORCID ID: 0009-0005-3123-3039; 6th-year student majoring in General Medicine, Institute of Fundamental Medicine and Biology, Kazan Federal University, 18 Kremlyovskaya str., 420008 Kazan, Russia. E-mail: sokolovaalina2020@mail.ru

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 DYNAMICS OF AND TRENDS IN THE INCIDENCE IN PREGNANT, LABORING AND POSTPARTUM WOMEN IN THE REPUBLIC OF DAGESTAN

GATSAYNIEVA HADIZHAT A., ORCID ID: 0009-0003-4814-0491; Head of the Department of Gynecology, Republican Clinical Hospital No. 2, 31 Magomed Gadzhiev str., 367000 Makhachkala, Russia. Tel.: +7(960)421-68-60. E-mail: hadiga81@mail.ru

KONOVALOV OLEG E., ORCID ID: 0000-0003-1974-9882; Dr. sc. med., Professor at the Department of Public Health, Healthcare and Hygiene, Institute of Medicine, Patrice Lumumba Peoples’ Friendship University of Russia, 10 Miklouho-Maclay str., 117198 Moscow, Russia. Tel.: +7(910)508-10-45. E-mail: konovalov_oe@mail.ru

SHULAEV ALEXEY V., ORCID ID: 0000-0002-2073-2538; Dr. sc. med., Professor, Head of the Department of General Hygiene, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. Tel.: +7(987)213-67-12. E-mail: alexs_shu@mail.ru

Abstract. Introduction. In accordance with the concept of Russia’s demographic policy for the period until 2025, the priorities include reducing the level of reproductive losses, strengthening the reproductive health of the population, and finding reserves to increase birth rates. Aim of the study is to analyze the dynamics and trends in birth, and morbidity rates among pregnant women, women in labor, and postpartum, as well as maternal mortality in the Republic of Dagestan. Materials and Methods. Materials were taken from official statistical reports for the period 2013-2022. The above rates were compared for the Republic of Dagestan, the North Caucasus Federal District, and the Russian Federation as a whole. In analyzing time series, the main trends in rates changing were identified by modeling trends using the approximation method. Results and Discussion. In 2013-2022, the birth rates in the Republic of Dagestan were constantly higher than in the comparison territories. At the same time, among the constituent regions of the North Caucasian Federal District, the Republic of Dagestan ranked 3rd out of 7 in terms of birth rates in 2022. The structure of morbidity among pregnant women in the North Caucasian Federal District, the Russian Federation as a whole, and the Republic of Dagestan is very similar, and the most common are the threat of miscarriage and premature birth. The proportion of normal births in the Republic of Dagestan during the entire observation period was lower than in other territories, but unlike the latter, it had a statistically significant upward trend. At the same time, in the structure of morbidity among women in labor and postpartum, about a half was accounted for by pre-existing hypertension, approximately 1/3 was accounted for by moderate preeclampsia, and 1/10 was accounted for by severe preeclampsia. Maternal mortality in the Republic had significant year-over-year fluctuations and most often exceeded the relevant rates in the territories of comparison. Conclusions. Organizational and managerial decisions aimed at improving the medical and demographic situation in the Republic must be developed and implemented taking into account the current trends in the rates of birth and morbidity among pregnant women, women in labor and postpartum, as well as in the maternal mortality rates.

Keywords: pregnant women, women in labor and postpartum, morbidity, dynamics and trends, Republic of Dagestan.

For reference: Gatsaynieva HA, Konovalov OE, Shulaev AV. Dynamics of and trends in the incidence in pregnant, laboring and postpartum women in the Republic of Dagestan. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (3): 15-21. DOI: 10.20969/VSKM.2024.17(3).15-21.

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 PREVALENCE AND INCIDENCE OF MULTIPLE SCLEROSIS IN THE CITY OF BAKU (REPUBLIC OF AZERBAIJAN)

GULIYEVA AYGUN I., ORCID ID: 0000-0002-7235-4444; Assistant Professor at the Department of Neurology and Clinical Neurophysiology, Azerbaijan State Advanced Training Institute for Doctors named after A. Aliyev, Baku, Azerbaijan, AZ1012, Azerbaijan Republic, Baku, Muzaffar Hasanov str 35. Mob.: +994504092731. Е-mail: 15.2012@mail.ru

Abstract. Introduction. Multiple sclerosis is a common neurological disease that causes inflammation and degeneration in the central nervous system. Globally, there is a growing trend in the prevalence of multiple sclerosis, with various incidences ranging from stable to increasing. Aim. To determine the prevalence and incidence of multiple sclerosis in the city of Baku. Materials and Methods. The study was conducted based on the State program. A total of 535 patients were diagnosed with multiple sclerosis between 2013 and 2019. Of these, 70.1% were female and 29.9% were male. The data was processed by the Statistica for Windows 10 software package using absolute and relative indicators.Results and Discussion. The overall prevalence of multiple sclerosis was 23.3 cases per 100,000 population by 2019. At the same time, the indicator increased in both women and men (from 12.7 to 32.5 in women and from 7.6 to 14.0 in men, respectively). Patients in the age group from 20 to 40 years prevailed over the rest. In the group under 19 years of age, men predominated, and starting from 20 years of age, women predominated. The prevalence of multiple sclerosis among residents of the central areas of the city was higher than in coastal areas, their ratio was 1.4:1.0. The incidence rate remained relatively stable over the study period (2.1–2.9/100,000), while the rate increased from 2.7 to 3.7 in women and decreased from 2.1 to 0.9 in men. Conclusions. The prevalence of multiple sclerosis in the city of Baku showed an increasing trend, with the city being classified as a medium-risk zone for MS. The indicator prevailed among women and residents of the central regions of the city. The incidence remained stable due to an increase in the rate among women with a parallel decrease among men. The incidence of MS prevailed in the age range from 20 to 40 years.

Keywords: multiple sclerosis, prevalence, incidence.

For reference: Guliyeva AI. Prevalence and incidence of multiple sclerosis in the city of Baku (Republic of Azerbaijan). The Bulletin of Contemporary Clinical Medicine. 2024; 17 (3): 22-28. DOI: 10.20969/VSKM.2024.17(3).22-28.

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 EXPERIENCE IN THE TREATMENT OF PATIENTS WITH DIVERTICULAR COLON FISTULAS

KARPUKHIN OLEG Yu., ORCID ID: 0000-0002-7479-4945, Scopus Author ID 57218195015, Researcher ID J-6767-2013; Dr. sc. med., Professor at the Department of Surgical Diseases, Kazan State Medical University, Honored Doctor of the Republic of Tatarstan. 49 Butlerov str., 420012 Kazan, Republic of Tatarstan, Russia; Advis Сurator at the Department of Coloproctology, Republican Clinical Hospital, 138 Orenburgsky Trackt, 420064 Kazan, Republic of Tatarstan, Russia. E-mail: oleg_karpukhin@mail.ru

SHAKIROV RAIS R., ORCID ID: 0000-0001-8344-2696, Researcher ID IXW-5083-2023, Scopus Author ID 57836387500; Assistant Professor at the Department of Surgical Diseases, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Republic of Tatarstan, Russia; physician at the Department of Coloproctology, Republican Clinical Hospital, 138 Orenburgsky Trakt, 420064 Kazan, Republic of Tatarstan, Russia. E-mail: raiskazan2@mail.ru

PANKRATOVA YULIA S., ORCID ID: 0000-0001-7498-2412, Researcher ID IXW-5003-2023, Scopus Author ID 57462993200; Assistant Professor at the Department of Surgical Diseases, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Republic of Tatarstan, Russia; physician at the Surgery Department No. 1, Republican Clinical Hospital, 138 Orenburgsky Trakt, 420064 Kazan, Republic of Tatarstan, Russia. E-mail: iuliiaps@gmail.com

ZIGANSHIN MARAT I., ORCID ID: 0000-0002-5184-2975; Head of the Department of Coloproctology, Republican Clinical Hospital, Honored Doctor of the Republic of Tatarstan. 138 Orenburgsky Trakt, 420064 Kazan, Republic of Tatarstan, Russia. E-mail: zigamarat@yandex.ru

SHAKUROV AIDAR F., ORCID ID: 0000-0001-6617-8619; Cand. sc. med., Assistant Professor at the Department of Surgical Diseases, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Republic of Tatarstan, Russia; physician at the Department of Coloproctology, Republican Clinical Hospital, 138 Orenburgsky Trakt, 420064 Kazan, Republic of Tatarstan, Russia. E-mail: aydarsha@gmail.com

Abstract. Introduction. In the 21st century, a massive increase was noted in the incidence of diverticular disease (DD) by more than 10 times with an increase in the frequency of its complications ranging from 5 to 25%. According to the literature, the colon fistulation frequency is 5-30%, over a half of such formations being colovesical fistulas. The problem of surgical approaches to the purulent-inflammatory complications of DD is far from being resolved. Despite the fact that diverticular disease is a benign pathology, inflammatory process often creates serious technical difficulties in surgery due to the violation of the anatomical relationship of the intestine with the surrounding organs, while surgeries often affect several organs with a high infection risk. Aim. Analysis of the results of the treatment of patients with diverticular colon fistulas in a specialized department of a multidisciplinary hospital. Materials and Methods. Treatment outcomes were analyzed retrospectively in 347 patients with diverticular colon disease complications for the period from 2013 to 2022. The study included 17 patients with diverticular fistulas: 14 (82.4%) patients with internal (intestinal-urinary (13) and intestinal-vaginal (1)) fistulas and 3 (17.6%) with external ones. Results and Discussion. The therapeutic and diagnostic algorithm for diverticular fistulas required a wide range of diagnostic methods and a multidisciplinary approach. Surgery remains the single treatment option for this pathology. The choice of the surgical procedure depended on the inflammatory process severity, its spread to the surrounding abdominal organs, and the largest diverticula accumulation in the gut. In the group of patients with intestinal-urinary fistulas, the resection was not limited to the removal of the colon segment only. In 9 (52.9%) cases, it was expanded to the anterior rectum resection due to the inflammation transition to its upper ampullary region. We are supporters of the one-stage surgical procedures with forming the primary anastomosis in patients with diverticular fistulas. We give preference to the Sigal-Ramazanov invagination anastomosis that allows avoiding the anastomosis due to creating a duplicate of the intestinal wall hiding the anastomosis zone. The paper identifies probable predictors of complicating diverticular disease with fistulation. Conclusions. Choosing the optimal treatment option for patients with diverticular disease complications is a difficult problem. It is better to operate on them in the coloproctology departments of multidisciplinary hospitals with the established good interaction among the members of a multidisciplinary team.

Keywords: diverticular disease complications, intestinal-urinary fistulas, multidisciplinary approach, surgery

For reference: Karpukhin OYu, Shakirov RR, Pankratova YuS, et al. Experience in the treatment of patients with diverticular colon fistulas. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (3): 29-35.DOI: 10.20969/VSKM.2024.17(3).29-35.

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 CLINICAL AND PATHOPHYSIOLOGICAL ASPECTS OF MICROVESICULAR COMPOSITION OF PERIPHERAL BLOOD IN PREGNANT WOMEN WITH PREECLAMPSIA

MUSTAFIN ILSHAT G., ORCID ID: 0000-0001-9683-3012, Dr. sc. med., Professor, Department of Biochemistry and Clinical Laboratory Diagnostics, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. Е-mail: ilshat64@mail.ru

KURMANBAEV TIMUR E., ORCID ID: 0000-0003-0644-5767, Cand. sc. med., Senior Lecturer, Department of Obstetrics and Gynecology, S.M. Kirov Military Medical Academy, 6 Klinicheskaya str., 194044 Saint Petersburg, Russia. E-mail: timka_rus@inbox.ru

YUPATOV EVGENII YU., ORCID ID: 0000-0001-8945-8912, Cand. sc. med., Associate Professor, Head of the Department of Obstetrics and Gynecology, Kazan State Medical Academy, 36 Butlerova str., 420015 Kazan, Russia; Associate Professor, Department of Obstetrics and Gynecology, Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, 74 K. Marx str., 420012 Kazan, Russia. E-mail: e.yupatov@mcclinics.ru

NABIULLINA ROSA M., ORCID ID: 0000-0001-5942-5335, Cand. sc. med., Assistant Professor, Head of the Department of Biochemistry and Clinical Laboratory Diagnostics, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. E-mail: nabiullina.rosa@yandex.ru

SAFINA NELLY A., ORCID ID: 0000-0002-2231-3716, Cand. sc. biol., Faculty Member, Department of Biochemistry and Clinical Laboratory Diagnostics, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. E-mail: nellyasafina@mail.ru

MUKHAMETZYANOVA ZARINA R., ORCID ID: 0000-0002-7525-7455, Postgraduate Student at the Department of Biochemistry and Clinical Laboratory Diagnostics, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. E-mail: zarinam75@gmail.com

SAMIGULLIN DMITRIY V., ORCID ID: 0000-0001-6019-5514, Cand. sc. biol., Head of the Laboratory of Biophysics and Synaptic Processes, Kazan Institute of Biochemistry and Biophysics, FRC Kazan Scientific Center, Russian Academy of Sciences, 2/31 Lobachevsky str., 420111 Kazan, Russia; Institute for Radio-Electronics and Telecommunications, Kazan National Research Technical University named after A. N. Tupolev – KAI, 10 K. Marx str., 420111 Kazan, Russia. E-mail: samid75@mail.ru

FREDERIKS ELENA V., ORCID ID: 0000-0002-2513-6209, Cand. sc. med., Obstetrician-Gynecologist, Chief Physician, Maternity Hospital No. 13, 4 Kostromskaya str., 191124 St. Petersburg, Russia. E-mail: evfrederiks@gmail.com

LEONOVA MARGARITA D., ORCID ID: 0000-0002-3813-2995, Obstetrician-Gynecologist, Head of the Maternity Department, Maternity Hospital No. 13, 4 Kostromskaya str., 191124 St. Petersburg, Russia. E-mail: _margarita_@bk.ru

GAVRILOVA VICTORIA B., ORCID ID: 0009-0008-8002-645X, Clinical Resident in Clinical Laboratory Diagnostics, Kazan (Volga Region) Federal University, 74 K. Marx Str.,420012 Kazan, Russia. E-mail: viktoriyag24@gmail.com

ZHOGLO ALEXANDER O., ORCID ID: 0000-0001-9660-7368, Clinical Resident at the Department of Obstetrics, Gynecology and Reproductive Medicine, Pavlov First Saint Petersburg State Medical University, 6-8 Lev Tolstoy str., 197022 St. Petersburg, Russia. E-mail: zhoglo_95@mail.ru

Abstract. Introduction. Preeclampsia is a pregnancy complication characterized by the development of arterial hypertension after 20 weeks of gestation, proteinuria, and/or oedemas. The pathogenesis of preeclampsia remains unclear to this day. Some studies have shown the importance of microvesicles in the pathogenesis of various pathological conditions. Involvement of microvesicles in the preeclampsia pathogenesis is a relevant issue. Taking into account all of the above, we have made an attempt to consider the pathogenesis of preeclampsia from the perspective of clinical and laboratory data. Aim. To establish the importance of microvesicles circulating in peripheral blood, their quantity and phenotype in the pathogenesis of preeclampsia. Materials and Methods. A one-stage cohort study was conducted, including 105 pregnant women: 30 pregnant women with severe preeclampsia (group 1), 35 pregnant women with mild preeclampsia (group 2), and 40 pregnant women without hypertensive syndrome (group 3), at 29–40 weeks of gestation. All patients were delivered surgically (Joel-Cohen laparotomy, cesarean section in the lower segment). All pregnant women underwent blood sampling to define the number and phenotypes of microvesicles (using flow cytometry) and laser scanning microscopy of the clot to confirm the presence of microvesicles of placental origin containing tissue factor, as well as the lipopolysaccharide of gram-negative microorganisms. Results and Discussion. In the group of patients with severe preeclampsia, a statistically significant increase was found in the number of placental, erythrocyte microvesicles, microvesicles with the tissue factor and lipopolysaccharide, compared to the group of patients with mild preeclampsia and pregnant women without hypertensive syndrome. In the group of patients with mild preeclampsia, a statistically significant increase was found in microvesicles with tissue factor and lipopolysaccharide, compared to pregnant women without hypertensive syndrome. The data obtained from the study confirm the fact that severe preeclampsia is a separate nosological entity, most likely pregnancy-associated thrombotic microangiopathy. Conclusions. The data obtained from the study indicate the need for further research to clarify the importance of microvesicles in the preeclampsia pathogenesis.

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 EARLY DIAGNOSIS OF LATE-ONSET BRONCHIAL ASTHMA IN COMORBID PATIENTS

POSTNIKOVA LARISA B., ORCID ID: 0000-0002-8509-7133, Professor, Dr. sc. med., Consulting Physician, City Clinical Hospital No. 38; 22 Chernyshevsky str., 603000 Nizhny Novgorod, Russian Federation. E-mail: plbreath@mail.ruSIMULIN MICHAIL A., ORCID ID: 0009-0001-3391-1498, internist, City Clinical Hospital No. 38; 22 Chernyshevsky str., 603000 Nizhny Novgorod, Russian Federation. E-mail: si.misha@mail.ru

KUBYSHEVA NAILYA I., ORCID ID: 0000-0002-5582-5814, Dr. sc. bio., Senior Researcher Fellow at the Medical Informatics Research Laboratory, Kazan (Volga Region) Federal University; 18 Kremlevskaya str., 420008 Kazan, Russian Federation. E-mail: aibolit70@mail.ru

GRIGORYEVA NATALIYA YU., ORCID ID: 0000-0001-6795-7884, Professor, Dr. sc. med., Head of the Department of Clinical Medicine, National Research Lobachevsky State University; 23 Gagarin Prospect, 603950 Nizhny Novgorod, Russian Federation. E-mail: grigoreva28@mail.ru

POGREBETSKAYA VERA A., ORCID ID: 0000-0002-3677-7052, Chief Physician, City Clinical Hospital No. 38; 22 Chernyshevsky str., 603000 Nizhny Novgorod, Russian Federation. E-mail: mlpu38zamlech@yandex.ru

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4. He X, Cheng G, He L, et al. Adults with current asthma but not former asthma have higher all-cause and cardiovascular mortality: a population-based prospective cohort study. Sci Rep. 2021; 11: 1329. DOI: 10.1038/ s41598-020-79264-4

5. Chuchalin AG, Khaltaev N, Antonov NS, et al. Chronic respiratory diseases and risk factors in 12 regions of the Russian Federation. Int J Chron Obstruct Pulmon Dis. 2014; 9: 963–974. DOI: 10.2147/COPD.S67283

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11. Ilmarinen P, Pardo A, Tuomisto LE, et al. Long-Term Prognosis Of New Adult-Onset Asthma In Obese Patients. Eur Respir J. 2021; 57: 2001209. DOI: 10.1183/13993003.01209-2020

12. Baek EJ, Jung HU, Ha TW, et al. Genome-Wide Interaction Study Of Late-Onset Asthma With Seven Environmental Factors Using A Structured Linear Mixed Model In Europeans. Front Genet. 2022; 13: 765502. DOI: 10.3389/ fgene.2022.765502

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24. Quirce S, Heffler E, Nenasheva N, et al. Revisiting late-onset asthma: clinical characteristics and association with allergy. J Asthma Allergy. 2020; 13: 743–752. DOI: 10.2147/JAA.S282205

 INFORMATION ON METHODS AND INSTRUMENTS FOR ASSESSING SYMPTOMS IN PATIENTS WITH ATRIAL FIBRILLATION: a literature review

GALYAUTDINOV GENSHAT S., ORCID ID: 0000-0001-7403-0200, Dr. sc. med., Professor at the Department of Hospital Therapy, Dean of the Faculty of Medicine, Kazan State Medical University. 36 Butlerov str., 420012 Kazan, Russia. E-mail: galgen077@mail.ru

ZHIDYAEVSKIJ ALEXANDER G., ORCID ID: 0000-0002-4245-5201. Cand. sc. med, Assistant Professor, Department of Psychiatry and Medical Psychology, Kazan State Medical University, 36 Butlerov str., 420012 Kazan, Russia. E-mail: zhidyaevskij@mail.ru

GALEEVA SHAMILYA S., ORCID ID: 0000-0001-8654-1112. Therapist at the Department of Therapeutics, Clinic of the Medical University, 12 Sharif Kamal str., 420108 Kazan, Russia. E-mail: g.s.0101@yandex.ru

Abstract. Introduction. Atrial fibrillation is the most common arrhythmia of high medical and socio-economic importance. Most patients with atrial fibrillation report symptoms that can lead to decreasing their quality of life and functional status. When assessing the severity of the patient condition, the attending physician relies on data obtained by instrumental examination methods, physical examination, and the presence of complications of the disease; however, in addition to objective data, the patient’s subjective assessment of their condition is also important for treatment. In our opinion, the key is the availability of simple and understandable tools for patients to assess the impact of symptoms on their well-being, physical activity, professional and non-professional activities, as well as their psycho-emotional state. The literature contains many scales and questionnaires developed for the convenience of the physician-patient contact. Aim.To examine the advantages and disadvantages of available methods for assessing atrial fibrillation patients’ symptoms, quality of life, and functional statuses. Materials and Methods. To perform the literature analysis, we used international database PubMed. Results and Discussion. Over the years, various methods have been developed to assess the severity of atrial fibrillation. Each of the tools assesses to varying degrees the symptoms of the disease and their impact on the patients’ physical conditions, performance, everyday activities, psycho-emotional states, and other aspects of life. Conclusions. To adequately assess the severity of the disease, monitor the dynamics, and further correct the surveillance of a patient with atrial fibrillation, it would be reasonable to develop a method allowing a comprehensive, subjective, and objective assessment of the severity of arrhythmia.

Keywords: atrial fibrillation; severity of atrial fibrillation; burden of atrial fibrillation; quality of life; review.

For reference: Galyautdinov GS, Zhidyaevskij AG, Galeeva SS. Information on methods and instruments for assessing symptoms in patients with atrial fibrillation: a literature review. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (3): 53-58. DOI: 10.20969/VSKM.2024.17(3).53-58.

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 COMPLICATIONS IN SURGICAL TREATMENT OF RECTAL CANCER AS A CLINICAL-ORGANIZATIONAL AND MEDICAL-SOCIAL PROBLEM (literature review)

KOSTIN ANDREY A., ORCID ID: 0000-0002-0792-6012; Corresponding Member of the Russian Academy of Sciences, Dr. sc. med., Professor of the Russian Academy of Sciences, First Vice Rector – Vice Rector for Research; Head of the Department of Urology and Operational Nephrology with the Onco-Urology Course, Patrice Lumumba Peoples’ Friendship University of Russia, 6 Miklukho-Maclay str., 117198 Moscow, Russia; Leading Researcher, National Medical Research Radiological Centre, 4 Koroleva str., 249031 Obninsk, Kaluga Region, Russian Federation. Tel.: + 7 (495) 434-66-82. Е-mail: kostin@nmirc.ru

RYABOV MIKHAIL M., ORCID ID: 0000-0003-3942-3783; Cand. sc. med., Assistant Professor at the Department of General Surgery, Yaroslavl State Medical University, 5 Revolutionary str., Yaroslavl, Russia. Tel.: +7 (903) 897-08-70. Е-mail: mihail_ryabov@mail.ru

KONOVALOV OLEG E., ORCID ID: 0000-0003-1974-9882; Dr. sc. med., Professor at the Department of Public Health, Healthcare and Hygiene, Institute of Medicine, Patrice Lumumba Peoples’ Friendship University of Russia, 10 Miklouho-Maclay str., Bldg. 2, 117198 Moscow, Russia. Tel.: +7(910)508-10-45. Е-mail: konovalov_oe@mail.ru

SHULAEV ALEXEY V., ORCID ID: 0000-0002-2073-2538; Dr. sc. med., Professor, Head of the Department of General Hygiene, Kazan State Medical University, 49 Butlerov str., Kazan, Russia. Tel. +7(987)213-67-12. Е-mail: alexs_shu@mail.ru

 CARDIOVACULAR COMORBIDITY IN PATIENTS WITH PSORIASIS

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. Psoriatic disease is a genetically determined disease of a multifactorial nature that affects about 2% of the population. According to modern concepts of this pathology, there is a high level of comorbidities, especially those associated with damage to the cardiovascular system. The aim of the study is a comprehensive analysis of the features of epidemiological and clinical data linking psoriasis with cardiovascular risk factors and cardiovascular diseases. Material and Methods. A review and analysis of modern scientific data in the databases, such as eLibrary, PubMed/Medline, Web of Science, Google Scholar, and Cyberleninka for the period from 2000 to the present. Results and Discussion. Up-to-date information has been collected regarding comorbid cardiovascular pathology in psoriasis. We systematized the data related to the analysis of possible pathophysiological mechanisms that justify this relationship and analyzed the methods of cardiovascular risk stratification in patients with psoriasis. Conclusions. Various studies have shown that psoriasis is associated with a higher prevalence of cardiovascular diseases, including hypertension, diabetes mellitus, dyslipidemia, obesity, and metabolic syndrome. The relationship is discussed between psoriasis severity and the risk of developing cardiovascular diseases, as well as prognostic risks with mortality rates. The common pathogenetic mechanisms proposed include genetic factors, inflammatory pathways, adipokine secretion, insulin resistance, lipoprotein composition and function, angiogenesis, oxidative stress, and hypercoagulability.

Keywords: psoriasis, cardiovascular risk, cardiovascular diseases.

For reference: Mutalova EG, Arslanova RМ, Khismatullina ZR, et al. Cardiovascular comorbidity in patients with psoriasis. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (3): 67-72. DOI: 10.20969/VSKM.2024.17(3).67-72.

 COVID-19 IN SYRIA: EXPLORING THE SOCIOECONOMIC, HEALTH, PSYCHOLOGICAL AND HUMANITARIAN IMPACTS AND MANIFESTATIONS

NEZAMI SULTAN A., ORCID ID: 0009-0000-7463-8144, Researcher ID: JJD-1344-2023; 4th-year undergraduate student, General Medicine, Samara State Medical University, 89 Chapaevskaya str., 443099 Samara, Samara Region, Volga Federal District, Russia. Tel.: +79161148529, E-mail: sultannezame9@gmail.com

 ROLE OF GUT MICROBIOTA AND SELECTED METABOLIC PRODUCTS IN THE DEVELOPMENT OF CHILDHOOD OBESITY

SKVORTSOVA OLGA V., ORCID ID: 0000-0003-3329-6445, Postgraduate Student, Department of Pediatrics, Institute of Professional Education, Samara State Medical University, 89 Chapaevskaya str., 443099 Samara, Russia. E-mail: skvorcova_a@bk.ru

MIGACHEVA NATALIA B., ORCID ID: 0000-0003-0941-9871, Dr. sc. med., Head of the Department of Pediatrics, Institute of Professional Education, Samara State Medical University, 89 Chapaevskaya str., 443099 Samara, Russia. E-mail: nbmigacheva@gmail.com

KAGANOVA TATIANA I., ORCID ID: 0000-0002-1559-3908, Dr. sc. med., Professor at the Department of Pediatrics, Institute of Professional Education, Samara State Medical University, 89 Chapaevskaya str., 443099 Samara, Russia. E-mail: t.i.kaganova@samsmu.ru

LYAMIN ARTEM V., ORCID ID: 0000-0002-5905-1895, Dr. sc. med., Director of the Scientific and Educational Professional Center for Genetic and Laboratory Technologies, Samara State Medical University, 89 Chapaevskaya str., 443099 Samara, Russia. E-mail: a.v.lyamin@samsmu.ru

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 ACQUIRED HEMOPHILIA A IN THE MODERN MEDICAL REALITY: PRACTICAL CLINICAL EXPERIENCE

ADIEVA ADELYA A., ORCID ID: 0009–0004–1497–7119, Student at the Department of General Medicine, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. Tel.: +79872632783. Е-mail: adelya_adieva@mail.ru

IVANOVA ELENA V., ORCID ID: 0009–0007–6678–8362, Student at the Department of General Medicine, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. Tel.: +79603010625. Е-mail: elena_ivanova2212@mail.ru

POLOVINKINA EKATERINA N., ORCID ID: 0009–0007–4267–4889, Physician at the Department of Hematology, Republican Clinical Hospital, 138 Orenburg tract str., 420064 Kazan, Russia. E-mail: ekaterina.polovinkina1992@mail.ru

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 RESPONSES TO SEQUENTIAL SURGERY AND INTERFERON THERAPY OF THE NEUROENDOCRINE PANCREATIC CANCER METASTASES IN A FEMALE PATIENT WITH VON HIPPEL-LINDAU DISEASE

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, 414000 Astrakhan, Russia. Tel. +7-903-321-92-57. E-mail: demidovfamily@rambler.ru

SLUVKO LEON V., ORCID ID: 0009-0005-1697-9377; Cand. sc. med., Associate Professor, Department of Hospital Therapy, Astrakhan State Medical University, 121 Bakinskaya str., 414000 Astrakhan, Russia; Head of of the Department of Abdominal Surgery, Regional Clinical Oncology Dispensary, 57 B. Alekseeva str., 414041 Astrakhan, Russia. Tel. +7-908-611-89-20. E-mail: IsIuvko@mail.ru

DYAKOVA OLGA N., ORCID ID: 0000-0001-7444-530X, Cand. sc. med., Associate Professor, Department of Hospital Therapy, Astrakhan State Medical University, 121 Bakinskaya str., 414000 Astrakhan, Russia. Tel. +7-927-575-95-01. E-mail: dekanat.fis.agma@gmail.com

VOROBYOVA ANNA A., ORCID ID: 0000-0003-3962-3662, Cand. sc. med., Associate Professor, Department of Propaedeutics of Internal Diseases, Astrakhan State Medical University, 121 Bakinskaya str., 414000 Astrakhan, Russia. Tel. +7-988177-52-87. E-mail: Annavorobieva74@yandex.ru

FEDOTOVA ANNA D., ORCID ID: 0009-0005-3404-9552, Radiotherapist, Russian Scientific Center for Radiology, 86 Profsoyuznaya str., Bldg. 1, 117485 Moscow, Russia. Tel. +7-916-527-34-75. E-mail: Anna2512@yandex.ru

GORBUNOVA OKSANA E., ORCID ID: 0000-0002-9762-1289, Assistant Professor, Department of Hospital Therapy, Astrakhan State Medical University, 121 Bakinskaya str., 414000 Astrakhan, Russia. Tel. +7-917-186-92-96. E-mail: gor-ox@mail.ru

PANOVA TAMARA N., ORCID ID: 0009-0003-8237-2296, Dr. sc. med., Professor at the Department of Hospital Therapy, Astrakhan State Medical University, 121 Bakinskaya str., 414000 Astrakhan, Russia. Tel. +7-988-174-52-54. E-mail: tamara-panova@yandex.ru

Abstract. Introduction. The article provides a literature review on the epidemiology, diagnosis, and treatment of neuroendocrine tumors. The morpho-functional classification by WHO 2022 is presented with the division of neuroendocrine tumors into three groups. Justifications are given for the choice of instrumental methods of topical diagnostics and the need for determining universal and specific biochemical markers in blood serum or plasma. The principles are indicated for choosing the advanced methods of treating neuroendocrine tumors. Aim. To review the scientific literature on neuroendocrine tumors, providing our own clinical observations. Materials and Methods.Russian- and English-language literature sources on this disease were searched for in the databases, such as PubMed, Medscape, Cochrane Library, and eLibrary. Clinical case of our female patient V., 36 years old, with von Hippel-Lindau disease (heterozygous mutation R167W of the VHL gene). Results and Discussion. As an example, we describe a clinical case of surgical treatment followed by long-term use of interferons in a female patient with neuroendocrine pancreatic cancer with metastases to the liver and retroperitoneal lymph nodes. Histological examination of the surgical material revealed highly differentiated neuroendocrine cancer with low malignant potential. A screening examination of the genetic syndrome components revealed a heterozygous mutation R167W of the VHL gene. Her survival under treatment exceeded 9.5 years, including more than 4.5 years from the start of interferon therapy. This pathology occurred in a young woman with one of the rare genetic multiorgan hereditary forms of neuroendocrine tumors, Von Hippel-Lindau disease that manifested itself as a combination of benign (retinal angiomatosis of both eyes and adenomas of both adrenal glands) and malignant diseases (pancreatic cancer). Conclusions. The given clinical example demonstrates that in a patient with highly differentiated metastatic pancreatic cancer, after distal subtotal resection of the pancreas, splenectomy, retroperitoneal lymphadenectomy, followed by treatment with interferons, life expectancy was more than 9.5 years, including more than 4.5 years from the start of therapy with interferons only. Despite the numerous side effects of interferons described in the literature, the patient tolerated the treatment well. At the same time, a connection between the hypothyroidism detected in the patient and treatment with interferons cannot be ruled out, since dysfunction of the thyroid gland is one of its side effects.

Keywords: APUD system, Von Hippel-Lindau disease, neuroendocrine tumors, pancreatic cancer metastases, surgery and interferon therapy.

For reference: Demidov AA, Sluvko LV, Dyakova ON, et al. Responses to sequential surgery and interferon therapy of the neuroendocrine pancreatic cancer metastases in a female patient with Von Hippel-Lindau disease. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (3): 94-100. DOI: 10.20969/VSKM.2024.17(3).94-100.

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NIKITINA LOUISE I., ORCID ID: 0000-0003-4893-0314; Cand. sc. med., Associate Professor, Head of the Department of Dental Diseases and New Technologies, Chuvash State University, 45 Moskovsky Ave., 428015 Cheboksary, Russia. E-mail: prop.stom.zab@mail.ru

MUKHAMEDZHANOVA LYUBOV R., ORCID ID: 0000-0003-0752-6497; Dr. sc. med., Professor, Head of the Department of Therapeutic Dentistry, Pediatric Dentistry and Orthodontics, Kazan State Medical Academy – Branch Campus of the Russian Medical Academy of Continuous Professional Education, 36 Butlerov str., 420012 Kazan, Russia; Professor at the Department of Dental Diseases and New Technologies, Chuvash State University, 45 Moskovsky Ave., 428015 Cheboksary, Russia. E-mail: lr71@bk.ru

GROMOVA ANNA S., ORCID ID: 0000-0002-5554-7068; Department of Dental Diseases and New Technologies, Chuvash State University, 45 Moskovsky Ave., 428015 Cheboksary, Russia. E-mail: prop.stom.zab@mail.ru

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 DIFFICULTIES IN DIAGNOSING COMPLICATIONS OF DUODENAL DIVERTICULAR DISEASE

YAROVENKO GALINA V., ORCID ID: 0000-0002-5043-7193; Dr. sc. .med., Associate Professor, Professor at the Department and Clinic of Hospital Surgery, Samara State Medical University, 89 Chapaevskaya str., 443099 Samara, Russia. E-mail: yarovenko_galina@mail.ru

KATORKIN SERGEY E., ORCID ID: 0000-0001-7473-6692, Dr. sc. .med., Professor, Head of the Department and Clinic of Hospital Surgery, Samara State Medical University, 89 Chapaevskaya str., 443099 Samara, Russia.
E-mail: katorkinse@mail.ru

KOLTSOV ANTON E., ORCID ID: 0009-0008-2487-9239, Student, Institute of Clinical Medicine, Samara State Medical University, 89 Chapaevskaya str., 443099 Samara, Russia. E-mail: koltsovantoha@yandex.ru

AKANIN MAKSIM S., ORCID ID: 0009-0002-5508-8575, Student, Institute of Clinical Medicine, Samara State Medical University, 89 Chapaevskaya str., 443099 Samara, Russia. E-mail: akkanin2@mail.ru

Abstract. Introduction. Duodenal diverticulum is a hernia‒like protrusion of the duodenal wall. In terms of prevalence, this disease ranks second among all diverticula of the gastrointestinal tract after colonic diverticula. Aim. To substantiate the difficulty of diagnosing duodenal diverticulum perforation, based on a clinical case. Materials and Methods. A clinical case dated December 2021 of successful diagnostics and treatment of duodenal diverticulum perforation in female patient A. aged 68 is presented, based on the practice of the surgeons of the Surgery Unit in the Clinic of Hospital Surgery of Samara State Medical University. A set of laboratory investigations was performed, such as clinical blood analysis, biochemical blood analysis, coagulation profile, clinical urine analysis, and blood tests for HIV, viral hepatitis, and syphilis. Instrumental diagnostic methods were used, such as ultrasound (Aloka SSD 1700 (Japan)), CT (Revolution EVO (Russia)) of abdominal organs, review radiography, and Napalkov test. Results and Discussion. Laboratory and instrumental diagnostics, such as ultrasound and survey radiography, and primary laparotomy turned out to be insufficient for correct diagnosis and reasonable treatment. Napalkov test was performed, which revealed the contrast agent flow into retroperitoneum. The patient underwent relaparotomy, during which the duodenal diverticulum perforation by a foreign body (a fragment of a laurel leaf) was found. Conclusions. The case presented is an example of timely diagnosis of duodenal diverticulum perforation. The surgeons’ experience allowed them to suspect perforation in a short time, which helped avoid serious complications and contributed to the patient’s recovery. With timely diagnosis of such a rare and grave complication as duodenal diverticulum perforation, its clinical cure is justified.

Keywords: diverticulum, diverticular disease, duodenum, diverticular perforation, diagnosis, surgical treatment.

For reference: Yarovenko GV, Katorkin SE, Koltsov AE, Akanin MS. Difficulties in diagnosing complications of duodenal diverticular disease. The Bulletin of Contemporary Clinical Medicine. 2024; 17(3): 108-111. DOI: 10.20969/VSKM.2024.17(3).108-111.