The Bulletin of Contemporary Clinical Medicine最新文献

{"title":"CURRENT ISSUES IN SURGICAL TREATMENT OF HINDFOOT DEFORMITIES","authors":"Ilya E. Gubar, S. Leonova, I. Usoltsev","doi":"10.20969/vskm.2023.16(6).95-102","DOIUrl":"https://doi.org/10.20969/vskm.2023.16(6).95-102","url":null,"abstract":"Abstract. Introduction. The review analyzes and summarizes the results of studying the surgical treatment of traumatic and non-traumatic hindfoot deformities with subtalar joint osteoarthritis. Relevance of this issue is supported by highly frequent unsatisfactory results achieved in primary care, which often lead to post-traumatic subtalar arthrosis, high percentage of the disablement of mostly working-age patients, and economic costs associated with their further treatment and rehabilitation. Subtalar arthrodesis, in combination with bone grafting augmentation with auto-, allo- or xenograft and internal fixation, is the most common surgical technique for patients of this category. Aim. To study the advantages and disadvantages of the known surgical techniques used in treatment of posttraumatic hindfoot deformities. Materials and Methods. To perform the literature analysis, we used international databases, such as Web of Science, Scopus, and PubMed, as well as the domestic library system, eLibrary. Results and Discussion. Despite good surgical treatment outcomes presented in the publications, some failures were registered, such as insufficient deformity correction, arthrodesis nonunion due to the bone graft migration, bone graft osteolysis, metal structure instability, and infectious complications. According to the authors, the key reason for some unsatisfactory results in non-infectious cases was the lack of preoperative planning, including accurate calculations of the necessary hindfoot deformity correction and of the optimal extent of bone grafting.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139299526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CETP RS247616 POLYMORPHISM IN PATIENTS WITH CHRONIC HEART FAILURE AND CORONARY HEART DISEASE: TRAITS OF LIPID METABOLISM AND EFFECTIVENESS OF STATIN THERAPY","authors":"Elena V. Khazova, Olga V. Bulashova, Elena V. Valeeva, M. I. Malkova","doi":"10.20969/vskm.2023.16(6).67-77","DOIUrl":"https://doi.org/10.20969/vskm.2023.16(6).67-77","url":null,"abstract":"Abstract. Introduction. Dyslipidemia is a modifiable risk factor for cardiovascular complications in patients with chronic ischemia-induced heart failure. Being the best-known class of drugs, statins effectively reduce cardiovascular mortality in all age groups. Effectiveness of using lipid-lowering drugs is determined by some factors, including genetic ones. Polymorphism rs247616 of the CETP (cholesterol ester transfer protein) gene is associated with changing high-density lipoprotein levels in blood serum. Aim. To analyze the clinical parameters and effectiveness of lipid-lowering therapy in stable chronic ischemia-induced heart failure patients with the rs247616 polymorphism of the CETP gene. Materials and Methods. We examined 517 patients with chronic ischemia-induced heart failure, aged 66.4±10.4 years, of both sexes. A genetic control of 118 conditionally healthy individuals was included. We analyzed the allele frequency of the CETP rs247616 occurrences, clinical characteristics, statin administration frequency, dose range, and achieving the lipid metabolism goals, including in relation to the genotype. Results and Discussion. Statins were prescribed to 28.8% of patients with chronic heart failure, with 42.3% receiving the minimum dosage and 35.6% receiving the average therapeutic dosage. Frequency of TT-genotype and T allele of the CETP rs247616 was higher in patients with chronic heart failure compared with controls (13.2% and 10.2%, p=0.026, 35% and 26.7%, p=0.014). It was found that CC-genotype has a protective effect against the development of chronic heart failure (CC vs CT+TT, OR=0.57, 95%CI:0.38-0.86). In patients with CC-genotype chronic heart failure, a lower level of high-density lipoproteins was observed (1.12±0.37 and 1.25±0.37 mmol/l, p=0.012), as compared to the carriers of T allele (CT+TT). Percentage of individuals with total cholesterol levels below 4.5 mmol/l (33.3%, 29.7%, and 37.5%) and triglyceride levels < 1.7 mmol/l (36.5%, 25%, and 37.5%) did not differ between CC-, CT-, and TT-genotypes, respectively. There is a trend towards an increase in the proportion of the carriers of T allele and TT-genotype with low-density lipoprotein levels < 1.8 mmol/l (30.8%, 45.5%, and 50%) and non-high-density lipoproteins levels<2.6 mmol/l (29.4%, 31.2%, and 50%). Conclusions. Effectiveness of statin therapy is low: 38.1 % of patients had the total cholesterol levels < 4.5 mmol/l, 11% had low-density lipoprotein levels <1.8 mmol/l, 50.6% had triglyceride levels <1.7 mmol/l, and 12.2% of patients had non-high-density lipoprotein levels <2.6 mmol/l. Protective effect of CC-genotype was found regarding the genesis of chronic heart failure.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139303214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIGH-RESOLUTION ELECTROCARDIOGRAPHY IN CLINICAL PRACTICE","authors":"V. Oslopov, A. V. Kushcheva, Amir R. Khairullin, Z. M. Kadyrova, J. Oslopova, E. V. Khazova, Yana D. Grishina, Zulfiya F. Kim","doi":"10.20969/vskm.2023.16(6).110-122","DOIUrl":"https://doi.org/10.20969/vskm.2023.16(6).110-122","url":null,"abstract":"Abstract. Introduction. Current technological progress and advances in electronics and medical equipment allow reaching unprecedented heights in the detection of various arrhythmic conditions, while such conditions can be observed directly at the time of their occurrence. Nevertheless, there is an issue related to predicting life-threatening conditions that may lead to cardiac arrest causing sudden cardiac death. We should also note some difficulties in timely predicting myocardial infarction. Therefore, it is necessary to develop new or implement the existing technologies that allow ensuring high susceptibility and specificity toward these disorders. Aim. To study the potential of high-frequency electrocardiography regarding identifying additional criteria for myocardial ischemia and informing about the possible development of cardiac arrhythmia. Materials and Methods. Methodological approaches: We searched for and analyzed sources in the NCBI and eLibrary databases and in Google Scholar using the following keywords: Advanced ECG, High Frequency ECG, and HF ECG ischaemia. The search was filtered for the years 1930-2022. Publications containing only summaries, abstracts, or duplicated information were excluded from the analysis. Thus, this present descriptive review includes generalized and systematized data from 50 sources, encompassing current clinical trials, reports, and systematic reviews. Results and Discussion. High-frequency electrocardiography is the most promising method in terms of the qualities required for a technique to register such disorders. When forming a cardiogram, the high-frequency electrocardiography method has three stages: 1) Registration of high-frequency electrical cardiac potentials; 2) signal amplification due to the computational performance to enhance the resolution; and 3) signal averaging through mathematical computations and further filtering the necessary sectors of the electrocardiogram. Combining the stages presented above allows registering low-amplitude signals, which would be impossible when using standard electrocardiography techniques. Low-amplitude signals provide important diagnostic information in risk stratification regarding life-threatening cardiovascular diseases. Detecting delayed myocardium depolarization potentials, ventricular late potentials, and atrial late potentials is an important task in identifying these pathologic conditions. Conclusions. Over thirty years, the high-frequency electrocardiography technique has been frequently studied and tested in various countries, such as the USA, Israel, Spain, Italy, South Korea, Japan, Russia, Austria, and Great Britain. These studies have proven the advantage of this method over the standard method of recording the electrical potentials of heart. This paper presents information on the studies and the facts proving the efficacy of the high-resolution electrocardiography technique.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139294186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DIGITAL RESOURCES IN PREDICTION OF PREECLAMPSIA AND FETAL GROWTH RESTRICTION","authors":"A. V. Ganeeva, Polina L. Kapelyushnik","doi":"10.20969/vskm.2023.16(6).19-24","DOIUrl":"https://doi.org/10.20969/vskm.2023.16(6).19-24","url":null,"abstract":"Abstact. Introduction. Preeclampsia and fetal growth restriction are pregnancy complications related to Great Obstetrical Syndromes and having a similar pathogenesis. No antipathogenetic therapy methods have been found for both pathologies, but there is a means of prevention: Acetylsalicylic acid. The drug is effective only in high-risk pregnant women; therefore, various models are being developed to predict preeclampsia and fetal growth restriction, including digital models. They aim to help select patients who need that prophylaxis. Aim. This study is aiming to create a digital model for the early prediction of preeclampsia, based on the patient’s electronic medical card. Materials and Methods. The investigation involved 231 pregnant women. An algorithm was developed for the early prediction of preeclampsia and fetal growth restriction, based on detecting a combination of systemic and local hemodynamic markers: High variability of blood pressure between visits (long-term variability) and high resistance of blood flow in uterine arteries. Long-term (intervisit) variability of blood pressure is calculated for each trimester: First, the arithmetic mean is calculated among the values of systolic blood pressure at successive visits; second, the standard deviation is computed based on the result. Uterine arteries are checked using Doppler ultrasound technology at 11-13 weeks of gestation: Resistivity of blood flow (peripheral resistivity) in the right and left uterine arteries is assessed. Results and Discussion. For this new prediction algorithm, a digital model was developed, the ECAPP program (registration certificate No. 2018660666 – Electronic Prenatal Record with assessing the risk of developing preeclampsia based on blood pressure variability and uterine blood flow resistance). Conclusions. The IT resource presented has a potential for the effective early prediction of preeclampsia, as well as for predicting fetal growth restriction. Keywords: preeclampsia, fetal growth restriction, prognosis, digital model.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139304347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE QUALITY OF LIFE OF FAMILIES WITH CHILDREN WITH AUTISM SPECTRUM DISORDERS IN COMPARISON WITH THE QUALITY OF LIFE OF FAMILIES WITH NEUROTYPICAL CHILDREN: SURVEY RESULTS AND INTERVIEWS","authors":"I. Kuznetsova, L. M. Mukharyamova, Z. Saveleva, Leylya R. Garapshina, M. S. Kuznetsov","doi":"10.20969/vskm.2022.15(2).36-43","DOIUrl":"https://doi.org/10.20969/vskm.2022.15(2).36-43","url":null,"abstract":"Introduction. The significant increase in the number of people with autism spectrum disorders (ASD) today makes it relevant to study the quality of life of families raising children with ASD compared to families of neurotypical children. Aim. The aim of the study was to identify the quality of life of families with children with ASD and to compare it with the quality of life of families with neurotypical children to determine the level of deprivation. Material and Methods. The study involved: 1. А survey of parents of neurotypical children and children with autism, based on The Beach Center on Disability at the University of Kansas «Concepts and Methods for Measuring Family Quality of Life» questionnaire. Verification of this instrument was ensured by double translating the questionnaire (English-Russian-English), and a pilot survey of parents (N=112) was conducted. One hundred and nine parents of neurotypical children in 19 Russian cities were interviewed. 2. Semi-structured interviews with parents of children with ASD (N=40). We performed a standardization procedure in which the responses of the participants were converted into scores for each subscale by calculating the average score. Results and discussion. The survey showed a set of problems in the accessibility of social and medical care, education, and safety concerns that were significantly lower compared to the results of the survey of parents of neurotypical children. Comparison of the survey data with the results of parent interviews revealed detailed experiences of daily life for families with children with ASD. There were significant differences in seeking medical care: 82.5% of parents with neurotypical children are satisfied with the medical care they receive, while for parents of children with ASD, this figure is much lower - 64.3%. Slightly more than half are satisfied with home, work, school and neighborhood safety (42.9% satisfied, 9.8% completely satisfied). The proportion of parents of neurotypical children who are completely satisfied with safety is 28.4% and 42.2% who are satisfied. Most parents support inclusive or integrative education (they could choose more than one answer). 72.3% considered the most effective education for children with autism in classes with children without disabilities, a little more than half (54.5%) supported inclusive education. They also consider education in special classes in general schools to be effective. 8.9% of parents support home schooling. Conclusion. The findings reveal dangerous trends in the marginalization of families with children with ASD compared to families with neurotypical children. The solution to the problems of social integration must consider the indicators of these inequalities, both in terms of the quality of life of both the child and his/her immediate family.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124785404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"APPLICATION OF ORGANIC COMPOUNDS IN THERAPEUTIC PRACTICE FOR LIVER FUNCTION DISTURBANCES","authors":"Tatiana V. Sorokina, V. V. Davydova, N. Y. Kolesnik, Alyona I. Bolvantseva, Y. Samoylova, O. Oleynik, I. Tolmachev","doi":"10.20969/vskm.2022.15(2).60-66","DOIUrl":"https://doi.org/10.20969/vskm.2022.15(2).60-66","url":null,"abstract":"Introduction. The nonspecificity of the clinical manifestations of the initial stage of non-alcoholic fatty liver disease (NAFLD) - the stage of steatosis, is the reason for the untimely correction and progression of this disease. Aim. The aim of the study was to conduct a randomized open comparative study to determine the effectiveness of the use of the food supplement FanDetox as a source of organic compounds in liver function disorders. Material and methods. This study was a single-center randomized open one and included the study of the possibility of using the herbal product FanDetox in the complex therapy of NAFLD in patients aged 18 to 75 years with a verified diagnosis of obesity and the presence of signs of steatohepatosis, against the background of basic therapy with Carsil Forte. The study was conducted with the involvement of 68 people matched by sex and age, 34 of whom made up the main observation group, whose participants took the study product 1 sachet 2 times a day after meals, in the form of a suspension obtained after mixing the powder in 100 ml of water. The rest 34 patients made up the comparison group. Carsil Forte was chosen as a background drug for both groups. The duration of therapy for each study participant was 3 months. The follow-up process included patient visits with a detailed medical history, therapeutic examination, and laboratory and instrumental examinations. Statistical analysis was carried out using the IBM SPSS Statistics 23 program. Results and discussion. As a result, an improvement in the subjective well-being of patients, a decrease in the echoscopic manifestations of fatty hepatosis, a decrease in the longitudinal size of the liver, a decrease in the manifestations of the cytolysis syndrome and bilirubin levels, as well as a significant positive dynamics of the lipid spectrum in the blood of patients who received complex therapy, including the use of the FanDetox biologically active additive, compared with the comparison group undergoing therapy with the background drug Carsil Forte, were shown. Conclusion. It has been established that taking the food supplement FanDetox helps to reduce the manifestations of fatty hepatosis, reduce the longitudinal size of the liver, blood biochemistry indicators and the general well-being of patients.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"97 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115827595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE STATE OF HEALTH OF ADOLESCENTS STUDYING IN INSTITUTIONS OF PRIMARY VOCATIONAL EDUCATION","authors":"Shakhla M. Balayeva","doi":"10.20969/vskm.2022.15(2).15-21","DOIUrl":"https://doi.org/10.20969/vskm.2022.15(2).15-21","url":null,"abstract":"Introduction. Vocational education institutions are characterized by the impact of a set of diverse risk factors that are potentially dangerous to the health of student adolescents and can lead to illness. And this raises questions of preserving the health of the future labor potential as a priority task and requires the development and implementation of new methodological approaches to improve and organize medical care. Aim. The aim was to study the morbidity of students to assess the dynamics of changes in the state of health of students during the period of initial vocational train- ing with further development of preventive measures. Material and methods. The data of a comprehensive medical examination, questionnaires on the identification and prevalence of complaints about the state of health, indicators of chronic morbidity in students of primary vocational education institutions have been analyzed. Results and discus- sion. In comparison with the first year of study, the incidence of diseases of the nervous system increases by 43,8%, diseases of the digestive system – 41,7%, diseases of the musculoskeletal system and connective tissue – 29,5%, diseases of the eye and its accessory apparatus – 13,4% and for diseases of the genitourinary system - by 12,8%. In adolescents studying in different working conditions, there is a repeated frequency of complaints of a different nature. Among the trainees of the oil and gas production operator and carpenter, a high frequency of complaints was noted from the urinary system, skin and allergic reactions; carpet weaver - from the nervous, musculoskeletal system, skin and vision; in adolescent seamstresses - from the nervous, cardiovascular system with frequent allergic reactions; adolescents who are trained as chefs have a higher prevalence of complaints related to the cardiovascular system and allergic reactions. Conclusion. Despite the short contact of students with various production factors during labor training, unfavorable occupational and production risk factors can cause disruption of the regulatory mechanisms of physiological adaptation in adolescents.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130990848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LEVELS OF MEDIUM- AND LOW-MOLECULAR-WEIGHT SUBSTANCES AND OLIGOPEPTIDES IN PATIENTS WITH MYOCARDIAL INFARCTION AGAINST CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH SINGLE- AND MULTIVESSEL CORONARY ARTERY DISEASE","authors":"T. Prokofyeva, O. Bashkina, O. S. Polunina, L. Voronina, I. V. Sevostyanova, E. Polunina","doi":"10.20969/vskm.2022.15(2).49-59","DOIUrl":"https://doi.org/10.20969/vskm.2022.15(2).49-59","url":null,"abstract":"Introduction. The presence of endogenous intoxication syndrome in somatic pathology worsens the course and prognosis of diseases. It is especially urgent to study this syndrome in comorbid pathology, in particular, in myocardial infarction development in patients with chronic obstructive pulmonary disease. The objective markers of endogenous intoxication are medium and low molecular weight substances and oligopeptides. Aim. The aim is to estimate the severity of endogenous intoxication syndrome by studying the levels of medium and low molecular weight substances and oligopeptides in patients with myocardial infarction developed against the background of chronic obstructive pulmonary disease depending on the number of coronary arteries affected. Material and meth- ods. 225 patients with myocardial infarction were examined. In 130 of them the infarction developed as monosomal disease, and in 195 - against the background of previously documented chronic obstructive pulmonary disease. Among patients with myocardial infarction as monoinflammation, 71 (64.5%) had a single-vessel lesion and 59 (35.5%) had a multivessel lesion. Among patients with myocardial infarction against chronic obstructive pulmonary disease, lesion of the 1st coronary artery was found in 50 patients (25.6%), and multivessel lesion was found in 145 (74.4%). The comparison group included 110 somatically healthy subjects. We used direct spectrometry (according to M.Y. Malakhova, 1995) to determine the levels of medium and low molecular weight substances and oligopep- tides. Statistical data processing was carried out using software package SPSS 26.0. Results and discussion. In the group of patients with myocardial infarction the levels of medium and low molecular weight substances and oligopeptides and calculated indices showed significant differences in single- and multivessel lesions. In the 1st coronary artery lesion, the indices in most cases were comparable with the values in the control group. In the group of myocardial infarction patients with multivessel lesions, the values of medium and low molecular weight substances and oligopeptides increased significantly. In patients with myocardial infarction against the background of chronic obstructive pulmonary disease, all intoxication parameters were significantly higher compared not only with the control, but also with patients with myocardial infarction as monoinflammation. However, the values in the subgroups with single and multivessel lesions did not demonstrate statistical reliability. Conclusion. The number of affected vessels, and hence the volume of ischemic myocardium, affects the severity of endogenous intoxication in patients with myocardial infarction as mononasal. In this case, the elimination function of the excretory organs is not impaired, which means that the level of intoxication is due to the production of toxins in conditions of ischemia and myocardial necrosis. In conditions of cardiorespiratory comorbidity c","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132566716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SELECTED ASPECTS OF TREATMENT OF PATIENTS WITH NEWLY DIAGNOSED PULMONARY TUBERCULOSIS WITH MULTIDRUG-RESISTANT COMBINATION AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE: IN THE FOCUS OF INHALED GLUCOCORTICOSTEROIDS","authors":"N. Bagisheva, A. Mordyk, M. Moiseeva, K. Nesterova, E. Nebesnaya, S. Sitnikova","doi":"10.20969/vskm.2022.15(2).7-14","DOIUrl":"https://doi.org/10.20969/vskm.2022.15(2).7-14","url":null,"abstract":"Introduction. The problem of treating tuberculosis (TB) remains relevant, due to the growth of drug-resistant forms of mycobacterium tuberculosis and an increase in the incidence of TB in persons with comorbid bronchopulmonary pathology, which requires comprehensive management of this category of patients, with mandatory drug correction of concomitant pathology. Aim. The aim of this study was to assess the effect of inhaled glucocorticosteroids (budesonide / formoterol 160 / 4.5 in an Inhaler device) on the efficacy of TB therapy in patients with newly diagnosed multidrug-resistant tuberculosis (MDR) who developed in the presence of chronic obstructive pulmonary disease (COPD). Material and methods. A simple, prospective, comparative study in accordance with the inclusion criteria included 40 patients admitted to an anti-tuberculosis dispensary with newly diagnosed MDR tuberculosis with COPD. The diagnosis of TB and COPD was confirmed using radiographic, functional and laboratory research methods. Group 1, age Me (25; 75) 55.5 (46; 58) years - 22 patients with MDR + COPD tuberculosis who, simultaneously with TB chemotherapy, received a short-acting M-anticholinergic blocker, 2 inhalations 4 times a day, group 2, age 54.5 (51; 58) years - 18 patients with MDR + COPD tuberculosis, simultaneously with TB chemotherapy received a combination of ICS with a long-acting bronchodilator (beta-2-agonist (LABA)), budesonide + formoterol 160 / 4.5 μg dose - 2 inhalations 2 times a day (in an inhaler device). Duration of observation is 9 months. Results and discussion. After 9 months of observation, closure of decay cavities in 63.6% in group 1 and 83.3% in group 2 (χ² = 0.3; p = 0.581), smear negativity in 90.9% of cases in group 1 and in 100, 0% in group 2, respectively (χ² = 0.04 p = 0.834), abacillated 63.3% and 100.0% in groups 1 and 2, respectively (χ² = 0.46; p = 0.496). Against the background of the use of ICS in the intensive phase of TB chemotherapy simultaneously with antibiotic therapy, there was a decrease in the time of abacillation and closure of decay cavities in comparison with the group that did not receive ICS. At the same time in broncholics, the use of ICS made it possible to quickly stop the broncho-obstructive syndrome, improve the quality of life and compliance with long-term anti-tuberculosis therapy. An additional nonspecific anti-inflammatory effect of ICS promoted the active resorption of infiltrative changes and the cure of a specific process, reducing the duration of the main course of treatment, including in patients with MDR. Conclusion. Patients of the anti-tuberculosis dispensary with concomitant bronchopulmonary pathology need complex treatment aimed at correcting comorbid conditions, simultaneously with chemotherapy for tuberculosis. The use of ICS in addition to long-acting bronchodilators (LABA, LDAH) in patients with COPD for the correction of broncho-obstructive syndrome in the intensive phase of TB treatment can reduce ","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115101295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE USE OF ENDONASAL ELECTROPHORESIS WITH MEXIDOL IN COMBINATION WITH ACUPUNCTURE IN THE TREATMENT OF PATIENTS WITH POST-COVID ANOSMIA","authors":"M. Al-Zamil, M. N. Puzin, A. Shulaev, E. Kiparisova, Alexander V. Lubimov, T. Y. Shilova, Lia SH. Ramazanova, S. M. Makkaeva, Alexander P. Skorokhodov, Nina A. Gunter","doi":"10.20969/vskm.2022.15(2).124-130","DOIUrl":"https://doi.org/10.20969/vskm.2022.15(2).124-130","url":null,"abstract":"Introduction. A change or lack of odor in patients after suffering from Covid-19 caused the development of serious disturbances in appetite and nutrition, which led to a decrease in body weight and a deterioration in the function of the digestive system as a whole, followed by alimentary damage to internal organs. Aim. To study the effectiveness of the combined use of endonasal electrophoresis and acupuncture in the treatment of patients with post-covid anosmia. Materials and methods: 30 patients with a confirmed diagnosis of COVID-19 were under our supervision. All patients suffered from post-covid anosmia. 15 patients underwent exclusively drug therapy (control group) and 15 patients, in addition to drug therapy, underwent a course of endonasal electrophoresis of 5% Mexidol solution and acupuncture. All patients underwent testing of olfactory nerve function with the Sniffin ‘Sticks test before and after treatment. Results and its discussions: it was found that the use of endonasal electrophoresis in combination with acupuncture significantly enhances the effectiveness of drug therapy in improving the parameters of the olfactory nerve in the threshold test by 143.5% (p <0.01), the discriminatory test by 129.5% (p <0, 01), the identification test by 184.5% (p <0.01) and by the total number of points by 148.7% (p <0.01). Conclusion: High efficiency of combined use of endonasal electrophoresis of 5% Mexidol solution and acupuncture in the treatment of patients with post-covid anosmia was detected. This method of treatment increases the effectiveness of drug therapy by 1.5 times.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130596131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}