Vol. 17 Suppl. 1 (2024)

VSKM 2024 suppl 1

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ORIGINAL RESEARCH

Periodic medical examinations: their effectiveness and role in early detection of diseases Garipova R.V. (Russia, Kazan), Berkheeva Z.M. (Russia, Kazan), Miftakhova S.N. (Russia, Kazan), Galiullin I.M. (Russia, Kazan), Safina K.R. (Russia, Kazan), Arkhipov E.V. (Russia, Kazan), Ishteryakova O.A. (Russia, Kazan), Sabitova M.M. (Russia, Kazan) P. 7

Provision of medical rehabilitation care to orthopedic and trauma patients in the Republic of Tatarstan Delyan A.M. (Russia, Kazan), Bodrova R.A. (Russia, Kazan), Vagizova A.M. (Russia, Kazan), Sadrutdinova A.A. (Russia, Kazan), Galimullina I.I. (Russia, Kazan) P. 16

Atrial fibrillation and quality of life of patients receiving various groups of indirect anticoagulants Ishmurzin G.P. (Russia, Kazan), Podolskaya A.A. (Russia, Kazan) P. 22

Impact of coronavirus infection and SARS-CoV-2 vaccination on the course of chronic urticaria Klyucharova A.R. (Russia, Kazan), Delian V.Y. (Russia, Kazan) P. 27

Severe acute pancreatitis: options of tactical aproaches to treatment Malkov I.S. (Russia, Kazan), Zaynutdinov A.M. (Russia, Kazan), Makarov D.V. (Russia, Kazan), Kurochkin S.V. (Russia, Kazan), Nuriev I.I. (Russia, Kazan), Gubaev R.F. (Russia, Kazan) P. 33

Cause analysis of the labor opportunism of clinical staff Minnullin M.M. (Russia, Kazan), Bodrov O.G. (Russia, Kazan), Delyan A.M. (Russia, Kazan), Bodrova R.A. (Russia, Kazan) P. 40

Osteoporosis risk in women with breast vascular calcifications revealed at mammography Pasynkova O.O. (Russia, Yoshkar-Ola), Krasilnikov A.V. (Russia, Yoshkar-Ola), Pasynkov D.V. (Russia, Yoshkar-Ola), Klyushkin I.V. (Russia, Kazan), Fatikhov R.I. (Russia, Kazan) P. 48

Association of breast vascular calcifications at mammography with gastrointestinal tract pathology Pasynkov D.V. (Russia, Yoshkar-Ola), Krasilnikov A.V. (Russia, Yoshkar-Ola), Pasynkova O.O. (Russia, Yoshkar-Ola), Klyushkin I.V. (Russia, Kazan), Fatikhov R.I. (Russia, Kazan) P. 54

REVIEWS

Abdominal wall endometriosis: a multidisciplinary approach (Literature review) Gabidullina R.I. (Russia, Kazan), Minnullina F.F. (Russia, Kazan), Syrmatova L.I. (Russia, Kazan) Mametova N.A. (Russia, Kazan) P. 60

Postoperative ventral hernias: unresolved issues of diagnosis and surgery tactics Dobrokvashin S.V. (Russia, Kazan), Izmailov A.G. (Russia, Kazan), Yantykova A.A. (Russia, Kazan), Ovchinnikov P.D. (Russia, Kazan), Volkov D.E. (Russia, Kazan), Klyushkin I.V. (Russia, Kazan), Fatikhov R.I. (Russia, Kazan) P. 67

PRACTICAL EXPERIENCE

Masks of acute cerebrovascular accidents in young people: posterior reversible encephalopathy syndrome Valeeva K.G. (Russia, Kazan), Vaskayeva G.R. (Russia, Kazan), Danilova T.V. (Russia, Kazan) P. 75

Cardiac rehabilitation for a patient with myasthenia gravis after coronary bypass grafting using bilateral internal mammary arteries. A clinical case Gumarova L.Sh. (Russia, Kazan), Gorelkin I.V. (Russia, Kazan), Bodrova R.A. (Russia, Kazan), Shaikhutdinova Z.A. (Russia, Kazan), Romanova O.V. (Russia, Kazan), Abubakirova A.K. (Russia, Kazan), Akmetzyanova G.A. (Russia, Kazan) P. 83

Acute generalized exanthematous pustulosis: a short review and case report Delian V.Y. (Russia, Kazan), Klyucharova A.R. (Russia, Kazan), Zakirova G.N. (Russia, Kazan), Iakovleva K.A. (Russia, Kazan) P. 90

A clinical case of acute phenol intoxication as an occupational disease: basic regulatory documents Delyan A.M. (Russia, Kazan), Galiullin I.M. (Russia, Kazan), Nasibullina A.R. (Russia, Kazan), Melnikov E.A. (Russia, Kazan), Garipova R.V. (Russia, Kazan), Miftakhova S.N. (Russia, Kazan) P. 101

Peripartum cardiomyopathy developed after delivery as a rare cause of heart failure: a case report Dimitrieva D.V. (Russia, Kazan), Tronin K.D. (Russia, Kazan), Zakirova E.B. (Russia, Kazan), Slepuha E.G. (Russia, Kazan), Mukhitova E.I. (Russia, Kazan), Bazaeva N.V. (Russia, Kazan), Khazova E.V. (Russia, Kazan), Bulashova O.V. (Russia, Kazan) P. 107

Post-dural puncture headache: epidural blood patch application case report Zabirova K.R. (Russia, Kazan), Popova N.A. (Russia, Kazan), Hakimova A.R. (Russia, Kazan), Korotkova A.S. (Russia, Kazan) P. 113

A clinical case of acromegaly with normal GH and elevated insulin-like growth factor – 1 levels Nasybullina F.A. (Russia, Kazan), Petrova T.A. (Russia, Kazan), Myagkova N.A. (Russia, Kazan), Kamaev R.R. (Russia, Kazan), Gainullina L.I. (Russia, Kazan), Vagapova G.R. (Russia, Kazan), Valeeva F.V., (Russia, Kazan) P. 117

Features of ischemic stroke in presence of vasculopathy and compensation abilities of the brain: a clinical case Perminova S.K. (Russia, Kazan), Nazipova A.Ya. (Russia, Kazan), Dvorzhak A.S. (Russia, Kazan) P. 122

A clinical case of infective endocarditis complicated by meningoencephalitis Khamitov R.F. (Russia, Kazan), Sattarova F.I. (Russia, Kazan) P. 128

New advances in the treatment of chronic pancreatic fistulas Chikaev V.F. (Russia, Kazan), Melnikov E.A. (Russia, Kazan), Petukhov D.M. (Russia, Kazan), Mannanov R.F. (Russia, Kazan), Ajdarov A.A. (Russia, Kazan) P. 133

A clinical case of successful surgery of a second-trimester pregnant patient with hereditary gastrointestinal polyposis complicated by intussusceptive small-intestinal obstruction Shaymardanov R.S. (Russia, Kazan), Gubaev R.F. (Russia, Kazan), Bagautdinov E.B. (Russia, Kazan), Melnikov E.A. (Russia, Kazan), Fatkullin F.I. (Russia, Kazan), Kurochkin S.V. (Russia, Kazan) P. 139

Electrocardiographic patterns of sudden cardiac death in a patient with myocardial infarction and communityacquired pneumonia caused by the new coronavirus infection Shulaeva P.A. (Russia, Kazan), Khazova E.V., (Russia, Kazan), Malkova M.I. (Russia, Kazan) P. 147

DURING THE IMPOSING OF THE NUMBER

Current rural availability of cancer care and of active malignancy detection in the most common sites Novikova S.V. (Russia, Kazan) P. 157

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ORIGINAL RESEARCH

UDC 616-057-084:331.483.2

DOI: 10.20969/VSKM.2024.17(suppl.1).7-15

PDF download PERIODIC MEDICAL EXAMINATIONS: THEIR EFFECTIVENESS AND ROLE IN EARLY DETECTION OF DISEASES

GARIPOVA RAILYA V., ORCID ID: 0000-0001-8986-8030; SCOPUS Author ID: 54904191000; Dr. sc. med., Professor at the Department of Hygiene and Occupational Medicine, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. Professor at the Department of General Hygiene, Kazan State Medical Academy – Branch of the Russian Medical Academy of Postgraduate Education, 36 Butlerov str., 420012, Kazan, Russia. Professor at the Department of Рreventive Medicine, Institute of Biology and Fundamental Medicine, Kazan Federal University, 74 Karl Marx str., 420012 Kazan, Russia. Tel.: +7 (917) 255-38-44. Е-mail: railyagaripova@mail.ru

BERKHEEVA ZUKHRA M., ORCID ID: 0000-0003-3224-4184, Cand. sc. med., Associate Professor, Department of Preventive Medicine and Human Ecology, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. Tel.: +7 (905) 310-74-46. Е-mail: kgmu_profpat@mail.ru

MIFTAKHOVA SVETLANA N., Head of the Department of Preventive Мedical Еxaminations, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshall Chuikov str., 420103 Kazan, Russiа. Tel.: +7 (917) 399-29-11. Е-mail: m.svn@yandex.ru

GALIULLIN ILGIZ M., Head of the Department of Extra-Budgetary Activities, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshall Chuikov str., 420103 Kazan, Russiа. Tel.: +7 (905) 377-70-97. Е-mail: gkb7-01@mail.ru SAFINA KADRIYA R., ORCID ID: 0009-0006-0673-623Х, Head of the Republican Сenter of Occupational Diseases, 7 Lechebnaya str., 420036, Kazan, Russia. Tel.: +7 (927) 424-67-51. Е-mail: kadriya-safina@mail.ru

ARKHIPOV EVGENY V., ORCID ID: 0000-0003-0654-1046; SCOPUS Author ID: 56997299700; Cand. sc. med., Associate Professor, Department of Polyclinical Therapy and General Medical Practice, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia; Physician at the Clinical and Expert Department, City Clinical Hospital No 7 named after M.N. Sadykov, 54 Marshall Chuikov str., 420103 Kazan, Russia. Tel.: +7 (903) 342-53-25. Е-mail: jekaland@mail.ru

ISHTERYAKOVA OLGA A., ORCID ID: 0000-0002-9695-7717, Cand. sc. med., Associate Professor, Department of Hygiene and Occupational Medicine, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia; Associate Professor, Department of Rehabilitation and Sports Medicine, Kazan State Medical Academy – Branch of the Russian Medical Academy of Postgraduate Education, 36 Butlerov str., 420012 Kazan, Russia. Tel.: +7 (905) 315-77-69. Е-mail: olga_kazan-91@mail.ru 

SABITOVA MINZILYA M., ORCID ID: 0000-0003-1843-9225, Assistant Professor at the Department of General Hygiene, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. Tel.: +7 (927) 677-44-37. Е-mail: mms80@bk.ru

Abstract. Introduction. Periodic medical examinations are aimed at dynamic monitoring of the employees’ health status and timely detection of occupational and somatic diseases. Aim of the study is to assess the effectiveness of periodic medical examinations for the years 2019-2023, based on the analysis of annual reports of 45 territories of the Republic of Tatarstan. Materials and Methods. The study used annual reports of the republic’s and city centers of occupational pathology. For statistical analysis, the methods of descriptive statistics and tabular presentation were used, qualitative indicators are presented as absolute (n) and relative values (%) of the occurrence of the feature studied. To study the differences in qualitative features of several populations, the c2 (chi-square) criterion was used. Results and Discussion. About 300 thousand employees undergo periodic medical examinations in the republic annually (297,313 people in 2019, 277,291 in 2020, 273,294 in 2021, 316,508 in 2022, and 307,437 in 2023). On average, the coverage of periodic medical examinations is 96-97%. In 2023, cases of occupational diseases were registered in 15 administrative territories, including Kazan and Naberezhnye Chelny (19 in 2019, 20 in 2020, 20 in 2021,and 27 in 2022). For the first time, 32,216 chronic somatic diseases were identified in 2023, accounting for 10.5% of all those who underwent periodic medical examinations (7.9 % in 2022, 11.7% in 2021, 11.2% in 2020, and 11.7% in 2019). It is still problematic to organize medical examinations of those employed by agricultural enterprises. Not all eligible persons undergo a medical examination; at many enterprises, medical examinations are carried out only for those belonging to decreed groups and/or working in contact with pesticides. Conclusions. An important prerequisite for the timely detection of initial forms of occupational and somatic diseases, early signs of the impact of harmful production factors on the employees’ health with the subsequent formation of risk groups for the development of occupational diseases should be mandatory periodic medical examinations conducted in the center of occupational pathology for persons with 5 years of working experience in harmful working conditions, with repeatedly conducting the same once every 5 years. Industrial medical examinations contribute to the detection of diseases at early stages.

Keywords: periodic medical examinations, occupational diseases, somatic diseases, industrial medical examination, medical care of employees.

For reference. Garipova RV, Berkheeva ZM, Miftakhova SN, et al. Periodic medical examinations: Their effectiveness and role in early detection of diseases. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (suppl.1): 7-15. DOI:10.20969/VSKM.2024.17(suppl.1).7-15.

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UDC 616.7:615.8

DOI: 10.20969/VSKM.2024.17(suppl.1).16-21

PDF download PROVISION OF MEDICAL REHABILITATION CARE TO ORTHOPEDIC AND TRAUMA PATIENTS IN THE REPUBLIC OF TATARSTAN

DELYAN ARTUR M., ORCID ID: 0000-0002-2328-7679; Chief Physician, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Chuikov str., 420103 Kazan, Russia. E-mail: gkb7@bk.ru

BODROVA RESEDA A., ORCID ID: 0000-0003-3540-0162; Dr. sc. med., Associate Professor, Head of the Department of Rehabilitation and Sports Medicine, Kazan State Medical Academy, 36 Butlerov str., 420012 Kazan, Russia; Chief Medical Rehabilitation Consultant at the Ministry of Health of RT, 54 Chuikov str., 420103 Kazan, Russia. E-mail: bodrovarezeda@yandex.ru

VAGIZOVA AYSYLU M., ORCID ID: 0009-0009-4677-4785.; Head of the Department of Medical Rehabilitation for Patients with CNS/PNS/Musculoskeletal Disorders, City Clinical Hospital 7 named after M.N. Sadykov, 54 Chuikov str., 420103 Kazan, Russia. E-mail: vagizova.aysilu@yandex.ru

SADRUTDINOVA ADILYA A., ORCID ID: 0009-007-4284-1974; Postgraduate Student and Teaching Assistant at the Department of Rehabilitation and Sports Medicine, Kazan State Medical Academy; Neurologist at the Outpatient Department of Medical Rehabilitation, City Clinical Hospital No.7 named after M. N. Sadykov, 54 Chuikov str., 420103 Kazan, Russia. E-mail: adelchik36@gmail.com

GALIMULLINA INDIRA I., ORCID ID: 0009-0001-9059-3553; Resident Physician at the Department of Rehabilitation and Sports Medicine, Kazan State Medical Academy, 36 Butlerov str., 420012 Kazan, Russia; Physician at City Clinical Hospital 7 named after M.N. Sadykov, 54 Chuikov str., 420103 Kazan, Russia. E-mail: indira18.03.98@yandex.ru

Abstracts. Introduction. In the Republic of Tatarstan, orthopedic and trauma diseases occupy the third place among the diseases leading to disability among adults. Timely patients’ rehabilitation allows restoring their previous activity and preventing complications. Aim of the study was to evaluate the effectiveness of the medical rehabilitation system for orthopedic and trauma patients over the last three years. Materials and Methods. The clinical and expert statistical method, the method of generalization, and comparative analysis were used to process the data of patients with orthopedic and trauma diseases, who had been provided with medical rehabilitation care for the last three years. Statistical data were used, provided by the General Office of Medical and Social Assessment in the Republic of Tatarstan, by the Ministry of Labor and Social Protection of the Russian Federation, and by the Ministry of Health of the Republic of Tatarstan. Statistical analysis was performed using the GraphPadPrism 9 software package. Quantitative variables were presented as medians and quartiles, while qualitative variables were presented as percentages. Comparative analysis (for dependent samples) was based on determining the reliability of the difference between indicators using the Wilcoxon test. Differences at p < 0.05 were considered statistically significant. Results and Discussion. In the Republic of Tatarstan, the number of patients who received medical rehabilitation increased by 32% in 2023, of which the number of orthopedic and trauma patients increased by 31%. In 2023, the number of the first-time declared group I disabled decreased by 0.6% and of first-time declared group II ones by 0.7%, while medical rehabilitation of patients increased by 53% in round-the-clock inpatient facilities and by 37% in outpatient facilities. Conclusions. Increased number of orthopedic and trauma patients provided with medical rehabilitation care at the inpatient and outpatient stages, led to a decrease in the number of the first-time declared group I disabled by 0.6% and the first-time declared group II disabled by 0.7% This substantiates the need for further development of medical rehabilitation in the traumatology and orthopedics area to return the patient to social and domestic activities, preserve their working potential, and stabilize their health.

Keywords: medical rehabilitation, orthopedic and trauma patients, disabled groups.

For reference: Delian AM, Bodrova RA, Vagizova AM, et al. Provision of medical rehabilitation care to orthopedic and trauma patients in the Republic of Tatarstan. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (suppl.1): 16-21. DOI: 10.20969/VSKM.2024.17(suppl.1).16-21.

REFERENCES

 

1. Информационно-аналитический справочник Деятельности Федерального казенного учреждения // Главное бюро медико-социальной экспертизы по Республике Татарстан Министерства труда и социальной защиты Российской Федерации. – Казань, 2022. – С. 66-86. [Glavnoe byuro mediko_socialnoi ekspertizi po Respublike Tatarstan Ministerstva truda i socialnoi zaschiti Rossiiskoi Federacii [Main Bureau of Medical and Social Expertise in the Republic of Tatarstan of the Ministry of Labor and Social Protection of the Russian Federation]. Informacionno-analiticheskii spravochnik Deyatelnosti Federalnogo kazennogo uchrejdeniya [Information and analytical directory of the activities of the Federal State Institution]. Kazan [Kazan]. 2022; 66-86 (In Russ.)].

2. Гурьянова Е.А. Основы медицинской реабилитации. – Чебоксары: Издательство Чувашского университета, 2019. – 311 с. [Guryanova EA. Osnovi medicinskoi reabilitacii [Fundamentals of medical rehabilitation]. Cheboksari: Izdatelstvo Chuvashskogo universiteta [Сheboksary: Chuvash University press]. 2019; 311 р. (In Russ.)].

3. Приказ Министерства здравоохранения РФ от 31 июля 2020 г. No 788н Об утверждении Порядка организации медицинской реабилитации взрослых. – Москва, 2020. – С.1-15. [Prikaz Ministerstva zdravoohraneniya RF ot 31 iyulya 2020 goda No 788n Ob utverjdenii Poryadka organizacii medicinskoi reabilitacii vzroslih [Order of the Ministry of Health of the Russian Federation No 788n dated July 31, 2020 On Approval of the Procedure for Organization of Medical Rehabilitation of Adults]. Moskva [Moscow]. 2020; 1-15 (In Russ.)].

4. Приказ Министерства здравоохранения РТ от 01.02.2021 г. No107 Об организации медицинской реабилитации взрослого населения в медицинских организациях Республики Татарстан // Казань, 2021. – С.10-20. [Prikaz Ministerstva zdravoohraneniya RT ot 01/02/2021 goda No107 Ob organizacii medicinskoi reabilitacii vzroslogo naseleniya v medicinskih organizaciyah Respubliki [Order of the Ministry of Health of the Republic of Tajikistan from 01/02/2021 No 107 On organization of medical rehabilitation of adult population in medical organizations of the Republic of Tatarstan]. Kazan. 2021; 10-20 (In Russ.)].

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8. Министерство здравоохранения Республики Татарстан. Проект Региональной программы «Оптимальная для восстановления здоровья медицинская реабилитация в Республике Татарстан» от 27.06.2023. – Казань, 2023. – 55-56 c. [Ministerstvo zdravookhraneniya Respubliki Tatarstan [Ministry of Health of the Republic of Tatarstan]. Proekt Regionalnoi programmi Optimalnaya dlya vosstanovleniya zdorovya medicinskaya reabilitaciya v Respublike Tatarstan ot 27/06/2023 [Draft of the Regional Program Optimal for health restoration medical rehabilitation in the Republic of Tatarstan dated 26/04/2022]. Kazan [Kazan]. 2023; 55-56 р. (In Russ.)]. https://docs.cntd.ru/document/406764373

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10. Министерство здравоохранения Российской Федерации, Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр травматологии и ортопедии имени Н.Н. Приорова». Статистический сборник «Травматизм, ортопедическая заболеваемость, организация травматолого-ортопедической помощи в Российской Федерации в 2019 году». – Москва, 2021. – 120 с. [Ministerstvo zdravookhraneniya Rossiyskoy Federatsii, Federal’noye gosudarstvennoye byudzhetnoye uchrezhdeniye «Natsional’nyy meditsinskiy issledovatel’skiy tsentr travmatologii i ortopedii imeni N.N. Priorova» [Ministry of Health of the Russian Federation, Federal State Budgetary Institution «National Medical Research Center of Traumatology and Orthopedics named after NN Priorov»]. Statisticheskiy sbornik «Travmatizm, ortopedicheskaya zabolevayemost’, organizatsiya travmatologo-ortopedicheskoy pomoshchi v Rossiyskoy Federatsii v 2019 godu» [Statistical digest “Injuries, orthopedic morbidity, organization of trauma and orthopedic care in the Russian Federation in 2019”]. Moskva [Moscow]. 2021; 120 p. (In Russ.)]. https://cito-priorov.ru/cito/files/science/sbornik.pdf

 

UDC 615.036

DOI: 10.20969/VSKM.2024.17(suppl.1).22-26

PDF download ATRIAL FIBRILLATION AND QUALITY OF LIFE OF PATIENTS RECEIVING VARIOUS GROUPS OF INDIRECT ANTICOAGULANTS

ISHMURZIN GENNADY P. ORCID ID: 0000-0002-0962-5790; Cand. sc. med., Associate Professor, Department
of Internal Diseases, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. E-mail: ishm08@mail.ru

PODOLSKAYA ALLA A. ORCID ID: 0000-0002-9474-7601; Cand. sc. med., Head of the Cardiology Department No. 4, City Clinical Hospital No. 7 named after M. N. Sadykov, 54 Marshal Chuikov str., 420103 Kazan, Russia. E-mail: alla.podolsckaya@yandex.ru

Abstract. Introduction. Atrial fibrillation remains one of the most common cardiac arrhythmias. Due to the world’s population aging, it is predicted that the number of patients with atrial fibrillation will reach 14-17 million people in Europe alone by 2030 and only continue to increase annually. The presence of this arrhythmia is associated with an increased risk of life-threatening thromboembolic complications. At the same time, a balanced and reasonable choice of anticoagulant therapy determines the prognosis of patients with atrial fibrillation. Aim. To analyze the physical and mental health components and coagulogram parameters in patients with atrial fibrillation, associated with receiving different groups of indirect anticoagulants. Materials and Methods. The study involved 50 patients diagnosed with atrial fibrillation and stayin in the therapeutic department of one of clinical hospitals in Kazan. All patients were divided into groups according to the form of atrial fibrillation, as well as into subgroups for taking warfarin, taking new oral anticoagulants, and without anticoagulant therapy being prescribed. Physical and mental health components were assessed out using the SF-36 questionnaire. Results and Discussion. The best indicators of the physical health component were found among patients with permanent atrial fibrillation taking warfarin, while the worst indicators were in the group of persistent atrial fibrillation who did not take anticoagulants at all. The mental health component was assessed higher in patients with persistent atrial fibrillation taking new oral anticoagulants, while the lowest values were observed among patients with persistent atrial fibrillation taking warfarin. According to the coagulogram data, there were no honestly significant differences among patients taking various groups of anticoagulants. Conclusions. In general, patients with atrial fibrillation may have insufficient adherence to anticoagulant treatment, which is associated with affordability, as well as the patient’s low awareness of atrial fibrillation complications. The data obtained indicate that the physical health component is higher and coagulogram indices are better in patients with permanent atrial fibrillation taking warfarin, whereas the best mental state is observed in patients taking new oral anticoagulants.

Keywords: atrial fibrillation, anticoagulants, warfarin, new oral anticoagulants.

For reference: Ishmurzin GP, Podolskaya AA. Atrial fibrillation and quality of life of patients receiving various groups of indirect anticoagulants. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (suppl.1): 22-26. DOI: 10.20969/VSKM.2024.17(suppl.1).22-26.

REFERENCES 

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  4. Joglar JA, Chung MK, Armbruster AL, et al. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2024; 149 (1): e1-e156. DOI: 10.1161/CIR.0000000000001193

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  6. Петров В.И., Шаталова О.В., Маслаков А.С. Анализ антитромботической терапии у больных с постоянной формой фибрилляции предсердий (фармакоэпидемиологическое исследование) // Рациональная Фармакотерапия в Кардиологии. – 2014. – No 10 (2). – С.174–178. [Petrov VI, Shatalova OV, Maslakov AS. Analiz antitromboticheskoj terapii u bol’nyh s postoyannoj formoj fibrillyacii predserdij (farmakoepidemiologicheskoe issledovanie) [Analysis of antithrombotic therapy in patients with persistent atrial fibrillation (pharmacoepidemiological study)]. Racional’naya Farmakoterapiya v Kardiologii [Rational Pharmacotherapy in Cardiology]. 2014; 10 (2): 94–104. (In Russ.)]. DOI: 10.20996/1819-6446-2014-10-2-174-178

  7. Lip GYH, Nieuwlaat R, Pisters R, et al Refining Clinical Risk Stratification for Predicting Stroke and Thromboembolism in Atrial Fibrillation Using a Novel Risk Factor–Based Approach The Euro Heart Survey on Atrial Fibrillation. CHEST. 2010; 137: 263–272. DOI: 10.1378/ chest.09-1584

  8. European Heart Rhythm Association; European Association for Cardio-Thoracic Surgery; Camm AJ, Kirchhof P, Lip GY, et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J. 2010; 31 (19): 2369-429. DOI: 10.1093/ eurheartj/ehq278

  9. Явелов И.С. Основные показания к применению пероральных антикоагулянтов: как выбрать оптимальный препарат // Качественная клиническая практика. – 2017. – No 3. – С.53-60. [Yavelov IS. Osnovnye pokazaniya k primeneniyu peroral’nyh antikoagulyantov: kak vybrat’ optimal’nyj preparat [The main indications for the use of oral anticoagulants: how to choose the optimal drug]. Kachestvennaya klinicheskaya praktika [High-quality clinical practice]. 2017; 3: 53–60. (In Russ.)].

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UDC 616. 514:616.9:578.834.1:615.37

DOI: 10.20969/VSKM.2024.17(suppl.1).27-32

PDF download IMPACT OF CORONAVIRUS INFECTION AND SARS-COV-2 VACCINATION ON THE COURSE OF CHRONIC URTICARIA

KLYUCHAROVA ALIYA R., ORCID ID: 0000-0001-9045-5831; Cand. sc. med., Allergy and Immunology Specialist at the City Center of Allergology and Immunology, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Chuikov str., 420103 Kazan, Russia; Associate Professor, Department of Internal Diseases, Institute of Fundamental Medicine and Biology, Kazan Federal University, 74 Karl Marx str., 420012 Kazan, Russia. E-mail: aliluia@yandex.ru

DELIAN VICTORIA Y., ORCID ID: 0000-0001-6816-4253, SPIN-code: 5562-4056, Cand. sc. med., Head of the City Center of Allergology and Immunology, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Chuikov str., 420103 Kazan, Russia; Associate Professor, Department of Allergology and Immunology, Kazan State Medical Academy, 36 Butlerova str., 420012 Kazan, Russia. E-mail: viktoria_delyan@mail.ru

Abstract. Introduction. According to its definition, urticaria refers to a group of diseases characterized by the development of wheals, angioedema, or both. Most often, chronic urticaria is triggered by stress, hormonal drugs, consumption of products containing food colorants, preservatives, gastrointestinal diseases, autoimmune pathology, as well as by infections, including COVID-19. Due to the fact that the coronavirus epidemic set on relatively recently, the effect of this virus, as well as of SARS-CoV-2 vaccination, on the course of chronic urticaria has not been studied in sufficient detail. Aim. Evaluation of the impact of SARS-CoV-2 and COVID-19 vaccination on the course of chronic urticaria. Materials and Methods. The impact of SARS-CoV-2 and COVID-19 vaccination on the course of chronic urticaria was assessed in 100 patients from 2021 to 2023, using the questionnaire developed and the UCT questionnaire. Patients aged 39±15 years participated in the survey. Results and Discussion. The duration of chronic urticaria in most respondents (58%) was more than 2 years, and in only 7% less than a year. According to the UCT results, urticaria symptoms were controlled in 67% of patients before the SARS-CoV-2 epidemic. 64 people recovered from COVID-19; however, exacerbation of urticaria associated with SARS-CoV-2 was observed in 35.9% of patients, while the disease onset was found in 3.1% of them. It should be noted that exacerbation of urticaria developed during COVID-19 persisted in all patients for 3 months, and in a half of them for 6 months after the infection. 67 patients were vaccinated against COVID-19: 63 with Gam-COVID-Vac and 4 with CoviVac, while immunoprophylaxis was not recommended for 15 patients due to their uncontrolled urticaria. 23.8% patients vaccinated with Gam-COVID-Vac experienced fever and headache on the first day. Only 8% of patients experienced exacerbation of urticaria. Conclusions. Patients with chronic urticaria usually have a mild form of COVID-19. However, SARS-CoV-2 causes exacerbation or onset of urticaria in 35.9% of cases. Vaccination with Gam-COVID-Vac is well tolerated by patients with chronic urticaria, and only 8% of patients experience exacerbation of the disease.

Keywords: chronic urticaria, SARS-CoV-2, COVID-19, vaccination.

For reference: Klyucharova AR, Delian VI. Impact of Coronavirus Infection and SARS-CoV-2 Vaccination on the Course of Chronic Urticaria. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (suppl.1): 27-32. DOI: 10.20969/VSKM.2024.17(suppl.1).27-32.

REFERENCES

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  12. Genovese G, Moltrasio C, Berti E, Marzano AV. Skin Manifestations Associated with COVID-19: Current Knowledge and Future Perspectives. Dermatology. 2021; 237 (1): 1-12. DOI: 10.1159/000512932

  13. Gottlieb M, Long B. Dermatologic manifestations and complications of COVID-19. Am J Emerg Med. 2020; 38 (9): 1715-1721. DOI: 10.1016/j.ajem.2020.06.011

  14. Kocatürk E, Salman A, Cherrez-Ojeda I, et al. The global impact of the COVID-19 pandemic on the management and course of chronic urticaria. Allergy. 2021; 76: 816–830. DOI: 10.1111/all.14687

  15. Muntean IA, Pintea I, Bocsan IC, et al. COVID-19 Disease Leading to Chronic Spontaneous Urticaria Exacerbation: A Romanian Retrospective Study. Healthcare (Basel). 2021; 9 (9): 1144. DOI: 10.3390/healthcare9091144

  16. Grieco T, Ambrosio L, Trovato F, et al. Effects of Vaccination against COVID-19 in Chronic Spontaneous and Inducible Urticaria (CSU/CIU) Patients: A Monocentric Study. J Clin Med. 2022; 11 (7): 1822. DOI: 10.3390/jcm11071822

  17. Kocatürk E, Salameh P, Sarac E, et al. Urticaria exacerbations and adverse reactions in patients with chronic urticaria receiving COVID-19 vaccination: Results of the UCARE COVAC-CU study. J Allergy Clin Immunol. 2023; 152 (5): 1095-1106. DOI: 10.1016/j.jaci.2023.07.019

  18. Kocatürk E, Muñoz M, Elieh-Ali-Komi D, et al. How Infection and Vaccination Are Linked to Acute and Chronic Urticaria: A Special Focus on COVID-19. Viruses. 2023; 15 (7): 1585. DOI: 10.3390/v15071585

 

 

UDC 616-035

DOI: 10.20969/VSKM.2024.17(suppl.1).33-39

PDF download SEVERE ACUTE PANCREATITIS: OPTIONS OF TACTICAL APROACHES TO TREATMENT

MALKOV IGOR S., ORCID ID: 0000-0003-2350-5178, Scopus Author ID: 7003868993; Dr. sc med., Professor, Head of the Department of Surgery, Kazan State Medical Academy, 36 Butlerov str., 420012 Kazan, Russia. E-mail: ismalkov@yahoo.com

ZAYNUTDINOV AZAT M., ORCID ID: 0000-0003-2090-4034; Cand. sc. med., Associate Professor at the Department of Surgery, Kazan State Medical Academy, 36 Butlerov str., 420012 Kazan, Russia. E-mail: zainutdinov@mail.ru

MAKAROV DENIS V., ORCID ID: 0000-003-2246-9849; Endoscopist at the Department of Endoscopy, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Chuikova str., 420103 Kazan, Russia. E-mail: Makarovden90@gmail.com 

KUROCHKIN SERGEY V., ORCID ID: 0000-0002-8043-3871; Cand. sc. med, Head of the Department of Radiology, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Chuikova str., 420103 Kazan, Russia. E-mail: kurochkin.70@bk.ru

NURIEV ILMIR I., ORCID ID: 0009-0002-7138-6126; Surgeon at the Surgery Department 1, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Chuikova str., 420103 Kazan, Russia. E-mail: nurievmd@gmail.com

GUBAEV RUSLAN F., 0000-0003-3526-413Х; Head of Surgery Department 1, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Chuikova str., 420103 Kazan, Russia. E-mail: gubaevrus@mail.ru

Abstract. Introduction. Severe acute pancreatitis still remains a pressing issue of urgent abdominal surgery. Aim: To provide a multifactorial analysis of managing patients with severe acute pancreatitis and assess the efficiency of the treatment approaches used. Materials and Methods. Our study included 94 patients with severe acute pancreatitis, aged 30 to 76 years (average age 48.6+10.1), admitted to Surgery Departments 1 and 2 of Kazan City Clinical Hospital 7 over the last 10 years. There were 58 (61.7 %) male patients and 36 (38.3 %) female patients. We did not include patients with severe comorbid diseases, pregnant patients, drug addicts, or those refusing to be involved in our study. Extremely severe, fulminant forms of acute pancreatitis were also excluded, namely: SOFA ≥ 7 and/or intraabdominal pressure >25 mm Hg persisting after 48 hours from the onset of the disease. 30 (31.9%) patients were admitted within the first 24h, 44 (46.8%) patients within 24-72h, and 20 (21.3%) within 3-5 days upon the onset. Examination of the patients included clinical, laboratory, and imaging approaches. We used conservative methods, such as massive infusions, epidural block, and parenteral feeding with gradually changing into enteral feeding. Minimal invasive approaches were used, such as laparoscopy, ultrasound-controlled liquid inclusions drainage, and endoscopic main pancreatic duct stenting. Transabdominal and extraperitoneal open surgeries were performed, as well. The findings were evaluated statistically using Statistica 6.0. In evaluating nonparametric values, we calculated criterion χ2 (chi-squared test). Differences in the results were considered statistically significant at p<0.05. Results and Discussion. Our analysis of current approaches to the treatment of severe acute pancreatitis showed benefits of intensive care combined with minimal invasive surgery performed at the onset of the disease. This allowed increasing the patients’ survival rates to 81.9 % and reducing mortality to 18.1 %. Conclusions. Unsatisfactory treatment outcomes of severe acute pancreatitis are mostly caused by inaccurate evaluation of the disease severity at admission and, therefore, delayed initiation of intensive care.

Keywords: severe acute pancreatitis, x-ray examination, laparoscopy, stenting, ultrasound-controlled liquid inclusions drainage, enteral feeding.

For reference: Malkov IS, Zaynutdinov AM, Makarov DV, et al. Severe acute pancreatitis: options of tactical approaches in treatment. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (suppl.1): 33-39. DOI: 10.20969/VSKM.2024.17(suppl.1).33-39.

REFERENCES 

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  6. Багдатьев, В.Е., Гольдина О.А., Горбачевский Ю.В. Комплексная терапия деструктивного панкреатита. Определяющая роль правильного выбора инфузионной терапии // Вестник интенсивной терапии. – 2008. – No 3. – С.26–32. [Bagdatiev VE, Goldina OA, Gorbachevsky YuV. Kompleksnaya terapiya destruktivnogo pankreatita; Opredelyayushchaya rol’ pravil’nogo vybora infuzionnoj terapii [Complex therapy of destructive pancreatitis; The determining role of the correct choice of infusion therapy]. Vestnik intensivnoj terapii [Bulletin of intensive care]. 2008; 3: 26–32. (In Russ.)].

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UDC 616.7

DOI: 10.20969/VSKM.2024.17(suppl.1).40-47

PDF download CAUSE ANALYSIS OF THE LABOR OPPORTUNISM OF CLINICAL STAFF

MINNULLIN MARSEL M., ORCID ID: 0000-0001-9761-003X; Cand. sc. med., Minister of Health of the Republic of Tatarstan, 40/11 Butlerova str., 420120 Kazan, Russia. E-mail: Marsel.Minnullin@tatar.ru

BODROV OLEG G., ORCID ID: 0000-0003-4322-6053; Cand. sc. econ., Associate Professor, Department of Economic Theory and Econometrics, Institute of Management, Economics and Finance, Kazan (Volga Region) Federal University, 6/20 Kremlevskaya str., 420008 Kazan, Russia. E-mail: bodrov7@yandex.ru

DELYAN ARTUR M., ORCID ID: 0000-0002-2328-7679; Cand. sc. med., Chief Physician, City Clinical Hospital No. 7, 54 Chuikov str., 420103 Kazan, Russia. E-mail: gkb7@bk.ru

BODROVA REZEDA A., ORCID ID: 0000-0003-3540-0162; Dr. sc. med., Associate Professor, Head of the Department of Rehabilitation and Sports Medicine, Kazan State Medical Academy, Chief External Expert of the Ministry of Health of the Republic of Tatarstan on Medical Rehabilitation, K54 Chuikov str., 420103 Kazan, Russia. E-mail: bodrovarezeda@yandex.ru

Abstract. Introduction. The nature of labor opportunism, especially in Russian institutions, is informal, it acts as a “counterbalance” to the existing formal legally accepted rules, supplementing their shortcomings, outdated provisions, and ineffective communication processes created based on the above. The opportunism of personnel and organizational leaders is aimed at restoring the broken balance between their mutual expectations. Labor opportunism is the response to the management opportunism found in most organizations in abundance. The aim of the study is to analyze the methods of detecting and quantifying the level of the staff labor opportunism based on the analysis of labor opportunism of the clinical staff and forms of its external manifestations, taking into account the job categories of employees at different hierarchical levels. Special attention is paid to studying the causes of the employees’ labor opportunism. Materials and Methods. The questionnaire survey findings of 618 healthcare professionals of the hospital and 42 managers of different levels were analyzed using the Gretl application software package. In accordance with the study purpose, the necessary statistical calculations were carried out using the methods of correlation, analysis of variance, t-criterion, and regression analysis. Results and Discussion. The predicted opportunism level of the hospital management was 0.40, which is significantly higher than the staff opportunism level, which was 0.28. Increase in the office managers’ trust in their employees leads to an increase in the staff labor opportunism, abusing this trust [R=0.50, R2=0.25, F=5.08, p <0.05]. To a greater extent, management opportunism is manifested by regularly loading subordinates with work assignments beyond the scope of their functional responsibilities [R=0.48, R2=0.23, p<0.01]. Hospital management opportunism depends on that of department managers by 68.3%. The findings obtained in the study allow us to assert that the source of labor opportunism in a clinic is the opportunism interdependence of the hospital management and department managers. The mean quantitative score of the opportunism level of the hospital department managers is Y=0.39. The stability of the opportunistic balance in the clinic is almost perfect as it is the closest to 1. This result is very close to the equilibrium result. Conclusions. The findings obtained in the study allow us to state that the source of labor opportunism in the clinic is the opportunism interdependence of the hospital management and department managers. The nature of this interaction generates relevant wave effects used to identify the opportunism level of the entire clinic staff. To test the validity of this conclusion, models 6 and 7 of paired regressions were constructed, whereby the strength of the mutual influence of these factors can be assessed based on the regression coefficients obtained.

Keywords: labor opportunism, regression model, opportunism trap, opportunism stability.

For reference: Minnullin MM, Bodrov OG, Delyan AM, Bodrova RA. Cause analysis of the labor opportunism of the clinical staff. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (suppl.1): 40-47. DOI: 10.20969/VSKM.2024.17(suppl.1).40-47.

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  1. Уильямсон О.Э. Поведенческие предпосылки современного экономического анализа, перевод А.В. Белянина // Thesis. – 1993. – Вып. 3. – С.39-49. [Williamson OE. Povedencheskie predposilki sovremennogo ekonomicheskogo analiza: perevod AV Belyanina [The behavioral assumptions of modern economic analysis: translation by AV Belyanin]. Thesis [Thesis]. 1993; 3: 39-49. (In Russ.)].

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  4. Бодров О.Г. Оценка причин трудового оппортунизма среди персонала // Казанский экономический вестник. – 2013. – No 5. – С.13-21. [Bodrov OG. Ocenka prichin trudovogo opportunizma sredi personal [Estimation of the causes of labour opportunism among personnel]. Kazanskii ekonomicheskii vestnik [Kazan Economic Bulletin]. 2013, 5: 13-21. (In Russ.)].

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  7. Wafai K. Opportunism in organizations. Journal of Law, Economics, and Organization. 2010; 26 (1): 158-181. DOI:10.1093/jleo/ewn025

  8. Bevia C, Corchón L. Rational Sabotage in Cooperative Production with Heterogeneous Agents. Topics in Theoretical Economics. 2006; 6(1): 29. DOI: 10.2202/ 1534-598X.1240

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UDC: 616-005.3

DOI: 10.20969/VSKM.2024.17(suppl.1).48-53

PDF download OSTEOPOROSIS RISK IN WOMEN WITH BREAST VASCULAR CALCIFICATIONS REVEALED AT MAMMOGRAPHY

PASYNKOVA OLGA O., ORCID ID: 0000-0001-9117-8151; Scopus Author ID: 8248104000; Web of Science Researcher ID AGW-8627-2022, RSCI Author ID 218546; SPIN-code: 7853-0545. Cand. sc. med., Associate Professor, Associate Professor at the Department of Fundamental Medicine, Medical Institute of Mari State University, 1 Lenin sq., 424000 Yoshkar-Ola, Russia. E-mail: o.o.pasynkova@yandex.ru

KRASILNIKOV ALEXEI V., ORCID ID: 0000-0002-3992-8135, Chief Physician of the Republic’s Clinical Veterans’ Hospital, 24 Osipenko str., 424037 Yoshkar-Ola, Russia. E-mail: krasdoc@yandex.ru

PASYNKOV DMITRY V., ORCID ID: 0000-0003-1888-2307, Scopus Author ID: 57194777454; Web of Science Researcher ID: HJH-2122-2023, RSCI Author ID: 963099; SPIN-код: 7264-3745; Cand. sc. med., Associate Professor at the Department of Diagnostic Ultrasound, Kazan State Medical Academy; Head of the Department of Radiology and Oncology, Medical Institute, Mari State University; Head of Radiology Department, Republic’s Clinical Oncological Dispensary. E-mail: passynkov@mail.ru.

KLYUSHKIN IVAN V. ORCID ID: 0000-0002-5654-6710; Dr. sc. med., Professor, Head of the Research Department, City Clinical Hospital No. 7 named after. M.N. Sadykova, 54 Marshala Chuikova str., 420103 Kazan, Russia; Professor at the Department of General Surgery, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. Tel.: +7 843 2360652. E-mail: hirurgivan@mail.ru

FATIKHOV RUSLAN I., ORCID ID: 0000-0002-7322-8853 SPIN: 1072-2995, Researcher ID (WOS) IAR-4981-2023, Research Supervisor at the Center of Endourology, City Clinical Hospital No. 7 named after M.N. Sadykov,
54 Marshala Chuikova str., 420103 Kazan, Russia; Assistant Professor at the Department of General Surgery, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. E-mail: 74ruslan@rambler.ru (Corresponding Author)

Abstract. Introduction. Calcium salt deposits in the breast vessel walls can share the mutual mechanisms compared to the ones of bone tissue mineralization mediated by the osteoprotegerin or receptors of the protein glycation end products. Aim: To assess the risk of osteoporosis or other mineral turnover disturbances in women with breast vascular calcifications found on mammography. Materials and Methods. Our study included 189 female patients who underwent mammography in 2018 and then were followed up to the year 2023. They were divided into the three groups: No calcifications group, moderate (grade 1-2) calcifications group, and pronounced (grade 3-4) calcifications group. All the patients underwent screening mammography, the dual-energy X-ray absorptiometry, and serum biochemistry tests (25-hydroxyvitamin D, total and ionized calcium, phosphorus, and magnesium). Results and Discussion. In 2018, 57 (30.16%) patients had breast vascular calcifications. The increased calcification degree was associated with the age. The most significant changes were found in TBS T-score values: In the moderate calcifications group, it was 27.5% lower compared to the no calcifications group (p=0.042); while in the pronounced calcifications group, it was 41.7% lower compared to the no calcifications group (p=0.007). Conclusions. Breast vascular calcifications are associated with the significant drop of TBS T-score values (from -2.31 to -3.97; р=0.008).

Keywords: mineral density, trabecular bone score, TBS, calcium, magnesium, phosphorus, vitamin D.

For reference: Pasynkova ОО, Krasilnikov АV, Pasynkov DV, et al. Osteoporosis risk in women with breast vascular calcifications revealed at mammography. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (suppl.1): 48-53. DOI: 10.20969/VSKM.2024.17(suppl.1).48-53.

REFERENCES

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  2. Hendriks EJ, de Jong PA, van der Graaf Y, et al. Breast arterial calcifications: a systematic review and meta-analysis of their determinants and their association with cardiovascular events. Atherosclerosis. 2015; 239: 11–20. DOI: 10.1016/j. atherosclerosis.2014.12.035

  3. Haq A, Veerati T, Walser-Kuntz E, et al. Coronary artery calcium and the risk of cardiovascular events and mortality in younger adults: a meta-analysis. European Journal of Preventive Cardiology. 2023; zwad399. DOI:10.1093/eurjpc/zwad399

  4. Lee SJ, Lee I-K, Jeon J-H. Vascular Calcification–New Insights into Its Mechanism. International Journal of Molecular Sciences. 2020; 21 (8): 2685. DOI: 10.3390/ijms21082685

  5. Yoon YE, Kim KM, Lee W, et al. Breast Arterial Calcification is Associated with the Progression of Coronary Atherosclerosis in Asymptomatic Women: A Preliminary Retrospective Cohort Study. Sci Rep. 2020; 10 (1): 2755. DOI: 10.1038/s41598-020-59606-y

  6. Ahn KJ, Kim YJ, Cho HJ, et al. Correlation between breast arterial calcification detected on mammography and cerebral artery disease. Arch Gynecol Obstet. 2011; 284 (4): 957-964. DOI: 10.1007/s00404-010-1742-4

  7. Martini N, Streckwall L, McCarthy AD. Osteoporosis and vascular calcifications. Endocrine connections. 2023; 12 (11): e230305. DOI: 10.1530/EC-23-0305

8. Gebre AK, Lewis JR, Leow K, et al. Abdominal Aortic Calcification, Bone Mineral Density, and Fractures: A Systematic Review and Meta-analysis of Observational Studies. J Gerontol A Biol Sci Med Sci. 2023; 78 (7): 1147-1154. DOI: 10.1093/gerona/glac171

9. Пасынков Д.В., Пасынкова О.О., Красильников А.В., [и др.]. Выраженные сосудистые кальцинаты молочных желез как потенциальный маркер остеопороза // Вестник современной клинической медицины. – 2023. – Т.16, прил. 1. – С.85-91. [Pasynkov DV, Pasynkova OO, Krasil’nikov AV, et al. Vyrazhennye sosudistye kal’cinaty molochnyh zhelez kak potencial’nyj marker osteoporoza [Evident breast vascular calcifications as a promising osteoporosis marker]. Vestnik sovremennoj klinicheskoj mediciny [The Bulletin of Contemporary Clinical Medicine]. 2023; 16 (suppl. 1): 85-91. (In Russ.)]. DOI: 10.20969/VSKM.2023.16 (suppl.1).85-91

10. Atci N, Elverici E, Kurt RK, et al. Association of breast arterial calcification and osteoporosis in Turkish women. Pak J Med Sci. 2015; 31 (2): 444-447. DOI: 10.12669/pjms.312.6120

11. ReddyJ,BilezikianJP,SmithSJ,etal.Reducedbonemineral density is associated with breast arterial calcification. The Journal of clinical endocrinology and metabolism. 2008; 93 (1): 208–211. DOI: 10.1210/jc.2007-0693

12. Nasser EJ, Iglésias ER, Ferreira JA, et al. Association of breast vascular calcifications with low bone mass in postmenopausal women. Climacteric. 2014; 17 (4): 486-491. DOI: 10.3109/13697137.2013.869672

13. Adibi A, Rabani F, Hovsepian S. Bone Density in Postmeno-pausal Women with or without Breast Arterial Calcification. Advanced biomedical Research. 2018; 6 (1): 36. DOI; 10.4103/2277-9175.203161

14. Iribarren C, Chandra M, Molloi S, et al. No Association Between Bone Mineral Density and Breast Arterial Calcification Among Postmenopausal Women. J Endocr Soc. 2019; 4 (2): bvz026. DOI: 10.1210/jendso/bvz026

15. Rajan R, Cherian KE, Kapoor N, Paul TV. Trabecular Bone Score-An Emerging Tool in the Management of Osteoporosis. Indian J Endocrinol Metab. 2020; 24 (3): 237-243. DOI: 10.4103/ijem.IJEM_147_20

16. Shevroja E, Reginster JY, Lamy O, et al. Update on the clinical use of trabecular bone score (TBS) in the management of osteoporosis: results of an expert group meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), and the International Osteoporosis Foundation (IOF) under the auspices of WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging. Osteoporos Int. 2023; 34 (9): 1501-1529. DOI: 10.1007/ s00198-023-06817-4

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21. El Miedany Y, Elwakil W, Abu-Zaid MH, et al. Update on the utility of trabecular bone score (TBS) in clinical practice for the management of osteoporosis: a systematic review by the Egyptian Academy of Bone and Muscle Health. Egypt Rheumatol Rehabil. 2024; 51 (1): 18. DOI: 10.1186/s43166-024-00252-x

 

 

UDC: 616.13-004.6+616-32/.37

DOI: 10.20969/VSKM.2024.17(suppl.1).54-59

PDF download ASSOCIATION OF BREAST VASCULAR CALCIFICATIONS AT MAMMOGRAPHY WITH GASTROINTESTINAL TRACT PATHOLOGY

PASYNKOV DMITRY V., ORCID ID: 0000-0003-1888-2307, Scopus Author ID: 57194777454; Web of Science Researcher ID: HJH-2122-2023, RSCI Author ID: 963099; SPIN сode: 7264-3745; Cand. sc. med., Associate Professor at the Department of Diagnostic Ultrasound, Kazan State Medical Academy; Head of the Department of Radiology and Oncology, Medical Institute, Mari State University; Head of Radiology Department, Republic’s Clinical Oncological Dispensary. E-mail: passynkov@mail.ru

KRASILNIKOV ALEXEI V., ORCID ID: 0000-0002-3992-8135, Chief Physician of the Republic’s Clinical Veterans’ Hospital, 24 Osipenko str., 424037 Yoshkar-Ola, Russia. E-mail: krasdoc@yandex.ru

PASYNKOVA OLGA O., ORCID ID: 0000-0001-9117-8151; Scopus Author ID: 8248104000; Web of Science Researcher ID AGW-8627-2022, RSCI Author ID 218546; SPIN-code: 7853-0545. Cand. sc. med., Associate Professor, Associate Professor at the Department of Fundamental Medicine, Medical Institute of Mari State University, 1 Lenin sq., 424000 Yoshkar-Ola, Russia. E-mail: o.o.pasynkova@yandex.ru

KLYUSHKIN IVAN V. ORCID ID: 0000-0002-5654-6710; Dr. sc. med., City Clinical Hospital No. 7, Kazan, Professor, Professor at the Department of General Surgery, Kazan State Medical University, 49 Butlerova str., 420012 Kazan, Russia. Tel.: +7-843-236-06-52. E-mail: hirurgivan@mail.ru

FATIKHOV RUSLAN I., ORCID ID: 0000-0002-7322-8853 SPIN-code (RSCI) 1072-2995, Researcher ID (WoS) IAR-4981- 2023, Associate Professor at the Department of General Surgery, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. E-mail: 74ruslan@rambler.ru (corresponding author)

Abstract. Introduction. Calcium deposits in the breast vessels can be related to the calcium absorption disturbances in the gastrointestinal tract. Aim is to assess the association of the gastrointestinal pathology risk in women with breast vascular calcifications found at mammography. Materials and Methods. We included 193 patients examined using mammography in 2018. They were then followed up to the year 2023 and divided into two groups: No-calcification group and detectable-calcification group. Gastrointestinal pathology was registered in patient medical records. Results and Discussion. In 2018, 66 (34.2%) patients had breast vascular calcifications. In the detectable-calcification group, the nonspecific intestinal motility disorders were observed two times more frequently compared to the no-calcification group (relative risk [RR]: 2.34; 95%, confidence interval [CL]: 1.04 – 5.38; p=0.037). On the contrary, in the no-calcification group the rate of both esophagitis and gastroesophageal reflux was 4 timed higher than in the detectable-calcification group (RR: 4.29; 95%, CI: 0.95 – 19.34, p=0.041). At the end of the follow-up, the gallbladder stones were found approximately 2 times more frequently in the detectable-calcification group (ОР=2.22; 95%, CI: 1.15 – 4.3; p=0.017). Conclusions. The detectable breast vascular calcifications were associated with the higher gallbladder stones risk during subsequent 6 years (RR: 4.8; 95%, CI: 1.55 – 14.92; р=0.003) compared to the no-calcification group (4.7% versus 19.2%). At the same time, we found no association of the detectable breast vascular calcifications with the risk of hepatic steatosis / nonalcoholic fatty liver disease, gastritis, gastro-duodenitis, hiatal hernia, or pancreatitis.

Keywords: gallstones, gallstone disease, cholecystectomy, diverticular disease, peptic ulcer disease, colitis, intestinal motility disorders, hepatic steatosis, nonalcoholic fatty liver disease, pancreatitis, gastritis, duodenitis, gastroesophageal reflux disease, breast vascular calcifications, mammography.

For reference: Pasynkov DV, Krasilnikov АV, Pasynkova ОО, et al. Association of breast vascular calcifications at mammography with gastrointestinal tract pathology. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (suppl.1): 54-59. DOI: 10.20969/VSKM.2024.17(suppl.1).54-59.

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3. Nohara-Shitama Y, Mok Y, Ballew SH, et al. Associations of dietary calcium and phosphorus with vascular and valvular calcification: the ARIC Study. JACC: Advances. 2024; 3 (7_Part_1): 100993. DOI: 10.1016/j.jacadv.2024.100993

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10. Пасынков Д.В., Пасынкова О.О., Красильников А.В., [и др.]. Выраженные сосудистые кальцинаты молочных желез как потенциальный маркер остеопороза // Вестник современной клинической медицины. – 2023. – Т.16, прил. 1. – С. 85-91. [Pasynkov DV, Pasynkova OO, Krasil’nikov AV, et al. Vyrazhennye sosudistye kal’cinaty molochnyh zhelez kak potencial’nyj marker osteoporoza [Evident breast vascular calcifications as a promising osteoporosis marker]. Vestnik sovremennoj klinicheskoj mediciny [The Bulletin of Contemporary Clinical Medicine]. 2023; 16 (suppl. 1): 85-91. (In Russ.)]. DOI: 10.20969/VSKM.2023.16 (suppl.1).85-91

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REVIEWS

UDC 618.145

DOI: 10.20969/VSKM.2024.17(suppl.1).60-66

PDF download ABDOMINAL WALL ENDOMETRIOSIS: A MULTIDISCIPLINARY APPROACH (Literature review)

GABIDULLINA RUSHANIA I., ORCID ID: 0000-0002-7567-6043; Scopus Author ID 57215670415, Dr. sc. med., Professor, Head of the Department of Obstetrics and Gynecology named after Prof. V. S. Gruzdev, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. E-mail: ru.gabidullina@yandex.ru

MINNULLINA FARIDA F., ODCID ID: 0000-0001-8270-085x, Cand. sc. med., Associate Professor, Head of the Department of Obstetrics and Gynecology, Institute of Biology and Fundamental Medicine, Kazan Federal University, 74 Karl Marx str., 420012 Kazan, Russia; Head of the Department of Gynecology, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshal Chuikov str., 420103 Kazan, Russia. Tel.+7-843-237-72-48. E-mail: minnullina_f@mail.ru

SYRMATOVA LYAJSAN I., ORCID ID: 0000-0003-2393-7157; Head of the Center of Endosurgery in Gynecology, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshal Chuikov str., 420103 Kazan, Russia.
Tel.+7 -843-237-72-48; Е-mail: lsirmatova@mail.ru

MAMETOVA NAILIA A., ORCID ID: 0009-0004-5138-1218; Fourth-year student at the Faculty of General Medicine, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. E-mail: mametova-nailya@mail.ru

Abstract. Introduction. Abdominal wall endometriosis characterized by the presence of ectopic endometrial glands or stroma in the abdominal wall, is a rare form of extragenital endometriosis, but can have a significant negative impact on the quality of women’s life. Abdominal wall endometriosis is mostly iatrogenic and is associated with cesarean section or gynecological operations involving hysterotomy. Given the steady increase in the frequency of cesarean sections, it is expected that the number of cases of abdominal wall endometriosis will continue to grow. Aim: To provide updated information on abdominal wall endometriosis from an interdisciplinary perspective. Materials and Methods. A review of publications based on research using the keywords endometriosis, abdominal wall endometriosis, scar endometriosis, cesarean section scar endometriosis, umbilical endometriosis, and inguinal endometriosis, based on search results in electronic resources in Russian and international systems (eLibrary, PubMed, MedLine, and Crossref) for the last 7 years, from 2017 to 2024. Results and Discussion. Abdominal wall endometriosis occurs with a frequency of 0.04%–5.5%. A typical manifestation is a painful formation in the abdominal wall. The pain syndrome intensity may be determined by the menstrual cycle phase. Endometrioid foci can develop primarily (spontaneously) and secondarily in the postoperative scar area. By localization, abdominal wall endometriosis is divided into cicatricial, umbilical, and inguinal. The average age as of diagnosis is 32-36 years, while the time from surgery to endometriosis identification varies from 3 months to 2 decades. Clinically, the diagnosis is established in 20-50% of cases, and with using additional imaging methods, such as ultrasound, CT, and MRI, this level reaches 70%. Cases of malignant transformation are extremely rare and amount to about 1%. The question remains controversial regarding the relationship of abdominal wall endometriosis to the presence of other concomitant endometriosis forms. Currently, the gold standard of treatment is wide excision of endometrioid foci, including the surrounding fibrous tissue. The recurrence rate varies from 1.5 to 28.6%. Conclusion. Interdisciplinary collaboration involving gynecologists, surgeons, imaging specialists, and pathologists is necessary for early diagnosis and optimization of abdominal wall endometriosis patient treatment.

Keywords: endometriosis, abdominal wall endometriosis, scar endometriosis, scar endometriosis after cesarean section, umbilical endometriosis, inguinal endometriosis.

For reference: Gabidullina RI, Minnullina FF, Syrmatova LI, Mametova NA. Abdominal wall endometriosis: A multidisciplinary approach (Literature review). The Bulletin of Contemporary Clinical Medicine. 2024; 17 (suppl.1): 60-66. DOI: 10.20969/VSKM.2024.17(suppl.1).60-66.

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UDC 617.55-007.43

DOI: 10.20969/VSKM.2024.17(suppl.1).67-74

PDF download POSTOPERATIVE VENTRAL HERNIAS: UNRESOLVED ISSUES OF DIAGNOSIS AND SURGERY TACTICS

DOBROKVASHIN SERGEY V., ORCID ID: 0000-0002-9817-9816, Dr. sc. med., Professor, Head of the Department of General Surgery, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. E-mail: gsurgery1@yandex.ru 

IZMAILOV ALEXANDER G., ORCID ID: 0000-0001-9559-550X, Dr. sc. med., Associate Professor, Department of General Surgery, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. E-mail: izmailov_alex@mail.ru

YANTYKOVA AZALIA A., ORCID ID: 0009-0003-7319-1231, 4th-year student of the Faculty of Medicine, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. E-mail: azalia-302003@mail.ru

OVCHINNIKOV PAVEL D., ORCID ID: 0009-0008-2370-7531, Assistant Professor at the Department of General Surgery, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. E-mail: pavelov4innikov@icloud.com

VOLKOV DMITRY E., ORCID ID: 0000-0002-7253-3370, Cand. sc. med., Associate Professor, Department of General Surgery, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. E-mail: gsurgery1@yandex.ru

KLYUSHKIN IVAN V. ORCID ID: 0000-0002-5654-6710, Dr. sc. med., Professor, Head of the Research Department, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshala Chuikova str., 420103 Kazan, Russia; Professor at the Department of General Surgery, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia; Tel.: +7-843-236-06-52. E-mail: hirurgivan@mail.ru

FATIKHOV RUSLAN I., ORCID ID: 0000-0002-7322-8853 SPIN: 1072-2995, Researcher ID (WOS) IAR-4981-2023, Cand. sc. med., Research Director of the Center of Endourology, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshala Chuikova str., 420103 Kazan, Russia; Assistent Professor at the Department of General Surgery, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. E-mail: 74ruslan@rambler.ru

Abstracts. Introduction. Postoperative ventral hernias are formed in 15-30% of cases after abdominal surgeries. Patients with postoperative ventral hernias rank 2nd after inguinal hernias, accounting for up to 22% of the total number of abdominal hernias. The advent of tension-free hernioplasty using synthetic implants helped solve some herniology issues: Number of relapses in the late postoperative period has significantly decreased. Aim of the study was to analyze the literature in accordance with modern problems regarding the surgical approaches to the treatment of postoperative ventral hernias. Materials and Methods. The literature review was made using the method of searching for publications in the PubMed databases. Results and Discussion. Computed tomography is the most informative in diagnosing the condition of the anterior abdominal wall tissues in patients with postoperative ventral hernias. The fundamental issue is the choice of abdominal wall layers for placing and strengthening the implant. An implant can be placed in the abdominal wall layers by different methods: Intraperitoneal, preperitoneal, retromuscular, and, in some cases, subaponeurotic and supra-aponeurotic. Conclusions. The use of combined methods of plastic surgery of the anterior abdominal wall for large postoperative ventral hernias using the sublay-inlay technique allows avoiding high traumatic effect of the operation and reducing the recurrence rate. In case of large postoperative ventral hernias, improving the optimal open surgery methods remains relevant.

Keywords: ventral hernias, review, implant, seroma, surgical tactics.

For reference: Dobrokvashin SV, Izmailov AG, Yantykova AA, et al. Postoperative ventral hernias: Unresolved issues of diagnosis and surgery tactics. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (suppl.1): 67-74. DOI: 10.20969/VSKM.2024.17(suppl.1).67-74.

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PRACTICAL EXPERIENCE

UDC: 616-009.862

DOI: 10.20969/VSKM.2024.17(suppl.1).75-82

PDF download MASKS OF ACUTE CEREBROVASCULAR ACCIDENTS IN YOUNG PEOPLE: POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME

VALEEVA KADRIA G., ORCID ID: 009-0001-4699-9257, Neurologist, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshal Chuikov str., 420103 Kazan, Russia. E-mail: valeevakadria@yandex.ru

VASKAYEVA GULNAZ R., ORCID ID: 0000-0001-6565-7642, Neurologist, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshal Chuikov str., 420103 Kazan, Russia. E-mail: gulnaz. vaskaeva@gmail.com DANILOVA TATIANA V., ORCID ID: 0000-0001-6926-6155, Dr. sc. med., Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. E-mail: tatvdan@yandex.ru

Abstract. Introduction. Posterior Reversible Encephalopathy Syndrome is a clinical radiological syndrome characterized by acute, potentially reversible vasogenic edema of the subcortical white matter of the brain, predominantly involving the occipital and parietal lobes. Aim was to discuss the difficulties in diagnosing this syndrome. Material and Methods. A clinical case of a patient was analyzed, who had been admitted to a medical facility with acute severe neurological symptoms arising from uncontrolled arterial hypertension and kidney pathology. Results and Discussion. The patient manifested an acute development of the disease, severe headache, focal neurological symptoms, confusion, epileptic seizure, and the characteristic signs of the disease on neuroimaging. Conclusions. This clinical case illustrates the variety of predisposing factors and clinical and radiological manifestations of the posterior reversible encephalopathy syndrome. The case presented emphasizes the importance of including posterior reversible encephalopathy syndrome in the differential diagnosis of acute neurological symptoms, especially in the presence of risk factors, such as arterial hypertension, alcohol exposure, kidney pathology, and previous brain injuries; and it also demonstrates the key role of magnetic resonance imaging in diagnosing and preventing potentially irreversible brain changes.

Keywords: posterior reversible encephalopathy syndrome, magnetic resonance imaging.

For reference: Valeeva KG, Vaskaeva GR, Danilova TV. Masks of acute cerebrovascular accidents in young people: Posterior reversible encephalopathy syndrome. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (suppl.1): 75-82. DOI: 10.20969/VSKM.2024.17(suppl.1).75-82.

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UDC: 616.12-089:615.8

DOI: 10.20969/VSKM.2024.17(suppl.1).83-89

PDF download CARDIAC REHABILITATION FOR A PATIENT WITH MYASTHENIA GRAVIS AFTER CORONARY BYPASS GRAFTING USING BILATERAL INTERNAL MAMMARY ARTERIES. A clinical case

GUMAROVA LAYSYAN SH., ORCID ID: 0000-0002-5743-8113, Cand. sc. med., Associate Professor, Department of Rehabilitation and Sports Medicine, Kazan State Medical Academy – Branch of the Russian Medical Academy of Postgraduate Education, 36 Butlerov str., 420012 Kazan, Russia. Head of the Department of Medical Rehabilitation of Patients with Internal Diseases, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshall Chuikov str., 420103 Kazan, Russiа. E-mail: lyaisan@inbox.ru

GORELKIN IVAN V., ORCID ID: 0009-0003-0416-2015, Physician, Department of Medical Rehabilitation of Patients with Internal Diseases, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshall Chuikov str., 420103 Kazan, Russiа. E-mail: marcus@mail.ru

BODROVA REZEDA A., ORCID ID: 0000-0003-3540- 0162, Dr. sc. med., Associate Professor, Head of the Department of Rehabilitation and Sports Medicine, Kazan State Medical Academy – Branch of the Russian Medical Academy
of Postgraduate Education, 36 Butlerov str., 420012, Kazan, Russia, e-mail: bodrovarezeda@yandex.ru

SHAIKHUTDINOVA ZULFIYA A., ORCID ID: 0000-0002-3457-0138, Deputy Chief Physician, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshall Chuikov str., 420103 Kazan, Russiа. E-mail: zulfiya.shaih@yandex.ru.

ROMANOVA OLGA V., ORCID ID: 0009-0005-8722-7113, Physician, Department of Medical Rehabilitation of Patients with Internal Diseases, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshall Chuikov str., 420103 Kazan, Russiа. E-mail: romanovarov@mail.ru

ABUBAKIROVA ALBINA K., ORCID ID: 0009-0006-4744-9210, Cardiologist, Department of Medical Rehabilitation of Patients with Internal Diseases, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshall Chuikov str.,
420103 Kazan, Russiа. E-mail: abr635@yandex.ru

AKMETZYANOVA GULISA A., ORCID ID: 0000-0002-5743-8113 Cand. sc. med, Associate Professor at the Department of Healthcare Management, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. E-mail: gulisa_ak@inbox.ru

Abstract. Introduction. Myasthenia gravis is an autoimmune neuromuscular disease mostly characterized by the formation of antibodies to postsynaptic acetylcholine receptors, leading to weakness aggravated by physical activity. Due to the high prevalence of coronary artery disease worldwide, there is a high probability of its development in patients with myasthenia gravis. Physical training in patients after acute coronary syndrome has proven efficacy in improving quality of life and the outcome. Currently, there is a lack of research in the safety of physical training in myasthenia gravis, so cardiac rehabilitation of these patients is a unique challenge for clinicians. Aim of the study was to evaluate the effect of rehabilitation measures in a patient with myasthenia gravis after coronary bypass grafting using bilateral internal mammary arteries at the inpatient stage of medical rehabilitation. Materials and Methods. A clinical case of a female patient after coronary bypass grafting using bilateral internal mammary arteries is presented, which has been observed for 31 years due to myasthenia gravis (G70.0). The patient was examined by the specialists of a multidisciplinary rehabilitation team, using clinical, laboratory, and instrumental research methods. After establishing the rehabilitation diagnosis and potential, an individual medical rehabilitation plan was developed, which, against the background of drug therapy, included: Electrocardiogram-guided aerobic physical training, laser therapy, and occupational therapy. Results of the rehabilitation measures were assessed using the six-minute walk test (m), the Functional Independence Measurement scale (points), and the QMGS (quantitative myasthenia gravis score for the assessment of the severity of clinical myasthenia symptoms) scale. Results and Discussion. The patient tolerated 5 sessions of aerobic physical training well, demonstrating a noticeable improvement in aerobic capacity, endurance, and physical activity test results. No side effects were noted. Conclusions. Personalized physical training programs are feasible and effective in cardiac rehabilitation of patients with myasthenia gravis. Further research is reasonable and necessary in the rehabilitation of cardiac patients with concomitant autoimmune neuromuscular disease.

Keywords: coronary bypass grafting using bilateral internal mammary arteries, myasthenia gravis (MG), cardiac rehabilitation, exercise tolerance.

For reference: Gumarova LSh, Gorelkin IV, Bodrova RA, et al. Cardiac rehabilitation for a patient with myasthenia gravis after coronary bypass grafting using bilateral internal mammary arteries. A clinical case. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (suppl.1): 83-89. DOI: 10.20969/VSKM.2024.17(suppl.1).83-89.

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UDC 616.065-056.43:612.017.3

DOI: 10.20969/VSKM.2024.17(suppl.1).90-100

PDF download ACUTE GENERALIZED EXANTHEMATOUS PUSTULOSIS: A SHORT REVIEW AND CASE REPORT

DELIAN VICTORIA Y., ORCID ID: 0000-0001-6816-4253, SPIN-code: 5562-4056, Cand. sc. med., Head of the City Center orf Allergology and Immunology, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Chuikov str., 420103 Kazan, Russia; Associate Professor, Department of Allergology and Immunology, Kazan State Medical Academy, 36 Butlerova str., 420012 Kazan, Russia. E-mail: viktoria_delyan@mail.ru

KLYUCHAROVA ALIYA R., ORCID ID: 0000-0001-9045-5831; Cand. sc. med., Allergy and Immunology Specialist at the City Center of Allergology and Immunology, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Chuikov str., 420103 Kazan, Russia; Associate Professor, Department of Internal Diseases, Institute of Fundamental Medicine and Biology, Kazan Federal University, 74 Karl Marx str., 420012 Kazan, Russia. E-mail: aliluia@yandex.ru

ZAKIROVA GUZEL N., ORCID ID: 0000-0002-7980-9165; Head of the Consultative and Diagnostic Department, City Center of Allergology and Immunology, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Chuikov str., 420103 Kazan, Russia; Assistant Professor at the Department of Allergology and Immunology, Kazan State Medical Academy, 36 Butlerov str., 420012 Kazan, Russia. E-mail: zakirova.guzel@gmail.com

IAKOVLEVA KSENIIA A., ORCID ID:0009-0006-85298855; Resident Physician, Department of Allergology and Immunology, Kazan State Medical Academy, 36 Butlerov str., 420012 Kazan, Russia. E-mail: dr.yakovlevaka@gmail.com

Abstract. Introduction. Acute generalized exanthematous pustulosis is a rare cutaneous adverse drug reaction. The disease has a complex development mechanism, involving various subpopulations of T cells and monocytes, characterized by a genetically determined imbalance in IL-36 signaling. This reaction has an acute onset, a variety of clinical manifestations, and a self-limited course after drug discontinuation. Aim: Exemplifying by our own clinical observation, to present an algorithm for diagnosing and managing acute generalized exanthematous pustulosis. Material and Methods. Patient Kh., 55 years old, was hospitalized in the vascular neurology department due to ischemic stroke in the posterior circulation system, in the form of vestibulopathy, and left hemiataxia, unspecified pathogenetic subtype. Abundant itchy pustules appeared on the skin of the trunk, upper and lower extremities, weakness, lethargy, and body temperature increase up to 38–38.5oС on the 4th day of treatment. General clinical, laboratory, and instrumental examination methods were used. Results and Discussion. Examination revealed extensive foci of edematous erythema, multiple non-follicular small pustules, an increase in the absolute number of neutrophils to 18,500 cells/μl and eosinophils to 1,250 cells/μl in the general blood test, a moderate increase in the levels of liver transaminases in the biochemical analysis, and a slight pleural effusion on the right in ultrasound. The use of the EuroSCAR scale, based on the assessment of clinical symptoms, morphology of skin lesions, and histological picture of the disease, helped set a correct diagnosis and choose a patient management approach. The patient received treatment with systemic and local glucocorticosteroids, manifesting with good positive changes. Conclusions. Using the EuroSCAR scale developed by a team of international experts helps set the diagnosis of acute generalized exanthematous pustulosis. Immediate discontinuation of the causally significant drug is a prerequisite for successful patient management. Local therapy using disinfectant solutions, topical glucocorticosteroids, and moisturizing lotions is the initial approach to managing a patient with acute generalized exanthematous pustulosis.

Keywords: severe cutaneous adverse reactions, acute generalized exanthematous pustulosis, drug allergy, drug hypersensitivity reactions, T cells.

For reference: Delian VY, Klyucharova AR, Zakirova GN, Iakovleva KA. Acute generalized exanthematous pustulosis: A short review and case report. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (suppl.1): 90-100. DOI: 10.20969/VSKM.2024.17(suppl.1).90-100.

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UDC 615.917

DOI: 10.20969/VSKM.2024.17(suppl.1).101-106

PDF download A CLINICAL CASE OF ACUTE PHENOL INTOXICATION AS AN OCCUPATIONAL DISEASE: BASIC REGULATORY DOCUMENTS

DELYAN ARTUR M., ORCID ID: 0000-0002-2328-7679; Chief Physician, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Chuikov str., 420103 Kazan, Russia; Assistant Professor, Department of Рreventive Medicine, Institute of Biology and Fundamental Medicine, Kazan Federal University, 74 Karl Marx str., 420012 Kazan, Russia. Tel.: +7 (843) 598-40-34. E-mail: gkb7@bk.ru

GALIULLIN ILGIZ M., Head of the Department of Extra-Budgetary Activities, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Chuikov str., 420103 Kazan, Russiа. Tel.: +7 (905) 377-70-97. Е-mail: gkb7-01@mail.ru NASIBULLINA ALIYA R., Head of the Department of Тoxicology, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Chuikov str., 420103 Kazan, Russiа. Tel.: +7 (919) 646-76-07. Е-mail: gbk7@bk.ru

MELNIKOV EVGENIJ A., ORCID ID: 0009-0006-7068-7655; Cand. sc. med., Deputy Chief Physician, City Clinical Hospital No. 7 named after M. N. Sadykov, 54 Chuikov str., 420103 Kazan, Russia. Tel.: +7 (843) 598-40-34.
E-mail: emelnik72@mail.ru

GARIPOVA RAILYA V., ORCID ID: 0000-0001-8986-8030; SCOPUS Author ID: 54904191000; Dr. sc. med., Professor at the Department of Hygiene and Occupational Medicine, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia; Professor at the Department of General Hygiene, Kazan State Medical Academy – Branch of the Russian Medical Academy of Postgraduate Education, 36 Butlerov str., 420012 Kazan, Russia; Professor at the Department of Рreventive Medicine, Institute of Biology and Fundamental Medicine, Kazan Federal University, 74 Karl Marx str., 420012 Kazan, Russia. Tel.: +7 (917) 255-38-44. Е-mail: railyagaripova@mail.ru

MIFTAKHOVA SVETLANA N., Head of the Department of Preventive Мedical Еxaminations, City Clinical Hospital No 7 named after M.N. Sadykov, 54 Chuikov str., 420103 Kazan, Russiа. Tel.: +7 (917) 399-29-11. Е-mail: m.svn@yandex.ru

Abstract. Introduction. Phenol (hydroxybenzene) can cause acute poisoning that may occur through inhalation of its high concentrations or from skin contact. Acute intoxication is manifested by damaging the central nervous system with the development of cerebral disorders. Changes in the blood can manifest as redistributive leukocytosis. Aim of the study is to analyze the clinical observation of a patient with acute phenol poisoning who was admitted at the Department of Toxicology in City Clinical Hospital No. 7 named after M.N. Sadykov. Materials and Methods. Patient I. was taken by an ambulance team from enterprise N, where, while working with phenol and wearing personal protective equipment, he received a chemical injury in contact with the substance. Results and Discussion. At the admission time, the condition was assessed as stable and severe. Final diagnosis by ICD-10: T54.0: Toxic effect: Phenol and phenol homologues. Complications of the underlying disease: Toxic encephalopathy. Primary intoxication delirium. Concomitant diseases: Chemical burn with phenol (acid) of the 1st degree on an area of 6% of the body surface. Conclusions. To resolve the issue of occupational disease and examine his/her professional aptitude, the employee must be sent to the City Center of Occupational Disease within the structure of the City Clinical Hospital No. 7.

Keywords: phenol, acute intoxication, occupational diseases, medical care procedure

For reference: Delyan AM, Galiullin IM, Nasibullina AR, et al. A clinical case of acute phenol intoxication as an occupational disease: Basic regulatory documents. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (suppl.1): 101-106. DOI: 10.20969/VSKM.2024.17(suppl.1).101-106.

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  6. Приказ Минздрава России от 05.05.2016 No 282н «Об утверждении порядка проведения экспертизы профессиональной пригодности и формы медицинского заключения о пригодности или непригодности к выполнению отдельных видов работ». [Prikaz Minzdrava Rossii ot 05/05/2016 No 282n «Ob utverzhdenii poryadka provedeniya ekspertizy professional’noj prigodnosti i formy medicinskogo zaklyucheniya o prigodnosti ili neprigodnosti k vypolneniyu otdel’nyh vidov rabot». 2016. [Order of the Ministry of Health of the Russian Federation dated 05.05.2016 No. 282n «On approval of the procedure for conducting an examination of professional suitability and the form of a medical report on suitability or unsuitability for performing certain types of work». 2016. (In Russ.)].

  7. Приказ Минздрава России от 31.07.2020 No 788н «Об утверждении Порядка организации медицинской реабилитации взрослых». [Prikaz Minzdrava Rossii ot 31/07/2020 No 788n «Ob utverzhdenii Poryadka organizaczii mediczinskoj reabilitaczii vzroslykh». 2020. [Order of the Ministry of Health of Russia dated July 31, 2020 No 788n «On approval of the Procedure for organizing medical rehabilitation of adults». 2020. (In Russ.)].

  8. Приказ Минтруда России от 30.09.2020 No 687н «Об утверждении критериев определения степени утраты профессиональной трудоспособности в результате несчастных случаев на производстве и профессиональных заболеваний» [Prikaz Mintruda Rossii ot 30/09/2020 No 687n «Ob utverzhdenii kriteriev opredeleniya stepeni utraty` professional`noj trudosposobnosti v rezul`tate neschastny`kh sluchaev na proizvodstve i professional`ny`kh zabolevanij». 2020. [Order of the Ministry of Labor of Russia dated September 30, 2020 No 687n «On approval of criteria for determining the degree of loss of professional ability to work as a result of industrial accidents and occupational diseases». 2020. (In Russ.)].

  9. Приказ Минтруда и социальной защиты Российской Федерации от 27.08.2019 No 585н «О классификациях и критериях, используемых при осуществлении медико-социальной экспертизы граждан федеральными государственными учреждениями медико-социальной экспертизы». [Рrikaz Mintruda i soczial`noj zashhity` Rossijskoj Federaczii ot 27/08/2019 No 585n «O klassifikacziyakh i kriteriyakh, ispol`zuemy`kh pri osushhestvlenii mediko-soczial`noj e`kspertizy` grazhdan federal`ny`mi gosudarstvenny`mi uchrezhdeniyami mediko-soczial`noj e`kspertizy». 2019. [Order of the Ministry of Labor and Social Protection of the Russian Federation dated August 27, 2019 N 585n “On classifications and criteria used in the implementation of medical and social examination of citizens by federal state institutions of medical and social examination». 2019. (In Russ.)].

 

 

UDC: 618.3-06:616.12-008.46

DOI: 10.20969/VSKM.2024.17(suppl.1).107-112

PDF download PERIPARTUM CARDIOMYOPATHY DEVELOPED AFTER DELIVERY AS A RARE CAUSE OF HEART FAILURE: A CASE REPORT

DIMITRIEVA DARYA V., ORCID ID: 0009-0005-7263-6467; student, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. Е-mail: darya.dimitrieva@list.ru

TRONIN KIRILL D., ORCID ID: 0009-0002-7139-1160; student, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. Е-mail: kirilltronin981@gmail.com

ZAKIROVA ELVIRA B., ORCID ID: 0000-0002-4653-1734; Cand. sc. med., Deputy Chief Physician for Diagnostics, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 M. Chuikov str., 420103 Kazan, Russia. Е-mail: frolova.67@mail.ru

SLEPUHA ELENA G., ORCID ID: 0000-0002-5122-7235; Cand. sc. med., Head of Cardiology Department No. 3, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 M. Chuikov str., 420103 Kazan, Russia. Е-mail: slepuha_elena@mail.ru

MUKHITOVA ELZA I., ORCID ID: 0000-0002-0950-0277; Cardiologist, Cardiology Department No. 4, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 M. Chuikov str., 420103 Kazan, Russia. Е-mail: elza100487@mail.ru

BAZAEVA NATALYA V., Cardiologist, Cardiology Department No. 3, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 M. Chuikov str., 420103 Kazan, Russia. Е-mail: nata.bazaeva@yandex.ru

KHAZOVA ELENA V., ORCID ID: 0000-0001-8050-2892; SCOPUS Author ID: 57205153574; Cand. sc. med., Associate Professor at the Propaedeutics of Internal Diseases Department named after Professor S. S. Zimnitsky, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. Е-mail: hazova_elena@mail.ru

BULASHOVA OLGA V., ORCID ID: 0000-0002-7228-5848; SCOPUS Author ID: 6507198087, RSCI Author ID: 46110692, Dr. sc. med., Professor at the Propaedeutics of Internal Diseases Department named after Professor S. S. Zimnitsky, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. Е-mail: boulashova@yandex.ru

Abstract. Introduction. Peripartum cardiomyopathy is a rare, idiopathic myocardial disease occurring during pregnancy or within 5 months after delivery and characterized by the decreased contractility of the left ventricular myocardium. Insufficient awareness of physicians about this rare pathology creates prerequisites for the description of interesting clinical observations. This article presents a case follow-up (for 5 months) of female patient R. with diagnosed peripartum cardiomyopathy at the age of 31 years after childbirth. Before and during pregnancy, no risk factors or pathology of cardiovascular system, or myocardium exposure to toxic substances were identified. Patient R. first sought medical attention 3 months after her fourth delivery (in total, there were 5 pregnancies and 4 deliveries without pathologies) and prolonged breastfeeding, symptoms of heart failure appeared and rapidly progressed. Aim. To present a clinical case of peripartum cardiomyopathy developed in the postpartum period. Materials and Methods. A clinical case of peripartum cardiomyopathy of patient R. was analzed, who voluntarily signed the informed consent for examination and permission to anonymously publish personal medical information. Results and Discussion. Peripartum cardiomyopathy is a diagnosis of exclusion; therefore, an important stage is differential diagnosis with manifestations of pre-eclampsia and myocarditis. Untimely diagnosis of peripartum cardiomyopathy, in some cases, is due to lack of physicians’ awareness. An important criterion for diagnosing peripartum cardiomyopathy is the absence of any previously diagnosed cardiovascular diseases; therefore, the first priority is to exclude heart valve defects and dilated cardiomyopathy. In addition, it is necessary to exclude pregnancy-mediated hemodynamic changes, as well as differential diagnosis with such conditions as myocarditis, Takotsubo syndrome, pulmonary embolism, acute coronary syndrome, and human immunodeficiency virus. Conclusions. Thus, the factors contributing to the development of peripartum cardiomyopathy in patient R. were as follows: Age over 30 years, 4 childbirths, iron deficiency anemia. Three diagnostic criteria have formed the basis for the diagnosis of peripartum cardiomyopathy: 1) debut of heart failure within 5 months after delivery; 2) no newly diagnosed heart disease more than 1 month before delivery or any other causes of chronic heart failure; and 3) left ventricular dysfunction according to the findings of echocardioscopy and magnetic resonance imaging with the ejection fraction decreased down to 13 %.

Keywords: peripartum cardiomyopathy, heart failure.

For reference: Dimitrieva DV, Tronin KD, Zakirova EB, et al. Peripartum cardiomyopathy developed after delivery as a rare cause of heart failure: A case report. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (suppl.1): 107-112. DOI: 10.20969/VSKM.2024.17(suppl.1).107-112.

REFERENCES 

  1. McNamara DM, Elkayam U, Alharethi R, et al. Clinical outcomes for peripartum cardiomyopathy in North America: results of the IPAC Study (Investigations of Pregnancy-Associated Cardiomyopathy). J Am Coll Cardiol. 2015; 66: 905-14. DOI: 10.1016/j.jacc.2015.06.1309

  2. Pfeffer TJ, Hilfiker-Kleiner D. Pregnancy and heart disease: pregnancy-associated hypertension and peripartum cardiomyopathy. Curr Probl Cardiol. 2018; 43 (9): 364-388. DOI: 10.1016/j.cpcardiol.2017.10.005

  3. Safirstein JG, Ro AS, Gradhi S, et al. Predictors of left ventricular recovery in a cohort of peripartum cardiomyopathy patients recruited via the internet. Int J Cardiol. 2012; 154: 27-31. DOI: 10.1016/j. ijcard.2010.08.065

  4. Иосава И.К., Суворова Н.Н., Савина Н.М. Предикторы прогноза перипартальной кардиомиопатии: современное состояние проблемы // Кремлевская медицина. Клинический вестник. – 2020. – No 3. – С.87-97. [Iosava IK, Suvorova NN, Savina NM. Prediktory prognoza peripartal’noy kardiomiopatii: sovremennoye sostoyaniye problemy [Predictors of prognosis of peripartum cardiomyopathy: the current state of the problem]. Kremlevskaya meditsina; Klinicheskiy vestnik [Kremlin Medicine; Clinical Bulletin]. 2020; 3: 87-97. (In Russ.)]. DOI: 10.15829/1560-4071-2014-11-76-82

  5. Веселовская Н.Г., Чумакова Г.А., Николаева М.Г., [и др.]. Перипартальная кардиомиопатия: патогенез, клиника, диагностика, лечение, прогноз // Русский медицинский журнал. – 2021. – No10 – С.44-48. [Veselovskaya NG, Chumakova GA, Nikolaeva MG, et al. Peripartal’naya kardiomiopatiya: patogenez, klinika, diagnostika, lecheniye, prognoz [Peripartum cardiomyopathy: pathogenesis, clinic, diagnosis, treatment, prognosis]. Russkiy meditsinskiy zhurnal [Russian Medical Journal]. 2021; 10: 44-48. (In Russ.)].

  6. Ильвина Ю.В., Федорова Т.А., Лощиц Н.В., [и др.]. Перипартальная кардиомиопатия: клиническое наблюдение // Сеченовский вестник. – 2020. – Т.11. No1 – С.71-77. [Ilvina YV, Fedorova TA, Loschits NV, et al. Peripartal’naya kardiomiopatiya: klinicheskoye nablyudeniye [Peripartum cardiomyopathy: clinical observation]. Sechenovskiy vestnik [Sechenov Bulletin]. 2020; 11 (1): 71-77. (In Russ.)]. DOI: 10.47093/2218-7332.2020.11.1.71-77

  7. Onusko E, McDermott MR, Robbins N. Probenecid treatment improves outcomes in a novel mouse model of peripartum cardiomyopathy. PLoS One. 2020; 15 (3): e0230386. DOI: 10.1371/journal.pone.023038631

  8. Honigberg MC, Givertz MM. Peripartum cardiomyopathy. BMJ. 2019; 364: k5287. DOI: 10.1136/bmj.k5287

  9. Arany Z, Elkayam U. Peripartum сardiomyopathy. Circulation. 2016; 133 (14): 1397–409. DOI: 10.1161/ CIRCULATIONAHA.115.020491

  10. Курбанов Р.Д., Абдуллаев Т.А., Мирзарахимова С.Т., [и др.]. Послеродовая (перипартальная) кардиомиопатия: некоторые особенности клинической картины и течения заболевания // Кардиология. – 2012. – Т.52, No6 – С.35–47. [Kurbanov RD, Abdullaev TA, Mirzarakhimova ST, et al. Poslerodovaya (peripartal’naya) kardiomiopatiya: nekotoryye osobennosti klinicheskoy kartiny i techeniya zabolevaniya [Postpartum (peripartum) cardiomyopathy: some features of the clinical picture and course of the disease]. Kardiologiya [Cardiology]. 2012;.52 (6): 35-47. (In Russ.)].

  11. Бегиев Б., Ураимов Ж., Жанбаева А.К., [и др.] Клиническое наблюдение перипартальной кардиомиопатии // Бюллетень науки и практики. – 2022. – Т. 8, No1. – С.101-106. [Begiev B, Uraimov J, Zhanbaeva AK, et al. Klinicheskoye nablyudeniye peripartal’noy kardiomiopatii [Clinical observation of peripartum cardiomyopathy]. Byulleten’ nauki i praktiki [Bulletin of Science and Practice]. 2022; 8 (1): 101-106. (In Russ.)]. DOI: 10. 33619/2414-2948/74/14

 

UDC: 616-009.7

DOI: 10.20969/VSKM.2024.17(suppl.1).113-116

PDF download POST-DURAL PUNCTURE HEADACHE: EPIDURAL BLOOD PATCH APPLICATION CASE REPORT

ZABIROVA KARINA R., ORCID ID: 0000-0002-4501-126Х; Second-Year Resident Physician, Senior Assistant at the Department of Neurology, Institute of Biology and Fundamental Medicine, Kazan Federal University, 74 Karl Marx str., 420012 Kazan, Russia; Physician at the Department of Neurology, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshal Chuikov str., 420103 Kazan, Russia. E-mail: karinazabir@yandex.ru

POPOVA NATALIA A. ORCID ID: 0009-0003-0919-1034; Cand. sc. med., Assistant Professor at the Department of Neurology, Institute of Biology and Fundamental Medicine, Kazan Federal University, 74 Karl Marx str., 420012 Kazan, Russia; Head of the Department of Neurology, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshal Chuikov str., 420103 Kazan, Russia. E-mail: p_nathali@mail.ru

HAKIMOVA ALBINA R. ORCID ID: 0009-0005-2395-9366; Assistant Professor at the Department of Neurology, Institute of Biology and Fundamental Medicine, Kazan Federal University, 74 Karl Marx str., 420012 Kazan, Russia; Physician at of the Department of Neurology, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshal Chuikov str., 420103 Kazan, Russia. E-mail: dralbina@mail.ru

KOROTKOVA ALESYA S. ORCID ID: 0009-0006-6516-2264; Assistant Professor at the Department of Anesthesiology and Reanimatology, Disaster Medicine, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia; Doctor of the Department of Anesthesiology and Resuscitation No. 1, “City Clinical Hospital No. 7 named after M.N. Sadykov”, 54 Marshal Chuikov St., 420103 Kazan, Russia. E-mail: Alesya_@inbox.ru

Abstract. Introduction. Post-dural puncture headache is the most common complication of spinal anesthesia. It is a headache caused by the loss of cerebrospinal fluid, appears or intensifies when taking an upright stance, decreases upon taking a horizontal position, and is accompanied by at least one of the following symptoms: Pain and stiffness in the neck, tinnitus, hearing loss, photophobia, and nausea. Despite the presence of numerous reviews on the prevention and treatment of post-dural puncture headache, most of them do not provide any structured recommendations. The aim of the study was to analyze the effectiveness of epidural blood patch. Materials and Methods. The article provides a case report on a patient with a post-dural puncture headache, who was treated with using the epidural blood patch technique. Results and Discussion. Patient S., 38 years old, complaining of a headache that worsens with verticalization, turned to City Clinical Hospital No. 7 named after M.N. Sadykov. It is known from the anamnesis that on the day after spinal anesthesia, when trying to verticalize, he felt a headache, that did not bother him while lying down. Infusion therapy was performed with a temporary effect. Due to the ineffectiveness of conservative therapy at the previous stage of treatment, it was decided to use an epidural blood patch. The clinical case presented demonstrates the need for limiting the period of conservative treatment of postdural headache and high effectiveness of epidural blood patch with rapid achievement of a clinical result. Conclusions. The advanced technique of epidural blood patch is much more efficient for the treatment of post-dural puncture headaches, compared to conservative treatment methods. The findings allow starting this procedure in a timely manner, improving the quality of patients’ life without wasting time on using ineffective conservative therapy.

Keywords: post-puncture headache, epidural blood patch, complications of spinal anesthesia.

For reference: Zabirova KR, Popova NA, Hakimova AR, Korotkova AS. Post-dural puncture headache: Epidural blood patch application case report. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (suppl.1): 113-116. DOI: 10.20969/VSKM.2024.17(suppl.1).113-116.

REFERENCES 

1. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018; 38 (1): 1-211. DOI: 10.1177/0333102417738202

2. Uppal V, Russell R, Sondekoppam RV, et al. Evidence-based clinical practice guidelines on postdural puncture headache: a consensus report from a multisociety international working group. Reg Anesth Pain Med. 2024; 49 (7): 471-501. DOI: 10.1136/rapm-2023-104817

3. Sachs A, Smiley R. Post-dural puncture headache: the worst common complication in obstetric anesthesia. Semin Perinatol. 2014; 38 (6): 386-94. DOI: 10.1053/j. semperi.2014.07.007

4. Russell R, Laxton C, Lucas DN, et al. Treatment of obstetric post-dural puncture headache. Part 1: conservative and pharmacological management Int J Obstet Anesth. 2019; 38: 93-103. DOI: 10.1016/j.ijoa.2018.12.006

5. Statement on post-dural puncture headache management. Available: https://www.asahq.org/standards-and-guidelines/statement-on-post-dural-puncture-headache-management

6. Фесенко В.С. Постпункционная головная боль: этиология, патогенез, проявления // Междунар. неврол. журн.; МНЖ. - 2015. No8 (78). – C.77-85. [Fesenko VS. Postpunktsionnaya golovnaya bol’: etiologiya, patogenez, proyavleniya [Post-dural puncture headache: etiology, pathogenesis, manifestations]. Mezhdunarodnyy nevrologicheskiy zhurnal [International Neurological Journal]. 2015; 8 (78): 77-85 (In Russ.)].

7. Amorim JA, Gomes de Barros MV, Valença MM. Postdural (post-lumbar) puncture headache: risk factors and clinical features. Cephalalgia. 2012; 32 (12): 916-923. DOI: 10.1177/0333102412453951

8. Общероссийская общественная организация «Федерация анестезиологов и реаниматологов». Клинические рекомендации «Постпункционная головная боль (ППГБ). – Москва, 2018. – 11 с. [Obshcherossijskaya obshchestvennaya organizaciya «Federaciya anesteziologov i reanimatologov» [All-Russian public organization «Federation of Anesthesiologists and Resuscitators»]. Klinicheskie rekomendacii Postpunkcionnaya golovnaya bol’ (PPGB) [Clinical guidelines “Post-dural puncture headache (PDPH)]. Moskva [Moscow]. 2018; 11 p. (In Russ.)]. Режим доступа [URL]: https://bsmp-kursk.ru/assets/files/local-protocols/ARO/ postpunkcionnaya-golovnaya-bol.pdf

9. Uppal V, Russell R, Sondekoppam RV, et al. Evidence-based clinical practice guidelines on postdural puncture headache: a consensus report from a multisociety international working group. Reg Anesth Pain Med. 2024; 49 (7): 471-501. DOI: 10.1136/rapm-2023-104817

 

UDC 616.433

DOI: 10.20969/VSKM.2024.17(suppl.1).117-121

PDF download A CLINICAL CASE OF ACROMEGALY WITH NORMAL GH AND ELEVATED INSULIN-LIKE GROWTH FACTOR – 1 LEVELS

NASYBULLINA FARIDA A., ORCID ID: 0000-0003-2180-4414; Researcher ID GXH-3189-2022; RSCI Author ID 777510; SPIN code: 3121-0016, Endocrinologist at the Endocrinology Department, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshal Chuikov, 420103 Kazan, Russia. Tel.: +79172561759. E-mail: nasybullinaf@mail.ru

PETROVA TATIANA A., ORCID ID: 0009-0007-7063-3857; Head of the Endocrinology Department, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshal Chuikov str., 420103 Kazan, Russia. E-mail: tanuha1976@bk.ru

MYAGKOVA NATALIA A., ORCID ID: 0009-0002-6619-244X; Endocrinologist at the Endocrinology department, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshal Chuikov str., 420103 Kazan, Russia. E-mail: natmyag@gmail.com

KAMAEV RINAT R., ORCID ID: 0009-0007-8669-4400; Endocrinologist at the Endocrinology Department, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshal Chuikova str., 420103 Kazan, Russia. E-mail: rrinatto@yandex.ru

GAINULLINA LILIYA I., ORCID ID: 0009-0006-4824-7127; Endocrinologist at the Endocrinology Department, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshal Chuikov str., 420103 Kazan, Russia. E-mail: malish.kaz@mail .ru

VAGAPOVA GULNAR R., ORCID ID: 0000-0001-8493-7893, Scopus Author ID: 56663181000, Researcher ID: C-1421- 2019, RSCI Author ID: 284254, Dr. sc. med., Professor, Corresponding Member of the Academy of Sciences of the Republic of Tatarstan; Head of the Department of Endocrinology, Kazan State Medical Academy, 11 Mushtari str., 420012 Kazan, Republic of Tatarstan, Russia. E-mail: g.r.vagapova@gmail.com

VALEEVA FARIDA V., ORCID ID: 0000-0001-6000-8002; SPIN code 2082-3980; Author ID: 784269; Dr. sc. med., Professor, Head of the Department of Endocrinology, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Republic of Tatarstan, Russia. E-mail: val-farida@yandex.ru

Abstract. Introduction. Prevalence of acromegaly is 4.6 cases per 1 million people, and the incidence is 116.9 new cases per 1 million annually. At the same time, the manifestations of acromegaly can be insidious, and despite advances in this area, there are significant delays in the diagnosis of the disease, thereby worsening the prognosis for patients. Aim. To study the features of laboratory diagnostics of acromegaly. Materials and Methods. This article presents a clinical case of a 56-year-old female patient with discordant values: Elevated insulin-like growth factor-1 and normal somatotropic hormone levels. Results and Discussion. Levels of somatotropic hormone and insulin-like growth factor-1 are closely correlated. However, up to 30% of patients have discrepancies in these indicators. The most common variant is a combination of elevated insulin-like growth factor-1 levels with normal growth hormone levels, which most likely reflects the onset of a pathological process or a milder form of the disease. Conclusions. In connection with the findings obtained in this clinical case, attention should be paid to the importance of a comprehensive approach to examining patients for acromegaly, using all available laboratory techniques, along with anamnesis, clinical features, and imaging studies.

Keywords: acromegaly, insulin-like growth factor-1, IGF-1, growth hormone, STH, pituitary adenoma.

For reference: Nasybullina FA, Petrova TA, Myagkova NA, et al. A clinical case of acromegaly with normal GH and elevated insulin-like growth factor-1 levels. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (suppl.1): 117-121. DOI: 10.20969/VSKM.2024.17(suppl.1).117-121.

REFERENCES 

  1. Dineen R, Stewart PM, Sherlock M. Acromegaly. QJM: An International Journal of Medicine. 2017; 110 (7): 411–420. DOI: 10.1093/qjmed/hcw004

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  3. Melmed S. Medical progress: Acromegaly. N Engl J Med. 2006; 355(24): 2558-73. DOI: 10.1056/NEJMra062453

  4. Esposito D, Ragnarsson O, Johannsson G, Olsson DS. Prolonged diagnostic delay in acromegaly is associated with increased morbidity and mortality. Eur J Endocrinol. 2020; 182 (6): 523-531. DOI: 10.1530/EJE-20-0019

  5. Caron P, Brue T, Raverot G, et al. Signs and symptoms of acromegaly at diagnosis: the physician’s and the patient’s perspectives in the ACRO-POLIS study. Endocrine. 2019; 63 (1): 120-129. DOI: 10.1007/s12020-018-1764-4

  6. Zarool-Hassan R, Conaglen HM, Conaglen JV, Elston MS. Symptoms and signs of acromegaly: an ongoing need to raise awareness among healthcare practitioners. J Prim Health Care. 2016; 8 (2): 157-63. DOI: 10.1071/HC15033

  7. Федеральные клинические рекомендации. Акромегалия: клиника, диагностика, дифференциальная диагностика, методы лечения. – Москва, 2013. – 35 с. [Federal’nye klinicheskie rekomendacii [Federal clinical guidelines]. Akromegaliya: klinika, diagnostika, differencial’naya diagnostika, metody lecheniya [Acromegaly: clinic, diagnosis, differential diagnosis, treatment methods]. Moskva [Moscow]. 2013; 35 p. (in Russ.)].

  8. Akirov A, Masri-Iraqi H, Dotan I, Shimon I. The Biochemical Diagnosis of Acromegaly. J Clin Med. 2021; 10: 1147. DOI: 10.3390/jcm10051147

  9. Regazzo D, Losa M, Albiger NM, et al. The GIP/GIPR axis is functionally linked to GH-secretion increase in a significant proportion of gsp-somatotropinomas. Eur J Endocrinol. 2017; 176 (5): 543-553. DOI: 10.1530/EJE-16-0831

  10. Mukai K, Otsuki M, Tamada D, et al. Clinical Characteristics of Acromegalic Patients With Paradoxical GH Response to Oral Glucose Load. J Clin Endocrinol Metab. 2019; 104 (5): 1637-1644. DOI: 10.1210/jc.2018-00975

  11. Hage M, Kamenický P, Chanson P. Growth Hormone Response to Oral Glucose Load: From Normal to Pathological Conditions. Neuroendocrinology. 2019; 108 (3): 244-255. DOI: 10.1159/000497214

  12. Rosario PW, Calsolari MR. Safety and specificity of the growth hormone suppression test in patients with diabetes. Endocrine. 2015; 48 (1): 329-33. DOI: 10.1007/s12020-014-0282-2

  13. Dobri G, Niwattisaiwong S, Bena JF, et al. Is GH nadir during OGTT a reliable test for diagnosis of acromegaly in patients with abnormal glucose metabolism? Endocrine. 2019; 64 (1): 139-146. DOI: 10.1007/s12020-018-1805-z

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  15. Rosario PW, Calsolari MR. Elevated IGF-1 with GH suppression after an oral glucose overload: Incipient acromegaly or falsepositive IGF-1? Arch Endocrinol Metab. 2016; 60 (6): 510-514. DOI: 10.1590/2359-3997000000193

  16. Kanakis GA, Chrisoulidou A, Bargiota A, et al. The ongoing challenge of discrepant growth hormone and insulin-like growth factor I results in the evaluation of treated acromegalic patients: a systematic review and meta-analysis. Clin Endocrinol (Oxf). 2016; 85 (5): 681-688. DOI: 10.1111/cen.13129

  17. DimarakiEV,JaffeCA,DeMott-FribergR,etal.Acromegaly with apparently normal GH secretion: implications for diagnosis and follow-up. J Clin Endocrinol Metab. 2002; 87 (8): 3537-42. DOI: 10.1210/jcem.87.8.8658

  18. Butz LB, Sullivan SE, Chandler WF, et al. “Micromegaly”: an update on the prevalence of acromegaly with apparently normal GH secretion in the modern era. Pituitary. 2016; 19 (6): 547-551. DOI: 10.1007/s11102-016-0735-0

  19. Dimaraki EV, Jaffe CA, DeMott-Friberg R, et al. Acromegaly with apparently normal GH secretion: implications for diagnosis and follow-up. J Clin Endocrinol Metab. 2002; 87 (8): 3537-42. DOI: 10.1210/jcem.87.8.8658

  20. Schilbach K, Bidlingmaier M. Laboratory investigations in the diagnosis and follow-up of GH-related disorders. Arch Endocrinol Metab. 2019; 63 (6): 618-629. DOI: 10.20945/2359-3997000000192

 

UDC 616.831-005.1

DOI: 10.20969/VSKM.2024.17(suppl.1).122-127

PDF download FEATURES OF ISCHEMIC STROKE IN PRESENCE OF VASCULOPATHY AND COMPENSATION ABILITIES OF THE BRAIN: A CLINICAL CASE

PERMINOVA SVETLANA K., ORCID ID: 0009-0004-8056-8188; Cand. sc. med., Neurologist at the Department of Neurology for Patients with Stroke, City Clinical Hospital No. 7 named after. M.N. Sadykova, 54 Chuikova str., 420103 Kazan, Russia. Tel.: +79625493011. E-mail: sveta1perminova@yandex.ru

NAZIPOVA ALFIYA YA., ORCID ID: 0009-0007-8690-456Х, Cand. sc. med., Head of the Department of Neurology for Patients with Stroke, City Clinical Hospital No. 7 named after. M.N. Sadykova, 54 Chuikova str., 420103 Kazan, Russia. Tel.: +79179239786. E-mail: nazipova.a@yandex.ru

DVORZHAK ANTON S., ORCID ID: 0009-0000-0525-3304, Resident Physician at the Department of Neurology, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. Tel.: +79991647041. E-mail: anton_dv@bk.ru

Abstract. Introduction. Vasculopathies are inflammations of the walls of blood vessels, in which immunopathological processes cause endothelial dysfunction of the vessels. Changes in endothelial dysfunction are a universal pathogenetic mechanism for the development of ischemic circulatory disorders. Given the permanent development of ideas about immunopathological disorders, situations may arise with the need for revising the features of the cause of acute circulatory disorders in a particular case. Aim. To demonstrate the features of ischemic stroke in presence of vasculopathy and the compensatory capabilities of the brain. Materials and methods. A clinical case of female patient F., 77 years old, with vasculitis-associated ischemic stroke is presented. Results and Discussion. In vasculitis, the vascular walls are attacked by the body’s immune system, which leads to structural disorders. Short-term exposure of the vascular wall endothelium to the pathological factor leads to hypercoagulation, hypertonus, and production of inflammatory cytokines. It has been proven that endothelial activation is a favorable reaction that promotes an immune response to the pathogen. Cessation of the pathogenic stimulus leads to a rapid return of the endothelium from the activated state to the physiological one. Accordingly, the course of ischemic stroke in immunopathological disorders may be atypical and, therefore, additional diagnostic methods and therapy correction are needed, taking into account the pathogenetic factor, considering the mechanisms of brain plasticity. Conclusions. The increasing frequency of autoimmune diseases necessitates a deeper understanding of the mechanisms, diagnostics and treatment of acute cerebrovascular accidents. Ischemic stroke with some existing brain processes develops with latent symptoms, which indicates the great compensation abilities of the brain, which can be a theoretical basis for neurorehabilitation.

Keywords: ischemic stroke, vasculopathy, compensation abilities.

For reference: Perminova SK, Nazipova AYa, Dvorak AS. Features of ischemic stroke in presence vasculopathy and compensation abilities of the brain: A clinical case. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (suppl.1): 122-127. DOI: 10.20969/VSKM.2024.17(suppl.1).122-127.

REFERENCES

 

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UDC 616.126.422

DOI: 10.20969/VSKM.2024.17(suppl.1).128-132

PDF download A CLINICAL CASE OF INFECTIVE ENDOCARDITIS COMPLICATED BY MENINGOENCEPHALITIS

KHAMITOV RUSTEM F., ORCID ID: 0000-0001-8821-0421; Dr. sc. med., Professor, Head of the Department of Internal Medicine, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. Tel.: +7(843)224-51-31.
E-mail: rhamitov@mail.ru

SATTAROVA FIRYUZA I., ORCID ID: 0009-0002-1157-0984; Assistant Professor at the Department of Internal Diseases, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. Tel.: +7(843)224-51-31. E-mail: firyuzaildarovna@yandex.ru

Abstract. Introduction. Infective endocarditis is an infectious and inflammatory disease of the cardiovascular system with damage to the valvular structures of endocardium, artificial valves or parietal endocardium with the development of polyposis and ulcerative changes in the damaged heart structures and destruction of their functions. Injection drug users are at risk of developing infective endocarditis. Among them, the incidence ranges from 2 to 5% per year. Complications of infective endocarditis often include heart failure, pneumonia, and damage to the nervous system (mainly acute cerebrovascular accident). The prevalence of meningitis and meningoencephalitis in infective endocarditis is approximately 3%. Aim. Using a clinical example, analyze the features of infective endocarditis complicated by meningoencephalitis. Materials and Methods. Review of international and national publications in the PubMed and eLibrary databases regarding the infective endocarditis developing complications. A clinical case of infective endocarditis associated with intravenous administration of drugs, manifested as acute cerebrovascular accident complicated by secondary meningoencephalitis. Results and Discussion. This paper considers the case of a 20-year-old female patient with infective endocarditis associated with intravenous drug use. The disease debuted with acute cerebrovascular accidents of cardioembolic origin. During hospitalization, she received statins, rivaroxaban and acetylsalicylic acid, cefazolin, metronidazole, and levofloxacin. She was discharged with partial regression of neurological formations. The temperature held up within the range of 37.5 to 38.5 °C. The patient followed the recommendations partially (she only took statins). 2 weeks after discharge, there were episodic increases in her body temperature up to 40°C appeared, and her general weakness progressed. She was forced to go to the hospital emergency room. The data identified, such as three times vomiting, severe pain in the right extremities, periodic convulsive twitching in the extremities, speech impairment, stiff neck muscles by 4 transverse fingers, positive upper and lower Brudzinski signs, and increased sensitivity to light and loud sounds, updated the diagnostic search for meningoencephalitis. During diagnosing, the results of cerebrospinal fluid culture verified secondary meningoencephalitis caused by Staphylococcus haemolyticus. The patient received linezolid and vancomycin for 14 days. She was discharged with improvement in form of the neurological syndrome regression. It is recommended to continue outpatient treatment with linezolid for up to 1 month and follow up with a cardiac surgeon. Conclusions. The clinical case presented demonstrates the importance of multidisciplinary examination of patients with IE for the timely detection of extracardiac complications and clarification of indications for invasive diagnostics, including in form of lumbar puncture with cerebrospinal fluid culture. This approach contributes to a timely selection of adequate therapy and determines the outcome of the disease.

Keywords: infective endocarditis, meningoencephalitis, Staphylococcus haemolyticus.

For reference: Khamitov RF, Sattarova FI. A clinical case of infective endocarditis complicated by meningoencephalitis. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (suppl.1):128-132. DOI: 10.20969/VSKM.2024.17(suppl.1).128-132.

REFERENCES

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  2. Menafra G, Pingitore A, Gurgo A, et al. Recurrent infective endocarditis in a drug addict. Clinical Case Reports and Reviews. 2018; 4 (4): 1-3. DOI: 10.15761/CCRR.1000409

  3. Демко И.В., Пелиновская Л.И., Манхаева М.В., [и др.]. Особенности течения инфекционного эндокардита у инъекционных наркоманов // Российский кардиологический журнал. – 2019. – Т. 24, вып. 6. – С.97–102. [Demko IV, Pelinovskaja LI, Manhaeva MV, et al. Osobennosti techenija infekcionnogo jendokardita u injekcionnyh narkomanov [Features of infective endocarditis in injection drug users]. Rossijskij kardiologicheskij zhurnal [Russian Journal of Cardiology]. 2019; 24 (6): 97–102. (In Russ.)]. DOI: 10.15829/1560-4071-2019-6-97-102

  4. Дорофеев Е.В., Тюрин В.П. Диагностика и дифференциальный диагноз инфекционного эндокардита // Вестник Национального медико-хирургического Центра им. НИ Пирогова. – 2012. – Т. 7, вып. 2. – С.122-126. [Dorofeev EV, Tjurin VP. Diagnostika i differencial’nyj diagnoz infekcionnogo jendokardita [Diagnosis and differential diagnosis of infectious endocarditis]. Vestnik Nacional’nogo mediko-hirurgicheskogo Centra imeni NI Pirogova [Bulletin of Pirogov National Medical & Surgical Center]. 2012; 7 (2): 122-126. (In Russ.)].

  5. Meel R. Right-Sided Infective Endocarditis Secondary to Intravenous Drug Abuse. Infective Endocarditis; IntechOpen. 2019. DOI: 10.5772/intechopen.84319

  6. Халиуллина С.В., Анохин В.А., Солуянова Ю.С., [и др.]. Инфекционный эндокардит у ВИЧ-инфицированных потребителей инъекционных наркотиков // Практическая медицина. – 2020. – Т. 18, вып. 1. – С.88-92. [Haliullina SV, Anohin VA, Solujanova JuS, et al. Infekcionnyj jendokardit u VICН-inficirovannyh potrebitelej injekcionnyh narkotikov [Infectious endocarditis in HIV-infected injecting drug users]. Prakticheskaja medicina [Practical medicine]. 2020; 18 (1): 88-92 (In Russ.)]. DOI: 10.32000/2072-1757-2020-1-88-92

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  14. Данилов А.И., Козлов С.Н., Сливкин М.Д. Неврологические осложнения инфекционного эндокардита // Клиническая фармакология и терапия. – 2020. – Т. 29, вып. 1. – С.48-52. [Danilov AI, Kozlov SN, Slivkin MD. Nevrologicheskie oslozhnenija infekcionnogo jendokardita [Neurological complications of infective endocarditis]. Klinicheskaja farmakologija i terapija [Clinical pharmacology and therapy]. 2020; 29 (1): 48-52. (In Russ.)]. DOI 10.32756/0869-5490-2020-1-48-52

 

 

UDC 616-001.314.42:614.21

DOI: 10.20969/VSKM.2024.17(suppl.1).133-138

PDF download NEW ADVANCES IN THE TREATMENT OF CHRONIC PANCREATIC FISTULAS

CHIKAEV VYACHESLAV F., ORCID ID: 0000-0002-4135-0387; Dr. sc. med., Professor, Department of Traumatology, Orthopedics, and Extreme Surgery, Kazan State Medical University., 49 Butlerov st., 420012 Kazan, Russia.
Tel.: +7-927-434-48-29. E-mail: prof.chikaev@gmail.com

MELNIKOV EVGENIJ A., ORCID ID: 0009-0006-7068-7655; Cand. sc. med., Deputy Chief Physician for Surgery, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Chuikov str., 420103 Kazan, Russia. Tel.: +7-903-344-39-80. E-mail: emelnik72@mail.ru

PETUKHOV DENIS M., ORCID ID: 0000-0002-5946-2950; Surgeon, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Chuikov str., 420103 Kazan, Russia. Tel.: +7-917-276-89-76. E-mail petuhoff@gmail.com

MANNANOV RAVIL F., ORCID ID: 0009-0004-6121-8537; Surgeon, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Chuikov str., 420103 Kazan, Russia. Tel.: +7-987-224-26-10. E-mail: ravilmannanov89@gmail.com

AJDAROV AZAT A., ORCID ID: 0009-0009-9492-168X; Surgeon, City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Chuikov str., 420103 Kazan, Russia. Tel.: +7-965-595-31-61. E-mail: azat0410@yandex.ru

Abstract. Introduction. External post-necrotic pancreatic fistulas can persist for months, worsening the quality of the patient’s life. Conservative and minimally invasive treatment methods are priorities for this pathology, with the primary focus on diagnosing and correcting intraductal hypertension. Aim. To present clinical observations on the minimally invasive elimination of external pancreatic fistulas resulting from necrotizing pancreatitis. Materials and Methods. We analyzed cases of 6 patients over 3 years with necrotic forms of acute pancreatitis that developed complications, such as persistent external pancreatic fistulas. After having verified the fistula and corrected intraductal hypertension, we performed sclerotherapy on these external fistulas. This article also describes the first one of these clinical cases. Results and Discussions. In all six cases, we observed the rapid closure of chronic post-necrotic pancreatic fistulas and maintenance of the achieved effect over more than a year of follow-up. Conclusions. Experience of Russian and foreign surgery colleagues shows the priority of using minimally invasive techniques in treating most complications of necrotizing pancreatitis, particularly external pancreatic fistulas. Extensive surgical interventions in such patients generally carry high risks. We were the first to apply sclerotherapy using aethoxysklerol for this complication; the successful experience suggests its further application, alone or in combination with other minimally invasive techniques.

Keywords: necrotizing pancreatitis, external fistula, pancreatic fistula, sclerotherapy

For reference: Chikaev VF, Melnikov EA, Petukhov DM. New advances in the treatment of conic pancreatic fistulas. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (suppl.1): 133-138. DOI: 10.20969/VSKM.2024.17(suppl.1).133-138.

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2. Meierhofer C, Fuegger R, Biebl M, et al. Pancreatic Fistulas: Current Evidence and Strategy–A Narrative Review. J Clin Med. 2023.; 12 (15): 5046. DOI: 10.3390/ jcm12155046

3. Bassi C, Dervenis C, Butturini G, et al. Postoperative pancreatic fistula: An international study group (ISGPF) definition. Surgery. 2005; 138 (1): 8–13. DOI: 0.1016/j. surg.2005.05.001

4. Dronov OI, Kovalska IO, Horlach AI, et al. Prediction of external pancreatic fistula development in patients with acute infected necrotizing pancreatitis. Wiad Lek. 2023; 76 (11): 2365–2371. DOI: 10.36740/WLek202311104

5. Di Mitri R, Amata M, Scimeca D, et al. Cystoduodenal fistula: unusual complication after acute necrotizing pancreatitis with collection. Endoscopy. 2021; 53 (07): 247–248. DOI: 10.1055/a-1252-2069

6. Perri G, Marchegiani G, Partelli S, et al. Preoperative risk stratification of postoperative pancreatic fistula: A risk-tree predictive model for pancreatoduodenectomy. Surgery. 2021; 170 (6): 1596–1601. DOI: 10.1016/j. surg.2021.06.046

7. Bassi C, Marchegiani G, Dervenis C, et al. The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 Years After. Surgery. 2017; 161 (3): 584–591. DOI: 10.1016/j. surg.2016.11.014

8. Котельникова Л.П., Плаксин С.А., Бурнышев И.Г. [и др.]. Факторы риска формирования наружных и внутренних панкреатических свищей после панкреонекроза. // Анналы хирургической гепатологии. – 2021. – Т. 26, No2. – С.39–49. [Kotelnikova LP, Plaksin SA, Burnyshev IG, et al. Faktory riska formirovaniya naruzhnyh I vnutrennih pancreaticheskih svischey posle pankreonekroza [Predictors for external and internal pancreatic fistulas after pancreatic necrosis]. Annaly Khirurgicheskoy Gepatologii [Ann HPB Surg]. 2021; 26 (2): 39–49. (in Russ.)]. DOI: 10.16931/10.16931/1995-5464.2021-2-39-49

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UDC: 616.001.314.42:614.21

DOI: 10.20969/VSKM.2024.17(suppl.1).139-146

PDF download A CLINICAL CASE OF SUCCESSFUL SURGERY OF A SECOND-TRIMESTER PREGNANT PATIENT WITH HEREDITARY GASTROINTESTINAL POLYPOSIS COMPLICATED BY INTUSSUSCEPTIVE SMALL-INTESTINAL OBSTRUCTION

SHAYMARDANOV RAVIL S., ORCID ID 0000-0003-3526-413X; Cand. sc. med., Professor of the Department of Surgery, Kazan State Medical Academy, 36 Butlerov str., 420012 Kazan, Russia. E-mail: gubaevrus@mail.ru

GUBAEV RUSLAN F., ORCID ID 0000-0003-3526-413X; Head of Surgery Department 1, City Clinical Hospital No. 7, 54 Chuikova str., 420103 Kazan, Russia. E-mail: gubaevrus@mail.ru

BAGAUTDINOV ELDAR B., ORCID ID 0000-0002-5218-7909; Cand. sc. med., Surgeon, Surgery Department 1, City Clinical Hospital No. 7, 54 Chuikova str., 420103 Kazan, Russia. E-mail: eldarbagautdinof@yandex.ru

MELNIKOV EVGENIY A., ORCID ID 0009-0006-7068-7655; Cand. sc. med., Deputy Chief of Surgery, City Clinical Hospital No. 7, 54 Chuikova str., 420103 Kazan, Russia. E-mail: emelnik72@mail.ru

FATKULLIN FARID I., ORCID ID 0000-0002-5806-9153; Cand. sc. med., Head of the Maternity Department, Perinatal Center, City Clinical Hospital No. 7, 54 Chuikova str., 420103 Kazan, Russia. E-mail: ffatkullin@ya.ru

KUROCHKIN SERGEY V., ORCID ID 0000-0002-8043-3871; Cand. sc. med., Head of the Diagnostic Radiology Department, City Clinical Hospital No. 7, 54 Chuikova str., 420103 Kazan, Russia. E-mail: kurochkin.70@bk.ru

Abstract. Introduction. One of the complications of hereditary gastrointestinal polyposis, including Peutz-Jeghers syndrome, is intussusception. Intussusception is the most common phenomenon in pediatric practice. This is a rare complication in adults with hereditary gastrointestinal polyposis. Only 2-3 intussusception surgery cases related to gastrointestinal polyposis during pregnancy were described in publications. In Russia, we have not found any publications describing successful surgeries of second-trimester pregnant patients with hereditary gastrointestinal polyposis complicated by small intestinal intussusception. Aim. To present a rare case of a successful surgery of a second-trimester pregnant patient with hereditary gastrointestinal polyposis complicated by intussusceptive small-bowel obstruction. Materials and Methods. A female patient, born in 1988, was admitted in the Gynecology Department of City Clinical Hospital No. 7 named after. M.N. Sadykov with the diagnosis of pregnancy II, 21-22 weeks, vomiting of pregnant women, a uterine scar, a burdened obstetric history, and mild anemia. A conservative treatment was carried out. The patient has suffered from the gastrointestinal polyposis since her childhood; she was followed up by an oncologist; polyps were removed endoscopically several times; the polyps were benign. Results and Discussion. Based on the examination findings, she was transferred to the Surgery Department with subsequent surgery for acute intussusception and small bowel obstruction and jejunal polyps. The postoperative period was complicated by the threat of premature birth, which was stopped in the Maternity Hospital, a few months later a healthy boy was born, the patient was subsequently examined by a surgeon, there were no complaints, the child was healthy, and recommendations were given. Macroscopic specimens histologically: Adenomatous polyps. Thus, in our opinion, despite the histological conclusion, the patient has PJS with a complicated course during pregnancy in form of intussusception and small bowel obstruction. Conclusions. Intussusception due to hereditary gastrointestinal polyposis in pregnant patients is an extremely rare acute surgical disease of abdominal organs. For diagnosis, along with clinical research methods and abdomen radiography, ultrasound and MRI should be used. Surgery is the main treatment method for intussusception due to hereditary gastrointestinal polyposis in pregnant patients.

Keywords: polyposis, Peutz-Jeghers syndrome, intussusception, pregnancy, diagnosis.

For reference: Shaimardanov RSh, Gubaev RF, Bagautdinov EB, et al. A clinical case of successful surgery of a second-trimester pregnant patient with hereditary gastrointestinal polyposis complicated by intussuscep- tive small-intestinal obstruction. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (suppl.1): 139-146. DOI: 10.20969/VSKM.2024.17(suppl.1).139-146.

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UDC 616.98:578.834.1:616.12-036.886+616.24-002

DOI: 10.20969/VSKM.2024.17(suppl.1).147-156

PDF download ELECTROCARDIOGRAPHIC PATTERNS OF SUDDEN CARDIAC DEATH IN A PATIENT WITH MYOCARDIAL INFARCTION AND COMMUNITY-ACQUIRED PNEUMONIA CAUSED BY THE NEW CORONAVIRUS INFECTION

SHULAEVA POLINA A., ORCID ID: 0009-0009-9256-8640; student, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. Tel.: +79674624949. E-mail: pln2005@mail.ru (corresponding author)

KHAZOVA ELENA V., ORCID ID: 0000-0001-8050-2892; SCOPUS Author ID: 57205153574; Cand. sc. med., Associate Professor at the Propaedeutics of Internal Diseases Department named after Professor S. S. Zimnitsky, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia. Е-mail: hazova_elena@mail.ru

MALKOVA MARIA I., ORCID ID: 0000-0002-1368-2915, SCOPUS Author ID: 58683592400; Cand. sc. med., Assistant Professor at the Propaedeutics of Internal Diseases Department named after Professor S. S. Zimnitsky, Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia; Head of the Department of Functional Diagnostics, City Clinical Hospital No. 7 named after M. N. Sadykov, 54 М. Chuikova str., 420103 Kazan, Russia. Е-mail: marimalk@yandex.ru

Abstract. Introduction. Sudden death remains a major public health problem causing death in 25–50% of patients with a previous myocardial infarction. Studying and searching for new prognostic risk factors for sudden cardiac death are an extremely difficult task. Atrioventricular dissociation may be one of the significant cardiac complications of acute myocardial infarction in a patient diagnosed with a new coronavirus infection. Aim was to present a clinical case of patient G. born in 1936 with sudden cardiac death registered during 24-hour electrocardiography monitoring, which was preceded by arrhythmogenic myocardial activity and atrioventricular dissociation. Materials and Methods. Literature was reviewed, and patient G.’s medical background was studied. Results and Discussion. Changes are shown that took place in the in arrhythmogenic myocardial activity preceding asystole in patient G. born in 1936, who was hospitalized with a diagnosis of coronary heart disease. Repeated myocardial infarction of the inferior wall of the left ventricle dated November 11, 2023. Post-infarction cardiosclerosis (1986). Rhythm and conduction disturbances are a paroxysmal form of atrial fibrillation. First-degree atrioventricular block, complete right bundle branch block. Hypertension stage 3, risk 4. Controlled arterial hypertension. Target blood pressure 120-129/70-79 mm Hg. Hypertrophy of the walls and dilatation of the cavities of the left ventricle and of the left and right atria. Chronic heart failure 2B (Simpson ejection fraction 29%). Functional class III. Bilateral hydrothorax. Community-acquired right-sided pneumonia, severe. Respiratory failure 1-2. Type 2 diabetes mellitus, target glycated hemoglobin level below 8%. Chronic kidney disease C3a (glomerular filtration rate 55 ml/min/1.73 m2). New coronavirus infection (PCR SARS-COV-2 diagnosed on November 21, 2023). Conclusions. In the presented case report, electrophysiological instability of the myocardium preceding asystole in patient G. was recorded on a long-term electrocardiogram recording, the patient having the verified leading risk factors for sudden cardiac death, such as hemodynamically significant ventricular arrhythmias, myocardial infarction, episodes of atrioventricular dissociation, heart failure with the reduced left ventricular ejection fraction, and coronavirus infection.

Keywords: electrical instability of the myocardium, sudden cardiac death, atrioventricular dissociation, myocardial infarction, new coronavirus infection, community-acquired pneumonia

For reference: Shulaeva PA, Khazova EV, Malkova MI. Electrocardiographic patterns of sudden cardiac death in a patient with myocardial infarction and community-acquired pneumonia caused by the new coronavirus infection. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (suppl.1): 147-156. DOI: 10.20969/VSKM.2024.17(suppl.1).147-156.

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DURING THE IMPOSING OF THE NUMBER

UDC2.616-006.6-036.1:614.253.8:316.6

DOI: 10.20969/VSKM.2024.17(suppl.1).157-165

PDF download CURRENT RURAL AVAILABILITY OF CANCER CARE AND OF ACTIVE MALIGNANCY DETECTION IN THE MOST COMMON SITES

NOVIKOVA SVETLANA V., ORCID ID: 0009-0002-1267-8655; Assistant Professor at the Department of Oncology, Radiation Diagnostics and Radiation Therapy, South Ural State Medical University, 36 Truda str., 455049 Magnitogorsk, Russia. E-mail: novikova.sv@novomed-mc.ru

Abstract. Introduction. Since 2018, according to P.A. Herzen Moscow Oncology Research Institute, the following sites have become the most common in terms of their detection: In women, breast cancer (51.5%) and uterine (endometrial) cancer (18.9%); and in men, lung cancer (47.6%) and prostate cancer (41.6%). At the same time, there is a systematic increase in the incidence of these four leading cancers, but oncologists are especially concerned about the high neglecting level of these cancers. When analyzing the reasons for the high neglect of malignancies, the competence and oncological alertness of medical personnel are mentioned most often, but little attention is paid to the influence of various aspects of cancer care availability. Aim. Analysis of the current rural availability of cancer care. Materials and Methods. The study was conducted using a survey of the general population of patients with breast cancer, lung cancer, prostate cancer and uterine cancer who applied for various reasons to the outpatient cancer care center during the year 2021. A total of 342 patients participated in the study: 93 female patients with breast cancer and 65 with uterine cancer, as well as 96 male patients with lung cancer and 88 with prostate cancer. Results and Discussion. Studying the age structure of respondents revealed the advantage of people with limited mobility. In all four sets, the proportion of patients living alone is high. Patients’ families have per capita income at the minimum subsistence level. At the first suspicions of a tumor, 5.6% of all respondents sought help from their district oncologist. As a result of these untargeted references, only 4.2% of lung cancer patients, 6.6% of breast cancer patients, 10.8% of endometrial cancer patients, and 13.7% of prostate cancer patients were diagnosed at the first visit.From 46.3% of breast cancer patients to 69.4% of prostate cancer patients have already stopped attending medical checkups a long time ago. After they have retired, rural people stop attending medical checkups and thereby deprive themselves of the chance of detecting a malignant tumor at early stages. And this is where transport and economic problems appear: There is no direct route to Magnitogorsk, there are no convenient intra-route transfers, there are no return routes to their village, and in general such trips are too expensive for rural retirees. Together, all these availability aspects make cancer care difficult to access for rural population. Conclusions. Low availability of oncological care to rural population is caused by understaffing of district oncologists, poor transportation accessibility of Magnitogorsk, their low financial position, and lack of preventive examinations.

Keywords: uterine cancer, endometrial cancer, breast cancer, lung cancer, male prostate cancer, rural municipal areas.

For reference: Novikova SV. Current rural availability of cancer care and of active malignancy detection in the most common sites. The Bulletin of Contemporary Clinical Medicine. 2024; 17 (suppl.1): 157-165. DOI: 10.20969/VSKM.2024.17(suppl.1).157-165.

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