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ORIGINAL RESEARCH
REVIEWS
Artificial intelligence potential in medical records Ivantsov E.N., Khasanov N.R. P. 72
ORGANIZATION OF HEALTHCARE
PRACTICAL EXPERIENCE
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ORIGINAL RESEARCH
УДК: [616.831.2:615.82] - 053.32 DOI: 10.20969/VSKM.2025.18(suppl.1).7-11
Active mechanotherapy in the rehabilitation of patients with lower limb fractures, injured in road accidents
Rezeda A. Bodrova1, 2, Arthur M. Delyan1, Marat M. Ilyasov3, Niyaz I. Sarvarov1, 2
1City Clinical Hospital No.7 named after M.N. Sadykov, 54 Marshal Chuykov str., 420103 Kazan, Russia
2Kazan State Medical Academy – Branch of the Russian Medical Academy of Postgraduate Education, 36 Butlerov str., 420012 Kazan, Russia
3Chairman of the Independent non-profit organization for the support of people with disabilities “I Can Do It”, 44 Engels str., Bavly, Russia
Abstract. Introduction. Recently, the number has increased of road traffi c accidents that result in serious body harms, particularly in the severe fractures of the lower limb bones of varying localization and severity, leading to impaired mobility and activity, which affects the patients’ quality of life. Only comprehensive rehabilitation allows us to restore impaired body functions and return the patient to their normal everyday life. Aim. To study the eff ectiveness of active mechanotherapy in the rehabilitation of patients with the consequences of lower limb fractures. Materials and Methods. To study the eff ectiveness of active mechanotherapy, 140 patients were included, with the diagnoses of ICD-10 T02.3 Fractures involving multiple regions of one lower limb and T02.5 Fractures involving multiple regions of both lower limbs, all undergoing inpatient medical rehabilitation at City Clinical Hospital No. 7 named after M.N. Sadykov. Two groups of patients were randomly selected: Group I (control group, n = 70) and Group II (study group, n = 70). Group I were rehabilitated medically according to the guidelines [2], Group II underwent active mechanotherapy using Ilyasov training devices during medical rehabilitation. The eff ectiveness of active mechanotherapy was assessed using clinical and instrumental research methods, such as VAS (Visual Analogue Scale); RMS (Rehabilitation Routing Scale); FIM (Functional Independence Scale); Rivermead Mobility Index; HADS (Anxiety and Depression Scale); and EQ-5D (Quality of Life Assessment) Questionnaire, at the time of the patients’ admission and discharge. Results and Discussion. In patients of group II (study), against the background of active mechanotherapy, there was a decrease in pain syndrome by 35.5% (p < 0.001), in the degree of dependence on others according to the SRM scale by 27.9% (p < 0.05), an improvement in the FIM scale indicators by 21.8% (p < 0.05), and an increase in the Rivermead mobility index by 100% (p < 0.001). It should be noted that these patients also had positive changes in the HADS scale (improvement of their psychological and emotional background by 50% (p < 0.001)) and quality of life on the EQ-5D scale by 141.9% (p < 0.005), all compared to Group I (control). Conclusions. The results obtained indicate an increase in the quality of life by 1.3 times, FIM indicators by 1.4 times, and a decrease in pain syndrome by 1.5 times in patient s of the study group (Group II) compared to the control group (Group I), the patients in which did not undergo any active mechanotherapy using Ilyasov training devices d uring medical rehabilitation.
Keywords: bone fractures, lower limb fractures, active mechanotherapy, rehabilitation aft er fractures, medical rehabilitation.
For citation: Bodrova, R.A.; Delyan, A.M;, Ilyasov, M.M.; Sarvarov, N.I. Active mechanotherapy in the rehabilitation of patientswith lower limb f ractures, injured in road accidents. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 7-11.DOI: 10.20969/VSKM.2025.18(suppl.1).7-11.
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3. Бухарин В.А., Крысюк О.Б., Слухай С.И. Применение современных методов реабилитации при переломах нижних конечностей // Научно-теоретический журнал “Ученые записки». – 2014. – №3(109). – C.43-45. Bukharin VA, Krysyuk OB, Sluhai SI. Application of modern methods of rehabilitation for fractures of the lower extremities [Application of modern methods of rehabilitation for fractures of the lower extremities]. Scientific and theoretical journal “Scientifi c Notes” [Scientific and theoretical journal “Scientifi c Notes”]. 2014; 3 (109): 43-45. (In Russ.). DOI: 10.5930/issn.1994-4683.2014.03.109.p43-45.
УДК: [616.831.2:615.82] - 053.32 DOI: 10.20969/VSKM.2025.18(suppl.1).12-17
Efficiency of medical rehabilitation for lower limb fractures in road traffic accident victims
Lyudmila F. Vasilieva2, Arthur M. Delyan1, Rezeda A. Bodrova1, 2, Mariya E. Kurochkina1, Gulnaz R. Gabdrakhmanova2
1City Clinical Hospital No.7 named after M.N. Sadykov, 54 Marshal Chuykov str., 420103 Kazan, Russia
2Kazan State Medical Academy – Branch of the Russian Medical Academy of Postgraduate Education, 36 Butlerov str., 420012 Kazan, Russia
Abstract. Introduction. General traumatism indicators show an upward trend in most federal districts of Russia. An annual increase is also noted in the incidence rate of primary morbidity within the class of Injuries, Poisoning, and Some Other Consequences of External Infl uences. Among body parts injured by road traffi c accidents in working-age adults, the leading ones are ankle and foot, knee, and lower leg. Patients with lower limb fractures account for 8.5–25% of the total number of victims with musculoskeletal fractures. Fractures of the lower extremities are characterized by long healing periods, persistent contractures, impaired joint surface congruency, and changes in the walking biomechanics. Only early medical rehabilitation can eliminate trauma-induced asymmetry, relieve pain, and restore previous motor activity. Aim. To investigate the efficiency of medical rehabilitation for lower limb fractures in road traffi c accident victims. Materials and Methods. A total of 70 patients were observed with lower limb fractures caused by road traffi c accidents. All patients received a rehabilitation course at City Clinical Hospital No. 7 in Kazan. Patients were divided into two groups: I – control group (n=35) and II – study group (n=35). The comprehensive rehabilitation program for patients in group I included physiotherapy, therapeutic exercise, and mechanotherapy. Group II, in addition to the aforementioned treatment technologies, received balance therapy. The eff ectiveness of the measures taken was assessed using a series of functional scales. Results and Discussion. More pronounced statistically significant positive dynamics were observed in the study group patients by the end of the medical rehabilitation course. Conclusions. The study showed that patients in the study group experienced a signifi cant reduction in pain, some improvements in their functional independence, and wider range of motion, as compared to patients in the control group.
Keywords: medical rehabilitation, lower limb fracture, road traffic accident.
For citation: Vasilieva, L.F.; Delyan, A.M.; Bodrova, R.A.; et al. Efficiency of medical rehabilitation for lower limb fractures in road traffic accident victims. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (Suppl. 1): 12-17. DOI: 10.20969/VSKM.2025.18(suppl.1).12-17.
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УДК 617.423-001.4 DOI: 10.20969/VSKM.2025.18(su ppl.1).18-25
Ways to improve the methods of managing postoperative wound complications in surgical patients
Sergey V. Dobrokvashin1, Alexander G. Izmailov1, Sergey G. Izmailov2,3, Dmitry E. Volkov1, Ivan V. Klyushkin1, Ruslan I. Fatikhov1, Azalia A. Yantykova1, Zilya A. Safiullina1, Ainur A. Shaimardanov1
1Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
2City Clinical Hospital No. 7 named after E.L. Berezov, 66a Oktyabrskoy Revolyutsii str., 603011 Nizhny Novgorod, Russia
3Nizhny Novgorod State Technical University named after R.E. Alekseev, 24 Minin str., 603155 Nizhny Novgorod, Russia
4City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshal Chuykov str., 420103 Kazan, Russia
Abstract. Introduction. Excessively traumatizing the tissues is a critical concern in surgical interventions. Current methods and devices for minimizing such traumas are far from optimal. Therefore, continuously improving the existing and developing new adaptations are underway to reduce excessive tissue damage. These include innovations in surgical needles, wound edge approximation devices, drainage techniques, and postoperative wound management. Aim. To improve treatment outcomes for surgical patients by developing and implementing a program of perioperative management of purulent-infl ammatory wound complications. Materials and Methods. A comparative analysis was conducted regarding the methods developed for preventing and treating postoperative wound complications versus traditional methods in 980 patients undergoing planned and emergency surgeries for various abdominal and soft tissue pathologies in surgical departments. Group I (Investigational): 473 patients. Prevention and treatment of postoperative wound complications were performed using the newly developed technical means and methods. Group II (Clinical Comparison): 507 patients. Postoperative wound complications were prevented and treated using traditional methods. Results and Discussion. The fi rst series of experiments focused on studying the processes of soft tissue traumatization when puncturing with traditional and modifi ed atraumatic surgical needles. The use of the modified surgical needle, as compared to the traditional one, accelerated tissue recovery at the injury site. This was evidenced by a reduced area of leukocyte infi ltration, the decreased edema of collagen fi bers, weaker hemorrhage at the puncture site, and improved tissue vascularization. The second series of experiments investigated how the use of the modifi ed atraumatic surgic al needle infl uences on the reparative regeneration processes of experimentally infected soft tissue wounds. In the clinical section, an instrument was utilized for treating the wound surface of relaparotomy wounds. Wound surface cleanliness was achieved in the investigational group after two treatments, which was 1.8 times fewer than in the clinical comparison group (p<0.05). The edge approximation device, in its clinical application, demonstrated advantages over traditional methods, particularly in facilitating the excision of large lipomas. Conclusions. A reduction in the incidence of postoperative wound complications can be achieved through a comprehensive program encompassing preoperative, intraoperative, and postoperative prevention and treatment strategies. This research enables the development of practical recommendations for the utilization of these methods at various stages of surgical intervention and in the postoperative period.
Keywords: seroma, device, tissue dissection, postoperative wound suppuration, surgical needle.
For citation: Dobrokvashin, S.V.; Izmailov, A.G.; Izmailov, S.G.; et al. Ways to improve the methods of managing postoperative wound complications in surgical patients. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 18-25. DOI: 10.20969/VSKM.2025.18(suppl.1).18-25.
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УДК 616. 514:616.9:578.834.1:615.37 DOI: 10.20969/VSKM.2025.18(sup pl.1).26-33
Omalizumab treatment efficacy evaluation for chronic spontaneous urticaria (actual clinical experience results)
Aliya R. Klyucharova1,2, Viktoria Y. Delian1,3, Guzel N. Zakirova1,3
1City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Chuykov str., 420103 Kazan, Russia
2Institute of Fundamental Medicine and Biology, Kazan Federal University, 74 Karl Marx str., 420012 Kazan, Russia
3Kazan State Medical Academy – Branch of the Russian Medical Academy of Postgraduate Education, 36 Butlerov str., 420012 Kazan, Russia
Abstract. Introduction. Urticaria is one of the most common dermatoses and belongs to a group of diseases characterized by the appearance of itchy wheals and/or angioedema. The use of second-generation antihistamines in standard dosage is the first-line therapy for chronic spontaneous urticaria, which is only eff ective in 45–77% of cases. Where there is no control over the disease symptoms, it is recommended to increase the dosage of the prescribed antihistamine by 2-4 times and complete the treatment with omalizumab. There are several theories explaining the omalizumab eff ect provided onto the urticaria pathogenesis, but none of them reveals any complete information on the effi cacy of immunobiological therapy among patients that are refractory t o antihistamines. Aim. To evaluate the omalizumab therapy effi cacy for chronic spontaneous urticaria based on our clinical experience. Materials and Methods. Effi cacy of immunobiological therapy with omalizumab was analyzed in 32 patients with out-of-control severe chronic spontaneous urticaria. Results and Discussion. The prescribed immunobiological therapy with omalizumab was effi cient in 24 patients. It should be noted that the response to the prescribed therapy was complete and occurred after the administration of 1-3 doses of the drug in 19 patients with chronic spontaneous urticaria, while control over the disease symptoms was delayed after the 5th or 6th injection in 5 patients. Including omalizumab in the basic therapy of chronic spontaneous urticaria made it possible to reduce the severity of skin symptoms and skin itching intensity, to refuse the use of systemic glucocorticosteroids, and (in most patients) to reduce the dose of antihistamines. Conclusions. Omalizumab therapy is a highly effi cient method of treating most patients with severe chronic spontaneous urticaria. In the absence of a therapeutic eff ect after the fi rst doses of the drug, treatment of urticaria with omalizumab should be continued for 5–6 months, since some patients are late responders.
Keywords: urticaria, chronic spontaneous urticaria, UAS 7, UCT, omalizumab.
For citation: Klyucharova, A.R.; Delyan, V.Y.; Zakirova, G.N. Omalizumab treatment effi cacy evaluation for chronic spontaneous urticaria (actual clinical experience results). The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 26-33. DOI: 10.20969/VSKM.2025.18(suppl.1).26-33.
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9. Kaplan AP, Giménez-Arnau AM, Saini SS. Mechanisms of action that contribute to effi cacy of omalizumab in chronic spontaneous urticaria. Allergy. 2017; 72(4): 519–533. DOI: 10.1111/all.13083
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УДК 617.7:613.95 DOI: 10.20969/VSKM.2025.18(suppl.1).34-40
Medical and social characteristics of families having children with eye diseases
Nikita D. Kuzmin1,4, Nataliya V. Ustinova2,5, Nadezhda A. Pozdeyeva1,4, Varvara S. Vasichkina3, Svetlana V. Kuzmina3, Ilgiz M. Galiullin6
1Cheboksary Branch of S.N. Fyodorov Eye Microsurgery Complex, 10 Traktorostroiteley Ave., 428028 Cheboksary, Russia
2B.V. Petrovsky National Research Centre of Surgery, Scientific and Clinical Center No. 2, Research Institute of Pediatrics and Children’s Health Protection, 2 Abrikosovsky Lane, 119991 Moscow, Russia
3Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
4Institute for Advanced Medical Education, 27 Mikhail Sespele str., 428003 Cheboksary, Russia
5G.E. Sukhareva Scientific and Practical Center for Mental Health of Children and Adolescents, 21A 5th Donskoy Proezd str., 119334 Moscow, Russia
6City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Chuykov str., 420103 Kazan, Russiа
Abstract. Introduction. Studying the satisfaction among families having visually impaired children with their lifestyles and living con ditions is crucial for healthcare professionals. This research allows for future planning of measures to improve these aspects and facilitate the successful social integration of children with eye diseases. Aim. To analyze the socio-medical characteristics of families with visually impaired children within the framework of a project promoting the social integration of children with disabilities. Materials and Methods. A complete enumeration method was used to survey the members of 83 families with children with disabilities (blind and visually impaired) who attend specialized groups in a preschool educational institution. A specially designed questionnaire was utilized, which included socio-demographic characteristics and sections of questions refl ecting the families’ quality of life and various levels of satisfaction. For statistical processing, Microsoft Excel for Windows spreadsheet editor was used for database creation, and STATISTICA version 6.1 software package for data analysis. A p-value of <0.05 was considered statistically signifi cant. Results and Discussion. Satisfaction with family lifestyle and living conditions correlated directly with parents’ marital status (82% of parents were legally married), education level (75% held higher education degrees), employment, and fi nancial well-being (48% worked full-time and could spend RUB 14,000 to RUB 19,000 per family member per month). Conclusions. To enhance the quality of life for children with eye pathology, it is essential to develop early diagnostic programs, train specialists in working with visually impaired children, ensure access to various types of hardware and alternative therapies, and promote the inclusion of these children into mainstream educational groups with typicall y developing students. Keywords: children with eye pathology, medical and social characteristics of families, inclusion, preschool educational institution
For citation: K uzmin, N.D; Ustinova, N.V.; Pozdeyeva, N.A.; et al. Medical and social characteristics of families having children with eye diseases. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 34-40. DOI: 10.20969/VSKM.2025.18(suppl.1).34-40.
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8. Воскресенская А., Поздеева Н., Васильева Т., [и др.]. Клинико-морфологические проявления аниридиально-ассоциированной кератопатии по данным оптической когерентной томографии переднего отрезка глаза и конфокальной микроскопии in vivo // OculSurf. – 2017. – № 15 (4). – С.759-769. Voskresenskaya A, Pozdeeva N, Vasil`eva T, et al. Kliniko-morfologicheskie proyavleniya aniridial`no-associirovannoj keratopatii po danny`m opticheskoj kogerentnoj tomografi i perednego otrezka glaza i konfokal`noj mikroskopii in vivo [Clinical and morphological manifestations of aniridia-associated keratopathy on anterior segment optical coherence tomography and in vivo confocal microscopy]. OculSurf. 2017; 15 (4): 759-769. DOI: 10.1016/j.jtos.2017.07.001
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10. Voskresenskaya A, Pozdeyeva N, Batkov Y, et al. Morphometric analysis of the lens in human aniridia and mouse Small eye. Exp Eye Res. 2021 Feb; 203: 108371. DOI: 10.1016/j.exer.2020.108371
УДК: [616.831.2:615.82] – 053.32 DOI: 10.20969/VSKM.2025.18(suppl.1).41-46
Motor development features in preterm infants
Darya L. Nefedeva1,2, Rezeda A. Bodrova1,3, Leisan I. Abdrakhmanova4,5, Lyudmila F. Vasileva1
1Kazan State Medical Academy – Branch of the Russian Medical Academy of Postgraduate Education, 11 Mushtari str., 420012 Kazan, Russia
2Kazan (Volga Region) Federal University Branch, 294 Sharof Rashidov str., 130100 Jizzakh, Uzbekistan
3City Clinical Hospital No. 7, 54 Chuykov str., 420103 Kazan, Russia
4Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
5City Children’s Polyclinic No. 7, 23 Chuykov str., 420057 Kazan, Russia
Abstract. Introduction. Premature infants frequently exhibit delayed motor development. Aim. This study aims to investigate the features of motor ontogeny in premature infants and identify factors infl uencing its development. Materials and Methods. The study included 191 prematurely born infants. All preterm infants were divided into two groups based on their birth weight. The comparison group consisted of 30 full-term infants with perinatal brain damage. All patients were followed up on an outpatient basis during their fi rst three years of life; their medical histories were studied, comprehensive clinical and diagnostic neurological examinations were performed, and habilitation was provided when indicated. Development of sensory and motor systems, cognitive functions, and speech was assessed using I.A. Skvortsova’s Psychoneurological Function Development Chart. The data were processed mathematically using methods of variational statistics. Results and Discussion. The study confi rmed data on the delayed development of motor functions, which was more pronounced in deeply preterm infants. It also established a dependence of motor ontogeny on the quality of aff erent information received by the child and on respiratory disorders. Conclusions. Duration of mechanical ventilation, progression of bronchopulmonary dysplasia, and impairments in the development of sensory analyzers aff ect negatively the prognosis for motor function development in preterm patients. Furthermore, a negative trend in motor development correlates with poorer speech and cognitive outcomes.
Keywords: preterm infants, very low and extremely low birth weight, motor development
For citation: Nefedeva, D.L.; Bodrova, R.A.; Abdrakhmanova, L.I., Vasileva L.F. Motor development features in preterm infants. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 41-46. DOI: 10.20969/VSKM.2025.18(suppl.1).41-46.
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УДК: 616.13-004.6+616-32/.37. DOI: 10.20969/VSKM.2025.18(suppl.1).47-54
Lipid profile alterations in patients with vascular breast calcification detected by mammography
Olga O. Pasynkova1, Evgenia A. Atsel2, Dmitry V. Pasynkov1,3, Olga V. Busygina1, Saida F. Subkhankulova2, Ivan V. Klyushkin4,5, Ruslan I. Fatikhov4,5
1 Mari State University, 1 Lenin Sq., 424000 Yoshkar-Ola, Russia
2 Kazan State Medical Academy – Branch of the Russian Medical Academy of Continuous Professional Education of the Ministry of Health of Russia, Kazan, 36 Butlerova str., 420012 Kazan, Russia
3 Republican Clinical Oncology Dispensary of the Republic of Mari El, Yoshkar-Ola, 424037, 22 Osipenko St.
4 Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
5 City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshal Chuykov str., 420103 Kazan, Russia
Abstract. Introduction. Vascular breast calcifi cation visible at mammography may represent an independent predictor of the coronary heart disease and increased risk of myocardial infarction. Aim. To assess the associations between the breast vascular calcifi cations and lipid profi le parameters in women older than 40 years old. Materials and Methods. This study included 802 observation cases of women aged 41–70 years. We defi ned three age subgroups: Subgroup 1 (41–50 years old); subgroup 2 (51–60 years old); and subgroup 3 (61–70 years old). The following lipid profi le parameters were assessed: Total cholesterol, triglycerides, high-density lipoproteins, low-density lipoproteins, very low-density lipoproteins, and non-high-density lipoproteins. Results and Discussion. In the middle-aged subgroup, the total cholesterol values (median of the mean levels) were 12.67% higher in patients with no calcifi cation, compared to the patients with 1-2 grade calcifi cations (p=0.001). Women with 1-2 grade calcifi cations had 4.54% lower median values of low-density lipoproteins (р=0.034), 15.84% lower high-density lipoproteins (р=0.010), 10.3% lower non-high-density lipoproteins (p=0.001), compared to those with no calcifi cation. In the youngest-age subgroup, the median of the mean values of triglyceride level was 6.43% lower in patients with 1-2 grade calcifi cations (р=0.043), median high-density lipoprotein value was 19.52% lower (р=0.004), and median low-density lipoprotein value was 24.46% lower (р=0.047) in women with 1-2 grade calcifi cations compared to those with no calcification. In the eldest-age subgroup, the triglyceride levels were 3.62% lower in women with no calcifi cations compared to those with 3-4 grade calcifi cations (р=0.033). Conclusions. Women of the youngest- and middle-aged subgroups with 1-2 grade breast vascular calcifi cations seem to have less atherogenic lipid profi le compared to those with no calcifi cation; however, 3-4 grade calcifi cations are associated with higher atherogenicity in the eldest-age subgroup. The observed quadruple lowering of total cholesterol, high-density lipoproteins, low-density lipoproteins, and non-high-density lipoproteins in women with 1-2 grade calcifi cations in the middle- and eldest-age subgroups requires the future research.
Keywords: mammography, vascular calcifi cation, total cholesterol, triglycerides, high-density lipoprotein, very low-density lipoprotein, low-density lipoprotein.
For citation: Pasynkova, О.О.; Atsel, Е.А.; Pasynkov, D.V.; et al. Lipid profi le alterations in patients with vascular breast calcifi cation detected by mammography. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 47–54. DOI: 10.20969/VSKM.2025.18(suppl.1).47-54.
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УДК: 616.13-004.6+616-32/.37 DOI: 10.20969/VSKM.2025.18(suppl.1).55-61
Evaluation of the degree of vascular breast calcifications on digital mammograms: A comparative analysis of the informative values of visual qualitative assessment and automated quantification
Dmitry V. Pasynkov1,2,3, Ivan A. Egoshin1, Alexey A. Kolchev4, Еvgenia А. Atsel3,Оlga О. Pasynkova1, Оlga V. Busygina1, Ivan V. Klyushkin5,6, Ruslan I. Fatikhov1,5,6
1 Mari State University, 1 Lenin sq., 424001 Yoshkar-Ola, Russia
2Republican Clinical Oncology Dispensary of the Republic of Mari El, 22 Osipenko str., 424037 Yoshkar-Ola, Russia
3Kazan State Medical Academy – Branch of the Russian Medical Academy of Continuous Professional Education of the Ministry of Health of Russia,
36 Butlerova str., 420012 Kazan, Russia
4 Kazan (Volga Region) Federal University”,18 Kremliovskaya str., 420008 Kazan, Russia.
5 Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
6 City Clinical Hospital No.7 named after M.N. Sadykov, 54 Marshal Chuykov str., 420103 Kazan, Russia
Abstract. Introduction. Mammography is frequently used in the clinical routine and provides some additional information. Particularly, it can identify vascular calcifi cations with high sensitivity and specifi city. It is showed that such calcifi cations are associated with cardiovascular pathology, osteoporosis, hypothyroidism, etc.; at the same time, it was noted that it is reasonable both to detect calcifi cations and to quantify them. Aim. To develop an approach to the automated detection and quantifi cation of vascular breast calcifi cations on mammography images and check its clinical value. Materials and Methods. We used 154 sets of mammography images. Degree of vascular calcifi cations was assessed visually according to the classifi cation proposed, and it was also quantifi ed automatically using the software package developed. We assessed the variability of the visual assessment and the comparability degree of qualitative and quantitative approaches. Results and Discussion. Visual assessments performed by diff erent experts were comparable in 76.54% of cases (mean). On the contrary, the software outcomes for the same images were completely identical. The quantitative and qualitative assessments gave identical results in the 53.42% of all cases (mean; r2 = -0.523; р=0.01). In the majority of other outcomes, there was a grade increase/decrease according to the software output by degree 1 (36 of 50; 72.0%); however, we also noted the diff erences by 2 (10 of 50; 20.0%) or even 3 (4 of 50; 8.0%) degrees. Conclusions. Automated quantifi cation of vascular breast calcifi cations corrected the outcomes of qualitative visual assessment in 23.91% of cases with no calcifi cations (0 grade), in 83.33% of cases with grade 1 calcifi cation, in 63.64% of cases with grade 2 calcifi cation, in 28.57% of cases with grade 3 calcifi cation, and in 33.33% of cases with grade 4 calcifi cation.
Keywords: mammography, vascular calcifi cation, automated quantifi cation, visual assessment.
For citation: Pasynkov, DV; Egoshin, IA; Kolchev, AA; et al. Evaluation of the degree of vascular breast calcifi cations on digital mammograms: A comparative analysis of the informative values of visual qualitative ass essment and automated quantification. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 55-61. DOI: 10.20969/VSKM.2025.18(suppl.1).55-61.
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УДК: [616.831.2:615.82] - 053.32 DOI: 10.20969/VSKM.2025.18(suppl.1).62-65
Comprehensive correction of the psychoemotional state of patients with post-covid syndrome
Roman O. Tchaikovsky1,2, Arthur M. Delyan1, Rezeda A. Bodrova1,2, Guzel M. Karimova1,2
1City Clinical Hospital No.7 named after M.N. Sadykov, 54 Marshal Chuykov str., 420103 Kazan, Russia
2Kazan State Medical Academy – Branch of the Russian Medical Academy of Postgraduate Education, 36 Butlerov str., 420012 Kazan, Russia
Abstract. Introduction. Numbers of patients with post-covid syndrome increase annually, which is associated with a high frequency of residual eff ects. This article presents the biofeedback technology in correcting the psychoemotional state of patients suff ering from post-covid syndrome. Aim was to investigate the biofeedback effi cacy in correcting psychoemotional background in patients with post-COVID syndrome. Materials and Methods. The study included 65 people divided into 2 groups. In the study group, patients underwent a rehabilitation program, including a set of procedures on the DEVIRTA hardware and software multimedia complex with a biofeedback function (BFB), and halotherapy procedures. Results and Discussion. As a result of rehabilitation, the rehabilitation routing scale (RRS) was 53.8% lower in the study group than in the control group. In the study group, reliable improvements were found: A 23.1% (p = 0.0019) increase in the EQ-5D quality of life questionnaire scores; according to the mMRC scale, a reliable decrease of 55.6% (p <0.001) in the dyspnea score in the study group patients, and a decrease of 63% (p = 0.0019) in the severity of depression symptoms, all compared to the control group. Conclusions. The study results showed that the use of biofeedback technologies in the comprehensive rehabilitation of patients with post-COVID syndrome can increase their tolerance to physical activity, improve their overall well-being, improve their psychoemotional mood, and enhance the quality of their life by 84.8%.
Keywords: SARS-CoV-2, post-COVID syndrome, medical rehabilitation.
For citation: Tchaikovsky, R.O.; Delyan, A.M.; Bodrova, R. A.; Karimova, G.M. Comprehensive correction of the psychoemotional state of patients with post-covid syndrome. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 62-65. DOI: 10.20969/VSKM.2025.18(suppl.1).62-65.
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REVIEWS
УДК:616.24-008.4-02:178.7:663.98 DOI: 10. 20969/VSKM.2025.18(suppl.1).66-71
EVALI, the vapers’ disease: Difficulties in differential diagnosis
Ramil V. Gataullin1, Adelina A. Galiullina2, Valeria A. Denisova2, Maxim A. Makarov2, Aida R. Sadykova2,3, Guzel M. Ilalova1
1City Clinical Hospital No. 11, 34/24 Maximov str., 420127 Kazan, Russia
2Kazan State Medical University, 49 Butlerov str., Kazan, 420012, Russia
3City Clinical Hospital No. 7 named after M.N. Sadikov, 54 Marshal Chuykov St., Kazan, 420103, Russia
Abstract. Introduction. Electronic cigarettes have become popular as a “safe” way to smoke among the younger generation. However, the use of e-cigarettes has given rise to a new disease – EVALI (E-cigarette or Vaping product use-Associated Lung Injury), a severe lung injury associated with e-cigarette and vaping product use. Diffi culties in diagnosing and diff erentiating the disease from other respiratory illnesses have emphasized the importance of studying the pathogenetic and pathophysiological mechanisms of pathology development due to vaping, as well as the search for eff ective methods of the disease diagnosis, treatment, and prevention. Aim. To analyze data from contemporary research focused on studying criteria for the diff erential diagnosis of EVALI. Materials and Methods. A search and subsequent analysis of scientifi c publications were conducted using the query “EVALI diagnostic criteria” in the databases PubMed, eLibrary, ScienceDirect, and NCBI (National Library of Medicine). Results and Discussion. Clinical picture of EVALI includes: Moderate fever, weight loss, progressive dyspnea of mixed nature, pleuritic chest pain, dry cough, and persistent tachycardia. Auscultation reveals crepitations (rales) and fine moist crackles in the lower lung fi elds, associated with bronchovesicular breathing. Computed tomography scans demonstrate bilateral diff use ground-glass opacities, predominantly in the basal regions, along with subpleural, peribronchovascular, and lobular consolidation. For diff erential diagnosis, specifi c characteristics of other patterns are important to consider: Diffuse alveolar damage may present with lobular narrowing and signs of alveolar collapse; interlobular septal thickening with bilateral pleural eff usions of mild to moderate severity, with or without centrilobular ground-glass nodules, are characteristic of acute eosinophilic pneumonia; and lobular narrowing with centrilobular ground-glass nodules are seen in interstitial organizing pneumonia. Blood tests reveal an elevated leukocyte count with neutrophilic predominance and increased infl ammatory markers such as erythrocyte sedimentation rate, C-reactive protein, and procalcitonin. In lung biopsy samples, foamy macrophages and excessive vacuolization of alveolar cells (pneumocytes) are observed. Bronchoalveolar lavage may contain tetrahydrocannabinol or vitamin E acetate, and lipophages. Urine cannabinoid screening reveals tetrahydrocannabinol metabolites. The underlying pathology involves acute injury to the lung interstitium and bronchiolar epithelium due to the deposition of formaldehyde, vitamin E acetate, acetone, and nitrosamines, formed during heating, within macrophages. Oils deposit on the alveolar walls, forming a lipid fi lm that impairs gas exchange. The presence of potential oxidative stress biomarkers – 8-hydroxydeoxyguanosine and 8-isoprostane, as well as decreased levels of the pro-resolving lipid mediator RvD1 (resolvin D1) and the anti-infl ammatory airway epithelial marker CC10/16 (Club cell protein 10/16), may be utilized in future diagnostics. Conclusions. Further research is necessary for a better understanding of EVALI’s clinical forms and developmental mechanisms, to develop effective methods of diagnosis, treatment, and prevention, and to refi ne its diff erentiation from other respiratory system diseases.
Keywords: EVALI disease, electronic cigarettes, X-ray picture in EVALI, diff erential diagnosis.
For citation: Gataullin R.V; Galiullina A.A.; Denisova V.A.; et al. EVALI, the vapers’ disease: Difficulties in differential diagnosis. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 66-71. DOI: 10.20969/VSKM.2025.18(suppl.1).66-71.
REFERENCES
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УДК: 614.254.1;004.838.3 DOI: 10.20969/VSKM.2025.18(suppl.1).72-76
Artificial intelligence potential in medical records
Evgeny N. Ivantsov1, Niaz R. Khasanov1
1 Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
Abstract. Introduction. Contemporary healthcare systems are facing a growing challenge of administrative burden on medical professionals, related to documentation management. Both in Russia and abroad, the implementation of electronic medical records often leads to a paradoxical outcome: An increase in time spent on documentation processes. Aim. To evaluate the capabilities of modern artifi cial intelligence systems in automating and optimizing medical documentation processes, and to identify key barriers to their implementation. Materials and Methods. A comparative analysis of scientifi c literature and internet publications was conducted using search engines (Yandex), electronic libraries (CyberLeninka, PubMed), and neural network models (DeepSeek-V3, GigaChat). The following methods were used: Induction, deduction, and representation of graphical and tabular data. Results and Discussion. Studies show that Russian physicians spend 35-50% of their working time on documentation, with up to 30% of that time spent on data duplication. International data demonstrate similar issues. Promising artificial intelligence solutions, such as voice input or automated diagnostics, have been identifi ed; however, their implementation is hindered by the following: Compatibility issues with outdated information technology systems, a lack of clear certification mechanisms, insuffi cient evidence of their eff ectiveness, and the necessity of medical personnel training. Conclusions. For the successful integration of artifi cial intelligence into medical documentation, the following is required: Ensuring compatibility with existing systems, developing transparent certifi cation mechanisms, and creating training programs for medical professionals.
Keyw ords: artificial intelligence, medical documentation, electronic medical records, healthcare automation, clinical information system, digitalization of medicine.
For citation: Ivantsov, E.N.; Khasanov, N.R. Artifi cial intelligence potential in medical records. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 72-76. DOI: 10.20969/VSKM.2025.18(suppl.1).72-76.
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Influence of epigenetic factors on the development of autoimmune diseases, such as systemic lupus erythematosus
Maxim A. Makarov1, Soltan R. Shamgunov1, Elizaveta M. Vavilova1, Aida R. Sadykova1,2, Ramziya T. Khabiboullina3, Elena V. Moiseenko3
1Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
2City Clinical Hospital No. 7, 54 Chuykova str., 420132 Kazan, Russia
3City Clinical Hospital No. 11, 34/24 Maximov str., 420127 Kazan, Russia
Abstract. Introduction. Etiology of many autoimmune diseases remains understudied. Consequently, increasing attention is paid to epigenetic mechanisms. These mechanisms both clarify the etiology of this group of diseases and open new avenues for diagnosis and treatment thereof. Aim. To conduct an analysis of current research data focusing on epigenetic factors affecting the development of autoimmune diseases, such as systemic lupus erythematosus. Materials and Methods. Current literature was reviewed regarding the genetic and epigenetic aspects of autoimmune disease development, specifi cally systemic lupus erythematosus. The sources used include PubMed, NCBI, eLibrary , and ScienceDirect. Results and Discussion. Key epigenetic mechanisms include DNA methylation, histone modifi cations, and non-coding RNAs. Systemic lupus erythematosus is a multifactorial autoimmune disease where epigenetic changes play a crucial role in its pathogenesis. Epigenetic regulation in systemic lupus erythematosus involves both hypomethylation and hypermethylation of various genes, ultimately leading to the activation of autoreactive sequences and the disruption of immune tolerance. Histone modifi cations, such as acetylation and methylation, also influence gene expression, often correlating with disease activity. MicroRNAs, such as miR-21 and miR-146a, regulate the expression of genes involved in immune processes. Their dysregulation contributes to the development of an autoimmune response. Conclusions. Research in the epigenetics allows for a deeper understanding of the pathogenesis of systemic lupus erythematosus. Epigenetic mechanisms play a signifi cant role in the disruption of immune tolerance and the development of autoimmune reactions. Further study of these mechanisms may contribute to the development of novel approaches to the diagnosis and treatment of systemic lupus erythematosus.
Keywords: systemic lupus erythematosus, autoimmune diseases, epigenetics, DNA methylation, histone modifi cations, non-coding RNAs.
For citation: Makarov, M.A.; Shamgunov, S.R.; Vavilova E.M.; et al. Infl uence of epigenetic factors on the development of autoimmune diseases, such as systemic lupus erythematosus. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 77-82. DOI: 10.20969/VSKM.2025.18(suppl.1).77-82.
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УДК 616-035 DOI: 10.20969/VSKM.2025.18(suppl.1).83-89
Morbid obesity: A multidisciplinary approach to solving the problem
Igor S. Malkov1, Alina Z. Sadeeva1, Ruslan F. Gubaev2
1Kazan State Medical Academy – Branch of the Russian Medical Academy of Postgraduate Education, 36 Butlerov str., 420012 Kazan, Russia
2City Hospital 7 named after M.N. Sadykov, 54 Chuykov str., 420103 Kazan, Russia
Abstract. Introduction. In Russia, the number of patients with morbid obesity becomes comparable to that in the USA and European countries. Thus, the overweight people are 43–57% of the population, while those with obesity are 22–36%, and this fi gure does not tend to decrease. It is predicted that by 2030, almost 50% of the world’s adult population will suffer from this pathology. Morbid obesity treatment is a complicated problem because this disease is associated with psychiatric and somatic pathologies. Aim of the study: to provide relevant information about morbid obesity from a multidisciplinary point of view. Materials and Methods. Current literature was reviewed based on search results in the eLibrary and PubMed electronic databases using the “morbid obesity” query. Results and Discussion. Treatment with conservative methods, such as lifestyle changes, increased physical activity, changes in eating behavior, and drug therapy, does not provide the desired effect in high-degree obesity and leads to relapses in 98% of cases. To date, bariatric surgery is the most eff ective method to combat metabolic disorders. It ensures sustainable weight loss and has a positive eff ect on obesity-related comorbidities. Number of such surgeries performed worldwide increases with every passing year. Indications for surgical intervention are based on a careful assessment of the potential risks and benefi ts of a particular method. The greatest number of postoperative complications are associated with suture failure, intra-abdominal bleeding, vagus nerve injury, anastomosis stricture, pulmonary embolism, infection, peptic ulcer of the anastomosis, and dumping syndrome. There is evidence of increased incidence of gastric cancer after bariatric bypass surgery, localized mainly in the “disconnected” stomach and diagnosed at a late stage. Conclusions. A comprehensive examination of morbid obesity patients involving a general practitioner, dietitian, endocrinologist, psychotherapist, anesthesiologist, and surgeon, is necessary to choose a personalized method of treatment.
Keywords: morbid obesity, eating behavior, drug therapy of obesity, bariatric surgery.
For citation: Malkov, I.S.; Sadeeva, A.Z.; Gubaev, R.F. Morbid obesity: A multi disciplin ary approach to solving the problem. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 83-89. DOI: 10.20969/VSKM.2025.18(suppl.1).83-89.
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УДК: 616.441-008.63:616.13-004.6:576.32/.36 DOI: 10. 20969/VSKM.2025.18(suppl.1).90-95
Cellular and biochemical mechanisms of early atherosclerosis in hypothyroidism: Role of thyroid hormones
Aida R. Sadykova1,2, Zahar V. Ivanov1, Kamil U. Gimadiev1, Maxim A. Makarov1, Alsu M. Sadykova2, Aigoul M. Kozlova3
1Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
2City Clinical Hospital No. 7, 54 Chuykova str., 420132 Kazan, Russia
3Republican Clinical Oncology Dispensary, 29 Sibirsky Trakt str., 420029 Kazan, Russia
Abstract. Introduction. Hypothyroidism, including its subclinical form, is a common endocrine disorder associated with an increased risk of early atherosclerosis and cardiovascular diseases. Understanding the cellular and biochemical mechanisms underlying this relationship is critical for developing effi cient strategies aimed at the prevention and treatment of cardiovascular complications in patients with hypothyroidism. The limited understanding of these mechanisms restricts the possibilities of taking preventive measures and optimizing the therapy. Aim. To review the state of knowledge regarding the cellular and biochemical mechanisms of how hypothyroidism aff ects the early development and progression of atherosclerotic process. Materials and Methods. Publications in the bibliographical databases were reviewed, such as CyberLeninka, PubMed, and eLibrary. Results and Discussion. The fi ndings of this study confi rm that hypothyroidism, including its subclinical form, affects adversely the endothelium, contributing to the development of atherosclerosis. Impaired nitric oxide production, increased oxidative stress, and dyslipidemia lead to endothelial dysfunction. Elevated levels of oxidized low-density lipoproteins and arginase further exacerbate vascular impairments. Hypothyroidism is accompanied by chronic infl ammation, an increased level of C-reactive protein, interleukin-6, and tumor necrosis factor-alpha. These changes promote macrophage activation and formation of atherosclerotic plaques. Particular attention is given to the role of thyroid-stimulating hormone. Regardless of thyroid hormone levels, thyroid-stimulating hormone promotes infl ammation and accelerates atherosclerosis progression. Experimental models have shown that thyroid-stimulating hormone activates pro-infl ammatory pathways NF-κB and mitogen-activated protein kinase in macrophages, increasing levels of interleukin-6 and tumor necrosis factor-alpha and impairing cholesterol effl ux. Clinical studies confi rm that subclinical hypothyroidism is associated with an increased risk of cardiovascular diseases, including myocardial infarction and coronary heart disease. Patients having this condition exhibit higher arterial stiffness and mortality rate due to cardiovascular complications. Conclusions. The data obtained emphasize the importance of monitoring the thyroid function and contro lling the thyrotropin levels in the prevention of cardiovascular diseases, especially in patients with subclinical hypothyroidism.
Keywords: hypothyroidism, thyroid-stimulating hormone, atherosclerosis, nitric oxide, endothelial dysfunction.
For citation: Sadykova, A.R.; Ivanov, Z.V.; Gimadiev, K.U.; et al. Cellular and biochemical mechanisms of early atherosclerosis in hypothyroidism: Role of thyroid hormones. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 90-95. DOI: 10.20969/VSKM.2025.18(suppl.1).90-95.
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УДК: 616-036.22 DOI: 10.20969/VSKM.2025.18(suppl.1).96-102
Problems and focus areas in ensuring epidemiological welfare in a multidisciplinary healthcare facility
Natalia D. Shaikhrazieva1,2, Dmitriy V. Lopushov1, Farida N. Sabayeva1
1Kazan State Medical Academy – Branch of the Russian Medical Academy of Postgraduate Education, 36 Butlerov str., 420012 Kazan, Russia
2City Clinical Hospital №7 named after M.N. Sadykov, 54 M. Chuikov str., 420103 Kazan, Russia
Abstract. Introduction. Despite advancements in modern healthcare, the issue of epidemiological safety remains paramount and signifi cant for healthcare professionals in large multidisciplinary hospitals. Aim. To analyze information on current advancements regarding the epidemiological safety of healthcare professionals in large multidisciplinary hospitals. Materials and Methods. To analyze information on the current advancements in epidemiological safety, we used data from open electronic scientifi c literature databases, such as PubMed, eLibrary.Ru, Scopus, and Dimensions, with the search period of up to 15 years. Results and Discussion. This review examines the current trends in epidemiological safety within medical organizations and highlights its key components. Particular emphasis is placed on the development of regulatory documents, such as standard operating procedures or clinical guidelines, concerning various aspects of ensuring epidemiological welfare in healthcare facilities. Some other issues are of great importance, too, such as staffi ng, expanding hospital hygiene training for physicians of various disciplines, creating electronic distance learning modules, and arranging relevant workshops. A crucial aspect in improving the detection of healthcare-associated infections (HAIs) is the implementation of a strategy for infection risk assessment and the proactive adoption of measures aimed at minimizing such risks within medical organizations. Using key performance indicators (KPIs) in epidemiological safety, conducting audits, and harmonizing with the existing international criteria will enable healthcare facilities to achieve a new level of medical care in terms of epidemiological safety. Conclusions. Ensuring epidemiological welfare in healthcare facilities is a critical aspect of their operations, aimed at preventing the spread of infectious diseases and ensuring the safety of both patients and staff . Key focus areas include strengthening the preventive measures, enhancing the epidemiological surveillance, improving the staff competency in epidemiology and infection control, rationally using antibiotics to mitigate the antibiotic resistance risk, implementing systems for monitoring the use of antimicrobial agents, optimizing disinfection and sterilization protocols, and implementing automated systems for treating and storing medical instruments. Employing innovative approaches to ensuring epidemiological safety improves the patients’ treatment outcomes, prevents complications, and facilitates a faster restoration of their functional capacities.
Keywords: infections related to medical care; epidemiological safety
For citation: Shaikhrazieva, N.D.; Lopushov, D.V.; Sabayeva, F .N. Problems and focus areas in ensuring epidemiological welfare in a multidisciplinary healthcare facility. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (su ppl.1): 96-102. DOI: 10.20969/VSKM.2025.18(suppl.1).96-102.
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ORGANIZATION OF HEALTHCARE
УДК 614.253.4:616-057-055.2 DOI: 10.20969/VSKM.2025.18(sup pl.1).103-109
Monitoring women’s health: Routine examination results
Railya V. Garipova1,2,3, Kadriya R. Safina4, Svetlana N. Miftakhova5, Evgeny V. Arkhipov1,2,5, Artur M. Delyan5, Ilgiz M. Galiullin5
1 Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
2 Institute of Biology and Fundamental Medicine, Kazan Federal University, 74 Karl Marx str., 420012 Kazan, Russia
3 Kazan State Medical Academy – Branch of the Russian Medical Academy of Postgraduate Education, 36 Butlerov str., 420012 Kazan, Russia
4 City Clinical Hospital No. 12, 7 Lechebnaya str., 420036 Kazan, Russia
5 City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Chuykov str., 420103 Kazan, Russiа
Abstract. Introduction. Routine examinations are an important tool for dynamic monitoring of the health status of those employed in jobs with harmful and/or hazardous working conditions. They allow timely detecting occupational and somatic diseases, initiating treatment, and assessing occupational fi tness. Particular attention is paid to working women mostly employed in the agro-industrial complex, public catering, trade, healthcare, childcare institutions, and other sectors. Aim. To assess, based on fi nal reports and annual summaries, the effi cacy of routine examinations of female population in the Republic of Tatarstan for the years 2022–2024, with an analysis of occupational morbidity indicators and the pattern of newly diagnosed somatic diseases. Materials and Methods. The study was based on annual summaries and fi nal reports of routine examinations across 45 territories of the Republic of Tatarstan, as well as statistical data from the republican and municipal centers of occupational pathology. Statistical analysis included descriptive methods and tabular presentation, with qualitative indicators presented as absolute (n) and relative (%) frequencies of the trait being studied. Diff erences in qualitative characteristics throughout various arrays were assessed using the χ² (chi-square) criterion. Results and Discussion. Over the three-year period, 568,392 women underwent routine medical examinations (coverage: 97.1–97.6%). A decrease was observed in the proportion of unfi tness for work (from 0.27% to 0.15%) and in cases without issuing any conclusion due to diffi culties in specify the degree of occupational fitness (from 0.38% to 0.09%), while the need for additional examinations and dispensary follow-up was found to increase. Suspected occupational diseases were identifi ed in 384 women, with diagnoses confi rmed in 137 individuals (236 cases). The pattern of occupational diseases is biased toward musculoskeletal and peripheral nervous system disorders, ear diseases, respiratory diseases, skin diseases, and infectious diseases. Among somatic pathologies, the most frequent were nutritional and metabolic disorders, blood diseases, and cardiovascular diseases. Conclusions. Routine medical examinations of working women in the Republic of Tatarstan are characterized by high coverage and effi cacy, contributing to the early detection of occupational and somatic diseases. Analysis of statistical data over the reporting period revealed an increase in the proportion of individuals diagnosed with two or more occupational diseases, as well as the share of women receiving recommendations for reasonable job placement and referral to a medical and social assessment institution. This highlights the issue of delayed referring women with the early manifestations of occupational diseases to occupational pathology centers. It is recommended that industry-related medical examinations include an assessme nt of women’s reproductive health, which would broaden the scope of preventive measures and strengthen their social orientation.
Keywords: routine medical examination, w omen’s health, early disease detection, preventive medicine.
For citation: Garipova, R.V.; Safina, K.R.; Miftakhova, S.N.; et al. Monitoring women’s health: Routine examination results. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 103-109. DOI: 10.20969/VSKM.2025.18(suppl.1).103-109.
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6. Приказ Минздрава России от 28.01.2021 № 29н «Об утверждении Порядка проведения обязательных предварительных осмотров работников, предусмотренных частью четвертой статьи 213 Трудового кодекса Российской Федерации, перечня медицинских противопоказаний к осуществлению работ с вредными и (или) опасными производственными факторами, а также работам, при выполнении которых проводятся обязательные предварительные и периодические медицинские осмотры». Prikaz Minzdrava Rossii ot 28/01/2021 № 29n «Ob utverzhdenii Poryadka provedeniya obyazatelnykh predvaritelnykh osmotrov rabotnikov, predusmotrennykh chastyu chetvertoj stati 213 Trudovogo kodeksa Rossijskoj Federaczii, perechnya mediczinskikh protivopokazanij k osushhestvleniyu rabot s vrednymi i (ili) opasnymi proizvodstvennymi faktorami, a takzhe rabotam, pri vypolnenii kotorykh provodyatsya obyazatelnye predvaritelny`e i periodicheskie mediczinskie osmotry» [Order of the Ministry of Health of Russia dated January 28, 2021 № 29n «On approval of the Procedure for conducting mandatory preliminary examinations of workers provided for in part four of Article 213 of the Labor Code of the Russian Federation, a list of medical contraindications for carrying out work with harmful and (or) hazardous production factors, as well as work during which mandatory preliminary and periodic medical examinations are carried out»]. 2021. (In Russ.).
7. Постановление Правительства Российской Федерации от 15.12.2000 № 967 «Об утверждении Положения о расследовании и учете профессиональных заболеваний». Postanovlenie Pravitel’stva Rossiyskoy Federatsii ot 15/12/2000 № 967 «Ob utverzhdenii Polozheniya o rassledovanii i uchete professional’nykh zabolevaniy» [Resolution of the Government of the Russian Federation dated December 15, 2000 № 967 «On approval of the Regulation on the investigation and registration of occupational diseases»]. 2000. (In Russ.)
8. Постановление Правительства Российской Федерации от 05.07 2022 № 1206 «О порядке расследования и учета случаев профессиональных заболеваний работников». Postanovlenie Pravitel’stva Rossiyskoy Federatsii ot 05/07/2022 № 1206 «O poryadke rassledovaniya i ucheta sluchaev professional’nykh zabolevaniy rabotnikov» [Resolution of the Government of the Russian Federation dated July 5, 2022 № 1206 «On the procedure for investigating and registering cases of occupational diseases of workers»]. 2022. (In Russ.).
9. Приказ Минздрава России от 05.05.2016 № 282н «Об утверждении порядка проведения экспертизы профессиональной пригодности и формы медицинского заключения о пригодности или непригодности к выполнению отдельных видов работ». Prikaz Minzdrava Rossii ot 05/05/2016 № 282n «Ob utverzhdenii poryadka provedeniya ekspertizy professional’noj prigodnosti i formy medicinskogo zaklyucheniya o prigodnosti ili neprigodnosti k vypolneniyu otdel’nyh vidov rabot». [Order of the Ministry of Health of the Russian Federation dated May 5, 2016 № 282n «On approval of the procedure for conducting an examination of professional suitability and the form of a medical report on suitability or unsuitability for performing certain types of work»]. 2016. (In Russ.).
10. Приказ Минздрава России от 25.03.2025 № 147н «Об утверждении Порядка проведения экспертизы профессиональной пригодности и формы медицинского заключения о пригодности или непригодности к выполнению отдельных видов работ». Prikaz Minzdrava Rossii ot 25/03/2025 № 147n «Ob utverzhdenii Poryadka provedeniya ekspertizy professional’noy prigodnosti i formy medicinskogo zaklyucheniya o prigodnosti ili neprigodnosti k vypolneniyu otdel’nyh vidov rabot». [Order of the Ministry of Health of Russia dated March 25, 2025 № 147n «On approval of the procedure for conducting an examination of professional suitability and the form of a medical report on suitability or unsuitability for performing certain types of work»]. 2025. (In Russ.).
11. Приказ Министерства здравоохранения Российской Федерации от 27 апреля 2021 г. № 404н «Об утверждении Порядка проведения профилактического медицинского осмотра и диспансеризации определенных групп взрослого населения». Prikaz Ministerstva zdravookhraneniya Rossiyskoy Federatsii ot 27 aprelya 2021 goda № 404n «Ob utverzhdenii Poryadka provedeniya profi lakticheskogo medicinskogo osmotra i dispensarizatsii opredelennykh grupp vzroslogo naseleniya» [Order of the Ministry of Health of the Russian Federation dated April 27, 2021 № 404n «On approval of the procedure for conducting preventive medical examinations and dispensarization of certain adult population groups»]. 2021. (In Russ.).
12. Письмо Министерства здравоохранения Российской Федерации от 8 апреля 2024 г. № 17-6/И/2-6434 «О направлении методических рекомендаций по диспансеризации мужчин и женщин репродуктивного возраста с целью оценки репродуктивного здоровья». Pismo Ministerstva zdravookhraneniya Rossiyskoy Federatsii ot 8 aprelya 2024 goda № 17-6/I/2-6434 «O napravlenii metodicheskikh rekomendatsiy po dispensarizatsii muzhchin i zhenshchin reproduktivnogo vozrasta s tsel’yu otsenki reproduktivnogo zdorov’ya» [Letter of the Ministry of Health of the Russian Federation dated April 8, 2024 № 17-6/I/2-6434 «On the submission of methodological recommendations for dispensarization of men and women of reproductive age for assessment of reproductive health»]. 2024. (In Russ.).
13. Приказ Минздрава России от 19 июля 2024 г. № 378н «О внесении изменений в порядок проведения профилактического медицинского осмотра и диспансеризации определенных групп взрослого населения, утвержденный приказом Министерства здравоохранения Российской Федерации от 27 апреля 2021 г. № 404н». Prikaz Minzdrava Rossii ot 19 iyulya 2024 goda № 378n «O vnesenii izmeneniy v Poryadok provedeniya profi lakticheskogo medicinskogo osmotra i dispensarizatsii opredelennykh grupp vzroslogo naseleniya, utverzhdennyy prikazom Ministerstva zdravookhraneniya Rossiyskoy Federatsii ot 27 aprelya 2021 goda № 404n» [Order of the Ministry of Health of Russia dated July 19, 2024 № 378n «On amendments to the procedure for conducting preventive medical examinations and dispensarization of certain adult population groups, approved by the order of the Ministry of Health of the Russian Federation dated April 27, 2021 № 404n»]. 2024. (In Russ.).
УДК 614.2DOI: 10.20969/VSKM.2025.18(suppl.1).110-116
Analysis of supervisory activities at City Clinical Hospital No. 7 named after M.N. Sadykov in Kazan
Marsel M. Sadykov1, Artur M. Delyan1, Liliya I. Akhmetova1, Lidiya I. Sabirova1, Nina Y. Novikova1
1City Clinical Hospital No.7 named after M.N. Sadykov, 54 Marshal Chuykov str., 420103 Kazan, Russia
Abstract. Introduction. In the Russian Federation, and particularly in the Republic of Tatarstan, one of the key objectives of the National Healthcare Project is to solve the issue of mortality, including in rural areas. Current priorities in managing medical care for rural residents include the effi cient use of the existing healthcare resources, as well as improving the accessibility and quality of medical care. To enhance and coordinate primary healthcare for the people in the Republic of Tatarstan, Ordinance No. 1379 “On Arranging the Supervisory Activities of Medical Institutions in the Republic of Tatarstan” was issued by the Ministry of Health of the Republic of Tatarstan on August 21, 2020. In accordance with this Ordinance, City Clinical Hospital No. 7 was instructed to organize supervisory activities for medical institutions in ten northwestern municipal districts of the Republic of Tatarstan to dynamically monitor the provision of medical care. Aim. To analyze the effi ciency of supervisory activities concerning therapeutic and preventive care for the residents of the supervised districts. Materials and Methods. Analytical materials were studied contained in the offi cial statistics of the Ministry of Health of the Republic of Tatarstan and the Territorial Body of the Federal State Service in the Republic of Tatarstan. Methods of descriptive statistics for the years 2023 and 2024, tabular presentation, and qualitative indicators expressed as relative values (%) of the studied characteristic’s occurrence were applied to the statistical analysis. Data were analyzed using the tools of the MS Excel software package. Results and Discussion. A structural unit was designated within City Clinical Hospital No. 7 to guide and control the activities of medical institutions in the supervised districts. Statistical indicators, expert control of medical care provision, and the human resources and material-technical potential of the medical institutions were analyzed in the supervised districts. The analysis of mortality structure by nosological forms in the supervised districts revealed the following pattern: Top three causes were circulatory diseases, malignant neoplasms, and external death factors. Thus, the key problematic areas aff ecting mortality reduction and potential solutions were identifi ed and structured. Conclusions. Supervisory activities performed in 2023-2024 allowed the increased coverage of preventive measures, improved accessibility and timeliness of therapeutic and preventive care, and enhanced provision of high-tech medical care, including routing the severe patients. These measures resulted in positive trends in reducing mortality caused by circulatory diseases and achieving preventive care targets. Thus, arranging the effi cient supervisory activities helps improve the quality of medical care provided and contributes to reducing the population mortality.
Keywords: supervisory activities, National Healthcare Project, demography, mortality.
For citation: Sadykov, M.M; Delyan, A.M; Akhmetova, L.I; et al. Analysis of supervisory activities at City Clinical Hospital No. 7 named after M.N. Sadykov in Kazan. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 110-116. DOI: 10.20969/VSKM.2025.18(suppl.1).110-116.
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УДК: 378.046.4:001.891.54:614.23:616.5 DOI: 10.20969/VSKM.2 025.18(suppl.1).117-121
Simulation training in continuing professional education programs for dermatovenerologists and cosmetologists
Laysan A. Khaertdinova1, Yulia V. Valeeva1, Raushania F. Gaifullina1, Almaz T. Garaev1, Elena V. Kiyasova1, Venera M. Satdarova1, Marat I. Timerzyanov1, Artur M. Delyan1, Elza M. Kashapova1
1 Kazan Federal University, 18 Kremlevskaya str., 420008 Kazan, Russia
Abstract. Introduction. Digitalization of the educational environment of universities and the active implementation of advanced interactive methods adapts the educational process in accordance with the professional tasks and needs of the target audience. Aim. To evaluate the impact of simulation training on the acquisition of practical skills in providing fi rst aid and emergency medical care by dermatovenerologists and cosmetologists. Materials and Methods. The Emergency Medical Care simulation course is integrated into the training programs for dermatovenerologists and cosmetologists. In 2019–2025, 132 physicians have been trained at the Simulation Center of the Institute of Fundamental Medicine and Biology in Kazan (Volga Region) Federal University. The training topics simulate various clinical situations in dermatovenereology and cosmetology. For each practical lesson, unique scenarios have been created with training in virtual conditions, as close as possible to the reality of practical activities. Results and Discussion. The results of the simulation trainings conducted demonstrate as follows: Before the start of the training, there was a low self-assessment of knowledge regarding the emergency care providing issues, a lack of practical skills, but at the same time, the physicians were interested in taking the simulation course; upon completion of the course, there were the suffi cient knowledge level, the confi dence in implementing the algorithm of actions, the efficacy of approaches, and the readiness to provide medical care in an emer gency. Conclusions. The authors’ experience presented in this paper emphasizes the importance of introducing interactive forms and methods of digital learning into continuing professional education programs, allowing the qualitative improvement of competencies to comply with federal standards.
Keywords: dermatovenereology, cosmetology, personnel training, simulation training technologies, emergency care.
For citation: Khaertdinova, L.A.; Valeeva, Y.V.; Gaifullina, R.F.; et al. Simulation training in continuing professional education programs for dermatovenerologists and cosmetologists. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 117-121. DOI: 10.20969/VSKM.2025.18(suppl.1).117-121.
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5. Юдаева Ю.А. Симуляционный курс «Неотложная помощь» в программе повышения квалификации врача-косметолога // Современные проблемы науки и образования. – 2017. – №2. Yudaeva YuA. Simulyacionnyj kurs «Neotlozhnaya pomoshch’» v programme povysheniya kvalifi kacii vracha-kosmetologa [Simulation course “Emergency Care” in the advanced training program for a cosmetologist]. Sovremennye problemy nauki i obrazovaniya [Modern problems of science and education]. 2017; 2. (In Russ.). Режим доступа [URL]: https://science-education.ru/ru/article/view?id=26257
6. Хаертдинова Л.А., Вафина Г.Г., Бильдюк Е.В., Касаткина С.Б. Симуляционные технологии в обучении и становлении врача-дерматовенеролога // Современные проблемы науки и образования. – 2025. – №1. Khaertdinova LA, Vafi na GG, Bil’dyuk EV, Kasatkina SB. Simulyacionnye tekhnologii v obuchenii i stanovlenii vracha-dermatovenerologa [Simulation technologies in the training and development of dermatovenereologists]. Sovremennye problemy nauki i obrazovaniya [Modern problems of science and education]. 2025; 1. (In Russ.). Режим доступа [URL]: https://science-education.ru/ru/article/view?id=33924 DOI: 10.17513/spno.33924
7. Хаертдинова Л.А., Валеева Ю.В., Киясова Е.В., Сатдарова В.М. Симуляционный курс «Оказание первой помощи» в профессиональном обучении специалистов для эстетической косметологии, не имеющих медицинского образования // Современные проблемы науки и образования. – 2023. – №4. Khaertdinova LA, Valeeva YuV, Kiyasova EV, Satdarova VM. Simulyacionnyj kurs «Okazanie pervoj pomoshchi» v professional’nom obuchenii specialistov dlya esteticheskoj kosmetologii, ne imeyushchih medicinskogo obrazovaniya [A simulation course on “First Aid” for professional training of aesthetic cosmetology specialists without a medical background]. Sovremennye problemy nauki i obrazovaniya [Modern problems of science and education]. 2023; 4. (In Russ.). Режим доступа [URL]: https://science-education.ru/ru/article/view?id=32856 DOI: 10.17513/spno.32856
8. Bienstock J, Heuer A. A review on the evolution of simulation-based training to help build a safer future. Medicine. 2022; 101(25): e29503. DOI: 10.1097/MD.0000000000029503
PRACTICAL EXPERIENCE
УДК: 616.127-005.4-073.756.8 DOI: 10.20969/VSKM.2025.18(suppl.1).122-126
Hairy-cell leukemia complicated by thrombosis of the left common iliac vein and inferior vena cava
Gulia R. Gainullina1, Zukhra R. Gubaidullina1,Gulnara I. Zagidullina1, Venera N. Mukhamadieva1, Leisan I. Myasoutova1,2, Artem G. Vasilev1, Ravia G. Mukhina1
1M.N. Sadykov Municipal Clinical Hospital No. 7, 54 Marshal Chuikov str., 420103 Kazan, Russia
2Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
Abstract. Introduction. Hairy-cell leukemia is a rare chronic B-cell lymphoproliferative disorder that most often affects the bone marrow and spleen. Hairy-cell leukemia is characterized by leukopenia with neutropenia and monocytopenia, as well as by anemia and thrombocytopenia. Clinical symptoms of (one-, two-, or three-lineage) cytopenia depend on its severity; in general, anemia remains compensated for a long time, while thrombocytopenia is often asymptomatic or shows a mild hemorrhagic syndrome. Diff erential diagnosis of hairy-cell leukemia should include all conditions associated with cytopenia, lymphocytosis, and splenomegaly. Aim. To present a clinical case of hairy-cell leukemia complicated by thrombosis of the left common iliac vein and inferior vena cava, and to demonstrate its diff erential diagnosis from systemic lupus erythematosus. Materials and Methods. A clinical case of hairy-cell leukemia is described. A 54-year-old female patient consulted infectious disease specialists, rheumatologists, hematologists, and oncologists due to rash, fever, and bicytopenia. Thrombosis was diagnosed in her left common iliac vein and inferior vena cava. Bone marrow trephine biopsy and immunophenotyping were performed, revealing hairy cells and B-lymphocytes expressing CD19, CD20, CD22, CD11c, and CD103 markers. Results and Discussion. The patient was admitted with complaints of general weakness, fever up to 38.5°С, and widespread skin rash. Examination revealed leukopenia (1.5×109/L), anemia (80 g/L), the presence of IgG antibodies to ribosomal protein P, splenomegaly, and thrombosis of the left common iliac vein and inferior vena cava, as confi rmed by abdominal computed tomography. Thrombectomy of the inferior vena cava and the lymph node biopsy were performed. Based on negative immunological tests (ANA, anti-dsDNA antibodies), rheumatologists excluded the presence of an autoimmune disease. Following immunohistochemical analysis of the lymph node biopsy, oncologists ruled out the PEComa. The fi ndings from the trephine biopsy and immunophenotyping were consistent with bone marrow involvement typical of hairy-cell leukemia. Conclusions. An extensive diagnostic workup involving the multidisciplinary approach was conducted to confi rm the diagnosis of hairy-cell leukemia.
Keywords: hairy-cell leukemia, thrombosis, cytopenia, systemic lupus erythematosus
For citation: Gainullina G.R., Gubaidullina Z.R., Zagidullina G.I., et al. Hairy-cell leukemia complicated by thrombosis of the left common iliac vein and inferior vena cava. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (su ppl.1):, 122-126. DOI: 10.20969/VSKM.2025.18(su ppl.1).122-126.
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УДК: 616-007-053.1 DOI: 10.20969/VSKM.2025.18(suppl.1).127-131
Congenital abnormal divergence of the right coronary artery from the ascending aorta (a clinical case)
Leysan I. Gaynutdinova1, Elvira B. Zakirova1, Sergey V. Kurochkin1, Elena V. Generalova2,3
1City Clinical Hospital No. 7, 54 Marshal Chuikov str., 420103 Kazan, Russia
2Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
3St Joseph University in Tanzania, School of Medicine, Dar es Salaam P.O. Box 11007, United Republic of Tanzania
Abstract. Introduction. Congenital anomalies of a coronary artery are relatively rare, but at the same time signifi cant pathology. The frequency of occurrence in the adult population is estimated to be 0.1–3%. In vivo diagnosis of anomalies in the coronary bed development does not exceed 20% of cases. In the clinical guidelines “Coronary vascular malformation,” CT coronary angiography is recommended to clarify the anatomy of the coronary vessels. Aim. To present own clinical observation of methods choice for diagnostics of congenital anomaly of the right coronary artery. Materials and Methods. This article describes a clinical case of a 72-year-old patient with a congenital abnormal divergence of the right coronary artery from the ascending aorta, diagnosed using multispiral computed tomography. Results and Discussion. Patient R., 72 years old, was hospitalized in the cardiology department of the State Autonomous Healthcare Institution “City Clinical Hospital No. 7 named after M.N. Sadykov” with complaints of pressing dull chest pains radiating to the left arm, which occurred on background of physical exertion and atrial fi brillation paroxysm. The medical history data were analyzed, instrumental diagnostic studies were performed. A number of methods are used to diagnose abnormal coronary artery divergence, but unfortunately none of them guarantees 100% reliability. In this clinical case, the results of both ECG and echocardiography proved to be uninformative in terms of detecting anomalies in the discharge of coronary vessels. Multispiral computed tomography angiography was performed to make the diagnosis. This method allowed us to make the diagnosis: Congenital abnormal divergence of the right coronary artery from the ascending aorta. Conclusion. This clinical case demonstrates that multispiral computed tomography of the coronary arteries is the preferred technique for detecting anomalies of coronary arteries.
Keywords: abnormal divergence of the coronary artery, multispiral computed tomography angiography, ascending aorta, congenital anomaly.
For citation: Gaynutdinova, L.I.; Zakirova, E.B.; Kurochkin, S.V.; Generalova, E.V. Congenital abnormal divergence of the right coronary artery from the ascending aorta (clinical case). The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 127-131. DOI: 10.20969/VSKM.2025.18(suppl.1).127-131.
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УДК 331.45:616.98:578.828.6+616.995.132 DOI: 10.20969/VSKM.2025.18(suppl.1).132-139
Regulatory aspects of оccupational suitability assessment: A clinical case of multiple echinococcosis in an HIV-positive female patient
Fayruza S. Gilmullina1,2, Farida M. Yakupova1,3, Ildar G. Idrisov4, Ayrat T. Beshimov4, Alina M. Nasyrtdinova3, Railya V. Garipova 1,3, Svetlana N. Miftakhova5 , Artur M. Delyan5, Ilgiz M. Galiullin5
1Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
2Republican Clinical Infectious Diseases Hospital named after Prof. A.F. Agafonov, 83 Pobedy Ave., 420140 Kazan, Russia
3Institute of Biology and Fundamental Medicine, Kazan Federal University, 74 Karl Marx str., 420012 Kazan, Russia
4Republican Center for Prevention and Control of AIDS and Infectious Diseases, 65 Nikolai Ershov str., 420061 Kazan, Russia
5City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Chuikov str., 420103 Kazan, Russiа
Abstract. Introduction. Echinococcosis is a serious zoonotic infection caused by larvae of the genus Echinococcus. In echinococcosis-endemic regions with a high prevalence of HIV infection, a signifi cant proportion of individuals may present with combined infectious and parasitic conditions, which should be considered during occupational fi tness examinations conducted as part of pre-employment and periodic medical check-ups. Aim. To present a clinical case of multiple echinococcosis diagnosed in an HIV-positive patient during a routine occupational health examination, followed by an occupational fi tness evaluation at the City Center for Occupational Pathology. Materials and Methods. Medical records of patient N. were analyzed, a 45-year-old woman with a verifi ed diagnosis of HIV infection (stage 4B) and multiple echinococcosis aff ecting the liver, spleen, and lungs. Results and Discussion. Fluorographic examination revealed lesions in the left lung; subsequent ultrasound examination identifi ed multicystic lesions in the liver and spleen. During the periodic medical check-ups, the patient reported productive cough, chest pain, and weight loss. She was referred for further evaluation by an oncologist and an infectious disease expert. The patient refused radical surgical treatment for hepatic and splenic echinococcosis; surgical intervention for pulmonary cysts was deemed inappropriate due to their localizations. Based on the occupational fi tness examination conducted at the City Center for Occupational Pathology, a medical opinion was issued identifying contraindications for working in food industry, catering and trade, water supply facilities, healthcare institutions, childcare facilities, and companies involved in public utilities and household services. Conclusions. This clinical case illustrates the diagnostic and therapeutic challenges associated with the progression of helminthic disease in the context of HIV infection and highlights the legal grounds for issuing a medical opinion of occupational unfi tness for certain types of working activities.
Keywords: periodic medical examinations; occupational fi tness examination; legal regulation; HIV infection; multiple echinococcosis.
For citation: Gilmullina, F.S.; Yakupova, F.M.; Idrisov, I.G.; et al. Regulatory aspects of оccupational suitability assessment: A clinical case of multiple echinococcosis in an HIV-positive female patient. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 132-139. DOI: 10.20969/VSKM.2025.18(suppl.1).132-139.
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22. Приказ Минздрава России от 05.05.2016 № 282н «Об утверждении порядка проведения экспертизы профессиональной пригодности и формы медицинского заключения о пригодности или непригодности к выполнению отдельных видов работ». Prikaz Minzdrava Rossii ot 05.05.2016 № 282n «Ob utverzhdenii poryadka provedeniya ekspertizy professional’noj prigodnosti i formy medicinskogo zaklyucheniya o prigodnosti ili neprigodnosti k vypolneniyu otdel’nyh vidov rabot» [Order of the Ministry of Health of the Russian Federation dated 05.05.2016 №. 282n «On approval of the procedure for conducting an examination of professional suitability and the form of a medical report on suitability or unsuitability for performing certain types of work»]. (In Russ.).
23. Приказ Минздрава России от 25.03.2025 № 147н «Об утверждении Порядка проведения экспертизы профессиональной пригодности и формы медицинского заключения о пригодности или непригодности к выполнению отдельных видов работ». Prikaz Minzdrava Rossii ot 25.03.2025 № 147n «Ob utverzhdenii Poryadka provedeniya ekspertizy professional’noy prigodnosti i formy medicinskogo zaklyucheniya o prigodnosti ili neprigodnosti k vypolneniyu otdel’nyh vidov rabot» [Order of the Ministry of Health of Russia dated March 25, 2025 № 147n « On approval of the procedure for conducting an examination of professional suitability and the form of a medical report on suitability or unsuitability for performing certain types of work»]. (In Russ.).
УДК 616.831-002-07:614:616-083 DOI: 10.20969/VSKM.2025.18(suppl.1).140-144
A sporadic case of motor neuron disease: From periodic medical check-ups to diagnosis
Artur M. Delyan1, Ilgiz M. Galiullin1, Gulnara Kh. Garipova1, Leysan I. Gaynutdinova1, Railya V. Garipova,2,3, Svetlana N. Miftakhova1, E.V. Arkhipov1,2
1City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Chuykov str., 420103 Kazan, Russiа
2Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
3Institute of Biology and Fundamental Medicine, Kazan Federal University, 74 Karl Marx str., 420012 Kazan, Russia
Abstract. Introduction. Periodic medical check-ups conducted regularly for those engaged in working in harmful and/or hazardous conditions, help diagnose diseases at an early stage, start timely treatment, and determine whether their health status is appropriate for performing certain types of working activities. Aim. To analyze the clinical observation of a patient with motor neuron disease identifi ed based on the fi ndings of a periodic medical check-up and sent to the city center for examining for occupational pathology to clarify the diagnosis and assess his occupational suitability. Materials and Methods. The following was performed: Clinical examination of patient O. (male, 59 years) and analysis of his medical documents, findings of his medical check-ups, sanitary-hygienic information on his labor conditions, and data on his working activities. Results and Discussion. City Center of Occupational Pathology Examination diagnosed ICD-10 G12.2 Motor neuron disease. Conclusions. A high-quality periodic medical check-up made it possible to promptly suspect and send the patient with a neurodegenerative disease to the occupational pathology center, recommend the necessary treatment and medical rehabilitation, and exclude any contacts with harmful/hazardous occupational factors.
Keywords: periodic medical check-ups, occupational suitability assessment, motor neuron disease.
For citation: Delyan, A.M.; Galiullin, I.M.; Garipova, G.Kh.; et al. A sporadic case of motor neuron disease: From periodic medical check-ups to diagnosis. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 140-144. DOI: 10.20969/VSKM.2025.18(suppl.1).140-144.
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6. Приказ Минздрава России от 28.01.2021 № 29н «Об утверждении Порядка проведения обязательных предварительных осмотров работников, предусмотренных частью четвертой статьи 213 Трудового кодекса Российской Федерации, перечня медицинских противопоказаний к осуществлению работ с вредными и (или) опасными производственными факторами, а также работам, при выполнении которых проводятся обязательные предварительные и периодические медицинские осмотры». Prikaz Minzdrava Rossii ot 28.01.2021 №29n «Ob utverzhdenii Poryadka provedeniya obyazatel`ny`kh predvaritel`ny`kh osmotrov rabotnikov, predusmotrenny`kh chast`yu chetvertoj stat`i 213 Trudovogo kodeksa Rossijskoj Federaczii, perechnya mediczinskikh protivopokazanij k osushhestvleniyu rabot s vredny`mi i (ili) opasny`mi proizvodstvenny`mi faktorami, a takzhe rabotam, pri vy`polnenii kotory`kh provodyatsya obyazatel`ny`e predvaritel`ny`e i periodicheskie mediczinskie osmotry». [Order of the Ministry of Health of Russia dated January 28, 2021 № 29n «On approval of the Procedure for conducting mandatory preliminary examinations of workers provided for in part four of Article 213 of the Labor Code of the Russian Federation, a list of medical contraindications for carrying out work with harmful and (or) hazardous production factors, as well as work, during which mandatory preliminary and periodic medical examinations are carried out»]. (In Russ.).
7. Приказ Минздрава России от 05.05.2016 № 282н «Об утверждении порядка проведения экспертизы профессиональной пригодности и формы медицинского заключения о пригодности или непригодности к выполнению отдельных видов работ». Prikaz Minzdrava Rossii ot 05.05.2016 № 282n «Ob utverzhdenii poryadka provedeniya ekspertizy professional’noj prigodnosti i formy medicinskogo zaklyucheniya o prigodnosti ili neprigodnosti k vypolneniyu otdel’nyh vidov rabot». [Order of the Ministry of Health of the Russian Federation dated 05.05.2016 №. 282n «On approval of the procedure for conducting an examination of professional suitability and the form of a medical report on suitability or unsuitability for performing certain types of work»]. (In Russ.).
8. Приказ Минздрава России от 25.03.2025 № 147н «Об утверждении Порядка проведения экспертизы профессиональной пригодности и формы медицинского заключения о пригодности или непригодности к выполнению отдельных видов работ». Prikaz Minzdrava Rossii ot 25.03.2025 № 147n «Ob utverzhdenii Poryadka provedeniya ekspertizy professional’noy prigodnosti i formy medicinskogo zaklyucheniya o prigodnosti ili neprigodnosti k vypolneniyu otdel’nyh vidov rabot» [Order of the Ministry of Health of Russia dated March 25, 2025 № 147n « On approval of the procedure for conducting an examination of professional suitability and the form of a medical report on suitability or unsuitability for performing certain types of work»]. (In Russ.).
9. NICE guideline: motor neuron disease assessment and management. Feb 2016. Available from: https://www.nice.org.uk/guidance/ng42
10. Приказ Минтруда России от 26.07.2024 № 374н «Об утверждении классификаций и критериев, используемых при осуществлении медико-социальной экспертизы граждан федеральными учреждениями медико-социальной экспертизы». Prikaz Mintruda Rossii ot 26.07.2024 № 374n «Ob utverzhdenii klassifi kaciy i kriteriev, ispol’zuemykh pri osushchestvlenii mediko-sotsial’noy ekspertizy grazhdan federal’nymi uchrezhdeniyami mediko-social’noj ekspertizy» [Order of the Ministry of Labor of Russia dated July 26, 2024 № 374n «On approval of classifi cations and criteria used in the medical and social expertise of citizens by federal institutions of medical and social expertise»]. (In Russ.). 11. Приказ Минздрава России от 31.07.2020 № 788н «Об утверждении Порядка организации медицинской реабилитации взрослых». Prikaz Minzdrava Rossii ot 31.07.2020 № 788n «Ob utverzhdenii Poryadka organizacii medicinskoy reabilitatsii vzroslykh» [Order of the Ministry of Health of Russia dated July 31, 2020 № 788n «On approval of the Procedure for organizing medical rehabilitation of adults»]. (In Russ.).
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УДК: 616.831.2:615.82 DOI: 10.20969/VSKM.2025.18(suppl.1).145-150
Headache associated with cerebrospinal fluid hypotension. Secondary headache with dura mater osteophyte perforation at the Th6-Th7 level: A case report
Karina R. Zabirova1, 3, Natalya A. Popova1, 3, Albina R. Hakimova1, 3, Nail T. Khairullin2, 3, Elza F. Fatyhova2, 4
1Institute of Biology and Fundamental Medicine, Kazan Federal University, 74 Karl Marx str., 420012 Kazan, Russia
2Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
3City Clinical Hospital No. 7, 54 Chuykov str., 420103 Kazan, Russia
4Children’s Republican Clinical Hospital, 140 Orenburgsky Trakt str., 420138 Kazan, Russia
Abstract. Introduction. Currently, it is believed that most cases of spontaneous intracranial hypotension result from a spontaneous leakage of cerebrospinal fl uid. The estimated prevalence among the population ranges from 1 in 50,000 to 1 in 20,000 cases of spontaneous cerebrospinal fl uid leakage occurring in emergency departments. A typical patient is usually middle-aged with complaints of orthostatic headaches associated with low cerebrospinal fl uid volume and pressure with no history of any interventions or injuries. Aim. To describe the diagnostic search for possible causes of the patient’s orthostatic headache. Materials and Methods. A clinical case is described of a patient with secondary headache associated with dura mater osteophyte perforation at the Th6-Th7 level. Results and Discussion. Female patient S., 38 years old, complaining of a bilateral persistent headache accompanied by tinnitus and back pain, appeared in the admission department of City Clinical Hospital No. 7 named after M. N. Sadykov. It is known from the medical history that upon lifting a weight, the patient developed back pain, and later had a headache. Conservative NSAID therapy at the outpatient stage proved ineffective. During her hospitalization in the neurological department, the patient underwent some diagnostic tests, including CT scanning her thoracic spine, ultrasound of the paravertebral muscles, MRI of the cervical and thoracic spine with contrast enhancement, and a consultation with physicians, as a result of which thhe fi nal diagnosis was made. Conclusion. The clinical case above demonstrates the need for a full-fl edged collection of complaints and medical history, as well as a complete neurological examination.
Keywords: orthostatic headache, spontaneous intracranial hypotension, secondary headache.
For citation: Zabirova, K.R.; Popova, N.A.; Hakimova, A.R. Headache associated with cerebrospinal fl uid hypotension. Secondary headache with dura mater osteophyte perforation at the Th6-Th7 level: A case report. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 145-150. DOI: 10.20969/VSKM.2025.18(suppl.1).145-150.
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4. Dash D, Jalali A, Harsh V, Omeis I. Transpedicular surgical approach for the management of thoracic osteophyte-induced intracranial hypotension refractory to non-operative modalities: case report and review of literature. Eur Spine J. 2016 May;25 Suppl 1:209-15. DOI: 10.1007/s00586-016-4408-5
5. Vishteh AG, Schievink WI, Baskin JJ, Sonntag VK. Cervical bone spur presenting with spontaneous intracranial hypotension. Case report. J Neurosurg. 1998 Sep;89(3):483-4. DOI: 10.3171/jns.1998.89.3.0483
6. Winter SC, Maartens NF, Anslow P, Teddy PJ. Spontaneous intracranial hypotension due to thoracic disc herniation. Case report. J Neurosurg. 2002 Apr;96(3 Suppl):343-5. DOI: 10.3171/spi.2002.96.3.0343
7. Yokota H, Yokoyama K, Noguchi H, Uchiyama Y, Iwasaki S, Sakaki T. Thoracic osteophyte causing spontaneous intracranial hypotension. Cephalalgia. 2008 Apr;28(4):396-8. DOI: 10.1111/j.1468-2982.2008.01536.x
8. Kewlani B, Garton ALA, Hussain I, Chazen JL, Robbins MS, Baaj AA, Greenfi eld JP. Intracranial hypotension due to ventral thoracic dural tear secondary to osteophyte complex: resolution after transdural thoracic microdiscectomy with dural repair. Illustrative case. J Neurosurg Case Lessons. 2022 Mar 28;3(13):CASE21615. DOI: 10.3171/CASE21615
9. Reina MA, Alvarez-Linera J, López A, Benito-León J, De Andrés JA, Sola RG. Aportaciones de la resonancia magnética en la cefalea pospunción dural y en pacientes que cursan con hipotensión de líquido cefalorraquídeo [Magnetic resonance in dural post-puncture headache in patient with cerebrospinal fl uid hypotension]. Rev Esp Anestesiol Reanim. 2002 Feb;49(2):89-100. Spanish.
10. Hasiloglu ZI, Abuzayed B, Imal AE, Cagil E, Albayram S. Spontaneous intracranial hypotension due to intradural thoracic osteophyte with superimposed disc herniation: report of two cases. Eur Spine J. 2012 Jun;21 Suppl 4(Suppl 4):S383-6. DOI: 10.1007/s00586-011-1828-0
УДК: 616.12-007.2-073.756.8 DOI:10.20969/VSKM.2025.18(suppl.1).151-154
A clinical case of managing a patient with partial anomalous pulmonary venous drainage
Elvira B. Zakirova1, Sergey V. Kurochkin1, Denis V. Shames1, Artemiy S. Baranov1,2, Elena S. Sorokina1, Leysan I. Gainutdinova1
1City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshal Chuykov str., 420103 Kazan, Russia
2Institute of Biology and Fundamental Medicine, Kazan Federal University, 74 Karl Marx str., 420012 Kazan, Russia
Abstract. Introduction. Partial anomalous pulmonary venous drainage is a rare (the prevalence of this anomaly is 0.4–0.7% in the general population) congenital heart defect, in which one or more pulmonary veins fail to connect to the left atrium and instead drain into the right atrium, coronary sinus, or the superior or inferior vena cava systems. Like many other congenital heart defects, this anomaly is often diagnosed and manifests in early childhood. However, some patients with an asymptomatic course remain undiagnosed, which can later lead to life-threatening supraventricular arrhythmias. Insuffi cient awareness of physicians about this rare pathology creates prerequisites for the description of clinical observations Aim. To present a clinical case of the diagnosis and treatment of an adult patient with a rare congenital heart defect – partial anomalous pulmonary venous drainage associated with a sinus venosus atrial septal defect. Materials and Methods. A clinical case of partial anomalous pulmonary venous drainage was analyzed in patient Ch. (female, 56 years) who voluntarily had signed the informed consent for examination and permission to anonymously publish personal medical information. The authors used primary medical records (patient history) for this paper. It presents the details of medical history, clinical manifestations, and examination fi ndings. Results and Discussion. Instrumental diagnostic tests were performed on the patient. Previous electrocardiograms and Holter monitoring revealed paroxysms of atrial fi brillation with episodes of aberrant ventricular conduction at a heart rate exceeding 150 bpm. Multispiral computed tomography (MSCT) synchronized with ECG was performed to map the pulmonary veins, revealing that the right superior pulmonary vein drained into the superior vena cava and, additionally, a fl ow acceleration was detected in the middle third of the interatrial septum. For further diagnostic confi rmation, echocardiography was performed, showing normal heart chambers, satisfactory ventricular contractility, coronary sinus dilation, and moderate pulmonary hypertension. The patient underwent cryoablation of the pulmonary vein ostia. Postoperative ECG showed sinus rhythm, and the patient was discharged in a satisfactory condition. Conclusions. Partial anomalous pulmonary venous drainage is a rare condition in clinical practice. In this case, the diagnosis was confi rmed based on medical history, clinical presentation, and laboratory-instrumental findings. A signifi cant risk factor in our patient was her familial predisposition.
Keywords: partial anomalous pulmonary venous drainage, atrial fibrillation, multispiral computed tomography, echocardiography
For citation: Zakirova, E.B.; Kurochkin, S.V.; Shames, D.V.; et al. A clinical case of managing a patient with partial anomalous pulmonary venous drainage. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 151-154. DOI: 10.20969/VSKM.2025.18(suppl.1).151-154.
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5. Rizzi S, Ströker E, El Housari M, et al. Cryoballoon ablation of atrial fibrillation in a patient with partial anomalous pulmonary vein drainage in the superior vena cava. HeartRhythm Case Rep. 2021; 8(2): 119-121. DOI: 10.1016/j.hrcr.2021.11.009
6. Douglas YL, Jongbloed MRM, den Hartog WCE, et al. Pulmonary vein and atrial wall pathology in human total anomalous pulmonary venous connection. Int J Cardiol. 2009; 134: 302–312. DOI: 10.1016/j.ijcard.2008.11.098
7. Ленский А. Г. Опыт коррекции аномального впадения правых легочных вен в верхнюю полую вену // Патология кровообращения и кардиохирургия. – 1997. – № 1. – С. 81-83. Lenskij AG. Experience in correcting anomalous entry of the right pulmonary veins into the superior vena cava [Experience in correcting anomalous entry of the right pulmonary veins into the superior vena cava]. Circulatory pathology and cardiac surgery [Circulatory pathology and cardiac surgery]. 1997; 1: 81-83. (In Russ.).
8. Подзолков В.П. Реабилитация больных после хирургического лечения врожденных пороков сердца // Москва: НМИЦ ССХ им. А.Н. Бакулева. – 2015. Podzolkov VP. Rehabilitation of patients after surgical treatment of congenital heart defects [Rehabilitation of patients after surgical treatment of congenital heart defects]. Moscow: NMITs SSH im. A.N. Bakuleva [Moscow: NMITs SSH im. AN Bakuleva]. 2015. (In Russ.).
9. Kim C, Cho YH, Lee M, et al. Surgery for partial anomalous pulmonary venous connections: modifi cation of the warden procedure with a right atrial appendage fl ap. Korean J Thorac Cardiovasc Surg. 2014; 47(2): 94-9. DOI: 10.5090/kjtcs.2014.47.2.94
10. Overeinder I, GuimarãesOsório T, Călburean PA, et al. Comparison between superior vena cava ablation in addition to pulmonary vein isolation and standard pulmonary vein isolation in patients with paroxysmal atrial fi brillation with the cryoballoon technique. J Interv Card Electrophysiol. 2021; 62(3): 579-586. DOI: 10.1007/s10840-020-00932-6
УДК 616.348-002-07 DOI: 10.20969/VSKM.2025.18(suppl.1).155-159
Clinical case of collagenous microscopic colitis
Dilyara G. Iskhakova1, Elena V. Khazova2, Renata R. Savzikhanova2, Yulduz A. Kazykhanova1, Roman N. Kulagin1, Gulnara R. Gayazova1, Natalia O. Khaertdinova1
1City Clinical Hospital No. 7 named M.N. Sadykov, 54 M. Chuykov str., 420103 Kazan, Russia
2Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
Abstract. Introduction. Microscopic colitis is a common cause of watery diarrhea. The diffi culties in diagnosing microscopic colitis are due to both the absence of macroscopic changes in the intestine and the overlap of the symptom of non-bloody diarrhea with some other diseases. The decisive stage of diff erential diagnosis and determination of the microscopic colitis subtype is its histological examination and correct interpretation. Aim. To present data on the clinical manifestations of collagenous microscopic colitis in combination with celiac disease using a clinical example of a 45-year-old female patient. Material and Methods. This article describes a clinical case demonstrating possible triggers for the manifestation of collagenous microscopic colitis in a patient with celiac disease, as well as the stages of diagnosis verifi cation, in comparison with literary data. Results and discussion. Microscopic colitis and celiac disease were diagnosed during a planned hospitalization of a 45-year-old patient. Disease activity was evidenced by the patient’s complaints of unformed, sometimes watery, three-times-a-day stool. Among the probable triggers identifi ed in the patient, there was a previous acute intestinal infection, intestinal dysbacteriosis associated with Enterobacter kobei. Conclusions. The case presented demonstrates difficulties in diagnosing microscopic colitis. Combination of microscopic colitis and celiac disease described in this study further complicates the differential diagnostic search, but at the same time, does not exclude the possible commonality of the pathogenesis of various autoimmune diseases in this group of patients.
Keywords: microscopic colitis, collagenous colitis, celiac disease.
For citation: Iskhakova, D.G.; Khazova, E.V.; Savzikhanova, R.R; et al. Clinical case of collagenous microscopic colitis. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1):155-159. DOI: 10.20969/VSKM.2025.18(suppl.1).155-159.
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2. Freeman HJ. Collagenous colitis associated with novel sprue-like intestinal diseases. Gastroenterol Hepatol Bed Bench. 2023; 16(2): 145-150. DOI: 10.22037/ghfbb.v16i2.2698
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5. El-Matary W, Girgis S, Huynh H, Turner J, Diederichs B. Microscopic colitis in children. Dig Dis Sci. 2010; 55 (7): 1996- 2001. DOI:10.1007/s10620-009-0964-4
6. Волчкова Е.А., Легкова К.С., Ардатская М.Д. Микроскопический колит неполного коллагенового типа в сочетании с лактазной недостаточностью. Медицинский совет. – 2023. – Т. 17, №18. – С. 142–150. Volchkova EA, Legkova KS, Ardatskaya MD. Mikroskopicheskij kolit nepolnogo kollagenovogo tipa v sochetanii s laktaznoj nedostatochnost’yu [Microscopic colitis of incomplete collagen type in combination with lactase defi ciency]. Medicinskij sovet [Medical advice]. 2023;17(18):142–150. (In Russ.). DOI: 10.21518/мс2023-387
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8. Nimri FM, Muhanna A, Almomani Z, Khazaaleh S, Alomari M, et al. The association between microscopic colitis and celiac disease; a systematic review and meta-analysis. Ann Gastroenterol. 2022; 35: 281–289. DOI: 10.20524/aog.2022.0714
9. Roth B, Ohlsson B. Microscopic colitis found together with celiac disease in a female population is associated with one episode of lymphocytic colitis. BMC Gastroenterol. 2024; 24 (1): 70. DOI: 10.1186/s12876-024-03158-2
10. Marlicz W, Skonieczna-Żydecka K, Yung DE, Loniewski I, Koulaouzidis A. Endoscopic fi ndings and colonic perforation in microscopic colitis: A systematic review. Digestive and Liver Disease. 2004; 49: 1073–1085. DOI: 10.1016/j.dld.2017.07.015
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13. Bergman D, Khalili H, Lebwohl B, Roelstraete B, Green PHR, et al. Celiac disease and risk of microscopic colitis: A nationwide population-based matched cohort study. United European Gastroenterol J. 2023; 11(2): 189-201. DOI: 10.1002/ueg2.12374
14. Ström A, Stenlund H, Ohlsson B. The Metabolomic Profile of Microscopic Colitis Is Aff ected by Smoking but Not Histopathological Diagnosis, Clinical Course, Symptoms, or Treatment. Metabolites. 2024; 14(6): 303. DOI: 10.3390/metabo14060303
15. Mihaly E, Patai Á, Tulassay Z. Controversials of Microscopic Colitis. Front Med (Lausanne). 2021; 8:717438. DOI: 10.3389/fmed.2021.717438
УДК: 616.343-007.24 DOI: 10.20969/VSKM.2025.18(suppl.1).160-165
Common carotid artery dissection complicated by acute ischemic stroke in a young patient
Sergey V. Kurochkin2, Liliya M. Makhmutova1, Nail R. Zakirzhanov2, Elmira R. Khusainova2, Elvira B. Zakirova2, Ildar G. Khalilov2
1Institute of Biology and Fundamental Medicine, Kazan Federal University, 74 Karl Marx str., 420012 Kazan, Russia
2City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshal Chuykov str., 420103 Kazan, Russia
Abstract. Introduction. Common carotid artery dissection (CCAD) is a rare (2–3 cases per 100,000 population per year) but clinically signifi cant vascular pathology that often leads to ischemic stroke, particularly in young and middle-aged individuals. Diagnosis of CCAD presents certain challenges, especially in the presence of underlying atherosclerosis or traumatic injury, which may mask the vascular lesion. Computed tomography angiography (CTA) is currently the most informative method for detecting dissections. Aim. To present a clinical case of CCA dissection diagnosed at a late stage in the management of a patient with ischemic stroke. Materials and Methods. A case is described of a spontaneous dissection in a 43-year-old male patient who was admitted to a medical rehabilitation unit following an ischemic stroke. Clinical data and fi ndings obtained by instrumental investigation methods are presented. Results and Discussion. During the diagnostic process, including examinations performed during the rehabilitation phase, signs of dissection in the distal segment of the right CCA were revealed, with intimal fl ap formation and more than 70% luminal stenosis. As a result, surgery was planned and performed, i.e., prosthetic ССА. Based on the data from his initial hospitalization, including clinical history and instrumental diagnostics, a spontaneous dissection of the distal CCA was assumed, likely with a traumatic component, leading to the development of an ischemic stroke. Conclusions. This clinical case emphasizes the importance of sequential vascular imaging in ischemic strokes of unclear etiology. This case highlights the importance of staged vascular imaging in ischemic strokes of unclear etiology. CTA and ultrasound of the neck vessels allowed to verify the dissection of the common carotid artery and to adjust the treatment tactics. The results obtained confi rm the CTA signifi cance in the examination of patients with stroke of unclear etiology for timely diagnosis of rare but clinically signifi cant vascular lesions.
Keywords: common carotid artery dissection, ischemic stroke, CTA, vascular surgery, neck trauma, prosthetics.
For citation. Kurochkin, S.V.; Makhmutova, L.M.; Zakirzhanov, N.R. et al. Common carotid artery dissection complicated by acute ischemic stroke in a young patient. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 160-165. DOI: 10.20969/VSKM.2025.18(suppl.1).160-165.
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2. Schievink WI. Spontaneous dissection of the carotid and vertebral arteries. New England Journal of Medicine. 2001; 344(12): 898-906. DOI: 10.1056/NEJM200103223441206
3. Мамонов Н.А., Петров А.Е., Горощенко С.А., [и др.]. Внутрисосудистое лечение экстракраниальных диссекционных аневризм брахиоцефальных артерий //Журнал «Вопросы нейрохирургии» им. НН Бурденко. – 2021. – Т. 85. – №. 6. – С. 16-24. Mamonov NA, Petrov AE, Goroshchenko SA, et al. Vnutrisosudistoye lecheniye extracranial’nykh disseccionnykh anevrizm brachiocephal’nukh arteriy [Intravascular treatment of extracranial dissection aneurysms of the brachiocephalic arteries]. Zhurnal “Voprosy neirokhirurgii” im.NN Burdenko [Burdenko’s Journal of Neurosurgery]. 2021;85(6):16-24. (In Russ.).
4. Евдокимов А. Г., Шмырев В. И., Баскова Т. Г. [и др.]. Лечение диссекции внутренней сонной артерии – профилактика ишемического инсульта // Кремлевская медицина. Клинический вестник. – 2012. – №3. – С. 61-62. Evdokimov AG, Shmyrev VI, Baskova TG, et al. Lecheniye disseccii vnutrenney sonnoy arterii-profilactika ishemicheskogo insul’ta [Treatment of internal carotid artery dissection – prevention of ischemic stroke]. Kremlevskaya medicina.Klinicheskiy vestnik [Kremlin Medicine. Clinical Bulletin]. 2012; 3: 61-62. (In Russ.).
5. Zach V, Zhovtis S, Kirchoff -Torres KF, Weinberger JM. Common carotid artery dissection: a case report and review of the literature. Journal of Stroke and Cerebrovascular Diseases. 2012; 21(1): 52-60. DOI: 10.1016/j.jstrokecerebrovasdis.2010.05. 001
6. Toelen C, Goverde P, Van Hee R. Dissection of the common carotid artery: a case report. Acta Chirurgica Belgica. 2009; 109(2):224-227. DOI: 10.1080/00015458.2009.11680409
7. Blum CA, Yaghi S. Cervical artery dissection: a review of the epidemiology, pathophysiology, treatment, and outcome. Archives of neuroscience. 2015; 2(4): e26670. DOI: 10.5812/archneurosci.26670
8. Яриков А. В., Логутов А.О., Муравина Е.А. [и др.]. Диссекция брахиоцефальных и интракраниальных артерий: этиология, клиника, диагностика и лечение // Бюллетень науки и практики. – 2023. – Т. 9. – №. 5. – С. 235-256. Yarikov AV, Logutov AO, Muravina EA, et al. Dissektsiya brachiotsefal’nykh i intrakranial’nykh areriy: etiologiya, klinilka, diagnostika i lecheniye [Dissection of Brachiocephalic and Intracranial Arteries: Etiology, Clinic, Diagnosis and Treatment]. Byulleten’ nauki I praktiki [Bulletin of Science and Practice]. 2023; 9(5): 235-256. (In Russ.)]. DOI:10.33619/2414-2948/90/32
9. Древаль М. В., Калашникова Л.А., Кротенкова М.В. [и др.]. Двусторонняя травматическая диссекция внутренних сонных артерий – трудности диагностики //Лучевая диагностика и терапия. – 2013. – №. 1. – С. 78-84. Dreval’ MV, Kalashnikova LA, Krotenkova MV, et al. Dvustoronnyaya travmaticheskaya dissektsiya vnutrennikh sonnykh arteriy-trudnosti diagnostiki [Bilateral traumatic internal carotid arteries dissection – difficulties of diagnostic]. Luchevaya diagnostika i terapiya [Diagnostic radiology and radiotherapy]. 2013; 1:78-84. (In Russ.).
10. Лесных Т. А., Древаль М.В., Данилова М.С. [и др.]. Магнитно-резонансная томография в диагностике последствий перенесенной диссекции брахиоцефальных артерий //Лучевая диагностика и терапия. – 2021. – Т. 12. – №. 2. – С. 92-97. Lesnykh TA, Dreval’ MV, Danilova MS, et al. Magnitno-rezonansnaya tomografiya v diagnostike posledstviy perenesennoy dissektsii brachiotsefal’nykh arteriy [Magnetic resonance imaging in diagnostics of consequences of transferred dissection of brachiocephalic arteries]. Luchevaya diagnostika i terapiya [Diagnostic radiology and radiotherapy]. 2021; 12(2):92-97. (In Russ.).
УДК: 616.343-007.24 DOI: 10.20969/VSKM.2025.18(suppl.1).166-169
A clinical case of diagnosing small intestinal diverticulosis in the elderly
Liliya M. Makhmutova1, Sergey V. Kurochkin2, Elvira B. Zakirova2, Alfar Z. Lotfullin2
1Institute of Biology and Fundamental Medicine, Kazan Federal University, 74 Karl Marx str., 420012 Kazan, Russia
2City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshal Chuykov str., 420103 Kazan, Russia
Abstract. Introduction. Small intestinal diverticulosis is a rare condition (the prevalence of the disease in the population is estimated at 0.5–2.3 %) characterized by forming sac-like protrusions in the intestinal wall. Clinical presentation of the disease is nonspecifi c, which makes timely diagnosis challenging. This case demonstrates that the widespread adoption of small bowel computed tomography (CT enterography) in clinical practice can signifi cantly improve the diagnosis of rare small intestinal diseases. Aim. To present our clinical case of diagnosing a rare pathology: Small intestinal diverticulosis. Materials and Methods. A 77-year-old patient appeared with complaints of gastrointestinal bleeding. The article presents the patient’s medical history, clinical manifestations, and diagnostic fi ndings, which formed the basis for the management strategy. Results and Discussion. Initial diagnostic methods failed to identify the source of bleeding. CT enterography revealed multiple diverticula in both the small and large intestines, along with thickening of the ileal wall. This imaging modality was critical in establishing the diagnosis. Conclusions. CT enterography is the method of choice for diagnosing small intestinal diverticulosis. It provides precise visualization, facilitates the identifi cation of complications, and helps guide treatment planning.
Keywords: CT enterography, small intestinal diverticulosis, gastrointestinal bleeding
For citation. Makhmutova, L.M.; Kurochkin, S.V.; Zakirova, E.B.; Lotfullin, A.Z. A clinical case of diagnosing small intestinal diverticulosis in the elderly. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 166-169. DOI: 10.20969/VSKM.2025.18(suppl.1).166-169.
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1. Sarıtaş AG, İpek T, Alış H, et al. Jejunal diverticulosis complicated with perforation: a rare acute abdomen etiology. Int J Surg Case Rep. 2019; 63: 101–103. DOI: 10.1016/j.ijscr.2019.09.013
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6. Labutin LK, Rostovtsev MV, Nudnov NV, et al. Ispolzovaniye kompyuternoy tomografi i v diagnostike divertikuleza toshchey kishki. oslozhnennogo divertikulitom i kishechnym krovotecheniyem [Use of computed tomography in the diagnosis of jejunal diverticulosis complicated by diverticulitis and intestinal bleeding]. Vestnik Rentgenolodii i Radiologii [Bulletin of Radiology and Radiology]. 2022;103(1–3):62–68. (In Russ.).
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УДК 616.127-005.4-073.756.8 DOI: 10.20969/VSKM.2025.18(suppl.1).170-174
Magnetic resonance imaging as a method of choice in the diagnosis of pelvic prolapse: Presentation of clinical material
Farida F. Minnullina1,2, Sergey V. Kurochkin1, Liliya M. Mukhametzyanova1,2, Elena S. Sorokina1, Maria S. Kopayeva1
1State Clinical Hospital No. 7, 54 Marshal Chuykov str., 420103 Kazan, Russia
2Institute of Biology and Fundamental Medicine, Kazan Federal University, 74 Karl Marx str., 420012 Kazan, Russia
Abstract. Introduction. Traditional methods of diagnosing pelvic prolapse, including clinical check-ups and ultrasound examinations, have certain limitations in assessing the severity of the disease and the condition of the pelvic support apparatus. In this regard, there is a need for using more informative diagnostic methods to get a detailed picture of the pathophysiological changes in the pelvic organs. Magnetic resonance imaging (MRI) is an advanced non-invasive imaging technique with high resolution and the ability to obtain multi-plane images of soft tissues. Aim. To analyze the MRI potential in the complex diagnosis of pelvic prolapse, evaluate its informative value as compared to traditional examination methods, and develop an optimal algorithm of using this method in clinical practice. Materials and Methods. This article describes a clinical case of a reproductive-age female patient without any clinical manifestations of moderate vaginal wall prolapse with a change in the levator muscle complex. MRI examination detected the signs of prolapse in the posterior compartment of the pelvic floor. Timely detection of this pathology made it possible to give the patient appropriate recommendations and adjust the treatment plan in order to further reduce the risk of recurrent vaginal wall prolapse and lower quality of life. Conclusions. Improving diagnostic approaches to the detection and assessment of the severity of pelvic prolapse will enhance the treatment effi cacy and improve the quality of life of patients suff ering from this pathology.
Keywords: pelvic prolapse, pelvic fl oor, magnetic resonance imaging
For citation: Minnullina, F.F., Kurochkin, S.V., Mukhametzyanova, L.M., [et al]. Magnetic resonance imaging as a method of choice in the diagnosis of pelvic organ prolapse: presentation of clinical material. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1):170-174. DOI: 10.20969/VSKM.2025.18(suppl.1).170-174.
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2. Luo J, Swenson CW, Betschart C, Feng F, Wang H, Ashton-Miller JA, DeLancey JOL. Comparison of in vivo visco-hyperelastic properties of uterine suspensory tissue in women with and without pelvic organ prolapse. J Mech Behav Biomed Mater. 2023 Jan; 137:105544. DOI: 10.1016/j.jmbbm.2022.105544
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7. Xie B, Chen L, Xue Z, English EM, Fenner DE, Gaetke-Udager K, et al. Comparison of measurement systems for posterior vaginal wall prolapse on magnetic resonance imaging. Int Urogynecol J. 2019;30(8):1269–77. DOI:10.1007/s00192-019-03939-4
8. Huang WC, Yang JM, Chen HF. Four-dimensional introital ultrasound in assessing perioperative pelvic fl oor muscle functions of women with cystoceles. Ultraschall Med. 2020;42(4):e31–41. DOI :10.1055/a-1109-2493
9. Lin FC, Funk JT, Tiwari HA, Kalb BT, Twiss CO. Dynamic Pelvic Magnetic Resonance Imaging Evaluation of Pelvic Organ Prolapse Compared to Physical Examination Findings. 2018 Sep:119:49-54. DOI: 10.1016/j.urology.2018.05.031
10. Abdulaziz M, Kavanagh A, Stothers L, Macnab AJ. Relevance of open magnetic resonance imaging position (sitting and standing) to quantify pelvic organ prolapse in women. Can Urol Assoc J. 2018;12(11):E453–60. DOI:10.5489/cuaj.5186
11. Pannu HK, Scatarige JC, Eng J. MRI diagnosis of pelvic organ prolapse compared with clinical examination. Acad Radiol. 2011;18(10):1245–51. DO I:10.1016/j.acra.2011.05.010
12. Lipetskaia L, Gupta A, Cheung RYK, Khullar V, Ismail S, Bradley M, Karmakar R, Clifton S, Doo J, Quiroz L. International Urogynecological Consultation Chapter 2.2: Imaging in the Diagnosis of Pelvic Organ Prolapse. Int Urogynecol J. 2025 Apr;36(4):759-781. DOI:10.1007/s00192-024-05948-4
13. Singh K, Reid WM, Berger LA. Assessment and grading of pelvic organ prolapse by use of vdynamic magnetic resonance imaging. Am J Obstet Gynecol. 2001;185(1):71–7.
14. Pollock GR, Twiss CO, Chartier S, Vedantham S, Funk J, Arif Tiwari H. Comparison of magnetic resonance defecography grading with POP-Q staging and Baden-Walker grading in the evaluation of female pelvic organ prolapse. Abdom Radiol. 2019;12:12. DOI :10.1007/s00261-019-02313-8
УДК: 616.127-005.4-073.756.8 DOI: 10.20969/VSKM.2025.18(suppl.1).175-180
Сlinical cases of hypokalemia in a multidisciplinary hospital
Farida A. Nasybullina1, Tatiana A. Petrova1, Natalia A. Myagkova1, Lilia F. Zaripova1, Rinat R. Kamaev1, Gulnar R. Vagapova2, Farida V. Valeeva3
1City Clinical Hospital No. 7 named after M.N. Sadykov, 54 Marshal Chuykov str., 420103 Kazan, Russia
2Kazan State Medical Academy – Branch of the Russian Medical Academy of Postgraduate Education, 36 Butlerov str., 420012 Kazan, Russia
3Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
Abstract. Introduction. Hypokalemia prevalence in the overall population is low, i. e., under 1%, but it increases significantly in hospitalized patients, reaching 47–76% in patients in serious and critical condition. Aim. To study the variety of clinical manifestations of hypokalemia syndrome. Materials and Methods. This article describes the clinical cases of hypokalemia syndrome as manifestations of various pathological conditions. Results and Discussion. Clinical picture of hypokalemia is characterized by several symptoms, from mild muscle weakness to severe paralysis, based on the potassium defi ciency severity. The diagnosis is confi rmed by measuring potassium levels in blood serum, and the treatment is aimed at replenishing the potassium content orally or intravenously in parallel with the diagnostic search for the disease that has led to these electrolyte changes. Conclusions. In connection with the results obtained from these clinical examples, attention should be paid to the importance of timely identifying the cause of hypokalemia to successfully correct and prevent complications.
Keywords: hypokalemia, hyperaldosteronism, Cushing disease, kidney apostematosis.
For citation: Nasybullina F.A., Petrova T.A., Myagkova N.A., et al. Clinical cases of hypokalemia in a multidisciplinary hospital // The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 175-180. DOI: 10.20969/VSKM.2025.18(suppl.1).175-180.
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УДК 616-003.821 DOI: 10.20969/VSKM.2025.18(suppl.1).181-188
A case of amyloid macroglossia, or How the final diagnosis was arrived at retrospectively 10 years after the patient’s death
Vladimir N. Oslopov1, Yuliana S. Mishanina1, Svetlana I. Safiullina2, Yulia V. Oslopova2, Elena V. Khazova1, Darya V. Oslopova3, Sergey A. Kichatov1, Rustem M. Khisamiev4, Zulfia F. Kim1,5, Daria S. Makarova2, Anna A. Terekhova1
1Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
2Institute of Biology and Fundamental Medicine, Kazan Federal University, 74 Karl Marx str., 420012 Kazan, Russia
3Children’s City Polyclinic No. 9, 6 Adoratsky str., 420133 Kazan, Russia
4 Republican Clinical Infectious Diseases Hospital named prof. A.F. Agafonov, 83 Pobedy Av., 420140 Kazan, Russia
5City Clinical Hospital No. 7 named M.N. Sadykov, 54 M. Chuykov str., 420103 Kazan, Russia
Abstract. Introduction. Primary idiopathic amyloidosis (AL amyloidosis) is a rare disease from the group of paraproteinemic hemoblastoses, characterized by pathological secretion of free light chains, deposited as amyloid in organs and tissues, leading to their dysfunction. Macroglossia is a rare but rather characteristic symptom of AL amyloidosis. Aim. To present data on the clinical course of AL amyloidosis, typical laboratory changes, and instrumental fi ndings based on the clinical case of a patient who had been unsuccessfully examined for one year due to progressive macroglossia. Materials and Methods. Patient M., 58 years old, was examined by several medical experts regarding progressive macroglossia for one year. Only a tongue biopsy with Congo red staining revealed amyloid deposits. Subsequent immunochemical investigations, including immunofi xation and quantitative determination of free light chains in blood and urine, revealed κ-chain secretion, confi rming the clonal nature of the disease. Based on these fi ndings, the patient was diagnosed with Bence Jones multiple myeloma. He received three courses of polychemotherapy, but died 1.5 years after the onset of the fi rst symptoms. Results and Discussion. A retrospective review of the patient’s medical history (ten years after his death) revealed inconsistencies between the clinical presentation, laboratory and instrumental fi ndings, and the diagnosis of Bence Jones multiple myeloma established in 2014. The absence of typical multiple myeloma symptoms (CRAB criteria), a normal plasma cell count in the bone marrow, and no evidence of tumor activity on positron emission tomography excluded the diagnosis of multiple myeloma. The following symptoms were underestimated: Progression of macroglossia, confi rmed amyloid deposition in the tongue, and the elevated level of free light κ-chains with a high κ/λ ratio. This led to a delayed diagnosis of plasma cell dyscrasia and a subsequent delay in treatment initiation. Conclusions. AL amyloidosis is a rare plasma cell dyscrasia that requires careful diff erential diagnosis from various forms of multiple myeloma, including its atypical variants. Underestimation of an obvious symptom, such as progressive macroglossia, led to the loss of very important time for treatment.
Keywords: macroglossia, amyloidosis, multiple myeloma, immunofi xation, free light chains.
For citation: Oslopov, V.N.; Mishanina, Y.S.; Safi ullina, S.I.; et al. A case of amyloid macroglossia, or How the fi nal diagnosis was arrived at retrospectively 10 years after the patient’s death. The Bulletin of Contemporary clinical medicine. 2025; 18 (suppl.1): 181-188. DOI: 10.20969/VSKM.2025.18(suppl.1).181-188.
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УДК 616.124-008.311-02-07-053.81 DOI: 10.20969/VSKM.2025.18(suppl.1).189-195
Causes and diagnostic aspects of ventricular tachycardia in young patients: A case report
Elena V. Khazova1, Polina A. Shulaeva1, Maria I. Malkova 1,2
1Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
2City Clinical Hospital No. 7 named M.N. Sadykov, 54, Chuikov str., 420103 Kazan, Russia
Abstract. Introduction Drawing the attention of doctors to diagnostic approaches and treatment of ventricular tachycardia in young patients, including those without signs of organic heart damage, is an important area in preventing sudden cardiac death. Aim. To present data on the etiology variants, clinical manifestations, and interpretation of tachycardia with wide QRS complexes on a clinical case of a 45-year-old female patient. Materials and Methods. Literature was reviewed, and the medical history of patient T. was studied. Results and Discussion. Factors are presented that underlie ventricular arrhythmias of non-coronary origin in young patients. Variability of clinical manifestations and options for interpreting tachycardia with wide QRS complexes in patients without any organic heart damages. Exemplifi ed by a clinical case of female patient T. born in 1980, without any bad habits, and with controlled arterial hypertension, we present the stages of the diagnostic search for ventricular tachycardia and the dynamics of arrhythmogenic myocardial activity, associated with therapy. The key points are presented regarding the diagnostic search for the causes of ventricular arrhythmias in a multidisciplinary hospital, while the coronary genesis of ventricular ectopias is excluded. An important point was the assessment of the concentration of thyroid hormones, infl ammatory markers, which did not exceed the reference values. Analysis of electrolytes revealed minor magnesium. Based on the therapy, positive changes were noted, including according to the data of daily monitoring of electrocardiography over time. Conclusions. The clinical case presented is interesting in terms of the diagnostic search for the causes of ventricular arrhythmogenic activity.
Keywords: rhythm disturbance, ventricular tachycardia, young age, hypomagnesemia.
For citation. Khazova, E.V.; Shulaeva, P.A.; Malkova, M.I. Causes and diagnostic aspects of ventricular tachycardia in young patients: a case report. The Bulletin of Contemporary clinical medicine. 2025; 18 (suppl.1): 189-195. DOI: 10.20969/VSKM.2025.18(suppl.1).189-195.
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УДК 616.231-008.41; 616-006.04 DOI: 10.20969/VSKM.2025.18(suppl.1).196-200
Clinical masks of chronic obstructive pulmonary disease exacerbations: A case study
Rustem F. Khamitov1, Firyuza I. Sattarova1, Leisana Z. Arslanova2
1 Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
2 City Clinical Hospital No. 7, 54 Marshal Chuykov str., Sadykov, 420103 Kazan, Russia
Abstract. Introduction. Chronic obstructive pulmonary disease is one of the leading causes of mortality worldwide. Its exacerbations require diff erential diagnosis with various nosologies, primarily manifested by productive cough and dyspnea. In addition to common diseases, it is important to remember about cancer. In patients with cancer of the thoracic esophagus, the tumor invasion into the bronchi, trachea and pleura can be observed in 60% of cases. Complaints of productive cough and dyspnea that appear may be the fi rst signs of an esophageal space-occupying mass. Aim. To present a clinical case of esophageal cancer invading the respiratory tract, simulating an exacerbation of chronic obstructive pulmonary disease. Materials and Methods. Review of domestic and foreign publications on the PubMed and eLibrary databases. A clinical case of a patient with primarily diagnosed malignant tumor of the middle third of the esophagus with the signs of mural invasion into the trachea and invasion into the left main bronchus, which proceeded under the clinical mask of an exacerbation of chronic obstructive pulmonary disease. Results and Discussion. The fi rst signs were respiratory symptoms in the form of productive cough and dyspnea in a patient with risk factors for chronic obstructive pulmonary disease. Bronchopulmonary disease was indicated by instrumental data in the form of obstructive ventilatory disorders of emphysema. Incorrect initial description of CT scan results was of very negative value for cancer diagnostics, as well as sputum examination on automatic analyzer, which did not show any food pieces in it. Conclusions. Smoking is a risk factor for the development of both chronic obstructive pulmonary disease and cardiovascular comorbidity, and cancer. In cases of no obvious eff ects from the traditional bronchodilator and anti-infl ammatory therapy of the chronic obstructive pulmonary disease “exacerbation” within the expected time, a diagnostic search should be actualized, which should also include cancer search, despite the absence of hemoptysis, pain syndrome, or swallowing diffi culties. In case of inconsistency between the descriptions of the instrumental study findings and the current diagnostic hypotheses, case conferences should be held involving the related experts and/or repeated studies should be conducted.
Keywords: COPD, exacerbation, esophageal cancer
For citation: Khamitov, R.F.; Sattarova, F.I.; Arslanova L. Z. Clinical masks of chronic obstructive pulmonary disease exacerbations: A case study. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 196-200. DOI: 10.20969/VSKM.2025.18(suppl.1).196-200.
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УДК 616-001.33: 616-035.2 DOI: 10.20969/VSKM.2025.18(suppl.1).201-206
Features of organ-preserving treatment strategy in case of spleen injury or pathology
Vyacheslav F. Chikaev1, Rinat A. Ibragimov2, Denis M. Petukhov3, Andrej A. Andreev3, Ravil F. Mannanov3
1Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
2City Clinical Hospital No. 12, 7 Lechebnaya str., 420036 Kazan, Russia
3City Clinical Hospital No. 7, 54 Chuykov str., 420103 Kazan, Russia
Abstract. Introduction. Spleen is an important organ of the immune system, previously considered to be rudimental. Post-splenectomy syndrome and hyposplenism are accompanied by acquired immunodefi ciency and hemostatic disorders. Therefore, the previously widespread indications for splenectomy in splenic diseases and injuries are now being increasingly replaced by non-surgical treatment and organ-preserving approaches. Aim. To analyze the current clinical practices in the management of splenic injuries and pathological processes, based on clinical observations in surgical hospitals in Kazan. Materials and Methods. A retrospective analysis was conducted using medical records of 137 patients with splenic injuries and pathological processes treated in surgical hospitals in Kazan in 2015–2024. The study analyzed the structure of the injuries, gender distribution, and characteristics of the treatment approaches and surgical interventions applied. Clinical cases are presented illustrating commonly accepted and widely practiced approaches. Results and Discussion. Traumatic injuries (including cases of long-term post-traumatic conditions) accounted for 99.2% (n = 136), and one case of splenic vein thrombosis was also included. Among splenic traumatic injuries, 83.2% (n = 113) were blunt traumas and 16.7% (n = 23) were open wounded. Males predominated, comprising 77.3% (n = 105) of cases. Isolated splenic injuries were identifi ed in 62.1% (n = 84), while injuries combined with other organs were observed in 38.2% (n = 52). Surgical interventions were more frequently required in patients under 45 years – 68.3% (n = 93). Splenectomy was performed in 74% (n = 100) of splenic injury cases, and also in the single case of splenic vein thrombosis. Organ-preserving surgeries were made in 21% (n = 28) of splenic injuries, and conservative treatment was used in 6% (n = 8) of cases. Conclusions. Surgical strategy for splenic trauma depends on the specific clinical situation. The risk of immune dysfunction and thrombotic disorders necessitates always considering the possibility of preserving the spleen. In Russian clinical practice, splenectomy still predominates as the surgical approach to splenic injuries. The use of scoring systems in traumatic splenic injuries helps reduce surgical interventions in favor of conservative treatment in the low-risk groups of patients. We present successful examples of this approach being applied in real clinical practice in third-level surgical hospitals in Kazan and anticipate its broader adoption in the future.
Keywords: splenic injury, splenectomy, post-splenectomy syndrome, non-operative tactics
For citation: Chikaev, V.F.; Ibragimov, R.A.; Petukhov, D.M.; et al. Features of organ-preserving treatment strategy in case of spleen injury or pathology. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 201-206. DOI: 10.20969/VSKM.2025.18(suppl.1).201-206.
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УДК: 616.127-005.8:616.124.6-007.253 DOI: 10.20969/VSKM.2025.18(suppl.1).207-210
A clinical case of managing a geriatric comorbid female patient with complicated myocardial infarction and severe aortic stenosis using high-tech treatment methods in a modern multidisciplinary hospital
Iskander F. Yakupov1, Alexander A. Vanyushin1, Ruzal M. Garafiev1
1City Clinical Hospital No. 7 named after M. N. Sadykov, 54 Marshal Chuykov str., 420103 Kazan, Russia
Abstracts. Introduction. Myocardial infarction (MI) is one of the most important causes of morbidity and mortality worldwide. Ventricular septal defect (VSD) due to septal rupture is a mechanical complication of MI. Aim. To demonstrate the possibilities and stages of resuscitative management of and surgical (endovascular) approaches to treating elderly patients in a multidisciplinary hospital. Materials and Methods.We analyzed the patient’s medical history and scientifi c literature data on the treatment of patients with periinfarction ventricular septal defect and severe aortic stenosis. Results and Discussion. Surgical intervention in the early stages of myocardial infarction is associated with high intra- and perioperative risks. Resuscitation management of patients, monitoring of key vital signs and functions, prevention and management of complications, and the use of extracorporeal membrane oxygenation (ECMO) play a crucial role. Transcatheter closure of VSD using occluders is a promising treatment technique for patients with MI complicated by ventricular septal rupture. It helps stabilize the patient’s condition, reduce pathological blood shunting into the right ventricle, and improve the body’s functional state. Conclusions. Despite all the advantages of transcatheter VSD closure, it is essential to consider the anatomical features of the defect and comorbidities, as well as conduct careful patient selection. Further research is needed to determine the optimal treatment strategy and evaluate the long-term outcomes of transcatheter VSD closure.
Keywords: myocardial infarction, interventricular septal defect.
For citation: Yakupov, I. F.; Vanyushin, A. A.; Garafi ev, R. M. A clinical case of managing a geriatric comorbid female patient with complicated myocardial infarction and severe aortic stenosis using high-tech treatment methods in a modern multidisciplinary hospital. The Bulletin of Contemporary Clinical Medicine. 2025; 18 (suppl.1): 207-210. DOI: 10.20969/VSKM.2025.18(suppl.1).207-210.
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