Vol 34, No 4 (2023)

Arterial hypotension is a systemic hemodynamic disorder that is defined as a decrease in blood pressure below 90/60 mm Hg, caused by changes in cardiac output or systemic vascular resistance or both of these values, and that can lead to organ and tissue hypoperfusion. The review considers the epidemiology, etiology, and pathogenesis of this condition. Particular attention is paid to the classification of hypotension based on various biometric parameters, by the rate of occurrence and time of exposure, taking into account the impact on organ perfusion. The symptomatology and diagnosis of hypotension are analyzed; its complications are described.

The paper presents the evolution of classification notions of vibration disease as well as modern approaches to classification, diagnostics, prevention, examination of professional fitness, examination of relation of disease to profession in vibration disease developed under the influence of local and general vibration in industrial workers.

The COVID-19 pandemic has made it possible to study many aspects of the laboratory diagnosis of this infection, including the assessment of the viral load and viral activity of SARS-CoV-2. The review presents data on modern views on the virological characteristics of the SARS-CoV-2 virus, however, many aspects of this problem remain debatable. The issues of the relationship between the level of viral load and the clinical profile of patients are proposed for discussion, and the possibility of using the obtained data in practical healthcare is discussed. The control of viral load in patients with COVID-19 has not only a certain clinical significance, but is also undoubtedly important in the epidemiological aspect. Monitoring of a number of SARS-CoV-2 parameters. will allow to solve practical problems in the context of the ongoing pandemic.

The article presents an analysis of the epidemiological situation of ixode tick-borne borreliosis (TBE) in the Northern territory of the Krasnoyarsk region for the period 2008–2022. The subject of the investigation was the incidence rates of TBE, contamination of Ixodes ticks with Borrelia burgdorferi sl. 293 cases were registered (16,33 on 100 thousand population). The studies have significantly expanded the idea of the number of infections of Ixodes ticks. Monitoring data showed activity and potential danger of natural foci of the Northern territory of the Krasnoyarsk region. The real threat of infection exists both in forests and in cities and suburban areas.

In patients with a painful form of external genital endometriosis (EGE), the prevailing symptom is chronic pelvic pain, which significantly reduces the quality of life (QoL). It causes disorders of the physical, psycho-emotional and sexual health of women of reproductive age, leading to distress, maladaptation, anxiety-depressive disorders, disruption of social functioning and family relationships.

Objective. To evaluate the effectiveness of the rehabilitation program for women with a painful form of EGE after radical treatment in the rehabilitation period.

Materials and methods. In the examined cohort were included a total of 104 patients of reproductive age 42.4±3.7 years with a painful form of EGE after radical treatment: Group 1 – 49 women with "active" rehabilitation; Group 2 – 55 patients with "passive" rehabilitation tactics in accordance with standards and National Clinical Guidelines. Integral assessment of QoL (objective) was performed using clinical, laboratory (cancer antigen-125 (CA-125), cancer antigen-19.9 (CA-19.9), interleukin-6 (IL-6), tumor necrosis factor (TNF), femoflor – 16, pH-metric titration), and instrumental studies (ultrasound, magnetic resonance imaging (MRI)). At the control points: before, in 5–9 days, 1,3,6 and 12 months after surgical treatment.

Results. Patients with "active" rehabilitation tactics (Group 1) had a significantly more pronounced decrease in the levels of the assessed biomarkers in blood serum, normalization of the urogenital tract microbiocenosis and restoration of pelvic organs and structures, unlike patients in the comparison group.

Conclusion. The use of comprehensive personalized rehabilitation in patients with painful form of EGE after radical treatment has demonstrated its effectiveness. Widespread introduction of rehabilitation programs into routine clinical practice is necessary.

The hereditary predisposition of coronary heart disease is well known, especially in first-degree relatives. We present two cases – mother and son with coronary artery involvement. Initially, endovascular treatment was performed on a 44-year-old son admitted with acute myocardial infarction, 7 years later developed restenosis in the stent, which required repeated intervention. Four months later coronarography and stenting was performed his mother 78 years old with acute myocardial infarction. Genetic factors can influence both the risk of coronary heart disease and the risk of in-stent restenosis.

A comprehensive examination was made in 81 patients with chronic cerebrovascular disease (CVD) concurrent with type 2 diabetes mellitus. The patients were divided into 3 groups: 1) patients with mild cognitive impairment (CI) (Study Group 1); 2) patients with moderate CI (Study Group 2); 3) patients without CI (a comparison group). The investigators studied the neuroimaging structure of the brain substance (BS) and the state of the brachiocephalic vessels. The study showed that the morphofunctional changes in the brain were most pronounced in moderate CI Group 2, which confirmed the association between the severity of clinical manifestations of CVD and atherosclerotic lesions of the cerebral vessels and degenerative changes in the BS. Analysis of MMSE and MoCA scores indicated statistically significant differences between the indicators of the comparison group and the study groups, as well as between those of Groups 1 and 2. There were statistically significant differences in the incidence of postischemic subcortical cysts in the brain between Group 2 and the comparison group, as well as between Groups 1 and 2.

The article presents the results of duplex scanning of the common carotid arteries (CCA) and assessment of the structural and functional state of the vascular bed of 57 women with arterial hypertension (AH) with hypoestrogenemia. It was found that with hypertension with a reduced level of estradiol, the lumen of the OCA increases, the speed of blood flow in the carotid arteries decreases, which indicates vascular remodeling. In the studied patients, in every third case, an inertial type of vasomotor reaction is detected before treatment, which indicates the contribution of dishormonosis to the progression of hypertension due to the development of endothelial dysfunction. Combined therapy with phytoestrogens and ACE inhibitors improves the structural and functional characteristics of the vascular wall, reduces arterial stiffness. The drug Femoklim is a source of phytohormones, hormones of entomological origin and natural antioxidants, has a positive effect on the state of the vascular system, improves blood microcirculation, is a capillary protector, has a complex harmonizing effect on the body.

Objective. To study the relationship between vitamin D level and biochemical blood parameters in patients over 60 years of age with osteoarthritis (OA).

Material and methods. In the investigation 200 patients aged 60–80 years (mean age – 69,03±2,34 years; 170 [85%] women and 30 [15%] men) with OA being observed in the out-patient medical institutions of Murmansk including 100 patients after total joint replacement took part. Vitamin D, triglycerides, thyroid stimulating hormone (TSH), total cholesterol, low and high density lipoproteins, blood glucose, uric acid, creatinine, total protein, and blood calcium levels were determined in all patients.

Results. Vitamin D deficiency was more frequently observed in the group of patients who did not receive surgical treatment compared to patients who underwent arthroplasty. A statistically significant relationship between vitamin D level and blood glucose was detected in the group of non-prosthetic patients. The relationship between vitamin D level, albumin and TSH was revealed in the group of prosthetic patients.

Respiratory tract infections are the main cause of temporary disability for work and take a major toll on economies in whole world. Early and accurate detection of etiological agent will improve treatment efficiency and prevent spreading of epidemy. The reagent kit for simultaneous detection of influenza A, B virus, H1pdm09 influenza A strain and coronavirus SARS-CoV-2 was developed. For clinical validation TIB Molbiol (E gene) kit (for detection of SARS-CoV-2) and CDC Influenza Virus Real-Time RT-PCR Panel Influenza A/B typing Panel were used. The assay has shown high sensitivity and specificity against different strains of SARS-CoV-2 and influenza viruses. The analytical sensitivity was 500 copies/ml for detection of Influenza A and B viruses and 250 copies/ml for SARS-CoV-2. No cross-reaction with other respiratory pathogens was detected. Clinical sensitivity and specificity against comparator test were 100%. Developed reagent kit intended for use in clinical laboratories for differentiating diagnosis of coronaviral infection and influenza A and B.