No 88 (2022)

In rehabilitation of patients having post COVID syndrome together with cardiovascular system diseases there can be used not only standard methods, but the programs with physical methods of the influence aimed at improvement of microcirculation, metabolic processes and also have anti-inflammatory, vasodilator, thrombolytic, analgesic and sedative effect.

The article describes in vivo screening studies of 4 samples of partially hydrogenated pyridine derivatives synthesized at the Research Laboratory "Chemex" on a model of steroid diabetes mellitus. Steroid diabetes mellitus was modeled in 18 month old outbred laboratory rats for 13 days by intraperitoneal administration of dexamethasone at the rate of 125 µg/kg of body weight. Pharmacocorrection was carried out by intragastric administration at a dose of 1 mg/kg of body weight for 21 days of compounds of 1,4-dihydropyridine derivatives (cv140, cv-150), and 1,2,3,4-tetrahydropyridine derivatives (cv-083, jen 09 - 039). Hypoglycemic activity was noted in all 4 test compounds. In addition to hypoglycemic activity, additional pharmacological activity was found that positively affects the metabolic processes of late diabetic complications. Pharmacocorrection of metabolic and psychosomatic status was confirmed by visual observations, as well as biochemical blood analysis. The most promising for further research are compounds with laboratory codes cv-140 and cv-150.

The structure of diagnoses and age and gender characteristics of patients seeking medical care after a new coronavirus infection COVID-19 are analyzed. A cluster of the most characteristic symptoms present in patients who have undergone COVID-19 has been identified. The features of the delayed effect of the new coronavirus infection COVID-19 on the adult heart were studied on the basis of magnetic resonance imaging of the heart with contrast enhancement. An algorithm for selecting patients with suspected heart disease after COVID-19 for in-depth examination is proposed.

The article discusses the clinical and epidemiological features of the modern course and laboratory diagnosis of Q fever (QF) or coxiellosis, which is one of the zoonotic natural focal infectious diseases of the Voronezh region. Coxiellosis is a systemic natural focal zoonotic disease with a wide geographic range. Our region is officially included in the statistics of regions where the disease is registered almost annually. Difficulties in the clinical diagnosis of Q fever are due to pronounced polymorphism of manifestations of the disease and the absence of pathognomonic symptoms. The possibility of a chronic course with the development of endocarditis worsens the prognosis of the disease due to high mortality (up to 60%). This disease requires attention and careful study by modern internists. To make a diagnosis, it is necessary to know epizootological data, epidemiological history, clinical manifestations of the disease, the results of laboratory studies, which detect antibodies to Burnet's coxiella and pathogen DNA: Methods of enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) are used.

As shown by international and domestic studies, obesity is diagnosed in the majority of BA patients. At the present stage, a number of foreign and domestic scientists focus on the effectiveness of physical activity and a balanced low-calorie diet in the course of asthma. The scientific study presents data on the analysis of the effectiveness of physical activity and a low-calorie diet included in the complex treatment of patients with asthma and obesity. When using personalized therapy of patients with an emphasis on dosed physical exercises and balanced diet therapy, significantly positive dynamics of anthropometric parameters, the course of asthma, a statistically significant decrease in the severity of clinical manifestations of asthma, the achievement of optimal control over the disease and an increase in exercise tolerance were noted.

Acute cerebrovascular accident (ONMC) is still one of the leading causes of mortality and disability among all nosological diseases. Ischemic stroke (AI) may be the first clinical manifestation of a cardioembolic variant in cardiovascular pathology (CCC). Cardiac embolism accounts for about 1/4 of AI. Strokes due to cardioembolism are usually severe and are prone to early and distant relapses. Cardioembolism can be suspected by clinical signs, but is often difficult to diagnose. Magnetic resonance imaging (MRI), transcranial dopplerography, echocardiogram, Holter and electrophysiological studies can help establish the source of cardioembolism. The bicuspid aortic valve (DAK) is by far the most common congenital heart disease (PRS). Remaining asymptomatic for a long time, it can eventually be complicated by the development of aortic stenosis or aortic insufficiency. DAC is also associated with aortic aneurysm and its dissection. Given the high prevalence of this defect and the severity of the complications, it is believed to be responsible for more deaths than all other congenital heart defects combined. Therefore, it is relevant to determine the characteristics of patient management taking into account comorbid pathology and the formation of a multi-disciplinary team (MDB) for an individual approach to the rehabilitation and treatment of patients with DAK. The article details the clinical case of a 47-year-old patient with AI and newly diagnosed DAK in the absence of obvious clinical signs of heart disease. The importance of routine assessment of cardioembolic sources of all AI development options is emphasized. As well as detailed consideration of the modern possibilities of conservative treatment of AI and effective rehabilitation methods.

The paper analyzes the frequency of polymorphism of enzymes of the cytochrome P 450 (CYP) family in regional conditions in residents of the Voronezh region. As a result of studies performed in 2021 in 69 residents of the Voronezh region during genetic testing of CYP 2C19 isoenzymes, the frequency of occurrence of "slow" metabolizers (15.8% of patients), "fast" metabolizers (2.8% of patients) was established. To assess the relationship between the phenotype and genotype of patients, a Born aggregogram was performed, which reflects the functional activity of platelets. The aggregation ability (aggregation ≥ 40%) of platelets was observed in patients who had a decrease in the metabolic rate of CYP 2C19.

The article presents the literature data on the main difficulties faced by a forensic expert during the examination of injuries received in childhood. Examples of the influence of anatomical and physiological features of the child's body and the resulting damage mechanisms are considered.