Age-specific normative data of computerized capillaroscopy and laser Doppler flowmetry
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01.01.2018 |
Geppe N.
Kolosova N.
Gerasimov A.
Denisova A.
Botneva A.
Lozko N.
Denisova V.
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Voprosy Prakticheskoi Pediatrii |
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0 |
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© 2018 Dynasty Publishing House. All rights reserved. The objective. To determine age-related specificities of microcirculation-tissue systems in children from varied age groups. Patients and methods. We analysed the results of examining healthy children aged 3 to 17 years and also young people under 25 years of age with the use of nail-fold capillaroscopy (n = 65) and laser Doppler flowmetry(n = 50). Results. According to capillaroscopy, no significant differences in microcirculation parameters in children of varied age have been obtained, but as has been found, diameters of all parts of capillaries and the width of perivascular spaces increased to some extent with children's age. Also, the density of first-line capillaries increased with age in the examined patients. The average microcirculation values obtained by LDF did not show any statistically significant difference between children from the age group 7 to 13 years and children aged 13 to 18 years. Microcirculation parameters are not dependent on a patient's age. The average values of PI may be used as reference parameters for diagnosing microcirculation impairments in children with varied pathologies. Conclusion. The capillaroscopy values and basal microcirculation values that we have obtained may be used in practically healthy children for comparison with such values in children with varied pathologies, which might be helpful in diagnosing various diseases and disorders at early stages and exercising control over treatment with selection of individual pharmacotherapy.
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Typical forms of liver pathology in children
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01.01.2018 |
Litvitskiy P.
Maltseva L.
Morozova O.
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Voprosy Sovremennoi Pediatrii - Current Pediatrics |
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0 |
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© 2018 Publishing House of the Union of Pediatricians. All rights reserved. This lecture for the system of postgraduate medical education analyzes causes, types, key links of pathogenesis, and manifestations of the main typical forms of liver pathology-liver failure, hepatic coma, jaundice, cholemia, acholia, cholelithiasis, and their complications in children. To control the retention of the lecture material, case problems and multiple-choice tests are given.
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Clinical and pharmacological approaches to optimize the dosing regimen of antibacterial drugs in pediatrics
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01.01.2018 |
Lazareva N.
Chikh E.
Drozdov V.
Rebrova E.
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Voprosy Sovremennoi Pediatrii - Current Pediatrics |
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0 |
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© 2018 Publishing House of the Union of Pediatricians. All rights reserved. The rational use of antibacterial drugs in children implies an adequate choice of the necessary medication, its dosing regimen, and the duration of treatment in order to achieve maximum efficacy and minimize toxic effects. The knowledge of pharmacokinetic and pharmacodynamic profiles of the antibacterial drug plays a crucial role for optimizing the dosing regimen. The strategy of individual choice of the dosing regimen, taking into account the principles of pharmacokinetics and pharmacodynamics, can be especially effective in patients with the expectedly changed parameters of pharmacokinetics and in infections caused by bacteria strains with low sensitivity to antibiotics. The review presents a contemporary view of pharmacokinetic and pharmacodynamic profiles of antibacterial drugs most commonly used in pediatrics and their relationship to the clinical efficacy of the administered therapy.
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Clinical and anamnestic, immunological, echographic, and hysteroscopic features of chronic endometritis associated with impaired reproductive function
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01.01.2018 |
Ishenko A.
Unanyan A.
Kogan E.
Demura T.
Kossovich J.
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Vestnik Rossiiskoi Akademii Meditsinskikh Nauk |
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1 |
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© 2018 Izdatel'stvo Meditsina. All rights reserved. Background: The widespread prevalence of infertility, the low effectiveness of assisted reproductive technologies (ART), and the high incidence of chronic endometritis (CE) in infertile women determine the relevance of the considered problem. The aim of the study was to determine the clinical and anamnestic, laboratory, and instrumental features of CE associated with infertility and unsuccessful IVF cycles in women of reproductive age. Materials and methods: The study enrollred 150 women of reproductive age with morphologically established CE (main group, n=120) and without CE (control group, n=30). A subgroup I of the main group included 64 patients with infertility and IVF failures, a subgroup II - 56 fertile women. In addition to anamnesis collection and identification of CE clinical features, all patients underwent infectious screening, immunological and immunohistochemical analysis, ultrasound examination of pelvic organs with dopplerometry, and office hysteroscopy. A comparative analysis of the data obtained from subgroups of the main group was conducted. Results: Histological study of endometrial pipelle-biopsy specimens on the 7-10th day of the cycle revealed CE in all patients of the main group. We found prevalence of mean duration of CE in the subgroup I relative to subgroup II - 5.5±0.06 years and 2.4±0.07 years, respectively (p<0.001). Infectious screening showed that 58 (90.6%) patients of the I subgroup had sterile endometrial seeding which was 16.9 times higher than in subgroup II (p<0.0001). Immunological analysis determined the presence of AEAT in all patients of the subgroup I, 43 of which (67.2%) were above 265 U/ml, while 51 (91.1%) of subgroup II had no AEAT (p<0.001). Immunohistochemical analysis of the endometrium on the 18th-24th day of the cycle established high expression of CD16, CD20, CD56, and HLADRII in 58 (90.6%) patients of the subgroup I, whereas in 54 patients (96.4%) of II subgroup high expression of CD16 and CD20 with low amount of CD56- and HLA-DRII-positive cells was registered (p<0.001). We determined prognostically significant clinical and anamnestic risk factors predisposing to the development of infertility in patients with CE (p<0, 05). We revealed certain echographic, dopplerometric, and hysteroscopic criteria of CE demonstrating the critical disruption of endometrial receptivity in infertile women. Conclusion: Most patients (90.6%) with infertility had autoimmune component of CE characterized by prolonged (more than 5 years) course, high serum level of AEAT, sterile endometrial crops, and high expression of inflammation markers CD16, CD20, CD56 and HLA-DRII .
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Characteristics of personality and psychological aspects of suicidal behavior prevention in medical students
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01.01.2018 |
Chritinin D.
Esin A.
Sumarokova M.
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Zhurnal Nevrologii i Psihiatrii imeni S.S. Korsakova |
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© 2018, Media Sphera Publishing Group. All rights reserved. Objective. To study the formation and dynamics of development of suicidal behavior (SB) in medical students based on a personality/psychological approach. Material and methods. Two hundred and seventy-two students with- (n=75) and without SB (n=197) were examined. Psychopathological and psychological methods, and several questionnaires and scales were used. Results and conclusion. Personality and environmental characteristics as well as family loading were the leading factors of SB formation. Based on the results obtained, the authors developed a complex of preventive measures in the frames of three types of prevention (common, selective and indicative).
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Changes in walking in the elderly
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01.01.2018 |
Damulin I.
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Zhurnal Nevrologii i Psihiatrii imeni S.S. Korsakova |
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1 |
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© 2018, Media Sphera Publishing Group. All rights reserved. The article addresses gait disturbances in the elderly. It emphasizes that the system that maintains the balance in resting conditions and gait is based on the hierarchical principle and its function depends on the maintenance of integration between vestibular, visual and somatosensory information as well as on cognitive functions. Walking depends on the integrity of frontal-subcortical neuronal circles that support regulatory functions. The main pathogenetic mechanisms of age-related disturbances of balance and gait are a decrease in the efficacy of spinal motorneurons activation caused by Ia-afferentation, a decrease in cortical activation and excitability of corticospinal pathways and in the intensity of intracortical inhibition. The causes of age-related changes in walking are not confined to a single system (e.g., one sensory modality) but have a multisystem character and are involved in many structures. The author analyses the results of recent studies that use functional neuroimaging methods.
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Migraine «masks»: Differential diagnosis of acute headache
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01.01.2018 |
Sergeev A.
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Zhurnal Nevrologii i Psihiatrii imeni S.S. Korsakova |
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0 |
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© 2018, Media Sphera Publishing Group. All rights reserved. Differential diagnosis of migraine, can be difficult, especially of migraine with aura. On the one hand, some diseases can produce symptoms similar to migraine (cerebral aneurysm before rupture, reversible cerebral vasoconstriction syndrome). On the other hand, migraine with aura and some other disorders are conditions that have common pathophysiological mechanisms (e.g., CADASIL and MELAS syndrome, antiphospholipid syndrome). Thirdly, clinical presentations of migraine are often difficult to distinguish from features of other headache conditions (migraine with aura - transient ischemic attack, migraine with visual aura - occipital epilepsy). The author discusses the differential diagnosis of acute headache, especially thunderclap headache, and main strategies of effective treatment of migraine attacks.
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Selecting clinical and laboratory methods of manufacture of orthopaedic titanium alloy structures using a biopotentiometer
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01.01.2018 |
Yumashev A.
Utyuzh A.
Mikhailova M.
Samusenkov V.
Volchkova I.
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Current Science |
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0 |
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©. 2018, Current Science Association, Bengaluru. All Rights Reserved. The present communication aims at determining an optimum method of manufacture of orthopaedic arch titanium alloy dentures that would not cause galvanosis in patients using such dentures. A clinical randomized controlled retrospective study was conducted. Sixty patients who used arch titanium alloy dentures were examined. Three measurements of electrochemical potentials in various areas of the oral cavity were done in all patients, using a biopotentiometer. Linear prediction of differences in potentials in measurement areas 1-3 for the control group (CG) of patients exhibited minor growth dynamics, which can be indicative of the risk of galvanosis in CG patients in the future.
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Preeclampsia and lower maternal mortality in Russia
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01.01.2018 |
Sidorova I.
Nikitina N.
Unanyan A.
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Akusherstvo i Ginekologiya (Russian Federation) |
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2 |
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© Bionika Media Ltd. Objective. To study the most important aspects of maternal mortality from preeclampsia, eclampsia, the current clinical features of the most severe forms of this complication of pregnancy, as well as main defects in rendering qualified medical care, including those in the development of complications. Subjects and methods. A confidential audit of maternal mortality was conducted in different regions of the Russian Federation in 2013-2015. A total of 270 anonymous copies of primary medical records were analyzed. Results. The features of development and progression of the most severe forms of preeclampsia and eclampsia were identified. The development of preeclampsia in the presence of previous extragenital diseases was seen in most clinical cases. Early clinical manifestation is characteristic in the vast majority of women; and the non-classical (atypical) clinical picture of the disease is also common. Conclusion. Practical activities are proposed, which are aimed at reducing maternal mortality from preeclampsia in Russia.
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Choice of combined oral contraception for adolescent girls and young women
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01.01.2018 |
Kuznetsova I.
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Akusherstvo i Ginekologiya (Russian Federation) |
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0 |
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© Bionika Media Ltd. Objective. To carry out a systematic analysis of the data available in the literature on the use of combined oral contraceptives (COCs) by adolescent girls and young women. Material and methods. Foreign and Russian articles published in the past 15 years were sought in the international citation database Pubmed for their analysis. Results. The paper highlights the factors influencing adherence to COC use in adolescent girls and young women (a fear of complications and side effects, the lack of responsibility in young women, a low level of awareness of the benefits and risks of hormonal contraception). It is shown that after adequate medical consultation, the use of COC by adolescent girls and young women can offer additional health and quality of life benefits. Conclusion. The correct choice of a dosage regimen and hormonal components in the composition of COCs is a guarantee for adherence to contraception in young female users. COCs containing drospirenone and a microdose of ethinyl estradiol (a 24/4 regimen) are one of the most attractive combinations for most adolescent girls and young women today.
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Prospects of a Search for Kappa-Opioid Receptor Agonists with Analgesic Activity (Review)
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01.01.2018 |
Zaitseva N.
Galan S.
Pavlova L.
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Pharmaceutical Chemistry Journal |
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0 |
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© 2018, Springer Science+Business Media, LLC, part of Springer Nature. Current approaches to the search for new kappa-opioid receptor (κ-OR) agonists with potential analgesic activity are reviewed. Agents with peripheral activity and biased agonists are most promising for development. Signal events initiated by κ-OR activation are considered. Chemical structures of presently known κ-OR agonists are presented.
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On the occasion of the 150<sup>th</sup> anniversary of the death of А.О. armfeld
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01.01.2018 |
Lomakin Y.
Khodulapov A.
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Sudebno-Meditsinskaya Ekspertiza |
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0 |
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© 2018, Media Sphera Publishing Group. All rights reserved. This article was designed to overview the scientific and historical legacy left by Aleksandr Osipovich Armfeld, a Russian expert in forensic medicine and outstanding educationalist whose activities date back to the first half of the 19th century. А.О. Armfeld did brilliantly at the defense of his doctorate thesis which allowed him to soon occupy the position of the head of the Department of the Art of Medical Science in which capacity he was able to fully bring his pedagogical talent to light. The unprecedented capabilities of А.О. Armfeld enabled him to create a literary monument to E.O. Mukhin, the founder of forensic medicine in this country. This biographical sketch written by А.О. Armfeld thus far remains an important source of information of unique historical and scientific value and continues to be used in the studies devoted to the history and development of the Russian school of forensic medicine during the pre-reform period.
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Rare case of orbital nodular fasciitis
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01.01.2018 |
Grusha Y.
Ismailova D.
Kochetkov P.
Fedorov A.
Dzemeshkevich V.
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Clinical and Experimental Surgery |
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© 2018 GEOTAR Media. All rights reserved. A rare case of orbital nodular fasciitis in young female is presented. This case is of interest not only because of diagnosis but also due to localization of the mass with inferior orbital wall destruction and extension into maxillary sinus. The efficacy of surgical treatment is demonstrated. Excision of the mass was two-staged, the first performed by ophthalmologist and the second performed by ENT-specialist. Orbital implant was used to close bone defect after the mass was removed.
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Instrumental assessment of the face skin aging in women
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01.01.2018 |
Manturova N.
Stupin V.
Smirnova G.
Silina E.
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Serbian Journal of Experimental and Clinical Research |
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0 |
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© 2018, University of Kragujevac, Faculty of Science. All rights reserved. The aim of this study is to conduct several non-invasive methods for assessing the level of circulatory disturbance, elasticity and aging of skin in patients of different age groups in order to expand the diagnostic capabilities and evaluate the effectiveness of current research in aesthetic medicine. Clinical and instrumental exploration of 160 women aged 17 to 75 years with varying degrees of involutional skin changes was carried out. To objectify the assessment of skin condition, in all group of patients modern instrumental methods were used, such as: elastometry, ultrasound examination of the skin, laser Doppler flowmetry, transcutaneous oxygen tension. Concurrent implementation of several non-invasive methods for assessing the level of circulatory disturbance, elasticity and aging of the skin, allowed us to find new possibilities for studying the functional state of the skin. These methods extend the possibilities of ultrasonic research methods used today in aesthetic cosmetology. The obtained comparative data of elastometry, ultrasonography, laser Doppler flowmetry and transcutaneous oximetry in patients of different age groups showed the presence of elasticity and structure defect, skin thickness and subcutaneous fat, as well as microcirculation changes since 25 years and marked changes after 40 years.
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The echo of the Khabarovsk trials: The ussr and the allegation campaign against the USA of using biological warfare during the Korean war (1950–1953)
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01.01.2018 |
Romanova V.
Shulatov Y.
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History of Medicine |
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© VV Romanova, YA Shulatov. During the Korean War (1950–1953), China and North Korea accused the US of waging bacteriological warfare, including the use of biological weapons developed Japanese war criminals from Unit 731, who had been convicted during the Khabarovsk Trials in 1949. The Soviet Union did not immediately join in the allegation campaign against the Allies, with the Soviet Foreign Ministry initially taking a restrained stance. However, with Moscow’s backing and active involvement in international orga-nisations and the media, a powerful propaganda campaign was unleashed against American-led UN troops in Korea, as well as the political leadership of the US. The campaign was markedly political in nature and it involved many prominent individuals, including public figures from Western countries. An extensive action plan was developed, although its implementation was incoherent, which was a reflection of both the lack of evidence and a rapidly changing international environment. The article demonstrates how the Soviet stance on the use of biological warfare during the Korean War changed and reveals how the extensive campaign was launched amid the Cold War.
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Features of the formation of the health care system in Transbaikal during the period of the Far Eastern Republic
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01.01.2018 |
Batoev S.
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History of Medicine |
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© SD Batoev. The formation of the health care system in Transbaikal after the revolution of 1917–1918 had a number of essential features that will be covered in this paper. In 1919, the organization of medical care in Transbaikal retained its pre-revolutionary structure. In connection with the tense political situation in eastern Russia and the serious danger of a military conflict with Japan, in the spring of 1920, a buffer state was created – the Far Eastern Republic (FER). The FER Ministry of Health was established within the framework of the administrative territorial unit. During this period, the Ministry of Health had to fight epidemics, organize medical and sanitary assistance for the population and provide medical support for the People’s Revolutionary Army. Throughout the FER’s territory, free access to all types of medical care (outpatient, inpatient, sanatorium and dental) was introduced for all working groups of the population. From that point on, the state medical authorities consolidated and directed all the FER’s medical and sanitary and veterinary affairs. The Ministry of Health consisted of a civilian and military administrative unit, a medical and veterinary council and local health institutions for the indigenous population. The institutions were involved in the organization of health care and conducted medical and preventive activities and statistical studies. Despite Soviet Russia’s comprehensive assistance, the FER’s economic situation remained dire and unstable. The deficit of skilled health workers and medical institutions prevented the improvement of the health care situation. Radical changes in the public health system became possible only after the accession of Transbaikal to the RSFSR. In the territory of Transbaikal during the existence of the FER (from the spring of 1920 to the end of 1922), the formation of a health care system aimed at providing all segments of the region’s population with access to qualified medical care was an ongoing process.
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Rational approach to patients treatment with type 2 diabetes and obesity: Results of the All-Russian observational program «AURORA»
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01.01.2018 |
Dedov I.
Romantsova T.
Shestakova M.
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Obesity and Metabolism |
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0 |
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© Russian Association of Endocrinologists, 2018. Background: As in many other developed nations, the problem of obesity and type 2 diabetes is acute in Russia. In Russia, the only combination of sibutramine and metformine (Reduxin®Met) is authorized to reduce body mass and prevention development of type 2 diabetes mellitus or its complication. The article presents the results of the observational program “AVRORA”. Aim: Evaluation of the effectiveness and safety of Reduxin®Met (sibutramine + microcrystalline cellulose + Metformin) in patients with type 2 diabetes and alimentary obesity in routine clinical practice. Materials & methods: The observational program “AVRORA” was conducted from September 2016 to October 2017 under the auspices of the Endocrinological Scientific Center and the Russian Association of Endocrinologists. The “AVRORA” program was a multicenter, non-interventional study of patients to whom the attending physicians prescribed Reduxin®Met, a set (tablets + capsules), in accordance with the instruction for medical use as part of routine clinical practice. The treated group included patients of both sexes, aged 18–65 years, with an established diagnosis of obesity in combination with type 2 diabetes. The duration of the drug usage was determined by the attending physician and was up to 6 months. Reduxine®Met was prescribed in addition to the existing glucose-lowering therapy, the dose of metformin was adjusted to the patient's needs. Results: The “AVRORA” study was attended by 259 doctors and 5,812 patients in 240 medical institutions from 12 cities of the Russian Federation. The average age of patients was 46.6 ± 10.5 years, the ratio of male / female -24% / 76%. The decreasing of BMI during 6 months of the therapy amounted to 5.4 ± 2.3 kg / m2 (on average, 15.1 ± 6.4 kg). After 3 months of the therapy 81.6% of patients achieved clinically significant weight loss of 10.6% or more. The average decrease in waist circumference during 6 months of therapy was 13.8 ± 7.4 cm. A decrease of indicators of glycemic control and lipid metabolism right up to the target values was observed. Conclusions: In “AVRORA” study it was shown that addition of Reduxine®Met (sibutramine+ microcrystalline cellulose+met-formine) to the complex therapy of the diabetes in combination with obesity according to approved indications is safe and effective for long-term treatment in regards to weight loss, regulation of lipemic index, glucose profile and quality of life.
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Medical care for children with cancer in the Central Federal District
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01.01.2018 |
Rykov M.
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Rossiyskiy Vestnik Perinatologii i Pediatrii |
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0 |
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© 2018 National Academy of Pediatric Science and Innovation. All rights reserved. Relevance. Statistical indicators are the basis for planning of the organization of medical care for children with cancer, as well as analysis of the effectiveness of medical care. Materials and methods. The authors have analyzed operational reports for 2017 of the executive authorities in the field of health care of 18 objects of the Russian Federation being part of the Central Federal District. Results. There 9 pediatric oncology departments, there are 464 children’s oncological beds, the bed occupancy per year is 319.3. There are 91 doctors providing medical care to children with cancer, 64 (70.3%) of the doctors have a certificate of pediatric oncologist. In 11 subjects there are no Departments for Pediatric Oncology. There are 821 primary patients with malignant neoplasms. There are 156 deceased patients, 66 of them were diagnosed in 2017. 52 (6.3%) patients are revealed actively. There were 12 (per 100 thousand for the age group of 0–17 years) cases of incidence of malignant neoplasms, mortality is 2.3 (per 100 thousand for the age group of 0–17 years), one-year mortality is 8%. The average time taken to diagnose and to verify the diagnosis before the beginning of treatment remains unknown. Conclusion. Operational reports contain non-matching indicators, thus, the information is not completely reliable. Incidence rates are significantly lower than those in countries with high reliability of statistical data. The percentage of patients identified actively remains extremely low. In order to eliminate the noted defects, it is necessary to introduce a single database of children with cancer in the Russian Federation.
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Expediency and prospects of a vaccinal prevention of whooping cough without age restrictions
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01.01.2018 |
Mikheeva I.
Saltykova T.
Mikheeva M.
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Jurnal Infektologii |
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0 |
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2019 © Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All Rights Reserved. The goal of study was the epidemiological substantiation of optimization measures of a vaccinal prevention of whooping cough in the Russian Federation. Materials and methods. The retrospective descriptive epidemiological research has been conducted by analysis of the official statistical data on the whooping cough case rate (form No. 2) in 2005-2017 in the Russian Federation, as well as the data about preventive whooping cough inoculations (forms No. 5, No. 6) in 2005-2017 and about epidemic outbreakes in 2017 (form No. 23-17). The assessment of an economic damage from whooping cough in 2005-2017 has been carried out. Results. The following adverse characteristics of a modern epidemiological situation on whooping cough in Russia are shown: long-term recurrence of epidemic process, tendency of rising of a case rate of children of 0-2 years; high percentage of children of preschool and school age among whooping cough cases; prevalence among the patients with whooping cough of the children who have been vaccinated against this infection previously, epidemic outbreakes in children's collectives, the stability of a case rate of teenagers and adults with prevalence of the mild and the erased clinical forms of this infection. The risks due to weaknesses of the whooping cough vaccinal prevention are noted: the insufficient immunization coverage owing to falce contraindications and refusals of parents of vaccinations of children, noncompliance with terms and intervals between inoculations, lack of domestic vaccine for revaccination of children at the age of 5 years and older. Conclusion. It is necessary to introduce in the national vaccination schedule a preschool booster dose for children at the age of 6 and adolescents at 14 years with the combined reduced antigen content tetanus-diphtheria and acellular pertussis vaccines as well as the inoculations of this vaccine according to epidemiological indications to health workers, employees of educational institutions. A revaccination against whooping cough is recommended as “cocoon” for the persons contacting to not vaccinated child under 1 year of age.
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Comparative analysis of intra- and postoperative complications of retroperitoneoscopic and laparoscopic nephrectomy for large tumors
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01.01.2018 |
Kadyrov Z.
Odilov A.
Yagudaev D.
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Onkourologiya |
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1 |
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© 2018 ABC-press Publishing House. All rights reserved. The objective is to perform comparative analysis of intra- and postoperative complications of retroperitoneoscopic radical nephrectomy (RRN) and laparoscopic radical nephrectomy (LRN) for large tumors. Materials and methods. The study includes examination and treatment data for 108 patients with stage T1–3a renal cell carcinoma. Results and conclusion. A number of advantages of RRN compared to LRN were demonstrated associated with shorter surgery duration with fast processing of the renal pedicle, lower blood loss, lower use of analgesics in the postoperative period, shorter duration of hospitalization, and quick recovery after the surgery. The rate of intra- and postoperative complications for RRN was 19.2 and 17.3 %, for LRN – 33.9 and 37.5 %, respectively. Complications associated with abdominal organs were absent for RRN. After LRN, the rate of serious complications was significantly higher than after RRN.
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