Сибирское медицинское обозрение. 2020. № 3 View full textКоличество просмотров : 5931
Volkova O.V., Shesternya P.A.
Strategies and trends for organization of medical and psychological assistance in post-pandemic period
Volkova OV, Shesternya PA. Strategies and trends for organization of medical and psychological assistance in post-pandemic period. Siberian Medical Review.2020;(3):5-10. DOI 10.20333/2500136-2020-3-5-10
Volkova Olesya Vladimirovna PhD, Associate professor, Clinical psychology and psychotherapy department; Krasnoyarsk State Medical University; Address: 9-15, Astrakhanskaya street, 660037; phone: +7 (950) 9950409; E-mai: firstname.lastname@example.org
Shesternya Pavel Anatolievich Cand.Med.Sc., Professor of the Department of Internal Diseases №1; Professor V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University; email@example.com
Th e article presents an analysis of current situation of COVID-19 pandemic period from the point of view of clinical psychology and general medical practice. Potential negative consequences related to psychological state and features of somatic health of population are described. The latest data presented in foreign studies for the first quarter of 2020, systematizing the problem of coronavirus pandemic from the perspective of psychology and biomedicine, is systematized. A comparative analysis of psychological diffi culties that population is currently facing, and phenomenon of learned helplessness structure is carried out. Taking into account global experience, as well as methodological principles of systematic approach, a scheme for organizing medical and psychological assistance in post-pandemic period is proposed.
Keywords: pandemic, post-pandemic period, COVID-19, psychological health, somatic health, medical and psychological assistance, learned helplessness.
Achievements, threats and risks of medical and pharmaceutical activities in the Republic of Belarus
Glushanko VS, Shulmin AV, Kugach VV, Tarasova EN, KhutkinaGA, Тihonova NV. Achievements, threats and risks of medical and pharmaceutical activities in the Republic of Belarus. Siberian Medical Review.2020;(3):11-19. DOI 10.20333/2500136-2020-3-11-19
Th e article presents an analysis of modern approaches to optimize the activities of medical-pharmaceutical complex in the Republic of Belarus on the basis of assessment of the threats and risks existing in the country that prevent its development. Particular attention is paid to the analysis of population health state in the republic, impairment of which has been observed in recent years (negative natural growth, extreme mortality among males aged 15-60 in the country, signifi cant excess of mortality among urban population). Approaches to improve the effi ciency and quality of medical and pharmaceutical care in the Republic of Belarus based on risk management in this area are proposed.
Keywords: risks, challenges, threats, Belarusian healthcare model, medical-pharmaceutical complex, public health, healthcare fi nancing, risk / management
Kaschenko VA, Mitsinskaya AI, Sokolov AY, Shishkin AN, Varzin SA, Neymark AE, Mekhtiev SN, Lodygin AV, Mitsinskiy MA, Akhmetov AD. Obesity and non-alcoholic fatty liver disease: therapeutic options. Siberian Medical Review.2020;(3):20-29. DOI 10.20333/2500136-2020-3-20-29
Treatment problem of non-alcoholic fatty liver disease (NAFLD) in obesity is becoming increasingly important due to the steady increase in this disease prevalence. NAFLD is associated with the development of a number of comorbid pathologies, which signifi cantly reduces patients’ life expectancy and mediates significant financial costs for their treatment. A large number of NAFLD treatment methods have been developed, while the issue of conservative methods eff ectiveness remains debatable. Th e article provides an overview of current therapeutic approaches to NAFLD treatment in case of obesity with the discussion of available medications used in treatment of this disease.
Keywords: non-alcoholic fatty liver disease, obesity, metabolic syndrome, NAFLD therapy
Rachkovskaya VV, Gorbunov AP, Pashov AI, Volkova LV. Th e use of mass spectrometry in cervical pathology diagnostics (literature review). Siberian Medical Review.2020;(3):30-37. DOI: 10.20333/2500136-2020-3-30-37. DOI 10.20333/2500136-2020-3-30-37
The scientifi c review covers the problem of early cervical pathology diagnostics. Etiopathogenetic factors for the development of cervical intraepithelial neoplasia and cervical cancer are briefl y described along with the possibilities and diffi culties of their diagnosis. Much attention is paid to new and promising method for cervical pathology diagnostics such as the study of proteomic composition of cervicovaginal mucus and other biological fl uids by means of mass spectrometrometer. Literature data review on eff ectiveness of this technique used in gynecology is given. It is supposed that in future, the technique and the received protein components can be used in practice of obstetrician-gynecologist to identify early cervix pathologies and to prevent complications.
Keywords: mass spectrometrometer, cervix uteri, cervical cancer, co-morbidity of cervix of the uterus, Pap test, human papillomavirus, cervical dysplasia, cervicovaginal fluid, proteomic analysis.
Еremina ЕN, Каrаkhanian АR, Vаkhrunin DА, Тitоv КS, Zukоv RА. Molecular genetic markers of pigmented skin melanoma (literature review). Siberian Medical Review.2020;(3):38-46. DOI 10.20333/2500136-2020-3-38-46
Th is review provides data on genetic melanoma markers over the past few years. p16 cyclin-dependent kinase inhibitor gene (CDKN2A), which was identifi ed as the fi rst gene for the development of skin melanoma more than 20 years ago, is still the gene of the main high-risk. Th ere was cyclin-dependent kinase 4 (CDK4), responsible for cell proliferation presented. Recent advance in molecular genetics has revealed new genes involved in melanoma pathogenesis: breast cancer gene 1 (BRCA1) associated protein 1 (BAP1), CXCL1 genes, telomerase catalytic subunit (TERT), telomere 1 protection (POT1), ACD and TERF2IP. Along with such genes as melanocortin 1 receptor (MC1R) and transcription factor, mutation of which is accompanied by microphthalmos (MITF), are of moderate risk. Th e review also covers a number of other low-penetrant genes of prognostic value.
Keywords: skin melanoma, genetic markers, CDKN2A, CDK4, MITF, TERT, MC1R.
Problems of acetylsalicylic acid resistance in ischemic stroke prevention (literature review)
Everstova TE, Nikolaeva TYa. Problems of acetylsalicylic acid resistance in ischemic stroke prevention (literature review). Siberian Medical Review. 2020;(3):47-53.. DOI 10.20333/2500136-2020-3-47-53
Th e study of antiplatelet drugs resistance requires new approaches using genetic methods. Acetylsalicylic acid is widely used in initial and secondary ischemic stroke prevention. According to various literature sources, some patients undergoing aspirin therapy, face with the development of thrombotic events, despite prolonged use of the drug. Th is article provides data on the causes of clinical resistance and the role of genetic factors. For today, the causes of aspirin resistance are complex and not always can be scientifi cally explained. Genetic factors in the development of antiplatelet therapy resistance are of particular interest.
Keywords: ischemic stroke, acetylsalicylic acid, prevention, aspirin resistance, clinical resistance, genetic factors
Morozov AM, Sergeev AN, Sergeev NA, Dubatolov GA, Ryzhova TS, Pakhomov MA, Peltikhina OV. Modern methods of stimulating process of postoperative wounds regeneration. Siberian Medical Review. 2020;(3):54-60. DOI 10.20333/2500136-2020-3-54-60
Understanding the features of wound process mechanisms creates fundamental prerequisites for the development of promising methods of stimulating wounds regeneration that have positive eff ect at various phases of wound healing process and have systemic, local or complex effect. The present article touches on basic methods of each group, namely biological methods using collagen, hyaluronic acid, proteolytic enzymes and blood components. Chemical methods using pyrimidine drugs series, immunomodulating and antioxidant drugs, as well as physical methods based on the action of electromagnetic fi elds, ultrasounds, electric currents, ultraviolet and laser radiation are described. Fundamentally new gene-therapeutic approach based on the use of species-specific genes of protein factors is of particular interest
Keywords: wound healing, stimulation, regeneration process, wounds, wound process
Petrova MM, Shnayder NA, Pronina EA, Bobrova OP. Diagnosis of neuropathic pain: scales and questionnaires. Siberian Medical Review.2020;(3):61-69. DOI 10.20333/2500136-2020-3-61-69
Diagnosis of neuropathic pain can be diffi cult for primary care professionals. Chronic pain is oft en underestimated and is not treatable. Several scales and questionnaires have been developed assessing pain presence, pain intensity, pain allocation, as well as psychological and functional eff ects of pain, including assessment of symptoms in a patient, and some being supplemented by simple methods of clinical examinations to detect signs of nervous system damage. Screening tools are not ideal, and it would be incorrect to think that they can replace clinical assessment. However, the greatest benefi t will be for screening purposes to help a specialist identify neuropathic pain or pain that has predominantly neuropathic component.
Keywords: neuropathic pain, diagnosis, screening, pain assessment, questionnaires, scales.
miR-204-5p level modulation that induces formation of premetastatic niche in B16 melanoma in vivo model
Lavrentev SN, Aksenenko MB, Averchuk AS, Zinchenko IS. miR-204-5p level modulation that induces formation of premetastatic niche in B16 melanoma in vivo model. Siberian Medical Review.2020;(3):70-77. DOI 10.20333/2500136-2020-3-70-77
Th e aim of the research. Determination of microRNA profi le in metastasis target organs aft er experimental increase of their level by synthetic analogue miR-204-5p in vivo. Material and methods.Th e study was performed in laboratory mice of C57Bl6 line who were implanted with B16 melanoma culture cells to form subcutaneous solid tumor. Animals that were inoculated with melanoma were divided into III groups: check (n = 3); negative check (n = 5); experimental (n = 6), animals of this group got synthetic analogue (simulator) of the studied miR-204-5p microRNA, at a dosage of 1.2 mg / kg in the form of a solution. Results. Th e study of miR-204-5p expression in tissues of kidneys, lungs, and liver of experimental animals showed an increase in this miRNA expression ninefold compared with the check one in kidney tissues. Next, microRNA expression profi le of this tissue was determined. Microchipping results showed that aft er miR-204-5p simulator introduction, the level of 12 miRNAs changes, while 9 miRNAs had a reduced expression level of more than 2 times. These miRNAs are involved in regulation of component genes of 47 intracellular signal transmission mechanisms. Signal transmission mechanisms regulated by miRNAs with the highest change level included signaling pathways of mitogen-activated protein kinases (MAPK), proteoglycans in case of cancer, renal cell kidney carcinoma, cell adhesion, lysine degradation, regulation of calcium reabsorption and synthesis of various types of hormones. Conclusion. When introducing antisense nucleotides, their increased concentration, and hence the expected eff ects, are observed in kidney tissues. Analysis of signaling cascades regulated by miRNAs with the highest change level showed transformation of signaling mechanisms functionally associated with carcinogenesis, including kidney cancer. Similar result may indicate possible formation of premetastatic niches in kidney tissue of experimental animals
Keywords: miRNA, miR-204-5p, melanoma, signaling pathways, target genes, metastasis, bioinformatic analysis
Antitumor activity of sulfated polysaccharides of Chondrus armatus alga of the Sea of Japan
Vikhareva VV, Leontieva EA, Begun MA, Chichinskas E, Kalitnik AA, Khotimchenko MYu. Antitumor activity of sulfated polysaccharides of Chondrus armatus alga of the Sea of Japan. Siberian Medical Review.2020;(3):78-85.. DOI 10.20333/2500136-2020-3-78-85
The aim of the research. Carrageenans are polysaccharides of red Chondrus armatus alga. Antitumor properties of carrageenans and their low molecular weight derivatives are to be studied along with their degradation products, and the dependence on chemical structure and molecular weight. Material and methods. Th e antitumor eff ect of carrageenans obtained and characterized on the basis of Pharmacology and Biological Tests Laboratory of Biomedicine School in FEFU was studied in cells of C127, HeLa, SW-620, HTB-30 and RPE lines using MTT test and staining with propidium iodide and Hoechst fluorescent dyes. Results. A pronounced antitumor eff ect of κ- and λ-carrageenans obtained from Chondrus armatus alga and products of their hydrolysis in relation to cells of tumor culture C127 was found. Kappa and lambda-carrageenans in low concentrations of 50-100 μg / ml exhibit cytotoxic eff ect and antiproliferative, comparable to the effect of “Paclitaxel” antitumor drug. Conclusion. Carrageenans show selective cytotoxicity to various tumor lines, while antitumor eff ect of carrageenans depends on their chemical structure and molecular weight. Th e advantages of carrageenans as potential antitumor agents is their low toxicity to normal body cells and, along with a pronounced cytotoxic and antiproliferative eff ect on tumor cells.
Keywords: carrageenans, Chondrus armatus, antitumor activity, MTT test, fluorescence staining, cytotoxic eff ect, antiproliferative eff ect
The effect of inhaled anesthetics on jugular oximetry during aneurysms clipping of intracranial arteries
Dovbysh NYu, Gritsan AI, Kurnosov DA, Stepanenko NA. The effect of inhaled anesthetics on jugular oximetry during aneurysms clipping of intracranial arteries. Siberian Medical Review. 2020;(3):86-91. DOI 10.20333/2500136-2020-3-86-91
Th e aim of the research is to assess the eff ect of inhalation anesthetics, such as desfl urane and sevofl urane, used during general anesthesia, on jugular venous oximetry parameters change. Material and methods. Th e analysis of indicators of central hemodynamics, blood loss and jugular venous oximetry at various stages of clipping in patients with ruptured intracranial arteries aneurysms in 2 groups, 30 patients in total: 1 group of patients, where desfl urane was used during general anesthesia and 2 group of patients – general anesthesia with sevofl urane. Results. Patients from both groups were compared according to severity of subarachnoid hemorrhage and its intensity. When conducting general anesthesia with both desfl urane and sevofl urane, common hemodynamic changes were observed that were not statistically diff erent; the volume of intraoperative blood loss and hemoglobin level in patients of these groups also did not have statistically signifi cant diff erence. At the same time, in patients of group 1 at II-V stages, jugular oximetry indexes were statistically signifi cantly higher than in patients of group 2. Conclusion. Th e use of desfl urane as general anesthesia during such surgical intervention as clipping of ruptured intracranial aneurysms, compared with sevofl urane, is accompanied by higher jugular oximetry indexes, which corresponds to greater decrease in brain neurons metabolic activity. A more pronounced decrease in brain neurons metabolic activity has favorable protective eff ect and should be taken into account when choosing inhalant anesthetic
Keywords: general anesthesia, desfl urane, sevofl urane, clipping of intracranial aneurysms, subarachnoid hemorrhage, jugular oximetry
Troitskaya NI, Shapovalov KG, Golyatin YuA, Damdinov RI. Systemic microcirculation changes in diabetic foot syndrome. Siberian Medical Review.2020;(3):92-96.. DOI 10.20333/2500136-2020-3-92-96
The aim of the research is to study the state of systemic microcirculation in patients with diabetes mellitus depending on the development of diabetic foot syndrome. Material and methods. The state of systemic microcirculation was studied in 60 patients. Group I consists of 30 patients without diabetic foot, group II consists of 30 patients with diabetic foot. Comparison group includes 30 healthy people. Results. Microcirculation index (M) in patients of group II is lower than in the check group and in group I by 1.4 times (р<0,05; p1 <0,05). Th e average perfusion fl uctuation value (σ) relative to blood fl ow arithmetic mean M in the group of patients with diabetic foot is lower than in the comparison group by 1.6 times (p = 0.002). Th e level of maximumfl uctuation amplitude in endothelial range (Aэ) in patients of groups I and II is lower than in the check group by 1.4 times (p = 0.03; p1 = 0.03). Th e value of maximum fl uctuationamplitude in neurogenic range (Aн) incase of diabetic foot is 1.4 times lower than in the check group (p = 0.010). Maximum amplitude index in myogenic range (Aм) in patients of group II is lower than in the comparison group by 1.6 times (p = 0.002). The level of maximum fl uctuation amplitude of blood fl ow in the respiratory range (Ад) in group II is 1.6 times (p = 0.002)lower than in the check group. Maximum amplitude value in pulse range (Ac) in the group of patients with diabetic foot is 1.2 times (p = 0.002)lower than in the check one. Conclusion. Microcirculatory disorders at systemic level, manifested by the decrease in average perfusion, intensity of active and passive mechanisms of microvasculature regulation in diabetic foot syndrome, indicate more pronounced systemic changes at the level of microcirculatory vessels relative to patients with uncomplicated diabetes, which requires screening and identifi cation of increased risk of this complications group
Keywords: microcirculation, diabetes mellitus, diabetic foot, laser Doppler flowmetry, microcirculation index, blood fl ow oscillations
Kravchenko EN, Kuklina LV. Prenatal infections in the structure of early neonatal mortality. Siberian Medical Review.2020;(3):97-100.. DOI 10.20333/2500136-2020-3-97-100
Th e aim of the research is to study the proportion of prenatal infections in the structure of early neonatal mortality in Omsk region for the period of 2010-2018. Material and methods. Retrospective analysis of the dynamics and structure of early neonatal mortality reasons in Omsk region for the period of 2010-2018 was carried out. “Information on medical care for pregnant women, parturient women and puerperants” (Form No. 32) and protocols of the pathoanatomical study of newborns who died in the early neonatal period were used for the analysis. Results. From 2010 to 2018, 597 cases of early neonatal mortality in total were recorded in Omsk Region, 171 of which were full-term, 211 were premature in pregnancy and 28-37 weeks prematurely, 215 were premature with VLBW. Th e main reasons for early neonatal mortality of mature fetuses in Omsk region are: congenital malformations (18.1 %) and intrauterine asphyxia (15.7 %); in premature fetuses the leading reasons are: respiratory disorders in the newborn (fetal distress) – 24.6 % in the group of preterm births at 28-37 weeks and 43.7 % at very early preterm delivery. Conclusion. Prenatal infections are the main cause of RNS in full-term fetuses, accounting for 24.3 % of the total number of deaths in the early neonatal period (congenital pneumonia P23 – 10 %, infectious diseases specifi c for the perinatal period P35-P39 – 14.3 %). Infectious pathology is oft en combined with such diagnoses as intrauterine hypoxia, asphyxia in childbirth, cerebral ischemia, congenital malformations of the fetus, intracranial non-traumatic hemorrhages in the fetus and newborn, which are among the main diagnosis. According to the pathological fi ndings in full-term infants, infectious diseases specific for the perinatal period (P35-P39) were associated in 21.4 % of cases, in children with ENMT – in 24.2 %, in premature babies of 28-37 weeks – 23.1 %.
Keywords: prenatal infections, early neonatal mortality
Сlinical case: non-diff erentiated cardiomyopathy (non-compact left ventricular myocardium) in a child
Skudarnov EV, Lobanov YuF, Grigorevskaya OA, Bayunova DM, Strozenko LA, Miller VE, Ponomarev VS. Сlinical case: non-diff erentiated cardiomyopathy (non-compact left ventricular myocardium) in a child. Siberian Medical Review.2020;(3):101-105.. DOI 10.20333/2500136-2020-3-101-105
The article is devoted to such urgent problem of cardiology as diagnosis of undiff erentiated cardiomyopathies. Clinical symptoms and diagnostic methods for myocardial diseases are described on the basis of which a pediatrician may suspect cardiomyopathy. A case of undiff erentiated cardiomyopathy (non-compact left ventricular myocardium) in a 16-year-old child is presented. It was noted that diagnostic diffi culties in the onset of the disease were associated with non-specifi city of clinical symptoms in children. Diagnosis of cardiomyopathies should be based on the following: history, clinical finding, data of echocardiography and myocardium MRI, 24-hour ECG monitoring and bicycle ergometry and their comparison with cases of undiff erentiated cardiomyopathy in children previously described in literature
Keywords: children, diagnosis, non-compact myocardium, cardiomyopathy
Clinical case: non-compact left and right ventricular myocardium combined with pulmonary arteriovenous bypass
Barakin AO, Tolstikova TV, Bregel LV, KnyazevaNA. Clinical case: non-compact left and right ventricular myocardium combined with pulmonary arteriovenous bypass. Siberian Medical Review. 2020;(3):106-110. DOI 10.20333/2500136-2020-3-106-110
Th e article describes a rare clinical case of supervising a month-old child with such rare disease as non-compact left and right ventricular myocardium complicated by arteriovenous bypass in the lungs with high pulmonary hypertension and pneumonia. Echocardiographic picture is presented, the possibilities of advanced ultrasound diagnostic techniques for the detection of arteriovenous shunts are evaluated.
Keywords: ultrasound diagnostics, cardiomyopathy, non-compact myocardium, echocardiography, arteriovenous shunts, children
Component analysis of mortality dynamics in Krasnoyarsk Territory
Narkevich AN, Mironova AA. Component analysis of mortality dynamics in Krasnoyarsk Territory. Siberian Medical Review.2020;(3):111-116.. DOI 10.20333/2500136-2020-3-111-116
Narkevich Artem N. Cand. Med. Sci.; Professor V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University; firstname.lastname@example.org
Th e aim of the research is to analyze the infl uence of mortality rate changes in Krasnoyarsk Territory to the dynamics of life expectancy indicator for the period from 2012 to 2016. Material and methods. Th e data of Krasnoyarsk Territory statistical yearbooks issued by Offi ce of Federal State Statistics Service for Krasnoyarsk Territory, Republic of Khakassia and Republic of Tuva, as well as primary mortality databases for urban districts and municipal districts of Krasnoyarsk Territory for the period from 2012 to 2016, were used. Th e dynamics of life expectancy indicator, total mortality, mortality and average age of the dead according to the main death cause groups is analyzed. Analysis of mortality dynamics influence in certain age groups and infl uence of mortality changes from various causes on the dynamics of life expectancy was calculated using E. M. Andreeva method. Results. Mortality of Krasnoyarsk Territory population for the period from 2012 to 2016 decreased by 3.9 %, the average age of the dead increased by 2.2 %, and life expectancy increased by 2.3 %. During the analyzed period, the greatest increase was determined in mortality due to blood diseases, blood-forming organs, and certain disorders involving immune mechanism, diseases of nervous system, and diseases of skin and subcutaneous tissue. Mortality index from mental and behavioral disorders, certain conditions that occur in perinatal period and old age and inaccurately identifi ed and unknown causes of death decreased to a greater extent. The largest negative contribution to life expectancy dynamics of Krasnoyarsk Territory population is associated with mortality change due to neoplasms in the age group of 75-79 years, some infectious and parasitic diseases in the age group of 35-39 years, diseases of digestive system in the age group of 40-44 years and neoplasms in the age groups of 80-84 and 85-89 years. Conclusion. Th e analysis made it possible to identify the components of mortality change that contribute more to the increase in life expectancy of Krasnoyarsk Territory population, as well as components that reduce its growth rate.
Keywords: life expectancy, mortality, death causes, component analysis, age groups, neoplasms, circulatory system diseases