Vol 5, No 3 (2020)

Gerontology and geriatrics

A specific feature of the diagnosis of primary arterial hypertension in elderly patients

Volobuev A.N., Romanchuk P.I.

Abstract

Objective – the analysis of a group of factors, leading to the increase of pulse pressure in the direction from aorta to microcirculation vessels, in order to define the diagnostic criterion for exception of primary arterial hypertension.

Material and methods. In the study, the modelling of the functions of arteries in cardiovascular system was used.

Results. The role of the increase of pulse pressure to the periphery of blood circulation was regarded as the diagnostic attribute of exception of the primary arterial hypertension. It was noted, that physical factors of the increase of pulse pressure to the periphery of blood circulation were insignificant. The cardiovascular reflex has the major influence on the increase of pulse pressure, its deterioration results in the decrease of this pressure.

Conclusion. The analysis revealed the fact, that the normal ankle-brachial index allows for exclusion of primary arterial hypertension in a patient, even if the absolute values of arterial pressure are in the limits corresponding to this disease.

Science and Innovations in Medicine. 2020;5(3):148-153
pages 148-153 views

Hygiene

Study of compliance to rational nutrition in various professional groups living in the Russian Federation and the Republic of Tajikistan

Sazonova O.V., Daburov K.N., Gorbachev D.O., Borodina L.М., Gavryushin M.Y., Sharifov R.N., Rakhmonaliev O.B.

Abstract

Objective – to study the adherence to the principles of rational nutrition by representatives of various professional groups living in the Russian Federation and the Republic of Tajikistan.

Material and methods. The study was conducted using a questionnaire-survey method among 543 mental workers of the Samara region and 158 students of the Avicenna Tajik State Medical University (Republic of Tajikistan), followed by statistical processing of the data.

Results. Violations of the principles of rational nutrition are common in various professional groups of the working-age population, including among students of a medical university. According to anthropometric studies, 61% of the surveyed workers were overweight and obese; in the group of students this indicator was only 8%, 29% of students were underweight. Violations of nutrition regimen were found among 31.1% of employees and 38% of students. Factor analysis of the actual nutrition of workers revealed 5 types of nutrition models characterized by a stereotype of eating behavior due to the consumption of certain foods and beverage. The regression analysis confirmed the relationship between the risk of obesity and adherence to types 2, 4 and 5 of nutritional models; an individual's adherence to nutritional model type 3 reduced this risk. In the group of the surveyed, the deterioration of the diet quality was revealed due to the excessive consumption of high-calorie foods, "fast food", sweet carbonated drinks, as well as insufficient consumption of vegetables, fruits, fish. The correlation analysis established the relationship between the body mass index and complaints presented by the survey participants concerning the cardiovascular, digestive, endocrine and musculoskeletal systems. The study identified the most common alimentary-dependent pathologies among students such as gastritis, chronic pancreatitis, and chronic cholecystitis.

Conclusion. The revealed violations of the principles of rational nutrition, the nutritional status, form the risks of development of the gastrointestinal tract diseases, metabolic disorders and cardiovascular pathology. The results obtained indicate the need of preventive measures in relation to the adherence to the principles of rational nutrition, creating awareness in various professional groups of the population, including students of medical universities in different states.

Science and Innovations in Medicine. 2020;5(3):154-158
pages 154-158 views

The use of electronic devices in transport by medical students: Risks assessment

Skoblina N.A., Markelova S.V., Kozyreva F.U., Bulatseva M.B., Goncharova G.A., Drozdovskaya V.V., Kondrashkina A.S.

Abstract

Objective – to study the way medical students are using electronic devices in subway cars, to check their self-assessment of the concomitant risks, and to evaluate the level of artificial lighting in the subway cars.

Material and methods. The study involved the sociological, instrumental, and statistical methods. 123 students of the "Medical College No. 2", 272 students of Pirogov Medical University, 176 teachers of the university and the college were interviewed. The traceable measurement of the level of artificial illumination in the subway cars was done using the combined instrument "TKA-PKM (43)". Statistical processing was performed using the software package Statistica 10.0.

Results. 79.7% of college students, 93.4% of university students and 30.9% of teachers use electronic devices on public transport daily. The risk of using electronic devices in transport is subjectively underestimated by 21.9% of college students, 49.2% of university students and 16.4% of teachers. The study revealed that in the wi-fi zone of Moscow Metro passenger trains in cars of 81-714 and 81-714.5m types, the artificial illumination was not providing optimal conditions for visual performance. In the hygienic education of medical students, the university and college teachers should play a leading role, as they have professional knowledge on healthy lifestyle issues and are able to use this knowledge in their professional activities.

Conclusion. We identified the risk factor that contributes to development of vision disorders in the medical students. This factor is controllable and can be neutralised by the formation of healthy lifestyle skills among medical students.

Keywords: electronic devices, artificial lighting, organ of sight, hygienic education.

Conflict of interest: nothing to disclose.

Science and Innovations in Medicine. 2020;5(3):159-163
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Diagnostic radiology, radiation therapy

Lumbar spine segmental instability in degenerative spine conditions

Fraerman A.P., Yarikov A.V., Kotelnikov A.O., Smirnov I.I., Leonov V.A., Khomchenkov M.V., Perlmutter O.A., Sosnin A.G.

Abstract

12–40% of people with low back pain have spinal instability in degenerative-dystrophic diseases of the spine. The paper highlights the biomechanical basis for the development of segmental instability and discusses various hypotheses for the development of this condition. The authors describe the modern methods of neuroimaging used in the diagnosis of segmental instability, such as radiography, functional spondylography, CT, functional CT, MRI.

Further, the paper presents provocative tests used in the diagnosis of instability: passive extension of the lumbar spine, standing, sitting, pron-instability, "scissors", compression of spinous processes, forward lean in standing position, and some others.

The authors shared their experience in diagnosing segmental instability.

However, the discrepancy between the data of instrumental examinations and patient complaints, poorly studied rotational and lateral instability in osteochondrosis indicate the need for a more detailed study of the instability of the spine as a whole.

Science and Innovations in Medicine. 2020;5(3):164-169
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Complex neuroimaging of traumatic brain injury: radiography and computed tomography

Yarikov A.V., Ermolaev A.Y., Leonov V.A., Kalinkin A.A., Fraerman A.P., Astakhov A.I., Rudnev Y.V.

Abstract

Every year, 1.5 million people die from traumatic brain injury, 50 thousand of them in Russia. A modern diagnostics of traumatic brain injury (TBI) reduces the mortality and improves the quality of medical care. The article discusses the advanced instrumental methods for diagnosing TBI: X-ray and CT of the skull, CT angiography, CT cisternography (CT-C), CT perfusion and selective cerebral angiography.

The advantages and disadvantages of each method are considered. The authors also described the indications for each of the above-mentioned methods.

Science and Innovations in Medicine. 2020;5(3):170-175
pages 170-175 views

Public Health and Healthcare

Availability of radiation diagnostic equipment for examination of cancer patients in healthcare institutions

Lomakov S.Y.

Abstract

Objectives – to analyze the equipment of health care institutions, engaged in providing medical care to patients with cancer, with medical devices for diagnostic radiology.

Materials and methods. The data from official reporting forms of medical organizations in Saint Petersburg on the availability of medical equipment for diagnostic radiology were analyzed for the period of 5 years using a continuous sampling method. The obtained data were statistically processed with the calculation of statistical series, extensive and intensive indicators. The Student t-test was used to assess the statistically significant differences in indicators in individual years of observation.

Results. In the period from 2013 to 2018, the analysis showed an increase of the availability of diagnostic radiology devices in the medical organizations in St. Petersburg, particularly for ultrasound equipment – by 39.7%, x-ray machines – by 9.5%, CT machines – by 23.9%, MRI machines – by 16.6%, SPECT and PET devices. At the same time, a uniform increase in the number of ultrasound and x-ray medical equipment was observed in urban and Federal medical organizations, while the rate of "heavy" radiation medical equipment (CT, MRI, PET, SPECT) was higher in Federal medical institutions.

Conclusion. Despite the marked increase in the equipment of medical institutions, a significant part of medical radiation equipment has been in use for 10 years or longer (from 14.4% to 29.8% for certain types of medical equipment) and requires a scheduled replacement.

Science and Innovations in Medicine. 2020;5(3):176-180
pages 176-180 views

Oncology

Identification of the site for biopsy in oral mucosa cancer diagnostics

Orlov A.E., Gabrielyan A.G., Kaganov O.I., Postnikov M.A., Trunin D.A., Denisova Y.L.

Abstract

Objective – to refine the method of incisional biopsy in the diagnosis of oral mucosa cancer using the auto-fluorescent stomatoscopy.

Materials and method. The study was conducted on the base of the Samara Regional Clinical Oncology Center. The inclusion criterion for patients was the diagnose of the oral mucosa cancer of various localization. Patients were divided into 2 groups. The main group included patients (n=43), who were being diagnosed for cancer with the help of optimized incisional biopsy of the oral mucosa formations, using the "AFS-400" autofluorescence complex and glasses with a green light filter for identification. The patients of the control group (n=46) received the standard biopsy procedure under direct vision.

Results. The first incisional biopsies revealed cancer in 25 (54%) patients of the control group and in 36 (84%) patients of the main group. A histological verification of the diagnosis was necessary in 7 (16%) patients of the main group and required the second biopsy. In the control group, for the same purpose, 17 (37%) patients underwent the second biopsy and 4 (9%) patients required the third biopsy procedure. Exophytic-papillary forms of cancer were the most complex for histological verification. The primary biopsy of these cases was effective in 16 (37%) patients in the main group and in 8 (17%) patients in the control group (p = 0.036). In patients with initial stages of cancer (I-II), with the first incision biopsy, the histological verification of cancer was achieved in 16 (37%) cases in the main group and in 8 (17%) cases in the control group (p = 0.036).

Conclusion. The use of the "AFS-400" autofluorescent complex and glasses with a green light filter for incisional biopsy of oral mucosal formations allows histological verification of cancer with the first biopsy in 84% of cases, including in stages I - II – in 16 (37%) cases and in exophytic papillary forms – in 16 (37%) cases. The significant difference was registered for the similar indicators of the control group (p = 0.036).

Science and Innovations in Medicine. 2020;5(3):181-185
pages 181-185 views

Transplantology and artificial organs

Successful experience of liver transplantation at the Samara Center of organ and tissue transplantation (a clinical case)

Kolsanov A.V., Fatenkov O.V., Mironov A.A., Myakotnykh M.N., Pirogova Y.Y., Grebennikov V.V., Tkebuchava I.V., Kharitonov B.I.

Abstract

Objective – to summarize the available data on the liver transplantation (LT) case.

The work describes the indications and contraindications for LT, examination of a potential recipient before the operation, the maintenance of a waiting list. A clinical case is presented – the first successful liver transplantation in the Samara Center of organ and tissue transplantation.

Science and Innovations in Medicine. 2020;5(3):186-192
pages 186-192 views

Phthisiology

Iron metabolism in tuberculosis and iron-containing chemotherapeutic drugs for its treatment

Borodulin B.E., Yakovleva E.V., Borodulina E.A., Komissarova O.G.

Abstract

This review included the Russian and international articles on the iron metabolism in tuberculosis and the use of iron-containing drugs in the treatment of tuberculosis over the past 20 years. The main topics covered by the researchers include the features of iron metabolism in mycobacteria, the varieties and pathogenesis of anemia that can develop in tuberculosis: iron deficiency (absolute iron deficiency), associated with a chronic disease (relative iron deficiency) or drug-induced anemia (siderohrestic, hemolytic, aplastic). The possible correction of treatment regimens for tuberculosis is analyzed – with the introduction of a complex compound of iron with isoniazid in order to reduce undesirable adverse reactions to isoniazid .

The literature search for this review was performed using the RSCI, CyberLeninka, Scopus, Web of Science, MedLine, PubMed databases.

Science and Innovations in Medicine. 2020;5(3):193-196
pages 193-196 views

Surgery

Autologous mesenchymal stem cells in treatment of liver cirrhosis: evaluation of effectiveness and visualization method

Kotkas I.E., Enukashvili N.I., Asadulayev S.M., Chubar A.V.

Abstract

Through clinical observation, we present an assessment of the autologous mesenchymal stem cells effectiveness in treatment of liver cirrhosis of alimentary etiology. In order to determine the localization of the implanted cell structures, the stem cells were previously labeled with iron (II, III) oxide nanoparticles (IONPs). Further MRI visualization helped to detect the cell structures stained with iron oxide nanoparticles in the human body. In 6 months after the cell therapy, the patient underwent clinical and biochemical blood tests, MEGX test, elastography and subjective health assessment test. The tests data analysis revealed the improvement of the values of all examined parameters after the cell treatment. Also in 6 and 12 months after the treatment, a liver biopsy was performed from the area where the implanted stem cells were visualized. In histological examination of liver bioptates obtained from the area of MSC transplantation, the largest number of stained cells was observed in liver micronodes, as well as at the boundaries of micronodes and fibrous septa. A portion of the bioptate obtained in 12 months after transplantation was used to produce primary cell cultures. Before the first re-seeding of the cultures, cell colonies of both fibroblast-like morphology and epithelial were detected in them. Both types of colonies contained the particles.

Conducting the cell therapy to a patient with liver cirrhosis of alimentary etiology contributed to improving the laboratory and instrumental examinations indicators. The patient had come through the treatment procedure satisfactorily, no complications were registered.

Science and Innovations in Medicine. 2020;5(3):197-203
pages 197-203 views

Modern approach to the treatment of stage IV decubitus ulcers

Sonis A.G., Fomin A.V., Ladonin S.V., Sefedinova M.Y., Bezrukova M.A., Alekseev D.G.

Abstract

Objective – a retrospective assessment of the bedsores' features, the optimization of treatment tactics, evaluation of long-term treatment results.

Material and methods. The study group included 38 patients with stage IV decubitus ulcers according to the classification of AHCPR localized in the sacral region, the area of the ischial tuberosity and the greater trochanter.

Results. We determined the critical time intervals for the decubitus ulcers occurrence. It has been found that in most patients bedsores are remaining for a long period of time. The modern complex methods for the IV stage decubitus ulcers treatment with the plastics of the soft tissue defects revealed their reliably higher effectiveness.

Conclusion. The formation of bedsores most often occurs during the first month after the injury and three years after the injury. The treatment of patients with this pathology should be comprehensive and carried out in the well-equipped purulent surgery department by the specialists experienced in treating such patients. The plastic surgery by displaced blood-supplying flaps contributes to success in the treatment of stage IV bedsores.

Science and Innovations in Medicine. 2020;5(3):204-209
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Cytology

Fibroblasts as the subject of proliferative activity research in vitro

Kuzmicheva V.I., Volova L.T., Gilmiyarova F.N., Bykov I.M., Avdeeva E.V., Kolotieva N.A.

Abstract

This review presents the data devoted to anatomical and functional diversity of fibroblasts, peculiarities of metabolic processes and energy exchange in these cells.

In particular, the changes in fibroblast proliferative activity depending on various factors are discussed. The review shows the influence of the malate dehydrogenase shuttle system on the activity of metabolic processes and the life span of fibroblasts in vitro. The increase of cell cultivation time in vitro is associated with the cytosolic isoform of this enzyme.

The stability of fibroblast cell culture to the activation of free-radical processes and peroxidation with addition of biologically active compounds is described and followed by a discussion of the role of separate metabolites in providing free-radical protection and maintenance of the proliferative potential of cells.

Science and Innovations in Medicine. 2020;5(3):210-215
pages 210-215 views

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