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ORIGINAL RESEARCH
REVIEWS
PRACTICAL EXPERIENCE
ORGANIZATION OF HEALTHCARE
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ORIGINAL RESEARCH
UDC: 616.127-005.4-073.756.8 DOI: 10.20969/VSKM.2025.18(3).7-13
Impact of patient comorbidity on the course of community-acquired pneumonia
Nail B. Amirov1,2, Kamilia N. Sakhabetdinova1, Bulat A. Sakhabetdinov1,3
1Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
2 Medical Unit of the Ministry of Internal Affairs of the Russian Federation in the Republic of Tatarstan, 132 Orenburg Route str., 420059 Kazan, Russia
3Zelenodolsk Central District Hospital, 1 Gogolya str., 422540 Zelenodolsk, Russia
Abstract. Introduction. Today, community-acquired pneumonia is still one of the most common infectious diseases and is a signifi cant cause of morbidity and mortality worldwide. Concomitant diseases, often associated with rapid progression, a higher risk of complications, and high mortality, have a signifi cant impact on the prognosis of community-acquired pneumonia, which needs assessing the comorbidity of patients to control the risks of complications and prompt therapy correction. One of the most widely used comorbidity scales is the Charlson Comorbidity Index that not only considers the age characteristics of the most common specifi c diseases, but also allows assessing the long-term prognosis of patients with community-acquired pneumonia. Aim. To study the features of the comorbidity infl uence upon the course of community-acquired pneumonia using the Charlson Comorbidity Index. Materials and Methods. Analysis of case histories of 112 patients with community-acquired pneumonia hospitalized in the Internal Medicine Department No. 2 of Kazan City Clinical Hospital No. 7 from September 2023 to September 2024. Results and Discussion. Gender distribution was as follows: 52.6% (59 patients) were women and 47.3% (53 patients) were men. The age ranged from 18 to 89 years, the median was 53.5 years, the mode was 62 years. Based on the Charlson Comorbidity Index (CCI), the patients were divided into 2 groups: Group 1 scoring up to 3 points (74 patients, 66.07%) and group 2 scoring 4 points or higher (38 patients, 33.9%). Among patients in both groups, the most common concomitant pathologies were myocardial infarction, chronic heart failure, peripheral vascular disease, gastric ulcer and duodenal ulcer; cirrhosis and portal hypertension, chronic hepatitis, diabetes mellitus with target-organ damage; and malignant neoplasms. Conclusions. One of the main factors determining the severity of community-acquired pneumonia is the presence of concomitant pathologies (comorbidities) in patients of diff erent ages. At the same time, a high comorbidity index is most typical for people at past-retiring age, and includes cardiovascular diseases, chronic non-specific inflammatory airway diseases, and liver and kidney diseases. Comorbidity in patients determines the etiology of the infectious process caused, and often predisposes to multiresistant pathogens of atypical pneumonia in patients with a higher comorbidity index. Patients with a high comorbidity index have also a more severe course of pneumonia, predominate pulmonary and systemic complications, more pronounced clinical manifestations, and a more unfavorable prognosis compared to patients with a low comorbidity index.
Keywords: comorbidity, community-acquired pneumonia, Charlson Comorbidity Index.
For citation: Amirov, N.B.; Sakhabetdinova, K.N.; Sakhabetdinov, B.A. Impact of patient comorbidity on the course of community-acquired pneumonia. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (3), 7-13. DOI: 10.20969/VSKM.2025.18(3).7-13.
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UDC 616.71-018.44-002-08 DOI: 10.20969/ VSKM.2025.18(3).14-20
Clinical and biochemical analysis of the effectiveness of the combined treatment of acute purulent Candida-associated periostitis
Alexandra A. Gavrilenko1, Sergey G. Bezrukov1, Lyudmila A. Filippova1, Konstantin G. Bom1, Svetlana A. Demyanenko1
1 Order of the Red Banner of Labor S.I. Georgievsky Medical Institute, V.I. Vernadsky Crimean Federal University, 5/7 Lenin str., 295006 Simferopol, Republic of Crimea, Russia.
Abstract. Introduction. The major role in the occurrence, development, and course of acute suppurative odontogenic periostitis is attributed to the oral microbiota. Along with epidermal bacteria and Staphylococcus aureus, the microbiota includes yeast-like fungi of the Candida genus, whose virulence and concentration signifi cantly infl uence the outcome of this disease. Aim of the study is to evaluate the eff ectiveness of treatment for odontogenic periostitis caused by Candida-associated infection using clinical and biochemical methods, including the incorporation of topical antifungal agents into the therapeutic complex. Materials and Methods. Fifty patients with acute suppurative odontogenic periostitis were observed. All patients underwent periosteotomy by the standard technique with the removal of the infected tooth that has been the source of infection. They received standard therapy, i. e., oral antibacterial medication, non-steroidal anti-infl ammatory drugs, and a multivitamin complex. Based on the local treatment method, the subjects were divided into two groups: Main group (25 patients) and control group (25 patients). After periosteotomy, all patients in both groups had their wounds irrigated daily with an antiseptic solution (0.05% chlorhexidine), but in the main group, a dressing with Sanguiritrin diluted 1:40 was additionally applied to the purulent wounds for 15 minutes, followed by the introduction of the Emalan hydrogel into the postoperative wounds. The state of proteolytic trypsin-like and elastase-like activities in oral fl uid was studied. Trypsin-like activity was measured spectrophotometrically, and elastase-like activity was assessed by hydrolysis of a synthetic substrate. Statistical analysis was performed using parametric and non-parametric criteria. Results and Discussion. On day 3 already, the trypsin-like and elastase-like activities in saliva of the main group patients signifi cantly decreased and did not diff er statistically from their pre-periostectomy levels, indicating a more pronounced reduction in local infl ammatory reactions in the postoperative period compared to the control group. By day 10, these indicators returned to normal. The infl ammatory reactions in the main group were less intense. Conclusions. The inclusion of antifunga l agents containing Sanguiritrin and the collagen hydrogel Emalan into the treatment complex for patients with acute suppurative odontogenic periostitis caused by Candida-associated infection enhances its eff ectiveness, ensuring rapid regression of the main clinical symptoms and proteolytic activity indicators in oral fl uid.
Keywords: Candida-associated periostitis , enzymes of oral fl uid, trypsin-like activity, elastase-like activity, EPA, TPA.
For citation: Gavrilenko, A.A.; Bezrukov, S.G.; Filippova, L.A.; et al. Clinical and biochemical analysis of the effectiveness of the combined treatment of acute purulent Candida-associated periostitis. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (3), 14-20. DOI: 10.20969/VSKM.2025.18(3).14-20.
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UDC: 616.31+616.716.8:616.7-057.874:796.071-053.6 DOI: 10.20969/VSKM.2025.18(3 ).21-28
Comparative analysis of the dental and musculoskeletal system of schoolchildren and adolescent athletes
Ildar R. Gainullin1, Lilya A. Ignatieva1, Aleksandra V. Ryskina1, Kamila I. Minnulina1
1Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
Abstract. Introduction. Correlation between the state of stomatognathic and postural systems of the body is actively being studied in modern orthodontic and osteopathic practice. This article presents data from a comparative analysis on the prevalence of disorders of thedental and musculoskeletal systems in schoolchildren and adolescent athletes. Aim. The research was aiming at assessing the dental and musculoskeletal system status of schoolchildren and adolescent athletes. Materials and Methods. In this study, 72 male adolescents aged 14-15 years were examined, including 36 professional athletes (the Rubin football team) and 36 secondary schoolchildren, respectively. Orthodontic and osteopathic examinations were performed according to a generally accepted methodology, to assess the dental and musculoskeletal system, and the KOMOT method was also used with optical-topographic equipment. The data collected was processed using descriptive statistics methods (quantity, percentage) and the analysis of diff erences in the percentage of a qualitative feature in two groups using the nonparametric Chi-square test. Results and Discussion. The study has shown that dysfunctions of the dentaland the musculoskeletal system were identifi ed in both athletes and ordinary schoolchildren, but their prevalence varies based on the group. Signifi cant diff erences were found in posture, position of the pelvis and thoracic spine, frequency of occurrence of bite types, facial profi le, and respiratory and swallowing functions. Adolescents who are not involved in sports were found to be signifi cantly more prone to dental, respiratory, and swallowing disorders and to changes in the musculoskeletal system. Conclusions. Sports activities have a beneficial effect on the formation of healthy posture and the correct the dental system development. The implementation of an integrated approach to assessing the state of the stomatognathic and postural systems of the body contributes to the timely detection and correction of disfunctions, thereby contributing to the overall health improvement.
Keywords: dental system, musculoskeletal system, stomatognathic system.
For citation: Gainullin, I.R.; Ignatieva, L.A.; Ryskina, A.V.; Minnulina, K.I . Comparative analysis of the dental and musculoskeletal system of schoolchildren and adolescent athletes. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (3), 21-28. DOI: 10.20969/VSKM.2025.18(3).21-28.
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UDC: 616.311.2-002-053.2:615.322(470-924.71) DOI: 10.20969/VSKM.2025 .18(3).29-34
Using natural factors in the treatment of chronic catarrhal gingivitis in children aged 11-12 years
Zhanna A. Dovbnya1, Olga P. Galkina1, Galina G. Golovskaya1, Olga Yu. Poleshchuk1, Sofya A. Kucha1, Zarema A. Izmailova1
1The 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. Epidemiological studies demonstrate a high prevalence of periodontal tissue disease among children and young people. In this cohort, it is preferable for the treatment of periodontal tissue pathology to use medicines that have a high therapeutic eff ect and practically no side eff ects. Aim. Evaluation of the eff ectiveness of a therapeutic and prophylactic complex containing herbal and mineral products of Crimea in the prevention and treatment of chronic catarrhal gingivitis in puberty children. Materials and Methods. 44 children aged 11-12 years with chronic catarrhal gingivitis were examined. The control group consisted of 21 children of the same age with clinically healthy periodontal tissues. After the mouth sanitation and professional hygienic cleansing, chronic catarrhal gingivitis was treated using applications of essential oils, such as mint, pine, fennel, and eucalyptus, taken in equal proportions and based on bentonite clay, in a ratio of 10:1. Applications were made daily for 20 minutes. The course of treatment included 10 procedures. Dental paraclinical and laboratory parameters were determined before starting the treatment of gingivitis, on the 5th day of treatment, after 6 mouths, and after 1 year. Statistical processing was performed using the standard method of variation statistics. Student’s t-test was used to compare the average indicators. Results and Discussion. The criterion for the eff ectiveness of chronic catarrhal gingivitis treatment was the positive dynamics in dental paraclinical indices. The course of treatment showed a decrease in the concentration of malondialdehyde by 1.7 times (p<0,001), and an increase in catalase activity by 2.8 times (p<0,05) in the antioxidant protection system. The indicators were approaching healthy children’s levels. There was a positive shift in the antioxidant protection system. There was a decrease in the level of oxidative modifi cation of proteins by 1.8 times down to the values of children in the control group. Conclusions. The proposed complex of therapeutic and prophylactic measures for the treatment of chronic catarrhal gingivitis helps reduce the treatment duration and allows achieving stable remission in puberty children.
Keywords: children, gingivitis, treatment, natural factors, essential oils, bentonite clay.
For citation: Dovbnya, Zh.A.; Galkina, O.P.; Golovskaya, G.G.; et al. Using natural factors in the treatment of chronic catarrhal gingivitis in children aged 11-12 years. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (3), 29-34. DOI: 10.20969/VSKM.2025.18(3).29-34.
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UDC: 616.155.392.8: 658.7.03 DOI: 10.20969/VSKM.2025.18(3 ).35-46
Analysis of efficiency and effectiveness of procurement of pharmaceuticals for treating patients with chronic myeloid leukemia in the Tyumen Region
Artem V. Zhuravlev1, Olga I. Knysh1, Irina A. Zarubina1
1Tyumen State Medical University, 54 Odesskaya str., 625023 Tyumen, Russian Federation
Abstracts. Introduction. Research in the fi eld of pharmacotherapy of oncologic diseases is a priority development area of national medicine and pharmacy. Organization of high-quality and timely treatment of patients with chronic myeloid leukemia requires large fi nancial resources; that is why it is necessary to constantly evaluate the eff ectiveness of procurement of pharmaceuticals for treating this group of patients. Aim. To analyze the effi ciency and eff ectiveness of procurement of pharmaceuticals for the therapy of patients with chronic myeloid leukemia in the Tyumen Region. Materials and Methods. The subjects of the study were selected based on analyzing scientifi c literature. Data from the unifi ed procurement information system Goszakupki were used to collect information on procurement. Using mathematical and graphical methods, the data were processed, which were used to calculate the economic effi ciency of procurement. Results and Discussion. Based on analyzing the data on the procurement of pharmaceuticals, the growth rates of the studied factors were determined, and the reasons to change them were identified. Conclusions. Various factors may aff ect the procurement process, resulting in the procurement being recognized as failed or invalid. Disruption of supplying medicines for treating patients with chronic myeloid leukemia may lead to a decrease in the therapy efficacy. Reducing the cost of procurement agreed upon by the participants allows saving fi nancial resources to a large extent.
Keywords: procurement of medicines, chronic myeloid leukemia, tyrosine kinase inhibitors, procurement efficiency.
For citation: Zhuravlev, A.V.; Knysh, O.I.; Zarubina, I.A. Analysis of effi ciency and eff ectiveness of procurement of pharmaceuticals for treating patients with chronic myeloid leukemia in the Tyumen Region. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (3),35-46. DOI: 10.20969/VSKM.2025.18(3).35-46.
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UDC 616.24–002 DOI: 10.20969/VSKM.2025.18(3 ).47-53
Diagnosis of community-acquired pneumonia and tuberculosis in a pulmonology department during the decline in the rate of the novel coronavirus infection cases
Snezhana A. Zubakina1, Elena V. Yakovleva1, Elena A. Borodulina1, Ekaterina P. Eremenko1, Elizaveta S. Vdoushkina1, Kristina V. Zhilinskaya1
1Samara State Medical University, 89 Chapaevskaya str., 443099 Samara, Russia
Abstracts Introduction. In the period of pandemic outbreaks of viral infections, such as COVID-19, the problem of diff erentially diagnosing pulmonary tuberculosis takes new features, especially in lung lesions aff ecting areas characteristic of tuberculosis and with a history of tuberculosis. Aim of the study was to determine the peculiarities of diagnosing tuberculosis in patients with community-acquired pneumonia during the decline in the rate of the novel coronavirus infection cases. Materials and Methods. Using the continuous sampling method, we selected a total of 120 case histories of patients with a verifi ed diagnosis of pulmonary tuberculosis, admitted for inpatient treatment in the pulmonology department (n=120). The criterion for dividing into groups was the history of pulmonary tuberculosis. Two groups were formed: The fi rst one consisted of 94 patients with a history of tuberculosis (de-registered for a phthisiatrist: 65.9% (62/94) recovered, 21.2% (20/94) were in the clinical cure group, 8.5% (8/94) received treatment on an outpatient basis, and 4.2% (4/94) withdrew from treatment), while the second one consisted of 26 patients with no history of tuberculosis. Inclusion criteria: Hospitalization by ambulance with a diagnosis of community-acquired pneumonia and no MBT on microscopy in the emergency room. Non-inclusion criteria: MBT detected at the level of the emergency room with transfer to a TB dispensary. The fi ndings were processed statistically using the MedCalc 19.2.6. statistical software. Results and Discussion. Among all patients with diagnosed tuberculosis in the pulmonology hospital, 78.3% had a history of previous tuberculosis, and sputum/BALG showed more frequent detection of nonspecifi c fl ora (45.7%) vs. (19.2%), p=0.058 and SARS-CoV-2 22.3% vs. 3.9%, p=0.034 compared to those without a history of tuberculosis. HIV-infection was detected in 55.3% in the fi rst group and in 76.9% in the second group (p=0.038). Indications for treatment in the ORIT setting were 37.5% (n=45) with a CURB-65 score of 4; while the remaining patients had a score of 2-3. Conclusions. The factors complicating the diagnosis of tuberculosis in the pulmonology department were concomitant coronavirus infection; concomitant HIV-infection; severe clinical course; multisegmental nature of lung lesions; and absence of decay cavities or sputum. In case of ineff ective EP treatment, it is important to remain vigilant and continue diagnostic testing, considering potential mixed infection, especially in persons with HIV-infection.
Keywords: tuberculosis, community-acquired pneumonia, new coronavirus infection, diff erential diagnosis, HIV-infection.
For citation: Zubakina, S.A.; Yakovleva, E.V.; Borodulina, E.A.; et al. Diagnosis of community-acquired pneumonia and tuberculosis in a pulmonology department during the decline in the rate of the novel coronavirus infection cases. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (3), 47-53. DOI: 10.20969/VSKM.2025.18(3).47-53.
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UDC: 617.735:616.071 DOI: 10.20969/VSKM.2025.18(3).54-59
New capabilities of early diabetic retinopathy detection
Ivan Y. Tanin1, Ludmila A. Ivanova1, Margarita A. Kovalchuk1, Zamira A. Gish1
1 Kuban State Medical University, 4 Sedin str., 350063 Krasnodar, Russia
Abstract. Introduction. Diabetic retinopathy is a progressive retinal disease that results from a prolonged state of high blood sugar levels (hyperglycemia) in people with diabetes mellitus. Genetic polymorphisms in various genes responsible for metabolism, vascular regulation, and oxidative stress can have a signifi cant impact on the risk and severity of diabetic retinopathy. For example, genes related to nitric oxide synthesis (NOS3 gene), angiogenesis (VEGFA gene), and drug metabolism (CYP2C19 gene) may modify protective and attacking mechanisms that infl uence upon the disease progression. In addition to genetic factors, oxidative stress is essential to the pathogenesis of diabetic retinopathy. In diabetes, free radicals accumulate, leading to cell damage, infl ammatory response development, and further deterioration of retinal vascular function. The body’s antioxidant system, consisting of various enzymes and molecules, aims to counteract oxidative stress. However, if they are insuffi cient or overactive, there may be a loss of normal vascular function, which aggravates the development of retinopathy. Aim. To identify the infl uence of genetic factors and oxidative stress on the development of diabetic retinopathy. Material and Methods. 100 patients were studied, diagnosed with type 2 diabetes mellitus, aged 40-75 years, with and without diabetic retinopathy, duration of type 2 diabetes mellitus over 5 years, without any severe concomitant pathologies. Results and Discussion. A significant predominance was found in the proportion of homozygous carriers for allele 2 of the NOS3 gene and VEGFA gene in patients with diabetic retinopathy. The CYP2C19 gene and ITGA2 gene analysis fi ndings also confi rm the tendencies to increase the proportion of homozygous and decrease the proportion of heterozygous carriers in patients with diabetic retinopathy. High levels of oxidative stress markers were also detected in patients with type 2 diabetes mellitus and diabetic retinopathy, which indicates a signifi cant damage to cell membranes and confi rms the adaptive mechanisms of the body seeking to compensate for oxidative stress. Conclusions. The fi ndings demonstrate that diff erences in genetic background, as well as increased levels of free radical oxidation, may be essential to the pathogenesis of this disease.
Keywords: diabetic retinopathy, type 2 diabetes mellitus, oxidative stress, genetic polymorphisms.
For citation: Tanin, I.Y.; Ivanova, L.A.; Kovalchuk, M.A.; Gish, Z.A. New capabilities of early diabetic retinopathy detection. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (3), 54-59. DOI: 10.20969/VSKM.2025.18(3).54-59.
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11. Jenkins AJ, Joglekar MV, Hardikar AA, et al. Biomarkers in Diabetic Retinopathy. Rev Diabet Stud. 2015;12(1-2):159-195. DOI:10.1900/RDS.2015.12.159
12. Аметов А.С. Патофизиологический подход как основа выбора стратегии успешного лечения сахарного диабета 2 типа // Фарматека. – 2017. – №5. – С. 28-35. [Ametov AS. Patofiziologicheskij podhod kak osnova vybora strategii uspeshnogo lecheniya saharnogo diabeta 2 tipa [Pathophysiological approach as a basis for the selection of strategy for the success treatment of type 2 diabetes mellitus]. Farmateka [Pharmateka]. 2017; 5: 28−35. (In Russ.)].
13. Joanna Wróblewska, Jarosław Nuszkiewicz, Marcin Wróblewski, et al. Selected trace elements and their impact on redox homeostasis in eye health. Biomolecules. 2024; 14 (11):1356. DOI: 10.3390/biom14111356
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16. Исхакова А.Г., Тороповский А.Н., Павлова О.Н., [и др.] Оценка взаимосвязи прогрессирования диабетической ретинопатии с генотипами полиморфных генов у пациентов без предварительного диагноза «Диабетическая ретинопатия» // Вестник новых медицинских технологий. – 2023. – Т.17. – №2. – С.116-123. [Iskhakova AG, Toropovskij AN, Pavlova ON, et al. Ocenka vzaimosvyazi progressirovaniya diabeticheskoj retinopatii s genotipami polimorfnyh genov u pacientov bez predvaritel’nogo diagnoza «Diabeticheskaya retinopatiya» [Evaluation of the relationship of the progression of diabetic retinopathy with genotypes of polymorphic genes in patients without preliminary diagnosis of “diabetic retinopathy”]. Vestnik novyh medicinskih tekhnologij [Bulletin of new medical technologies]. 2023; 17(2): 116-123. (In Russ.)]. DOI: 10.24412/2075-4094-2023-2-3-3
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UDC: 616.89-02:616.892-616.1/.4-0728 DOI: 10.20969/VSKM.2025. 18(3).60-66
Impact of iron deficiency correction on the functional capacity of patients with chronic cardiac failure during 12 months after myocardial infarction
Natalya A. Tarasova1, Dilyara R. Khastieva1, Niaz R. Khasanov1
1Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
Abstract. Introduction. Existing data suggest that iron deficiency worsens the course of ischemic heart disease and chronic heart failure. Aim. To study the eff ect of iron defi ciency correction on the functional status of patients with chronic heart failure who have experienced myocardial infarction. Materials and Methods. 106 patients (48 women (45.2%) and 58 men (54.7%)) were hospitalized in the emergency cardiology department of the City Clinical Hospital No. 7 named after M.N. Sadykov (Kazan) for myocardial infarction in 2022-2023. Patients were divided into 2 groups depending on the presence of iron defi ciency. Group 1 consisted of 59 (55.6%) patients diagnosed with iron defi ciency, Group 2 consisted of 47 (44.4%) patients with normal iron status. The groups were comparable in terms of gender and drug therapy, comorbidities, with the exception of the prevalence of atrial fi brillation which was more common in the patients of Group 1; chronic kidney disease and a family history of cardiovascular diseases were more common in the patients of Group 2. Patients with iron defi ciency underwent treatment to correct it; all patients were tested for their functional class of heart failure, and the results of the six-minute walk test were assessed. The follow-up period was 12 months. Based on the iron defi ciency compensation at the 2nd visit, patients in Group 1 were divided into subgroup A (compensated iron defi ciency, n=40) and subgroup B (uncompensated iron defi ciency, n=19). The fi ndings were processed statistically using parametric and non-parametric criteria. Results and Discussion. A statistically signifi cant increase in the values of the six-minute walk test was found in Group 2: The median value of the six-minute walk test at visit 1 was 310.0 [250.0-400.0] m, while it was 350.0 [280.0-400.0] m at the fi nal visit after 12 months, p<0.001. In Group 1, no signifi cant changes in the six-minute walk test were found. No diff erences were found in the distribution of patients by their functional classes of heart failure in Groups 1 and 2. Signifi cant diff erences in the distribution of functional classes of heart failure were detected in subgroups A and B: By visit 2, there had been more individuals with functional class I in subgroup A than in subgroup B (15(37.5%) and 2(10.5%), respectively, p=0.048). At visit 2, the number of individuals with functional class III was signifi cantly higher among patients in subgroup B: 10 (25.0%) in subgroup A and 10 (52.5%) in subgroup B (p=0.037). Conclusions. Normal iron status is associated with improved functional status indicators of patients with chronic heart failure during a year of follow-up after myocardial infarction. Effective correction of iron defi ciency in patients with chronic heart failure who have experienced myocardial infarction contributes to lowering the functional class of heart failure.
Keywords: iron deficiency, heart failure, six-minute walk test, functional capacity, myocardial infarction.
For citation: Tarasova, N.A.; Khastieva, D.R.; Khasanov, N.R. Impact of iron defi ciency correction on the functional capacity of patients with chronic cardiac failure during 12 months after myocardial infarction. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (3), 60-66. DOI: 10.20969/VSKM.2025.18(3).60-66.
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UDC 617.7-007.681:628.9 DOI: 10.20969 /VSKM.2025.18(3).67-72
Early diagnosis of glaucoma using illuminance tests
Diana A. Teuvazhukova1, Lusine L. Arutyunyan2,3, Tamara G. Tlupova1
1Kabardino-Balkarian State University named after H.M. Berbekov, 173 Chernyshevsky str., 360004 Nalchik, Russia
2 Russian Medical Academy of Continuous Professional Education at the Ministry of Health of the Russian Federation,
2/1 Barrikadnaya str., Bldg. 1, 125993 Moscow, Russia
3 Vostok-Prozrenie Eye Center, 10 Polina Osipenko str., Bldg. 1, 123007 Moscow, Russia
Abstract. Introduction. Glaucoma is a chronic genetic multifactorial, rapidly progressing eye disease with a high risk of vision loss. Both ocular and systemic factors are essential to the development of this pathology. The aim of the study was to investigate the infl uence of diff erent lighting conditions on visual acuity and to assess their clinical signifi cance for the development of new methods for early diagnosis of glaucoma. Materials and Methods. A clinical study was conducted involving 340 patients (680 eyes, main group) with glaucoma and 500 relatively healthy individuals (control group). Clinical examination methods included tonometry, biomicroscopy, autorefractometry, and others. Visual acuity was determined in conjunction with lighting tests, using a self-developed device (Russian Patent No. 2269921). The data obtained was processed statistically using the Mathcad PLUS 6.0 software package, including calculation of arithmetic mean (M), standard deviation (σ), and Student’s t-test (t). Diff erences were considered statistically signifi cant at p < 0.05. Results and Discussion. It was noted that the development of glaucoma is accompanied by signifi cant changes in the ocular apparatus. Compared to normal values, glaucoma patients showed signifi cantly increased intraocular pressure, ophthalmic disorders (myopia, emmetropia, hypermetropia), morphometric changes (increased corneal thickness), and functional imbalance (increased MD and PSD indices). Moreover, a statistically signifi cant diff erence was identified in changes in visual acuity in conjunction with lighting tests in glaucoma patients, starting from the early disease stages. Conclusions. The fi ndings confi rm the importance of developing new meth ods for early diagnosis of glaucoma. The influence of lighting tests on the dynamics of visual acuity was found in healthy individuals and glaucoma patients. The device proposed, unlike others, allows the detection and assessment of visual acuity under varying lighting conditions and can be used during medical check-ups to identify individuals with various gerontological diseases, such as glaucoma.
Keywords: glaucoma, illuminance, test, eye, diagnostics.
For citation: Teuvazhukova, D.A.; Arutyunyan, L.L.; Tlupova, T.G. Early diagnosis of glaucoma using illuminance tests. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (3), 67-72. DOI: 10.20969/VSKM.2025.18(3).67-72.
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UDC: 615.322 DOI: 10.20969/VSKM.2025.18(3 ).73-80
Influence of a phytocompound with nootropic properties on human cardiovascular fitness
Olga V. Filatova1, Daniel D. Mamyshev1, Evgenia I. Romashko1, Inna Yu. Voronina1, Ruslan I. Khalimov1, Natalya A. Shishkina1, Polina E. Bannikova1
1Altai State University, 61 Lenin Ave., 656049 Barnaul, Russia
Abstract. Introduction. Development of new nootropic drugs requires systematizing the existing knowledge and conducting both experimental and clinical studies to deeply investigate their effi cacy and modes of action. Aim. To evaluate the eff ect of a phytocompound with nootropic properties on the cardiovascular fi tness of conditionally healthy individuals. Materials and Methods. Before and after a course of phytocompound administration, the subjects underwent a comprehensive examination, including a study of the autonomic nervous system using the standard A.D. Solovyova table; electrocardiography with the assessment of heart rate variability; hemodynamic parameters were studied using laser Doppler fl owmetry channels and fl uorescence spectroscopy methods, implemented in the LAZMA ST diagnostic device. Results and Discussion. The analytical study has shown that the use of a phytocompound with nootropic properties optimizes the interaction of the sympathetic and parasympathetic parts of the autonomic nervous system, ensuring their balanced functioning. The eff ect of the phytocompound provided upon microcirculation indicators depends on the initial tone of the autonomic nervous system: In individuals with eutonia and sympathicotonia, the microcirculatory bloodstream condition improves in response to the course of administering a phytocompound with nootropic properties (the microcirculation index and the average value of nutritive blood fl ow increase), and their cellular metabolism improves (the oxidative metabolism index increases). In subjects with vagotonia, on the contrary, a decrease in blood fl ow was shown due to the weakening of the parasympathetic infl uence of the autonomic nervous system and, accordingly, the strengthening of the sympathetic infl uence, into the microcirculatory bloodstream, and a decrease in the oxidative metabolism index. Conclusions. The results of the comprehensive study demonstrated the pronounced nootropic propert ies of the new phytocompound, the mode of action of which is determined by the harmonization of the sympathetic-parasympathetic balance of the autonomic nervous system and the associated changes in the microcirculatory bloodstream condition and cellular met abolism.
Keywords: nootropic agents; cardiovascular system; autonomic nervous system; microcirculation.
For citation: Filatova, O.V.; Mamyshev, D.D.; Romashko, E.I.; et al. Infl uence of a phytocompound with nootropic properties on the human cardiovascular fi tness. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (3), 73-80. DOI: 10.20969/VSKM.2025.18(3).73-80.
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UDC:617.52+616.716.8]-002.34:611.018.53-074/.078 DOI: 10.20969/VSKM.2025.18( 3).81-86
Role of integral leukocyte intoxication indices in assessing the severity of maxillofacial furuncles
Maria S. Fleryanovich1, Irina O. Pohodenko-Chudakova2
1Vitebsk State Order of Friendship of Peoples Medical University, 27 Frunze Ave., 210009 Vitebsk, Republic of Belarus
2Belarusian State Order of Friendship of Peoples Medical University, 83 Dzerzhinskogo Ave., 220083 Minsk, Republic of Belarus
Abstract. Introduction. Despite the wide possibilities of integral intoxication indices, there is a defi cit of evidence-based data in the specialized literature regarding their informativeness in patients with maxillofacial furuncles. Aim of the study was to conduct a comparative evaluation of integral intoxication indices based on the retrospective analysis of medical records of persons with maxillofacial furuncles and to identify the most informative of them for patients in this category. Materials and Methods. Retrospective analysis was performed on 92 medical records of inpatients (40 women and 52 men) treated in Vitebsk Regional Clinical Hospital with the diagnosis of a furuncle in the maxillofacial region. Twenty practically healthy people (10 men and 10 women), who made up the comparison group, participated in the study. All patients of the sample and control groups did a general blood test, based on which the following was calculated: V. K. Ostrovsky’s leukocytic intoxication index; nuclear index; lymphocyte-granulocyte index; and blood leukocyte shift index. Deviation from normal distribution was assessed using the Kolmogorov-Smirnov test, which justifi ed the use of non-parametric statistical methods. Quantitative data were described using the median, 25th and 75th percentiles, and the minimum and maximum values. Group-based comparisons of quantitative indicators were performed using the Mann-Whitney U test, while diff erences in dependent groups were assessed by the Wilcoxon signed-rank test. Qualitative data were analyzed using Pearson’s χ² test. The results obtained were considered statistically signifi cant at p < 0.05. Results and Discussion. V. K. Ostrovsky leukocytic intoxication index values in the sample patients were characterized by a signifi cant increase as compared with normal ranges. Moreover, the index had increased values in 67 out of 80 patients, which equaled 83.8%. In persons with maxillofacial furuncles, the blood leukocyte shift index values also signifi cantly exceeded the normal levels. Increased values of this index were found in 66 out of 80 patients, i. e. 82.5%, which is consistent with the data contained in specialized literature and does not contradict them. Conclusions. V. K. Ostrovsky’s leukocytic intoxication index and blood leukocyte shift index, which are informative in the development and further course of maxillofacial furuncles, have been determined and can be used both for predicting the course of the disease and evaluating the treatment efficacy.
Keywords: leukocyte index, furuncle, maxillofacial region, infectious-infl ammatory process, endogenous intoxication, sensitization.
For citation: Fleryanovich, M.S.; Pohodenko-Chudakova, I.O. Role of integral leukocyte intoxicatio n indices in assessing the severity of maxillofacial furuncles. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (3), 81-86. DOI: 10.20969/VSKM.2025.18(3).81-86.
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UDC: 612.085.1; 612.216.2; 612.235; 616.079 DOI: 10.20969/VSKM.2025.18(3 ).87-97
Correlation between structural and functional changes in the respiratory system of patients with lymphangioleiomyomatosis
Alexander V. Cherniak1,2, Malika Kh. Mustafina3,1, Marina A. Makarova4,1,2, Pavel V. Pakhomov5, Ekaterina S. Pershina6, Stanislav D. Gorbunkov1, Philipp Yu. Kopylov3
1Federal State Budgetary Institution “Pulmonology Scientific Research Institute” under Federal Medical and Biological Agency of Russian Federation, 28 Orekhovy Blvd., Bldg. 10, 115682 Moscow, Russia
2City Clinical Hospital named after S.S. Yudin of Moscow Department of Health, 1 Academician Millionshchikov str., 115487 Moscow, Russia
3I.M. Sechenov First Moscow State Medical University (Sechenov University), 8 Trubetskaya str., Bldg. 2, 119991 Moscow, Russia
4N.I. Pirogov Russian National Research Medical University, 1 Ostrovityanova str., Bldg. 6, 117513 Moscow, Russia
5National Medical Research Center of Otorhinolaryngology, Federal Medical and Biological Agency of Russia,
30 Volokolamskoye Hwy, Bldg. 2, 123182 Moscow, Russia
6N.I. Pirogov City Clinical Hospital No.1, Moscow Health Department, 8 Leninsky Ave., 119049 Moscow, Russia
Abstract. Background. Lymphangioleiomyomatosis is a rare progressive systemic disease that usually leads to cystic lung lesions. High-resolution computed tomography of the lungs reveals well-defi ned rounded thin-walled cysts located symmetrically and evenly in both lungs in the majority of women with lymphangioleiomyomatosis. Structural changes in the lungs lead to a reduced lung function. Aim. The aim of this study was to evaluate clinical, functional, and structural changes in the lungs and determine whether there are any correlations between them in patients with lymphangioleiomyomatosis. Materials and Methods. A cross-sectional observational study was conducted in 36 women with lymphangioleiomyomatosis, aged 28 to 68 years, observed in the National Registry of the Russian Respiratory Society of Lymphangioleiomyomatosis Patients. All patients underwent questionnaires, dyspnea assessment, and computed tomography data analysis with determination of the volume of lung cystic transformation (%) and pulmonary function results. Statistical analysis was performed using the STATISTICA 10.0 applied software package (StatSoft Inc., USA). To assess the distribution characteristics of quantitative variables, the Shapiro-Wilk W-test was used. For variables with a normal distribution, data are presented as mean ± standard deviation (SD), while for the others they were presented as median (Me) (lower quartile; upper quartile). For categorical variables, the proportion and absolute number of values were determined. Correlation analysis was conducted using Spearman’s rank correlation. The significance level was set at 0.05 in the study. Results and Discussion. The volume of cysts was 22 (7;34) %. In 25 (69%) patients, a decrease was detected in the diff usion capacity index. Obstructive impairments were diagnosed in 19 (53%) patients. Restrictive impairments, mixed disorder, and non-specifi c ventilatory impairment patterns were diagnosed in 1 case each. The value of the “poorly communicating fraction” was 18 (12; 26) %, this index was increased in 21 (58%) patients. Statistically signifi cant correlations were found between clinical, functional, and structural indicators. The strongest correlations were found between the volume of lung cysts in %, the diff usion capacity index (R=-0.622, p<0.005), and “poorly communicating fraction” (R=0.561, p<0.005). Conclusion. The diff usion capacity of the lungs is reduced in the majority of women with lymphangioleiomyomatosis. Patients with lymphangioleiomyomatosis are characterized by respiratory mechanics disorders, such as obstructive impairments, ventilation distribution heterogeneity at rest, and air trapping. Clinical and functional indicators correlate with the volume of lung cystic transformation in lymphangioleiomyomatosis patients.
Keywords: lymphangioleiomyomatosis, cysts in the lungs, lung function, spirometry, diff usion capacity, high-resolution computed tomography
For citation: Cherniak, A.V.; Mustafi na, M.Kh.; Makarova, M.A.; et al. Correlation between structural and functional changes in the respiratory system of patients with lymphangioleiomyomatosis. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (3), 87-97. DOI: 10.20969/VSKM.2025.18(3).87-97.
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REVIEWS
UDC:617-019 DOI: 10.20969 /VSKM.2025.18(3).98-105
Rethinking the problem of “thin” endometrium
Zukhra A. Abusueva1, Kira L. Seydalieva1, Natella A. Stefanyan1, Svetlana Z. Aliyeva1, Abidat A. Aliyeva1, Magomed A. Isaev1, Nuriyana A. Aliyeva1
1Dagestan State Medical University, 1 Lenin Sq., 367005 Makhachkala, Russia
Abstract. Introduction: “Thin” endometrium is defi ned as an endometrial thickness of less than 7 mm in the mid-luteal phase. Endometrial thickness <7 mm is associated with infertility and negative outcomes in assisted reproductive technologies (ART). According to scientifi c publications, up to 67% of failed implantations in ART programs are due to impaired endometrial receptivity, which directly correlates with its morpho-functional characteristics, including thickness. Aim. To review the literature, analyze modern treatment methods of “thin” endometrium, and summarize available data on this issue. Materials and Methods. A search of studies was conducted in Russian and international databases covering the period from 2005 to 2025. Results and Discussion. The literature analysis included systematic reviews and randomized clinical trials investigating methods to improve endometrial thickness in patients with “thin endometrium. The main therapeutic strategies for treating “thin” endometrium include hormonal therapy (e.g., estrogen, tamoxifen), vasoactive drug therapy, stem cell therapy, autologous platelet-rich plasma, granulocyte colony-stimulating factor, and mixtures of carbon dioxide and nitrogen. Conclusions. Currently, a wide range of treatment methods for “thin” endometrium have been developed; however, the question of their effi cacy remains open. The global medical community continues to search for eff ective approaches to treat this pathology.
Keywords: thin endometrium, stem cells, autologous plasma, platelet-rich plasma, gr anulocyte colony-stimulating factor, tamoxifen, sildenafi l.
For citation: Abusueva, Z.A.; Seydalieva, K.L.; Stefanyan, N.A.; et al. Rethinking the problem of “thin” endometrium. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (3), 98-105. DOI: 10.20969/VSKM.2025.18(3).98-105.
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PRACTICAL EXPERIENCE
UDC: 614.2: 617-089-089.16-089 DOI: 10.20969/VSKM.2025.18(3).106-112
Using the FAST TRACK techniques in the postoperative management of patients with gastrointestinal cancers
Alexey V. Privalov1,2, Mikhail A. Drozhdin2, Polina V. Shatilova2, Yuri A. Tyukov2, Dmitry G. Voroshin1
1Chelyabinsk Region Clinical Center of Oncology and Nuclear Medicine, 42 Blucher str., 484084 Chelyabinsk, Russia
2South Ural State Medical University, 64 Vorovsky str., 454141 Chelyabinsk, Russia
Abstract. Introduction. One of the well-known methods aimed at solving the clinical tasks of intensive care is Fast track, the essence of which is an innovative strategy for managing the patient before, during and after surgery, which allows for the most eff ective management of the patient in intensive care, transfer to a specialized department, and the beginning of rehabilitation. The aim of the study was to analyze the Fast Track technique efficacy in preoperative preparation and postoperative management in the intensive care unit of patients with gastrointestinal cancers. Methods and Materials. This article is based on a study conducted in the Intensive Care Unit of Chelyabinsk Regional Clinical Center for Oncology and Nuclear Medicine. The paper investigates the Fast Track technique in the postoperative period in patients undergoing gastrointestinal surgery. The total number of patients participating in the study was 58 people aged 35 to 83 years who underwent surgeries on tumors of the stomach, large and small intestines, liver, and pancreas. Absolute values (number of individuals) and relative values (frequency, %) were used to describe parametric (categorical) data. Results and Discussion. The study revealed that early mobilization of patients in the postoperative period using special bandages contributes to faster recovery. Patients who started moving in the fi rst 6 hours after surgery spent 1 day less in the intensive care unit compared to those who started moving after 12 hours, and 2 days less compared to those who started moving within 18-24 hours after surgery. It was also found that the early resumption of oral nutrition after removal of the nasogastric tube reduces the time spent by patients in the intensive care unit. Conclusions. The study highlights that the use of Fast the Track techniques, such as early mobilization, urinary catheter removal, nasogastric tube removal, glucose control, and thrombosis prevention, can considerably reduce the time patients stay in intensive care and ensure their faster recovery. Taking into account the physiological condition and characteristics of each patient, the use of these methods can accelerate the recovery process and ensure the transfer of the patient to the specialized department within the first day after surgery.
Keywords: surgery, oncology, intensive care, rehabilitation.
For citation: Privalov, A.V.; Drozhdin, M.A.; Shatilova, P.V.; et al. Using the FAST TRACK techniques in the postoperative management of patients with gastrointestinal cancers. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (3), 106-112. DOI: 10.20969/VSKM.2025.18(3).106-112.
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ORGANIZATION OF HEALTHCARE
UDC: 614.23 DOI: 10.20969 /VSKM.2025.18(3).113-123
Training in clinical fellowship: Modernization trajectories within the Federal State Educational Standards
Raushania F. Gaifullina1, Aliya M. Shigabieva1, Afgat N. Galiullin1, Laysan A. Khaertdinova1, Renata A. Shakirova1, Ivan A. Kiiasov1,2, Damir А. Galiullin3
1Kazan Federal University, 18 Kremlevskaya str., 420008 Kazan, Russia
2Medical Unit of Kazan (Volga Region) Federal University, 18 Kremlevskaya str., 420008 Kazan, Russia
3Rehabilitation Center of the Yardam-Pomoshch Charitable Foundation, 4-A Serov str., 420095 Kazan, Russia
Abstract. Introduction. The modernization of the healthcare system requires enhancing the medical personnel training. Training in clinical fellowship, aimed at continuously improving knowledge and gradually acquiring the skills and competencies of medical and pharmaceutical personnel, is particularly relevant in terms of implementing the state policy within providing the population with high-quality medical care. The aim of the study is to analyze and optimize the activities the Center for Postgraduate Education at the Higher School of Medicine of the Institute of Fundamental Medicine and Biology of Kazan Federal University, based on updating fellowship programs in accordance with the Federal State Educational Standards. Materials and Methods. The study was conducted at the Institute of Fundamental Medicine and Biology of Kazan Federal University, where programs for training highly qualifi ed personnel in fellowship have been implemented since 2019. The study object was the key activity vectors of the Center for Postgraduate Education and ways to optimize them, aimed at improving the quality of medical personnel training. Research methods included analytical techniques, statistical and systemic analysis techniques, content analysis, and comparative analysis. Results and Discussion. Based on the analysis of scientifi c data, consideration of issues related to the eff ectiveness of legal and regulatory framework, and reports on the eff ectiveness and effi ciency of various mechanisms for improving the quality of higher education, modern approaches and educational technologies are considered that improve the training indicators of fellowship physicians. Current issues of the industry are analyzed and highlighted, and the advantages of introducing innovative educational technologies are emphasized that have been implemented in the activities of the Institute of Fundamental Medicine and Biology of Kazan Federal University. Conclusions. Training of medical personnel in clinical fellowship is the basis for improving the effi ciency and quality of medical care and increasing the effectiveness of the healthcare system. The experience gained by Kazan Federal University in training fellowship physicians shows the necessity of systematically optimizing the educational process in fellowship and increasing the effectiveness of g raduates’ activities.
Keywords: medical education, training, fellowship, postgraduate education.
For citation: Gaifullina, R.F.; Shigabieva, A.M.; Galiullin, A.N.; et al. Training in clinical fellowship: Modernization trajectories within the Federal State Educational Standards. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (3), 113-123. DOI: 10.20969/VSKM.2025.18(3).113-123.
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