L. Golovko, Головко Лилия Сергеевна, A. Safronenko, Сафроненко Андрей Владимирович, E. Gantsgorn, Ганцгорн Елена Владимировна, N. V. Sukhorukova, Сухорукова Наталья Владимировна, Yu. S. Maklyakov, Макляков Юрий Степанович
Aim. To assess the dynamics of coagulation parameters and the influence of its initial values on the development of postoperative thrombohemorrhagic complications in male and female patients undergoing large joint arthroplasty and received combination hemostatic and anticoagulant therapy. Methods. A retrospective analysis of the medical records (n=253) of patients with arthroplasty, were divided into two groups based on the time differences between prescription of hemostatic and anticoagulation therapy. The first group includes 145 patients (57.31%, 112 women and 33 men) with time differences ≤17 h, and the second group includes 108 patients (42.68%, 78 women and 30 men) with time differences 18–24 h. The dynamics of coagulation test results were analyzed, and the influence of its initial value on the risk of postoperative thrombosis or bleeding was assessed. Results. Thrombohemorrhagic complications were recorded in 27 (10.67%) patients, of which 22 (81.48%) were observed in group 1. In the first group, thrombosis developed in regimens with tranexamic acid (p=0.038) with 2.2 times higher incidence than in group 2 (p=0.023). The risk of thrombosis of women in the group 1 was increased by an initially low level of international normalized ratio [relative risk (RR) 13.333, p=0.00032] and activated partial thromboplastin time (RR=5.8, p=0.037). The risk of bleeding in group 1 increased by an increasing preoperative level of activated partial thromboplastin time (RR=18, p=0.0012 and RR=28, p=0.00022, respectively) for all patients and by a decreasing fibrinogen level (RR=23.25, p=0.00065) and platelets count (RR=10.2, p=0.038) for women. Conclusion. To minimize the risks of thrombosis and bleeding after arthroplasty, especially in patients with initial deviations of hemostasis parameters from the norm, and, in particular, when using tranexamic acid as a hemostatic agent, it is recommended to observe the time interval between hemostatic and anticoagulant pharmacotherapy for at least 18 hours.
{"title":"Complex analysis of coagulation tests in patients undergoing the combination of hemostatic and antithrombotic therapy following large joint arthroplasty","authors":"L. Golovko, Головко Лилия Сергеевна, A. Safronenko, Сафроненко Андрей Владимирович, E. Gantsgorn, Ганцгорн Елена Владимировна, N. V. Sukhorukova, Сухорукова Наталья Владимировна, Yu. S. Maklyakov, Макляков Юрий Степанович","doi":"10.17816/kmj2020-489","DOIUrl":"https://doi.org/10.17816/kmj2020-489","url":null,"abstract":"Aim. To assess the dynamics of coagulation parameters and the influence of its initial values on the development of postoperative thrombohemorrhagic complications in male and female patients undergoing large joint arthroplasty and received combination hemostatic and anticoagulant therapy. Methods. A retrospective analysis of the medical records (n=253) of patients with arthroplasty, were divided into two groups based on the time differences between prescription of hemostatic and anticoagulation therapy. The first group includes 145 patients (57.31%, 112 women and 33 men) with time differences ≤17 h, and the second group includes 108 patients (42.68%, 78 women and 30 men) with time differences 18–24 h. The dynamics of coagulation test results were analyzed, and the influence of its initial value on the risk of postoperative thrombosis or bleeding was assessed. Results. Thrombohemorrhagic complications were recorded in 27 (10.67%) patients, of which 22 (81.48%) were observed in group 1. In the first group, thrombosis developed in regimens with tranexamic acid (p=0.038) with 2.2 times higher incidence than in group 2 (p=0.023). The risk of thrombosis of women in the group 1 was increased by an initially low level of international normalized ratio [relative risk (RR) 13.333, p=0.00032] and activated partial thromboplastin time (RR=5.8, p=0.037). The risk of bleeding in group 1 increased by an increasing preoperative level of activated partial thromboplastin time (RR=18, p=0.0012 and RR=28, p=0.00022, respectively) for all patients and by a decreasing fibrinogen level (RR=23.25, p=0.00065) and platelets count (RR=10.2, p=0.038) for women. Conclusion. To minimize the risks of thrombosis and bleeding after arthroplasty, especially in patients with initial deviations of hemostasis parameters from the norm, and, in particular, when using tranexamic acid as a hemostatic agent, it is recommended to observe the time interval between hemostatic and anticoagulant pharmacotherapy for at least 18 hours.","PeriodicalId":17798,"journal":{"name":"Kazanskiy meditsinskiy zhurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89667515","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}
N. Epifantseva, Епифанцева Наталья Владимировна, A. N. Emelyanova, Емельянова Альвина Николаевна, E. N. Kalinina, Калинина Эльвира Николаевна, T. Karavaeva, Караваева Татьяна Михайловна
Aim. To determine the level of lipopolysaccharide-binding protein (LBP) in acute intestinal infection, depending on the etiology and severity of the disease, and the effect of interleukin (IL)-1β and IL-10 levels on the expression of LBP. Methods. Serum samples of 62 patients were assayed by solid phase enzyme-linked immunosorbent assay using a set of reagents ELISA (USA) and Vector-best (Novosibirsk) for levels of LBР, IL-1β, IL-10. The first group included 33 patients with bacterial intestinal infection, the second group consisted of 29 patients with viral diarrhea, and the control group comprised 20 conditionally healthy patients. Analyses were performed using Microsoft Excel 2010 and Statistica version 6.0 software. Statistical differences were determined by using the Mann–Whitney U Test, the p-value ≤0.05 were regarded as statistically significant. Spearman’s correlation coefficient was used to examine relationships. Shapiro–Wilk W test was used to check for normal distribution of the features. Results. We detected the presence of LBP in all the studied groups, with the content of LBP was significantly increased in the group of bacterial intestinal infections compared with other groups. With regard to disease severity, LBP level was the highest for mild acute intestinal infections caused by bacteria, and for viral diarrhea, fluctuations in LBP did not exceed the norm. In intestinal infections caused by bacteria, the levels of LBP were directly related to the levels of IL-1β and IL-10. Conclusion. Detection of LBP concentration can be used for the initial differential diagnosis of intestinal infections caused by bacteria, which would significantly narrow the diagnostic search and determine the tactics of etiotropic therapy; also, considering the relationship between the concentration of LBP and disease severity, this indicator can be used as a predictive sign of the course of the disease.
{"title":"The level of lipopolysaccharide-binding protein in acute intestinal infections, the effect of IL-1β and IL-10 on its production","authors":"N. Epifantseva, Епифанцева Наталья Владимировна, A. N. Emelyanova, Емельянова Альвина Николаевна, E. N. Kalinina, Калинина Эльвира Николаевна, T. Karavaeva, Караваева Татьяна Михайловна","doi":"10.17816/kmj2020-590","DOIUrl":"https://doi.org/10.17816/kmj2020-590","url":null,"abstract":"Aim. To determine the level of lipopolysaccharide-binding protein (LBP) in acute intestinal infection, depending on the etiology and severity of the disease, and the effect of interleukin (IL)-1β and IL-10 levels on the expression of LBP. Methods. Serum samples of 62 patients were assayed by solid phase enzyme-linked immunosorbent assay using a set of reagents ELISA (USA) and Vector-best (Novosibirsk) for levels of LBР, IL-1β, IL-10. The first group included 33 patients with bacterial intestinal infection, the second group consisted of 29 patients with viral diarrhea, and the control group comprised 20 conditionally healthy patients. Analyses were performed using Microsoft Excel 2010 and Statistica version 6.0 software. Statistical differences were determined by using the Mann–Whitney U Test, the p-value ≤0.05 were regarded as statistically significant. Spearman’s correlation coefficient was used to examine relationships. Shapiro–Wilk W test was used to check for normal distribution of the features. Results. We detected the presence of LBP in all the studied groups, with the content of LBP was significantly increased in the group of bacterial intestinal infections compared with other groups. With regard to disease severity, LBP level was the highest for mild acute intestinal infections caused by bacteria, and for viral diarrhea, fluctuations in LBP did not exceed the norm. In intestinal infections caused by bacteria, the levels of LBP were directly related to the levels of IL-1β and IL-10. Conclusion. Detection of LBP concentration can be used for the initial differential diagnosis of intestinal infections caused by bacteria, which would significantly narrow the diagnostic search and determine the tactics of etiotropic therapy; also, considering the relationship between the concentration of LBP and disease severity, this indicator can be used as a predictive sign of the course of the disease.","PeriodicalId":17798,"journal":{"name":"Kazanskiy meditsinskiy zhurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83673934","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}
A. Izmaylov, Измайлов Александр Геннадьевич, S. V. Dobrokvashin, Доброквашин Сергей Васильевич, S. G. Izmaylov, Измайлов Сергей Геннадьевич, A. E. Leontev, Леонтьев Андрей Евгеньевич, E. Lukoyanychev, Лукоянычев Егор Евгеньевич, A. Bodrov, Бодров Алексей Анатольевич, K. V. Kapustin, Капустин Константин Владимирович, A. Vorontsov, Воронцов Алексей Юрьевич, D. E. Volkov, Волков Дмитрий Евгеньевич
Aim. To improve the results of surgical treatment in patients with large lipomas by using the device for closing the edges of wounds, allowing local preventive hemostasis in the surgical wound area, to create optimal conditions for atraumatic suturing and thereby reduce the amount of intraoperative bleeding and subsequently reduce the amount of postoperative wound complications. Methods. The results of treatment of 105 patients with different localization of large lipomas were analyzed. Lipomas ranged from 8.0 to 20 cm in diameter. All patients were divided into 2 groups: the control group consisted of 53 (50.5%) patients for which used the traditional technique of tumor excision with closing surgical wounds, and the study group with 52 (49.5%) patients, for which to reduce tissue damage during tumor removal and the edges of wound suturing, one of the device variants developed by us was used, approximation-distraction device. Fisher's exact test was used for the comparison of the outcomes rate, a p-value <0.05 was considered statistically significant. Results. Surgical wound complications occurred in 7 (6.7%) of 105 patients. In the study group, surgical wound complications occurred in 1.9% (1 observation), in the control group 11.3% (6 observations). Surgical wound complications were severity grade I and grade IIIa. Complications of the first grade did not require a debridement and will regress on its own; in grade IIIa complications, an opening, excision and drainage surgical wounds were performed without general anesthesia. Conclusion. Moderate local selective near-tumor tissue compression that occurs when the device branches come closer to each other accelerates spontaneous thrombus formation in damaged small vessels. This creates favorable conditions for the surgeon to work in a “dry” wound.
{"title":"Optimization of the technique for removal of benign tumors and wound suturing in a general surgical hospital","authors":"A. Izmaylov, Измайлов Александр Геннадьевич, S. V. Dobrokvashin, Доброквашин Сергей Васильевич, S. G. Izmaylov, Измайлов Сергей Геннадьевич, A. E. Leontev, Леонтьев Андрей Евгеньевич, E. Lukoyanychev, Лукоянычев Егор Евгеньевич, A. Bodrov, Бодров Алексей Анатольевич, K. V. Kapustin, Капустин Константин Владимирович, A. Vorontsov, Воронцов Алексей Юрьевич, D. E. Volkov, Волков Дмитрий Евгеньевич","doi":"10.17816/kmj2020-579","DOIUrl":"https://doi.org/10.17816/kmj2020-579","url":null,"abstract":"Aim. To improve the results of surgical treatment in patients with large lipomas by using the device for closing the edges of wounds, allowing local preventive hemostasis in the surgical wound area, to create optimal conditions for atraumatic suturing and thereby reduce the amount of intraoperative bleeding and subsequently reduce the amount of postoperative wound complications. Methods. The results of treatment of 105 patients with different localization of large lipomas were analyzed. Lipomas ranged from 8.0 to 20 cm in diameter. All patients were divided into 2 groups: the control group consisted of 53 (50.5%) patients for which used the traditional technique of tumor excision with closing surgical wounds, and the study group with 52 (49.5%) patients, for which to reduce tissue damage during tumor removal and the edges of wound suturing, one of the device variants developed by us was used, approximation-distraction device. Fisher's exact test was used for the comparison of the outcomes rate, a p-value <0.05 was considered statistically significant. Results. Surgical wound complications occurred in 7 (6.7%) of 105 patients. In the study group, surgical wound complications occurred in 1.9% (1 observation), in the control group 11.3% (6 observations). Surgical wound complications were severity grade I and grade IIIa. Complications of the first grade did not require a debridement and will regress on its own; in grade IIIa complications, an opening, excision and drainage surgical wounds were performed without general anesthesia. Conclusion. Moderate local selective near-tumor tissue compression that occurs when the device branches come closer to each other accelerates spontaneous thrombus formation in damaged small vessels. This creates favorable conditions for the surgeon to work in a “dry” wound.","PeriodicalId":17798,"journal":{"name":"Kazanskiy meditsinskiy zhurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90683730","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}
E. Khaldeeva, Халдеева Елена Владимировна, N. Glushko, Глушко Надежда Ивановна, S. Lisovskaya, Лисовская Светлана Анатольевна, V. Parshakov, Паршаков Вениамин Романович, G. G. Khaidarova, Хайдарова Гульназ Гумяровна
Aim. To assess the degree of fungal contamination and the species composition of the fungal microbiota of residential apartments in Kazan Methods. A mycological study of 90 air samples and 60 samples from sites of fungal biodeterioration from the residential buildings of Kazan was carried out using cultural and microscopic methods. Results. The presence of micromycetes fungi were detected in 90% of air samples and 100% of samples from sites of biodeterioration. Higher fungal species diversity was noted in the sites, compared with air samples. Fungal concentrations in indoor air varied between 8 and 360 CFU/m 3 . Fungal community composition analysis of the sites of biodeterioration showed that the surfaces were more frequently contaminated by undemanding and capable of growth at different moisture levels fungal species (Penicillium spp., Aspergillus spp., Rhizopus stolonifer). The resulting fungal plaque can create conditions favorable for aggressive fungal species that actively damage materials (Chaetomium spp., Acremonium spp., Aureubasidium spp). Allergenic fungi, as well as potentially pathogenic and toxin-forming species, were widespread in the air that can be a health risk factor. A quantitative assessment of air mycobiota indicated the moderate level of fungal contamination. Conclusion. The presence of potentially pathogenic, allergenic and biodegradable fungal species in the sites of biodeterioration has been confirmed, as well as the relationship between airborne fungal contamination and the spread of fungi in indoors, confirming the need to prevent fungal biodeterioration and control indoor air quality.
{"title":"Indoor fungal contamination as a biological risk factor","authors":"E. Khaldeeva, Халдеева Елена Владимировна, N. Glushko, Глушко Надежда Ивановна, S. Lisovskaya, Лисовская Светлана Анатольевна, V. Parshakov, Паршаков Вениамин Романович, G. G. Khaidarova, Хайдарова Гульназ Гумяровна","doi":"10.17816/kmj2020-513","DOIUrl":"https://doi.org/10.17816/kmj2020-513","url":null,"abstract":"Aim. To assess the degree of fungal contamination and the species composition of the fungal microbiota of residential apartments in Kazan Methods. A mycological study of 90 air samples and 60 samples from sites of fungal biodeterioration from the residential buildings of Kazan was carried out using cultural and microscopic methods. Results. The presence of micromycetes fungi were detected in 90% of air samples and 100% of samples from sites of biodeterioration. Higher fungal species diversity was noted in the sites, compared with air samples. Fungal concentrations in indoor air varied between 8 and 360 CFU/m 3 . Fungal community composition analysis of the sites of biodeterioration showed that the surfaces were more frequently contaminated by undemanding and capable of growth at different moisture levels fungal species (Penicillium spp., Aspergillus spp., Rhizopus stolonifer). The resulting fungal plaque can create conditions favorable for aggressive fungal species that actively damage materials (Chaetomium spp., Acremonium spp., Aureubasidium spp). Allergenic fungi, as well as potentially pathogenic and toxin-forming species, were widespread in the air that can be a health risk factor. A quantitative assessment of air mycobiota indicated the moderate level of fungal contamination. Conclusion. The presence of potentially pathogenic, allergenic and biodegradable fungal species in the sites of biodeterioration has been confirmed, as well as the relationship between airborne fungal contamination and the spread of fungi in indoors, confirming the need to prevent fungal biodeterioration and control indoor air quality.","PeriodicalId":17798,"journal":{"name":"Kazanskiy meditsinskiy zhurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85140124","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}
D. Gaynetdinova, Гайнетдинова Дина Дамировна, A. A. Novoselova, Новоселова Анастасия Андреевна
Duchenne muscular dystrophy (DMD) is an X-linked progressive disease from the group of primary myopathies caused by mutations in the DMD gene and a lack of dystrophin protein in the muscle fiber in males. The review considered the prevalence of pathology, the most common causes of dystrophinopathy, and the role of dystrophin not only in the functioning of muscles but also in the architectural organization of the Central nervous system. The disease classification based on stages and forms, initial clinical manifestations of the early and late stages of the disease, as well as neuropsychological, orthopedic, respiratory and cardiovascular disorders, are described in detail. The relevant to date diagnostic algorithm for suspected DMD, biochemical blood analysis, genetic, morphological (immunocytochemical staining of muscles with dystrophin antibodies) and instrumental (ultrasound, MRI) methods of examination are presented in detail. Particular attention in the diagnosis of DMD and objectification of disorders is given to assessment tests [Bailey’s and Griffiths scales, Albert's Test of Infant Posture and Motor Assessment Scale, Expanded Hammersmith Functional Motor Scale (HFMSE), the Gross Motor Function Measure (GMFM), and the 6-minute walk test (6MWT)]. The review presents the advantages and disadvantages of modern invasive and non-invasive diagnostic techniques of the disease, indicating their reliability and the possibility of application at early stages, including prenatal. In conclusion, the treatment of DMD and its most frequent complications, both widely used in practice and at the stage of clinical research, is highlighted. It was emphasized the importance of rehabilitation measures that improve the duration and quality of life of patients with DMD. The main task of analyzing available sources on the most pressing issues of Duchenne muscular dystrophy was to stimulate research and social activity in resolving unsolved problems today.
{"title":"Current diagnosis and treatment of Duchenne muscular dystrophy","authors":"D. Gaynetdinova, Гайнетдинова Дина Дамировна, A. A. Novoselova, Новоселова Анастасия Андреевна","doi":"10.17816/kmj2020-530","DOIUrl":"https://doi.org/10.17816/kmj2020-530","url":null,"abstract":"Duchenne muscular dystrophy (DMD) is an X-linked progressive disease from the group of primary myopathies caused by mutations in the DMD gene and a lack of dystrophin protein in the muscle fiber in males. The review considered the prevalence of pathology, the most common causes of dystrophinopathy, and the role of dystrophin not only in the functioning of muscles but also in the architectural organization of the Central nervous system. The disease classification based on stages and forms, initial clinical manifestations of the early and late stages of the disease, as well as neuropsychological, orthopedic, respiratory and cardiovascular disorders, are described in detail. The relevant to date diagnostic algorithm for suspected DMD, biochemical blood analysis, genetic, morphological (immunocytochemical staining of muscles with dystrophin antibodies) and instrumental (ultrasound, MRI) methods of examination are presented in detail. Particular attention in the diagnosis of DMD and objectification of disorders is given to assessment tests [Bailey’s and Griffiths scales, Albert's Test of Infant Posture and Motor Assessment Scale, Expanded Hammersmith Functional Motor Scale (HFMSE), the Gross Motor Function Measure (GMFM), and the 6-minute walk test (6MWT)]. The review presents the advantages and disadvantages of modern invasive and non-invasive diagnostic techniques of the disease, indicating their reliability and the possibility of application at early stages, including prenatal. In conclusion, the treatment of DMD and its most frequent complications, both widely used in practice and at the stage of clinical research, is highlighted. It was emphasized the importance of rehabilitation measures that improve the duration and quality of life of patients with DMD. The main task of analyzing available sources on the most pressing issues of Duchenne muscular dystrophy was to stimulate research and social activity in resolving unsolved problems today.","PeriodicalId":17798,"journal":{"name":"Kazanskiy meditsinskiy zhurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86433890","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}
S. Kuzmina, Кузьмина Светлана Валерьевна, R. Garipova, Гарипова Раиля Валиевна, Z. M. Berhkeeva, Берхеева Зухра Миндияровна, K. Yakhin, Яхин Каусар Камилович
Aim. To study the structure of psychosocial maladjustment in chemical workers and assess the contribution of industrial and non-industrial risk factors in the formation of mental illness. Methods. It was analysed of hygienic assessment of the leading harmful production factors — chemical, physical, factors of severity and intensity of labor. During the periodic medical examination, the mental health status of 1,226 people was examined, with a focus on professional experience, mental hygiene aspects of production factors, as well as individual and personal characteristics of employees. Confidence intervals and standard errors estimating, the logistic regression models fitting were performed using R Statistical Software with significance level 0.05. Results. The working environment hazards in organic synthesis included chemical risk factor, continuous noise exceeding the permissible exposure limit, emotional stress and life-threatening conditions (fire and explosion hazards in the work). The general assessment of working conditions was performed using clauses 5.1–5.11 P 2.2.2006-05-harmful working conditions of the second-third degree (3.2–3.3). Working conditions at all stages of the manufacturing process of pyroxylin powders were assessed as harmful to the third-fourth degree (3.3–3.4), including the chemical factor, the severity and intensity of work, fire and explosion hazards in the work. It was revealed the dependence of the development of psychosocial maladjustment on non-work-related factors (such as the level of education, marital status), conditional work-related factors (level of material security). Also, the dependence of the structure of pre-existing mental health condition on the work-related and developmental characteristics (work experience) of labor in chemical production was found. Conclusion. Working conditions in the studied industries correspond to the 3rd harmful class, 2nd and 3rd degrees in the production of organic synthesis (3.2–3.3), while at the production of pyroxylic powders, it is close to dangerous (3.3–3.4); the structure and risk of the developmental process of employee maladjustment are determined by the feature effect of workplace hazards.
{"title":"Mental health of chemical workers: violation risk factors","authors":"S. Kuzmina, Кузьмина Светлана Валерьевна, R. Garipova, Гарипова Раиля Валиевна, Z. M. Berhkeeva, Берхеева Зухра Миндияровна, K. Yakhin, Яхин Каусар Камилович","doi":"10.17816/kmj2020-550","DOIUrl":"https://doi.org/10.17816/kmj2020-550","url":null,"abstract":"Aim. To study the structure of psychosocial maladjustment in chemical workers and assess the contribution of industrial and non-industrial risk factors in the formation of mental illness. Methods. It was analysed of hygienic assessment of the leading harmful production factors — chemical, physical, factors of severity and intensity of labor. During the periodic medical examination, the mental health status of 1,226 people was examined, with a focus on professional experience, mental hygiene aspects of production factors, as well as individual and personal characteristics of employees. Confidence intervals and standard errors estimating, the logistic regression models fitting were performed using R Statistical Software with significance level 0.05. Results. The working environment hazards in organic synthesis included chemical risk factor, continuous noise exceeding the permissible exposure limit, emotional stress and life-threatening conditions (fire and explosion hazards in the work). The general assessment of working conditions was performed using clauses 5.1–5.11 P 2.2.2006-05-harmful working conditions of the second-third degree (3.2–3.3). Working conditions at all stages of the manufacturing process of pyroxylin powders were assessed as harmful to the third-fourth degree (3.3–3.4), including the chemical factor, the severity and intensity of work, fire and explosion hazards in the work. It was revealed the dependence of the development of psychosocial maladjustment on non-work-related factors (such as the level of education, marital status), conditional work-related factors (level of material security). Also, the dependence of the structure of pre-existing mental health condition on the work-related and developmental characteristics (work experience) of labor in chemical production was found. Conclusion. Working conditions in the studied industries correspond to the 3rd harmful class, 2nd and 3rd degrees in the production of organic synthesis (3.2–3.3), while at the production of pyroxylic powders, it is close to dangerous (3.3–3.4); the structure and risk of the developmental process of employee maladjustment are determined by the feature effect of workplace hazards.","PeriodicalId":17798,"journal":{"name":"Kazanskiy meditsinskiy zhurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76102080","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}
A. G. Naumov, Наумов Алексей Георгиевич, A. Pavlunin, Павлунин Александр Васильевич, A. Golova, Голова Анастасия Юрьевна, N. Nikolskaya, Никольская Надежда Алексеевна, K. V. Mansurskaya, Мансурская Ксения Валерьевна, O. Samarina, Самарина Ольга Евгеньевна
The scientific challenge of combining the tuberculosis process and lung cancer has not been fully disclosed in modern literature. This primarily involves the low incidence of these two pathologies at the same time. This may contribute to difficulties in the qualitative and timely diagnosis of these diseases. Tuberculosis “hides” the radiological manifestations of a malignant tumor for a long time that contributing to its progression and the development of high mortality among patients. Lung cancer facilitates hemato- and lymphogenous spread of a specific pathogen. As an example, a clinical case of simultaneous occurrence of pulmonary tuberculosis and lung cancer which was observed in the patient admitted to the Department for patients with respiratory tuberculosis of Nizhny Novgorod regional clinical tuberculosis dispensary, was presented. We concluded that compliance with the algorithm of the mandatory diagnostic minimum when patients admitted to the general healthcare network, as well as compliance with the rules for population screening, especially among people over 45, will minimize the risks of delayed diagnosis in case of coexistence of respiratory tuberculosis and lung cancer.
{"title":"A clinical case of central cancer of the lung and infiltrative tuberculosis","authors":"A. G. Naumov, Наумов Алексей Георгиевич, A. Pavlunin, Павлунин Александр Васильевич, A. Golova, Голова Анастасия Юрьевна, N. Nikolskaya, Никольская Надежда Алексеевна, K. V. Mansurskaya, Мансурская Ксения Валерьевна, O. Samarina, Самарина Ольга Евгеньевна","doi":"10.17816/kmj2020-574","DOIUrl":"https://doi.org/10.17816/kmj2020-574","url":null,"abstract":"The scientific challenge of combining the tuberculosis process and lung cancer has not been fully disclosed in modern literature. This primarily involves the low incidence of these two pathologies at the same time. This may contribute to difficulties in the qualitative and timely diagnosis of these diseases. Tuberculosis “hides” the radiological manifestations of a malignant tumor for a long time that contributing to its progression and the development of high mortality among patients. Lung cancer facilitates hemato- and lymphogenous spread of a specific pathogen. As an example, a clinical case of simultaneous occurrence of pulmonary tuberculosis and lung cancer which was observed in the patient admitted to the Department for patients with respiratory tuberculosis of Nizhny Novgorod regional clinical tuberculosis dispensary, was presented. We concluded that compliance with the algorithm of the mandatory diagnostic minimum when patients admitted to the general healthcare network, as well as compliance with the rules for population screening, especially among people over 45, will minimize the risks of delayed diagnosis in case of coexistence of respiratory tuberculosis and lung cancer.","PeriodicalId":17798,"journal":{"name":"Kazanskiy meditsinskiy zhurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73915092","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}
K. R. Ziyakayeva, Зиякаева Клара Рашитовна, A. Kayumova, Каюмова Алия Фаритовна, F. Kayumov, Каюмов Фарит Амирянович, M. Y. Fazlyakhmetova, Фазлыахметова Минзаля Явдатовна
Aim. To assess the histomorphological state of lung, gastrointestinal and kidney tissues following exposure to copper-zinc-pyrite ore in the long-term model experiment. Methods. The study was performed on 60 outbred albino male rats, aged 3–4 months, weighting 200±30 g. The toxic effect of heavy metal salts of copper-zinc-pyrite ore on the animal's body was analyzed by the model of dosed oral injection of water with ore in a dose 600 mg/kg body weight for 120 days. Pieces of the stomach, small and colon, liver, lungs and kidneys were taken from control and experimental rats for histomorphological study on the 30th, 60th, 90th and 120th day of the experiment. Results. The structural disorders of the stomach lining were observed on the 30th day of the experiment: desquamated and dilapidated epithelial cells appeared in the preparations. On the 120th day, along with signs of epithelial desquamation and diffuse lymphocytic infiltration, the preparations contained large lymphoid follicles that occupy the full thickness of the gastric mucosa. The epithelial layer of the small intestine mucosa was disrupted on the 60th day. At day 120 diffuse infiltration and necrotic changes in the lining of the small intestine were recorded. Lymphomacrophagia infiltrations were observed during portal triad and inside the liver wedges of experimental animals on the 30th day of the experiment. By the end of the experiment, toxic hepatocyte dystrophy developed. On the 60th day, signs of bronchopneumonia appeared in the lung tissue. After 3 months, tubulopathy and tubulointerstitial nephritis were observed in the experimental animals. Conclusion. Prolonged administration of ore has led to pronounced inflammation and degenerative changes in the gastrointestinal tract, liver, kidney and lung tissues, accompanied by lymphocytic tissue reaction.
{"title":"Histomorphological changes in various rat tissues following chronic exposure to copper-zinc-pyrite ore","authors":"K. R. Ziyakayeva, Зиякаева Клара Рашитовна, A. Kayumova, Каюмова Алия Фаритовна, F. Kayumov, Каюмов Фарит Амирянович, M. Y. Fazlyakhmetova, Фазлыахметова Минзаля Явдатовна","doi":"10.17816/kmj2020-524","DOIUrl":"https://doi.org/10.17816/kmj2020-524","url":null,"abstract":"Aim. To assess the histomorphological state of lung, gastrointestinal and kidney tissues following exposure to copper-zinc-pyrite ore in the long-term model experiment. Methods. The study was performed on 60 outbred albino male rats, aged 3–4 months, weighting 200±30 g. The toxic effect of heavy metal salts of copper-zinc-pyrite ore on the animal's body was analyzed by the model of dosed oral injection of water with ore in a dose 600 mg/kg body weight for 120 days. Pieces of the stomach, small and colon, liver, lungs and kidneys were taken from control and experimental rats for histomorphological study on the 30th, 60th, 90th and 120th day of the experiment. Results. The structural disorders of the stomach lining were observed on the 30th day of the experiment: desquamated and dilapidated epithelial cells appeared in the preparations. On the 120th day, along with signs of epithelial desquamation and diffuse lymphocytic infiltration, the preparations contained large lymphoid follicles that occupy the full thickness of the gastric mucosa. The epithelial layer of the small intestine mucosa was disrupted on the 60th day. At day 120 diffuse infiltration and necrotic changes in the lining of the small intestine were recorded. Lymphomacrophagia infiltrations were observed during portal triad and inside the liver wedges of experimental animals on the 30th day of the experiment. By the end of the experiment, toxic hepatocyte dystrophy developed. On the 60th day, signs of bronchopneumonia appeared in the lung tissue. After 3 months, tubulopathy and tubulointerstitial nephritis were observed in the experimental animals. Conclusion. Prolonged administration of ore has led to pronounced inflammation and degenerative changes in the gastrointestinal tract, liver, kidney and lung tissues, accompanied by lymphocytic tissue reaction.","PeriodicalId":17798,"journal":{"name":"Kazanskiy meditsinskiy zhurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78557399","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}
A. V. Alekseeva, E. Berezkina, K. Moiseeva, Sh. D. Kharbediya
Aim. To assess the impact of the number of children in the family on breastfeeding duration and vaccination coverage. Methods. 1724 mothers of 1-year old children were randomly chosen from seven children's polyclinics in St. Petersburg for an anonymous survey that was conducted by a specially designed form “Questionnaire of a mother of 1-year old children”. The questionnaire comprised of 20 open-ended and closed-ended questions, and included questions about: (1) timing of the attachment to the breast in obstetric hospitals; (2) causes and timing of breastfeeding abandonment; (3) presence or absence of vaccinations in the first year of life according to the National preventive vaccination schedule; (4) and reasons for mothers refusing to vaccinate their children. Results. The proportion of mothers who started artificial feeding in maternity wards immediately after the birth of the baby was the smallest among women for whom this baby was the first-born (3.4%), and the largest among families with many children (11.3%). On average, mothers with one child are breastfed until 7.36±0.11 months, with two children until 8.29±0.11 months, with three or more children until 8.78±0.10 months. By using one-way analysis of variance (ANOVA), it was shown the effect of the number of children in the family on the duration of breastfeeding (F=3.3). Correlation analysis revealed the negative relationship of the number of children in the family with the proportion of women who continued breastfeeding until 3 and 6 months (r xy =–0.82 and r xy =–0.88, respectively), and positive relationship with the proportion of mothers who continued to breastfeeding the baby after reaching a year (r xy =0.89). 12.3% of children of one-child families were not vaccinated according to the National preventive vaccination schedule, 17.7% with two-child families, 28.1% in families with three or more children. It was revealed the significant cross-group effect of the number of children in the family to vaccination coverage (F=48.7). With an increase in the number of children in the family, vaccination coverage decreases, both in general (r xy =–0.88) and against individual infections, including hepatitis B, diphtheria, whooping cough, tetanus, polio, measles and rubella (r xy from –0.80 to –0.90). Conclusion. The number of children in a family impacts mothers' refusals of breastfeeding and vaccination; the more children in a family, the more prolonged breastfeeding, but less vaccination coverage due to the health status of children in the first year of life.
{"title":"The impact of the number of children in the family on the breastfeeding duration and vaccination coverage","authors":"A. V. Alekseeva, E. Berezkina, K. Moiseeva, Sh. D. Kharbediya","doi":"10.17816/kmj2020-538","DOIUrl":"https://doi.org/10.17816/kmj2020-538","url":null,"abstract":"Aim. To assess the impact of the number of children in the family on breastfeeding duration and vaccination coverage. Methods. 1724 mothers of 1-year old children were randomly chosen from seven children's polyclinics in St. Petersburg for an anonymous survey that was conducted by a specially designed form “Questionnaire of a mother of 1-year old children”. The questionnaire comprised of 20 open-ended and closed-ended questions, and included questions about: (1) timing of the attachment to the breast in obstetric hospitals; (2) causes and timing of breastfeeding abandonment; (3) presence or absence of vaccinations in the first year of life according to the National preventive vaccination schedule; (4) and reasons for mothers refusing to vaccinate their children. Results. The proportion of mothers who started artificial feeding in maternity wards immediately after the birth of the baby was the smallest among women for whom this baby was the first-born (3.4%), and the largest among families with many children (11.3%). On average, mothers with one child are breastfed until 7.36±0.11 months, with two children until 8.29±0.11 months, with three or more children until 8.78±0.10 months. By using one-way analysis of variance (ANOVA), it was shown the effect of the number of children in the family on the duration of breastfeeding (F=3.3). Correlation analysis revealed the negative relationship of the number of children in the family with the proportion of women who continued breastfeeding until 3 and 6 months (r xy =–0.82 and r xy =–0.88, respectively), and positive relationship with the proportion of mothers who continued to breastfeeding the baby after reaching a year (r xy =0.89). 12.3% of children of one-child families were not vaccinated according to the National preventive vaccination schedule, 17.7% with two-child families, 28.1% in families with three or more children. It was revealed the significant cross-group effect of the number of children in the family to vaccination coverage (F=48.7). With an increase in the number of children in the family, vaccination coverage decreases, both in general (r xy =–0.88) and against individual infections, including hepatitis B, diphtheria, whooping cough, tetanus, polio, measles and rubella (r xy from –0.80 to –0.90). Conclusion. The number of children in a family impacts mothers' refusals of breastfeeding and vaccination; the more children in a family, the more prolonged breastfeeding, but less vaccination coverage due to the health status of children in the first year of life.","PeriodicalId":17798,"journal":{"name":"Kazanskiy meditsinskiy zhurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87181940","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}
V. Oslopov, Ослопов Владимир Николаевич, Yu. S. Mishanina, Мишанина Юлиана Сергеевна
The study of life, medical and scientific activities of the outstanding domestic scientist S.S. Zimnitsky always causes and will cause great interest. The versatility of his talent as a scientist continues to amaze. Many of the issues that remain relevant today raised by S.S. Zimnitsky, not fully resolved in the XXI century. There were no answers to the well-known question asked by the seriously ill S.S. Zimnitsky to another prominent Russian scientist, the beacon of Russian physiological science — A.F. Samoilov. This question concerned the origin of the giant positive T wave in the first QRS complex after the ventricular extrasystole on the electrocardiogram. The question remained unanswered. We believe that this was because by the end of the 20s of the XX century (S.S. Zimnitsky died in 1927), the delicate mechanisms of repolarization processes were not able to understand, in both healthy and diseased myocardium. The article sets forth our original point of view on the genesis of such a T wave in S.S. Zimnitsky. We believe that a scientific discussion on this issue is quite possible. There is no doubt that both life and scientific activities of S.S. Zimnitsky has always attracted and will attract the attention of both medical historians and practical doctors, scientists and inquisitive students.
{"title":"To the question of S.S. Zimnitsky on the origin of the giant T wave after ventricular extrasystole on an electrocardiogram","authors":"V. Oslopov, Ослопов Владимир Николаевич, Yu. S. Mishanina, Мишанина Юлиана Сергеевна","doi":"10.17816/kmj2020-617","DOIUrl":"https://doi.org/10.17816/kmj2020-617","url":null,"abstract":"The study of life, medical and scientific activities of the outstanding domestic scientist S.S. Zimnitsky always causes and will cause great interest. The versatility of his talent as a scientist continues to amaze. Many of the issues that remain relevant today raised by S.S. Zimnitsky, not fully resolved in the XXI century. There were no answers to the well-known question asked by the seriously ill S.S. Zimnitsky to another prominent Russian scientist, the beacon of Russian physiological science — A.F. Samoilov. This question concerned the origin of the giant positive T wave in the first QRS complex after the ventricular extrasystole on the electrocardiogram. The question remained unanswered. We believe that this was because by the end of the 20s of the XX century (S.S. Zimnitsky died in 1927), the delicate mechanisms of repolarization processes were not able to understand, in both healthy and diseased myocardium. The article sets forth our original point of view on the genesis of such a T wave in S.S. Zimnitsky. We believe that a scientific discussion on this issue is quite possible. There is no doubt that both life and scientific activities of S.S. Zimnitsky has always attracted and will attract the attention of both medical historians and practical doctors, scientists and inquisitive students.","PeriodicalId":17798,"journal":{"name":"Kazanskiy meditsinskiy zhurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78269702","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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