No 86 (2021)

Articles

VITAMIN D AND ZINC LEVELS COMPARATIVE CHARACTERISTICS OF PATIENTS WITH ISOLATED AND COMBINED CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Velikaya O.V., Nedomolkina S.A., Nedomolkin S.V., Nesterova O.A., Martyshova O.S., Velikiy A.V.

Abstract

The article is devoted to comparative characteristics of the zinc and vitamin D levels state issues in patients with isolated COPD and in combination with other diseases (chronic laryngitis and residual fibrous changes in the lungs after clinically cured pulmonary tuberculosis). Comorbidity is an urgent problem of modern medicine. Many diseases have common risk factors and mechanisms of development. Currently, the presence fact of a respiratory system continuum is no longer disputed, therefore, risk factors and mechanisms for the development of chronic obstructive pulmonary disease comorbidity and other diseases of the respiratory system (upper respiratory tract and lower respiratory tract) may be identical and require detailed study. The aim of the study was to compare vitamin D levels and serum zinc levels in patients with isolated and combined course of chronic obstructive pulmonary disease with chronic diseases of the respiratory system. Materials and methods of research. The authors analyzed the zinc and vitamin D concentration in 3 groups: 1 - with isolated COPD, 2 - COPD in combination with chronic laryngitis and 3 - COPD in combination with residual fibrous changes after clinically cured pulmonary tuberculosis. The results of the study indicate the presence of the trace element zinc and vitamin D deficiency, which is a feature of the comorbidity manifestation of chronic obstructive pulmonary disease. Conclusions. Patients with both combined COPD and chronic laryngitis and isolated COPD have zinc and vitamin D deficiency. In patients with COPD and residual changes in the lungs in the form of fibrosis after cured pulmonary tuberculosis, vitamin D and zinc deficiency is also determined. Serum zinc and vitamin D levels are significantly lower in comorbid pathology compared to isolated COPD, which reflects their mutual influence and increases the risk of exacerbation of diseases. The inverse dependence of zinc and vitamin D levels on the values of FEV1 requires further research: the dependence study on the frequency of exacerbations of COPD, the smoker's index and other indicators.
Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2021;(86):4-10
pages 4-10 views

THE IMPORTANCE OF LOCAL MICROBIOLOGICAL MONITORING IN THE UROLOGY DEPARTMENTS OF A MULTIDISCIPLINE HOSPITAL

Batishcheva G.A., Bondarenko E.V., Gabbasova N.V., Goncharova N.Y., Gusakova E.B., Mazina O.L., Smolyaninova D.S.

Abstract

Local microbiological monitoring is essential to optimize antimicrobial therapy. The aim of the work was to carry out a comparative analysis of the structure and resistance of priority uropathogens of urinary tract infections in urological departments of various specializations of the regional hospital (department performing reconstructive plastic surgery and the department of oncourology). The material of the study was the results of bacteriological studies of urine samples. Statistical processing was carried out using Microsoft Excel. The study of the etiological structure of causative agents of urinary tract infections in two urological departments of the regional hospital confirmed the leading role of gram-negative microorganisms, the leaders of which are Escherichia coli, Klebsiella and Enterobacter. One fifth of Escherichia coli and Klebsiella were ESBL producers. Patients of the oncourology department had a higher level of Klebsiella resistance to cephalosporins, carbapenems and fosfomycin. Local microbiological monitoring, infection control over the rationality of antibiotic therapy are necessary to contain global antibiotic resistance and optimize antimicrobial therapy.
Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2021;(86):11-17
pages 11-17 views

THE LEUKOGRAM ENTROPY IN COVID-19

Grebennikova I.V., Makeeva A.V., Lidokhova O.V., Bolotskikh V.I., Berdnikov A.A., Savchenko A.P., Blinova Y.V.

Abstract

The assessment of body adaptation level was carried out according to the integral indicators of peripheral blood for 210 Covid-19 patients aged from 25 to 86 years. One of the methods for hemogram integral evaluation is the calculation of human leukogram entropy. The values of absolute and relative leukogram entropy of patients with coronavirus infection at admission and discharge were studied in comparison with normal (reference) values. The change in entropy was assessed as a maladaptive state of the organism. A significant increase in these indicators was found in dynamics (at admission, the absolute entropy was 1.16 ± 0.26 and at discharge 1.30± 0.20; the relative entropy was 50.11±11.25% and 56.17± 8.73%, respectively, p <0.01). The dependence between leukogram entropy and erythrocyte sedimentation rate (r=-0.16, p<0.05) was revealed. Thus, the information leukogram entropy allows, along with other laboratory indicators, to apply it in clinical practice as methods for assessing the severity of Covid-19 disease.
Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2021;(86):18-23
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ACUTE INFLAMMATORY DEMYELINING POLYNEUROPATHY AS A NEUROLOGICAL COMPLICATION COVID-19

Zolotykh D.I., Ulyanova O.V., Shevchenko D.S., Afanasyev S.N., Gurbik A.V.

Abstract

The COVID-19 pandemic, caused by the Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2), is on an unprecedented scale today since the 1918 influenza pandemic. Despite the fact that the predominant clinical picture is associated with respiratory diseases, neurological manifestations have begun to be diagnosed more and more often. Based on the knowledge of coronaviruses, especially those that cause epidemics of severe acute respiratory syndrome and Middle East respiratory syndrome, it can be expected that cases of damage to the central nervous system (CNS) and peripheral nervous system (PNS) caused by SARS-CoV-2 will soon time will be much more common. The first cases of acute inflammatory demyelinating polyneuropathy or Guinea-Barré syndrome (GBS) were described in 2020; despite the incomplete immunological examination, given the enormous difficulties in examining patients in the red zone, which could provide early clues about what can be expected in the coming months in relation to common acute autoimmune neurological conditions such as GBS, cranial moneuroneuritis, encephalitis, encephalomyelitis or myositis, which for many years we casually called post-viral, if we saw them after various infectious processes. The article discusses the development of acute inflammatory demyelinating polyneuropathy (AIDP) against the background of coronavirus infection. A clinical case of AIDP development in a patient against the background of a new coronavirus infection is presented.
Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2021;(86):24-29
pages 24-29 views

DYNAMICS OF RELEASE OF METHICILLIN-RESISTANT STAPHYLOCOCCI IN DEPARTMENTS OF MULTIDISCIPLINARY HOSPITAL AND RECOMMENDATIONS ON OPTIMISATION OF ANTIBACTERIAL THERAPY

Zolotukhin O.V., Denisova O.I., Bondarenko E.V., Shirshova E.G.

Abstract

Data of long-term microbiological monitoring of incidence rates of methicillin-resistant staphylococcus S. aureus (MRSA) and S. epidermidis (MRSE) in VOKB No. 1 of Voronezh are presented. It was found that the most common strains of epidermal staphylococcus occur in hospital conditions having a high level of methicillin resistance. At the same time, the epidermal staphylococcus is not aggressive, most often it only contaminates the biomaterial, but in immunocompromised patients it requires prescribing antibacterial therapy. Currently, strains of microorganisms with reduced sensitivity to antibiotics, recommended by the standards of treatment of purulent processes of various organ systems, are increasingly found. An increase in the minimum suppressive concentration (IPC) of the antibiotic in severe infection caused by methicillin-resistant staphylococci is associated with an increase in the number of complications of antibacterial therapy. Introduction of modern test systems to determine the sensitivity of methicillin-resistant forms of staphylococci to antibiotics, revision of antibacterial therapy tactics and the range of antibiotics purchased will significantly improve the results of treatment of purulent septic diseases
Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2021;(86):30-37
pages 30-37 views

ULTRASOUND EXAMINATION AS A METHOD FOR DIAGNOSING INFLAMMATORY LUNG AND PLEURAL DISEASES IN COVID-19

Ivanova A.S., Goncharova A.Y., Titova L.A.

Abstract

Issues of diagnostics of inflammatory lesions of lungs and pleura in coronavirus infection were studied, the issues of the prevalence of coronavirus infection and the need to study the possibility of using ultrasound examination methods for the diagnosis of pleuropulmonary lesions were considered. The aim of the work was to analyze these possibilities and evaluate the effectiveness of the use of ultrasound examination of the lungs and pleura in the context of the COVID-19 pandemic for various groups of patients. Comparison of visualization of symptoms of pulmonary lesions using computed tomography and ultrasound examination is carried out, characteristic signs of pulmonary pathology determined during ultrasound examination are indicated, the mechanisms of formation of a characteristic radiation pattern are considered, the advantages and disadvantages of the ultrasound method of examination are highlighted, the conditions for its use are determined and the possibility of use is assessed.
Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2021;(86):38-42
pages 38-42 views

COVID-19 IN CHILDREN

Razuvaev O.A., Kokoreva S.P., Razuvaeva Y.Y.

Abstract

At present, the relevance of the new coronavirus infection is not in any doubt. The pandemic is a health and economic problem for all countries on Earth. Under surveillance were 148 children with a new coronavirus infection hospitalized in a hospital in Voronezh from November 2020 to January 2021. Of these, 122 patients with COVID-19 during the acute course of infection and 26 patients with multisystemic inflammatory syndrome. Among children with acute coronavirus infection, school-age children prevailed. Most often, the disease was not severe, but 18% were diagnosed with a severe course. In the clinical picture, fever and cough prevailed, cataral syndrome took place without a pronounced exudative component. Lesion of pulmonary tissue was diagnosed in 62.7% of children, in 4.8% the volume of the lesion was more than 50%. At this period the critical form of COVID-19 - multisystem inflammatory syndrome was first diagnosed.
Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2021;(86):43-49
pages 43-49 views

NEW CORONAVIRAL INFECTION (COVID-19) AS A RISK FACTOR FOR THE DEVELOPMENT OF CEREBVASCULAR DISEASES

Ulyanova O.V., Sharova I.V., Chevychalov S.F.

Abstract

The incidence of cerebrovascular disease (CVD) in patients who test positive for SARS-CoV-2 ranges from 1% to 6%, potentially equating to a large number of people as the pandemic progresses in some countries. The pathological process in COVID-19 can involve the membranes of the brain, blood vessels, and the parenchyma of the brain. Arising under the influence of a virus that has penetrated the blood-brain barrier (BBB) into the central nervous system (CNS), cellular reactions, depending on the state of the T- and B-cell immunity of the patient, can be asymptomatic, monosymptomatic, or cause clinical manifestations of meningitis, encephalitis, encephalopathy. The defeat of the cranial, peripheral nerves, skeletal muscles is manifested by mono- and polyneuropathies, muscle fatigue, myalgia, rhabdomyolysis. The development of hypercoagulability leads to the formation of thrombosis, including in the vessels of the brain, leading to the development of ischemic stroke (IS) most often.
Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2021;(86):50-55
pages 50-55 views

THE DATA OF THE SURVEY OF PHARMACEUTICAL WORKERS ON THE PRESCRIPTION OF MEDICINES IN PHARMACY ORGANIZATIONS OF THE VORONEZH REGION

Berezhnova T.A., Lunyova E.A., Uymanova A.A.

Abstract

This work examines the awareness of pharmaceutical workers and doctors about the prescription of medicines, and also reflects the real situation in Voronezh and the Voronezh region. The study was conducted by the questionnaire method, which covered 100 pharmaceutical workers who sell medicines from pharmacies in Voronezh and the Voronezh region. The conducted survey of specialists showed that not all pharmaceutical workers are fully aware of the current regulatory document regulating prescription forms and the rules for their registration. During the survey, it was found out that 64% of respondents noted frequent visits to the pharmacy with a prescription written on a prescription form 107-1/y, which was 82%. From the statistics obtained, drugs that depress the central nervous system (sleeping pills, tranquilizers, antidepressants, sedatives, neuroleptics) are most often prescribed, which accounts for 91% of prescriptions. However, only 9% of cases bring prescriptions for antibiotics, which indicates that the release of antibacterial drugs is mainly carried out without a prescription. Thus, it is concluded that non-compliance with the rules for the release of medicines from pharmacies dramatically reduces the safety and effectiveness of their use by patients and leads to the further spread of self-medication.
Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2021;(86):56-60
pages 56-60 views

IMMUNOGLOBULINS - PRESENT AND FUTURE OF IMMUNOTHERAPY: LITERATURE REVIEW AND CLINICAL EXPERIENCE

Zemskov A.M., Zemskova V.A., Bakuleva N.I., Glagoleva A.B., Shiryaev O.J.

Abstract

A therapy of different pathologies still arises a question about the most effective ways of treatment. Scientists all over the world are still looking for an answer. A large measure of success has been achieved by immunological studies, showed a high potential of immunoglobulins in treatment of different pathologies. Immunoglobulins are blood proteins, produced by B - lymphocytes and plasma cells. Immunoglobulins perform a number of functions, the main of which is a protective function, triggered by “binding” and neutralization of foreign antigens (bacteria, viruses, fungi, parasites and protein toxins). For an average person, a number of immunoglobulins is about 25% of blood serum proteins. Actual studies triggered a production of so-called adaptive therapy. This type of treatment, based on transfer of active immunoglobulins to the place of immune response, has an acknowledged importance nowadays and promising future. Immunoglobulins has a destroying influence on microorganisms and bacteria and also immunotropic influence. Its practical application in clinical medicine can’t be overestimated: functions of immunoglobulins spread away from immunodiagnostics and immunoprophylaxis to non-specific stimulation of inoculation and immunocorrection of different infections and somatic pathologies. Also, immune proteins regulate an immunologic homeostasis and play a great role in treatment of immunodependent pathologies. However, there might be cases of treatment side effects. Nevertheless, using of hybridoma clones can solve an amount of preventive, diagnostic and therapeutic problems.
Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2021;(86):61-72
pages 61-72 views

FACTORS OF VIOLATION OF THE NUTRITIONAL STATUS OF CHILDREN WITH AUTISM SPECTRUM DISORDERS

Bavykina I.A., Bavykin D.V., Patritskaya M.V.

Abstract

Autism spectrum disorders are widespread all over the world. Scientists have not yet established the exact pathogenetic mechanisms of the pathology. One of the leading and often the first signs of the disease is selective appetite, which can lead to changes in the state of nutritional status. Also, the use of diet therapy as an additional method of correcting pathological changes in autism can lead to nutritional disorders. The article deals with topical issues of changes in nutritional status that may arise as a result of the selectivity of nutrition and the use of diet therapy.
Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2021;(86):73-79
pages 73-79 views

PSYCHOLOGICAL AND PEDAGOGICAL COMPETENCE AS THE BASIS OF PROFESSIONAL TRAINING OF STUDENTS MEDICAL UNIVERSITIES

Chernykh T.M., Elizarova I.O., Zoloedov V.I., Deshevykh Y.A.

Abstract

The article presents the results of studying the issue of professional training of medical university students in the conditions of the modern educational process. The competence-based approach, which is currently being implemented in the field of higher education, including medical education, allows for the training of specialists at a sufficiently high level. Graduates of medical universities should not only possess the knowledge, but also the necessary skills and abilities for the professional activity of a general practitioner. Many researchers have noted the peculiarities of medical professional activity. Psychological and pedagogical competence is an important component of this activity. Successful interaction of the doctor with the patient and his relatives is the basis of compliance therapy, increased adherence to treatment and, as a result, a favorable prognosis for the patient's life.
Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2021;(86):80-86
pages 80-86 views

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