Vol 25, No 1 (2019)

Articles
BASE TREND ON NUMBER OF RUSSIAN ADOLESCENTS (AGED 15-17) REQUIRE FOR MEDICAL SUPERVISION IN 2000-2015 YEARS
Banteva M.N., Matveev E.N., Manoshkina E.M.
Abstract
The increase in the incidence of adolescents in Russia is confirmed by many special studies. An analysis of the statistic data for 2000-2015 years, showed that in Russia there was an increase in the number of adolescents (15-17 years) require for medical supervision from 410 to 486 cases per 1000 of the corresponding population (18.5%), however over the last 5 years, it declines (an average annual growth of -1.1%). The highest growth in 15 years was found in the following classes: neoplasms (126.7%), congenital anomalies (malformations) (57.6%), diseases of the musculoskeletal system and connective tissue (58.2%), diseases of the cardiovascular system (55.0%). The decrease in the number of adolescents (15-17 years) require for medical supervision for the indicated period was in three classes: some infectious and parasitic diseases (-68.2%), mental and behavioral disorders (-46.2%), injuries and poisonings (-20.8%). The balance of the number of the studied group of adolescents in 2015 was negative and amounted to -9.1% due to the excess of the number of people taken out of the register (39.0%) over the number of registered persons (48.1%), what indicates a decrease in the number of adolescents require for medical supervision. At the same time, a positive balance was observed only in two classes: injuries and poisonings (42.1%), pregnancy, deliver and puerperium (9.1%). Negative balance of the studied contingent was observed for all other classes of diseases, the highest ones: congenital anomalies (malformations) (-17.9%), mental and behavioral disorders (14.9%), respiratory diseases (-14, 2). Since the health of children and adolescents determines the health of the future nation, its preservation is an important task, the implementation of which requires the development of prophylaxis for the prevention of diseases with the definition of their targeted introduction (school, home, healthcare institutions), as well as treatment of diseases of children and adolescents, including, the format of special medical observation.
Medical Journal of the Russian Federation. 2019;25(1):4-10
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PECULIARITIES OF MEDICAL CARE FOR PATIENTS IN DEPARTMENT OF NURSING CARE
Teptin S.E.
Abstract
The purpose of the study is to study the peculiarities of organization of care for patients in the nursing Office. An analysis of case histories of 504 patients treated in the Nursing Department and 200 questionnaires of patients and their relatives about the quality of care and assistance. Considered the composition of the patients, the availability of diagnostic studies and consultation expertise, especially providing diagnostic assistance offices, nursing care, treatment outcomes, consumer opinion medical services.
Medical Journal of the Russian Federation. 2019;25(1):11-15
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DECREASED REDOX-POTENTIAL AND HYPERPRODUCTION OF SUPEROXIDE ANION IN BLOOD PREDICTS CARDIAC ARRHYTHMIAS AFTER DIRECT SURGICAL MYOCARDIAL REVASCULARIZATION
Kovalev S.A., Chubirko I.M., Verikovsky V.A., Malikov V.E., Arzumanyan M.A., Sukoyan G.V.
Abstract
The aim of investigation was the evaluation of prognostic value of redox-potential decreasing and hyperproduction of superoxide anion in plasma with or without of total pool of pyridine nucleotides decreasing in the in-hospital complications after direct surgical myocardial revascularization. 303 patients (248 male and 48 female), mean age 58,6±6,8 years with diagnosis of ischemic heart disease and sinus rhythm without marked left ventricular dysfunction which undergoing coronary bypass graft surgery were included in the multicentral prospective study. European System for Cardiac Operative Risk Evaluation (EuroScore) and the incidence rates of post-procedural ischemic stroke CHADS2 and CHA2DS2-VASc score were calculated. Total pyridine nucleotide pool, redox-potential, hyperproduction of superoxide anion and activity of NADPH-oxidase in blood plasma were determinate before and one year after cardiac surgery. For statistical analysis the SPSS version 23.0 (SPSS Inc. Chicago, Ill) was used, all variables are expressed as mean±standard deviation (SD). The maximum of appearance of postoperative atrial fibrillation (POAF) developed in 34% patients after 1-2 days from cardiac surgery. In the cohort of patients with POAF complicated with decease of redox-potential NAD/NADH by 23% (р<0,01) in comparison with sinus rhythm maintenance group. In group with POAF the AF after 1 years maintained in 45% cases, and developed in 14,5% cases in group with post-operative sinus rhythm. In according with ROC-analysis the area incidence of POAF-NAD/NADH equal 0,92 (р<0,0001), sensitivity of 83,4% and specificity of 91,4%. Redox-potential NAD/NADH level with considered the concentration of superoxide anion and activity of NADPH oxidase in pre-operative plasma of patients undergoing surgical myocardil revascularization could accurately predict the onset of de novo POAF. Thus, plasma NAD/NADH could consider as a candidate for predictive biomarker of common arrhythmia under cardiac surgery.
Medical Journal of the Russian Federation. 2019;25(1):16-21
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PREDICTORS OF LONG-TERM ADVERSE PROGNOSIS IN PATIENTS WITH ACUTE CORONARY SYNDROME WITH ST-SEGMENT ELEVATION
Berns S.A., Zakharova V.A., Shmidt E.A., Golikova A.A., Lynev V.S., Zverev K.V.
Abstract
Aim: Identification of predictors of unfavorable annual prognosis in patients with acute coronary syndrome with ST-segment elevation (STEMI). Material and methods: The study included 69 patients with STEMI who were hospitalized in the period from March 2014 to January 2017 in the hospital named after Zhadkevich. The follow-up period was 12±3 months after the index STEMI Longterm prognosis was established in 62 (89.8%) patients. Results: the fatal outcome was observed in 7 (11.3%) patients. Nonfatal myocardial infarction developed in 10 (16.2%), hospitalization with heart failure decompensation - in 5 (8%), nonfatal acute cerebrovascular accident - in 3 (4.8%) patients. Predictors of adverse prognosis were: age >60 years, level of brain natriuretic peptide (BNP) >29.2 pmol/l, C-reactive protein (CRP) >4.7 mg/l, left ventricular ejection fraction (LVF) <42%. The final model for predicting adverse outcomes included age >60 years and BNP level >29.2 pmol/l. Conclusion: Adverse factors affecting the long-term outcome of the disease (12±3 months after the STEMI) are: BNP level >29.2 pmol/l, CRP level >4.7 mg/l, LV FV value <42% and age >60 years.
Medical Journal of the Russian Federation. 2019;25(1):22-27
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COMPARISON OF THE RESULTS OF LAPAROSCOPIC CRURORHAPHY AND ALLOPLASTIC FOR LARGE HERNIAS OF THE ESOPHAGEAL APERTURE OF THE DIAPHRAGM
Rozenfeld I.I., Chilikina D.L.
Abstract
The article describes the results of surgical treatment of 323 patients with large hernias of the esophageal aperture of the diaphragm with an area of a hernial defect of 10-20 cm2, which were operated from 2014 to 2017 on the basis of the surgical departments of the Tver region: Regional Clinical Hospital and the State Clinical Hospital No. 7 of the city Tver. In this study, the comparative results of crurorhaphy and alloplasty with large hiatal hernias were determined.
Medical Journal of the Russian Federation. 2019;25(1):28-31
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MOTIVATION OF PATIENTS TO PREVENTION AND TREATMENT OF DENTAL DISEASES
Khelminskaya N.M., Goncharova A.V., Kravets V.I., Krasnov N.M.
Abstract
The dental morbidity of the maxillofacial region was studied in1375 patients living in a large city and metropolis. Carry out the risk factors affecting the sikness rate, types and frequency of complications of the underlying spoted, incidence of concomitant diseases. Analysis of the dynamics of dentistrydiseases allows you to find an integrated approach to improvethe level of dental health of the population, and the development of effectivetherapeutic and preventive measures.
Medical Journal of the Russian Federation. 2019;25(1):32-35
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STANDARDIZATION OF DESCRIPTION OF MEDICAL PRODUCTS
Koshechkin K.A., Romanov B.K., Olefir Y.V.
Abstract
Prerequisites and results of the work carried out by the Scientific Centre for Expert Evaluation of Medicinal Products on the standardization of the values of international non-proprietary, grouping and chemical names of drugs, anatomic-therapeutic-chemical classification, dosage forms, dosage units and other data are presented. The information is reduced to the same unique values in terms of information about identical drugs. This information is required for inclusion in a single directory drugs classifier, created to automate the management of drug purchases and implementation of a system for monitoring the movement of drugs. The work also substantiates the need for further revision and updating of the previously conducted work on the unification of information fields, and the revision of positions that did not previously require processing due to their uniqueness. The prospects for standardization of the description of medicines within the framework of the single market of the countries of the Eurasian Economic Union are outlined.
Medical Journal of the Russian Federation. 2019;25(1):36-39
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HYALURONIDASE: AN EXPERIMENTAL CONFIRMATION OF THE PROPERTIES OF THE ENDOLYMPHATIC CONDUCTOR
Kukushkin G.V., Zhuravleva M.V., Sviridkina L.P., Yurov D.E.
Abstract
One of the major achievements of contemporaneous pharmacology is the clinical implementation of the agents (the so called “endolymphatic conductors”) that allow for targeted delivering of antibiotic into the lymphatic system. Their use provides the basis for the lymphotropic treatment method that has been implemented into various areas of medical practice. Hyaluronidase is the most known agent used for this purpose. It has been shown that its preliminary administration before the injection of an antibiotic can improve clinical efficacy of the treatment; however, there is a need in the experimental validation of this approach to antibacterial therapy. The study was aimed at evaluation of hyaluronidase effects on the rate of lymphatic drainage of tissues and cefotaxime pharmacokinetics. We measured the time of elimination of lymphotropic Evans blue dye from the mouse mesentery when administered against the background of hyaluronidase, changes in cefotaxime levels over 24 hours in rabbit plasma and in mice plasma, gut tissues and liver at 1,5 and 24 hours after combined administration of hyaluronidase and the antibiotic. In addition, we calculated the liver to plasma ratio for the antibiotic concentrations. The data obtained shows that hyaluronidase can stimulate tissue lymphatic drainage. Its preliminary administration results in higher cefotaxime levels in rabbit and mice plasma at all time points of the study, compared to cefotaxime monotherapy, with prolongation of its systemic circulation of up to 24 hours. The use of cefotaxime after hyaluronidase leads to an increase of its levels in the mice gut tissues both at 1,5 and 24 hours, but has no effect on the antibiotic accumulation in the liver of the animals. However, the calculated liver to plasma blood ratio of cefotaxime after the administration of hyaluronidase is significantly lower than in the animals with the antibiotic monotherapy. This may indirectly indicate to a decrease in the hepatic extraction of the antibiotic when administered with hyaluronidase. The study results confirm that hyaluronidase has the properties of a lymphatic stimulator and an endolymphatic conductor for the water-soluble antibiotic cefotaxime.
Medical Journal of the Russian Federation. 2019;25(1):40-43
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POSSIBLE MECHANISMS OF THYMUS PEPTIDES ANALGESIC ENDPOINT
Novoseletskaya A.V., Kiseleva N.M.
Abstract
Thymus polypeptides participate in stress-limiting system work. Considering that electropain stimulation is the main stress factor in many behavioral models, it is logical to assume that thymus polypeptides have analgesic activity. The objective of this research is study of opioid and serotoninergic systems role of thymus polypeptides analgesic endpoints implementation. The rats presented with tactivin and thymulin thymus peptides analgesic activity during tail withdrawal test, which is totally blocked by naloxone, and thus is based on opioid system activation. This effect is associated with appeared serotoninergic component of stress-induced analgesia. The possible mechanism of analgesic action and the role of serotoninergic system of thymus peptides were offered based on the results of the research conducted.
Medical Journal of the Russian Federation. 2019;25(1):44-48
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CASTRATION-RESISTANT PROSTATE CANCER: NEW PERSPECTIVES IN PHARMACOLOGICAL TREATMENT
Andreev D.A., Zavyalov A.A., Govorov A.V., Kokushkin K.A., Davidovskaya M.Y.
Abstract
Prostate cancer remains one of the most actual problems in oncourology due to its high prevalence and resistance to therapy. Within 5 years of active treatment and follow-up, the castration-resistant prostate cancer (CRPC) develops in 10-20% of patients. This type of disease course resists treatments and leads to death. Medical resources distinguish two different forms of CRPC: non-metastatic and metastatic. Such separation is critically important because each of two forms requires different treatment algorithms. This paper summarizes the main outlines of foreign clinical guidelines and reviews the new treatment options for non-metastatic and metastatic CRPC as wells as the design and results of key clinical trials on drug efficiency. To prepare the review, the comprehensive literature search was conducted using PubMed/Medline, the Cochrane Library, EMBASE, CyberLeninka, e-library databases. The search line included phrases containing the following words: prostate cancer, castration-resistant prostate cancer, drug therapy, treatment algorithms, clinical studies, etc. In accordance to foreign guidelines, it is essential to determine the high risk patients with non-metastatic CRPC and promptly apply new therapeutic options including apalutamide and enzalutamide, which have proven being effective in clinical trials as therapies that attenuate the transition of the non-metastatic CRPC to the metastatic stage. Foreign medical guidelines propose to apply a wider set of treatment algorithms for patients with metastatic CRPC, for instance: considerations on possibilities to use the cabazitaxel instead of docetaxel in the 1st line therapy in patients with pre-existing mild peripheral neuropathy, etc. as well as new therapies - pembrolizumab and sipuleucel-T. The issues regarding the selection of patients with CRPC for specific treatment algorithms and defining the optimal sequence of therapeutic regimens as well as combining various regimens with minimizing toxic effects and maximizing patient benefits remain unsolved.
Medical Journal of the Russian Federation. 2019;25(1):49-58
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VITAMIN D NEPHROPROTECTIVE STRATEGY OF CHILDREN WITH CHRONIC RENAL DISEASE
Semin S.G., Kolbe O.B., Moiseev A.B., Turchinskaya A.I., Vartapetova E.E.
Abstract
According to current conception, the process of forming of nephrosclerosis despite the origins is detected by the force of the same cellular and molecular mechanisms. Hence primary triggers cause elevated production of range of cellular response mediators, cytokines and growth factors such as transforming plateled-derived growth factor, fibroblast growth factor, interferon gamma, nuclear factor and others, by means of sequential processes, is followed by the replacement of kidney tissue. One of the most studied aspects of the process of nephrosclerosis is the influence of anginotensin II. Therefore, despite the triggering factors, development and progression of nephrosclerosis all children with chronic renal disease are in a risk group with predisposition for renal insufficiency and it is required to prescribe nephroprotective therapy, i.e. the drugs that will influence one of the links of the nephrosclerosis, in order to slow down its progression. Currently, with nephroprotective goal in early age are used the following elements - angiotensin converting enzyme inhibitors and angiotensin receptors, antogonists (blockers). Lately, the active search for effective and safe drugs with nephroprotective effect on one side and great interest towards undiscovered before qualities of Vitamin D caused a huge amount of works that support the effect of Vitamin D. Prescription of Vitamin D to animals with uremia was followed by the drop of apoptosis of podocides and loss of the protein that is contained in the split diaphragm that caused decrease in proteinuria. Vitamin D suppresses protophibrotic TGF-B1 in tubular epithelial cells. The regression of tubulointerstitial phibrosis under the influence of Vitamin D was confirmed based on the cases of animals with obstruction of urethra. Along with the use of the mentioned above groups of drugs, which effectiveness was proved experimentally and clinically, we strongly believe the more thorough study of the Vitamin D drug use is needed, especially to study the prevention and slowing down of the progression of nephrosclerosis in the cases of children with chronic renal disease. It is crucial to detect the exact dosage of the drug, the prescription period and the methods for the control of the effective concentration of the drug.
Medical Journal of the Russian Federation. 2019;25(1):59-64
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