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СОNTENTS
ANNIVERSARIES
ORIGINAL RESEARCH
Prevalence and causes of false positive results in neonatal screening Geraskin A.I. (Russia, Moscow), Konovalov O.E. (Russia, Moscow), Vitkovskaya I.P. (Russia, Moscow), Shulaev A.V. (Russia, Kazan), Potekhin O.E. (Russia,
Moscow), Kekeeva T.N. (Russia, Moscow) P.23
REVIEWS
Relationship between cognitive impairment and obesity Mutalova E.G. (Russia, Ufa), Nafikova A.I. (Russia, Ufa), Nigmatullina A.E. (Russia, Ufa), Galyautdinova V.R. (Russia, Ufa), Kamaltdinova G.J. (Russia, Ufa), Asadullina G.V. (Russia,
Ufa), Samigullina L.I. (Russia, Ufa), Rustyamova Z.Ya. (Russia, Ufa), Sadikova R.I. (Russia, Ufa), Frid S.A. (Russia, Ufa), Musina F.S. (Russia, Ufa), Zhumaniyazova A.A. (Russia, Ufa) P.115
PRACTICAL EXPERIENCE
Lyme borreliosis in a comorbid patient: Clinical mosaic, diagnostic and therapeutic issues Tolmacheva A.I. (Russia, Moscow), Novikova A.V. (Russia, Moscow), Andriyashkina D.Yu. (Russia, Moscow), Klimenko A.A. (Russia, Moscow),
Razitdinov A.I. (Russia, Kaluga) P.142
ORGANIZATION OF HEALTHCARE
UDC 61(470.41)(092)
DOI: 10.20969/VSKM.2025.18(1).7-13
Professor Nail B. Amirov: Life journey and contribution to the development of contemporary clinical medicine (in honor of the 75th anniversary of his birth)
Alexander A. Vizel1, Maria A. Daminova2, Maria S. Suntsova3, Lalita R. Yunusova4, Suriya V. Amirkhanova5, Rustem I. Shaymuratov1, Renata N. Amirova5
1 Kazan State Medical University, Ministry of Health of Russia, 49 Butlerov str., 420012 Kazan, Russia
2 Kazan State Medical Academy – Branch of the Russian Medical Academy of Continuous Professional Education, Ministry of Health of Russia, 36 Butlerov str., 420012 Kazan, Russia
3 Kazan National Research Technological University, 68 K. Marx str., 420015 Kazan, Russia
4 Tashkent State Dental Institute, 103 Makhtumkuli str., Yashnabad District, 100047 Tashkent, Uzbekistan
5 Editorial Office of the Bulletin of Contemporary Clinical Medicine Journal, 57 Vishnevsky str., Apt. 83, 420043 Kazan, Russia
Abstract. Introduction. March 4, 2025 marks 75 years since the birth of Nail B. Amirov, a medical luminary, Doctor of Science in Medicine, Professor at the Department of Outpatient Therapy and General Medical Practice of Kazan State Medical University. His knowledge and experience are in demand in both academic community and practical healthcare, where he serves as the Chief Visiting Therapist. In addition, Professor N.B. Amirov holds the position of Deputy Head for Research at the Clinical Hospital of the Medical Unit of the Ministry of Internal Affairs of Russia in the Republic of Tatarstan, which emphasizes his active involvement in the development of departmental medicine. Of particular note is his role as the Editor-in-Chief of the scientific and practical journal, Bulletin of Contemporary Clinical Medicine, which under his leadership has become a successful platform for exchanging best practices and research results in various areas of medicine. N.B. Amirov’s scientific achievements, teaching talent, and contribution to the development of healthcare have been recognized with high titles and awards, including those of the Honored Scientist and Educator, Member of the Russian Academy of Natural Sciences, Honored Doctor of the Republic of Tatarstan, and Laureate of the State Prize of the Republic of Tatarstan in Science and Technology. The aim of this publication is to inform the scientific and medical community about a significant event in the life of the Bulletin of Contemporary Clinical Medicine: The 75th anniversary of the birth of Professor Nail B. Amirov, our Editor-in-Chief, providing detailed information about his life journey, multifaceted professional activity, and significant achievements. Materials and Methods. This study used information from official sources dealing with describing N. B. Amirov’s life and activities, as well as the data reported by his colleagues and patients in a poll. Results and Discussion. The article provides comprehensive information about Professor N.B. Amirov’s research, educational and social activities, as well as detailed coverage of the main stages of his biography, from his early years to the present day. Particular attention is paid to N.B. Amirov’s contribution to the development of outpatient therapy, general medical practice, and departmental medicine. His scientific achievements, pedagogical methods, and contribution to the training of medical personnel are described in detail. Conclusions. Professor N. B. Amirov’s long and fruitful work, his outstanding scientific achievements, his teaching talent, and his high moral qualities serve as a valuable model for developing professional ethics and moral principles in young doctors and researchers.
Keywords: anniversary, Nail B. Amirov, Editor-in-Chief, Bulletin of Contemporary Clinical Medicine
For citation: Vizel, A.A.; Daminova, M.A.; Suntsova, M.S.; et al. Professor Nail B. Amirov: Life journey and contribution to the development of contemporary clinical medicine (in honor of the 75th anniversary of his birth). The Bulletin of Contemporary Clinical Medicine. 2025, 18 (1), 7–13. DOI: 10.20969/VSKM.2025.18(1).7-13.
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2. Профессор Наиль Багаувич Амиров // Казанский медицинский журнал. - 2010. – Т.91, No3. - С.427. [Professor Nail’ Bagauvich Amirov [Professor Nail Bagauvich Amirov]. Kazanskiy meditsinskiy zhurnal [Kazan Medical Journal]. 2010; 91 (3): 427. (In Russ.)]. Режим доступа [URL]: https://cyberleninka.ru/article/n/professor-nail-bagauvich-amirov/viewer
3. К 70-летию со дня рождения главного редактора журнала профессора Амирова Наиля Багаувича // Вестник современной клинической медицины. - 2022. - Т.13, No 1. - С.7-9. [K 70-letiyu so dnya rozhdeniya glavnogo redaktora zhurnala professora Amirova Nailya Bagauvicha [On the 70th anniversary of the birth of the editor-in-chief of the journal, Professor Amirov Nail Bagauvich.]. Vestnik sovremennoy klinicheskoy meditsiny [Bulletin of Contemporary Clinical Medicine]. 2022; 13 (1): 7-9. (In Russ.)]. DOI: 10.20969/VSKM.2020.13(1).7-9
4. Амиров Н.Б. Отдельные показатели гуморального и клеточного иммунитета и микроциркуляция у больных хроническим необструктивным бронхитом и системной склеродермией : автореферат дис. ... кандидата медицинских наук : 14.00.05, 14.00.39 / Казан. гос. мед. ин-т им. С. В. Курашова. — Казань, 1990. — 15 с. [Amirov NB. Otdel’nyye pokazateli gumoral’nogo i kletochnogo immuniteta i mikrotsirkulyatsiya u bol’nykh khronicheskim neobstruktivnym bronkhitom i sistemnoy sklerodermiyey : avtoreferat discertatsii kandidata meditsinskikh nauk [Selected indicators of humoral and cellular immunity and microcirculation in patients with chronic non-obstructive bronchitis and systemic scleroderma: abstract of the dissertation of a candidate of medical sciences]. Kazan’: Kazanskiy gosudarstvennyy meditsinskiy institut imeni SV Kurashova [Kazan: Kazan State Medical Institute named after SV Kurashov]. 1990; 15 p. (In Russ.)].
5. Амиров Н.Б. Клинические и патогенетические аспекты лазерной терапии в клинике внутренних болезней: автореф. дис. на ... д-ра мед. наук : 14.00.05 / Н. Б. Амиров; [Казан. гос. мед. ун-т]. - Казань: 2001. - 38 с. [Amirov NB. Klinicheskiye i patogeneticheskiye aspekty lazernoy terapii v klinike vnutrennikh bolezney: avtoreferat discertatsii doktora meditsinskikh nauk [Clinical and pathogenetic aspects of laser therapy in the clinic of internal diseases: abstract of the dissertation of a doctor of medical sciences.]. Kazan’: Kazanskiy gosudarstvennyy meditsinskiy institute [Kazan: Kazan State Medical Institute]. 2001; 38 p. (In Russ.)].
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7. Визель А.А., Даминова М.А., Амирова Р.Н., [и др.]. Анализ деятельности и развития медицинского научно-практического журнала «Вестник современной клинической медицины» за 10 лет (с 2008 по 2018 год) // Вестник современной клинической медицины. - 2018. - Т. 11. No 1. - С.7-16. [Vizel’ AA, Daminova MA, Amirova RN, et al. Analiz deyatel’nosti i razvitiya meditsinskogo nauchno-prakticheskogo zhurnala “Vestnik sovremennoy klinicheskoy meditsiny” za 10 let (s 2008 po 2018 god) [Analysis of the activities and development of the medical scientific and practical journal “Bulletin of Contemporary Clinical Medicine” for 10 years (from 2008 to 2018)]. Vestnik sovremennoy klinicheskoy meditsiny [Bulletin of Contemporary Clinical Medicine]. 2018; 11 (1): 7-16. (In Russ.)]. DOI: 10.20969/VSKM.2018.11(1).7-16
8. Амиров Н.Б., Визель А.А., Ким З.Ф., [и др.]. Динамика и показатели развития медицинского научно-практического журнала «Вестник современной клинической медицины» за 5 лет (с 2018 по 2022 год) // Вестник современной клинической медицины. - 2022. - Т. 15. No 6. - С.7-16. [Amirov NB, Vizel’ AA, Kim ZF, et al. Dinamika i pokazateli razvitiya meditsinskogo nauchnoprakticheskogo zhurnala “Vestnik sovremennoy klinicheskoy meditsiny” za 5 let (s 2018 po 2022 god) [Dynamics and indicators of development of the medical scientific and practical journal “Bulletin of Contemporary Clinical Medicine” for 5 years (from 2018 to 2022)]. Vestnik sovremennoy klinicheskoy meditsiny [Bulletin of Contemporary Clinical Medicine]. 2022; 15 (6): 7-16. (In Russ.)]. DOI: 10.20969/VSKM.2022.15(6).7-16
UDC: 615.243.4
DOI: 10.20969/VSKM.2025.18(1).14-22
Sociological study: Issues related to over-the-counter drugs for the treatment of gastroesophageal reflux disease
Kseniya S. Biryukova1, Dilyara Kh. Shakirova1, Sayar R. Abdulkhakov1
1 Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, 76 Karl Marx str., 420012 Kazan, Russia
Abstract. Introduction. Pharmaceutical consulting is essential and represents a priority function of pharmaceutical professionals. Patients need clear information about medications, their uses, possible side effects, interactions with other medications, and other issues related to their health. In the modern world, an increasing number of people prefer to independently diagnose and treat their own diseases, turning to the Internet or friends, i. e., self-medicate. Aim. Studying the situation in modern pharmacy regarding the informational needs of physicians, pharmacy employees, and visitors in the over-the-counter dispensing of drugs for the gastroesophageal reflux disease treatment. Materials and Methods. During the period from February to April 2024, a voluntary and anonymous survey was conducted in pharmaceutical organizations under the Tattekhmedpharm network and medical organizations in Kazan. For this study, 47 pharmacists, 29 physicians, and 228 visitors were interviewed. The data collected was processed using Microsoft Excel. Results and Discussion. The study shows that a significant proportion of consumers with heartburn symptoms go to the pharmacy without visiting a doctor, which reflects a passive attitude towards this condition. The choice of drugs is most often determined by their effectiveness, safety, and price. Patients trust pharmacists and, in most cases, follow their recommendations. Doctors also note an increase in the number of patients complaining of heartburn and regurgitation, as well as the problem of irrational self-medication. Some physicians are unfamiliar with the concept of responsible self-medication, indicating a need for increasing physicians’ awareness on this issue. Conclusions. Based on the results of the study, it can be assumed that there are unsatisfied informational needs among patients, as well as insufficient mutual understanding between them and pharmaceutical specialists and medical professionals. This highlights the importance of continued research in this sector and the need for developing new strategies to improve consulting the patients so as to improve the treatment efficacy for patients with gastroesophageal reflux disease.
Keywords: gastroesophageal reflux disease, heartburn, questionnaire, pharmaceutical consultation.
For citation: Biryukova, K.S.; Shakirova, D.Kh.; Abdulkhakov, S.R. Sociological study: Issues related to over-the-counter drugs for the treatment of gastroesophageal reflux disease. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (1),14-22.. DOI: 10.20969/VSKM.2025.18(1).14-22.
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UDC: 616-053.3-07-06
DOI: 10.20969/VSKM.2025.18(1).23-29
Prevalence and causes of false positive results in neonatal screening
Alexey I. Geraskin1,2, Oleg E. Konovalov1, Irina P. Vitkovskaya3,4, Alexey V. Shulaev5, Oleg E. Potekhin2, Tatiana N. Kekeeva2
1 Peoples’ Friendship University of Russia named after Patrice Lumumba, 10 Miklukho-Maklaya str, Bldg. 2, 117198 Moscow, Russia
2 Morozov Children’s City Clinical Hospital of the Moscow City Health Department, 1/9 4th Dobryninskiy Pereulok str., 119049 Moscow, Russia
3 Russian Research Institute of Health, 11 Dobrolyubova str., 127254 Moscow, Russia
4 Pirogov Russian National Research Medical University, 1 Ostrovityanova str., 117997 Moscow, Russia 5Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
Abstract. Introduction. The article reviews the current organizational issues of the neonatal and extended neonatal screening program. Aim. The aim of the study was to assess the prevalence of false positive results of neonatal and extended neonatal screening program among newborns classified as at risk for various hereditary diseases, and to identify key factors contributing to their occurrence. Materials and Methods. The study included data analysis of 116,584 newborns screened in 2023. At the end of the initial screening, 5,996 infants (5.14% of the total number of those screened) were included in the risk group for hereditary diseases, but after retesting, the number of children in the risk group decreased to 1,062, while 107 children had a confirmed hereditary disease. Results and Discussion. According to the results, the prevalence of false positive cases in the at-risk group was 98.2%, which has a significant impact on the burden on the health care system. Major organizational problems include underestimation of the risk of false positives in premature and low birth weight infants, early blood collection, and biomaterial transport errors. Conclusions. Introducing stricter protocols for specimen collection and processing, as well as better informing parents about possible outcomes, may reduce false positive cases and, therefore, stress in families. This study underscores the need for revising organizational processes in implementing the neonatal and extended neonatal screening program to increase its efficiency, minimize costs, and improve communication between health care providers and patients’ families. Keywords: false positive results, neonatal screening, extended neonatal screening, ethical issues.
For citation: Geraskin, A.I.; Konovalov, O.E.; Vitkovskaya, I.P.; et al. Prevalence and causes of false positive results in neonatal screening. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (1), 23-29. DOI: 10.20969/VSKM.2025.18(1).23-29.
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UDC: 616.12-008.331.1-071.1:616.153.96
DOI: 10.20969/VSKM.2025.18(1).30-36
Predicting the likelihood of an increase in cardiovascular risk in patients with essential arterial hypertension after 12-month follow-up
Ekaterina V. Zhivchikova1, Ekaterina A. Polunina2, Tatiana V. Prokofyeva2, Olga S. Polunina2
1 Astrakhan Clinical Hospital, Southern District Medical Center of the Federal Medical and Biological Agency of Russia, M. Gor kogo str. 13/14, 414000, Astrakhan, Russia
2 Astrakhan State Medical University, Bakinskaya str. 121, 414000, Astrakhan, Russia
Abstract. Introduction. It has been proven that the involvement of the Klotho protein in the regulation of cellular metabolism can be a decisive factor in protecting the heart and blood vessels. Klotho protein may become a potential marker of vascular catastrophes in arterial hypertension. Aim. To predict the probability of an increase in cardiovascular risk in patients with essential arterial hypertension after 12-month follow-up, using the decision tree method. Material and Methods. The study included 90 patients with arterial hypertension, stage I. All patients had uncontrolled arterial hypertension. Changes in cardiovascular risk and Klotho protein levels were assessed as of the patients’ enrollment in the study and after 12 months. Determination of Klotho protein in blood serum was carried out by enzyme immunoassay. Results and discussion. The most significant factors influencing the increase in cardiovascular risk in patients with arterial hypertension over a 12-month-long follow-up period (decision tree method) were the presence of a comorbid pathology (chronic kidney disease II, obesity, and chronic obstructive pulmonary disease) and Klotho protein levels. In the resulting decision tree, there were 3 levels with 10 nodes, of which 6 were terminal. The probability of an increase in cardiovascular risk was 2.7 times higher than in the general sample in patients who fell into the decision tree at nodes 3 and 5. These were patients with comorbid pathology and Klotho protein level <0.39 ng/ml (node 3), as well as patients with no comorbid pathology and Klotho protein level <0.19 ng/ml (node 5). The total proportion of correct predictions among the patients we studied was 97.8%. Conclusions: The model obtained for predicting the probability of an increase in cardiovascular risk in patients with arterial hypertension, I stage after 12 months, based on the construction of a decision tree, has a high sensitivity of 93,3% and specificity of 100,0%.
Keywords: arterial hypertension, cardiovascular risk, Klotho protein
For citation: Zhivchikova, E.V.; Polunina, E.A.; Prokofieva, T.V.; Polunina, O.S. Predicting the likelihood of an increase in cardiovascular risk in patients with essential arterial hypertension after 12-month follow-up. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (1), 30-36. DOI: 10.20969/VSKM.2025.18(1).30-36.
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UDC:616.31-083-053.2:616.831-051.3-007.12-008.6-009.1(045)
DOI:10.20969/VSKM.2025.18(1).37-41
Research in the effectiveness of oral hygiene training methods for children with Down syndrome
Larisa N. Kazakova1, Oksana S. Tereshchuk1, Valery V. Konnov1,2, Alexander V. Kuligin1, Ekaterina V. Mahonova1, Anastasiya V. Egorova1, Natalya V. Davydova1
1 Saratov State Medical University, 112 B Kazachya str., 410012 Saratov, Russia
2 Consultative Dental Clinic, S.R. Mirotvortsev Clinical Hospital, Saratov State Medical University, 137 Bolshaya Sadovaya str., 410054 Saratov, Russia
Abstract. Introduction. The number of children diagnosed with genetic diseases that manifest by disorders of various severity degrees and complicate the child’s social adaptation, steadily increases with each passing year. Limited communication abilities make it difficult to provide high-quality medical care using invasive treatment methods for dental pathology in these children. Therefore, the properly organized primary prevention of dental diseases in children with Down syndrome (DS) will reduce the patients’ need for treatment. However, the specificity of cognitive activity, motor functions, and emotional development in children with DS determine the search for new techniques of training hygienic skills as the main method of preventing dental diseases starting from an early age. Aim: To analyze the effectiveness of training methods for children with Down syndrome in mastering the standard tooth-brushing technique. Materials and Methods: Oral hygiene training methods were approbated in 2 groups of children with Down syndrome, 10 children in each, under the control of the Green-Vermillion index. The course included 9 sessions of 30 minutes each. Training involved two forms, specifically, business “interpersonal” game and multimedia training. Results and Discussion. In the first group of Down syndrome patients, the sequence of movements completely matched the standard on the seventh day of training for 7 out of 10 patients. By the ninth day of training, 9 out of 10 patients could repeat the sequence independently, with minimal errors. The hygiene level, on average, in the first group of children corresponded to a satisfactory value already on the seventh day of training. On the ninth day of training, a satisfactory average value of the Green-Vermillion Index was maintained in the first group. In the second group of Down syndrome patients, the sequence of movements matched the standard for 3 out of 10 patients on the seventh day of training. By the ninth day of training, the sequence of movements by the standard tooth-brushing method corresponded to the standard for 5 out of 10 children, the Green-Vermillion Index being characterized as satisfactory only in 3 out of 10 patients; on average the second group demonstrated a poor hygiene level. Conclusions. Based on the results of training in the standard tooth-brushing method to patients with DS, the most effective appeared to be the “interpersonal” business game with repeated practice of hand-to-hand movements and actions comments in combination with the praise to the imitating child. To create a dynamic stereotype, the training course should include at least nine sessions.
Keywords: children, Down syndrome, hygiene, oral cavity.
For citation: Kazakova, L.N.; Tereshchuk, O.S.; Konnov, V.V.; et al. Research in the effectiveness of oral hygiene training methods for children with Down syndrome. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (1),37–41. DOI: 10.20969/VSKM.2025.18(1).37-41.
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10. Максимова С.Ю., Губарева Д.С. Методические особенности обучения детей с синдромом Дауна двигательным действиям // Человек. Спорт. Медицина. – 2022. – Т. 22. – No 2. – С.158–163. [Maksimova SYu, Gubareva DS. Metodicheskie osobennosti obuchenija detej s sindromom Dauna dvigatel’nym dejstvijam [Motor skill acquisition in children with Down syndrome]. Chelovek; Sport; Medicina [Human; Sport; Medicine]. 2022; 22 (2); 158-163. (In Russ)]. DOI: 10.14529/hsm220219
UDC: 616.12-008.331.1-06:616.153.96:616.981.71
DOI: 10.20969/VSKM.2025.18(1).42-47
Prognostic significance of determining the heat shock protein 70 levels in arterial hypertension in patients after Astrakhan rickettsial fever
Kamilya V. Kotraleva1, Evgeniy A. Popov1, Olga S. Polunina1, Ekaterina A. Polunina1
1 Astrakhan State Medical University, 121 Bakinskaya str., 414000 Astrakhan, Russia
Abstract. Introduction. Infectious diseases can cause worsening of the course and prognosis of pre-existing arterial hypertension. In this regard, Astrakhan rickettsial fever is of interest: An acute transmissible, natural focal infectious disease characterized by cardiovascular complications. Heat shock protein 70 is one of the promising biomarkers involved in the pathogenesis of arterial hypertension. Aim: To determine the prognostic significance of identifying the heat shock protein 70 levels regarding the probability of changes in the progress of arterial hypertension in patients who have had Astrakhan rickettsial fever. Materials and Methods. A total of 38 patients were examined who had admitted for treatment to a hospital for infectious diseases with Astrakhan rickettsial fever associated with the background of essential arterial hypertension. Patients were analyzed for the average daily blood pressure levels, Astrakhan rickettsial fever complications, and the heat shock protein 70 levels in serum. Changes in the progress of arterial hypertension 4 months after discharge from the hospital were considered an increase in cardiovascular risk in arterial hypertension and/ or the stage of hypertensive disease. Results and Discussion: 4 months after discharge from the hospital, 8 people (21.1%) had an increase in the stage of hypertensive disease. A change in the stratification of cardiovascular risk in arterial hypertension was found in 8 people (21.1%). Heat shock protein 70 levels were significantly higher (p=0.029) statistically in patients with changes in the progress of arterial hypertension 4 months after Astrakhan rickettsial fever, compared to patients without any changes in the progress. The final prognostic model for determining the probability of changes in the arterial hypertension progress 4 months after Astrakhan rickettsial fever included heat shock protein 70 as a predictor. Conclusions. The following was established: Changes in the arterial hypertension progress after Astrakhan rickettsial fever 4 months after discharge from the hospital were detected in 31.6% of patients. An increase in the chances of changing the arterial hypertension progress after Astrakhan rickettsial fever was facilitated by the presence of a complicated course of Astrakhan rickettsial fever (5.9 times) and an increase in average daily blood pressure ≥140 mm Hg (systolic) and/or 90 mm Hg (diastolic) during the convalescence period of Astrakhan rickettsial fever (8 times). Determining the heat shock protein 70 levels at discharge from the hospital is essential for a personalized prognosis of changes in the arterial hypertension progress after Astrakhan rickettsial fever after 4 months. The developed and proposed prognostic model for predicting the probability of changes in the arterial hypertension progress 4 months after Astrakhan rickettsial fever has high sensitivity and specificity of 83.3% and 76.9%, respectively.
Keywords: arterial hypertension, Astrakhan rickettsial fever, heat shock protein 70.
For citation: Kotraleva KV, Popov EA, Polunina OS, Polunina EA. Prognostic significance of determining the heat shock protein 70 levels in arterial hypertension in patients after Astrakhan rickettsial fever. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (1), 42-47.. DOI: 10.20969/VSKM.2025.18(1).42-47.
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UDC 616.12-008.313.2
DOI: 10.20969/VSKM.2025.18(1).48-56
Complete blood count parameters as prognostic factor of new-onset atrial fibrillation in patients with ST-segment elevation myocardial infarction after percutaneous coronary intervention
Regina L. Pak1, Boris I. Geltser1, Karina I. Shakhgeldyan1,2, Nikita S. Kuksin1, Igor G. Domzhalov1, Evgenii A. Kokarev3
1 Far Eastern Federal University, 10/25 Ajax Bay, Russky Island, 690922 Vladivostok, Primorsky Krai, Russia
2 Vladivostok State University, 41 Gogolya Str., 690922 Vladivostok, Primorsky Krai, Russia
3 Regional Clinical Hospital No1, 57 Aleutskaya Str., 690091 Vladivostok, Primorsky Krai, Russia
Abstract. Introduction. Atrial fibrillation (AF) that develops in patients with ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) worsens their short- and long-term prognosis. Aim. The aim of the study was to assess the predictive significance of clinical blood count parameters in STEMI patients for developing prognostic models of post-PCI AF. Materials and Methods. A single-center retrospective study was conducted using data from 3,449 electronic medical records of STEMI patients. Two groups were identified, with 310 (9%) patients having newly diagnosed AF in the post-PCI period in the first group, and 3,139 (91%) patients without arrhythmia disturbances in the second group. Prognostic models were developed using univariate and multivariate logistic regressions. The accuracy of the models was evaluated using three metrics: Area under the ROC curve (AUC), sensitivity, and specificity. Results and Discussion. Multi-stage analysis of the predictive potential of complete blood count parameters in patients with ST-segment elevation myocardial infarction identified 3 factors among them that, in isolated form, were most strongly associated with the risk of developing atrial fibrillation after percutaneous coronary intervention. These included neutrophils greater than 70.1%, a systemic inflammatory response index greater than 4.54 conventional units, and eosinophils less than 0.6%. However, a model with the structure represented only by a combination of these predictors did not meet the acceptable prognosis quality for postoperative atrial fibrillation (AUC-0.674). This acceptable quality was with the model including indicators of patient age over 66 years, blood glucose content over 5.67 mmol/L, potassium less than 3.5 mmol/L, a history of myocardial infarction, and a heart rate exceeding 81 beats per minute (AUC= 0.772). At the same time, the algorithm combining the predictive potential of the above factors demonstrated the best prognostic accuracy (AUC-0.795). Conclusions. Prognostic resource of hematological markers of inflammatory response in relation to post-PCI AF is only realized when combined with other factors characterizing the functional and metabolic status of STEMI patients.
Keywords: ST-segment elevation myocardial infarction, percutaneous coronary intervention, atrial fibrillation, prognosis, complete blood count.
For citation: Pak, R.L.; Geltser, B.I.; Shakhgeldyan, K.I.; et al. Complete blood count parameters as prognostic factor of new-onset atrial fibrillation in patients with ST-segment elevation myocardial infarction after percutaneous coronary intervention. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (1), 48-56. DOI: 10.20969/VSKM.2025.18(1).48-56.
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UDC: 616.12-008.331.1-071.1:616.153.96
DOI: 10.20969/VSKM.2025.18(1).57-62
Prognostic significance of Klotho protein level in essential arterial hypertension
Olga S. Polunina1, Ekaterina V. Zhivchikova2, Tatiana V. Prokofyeva1, Ekaterina A. Polunina1
1 Astrakhan State Medical University, 121 Bakinskaya str., 414000 Astrakhan, Russia
2 Astrakhan Clinical Hospital, Southern District Medical Center of the Federal Medical and Biological Agency of Russia, 13/14 M. Gorkogo str., 414000 Astrakhan, Russia
Abstract. Introduction. Understanding the pathophysiological and pathogenetic mechanisms underlying essential arterial hypertension remains an unattainable task, which justifies the researchers’ constant focus on searching for new knowledge. Multifunctional Klotho protein is of interest in this regard, indicated in a wide range of studies. Aim. To study Klotho protein levels in patients with stage I arterial hypertension, in terms of the prognostic significance of cardiovascular risk increase after 12 months. Material and Methods. Two groups were examined: 90 patients with arterial hypertension and 30 somatically healthy individuals as a control group. The change in cardiovascular risk was assessed after 12 months. Klotho protein levels were quantified in blood serum using enzyme immunoassay. Results and Discussion. In patients with arterial hypertension, Klotho protein levels were statistically significantly lower (p<0.001) than in somatically healthy individuals. After 12 months, an increase in cardiovascular risk was found in 33 (33.3%) patients. After 12 months, patients with arterial hypertension had a statistically significant decrease in Klotho protein levels (p=0.002) from 0.33 [0.24; 0.42] ng/ml to 0.31 [0.17; 0.42] ng/ml. In patients who experienced an increase in cardiovascular risk after 12 months, Klotho protein levels were statistically significantly lower (p=0.002) than in patients with unchanged cardiovascular risk. Using ROC analysis, a “cut-off point” was determined for the Klotho protein level that allows optimizing the prognosis of an increase in cardiovascular risk after 12 months in patients with stage I arterial hypertension. Conclusions: If Klotho protein level is below 0.32 ng/ml in patients with stage I arterial hypertension, an increase in cardiovascular risk is predicted after 12 months. The sensitivity and specificity of the method were 78.8% and 78.9%, respectively.
Keywords: arterial hypertension, cardiovascular risk, Klotho protein
For citation: Polunina, O.S.; Zhivchikova, E.V.; Prokofieva, T.V.; Polunina, E.A. Prognostic significance of Klotho protein level in essential arterial hypertension. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (1), 57-62. DOI: 10.20969/VSKM.2025.18(1).57-62.
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UDC: 616.12-008.131.1-347.639-616.154
DOI: 10.20969/VSKM.2025.18(1).63-70
Relationship of asymmetric dimethylarginine level with metabolic disorders and arterial hypertension stages in children
Natalia A. Revenko1, Nikolay N. Kaladze1, Olga A. Revenko1, Tatiana V. Polonevich1, Anna A. Kornienko1, Sofia V. Biganova1
1 The Order of the Red Banner of Labor Medical Institute named after S.I. Georgievsky, V.I. Vernadsky Crimean Federal University, 5/7 Lenin Blvd., 295600 Simferopol, Russia
Abstract. Introduction. Endothelial dysfunction is of great importance in the development of arterial hypertension. It arises due to high production of vasoconstrictors, including asymmetric dimethylarginine. Aim. To determine the significance of asymmetric dimethylarginine in the development of endothelial dysfunction in children with arterial hypertension and metabolic disorders. Material and Methods. 123 children with arterial hypertension were examined. Along with complete clinical, laboratory, and instrumental examinations, the concentration of asymmetric dimethylarginine in blood serum was assessed. Results and Discussion. It was found that children with arterial hypertension and signs of metabolic syndrome have endothelial dysfunction, statistically significantly different from indicators in children with arterial hypertension without metabolic disorders, the level of which increases with the disease stabilization. Assessments of the possible development and progression of the disease and favorable course are presented, as depending on the dynamics of asymmetric dimethylarginine profiles. Positive statistically significant correlations were obtained between the asymmetric dimethylarginine levels and body mass index, waist circumference, blood pressure indicators, and duration of the disease. Conclusions. The results obtained suggest that asymmetric dimethylarginine in children is involved in the formation and progression of arterial hypertension and metabolic syndrome.
Keywords: arterial hypertension, metabolic syndrome, asymmetric dimethylarginine, endothelial dysfunction, children. For citation: Revenko, N.A.; Kaladze, N.N.; Revenko, O.A.; et al. Relationship of asymmetric dimethylarginine level with metabolic disorders and arterial hypertension stages in children. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (1), 63-70. DOI: 10.20969/VSKM.2025.18(1).63-70.
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UDC: 616-06
DOI: 10.20969/VSKM.2025.18(1).71-80
A multimorbid patient: Relationship between tuberculosis, somatic diseases, and some mental disorders
Oleg A. Serov1, Natalya V. Tursunova1, Elena M. Zhukova1
1 Novosibirsk Research Institute of Tuberculosis, 81a Okhotskaya str., 630040 Novosibirsk, Russia
Abstract. Introduction. One of the reasons for the adverse results of anti-tuberculosis treatment is the impairment of the patient’s emotional state and the development of their psychological distress with the symptoms of anxiety and depression. Another problem is the combination of tuberculosis with other somatic diseases, which results in prescribing more medications and increasing the number of adverse chemotherapy responses, reduces their treatment adherence, and leads to developing drug-resistant tuberculosis strains. Identifying the correlation relationship between tuberculosis, somatic diseases, and mental disorders is an urgent task of contemporary medicine in terms of selecting the optimal treatment approaches to such multimorbid patients. The aim was to study the relationship between the clinical manifestations of anxiety and depression and comorbid status in patients with different clinical forms of tuberculosis. Materials and Methods. The study included 265 patients with various clinical forms of respiratory tuberculosis. The lung tissue damage degree was assessed, as well as the total area of the lung tissue decay, massiveness of bacterial excretion, drug resistance range of the causative agent, and bronchial obstruction severity degree according to the forced expiration volume within the 1st second (FEV1). To identify the patients’ comorbidity levels, we used the Cumulative Illness Rating Scale. To assess the patients’ emotional states, we used the Hospital Anxiety and Depression Score. Results and Discussion. In the most severe group in terms of clinical manifestations of tuberculosis, such as weight loss, bacterial excretion, drug resistance of the pathogen, the proportion of strains with extensive drug resistance, a high drug resistance index, the predominance of destructive changes in the lungs and their significantly larger area, the degree of prevalence in the lungs, and the bronchial obstruction index, the study included patients with fibrous-cavernous tuberculosis compared with patients with disseminated, infiltrative forms and tuberculomas. Disseminated tuberculosis was the next most severe; and the least severe symptoms (according to these criteria) were in patients with tuberculomas. The most common comorbidities in tuberculosis patients under study were gastrointestinal diseases (37.35%) and cardiovascular diseases (24.9%). The highest comorbidity index was observed in patients with disseminated (5.75) and fibrous-cavernous tuberculosis (5.5), the lowest - with tuberculomas (4.56). Depressive symptoms in the study were significantly associated with a high frequency of perceived symptoms of physical illness and/or high comorbidity, clinical manifestations of tuberculosis. The depression indicator had positive correlations with the number of the patient’s complaints (R = 0.28), the comorbidity degree (R = 0.12), and the decay area in the lungs (R = 0.12). The most severe depression manifestations accompanied fibrous-cavernous tuberculosis. Patients with tuberculomas had the lowest level of depression. Conclusions. The data obtained can be used to select impact points when creating optimized treatment programs for multimorbid patients with tuberculosis.
Keywords: pulmonary tuberculosis, anxiety, depression, hypertension, chronic obstructive pulmonary disease, diabetes mellitus.
For citation: Serov, O.A.; Tursunova, N.V.; Zhukova, E.M. A multimorbid patient: Relationship between tuberculosis, somatic diseases, and some mental disorders. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (1), 71-80. DOI: 10.20969/VSKM.2025.18(1).71-80.
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UDC: 616.24-002.5-006:616.379-008.64
DOI: 10.20969/VSKM.2025.18(1).81-89
Efficacy of chemotherapy and long-term treatment outcomes in patients with multidrug- and extensively drug-resistant tuberculosis with premature withdrawal of chemotherapy
Alexey M. Tikhonov1, Andrey V. Zakharov1, Marina V. Burakova1,2, Olga M. Gordeeva1, Elena V. Krasnikova1, Vladimir V. Romanov1
1 Central Research Institute of Tuberculosis, 2 Yauzskaya Alley, 107564, Moscow, Russia
2 Peoples’ Friendship University of Russia named after Patrice Lumumba, 6 Miklukho-Maklaya str., 6, 117198, Moscow, Russia
Abstract. Introduction. The problem of mycobacterium tuberculosis resistance requires the effective implementation of a strategy to curb the growth of the pathogen’s drug resistance, namely, monitoring the competent administration of anti-tuberculosis drugs, and developing new chemotherapy regimens to improve the treatment efficacy. Aim. To study the long-term outcomes of shortened multidrug- and extensively drug-resistant pulmonary tuberculosis treatment regimens based on the analysis of the clinical course of the disease and the chemotherapy efficacy in patients who interrupted treatment for various reasons at earlier stages than provided for by official Clinical Recommendations. Materials and Methods. Chemotherapy efficacy and long-term treatment outcomes were analyzed retrospectively in 43 patients treated at CTRI in 2015-2021 and prematurely ceased the main chemotherapy cycle for various reasons. Inclusion criteria: Patients with the established and verified diagnosis of pulmonary tuberculosis, with or without any compensated concomitant pathology, and with the established bacterial excretion with multidrug- and extensively drugresistant pulmonary tuberculosis. The study had a retrospective, analytical design. Therefore, it was not required to obtain approval from the local ethics committee. Study object: Medical and outpatient records of patients hospitalized and examined in the consulting department after discharge from the hospital. Results and Discussion. The treatment efficacy indicator, according to the criterion of cessation of bacterial excretion after 6 months of chemotherapy, was 90.7%, i. e., 39/43 patients, and after 12 months the cessation of bacterial excretion was achieved in all patients (100%, i. e., 43/43 p.). Closure of the cavities was found in 38.1%, i. e., in 8/21 patients, after 6 months of treatment, andin 95.2%, i. e., 20/21 patients after 12 months. Conclusions. The main chemotherapy cycle continued for 6-9 months in 20.9% of cases, 9-12 months in 37.2% of cases, and 12-15 months in 41.9% of cases. Among the main reasons for premature discontinuation of chemotherapy, the largest share was the unauthorized cessation of treatment (29.8%) and the lack of necessary chemotherapy drugs in regional anti-tuberculosis institutions (25.5%). 12 months after completion of chemotherapy, no cases of relapse of tuberculosis were detected. By 24 months of observation, relapses of the disease were registered in 18.6% (8/43 patients). A study based on real clinical practice materials shows that complex treatment of patients with multidrug- and extensively drug-resistant pulmonary tuberculosis using modern chemotherapy drugs, including bedaquiline, in combination with the use of surgical methods allows achieving high rates of treatment efficacy even in conditions of the forced premature chemotherapy withdrawal and creates the prerequisites for further research in the shortened treatment regimens for patients with multidrug-resistant tuberculosis.
Keywords: tuberculosis, drug resistance, chemotherapy, premature termination of treatment, short cycle
For citation: Tikhonov, A.M.; Zakharov, A.V.; Burakova, M.V.; et al. Efficacy of chemotherapy and long-term treatment outcomes in patients with multidrug-and extensively drug-resistant tuberculosis with premature withdrawal of chemotherapy. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (1), 81-89. DOI: 10.20969/VSKM.2025.18(1).81-89.
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UDC: 339.13: 614.27
DOI: 10.20969/VSKM.2025.18(1).90-97
Analysis of the potential and prospects for selling pharmacy products via the Internet
Irina E. Ulianova, Svetlana N. Egorova
Kazan State Medical University, 49 Butlerov str., 420012 Kazan
Abstract. Introduction. Currently, online commerce is becoming increasingly popular, and the online sales of pharmaceuticals are not an exception. The research literature provides the findings obtained from analyses on selling consumer goods. However, the strengths, weaknesses, threats, and opportunities related to the online sales of medical products, as well as the development of an online trading strategy, are still being identified. The aim of this study is to analyze the current situation of online pharmacies and to identify opportunities for developing and improving services in the online sales of pharmaceuticals. Materials and Methods. The study subject is the research literature data and the national standard GOST R 58531-2019: Organization management. Guidelines for the implementation of sustainable management in small and medium-sized enterprises. The methods of logical and comparative analysis, as well as content analysis, were used in this study. Results and Discussion. The study identified strengths, weaknesses, threats, and opportunities for online commerce in general and for the remote sales of pharmacy products, based on research literature. Additionally, strengths of the online drug trade were formulated, such as increasing the availability of medications to the public and confidentiality in sensitive matters. The weaknesses include issues regarding the return of pharmaceuticals and insufficient online pharmaceutical consulting levels. Potential threats are legislative restrictions, vulnerability to cyberattacks, and leaks of confidential information. Opportunities include technology development to ensure product safety and quality, as well as investments in artificial-intelligence-supported technologies. Conclusions. The current state of online pharmacy has been explored, and a strategy for the future development of this field has been developed. The importance of improving online consultations has been recognized, as well as the need for establishing ethical guidelines for online sales of medications and other pharmaceuticals.
Keywords: SWOT analysis, online pharmacies, pharmaceutical consulting, ethical principles.
For citation: Ulianova, I.E.; Egorova, S.N. Analysis of the potential and prospects for selling pharmacy products via the Internet. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (1), 90-97. DOI: 10.20969/VSKM.2025.18(1).90-97.
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UDC: 04.852:07.76
DOI: 10.20969/VSKM.2025.18(1).98-106
Interpretable machine learning models as an instrument for explaining predictive assessments in cardiology
Karina I. Shakhgeldyan1,2, Vladislav U. Rublev1,3, Nikita S. Kuksin1, Regina L. Pak1, Boris I. Geltser1
1 Far Eastern Federal University, 10/25 Ajax Bay, Russky Island, 690922 Vladivostok, Primorsky Krai, Russia
2 Vladivostok State University, 41 Gogolya Str., 690922 Vladivostok, Primorsky Krai, Russia
3 Regional Clinical Hospital No. 1, 57 Aleutskaya Str., 690091 Vladivostok, Primorsky Krai, Russia
Abstract. Introduction. In-hospital mortality during coronary artery bypass grafting in patients with coronary artery disease varies from 1 to 6%. In recent years, machine learning methods have been increasingly used to predict in-hospital mortality after coronary artery bypass grafting. However, their widespread implementation in clinical practice is limited by the non-transparency of the predictive results. Aim. The aim of the study is to develop interpretable machine learning models for predicting in–hospital mortality in patients with coronary artery disease after coronary artery bypass grafting, based on the multi–level categorization of continuous predictors. Materials and Methods. A single-center retrospective study was conducted using data from 1504 case histories of patients with coronary artery disease after coronary artery bypass grafting. Two groups were identified: The first one included 79 (5.3%) patients who had died in the hospital, and the second one included 1425 (94.7%) patients with favorable coronary artery bypass grafting outcomes. Statistical analysis methods were used to select predictors, and models were developed using machine learning methods, such as multivariate logistic regression, random forest, and stochastic gradient boosting. Grid search optimization and the Shapley additive explanation method were used for the multi-level categorization of predictors. Results and Discussion. As a result of the multi-step analysis of the clinical and functional status indicators in patients with coronary artery disease, in-hospital mortality predictors were identified, validated, and categorized. Predictive models of in-hospital mortality with multi-level categorization of predictors surpassed the models with continuous predictors in terms of performance (AUC 0.882 vs 0.856) and provided clinical interpretability of the generated conclusions. Conclusions. Interpretable predictive machine learning models have been developed, with the main element being the multi-level categorization of in-hospital mortality predictors. This approach was characterized by high accuracy and interpretability of the prediction results, which allows using it for other cardiological conditions.
Keywords: predictive models, multi-level categorization, in-hospital mortality, coronary artery bypass grafting, Shapley additive explanation method.
For citation: Shakhgeldyan, K.I.; Rublev, V.U.; Kuksin, N.S.; et al. Interpretable machine learning models as an instrument for explaining predictive assessments in cardiology. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (1), 98-106. DOI: 10.20969/VSKM.2025.18(1).98-106.
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UDC: 616.127-008: 575.113.1
DOI: 10.20969/VSKM.2025.18(1).107-114
Role of epigenetic factors in the development of cardiomyopathies
Maxim A. Makarov1, Aida R. Sadykova1, Aisylu A. Suleymanova1, Aigul I. Shakirova1, Aigoul M. Kozlova2, Tamara S. Zimina3
1 Kazan State Medical University, 49 Butlerov Str., 420012 Kazan, Russia
2 Republican Clinical Oncology Dispensary, 29 Sibirskiy Tract Str., 420029 Kazan, Russia 3City Clinical Hospital No. 11, 34/24 Maximov Str., 420127 Kazan, Russia
Abstract. Introduction. Currently, epigenetics is given a special place in medicine. This is a fairly new and intensively developing area. Progressive development of epigenetics gives us an opportunity to study various serious diseases, including cardiomyopathy. Due to this, in recent years, the main mechanisms have been identified for epigenetic regulation in the development of cardiomyopathy. Aim. To study the role of epigenetic factors in the development of cardiomyopathies for identifying potential biomarkers, predicting the risk of the disease evolvement, and developing new therapeutic strategies. Material and Methods. Modern research data are analyzed regarding the role of epigenetic factors affecting the development of cardiomyopathies. Results and Discussion. Epigenetics, especially in the context of cardiovascular diseases, is an important research area. In recent years, knowing the role of epigenetic modifications, such as deoxyribonucleic acid methylation, histone modifications, and non-coding ribonucleic acids, in the pathogenesis of various cardiomyopathies, has significantly expanded. Epigenetic changes can lead to abnormal electrophysiological properties of cells, affect calcium handling, and increase the risk of arrhythmias. Histone modifications, such as acetylation and methylation, regulate the activity of promoters and influence the expression of genes associated with hypertrophy and cardiac function. Non-coding RNAs, including microRNAs, control gene activity at the post-transcriptional level, which has significant consequences for cardiomyocytes. Conclusions. Epigenetic processes play a significant role in implementing the genetic program of cardiomyopathy disease. They determine the formation peculiarities of various signs and mechanisms of development, both in normal and pathological conditions. However, epigenetic studies give us an advantage in both better understanding of the disease characteristics and developing new approaches to the diagnosis, as well as the treatment of pathologies based on the data obtained.
Keywords: cardiomyopathy, epigenetics, DNA methylation, histone modification, non-coding RNAs.
For citation: Makarov, M.A.; Sadykova, A.R.; Suleymanova, A.A.; et al. Role of the epigenetic factors in the development of cardiomyopathies. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (1), 107-114. DOI: 10.20969/VSKM.2025.18(1).107-114.
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UDC 616-056.52
DOI: 10.20969/VSKM.2025.18(1).115-123
Relationship between cognitive impairment and obesity
Elvira G. Mutalova1, Azalia I. Nafikova1, Albina E. Nigmatullina1, Velena R. Galyautdinova1, Gulnara J. Kamaltdinova1, Gulnara V. Asadullina1, Liana I. Samigullina1, Zulfiya Ya. Rustyamova1, Regina I. Sadikova1, Svetlana A. Frid1, Flarisa S. Musina1, Altinai A. Zhumaniyazova2
1 Bashkir State Medical University, 3 Lenin str., 450000 Ufa, Russia
2 City Clinical Hospital No. 13, 28 Nezhinskaya str., 450112 Ufa, Russia
Abstract. Introduction. Currently, the growth of the overweight and obese population is increasing every year, which confirms that the problem in question has been assigned the status of a non-infectious epidemic of the 21st century. At the same time, the prevalence of cognitive impairment is extremely high among the global population. According to the World Health Organization (WHO), there are suggestions that due to the increased life expectancy, this figure may have grown threefold by 2050. The aim of this study is to analyze data published in modern literature, which links obesity with cognitive impairment. Materials and Methods. The review includes data from foreign and domestic studies published in electronic bibliographic databases, such as Pubmed, Cochrane Library, Web of Science, Google Scholar, and Cyberleninka, over the past 10 years. Publications were analyzed that provide information on risk factors and pathogenetic aspects of obesity and cognitive impairment. Results and Discussion. Relevant information was collected regarding the comorbidity of cognitive changes in obesity. We have systematized the data related to the analysis of possible pathophysiological mechanisms justifying this relationship and analyzed the gender- and age-related characteristics of the nature of cognitive impairment. Conclusions. Various studies have shown that obesity is associated with a high prevalence of developing cognitive impairment. In the development of cognitive impairment in obese patients, a combination of factors is essential, namely, hyperleptinemia, leptin resistance, hyperinsulinemia and impaired carbohydrate tolerance, increased activity of pro-inflammatory markers, endothelial dysfunction and hypercholesterolemia, as well as polymorphic gene variants and the endocannabinoid system. According to the research findings, changes in overweight and obesity mainly occur in the form of mild cognitive decline affecting memory, attention, language, praxis, and learning ability. Age-related differences have been identified regarding cognitive changes in obesity: In children and adolescents, these changes are more often associated with impaired memory function and concentration, while in middle-aged people – with general cognitive decline.
Keywords: obesity, cognitive dysfunction, leptin, insulin resistance, hypertriglyceridemia, inflammation, endothelial dysfunction, metabolic syndrome.
For citation: Mutalova, E.G.; Nafikova, A.I.; Nigmatullina, A.E.; et al. Relationship between cognitive impairment and obesity. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (1), 115-123. DOI: 10.20969/VSKM.2025.18(1).115-123.
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UDC 612-008.312.2:575.113.1
DOI: 10.20969/VSKM.2025.18(1).124-131
Role of the genetic and epigenetic factors in the development of atrial fibrillation
Aida R. Sadykova1, Kirill A. Rakov1, Matvei E. Khramov1, Maxim A Makarov1, Alsu M. Sadykova2, Svetlana Sh. Krivonosova3
1 Kazan State Medical University, 49 Butlerov Str., 420012 Kazan, Russia
2 City Clinical Hospital No. 7, 54 Chuykova Str., 420132 Kazan, Russia
3 City Clinical Hospital No. 11, 34/24 Maximov Str., 420127 Kazan, Russia
Abstract. Aim of this review is to analyze the results of modern studies on the epigenetic factors influencing the development of atrial fibrillation. Materials and Methods. The most modern literature was reviewed, discussing the genetic and epigenetic factors influencing the development of atrial fibrillation. Sources: PubMed, ResearchGate, eLibrary, Cyberleninka. Results and Discussion. The main epigenetic mechanisms are DNA methylation, histone configurations, and non-coding RNAs. Atrial fibrillation is the most common cardiac arrhythmia in the general population, and therefore, significant efforts are being made to understand the molecular substrates underlying AF. The epigenetic AF regulation is gradually being deciphered. Thus, in the upcoming years, there is a significant chance of rapid growth in research revealing the contribution of epigenetic mechanisms to the AF-associated substrates, such as genetic regulation networks linking DNA methylation and/or histone modifications in the regulation of transcription of AF-associated key factors, such as PITX2, TBX5, and ZFHX3, among others, or complex gene regulatory networks of lncRNA-microRNA- mRNA, affecting the electrophysiological substrates and structural remodeling substrates underlying AF. Conclusions. Epigenetic factors, along with genetic ones, play an important role in the development of atrial fibrillation. Studying them is important to identify the biological markers of this disease development and targets for its pharmacotherapy.
Keywords: atrial fibrillation, epigenetics, DNA methylation, histone modifications, non-coding RNAs
For citation: Sadykova, A.R.; Rakov, K.A.; Khramov, M.E.; et al. Role of the genetic and epigenetic factors in the development of atrial fibrillation. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (1), 124-131. DOI: 10.20969/VSKM.2025.18(1).124-131.
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UDC 616.31-02-053.2
DOI: 10.20969/VSKM.2025.18(1).132-141
Factors affecting occurrence and development of dental diseases in preschool children (literature review)
Madina N. Khadyeva
Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
Abstract. Introduction. This article deals with an urgent problem in dental practice: Studying the most common dental diseases in preschool children and the factors that contribute to their development and emergence. The aim of the study was to obtain information regarding factors that may affect the development of dental diseases among preschool kids. Materials and Methods. While preparing this material, over 60 sources of national and foreign literature were analyzed, as well as the data from the eLibrary, PubMed, Google, JADA, and Cyberleninka databases. Results and Discussion. The article presents new data on the prevalence of major dental diseases among preschool children living in different regions in Russia and worldwide, as well as the factors contributing to the development of dental diseases, such as tooth decay and its complications, dental abnormalities, non-carious dental lesions, and periodontal diseases. Socio-economic, behavioral, and biological factors, environmental risk factors, and combinations of both were analyzed. The influence of antenatal and perinatal periods is covered as a possible risk factor of the development of oral diseases in young children. Conclusions. Dental diseases in children are multifactorial in nature; therefore, the complex of preventive measures should also be systemic in nature and focused on various elements of pathogenesis.
Keywords: caries and its complications, preschool children, periodontal diseases, malocclusion pathology, non-carious dental diseases.
For citation: Khadyeva, M.N. Factors affecting occurrence and development dental diseases in preschool children. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (1), 132-141. DOI: 10.20969/VSKM.2025.18(1).132-141.
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UDC: 616.981.717-022.39
DOI: 10.20969/VSKM.2025.18(1).142-152
Lyme borreliosis in a comorbid patient: Clinical mosaic, diagnostic and therapeutic issues
Alina I. Tolmacheva1, Anna V. Novikova1, Daria Yu. Andriyashkina1, Alesya A. Klimenko1, Aleksej I. Razitdinov2
1 N.I. Pirogov Russian National Research Medical University. Ostrovityanova str., 117513 Moscow, Russia
2 Kaluga State University named after K. E. Tsiolkovski. 26 Stepan Razin str., 248023 Kaluga, Russia
Abstract. Introduction. Tick-borne borreliosis is characterized by polysystemic manifestations with a tendency to become chronic. If no antibiotic therapy is provided, the course of comorbidities (cardiovascular, cerebral and articular) significantly worsens in the elderly patients. Aim. To present data on Lyme borreliosis associated with polysystemic damage manifested as developing severe neuroborreliosis, monoarthritis, extensive acrodermatitis, and carditis based on the clinical case of an elderly female patient hospitalized with a clinical pattern of acute myocardial infarction and focal neurologic signs 1.5 months after a tick bite. Materials and Methods. Patient T. (77 yo, F) was admitted with suspected acute coronary syndrome (ACS) to City Clinical Hospital No. 1 named after N. I. Pirogov. Coronary angiography did not reveal any coronary stenosis, while the echocardiography identified calcified aortic stenosis. After five days in the hospital, the patient had the right facial nerve paresis developed, and her pain in the back and right half of her body intensified. The patient was transferred to the Neurological Department. Brain CT scanning excluded stroke; the patient was consulted by an infectious disease expert and diagnosed with Herpes zoster. Results and Discussion. Due to pain in the right shoulder joint, the patient was consulted by the staff of the RNRMU named after N.I. Pirogov. The patient had a history of a tick bite 1.5 months before, with the development of annular erythema, thoracic polyradiculoneuritis, right shoulder joint arthritis, acrodermatitis, and cognitive deficit. Based on the patient’s history and her examination, Lyme disease was diagnosed at the dissemination stage, with the nervous system damage (Bannwarth syndrome, right facial nerve paresis, right small pectoral nerve paresis, and encephalopathy), as well as extensive acrodermatitis, carditis, and monoarthritis. Doxycycline was prescribed (for 21 days) to be followed by a cycle of Bicillin-5 (for 4 months); the lesions of the nervous system, skin and joints completely regressed, with memory and physical ability restored. Conclusions. Borreliosis can imitate acute conditions, including myocardial infarction, stroke, herpetic infection, intercostal neuralgia, and cervical plexus plexopathy, with the risk of patient’s disability in case the causative agent is not eradicated. Detailed medical history (including the epidemiological history) and thorough examination are the cornerstones of diagnosing Lyme disease, and prolonged antibiotic therapy may be considered in patients with persistent neurological symptoms.
Keywords: Lyme borreliosis, neuroborreliosis, Lyme carditis, Lyme arthritis, pterygoid scapula syndrome, antibiotic therapy.
For citation: Tolmacheva, A.I.; Novikova, A.V.; Andriyashkina, D.U.; et al. Lyme borreliosis in a comorbid patient: Clinical mosaic, diagnostic and therapeutic issues. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (1), 142-152. DOI: 10.20969/VSKM.2025.18(1).142-152.
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UDC: 614.253.8:616.31-089-01
DOI: 10.20969/VSKM.2025.18(1).153-159
Medical and social characteristics of patients with dental implantation in dental healthcare providers of various forms of ownership
Alexander A. Astafiev1, Oleg E. Konovalov1, Igor S. Kopetsky2, Alexey V. Shulaev3, Olga Yu. Guseva2, Andrey I. Kopetsky2
1 Peoples’ Friendship University of Russia named after Patrice Lumumba, 10 Miklukho-Maklaya str., 117198 Moscow, Russia
2 Pirogov Russian National Research Medical University, 1 Ostrovityanova str., 117997 Moscow, Russia
3 Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
Abstract. Introduction. Dental implantology treatment is a medical procedure, the demand for which is constantly increasing today. Aim. The aim of the study is to analyze the sociological data of patients, and to study their opinions regarding the dental services provided to them. Materials and Methods. The basis for the study was medical and social data, such as gender, age, and education, of patients who applied for any dental care related to dental implantation in medical institutions of private (limited liability company) and public (clinical and diagnostic medical center at a higher education institution) forms of ownership. Results and Discussion. The objectives of the study were to obtain the patients’ generalized characteristics in form of a typical social portrait, as well as to assess the patient satisfaction levels with the functional and cosmetic efficiency of the surgical and orthopedic dental-implant-based treatment. The findings obtained can be useful in planning promotional campaigns and evaluating their effectiveness, and the data are also important for identifying risk groups for patient adherence to treatment with dental implants. Conclusions. The analysis presented can be considered as a methodologically sound tool for identifying key factors affecting the efficiency and availability of dental services.
Keywords: dental implantation, patients, medical and social characteristics.
For citation: Astafiev, A.A.; Konovalov, O.E.; Kopetsky, I.S.; et al. Medical and social characteristics of patients with dental implantation in dental healthcare providers of various forms of ownership The Bulletin of Contemporary Clinical Medicine. 2025, 18 (1), 153-159. DOI: 10.20969/VSKM.2025.18(1).153-159.
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UDC 61-057.875:378
DOI: 10.20969/VSKM.2025.18(1).160-166
Treatment adherence as a component of professional competence of medical university students
Alexey V. Breusov1,3, Victoria A. Solyanina1, Vera V. Ryndina1, Alexey V. Shulaev2, Alla I. Ovod1, Victoria A. Minenok1
1 Kursk State Medical University, 3 Karl Marx str., 3305041 Kursk, Russia
2 Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
3 Peoples’ Friendship University of Russia named after Patrice Lumumba, 6 Miklukho-Maklaya str., 117198 Moscow
Abstract. Introduction. Previous studies of treatment adherence among patients, medical students, and physicians suggest that there are significant differences in their views of the factors that lead to non-adherence to medication. This in turn may lead to failure to recognize the causes of patients’ non-adherence. Adherence concepts are integrated into the curricula of many medical and pharmaceutical schools worldwide to prevent unnecessary expenses within the healthcare system. Medical students training is focused on interaction with real consumers of medications. To understand their experiences and prospects, as well as the psychological states associated with the patients’ health, a “pill experience” is used. Aim. To study the needs and limitations in compliant behavior and the level of potential treatment adherence of the students at Kursk State Medical University. Materials and Methods. 1,063 1st-6th-year students of the Medical Faculty of Kursk State Medical University, aged 20.23±0.1 years, were surveyed using a questionnaire for the quantification of treatment adherence (KOP-25). The findings obtained were analyzed using statistical processing methods. Results and Discussion. The average level of integrated treatment adherence among medical students was 52.9%±0.5%. Among all adherence indicators, the lowest level was for adherence to lifestyle modification (43.2%±0.5%), the average level was for adherence to drug therapy (56.3%±0.6%), and the highest was for adherence to medical support (62.1%±0.5%) (no gender differences were found). This may illustrate the respondents’ insufficient understanding of their role in the treatment and control of the risk of occurrence and development of chronic diseases, and their lack of motivation to maintain their health. The treatment adherence level in the 1st year is significantly higher than in other years (p≤0.05). Students suffering from chronic diseases, especially congenital ones, showed a lower rate of adherence compared to healthy individuals. At Kursk State Medical University, senior students are introduced to the main aspects of treatment adherence when studying subjects, such as outpatient therapy (31.3%) and public health and healthcare (28.9%). The largest part of the students (84.5%) expressed the opinion that a physician influences their patient’s adherence to treatment significantly. Conclusions. It is necessary to include the additional studies of the treatment adherence issues into the educational programs for training future medical professionals.
Keywords: adherence to treatment, compliant behavior, medical literacy.
For citation: Breusov, A.V.; Solyanina, V.A.; Ryndina, V.V.; et al. Treatment adherence as a component of professional competence of medical university students. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (1), 160-166. DOI: 10.20969/VSKM.2025.18(1).160-166.
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