Kubanskii nauchnyi meditsinskii vestnik最新文献

{"title":"Germline mutations in patients with oral mucosal leukoplakia and squamous cell carcinoma: a prospective observational study","authors":"N. A. Karpuk, S. Rubnikovich, O. C. Mazur, I. V. Zhyltsov, I. Karpuk, A. Mikhalenka","doi":"10.25207/1608-6228-2023-30-2-15-24","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-2-15-24","url":null,"abstract":"Background. The number of studies devoted to the molecular genetics of oral mucosal leukoplakia and squamous cell carcinoma is small, while the obtained results are usually preliminary in nature. We can assume the existence of region-specific pathogenic genetic variants involved in the development of oral mucosal leukoplakia and squamous cell carcinoma. With the knowledge of such variants, it would become possible to develop PCR (polymerase chain reaction) and NGS (next-generation sequencing) test systems for the detection of clinically significant germline mutations.Objectives — to identify pathogenic germline genetic variants in patients with oral mucosal leukoplakia accompanied by grade 1 epithelial dysplasia, as well as oral mucosal squamous cell carcinoma, using new-generation sequencing.Methods. Study design: prospective, observational, cross-sectional, without a control group. The sample included patients (48 persons) of either sex (18 years of age or older) with the following proven and morphologically confirmed diagnoses: oral mucosal leukoplakia accompanied by grade 1 squamous intraepithelial neoplasia of epithelium (24 people) and oral mucosal squamous cell carcinoma (24 people), who sought medical care at the Vitebsk Regional Clinical Dental Center and Vitebsk Regional Clinical Oncological Center in 2019–2020. The identified pathogenic and presumably pathogenic genetic variants involved in the development of these diseases were quantitatively assessed. The study was conducted at the Shareable Core Facilities GENOME of the Institute of Genetics and Cytology of the National Academy of Sciences of Belarus. In order to isolate deoxyribonucleic acid (DNA) from blood samples, a QIAamp DNA FFPE Tissue Kit (Qiagen, Germany) was used. The preparation of DNA libraries and sequencing were carried out by means of an Illumina NextSeq 550 sequencing system (Illumina, Inc., USA) using an Illumina Nextera DNA Exome kit (USA). Bioinformatic analysis was conducted using Illumina BaseSpace specialized software (USA) and Galaxy Project (Galaxy Community, an international non-profit project) in accordance with current guidelines. The obtained data were statistically processed employing specialized software packages Statistica 12 (StatSoft, Inc., USA) and MedCalc 18.9.1 (MedCalc Software, Ltd, Belgium).Results. Next-generation whole-exome sequencing of deoxyribonucleic acid samples isolated from the blood of patients with oral mucosal leukoplakia and squamous cell carcinoma has been conducted in the Republic of Belarus for the first time. The total number of unique germline genetic variants in the exome of both groups of patients was shown to be very high, yet most of them were not pathogenic. In the examined patients, the majority of germline mutations were found to be localized only in 19 exome genes: MAP2K3, DNAH5, HSPG2, OBSCN, SYNE1, HLA-DRB1, HLA-DQA1, HLA-DQB1, HLA-A, HLA-B, PKD1L2, TTN, AHNAK2, PDE4DIP, MUC3A, MUC4, MUC12, MUC16, and MUC17. In both","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49612764","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":"Analysis of Protein Markers in Plasma of Patients with Drug Dependence Syndrome: Observational Clinical Study","authors":"I. Bykov, D. Lubchenko, K. Popov, A. N. Stolyarova, M. Popova, O. Tsymbalov, E. E. Esaulenko","doi":"10.25207/1608-6228-2023-30-2-25-34","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-2-25-34","url":null,"abstract":"Background. In drug addiction treatment, the diagnostic process is based on the chemical toxicological determination of the intoxication substrate or its metabolite. Laboratory monitoring and prediction issues that could form the basis of secondary prevention remain unresolved. Specific nervous tissue proteins are considered to be the most promising laboratory markers of drug pathology.Objective — to determine some potential biomarkers of protein-chemical nature in the plasma of patients with drug dependence syndrome.Methods. The study was conducted according to the design of an observational clinical trial at the Narcological Dispensary of Krasnodar Krai in the period from 07.2021 to 07.2022. The main group (group 2) included 31 patients diagnosed with substance dependence syndrome. The control group (group 1, n = 15) consisted of healthy subjects submitted to occupational medical examinations. During the detoxification-stabilization therapy and rehabilitation, 5 proteins were determined in the plasma: brainand glial-derived neurotrophic factors, neuron-specific enolase, alpha-synuclein and calcium-binding protein S100B. Statistical analysis of the data involved the Mann-Whitney test for comparing the values of the control and experimental groups and the Wilcoxon test for comparing the values of one group obtained at different stages of observation. The calculations were carried out using StatPlus version 7 (AnalystSoft Inc., USA).Results. A total of 31 patients were included in the main group, 18 of them were followed up with a diagnosis of opioid dependence syndrome (n = 11) or psychostimulant dependence syndrome (n = 7). Patients dropped out of the study due to their refusal to participate in the study or undergo rehabilitation, or due to relapse of the disease. When admitted to the hospital, patients indicated a 45% decrease in brain-derived neurotrophic factor in the plasma ( p < 0.001), and a 3.9-fold decrease after rehabilitation course ( p < 0.001). Glial-derived neurotrophic factor in the plasma exceeded the controls 1.9 times ( p < 0.001) upon admission to hospital, but rapidly returned to normal values thereafter. Level of neuron-specific enolase in the plasma was also poor, 36% lower than the controls ( p <0.001), but approached the control values by the end of rehabilitation.Conclusion. The study obtained data indicating the changes in neurotrophic factors in the blood plasma of patients with opioid or psychostimulant dependence. The rehabilitation period was marked by a relatively rapid improving level of neurotrophins; however, brain-derived neurotrophic factor remained reduced despite the successful treatment, which may indicate the irreversible changes.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43270404","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":"Efficacy of Physical Rehabilitation after Anterior Cruciate Ligament Reconstruction: Non-Randomized Trial","authors":"I. I. Radysh, L. S. Kruglova, V. Boyarintsev, N. V. Vasilchenko","doi":"10.25207/1608-6228-2023-30-2-35-43","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-2-35-43","url":null,"abstract":"Background. Anterior cruciate ligament rupture is the most common knee joint injury, especially in young people with a healthy and active lifestyle. The concept of quality of life has been dynamically developing. The scope of its application is expanding in various fields of medicine to provide a comprehensive assessment of treatment and rehabilitation efficacy.Objective — to assess the feasibility of complex individual physical rehabilitation of patients after early and delayed arthroscopic reconstruction of the anterior cruciate ligament (ACL).Methods. Open simple non-randomized trial enrolled 834 patients with the anterior cruciate ligament rupture of the knee joint. In the first group (431 patients), ACL plastic surgery was performed in the early stages — between weeks 2 and 6. In the second group (403 patients), ACL reconstruction was performed in the later stages — from week 7 to 1 year, inclusive. Each group was divided into two subgroups — the main one, in which restorative treatment and comprehensive individual rehabilitation were carried out, and the control group, with rehabilitation treatment in accordance with the standards of postoperative treatment. The study was conducted in Traumatology, Orthopedics and Medical Rehabilitation Unit of Clinical Hospital No. 1. Patients were included in the trial from 2016 to 2021. The follow-up period for each patient was one year. Statistical data processing was performed by means of Statistica 12.0 (StatSoft, Inc., USA). Independent samples were compared using non-parametric criteria: Mann — Whitney U-test and Wilcoxon T-test.Results. No statistical differences were found in the distribution according to gender, age and body mass index. A comparative analysis of scale medians of Medical Outcomes Study 36Item Short-Form Health Survey (MOSSF-36), conducted in patients before surgery, revealed no statistically significant differences ( p>0.05) between the main and control subgroups in both groups. Analyzing medians before ACL reconstruction showed a significant decrease in comparison with population studies ( p < 0.0001, Mann — Whitney U-test). The analysis of physical and mental component summaries via MOSSF-36 revealed statistically significant differences in the effectiveness of treatment of patients in 1 year after ACL plastic surgery and complex individual rehabilitation. Thus, in the main subgroups, the values of treatment efficacy medians were significantly higher than in the control ones, regardless of the timing of ACL plastic surgery ( p < 0.001, Mann — Whitney U-test). The results testify to higher median efficacy values in patients of the main subgroup of group 1 than in other subgroups ( p < 0.001, Mann — Whitney U-test). The study of correlative relationships demonstrated a stronger relationship between the medians of physical and mental component summaries in the main subgroup of the first group (correlation coefficient = 0.76), if compared to the main subgroup of the second group (co","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48431162","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":"Polyarteritis Nodosa: Clinical Cases in Boys 12 and 9 Years Old","authors":"A. Burlutskaya, V. E. Tril, N. Saveleva, D. V. Ustuzhanina, J. V. Pisotskaya, S. M. Bogacheva","doi":"10.25207/1608-6228-2023-30-2-89-101","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-2-89-101","url":null,"abstract":"Background. Polyarteritis nodosa is an acute, subacute or chronic immune complex disease associated with peripheral and visceral artery involvement, predominantly of middle and small sizes, development of destructive-proliferative arteritis and subsequent peripheral and visceral ischaemia.Cases description. The present paper describes two clinical cases of polyarteritis nodosa in patient R., aged 12, and patient A., aged 9, and demonstrates the difficulties of diagnosing the disease in its early stages. Patient R., aged 12, was admitted to the Rheumatology Unit of the Krasnodar Krai Children’s Clinical Hospital with complaints of red, patchy, dense rash on the palms and plantar surface of the feet. The child has been ill since September 2017, and after a history of tonsillitis suffered a fever of 37 °C, pain in the right heel area, nodular thickening on the feet, livedo reticularis, swelling of both hands. The disease had a recurrent course. The boy was treated with prednisolone, mycophenolate mofetil, hydroxychloroquine and three courses of rituximab (April 2018, January 2019, September 2020). Repeated courses of human normal immunoglobulin and alprostadil therapy were carried out. The treatment showed positive dynamics, fever was eliminated, general well-being improved, and acute inflammatory markers in blood became normal. The skin retained minimal manifestation of livedo, nodularities on the feet did not progress in dynamics. Patient A. was admitted to the Rheumatology Unit of the Krasnodar Krai Children’s Clinical Hospital in April 2022 with complaints of weakness, myalgia of the lower extremities and necrosis foci in the left lumbar region. The medical history indicates that in March 2022, the boy, being in good health before, developed a bluish, painful rash on his lower legs after a workout. Skin changes and soreness resolved on their own without treatment. After examination, a diagnosis was made as follows: juvenile polyarteritis nodosa, activity score — 3.Conclusion. The diagnosis of polyarteritis nodosa can be often problematic due to the very character of the disease featured by absence of specific symptoms, by polymorphism of clinical manifestations, and by lack of clear diagnostic and laboratory markers.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41949790","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":"Comparative Evaluation of the Effect of Hepatoprotectors on Oxidative Homeostasis in the Blood of Patients with Alcoholic Hepatitis: A Randomized Experimental Study","authors":"I. Bykov, G. Ermakova, K. Popov, I. Tsymbalyuk, M. I. Bykov, Y. E. Denisova, S. M. Tutarisheva","doi":"10.25207/1608-6228-2023-30-1-88-97","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-1-88-97","url":null,"abstract":"Background. An analysis of published results on the chemical structure, pharmacodynamics and pharmacokinetics of hepatoprotective agents, as well as their practical application, shows that a holistic view on the pharmacology of hepatoprotective agents is yet to be developed. Thus, the relationship between antioxidant activity and the effectiveness of reducing hepatocyte cytolysis remains unclear. Another difficult question concerns indications for the application of hepatoprotectors, selection of a particular drug and treatment duration.Objectives. To investigate the effects of hepatoprotective agents with different mechanisms of action on the indicators of oxidative metabolism in the blood of patients with alcoholic hepatitis.Methods. Four groups of patients were involved in the study. The 1st group consisted of relatively healthy male patients (n = 15). The remaining groups (10 individuals in each) were represented by patients with moderate alcoholic hepatitis. Patients of the 2nd group received remaxol; patients of the 3rd group received ademetionine; patients of the 4th group received ursodeoxycholic acid. Prior to and following treatment, the indicators of cytolysis and oxidative stress in blood were determined. Statistical data processing was carried out using the StatPlus v 7 (AnalystSoft Inc.) software package.Results. According to the observed changes in the cytolytic syndrome marker enzymes, all three hepatoprotectors under study expressed comparable efficacy. After treatment according to any of the applied schemes, the ALT and AST activity in the blood plasma decreased by 56–68% and 75–81%, respectively, compared to their initial values. In comparison with the control group, the total antioxidant activity of the blood plasma decreased by 20–27%; the content of TBA-reactive products in the erythrocyte suspension increased by 61–87%. The remaxol, ademethionine or ursodeoxycholic acid therapy led to a partial normalization of the abovementioned parameters without significant differences between the experimental groups. The concentration of reduced glutathione in the erythrocyte suspension and the content of thiol groups in the blood plasma of patients were reduced in comparison with the control group by 16% and 26%, respectively. After therapy, these indicators also increased by 12–15%, although no predominant effect of either of the studied hepatoprotectors was revealed.Conclusion. The conducted comparative study indicated the absence of a specific antioxidant effect among the pharmacological mechanisms of action of remaxol, ademethionine and ursodeoxycholic acid. In this regard, further research should be carried out to investigate the effect of hepatoprotective drugs on pathobiochemical changes and to analyse a relationship between the antioxidant effect and the efficacy of reducing the level of hepatocyte cytolysis.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48383505","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":"Clinical and Morphological Analysis of Efficacy of Intraperitoneal Ozone Application in Experimental Colitis: Preclinical Randomized Experimental Study","authors":"M. Osikov, N. V. Kaygorodtceva, M. Boyko, L. V. Astachova","doi":"10.25207/1608-6228-2023-30-1-98-108","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-1-98-108","url":null,"abstract":"Background. Inflammatory bowel diseases — Crohn’s disease and ulcerative colitis — are chronic gastrointestinal diseases affecting young people of working age. An alternative to basic therapy (5-aminosalicylic acid) for inflammatory bowel disease is the use of ozone, which has anti-inflammatory, immunomodulatory, antibacterial properties and no side effects in therapeutic concentrations. Objective. To perform clinical and morphological analysis of efficacy of intraperitoneal ozone application in experimental colitis.Methods. The study was conducted on 73 male Wistar rats weighing 200-250 g. The animals were divided into four groups by simple randomization. Check studies were performed on the second, fourth and sixth days. Oxazolone-induced colitis was simulated in two stages using a 3%-alcohol oxazolone solution. Ozone-acid mixture was obtained on “UOTA-60-01” unit (“Medozone”, Russia). Rectal suppositories with 5-aminosalicylic acid were prepared on the basis of rectal suppositories “Salofalk”. Clinical status was assessed daily according to the disease activity index (DAI) scale. Morphological evaluation of colon lesion tissue fragments was carried out using a PrimoStar microscope (CarlZeiss, Germany). Colon tissue damage was assessed using tissue damage index (TDI). Statistical analysis was conducted with SPSS Statistics 19 (IBM, USA).Results. Clinical and morphological picture of the large intestine lesion in oxazolone-induced colitis on days 2, 4 and 6 is consistent with the changes typical of inflammatory bowel disease in humans. Daily intraperitoneal insufflation of ozone at a dose of 0.05 mg/kg in oxazolone-induced colitis leads to partial restoration of DAI, reduction in neutrophils, eosinophils, histiocytes, and fibroblasts in the lesion, as well as to a decrease in ulcerous defect diameter and TDI. The effects of intraperitoneal insufflations of ozone in oxazolone-induced colitis as compared to rectal suppositories with 50 mg of 5-aminosalicylic acid every 12 hours were less marked for the DAI index on day 4; for the number of eosinophils, plasma cells, histiocytes — on day 2, 4 and 6; for lymphocytes — on day 6.Conclusion. Clinical and morphological picture of the large intestine lesion in ozone-induced colitis correlates with the changes typical of inflammatory bowel disease in humans. The positive effect of ozone in ozone-induced colitis was driven by its anti-inflammatory properties through the activation of Nrf2 and by its antioxidant properties through the inhibition of Keap1.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42560138","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":"Evaluating the Developed Model of Experimental Rhinitis in Laboratory Rats: Pre-Clinical Experimental Randomized Study","authors":"I. Y. Berest, T. Tananakina, O. Teleshova, E. Burgelo, R. A. Parinov, A. Koretsky","doi":"10.25207/1608-6228-2023-30-1-78-87","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-1-78-87","url":null,"abstract":"Background. Among the damaging factors affecting the mucociliary system of the nasal cavity, surgical wound is of particular relevance in the practice of an otorhinolaryngologist. The clinical assessment of regeneration of the mucociliary system is associated with certain diffi culties, since the intravital morphological examination of the nasal mucosa in patients is traumatic. Therefore, the development of animal models of experimental rhinitis is considered to be highly relevant in order to study the dynamics of mucociliary pathomorphological changes and assess the epithelium regeneration.Objectives. To evaluate the developed model of experimental rhinitis in laboratory rats by studying clinical, morphological and biochemical changes in the infl ammatory process.Methods. The experimental rhinitis model was developed and tested on 60 mature male Wistar rats. All animals were randomized into two groups: experimental group #1 (n = 30) — rats in which experimental rhinitis modeling was performed and group #2 (n = 30) — control, intact animals. In the course of the experiment, the authors examined the content of CRP in blood, evaluated the differential blood cell count, and studied a morphology of the nasal septum mucosa in 2, 5, 10 days after the injury to assess the dynamics of the infl ammatory process in rats of both groups. Statistical analysis of the study results was carried out by means of Statistica 8.0 (StatSoft Inc., USA).Results. After injury, the rats from group #1 developed acute rhinitis, which was clinically manifested by the release of mucous or mucopurulent secretion from the nostrils, sneezing and scratching the nose. An increase in CRP, band and segmented neutrophils, and a decrease in lymphocytes were observed in blood of the rats from group #1 in comparison with the control group. Microscopic analysis of changes in the nasal septum mucosa showed that the acute phase of exudative infl ammation developed on the second day: vascular congestion, edema, neutrophilic infl ammatory infi ltration of the submucosal membrane were observed against the background of foci of epithelial necrosis. The proportion of lymphocytes and macrophages in the infl ammatory infi ltrate increased by the fi fth day, initial signs of restoration of epithelial tissue — the formation of an undifferentiated regenerating epithelium — appeared by the tenth day.Conclusion. The results of the study show that an adequate experimental model of acute rhinitis in laboratory animals have been obtained. An acute infl ammatory process is characterized by clinical manifestations and changes in blood parameters. Particular destructive and reparative-proliferative changes develop in the mucous membrane of the nasal septum of experimental animals as a result of a surgical wound.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45686752","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":"Integrative Analysis of Predictors for Unfavorable Course of Parkinson Disease According to Medical Care Assessment: Cohort Retrospective Study","authors":"S. V. Shtaimets, N. Zhukova, M. Katina, I. Zhukova, A. Agasheva, D. Novotnyy","doi":"10.25207/1608-6228-2023-30-1-69-77","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-1-69-77","url":null,"abstract":"Background. Parkinson's disease is a neurodegenerative disorder that leads to severe disability, especially in its advanced stages. Medical care should be performed in accordance with modern clinical recommendations and standards. Assessment of the quality of medical care in the Russian Federation is carried out via examination of medical documentation by insurance experts regarding compliance with Russian standards and other regulatory documents.Objective. To study the predictors for unfavorable course of Parkinson's disease based on routine examinations of the quality of medical care.Methods. The cohort retrospective study included 7,264 examinations of the medical care quality of 1,754 patients with Parkinson's disease for the period from 2011 to 2018 in the Russian Federation. The study focused on two indicators: presence/absence of disease progression and determination/aggravation of a degree of disability or maintenance of the previous social and professional activity. The obtained data were used to develop diagnostic tables with prognostic factors of Parkinson's disease according to A. Wald. Statistical analysis of the results was carried out using Statistica 13 (StatSoft, USA). Results. Diagnostic tables have been developed to determine the prognostic factors affecting the progression of Parkinson's disease and, accordingly, decreasing the degree of social and/ or professional activity and to assess the diagnostic factors when the risk of the disease aggravation will be more than 95%.Conclusion. The greatest progression of Parkinson's disease (p < 0.05) was observed in the cases of poor collection of complaints, history and clinical evaluation of the patient's condition, inadequate prescription or absence of prescription of levodopa when indicated, as well as defects in the correction of additional disorders. The likelihood of social disadaptation in patients with Parkinson's disease (p < 0.05) was found to be greater in the cases of poor collection of complaints and history, neurological examination and clinical evaluation of the patient's condition as well as inadequate prescription or absence of prescription of levodopa when indicated.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48616571","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":"Model for Predicting Risk of Postpartum Purulent-Inflammatory Complications after Cesarean Section: Cohort Retrospective Study","authors":"I. I. Kutsenko, I. O. Borovikov, A. S. Magay, V. P. Bulgakova, O. I. Borovikova","doi":"10.25207/1608-6228-2023-30-1-26-36","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-1-26-36","url":null,"abstract":"Background. Relevance of the study is related to the lack of a unified strategy for determining the risk of infectious complications of puerperium. Currently, the specialists use the collected data from studies documenting the main factors of infection in a population or cohorts of postpartum women. However, accuracy of these factors is not established and prognosis could not be personalized. The paper analyzes significant risk factors for the infectious complications associated with cesarean section (C-Section) and develops a model for their prognosis and an individual assessment of the risk of postpartum infection in order to take timely preventive measures. Objective. To identify predictors of postpartum purulent-inflammatory complications after cesarean section, to evaluate their predictive value, and to develop a statistical model for determining the risk of their occurrence.Methods. The cohort retrospective study (January 2019 to January 2022) was conducted in four obstetric health facilities of Krasnodar and was focused on analysis of medical records. Anamnestic, clinical and laboratory data of all women after cesarean section delivery were collected. Model: a patient diagnosed with any infection associated with cesarean section within 42 days after delivery — postoperative suture infection, endometritis, peritonitis, thrombophlebitis, sepsis. Infections were grouped to carry out a single risk assessment with an internal validation test and to develop a multifactor logistic regression model. All analyses were conducted using version R 3.2.3 (SPSS Inc., Chicago, IL) and Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD).Results. Infection associated with cesarean section occurred in 2.50% of women (n = 548; 95% CI 2.6–3.5), suture disruption — in 0.59% (n = 129; 95%, CI 0.41–0.81), endometritis — 1.46% (n = 321; 95%, CI 1.15–1.94), peritonitis — 0.16% (n = 35; 95%, CI 0.11–0.20), thrombophlebitis 0.04% (n = 9; 95%, CI 0.01–0.05), sepsis 0.25% (n = 54; 95%, CI 0.15–0.35). The authors have identified 14 major variables with a high prognostic risk for the development of infectious complications of puerperium. The model differentiated women with and without purulent inflammatory complications of puerperium by internal validation (concordance index = 0.712, 95%, CI 0.672–0.755).Conclusion. The developed model can be used to accurately predict the risk of infectious complications after abdominal delivery and to identify high-risk patients. It ensures a differentiated approach with a possibility to expand studies and strengthen antibiotic therapy, which promotes reduction of surgical site puerperal infection.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47102458","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":"Risk of Developing Severe Alimentary-Constitutional Obesity and Metabolic Disorders: Interventional Comparative Study","authors":"M. B. Lyasnikova, N. Belyakova, I. Tsvetkova, A. Rodionov, A. Lareva","doi":"10.25207/1608-6228-2023-30-1-49-57","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-1-49-57","url":null,"abstract":"Background. The relevance of alimentary-constitutional obesity, especially its severe forms, is associated with a number of metabolic disorders, subsequently leading to serious chronic noncommunicable diseases.Objective. To identify factors that increase the risk of severe alimentary-constitutional obesity and metabolic disorders.Methods. A follow-up group of 426 patients aged 18 to 65 years was formed among those seeking help from an endocrinologist for overweight or obesity. The diagnosis of alimentary-constitutional obesity was confirmed at the initial examination in the outpatient clinic setting. Depending on the severity of obesity and the type of fat deposition according to anthropometric data (body mass index, waist circumference), the study participants were ratified into two study groups. The research was conducted between 2010 and 2017 in outpatient settings and was based on a cross-sectional comparative study. In order to assess the risk of severe obesity and factors associated with it, the authors studied medical history data, results of physical examination, including blood pressure level, laboratory examination with analysis of carbohydrate, fat metabolism and liver function, assessed eating behaviour, and performed diagnosis of anxiety-depressive disorder. Statistical analysis of the results was carried out using Statistica 10 (StatSoft, USA).Results. Women are more likely to see an endocrinologist with less severe obesity than men. Severe obesity risk is higher in middle-aged and elderly people, as well as in hereditary tainted patients and those having a history of obesity for more than 10 years. Severe obesity itself is a significant risk for metabolic events, with a 4-fold higher risk of hyperglycaemia and hypercholesterolaemia (due to very low density lipoproteins) and a 5-fold higher risk of hyperinsulinaemia and insulin resistance.Conclusion. Analysis of severe obesity risks has shown that earlier personal commitment to a healthy lifestyle is essential for weight loss and subsequent improvement of metabolic parameters, particularly in men and those aged 45 years or older.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45012837","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}