PLACE OF UNIVERSITY SCIENCE AND SMOLENSK STATE MEDICAL UNIVERSITY DURING THE PERIOD OF IMPLEMENTATION OF THE NATIONAL PROJECT “SCIENCE”: PROBLEMS AND PROSPECTS
Kozlov R.S., Bekezin V.V.
UDC: 61.04
Abstract: The article briefly describes the main stages of National Project “Science” and the «Strategy for the Development of Medical Science in Russia for the period until 2025». The difficulties in the development of university science at the present stage are formulated. The scientific projects implementedby scientists of Smolensk State Medical University as part of the state task of the Ministry of Health of Russia (from 10 to 15 scientific studies per year in the framework of 5-7 scientific platforms) in 2012-2019 are presented. The article describes the main scientific and innovative achievements of the university over the past decade.
Key words: Смоленский государственный медицинский университет, научная деятельность, стратегия развития медицинской науки, Smolensk State Medical University, scientific activity, development strategy of medical science
INFLUENCE OF REDOX-ACTIVE METAL COMPLEXES ON HYPOXIA MARKERS IN BLOOD PLASMA
Evseev A.V., Surmenjov D.V., Belenky E.A., Pereverzev V.A., Evseeva M.A., Andrjuk O.A., Zhurovich M.V., Pobozhy M.A.
UDC: 616-001.8:615.35
Abstract: Objective. To study the severity of expression of markers of hypoxia in the blood of rats and peculiarities of changes of indicators of the blood plasma redox state in acute hypoxia with hypercapnia after introduction of metal complex and aminothiol antihypoxants. Methods. The experiments were performed on male rats of the Wistar line. Acute hypoxia with hypercapnia (AH+Hc) was simulated by placing the animals in a glass container with a volume of 1.0 L. Metal-complex substance πQ2721 and aminothiol antihypoxic compounds Amthizole and Sunazole were injected once at doses of 50 and 100 mg/kg 60 min before AH+Hc. The result was assessed according to animal life-span in conditions of AH+Hc. The level of hypoxia markers HIF1Α, EPO (erythropoietin) and indicators of redox state - MDA and SOD were determined in blood plasma by ELISA. In the second part of the study, the effect of antihypoxants (out of hypoxia) on the level of HIF1A, EPO and redox indicators in 1 and 24 hours at a dose of 100 mg/kg was evaluated. Results. Markers of hypoxia showed a clear reaction in AH+Hc condition. After the administration of the substance πQ2721 at a dose of 100 mg/kg, a significant increase in the content of HIF1α and EPO was observed in comparison with AH+Hc and especially with the control. Aminothiol substances at the same dose had a deterrent effect. In the study of the redox state of blood, it was noted that substance πQ2721 reduces the level of MDA in AH+Hc and thus has no effect on SOD. Similar type of reaction was provided by Sunazole. Amthizole along with a decrease in MDA level, reduced SOD activity. In the second part of the study, it was noted that, despite the ability of the used substances to cause HIF1α expression 1 hour following their introduction, the antihypoxic effect after a day was observed only in introduction of πQ2721. Conclusions. Despite the fact that the antihypoxic effect of metal complex compounds πQ2721 is comparable to the aminothiol antihypoxants effects, it is apparently realized through its own mechanisms - not antihypoxic, but the opposite - hypoxic. The substance πQ2721 has confirmed its ability to provide redox balance in the organism.
Key words: металлокомплексные вещества, аминотиоловые антигипоксанты, острая гипоксия, маркёры гипоксии, редокс-состояние, Metal complex substances aminothiol antihypoxants, acute hypoxia, markers of hypoxia, redox state
THE ROLE OF SIALIDASES IN REVERSION OF MALIGNANT PHENOTYPE OF TUMOUR CELLS DERIVED FROM MUSCLE AND NEURAL TISSUE
Proshin Sergei N., Makushina Anastasiya A., Koroleva Yuliya A., Zhukova Tat’yana Y., Djabrailova Milana M., Kolesnik Yanina О., Saigidmagomedov Magomed A., Dzeitov Ali Hk., Hkalturina Polina B., Veizer Valentina O.
UDC: 16-01/09
Abstract: Objective. To elucidate the role of lysosomal and plasma-membrane ganglioside sialidases for tumours derived from muscle and neural tissues. Methods. The treatment of human neuroblastoma NB-1 cells by db-cAMP induced the high frequency of neural cells bearing neurite as well as more than two-fold elevated activity of sialidase associated with plasma-membrane ganglioside sialidase (PMGS). The elevated silaidase activity was accompanied by increasing the quantity of mRNA for that enzyme as was estimated by RT-PCR. The metastatic potential of tumour cells of rat rhabdomyosarcoma was estimated by inoculation tumour cell into rats. Then tumour cell clones were estimated by molecular and genetic techniques for sialidase activity. Results. The neural cells with elevated PMGS activity and developed neurite were shown to have high activity of another enzyme (acetylcholinesterase) that is strongly considered as a biochemical marker of neural cell differentiation. The lysosomal sialidase activity has been shown to be associated with inhibition of metastatic potential of tumour cells of rat rhabdomyosarcoma. The low metastatic ability of rhabdomyosarcoma was also associated with elevated frequency of nuclear anomalies of tumour cells like internuclear bridging. The PMGS was not shown to influence the rat rhabdomyosarcoma metastasis. Conclusion. The results presented in this paper strengthen an idea that sialidases hydrolyzing sialoconjugates including unique glycosphingolipids as gangliosides can influence directly and/or indirectly on cell pathophysiology and morphology.
Key words: sialidases, neural cells, rhabdomyosarcoma
APPROXIMATION OF CAUSAL DEPENDENCIES IN PHARMACOLOGICAL STUDIES
Lyamec L.L., Evseev A.V., Derevtsova S.N., Adamov P.G., Frolova O.A., Kozlova E.K., Kolpakova M.A., Solovyova I.N., Koshevarova N.P., Dmitrieva E.V., Petrov I.E.
UDC: 519. 253
Abstract: Objective. To develop an easy-to-understand and automated method using modern information technologies for approximating causal dependencies obtained in single-factor pharmacological experiments with exponential polynomials. The study is relevant because its results have obvious practical significance. Achieving this goal will allow you to determine the sequence of statistical processing of primary experimental data, simplify the calculation of coefficients in a mathematical model and reduce the time spent on their implementation, as well as make the approximation of exponential functions more accessible to researchers who do not have special mathematical training. Method. Conducting a single-factor pharmacological experiment and approximating the causal dependencies obtained as a result of the study are represented by a sequence of actions that are combined in three main stages. The first stage includes planning and conducting a single-factor pharmacological experiment, as well as statistical calculations related to finding group sample averages and medians. The second stage includes actions aimed at calculating the coefficients of the exponential polynomial. At the third stage, we calculate values that allow us to estimate the accuracy of approximation by exponential functions. The implementation of these steps allows us to obtain the results of calculations necessary for approximating causal dependencies with exponential polynomials during a single-factor pharmacological experiment. Results. A method for statistical analysis of experimental data obtained during single-factor pharmacological experiments has been developed. The method is structured in three consecutive stages of calculations that are necessary to justify the possibility of approximating experimental data with an exponential polynomial, calculating the coefficients of this mathematical model, and evaluating the accuracy of the approximation. To automate calculations, it is proposed to use the functions of the Excel table processor and Internet resources that are in the public domain. Conclusion. The developed method for approximating causal (cause-and-effect) dependencies obtained as a result of one-factor experiments may be of practical interest to researchers conducting research in the field of pharmacology, evidence-based medicine and using statistical methods for analyzing experimental data.
Key words: однофакторный эксперимент, фармакологическое воздействие, статистический анализ, математическая модель, аппроксимация, экспоненциальный полином, one-factor experiment, pharmacological effects, statistical analysis, mathematical model, approximation, exponential polynomial
POSSIBILITIES OF ANTIHYPOXANT USE FOR MITOCHONDRIAL DYSFUNCTIONS
Novikov V.E., Levchenkova O.S., Ivantsova E.N.
UDC: 616-092.18:615.03
Abstract: Objective. To analyze the effectiveness of drugs with antihypoxic effect in the treatment of mitochondrial dysfunctions. Methods. Collection, systematization and analysis of experimental and clinical data of current scientific research about the problem. Results. Mitochondrial dysfunctions (MD) can be caused by genetic disorders of the mitochondrial or nuclear genome (primary MD or the mitochondrial diseases), as well as structural, functional and biochemical defects of mitochondria caused by other diseases (secondary MD). MD are characterized by impaired tissue respiration, ATP synthesis deficiency and decreased energy metabolism. The clinical implications of MD are polysystemic and polymorphic. The energotropic pharmacotherapy including drugs with an antihypoxic effect is used for MD treatment. The results of antihypoxant usage with different structure and mechanism of action for treatment of primary and secondary MD are presented in the paper. The use of energotropic agents for MD treatment is not always effective. It is more rational to use the drug combination that influences different stages of energy production. The combinations of L-carnitine, coenzyme Q10, cytochrome C and succinate-containing drugs are frequently used for MD. However, the usage of energotropic and antihypoxic drugs is not able to cure the patients and stop the progression of all disease displays. Conclusion.The use of energotropic agents in the MD treatment requires further research. Numerous issues remain open (daily drug doses choice, treatment duration, rational combinations). The phenotype variability and the uniqueness of diagnosed cases, clinical and genetic differences between patient groups with mitochondrial diseases fail to create homogeneous samplings for therapy effectiveness and safety analysis. The literature data are the results of different degrees of reliability. They do not allow to evaluate completely the possibilities of antihypoxant use in the MD treatment. It is necessary to unify requirements for investigations related to mitochondrial disorders, which, in combination with a constant improvement of MD pathogenesis knowledge will contribute to the development of more effective treatment regimens.
Key words: митохондрии, митохондриальные дисфункции, митохондриальные болезни, энерготропные средства, антигипоксанты, mitochondria, mitochondrial dysfunctions, mitochondrial diseases, energotropic drugs, antihypoxants
WATER IS THE STRUCTURAL MATRIX OF LIFE
Farashchuk N.F.
UDC: 546.212
Abstract: Objective. To summarize the results of research of water structural fractions in the animal and human blood at extreme exposures and pathological conditions carried out by the staff of the SSMU. Methods.This paper represents the results of scientific papers and theses analysis on this problem, written by the author and staff of the SSMU over the past 30 years. Results.The dependence of changes in the biopolymers degree of hydration in the blood of animals during their adaptation to external factorsis established by experiment. In the development of stress-response to the external environment during the period of urgent adaptation, the biopolymers degree of hydration increases in the resistance stage and decreases in the stage of exhaustion, it is fixed at the higher level than normal as a result of long-term adaptation and decreases in the development of disadaptation. In this connection, the conceptions of the structural basis of the body's adaptation are expanding. Adaptive stabilization of tissue structures consists not only in quantitative changes, in particular in the accumulation of stress-proteins, but also in the spatial change of the most important biopolymers, which corresponds to the greatest degree of their hydration. The formation of the structured hydrate shell of biopolymers and subcellular structures is a universal adaptive mechanism. Conclusions. Disturbance of the internal medium of the body, which occurs during extreme influences on the body and diseases, causes the change of the water structure in the blood as in an integrating medium. The ratio of the amount of associated and free water in the human blood is a non-specific indicator of internal medium state of the body, which doesn’t change the subject to the sex within acme, which allows referring it to the number of the basic health parameters. This molecular level criterion shows effectiveness of the treatment and the degree of patients’rehabilitation. There is a correlation between water structure indicators and results of general clinical, biochemical and functional research. This confirms the fact that the structural formations of water are the matrix for the development of fundamental processes in the human body.
Key words: кровь, структура воды, гидратация, внешние факторы, патологические состояния, адаптация, blood, the structure of water, hydration, environmental conditions, pathological conditions, adaptation
PRINCIPAL DIAGNOSTICS OF PRIMARY ARTERIAL HYPERTENSION IN CHILDREN AND ADOLESCENTS: RISK FACTORS, PRIMARY PREVENTION
Bekesin V.V., Kozlova L.V., Borsukov A.V., Druzhinina T.V., Peresetskaya O.V., Oleinikova V.M., Fakikh I.M., Kozlova E.U., Korotkaya N.N., Polyakova O.M.
UDC: 616.12-008.331.1
Abstract: Objective. To summarize the literature data and the results of our own longitudinal studies in the field of studying risk factors, early diagnosis and primary prevention of primary arterial hypertension in adolescent children. Methods. As part of a longitudinal study of school-aged children (10-17 years old), a multi-stage coupled statistical analysis of the results of a comprehensive examination (clinical and anthropometric, laboratory and instrumental studies) and outpatient blood pressure was performed. Results. The article studies the relatively new early risk criteria for the development of arterial hypertension: arterial hypertension of the “white coat”, “latent” obesity, oxidative stress and endothelial dysfunction; as well as conditions associated with obesity (fatty hepatosis, nephropathy). According to the results of a comprehensive examination of adolescent children, it is proposed to distinguish three groups of cardiovascular risk-low, medium, high. Differentiated algorithms of primary prevention of hypertension in adolescent children are recommended taking risk into account. Conclusions. Primary prevention of cardiovascular risks (arterial hypertension) should be an important direction in the work of the pediatric service during the implementation of the federal project "Development of Children's Health Care" (2019-2024).
Key words: первичная артериальная гипертензия, донозологическая диагностика, факторы риска, профилактика, primary arterial hypertension, prenosological diagnosis, risk factors, prevention
ROLE OF NUTRIENTS FOR CHILDREN'S HEALTH: LONG-TERM CONSEQUENCES OF DEFICIENCY AND ITS CORRELATION WITH DISEASES
Legonkova T.I., Shtykova O.N., Stepina T.G., Vojtenkova O.V., Stolarova L.A.
UDC: 616.39+612.015.6-053.2
Abstract: Objective.The aim of the studywas to analyze the impact of micronutrient deficiency of children born to mothers with established nutritional security during pregnancy to optimize preventive measures and correction of the deficiency of nutrients based on a comprehensive clinical and functional and laboratory study. Methods. We examined 316 pregnant women and their newborns. Prospective observation of children from the period of newborns to adolescence was carried out. The protocols included anamnesis data, results of clinical, laboratory and instrumental studies followed by a comprehensive assessment of health status. Results. Awide prevalence of essential nutrient deficiencies of pregnant women and children was revealed. Analysis of the actual nutrition of children of preschool and school age revealed insufficient intake of vitamins of groups a, B, C, D β-carotene, calcium magnesium, zinc, selenium, potassium, phosphorus and polyunsaturated fatty acids. The influence of essential trace element deficiency on the linear growth of the child, the harmonious physical and neuro-psychical development, alimentary-dependent pathology, disorders of the musculoskeletal system, visual analyzer, gastrointestinal tract, resistance were established. Children with zinc deficiency have lower bone mass values (according to bioimpedance analysis), bone strength (according to the osteodensitometry), a specific marker of the state of bone tissue - the bone alkaline phosphatase isoenzyme. Conclusions. It is necessary to monitor the availability of essential nutrients in risk groups based on the wide prevalence of deficiency conditions in pregnant women and children of different ages.It is necessary to carry out prevention and correction of deficiency in order to optimize the control of children with a deficit of essential nutrients from the moment of birth to adolescence.
Key words: нутриенты, эссенциальные микроэлементы, фактическое питание, дети, новорожденные, дошкольный и школьный возраст, nutrients, essential trace elements, actual nutrition, children, newborns, preschool and school age
CLINICAL AND AGE CHARACTERISTICS OF CHILDREN AND TEENAGERS WHO RECEIVED PLANNED AND EMERGENCY SURGICAL INTERVENTIONS UNDER GENERAL ANESTHESIA
Avdeeva T.G., Ostreikov I.F., Evseev A.V., Usachev R.K.
UDC: 616-053.2-089.5
Abstract: Objective . To study the clinical, age and gender characteristics of children receiving emergency and planned surgery under general anesthesia according to the Department of anesthesiology and intensive care of Smolensk regional clinical hospital for 2018, and set the frequency of somatic diseases that affect the development of complications and the course of the early postoperative time. Methods. The article analyzes and presents statistical data on the frequency of emergency and planned surgical intervention in children in the city of Smolensk in 2018, depending on age, gender and the presence of somatic diseases. Data is presented in accordance with the annual reports of the Department of Anesthesiology and intensive care of Smolensk regional clinical hospital. For the first time, data on concomitant somatic pathologies in children who underwent surgery are presented, and their frequency of occurrence is determined. Taking into account age, children were divided by gender and age groups: 1st-from 0 to 3 years, 2nd - from 4 to 7 years, 3rd-8-12 years, 4th-13-18 years, which corresponds to the age periodical [2]. This age distribution is applied to children who have received both emergency and planned anaesthetics. At the same time, the timing of children's stay (bed-day) in the intensive care unit for each age group was taken into account, taking into account the developed complications, in the presence of certain somatic diseases. Results. The age and gender characteristics of children undergoing emergency and planned surgical intervention were established. It was reliably revealed that the most frequently operated on emergency indications are children aged 13 to 18 years. The most extensive group of children undergoing planned surgical interventions is the group of children from 4 to 7 years. According to the results of further detailed analysis, it was found that in this group of children (4-7 years old), boys make up the majority (58%) of the total number of operated children. When studying the features of somatic pathologies characteristic of each group of children depending on age, it was found that in the group 0-3, the presence of concomitant congenital malformations is most often characteristic (26.3%), and in the groups of children 4-7, 8-12, 13-18 years, respiratory system diseases come out in the first place - 32%, 28% and 28.3%, respectively. When analyzing the average number of hospital bed days in children, depending on age characteristics and the presence or absence of concomitant somatic diseases, a directly proportional relationship was established that the early recovery postoperative period in children with concomitant diseases (regardless of the main pathology requiring surgical correction) is longer than in children without a concomitant background. The relationship between the age and the number of bed days in the hospital was established: young children (0-3 years old) require longer observation in the Department. Conclusion. The conducted research allows us to establish the age and gender characteristics of children who received planned and emergency General anesthesia during the year in a large intensive care unit at the regional multidisciplinary hospital of the Smolensk region. The paper focuses on the existing concomitant diseases in children, which on the one hand should be taken into account when prescribing certain drugs that have a narcotic effect, and on the other hand, determine the choice of therapy to facilitate the postoperative period, to prevent the development of complications. of therapy to facilitate the postoperative period, to prevent the development of complications.
Key words: дети, возрастные и половые особенности детей, общий наркоз, соматические заболевания, плановые и экстренные оперативные вмешательства, children, general anesthesia, somatic diseases, surgical intervention
CLINICAL CASE OF LEUKOENCEPHALOPATHY WITH BRAIN STEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION
Simonenko Vadim V., Vakal Tatyana N., Mikhalik Dmitrii S., Zhukov Gennadii V., Nikolaenkova Ludviga I., Egorova Anastasia O.
UDC: 616.8-056.76
Abstract: Objective. To demonstrate a case history of leukoencephalopathy with predominant brain stem and spinal cord involvement and lactate elevation with onset in adult female patient. Methods. The authors described a clinical case of adult female patient with leukoencephalopathy with predominant brain stem and spinal cord involvement and lactate elevation. An analysis of clinical information in Russian and foreign references on prevalence of this disease in population, its clinical signs, diagnostic peculiarities and management was performed. Results. Differential diagnosis of demyelinating central nervous system lesions in the female patient aged 31 years was successively fulfilled with the identification of leukoencephalopathy with predominant brain stem and spinal cord involvement and lactate elevation with late onset at the neurological department of Smolensk Railway Station Clinical Hospital. Conclusion. In general practice it should be remembered of possibility to encounter the clinic signs of the relatively rare hereditary disease, such as leukoencephalopathy with predominant brain stem and spinal cord involvement and lactate elevation with late onset.
Key words: leukoencephalopathy, brain stem, spinal cord, magnetic resonance imaging, case history, рассеянный склероз, аутоиммунное заболевание, эмпиема плевры, клинический случай
COMPARATIVE CHARACTERISTIC OF MECHANICAL STRENGTH PROPERTIES OF THE CARBON NANOSTRUCTURAL IMPLANT AND NATIVE BONE
Gavryushenko N.S., Batrakov S.Yu., Balametov S.G.
UDC: 617-089:616-7
Abstract: Objective. Comparative characteristic of mechanical-strength properties of carbon nanostructural implant (CNI) and native bone in physiological loading. Methods. Researches on a testing machine of LFM of 50 kN on exemplars of the CNI and native bone were conducted. About 3 specimens from each material were taken. By means of this testing machine the presented specimens were subjected to compression. The obtained data in the form of ultimate strength were transformed by means of the firmware computer on graphics and gave an assessment to strength properties of the specimens. These data were transformed to charts for calculation of the relative deformation of the specimens of the CNI and native bone. Results. The received results of mechanical-strength properties of the specimens of the CNI and native bone have various values. Data were calculated on charts, taking into account possible physiological loading. Strength properties in the form of value of ultimate strength of a native bone slightly exceed those for CNI. However, such values of the relative deformation as rigidity index, specimens of CNI were twice higher than in native bone. Conclusion.The received results of mechanical-strength properties of the specimens of the CNI and native bone have various values. Data were calculated on charts, taking into account possible physiological loading. Strength properties in the form of value of ultimate strength of a native bone slightly exceed those of CNI. However, such values of the relative deformation as rigidity index, specimens of CNI are twice higher than in native bone.
Key words: углеродный наноструктурный имплантат, нативная кость, испытательная машина, физиологическая нагрузка, carbon nanostructural implant, native bone, testing machine, physiological loading
ASSESSMENT OF CLINICAL AND LABORATORY DATA AND RESULTS OF ELECTROCARDIOGRAPHIC RESEARCH OF PATIENTS WITH CHRONIC PANCREATITIS IN SMOLENSK REGION
Ivanishkina E.V., Karuk M.V., Banenis M.G., Volk S.V., Zagubnaia E.S.
UDC: 616.37-002:616.12-073.97
Abstract: Objective. To study the spread of risk factors of Chronic Pancreatitis (CP) development, clinical and laboratory properties of the disease tendency in modern conditions, features in ECG of patients with CP in Smolensk region for optimization of diagnostic, cure and prophylaxis. Methods. In order to study the role of risk factors of developing CP in patients of Smolensk region, a questionnaire was carried out on 37 patients (26 women and 11 men) in gastroenterological department of Smolensk Regional Clinical Hospital at the age from 30 up to 80 years old (51,4±2,72) by form which was created by us. Analysis of clinical features of CP in modern conditions was conducted in 59 patients of Smolensk region, who were on hospitalization in gastroenterological department of Smolensk regional clinical hospital (40 men (67,8%) and 19 women (32,2%). The average age of the patients was 51,0±1,62 years old (Min 31 years old, Max 78 years old) Results. As risk factors of developing CP in patients of Smolensk region we revealed alcohol abuse in addition with tobacco smoking, malnutrition with predominant fatty foods, overeating. Asthese reasons are removable riskfactorsofCP, its revealing is important in prophylaxis of developing this disease and its exacerbation, and moreover in diagnostic of pancreas lesion. For a part of patients, the reason of pancreas lesion is pathology of the biliary system. Clinical manifestations of chronic pancreatitis are very variable, combined with disorders of the biliary system. The dominativesymptomispainbutnotalwayswithtypical localization and character. Among biochemical syndromes dominates the cytolytic one;an increase of amylase level in serumand hyperglycemia are noted. InECGnon-specificchangesinrhythmand conduction, signs of hypertrophy of left ventricular, changes in myocardial repolarizationwere revealed. Conclusion. The study of general characteristics of patients with CH as well as the role of main risk factors are of prime necessity in early diagnostic of the disease and modern correction of factors, influencingthe effectiveness of therapy.
Key words: хронический панкреатит, факторы риска, клинико-лабораторные показатели, электрокардиографическое исследование, chronicpancreatitis, risksfactors, clinic-laboratory indicator, ECG research
DIAGNOSTIC VALUE OF THE METHOD FOR DETERMINING NON-SPECIFIC ADAPTIVE BLOOD REACTIONS IN ASSESSING MENTAL STATUS IN CHILDREN AND ADOLESCENTS
Ulasen T.V., Avdeeva T.G., Marchenkova O.N.
UDC: 616.15-07:616.89-053.2
Abstract: Objective. To evaluate the spectrum of adaptive (physiological) reactions of the body in the structure of the general adaptive potential in children and adolescents with different marital status, who first entered social protection institutions. Methods. A survey of pupils of social protection institutions was carried out using clinical, psychopathological, psychodiagnostic and laboratory methods (methods for evaluating non-specific adaptive blood reactions according to the morphological composition of white blood cells). Results. The data obtained indicate the prevalence of nonspecific adaptation reactions among pupils of social protection institutions, reflecting the tension of physiological adaptation systems: stress reactions, training reactions. In secondary school students, by contrast, reactions of calm activation are statistically more common. Conclusion. Taking into account the revealed features of adaptation processes will allowto optimize the programs of treatment and preventive measures among pupils of social protection institutions in the work of doctors and teachers.
Key words: неспецифические адаптационные реакции крови, адаптационный потенциал, воспитанники социозащитного учреждения, non-specific adaptive blood reactions, adaptive potential, pupils of a social protection institution
PREVALENCE OF HYPERGLYCEMIC DISORDERS OF CARBOHYDRATE METABOLISM IN HEALTHY YOUNG PEOPLE WITH DIFFERENT ATTITUDES TO THE CONSUMPTION OF ALCOHOL
Blazhko A.S., Pereverzev V.A., Sikorsky A.V., Evseev A.V., Osipova N.N., Nikitina O.S., Yurenya E.V., Yeremeychik S.M., Velkom M.O., Razvodovsky Yu.E., Pereverzeva E.V.
UDC: 612.015.32-053.81:016-056.8
Abstract: Objective. To determine the prevalence of hyperglycemic disorders of carbohydrate metabolism, detected by the standard oral test for glucose tolerance (OGTT) and different methods of analyzing the results, as well as assessing the risks of their development under the influence of ethanolamong healthy young people of both sexes, who consume and do not drink alcohol. Methods. The study was carried out with the participation of 116 young healthy people (88 women and 28 men) 19-29 years old, not on the dispensary account. In each subject, regardless of thegender, the glucose content in whole capillary blood (GCWCB) was determined many times taken from the 4th finger of the non-working hand. The first (1st) definition of the GCWCB was carried out in the subjects in a state of functional rest on an empty stomach. The following definitions of glycemia were carried out during the mental work of the fasting: filling out standard questionnaires ("AUDIT" etc.), performing mental health tests and working with texts. Then, after 16-18 hours of fasting and 6 hours of mental stress, all subjects were givenOGTT , during which the GCWCB was determined initially, 30, 60, 90 and 120 minutes after taking 75 grams of glucose dissolved in a glass of water (200-250 ml).The GCWCB was defined by a glucose-oxide method with amperometric detection. The results were analyzed in accordance with the recommendations of WHO-1985, 1999; ISPAD, 2018; Ministry of Health of the Republic of Belarus, 2019; calculation of glycemic coefficients. Results. Analysis of the results of GCWCB at the state of functional rest and during OGTT, according to the recommendations of WHO (1985, 1999), ISPAD (2018) and Ministry of Health of the Republic of Belarus (2019), showed the presence of impaired carbohydrate metabolism in 17 subjects, the prevalence of which was 14.7±3, 3% (p<0.001). These identified impaired carbohydrate metabolism included the following types: impaired fasting glycemia (IFG) - 12 cases (prevalence 10.3±2.8% / p<0.001 /); impaired glucose tolerance (ITG) - 4 cases (prevalence 6.0±2.2% / p<0.01 /); type 2 diabetes mellitus (DM) - 3 cases. Sixteen young people with known impaired carbohydrate metabolism (including all cases of ITG and DM) drank alcohol. A comparative analysis of the prevalence of glucose tolerance by the glycemic coefficients of Baldwin, Rafalsky and Sokolnikov revealed 2.66-5.35 times (p<0.001) a higher relative risk of its development in young people who drink alcohol. The result of this additional increase in the glucose tolerance of cells by ethanol in women is the emergence of such clinically important types of impaired carbohydrate metabolism as DM and IGT. The prevalence of these types of impaired carbohydrate metabolism (8.0±2.9% / p<0.01 /) in young women who consume alcohol is statistically significant. Conclusion . An analysis of the results of OGTT (taking into account glycemic coefficients) shows an extremely high (75-85% in men and 78,6-90,5% in women) probability of developing hyperglycemic impaired carbohydrate metabolism in young people who drink alcohol, especially in women. The above facts indicate the need to consider ethanol as an independent and significant risk factor for the development of IFG, ITG and type 2 DM, and also allow us to recommend a rating score for the “low risk mode” of its (alcohol) consumption on the AUDIT test scale (1-7 points, or <8 points) to limit only 1 point (or <2 points) for women.
Key words: глюкоза, гликемия, цельная капиллярная кровь, сахарный диабет, нарушения углеводного обмена, glucose, glycemia, whole capillary blood, diabetes mellitus, carbohydrate metabolism disorders
DYNAMICS OF THE RATIO OF WATER FRACTIONS IN WHOLE BLOOD, PLASMA AND FORMED ELEMENTS IN PATIENTS IN THE ACUTE PERIOD OF MYOCARDIAL INFARCTION
Levina Ju.V., Farashhuk N.F., Kozyrev O.A., Litvinova I.A., Kirsova M.P.
UDC: 616.127-005.8
Abstract: Objective. To study the dynamics of changes in hydration (content of total, free and bound fraction of water) of whole blood, formed elements and blood plasma in patients with acute myocardial infarction on admission, on the 3 day following admission and before discharge from the hospital; to compare the results of the distribution of water fractions with the indices of healthy people. Methods. The study examined 35 patients with acute myocardial infarction (63% male, 37% female; the average age - 58±10 years) as well as 35 healthy people (69% male, 31% female; the average age - 46±11 years). In all patients, the amount of total, free and bound water in whole blood, plasma and erythrocyte mass was determined by the dilatometric method in the modification of H.F. Farashchuk on admission and in dynamics. Results. There was an increase in the bound fraction of water in whole blood by 12% in patients with myocardial infarction upon admission to the hospital, by 7% on the 3rd day of stay and by 8% before discharge. Plasma analysis showed an increase in the bound fraction of water by 10.5% on admission, by 3.9% on the 3rd day of hospitalization and a decrease by 6.1% before discharge from the hospital. In the erythrocyte mass, an increase in the bound fraction of water on admission by 8.6%, on the 3rd day of hospital stay by 7.8% and before discharge by 8.6% was noted. An increase of erythrocyte mass hydration coefficients by 11% on admission in patients with myocardial infarction was revealed. Conclusion. An increase in the amount of bound water fraction of blood elements should be regarded as a predictor of a high risk of myocardial infarction; an increase in the amount of bound water fraction of whole blood, plasma and blood elements, as well as an increase in their hydration in patients with myocardial infarction should be regarded as an indicator of an adequate adaptive reaction of the body to the pathological process.
Key words: инфаркт миокарда, фракции воды, коэффициент гидратации, myocardial infarction, water fraction, hydration coefficient
DIFFICULTIES OF DIAGNOSTICS IN CASE OF LETHAL OUTCOME FROM HEMORRHAGIC FEVER WITH RENAL SYNDROME
Dmitriev I.V., Kireeva O.K.
UDC: 616.92/.93
Abstract: Objective. To analyze difficulties in the diagnosis ofhemorrhagic fever with renal syndromeand properties of its course for the possibility of earlier diagnosis of this infection. Methods. The scientific information of domestic and foreign sources was analyzed regarding Hantavirus infection, including hemorrhagic fever with renal syndrome. A comprehensive research of the medical history materials and the results of morphological methods was conducted in order to study the case of a patient’s lethal outcome from hemorrhagic fever with renal syndrome. Results. A 66-year-old patient’s condition aggravation was the reason for her medical help request and an indication for hospitalization (shock of 2 tbsp.). The absence of fever, pallor of the skin, the predominance of complaints from the intestines and mild renal syndrome are considered to be the particularity of this clinical case. Abrupt deterioration in the condition of the patient with massive multiple organ pathology, developing severe DIC and acute lung damage made it difficult to identify the main clinical criteria of hemorrhagic fever with renal syndrome. At the same time, at the autopsy, only the concrete cause of death was clearly identified (massive subarachnoid hemorrhage with the penetration of blood into the ventricular system of the brain), but its root cause was clarified later when the data of additional studies were ready, including the presence of antibodies to Hantavirus in the blood: titer - 1/128, in the formulation up to 1/1024. Conclusions. The described case of death from Hantavirus infection shows the complexity of the clinical and morphological diagnosis of this disease. The presented analysis of individual symptoms of the disease and its morphological manifestations provides additional data for a better understanding of Hantavirus infection in the case of its occurrence in polymorphic (atypical) forms. These data increase the probability of diagnosing this infection at an early stage and, therefore, prevent its possible complications.
Key words: хантавирусная инфекция, геморрагическая лихорадка с почечным синдромом, клиника, морфология, Hantavirus infection, hemorrhagic fever with renal syndrome, clinic, morphology
CYSTIC FIBROSIS: FROM DIAGNOSIS TO LUNG TRANSPLANTATION. CLINICAL CASE REPORT
Punin A.A., Bekesin V.V., Molotkov A.O., Tryapyshko A.A., Petrunina N.E., Punina A.A., Shuvalov A.D.
UDC: 616.1/.9+616-056.7+616-053.2
Abstract: Objective. Analysis of the clinical case of patient N, born in 1995, with the diagnosis of cystic fibrosis, pulmonary-intestinal form, severe course, from diagnosis to lung transplantation. Exchange of experience in management of patients with cystic fibrosis between pediatricians, therapists, pulmonologists. Methods. Comprehensive study and retrospective analysis of case history materials, outpatient card, the results of clinical, laboratory and instrumental methods of examination of patient N. Results. In the demonstrated clinical case, the patient from childhood suffers from a mixed form of cystic fibrosis. For several years, it was not possible to confirm the proposed diagnosis: a sweat test, the “gold standard” of diagnosis, stayed borderline. However, based on the characteristic clinical picture, the necessary basic therapy was prescribed. After the appearance of molecular genetic methods, using DNA diagnostics, “severe” mutations in the CFTR gene were detected - the diagnosis was confirmed. Despite the well-timed and adequate treatment, the disease was progressing, the condition of the girl was worsening. The question about lung transplantation was raised - the only way to save the lives of patients with cystic fibrosis. At the age of 24 years, due to severe decompensation of the respiratory system, the patient successfully underwent bilateral lung transplantation. Currently, the condition of the girl is regarded satisfactory. Conclusion. Thus, the example of the clinical case that is difficult to diagnose and treat, resulting in successful lung transplantation and stabilization of the patient’s condition, shows the need for joint successive work by pediatricians, therapists and transplant surgeons to help as many patients as possible with cystic fibrosis.
Key words: муковисцидоз, неонатальный скрининг, потовая проба, трансплантация легких, cystic fibrosis, newborn screening, sweat test, lung transplantation
ULTRASOUND SHEAR WAVE ELASTOGRAPHY WITH MULTIPARAMETRIC MAGNETIC RESONANCE IMAGING IN PLANNING OF PROSTATE BIOPSY
Shimanets S.V., Karman A.V., Zakharava V.A., Rybalko Ya.S., Nabebina T.I., Letkovskaya T.A., Krasny S.A.
UDC: 616.65-006.6:616-073.4-8(476)
Abstract: Objective. Evaluation of diagnostic value of Transrectal Ultrasound (TrUS) Shear Wave Elastography (SWE) along with multiparametric Magnetic Resonance Imaging (mpMRI) through complex comparison of findings of radiation methods of visualization and the results of histological examination of the systematic and target stages of biopsies in diagnosis of prostate cancer (PCa). Methods. 78 patients with suspected PCa were included (and analyzed) into the study. Increase in total prostate-specific antigen (PSA) levels by more than 2.5 ng/ml served as the main criterion for adding a patient to the study group. The diagnostic complex applied in the study comprised mpMRI, TrUS with SWE (TrUS-SWE) and the systematic stage of prostate biopsy with the target stage of taking the biopsy material from suspicious foci. Results. Histological examination revealed PCa in 41/78 (52.6%) patients, of which clinically significant (csPCa) with ISUP Grade Group (GG) ≥2 (Gleason ≥3+4) was registered in 16/78 (20.5%) subjects. Comprehensive analysis of TrUS-SWE aimed to determine the overall assessment category of likelihood (probability) of the presence of PCa based on the severity of combination of signs of various modes in charge of assessing echogenicity, vascularization and stiffness parameters. Sensitivity/specificity (accuracy) rate of TrUS-SWE at assessment ≥4 (≥ high probability, i.e. cancer is most likely to be present) in verification of a tumor with GG ≥1 equaled to 58.1/74.4% (67.6%) and a tumor with GG ≥2 - 91.7/69.8% (73.3%), correspondingly. Combined application of mpMRI and TrUS-SWE enabled to improve the quality rate of diagnostic model in detecting csPCa GG ≥2 by increasing the area under the curve in the ROC analysis up to 0.851 (p<0.001). In spite of the target stage biopsy material containing a smaller number of obtained tissue cores as compared to the systematic (medians of 5.0 and 24.0, correspondingly) one, the target stage would have the cases of PCa (48.8% and 44.8%, correspondingly; (p=0.719)) compatible with the systemic stage, including GG 1 and csPCa GG ≥2. However, it would tend to possess an increased detection efficiency rate of PCa due to the proportion of carcinoma-positive cores (45.0% and 12.5%, correspondingly) and the proportion of tumor tissue (20.0% and 4.5%, correspondingly) (p<0.05). Conclusion. Ultrasound SWE enables to improve the diagnostic efficacy rate of PCa by performing the target biopsy stage from suspicious foci according to the mpMRI and/or TrUS-SWE data.
Key words: клинически значимый рак предстательной железы (кзРПЖ), мультипараметрическая магнитно-резонансная томография (мпМРТ), трансректальное ультразвуковое исследование (ТрУЗИ) c эластографией сдвиговой волны (ЭСВ) (ТрУЗИ-ЭСВ), систематический и целевой этапы биопсии предстательной железы, clinically significant Prostate Cancer (csPCa), multiparametric Magnetic Resonance Imaging (mpMRI), Transrectal Ultrasound (TrUS) with Shear Wave Elastography (SWE) (TrUS-SWE), systematic and target stages of prostate biopsy
EVALUATION OF THE EFFECTIVENESS OF TREATMENT OF HYPERESTHESIA OF HARD DENTAL TISSUES IN DENTAL PRACTICE
Shashmurina Victoria R., Kupreeva Irina V., Devlikanova Liliya I., Mishutina Olga L., Volchenkova Galina V., Shashmurina Anna B.
UDC: 616.314-089.13
Abstract: Objective. To study the clinical effectiveness of treatment of hyperesthesia of hard tissues of teeth. Methods.The treatment of hyperesthesia of hard tissues of teeth 118 was carried out in 63 patients aged 18 to 60 years. After the examination according to the standard method, the patients were divided into 3 groups depending on the treatment algorithm used. Non-invasive treatment of hyperesthesia of hard tissues of teeth was carried out in patients of group 1 using the means for professional use (application of the suspension «Desensetin») and home use (toothpaste, mouthwash and toothbrush «Lacalut sensitive»). Patients of group 2 were prescribed only toothpaste with mouthwash with a toothbrush «Lacalut sensitive». Patients of group 3 was carried out by application only suspension «Desensetin» on problem areas of the teeth. Results. The results of treatment demonstrated high effectiveness especially in complex application of suspension «Desensetin» and toothpaste with the mouthwash and toothbrush «Lacalut sensitive» treatment and preventive measures in hyperesthesia of hard dental tissues. Conclusion. In the course of the study it was established that the suspension of the «Desensetin» and toothpaste with mouthwash and a toothbrush «Lacalut sensitive» can be effectively applied for the treatment and prevention of hyperesthesia of hard tissues of teeth have a marked antisensitivity action. The use of the suspension «Desensetin» and toothpaste with mouthwash «Lacalut sensitive» in combination with a toothbrush «Lacalut sensitive» leads to the elimination of increased sensitivity of teeth to various types of stimuli (thermal, chemical, tactile), which is confirmed by a significant (p<0.01) decrease in 100% of objective indices of prevalence and intensity of dental hyperesthesia.
Key words: hyperesthesia of hard tissues of teeth, desensitin, «Lacalut sensitive», comprehensive therapy, гиперестезия твёрдых тканей зубов, десенсетин, «Lacalut sensitive», комплексная терапия
IMPROVING THE SAFETY OF LOCAL ANESTHESIA IN DENTISTRY BY INCREASING THE EFFICIENCY OF THE ASPIRATION TEST
Kuzmina E.V., Sotnikova M.V., Korotchenkova N.S., Kostyuchenkova Ya.A., Kuftyrev D.A.
UDC: 6.16.31-009.614
Abstract: Objective. Evaluation of the aspiration test effectiveness in local anesthesia with using carpool syringes of different plunger design and different diameters of needles. Methods. The study involved 2200 patients (20 to 75 years old) who underwent dental treatment under local anesthesia. Disposable and carpool syringes of 6 types differing in the shape of a plunger were used for infiltration and conduction anesthesia. Infiltration anesthesia in the area of teeth 1.3, 2.3, 1.8, 2.8 was performed with 3 types of needles: G22 (0,7 mm), G27 (0,4 mm), G30 (0,3 mm), and conductive anesthesia of the mandible - 2 types of needles: G22 (0,7 mm), G27 (0,4 mm). Results. Disposable syringe and carpool syringe with plunger "anchor" and "corkscrew" type allowed to carry out the aspiration test in 100% of cases, "sickle" type - in 80%. The "hook» and "arrow" design of the syringe plunger allowed performing the aspiration test only in 6% of anesthesia cases. When using a carpool syringe with a "flat" plunger, conduction of the aspiration test was impossible The study revealed that using a smaller needle diameter more often led to a positive aspiration test. Conclusion.The most effective and convenient to performing aspiration tests are carpool syringes with plungers "anchor" and "corkscrew" shape. The aspiration test performing should be recommended when using G30 needles for infiltration anesthesia. In conductive anesthesia dentists should use G27 needles, since the frequency of intravascular injection of anesthetic is less in this case.
Key words: местная анестезия, аспирационная проба, карпульный шприц, внутрисосудистое введение анестетика, local anesthesia, aspiration test, carpool syringe, intravascular injection of anesthetic
ASSESSMENT OF CHANGES IN CENTRAL HEMODYNAMIC AND MYOCARDIAL CONTRACTILITY IN PATIENTS WITH PHLEGMONS OF THE MAXILLOFACIAL REGION
Zabelin A.S., Shkitin V.A.
UDC: 617.52-002.36
Abstract: Objective. Central hemodynamic and myocardial contractility assessment in patients with phlegmons of the maxillofacial region. Methods. 73 patients with phlegmons of the maxillofacial region were examined and treated. All patients were divided into 3 groups on the basis of haematological and biochemical parameters, the severity of the disease, and the degree of endogenous intoxication. There were calculated the average dynamic pressure, stroke volume and cardiac output, and integral macrohaemodynamic indicator - shock index. Myocardial contractility was evaluated on the grounds of echocardiography. Results. Centralhaemodynamic and myocardial contractility impairment were found to depend on the severity of pyo-inflammatory process and the degree of endogenous intoxication. Conclusion. The study indicates an adverse effect of endogenous intoxication on the functionality of the cardiovascular system in patients with phlegmons of the face and neck. Patients of the third group were estimated to have the most significant changes. They had the pyo-inflammatory process, which spread to several fibrous spaces or had a progressive course. In this way, central haemodynamic and myocardial contractility indicators were assessed as adaptive or protective-adaptive in patients of the first and the second groups, but they were hyperdynamic in the third one.
Key words: флегмоны челюстно-лицевой области, эндогенная интоксикация, центральная гемодинамика и сократительная способность миокарда, maxillofacial phlegmons, an endogenous intoxication, central haemodynamic and myocardial contractility
FLUORIDEPROPHYLAXIS OF CARIES AS AN IMPORTANT COMPONENT OF COOPERATION BETWEEN A CHILD AND A DENTIST
Stepanova T.S., Kuzminskaya O.Yu., Fadeeva O.M.
UDC: 616.314-08-039.71
Abstract: Objective. Increasing the child's compliance with the doctor at the dental appointment through the use of ProfluoridVarnish (Voco) varnish. Methods. In the design of a simple open clinical study on an outpatient basis among children from 4 to 12 years old and their parents, the role of fluoroprophylaxis with ProfluoridVarnish varnish (VoCo) in assessing the collaboration of young patients with a dentist was evaluated. Results. The use of this drug in most cases makes a favorable impression on the child and helps the attending physician to increase patient compliance due to taste diversity, pleasant aroma and patient participation in the choice of taste. In 95% of cases, children agreed to cleaning followed by fluoridation, and parents were motivated to conduct this procedure on a regular basis. Conclusion. The use of ProfluoridVarnish (VoCo) has been proven to increase the compliance of a young patient and establish a positive relationship between the dentist, the child and the parents. The experience gained indicates that the non-contact young patients described above later interact more easily with the dentist during invasive treatment.
Key words: фтор, фторпрофилактика, гигиена, фторирование, детская стоматология, fluorine, fluoroprophylaxis, hygiene, fluoridation, pediatric dentistry
DIABETIC CARDIOVASCULAR AUTONOMOUS NEUROPATHY IN CHILDREN AND ADOLESCENTS
Alimova I.L.
UDC: 616.379-008.64-053.2:616.12
Abstract: Objective. Тo analyze the main results of scientific research of the Department of Hospital Pediatrics with a course of neonatology on the problem of cardiovascular autonomic neuropathy in children and adolescents with type 1 diabetes. Methods. The analysis of the scientific activities of the department, publications, materials of doctoral and master's theses performed at the department over the past 15 years. Results. Metabolic disorders and features of carbohydrate metabolism, difficulties in diagnosing various forms of diabetic autonomic neuropathy are described. The prevalence of the cardiovascular form is characterized and the criteria for the diagnosis of gastrointestinal form are proposed according to the results of daily pH-metry. The results of the use of energetic drugs in the complex treatment of diabetic autonomic neuropathy are presented. Achievements are noted and prospects for further research are indicated. Conclusion. Despite the studies, the results obtained and the significant contribution of the Department of Hospital Pediatrics neonatology course in solving many problems associated with diabetic cardiac autonomic neuropathy, some questions regarding the screening, diagnosis and treatment of this complication in children and adolescents remain today not resolved.
Key words: диабетическая кардиоваскулярная автономная нейропатия, дети, подростки, диагностика, лечение, diabetic cardiovascular autonomic neuropathy, children, adolescents, diagnosis, treatment
INFECTIVE ENDOCARDITIS: CURRENT STATE OF THE PROBLEM
Danilov A.I., Kozlov S.N., Nikolina E.A.
UDC: 616.126-002 + 615.33
Abstract: Objective. Topresent the results of studies describing the features of diagnosis and therapy of infective endocarditis. Methods. The work was performed in the framework of studying the problem of infectious endocarditis in clinical practice. During the study,published data in the scientific literature were used. Results. In recent decades, an increase in reported cases of infective endocarditis has been observed in many countries. The main reason for this trend is an increase in the number and change in the ratio of the main risk factors, among which the most important in most countries is currently injecting drug addiction and other conditions that contribute to the systematic violation of the integrity of the peripheral vascular bed. Despite the success achieved in the management of patients with infective endocarditis, the mortality rate for this disease remains quite high, amounting to more than 20% according to individual sources. Conclusions. Infective endocarditis can be caused by many microorganisms, most of which are gram-positive bacteria. However, over the past decades, significant changes have occurred in the etiological structure of the described nosology. The main one is the emergence of the leading etiological role of Staphylococcus aureus, which determines the acute course of the infectious process and a significant number of potential complications.
Key words: инфекционный эндокардит, факторы риска, микробиологическая диагностика, эхокардиография, антимикробная терапия, infective endocarditis, risk factors, microbiological diagnostics, echocardiography, antimicrobial therapy
ROLE OF MACRO- AND MICRONUTRIENTS IN THE PREVENTION AND CORRECTION OF COGNITIVE DISORDERS IN CHILDREN
Yaylenko A.A.
UDC: 616-053.2+613.22
Abstract: Objective. To provide data on the role of macro and micronutrients in the prevention and correction of cognitive disorders in children. Methods. Analysis of modern scientific data of domestic and foreign authors on this topic. Results. Nutrition and metabolism factors during the special limited periods of early human development, sensitive to their effects, can have a long-term programming effect on health, well-being and vitality in later periods of life. To date, there is a sufficient scientific basis on the role of nutritional prevention and correction of cognitive impairment, one of the reasons for the formation of which may be quantitative or qualitative malnutrition. Conclusion. Cognitive impairment in children is a significant medical and social problem that requires active action. The vast majority of cases of cognitive impairment, if already appeared, are prone to progression. The formation of cognitive impairment is often a consequence of quantitative or more often qualitative malnutrition, starting with the intrauterine period, so their prevention and correction should be comprehensive in compliance with quantitative and quality parameters of the diet within the physiological needs and possibilities of assimilation with the subsidy of micronutrients along with social, pedagogical, medical methods.
Key words: дети, критические периоды, когнитивные нарушения, макро-микронутриенты, профилактика, коррекция, pedagogical, medical methods, children, critical periods, cognitive impairment, macro-micronutrients, prevention, correction
EXPERIMENTAL STUDY OF TRANSDERMAL ETHYLMETHYLHYDROXYPYRIDINE SUCCINATE IMPACT ON FREE RADICAL OXIDATION PROCESSES IN THE TISSUE HOMOGENATE OF RATS BRAIN
Losenkova S.O., Novicov V.E.
UDC: 615.21
Abstract: Objective. The aim of this study was to assess the state of free-radical oxidation lipid processes and antioxidant activity in the brain tissue of rats in traumatic brain injury and against the background of its pharmacological correction of transdermular ethylmethylhydripiride succinate in a dose of 30 mg/kg using an express method based on registration of the biochemiluminometer. Methods. In 20 rats (equal ratio of males and females) the indicators of induced biochemiluminescence in the brain tissue of rats at traumatic brain injury, and against the background of pharmacological correction of ethylmethylhydripiridine succinate (mexidol) at its transdermal intake in a dose of 30 mg/kg in the form of transdermal therapeutic system (TDTS) were assessed and intra-abdominal administration in a dose of 15 mg/kg in a comparative aspect was given. Results. At pharmacological correction of edema-swelling of brain of animals cerebroprotective activity of ethyl methylhydroxypyridine succinate (mexidol) is proved at transdermal (percutaneous) introducing, which manifests itself not only in the reduction of the content of total and free water, increase in the content of bound water and coefficient of hydration, but also in decrease the activity of free radical oxidation processes in the tissue homogenate of brain in the course of transdermal introductionfor 5 days prior to the traumatic brain injury and 3 days after the injury in a dose of 30 mg/kgwithintervals of replacement of transdermal therapeutic system 1 time in 3 days. Conclusion. The results of the study indicate that the pharmacological activity of ethylmethylhydroxypiridine succinate during its transdermal (perskin) introduction is maintained. Transdermal ethylmethylhydroxypiridine succinate at a dose of 30 mg/kg during course administration reduces the activation of free-radical oxidation (SRO) processes in the homogenate of brain tissue.
Key words: антиоксиданты/антигипоксанты, черепно-мозговая травма, свободно-радикальное окисление липидов, трансдермальный этилметилгидроксипиридина сукцинат, antioxidants/antihypoxants, craniocerebral injury, free radical oxidation of lipids, transdermal ethyl methyl hydroxypyridine succinate
REVIEW OF THE LEGISLATIVE FRAMEWORK REGULATING ASPECTS OF MEDICAL AND PHARMACEUTICAL CARE FOR CHILDREN AND ADOLESCENTS WITH CARDIOVASCULAR DISEASES
Kozlova L.V., Krikova A.V., Mikhailova O.S.
UDC: 615.014:616.12-053.2
Abstract: Objective. Analysis of normative and legal documentation regulating aspects of medical and pharmaceutical care for children and adolescents with cardiovascular diseases. Methods. The content-analysis method was applied to study the legal framework regulating the provision of medical and pharmaceutical care to children and adolescents with cardiovascular diseases. Results. As a result of the content analysis of the regulatory framework regulating health care and the procedure for providing medical and pharmaceutical care to children and adolescents with cardiovascular diseases at the Federal and regional level, it was found that the Russian legislation is a structure which activities are aimed at preserving the life and health of children, reducing the prevalence of diseases and disability in the future working age. Conclusion. Russian legislation on the protection of children's health is represented by Federal Laws, Decrees and Orders of the President of the Russian Federation, Resolutions and Orders of the Government of the Russian Federation. The above-mentioned legal sources regulate the relations arising in the sphere of health protection of citizens, including children, teenagers and define legal, organizational and economic bases of health protection, the rights and duties of the person in the sphere of health protection, guarantees of realization of these rights, powers and responsibility of public authorities of the Russian Federation.
Key words: нормативно-правовое регулирование, дети и подростки, медицинская и фармацевтическая помощь, legal regulation, children and adolescents, medical and pharmaceutical care
PROBLEMS OF HEALTHCARE STANDARDIZATION: ATTITUDE OF DOCTORS TO STANDARDS AND MEDICAL ERRORS
Tikhonova N.K., Gavrilov S.N., Dehnich S.N., Kamanin E.I., Tikhonov V.G.
UDC: 614.2
Abstract: Objective.To assess the attitude of doctors to standards and characterize medical errors. Methods. The study interviewed 260 doctors from the Smolensk and Kaliningrad regions who provide medical care to children. The author's questionnaire was used to determine the attitude of practitioners to the Standards. We analyzed 346 accounting forms N112/y "History of the development of the child" and 63 - “Medical records of inpatients” of young children with a respiratory disease (ICD-10 code J 06.9; J 20.9). Results. Low (from 38.4% to 46.1%) awareness of doctors providing primary health care and specialized medical care for children about the standards of medical care for the main classes of diseases was established. At the same time, only 76.6% of hospital doctors and 85.1% of polyclinics used the Standards in practice, and 46.5% and 84.3% of them, respectively, consider the treatment according to the Standard more effective. Inadequate provision of primary health care to children was identified in 100% of cases, specialized - in 94.3% of cases. Conclusions. At present, the state of Russian healthcare is undergoing a series of transformations related to financing and management. The uncertainty of the object of payment and pricing, the inability to copy the standards for individual patients, lead to a vicious practice of their application. The lack of awareness of doctors about the Standards, the negative attitude and the refusal to use them require strengthened administration. The provisions of the legislative framework on the mandatory standards of medical care are ambiguous and require substantial clarification. It is necessary to formulate the concept and the causal complex of medical error, as well as inadequate medical care, in regulatory acts in the field of healthcare.
Key words: стандартизация, качество медицинской помощи, стандарты медицинской помощи, standardization, quality health care, standards of care
TUBERCULOSIS: EPIDEMIOLOGICAL SITUATION IN THE SMOLENSK REGION
Gudenkov M.A., Krikova A.V., Evseev A.V., Zaitseva V.M., Dmitrieva E.V.
UDC: 616-01/-099
Abstract: Objective. The aim of the study was toassess TB epidemiological situation in the Smolensk region in 2016-2018. Methods. Content analysis of the regulatory documentation regulating prevention, detection and treatment of socially significant diseases, including tuberculosis, was carried out. The data obtained from the reports of the Smolensk Region Physiatric Service for the period from 2016 to 2018 were analyzed. Descriptive statistics method was applied. Results. Strategic Regional Public Health Programme is aimed at improvement of TB epidemiological situation and significant reduction of TB incidence by the year 2025: in 2019 up to 45.0 per 100 thousand population; in 2020 up to 43.0 per 100 thousand population; in 2021 up to 41.0 per 100 thousand population; and in the year 2022 up to 39.0 per 100 thousand population; in 2023-to 37.0 per 100 thousand population; in 2024 up to 35.0 per 100 thousand population. Smolensk region is involved into the National TB Program to achieve the really ambitious goals by the year 2035. However, the achievement of the goals is possible if we are able to expand the scope and coverage of TB treatment and prevention activities, with a focus on high-impact, integrated and patient-centered approaches; to maximize the results with joint activities of the government, the community and private sector representatives; as well as to involve research and innovations that can significantly improve our results in TB prevention and treatment. Conclusion. According to statistic data, in 2018, 8,617 people died of tuberculosis infection in Russia, including 7,072 Russian residents (82.1%). In addition, 7,857 HIV-infected tuberculosis residents died. In 2018, 20,593 TB patients died of various causes. Of these, 8,022 patients were infected with HIV (39.0% of various-cause deaths). The figures demonstrate that HIV infection is able to prevent a significant reduction in "tuberculosis incidence" and can increase mortality rates in TB patients in several regions of the Russian Federation. In order to control immunization of the population, regional public health authorities organize regular monitoring of the campaigns of preventive vaccinations. The results of the activities are reported to the Smolensk Regional Department of Public Health Department for further preventive measures.
Key words: туберкулез, эпидемиология, заболеваемость, смертность, профилактика, tuberculosis, epidemiology, morbidity, mortality, prevention
DEVELOPMENT OF GERIATRIC SERVICES IN THE SMOLENSK REGION (HISTORICAL REVIEW)
Golovanova E.D., Schlyager E.V., Titova N.E.
UDC: 613.98(470.332)
Abstract: Objective. Analysis of the 20-year stage in the development of the geriatric service of the Smolensk region in the aspect of pedagogical, research and practical activities. Methods. Several types of different sources were used in the work on the stated topic: archival data from the teaching materials of the Department of Therapy, Functional and Ultrasound Diagnostics and the Department of General Medical Practice, outpatient therapy with the course of Geriatrics of the Faculty of Continuing Professional Education of SSMU, materials of scientific reports from these departments for the period 2000 -2020, data from the archive of the Hospital for War Veterans - orders, guidelines of the Ministry of Health of the Russian Federation, government decrees. All the materials studied were divided into three thematic sections: the pedagogical process, research work and the development of the medical service according to the profile of “geriatrics”. Results. Historically, training centers for improving care for elderly and senile patients were hospitals for War Veterans, where there was an accumulation of "experience" in working with older patients among doctors of various specialties, but mainly therapists, neurologists and psychiatrists as well as nursing staff. The use of hospitals as clinical bases for postgraduate training of doctors and undergraduate training of medical students in the specialty "Geriatrics" was the best tactic for improving the pedagogical process in this area of medicine. The contingent of hospital patients is represented by three age groups - the elderly, senile and “long-livers”, which gives a wide scope for scientific work: studying the epidemiology of age-associated diseases, the diagnosis of geriatric syndromes, studying various aspects of pharmacotherapy in patients of older age groups. Conducting a statistical analysis of the population changes in different age groups allows you to calculate the needs of the region for specialists in the geriatrics profile, determine their routing to the corresponding hospitals, determine the training needs for specialists of this profile for outpatient care, organize medical examination of citizens overworking age in medical organizations providing primary health care to the population of the Smolensk region. Conclusion. The development of geriatric services is a priority for healthcare due to a sharp increase in the number of patients of older age groups served by primary care physicians.
Key words: гериатрия, последипломная подготовка врачей, гериатрический центр, пожилой возраст, geriatrics, postgraduate training of doctors, geriatric center, advanced age
DEPARTMENT OF HOSPITAL PEDIATRICS WITH A NEONATOLOGY COURSE AT THE FACULTY OF CONTINUING PROFESSIONAL EDUCATION: ON THE 50TH ANNIVERSARY OF THE FOUNDATION
Alimova I.L., Ibatulin A.G., Novikova O.B., Pashinskaya N.B., Pleskachevskaya T.A.
Abstract: The Department of Hospital Pediatrics with a course of neonatology FDPO was founded in 1970 in connection with the opening of a pediatric faculty at the Smolensk Medical Institute. The great merit in the creation and development of the faculty of pediatrics and the department of hospital pediatrics belongs to Anna Timofeevna Petryaeva, doctor of medical sciences, professor, Honored Worker of Science of the Russian Federation, who worked as a professor of the department from 1970 to 1974.
CONTINUITY, SCIENTIFIC AND PEDAGOGICAL TRADITIONS OF THE DEPARTMENT OF PEDIATRIC PROPEDEUTICS (TO THE 50TH ANNIVERSARY OF THE DEPARTMENT)
Legon'kova T.I., Stepina T.G., Vojtenkova O.V., SHtykova O.N., Stolyarova L.A.
Abstract: The department of propaedeutics of childhood diseases and faculty pediatrics was organized in 1969 and in 2019 celebrated its 50th anniversary. The first head of the department was Antonina Georgievna Gracheva, a representative of the Smolensk Pediatricians School, founded by Anna Timofeevna Petryaeva. A.G. Gracheva - a graduate of the Smolensk Medical Institute, in 1963 she graduated from a clinical graduate school at the Department of Children's Diseases and in the same year she defended her thesis, and in 1972 - her doctorate. Under the guidance of A.G. Gracheva began the formation of the scientific work of the department, 6 candidate dissertations were completed (Chebykina N.I., Shkurkina L.G., Mikhalik R.V., Stepina T.G., Avdeeva T.G., Shestakova V.N.). The main scientific direction of the department was the pathogenesis, clinic and treatment of pneumonia, the study of lipid and carbohydrate metabolism in children and other pressing problems of pediatrics. In subsequent years, as Deputy Minister of Health of the Russian Federation for Maternity and Childhood, Gracheva A.G. has always been inextricably linked with the native institution.