Vol 7, No 2 (2022)

Hygiene

Sanitary and hygienic characteristics of the environment in the educational spaces of a sports university

Davletova N.C., Tafeeva E.A.

Abstract

Aim – assessment of sanitary and hygienic conditions in the classrooms of a sports university.

Material and methods. The following parameters were measured and analyzed: temperature, relative humidity, air velocity in 12 classrooms, 6 lecture halls and 3 sports halls. The national standards GOST 30494-2011 and Sanitary Rules and Regulations 2.1.2.3304-15 were applied for the assessment of the environmental parameters during an academic day in the cold and warm seasons.

Results. In the cold season, the temperature within the standard limits was registered only in 6.89 ± 0.84% of classrooms, in 18.10 ± 1.53% of lecture halls and in 9.17 ± 1.32% of the sports halls. In warm season, the excess of air temperature above acceptable values was more often observed in sports halls (81.25 ± 1.78% of samples). The increase in the average air temperature by the end of the school day in the cold period was 11.67 ± 0.44% in classrooms and 10.69 ± 0.54% in lecture halls, in the warm season the increase was 7.5 ± 0.88% and 11.11 ± 0.5%, respectively. The values of relative humidity in the warm period of the year were 43.89 ± 2.33% for classrooms, 44.33 ± 2.39% for lecture halls, and 43.98 ± 2.61% for sports halls. In the cold season, the relative air humidity was significantly lower than optimal values: on average, in the classrooms it did not exceed 12.98 ± 1.91%, in lecture rooms – 14.94 ± 2.39%, in sports halls – 17.29 ± 4.22%.

Conclusion. The study results dictate the need to strengthen continuous monitoring of microclimate parameters of educational spaces in a sports university, regular ventilation, adjustment of air conditioning systems for "heating" or "cooling" mode and their timely maintenance.

Science and Innovations in Medicine. 2022;7(2):76-80
pages 76-80 views

Infectious diseases

Fibrous lung tissue lesions: treatment opportunities for post-COVID-19 patients

Zhestkov A.V., Khamitov R.F., Vizel A.A., Zolotov M.O.

Abstract

The article presents the analysis of scientific databases eLIBRARY, PubMed, Scopus on the topic of COVID-19 adverse outcomes and the treatment methods for their prevention.

The post-COVID-19 syndrome is a pathological condition that includes persistent physical, medical and cognitive consequences of a new coronavirus disease, including persistent immunosuppression, as well as fibrosis of the lungs, heart and blood vessels. The morphological basis of acute respiratory distress syndrome in COVID-19 is severe diffuse alveolar damage characterized by hypoxemia, bilateral pulmonary infiltrates, and decreased lung compliance. A promising domestic drug, the use of which can reduce the risk of developing irreversible fibrotic changes in the lung tissue, is Longidaza.

Science and Innovations in Medicine. 2022;7(2):81-84
pages 81-84 views

Results of cytological examination of bone marrow aspirates in patients with HIV infection and cytopenia in correlation with viral load

Kalashnikova D.V., Mordyk A.V., Puzyreva L.V.

Abstract

Aim – determination of specific changes in the bone marrow in patients with HIV infection and cytopenia, depending on the viral load.

Material and methods. We analysed myelograms of patients with HIV infection and cytopenia. All patients had bicytopenia or pancytopenia in the hemogram.

Results. In patients with a viral load over 100 001 copies/ml, the hypocellularity of each of the hematopoietic cell line was significantly more often observed, hypercellularity was recorded only in the myelograms of patients with a viral load of less than 100 001 copies/ml. When assessing the signs of myelodysplasia in the bone marrow, changes in the megakaryocyte lineage (the formation of naked cells, dysmegakaryocytopoiesis) were typical for patients with a viral load of less than 10 000 copies/ml. Signs of dysplasia of the granulocytic lineage are more often determined in patients with a viral load of more than 100 001 copies/ml.

Science and Innovations in Medicine. 2022;7(2):85-88
pages 85-88 views

Cardiology

Extrasystolic arrhythmia: is it an additional risk factor of cryptogenic stroke?

Germanova O.A., Germanov A.V., Shchukin Y.V., Galati G.

Abstract

Aim – to study the development of ischemic stroke (IS) or transient ischemic attack (TIA) in patients with extrasystoles (ES), depending on the moment of ES ventricular systole occurrence in cardiocycle.

Material and methods. The study group included 440 patients with ES ≥ 700 per day; the control group consisted of 88 patients with ES < 700 per day. The following instrumental and laboratory methods were used: echocardiography, Doppler ultrasound of brachiocephalic arteries, 24-hours ECG monitoring, digital sphygmography of common carotid arteries; CT or MRI of the brain; lipid spectrum. The study group was divided into two subgroups according to the moment of ES ventricular systole occurrence in cardiocycle, regardless of ectopia: subgroup 1 – 120 patients with ES before the transmitral blood flow peak; subgroup 2 – 320 patients with ES after the transmitral blood flow peak. We analyzed the development of stroke or TIA during 1 year.

Results. For most parameters, subgroups 1, 2 and the control group were identical. The important differences were registered in the hemodynamic and kinetic parameters of common carotid arteries. The earlier the ES ventricular systole occurred in cardiocycle, the higher increase of the parameters was observed. During one year of follow-up, stroke and TIA occurred more frequently in subgroup 1.

Conclusion. ES is an additional risk factor for stroke. The most dangerous is ES with ventricular systole occurrence before transmitral blood flow peak. The wave of the 1st post-extrasystolic contraction causes additional trauma of arterial wall and can become a key factor for instability of atherosclerotic plaques with their defragmentation, embolism and stroke.

Science and Innovations in Medicine. 2022;7(2):89-94
pages 89-94 views

Fragmented QRS complex as a marker of myocardial fibrosis in patients with coronary artery disease

Gordeeva M.S., Parmon E.V., Karlina V.A., Ryzhkova D.V.

Abstract

Aim – to analyze the relationship between fQRS and myocardial fibrosis in CAD patients using SPECT.

Material and methods. Retrospectively, we have analyzed the anamnesis and examinations of 116 patients with suspected coronary heart disease. The fQRS was assessed according to the criteria of Das M. et al., 2006, along with the presence of a pathological Q wave and a slow increase in the amplitude of the R wave. We analysed the transient myocardial ischemia and/or myocardial scarring using stress/rest SPECT with technetium-99m.

Results. fQRS was significantly more frequently detected in patients with stable and partially reversible perfusion defects – 44.1% and 52.2%, respectively, versus 13.0% and 5.5% in patients without perfusion defects or with reversible perfusion defects, p < 0.05. Among 28 patients with QRS fragmentation and myocardial fibrosis, 19 (67.8%) had classical signs of fibrosis on the ECG, 9 (32.1%) had no ECG-registered fibrosis but fQRS was detected. The sensitivity of fQRS marker in detecting myocardial fibrosis reached 84.4%, the specificity was 63.3%.

Conclusion. fQRS complex is an informative marker for detecting myocardial scarring in patients with coronary artery disease. Analysis of fQRS in daily clinical practice may increase the diagnostic value of electrocardiography in the detection of fibrosis.

Science and Innovations in Medicine. 2022;7(2):95-102
pages 95-102 views

Perimenopause and the state of diastolic function of the left ventricle in women

Zelentsova L.R., Kuznetsov G.E., Tenchurina L.R., Shchetinina Y.S.

Abstract

Aim – to study the features of the diastolic function of the left ventricle, taking into account the gynecological history in women of perimenopausal age.

Material and methods. A single-stage cross-sectional study included 75 women aged 45 to 55 years. All women were examined, their anamnesis, including gynecological, was taken and gynecological status was established. Relying on echocardiography data, the women were divided into a group with normal left ventricular diastolic function and a group with diastolic dysfunction. Lipid and carbohydrate metabolism, the concentration of follicle-stimulating hormone were evaluated in all women.

Results. Study showed that women with detected type 1 diastolic dysfunction were older than women with normal diastolic heart function. In women with diastolic dysfunction, hypertension and negative metabolic indicators were more common; they were characterized by a greater number of pregnancies and abortions, if compared to women with unchanged heart function, in addition, they were more likely to be in early menopause.

Conclusion. Diastolic dysfunction is widespread in perimenopausal women, which is not always explained by traditional risk factors. There is a relationship between gynecological history and the development of diastolic dysfunction, but the pathogenetic mechanisms underlying this process in women remain unclear.

Science and Innovations in Medicine. 2022;7(2):103-108
pages 103-108 views

Public Health and Healthcare

The prospect of using a workstation by an endocrinologist for telemedicine counseling

Pervyshin N.A.

Abstract

The article provides a review of legislative acts, scientific articles, conference papers devoted to the problems of clinical use of telemedicine counseling. The official regulations of interactive telemedicine, the portals used for this service, formats, modes, payment methods were in the focus of our research. We analysed several examples of the telehealth services provided in the Russian Federation and abroad. Thus, we managed to identify the factors that, according to expert opinion, limit the widespread implementation of telemedicine counseling in clinical practice. We also gave general evaluation of the prospects of using an endocrinologist's workstation for consulting outpatients with diabetes mellitus for remote "doctor – patient" interaction and for clinical case teleconferences, as well as for integration of the formalized protocol, lying in the software basis, into fully functional medical and administrative information systems existing in the medical institution. A short example of the 3-year regular use of a workstation for admission of outpatients with diabetes mellitus in a city polyclinic illustrates the advantages of this method.

Science and Innovations in Medicine. 2022;7(2):109-115
pages 109-115 views

The current approach to the quality of medical care

Orlov A.E., Eremeev A.E., Proshina O.A., Podusova T.N.

Abstract

The article presents the analysis of the national and international literature on the problem of the quality of medical care. The focus is on the issues like the imbalance of the healthcare system, lack of personnel, insufficient material and technical support. The article also defines the main directions for development of the healthcare system aimed at improving the quality of service. In particular, it emphasizes that the solution of the problem of the quality of medical care is impossible without a well-thought-out personnel development strategy, the formation of clear motivating incentives, a radical change in the system of interaction between doctors and nursing staff.

It is important to ensure that all transformations in the healthcare sector should be discussed with the scientific and general medical community including the creation of special expert groups.

Science and Innovations in Medicine. 2022;7(2):116-123
pages 116-123 views

Otorhinolaryngology

Endonasal sinus lift as a new way of augmenting the alveolar process of the upper jaw

Volov N.V., Vladimirova T.Y., Sedykh M.I.

Abstract

Aim – to develop a new method of endonasal augmentation of the alveolar process of the upper jaw to reduce postoperative risks.

Material and methods. The study involved 10 patients during the period of December, 2019, and June, 2021. The examination methods were: computed tomography of the nose and paranasal sinuses, upper and lower jaw, and video-endoscopy of the nasal cavity. The patients received the indonasal sinus inlay with the use of allogenic bone chips.

Results. The surgical access through the lower nasal passage, under the lower nasal concha, allows to expose the maxillary sinus floor with preservation of mucous membrane integrity and to fill in the space between them with the allogenic bone material. Formation of a bone window in the lateral nasal wall using a piezotome prevents the rupture of the sinus mucous membrane. A bony fragment of the lateral nasal cavity wall transferred into the cavity of the maxillary sinus as one block with the mucosa creates additional protection for the Schneiderian membrane. Allogenic material introduced by endonasal method is substituted by the own organotypic tissue, restoring the lost volume of the maxillary sinus alveolar process.

Conclusion. The endonasal method of alveolar augmentation may be used in clinical practice as an alternative to the classic methods.

Science and Innovations in Medicine. 2022;7(2):124-127
pages 124-127 views

The study of local mucociliary clearance of the middle nasal meatus in clinically healthy individuals and patients with foreign body in the maxillary sinus

Mareev O.V., Mareev G.O., Ermakov I.Y., Fedosov I.V.

Abstract

Aim – to obtain the values of local mucociliary clearance (MCC) of the middle nasal meatus in normal conditions and in patients with foreign body in the maxillary sinuses.

Material and methods. To assess the local MCC, we used the original method of modern high-speed digital video recording of the microscopic picture of the specimen, followed by its mathematical processing. The study included a group of rhinologically healthy individuals (60 people) and a group of patients with foreign body in the maxillary sinus (90 people).

Results. We obtained the standard values of MCC in rhinologically healthy individuals (11.76 ± 3.01 Hz). In patients with foreign body in the maxillary sinuses, there was a correlation of the local MCC index with the severity of morphological changes, registered by computed tomography (CT), of the paranasal sinuses in the area of the middle nasal meatus and adjacent sinuses. Depending on the results of CT scanning, we identified 3 groups among the patients with foreign bodies in the maxillary sinuses – no morphological changes (CT1), changes outside the ostium (CT2) and pronounced morphological changes in the middle nasal meatus and surrounding paranasal sinuses (CT3). In the CT1 group the average values of the local MCC of the middle nasal meatus were 13.53 ± 2.46 Hz; in group CT2 – 11.71 ± 2.02 Hz; in the CT3 group – 6.84 ± 3.48 Hz. The differences in indicators in groups were statistically significant according to the Mann – Whitney test. The average value of the local MCC of the middle nasal meatus in patients without maxillary sinus mycetoma was 13.30 ± 2.91 Hz, in patients having maxillary sinus mycetoma – 10.74 ± 3.69 Hz; this difference was also statistically significant.

Science and Innovations in Medicine. 2022;7(2):128-133
pages 128-133 views

Traumatology and Orthopedics

Treatment of severe planovalgus foot deformity in a child

Bagdulina O.D., Lartsev Y.V., Shmelkov A.V., Pankratov A.S., Likholatov N.E., Ogurtsov D.A.

Abstract

Planovalgus foot deformity is one of the most common orthopedic conditions detected in childhood. According to the literature, it is present in 70% of children under 11 years with various degree of severity. Without timely correction, the common complications of this deformity are: arthrosis of the talonavicular joint, valgus deformity of the knee joints, impaired posture and functional scoliosis, pain syndrome, impaired function of the lower extremities, which is an indication for surgical treatment of this pathology.

The article presents a clinical case report of surgical treatment of a patient with severe planovalgus foot deformity. The main stages of surgical correction were tendon-muscle plasty, subtalar arthroeresis and Cotton osteotomy (wedging osteotomy of the medial sphenoid bone).

Relying on the results of surgical treatment of the patient, we conclude that the use of the combination of methods is valid for the treatment of patients with severe planovalgus foot deformity.

Science and Innovations in Medicine. 2022;7(2):134-138
pages 134-138 views

Treatment of the femoral bone secondary deformation in the area of solitary bone cyst with spongeous cadaver homotransplant

Likholatov N.E., Shmelkov A.V., Bagdulina O.D., Pankratov A.S.

Abstract

This article presents a clinical example of treatment of a patient with secondary post-traumatic deformity of the proximal femur due to a solitary bone cyst.

The cyst cavity was filled with spongeous bone homograft LYO-57, which served as a substrate for a consistent bone regeneration. The quality of the formed bone made it possible to perform corrective osteotomy of the proximal femur with stable osteosynthesis for the secondary deformity.

The results of treatment allow us to recommend this type of homotransplant for the treatment of patients with solitary bone cysts.

Science and Innovations in Medicine. 2022;7(2):139-143
pages 139-143 views


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