Oleg V. Dolgikh, Nina V. Zaitseva, Natalya A. Nikonoshina, Vadim B. Alekseev
{"title":"Features of neuroimmune and genetic profile in men with clinical manifestations of vegetative vascular dystonia of hypertensive type","authors":"Oleg V. Dolgikh, Nina V. Zaitseva, Natalya A. Nikonoshina, Vadim B. Alekseev","doi":"10.17816/kmj321738","DOIUrl":"https://doi.org/10.17816/kmj321738","url":null,"abstract":"Background. Identification of immune, neurohumoral and genetic markers of vegetative vascular dystonia of the hypertensive type is relevant in the aspect of prevention and early diagnosis of cardiovascular pathology in middle-aged men.
 Aim. To study the features of the immune and neurohumoral profile in middle-aged men with clinical manifestations of vegetative vascular dystonia of the hypertensive type, associated with polymorphic variants of candidate genes for blood vessel tone regulation.
 Material and methods. 113 middle-aged men (mean age 46.13.9 years) were examined. The observation group included 65 men (average age 45.34.6 years) with clinical manifestations of vegetative vascular dystonia of the hypertensive type. The comparison group included 48 men without signs of autonomic regulation dysfunction (average age 48.33.2 years). The groups were comparable in age (p=0.593), ethnic and social composition. The content of CD3+CD95+ lymphocytes was determined by flow cytometry; interleukin-6, total immunoglobulin E, adrenaline, serotonin by enzyme immunoassay. Polymorphic variants of the genes ADRB2 (rs1042713), ADD1 (rs4961), GNB3 (rs5443), HTR2A (rs7997012) were identified by real-time polymerase chain reaction. Statistical processing: comparison of arithmetic means using Student's t-test or MannWhitney U-test, calculation of odds ratio (OR) and 95% confidence interval (CI).
 Results. The immune profile of men with disorders of autonomic regulation was characterized by a deficiency of CD3+CD95+ lymphocytes against the background of overproduction of total immunoglobulin E and interleukin-6. The neurohumoral profile was characterized by excessive synthesis of adrenaline and serotonin. The development of symptoms of vegetative vascular dystonia of the hypertensive type was associated with the G allele of the ADRB2 gene (rs1042713) (OR=1.80; 95% CI=1.053.08; p 0.05), the G allele of the ADD1 gene (rs4961) (OR=3.51; 95% CI=1.279.67; p 0.05), C allele of the GNB3 gene (rs5443) (OR=2.30; 95% CI=1.214.37; p 0.05), A allele of the HTR2A gene (rs7997012) (OR=2.38; 95% CI=1.374.15; p 0.05).
 Conclusion. Changes in the immune profile were identified (deficiency of CD3+CD95+ lymphocytes, excess of total immunoglobulin E, interleukin-6), associated with hyperproduction of adrenaline and serotonin against the background of polymorphism of candidate genes for vascular tone regulation [ADRB2 (rs1042713), ADD1 (rs4961), HTR2A (rs7997012 ), GNB3 (rs5443)].","PeriodicalId":32248,"journal":{"name":"Kazanskij Medicinskij Zurnal","volume":"113 15","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135137763","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}
Roman E. Kalinin, Igor A. Suchkov, Andrey B. Agapov, Vladislav O. Povarov, Nina D. Mzhavanadze
{"title":"Features of various options for anticoagulant therapy for a new coronavirus infection against the background of obesity","authors":"Roman E. Kalinin, Igor A. Suchkov, Andrey B. Agapov, Vladislav O. Povarov, Nina D. Mzhavanadze","doi":"10.17816/kmj159398","DOIUrl":"https://doi.org/10.17816/kmj159398","url":null,"abstract":"Background. When treating a new coronavirus infection, the prevention of venous thromboembolic complications in obese patients is of particular importance.
 Aim. To analyze various options for anticoagulant therapy in obese and non-obese patients in the treatment of a new coronavirus infection.
 Material and methods. The patients were divided into two groups: the first group obese patients 151 (40.8%) people [average age 63 (5669) years], the second group without obesity 219 (59.2%) people [average age 63 (51.571.0) years], p=0.998. According to the prescribed anticoagulant and the presence of obesity, patients were divided into subgroups: subgroup 1 non-obese + low-molecular-weight heparin (n=114), subgroup 2 non-obese + unfractionated heparin (n=58), subgroup 3 obesity + low-molecular-weight heparin (n=76), subgroup 4 obesity + unfractionated heparin (n=66). Venous thrombotic complications and bleeding rates were assessed. Analysis of qualitative indicators was performed using Pearson 2 and Fisher tests. The distribution of quantitative indicators was assessed using the KolmogorovSmirnov and ShapiroWilk tests (p 0.05). Due to the non-normal distribution of indicators, mean values were presented as median (Me) and interquartile range (Q1Q3), and analysis was carried out using Wilcoxon, MannWhitney and KruskalWallis tests.
 Results. In nonobese patients, a comparable incidence of deep vein thrombosis was noted on low molecular weight heparin and unfractionated heparin 1 (0.9%) case versus 3 (5.2%) cases (p=0.102). At the same time, there was a statistically significant difference in the frequency of pulmonary embolism without a source according to autopsy data 2 (1.8%) versus 4 (6.9%) cases (p=0.004). In obese patients receiving unfractionated heparin, the incidence of this complication was higher and amounted to 9 (13.6%), and in patients receiving low molecular weight heparin 2 (2.6%) cases (p=0.004). A higher incidence of bleeding was observed in patients with obesity compared to patients without it (10.6 vs 4.7% of cases, p=0.045). When analyzing hemorrhagic complications, it was found that the incidence of major and significant bleeding was higher in patients receiving unfractionated heparin rather than low molecular weight heparin (16.7 vs 5.3% of cases, p 0.001).
 Conclusion. The use of low molecular weight heparin in obese patients with new coronavirus infection was associated with a low incidence of pulmonary embolism and bleeding compared with patients receiving unfractionated heparin.","PeriodicalId":32248,"journal":{"name":"Kazanskij Medicinskij Zurnal","volume":"23 10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135819778","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}
Oleg V Rukodaynyy, Denuts F. Moroga, Dmitry I. Kicha, Anna V. Fomina, Roman S. Goloshchapov-Aksenov
{"title":"Study of polymorbidity in patients with musculoskeletal diseases at the stage of medical and physical rehabilitation","authors":"Oleg V Rukodaynyy, Denuts F. Moroga, Dmitry I. Kicha, Anna V. Fomina, Roman S. Goloshchapov-Aksenov","doi":"10.17816/kmj397256","DOIUrl":"https://doi.org/10.17816/kmj397256","url":null,"abstract":"Background. The study of multimorbidity is an urgent task for assessing individual clinical risks and prognosis, developing a treatment and rehabilitation plan.
 Aim. To study multimorbidity in patients with chronic musculoskeletal diseases.
 Material and methods. The study was conducted in 20222023 on the basis of the medical center for the treatment of spine and joints DEMA and the Peoples' Friendship University of Russia named after Patrice Lumumba. Study subjects were patients with musculoskeletal diseases (n=212) who sought medical and physical rehabilitation. Men n=75 (average age 40.26.65 years, proportion of patients 60 years 20%), women n=137 (average age 47.26.84 years, proportion of patients 60 years 18%). The subject of the study was polymorbidity in patients with musculoskeletal diseases. The following methods were used: content analysis, analytical, statistical, mathematical, comparative analysis method.
 Results. Spinal diseases were detected in 79.2% of patients, and various dysfunctions of the musculoskeletal system were detected in 19.36%. 43 (20.28%) patients were diagnosed with two diseases of the musculoskeletal system. Women were more likely than men to be diagnosed with spinal osteochondrosis (p=0.015), cervicalgia (p=0.015), degenerative diseases of the hip and knee joints (p=0.022) and consequences of skeletal injuries (p=0.015). Of the concomitant diseases in all patients, eye (23.1%) and cardiovascular diseases (25.5%) were common. Women were more often diagnosed with endocrine (p=0.025), ophthalmic (p=0.001), gynecological (p=0.001) diseases, urolithiasis (p=0.025) and cholelithiasis (p=0.025); men with consequences of injuries/surgeries (p=0.025). Polymorbidity was established in 50.33% of patients 42 men and 72 women. Two and three concomitant chronic diseases were predominantly diagnosed in women, and six or more were diagnosed in men. All patients 60 years of age (25%) had three or more chronic diseases.
 Conclusion. Most patients with musculoskeletal pathology suffer from several chronic diseases.","PeriodicalId":32248,"journal":{"name":"Kazanskij Medicinskij Zurnal","volume":"53 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135820289","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}
Aleksandra V. Smirnova, Diana A. Kuzmina, Yuliya F. Semiglazova, Andrey K. Iordanischvili
{"title":"Changes in the level of C-reactive protein depending on the severity of localized periodontitis of traumatic etiology","authors":"Aleksandra V. Smirnova, Diana A. Kuzmina, Yuliya F. Semiglazova, Andrey K. Iordanischvili","doi":"10.17816/kmj569217","DOIUrl":"https://doi.org/10.17816/kmj569217","url":null,"abstract":"Background. The significant prevalence and course of inflammatory periodontal diseases are associated not only with the presence of known bacterial agents, but also with changes in the bodys immune system that occur as a result of aging.
 Aim. To establish the relationship between the level of C-reactive protein in the blood and the course of localized periodontitis of traumatic etiology.
 Material and methods. During 20162019 169 patients with localized periodontitis of traumatic etiology (average age 56.440.14 years) of mild (102 people) and moderate (67 patients) severity at the Department of General Practice Dentistry of the North-Western State Medical University named after I.I. Mechnikov were examined. An in-depth dental examination, determination of periodontal indices, assessment of laboratory parameters (determination of high-sensitivity C-reactive protein, assessment and calculation of the entropy of the blood leukocyte formula), complex treatment using splinting with orthopedic structures in the main group (69 patients) and without it in the comparison group (57 people) were carried out. Statistical processing of data was conducted using the ShapiroWilk, Pearson, KolmogorovSmirnov tests, Fishers exact test and 2 test, and calculation of relative risk.
 Results. Oral hygiene was good (hygiene index 0.540.18) and satisfactory (hygiene index 0.790.21) with mild and moderate severity, respectively. The local MullemanCowell index was increased by 2.7 times (1.430.50) with mild severity and almost 4 times (2.310.33) with moderate severity of localized periodontitis of traumatic etiology compared with general index (0.520.12; 0.640.18). In localized periodontitis of traumatic etiology of moderate severity, an increase in the number of monocytes (8.72.12109/l) and band neutrophils (5.41.47109/l), an increase in the relative entropy of the leukocyte blood count (72.321.12%) compared with mild severity (62.814.9%; p=0.00089) were identified. With C-reactive protein concentrations ranging from 3 to 10 mg/l, the risk of developing localized periodontitis of moderate traumatic etiology increased by 1.74 times compared with C-reactive protein levels of less than 3 mg/l (p=0.0022).
 Conclusion. In localized periodontitis of moderate traumatic etiology, an increase in the number of band neutrophils and monocytes, as well as the relative entropy of the leukocyte blood count was detected. Preclinical increases in the concentration of C-reactive protein contribute to an increase in the severity of the disease.","PeriodicalId":32248,"journal":{"name":"Kazanskij Medicinskij Zurnal","volume":"25 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135820229","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}
Vladimir A. Beloborodov, Ivan A. Stepanov, Georgiy A. Ryllo
{"title":"Possibilities of magnetic resonance imaging in visualizing the pudendal nerve in normal and pathological conditions","authors":"Vladimir A. Beloborodov, Ivan A. Stepanov, Georgiy A. Ryllo","doi":"10.17816/kmj508781","DOIUrl":"https://doi.org/10.17816/kmj508781","url":null,"abstract":"Until recently, imaging of peripheral nerves was limited from a technical point of view, as there was no established gold standard study protocol for the purpose of qualitative visualization of nerve trunks in normal and pathological conditions. With technical advances in magnetic resonance imaging and the advent of specialized high-resolution magnetic resonance neurography, it has become possible to visualize peripheral nerves of varying diameters. A literature search in the Pubmed, Medline, EMBASE, Cochrane Library, and eLibrary databases demonstrated the presence of several studies examining the capabilities of magnetic resonance imaging in visualizing the pudendal nerve in normal and pathological conditions. It must be emphasized that the results of these studies are consistent and largely complement each other. A generalization of the available data on the capabilities of magnetic resonance neurography of the pudendal nerve was the impetus for writing this literature review. Magnetic resonance neurography is a tissue-specific imaging method optimized for assessing the condition of peripheral nerves, including changes in the morphology of their bundle structure, signal, the diameter and length of nerve trunks, which can be caused by both anatomical features and pathological processes. Three-dimensional (3D) imaging is critical for studying the topography of peripheral nerves, identifying areas of compression or traumatic injury, and for preoperative planning. Magnetic resonance imaging in certain modes and sections allows to clearly visualize the pudendal nerve along almost its entire length, determine the nature of its branching and the features of its topographic and anatomical location. The anatomical characteristics of the pudendal nerve and its pathological changes obtained using magnetic resonance neurography can be used in everyday clinical practice by urologists, obstetricians-gynecologists and neurosurgeons for planning surgical interventions.","PeriodicalId":32248,"journal":{"name":"Kazanskij Medicinskij Zurnal","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135820230","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}
Tatiana V. Kalinkina, Natalia V. Lareva, Marina V. Chistyakova, Mikhail A. Serkin
{"title":"Indicators of heart rate variability and left ventricular deformation parameters in patients with hypertension in combination with left ventricular diastolic dysfunction","authors":"Tatiana V. Kalinkina, Natalia V. Lareva, Marina V. Chistyakova, Mikhail A. Serkin","doi":"10.17816/kmj109072","DOIUrl":"https://doi.org/10.17816/kmj109072","url":null,"abstract":"Background. Currently, there is little data on changes in the parameters of heart rate variability and the appearance of subclinical systolic dysfunction of the left ventricular myocardium in hypertensive patients with the development of diastolic dysfunction.
 Aim. To study indicators of heart rate variability and parameters of left ventricular deformation in patients with hypertension depending on the presence of diastolic dysfunction.
 Material and methods. 60 patients with stage III hypertension (28 women and 32 men) who were in the cardiology department of the clinical hospital and 30 healthy volunteers (23 men and 7 women) were examined. The mean age of the patients was 429.4 years, the age of healthy volunteers was 41.33.5 years. All subjects underwent Holter monitoring, echocardiographic determination of left ventricular diastolic dysfunction and global deformity. According to the presence of diastolic function of the left ventricle, patients with hypertension were divided into two groups: the first group included 30 patients without impaired diastolic function of the left ventricle according to the results of echocardiography, the second group included 30 patients with diastolic dysfunction, the third group (control) consisted of healthy volunteers. Correlation analysis was performed using the Spearman test. To compare two samples of continuous independent data, the MannWhitney U-test was used with the correction of the obtained p-values using the BenjaminHochberg test due to the multiple comparison procedure.
 Results. When studying heart rate variability, it was found that the power in the high frequency range in patients of the first group was reduced by 2.1 times compared with the control (p=0.0087), in patients of the second group by 3.4 times compared with healthy people (p=0.005). An imbalance of vegetative influences and a tendency to increase the balance of sympathetic and parasympathetic activity were found. In the study of the average value of the global deformation, it was found that it is lower by 41% in the second group, and in the third - by 48% compared with the control group (p=0.01 and p=0.0002, respectively). The mean values of the global strain were associated with a decrease in the standard deviation of the values of the normal RR intervals (r=0.60, p=0.0001), and the end-systolic and diastolic volumes were correlated with the LH/HF index (r=0.51, p=0.0021 and r=0.65, p=0.001, respectively).
 Conclusion. Heart rate variability and indicators of left ventricular deformation in patients with hypertension are reduced in the presence of its diastolic dysfunction.","PeriodicalId":32248,"journal":{"name":"Kazanskij Medicinskij Zurnal","volume":"23 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135933222","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}
Nadezhda I. Baranova, Liudmila A. Aschina, Alexandra I. Bolgova, Olga N. Lesina
{"title":"Effect of pharmacotherapy on the immune response in patients with COVID-19","authors":"Nadezhda I. Baranova, Liudmila A. Aschina, Alexandra I. Bolgova, Olga N. Lesina","doi":"10.17816/kmj322842","DOIUrl":"https://doi.org/10.17816/kmj322842","url":null,"abstract":"Background. The effect of pharmacotherapy used to treat patients with the new coronavirus infection COVID-19 on immune parameters after treatment has not been sufficiently studied.
 Aim. To study the effectiveness of pharmacotherapy and evaluate its impact on the immune response in patients with COVID-19.
 Material and methods. The subjects of the study were 98 patients with COVID-19 aged from 32 to 68 years who were treated at the Penza Regional Clinical Center for Specialized Types of Medical Care from November 2022 to March 2023. The average age of the patients was 5018 years. Computed tomography revealed pneumonia in all patients (CT1CT4). The outpatient observation group included patients with COVID-19 (n=32), who were characterized by a mild course of the disease, 36 patients with moderate severity of COVID-19, and 30 patients with severe and extremely severe disease. Patients with mild COVID-19 received molnupiravir as antiviral therapy, patients with moderate COVID-19 received favipiravir, and patients with severe and extremely severe COVID-19 received remdesivir. After treatment, 72 patients were examined on an outpatient basis 34 weeks after discharge from the hospital. In the blood of patients before and after treatment, the populations of T- and B-lymphocytes, the functional activity of T-lymphocytes, cytokine indicators tumor necrosis factor , interleukins-4, -10 and -18, interferon in cell supernatants were studied. Statistical analysis of the groups was carried out according to Wilcoxon, differences were considered significantly significant at p 0.05.
 Results. In the observation group (98 patients), in patients with mild disease (32 patients), recovery occurred in 31 (96.8%) people. With a moderate course of the disease, a favorable outcome with clinical and laboratory improvement was noted in 33 (91.7%) patients out of 36, and with a severe course of COVID-19 in 7 (23.4%) patients out of 30, 5 (16.6%) patients died, in 18 (60.0%) people after the 10th day of therapy complications from the cardiovascular system in the form of heart attacks and strokes were noted. After treatment in patients with COVID-19, the immune system showed an increase in the relative number of lymphocytes (p=0.034171), indicators of cytotoxic CD3+CD8+ T cells (p=0.001090), spontaneous synthesis of interferon (p=0.003246), induced production of interleukin-18 (p=0.003278), decrease in the absolute number of leukocytes (p=0.004319) and induced synthesis of interleukin-10 (p=0.042439).
 Conclusion. Regardless of the type of antiviral therapy administered, a high recovery rate was recorded in patients with mild and moderate disease compared with severe and extremely severe disease.","PeriodicalId":32248,"journal":{"name":"Kazanskij Medicinskij Zurnal","volume":"22 10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135933224","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}
Tatyana V. Ryabova, Damir I. Marapov, Alexander G. Zhidyaevskij, Liana L. Galimova, Laysan M. Mukharyamova
{"title":"Factors and conditions of successful professional adaptation of residents","authors":"Tatyana V. Ryabova, Damir I. Marapov, Alexander G. Zhidyaevskij, Liana L. Galimova, Laysan M. Mukharyamova","doi":"10.17816/kmj321747","DOIUrl":"https://doi.org/10.17816/kmj321747","url":null,"abstract":"Background. Residency is the main stage in the training of highly qualified medical personnel. Requirements for the level of training and professional values of future doctors are increasing, approaches to training and assessment technologies are changing, which imposes additional responsibility on all participants in the educational process: teachers, mentors and residents.
 Aim. To identify the factors and conditions that affect the professional adaptation of residents in the first months of training.
 Material and methods. The study involved 369 residents studying at Kazan State Medical University, Kazan (Volga region) Federal University, Kazan State Medical Academy, aged 22 to 36 years. Residents were subdivided into groups according to the following criteria: specialty, place of previous training, basis of training (by general competition, target, commercial), gender, age, clinical base of residency. An original questionnaire developed by the authors containing 27 questions was used. Questions of the questionnaire concerned various aspects of the adaptation of residents. Filling the questionnaire was anonymous and was carried out using Internet survey technology via Yandex Forms. Statistical analysis and visualization of the obtained data were performed using the StatTech v. 3.0.9. Categorical data were described with absolute values and percentages. Comparison of percentages in the analysis of multifield contingency tables was performed using Pearson's 2 test.
 Results. Satisfaction with training was considered as one of the indicators of successful adaptation of residents. Based on the results of the 1st and 2nd months of residency training, 48.2% of respondents showed satisfaction with their training. There were no significant differences in the degree of satisfaction among residents of various specialties (p=0.424). Statistically significant differences (method used Pearson's 2) were established by the presence of a mentor/curator, as well as cases of disrespectful attitude on the part of the medical staff of the clinical base where they were trained, patients and their relatives, and the administration of the institution (p 0.05). The dependence of the process of residents adaptation on the chosen specialty, place of previous training, the basis of training (by general competition, target, commercial), gender, age, clinical base of residency was not found.
 Conclusion. The conditions for successful adaptation of residents are the presence of a mentor from a medical organization, the accuracy of the instructions received, the frequency of meetings with a teacher/curator, the attention of the head of the department to the work and study of residents, and the motivation for learning from the residents themselves.","PeriodicalId":32248,"journal":{"name":"Kazanskij Medicinskij Zurnal","volume":"57 8","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136318329","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}
Svetlana I. Mazepa, Elena F. Kotovshchikova, Inna A. Veitsman, Natalia A. Lomakina, Mariya N. Nechaeva
{"title":"Features of the course of type 1 diabetes mellitus and its complications against the background of undifferentiated connective tissue dysplasia","authors":"Svetlana I. Mazepa, Elena F. Kotovshchikova, Inna A. Veitsman, Natalia A. Lomakina, Mariya N. Nechaeva","doi":"10.17816/kmj340788","DOIUrl":"https://doi.org/10.17816/kmj340788","url":null,"abstract":"Changes in connective tissue against the background of hyperglycemia in patients with type 1 diabetes mellitus is a morphological substrate for the formation of diabetic complications. The presence of undifferentiated connective tissue dysplasia in a patient with absolute insulin deficiency, the prevalence of individual external manifestations of which among young people is 85.4%, can increase the risk of developing and progressing complications of diabetes mellitus. The purpose of the review is to summarize the literature data on the impact of undifferentiated connective tissue dysplasia on the course of type 1 diabetes mellitus and its complications when they are combined in one patient. An analysis of the literature has shown that today there are single studies that have studied the specifics of the course of type 1 diabetes mellitus and its complications against the background of undifferentiated connective tissue dysplasia, with some aspects analyzed in children and adolescents, others in adults, which does not allow to draw clear conclusions. The results of these studies demonstrated earlier development and progression of such diabetic complications as nephropathy, neuropathy, post-injection lipodystrophy in patients with increased dysplastic stigma. According to some experts, patients with type 1 diabetes mellitus and concomitant undifferentiated connective tissue dysplasia should be allocated to a separate group of dispensary observation, since they may have a higher risk of developing and progressing rate of chronic complications of diabetes mellitus, which leads to a concomitant decrease in quality of life and increased risk of disability. However, to date, the question of the influence of increased dysplastic stigmatization on the course of type 1 diabetes mellitus has not been fully studied.","PeriodicalId":32248,"journal":{"name":"Kazanskij Medicinskij Zurnal","volume":"48 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135013825","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}
Alexander V. Kolesnikov, Elena R. Nemtsova, Tatyana M. Cherdantseva, Irina V. Kirsanova, Tatyana D. Kislyakova
{"title":"Effect of human lactoferrin solution on histological changes of rabbit cornea in alkaline burns","authors":"Alexander V. Kolesnikov, Elena R. Nemtsova, Tatyana M. Cherdantseva, Irina V. Kirsanova, Tatyana D. Kislyakova","doi":"10.17816/kmj115265","DOIUrl":"https://doi.org/10.17816/kmj115265","url":null,"abstract":"Background. Eye burns are a severe injury, accounting for 6.138.4% of all ophthalmic diseases. Alkaline burns are the most common and most severe forms of eye burns.
 Aim. Evaluation of the effectiveness of drug topical application based on human lactoferrin in alkaline cornea burns of the 3rd degree in the experiment.
 Material and methods. The study was conducted on 42 rabbits. It included two groups: the first (without treatment) alkaline burns during therapy with water for injection (1 drop 3 times a day) 21 rabbits, the second (experimental) treatment with lactoferrin solution (concentration 2.5 mg/ml, 1 drop 3 times a day) 21 rabbits. Alkaline burns were induced by applying a filter paper disc moistened with 5% sodium hydroxide solution to the cornea. 6 eyes of 3 intact animals served as controls. The effectiveness of the drug was evaluated by the rate of closure of the corneal epithelium defect, the time of suppression of the inflammatory reaction in the area of the defect and the limbus, the degree of restoration of the morphological structure of the cornea, as close as possible to the normal rabbit cornea. The obtained data were processed using the methods of variation statistics, the Statistica 10.0 software package. The significance of differences was assessed by calculating the median and interquartile interval. The critical level of significance for statistical criteria was taken as p=0.05.
 Results. From the 3rd day of the study, in the experimental treatment group, there was an acceleration of reepithelialization, restoration of the cornea's own substance, and a more rapid subsidence of inflammation compared to the control group. The thickness of the cornea in the center of the defect in the group without treatment was significantly higher than the values of intact animals at all periods of observation: on the 3rd day after the burn it was 615.99 [450.70794.07] m (p=0.000574), reached the maximum by day 7 it was 1363.16 [907.781543.44] m (p=0.000091), and by day 28 it decreased to 384.38 [376.03398.14] m (p=0.0000041). In the group with experimental treatment, the thickness of the cornea in the center of the defect also increased relative to intact animals, starting from the 1st day of pathology, reaching maximum values on the 3rd day 436.70 [415.57489.90] m (p=0.005589). The use of lactoferrin solution in comparison with the first group led to a significant decrease in the thickness of the cornea in the center of the defect on 7th (p=0.039985) and 28th days (p=0.0443).
 Conclusion. Local application of lactoferrin solution in alkaline burns of the cornea promotes faster regeneration of the epithelium and restoration of the stroma structure of the rabbit cornea.","PeriodicalId":32248,"journal":{"name":"Kazanskij Medicinskij Zurnal","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135244029","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}