Journal "Medicine"最新文献

{"title":"Experience of application of enriched immunoglobulin in adjuvant therapy in premature children with extremely low and very low body weight","authors":"Gulzhan Baigazieva, Kuralay Kuzerbayeva, K. Zhubanysheva, Akmaral Balganbayeva, Marzhan Otebayeva, Dildora Kenzhayeva, Balzhan Bektenbay, Rosa Arkhabayeva","doi":"10.31082/1728-452x-2020-211-212-1-2-61-66","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-211-212-1-2-61-66","url":null,"abstract":"The immune system of a premature newborn is characterized by quantitative and functional features that do not allow it to respond optimally to numerous pathogenic microorganisms against which during contact and during the first hours after birth they come into contact with a huge number of exogenous antigens of a viral, bacterial and fungal nature that were not previously known to him. This proves the relevance of the search for new directions for the effective prevention of mortality and severe morbidity in premature infants by changing the approach to the complex treatment of children with extremely low and very low body weight. Objective. To evaluate the effectiveness and safety of enriched intravenous immunoglobulins (IVIG) in children with extremely low body weight and very low birth weight in infants with lung infections in adjuvant therapy. Material and methods. A retrospective study and statistical analysis of the primary medical documentation “History of the development of the newborn” and “History of childbirth” of 49 preterm infants born with extremely low and very low body weight with intrauterine and neonatal pneumonia was carried out, the second group consisted of 66 children with a similar pathology, in the treatment of which enriched immunoglobulin therapy was not used. The collection of retrospective material was carried out from January 1st to December 31st, 2019 on the basis of the perinatal center of the Karasai central district hospital of the Almaty region. Results and discussion. We analyzed 49 stories of the development of newborn children with intrauterine and neonatal pneumonia, all children received a standard treatment package, including antibacterial, infusion and symptomatic therapy. As an immunomodulatory therapy, children received the Pentoglobin drug, which was registered and allowed from 0 months. The use of intravenous immunoglobulins has been studied as a method of treating intrauterine pneumonia and preventing the death of newborns children. The criteria for prescribing the drug were a sepsis clinic, a septiclike condition, pneumonia that did not give rise to initial antibiotic therapy, progressing according to the X-ray picture, laboratory changes (leukopenia, leukocytosis, neutropenia in combination with high CRP). Conclusions. The clinical efficacy of the use of an immunomodulating drug from the groups of enriched intravenous immunoglobulins in 49 premature infants with extremely low and very low body weight, with severe intrauterine and neonatal pneumonia was shown. It has been established that the inclusion of enriched intravenous immunoglobulin in the complex therapy of patients with severe neonatal pneumonia leads to a relief of clinical manifestations, a decrease in the risk of resistance of microorganisms to antibiotics and the risk of death. Keywords: premature infants, extremely low body weight, very low body weight, neonatal pneumonia, enriched intravenous immunoglobulins.","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73701756","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":"Spatial assessment of breast cancer mortality in Kazakhstan","authors":"Asem Toguzbayeva, N. Igissinov, G. Igissinova, Z. Bilyalova, D. Kulmirzayeva","doi":"10.31082/1728-452x-2020-211-212-1-2-26-30","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-211-212-1-2-26-30","url":null,"abstract":"Breast cancer (BC) mortality analysis at the regional level is important not only for assessing the current epidemiological situation, but also contributes to a better understanding of factors that may affect mortality. Aim. The purpose of the study is to assess the spatial deaths from BC in Kazakhstan. Material and methods. Investigation was retrospective between 2009-2018 years. The materials were collected by statistics Committee by the Ministry of National Economy of the Republic of Kazakhstan concerning the deaths from BC (ICD-10-C50). A method of compiling a cartogram based on the determination of the standard deviation (σ) from the mean (x) was applied. Mortality rates calculated per 100,000 female population were used. Results and discussion. A spatial assessment of breast cancer mortality was presented based on the calculation of mortality rates: low up to 12.80/0000; average from 12.8 to 17.30/0000, and high – above 17.30/0000. It was established that the North Kazakhstan (18.20/0000), Akmola (18.90/0000), East Kazakhstan (20.30/0000) and Pavlodar (22.20/0000) regions, as well as the city of Almaty (21.70/0000) relate to regions with high mortality rates. Conclusion. Features of mortality from BC in the republic have been established, while a spatial assessment (cartogram) of mortality indicates regions with different mortality rates. The obtained data are recommended to be used for monitoring and evaluation of anti-cancer measures – BC screening. Keywords: mortality, breast cancer, cartogram, Kazakhstan.","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90794980","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":"Evaluation changes in indicators of oncological service in breast cancer in Kazakhstan","authors":"N. Igissinov, Asem Toguzbayeva, G. Igissinova, Z. Bilyalova","doi":"10.31082/1728-452x-2020-211-212-1-2-16-20","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-211-212-1-2-16-20","url":null,"abstract":"According to estimates from the International Agency for Research on Cancer (IARC) by 2040 the global burden is expected to grow to 3 million new breast cancer cases and 1 million cancer deaths of this cause. Studying the indicators of the oncological service for breast cancer allows us to identify and evaluate the effectiveness of mammological screening in Kazakhstan. Aim. Evaluate some indicators of the oncological service at breast cancer in Kazakhstan in 2009 to 2018. Material and methods. The research material was data from the Ministry of Health of the Republic of Kazakhstan - annual form No.7 and No.35 regarding breast cancer (ICD 10 C50) for 2009-2018. - morbidity, mortality, early diagnosis, neglect, morphological verification. A retrospective study using descriptive and analytical methods of biomedical statistics was used as the main method. Results and discussion. For 2009-2018, 40,199 new cases of breast cancer were registered in the republic for the first time and 12,971 women died from this disease. The average annual crude incidence rate of breast cancer was 45.4±1.40/0000 (95% CI=42.8-48.1) and increased in dynamics from 39.5±0.70/0000 (2009) to 49.6±0.70/0000 in 2018, the difference was statistically significant (t=10.2 and p=0.000). In dynamics, mortality rates from breast cancer tended to statistically significant (t=7.95 and p=0.000) decrease from 16.5±0.40/0000 (2009) to 12.0±0.40/0000 in 2018 year, and the average annual crude mortality rate from breast cancer was 14.8 0.50/0000 (95% CI=13.7-15.8). The indicators of early diagnosis (the proportion of patients with stage I-II) improved from 71.1% (2009) to 87.6% in 2018, the proportion of patients with stage III decreased (from 22.2% to 8.6 %) and stage IV (from 6.4% to 3.6%) for the studied years, i.e. neglect rates are declining. The indicators of morphological verification in breast cancer have always been high and over the studied years improved from 93.4% to 99.1%. Conclusion. An analysis of the indicators of the oncological service at breast cancer revealed an improvement in morphological verification and early diagnosis, a decrease in neglect and mortality rates, which is undoubtedly associated with ongoing anti-cancer measures in Kazakhstan, which a regularly mammological screening. Keywords: breast cancer, incidence, mortality, early diagnosis, neglect, morphological neglect.","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91167712","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":"Effect of the composite immunostimulants of plant origin on the expression of some Th1 cell immune response genes","authors":"A. Turmagambetova, A. Bogoyavlenskiy, P. Alexyuk, M. Alexyuk, V. Berezin","doi":"10.31082/1728-452x-2020-211-212-1-2-47-54","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-211-212-1-2-47-54","url":null,"abstract":"The high variability of the influenza virus leads to its rapid adaptation to drugs and vaccines, which requires a change in the strategy and tactics against influenza infection. A deeper understanding of the nature of innate and adaptive immunity for influenza infection is required to create more effective means of influenza preventing and treating. The aim of the work was to study the changes in the levels of the main markers of specific Th1 antiviral immunity after introduction of a composite immunostimulant based on biologically active compounds of plant origin. Material and methods. Composite immunostimulants were mixed of purified pentacyclic triterpenoid betulin with purified methoxy flavonoids: nobiletin, hesperidin and isorhamnetin glycoside of plant origin. The expression level of the studied genes was determined by PCR. The genes IL-1, IL-2, and Ccr5 were chosen as markers of the Th1 immune response. Results and discussion. It was shown that immunostimulants compositions based on a combination of betulin with methoxy flavonoids (isorhamnetin glycoside, hesperidin and nobiletin) can significantly stimulate the expression of studied genes of Th1 cellular stage of the immune response. The highest activity of stimulating in expression of selected marker genes was found for the IL-2 gene (11-fold increase in expression activity), the smallest for the Ccr5 chemokine gene (2.2-fold increase in expression activity). Conclusions. The results show that immunostimulants compositions based on the combination of purified triterpene betulin glycoside with purified methoxy flavonoids can significantly effect on the structure of a specific immune response, which is of great importance for the creation of new preventive and therapeutic antiviral preparations. Keywords: betulin, isorhamnetin, nobiletin, hesperidin, adaptive immunity, Th1 immunity, genes expression.","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78788261","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 optimal combination of Lysinopril and Amlodipine for the treatment of patients with hypertension","authors":"G. Junusbekova, M. Tundybayeva, T. Leonovich, Manshuk Yeshniyazova, Rizvangul Namatova, S. Alimbayeva, Gani Tulepbergenov, Aizhan Kubeyeva","doi":"10.31082/1728-452x-2020-211-212-1-2-31-39","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-211-212-1-2-31-39","url":null,"abstract":"Arterial hypertension (AH) remains one of the most common diseases in the world. Reducing cardiovascular risk of mortality from cardiovascular complications is a priority in the treatment of hypertension. Targets of hypertension therapy is to achieve SBP/DBP <140/80 mm Hg. article, regardless of cardiovascular risk and comorbidity. The choice of antihypertensive therapy depends on blood pressure levels, the presence or absence of concomitant diseases, lesion of target organs. Effective and long-lasting control of AH proved by the use of combinations of antihypertensive drugs, including antagonists and ACE inhibitors. The purpose of the study. Evaluation of clinical efficacy and safety of fixed combination antihypertensive therapy using lisinopril combined with amlodipine in patients with hypertension. Material and methods. The study included 30 respondents from essential hypertension II-III degree (ESH/ESC, 2018) aged 35 to 75 years. Patients were treated with the schema a (lisinopril 10 mg, amlodipine 5 mg) and scheme b (lisinopril 20 mg, amlodipine 10 mg) fixed combination therapy with the drug VivaCor® once in the morning. The period of observation was 3 months. At the time of inclusion and at the end of the study all respondents was performed echocardiography, daily monitoring of blood pressure, evaluation of laboratory and instrumental methods of research. Results and discussion. The combination of lisinopril with amlodipine has a fairly high antihypertensive activity, provides a significant cardioprotective effect and is an integral part of antihypertensive therapy in the long-term strategy of administering patients with high hypertensive / very high total cardiovascular risk. Conclusions: 1. The use of a fixed combination of lisinopril and amlodipine in patients with hypertension instead of free or other two-component combinations leads to its target level within 3 months of therapy. 2. Taking a fixed combination of lisinopril and amlodipine is effective and safe. 3. Therapy using the combined drug VivaCor® in patients with high / very high risk of hypertension prevents further pathological remodeling of the heart. 4. The combination of amlodipine and lisinopril is metabolically neutral and well tolerated by patients. Keywords: arterial hypertension, lisinopril, amlodipine, VivaCor.","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79024253","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":"Current questions of assessing the risk of infection in the territory of the soil-dwelling of anthrax for expanding the activities of industrial enterprises","authors":"L. Lukhnova, U. Izbanova, Toktasyn Erubaev, T. Meka-Mechenko, S. Sharipova, Erlan Sansyzbayev, Altyn Rysbekova, N. Turebekov, V. Sushchikh, Gulbostan Kim, A. Abiyeva, Nursultan Kunzhan, Galymzhan Tazhibaev","doi":"10.31082/1728-452x-2020-211-212-1-2-40-46","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-211-212-1-2-40-46","url":null,"abstract":"In the structure of the economy of the Republic of Kazakhstan (RK) according to the latest statistics, the growth rate of industrial development is noted. Growth of industrial production in the regional context was provided in 14 regions out of 16. The mining sector provides more than 2.9% of employment and 18% of gross value added in the economy. The development of industry of Kazakhstan requires the development of new territories, which is often difficult due to the presence of soil-dwelling of anthrax (anthrax animal burial sites). The territory of Kazakhstan is unfavorable for anthrax. Complete elimination of the infection is not possible due to the existence of soil-dwelling of anthrax. The article is devoted to assessing the risk of infection of people and animals on the territory of the soil-dwelling of anthrax and the possibility of reducing the sanitary protection zone (SPZ) in connection with the development of industrial enterprises. Aim. Laboratory-diagnostic analyses of samples of soil, groundwater, risk assessment of infection of people and animals on-site soil-dwelling of anthrax for the scientific substantiation of safe reduction of the SPZ soil-dwelling of the anthrax, which is located at an industrial facility. Methods. Samples and groundwater collection was carried out in accordance with the guidelines. The properties of the strains isolated from the samples were studied in accordance with generally accepted methods. To achieve this aim, the following methods were used to study samples for the presence of the causative agent of anthrax: bacteriological, biological, serological (fluorescence immunoassay, indirect hemagglutination test), genetic (PCR). The risk of infection was assessed on the territory of the soil dwelling (Aktobe region, Khromtau district, Khromtau) of anthrax using data on the epizootic and epidemic situation of anthrax. Results and discussions. Comprehensive studies of soil, surface and groundwater have been carried out. In bacteriological studies of soil samples in crops on the Hottinger's agar, single large, flat, matte-gray rough colonies with uneven edges and fringed processes were found. It was determined that all allocated isolates are typical soil microorganisms of Bacillus cereus involved in soil mineralization. There is no anthrax agent in the samples. We have assessed the risk of infection of people and animals in the territory of the soil dwelling of anthrax. It was determined that there is a low risk of infection of susceptible animals and people with anthrax on the territory of a soil-dwelling located in the Khromtau district, Aktobe region on the territory of an industrial facility. Conclusions. To solve the problem of safe reduction of the SPZ of the soil-dwelling of anthrax in order to expand the activities of an industrial enterprise, it is recommended to conduct a systematic microbiological monitoring of the soil center territory for three years by taking at least 200 soil, groundwater and g","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85736689","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":"\"Point of no return\" in diabetic neuropathies: delusion or crime? International consensus","authors":"A. Barinov, Аsiya Khalimova, Saule Тuruspekova","doi":"10.31082/1728-452x-2020-211-212-1-2-75-84","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-211-212-1-2-75-84","url":null,"abstract":"Polyneuropathy in patients with diabetes mellitus is manifested by a lesion of peripheral sensory, motor and autonomic nervous system. Different severity of damage of sensory, motor and autonomic fibers in typical and atypical forms of diabetic polyneuropathy, require a differentiated approach to therapy, but not the rejection of its implementation. In an interdisciplinary consensus, consultations are held with physicians from different regions of the Russian Federation, and modern methods of diagnosing and assessing the severity of diabetic polyneuropathies, which determine the algorithm for treating patients, are discussed. Keywords: diabetic polyneuropathy, neuropathic pain, gabapentinoids, antidepressants, thioctic acid, benfotiamine, neurotropic therapy, pentasinergy, neuroplasticity, point of no return, therapeutic nihilism, interdisciplinary consensus on DPN.","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74578779","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}