Сибирское медицинское обозрение. 2022. № 1 View full textКоличество просмотров : 7724
Суванов БС, Шалин ВВ, Вирясова АА, Теричев АЕ, Вирясов ДВ.
Takayasu’s arteritis: a relevant problem in modern rheumatology (a literature review)
Suvanov BS, Shalin VV, Viryasova AA, Terichev AE, Viryasov DV, Babushkin IO, Ufaeva TV, Tyurina OA. Takayasu’s arteritis: a relevant problem in modern rheumatology (a literature review). Siberian Medical Review. 2022;(1):5-14. DOI 10.20333/25000136-2022-1-5-14
Takayasu’s arteritis is a rare chronic large-vessel vasculitis that predominantly aff ects the aorta, its major branches and pulmonary arteries. The exact occurrence rate of this pathology is unknown. However, it has been found that the disease is registered in 2.6 people per 1 million of the population in Russia, more often in young females. As with all rheumatic diseases, the issues of pathogenesis and therapy of non-specifi c aortoarteritis remain open. The complexity of pathogenetic reactions appears to be a problem for early diagnosis and selection of the correct therapy. This review covers the issues of pathogenesis and modern pharmacotherapy: tumor necrosis factors, pharmacotherapy and genetically engineered drugs. Th e review was written based on analysis of scientific literature. The eLIBRARY.RU, Cyberleninka, Pub Med, Cochrane Library databases were searched for materials published within the period of 2002-2021 with an emphasis on the past 5-10 years for the following keywords: Takayasu arteries, nonspecifi c aortroartery, systemic vasculitis, rheumatological diseases.
Keywords: Takayasu’s arteritis, vasculitis, infl ammation, systemic disease, blood vessels, aorta
Глухов А. А., Лаптиёва А. Ю., Андреев, А. А. Остроушко А. П
The effect of growth factor expression on liver regeneration
Glukhov AA, Laptiyova AYu, Andreev AA, Ostroushko AP. The effect of growth factor expression on liver regeneration. Siberian Medical Review. 2022;(1):15-22. DOI 10.20333/25000136-2022-1-15-22
Abstract. For today, liver pathology affects about 500 million people in the world, of which one million die annually, mainly due to primary and secondary malignant tumors. About 60 % of patients are shown to perform hepatic resection. The rate of recovery of anatomical and functional activity of the liver, the survival rate of patients are directly related to the regenerative potential of this organ. The aim of the research. To systematize data on the eff ect of growth factor expression on the activation of the reparative potential of the liver aft er resection. Material and methods. A review of the data in PubMed, Cochrane Library, ScienceDirect, eLibrary was carried out using the keywords “growth factors”, “liver regeneration”, “reparative potential”, “growth factors”, “liver regeneration”, “interleukins” and is limited to the period 2010-2021. In addition, a manual search for articles in journals was carried out. Exclusion criteria from the analysis: description of individual clinical cases; books and documents; comparison of treatment results. The final analysis included 45 sources out of 102 initially identified. Results. Th e process of liver regeneration is a complexly regulated system. After damage to the hepatic parenchyma, active substances are released in cells, the greatest value of which during liver regeneration is assigned to the expression of a number of interleukins (IL-1b, IL-6, IL-10), as well as growth factors (HGF, TGF-β, TNF). As a result of their infl uence, compensatory and adaptive mechanisms are activated, the proliferative activity of hepatocytes is increased, and the structural and functional integrity of the liver is gradually restored. Conclusion. To date, pronounced positive eff ects of growth factors and cytokines have been proven, however, due to the low bioavailability and the need for complex biotransformation in the body, the possibility of their use in medical practice continues to be difficult
Keywords: liver, regeneration, hepatocytes, reparative potential, growth factors, interleukins.
Макарова М. В., Вальков М. Ю., Гржибовский А. М
Features in registration of knee osteoarthritis across primary care institutions in Arkhangelsk
Makarova MV, Valkov MYu, Grjibovski AM. Features in registration of knee osteoarthritis across primary care institutions in Arkhangelsk. Siberian Medical Review. 2022;(1):23-31. DOI 10.20333/25000136-2022-1-23-31
Th e aim of the research. To carry out a comparative analysis of registration of primary and overall incidence of gonarthritis (GA) and the factors aff ecting these indices in clinics of Arkhangelsk. Material and methods. Th e population of Arkhangelsk is attached to fi ve main polyclinics: No. 1, 2, 4 (AGKP1, AGKP2, AGKP4), the fi rst city clinical hospital named aft er E. E. Volosevich (PGKB1) and the Primorsky Central district hospital (PPRCRB) together serving 74.7 % of the population. We formed a continuous sample based on the medical service utilisation rate in the attached population for gonarthritis patients within the period from 2016 to 2019. The analysed parameters were: gender, age, acute or chronic form of the disease, diagnosis according to ICD-10 and the specialist visited by the patient. The features in registration of GA at the level of primary healthcare institutions and their effect on primary and overall incidence were analysed. Results. In four years, a total of 3,282 of primary GA patients were registered in the fi ve clinics, the mean age was 55.9 years, female patients accounted to 1,952 (59 %), male patients – to 1,329 (41 %). Th e average annual levels of primary GA incidence per 1000 population ranged from 0.98 to 1.38, with the maximum of 3.05 registered in PGCB1. Th e overall incidence of GA per 1000 population in polyclinics 1, 2 and 4 was 26.2-27.4, with the values of 15.6 and 4.5 for PGKB 1 and PPRCRB, respectively. Patients over 60 years of age predominated in PGKB1 (48 %), amounting to 41 % in AGKP1, 27 % in AGKP2, 33 % in AGKP4, 32 % in PPRCRB. Maximal prevalence was 105 cases per 1000 population (1 % of the attached population) by 45 years in AGCP1, in other polyclinics the indicator was lower. More oft en, GA was diagnosed by general practitioners – 2296 (71 %), traumatologists and surgeons – 647 (20 %), rheumatologists – 302 (9 %). Th e most common diagnoses were M17.9-966 (30 %), M17.0 10 939 (29 %), less oft en: M17.2 – 66 (2 %) and M17.4 – 75 (2 %). Conclusion. Th ere is no unifi ed system of primary and general morbidity registration at the level of primary healthcare institutions within the same region. To objectify GA registration, it is necessary to introduce a single registry of patients.
Keywords: gonarthritis, knee joint, incidence, prevalence, Arkhangelsk, polyclinic
Жилина А. А., Ларева Н. В., Лузина Е. В., Цвингер С. М., Морозова Е. И
Prevalence of interleukin 1 beta gene polymorphism inpatients with gastroesophageal reflux disease living in the Transbaikal region
Zhilina AA, Lareva NV, Luzina EV, Tsvinger SM, Morozova EI. Prevalence of interleukin 1 beta gene polymorphism inpatients with gastroesophageal reflux disease living in the Transbaikal region. Siberian Medical Review. 2022;(1):32-36. DOI 10.20333/25000136-2022-1-32-36
Th e aim of the research. To study the frequency of genetic polymorphism of genes IL-1β 31T/C and IL-1β 511T/C in patients with gastroesophageal refl ux disease (GERD) living in the Trans-Baikal Territory. Material and methods. A total of 139 people residing in the Trans-Baikal Territory for at least three generations were surveyed. Group 1 included 79 patients with GERD (30 male, 49 female), Group 2 (control) included 60 subjects (28 male and 32 female) without clinical and instrumental signs of the disease. The median age was 43 [33; 57] and 44 [37; 54] years, respectively, p = 0.754. Th e groups were matched by the gender, p = 0.16. Th e diagnosis of GERD was established using the GerdQ questionnaire and/or the presence of refl ux esophagitis in endoscopic examination and the presence of pathological reflux in impedance pH measurements. Genotyping of interleukin 1 beta (IL-1β) polymorphic genes at positions 31T/C and 511 T/C was performed via the method of polymerase chain reaction. Results. Th e IL-1β 31C/C genotype was more common in the control group than in GERD patients (OR = 0.302 CI 95 % 0.088-1.034), p = 0.046. Th e study of the IL-1β 511T/C genotype did not show statistically signifi cant diff erences in the studied groups. Heartburn one or more times a week was more often observed in patients with the IL-1β 511T/T genotype (OR = 11.143 CI 95 % 1.357-91.523), p = 0.0076. Conclusion. Among the population of the Trans-Baikal Territory, the prevalence of the IL-1β 31C/C genotype is higher in persons without clinical and instrumental signs of gastroesophageal refl ux disease. The genotypes IL-1β 31T/T and IL-1β 511T/T are more common in GERD patients with the symptomatic course of the disease.
Keywords: гастроэзофагеальная рефлюксная болезнь, полиморфизм генов интерлейкина 1 бета, генотип, рн-импедансометрия, кислый рефлюкс, щелочной рефлюкс
Морозова Н. И., Мулерова Т. А., Цыганкова Д. П., Индукаева Е. В., Баздырев Е. Д., Нахратова О. В., Огарков М. Ю
Factors predisposing to carotid atherosclerosis progression in patients with arterial hypertension
Morozova NI, Mulerova ТА, Tsygankova DP, Indukaeva EV, Bazdyrev ED, Nahratova OV, Ogarkov MYu. Factors predisposing to carotid atherosclerosis progression in patients with arterial hypertension. Siberian Medical Review. 2022;(1):37-44. DOI 10.20333/25000136-2022-1-37-44
Th e aim of the research. To study clinical and genetic factors predisposing to progression of carotid artery atherosclerosis among the Shor people based on a 5-year dynamic follow-up of hypertensive patients. Material and methods. A prospective clinical and epidemiological study of the indigenous population of the Mountain Shoria was carried out including patients with arterial hypertension (367 subjects). Th e dynamics of the intima-media complex thickness and atherosclerotic plaque thickness was assessed 5 years later by repeat ultrasound examination of carotid arteries. Polymorphisms of ACE (I/D, rs 4340), AGT (c.803T>C, rs699), AGTR1 (A1166C, rs5186), ADRB1 (c.145A>G, Ser49Gly, rs1801252), ADRA2B (I/D, rs28365031), MTHFR (C677T, rs1801133) and eNOS (VNTR 4b/4a) genes were tested using polymerase chain reaction. Results. The 5-year observation of the indigenous population of the Mountain Shoria has shown that such factors as the age (p=0.011) and the course of arterial hypertension (3rd-degree AH, duration of the disease for over 10 years, failure to achieve the target level of arterial pressure during treatment) play a significant role in the frequent unfavourable dynamics of the intima-media complex thickness. Th e study has also established association between the development of the atherosclerotic process in carotid arteries and smoking (OR=1.52), abdominal obesity (OR=2.87) and impaired glucose tolerance (OR=2.94). The increased level of low-density lipoprotein cholesterol also determines the negative dynamics as manifested by the growth of the atherosclerotic plaque in brachiocephalic arteries (OR=1.93). A high risk of atherosclerosis in the Shor cohort is associated with carriership of the prognostically unfavourable D alleles of the ACE gene (OR=8.29), C of the AGTR1 gene (OR=7.04) and T of the MTHFR gene (OR=3.25). Conclusion. Th e 5-year prospective observation of the small indigenous population of the Shors has revealed certain clinical and genetic factors for patients with arterial hypertension that are associated with the carotid artery atherosclerosis. The polymorphism of certain candidate genes is an important strategic biomarker that can be used in the future for early diagnostics of diseases associated with atherosclerosis.
Keywords: ethnos, prospective observation, thickness of the intima-media complex, atherosclerotic plaque, polymorphism of candidate genes.
Кандрашкина Ю. А., Орлова Е. А., Левашова О. А., Виноградова О. П., Костина Е. М.
A study on the role of filaggrin in pathogenesis of atopic dermatitis during pregnancy
Kandrashkina YA, Orlova EA, Levashova OA, Vinogradova OP, Kostina EM. A study on the role of filaggrin in pathogenesis of atopic dermatitis during pregnancy. Siberian Medical Review. 2022;(1):45-50.. DOI 10.20333/25000136-2022-1-45-50
The aim of the research. To study the role of fi laggrin protein in pathogenesis of atopic dermatitis (AD) exacerbation during gestation and to evaluate the effectiveness of the “emollient + topical antipruritic agent” combination therapy. Material and methods. A total of 110 female patients were examined. Among them, 70 were pregnant women with exacerbation of AD, 20 were non-pregnant women with AD exacerbation and 20 were healthy pregnant women. The AD severity was assessed using a point scale – the SCORAD index. Pruritus characterisation was performed using the 5-D Itch Scale by Elman. Th e serum filaggrin protein level was measured by ELISA. The efficacy of the combination therapy was assessed aft er treatment and included evaluation of AD severity, pruritus, and filaggrin protein levels. Statistical processing of the results was carried out using the Statistica 6.0 application soft ware package. Results. As the result of the study, it was found that the serum fi laggrin level was higher in pregnant women with exacerbated AD than in the group of non-pregnant women with exacerbated AD (Mann-Whitney test, p = 0.007) and healthy pregnant women (Mann-Whitney test, p = 0.001). Filaggrin levels decreased after combination therapy. Pruritus evaluation revealed no signifi cant difference between the groups with exacerbated AD (Mann-Whitney test, p = 0.221). After treatment, a significant decrease (Mann-Whitney test, p = 0,001) in itching was noted in the group of pregnant women with AD exacerbation. The mean value of the SCORAD index before and aft er treatment in the group of pregnant women with AD decreased signifi cantly (Mann-Whitney test, p = 0.001). Conclusion. According to the data obtained, the level of fi laggrin in pregnant women with exacerbation of AD is signifi cantly higher than in the control groups. Against the background of combination therapy, there is positive dynamics of the clinical course of AD, as well as a decrease in the level of fi laggrin in the blood serum. Further research in this area is required.
Keywords: filaggrin, atopic dermatitis, pregnancy, treatment, emollients, topical antipruritic agents.
Панова М. С., Панченко А. С., Мудров В. А., Зиганшин А. М
Possibilities in early diagnostics of hypoxic brain damage in full-term newborns
Panova MS, Panchenko AS, Mudrov VA, Ziganshin AM. Possibilities in early diagnostics of hypoxic brain damage in full-term newborns. Siberian Medical Review. 2022;(1):51-58.. DOI 10.20333/25000136-2022-1-51-58
Panova MS, Panchenko AS, Mudrov VA, Ziganshin AM. Possibilities in early diagnostics of hypoxic brain damage in full-term newborns. Siberian Medical Review. 2022;(1):51-58.
Keywords: technology, early diagnosis, hypoxic damage, brain, full-term newborn.
Вокулова Ю. А., Жулев Е. Н
A method for evaluation of dental implant placement accuracy using digital technologies
Vokulova YuA, Zhulev EN. A method for evaluation of dental implant placement accuracy using digital technologies. Siberian Medical Review. 2022;(1):59-65. DOI 10.20333/25000136-2022-1-59-65
Th e aim of the research. To develop a method for evaluation of dental implant placement accuracy using surgical navigation templates created with application of digital technologies. Material and methods. Th e clinical study enrolled 11 patients (5 male and 6 female) with partial tooth loss. Prosthetic treatment of the patients was performed using 15 implants manufactured by the additive method and installed using navigational surgical templates. In a computer program that we developed (certificate of state registration of computer program No. 2021665044, 17.09.2021), images of the planned position of the implants were superimposed over images of the actually installed implants with subsequent measurement of linear deviations in the area of the apical and the coronal portions of the implants as well as angular deviations between the long axes of the implants. Results. Th e mean angular deviation in the sagittal plane between the planned position of the implants and the ones installed in the oral cavity was 4.453 ± 2.554°. Mean linear deviation was 1.713 ± 0.7506 mm in the apical portion of the implant and 1.499 ± 0.9248 mm in the coronal portion. Conclusion. During this study, deviations were found in the position of implants after surgery, which indicates the existence of certain errors in the method of using navigational surgical templates. Th e computer program we have proposed makes it possible to evaluate the accuracy of dental implant placement by measuring linear and angular deviations between their planned and actual position after surgery.
Keywords: digital dentistry, orthopedic dentistry, surgical dentistry, dental implants, navigational templates, 3D printer, intraoral scanner
Голенецкая Е. С., Толстикова Т. В., Брегель Л. В., Белькова Т. Ю.
On clinical manifestations of the new coronavirus infection in newborns
Golenetskaya ES, Tolstikova TV, Bregel LV, Belkova TY. On clinical manifestations of the new coronavirus infection in newborns. Siberian Medical Review. 2022;(1):66-71. DOI 10.20333/25000136-2022-1-66-71
The aim of the research. To study the specifics in manifestations of the new coronavirus infection in newborns. Material and methods. A retrospective analysis of observations of 28 newborns diagnosed with the new coronavirus infection SARS-CoV-2 dated from June to December 2020 was performed. Th e infants were transferred from the perinatal centre for hospitalisation to the infectious department of a children’s hospital. The patients were born to mothers with COVID-19 as well as mothers discharged from hospital and hospitalised later due to COVID-19 acquired through family contact. Clinical and laboratory data of 12 female and 16 male children aged 1 to 28 days were studied. Results. Clinical symptoms of the new coronavirus infection in newborns tend to be different: from asymptomatic course in 46.5 % of the patients to evident pneumonia in 50 % of the children. The newborns admitted with COVID-19 acquired through family contact had more severe disease manifestations. Conclusion. Amidst the pandemic rise of its incidence, the new coronavirus infection COVID-19 is not rare among newborns. COVID-19 newborns did not have a registered severe nosocomial infection, sepsis, multisystem inflammatory syndrome.
Keywords: SARS-CoV2 virus, newborns, perinatal center, COVID-19 family contact, new coronavirus infection COVID-19 clinical manifestation, pneumonia.
Малярчиков А. В., Шаповалов К. Г
The role of matrix metalloproteinase-2 and interleukin-2 receptor alpha subunit in development of critical condition in pneumonia patients with influenza (H1N1)
Malyarchikov AV, Shapovalov KG. Th e role of matrix metalloproteinase-2 and interleukin-2 receptor alpha subunit in development of critical condition in pneumonia patients with influenza (H1N1). Siberian Medical Review. 2022;(1):72-76. DOI 10.20333/25000136-2022-1-72-76
Th e aim of the research. To assess the role of matrix metalloproteinase-2 (MMP-2) and the alpha subunit of the interleukin-2 receptor (IL-2 Ra) in development of critical illness in pneumonia patients with underlying influenza A (H1N1). Material and methods. A total of 85 patients with pneumonia associated with infl uenza A (H1N1) were examined. Among them, 30 patients suff ered from severe pneumonia while 55 had non-severe pneumonia. Th e mean age of the patients amounted to 52 [38; 67]. Th e group was constituted by 48 % male and 52 % female patients. Th e diagnosis of infl uenza A / H1N1 was confi rmed by positive PCR test results. Th e CURB / CRB-65 scales were used to diagnose and assess the severity of pneumonia; this was also performed using SMART-COP, the Federal Clinical Guidelines of the Ministry of Health of the Russian Federation “Community-acquired pneumonia in adults”, 2019 and the IDSA / ATS criteria (pneumonia was considered severe in presence of one major or three minor criteria). Plasma concentration of MMP-2 and IL-2 Ra molecules (sCD25) was measured through flow cytometry with the Beckman Coulter analyser (USA) using LEGENDplex™ HU Immune Checkpoint Panel 1 and Human Vascular Inflammation Panel 1 Beckman Coulter (USA) multiplex assay kits. Results. It was established that patients with severe pneumonia and underlying infl uenza A (H1N1) had plasma concentration of MMP-2 and sCD25 increased 2-fold and 2.5-fold, respectively. Conclusion. Statistically signifi cant increase in the concentration of MMP-2 and IL-2 Ra in pneumonia patients with underlying influenza A (H1N1) indicates the occurrence of proinflammatory conditions for the development of a critical state, as well as the involvement of negative regulation components of the T-cell response into the cascade of adaptive immune responses, which is associated with severity of the condition.
Keywords: influenza A (H1N1), MMP-2, IL-2 Ra, systemic inflammation, multiple organ failure, pneumonia.
Куклина Г. М., Шмелев Е. И.
Broncho-obstructive syndrome in patients with sarcoidosis of the intrathoracic lymph nodes and lungs
Kuklina GM, Shmelev EI. Broncho-obstructive syndrome in patients with sarcoidosis of the intrathoracic lymph nodes and lungs. Siberian Medical Review. 2022;(1):77-82. DOI 10.20333/25000136-2022-1-77-82
The aim of the research. To study the features of the broncho-obstructive syndrome in patients with various forms of sarcoidosis of the intrathoracic lymph nodes and lungs, to assess the severity of clinical symptoms in patients depending on the form of the course of sarcoidosis combined with bronchial obstruction. Material and methods. A total of 1198 patients diagnosed with sarcoidosis were examined. All patients underwent physical examination, respiratory function assessment with a bronchodilation test, body plethysmography with evaluation of the diff usion capacity of the lungs, microbiological examination to exclude pulmonary tuberculosis with newly diagnosed sarcoidosis and X-ray examinations. Th e patients also underwent bronchological examination with a transbronchial biopsy of the lung to verify the diagnosis. Results. Upon comparison of various sarcoidosis course forms, it can be noted that bronchial obstruction occurs in all forms of the course of the disease with almost the same frequency, the percentage fl uctuations ranging from 20.3 % in recurrent sarcoidosis to 24.1 % in chronic sarcoidosis. Comorbidity in patients with sarcoidosis combined with bronchial obstruction occurs from 12.9 % in recurrent sarcoidosis to 24.3 % in newly diagnosed sarcoidosis. Conclusion. The data obtained on the prevalence of bronchial obstruction in patients with various forms of sarcoidosis suggest a positive effect of bronchodilatory therapy for this category of patients.
Keywords: broncho-obstructive syndrome, sarcoidosis of the intrathoracic lymph nodes and lungs, spirometry, respiratory symptoms.
Мамедов Т. Х., Дзюба Д. В., Наркевич А. Н.
Application of convolutional neural networks for recognition of diabetic retinopathy in digital images
Mamedov TH, Dzjuba DV, Narkevich AN. Application of convolutional neural networks for recognition of diabetic retinopathy in digital images. Siberian Medical Review. 2022;(1):83-87. DOI 10.20333/25000136-2022-1-83-87
The aim of the research. Training of a convolutional neural network for recognition of diabetic retinopathy in digital images of the ocular fundus. Material and methods. A set of digital images from the Kaggle open-access digital repository was used. Th e set included 12,498 scans of the ocular fundus: 4,584 scans included signs of diabetic retinopathy while 7,914 images did not have such signs. Th e images with signs of diabetic retinopathy were additionally subdivided according to the disease stages. Building of mathematical models for the convolutional neural network was performed in the PyCharm programming environment using the Python programming language. Results. Th e maximum accuracy achieved during training of the mathematical model of the convolutional neural network for classifi cation into 5 classes (absence of diabetic retinopathy signs and 4 stages in presence of such signs) was only 57.4 % [56.9; 57.9]. Training of the mathematical model of the convolutional neural network for binary classifi cation (presence of retinopathy at any stage or its absence) lead to 80.7 % accuracy [79.9; 81.2] in recognition of diabetic retinopathy on digital images of the eye retina. Conclusion. A trained convolutional neural network model for binary classifi cation provides for a sufficient degree of accuracy in classifi cation and recognition of presence of diabetic retinopathy in digital images of the eye retina. Therefore, this model may be applied for screening of diabetic retinopathy if integrated with medical information systems or relevant medical equipment.
Keywords: convolutional neural network, diabetic retinopathy, fundus, complication, machine learning, diagnostics.
Таранушенко Т. Е., Проскурина М. В., Киселева Н. Г
Peculiarities of diabetes mellitus manifestation in children (according to the local register of closed administrative-territorial entities in the Krasnoyarsk Territory)
Taranushenko TE, Proskurina MV, Kiseleva NG. Peculiarities of diabetes mellitus manifestation in children (according to the local register of closed administrative-territorial entities in the Krasnoyarsk Territory). Siberian Medical Review. 2022;(1):88-94. DOI 10.20333/25000136-2022-1-88-94
Th e aim of the research. To identify the features of the onset of type-1 diabetes in children and adolescents residing in the territory of a closed city through studying the following manifestations: medical history characteristics, the gender composition and age of patients, the season of the appearance of the initial symptoms as well as clinical manifestations and indicators of carbohydrate metabolism during the initial visit to an endocrinologist. Material and methods. While carrying out the work, the data of the regional registry of diabetes mellitus for the past ten years were studied as well as the information from outpatient records of children and adolescents with type-1 diabetes living in a closed territorial administrative unit in the Krasnoyarsk Territory. Anamnestic and clinical laboratory data were analysed, a comparative analysis with similar data of children in the Krasnoyarsk Territory and Russia was carried out. Results. The study revealed approximately the same quantity of sick children of both genders. The onset of the disease was more oft en noted in the spring-autumn period, the trigger mechanism was viral infection in the overwhelming number of cases. At the moment of manifestation, the bulk of the children had harmonious physical development, the indicators of carbohydrate metabolism indicated signifi cant decompensation. Conclusion. Th e article presents features of the course of the type-1 diabetes manifestation period in the studied cohort in relation to the age groups of children and the disease onset seasonality. For a broader understanding of the features of the type-1 diabetes onset in children and adolescents living in a closed city, it is necessary to continue research using data on the child population living in similar conditions.
Keywords: diabetes mellitus type 1, manifestation, children, adolescents, closed administrative-territorial unit, seasonality, age and gender peculiarities, course phases.
Решетников В. А., Бадимова А. В., Османов Э. М., Козлов В. В., Величко П. Б., Ефимов Д. В
Ways to improve the system of organization of dyamic follow-up care for ophthalmic patients
Reshetnikov VA, Badimova AV, Osmanov EM, Kozlov VV, Velichko PB, Efi mov DV. Ways to improve the system of organization of dyamic follow-up care for ophthalmic patients. Siberian Medical Review. 2022;(1):95-101. DOI 10.20333/25000136-2022-1-95-101
The aim of the research. To identify the most signifi cant problems in organisation of dynamic follow-up care (DFC) for patients with pathology of the eye and ts adnexa and to fi nd the ways for its improvement by determining a concerted view of experts on these issues. Material and methods. An expert survey of ophthalmologists was conducted at six ophthalmology hospitals in the Russian Federation. Kendall’s coefficient of concordance was used to measure the degree of agreement among experts. The survey results are presented as mean ranks of expert assessments. The Friedman test was used to assess the statistical significance of differences for individual issues. Th e study was carried out at the Sechenov University within the framework of the complex research topic No. 01201168237. Results. Only 1 (2.1%) expert expressed a positive assessment of the modern system of DFC for patients with eye disorders. Th e delay in referral of ophthalmic patients to surgical treatment is the most signifi cant problem in DFC organisation (Kendall coeff . = 0.896; р<0.001). According to the expert opinion, the main problems in assessment of the quality of medical checkups in ophthalmology are the low follow-up coverage of patients and the low frequency of adherence to the stages of medical checkups (Kendall coeff . = 0.851; р < 0.001). Conclusion. Among the priority measures aimed at increasing the eff ectiveness of follow-up care for patients with eye disorders, the experts mentioned solving the problem of staffi ng, development of special regulations for follow-up care for patients with diseases of the eye and the ocular adnexa. A set of indicators for monitoring the eff ectiveness of follow-up care for patients with eye disorders has been proposed.
Keywords: follow-up care, ophthalmology, expert assessment, monitoring, evaluation criteria
Москалева П. В., Шнайдер Н. А., Петрова М. М., Насырова Р. Ф.
Сonvulsive syndrome. Part 2
Moskaleva PV, Shnayder NA, Petrova MM, Nasyrova RF. Сonvulsive syndrome. Part 2. Siberian Medical Review. 2022;(1):102-113.. DOI 10.20333/25000136-2022-1-102-113
Th e convulsive syndrome is an urgent and potentially life-threatening condition in neurological, pediatric and general medical practice. Over the past decade, there has been a reconsideration of the definition of epilepsy and epileptic syndromes, including the convulsive syndrome. Additionally, the arsenal of pharmaceuticals for the relief of seizures in children and adults has expanded. In this connection, this lecture was created in two parts: this second part will consider treatment of convulsive syndrome at the pre-hospital and the hospital stages. The lecture is intended for neurologists, pediatricians, general practitioners, emergency doctors, anesthesiologists. In the system of continuing medical education, convulsive syndrome is considered within the framework of the postgraduate training program for doctors of these specialties.
Keywords: convulsive syndrome, status epilepticus, treatment, emergency care, drugs, routes of administration