Pub Date : 2020-12-13DOI: 10.31082/1728-452x-2020-215-216-5-6-7-14
Zhansaya Nessipbayeva, M. Bulegenova, M. Karazhanova, Dina Nurpisova
Leukemia is a hematopoetic tissue tumor with a primary lesion of the bone marrow, where the morphological substrate is the blast cell. Chromosomal and molecular genetic aberrations play a major role in the acute leukemia pathogenesis, determing the morphological, immunological and clinical features of the disease. Our study was aimed to to analyze retrospectively the structure and frequency of chromosomal aberrations in children with initially diagnosed acute leukemia. Material and methods. Medical histories retrospective analysis of children charged to oncohematology department of the «Scientific Center of Pediatrics and Pediatric Surgery» in Almaty for the period 2015 - 2017 was carried out. 310 histories with primary diagnosed acute leukemia were studied. Results and discussion. Among 310 patients different chromosome aberrations were isolated in 158 patients (51%) during cytogenetic and molecular cytogenetic (in situ hybridization) studies of bone marrow blast cells. A normal karyotype was observed in 102 patients (33%). Conclusion. The lymphoblastic variant of acute leukemia was determined in 75.5%, that indicates its leading role in AL structure among the children of different ages. AML was determined in 22.6% of all OL cases. The most frequent chromosomal rearrangement in ALL patients was blast cell chromosome hyperdiploidy (10,6%) and t(12;21)(p13;q22)/ETV6-RUNX1,which was detected in 37 (16%) patients. The most frequent AML abberation was t (8;21) (q22;q22)/RUNX1-RUNX1T1, identified in 15 (21.4%) patients. Keywords: acute leukemia, bone marrow, blast cells, karyotype, chromosomal aberrations, cytogenetic study.
{"title":"Comparative analysis of chromosomal aberrations in children with acute leukemia","authors":"Zhansaya Nessipbayeva, M. Bulegenova, M. Karazhanova, Dina Nurpisova","doi":"10.31082/1728-452x-2020-215-216-5-6-7-14","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-215-216-5-6-7-14","url":null,"abstract":"Leukemia is a hematopoetic tissue tumor with a primary lesion of the bone marrow, where the morphological substrate is the blast cell. Chromosomal and molecular genetic aberrations play a major role in the acute leukemia pathogenesis, determing the morphological, immunological and clinical features of the disease. Our study was aimed to to analyze retrospectively the structure and frequency of chromosomal aberrations in children with initially diagnosed acute leukemia. Material and methods. Medical histories retrospective analysis of children charged to oncohematology department of the «Scientific Center of Pediatrics and Pediatric Surgery» in Almaty for the period 2015 - 2017 was carried out. 310 histories with primary diagnosed acute leukemia were studied. Results and discussion. Among 310 patients different chromosome aberrations were isolated in 158 patients (51%) during cytogenetic and molecular cytogenetic (in situ hybridization) studies of bone marrow blast cells. A normal karyotype was observed in 102 patients (33%). Conclusion. The lymphoblastic variant of acute leukemia was determined in 75.5%, that indicates its leading role in AL structure among the children of different ages. AML was determined in 22.6% of all OL cases. The most frequent chromosomal rearrangement in ALL patients was blast cell chromosome hyperdiploidy (10,6%) and t(12;21)(p13;q22)/ETV6-RUNX1,which was detected in 37 (16%) patients. The most frequent AML abberation was t (8;21) (q22;q22)/RUNX1-RUNX1T1, identified in 15 (21.4%) patients. Keywords: acute leukemia, bone marrow, blast cells, karyotype, chromosomal aberrations, cytogenetic study.","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"102 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79045804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-13DOI: 10.31082/1728-452x-2020-215-216-5-6-32-37
S. Kulzhanova, G. Nurakhmetova, M. Konkayeva, Z. Smagulova
The list of etiotropic drugs recommended for the treatment of influenza and other acute respiratory viral infections is not very large and requires sufficient justification for rational tactics of their use. In accordance with the WHO strategy for combating influenza and SARS, it is necessary to continue research to study the clinical efficacy of antiviral drugs with a combined effect - etiotropic, pathogenetic and symptomatic. Enisamium iodide is one of such drugs for etiotropic and pathogenetic therapy of ARVI. Aim. To evaluate the clinical efficacy of the drug enisamium iodide (amizone) in the complex therapy of acute respiratory viral infections (ARVI). Material and methods. The randomized study included 40 patients who were treated during the epidemic season of influenza and ARVI 2019. Patients of the main group received enisamium iodide along with symptomatic therapy, the control group received only symptomatic therapy. The clinical efficacy of treatment was assessed by the duration of the main clinical symptoms of ARVI, the proportion of patients who developed complications requiring antibiotics. Statistical processing of the obtained data was carried out using the SPSS 12.0.2 software for Windows. Results and discussion. The results of a randomized study showed the clinical efficacy and safety of amizone (enisamium iodide) in the complex treatment of acute respiratory viral infections of various etiologies, compared with the use of only symptomatic therapy drugs. The duration of fever and the main clinical symptoms of acute respiratory viral infections were statistically significantly less in the study group than in the control group. Accordingly, the proportion of patients whose body temperature returned to normal on days 2–3 of treatment was statistically significantly higher in the group of patients taking enisamium iodide. Complications requiring antibiotic prescription have been reported only in control patients. Also, the drug was well tolerated and there were no side effects during its use. Conclusions. The results obtained confirmed that enisamium a iodide (amizon) has a good clinical effect in ARVI, reduces the likelihood of complications in patients. The high sensitivity of various respiratory viruses to the drug allows it to be used without etiological decoding of ARVI. Keywords: acute respiratory viral infections (ARVI), influenza, enisamium iodide (amizone), antiviral therapy, clinical efficacy, safety.
{"title":"Clinical effectiveness of the preparation Enisamium iodide in the complex treatment of ARVI","authors":"S. Kulzhanova, G. Nurakhmetova, M. Konkayeva, Z. Smagulova","doi":"10.31082/1728-452x-2020-215-216-5-6-32-37","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-215-216-5-6-32-37","url":null,"abstract":"The list of etiotropic drugs recommended for the treatment of influenza and other acute respiratory viral infections is not very large and requires sufficient justification for rational tactics of their use. In accordance with the WHO strategy for combating influenza and SARS, it is necessary to continue research to study the clinical efficacy of antiviral drugs with a combined effect - etiotropic, pathogenetic and symptomatic. Enisamium iodide is one of such drugs for etiotropic and pathogenetic therapy of ARVI. Aim. To evaluate the clinical efficacy of the drug enisamium iodide (amizone) in the complex therapy of acute respiratory viral infections (ARVI). Material and methods. The randomized study included 40 patients who were treated during the epidemic season of influenza and ARVI 2019. Patients of the main group received enisamium iodide along with symptomatic therapy, the control group received only symptomatic therapy. The clinical efficacy of treatment was assessed by the duration of the main clinical symptoms of ARVI, the proportion of patients who developed complications requiring antibiotics. Statistical processing of the obtained data was carried out using the SPSS 12.0.2 software for Windows. Results and discussion. The results of a randomized study showed the clinical efficacy and safety of amizone (enisamium iodide) in the complex treatment of acute respiratory viral infections of various etiologies, compared with the use of only symptomatic therapy drugs. The duration of fever and the main clinical symptoms of acute respiratory viral infections were statistically significantly less in the study group than in the control group. Accordingly, the proportion of patients whose body temperature returned to normal on days 2–3 of treatment was statistically significantly higher in the group of patients taking enisamium iodide. Complications requiring antibiotic prescription have been reported only in control patients. Also, the drug was well tolerated and there were no side effects during its use. Conclusions. The results obtained confirmed that enisamium a iodide (amizon) has a good clinical effect in ARVI, reduces the likelihood of complications in patients. The high sensitivity of various respiratory viruses to the drug allows it to be used without etiological decoding of ARVI. Keywords: acute respiratory viral infections (ARVI), influenza, enisamium iodide (amizone), antiviral therapy, clinical efficacy, safety.","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75711285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-13DOI: 10.31082/1728-452x-2020-215-216-5-6-2-6
Lyazat Orakbai, N. Dzhaynakbaev, Togzhan Salmenova, Alexandr Vdovcev, Azhar Adilkhanova, Zh M Meirmanova
Preserving and strengthening the health of orphaned children and children left without parental care is of great medical, social and public significance. The aim of the study. Assess the health status of adolescents without parental care. Material and methods. The object of the study was teenagers left without parental care (adolescents from 10 to 18 years old). The total sample size was 2,499 adolescents. Assessment of physical development was carried out on the hardware-software complex "Health-Express". This high-tech equipment, developed by the "Kazakh-Russian Medical University". Results and discussion. The authors have shown that at the present stage, there are negative trends in the number of children with disharmonious physical development due to lack of body length. For example, the frequency of identified disharmonious physical development in the age group 10-14 years was 71.8% and in the first childhood group 28.2%. The main reason for disharmonious physical development was a growth deficiency and moderate body weight deficiency. Conclusions. The main reason for the disharmonious physical development of adolescents left without parental care was a deficit in height and a moderate deficit in body weight. Keywords: physical development, teenagers, orphans, "Health-Express", body mass index, body length.
{"title":"Physical development of teenagers remaining without parental care","authors":"Lyazat Orakbai, N. Dzhaynakbaev, Togzhan Salmenova, Alexandr Vdovcev, Azhar Adilkhanova, Zh M Meirmanova","doi":"10.31082/1728-452x-2020-215-216-5-6-2-6","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-215-216-5-6-2-6","url":null,"abstract":"Preserving and strengthening the health of orphaned children and children left without parental care is of great medical, social and public significance. The aim of the study. Assess the health status of adolescents without parental care. Material and methods. The object of the study was teenagers left without parental care (adolescents from 10 to 18 years old). The total sample size was 2,499 adolescents. Assessment of physical development was carried out on the hardware-software complex \"Health-Express\". This high-tech equipment, developed by the \"Kazakh-Russian Medical University\". Results and discussion. The authors have shown that at the present stage, there are negative trends in the number of children with disharmonious physical development due to lack of body length. For example, the frequency of identified disharmonious physical development in the age group 10-14 years was 71.8% and in the first childhood group 28.2%. The main reason for disharmonious physical development was a growth deficiency and moderate body weight deficiency. Conclusions. The main reason for the disharmonious physical development of adolescents left without parental care was a deficit in height and a moderate deficit in body weight. Keywords: physical development, teenagers, orphans, \"Health-Express\", body mass index, body length.","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72944150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-13DOI: 10.31082/1728-452x-2020-215-216-5-6-15-23
Nazym Junusbayeva, B. Issayeva
Systemic sclerosis is the most common autoimmune disease associated with pulmonary hypertension. Pulmonary hypertension is a potential predictor of early death, and therefore, recently, interest in a comprehensive study of the diagnosis of pulmonary hypertension associated with systemic sclerosis has been increasing among researchers. Aim. Consideration of current diagnostic issues, as well as the principles of using diagnostic algorithms to verify pulmonary hypertension associated with systemic sclerosis, applied in daily clinical practice. Material and methods. In order to study the literature data, a search was carried out for information on this problem up to 10 years in depth in the Web of Science, PubMed/MEDLINE. During the search, the following terms were used individually and in combination: "systemic sclerosis", "pulmonary hypertension", "DETECT algorithm", "catheterization of the right heart chambers". The main search criteria were studies based on the study of patients with pulmonary hypertension associated with systemic sclerosis: meta-analyzes, original studies, retrospective and cohort studies. Results and discussion. The clinical symptoms of pulmonary hypertension can be nonspecific, which greatly complicates the diagnosis of the disease in the early stages. The absence of a specific clinical picture before the development of an advanced stage of pulmonary hypertension leads to late verification of the diagnosis. Key algorithms used in the daily practice of a doctor make it possible to minimize the number of undiagnosed cases of pulmonary hypertension. Conclusions. Diagnosis of PH associated with systemic sclerosis is often challenging for clinicians to practice. Early diagnosis and therefore treatment of PH are of paramount importance as they improve survival rates in patients with systemic sclerosis. Keywords: systemic sclerosis, pulmonary hypertension, screening, DETECT algorithm, right heart catheterization.
系统性硬化症是与肺动脉高压相关的最常见的自身免疫性疾病。肺动脉高压是早期死亡的潜在预测因素，因此，最近，研究人员对肺动脉高压与系统性硬化症相关诊断的综合研究越来越感兴趣。的目标。考虑当前诊断问题，以及在日常临床实践中使用诊断算法验证系统性硬化症相关肺动脉高压的原则。材料和方法。为了研究文献数据，在Web of Science, PubMed/MEDLINE上进行了长达10年的关于这个问题的深入搜索。在搜索过程中，以下术语被单独或组合使用:“系统性硬化症”、“肺动脉高压”、“DETECT算法”、“右心室导管插入”。主要检索标准是基于肺动脉高压合并系统性硬化症患者研究的研究:meta分析、原始研究、回顾性研究和队列研究。结果和讨论。肺动脉高压的临床症状可能是非特异性的，这大大增加了早期诊断的复杂性。在肺动脉高压发展到晚期之前缺乏具体的临床表现导致诊断的验证较晚。在医生的日常实践中使用的关键算法可以最大限度地减少未确诊的肺动脉高压病例的数量。结论。诊断PH与系统性硬化症往往是具有挑战性的临床医生的做法。早期诊断和治疗PH是至关重要的，因为它们提高了系统性硬化症患者的生存率。关键词:系统性硬化症，肺动脉高压，筛查，DETECT算法，右心导管。
{"title":"Diagnosis of pulmonary hypertension associated whith systemic sclerosis","authors":"Nazym Junusbayeva, B. Issayeva","doi":"10.31082/1728-452x-2020-215-216-5-6-15-23","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-215-216-5-6-15-23","url":null,"abstract":"Systemic sclerosis is the most common autoimmune disease associated with pulmonary hypertension. Pulmonary hypertension is a potential predictor of early death, and therefore, recently, interest in a comprehensive study of the diagnosis of pulmonary hypertension associated with systemic sclerosis has been increasing among researchers. Aim. Consideration of current diagnostic issues, as well as the principles of using diagnostic algorithms to verify pulmonary hypertension associated with systemic sclerosis, applied in daily clinical practice. Material and methods. In order to study the literature data, a search was carried out for information on this problem up to 10 years in depth in the Web of Science, PubMed/MEDLINE. During the search, the following terms were used individually and in combination: \"systemic sclerosis\", \"pulmonary hypertension\", \"DETECT algorithm\", \"catheterization of the right heart chambers\". The main search criteria were studies based on the study of patients with pulmonary hypertension associated with systemic sclerosis: meta-analyzes, original studies, retrospective and cohort studies. Results and discussion. The clinical symptoms of pulmonary hypertension can be nonspecific, which greatly complicates the diagnosis of the disease in the early stages. The absence of a specific clinical picture before the development of an advanced stage of pulmonary hypertension leads to late verification of the diagnosis. Key algorithms used in the daily practice of a doctor make it possible to minimize the number of undiagnosed cases of pulmonary hypertension. Conclusions. Diagnosis of PH associated with systemic sclerosis is often challenging for clinicians to practice. Early diagnosis and therefore treatment of PH are of paramount importance as they improve survival rates in patients with systemic sclerosis. Keywords: systemic sclerosis, pulmonary hypertension, screening, DETECT algorithm, right heart catheterization.","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82189877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-13DOI: 10.31082/1728-452x-2020-215-216-5-6-24-31
Madina Murzabayeva
Genetic engineering drugs are used to treat rheumatic diseases. Based on the results of multicenter studies, the effectiveness and safety of golimumab, a representative of the group of tumor necrosis factor inhibitors in various categories of patients, was proved.. Purpose of research.To evaluate the effectiveness of golimumab in the treatment of ankylosing spondylitis and rheumatoid arthritis. Material and methods. The efficacy of golimumab was analyzed based on clinical and laboratory data in 7 patients with ankylosing spondylitis and 6 patients with rheumatoid arthritis. These studies are described against the background of a one-year follow-up of patients. Results and discussion. The observation group consisted of 7 patients with ankylosing spondylarthritis (as) and 6 patients with a diagnosis of rheumatoid arthritis. In all patients with (as) at the beginning of the study, the BASDAI index >6 points, and in 5 patients, the ASDASRB index was 3.5±0.45. In 4 patients with the diagnosis (as), the BASFI index was 7±0.67, and in three patients-5±0.3. the BASMI Index in all studied patients revealed pronounced disorders and was 7.5±0.85. Positive dynamics was observed during golimumab therapy. A patient with a high degree of BASDAI activity >6 showed improvement on the 4th injection of golimumab, the Average score of BASDAI and BASFI indices on golimumab was lower by the 20th week, compared with the start of therapy. By the 24th week of therapy, the BASDAI index was down 31%. The follow-up group with the diagnosis of rheumatoid arthritis consisted of 6 patients, including 1 male and 5 female, with an average age of 38±0.5 years. In a male patient, the DAS-28 index was 5.2±0.06, the SDAI index was 27±0.05, and the CDAI index was 23±0.03. In women, the DAS-28 index was 3.8±0.03, and the SDAI index was 19±0.3 in 5 patients, and the CDAI index was 20±0.3. after adding golimumab, the General condition of all patients improved clinically after the second injection, and all indicators of inflammatory activity decreased. Golimumab is a human monoclonal antibody to tumor necrosis factor (TNF)α. The effect of golimumab is due to the binding and neutralization of soluble and membrane-bound forms of TNF)α. TNF)α. it is a cytokine detected in patients with rheumatoid arthritis, ankylosing spondylarthritis. Conclusion. Against the background of the use of golimumab, the clinical effect was noted in the form of complete relief of joint pain and positive dynamics according to the studied laboratory parameters. Keywords: rheumatoid arthritis, ankylosing spondylitis, golimumab, efficacy.
{"title":"Efficacy of golimumab in the treatment of ankylosing spondylitis and rheumatoid arthritis (own experience)","authors":"Madina Murzabayeva","doi":"10.31082/1728-452x-2020-215-216-5-6-24-31","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-215-216-5-6-24-31","url":null,"abstract":"Genetic engineering drugs are used to treat rheumatic diseases. Based on the results of multicenter studies, the effectiveness and safety of golimumab, a representative of the group of tumor necrosis factor inhibitors in various categories of patients, was proved.. Purpose of research.To evaluate the effectiveness of golimumab in the treatment of ankylosing spondylitis and rheumatoid arthritis. Material and methods. The efficacy of golimumab was analyzed based on clinical and laboratory data in 7 patients with ankylosing spondylitis and 6 patients with rheumatoid arthritis. These studies are described against the background of a one-year follow-up of patients. Results and discussion. The observation group consisted of 7 patients with ankylosing spondylarthritis (as) and 6 patients with a diagnosis of rheumatoid arthritis. In all patients with (as) at the beginning of the study, the BASDAI index >6 points, and in 5 patients, the ASDASRB index was 3.5±0.45. In 4 patients with the diagnosis (as), the BASFI index was 7±0.67, and in three patients-5±0.3. the BASMI Index in all studied patients revealed pronounced disorders and was 7.5±0.85. Positive dynamics was observed during golimumab therapy. A patient with a high degree of BASDAI activity >6 showed improvement on the 4th injection of golimumab, the Average score of BASDAI and BASFI indices on golimumab was lower by the 20th week, compared with the start of therapy. By the 24th week of therapy, the BASDAI index was down 31%. The follow-up group with the diagnosis of rheumatoid arthritis consisted of 6 patients, including 1 male and 5 female, with an average age of 38±0.5 years. In a male patient, the DAS-28 index was 5.2±0.06, the SDAI index was 27±0.05, and the CDAI index was 23±0.03. In women, the DAS-28 index was 3.8±0.03, and the SDAI index was 19±0.3 in 5 patients, and the CDAI index was 20±0.3. after adding golimumab, the General condition of all patients improved clinically after the second injection, and all indicators of inflammatory activity decreased. Golimumab is a human monoclonal antibody to tumor necrosis factor (TNF)α. The effect of golimumab is due to the binding and neutralization of soluble and membrane-bound forms of TNF)α. TNF)α. it is a cytokine detected in patients with rheumatoid arthritis, ankylosing spondylarthritis. Conclusion. Against the background of the use of golimumab, the clinical effect was noted in the form of complete relief of joint pain and positive dynamics according to the studied laboratory parameters. Keywords: rheumatoid arthritis, ankylosing spondylitis, golimumab, efficacy.","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90964781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-31DOI: 10.31082/1728-452x-2020-213-214-3-4-26-32
R. Bazarbekova, T. Ermakhanova, Oral Onlassynova, Ayaulym Alpan, A. Satybaldina, Ardak Orazbay, Malika Akhmerova, Aikerim Slamova, Zaure Mussakhanova
21-hydroxylase deficiency is the cause of one of the most common hereditary diseases - congenital adrenal hyperplasia (CAH). The level of residual activity of 21-hydroxylase determines the clinical form and severity of the course of the disease. The article presents the clinical characteristics of two forms of CAH – salt-wasting and simple virilizing. Objective. To study the clinical aspects of CAH due to 21-hydroxylase deficiency in children. Material and methods. We analyzed 57 archived case histories and 58 extracts from case histories of children from 0 to 18 years old with an established diagnosis of CAH. In general, the sample comprised cases, of which 36 were boys (48%) and 39 (52%) girls. Results and discussion. Of the 75 children with CAH, 43 (57.3%) had a salt-wasting form, 32 (42.7%) had a simple virilizing form. In children with salt-wasting form, the leading clinical manifestation was salt loss syndrome, with simple virilizing - viril syndrome. The average age of diagnosis with salt-wasting form was 1.5 months (from 1 to 2.6 months), with simple virilizing - 3 years (from 1.4 to 4.4 years). Conclusions. According to our data, in Kazakhstan, the salt- wasting form of СAH is diagnosed more often than a simple virilizing form (57.3% / 42.7%). The problems of timely diagnosis of CAH and in the selection of the appropriate passport gender of the child were identified. Keywords: congenital adrenal hyperplasia, 21-hydroxylase deficiency, salt-wasting form, simple virilizing form.
{"title":"Clinical aspects of congenital adrenal hyperplasia due to 21-hydroxylase deficiency","authors":"R. Bazarbekova, T. Ermakhanova, Oral Onlassynova, Ayaulym Alpan, A. Satybaldina, Ardak Orazbay, Malika Akhmerova, Aikerim Slamova, Zaure Mussakhanova","doi":"10.31082/1728-452x-2020-213-214-3-4-26-32","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-213-214-3-4-26-32","url":null,"abstract":"21-hydroxylase deficiency is the cause of one of the most common hereditary diseases - congenital adrenal hyperplasia (CAH). The level of residual activity of 21-hydroxylase determines the clinical form and severity of the course of the disease. The article presents the clinical characteristics of two forms of CAH – salt-wasting and simple virilizing. Objective. To study the clinical aspects of CAH due to 21-hydroxylase deficiency in children. Material and methods. We analyzed 57 archived case histories and 58 extracts from case histories of children from 0 to 18 years old with an established diagnosis of CAH. In general, the sample comprised cases, of which 36 were boys (48%) and 39 (52%) girls. Results and discussion. Of the 75 children with CAH, 43 (57.3%) had a salt-wasting form, 32 (42.7%) had a simple virilizing form. In children with salt-wasting form, the leading clinical manifestation was salt loss syndrome, with simple virilizing - viril syndrome. The average age of diagnosis with salt-wasting form was 1.5 months (from 1 to 2.6 months), with simple virilizing - 3 years (from 1.4 to 4.4 years). Conclusions. According to our data, in Kazakhstan, the salt- wasting form of СAH is diagnosed more often than a simple virilizing form (57.3% / 42.7%). The problems of timely diagnosis of CAH and in the selection of the appropriate passport gender of the child were identified. Keywords: congenital adrenal hyperplasia, 21-hydroxylase deficiency, salt-wasting form, simple virilizing form.","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78199923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-31DOI: 10.31082/1728-452x-2020-213-214-3-4-17-25
B. Akimniyazova, G. Kausova, T. Yeshmuratov, Gulstan Yesetova
Combined echinococcosis of the chest and abdominal cavity is one of the cause of morbidity and disability in the Republic of Kazakhstan (RK). Currently, a threatening situation has arisen in the countries of Central Asia due to the epidemiology of dangerous zoonosis - echinococcosis. There is a tendency for an increasing in the invasion of people by this helminth in Kazakhstan. In 2017, according to statistics, 217 cases of echinococcosis per 100,000 people was detected. Echinococcosis is one of the serious reasons for the increase in the number of surgeries. The purpose of this article is to analyze the clinical cases of combined echinococcosis of the chest and abdominal cavity received at the Department of Thoracic Surgery of the National Scientific Center for Surgery named after A.N. Syzganova since 1997 to 2009. Material and methods. We conducted a study of the surgical activity of the department, the distribution of patients with combined echinococcosis by factors of social status, contact with animals and place of residence, the nature of the combined lesion of echinococcosis of the organs of the chest and abdominal cavity, who received surgical treatment. Results and discussion. According to a study of 413 patients, were identified 534 cysts: single cysts: right (30 (5.6%)) and left (21 (4.0%)) lungs, both lungs (9 (1.7%)), subphrenic surface of the liver (40 (7.4%)); multiple cysts: right (84 (15.7%)) and left (51 (9.5%)) lung, both lungs (96 (17.9%)), liver (132 (24.7%)), liver and abdominal cavity (53 (9.9%)), mediastinum (14 (2.6%)), diaphragm and retroperitoneal space (4 (0.7%)). Simultaneous echinococcectomy of 2-3 organs was performed in 261 (63.3%) patients, phased echinococcectomy of several organs with an interval of 2 weeks to 6 months was performed in 152 (36.7%) patients. Postoperative complications were revealed in 35 (8.5%) patients who were associated with combined lesions of various organs, initially complicated forms of lesions, and late referral to a doctor after long unsuccessful treatment at the place of residence. In 17 (4%) patients with an empty echinococcal cyst, a postoperative pneumonia was observed, which was resolved conservatively. Complications in the form of exudative pleurisy were observed in 12 (2.9%) patients; pleural cavity punctures were performed for all. In 6 (1.4%) patients there was suppuration of the laparotomic postoperative wound. Conclusion. The endemicity of the zone, the high contagiousness of the par-asite, the wide age range of patients, the combined defeat with parasite of many organs and different cavities - all this indicates the relevance of this topic and require further discussion and improvement of diagnostic and therapeutic tactics. The necessary for a multidisciplinary approach, namely the inclusion of oncologists and TB specialists together with surgeons in the diagnostic algorithm, is fundamental to improving diagnostic results. The tactics of treatment of combined echinococcal le
{"title":"Diagnosis and treatment tactics features for combined echinococcosis of the chest and abdominal cavity","authors":"B. Akimniyazova, G. Kausova, T. Yeshmuratov, Gulstan Yesetova","doi":"10.31082/1728-452x-2020-213-214-3-4-17-25","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-213-214-3-4-17-25","url":null,"abstract":"Combined echinococcosis of the chest and abdominal cavity is one of the cause of morbidity and disability in the Republic of Kazakhstan (RK). Currently, a threatening situation has arisen in the countries of Central Asia due to the epidemiology of dangerous zoonosis - echinococcosis. There is a tendency for an increasing in the invasion of people by this helminth in Kazakhstan. In 2017, according to statistics, 217 cases of echinococcosis per 100,000 people was detected. Echinococcosis is one of the serious reasons for the increase in the number of surgeries. The purpose of this article is to analyze the clinical cases of combined echinococcosis of the chest and abdominal cavity received at the Department of Thoracic Surgery of the National Scientific Center for Surgery named after A.N. Syzganova since 1997 to 2009. Material and methods. We conducted a study of the surgical activity of the department, the distribution of patients with combined echinococcosis by factors of social status, contact with animals and place of residence, the nature of the combined lesion of echinococcosis of the organs of the chest and abdominal cavity, who received surgical treatment. Results and discussion. According to a study of 413 patients, were identified 534 cysts: single cysts: right (30 (5.6%)) and left (21 (4.0%)) lungs, both lungs (9 (1.7%)), subphrenic surface of the liver (40 (7.4%)); multiple cysts: right (84 (15.7%)) and left (51 (9.5%)) lung, both lungs (96 (17.9%)), liver (132 (24.7%)), liver and abdominal cavity (53 (9.9%)), mediastinum (14 (2.6%)), diaphragm and retroperitoneal space (4 (0.7%)). Simultaneous echinococcectomy of 2-3 organs was performed in 261 (63.3%) patients, phased echinococcectomy of several organs with an interval of 2 weeks to 6 months was performed in 152 (36.7%) patients. Postoperative complications were revealed in 35 (8.5%) patients who were associated with combined lesions of various organs, initially complicated forms of lesions, and late referral to a doctor after long unsuccessful treatment at the place of residence. In 17 (4%) patients with an empty echinococcal cyst, a postoperative pneumonia was observed, which was resolved conservatively. Complications in the form of exudative pleurisy were observed in 12 (2.9%) patients; pleural cavity punctures were performed for all. In 6 (1.4%) patients there was suppuration of the laparotomic postoperative wound. Conclusion. The endemicity of the zone, the high contagiousness of the par-asite, the wide age range of patients, the combined defeat with parasite of many organs and different cavities - all this indicates the relevance of this topic and require further discussion and improvement of diagnostic and therapeutic tactics. The necessary for a multidisciplinary approach, namely the inclusion of oncologists and TB specialists together with surgeons in the diagnostic algorithm, is fundamental to improving diagnostic results. The tactics of treatment of combined echinococcal le","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78130645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-31DOI: 10.31082/1728-452x-2020-213-214-3-4-2-7
A. Sugraliyev, Рlinio Cirillo
In this review, the authors describe the new concept of MicroCLOTS (microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome) - proposed by Italian multidisciplinary team headed by Ciceri F, et al. as the cause of atypical acute respiratory distress syndrome. Ciceri F, etal. hypothesise that, in predisposed individuals, alveolar viral damage is followed by an inflammatory reaction and by microvascular pulmonary thrombosis. This progressive endothelial thromboinflammatory syndrome may also involve the microvascular bed of the brain and other vital organs, leading to multiple organ failure and death. In addition, patients with COVID-19 often develop macrovascular venous thrombosis as a result of the activation of the Virchow triad. Microvascular and macrovascular thrombosis development in patients with COVID-19 is confirmed by ultrasound examination of the veins of the lower extremities and complete autopsy study. The data obtained indicate the importance of the prevention of venous thrombosis with LMWH (nadroparin, enoxaparin) and Fondaparinux sodium in all hospitalized patients with COVID-19. Keywords: COVID-19, аtypical acute respiratory distress syndrome, MicroCLOTS (microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome), thrombosis, hemostasis.
{"title":"Microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome. Prevention of venous thromboembolism in patients with COVID-19","authors":"A. Sugraliyev, Рlinio Cirillo","doi":"10.31082/1728-452x-2020-213-214-3-4-2-7","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-213-214-3-4-2-7","url":null,"abstract":"In this review, the authors describe the new concept of MicroCLOTS (microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome) - proposed by Italian multidisciplinary team headed by Ciceri F, et al. as the cause of atypical acute respiratory distress syndrome. Ciceri F, etal. hypothesise that, in predisposed individuals, alveolar viral damage is followed by an inflammatory reaction and by microvascular pulmonary thrombosis. This progressive endothelial thromboinflammatory syndrome may also involve the microvascular bed of the brain and other vital organs, leading to multiple organ failure and death. In addition, patients with COVID-19 often develop macrovascular venous thrombosis as a result of the activation of the Virchow triad. Microvascular and macrovascular thrombosis development in patients with COVID-19 is confirmed by ultrasound examination of the veins of the lower extremities and complete autopsy study. The data obtained indicate the importance of the prevention of venous thrombosis with LMWH (nadroparin, enoxaparin) and Fondaparinux sodium in all hospitalized patients with COVID-19. Keywords: COVID-19, аtypical acute respiratory distress syndrome, MicroCLOTS (microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome), thrombosis, hemostasis.","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88467915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-31DOI: 10.31082/1728-452x-2020-213-214-3-4-59-63
Yu Khaidarova, B. Isayeva, B. Seizhanova, Zharkynay Akhmetova, N. Batyrkhanova, A. Kulembayeva
Difficulties in diagnosing system lupus erythematosus аssociated with a diverse clinical picture where new signs of the disease appear throughout the disease, and a number of symptoms disappear. There are often cases of unusual onset of the disease with absence of skin manifestations asymptomatic course of the disease. Case summary. This article presents the history of a 37-year-old patient who had manifestations of systemic autoimmune disease with autoantibodies positivity in her debut, which led to an erroneous diagnosis and inadequate treatment. Discussion. The practice of a rheumatologist increasingly notes clinical cases requiring differential diagnosis between rheumatic diseases and paraneoplastic syndrome. "Rheumatological masks" can develop in malignant tumors of different localization at different stages of the disease, showing signs of damage to the bone-joint and ligament apparatus, muscles, vessels and internal organs. Keywords: systemic lupus erythematosus, lupus-like syndrome, paraneoplastic syndrome, differential diagnostics.
{"title":"Rheumatological mimics of oncological disorders: a case report","authors":"Yu Khaidarova, B. Isayeva, B. Seizhanova, Zharkynay Akhmetova, N. Batyrkhanova, A. Kulembayeva","doi":"10.31082/1728-452x-2020-213-214-3-4-59-63","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-213-214-3-4-59-63","url":null,"abstract":"Difficulties in diagnosing system lupus erythematosus аssociated with a diverse clinical picture where new signs of the disease appear throughout the disease, and a number of symptoms disappear. There are often cases of unusual onset of the disease with absence of skin manifestations asymptomatic course of the disease. Case summary. This article presents the history of a 37-year-old patient who had manifestations of systemic autoimmune disease with autoantibodies positivity in her debut, which led to an erroneous diagnosis and inadequate treatment. Discussion. The practice of a rheumatologist increasingly notes clinical cases requiring differential diagnosis between rheumatic diseases and paraneoplastic syndrome. \"Rheumatological masks\" can develop in malignant tumors of different localization at different stages of the disease, showing signs of damage to the bone-joint and ligament apparatus, muscles, vessels and internal organs. Keywords: systemic lupus erythematosus, lupus-like syndrome, paraneoplastic syndrome, differential diagnostics.","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72707739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-31DOI: 10.31082/1728-452x-2020-213-214-3-4-46-52
Nikolay Negai, N. Raspopova, K. Altynbekov, Maria Dzhamantayeva, N. Logacheva
In the presence of the COVID-19 epidemic, due to quarantine measures, millions of people around the world are under the stress of infection and have to adapt to new conditions of social functioning. The high risk of developing of mixed anxiety-depressive adaptation disorders in the presence of COVID-19 quarantine measures determines the relevance of this study. Study purpose. To study the prevalence and clinical level of mixed anxiety-depressive disorders in medical personnel under the COVID-19 quarantine regime. Material and methods. 51 employees of the Republican national enterprise on the right of economic jurisdiction “Republican scientific and practical center of mental health” (RSPCMH) were examined: doctors, junior and medium-level medical personnel. The main study method is psychometric (Hospital Anxiety and Depression Score – HADS). Results and discussion. The work presents an analytical review of literature data on the problem of adaptation disorders and current international studies on mental disorders in medical workers under the COVID-19 quarantine regime. According to the results of this study, affective disorders in the form of depressive and anxiety-depressive reactions within the framework of adaptation disorders were detected in 37.3% of the medical staff of the RSPCMH. Conclusions. It was found that the higher the risk of COVID-19 infection, the more often depression is detected and in departments with a lower risk of infection, more often mixed anxiety-depressive disorders are detected. Preventive measures aimed at increasing the stress tolerance of medical workers are recommended. Key words: COVID-19, stress, adaptation disorders, anxiety, depression, stress protectors, tranquilizers.
{"title":"Mixed anxiety-depressive adaptation disorders in the presence of the COVID-19 epidemic","authors":"Nikolay Negai, N. Raspopova, K. Altynbekov, Maria Dzhamantayeva, N. Logacheva","doi":"10.31082/1728-452x-2020-213-214-3-4-46-52","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-213-214-3-4-46-52","url":null,"abstract":"In the presence of the COVID-19 epidemic, due to quarantine measures, millions of people around the world are under the stress of infection and have to adapt to new conditions of social functioning. The high risk of developing of mixed anxiety-depressive adaptation disorders in the presence of COVID-19 quarantine measures determines the relevance of this study. Study purpose. To study the prevalence and clinical level of mixed anxiety-depressive disorders in medical personnel under the COVID-19 quarantine regime. Material and methods. 51 employees of the Republican national enterprise on the right of economic jurisdiction “Republican scientific and practical center of mental health” (RSPCMH) were examined: doctors, junior and medium-level medical personnel. The main study method is psychometric (Hospital Anxiety and Depression Score – HADS). Results and discussion. The work presents an analytical review of literature data on the problem of adaptation disorders and current international studies on mental disorders in medical workers under the COVID-19 quarantine regime. According to the results of this study, affective disorders in the form of depressive and anxiety-depressive reactions within the framework of adaptation disorders were detected in 37.3% of the medical staff of the RSPCMH. Conclusions. It was found that the higher the risk of COVID-19 infection, the more often depression is detected and in departments with a lower risk of infection, more often mixed anxiety-depressive disorders are detected. Preventive measures aimed at increasing the stress tolerance of medical workers are recommended. Key words: COVID-19, stress, adaptation disorders, anxiety, depression, stress protectors, tranquilizers.","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73405415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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