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№1 (17) 2020
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Health sciences
3-8
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Methodological approaches to the assessment of mutagenic activity in recreational areas of Altai Krai as a subject of the Russian Federation and the Republic of Armenia are proposed in the presented scientific research for the study of the combined action of factors of physical and chemical nature – natural radionuclides, electromagnetic radiation of radio-frequency range, and organochlorine pesticides. In the process of determining changes in cytogenetic indicators of the buccal epithelium in the population of the studied territories, it is expected to obtain objective information on the negative influence of radon and its daughter decay products, energy flux density of electromagnetic fields of radio-frequency range, and pesticides on human genome.
Keywords: mutagenic activity, physical factors, chemical factors, recreational areas, pesticides, radon, micronucleus test.
Keywords: mutagenic activity, physical factors, chemical factors, recreational areas, pesticides, radon, micronucleus test.
9-13
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The article presents the results of the multidimensional factor analysis, with the help of which the leading factors influencing epidemic processes of tick-borne viral encephalitis and Siberian tick-borne typhus in the territories of Altai Krai with combined foci of these infections were determined. The degree of influence of each of the leading factors on the morbidity level according to these nosologies in the studied territories was identified. The results of multiple and dual regression are presented carried out for the purpose of estimating the perspective value of the analyzed controlled factors necessary for the subsequent optimization of the planning system for the measures of epidemiological control of morbidity of tick-borne viral encephalitis and Siberian tick-borne typhus in the studied territory, which will also allow to form a planned trend of morbidity dynamics.
Keywords: combined foci, natural focal infections, tick-borne viral encephalitis, Siberian tick-borne typhus, endemic territories, determination of leading factors, multidimensional factor analysis.
Keywords: combined foci, natural focal infections, tick-borne viral encephalitis, Siberian tick-borne typhus, endemic territories, determination of leading factors, multidimensional factor analysis.
Fundamental medicine
14-18
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The purpose of the research is to study the acute toxicity of a new drug based on the products of velvet antler industry.
The object of the research was “Water extract of MARAL VELVET ANTLERS experimental SAMPLE” produced by OOO «KorolevFarm», made by order of the branch of Tomsk Scientific Research Institute of Spa Medicine and Physiotherapy of FSBI of Siberian FSCC of FMBA of Russia (batch: 071119(1), manufacturing date: 07.11.2019). During the study on laboratory mice and rats (50 individuals of both sexes), the study object was administered once intragastrically through the probe at doses of 2000 mg/kg, 5000 mg/kg, 7500 mg/kg, 10000 mg/kg, 15000 mg/kg. Then, for 14 days, the survival of the experimental animals, their general condition, behavior peculiarities, intensity and nature of motor activity were observed. Before the introduction of the study object and then twice a week, the weight of animals was measured.
It was found that after a single administration at doses of 2000 mg/kg, 5000 mg/kg, 7500 mg/kg, 10000 mg/kg, and 15000 mg/kg there were no recorded cases of experimental animals deaths. Clinical implications of intoxication and changes in behavioral reactions were not identified as well. When studying body mass dynamics of experimental animals, it was found that during 14 days of observation period there was a distinct tendency to increase the body weight of mice and rats of both sexes.
Keywords: drugs based on the products of velvet antler industry, acute toxicity.
The object of the research was “Water extract of MARAL VELVET ANTLERS experimental SAMPLE” produced by OOO «KorolevFarm», made by order of the branch of Tomsk Scientific Research Institute of Spa Medicine and Physiotherapy of FSBI of Siberian FSCC of FMBA of Russia (batch: 071119(1), manufacturing date: 07.11.2019). During the study on laboratory mice and rats (50 individuals of both sexes), the study object was administered once intragastrically through the probe at doses of 2000 mg/kg, 5000 mg/kg, 7500 mg/kg, 10000 mg/kg, 15000 mg/kg. Then, for 14 days, the survival of the experimental animals, their general condition, behavior peculiarities, intensity and nature of motor activity were observed. Before the introduction of the study object and then twice a week, the weight of animals was measured.
It was found that after a single administration at doses of 2000 mg/kg, 5000 mg/kg, 7500 mg/kg, 10000 mg/kg, and 15000 mg/kg there were no recorded cases of experimental animals deaths. Clinical implications of intoxication and changes in behavioral reactions were not identified as well. When studying body mass dynamics of experimental animals, it was found that during 14 days of observation period there was a distinct tendency to increase the body weight of mice and rats of both sexes.
Keywords: drugs based on the products of velvet antler industry, acute toxicity.
Mazko O.N., Makarova O.G., Bobrov I.P., Zharikova G.V., Korenovsky Yu.V., Azarova O.V., Kalnitsky A.S.
19-23
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The aim of the research is to study the effect of the infusion of the yellow bedstraw (Galium verum L.) herb (1:10) on the course of experimental oxalate nephrolithiasis in rats.
Experiments were carried out on 24 male Wistar rats weighing 225–260 g. To model oxalate nephrolithiasis, rats were given 1% ethylene glycol solution as a drinking for 6 weeks. The yellow bedstraw (Galium verum L.) herb infusion (1:10) was administered enterally in the amount of 1 ml/day, starting from the fourth week of the experiment.
The assessment of anti-lithogenic activity of the herbal product was carried out using morphological studies of rat kidneys.
The herbal infusion prevents the formation of new deposits (their number decreases by 43% compared to pathology; 2.6±0.5 in the control group and 1.5±0.3 in the herbal product treatment group) and slows down the formation of already presented ones: the size of calcium-positive formations decreases by 64% (p<0.01) relative to the rate of lithogenated rats. Three-week use of the yellow bedstraw (Galium verum L.) herb infusion (1:10) in the treatment mode ensures a weakening of the intensity of lithogenic processes in the kidneys, which helps to reduce the phenomena of inflammation, and also ensures the restoration of the structure and function of the renal epithelium.
Experiments were carried out on 24 male Wistar rats weighing 225–260 g. To model oxalate nephrolithiasis, rats were given 1% ethylene glycol solution as a drinking for 6 weeks. The yellow bedstraw (Galium verum L.) herb infusion (1:10) was administered enterally in the amount of 1 ml/day, starting from the fourth week of the experiment.
The assessment of anti-lithogenic activity of the herbal product was carried out using morphological studies of rat kidneys.
The herbal infusion prevents the formation of new deposits (their number decreases by 43% compared to pathology; 2.6±0.5 in the control group and 1.5±0.3 in the herbal product treatment group) and slows down the formation of already presented ones: the size of calcium-positive formations decreases by 64% (p<0.01) relative to the rate of lithogenated rats. Three-week use of the yellow bedstraw (Galium verum L.) herb infusion (1:10) in the treatment mode ensures a weakening of the intensity of lithogenic processes in the kidneys, which helps to reduce the phenomena of inflammation, and also ensures the restoration of the structure and function of the renal epithelium.
Keywords: yellow bedstraw (Galium verum L.) herb, urolithiasis, experimental oxalate nephrolithiasis, morphological studies.
24-27
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Bimanual motor coordination is one of the challenging programs to implement. At the same time, the peculiarities of intra-system functional correlation relations of parameters of the executing muscles have hardly been described, which was the aim of our work.
Materials and methods. In male and female test persons (39 men and 36 women) aged 18 to 20 years, F-wave and M-response parameters were recorded using the method of stimulation myography through neuromyoanalyzer NMA-4-01 “Neuromyan”, Russia. The study was conducted under standard conditions in accordance with the recommendations. In statistical processing, a complete correlation analysis was carried out and the coefficient of total multifaceted correlation was calculated.
Results and conclusion. Significant differences in intermodal correlation relations of the considered characteristics in groups of men and women were revealed, indicating peculiarities of the activity organization in nerve centers responsible for the implementation of the bimanual motor program.
Keywords: bimanual movements, stimulant electromyography, correlation.
Materials and methods. In male and female test persons (39 men and 36 women) aged 18 to 20 years, F-wave and M-response parameters were recorded using the method of stimulation myography through neuromyoanalyzer NMA-4-01 “Neuromyan”, Russia. The study was conducted under standard conditions in accordance with the recommendations. In statistical processing, a complete correlation analysis was carried out and the coefficient of total multifaceted correlation was calculated.
Results and conclusion. Significant differences in intermodal correlation relations of the considered characteristics in groups of men and women were revealed, indicating peculiarities of the activity organization in nerve centers responsible for the implementation of the bimanual motor program.
Keywords: bimanual movements, stimulant electromyography, correlation.
28-32
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The aim of this work was to identify variants and frequency of occurrence of genetic prothrombogenic polymorphisms in female patients – residents of Altai Krai depending on the severity of preeclampsia (PE). We studied allelic polymorphism of genes (Factor V Leiden, prothrombin FII, MTHFR, PAI-I) encoding different links of the hemostasis system in 312 patients who were retrospectively divided into three groups depending on the presence and severity of PE. Group 1 included 118 patients whose pregnancy was complicated by severe PE, group 2 – 94 patients whose pregnancy was complicated by moderate PE, group 3 – 100 patients who did not have such diagnosis. It was revealed that in patients with PE, regardless of its severity, combined prothrombogenic defects – homozygous variants in the genes MTHFR, FV, and PAI-I were found reliably more often compared to women who did not have this obstetric complication. The combination of three polymorphic alleles was only found in pregnant women with severe PE.
Keywords: preeclampsia, thrombophilia, genetic prothrombogenic polymorphisms.
Keywords: preeclampsia, thrombophilia, genetic prothrombogenic polymorphisms.
Clinical medicine
33-39
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Research objective. To evaluate the outcomes of surgical treatment of degree 3 pelvic floor muscle failure in elderly women.
Materials and methods. 86 elderly women (60 to 75 years old) suffering from degree 3 pelvic floor muscle failure (PFMF) were sampled and divided into two groups. In group J (n=56), patients received surgical treatment: correction of prolapse by the reticulate implant through transvaginal access with transobturator fixation, levatoroplasty. In group H (n=30), patients refused surgical treatment. Efficiency evaluation was carried out 12 months later: explicit and latent urinary incontinence at tension was detected with a cough test and a Valsalva test; the intensity of complaints was measured by the NRS scale; a quality of life was assessed through the PFDI-20 questionnaire.
The frequency of clinical symptoms of PFMF after 12 months was assessed as the primary outcome of surgical treatment; the frequency of latent and explicit urinary incontinence and the quality of life through the PFDI-20 questionnaire 12 months after treatment were studied as secondary outcomes.
Results. 12 months after treatment, group J patients experienced a statistically significant decrease in the frequency and intensity of complaints and PFMF symptoms. POPDI indicators in group J were better 12 months after treatment and amounted to 8.3 (4.2;12.5) points in group J and 79.2 (79.2;100) in group H, U[ 56;30]=2145, p=0.001; CRAD-8 indicators were 6.2 (3.1;6.2) in group J and 68.8 (62.5;71.9) in group H, U[56;30]=1967, p=0.742; UDI-6 indicators were 8.3 (4.2;8.3) in group J and 83.3 (79.2;87.5) in group H, U[56;30]=2145, p=0.001. The total PFDI-20 was 22.8 (11.5;27) points in group J and 227.2 (226.1;251) points in group H, U[56;30]=2155, p=0.001.
Conclusion. Surgical correction of prolapse with the use of reticulate implants is an effective treatment of degree 3 PFMF in elderly women.
Keywords: pelvic floor muscle failure, elderly age.
Materials and methods. 86 elderly women (60 to 75 years old) suffering from degree 3 pelvic floor muscle failure (PFMF) were sampled and divided into two groups. In group J (n=56), patients received surgical treatment: correction of prolapse by the reticulate implant through transvaginal access with transobturator fixation, levatoroplasty. In group H (n=30), patients refused surgical treatment. Efficiency evaluation was carried out 12 months later: explicit and latent urinary incontinence at tension was detected with a cough test and a Valsalva test; the intensity of complaints was measured by the NRS scale; a quality of life was assessed through the PFDI-20 questionnaire.
The frequency of clinical symptoms of PFMF after 12 months was assessed as the primary outcome of surgical treatment; the frequency of latent and explicit urinary incontinence and the quality of life through the PFDI-20 questionnaire 12 months after treatment were studied as secondary outcomes.
Results. 12 months after treatment, group J patients experienced a statistically significant decrease in the frequency and intensity of complaints and PFMF symptoms. POPDI indicators in group J were better 12 months after treatment and amounted to 8.3 (4.2;12.5) points in group J and 79.2 (79.2;100) in group H, U[ 56;30]=2145, p=0.001; CRAD-8 indicators were 6.2 (3.1;6.2) in group J and 68.8 (62.5;71.9) in group H, U[56;30]=1967, p=0.742; UDI-6 indicators were 8.3 (4.2;8.3) in group J and 83.3 (79.2;87.5) in group H, U[56;30]=2145, p=0.001. The total PFDI-20 was 22.8 (11.5;27) points in group J and 227.2 (226.1;251) points in group H, U[56;30]=2155, p=0.001.
Conclusion. Surgical correction of prolapse with the use of reticulate implants is an effective treatment of degree 3 PFMF in elderly women.
Keywords: pelvic floor muscle failure, elderly age.
40-46
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Despite advances in the CHF treatment in recent years, the mortality rate among this category of patients is steadily increasing, and the number of rehospitalizations and the need for high-tech healthcare delivery put a heavy burden of the financial cost on the health system. The aim of the study was to identify the most common causes leading to CHF and to assess risk factors for CVD in patients hospitalized with CHF decompensation.
Materials and methods. Pilot retrospective study. Analysis of 120 medical histories of patients who were consistently admitted to the therapeutic department of KSBHI CCH No. 11 of the city of Barnaul due to CHF decompensation for the period from July 2018 to September 2018.
Results. Among the hospitalized patients, the elderly dominated, women – by 18.4%, they were 6.4 years older than men. The most frequent cause of CHF is hypertensive disease (91.7%), atrial fibrillation takes the second place (60.0%), PICS – the third one (35.0%). Diabetes mellitus was detected in 30.0%, CKD in 56.7%; 72.5% had the comorbidity index amounting to 5 and above. About half of those hospitalized (55.8%) had FC 3 of CHF and intermediate EF of LV (48.3%). High frequency of RF was revealed: alcohol intake – 46.7%, insufficient PA – 77.5%, overweight and obesity – 90.0%, abdominal obesity – 67.5%, HHS – 63.3%, HTG – 42.5%, high LDL – 43.3%. Men compared to women were 19.0% more likely to have a family history of early CVD, 46.7% –alcohol intake, 71.4% – smoking, 14.2% – normal BMI.
Conclusion. Identified features allow to determine priority directions and develop strategies for treatment and prevention of CHF decompensation.
Keywords: chronic heart failure, decompensation, comorbidity, risk factors.
Materials and methods. Pilot retrospective study. Analysis of 120 medical histories of patients who were consistently admitted to the therapeutic department of KSBHI CCH No. 11 of the city of Barnaul due to CHF decompensation for the period from July 2018 to September 2018.
Results. Among the hospitalized patients, the elderly dominated, women – by 18.4%, they were 6.4 years older than men. The most frequent cause of CHF is hypertensive disease (91.7%), atrial fibrillation takes the second place (60.0%), PICS – the third one (35.0%). Diabetes mellitus was detected in 30.0%, CKD in 56.7%; 72.5% had the comorbidity index amounting to 5 and above. About half of those hospitalized (55.8%) had FC 3 of CHF and intermediate EF of LV (48.3%). High frequency of RF was revealed: alcohol intake – 46.7%, insufficient PA – 77.5%, overweight and obesity – 90.0%, abdominal obesity – 67.5%, HHS – 63.3%, HTG – 42.5%, high LDL – 43.3%. Men compared to women were 19.0% more likely to have a family history of early CVD, 46.7% –alcohol intake, 71.4% – smoking, 14.2% – normal BMI.
Conclusion. Identified features allow to determine priority directions and develop strategies for treatment and prevention of CHF decompensation.
Keywords: chronic heart failure, decompensation, comorbidity, risk factors.
47-50
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Research objective. To assess the nature of bone metabolism disorder in hemophilia patients depending on the degree of decrease of its mineralization.
Materials and methods. We examined 52 patients with severe hemophilia A and 5 patients with hemophilia B aged 17 to 50 years. Oxyproline in blood serum and urine, activity of bone alkaline blood phosphatase, and calcium and phosphorus content in blood and urine were investigated to evaluate destructive processes in bone tissue. All patients were given dual energy X-ray absorptiometry to determine BMD in the posterior-anterior projection of the lumbar spine and proximal sections of the femoral bone.
Results. According to dual energy X-ray absorptiometry, 65% of patients with severe hemophilia have an overall (systemic) reduction in BMD. During the initial stages of osteopenia development in patients with severe hemophilia, the acceleration of metabolism of organic bone matrix was found. In pronounced osteopenia and osteoporosis, metabolism disorders of the mineral part of bone tissue (increased release of calcium with urine) occurred.
Conclusion. Thus, the study of basic indicators of bone metabolism in combination with modern radiological research methods allows for more in-depth evaluation and control of the dynamics of destructive processes occurring in the bones of hemophilia patients.
Keywords: hemophilia, arthropathies, osteoporosis, osteodensitometry.
Materials and methods. We examined 52 patients with severe hemophilia A and 5 patients with hemophilia B aged 17 to 50 years. Oxyproline in blood serum and urine, activity of bone alkaline blood phosphatase, and calcium and phosphorus content in blood and urine were investigated to evaluate destructive processes in bone tissue. All patients were given dual energy X-ray absorptiometry to determine BMD in the posterior-anterior projection of the lumbar spine and proximal sections of the femoral bone.
Results. According to dual energy X-ray absorptiometry, 65% of patients with severe hemophilia have an overall (systemic) reduction in BMD. During the initial stages of osteopenia development in patients with severe hemophilia, the acceleration of metabolism of organic bone matrix was found. In pronounced osteopenia and osteoporosis, metabolism disorders of the mineral part of bone tissue (increased release of calcium with urine) occurred.
Conclusion. Thus, the study of basic indicators of bone metabolism in combination with modern radiological research methods allows for more in-depth evaluation and control of the dynamics of destructive processes occurring in the bones of hemophilia patients.
Keywords: hemophilia, arthropathies, osteoporosis, osteodensitometry.
Tseimakh A.E., Lazarev A.F., Sekerzhinskaya E.L., Kurtukov V.A., Mishchenko A.N., Teplukhin V.N., Shoikhet Ya.N.
51-58
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The technique of management of patients with malignant neoplasms of the hepatopancreatoduodenobiliary zone complicated by mechanical jaundice is analyzed in two nosologically comparable groups of patients. In the main group, which included 41 patients, palliative complex treatment was performed using local and systemic photodynamic therapy of neoplasms of the hepatopancreatoduodenobiliary zone complicated by mechanical jaundice, purulent cholangitis. In the comparison group of 165 patients, palliative complex treatment of complications was performed without photodynamic therapy. Against the background of local and systemic photodynamic therapy in the main group within a week after treatment, we found statistically significant reduction in the size of neoplasm in patients with malignant neoplasms of the pancreas gland according to ultrasound examination of the abdomen, as well as recovery of bile excretion in the intestine in 100% of patients with malignant neoplasms of the biliary tracts, the head of pancreas, increasing patient survival.
Keywords: malignant neoplasms of the hepatopancreatoduodenobiliary zone; mechanical jaundice; photodynamic therapy.
Keywords: malignant neoplasms of the hepatopancreatoduodenobiliary zone; mechanical jaundice; photodynamic therapy.
Pavlinov S.E., Yarikov A.V., Perl’mutter O.A., Boyarshinov A.A., Chertkov A.K., Kibirev A.B., Fraerman A.P.
59-64
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The prevalence of degenerative-dystrophic spine disorders remains high and constitutes 40% among all adult orthopedic diseases. This leads to a great economic loss for the state, as it is accompanied by a pronounced pain syndrome, leading to the incapacity of the patient. The paper analyzes the results of treatment of 120 patients with confirmed discoradicular conflict with a follow-up period of up to 1 year. Patients were divided into three groups depending on the way the surgery had been performed: cold plasma nucleoplasty, transforaminal endoscopic (TESSYS), and microsurgical removal of disc hernia. The score was based on the MacNab scale and the timing of the return to work. All techniques employed should be seen as complementary and alternative to each other rather than competing, and should only be applied after a thorough examination of the patient.
Keywords: spinal endoscopy, disc herniation, endoscopic discectomy, microdiscectomy, endermic endoscopic discectomy, percutaneous discectomy.
Keywords: spinal endoscopy, disc herniation, endoscopic discectomy, microdiscectomy, endermic endoscopic discectomy, percutaneous discectomy.